MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National SUID/SIDS Resource Center at Georgetown University. This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html and http://www.sidscenter.org/alert/archives.html
Multimedia Featured Resource: Improving Birth Outcomes in the U.S.: State Efforts to Reduce Prematurity provides examples of how a state can move forward in achieving the goal of prematurity reduction. The webinar, held on July 12, 2012, was co-sponsored by the Association of Maternal and Child Health Programs and the Association of State and Territorial Health Officials. Topics include the ASTHO president's challenge (the Healthy Babies Initiative) to decrease prematurity in the United States by 8 percent by 2014. Presenters highlight the experience and strategies of two states that have met the challenge goal (Alaska and Vermont) and one state currently working toward that goal (Oklahoma). Webinar slides are available at http://www.amchp.org/Calendar/Webinars/ArchivedWebinars/Documents/ReducingPrematuritySlides-Compiled.pdf
1. Expert Panel Provides Road Map for Schools in Preparing a Culturally Competent Health Work Force
Cultural Competence Education for Students in Medicine and Public Health: Report of an Expert Panel identifies competencies designed to enable faculty in medical schools and public health graduate schools and programs to standardize curricula, benchmark student performance, and prepare graduates for culturally competent practice. The report comprises recommendations of a joint expert panel of educators convened by the Association of American Medical Colleges and the Association of Schools of Public Health. The panel's recommendations aim to ensure that students acquire cultural competencies in their chosen fields to prepare them for successful practice, including the development and delivery of appropriate health care and population health programs, services, and policies for an increasingly diverse U.S. population. Contents include recommendations for embedding cultural competence education within and across curricula of medicine and public health, exemplary case studies, and a road map for the future. The report is available at http://www.asph.org/UserFiles/11-278%20CulturCompet%20Interactive%20final.pdf
2. Report Examines Alcohol Use and Binge Drinking Among Women of Childbearing Age
"These results indicate that binge drinking during pregnancy continues to be a concern," state the authors of a report published in the July 20, 2012, issue of Morbidity and Mortality Weekly Report. Alcohol use during pregnancy is a leading preventable cause of birth defects and developmental disabilities. In 2005, the Surgeon General issued an advisory urging women who are pregnant or who might become pregnant to abstain from alcohol use. Healthy People 2020 set specific targets for abstinence from alcohol use and binge drinking in the past 30 days among women ages 18-44. The report provides estimates of the prevalence of any alcohol use and binge drinking in the past 30 days among women ages 18-44 in the United States.
The Centers for Disease Control and Prevention aggregated and analyzed 2006-2010 Behavioral Risk Factor Surveillance System (BRFSS) data from all 50 states and the District of Columbia. The study population of 345,076 women ages 18-44 included 13,880 (4.0 percent) pregnant women and 331,196 (96.0 percent) nonpregnant women. The analyses examined, separately for pregnant and nonpregnant women, the association of selected demographic characteristics with any alcohol use and with binge drinking (the final model adjusted for age, race and ethnicity, education, employment, and marital status). Any alcohol use was defined as having at least one drink of any alcoholic beverage in the past 30 days. Binge drinking was defined for women as four or more drinks on an occasion in the past 30 days.
The authors found that
"Pregnant and nonpregnant women of childbearing age who misuse alcohol might benefit from public health interventions," state the authors, adding that alcohol "SBI [screening and brief interventions] and community level policy interventions . . . might be effective in reducing alcohol misuse among women and help to achieve the Healthy People 2020 goals."
Centers for Disease Control and Prevention. 2012. Alcohol use and binge drinking among women of childbearing age -- United States, 2006-2010. Morbidity and Mortality Weekly Report 61(28):534-535. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a4.htm
Readers: More information is available from the following MCH Library resource:
- Tobacco, Alcohol, and Substance Use During Preconception and Pregnancy: Resource Brief at
http://www.mchlibrary.info/guides/substancepregnancy.html
3. Authors Review SIDS Epidemiology and Risk Reduction: Then and Now
"It is critical for clinicians and other health professionals to understand and address some of the barriers that parents perceive about adopting safe sleep recommendations," state the authors of a review article published in the July 2012 issue of Pediatrics in Review. Although the rate of sudden infant death syndrome (SIDS) deaths has remained constant -- approximately 2,300 infants annually -- since 2001, many deaths that previously would have been classified as SIDS now are attributed to other sleep-related causes. The American Academy of Pediatrics Task Force on SIDS recently published a new
Policy Statement and Technical Report providing evidence-based guidance on the other causes of sleep-related infant deaths, such as soft bedding, prone sleep position, and bed sharing. The article references a 2007 review article on SIDS published in Pediatrics in Review and provides an update on the topic.
The authors discuss possible etiologic mechanisms for SIDS, risk factors for SIDS, the American Academy of Pediatrics' SIDS Task Force recommendations and underlying rationale, and the most common reasons for nonadherence to SIDS-risk-reduction recommendations. The article concludes with a summary of the following education and health messages:
Moon RY, Fu L. 2012. Sudden infant death syndrome: An update. Pediatrics in Review 33(7):314-320. Extract available at http://dx.doi.org/10.1542/pir.33-7-314.
Readers: More information is available from the following MCH Library resource:
- Infant Mortality and Pregnancy Loss: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_infmort.html
4. Study Evaluates Relationship Between Neighborhood Characteristics and Preterm Birth in Black Women
"We found no association between low neighborhood SES [socioeconomic status] and preterm birth among Black women residing in various areas of the USA," write the authors of an article published in Journal of Urban Health: Bulletin of the New York Academy of Medicine online on June 30, 2012. Preterm birth is the leading cause of neonatal mortality in the United States. Black women are twice as likely as white women to deliver prematurely, even after controlling for maternal factors. Black women are also more likely than white women with the same personal SES to live in disadvantaged neighborhoods. The authors of this article assessed whether a composite variable of seven neighborhood socioeconomic characteristics was related to self-reported preterm birth in a cohort of U.S. black women who represented a variety of educational levels and lived in a wide variety of neighborhoods. They also evaluated associations according to subtypes of preterm birth, including spontaneous and medically indicated preterm births. The final sample of 6,390 births included 5,433 term births and 957 preterm births, of which 505 were spontaneous and 452 were medically indicated.
The authors evaluated a composite variable, which was derived from seven U.S. Census Bureau indicators, in relation to self-reported preterm birth among women in the Black Women’s Health Study who delivered singleton births during 1995-2003. Indicators included (1) percentage of adults who have completed college, (2) percentage of households with interest or dividends or net rental income, (3) median household income, (4) percentage of white collar employment, (5) percentage of families with children headed by a single female, (6) percentage of adults living below the poverty line, and (7) median housing value.
The authors found that
The authors conclude that "since nearly all the study participants had completed high school, we could not informatively assess associations in women with less educational attainment. If indeed such women are at increased risk of preterm birth, it will be desirable to identify specific factors associated with higher educational attainment that may potentially shield adverse effects of residing in disadvantaged neighborhoods."
Phillips GS, Wise LA, Rich-Edwards JW, et al. 2012. Neighborhood socioeconomic status in relation to preterm birth in a U.S. cohort of black women. Journal of Urban Health: Bulletin of the New York Academy of Medicine [published online on June 30, 2012]. Abstract available at http://dx.doi.org/10.1007/s11524-012-9739-x
Readers: More information is available from the following MCH Library resources:
- Preconception and Pregnancy: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_pregnancy.html
- Racial and Ethnic Disparities in Health: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_race.html
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