Abstract
Use of Mobile Health in Prenatal and Postnatal Care - A Systematic Review
Toyin Akomolafe, MPH, B.Sc1, Swaha Pattanaik, MPH2 and Andrew R. Hansen, DrPH2
(1)Georgia Southern University, STATESBORO, GA, (2)Georgia Southern University, Statesboro, GA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Pre- and post-natal care are essential to mother and child survival from pregnancy-related complications. The use of mobile technology as a health monitoring tool, and service provision tracking device to improve health, healthcare delivery, and health service outcomes, prevent disease, and manage chronic diseases has been well-documented. We conducted a systematic review to examine the use of mobile technology in promoting and educating mothers on prenatal and postnatal care, and the outcomes of these interventions.
Methods: PubMed (Medline), CINAHL Complete, and PsycINFO were searched for primary articles on mobile technology interventions for prenatal and postnatal care published from 2000 to 2016. Key search terms included mobile technology, maternal health, pregnancy, prenatal and postnatal. Abstracts and full texts were reviewed by two reviewers using pre-determined inclusion and exclusion criteria. Eleven articles that met the inclusion criteria were assessed for quality and the content was analyzed.
Results: All the 11 studies were intervention studies, four of which were randomized control trials. Four studies investigated the influence of mobile phone technologies on behaviors and attitudes among mothers during pregnancy and breastfeeding. Health outcomes attributed to mobile technology included improved breastfeeding practices, increased antenatal care attendance and coverage, and reduced perinatal mortality.
Implication/Conclusion: Mobile technology interventions are very applicable in low-income settings where distance and cost of travel restrict access to maternal and newborn services. Thus, mobile phone interventions can facilitate health services by saving time, reduce the financial burden and other social costs for women.
Implementation of health education strategies, interventions and programs Public health or related research Social and behavioral sciences
Abstract
Exploring Differences in Maternal and Infant Characteristics of Deaths occurring within the First 24 Hours and 28 days of Life
Fatimah Bello, MD, MPH1 and Martha Wingate, DrPH, MPH2
(1)University of Alabama, Birmingham, AL, (2)University of Alabama at Birmingham School of Public Health, Birmingham, AL
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: It has been noted that the U.S. neonatal mortality rate is significantly higher compared to other developed nations. The high proportion of low birth weight births in the U.S partially explains this difference. Few studies have considered mortality rates differences by the timing of neonatal deaths. The purpose of this study is to examine maternal and infant characteristics associated with deaths within the first 24 hours (Phase 1) compared to those occurring between days 2 and 28 (Phase 2).
Methods: Deliveries to U.S. resident mothers were selected from the National Center for Health Statistics (NCHS) linked live birth-infant death cohort files. We calculated descriptive statistics comparing maternal and infant characteristics of Phases 1 and 2 and birth weight-specific mortality rates, examining racial differences.
Results: Of all neonatal deaths, roughly half (49.8%) occurred in Phase 1. Phase 1 deaths were significantly higher among primiparous mothers, but lower among mothers with hypertensive disorders and diabetes. Although mortality rates with Phase 1 and 2 were similar, (1.57 and 1.60 per 1000 live births, respectively), there were differences by race/ethnicity. At birthweights less than 500 grams, Phase 1 mortality rates were significantly higher (442.3 per 1000 live births) compared to Phase 2 (71.9 per 1000 live births), and there were significant differences by race/ethnicity.
Conclusions: There are differences between maternal and infant characteristics for Phase 1 and 2 deaths with substantial disparities by race/ethnicity. The contribution of Phase 1 deaths should be considered in the context of international comparisons.
Epidemiology Planning of health education strategies, interventions, and programs Public health or related research
Abstract
Factors associated with preconceptional multivitamin supplement intake: Mississippi Pregnancy Risk Assessment Monitoring System, 2009-2011
Mina Qobadi, PhD1 and Lei Zhang, PhD, MSc, MBA2
(1)Jackson State University, Jackson, MS, (2)Mississippi State Department of Health, Jackson, MS
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background:
Although adequate folic acid or multivitamins intake is associated with optimal foetal growth and a decrease risk of congenital abnormalities, few studies have investigated factors associated with multivitamin use. The aim of this study is to explore factors associated with preconceptional multivitamin supplement intake using a sample of women with recent live births in Mississippi.
Methods:
The 2009-2011 Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) data were analyzed in this study (n=3,836). PRAMS is an on-going national surveillance system designed to identify and monitor maternal behaviors and experiences before, during and after pregnancy among women who delivered a live birth. Descriptive analysis, Chi-square tests, and multiple logistic regression were conducted.
Results:
The overall prevalence of preconceptional multivitamin supplement intake was 37.6%. Preconceptional multivitamin supplement intake was significantly higher among women aged ≥30 years (50.3%), whites (40.2%), those with >high school (45.2%), those with annual income ≥$35,000 (54.7%), married women (46.8%), those who had intended pregnancy (50.5%), non-smokers (41.0%), and non-obese women (39.6%). Multivariable analysis showed that obese women (Adjusted Odds Ratio (aOR)= 0.60, 95% CI: 0.48-0.76), women who had unintended pregnancy (aOR= 0.48, 95% CI: 0.39-0.59) and smoked before pregnancy (aOR= 0.62, 95% CI: 0.48-0.80) were less likely to take preconceptional multivitamin supplement, after controlling for the covariates.
Conclusions:
Women who were obese, non-smokers or had unintended pregnancy were less likely to take preconceptional multivitamin supplement indicating that health providers should consider multiple targeted strategies to improve preconceptional multivitamin supplement intake among women of childbearing age.
Epidemiology Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Public health or related public policy Public health or related research
Abstract
Engaging and empowering a rural North Carolina community for positive change in reducing IMR: A survey and discussion
Maggie Blakemore, MSPH, BSN, RN; FNP, DNP Student and Peter Ahiawodzi, Ph.D., M.P.H., CPH
Campbell University, Buies Creek, NC
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Introduction: Among developed nations, the United States has one of the highest infant mortality rates (IMR). North Carolina has the 42nd highest IMR of all 50 states at a rate of 7.3. The rural North Carolina county surveyed exceeds the state’s average at 9.0, with African American or black rates being even higher at 14.7. The purpose of this survey was to identify factors impacting infant mortality in this rural population and to engage key stakeholders in discussion on multifactorial interventions that can be implemented to reduce IMR.
Methods: Ninety-six women (of whom 57% were black) who were pregnant or pregnant within the last 3 years took a 36-question survey while at the Health Department. The survey evaluated a multitude of factors that impact IMR and therefore woman’s health from the start or delay of perinatal care, father involvement, age at first pregnancy, breastfeeding obstacles, safe sleep habits, birth spacing, and plans to use birth control.
Results: We found that 31% of participants delayed care because they did not know they were pregnant. Also, woman whose providers did discuss birth control at prenatal visits were more likely to be planning or using birth control after delivery (p=0.01). Additionally, those with lower education levels and those that were employed were less likely to practice breastfeeding (OR 2.32, Cl=0.69-7.75; p=0.172, and OR=3.09; 95%Cl=0.91-10.49, p=0.71, respectively).
Conclusion: By identifying rural IMR factors, we engaged community stakeholders in discussing barriers and creating multifactorial solutions to decrease infant mortality while improving maternal health.
Administer health education strategies, interventions and programs Advocacy for health and health education Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs Provision of health care to the public Public health or related nursing
Abstract
Maternal Pregnancy History Factors Associated with Oral Cleft Risk in a Puerto Rican Population
Mairim Soto Ortiz, MPH, DrPH(c)1, Marilyn Soto, MA2, Ricardo Ledesma, MPH2, Maria I. Salcedo, DDS, MPH2, Natalio Debs, MD2, Lydia M. Lopez, DMD, MPH2, Jose Cordero, MD, MPH3 and Carmen J. Buxó, DrPH, MPH, MSc2
(1)Capella University, Minneapolis, MN, (2)University of Puerto Rico Medical Sciences Campus, San Juan, PR, (3)University of Georgia, Athens, GA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Oral clefts (CL/P) are described as a birth defect characterized by a complete/incomplete opening in lips and/or palate. In Puerto Rico (PR), this anomaly occupies the fifth position from birth defects monitored by the PR Birth Defects Surveillance System. Literature has identified maternal factors associated to CL/P risk as the first step to prevention. The aim of this study is to identify maternal pregnancy history risk factors for non-syndromic CL/P (nsCL/P) in a group of Puerto Rican women.
Methods: A case-control study (N=388) of (n=188) case-mothers and (n=200) control-mothers collected maternal factors from a pregnancy history questionnaire. The following variables were assessed: maternal medical conditions (before/during pregnancy), reproductive history, and medication usage (before/during pregnancy). Chi-square was calculated for differences between groups and Odds Ratio (OR) were estimated with a confidence interval (CI) of 95%. Adjusted ORs were calculated using multivariate logistic regression.
Results: Analysis for maternal medical characteristics showed statistically significant differences (p<0.05) among cases and controls for history of abortion (p=0.01), infections during pregnancy (p=0.03), alcohol consumption (p=0.04) and multivitamins intake (p=0.02) during pregnancy. Results showed that infections during pregnancy (OR= 1.61, 95% CI:1.05-2.45) increased the risk for nsCL/P. No statistically significant differences and risks were found for maternal conditions (e.g.,diabetes, gestational diabetes) and medications.
Conclusions: Infections during pregnancy was identified to increase the risk of having a child with nsCL/P. A larger sample will be able to isolate other factors and provide a better understanding of the etiology of nsCL/P in Puerto Rican/Hispanic populations.
Diversity and culture Epidemiology Implementation of health education strategies, interventions and programs Other professions or practice related to public health Public health or related research