261368 Maternal mental health status and receipt of preventive care for premature infants of mothers at high social-environmental risk

Wednesday, October 31, 2012 : 11:05 AM - 11:20 AM

Camille Fabiyi, MPH, PhD Candidate , School of Public Health, University of Illinois at Chicago, Chicago, IL
Kristin M. Rankin, PhD , Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL
Kathleen F. Norr, PhD , Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL
Zhuoying Li, BS , Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL
Rosemary White-Traut, PhD , Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL
     
Background: Well-child visits (WCV) according to the American Academy of Pediatrics recommendations ensure timely immunizations, health screenings, and monitoring of development, which are especially important for infants born prematurely. Mothers with poor mental health may not fully access preventive care for their infants.

Objective: To describe the relationship between maternal mental health and receipt of WCVs for premature infants of mothers at high social-environmental (SE) risk.

Methods: We analyzed baseline and follow-up interview data from an ongoing randomized trial testing a behavioral intervention for 150 mothers (50.7% Latina, 48.7% black) and premature infants (29-34 weeks gestational age) with at least two of ten SE risks (e.g., low education, poverty). Stratified analysis and log binomial regression were employed to estimate the association between high maternal state anxiety (STAI-Y1, highest quartile) and compliance with WCVs (self-reported), accounting for effect modification and confounding.

Results: 54% of infants attended all three visits recommended for their chronological ages (range: 2.5 - 4 months). Mothers with high anxiety had a higher prevalence of WCV non-compliance than those without high anxiety [Crude Prevalence Ratio (PR) = 1.6 (95% CI 1.1, 2.2)]. This relationship was stronger among women with depressive symptomatology [CES-D, Adjusted PR = 2.3 (95% CI 1.2, 4.5)] and low social support [PRQ-2000, lowest quartile, Adjusted PR = 2.7 (95% CI 1.2, 5.9)].

Discussion: Highly anxious mothers with co-morbid depression or low social support may need targeted interventions to improve utilization of preventive care for their premature infants, who are at risk of poor health outcomes.

Learning Areas:
Provision of health care to the public
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
After hearing this presentation, attendees will be able to: Describe the complex relationship between maternal mental health status and utilization of preventive health care for premature infants.

Keywords: Preventive Medicine, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as Project Director on this research study since 2009. I am also a PhD Candidate in the Maternal and Child Health Program at the UIC School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5140.0: Utilization of Preventive Health Services among Mothers and Infants