Search

Objectives Infant developmental outcomes may be influenced by a range of prenatal maternal characteristics. While there is some evidence to suggest that maternal-foetal attachment may be associated with infant developmental outcomes, there is a need to systematically review this evidence to guide future research and clinical practice. Methods Five electronic databases were systematically scanned. Key journals and reference lists were hand-searched. Papers were included if: (1) pregnant women were assessed for maternal-foetal attachment; (2) the infants were later assessed, under 2 years old, for any developmental outcome (e.g., social-emotional, cognition, motor, language, adaptive behaviour); and (3) they were published in English. Two independent reviewers used the STROBE checklist to appraise the quality of each paper. Results Of the 968 papers identified, eight were included in the review, and four of these were of low quality (<60 %) based on the STROBE. The developmental domains that were examined included: infant temperament (n = 5), adaptive behaviour (e.g., colic, sleep) (n = 2), and milestone attainment (n = 1). There is some evidence to suggest that lower maternal-foetal attachment is related to suboptimal developmental outcomes. However, these results should be interpreted with caution due to the limited and low quality studies available. Conclusions Although maternal-foetal attachment may be associated with infant developmental outcomes, future research is required which: (1) considers a range of developmental outcomes, (2) has increased scientific rigour, (3) assesses mother-infant dyads at different prenatal and postnatal time points, and (4) examines different target populations. [ABSTRACT FROM AUTHOR]

Background: A growing gap in exclusive breastfeeding across racial/ethnic groups in the United States includes a very low proportion of African American/Black women, with only 17.4% breastfeeding exclusively in 2015. While many quantitative studies examine these disparities, few qualitative studies have examined the overall experience of breastfeeding for Black women. Objective: The aim of this study is to evaluate the existing qualitative literature on experiences of African American/Black women who breastfeed to gain insight on barriers and facilitators unique to this population. Methods: This scoping review included studies that had a focus on any qualitative study design. Evidence was identified by searching electronic databases (PubMed, CINAHL, and PsychINFO). Results: Thirteen papers met the inclusion criteria for this review. Each study was summarized and then analyzed for content to produce a synthesis. Seven themes that influence Black women's experience with breastfeeding were identified: influence of interpersonal relationship on intention to and sustained breastfeeding experiences, influence of institutional systems on initiating and sustaining infant feeding decision, influence of personal beliefs on breastfeeding decisions and experience, material barriers and facilitators to breastfeeding experience, traditional stigma of breastfeeding, historical stigma of breastfeeding influences feeding choice in Black women, and negative impacts of body image. Conclusion: The breastfeeding experience for Black women is unique and poses additional areas for intervention based on cultural and historical stigma. Incorporating the identified factors into intervention design is key to creating more effective policies for improving breastfeeding rates in the Black women and closing the gap across racial/ethnic demographics in the United States. Still, more qualitative research with culturally relevant theories needs to be done to investigate the full scope and complexities of breastfeeding as a Black woman to develop messaging to encourage the behavior. Significance: What is Already Known on this Subject? Many barriers hinder women from breastfeeding, and disproportionately impact Black women, leading to growing disparities in breastfeeding rates. What does this study add? This scoping review synthesizes the findings from prior qualitative studies on the breastfeeding experiences of Black women, exploring the presence of current well-documented themes across studies, with additional attention to themes that may be unique for Black women to further investigate Black women's experiences with breastfeeding. [ABSTRACT FROM AUTHOR]

Introduction: The number of incarcerated pregnant women is increasing globally. With many having complex health and social backgrounds, incarceration provides opportunities for health interventions, including the chance to have their nutritional needs met. Despite the additional nutritional requirements of pregnancy being well documented, how these are being met within the correctional setting is currently poorly understood. Methods: A scoping review of the literature was conducted to identify the literature published between January 2010 and April 2023 related to the provision of nutrition for pregnant women in the international prison systems. Sixteen papers met the criteria for inclusion in the review. The relevant key findings were charted and thematically analysed. Results: Two themes were identified: 'the inconsistent reality of food provision' and 'choice, autonomy and food'. There is a clear disparity in the way in which diet is prioritised and provided to pregnant incarcerated women across several countries. Discussion: The findings highlight the need for a consistent approach to diet on a macro, global level to ensure the health of women and their infants in context. Significance: What is Already Known on This Subject?: Whilst the additional nutritional requirements of pregnant women are well known, how these translate into the correctional setting is unknown. What this Study Adds?: This scoping review provides a synthesis of the literature related to the provision of diet for incarcerated pregnant women. The findings highlight that prisons housing pregnant and breastfeeding women should ensure that evidence-based policies exist and are enforced to ensure an appropriate diet is provided. Furthermore, flexible access to water and additional snacks between meals should be ensured to meet the women's evolving nutritional needs across the childbearing continuum. [ABSTRACT FROM AUTHOR]

Introduction: Colonization with Group B Streptococcus in pregnancy is a major risk factor for neonatal infection. Universal screening for maternal streptococcal colonization and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions of neonatal early-onset Group B Streptococcus disease. To achieve the best neonatal outcomes, it is imperative for maternity healthcare providers to adhere to screening and management guidelines. Aim: This literature review uses a systematic approach and aims to provide a synthesis of what is known about compliance with Group B Streptococcus screening protocols in a variety of global settings, including maternity homes, private obstetric practice, and hospital clinical environments. Methods: The review was carried out using electronic databases as well as hand-searching of reference lists. Included papers reported primarily on compliance with Group B Streptococcus screening guidelines, potential factors which influence compliance rates, and implementations and outcomes of interventions. Results: Six international studies have been retained which all focused on adherence to Group B Streptococcus screening guidelines and demonstrated that different factors might have an influence on adherence to GBS screening protocols such as financial aspects and high caesarean section rates. Findings of relatively low compliance rates led to recognizing the need of developing improved strategies for optimising antenatal GBS screening adherence. Conclusion: Adhering to Group B Streptococcus screening guidelines to prevent neonatal infection is crucial. Various factors influence compliance rates such as financial aspects and high proportions of caesarean sections. The implementation of strategies and different forms of education can result in improved compliance rates. [ABSTRACT FROM AUTHOR]

Introduction: Intervention fidelity refers to whether an intervention is delivered as intended and can enhance interpretation of trial outcomes. Fidelity of interventions to reduce or prevent stress and anxiety during pregnancy and postpartum has yet to be examined despite inconsistent findings for intervention effects. This study systematically reviews use and/or reporting of intervention fidelity strategies in trials of interventions, delivered to (expectant) parents during pregnancy and postpartum, to reduce or prevent stress and/or anxiety. Methods: MEDLINE, Embase, CINAHL, PsychINFO, and Maternity and Infant Care were searched from inception to March 2019. Studies were included if they were randomised controlled trials including pregnant women, expectant fathers and/or partners during pregnancy, and/ or parents within the first two years postpartum. The National Institutes of Health Behavior Change Consortium checklist was used to assess fidelity across five domains (study design, provider training, delivery, receipt, enactment). Results: Sixteen papers (14 interventions) were identified. Average reported use of fidelity strategies was 'low' (45%), ranging from 17.5 to 76%. Fidelity ratings ranged from 22% for provider training to 54% for study design. Conclusions: Low levels of intervention fidelity may explain previous inconsistent effects of stress and anxiety reduction interventions. Important methodological areas for improvement include intervention provider training, fidelity of comparator conditions, and consideration of non-specific treatment effects. Increased methodological rigour in fidelity enhancement and assessment will improve intervention implementation and enhance examination of stress and anxiety reduction and prevention interventions delivered during pregnancy and the postpartum. [ABSTRACT FROM AUTHOR]

Lack of paternal involvement during pregnancy and infancy may account for a significant burden of the adverse pregnancy outcomes among black women and could therefore, represent an important avenue providing the opportunity to improve feto-infant health and survival. This study aimed to review the literature on paternal involvement during the perinatal period and its influence on feto-infant health and survival. Literature for this review was identified by searching the PubMed database from the National Center for Biotechnology Information at the US National Library of Medicine as well as the ISI Web of Knowledge Databases, OVID, and CINAHL. A total of seven papers were identified and included in this review. There is paucity of data in this domain. Overall findings suggest that paternal involvement during pregnancy may have important implications for maternal prenatal health behaviors and feto-infant health. Although results are limited, results suggest that paternal involvement has a positive influence on prenatal care usage, abstinence from alcohol and smoking, and a reduction in low birth weight and small for gestational age infants. None of the papers examined the relationship between stillbirth and paternal involvement. Additional studies with enhanced measures of paternal involvement are needed to better assess the role of fathers in enhancing prenatal health behaviors and pregnancy outcomes. Efforts should be made to include fathers in future studies and reduce reliance on maternal report and to investigate paternal roles across different racial groups so that appropriate interventions can be developed. [ABSTRACT FROM AUTHOR]

Improving maternal and child health is a key objective of the United Nations' Millennium Development Goals and the Healthy People goals for improving the health of Americans. Government initiatives are important particularly for reducing disparities that affect disadvantaged populations. Head Start, Healthy Start, WIC and Medicaid are four federal programs that target disparities in maternal and child health outcomes. This paper reviews recent evaluations of these programs to identify outcomes assessed and opportunities for further evaluation of these programs. We conducted a review of recent evaluation studies assessing the impact of four maternal and child health programs on a health or healthcare outcome. Sources for published literature included the PubMed, Academic Search Complete, CINAHL and PsycInfo databases. Titles and abstracts of studies were examined to determine if they met inclusion criteria. Included studies were categorized by type of outcome examined. Twenty peer-reviewed studies published between January 2006 and June 2011 met inclusion criteria. The majority of studies examined infant outcomes (11), followed by breastfeeding/nutrition (4), maternal health (3), and unintended pregnancy (2). Measures used were consistent across studies; however, findings on the impact of programs were mixed reflecting differences in selection of comparison group, data source and statistical methods. The impact of maternal and child health programs may vary by setting and population served, but inconclusive findings remain. Health service researchers can build upon current evaluations to increase our understanding of what works, help target resources, and improve evaluation of programs in the future. [ABSTRACT FROM AUTHOR]

Background: Maternal perinatal depression has been shown to have long lasting effects on children's development. Studies have described the relationship of perinatal depression on children's cognition, especially negative effects on intelligence quotient (IQ). However, a recent examination of the current studies to discern the patterns and strength of associations between perinatal depression and child IQ is not available. Objective: The purpose of this systematic review is to discern the effects of perinatal depression, prenatally and within the first 12 months of the postpartum period, on the IQ of the child aged 0–18 years old. Methods: We searched the electronic databases: PubMed and CINAHL. We identified 1633 studies, and included 17 studies in the final review based on pre-determined criteria. After the data was extracted, we assessed the strength of the study using the national heart, lung, and blood institute quality assessment tool for observational cohort and cross-sectional studies. This systematic review had a total sample of 10,757 participants. Results: Across the studies, we identified a relationship between limited maternal responsiveness due to postpartum depression and a decrease in full IQ scores in younger children. Male children were found to be more sensitive to the postpartum depression, resulting in a decrease in IQs, in comparison to female children. Conclusions: Policies should be implemented to identify women suffering from perinatal depression to mitigate the effects of the disorder for both the mother and her child. Significance: Maternal perinatal depression has been shown to have far-reaching effects on children's development. However, a recent examination of the current studies to discern the associations between perinatal depression and child IQ is not available. In this systematic review, we identified a relationship between limited maternal responsiveness due to postpartum depression and a decrease in full IQ scores in younger children. Male children were more sensitive to postpartum depression, resulting in a decrease in IQs, in comparison to female children.. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this systematic review is to describe polysubstance studies and their prevalence estimates among pregnant people in the US. Methods: This review was not subject to protocol preparation or registration with the International Prospective Register of Systematic Reviews (PROSPERO) because outcome data were not reported. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist was followed. Four scientific literature databases were used to identify articles published from January 1, 2009 to June 3, 2020 reporting prenatal exposure to two or more substances in the US. A standardized process of title and abstract screening followed by a two-phase full-text review was used to assess study eligibility. Results: A total of 119 studies were included: 7 case–control studies, 7 clinical trials, 76 cohort studies, and 29 cross-sectional studies. Studies varied with respect to study design, time period, region, sampling and participant selection, substances assessed, and method of exposure ascertainment. Commonly reported polysubstance prevalence estimates among studies of pregnant people included combinations with alcohol, marijuana, and/or tobacco/nicotine. The range of prevalence estimates was wide (alcohol 1–99%; marijuana 3–95%; tobacco/nicotine 2–95%). Discussion: Polysubstance use during pregnancy is common, especially with alcohol, marijuana, and/or tobacco/nicotine. Future research to assess polysubstance use during pregnancy could help better describe patterns and ultimately help mitigate its effects on maternal and infant health outcomes. [ABSTRACT FROM AUTHOR]

Objective: The literature review reports on programs and interventions that address postpartum depression (PPD) in African American women. African American women are at a higher risk of developing PPD compared to white women. The review will highlight and recommend approaches that may render positive outcomes in the future for this population. Methods: A systematic scoping literature review was conducted using Academic Search Complete, CINAHL, APA PsycArticles, APA PsychInfo, PubMed, Social Services Abstracts, and Social Work Abstracts. Keywords used in the search included "postpartum depression," "African American," and "interventions OR programs OR therapy OR treatment." Fourteen studies were selected, analyzed, and included in the review. Results: Group psychosocial, individual psychosocial, internet-based, and integrated care interventions were included. While many articles noted within group changes in depression symptoms, fewer studies documented between group differences. Studies that investigated subsamples of "high risk" participants or those that used "culturally tailored" approaches showed promise. Conclusion: The literature review yielded some examples of programs/interventions that target postpartum depression in African American women; however, results were mixed. More research is needed to confirm the most effective interventions to address postpartum depression in African American women. Significance: The data shows a limited number of public health interventions tailored to address and reduce postpartum depression in this marginalized population. The recommendations included in the review highlight the need for public health professionals to develop programs to support African American women during the postpartum period. [ABSTRACT FROM AUTHOR]

Introduction: The architecture and function of sleep during infancy and early childhood has not been fully described in the scientific literature. The impact of early sleep disruption on cognitive and physical development is also under-studied. The aim of this review was to investigate early childhood sleep development over the first two years and its association with neurodevelopment. Methods: This review was conducted according to the 2009 PRISMA guidelines. Four databases (OVID Medline, Pubmed, CINAHL, and Web of Science) were searched according to predefined search terms. Results: Ninety-three studies with approximately 90,000 subjects from demographically diverse backgrounds were included in this review. Sleep is the predominant state at birth. There is an increase in NREM and a decrease in REM sleep during the first two years. Changes in sleep architecture occur in tandem with development. There are more studies exploring sleep and early infancy compared to mid and late infancy and early childhood. Discussion: Sleep is critical for memory, learning, and socio-emotional development. Future longitudinal studies in infants and young children should focus on sleep architecture at each month of life to establish the emergence of key characteristics, especially from 7–24 months of age, during periods of rapid neurodevelopmental progress. [ABSTRACT FROM AUTHOR]

Objectives: A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. Methods: Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case–control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. Results: Thirty studies including six cohort- and twenty-four case–control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 – 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 – 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 – 17.19, p < 0.0001). Conclusions: Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to summarize the comprehension of a pictogram about the risk of medication use during pregnancy. Methods: A systematic review was performed using the PRISMA checklist of the PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycInfo, LILACS, Academic Search Premier, Scopus, and Web of Science databases, grey literature (Google Scholar and OpenAIRE), ClinicalTrials.gov website, and design journals and congresses. The search was performed since the database inception, without language or year of publication restrictions. Results: Twelve studies met the inclusion criteria for this review, 2 of which were randomized clinical trials. The pictograms and methods used varied widely among studies. The comprehension of the pregnancy pictograms had a complex communication outcome with a variation of 21–96%. Conclusions for Practice: The lack of a standard pictogram and uniform methods to evaluate the comprehension of the pregnancy pictogram made it challenging to reach a conclusion with the studies available to date on the safety and efficacy of the pregnancy pictogram to alert the risk of medication use. [ABSTRACT FROM AUTHOR]

Introduction: Vaccines are being developed against Group B Streptococcus and respiratory syncytial virus. These vaccines are designed to be given to pregnant women to protect infants; thus, their success depends on uptake in this population. Maternal immunization programs have struggled to achieve target coverage rates. This systematic narrative synthesis aims to define the most important barriers and facilitators for maternal immunization and to identify priority areas for future research. Methods: A search strategy was developed in Medline and adapted according to the requirements of additional search engines. Two reviewers independently reviewed the studies, using pre-specified inclusion and exclusion criteria. Results sections of included studies were coded, and thematic analysis was used to identify prominent themes. Results: 321 studies were included in the final review. Most studies came from North America (37%), Europe (26%) or East Asia, Australia and New Zealand (22%). Low-and middle-income countries were under-represented. Five percent of studies came from Sub-Saharan Africa, and 2% came from South Asia. The prominent factors impacting maternal immunization were provider recommendation, perceived risks and benefits of maternal vaccines for the infant, race, birthplace, and access to healthcare. Few studies explored reasons behind racial and socioeconomic disparities in maternal immunization rates. Discussion: A strong provider recommendation, equitable access to prenatal care and messaging that focuses on vaccine safety and infant benefits emerged as the key components for optimising vaccine uptake among pregnant women. Research among healthcare providers, minority groups and in low- and-middle-income countries was lacking. In anticipation of the expansion of maternal immunization programmes, focused research is needed to address these gaps and inform a successful public health strategy. [ABSTRACT FROM AUTHOR]

Introduction: The negative impacts of mental health disorders on the well-being of women and their infants are clear. However, less is known about the relationship between returning to work after giving birth and mental health. Previous reviews examined the relationship between maternity leave and mental health, but we defined return to work as the process of returning to part-time or full-time work after giving birth and caring for infant. This systematic review aims to: (1) describe operational definitions for return to work and (2) describe the evidence on the relationship between return to work and maternal mental health. Methods: We searched PubMed, PsycINFO, CINAHL, and Web of Science for peer-reviewed studies. Articles were selected if they were published within the past 20 years, examined at least one mental health condition (e.g., depression, anxiety), and included a study sample of U.S. working mothers. Results: We identified 20 articles published between 2001 and 2020. We found conflicting evidence from longitudinal and cross-sectional data demonstrating that return to work was associated with improvements and negative consequences to mental health. Work-related predictors of mental health included: access to paid maternity leave, work–family conflict, total workload, job flexibility, and coworker support. Discussion: This review provides evidence that return to work and mental health are related, though the study samples have limited generalizability to all U.S. working mothers. More research is needed to understand the direction of this relationship throughout the perinatal period and how return to work affects other mental health conditions (e.g., anxiety, stress). [ABSTRACT FROM AUTHOR]

Objectives: Although a number of early childhood development (ECD) interventions in healthcare settings in low- and middle-income countries (LMICs) have been developed to improve parent-directed outcomes and support ECD, their impact have yet to be established. This review assesses the effectiveness of healthcare-based ECD interventions in LMICs on the following key evidence-informed parenting outcomes affecting ECD: (1) responsive caregiving (2) cognitive stimulation and (3) parental mental health. Impacts on parental knowledge regarding ECD and parenting stress were also assessed. Methods: PubMed, PsycINFO, Scopus, CINAHL and Embase were searched. We included randomized controlled trials reporting effects of healthcare-based ECD interventions in LMICs on parent-directed outcomes in the first five years of life. Data extraction included study characteristics, design, sample size, participant characteristics, settings, intervention descriptions, and outcomes. Meta-analyses were conducted using random effects models. Results: 8 articles were included. Summary standardized mean differences demonstrated significant benefits of healthcare-based interventions in LMICs for improving: (1) cognitive stimulation (n = 4; SMD = 0.32; 95% CI: 0.08 to 0.56) and (2) ECD knowledge (n = 4; SMD = 0.44; 95% CI: 0.27 to 0.60). No significant effects were seen on maternal depression and parenting stress; only one study assessed parent-child interactions in the context of responsiveness. Limitations included small number of studies for moderation analysis, high heterogeneity, variability in measures used for outcomes and timing of assessments. Conclusions for practice: Our results demonstrate statistically significant effects of healthcare-based interventions in LMICs on improving key evidence-based parenting outcomes and offers one promising strategy to support children reach their full developmental potential. [ABSTRACT FROM AUTHOR]

Objectives: Community health worker (CHW) interventions have been shown to be effective in areas of maternal and child health (MCH), mostly in relation to infant and neonatal mortality. The specific aims of this review were to expand outcomes to include improving knowledge related to pregnancy and infant health and the receipt of antenatal care (ANC), along with birth outcomes. We also summarized the role, characteristics and activities of CHWs in interventions conducted in settings with demonstrated improvements in key MCH outcomes. Methods: Articles were retrieved from: PubMed, CINAHL, Global Health, Scopus, Web of Science, and the Cochrane Library from January 2008 through 2018. We included evaluation studies that utilized CHWs as all or part of an intervention to improve outcomes, were printed in English, and published in peer-reviewed journals. Results: Initial electronic database search identified 816 studies and 123 studies met inclusion criteria for full text review. The quality assessment resulted in 0 strong-, 19 moderate-, and 25 weak-rated studies. In most interventions, CHWs were a component of a larger intervention. The majority of the studies (n = 10) found that a CHW intervention can have a positive impact on outcomes. CHW interventions showed improvements in knowledge and ANC. When combined with clinical services, the interventions positively impacted birth outcomes. Most conducted home visits and utilized CHW that were members of the community. Conclusions for Practice: CHWs serve an important role as health educators conducting home visits as a member of the community they serve. They should also continue to collaborate with clinical providers to address MCH outcomes. [ABSTRACT FROM AUTHOR]

Introduction: This systematic review aims to determine the efficacy of interventions to support the self-management for parents of children with a chronic condition. An overview of prior research, regardless of the children's diagnosis, is lacking. Therefore, this systematic review provides an overview of the most recent available scientific literature that describes interventions to support self-management for parents of children with a chronic condition. Methods: A systematic search of Randomised Controlled Trials (RCTs) was conducted in CENTRAL, CINAHL, EMBASE, MEDLINE and PsychInfo. Studies that describe any type of self-management intervention or a combination of self-management interventions that support parents of children with a chronic condition between 0 and 18 years were included. The interventions and results were reported, hence categorized in the four areas of self-management: medical management, adjustment of lifestyle, shared decision-making and managing the consequences of a chronic condition. Results: The study included 23 RCTs. Due to the heterogeneity of the included studies a meta-analysis was impossible. Twenty studies showed statistically significant effects in favour of the intervention on at least one of the outcomes. Twenty-two studies showed risk of bias. The results indicate that disease management, (parent) group training, psycho-education and the Triple P intervention are effective interventions to support self-management. There were limited studies found in the areas lifestyle adjustment and shared decision making. Discussion: Effective interventions to support self-management for parents of children with a chronic condition are described, but the moderate quality of the studies hampers firm conclusions. [ABSTRACT FROM AUTHOR]

Introduction: Total adverse childhood experiences (ACEs) are gaining prominence as a risk factor for preterm birth (PTB). The emerging literature examining this relationship reports inconsistent findings. The purpose of this systematic review was to summarize the available evidence exploring whether total ACEs predict PTB. Methods: A total of 386 studies were returned from searches on PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Nine studies were selected for final analysis and synthesis based on reporting of total ACEs and preterm birth gestational weeks or standard definition of birth before 37 weeks' gestational age. A systematic review rather than meta-analysis was selected to present the findings given the clinical and methodological (e.g., sample studied, measurement tools) heterogeneity of the retrieved studies and pregnancy outcomes measured. Results: The nine studies report on birth outcomes for 6,087 women from a range of sociodemographic and ethnic backgrounds. Despite a wide range of study designs, measurement tools, and timings of ACEs exposure across studies, seven of the nine included studies showed significant relationships between ACEs and PTB. Conclusion: Systematic review of the literature suggests that total ACEs are associated with PTB and provides an overview on the known associations. However, to date only nine studies have assessed this link, and more studies are needed, to explore the associations between ACEs and PTB using appropriate and valid instruments and doing so among more diverse populations. Future research should also explore possible biological mechanisms (allostatic load), and moderating and mediating variables. [ABSTRACT FROM AUTHOR]

Objective: To describe characteristics and outcomes of Group Well-Child Care programs and provide recommendations for future research. Methods: Informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an electronic references database, manual search of bibliographies and peer-reviewed journals, and general Internet search were conducted including research published up to July 2019. English language, peer-reviewed research, with provision of medical care were included. Studies without published outcomes, not specific to well-child care, or included only one visit were excluded. Nineteen articles met review criteria. Study quality was assessed using the Downs and Black tool for rigor. Results: Programs typically included an individual medical examination, check-in, and group discussion. Demographics varied by race, ethnicity, age, income level, education and parity, though many were used specifically with underserved populations. Group size ranged from 3 to 10 and lasted an average of 1.5 h over a period of 6–24 months. Evidence suggests group well-child care is as effective as individual care with improvement noted for health-care utilization, weight outcomes, and more content covered. Design elements such as patient-led discussion, self-check-in, inclusion of other family members, and use of a variety of health care professionals and para-professionals may influence these outcomes. Conclusions: Group well-child care is useful in providing efficient and patient-centered care and shows promise for use in underserved populations. Future research should utilize more rigorous study design and include evaluations of program components and group processes to address implementation challenges and determine effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: Perinatal mood and anxiety disorders can have far reaching negative impact on both maternal mental health and child growth and development. Multimodal group parenting programs have been shown to improve maternal mental health symptoms however, they are often costly to provide and not accessible to many mothers, especially those mothers suffering from mental health symptoms. Therefore, the authors sought to answer the following question by undertaking a systematic review of the literature: are parenting interventions aimed at improving maternal-child interaction also a way to address mental health symptoms (i.e. depression, anxiety, stress) in mothers? Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. An online platform that supports the systematic review process and quality assessment according to Cochrane guidelines, Covidence, was used in conjunction with an adapted extraction tool to identify relevant studies and extract data for analysis. Results: 11 articles were included in the qualitative synthesis. There was great heterogeneity between study interventions and measurement of outcomes for maternal mental health symptoms which precluded meta-analysis. Conclusion: Studies reviewed did not demonstrate consistent evidence to recommend that parenting interventions leads to improvement in maternal mental health symptoms for depression, anxiety or stress. However, there was evidence that participating in parenting programs does not worsen these symptoms and some encouraging evidence that alternative delivery methods, beyond face to face, could, with more research, lead to more financially feasible and sustainable models of delivery of these types of interventions in the future. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this article was to describe the findings from a systematic review, quality review, and meta-analysis of risk factors for postpartum depression among adult Latinas in the United States. Methods: Databases were searched from inception to May 2020 for studies published in English related to Latina/Hispanic mothers and risk factors of postpartum depression. Of 115 abstracts screened, 10 met the inclusion criteria for the review and meta-analysis. Eleven risk factors from these studies were included: acculturation, age, economic stress, education, marital status, number of children, prenatal depression, recent and remote intimate partner violence (IPV), general social support, and partner/father's social support. Results: Partner/father's social support had a large effect size. Prenatal depression and recent IPV had medium effect sizes, while education, economic stress, general social support and remote IPV had small effect sizes. Negligible effect sizes were found for age, marital status, number of children, and acculturation. Conclusions: Prenatal depression, IPV, social support (general and from partner/father), economic stress and education are risk factors that should be screened for when working with perinatal Latinas. Future directions for clinical practice and research are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Warm handoffs intend to improve receipt of services by clients who receive referrals to services that are stigmatized or not easily accessible. Such strategies are characterized as the handoff or transfer of an individual between two service providers through a face-to-face, phone, or technology-assisted interaction. This approach may be useful for maternal and child health home visitors who provide direct services and facilitate connections to community resources for client families. However, little is known about the effectiveness of warm handoffs. Methods: A systematic review of the literature on warm handoffs was conducted with studies identified in four databases. Full text was reviewed for studies for which abstracts met inclusion criteria or for which abstracts were not available. Evidence tables summarizing study characteristics, outcome measures and data sources, intervention descriptions, intervention components, and study results were constructed. Results: Of the 42,816 unique articles identified, 32,163 titles/abstracts were screened, 227 qualified for full text review, and five comprised the study sample. Three studies examined referrals from substance use treatment centers to self-help groups, one from federally qualified health centers to community mental health clinics, and one from a mobile needle exchange program to substance use treatment/intake. Three studies showed increases in receipt of services by clients following referral between the warm handoff intervention and control group. Discussion: Current evidence regarding the effectiveness of warm handoffs is limited. An examination of the effectiveness of warm handoffs in the context of home visits is needed to assess whether they facilitate client referrals. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. Methods: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle–Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted. Results: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03–1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05–1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05–1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose–response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status. Conclusions: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia. [ABSTRACT FROM AUTHOR]

Objectives: Compelling evidence from observational studies shows that dietary patterns play a role in the development of depression and depressive symptoms in the general population. However, few studies have specifically sought to explore the association between maternal diet in the postpartum period and PPD. The purpose of this literature review was to synthesise data from existing published studies, examining the association between maternal postpartum diet and PPD symptoms. Methods: Relevant studies were identified by systematic search from the Cochrane, MEDLINE, EMBASE, CINAHL, PubMed and PsycInfo databases for articles published between 1835 and April 2020. Results: Of the 931 articles identified, six met eligibility criteria and were included. Four were cross-sectional and two were a cohort design. All but one study showed at least one inverse association, such that greater adherence to a healthy diet in the postpartum period was associated with fewer PPD symptoms. Specifically, if confirmed in further longitudinal and intervention studies, a balanced maternal diet with an emphasis on fruits, vegetables, fish, grains, legumes, and herbs could be a potential option for helping reduce the incidence of PPD. Conclusions: This review provides evidence that the postnatal diet could have an effect on PPD symptoms, although further longitudinal and intervention research is warranted. [ABSTRACT FROM AUTHOR]

Objectives: Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status. Methods: Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0–5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity. Results: The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval − 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; − 0.64, 3.36) and smallest for Down syndrome (0.38; − 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings. Conclusions for Practice: Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving. [ABSTRACT FROM AUTHOR]

Introduction: The extant literature has examined social inequalities in high-risk categories of birth weight and gestational age (i.e., low birth weight and preterm birth) with little attention given to their distributional nature. As such, a scoping review was conducted to understand how researchers have conceptualized and analyzed socioeconomic inequalities in entire distributions of these birth outcomes. Methods: Bibliographic databases were searched from their inception until August 2016 for articles from five similar, English-speaking, advanced capitalist democracies: Canada, United States, United Kingdom, Australia and New Zealand. Results: Twenty-one studies were included in the review, all of which provided rationales for examining socioeconomic inequalities in the entire distribution of birth weight. Yet, only three studies examined non-uniform associations of socioeconomic factors across the distribution of birth weight using conditional quantile regression, while the majority focused on mean birth weight using descriptive analysis or linear regression to analyze inequalities. Nevertheless, study results indicated that socioeconomic inequalities exist throughout the distribution of birth weight, extending beyond the high-risk category of low birth weight. Discussion: Although social inequalities in distributions of birth weight have been conceptualized, few studies have analytically engaged with this concept. As such, this review supports further investigation of distributional inequalities in birth outcomes using methodology which allows one to empirically quantify and explain differences in population risk distributions, rather than solely between infants born low birth weight or preterm birth, versus not. [ABSTRACT FROM AUTHOR]

Introduction Numerous studies have shown that the constructs of the Theory of Reasoned Action (TRA), Theory of Planned Behavior (TPB) and Breastfeeding Self-Efficacy (BSE) Framework can effectively identify relationships between maternal psychosocial factors and breastfeeding initiation. However, the ability of these theories to predict breastfeeding duration has not been adequately analyzed. The aim of the review was to examine the utility of the constructs of TRA/TPB and BSE to predict breastfeeding duration. Methods We conducted a literature search using Pubmed (1980-May 2015), Medline (1966-May 2015), CINAHL (1980-May 2015), EMBASE (1980-May 2015) and PsycINFO (1980-May 2015). We selected studies that were observational studies without randomization or blinding, using TRA, TPB or BSE as the framework for analysis. Only studies reporting on breastfeeding duration were included. Results Thirty studies were selected, which include four using TRA, 10 using TPB, 15 using BSE and one using a combination of TPB and BSE. Maternal intention and breastfeeding self-efficacy were found to be important predictors of breastfeeding duration. Inconsistent findings were found in assessing the relationship between maternal attitudes, subjective norms, perceived behavior control and breastfeeding duration. Discussion The inadequacy of these constructs in explaining breastfeeding duration indicates a need to further explore the role of maternal self-determination in breastfeeding behavior. [ABSTRACT FROM AUTHOR]

Objectives To ascertain the association between caesarean delivery and breastfeeding practices in China. Methods We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Electronic databases of CNKI, Medline, EMBASE, CINAHL, ProQuest and Science Direct were searched and screened to identify relevant articles from January 1990 to June 2015. Both fixed and random effect meta-analysis techniques were used to estimate the pooled effect size between caesarean delivery and breastfeeding outcomes at different time points. Sensitivity analysis and publication bias test were also conducted. Results Forty six studies were eligible for the qualitative synthesis of systematic review; among them, 27 studies were included for the meta-analysis. At the early postpartum period, the odds of exclusive breastfeeding after caesarean section was 47% (pooled OR 0.53, 95% CI 0.41, 0.68) lower than that after vaginal delivery. At 4 months postpartum, the odds of breastfeeding was similarly lower (pooled OR 0.61, 95% CI 0.53, 0.71) for caesarean mothers. Substantial heterogeneity among studies was detected for both breastfeeding outcomes. Subgroup analyses stratified by study design, time points of breastfeeding outcomes and definitions of breastfeeding all confirmed the negative association between caesarean section and breastfeeding prevalence. Conclusions In China, breastfeeding practices were affected adversely by caesarean delivery. Therefore, health policy to improve breastfeeding outcomes should take this into consideration. [ABSTRACT FROM AUTHOR]

Objectives A two-part review was undertaken to: (1) summarize current guidelines on the timing and frequency of postpartum follow-up care for generally healthy, non-high risk postpartum women and to delineate the evidence on which these guidelines are based; and, (2) summarize the results of intervention studies focused on increasing utilization of the postpartum visit for generally healthy, non-high risk postpartum women. Methods A review of guidelines from high and upper middle income countries published between 2000 and 2016 in English related to non-high risk postpartum follow-up visits was conducted in 2014-2016 using four databases and additional sources. In addition, articles published between 1990 and 2016 which evaluated interventions from high to upper middle income countries related to increasing attendance at the postpartum visit were gathered using three databases. Results This review located eight guidelines, all of which relied on expert opinion/group consensus as the evidence for their recommendations regarding the timing of the postpartum visit. The review located 19 intervention studies focused on increasing use of the postpartum visit; in 12 there was statistically significant evidence that these approaches improved utilization. However, no intervention strategy was evaluated more than a few times and many of the evaluations were relatively dated. Conclusions Guidelines for the timing of the postpartum visit are variable and are typically based on weak evidence; however, there is support for increased flexibility to meet women's needs. Additionally, while there is a diverse set of promising interventions to increase utilization of the postpartum visit, there is limited evaluative information. Future initiatives should focus on more rigorous evaluation. [ABSTRACT FROM AUTHOR]

Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors. [ABSTRACT FROM AUTHOR]

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, immune and cardiovascular systems, and behavioral responses resulting in pathophysiological effects. We suggest cultural-neutral composite measures of allostatic mediators (i.e., several biomarkers) of maternal perinatal distress as objective indicators of dysregulation in body systems in pregnant women in LMIC. Understanding causal links of maternal perinatal distress to preterm birth in women in LMIC should be a priority. The roles of allostasis and allostatic load are considered within the context of the health of pregnant women and fetuses/newborns in LMIC with emphasis on identifying objective indicators of the level of perinatal distress and protective factors or processes contributing to resilience while facing toxic stress. We propose a prospective study design with multiple measures across pregnancy and postpartum requiring complex statistical modeling. Building research capacity through partnering researchers in high-income countries and LMIC and reflecting on unique ethical challenges will be important to generating new knowledge in LMIC. [ABSTRACT FROM AUTHOR]

To examine whether an excess risk of maternal mortality exists among migrant women in Western Europe. We searched electronic databases for studies published 1970 through 2013 for all observational studies comparing maternal mortality between the host country and a defined migrant population. Results were derived from a random-effects meta-analysis, and statistical heterogeneity assessed by the I statistic. In sub-analyses we also calculated summary estimates stratified by direct and indirect death causes. We included 13 studies with more than 42 million women and 4,995 maternal deaths. Compared with indigenous born women, the pooled risk estimate (RR) was 2.00 with 95 % confidence interval (CI) of 1.72, 2.33. Migrant women had a non-significantly higher risk of dying from direct than indirect death causes; pooled RRs of 2.65 CI 1.88, 3.74 and 1.83 CI 1.37, 2.45. This meta-analysis provides evidence that migrant women in Western European countries have an excess risk of maternal mortality. [ABSTRACT FROM AUTHOR]

One in six children entering school experiences developmental delay. Maternal mental health represents one of the earliest, modifiable influences in a child's life. The objective of the review was to evaluate the association between maternal mental health and school-age child development, and we hypothesized there would be a negative association. Five databases were searched (Embase, CINAHL, Eric, PsycInfo, Medline). Key journals and reference lists were hand-searched. Two reviewers assessed studies based on inclusion criteria: (1) the exposure was any form of maternal mental health occurring during pregnancy or postpartum periods; (2) the outcome was child development (>48 months to 8 years); (3) the study recruited participants from developed countries; and (4) publication was in English between January, 1990 and December, 2012. Disagreements were resolved by consensus. Study quality was assessed by two reviewers using the Scottish Intercollegiate Guideline Network and disagreements were resolved by consensus. Data extraction was conducted by one reviewer using standardized forms. Maternal mental health problems in pregnancy and/or the postpartum period increased the likelihood that school-age children experienced suboptimal global, behavioral, cognitive, and socio-emotional development. The findings highlight the need for maternal mental health assessment during the prenatal, postnatal, and early childhood periods. [ABSTRACT FROM AUTHOR]

To conduct a systematic review of the evidence associating the medical home with beneficial health outcomes in healthy children. The English-language pediatric literature 1975-2011 was searched via PubMed, Embase and CINAHL. Inclusion criteria (the medical home as an independent variable, individual-level quantitative analysis, outpatient setting in the US, healthy children) and exclusion criteria (age >18, medical home operationalized with only one American Academy of Pediatrics component) were determined a priori. Presence of a medical home was examined in relation to three outcome measures: primary care services, health care utilization, and child well-being. Of 4,856 unique citations, 9 studies were included in the final systematic review, amassing 290,180 children from 6 data sources. Two drew on prospective cohort data; the remainder, on cross-sectional design. Children with a medical home were more likely to receive preventive medical care (2 studies), anticipatory guidance (1 study), and developmental screening (1 study); to have higher health-related quality of life (1 study); and were less likely to seek care in the emergency department (2 studies). The medical home was associated with full immunization status in only 1 of 4 studies examining this outcome. No protective effect of the medical home was found with regard to preventable hospitalization (1 study). The medical home is associated with beneficial health outcomes among healthy children. However, the evidence is limited in comparison with that for children with special health care needs. As healthy children represent the majority of the pediatric population, this lack of evidence represents a significant knowledge gap. [ABSTRACT FROM AUTHOR]

We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women. [ABSTRACT FROM AUTHOR]

Infantile colic, the cause of 10-20% of all early paediatrician visits, can lead to parental exhaustion and stress. A systematic review was conducted to examine whether dietary change provides an effective therapy for infantile colic. Six databases were searched from 1960, and 24 studies selected for inclusion. In breastfed infants, evidence suggests that a hypoallergenic maternal diet may be beneficial for reducing symptoms of colic. In formula-fed infants, colic may improve after changing from a standard cow's milk formula to either a hydrolysed protein formula or a soy-based formula. Fibre-supplemented formulae had no effect. Removal of poorly digested carbohydrates from the infant's diet has promise, but additional clinical studies must be conducted before a recommendation can be made. Use of a universal definition to measure symptoms of infantile colic and consistent analysis of urine and faecal samples would improve the evidence in this area. [ABSTRACT FROM AUTHOR]

The purpose of this article is to systematically review the literature on group-based prenatal care related to patient participation, attendance, satisfaction, knowledge, pregnancy and birth outcomes, and program cost. MEDLINE, CINAHL, and PsycINFO sources were searched for English-language articles published any time prior to June 2010. Manual searches of bibliographies were conducted and experts were consulted to identify possible sources. Descriptive, cross-sectional, cohort, and randomized control studies that assessed group-based prenatal care were selected. Of the 15 articles reviewed, 11 studies met inclusion criteria for analysis of the study attributes and outcome data related to patient participation, attendance, satisfaction, knowledge, as well as breastfeeding, pregnancy and birth outcomes, and program cost. Results from the review show that group prenatal care may be associated with improved patient and birth outcomes including reduction in the number of preterm deliveries, higher patient participation and satisfaction, and increased initiation of breastfeeding. Prenatal group care research is limited by relatively few studies, most of which lack rigor. The current model of prenatal group care lacks a theoretical framework for describing and evaluating group processes as well as intermediary factors of prenatal and birth outcomes. Research on group care would benefit from additional randomized controlled trials that assess cost and sustainability and formally evaluate group process and intermediary factors thought to account for improved outcomes. [ABSTRACT FROM AUTHOR]