Interpregnancy Primary Care and Social Support for African-American Women at Risk for Recurrent Very-low-birthweight Delivery: A Pilot Evaluation

Dunlop, Anne L.; Dubin, Cynthia; Raynor, B. Denise; Bugg, George W; Schmotzer, Brian; Brann, Alfred W.

doi:10.1007/s10995-007-0279-z

Cited by 37 publications

(25 citation statements)

References 51 publications

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“…Additionally, we include women of higher parity whereas other studies included first and second births only (30). Reducing the risk of short IPIs among NHB women may be one way to reduce racial ethnic disparities in preterm birth (30, 36–39); therefore more research on improving provision of postpartum contraception in publicly funded programs, particularly highly effective methods like intrauterine devices and contraceptive implants, is warranted for this high risk group (40, 41). …”

Section: Discussionmentioning

confidence: 99%

Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program

Tucker

Berrien

Menard

et al. 2015

Matern Child Health J

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Objective To determine which combination of risk factors from Community Care of North Carolina’s (CCNC) Pregnancy Medical Home (PMH) risk screening form was most predictive of preterm birth (PTB) by parity and race/ethnicity. Methods This retrospective cohort included pregnant Medicaid patients screened by the PMH program before 24 weeks gestation who delivered a live birth in North Carolina between September 2011-September 2012 (N=15,428). Data came from CCNC’s Case Management Information System, Medicaid claims, and birth certificates. Logistic regression with backward stepwise elimination was used to arrive at the final models. To internally validate the predictive model, we used bootstrapping techniques. Results The prevalence of PTB was 11%. Multifetal gestation, a previous PTB, cervical insufficiency, diabetes, renal disease, and hypertension were the strongest risk factors with odds ratios ranging from 2.34 to 10.78. Non-Hispanic black race, underweight, smoking during pregnancy, asthma, other chronic conditions, nulliparity, and a history of a low birth weight infant or fetal death/second trimester loss were additional predictors in the final predictive model. About half of the risk factors prioritized by the PMH program remained in our final model (ROC=0.66). The odds of PTB associated with food insecurity and obesity differed by parity. The influence of unsafe or unstable housing and short interpregnancy interval on PTB differed by race/ethnicity. Conclusions Evaluation of the PMH risk screen provides insight to ensure women at highest risk are prioritized for care management. Using multiple data sources, salient risk factors for PTB were identified, allowing for better-targeted approaches for PTB prevention.

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Section: Discussionmentioning

confidence: 99%

Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program

Tucker

Berrien

Menard

et al. 2015

Matern Child Health J

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“…Pilot studies of preconception and interconception care that increase accessibility and availability of coordinated well-women health care, provide social and behavioral case management as an avenue, and mitigate the effects of stress and social determinants show promise (23,44). But behavior interventions initiated in clinical or public health settings are administered without consideration of cultural context.…”

Section: Wwwannualreviewsorg • Infant Mortality Disparities and Carementioning

confidence: 99%

Disparities in Infant Mortality and Effective, Equitable Care: Are Infants Suffering from Benign Neglect?

Rowley

Hogan

2012

Annu. Rev. Public Health

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Quality care for infant mortality disparity elimination requires services that improve health status at both the individual and the population level. We examine disparity reduction due to effective care and ask the following question: Has clinical care ameliorated factors that make some populations more likely to have higher rates of infant mortality compared with other populations? Disparities in postneonatal mortality due to birth defects have emerged for non-Hispanic black and Hispanic infants. Surfactant and antenatal steroid therapy have been accompanied by growing disparities in respiratory distress syndrome mortality for black infants. Progesterone therapy has not reduced early preterm birth, the major contributor to mortality disparities among non-Hispanic black and Puerto Rican infants. The Back to Sleep campaign has minimally reduced SIDS disparities among American Indian/Alaska Native infants, but it has not reduced disparities among non-Hispanic black infants. In general, clinical care is not equitable and contributes to increasing disparities.

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“…One trial of interconceptional antibiotic treatment for women with a prior preterm birth failed to demonstrate reduced risk in the subsequent pregnancy (117, 118). Some evidence exists that prenatal treatment of severe periodontal disease reduces subsequent risk of preterm birth (119), and one pilot trial of interconceptional care (including primary care and dental treatment) for women with a prior very low birth weight infant showed a reduced risk of subsequent very low birth weight delivery for black women (120). …”

Section: Pre- and Periconceptional Maternal Healthmentioning

confidence: 99%

What Causes Racial Disparities in Very Preterm Birth? A Biosocial Perspective

Kramer

Hogue²

2009

Epidemiologic Reviews

218

154

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Very preterm birth (<32 weeks’ gestation) occurs in approximately 2% of live births but is a leading cause of infant mortality and morbidity in the United States. African-American women have a 2-fold to 3-fold elevated risk compared with non-Hispanic white women for reasons that are incompletely understood. This paper reviews the evidence for the biologic and social patterning of very preterm birth, with attention to leading hypotheses regarding the etiology of the racial disparity. A systematic review of the literature in the MEDLINE, CINAHL, PsycInfo, and EMBASE indices was conducted. The literature to date suggests a complex, multifactorial causal framework for understanding racial disparities in very preterm birth, with maternal inflammatory, vascular, or neuroendocrine dysfunction as proximal pathways and maternal exposure to stress, racial differences in preconceptional health, and genetic, epigenetic, and gene-environment interactions as more distal mediators. Interpersonal and institutionalized racism are mechanisms that may drive racially patterned differences. Current literature is limited in that research on social determinants and biologic processes of prematurity has been generally disconnected. Improved etiologic understanding and the potential for effective intervention may come with better integration of these research approaches.

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Interpregnancy Primary Care and Social Support for African-American Women at Risk for Recurrent Very-low-birthweight Delivery: A Pilot Evaluation

Cited by 37 publications

References 51 publications

Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program

Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program

Disparities in Infant Mortality and Effective, Equitable Care: Are Infants Suffering from Benign Neglect?

What Causes Racial Disparities in Very Preterm Birth? A Biosocial Perspective

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