scholarly journals Impact of Doulas on Healthy Birth Outcomes

2013 ◽  
Vol 22 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Kenneth J. Gruber ◽  
Susan H. Cupito ◽  
Christina F. Dobson
Keyword(s):  
Birth Weight ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
The Other ◽  
Adverse Birth Outcomes ◽  
Prenatal Health ◽  
Childbirth Education ◽  
Socially Disadvantaged ◽  
Birth Complication ◽  
Expectant Mothers

Birth outcomes of two groups of socially disadvantaged mothers at risk for adverse birth outcomes, one receiving prebirth assistance from a certified doula and the other representing a sample of birthing mothers who elected to not work with a doula, were compared. All of the mothers were participants in a prenatal health and childbirth education program. Expectant mothers matched with a doula had better birth outcomes. Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. Communication with and encouragement from a doula throughout the pregnancy may have increased the mother’s self-efficacy regarding her ability to impact her own pregnancy outcomes.

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

scholarly journals Risk of pre-term births and major birth defects resulting from paternal intake of COVID-19 medications prior to conception

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Silvia Rizzi ◽  
Maarten J. Wensink ◽  
Rune Lindahl-Jacobsen ◽  
Lu Tian ◽  
Ying Lu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Outcomes ◽  
Birth Defects ◽  
Sperm Quality ◽  
The Other ◽  
Reproductive Age ◽  
Adverse Birth Outcomes ◽  
Term Birth ◽  
Large Numbers ◽  
Term Births

Abstract Objective With the ongoing COVID-19 pandemic, large numbers of people will receive one of the several medications proposed to treat COVID-19, including patients of reproductive age. Given that some medications have shown adverse effects on sperm quality, there might be a transgenerational concern. We aim at examining the association between drugs proposed to treat COVID-19 when taken by the father around conception and any pre-term birth or major birth defects in offspring in a nation-wide cohort study using Danish registry data. Offspring whose father filled at least one prescription of the following medications in the 3 months preceding conception were considered exposed: chloroquine, hydroxychloroquine, losartan, azithromycin, naproxen, dexamethasone and prednisone. Results For azithromycin and naproxen, large numbers of offspring were exposed (> 1800 offspring), and we found no association with adverse birth outcomes. For chloroquine, losartan and dexamethasone, exposure was intermediate (~ 900 offspring), and there was no statistically significant association with birth defects. For hydroxychloroquine and prednisone, exposure was limited (< 300 offspring). Our evidence suggests that azithromycin and naproxen are safe with respect to pre-term birth and birth defects. For the other drugs investigated larger exposures are needed for conclusive statements.

scholarly journals Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

2021 ◽  
Author(s):  
Ane Bungum Kofoed ◽  
Laura Deen ◽  
Karin Sørig Hougaard ◽  
Kajsa Ugelvig Petersen ◽  
Harald William Meyer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Sex Ratio ◽  
Polychlorinated Biphenyls ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Exposure ◽  
Adverse Birth Outcomes ◽  
Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

scholarly journals Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

2018 ◽  
Vol 72 (12) ◽  
pp. 1104-1109 ◽  
Author(s):  
Alice Goisis ◽  
Hanna Remes ◽  
Kieron Barclay ◽  
Pekka Martikainen ◽  
Mikko Myrskylä
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Conclusive Evidence ◽  
Paternal Age ◽  
Adverse Birth Outcomes ◽  
Maternal Characteristics ◽  
Parental Characteristics ◽  
Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

Association of US state policy orientation with adverse birth outcomes: a longitudinal analysis

2021 ◽  
pp. jech-2020-214858
Author(s):  
Alicia R Riley ◽  
Daniel Collin ◽  
Jacob M Grumbach ◽  
Jacqueline M Torres ◽  
Rita Hamad
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
State Policy ◽  
Fixed Effects ◽  
State Policies ◽  
Adverse Birth Outcomes ◽  
Lower Odds ◽  
Policy Orientation

BackgroundThe current US context is marked by extreme right–left partisanship, which means that state policies tend to bundle together and are not experienced in isolation. While prior work has leveraged abrupt shifts in single policies to examine the effects of state policy on birth outcomes, we examined a holistic measure that captures political polarisation.MethodsData were drawn from national birth certificates for 2003–2017 (N=56 770 470). Outcomes included preterm birth, low birth weight, small-for-gestational age and other perinatal health measures. The primary exposure was a composite index of right–left state policy orientation, generated from historical data on 135 state policies. Multivariable regressions were used to estimate the association between state policy orientation and each outcome, adjusting for relevant covariates.ResultsCompared with infants born in states with right-leaning policy orientations, those born in left-leaning states had lower odds of adverse birth outcomes (eg, low birth weight: OR 0.95 (0.93, 0.97), preterm birth: OR 0.94 (0.92, 0.95)). Subgroup analyses revealed stronger associations for US-born and White mothers. With the inclusion of state fixed effects, left-leaning policy orientation was no longer associated with lower odds of adverse birth outcomes. Models were otherwise robust to alternative specifications.ConclusionWhile left-leaning state policy orientation has protective associations with a range of birth outcomes, the associations may be explained by stable characteristics of states, at least during the study period. Future studies should examine state policy orientation in association with other health outcomes and study periods.

scholarly journals A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes

2020 ◽  
Vol 17 (8) ◽  
pp. 2949 ◽  
Author(s):  
Selin Akaraci ◽  
Xiaoqi Feng ◽  
Thomas Suesse ◽  
Bin Jalaludin ◽  
Thomas Astell-Burt
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Birth Outcomes ◽  
Pregnancy Outcomes ◽  
Green Space ◽  
Meta Analysis ◽  
Population Level ◽  
Urban Greening ◽  
Lower Odds ◽  
Meta Analyses

Previous studies suggest that green and blue spaces may promote several health outcomes including birth outcomes. However, no synthesis of previous work has specifically asked policy-relevant questions of how much and what type is needed in every neighborhood to elicit these benefits at the population level. A systematic review and meta-analyses were conducted to synthesize thirty-seven studies on the association between residential green and blue spaces and pregnancy outcomes. Meta-analyses were performed for birth weight (BW), small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). Increase in residential greenness was statistically significantly associated with higher BW [β = 0.001, 95%CI: (<0.001, 0.002)] and lower odds of SGA [OR = 0.95, 95%CI: (0.92, 0.97)]. Associations between green space and LBW and PTB were as hypothesized but not statistically significant. Associations between blue spaces and pregnancy outcomes were not evident. No study explicitly examined questions of threshold, though some evidence of nonlinearity indicated that moderate amounts of green space may support more favorable pregnancy outcomes. Policy-relevant green and blue space exposures involving theory-driven thresholds warrant testing to ensure future investments in urban greening promote healthier pregnancy outcomes.

scholarly journals Mediators of Adverse Birth Outcomes Among Socially Disadvantaged Women

2012 ◽  
Vol 21 (6) ◽  
pp. 634-642 ◽  
Author(s):  
Amelia R. Gavin ◽  
Paula Nurius ◽  
Patricia Logan-Greene
Keyword(s):  
Birth Outcomes ◽  
Adverse Birth Outcomes ◽  
Socially Disadvantaged ◽  
Disadvantaged Women

scholarly journals Population birth outcomes in 2020 and experiences of expectant mothers during the COVID-19 pandemic: a ‘Born in Wales’ mixed methods study using routine data

2021 ◽  
Author(s):  
Hope Jones ◽  
Mike Seaborne ◽  
Laura Cowley ◽  
David Odd ◽  
Shantini Paranjothy ◽  
...  
Keyword(s):  
Birth Weight ◽  
Birth Outcomes ◽  
Online Survey ◽  
Negative Impact ◽  
National Level ◽  
Population Level ◽  
Significant Difference ◽  
Expectant Mothers ◽  
The Impact ◽  
Mothers Experiences

AbstractBackgroundPregnancy can be a stressful time and the COVID-19 pandemic has affected all aspects of life. This study aims to investigate the impact of the pandemic on population birth outcomes in Wales, rates of primary immunisations and examine expectant mothers’ experiences of pregnancy including self-reported levels of stress and anxiety.MethodsPopulation-level birth outcomes in Wales: Stillbirths, prematurity, birth weight and Caesarean section births before (2016–2019) and during (2020) the pandemic were compared using national-level routine anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. The first three scheduled primary immunisations were compared between 2019 and 2020. Self-reported pregnancy experience: 215 expectant mothers (aged 16+) in Wales completed an online survey about their experiences of pregnancy during the pandemic. The qualitative survey data was analysed using codebook thematic analysis.FindingsThere was no significant difference between annual outcomes including gestation and birth weight, stillbirths, and Caesarean sections for infants born in 2020 compared to 2016-2019. There was an increase in late term births (≥42 weeks gestation) during the first lockdown (OR: 1.28, p=0.019) and a decrease in moderate to late preterm births (32-36 weeks gestation) during the second lockdown (OR: 0.74, p=0.001). Fewer babies were born in 2020 (N=29,031) compared to 2016-2019 (average N=32,582). All babies received their immunisations in 2020, but there were minor delays in the timings of vaccines. Those due at 8-weeks were 8% less likely to be on time (within 28-days) and at 16-weeks, they were 19% less likely to be on time. The pandemic had a negative impact on the mental health of 71% of survey respondents, who reported anxiety, stress and loneliness; this was associated with attending scans without their partner, giving birth alone, and minimal contact with midwives.InterpretationThe pandemic had a negative impact on mothers’ experiences of pregnancy; however, population-level data suggests that this did not translate to adverse birth outcomes for babies born during the pandemic.

scholarly journals Geospatial analysis of exposure to violent crime during pregnancy and adverse birth outcomes: Evidence from São Paulo’s Western Region Birth Cohort

2020 ◽  
Author(s):  
Angelica Carreira dos Santos ◽  
Alexandra Brentani ◽  
Günther Fink
Keyword(s):  
Socioeconomic Status ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Violent Crime ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Violence Exposure ◽  
Western Region ◽  
Adverse Birth Outcomes ◽  
Violent Crimes

Abstract Background Low birth weight and prematurity remain leading causes of infant mortality and morbidity globally. Although an extensive literature has highlighted the importance of socioenvironmental characteristics for birth outcomes, the role of indirect violence on health remains fairly understudied. Methods Using geocoded birth records from the ongoing Western Region Birth Cohort ( Região Oeste Coorte – ROC-Cohort) of infants born between 2012-2014 and geocoded crime reports, we assessed the associations between exposure to violent crimes during pregnancy within a 1-km radius of mother’s residence and low birth weight, preterm delivery, and being born small-for-gestational-age. Violent crime exposure was categorized into quintiles. Multivariate logistic regressions were used to examine the associations between violence exposure and birth outcomes. Models were adjusted for sex, maternal age and education, socioeconomic status, and risk factors such as hypertension, diabetes, smoking, and drinking during pregnancy. ResultsAmong the 5,268 infants included, the average crime exposure during the first two trimesters of pregnancy ranged from 0.44 violent crimes in the least exposed quintile to 12.74 crimes in the most exposed. Compared to children with the lowest violence exposure, children in the highest exposure quintile were at higher odds of being born small-for-gestational-age (1.41[1.06-1.89]), preterm (1.35[1.01-1.80]), and low birth weight (1.42[1.03-1.98]). While socioeconomic status and maternal education were positively associated with lower violence exposure, no associations were found between these characteristics and the birth outcomes. Conclusions Higher exposure to external violent crimes in the close vicinity are associated with substantial increases in the odds of adverse birth outcomes. Policies to improve neighborhood safety can contribute not only to the short-term well-being of populations but may also have large social, economic, and health benefits in the long run.

scholarly journals The Association Between State-Level Racial Attitudes Assessed From Twitter Data and Adverse Birth Outcomes: Observational Study (Preprint)

2019 ◽  
Author(s):  
Thu T Nguyen ◽  
Nikki Adams ◽  
Dina Huang ◽  
M Maria Glymour ◽  
Amani M Allen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Birth Weight ◽  
Ethnic Minorities ◽  
Birth Outcomes ◽  
Black People ◽  
State Level ◽  
Adverse Birth Outcomes ◽  
White People ◽  
Machine Learning Model ◽  
Hispanic White

BACKGROUND In the United States, racial disparities in birth outcomes persist and have been widening. Interpersonal and structural racism are leading explanations for the continuing racial disparities in birth outcomes, but research to confirm the role of racism and evaluate trends in the impact of racism on health outcomes has been hampered by the challenge of measuring racism. Most research on discrimination relies on self-reported experiences of discrimination, and few studies have examined racial attitudes and bias at the US national level. OBJECTIVE This study aimed to investigate the associations between state-level Twitter-derived sentiments related to racial or ethnic minorities and birth outcomes. METHODS We utilized Twitter’s Streaming application programming interface to collect 26,027,740 tweets from June 2015 to December 2017, containing at least one race-related term. Sentiment analysis was performed using support vector machine, a supervised machine learning model. We constructed overall indicators of sentiment toward minorities and sentiment toward race-specific groups. For each year, state-level Twitter-derived sentiment data were merged with birth data for that year. The study participants were women who had singleton births with no congenital abnormalities from 2015 to 2017 and for whom data were available on gestational age (n=9,988,030) or birth weight (n=9,985,402). The main outcomes were low birth weight (birth weight ≤2499 g) and preterm birth (gestational age &lt;37 weeks). We estimated the incidence ratios controlling for individual-level maternal characteristics (sociodemographics, prenatal care, and health behaviors) and state-level demographics, using log binomial regression models. RESULTS The accuracy for identifying negative sentiments on comparing the machine learning model to manually labeled tweets was 91%. Mothers living in states in the highest tertile for negative sentiment tweets referencing racial or ethnic minorities had greater incidences of low birth weight (8% greater, 95% CI 4%-13%) and preterm birth (8% greater, 95% CI 0%-14%) compared with mothers living in states in the lowest tertile. More negative tweets referencing minorities were associated with adverse birth outcomes in the total population, including non-Hispanic white people and racial or ethnic minorities. In stratified subgroup analyses, more negative tweets referencing specific racial or ethnic minority groups (black people, Middle Eastern people, and Muslims) were associated with poor birth outcomes for black people and minorities. CONCLUSIONS A negative social context related to race was associated with poor birth outcomes for racial or ethnic minorities, as well as non-Hispanic white people.

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