Impact of State Prioritization of Safe Infant Sleep Programs on Supine Sleep Positioning for Non-Hispanic White and Non-Hispanic Black Infants

2021 ◽  
Author(s):  
Sunah S. Hwang ◽  
Suhong Tong ◽  
Laura Pyle ◽  
Catherine Battaglia ◽  
Beth McManus ◽  
...  
Keyword(s):  
Birth Certificates ◽  
Title V ◽  
Infant Sleep ◽  
Block Grant ◽  
Linear Regression Models ◽  
Supine Sleep ◽  
And Control ◽  
Infant Birth ◽  
Sleep Positioning ◽  
Hispanic White

Objective Investigate whether safe infant sleep prioritization by states through the Title V Maternal and Child Block Grant in 2010 differentially impacted maternal report of supine sleep positioning (SSP) for Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) U.S.-born infants. Methods We analyzed retrospective cross-sectional data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2005 to 2015 from 4 states: WV and OK (Intervention) and AR and UT (Control). PRAMS is a population-based surveillance system of maternal perinatal experiences which is linked to infant birth certificates. Piece-wise survey linear regression models were used to estimate the difference in the change in slopes of SSP percents in the pre- (2005–2009) and post- (2011–2015) periods, controlling for maternal and infant characteristics. Models were also stratified by race/ethnicity. Results From 2005 to 2015, for NHW infants, SSP improved from 61.5% and 70.2% to 82.8% and 82.3% for intervention and control states, respectively. For NHB infants, SSP improved from 30.6% and 26.5% to 64.5% and 53.1% for intervention and control states, respectively. After adjustment for maternal characteristics, there was no difference in the rate of SSP change from the pre- to post- intervention periods for either NHW or NHB infants in intervention or control groups. Conclusions and relevance Compared with control states that did not prioritize safe infant sleep in their 2010 Title V Block Grant needs assessment, intervention states experienced no difference in SSP improvement rates for NHW and NHB infants. While SSP increased for all infants during the study period, there was no causal relationship between states' prioritization of safe infant sleep and SSP improvement. More targeted approaches may be needed to reduce the racial/ethnic disparity in SSP and reduce the risk for sleep-associated infant death. Key Points

scholarly journals Is the Association of Diabetes With Uncontrolled Blood Pressure Stronger in Mexican Americans and Blacks Than in Whites Among Diagnosed Hypertensive Patients?

2013 ◽  
Vol 26 (11) ◽  
pp. 1328-1334 ◽  
Author(s):  
Xuefeng Liu ◽  
Ping Song
Keyword(s):  
Blood Pressure ◽  
Racial Differences ◽  
Mexican Americans ◽  
The United States ◽  
Linear Regression Models ◽  
Uncontrolled Blood Pressure ◽  
Hypertensive Patients ◽  
Health And Nutrition ◽  
Multistage Design ◽  
Hispanic White

Abstract BACKGROUND Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS A total of 6,134 diagnosed hypertensive subjects aged ≥20 years were collected from the National Health and Nutrition Examination Survey 1999–2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37–0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35–0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40–0.96). Mexican Americans have a stronger associaton of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.

Infant Sleep Position: Pediatricians' Advice to Parents

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 55-58
Author(s):  
Bonnie B. Hudak ◽  
Jane O'Donnell ◽  
Nadine Mazyrka
Keyword(s):  
Primary Care ◽  
New York ◽  
Primary Care Physicians ◽  
Sleep Position ◽  
Infant Sleep ◽  
Sources Of Information ◽  
Professional Literature ◽  
Infant Sleep Position ◽  
Supine Sleep ◽  
Question Survey

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.

scholarly journals Infant Sleep Positioning Practices and Sids in Israel

1999 ◽  
Vol 45 ◽  
pp. 38A-38A
Author(s):  
Janice Wasser ◽  
Adaya Barkay ◽  
Alex Leventhal
Keyword(s):  
Infant Sleep ◽  
Sleep Positioning

scholarly journals Maternal Health Behaviors and Infant Health Outcomes Among Arab American and Non-Hispanic White Mothers in Massachusetts, 2012-2016

2020 ◽  
Vol 135 (5) ◽  
pp. 658-667 ◽  
Author(s):  
Nadia N. Abuelezam ◽  
Adolfo G. Cuevas ◽  
Sandro Galea ◽  
Summer Sherburne Hawkins
Keyword(s):  
Maternal Health ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Infant Health ◽  
Arab American ◽  
Linear Regression Models ◽  
Effect Modifier ◽  
White Mothers ◽  
Maternal Health Outcomes ◽  
Hispanic White

Objectives The health profile of Arab American mothers and infants may differ from that of non–Arab American mothers and infants in the United States as a result of social stigma experienced in the historical and current sociopolitical climate. The objective of our study was to compare maternal health behaviors, maternal health outcomes, and infant health outcomes of Arab American mothers and non-Hispanic white mothers in Massachusetts and to assess the role of nativity as an effect modifier. Methods Using data from Massachusetts birth certificates (2012-2016), we conducted adjusted logistic and linear regression models for maternal health behaviors, maternal health outcomes, and infant health outcomes. We used Arab ethnicity as the exposure of interest and nativity as an effect modifier. Results Arab American mothers had higher odds than non-Hispanic white mothers of initiating breastfeeding (adjusted odds ratio [aOR] = 2.61; 95% CI, 2.39-2.86), giving birth to small-for-gestational-age infants (aOR = 1.28; 95% CI, 1.18-1.39), and having gestational diabetes (aOR = 1.31; 95% CI, 1.20-1.44). Among Arab American mothers, non–US-born mothers had higher odds than US-born mothers of having gestational diabetes (aOR = 1.80; 95% CI, 1.33-2.44) and lower odds of initiating prenatal care in the first trimester (aOR = 0.41; 95% CI, 0.33-0.50). In linear regression models, infants born to non–US-born Arab American mothers weighed 42.1 g (95% CI, −75.8 to −8.4 g) less than infants born to US-born Arab American mothers. Conclusion Although Arab American mothers engage in positive health behaviors, non–US-born mothers had poorer maternal health outcomes and access to prenatal care than US-born mothers, suggesting the need for targeted interventions for non–US-born Arab American mothers.

scholarly journals Snus in pregnancy and infant birth size: a mother–child birth cohort study

2019 ◽  
Vol 5 (4) ◽  
pp. 00255-2019
Author(s):  
Ina Kreyberg ◽  
Katarina Hilde ◽  
Karen Eline S. Bains ◽  
Kai-Håkon Carlsen ◽  
Berit Granum ◽  
...  
Keyword(s):  
Linear Regression ◽  
Birth Cohort ◽  
Early Pregnancy ◽  
Population Based ◽  
Birth Cohort Study ◽  
Birth Size ◽  
Linear Regression Models ◽  
Child Birth ◽  
Gestational Age At Birth ◽  
Infant Birth

RationaleWhile recent studies show that maternal use of snus during pregnancy is increasing, the potential effects on infant birth size is less investigated, with conflicting results.ObjectivesWe aimed to determine if maternal use of snus during pregnancy influences the infant anthropometric and proportional size measures at birth.MethodsIn 2313 mother–child pairs from the population-based, mother–child birth cohort PreventADALL (Preventing Atopic Dermatitis and ALLergies) in Norway and Sweden, we assessed nicotine exposure by electronic questionnaire(s) at 18 and 34 weeks of pregnancy, and anthropometric measurements at birth. Associations between snus exposure and birth size outcomes were analysed by general linear regression.ResultsBirthweight was not significantly different in infants exposed to snus in general, and up to 18 weeks of pregnancy in particular, when adjusting for relevant confounders including maternal age, gestational age at birth, pre-pregnancy body mass index, parity, fetal sex and maternal gestational weight gain up to 18 weeks. We found no significant effect of snus use on the other anthropometric or proportional size measures in multivariable linear regression models. Most women stopped snus use in early pregnancy.ConclusionExposure to snus use in early pregnancy, with most women stopping when knowing about their pregnancy, was not associated with birth size. We were unable to conclude on effects of continued snus use during pregnancy because of lack of exposure in our cohort.

scholarly journals Maternal and Infant Characteristics Associated with Prone and Lateral Infant Sleep Positioning in Washington State, 1996-2002

2008 ◽  
Vol 153 (2) ◽  
pp. 194-198.e3 ◽  
Author(s):  
Christy M. McKinney ◽  
Victoria L. Holt ◽  
Michael L. Cunningham ◽  
Brian G. Leroux ◽  
Jacqueline R. Starr
Keyword(s):  
Washington State ◽  
Infant Sleep ◽  
Sleep Positioning
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