Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
September 14, 2007
1. Journal Supplement Focuses on Use of Family Medical
History in Pediatric Primary Care Practice and Public Health
2. Brief Highlights State Support for Local Early
Childhood Systems Development
3. Authors Report on 15-Year Trends in Suicide Rates
Among Adolescents and Young Adults
4. Study Examines Racial Disparities in Risk for
Stillbirth Among Obese vs. Non-Obese Women
5. Article Evaluates School-Based Intervention to Lower
Incidence of Disordered Weight-Control Behaviors in Young Adolescents
************************************************************
1. JOURNAL SUPPLEMENT FOCUSES ON USE OF FAMILY MEDICAL HISTORY IN
PEDIATRIC PRIMARY CARE PRACTICE AND PUBLIC HEALTH
The September 2007 supplement to Pediatrics summarizes a workgroup
meeting to discuss extending the scope of the Centers for Disease
Control and Prevention's (CDC's) Family History Public Health
Initiative to include children and their families. The supplement,
published by the American Academy of Pediatrics, contains articles that
summarize the proceedings and explore four topics that emerged as
leading issues from the meeting. Topics include (1) optimizing use of
family history in primary care; (2) linking obstetric and pediatric
clinicians through preconception health care; (3) assessing potential
campaigns to prevent chronic disease, starting with family history
assessment in childhood; and (4) using birth defect family histories
for prevention efforts. The supplement content has been made available
on CDC's Web site at http://www.cdc.gov/ncbddd/bd/family_history.htm
************************************************************
2. BRIEF HIGHLIGHTS STATE SUPPORT FOR LOCAL EARLY CHILDHOOD SYSTEMS
DEVELOPMENT
Local Systems Development (Short Take No. 6) highlights the efforts of
10 states and illustrates various approaches for state-to-local support
for early childhood systems. The brief is the sixth in the Short Take
series published by the National Center for Children in Poverty's
Project Thrive, with support from the Maternal and Child Health Bureau.
The content is based on a review of state Early Childhood Comprehensive
System (ECCS) plans and proposals for evidence of local systems
development and on additional information collected from selected
states. A table presents information on the strategies states use,
alone or in combination, to support local communities. Strategy
approaches include the following: direct funding to communities;
policy, regulation, or guidance; and direct and indirect technical
support (such as offering tools). Statewide approaches used in Arizona,
Iowa, Ohio, and Vermont and targeted approaches used in Colorado,
Illinois, Massachusetts, Michigan, Oklahoma, and Washington are
discussed in detail. The authors conclude with key points. The brief is
available at http://www.nccp.org/publications/pdf/text_758.pdf
************************************************************
3. AUTHORS REPORT ON 15-YEAR TRENDS IN SUICIDE RATES AMONG ADOLESCENTS
AND YOUNG ADULTS
"The results suggest that increases in suicide and changes in suicidal
behavior might have occurred among youths in certain sex-age groups,
especially females ages 10-19," state the authors of a report published
in the September 7, 2007, issue of MMWR Weekly. In 2004, suicide was
the third leading cause of death among adolescents and young adults
ages 10-24 in the United States, accounting for 4,599 deaths. During
1990-2003, the combined suicide rate for adolescents and young adults
ages 10-24 declined by 28.5%. However, from 2003 to 2004, the rate
increased by 8.0%, the largest single-year increase during 1990-2004.
The report characterizes U.S. trends in suicide among adolescents and
young adults ages 10-24.
Annual data on suicides in the United States for the period 1990-2004
were obtained from the National Vital Statistics System by sex, three
age groups (ages 10-14, 15-19, and 20-24), and the three most common
suicide methods (firearm, hanging/suffocation, and poisoning). Suicide
trends were examined for each sex-age group overall and by method.
The authors found that
- The largest percentage increase in suicide rates from 2003 to
2004 was among females ages 10-14 (75.9%), followed by females ages
15-19 (32.3%), and males ages 15-19 (9.0%).
- From 1990 to 2004, significant downward trends were observed in
the rates of both firearm suicides and poisoning suicides among females
in each of the three age groups. A significant increase was observed in
the rate for suicides by hanging/suffocation. From 2003 to 2004,
hanging/suffocation suicide rates among females ages 10-14 and 15-19
increased by 119.4% and 43.5%, respectively.
The authors conclude that "closer examination of these trends is
warranted at federal and state levels. Where indicated, health
authorities and program directors should consider focusing
suicide-prevention activities on these groups to help prevent suicide
rates from increasing further."
Lubell KM, Kegler SR, Crosby AE, et al. 2007. Suicide trends among
youths and young adults aged 10-24 years United States, 1990-2004. MMWR
Weekly 56(35):905-908. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm?s_cid=mm5635a2_e
Readers: More information is available from the following MCH Library
resources:
-Mental Health in Children and Adolescents (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_mentalhealth.html
-Adolescent Mental Health (bibliography) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_adolmenhlth.html&-MaxRecords=all&-DoScript=auto_search_adolmenhlth&-search
************************************************************
4. STUDY EXAMINES RACIAL DISPARITIES IN RISK FOR STILLBIRTH AMONG OBESE
VS. NON-OBESE WOMEN
"We found a 40% increased likelihood for stillbirth among obese
compared with nonobese mothers," state the authors of an article
published in the September 2007 issue of Obstetrics and Gynecology.
Although the relationship between obesity in general and poor birth
outcomes has been fairly well articulated, data on the effect of
extreme obesity on birth outcomes is sparse. The article presents
findings from a study to estimate the magnitude of risk for stillbirth
across subsets of the maternal population, based on generally accepted
obesity subtypes.
Data for the analysis were drawn from Missouri's maternally linked
cohort data files in which siblings are linked to their biologic
mothers using unique identifiers. Records covering 1,577,082 births for
the period 1978-1997 were available for analysis. For the purpose of
the study, singleton pregnancies within the gestational age range of
20-44 weeks were selected. Using prepregnancy weight (measured at the
first prenatal visit) and height (as reported at the first prenatal
visit), women were classified on the basis of body mass index (BMI)
above 30 into three subsets: class 1 obesity (30-34.9), class 2 obesity
(35.0-39.9), and extreme obesity (40 or higher).
After exclusions, the final sample included 1,413,953 woman-fetus
pairs. Differences in maternal sociodemographic characteristics and
obstetric complications (restricted to the period 1989-1997) among
obese and non-obese women were evaluated. Cases of stillbirth among
obese women by obesity subtypes were also estimated. Using white women
with BMIs ranging from 18.5 to 24.9 (normal weight) as a reference, the
researchers estimated crude and adjusted risk of stillbirth among obese
women by obesity subtype, controlling for the effects of maternal race,
age, educational achievement, marital status, smoking habits during
pregnancy, adequacy of prenatal care received, fetal gender, and year
of birth.
The authors found that
- About 9.5% of the women had a BMI greater than 30 (12.8% among
blacks and 8.9% among whites).
- The likelihood of stillbirth was 40% greater for obese women,
compared with normal-weight women. The likelihood of stillbirth for
extremely obese women was more than 90% higher than the likelihood for
normal-weight women.
- Of the total number of stillbirths among obese women (N=1,149),
320 or 28% (stillbirth rate 11.4 per 1,000) occurred among black obese
women, while 829 or 72% (stillbirth rate 7.8 per 1,000) occurred among
white obese women.
- In both racial groups, the risk for stillbirth increased
progressively with increase in BMI in a dose-effect pattern. However,
black-white disparity in obesity-related stillbirth remained persistent
to the disadvantage of blacks, regardless of the obesity subtype.
"It is recommended that future research examines the linkage between
racial background and lethality of rising BMI on the fetus," conclude
the authors, adding that "strategies to reduce black-white disparities
in birth outcomes should consider targeting obese, black women."
Salihu HM, Dunlop A-L, Hedayatzadeh M, et al. 2007. Extreme obesity and
risk of stillbirth among black and white gravidas. Obstetrics and
Gynecology 110(3):552-557. Abstract available at http://www.greenjournal.org/cgi/content/short/110/3/552
Readers: More information is available from the following MCH Library
resources:
- Infant Mortality (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_infmort.html
- Racial and Ethnic Disparities in Health and Health Care (knowledge
path) at
http://www.mchlibrary.info/KnowledgePaths/kp_race.html
- Infant Mortality (bibliography) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_infmortality.html&-MaxRecords=all&-DoScript=auto_search_infmortality&-search
-Infant Mortality Prevention (organizations resource list) at
http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_infmort.html&-MaxRecords=all&-DoScript=auto_search_infmort&-search
************************************************************
5. ARTICLE EVALUATES SCHOOL-BASED INTERVENTION TO LOWER INCIDENCE OF
DISORDERED WEIGHT-CONTROL BEHAVIORS IN YOUNG ADOLESCENTS
"The present study adds novel empirical evidence in support of the
viability of integrating obesity and eating disorders prevention
initiatives," state the authors of an article published in the
September 2007 issue of Archives of Pediatric and Adolescent Medicine.
Eating disorders have substantial negative health consequences for
affected adolescents. In addition, disordered weight-control behaviors,
including self-induced vomiting or use of laxatives or diet pills to
control weight (which are often precursors to eating disorders) have
been positively associated with overweight in adolescents. A recent
analysis of the Planet Health obesity prevention intervention conducted
in middle-school students found an unexpected benefit: after 2 years in
intervention schools, girls' risk of reporting disordered
weight-control behaviors halved, compared with girls in control
schools. This article reports on a study to determine the effect of
Planet Health implemented in a randomized effectiveness trial on
incidence of disordered weight-control behaviors in middle-school girls
and boys. The present study extended beyond previous research on Planet
Health by including a larger sample, more recent data, and data for
boys.
The authors used a group-randomized design in which middle schools were
the unit of randomization and students were the unit of analysis.
Thirteen Massachusetts middle schools were stratified by type
(parochial or public), and public schools were further stratified by
racial and ethnic composition (75% white or higher or less than 75%
white). Schools were then randomly assigned as either an intervention
(Planet Health, a curriculum that includes health messages that focus
on physical activity, television viewing, and consumption of fruits,
vegetables, and fats) or as a control. All students in the 13 schools
who were in sixth or seventh grade at baseline were eligible to
participate. A total of 1,451 eligible students who completed the
follow-up questionnaire and did not report disordered weight-control
behaviors at baseline formed the total analytical sample.
The authors found that
- After 2 school years, 3.6% of girls in control schools, compared
with 1.2% of girls in intervention schools, reported new disordered
weight-control behaviors.
- The odds of adopting a disordered weight-control behavior were
reduced by two-thirds in girls in intervention schools compared with
girls in control schools.
- In models that also controlled for grade, race and ethnicity, and
overweight, the magnitude of the effect estimate associated with the
intervention for girls remained stable, changing less than 10%, but the
confidence interval widened to include the null value of 1.0.
- No protective effects of the intervention were observed for boys.
The authors conclude that "new research efforts will need to identify
protective strategies for early adolescent boys also and to understand
the mechanism of Planet Health and other strategies in school settings
that integrate obesity and eating disorders prevention."
Austin SB, Kim J, Wiecha J, et al. 2007. School-based overweight
preventive intervention lowers incidence of disordered weight-control
behaviors in early adolescent girls. Archives of Pediatric and
Adolescent Medicine 161(9):865-869. Abstract available at http://archpedi.ama-assn.org/cgi/content/abstract/161/9/865
Readers: More information is available from Bright Futures at
http://brightfutures.aap.org/web
http://www.brightfutures.org/nutrition/index.html
http://www.brightfutures.org/physicalactivity/about.htm
http://nutrition.utk.edu/max_resources/maximize
Information is also available from the following MCH Library resources:
- Overweight in Children and Adolescents (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html
- School Health (selected resources) at
http://www.mchlibrary.info/guides/schoolhealth.html
************************************************************
To subscribe to MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with SUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
To unsubscribe from MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with UNSUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
************************************************************
MCH Alert © 1998-2007 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
in Maternal and Child Health under its cooperative agreement
(U02MC00001) with the Maternal and Child Health Bureau, Health
Resources and Services Administration, U.S. Department of Health and
Human Services. The Maternal and Child Health Bureau reserves a
royalty-free, nonexclusive, and irrevocable right to use the work for
federal purposes and to authorize others to use the work for federal
purposes.
Permission is given to forward MCH Alert, in its entirety, to others.
For
all other uses, requests for permission to duplicate and use all or
part of the information contained in this publication should be sent to
mchalert@ncemch.org
The editors welcome your submissions, suggestions, and questions.
Please contact us at the address below.
MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun
MCH Alert
Maternal and Child Health Library
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/default.html
************************************************************