Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.

May 9, 2008

1. E-JOURNAL FOCUSES ON CHILDREN AND ELECTRONIC MEDIA

The spring 2008 issue of The Future of Children features nine articles on the most common forms of electronic media in use today and their influence on the well-being of children and adolescents. The e-journal, published by Princeton University's Woodrow Wilson School of Public and International Affairs and the Brookings Institution, is organized by children's outcomes and considers evidence separately for children vs. adolescents, boys vs. girls, and advantaged vs. disadvantaged children. Topics include how exposure to different media forms is linked with such aspects of child well-being as school achievement, cognition, engagement in extracurricular activities, social interaction with peers and family, aggression, fear and anxiety, risky behaviors, and healthy lifestyle choices. The full text issue, executive summary, and policy brief are available at http://www.futureofchildren.org/pubs-info2825/pubs-info_show.htm?doc_id=674322.

• In 2005-2006, breastfeeding rates exceeded the Healthy People 2010 goals of 75%.
• Breastfeeding rates at age 6 months did not achieve the Healthy People 2010 target goal of 50%.
• Breastfeeding rates were associated with race and ethnicity, maternal age, and family income status.

• Young women ages 15-25 had 15.1 million visits to obstetrician-gynecologists during 2005; 6.3 million of these visits were made by nonpregnant women. Young women in this age group had 21.9 million visits to primary care physicians, and 20.9 million of these visits were made by nonpregnant women.
• Although obstetrician-gynecologists conducted only 23.1% of all visits, they conducted 35.7% of the preventive care visits, 68.8% of visits with pelvic examinations, and 71.1% of visits with Pap tests.
• General and family practitioners conducted 24.6% of preventive care visits, and internists and pediatricians together conducted 39.7% of preventive care visits. Primary care physicians conducted 77.5% of visits with urinalyses.
• Among obstetrician-gynecologists, a chlamydia test was not done at 84.0% of visits for preventive care, 82.1% of visits where a pelvic examination was done, and 77.3% of visits where a Pap test was done.
• Among primary care physicians, a chlamydia test was not done at 93.2% of visits for preventive care and 99.1% of visits where a urinalysis was done.

• The rate of prophylactic use of oxytocin increased from 2.1% to 83.6% in the intervention hospitals and from 2.6% to 12.3% in the control hospitals.
• The intervention was associated with a decrease in the median episiotomy rate in intervention hospitals from 41.1% at baseline to 29.9% at the end of the intervention; the rate was stable in control hospitals.
• The intervention was associated with a statistically significant reduction in all postpartum hemorrhage indicators -- the rate of postpartum hemorrhage of 500 ml or more, the rate of postpartum hemorrhage of 1,000 ml or more, and the mean amount of postpartum blood loss.
• There was no evidence of an effect on other secondary outcome measures, although the study was not powered to exclude potentially important but rare clinical effects.
• In the intervention hospitals, the median rate of birth attendants' readiness to change increased from 14.4% to 55.9%, whereas the rate in the control hospitals remained stable.
• At the 1-year follow-up, the median rate of prophylactic use of oxytocin remained high in the intervention hospitals and low in the control hospitals. Also at the 1-year follow-up, the median episiotomy rate at intervention hospitals remained low, and the rate at control hospitals remained high.