The Interactive Effects of Race and Ethnicity and Mother's Residence on the Adequacy of Prenatal Care

1996 ◽  
Vol 12 (1) ◽  
pp. 6-18 ◽  
Author(s):  
Michael K. Miller ◽  
Leslie L. Clarke ◽  
Stan L. Albrecht ◽  
Frank L. Farmer
Author(s):  
Danica Loralyn Taylor ◽  
Janice F. Bell ◽  
Susan L. Adams ◽  
Christiana Drake

Abstract Introduction Passage of cannabis laws may impact cannabis use and the use of other substances. The suggested association is of particular concern in pregnant women where exposure to substances can cause harm to both the pregnant woman and fetus. The present study contributes to the minimal literature on factors associated with cannabis use during the preconception, prenatal, and postpartum periods including state legalization status, concurrent use of tobacco and e-cigarettes and adequacy of prenatal care. Methods We conducted a cross-sectional analysis using combined survey data from the 2016–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) collected from 36,391 women. Logistic regression was used to estimate the impact of state-legalization, adequacy of prenatal care, and other substance use on cannabis use during the preconception, prenatal, and post-partum periods. Results In the preconception model, residence in a recreationally legal state (OR: 2.37; 95% CI, 2.04–2.75) or medically legal state (OR:3.32; 95% CI, 2.90–3.80) compared to a non-legal state was associated with higher odds of cannabis use. In the prenatal model, residence in a recreationally legal state was associated with higher odds of cannabis use (OR: 1.51; 95% CI, 1.29–1.79) whereas there was no association with residence in a medically legal state. Tobacco use including e-cigarettes and moderate prenatal alcohol use were also significantly associated with cannabis use. Conclusion Recreational cannabis legalization is associated with the use of cannabis prior to, during, and after pregnancy. Renewed clinical and policy efforts may be warranted to update prenatal substance use prevention programs, educational campaigns, and provider education as cannabis legalization evolves.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Adele Schwartz Benzaken ◽  
Gerson Fernando Mendes Pereira ◽  
Alessandro Ricardo Caruso da Cunha ◽  
Flavia Moreno Alves de Souza ◽  
Valéria Saraceni

Abstract: To assess the adequacy of prenatal care offered in the Brazilian capital cities and the diagnosis of gestational syphilis through public data from health information systems. The modified Kotelchuck index for adequacy of prenatal care was built using Brazilian Information System on Live Births (SINASC) data. Data on gestational syphilis, congenital syphilis, estimated population coverage by the Family Health Strategy (FHS), the Municipal Human Development Index (MHDI) and data from National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) were accessed in public sites. The profile of pregnant women associated with inadequate care was assessed by logistic regression. In total, 685,286 births were analyzed. Only 2.3% of women did not attend prenatal appointments. The mean adequacy was 79.7%. No correlation was found between adequacy of prenatal care and FHS coverage (p = 0.172), but a positive correlation was found with the MHDI (p < 0.001). Inadequacy of prenatal care was associated with age below 20 years old, schooling less than 4 years, non-white skin color and not having a partner. Among the congenital syphilis cases, 17.2% of mothers did not attend prenatal care. Gestational syphilis more often affected vulnerable women, including a higher proportion of adolescents, women with low schooling, and women of non-white color. The PMAQ-AB showed a median availability of 27.3% for syphilis rapid tests, 67.7% for benzathine penicillin, and 86.7% for benzathine penicillin administration by health teams. The use of public data showed a low adequacy of prenatal care in Brazilian capitals, denoting insufficient quality for the diagnosis and treatment of gestational syphilis, despite the availability of supplies. Continuous monitoring can be carried out using public data, indicating to local strategies to eliminate congenital syphilis.


2016 ◽  
Vol 25 (2) ◽  
pp. 117-123 ◽  
Author(s):  
SeonAe Yeo ◽  
Jamie L. Crandell ◽  
Kathleen Jones-Vessey

2015 ◽  
Vol 125 ◽  
pp. 83S
Author(s):  
Paula Elena Smith ◽  
Stephen J. Bacak ◽  
J. Christopher Glantz ◽  
Loralei Lacina Thornburg

2020 ◽  
Vol 9 (1) ◽  
pp. 340
Author(s):  
Zahra Mohebbi-Dehnavi ◽  
Nahid Golmakani ◽  
Raziyeh Rahmati ◽  
Fatemeh Shaghaghi ◽  
Hadise Safinejad ◽  
...  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 715-715
Author(s):  
Yuri Jang ◽  
Eunyoung Choi ◽  
Yujin Franco ◽  
Nan Sook Park ◽  
David Chiriboga ◽  
...  

Abstract The aims of the study were: (1) to investigate the relationship between cognitive performance and cognitive health appraisals across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States and (2) to explore within-group variations by examining interactions between cognitive performance and background and health variables. The sample (N = 3,099) included 2,260 non-Hispanic White, 498 non-Hispanic Black, and 341 Hispanic adults aged 65 or older, from the 2016–2017 Harmonized Cognitive Assessment Protocol. Regression models of cognitive health appraisals, indicated by self-rated cognitive health, were examined in the entire sample and in racial and ethnic subgroups to test direct and interactive effects of cognitive performance, indicated by the Mini-Mental State Examination (MMSE). The regression model for the entire sample showed direct effects of cognitive performance and race/ethnicity on cognitive health appraisals, as well as a significant interaction between cognitive performance and being non-Hispanic Black. Cognitive performance and cognitive health appraisals were positively associated in non-Hispanic Whites but not significantly associated in non-Hispanic Blacks. Our subsequent analysis within each racial/ethnic group showed that the effect of cognitive performance in non-Hispanic Blacks and Hispanics became either reversed or nonsignificant when background and health variables were considered. Modification by age or chronic medical conditions in each racial and ethnic group was also observed. Overall, these findings suggest that perceptions and appraisals of cognitive health vary by race and ethnicity and hold implications for how these differences should be considered in research and practice with diverse groups of older adults.


2021 ◽  
Vol 45 ◽  
pp. 130-139
Author(s):  
Síntia Nascimento dos Reis ◽  
Isabela Guedes Paiva ◽  
Liliane da Consolação Campos Ribeiro ◽  
Endi Lanza Galvão ◽  
Helisamara Mota Guedes

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