Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
October 16, 2009
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Special Notice: The Agency for Healthcare Research and Quality is
offering an opportunity for public comment on the U.S. Preventive
Services Task Force draft recommendation on vision screening in
children ages 1 to 5. This public comment is part of an effort to
increase the transparency of the methods and processes of the task
force. The public comment period is open until October 23, 2009. More
information is available at http://www.ahrq.gov/clinic/uspstf/uspstf_form.
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1. Resource Center Publishes Oral Health Education Tools
in English and Spanish
2. New Edition of Women's Health Data Book Released
3. Study Explores Prevalence of Autism Spectrum Disorder
4. Article Examines Relationship Between Provision of
Family Planning Services and Unintended Pregnancy
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1. RESOURCE CENTER PUBLISHES ORAL HEALTH EDUCATION TOOLS IN ENGLISH
AND SPANISH
The National Maternal and Child Oral Health Resource Center has
published three educational brochures about the importance of oral
hygiene and oral care during pregnancy, infancy, and early childhood.
The brochures are available in English and Spanish and are written in a
style appropriate for all audiences, including those with lower
literacy levels. The brochures include the following:
- A Healthy Smile for You and Your Baby: Tips to Keep Your Baby
Healthy
(Una sonrisa saludable para tu bebé: Consejos para
mantener sano a tu bebé). This brochure is designed to educate
new and expecting parents about the importance of oral hygiene and oral
care during infancy. Topics include caring for an infant's gums and
teeth, giving healthy foods, and getting a dental checkup by age 1.
Additional topics include the importance of primary teeth, tips to help
parents keep their own mouths healthy, and resources for finding a
dentist.
- A Healthy Smile for You and Your Young Child: Tips to Keep Your
Child Healthy
(Una sonrisa saludable para tu niño
pequeño: Consejos para mantener sano a tu niño). This
brochure is designed to educate parents and other caregivers of young
children about oral hygiene and oral care during early childhood.
Topics include toothbrushing, flossing, eating healthy foods, and
getting dental checkups and treatment. Additional topics include the
importance of primary teeth, tips to help parents keep their own mouths
healthy, and resources for finding a dentist.
- Two Healthy Smiles: Tips to Keep You and Your Baby Healthy (Dos
sonrisas saludables: Consejos para mantenerte a ti y a tu bebé
sanos). This brochure is designed to educate women about the importance
of oral hygiene and oral care during pregnancy. Topics include
brushing, flossing, eating healthy foods, and getting dental checkups
and treatment. Additional topics include the impact of hormonal changes
during pregnancy on gum health, caring for an infant's gums and teeth,
and finding a dentist.
More information is available at http://www.mchoralhealth.org/materials/consumerbrochures.html
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2. NEW EDITION OF WOMEN'S HEALTH DATA BOOK RELEASED
Women's Health USA 2009, the eighth edition of the data book,
selectively highlights emerging issues and trends in women's health
using a variety of data sources. The data book, published by the Health
Resources and Services Administration's Maternal and Child Health
Bureau (MCHB), includes information and data on population
characteristics, health status, and health services utilization. New
topics in the 2009 edition include women veterans, bleeding disorders,
hearing problems, and severe headaches and migraines. There is also a
new section providing state-specific data on leading causes of death,
overweight and obesity, and smoking among women. A special supplement
on women's health along the U.S.-Mexico border is also new this year;
it covers a range of topics including population characteristics,
health insurance coverage, and reproductive health. Racial and ethnic,
sex, and socioeconomic disparities are highlighted throughout the
document where possible. The data book is intended to be a concise
reference for policymakers and program managers at the federal, state,
and local levels to identify and clarify issues affecting the health of
women. It is available at http://mchb.hrsa.gov/whusa09
Readers: MCHB has also released Child Health USA 2008-2009, an annual
report on the health status and service needs of children. The data
book is available at http://mchb.hrsa.gov/chusa08
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3. STUDY EXPLORES PREVALENCE OF AUTISM SPECTRUM DISORDER
"In 2007, 1.1 [percent] of US children aged 3 to 17 years (1 of 91
children in this age group) were reported to have currently diagnosed
ASD [autism spectrum disorder]. In addition, for nearly 40 [percent] of
all the children reported to have ever had an ASD diagnosis, a parent
or caregiver reported a past but not current ASD diagnosis," state the
authors of an article published in Pediatrics online on October 5,
2009. Given the reported increasing prevalence and associated impact on
children and families, continual monitoring of ASD remains an urgent
public health priority. The article examines parent-reported ASD
prevalence among U.S. children overall and within numerous
sociodemographic strata.
Data for the study were drawn from the 2007 National Survey of
Children's Health, a random-digit-dial telephone survey providing
national and state-specific information on the health and well-being of
children under age 18 based on interviews with their parents or
guardians. Analyses for the current study were limited to 78,037
children ages 3 to 17. Children classified as having ASD were those
with (1) a parent report of ever being told by a doctor or other health
professional that their child had ASD and (2) a parent report that the
child currently had ASD. The prevalence of ASD was examined overall and
according to selected demographic and socioeconomic characteristics.
The researchers also analyzed the prevalence of ASD according to the
severity of the condition as described by parents (mild, moderate, or
severe). A similar analytic approach was used to examine children whose
parents reported that they had been diagnosed with ASD in the past but
that they did not currently have the disorder, to determine how this
population of children differed according to selected demographic and
socioeconomic covariates from children whose parents reported that they
currently had ASD. The analyses also explored how the prevalence of
co-occurring emotional, behavioral, and developmental problems varied
among children whose parent reported that they currently had ASD and
among those whose parents reported that they did not. Finally, the
analyses compared the health care experiences of children whose parents
reported that they currently had ASD to the experiences of those who
had been diagnosed with ASD at one time but whose parents reported that
they did not currently have the disorder and to the experiences of
those who never had an ASD diagnosis.
The authors found that
- The weighted point prevalence of ASD based on parent reports of
currently having ASD was 110 per 10,000 children, representing an
estimated 673,000 U.S. children ages 3 to 17 whose parents reported
that they currently had ASD in 2007.
- The odds for boys having ASD were four times the odds for girls.
- Non-Hispanic black and non-Hispanic multiracial children had 57
percent and 42 percent lower odds, respectively, of having ASD than
non-Hispanic white children.
- Parents of 453 children in the survey reported that their child
had previously been diagnosed with ASD by a health professional but
that the child did not currently have ASD, representing 38.2 percent of
all children who met the ever-reported criterion.
- Among all children reported as ever diagnosed with ASD,
non-Hispanic black children were more likely and Hispanic children less
likely than non-Hispanic white children to not currently have ASD,
according to parent reports.
- Relative to children never diagnosed, children whose parents
reported that they currently had ASD had poorer perceived quality of
care, as indicated by lower odds of having received family-centered
care, needed care coordination, and care in a medical home.
"Our current estimate of 110 in 10,000 is higher than previous US
estimates. Methodologic changes between the surveys (with the inclusion
of Asperger disorder, pervasive developmental disorder, and other ASD)
and overall increases in public awareness and provider identification
of ASD might partly explain the increased prevalence," conclude the
authors.
Kogan MD, Blumberg SJ, Schieve LA, et al. 2009. Prevalence of
parent-reported diagnosis of autism spectrum disorder among children in
the US, 2007. Pediatrics [published online on October 5, 2009].
Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-1522v1
Readers: More information is available from the following MCH Library
resource:
- Autism Spectrum Disorders: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_autism.html
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4. ARTICLE EXAMINES RELATIONSHIP BETWEEN PROVISION OF FAMILY PLANNING
SERVICES AND UNINTENDED PREGNANCY
"Certain baseline characteristics of women seen in an STD clinic may be
associated with future unintended pregnancy," write the authors of an
article published in the Journal of Women's Health online (ahead of
print) on September 29, 2009. Both sexually transmitted diseases (STDs)
and unintended pregnancy are consequences of unprotected sexual
intercourse and disproportionately affect poor, young, minority women.
Few programs provide initial family planning services in an STD clinic.
The purpose of the study described in this article was to evaluate the
effectiveness of a program that provided both STD and family-planning
services by examining the relationship between baseline demographic and
clinical characteristics and incident pregnancy among women provided
initial contraceptive services who subsequently returned for STD/family
planning services.
The study was conducted using medical records of women provided family
planning services at the Denver Metro Health Clinic (DMHC), the STD
clinic operated by Denver Public Health, between 2003 and 2006.
Demographic and clinical characteristics collected at the initial visit
were used to classify clients' risk for subsequent pregnancy. Baseline
characteristics of women seen only during a single calendar year were
compared to those of women seen in 2 or more years (repeat attendees).
The analysis assessed incident pregnancy among all women ages 12-44 who
indicated no interest in pregnancy, received a method of contraception
at the initial STD clinic visit, and completed a baseline pregnancy
history. Subsequent analyses assessed the association between incident
pregnancy among the repeat attendees and factors associated with risk
of subsequent pregnancy.
The authors found that
- Over the 4 years of follow-up, there were 4,617 women who met the
criteria to be included in the cohort to examine incident pregnancy.
Among this group, 710 (15 percent) of women were seen in at least 2
separate years.
- Among the 710 repeat attendees, 642 women had complete follow-up
information and indicated no intention of pregnancy at any subsequent
visit.
- Among these 642 women, there were 124 (19%) total pregnancies.
- Stratifying by risk status for subsequent pregnancy, being high
risk for pregnancy was significantly associated with an increased rate
of incident pregnancy, compared with being low risk for pregnancy (37.3
percent vs. 17.5 percent).
- Controlling for age and race-ethnicity, incident pregnancy was
associated with previous pregnancy (OR 2.57), at or below 150 percent
of the federal poverty level (OR 2.22), and no contraceptive use at
last sexual encounter (OR 1.67).
- Incident pregnancy was not associated with educational level,
sexual frequency, age of first pregnancy, number of partners, prior
therapeutic abortion, or provision of effective contraception at the
initial STD clinic visit.
The results suggest "that continued use of effective contraception or
factors affecting continued contraceptive use should be targeted for
future research and program development," state the authors.
Shlay JD, Zolot L, Bell D, et al. 2009. Association between provision
of initial family planning services and unintended pregnancy among
women attending an STD clinic. Journal of Women’s Health [published
online ahead of print on September 29, 2009]. Abstract available at http://www.liebertonline.com/doi/abs/10.1089/jwh.2008.0966
Readers: More information is available from the following MCH Library
resource:
- Preconception and Pregnancy: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_pregnancy.html
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and
Child Health and Georgetown University. MCH Alert is produced by
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