Mental illness (MI), substance abuse (SA), and intentional injury (II) are known individual risk factors for adverse pregnancy outcomes. Their combined association with preterm birth (PTB) and low birth weight (LBW) remains relatively unexplored. We examined hospital utilization for the co-occurrence of II and MI or SA in pregnant women in Massachusetts and assessed their interactive association with PTB and LBW. This retrospective cohort study used ICD-9 and E-codes reported on linked birth and hospital utilization data to identify MI, SA, and II diagnoses during pregnancy for 176,845 Massachusetts resident women who delivered during 2002-2004. Adjusted odds ratios (OR) for the independent and joint associations of MI, SA, and II on PTB and LBW were calculated. Two thousand two hundred and eight women (1.6%) had a prenatal MI visit, 834 (0.5%) a prenatal SA visit, and 847 (0.5%) a prenatal II visit. Among them 163 women had MI and II visits and 69 had SA and II visits. SA, MI, and II were all significant predictors of LBW and PTB. Women with both SA and II had higher odds of PTB (OR 2.7 95% CI 1.3-5.7) and LBW (OR 5.3 95% CI 3.9-7.3) than women with neither diagnosis. Prenatal MI, SA, and II are risk factors for LBW and PTB. Women with SA and II co-diagnoses have greater risk of LBW and PTB than women with neither diagnosis. Screening, timely diagnosis, and treatment of women with co-occurring morbidities, particularly II and SA, should be incorporated into reproductive and perinatal health programs.

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Objectives The third round (R3) of the National Social Life, Health, and Aging Project, a nationally representative, longitudinal survey of community-residing older adults, consisted of 4,777 in-person interviews and 6,100 completed visits to households to identify newly eligible respondents. It revisited respondents from the first rounds (Cohort 1), born in the years 1920 through 1947, and added new respondents (Cohort 2) born in the years 1948 through 1965. Coresidential romantic partners of both cohorts were also eligible. Data collection included in-person questionnaires, up to 11 biomeasures, and a self-administered, postinterview paper questionnaire. Methods Questionnaire domains included social network and social support, elder mistreatment, physical health, cognitive function, romantic partners and sexuality, fertility and menopause, mental health, and employment and finances. Biomeasure collection included height, weight, waist circumference, blood pressure and heart rate, timed walk, balance, chair stands, smell, saliva passive drool in a tube (cortisol, dehydroepiandrosterone, estradiol, progesterone, testosterone), dried blood spots (C-reactive protein, Epstein–Barr virus antibodies, high-density lipoprotein cholesterol, hemoglobin, glycosylated hemoglobin [HbA1c], total cholesterol), and accelerometry (sleep patterns and physical activity). A brief questionnaire also collected data on respondents who were deceased or in too poor health to participate. Results Measures such as response and cooperation rates are provided to evaluate the design and implementation. Discussion This article describes innovation in the development and implementation of R3, the recruitment of a new cohort of respondents, and fidelity to prior rounds’ study design and data collection procedures.