Perinatal Experiences of Low-Income and Incarcerated Women

2014 ◽  
Author(s):  
Julie Poehlmann ◽  
Rebecca Shlafer
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Psychosocial Interventions ◽  
Significant Risk Factor ◽  
The United States ◽  
Incarcerated Women ◽  
Negative Effects ◽  
Pregnancy And Postpartum

Poverty is a significant risk factor for suboptimal pregnancy and infant outcomes. Because of widespread recognition of the negative effects of poverty during pregnancy, federal programs in the United States and other health and psychosocial interventions are available to improve pregnancy and postpartum outcomes, with some success. Incarceration is increasingly recognized as a significant risk for pregnant women and their children. When they enter jail or prison, 6–10% of incarcerated women are pregnant, and more than 1,400 women per year give birth while incarcerated. Pregnant prisoners are more likely to experience risk factors associated with poor perinatal outcomes and are likely to receive inadequate prenatal care, and many states still allow shackling of incarcerated women during labor and birth. Although few interventions are available for incarcerated pregnant women, several progressive programs, such as those involving doulas or nursery programs, are available for a minority of affected women.

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

Comparison of adverse perinatal outcomes after single-needle and double-needle CVS techniques

2017 ◽  
Vol 45 (2) ◽  
Author(s):  
Cenk Gezer ◽  
Atalay Ekin ◽  
Gokhan Goynumer ◽  
Kaan Pakay ◽  
Hicran Acar ◽  
...  
Keyword(s):  
Significant Risk ◽  
Perinatal Outcomes ◽  
Invasive Procedure ◽  
Significant Risk Factor ◽  
Adverse Outcomes ◽  
Control Group ◽  
Needle Technique ◽  
Adverse Perinatal Outcomes ◽  
Chorion Villus ◽  
The Impact

AbstractObjective:To determine the impact of the chorion villus sampling (CVS) technique on adverse perinatal outcomes.Methods:In this case-control study, 412 women who underwent CVS at 11–14 weeks of gestation and 231 women who did not undergo any invasive procedure were retrospectively evaluated. The women in the CVS group were further divided into two groups according to the use of single-needle technique (n=148) vs. double-needle technique (n=264). The adverse outcomes were compared between controls and the two CVS groups, and regression analysis was used to determine the significance of independent contribution.Results:The rate of preeclampsia for the control group was 2.2%, for the double-needle group was 3% and for the single-needle group was 8.1%. CVS with single-needle technique was found to be an independent and statistically significant risk factor for preeclampsia [odds ratio (OR)=2.1, 95% confidence interval (CI); 1.4–2.7, P=0.008].Conclusion:The risk of preeclampsia after CVS appears to be increased with single-needle technique compared with double-needle technique.

scholarly journals Decreasing Incidence of Skin and Soft-tissue Infections in 86 US Emergency Departments, 2009–2014

2018 ◽  
Vol 68 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Ethan Morgan ◽  
Sam Hohmann ◽  
Jessica P Ridgway ◽  
Robert S Daum ◽  
Michael Z David
Keyword(s):  
United States ◽  
Soft Tissue ◽  
Hiv Infection ◽  
Emergency Departments ◽  
Medical Center ◽  
Academic Medical Center ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The United States ◽  
Soft Tissue Infections

Abstract Background The incidence of skin and soft-tissue infections (SSTIs), for which human immunodeficiency virus (HIV) is a significant risk factor, in United States emergency departments (EDs) increased dramatically after 2000 with the emergence of community-associated methicillin-resistant Staphylococcus aureus. Few studies have examined SSTI incidence among HIV-infected and non–HIV-infected patients in the United States after 2010. Methods Data were obtained for patient encounters at all academic medical center EDs affiliated with the Vizient clinical data warehouse assigned an SSTI-associated code based on the International Classification of Diseases, Ninth Revision, between 1 January 2009 and 31 December 2014. The rate was calculated per 1000 ED encounters by year and stratified by SSTI, HIV infection, or both, and by age group, race, payer type, and region of care. Poisson regression was used to assess temporal change over the study period. Results In 2009–2014, a total of 47317 HIV-associated and 820440 SSTI-associated encounters were recorded among 25239781 ED patient encounters. The rate of SSTIs decreased by 8% among all patients and by 14.6%, among those with HIV infection. The SSTI incidence overall decreased from 32.0 to 29.7 per 1000 ED encounters between 2009 and 2014. HIV-infected patients had a significantly higher rate of SSTIs than HIV-uninfected patients (adjusted rate ratio, 1.91; 95% confidence interval, 1.84–1.99). Conclusions The decline in SSTI incidence in US EDs between 2009 and 2014 is a remarkable epidemiologic shift from the increase in SSTIs after 2000, and further research is necessary to assess reasons for this decrease.

scholarly journals Obstetric and perinatal outcomes in women with multiple pregnancy in Altai region

2019 ◽  
Vol 4 (3) ◽  
pp. 27-33
Author(s):  
S. V. Barinov ◽  
A. A. Belinina ◽  
I. V. Molchanova ◽  
O. V. Kolyado
Keyword(s):  
Preterm Birth ◽  
Ultrasound Examination ◽  
Multiple Pregnancy ◽  
Significant Risk ◽  
Perinatal Outcomes ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Altai Region ◽  
Cervical Pessary ◽  
Somatic Diseases

Aim. To study complications and perinatal outcomes of multiple pregnancy in women of the Altai Region.Materials and Methods. We recruited 678 consecutive pregnant women, including 378 with multiple pregnancy, with the subsequent analysis of clinical and ultrasound examination data as well as perinatal outcomes.Results. Women with multiple pregnancy were characterised by a significantly higher rate of gynecological and somatic diseases including pregnancy-related anemia (20.2% versus 4.3% in women with multiple and singleton pregnancy, respectively, OR = 6.0, 95% CI = 3.2-11.3). Further, multiple pregnancy was a significant risk factor for preterm birth (62.26% and 21.82%, respectively, OR = 5.9, 95% CI = 4.2-8.4, p ≤ 0.001). Application of cervical pessary was able to prolong the multiple pregnancy for 4 weeks.Conclusion. Prevention of threatening preterm birth in women with a multiple pregnancy using a cervical pessary improves perinatal outcomes. 

scholarly journals Nutritional Support and Prophylaxis of Azithromycin for Pregnant Women to Improve Birth Outcomes in Peri-Urban Slums of Karachi, Pakistan – A Protocol of Multi-arm Assessor Blinded Randomized Controlled Trial (Mumta PW Trial)

2021 ◽  
Author(s):  
Ameer Muhammad ◽  
Zoha Zahid Fazal ◽  
Benazir Baloch ◽  
Imran Nisar ◽  
Fyezah Jehan ◽  
...  
Keyword(s):  
Informed Consent ◽  
Pregnant Women ◽  
Low Income ◽  
Controlled Trial ◽  
Perinatal Outcomes ◽  
Urban Slum ◽  
Control Group ◽  
Maternal Undernutrition ◽  
Randomized Controlled ◽  
Group 2

Abstract BackgroundMaternal undernutrition is critical in the etiology of poor perinatal outcomes and accounts for 20% of small-for-gestational-age (SGA) births. High levels of food insecurity, antenatal undernourishment and childhood undernutrition necessitate the supplementation of fortified balanced energy-protein (BEP) during pregnancy in low-income settings especially with scarce literature available in this subject. Hence, this paper extensively covers the protocol of such a trial conducted in an urban slum of Karachi, Pakistan. Methods The trial is community-based, open-labelled, four-arm, and randomized controlled that will include parallel group assignments with a 1:1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. All pregnant women (PW), if identified between > 8 and <19 weeks of gestation based on ultrasound, will be offered routine antenatal care (ANC) counseling and voluntary participation in the trial after written informed consent. A total number of 1836 PW will be enrolled with informed consent and randomly allocated to one of the four arms receiving: (1) ANC counseling only (control group), (2) ANC counseling plus BEP supplement (intervention arm 1), (3) ANC counseling plus BEP supplement plus 2 doses Azithromycin (intervention arm 2), or (4) ANC counseling plus BEP supplement plus daily single dose of Nicotinamide and Choline (intervention arm 3). Trial Registration ClinicalTrials.gov NCT04012177. Registered on July 9, 2019. (https://clinicaltrials.gov/ct2/show/NCT04012177)

scholarly journals Causal Analysis of Health Interventions and Environments for Influencing the Spread of COVID-19 in the United States of America

2020 ◽  
Author(s):  
zhouxuan Li ◽  
Tao Xu ◽  
Kai Zhang ◽  
Hong-Wen Deng ◽  
Eric Boerwinkle ◽  
...  
Keyword(s):  
Risk Factor ◽  
Unemployment Rate ◽  
Additive Model ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The United States ◽  
Health Interventions ◽  
Health Crisis ◽  
The Us ◽  
Pharmaceutical Interventions

As of August 27, 2020, the number of cumulative cases of COVID-19 in the US exceeded 5,863,363 and included 180,595 deaths, thus causing a serious public health crisis. Curbing the spread of Covid-19 is still urgently needed. Given the lack of potential vaccines and effective medications, non-pharmaceutical interventions are the major option to curtail the spread of COVID-19. An accurate estimate of the potential impact of different non-pharmaceutical measures on containing, and identify risk factors influencing the spread of COVID-19 is crucial for planning the most effective interventions to curb the spread of COVID-19 and to reduce the deaths. Additive model-based bivariate causal discovery for scalar factors and multivariate Granger causality tests for time series factors are applied to the surveillance data of lab-confirmed Covid-19 cases in the US, University of Maryland Data (UMD) data, and Google mobility data from March 5, 2020 to August 25, 2020 in order to evaluate the contributions of social-biological factors, economics, the Google mobility indexes, and the rate of the virus test to the number of the new cases and number of deaths from COVID-19. We found that active cases/1000 people, workplaces, tests done/1000 people, imported COVID-19 cases, unemployment rate and unemployment claims/1000 people, mobility trends for places of residence (residential), retail and test capacity were the most significant risk factor for the new cases of COVID-19 in 23, 7, 6, 5, 4, 2, 1 and 1 states, respectively, and that active cases/1000 people, workplaces, residential, unemployment rate, imported COVID cases, unemployment claims/1000 people, transit stations, mobility trends (transit) , tests done/1000 people, grocery, testing capacity, retail, percentage of change in consumption, percentage of working from home were the most significant risk factor for the deaths of COVID-19 in 17, 10, 4, 4, 3, 2, 2, 2, 1, 1, 1, 1 states, respectively. We observed that no metrics showed significant evidence in mitigating the COVID-19 epidemic in FL and only a few metrics showed evidence in reducing the number of new cases of COVID-19 in AZ, NY and TX. Our results showed that the majority of non-pharmaceutical interventions had a large effect on slowing the transmission and reducing deaths, and that health interventions were still needed to contain COVID-19.

Parent-Based Models of Adolescent Substance Use

2018 ◽  
Author(s):  
Andrea M. Hussong ◽  
Ruth K. Smith
Keyword(s):  
Substance Use ◽  
Low Income ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Adolescent Substance Use ◽  
Low Income Countries ◽  
Negative Consequences ◽  
Adolescent Substance ◽  
Typical Time

Adolescence is the typical time of substance use onset and escalation around the world, though prevalence rates vary dramatically across countries. Given that substance use is a significant risk factor contributing to global disease burden, the consequences of substance abuse are staggering. Substantial evidence, primarily from high-income countries but increasingly corroborated by that from middle- and low-income countries, suggests that parents and families can play a key role in mitigating risk for substance use involvement and related negative consequences. This chapter reviews that evidence as well as features of family evidence-based interventions for adolescent substance use, highlighting two in particular, and discusses the role of such interventions in a multisectoral approach to prevention.

Facing Segregation

2018 ◽  
Keyword(s):  
Civil Rights ◽  
Low Income ◽  
Psychological Health ◽  
Urban Landscape ◽  
Historical Context ◽  
The United States ◽  
Urban Housing ◽  
Negative Effects ◽  
Income Development ◽  
The 1960S

Marking 50 years since the passage of the Fair Housing and Civil Rights Acts, this collection both builds on and departs from two generations of scholarship on urban development and inequality. The volume’s contributors provide historical context for patterns of segregation in the United States and present arguments for bold new policy actions ranging from the local to the national. Evidence for the negative effects of segregation and concentrated poverty in America’s cities now exists in abundance. Poor and underrepresented communities in segregated urban housing markets suffer diminished outcomes in education, economic mobility, political participation, and physical and psychological health. Many of the aggravating factors underlying this inequity have persisted or even grown worse in recent decades. Yet the level of energy and attention devoted to them by local and national policymakers has ebbed significantly from the levels that inspired the landmark civil rights legislation of the 1960s. This book refocuses our attention on achievable solutions by providing not just an overview of this timely subject but a roadmap forward, as the twenty-first century assesses the successes and failures of the housing policies inherited from the twentieth century. Instead of introducing new theories or empirical data sets describing the urban landscape, the book’s editors have gathered the field’s first collection of prescriptions for what ought to be done. Topics discussed include community development, the Community Reinvestment Act, education triage, housing choice vouchers, the Low-Income Housing Tax Credit, mixed-income development, and tax increment financing.

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