Maternal and Child Health Library

MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National Sudden and Unexpected Infant/Child and Pregnancy Loss Resource Center at Georgetown University. This and past issues are available online at http://www.mchlibrary.info/alert/archives.html and http://www.sidscenter.org/alert/archives.html.

July 31, 2009

1. BRIEF FEATURES HOME VISITING RESOURCES

Home Visiting: Resource Brief contains information about home visitation programs and the variety of family-focused services they offer to pregnant women and families with new infants and young children. The brief, produced by the Maternal and Child Health (MCH) Library at Georgetown University, lists Web sites and related MCH Library resources. Sample resources include testimonies and legislative updates such as an overview of the home visitation component of the president's fiscal-year 2010 budget proposal. Additional resources include issue briefs, testimonies, and research findings; policy statements; state and local program guidelines and examples; professional- and consumer-education materials; documents on program development, core competencies, supervision, and evaluation; curricula and training; and Webinars. A guide for home visitors on educating parents and caregivers about infant safe sleep is also provided. The brief is available at http://mchlibrary.info/guides/homevisiting.html.

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• There were 292,627 singleton deliveries at 34 to 36 weeks of gestation, representing 8.4 percent of singleton births from 34 to 41 weeks of gestation.
• There were 67,909 late preterm deliveries (23.2 percent) classified as having no recorded indication.
• Deliveries with no recorded indication were associated increasingly with higher maternal age; non-Hispanic white ethnicity; maternal educational level 13 or more years; deliveries occurring in the Midwest, South, and West regions of the Unites States; multiparity; and a history of previous infant with a birthweight of 4000 g or less.
• Deliveries with no recorded indication had significantly higher neonatal and infant mortality rates compared with deliveries attributed to isolated spontaneous labor but lower neonatal and infant mortality rates compared with deliveries associated with an obstetric indication or congenital anomaly.

• Health professionals were asked seven questions. They answered a mean number of 5.4 questions correctly.
• Almost all (88.8 percent) of health professionals were unaware that 2 to 4 months is the age range associated with the highest incidence of SIDS
• Fifty-seven health professionals (27 percent) were not able to identify the American Academy of Pediatrics recommended supine position as the safest infant sleep position.
• Almost all the health professionals (99.5 percent) agreed that certain measures can be taken to reduce the risk for SIDS, and 97.6 percent agreed that it is important to discuss risk-reduction strategies with every parent of an infant (ages 12 months or younger).
• When asked about the safest sleep position for a healthy infant under age 6 months, 147 (69.7 percent) said the back, 53 (25.1 percent) said the back or side is equally safe, 8 (3.8 percent) said the side, and 3 (1.4 percent) said the stomach or side is equally safe.
• When asked about their practices regarding educating parents about SIDS, 149 (70 percent) responded that they or someone in their office routinely talks to parents of young infants about SIDS and SIDS risk reduction.

• More than 80 percent of Healthy Start participants reported that they received health information concerning 13 selected topics after they became pregnant. The three topics participants reported receiving information on most often were eating healthy foods (reported by 96 percent), how to put their child to sleep (96 percent), and how to breastfeed (93 percent).
• Unmet need was low for most of the health care services, with the exception of dental appointments (11 percent reported they needed but did not receive help), child care (11 percent) and housing (13 percent).
• The vast majority of Healthy Start participants were satisfied with the services they received from Healthy Start and with their interactions with Healthy Start staff.
• There was a gap in achieving the Healthy People 2010 objective of 99 percent for the elimination of smoking during pregnancy both for Healthy Start participants (46 percent) and mothers with low incomes more generally (53 percent).
• Overall, the low-birthweight rate at the Healthy Start sites (7.5 percent) was similar to the rate for mothers with low incomes in the ECLS, but both rates were above the Healthy People 2010 objective (5 percent).
• Healthy Start participants' rates of ever breastfeeding (72 percent) and putting infants to sleep on their backs (70 percent) were at or near the Healthy People 2010 objectives and considerably higher than rates among mothers with low incomes in the ECLS.