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Introduction: Women with pre-pregnancy diabetes or pre-pregnancy hypertension have increased risks of complications during pregnancy. Women who obtain prenatal care in the first trimester receive necessary routine testing and disease management tools that aid in controlling such conditions. However, research on the association between pre-pregnancy hypertension and pre-pregnancy diabetes and prenatal care timing among US women is limited. Methods: This study used data from the 2018 National Vital Statistic System (n = 3,618,853). Trained personnel collected information on prenatal care timing, maternal conditions, and demographics. Multivariate logistic regression models evaluated the association between pre-pregnancy hypertension, pre-pregnancy diabetes and prenatal care timing. A stratified analysis was conducted to determine if race/ethnicity modified the associations. Results: After adjustment, women with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significant increased odds of receiving early prenatal care compared to women without these conditions (OR 1.23; 95% CI: 1.21-1.26 and OR 1.27; 95% CI: 1.24-1.31, respectively). Among non-Hispanic White, non-Hispanic Black, and Hispanic women, those with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significantly increased odds of receiving early prenatal care compared to women without those pre-existing conditions (P <.001). Discussion: Further research is needed on the transition from preconception care to obstetric care for women with pre-existing diabetes or hypertension. However, these findings suggest that women who have conditions that could cause pregnancy complications are pursuing early prenatal care services to mitigate the development of adverse maternal and infant health conditions. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about provider attitudes regarding safety of selected hormonal contraceptives among breastfeeding women. Methods: Using a nationwide survey, associations were analyzed between provider characteristics and perception of safety of combined oral contraceptives (COCs) in breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors and depot medroxyprogesterone acetate (DMPA) in breastfeeding women < 1 month postpartum and ≥ 1 month postpartum. Results: Approximately 68% of public-sector providers considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among non-physicians versus physicians (adjusted odds ratios [aOR] range 0.34–0.51) and those with a focus on adolescent health/pediatrics versus reproductive health (aOR 0.68, 95% confidence interval [CI] 0.47–0.99). Most public-sector providers considered DMPA safe for breastfeeding women during any time postpartum, with lower odds among non-physicians versus physicians (aOR range 0.20–0.54) and those with primary clinical focus other than reproductive health (aOR range 0.26–0.65). The majority of office-based physicians considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among those who did not use, versus those who used, CDC's contraceptive guidance (aOR 0.40, 95% CI 0.21–0.77). Most office-based physicians also considered DMPA safe for breastfeeding women during any time postpartum. Conclusions for Practice: A high proportion of providers considered use of selected hormonal contraceptives safe for breastfeeding women, consistent with evidence-based guidelines. However, certain provider groups might benefit from education regarding the safety of these methods for breastfeeding women. [ABSTRACT FROM AUTHOR]

Objectives Asian Americans are highly diverse in cultural, socioeconomic, and health conditions. We aimed to identify socioeconomic and cultural profiles of subgroups of Asian American children at high risk of obesity or overweight to inform targeted interventions. Methods A sample of 841 Asian American children and adolescents ages 6–19 from the 2011–2016 National Health and Nutrition Examination Survey was used. Multivariable logistic regression modeling was conducted. Analyses were also stratified by age (6–11 vs. 12–19). Key variables of interest were Asian ethnicity (Chinese, Korean/Japanese, Filipino, South Asian, and Southeast Asian) and parental educational level. Models adjusted for age, gender, nativity status, parental nativity status, and health insurance coverage. Results Filipino (AOR 2.79; 95% CI 1.30–6.00), Japanese/Korean (AOR 2.55; 95% CI 1.21–5.38), Southeast Asian (AOR 2.54; 95% CI 1.63–3.94), and South Asian (AOR 2.10; 95% CI 1.01–4.36) children ages 6–19 had higher odds of being obese/overweight than Chinese. Filipino (AOR 3.24; 95% CI 1.11–9.49) and Southeast Asian (AOR 2.47; 95% CI 1.22–5.01) ethnicities were associated with higher risk of obesity/overweight in adolescents ages 12–19. Having a parent with a 4-year college or advanced degree was inversely associated with obesity/overweight in US-born Asian adolescents (AOR 0.34; 95% CI 0.14–0.78). Conclusions for Practice Asian American children and adolescents in some Asian ethnic subgroups may be at higher risk of obesity/overweight than in others. Higher parental education level appears to protect US-born Asian American adolescents from being obese/overweight. Multi-sectoral efforts are needed to better understand and address sociocultural processes that increase childhood obesity/overweight in high-risk Asian subgroups. [ABSTRACT FROM AUTHOR]