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Background Postpartum depression is associated with negative physical and mental health outcomes for both the mother and infant. This study examines the relationship between a mother and/or her partner's pregnancy intentions and reported post-partum depressive symptoms (PPDs). Methods Using Louisiana pregnancy risk assessment monitoring system, 2000-2003, a secondary cross-sectional analysis was conducted on 5549 mothers, stratified by race, who delivered a singleton, live birth and whose infant was still alive at the time of the survey. Bivariate and multivariable logistic regressions were conducted, taking into account the complex survey design. Results In multivariable models, unwanted pregnancies were associated with severe PPDs (aOR 1.76, 95 % CI 1.23-2.53). Furthermore, the association between husbands/partners' who did not want or care about the pregnancy and mild PPDs remained for White women (aOR 1.32, 95 % CI 1.02-1.69); while among Black women, neither parent's pregnancy intention were associated with mild or severe PPDs. Conclusions This study supports existing research demonstrating the association between pregnancy intention and PPDs. This study contributes to the limited information on the role that partner pregnancy intention plays on maternal mental health outcomes, however further discussion is needed on the impact of this role across races. Findings can be used in programs aiming to reduce adverse mental health outcomes among high-risk mothers. [ABSTRACT FROM AUTHOR]

Ethnic minorities living in the US have lower utilization and access to prenatal care, resulting in an increased risk of adverse pregnancy outcomes. The present study examines utilization of prenatal care, perceived pregnancy related health, and perceived risk of adverse pregnancy outcomes among Arab women living in the USA cross-sectional study was conducted, consisting of a convenience sample of 170 Arab women. A structured questionnaire was administered by a face-to-face or telephone interview. Multivariable logistic regression was used to calculate adjusted Odds Ratios and 95% Confidence Intervals, controlling for potential confounders. All study participants had received prenatal care during their most recent pregnancy, and 90% had their first prenatal care visit before the 12th gestational week. The Arab women who were older ( P = 0.02), those with 12 years of education or less ( P = 0.002), and those who had lived in the US more than five years ( P = 0.0002) were more likely to report four or more pregnancies. In addition, more than one-third of the women reported having experienced a miscarriage (35.4%), which was significantly associated with gravida status ( P < 0.001). An association between perceived susceptibility for spontaneous abortion and stillbirth was also demonstrated ( P < 0.0001). Although Arab women reported good coverage of prenatal care, they perceived themselves as susceptible for several pregnancy complications and adverse pregnancy outcomes. Clinical guidelines for prenatal care to Arab women should therefore focus on their high parity and likelihood of miscarriages, in an attempt to reduce their risk of adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

To develop a framework, using Louisiana as a case study, for estimating the potential cost savings to individual states if families were able to meet current recommendations for breastfeeding. Using cost-analyses methods, cost savings, as well as, case and death reductions of infant illnesses and deaths on four selected infant diseases (respiratory tract infections, gastroenteritis, necrotizing enterocolitis, and Sudden Infant Death Syndrome) were calculated utilizing the most recent data of breastfeeding and low/very low birth weight rates in Louisiana. To estimate the incidence of a disease in exclusive breastfed infants and formula fed infants respectively, we used the following formula: x = s/br + 1 − b. Here 'x' is the incidence rate of one disease in formula fed infants, 's' is the overall incidence of the disease, 'b' is current breastfeeding rate and 'r' is the odds ratios in favor of breastfeeding. A total of $216,103,368 could be saved and 18 infant deaths prevented, by these four conditions alone, if 90% of newborns in Louisiana were exclusive breastfed for the first 6 months of life ($186,371,125 in savings and 16 infant deaths prevented with 80% compliance). Increased rates of breastfeeding to the level of Healthy People 2020 goals and beyond would yield significant cost savings to Louisiana. Other US states can use the presented framework to demonstrate cost savings associated with breastfeeding promotion and support interventions in their respective states. [ABSTRACT FROM AUTHOR]

Positive deviance inquiry is effective in identifying advantageous health behaviors and improving health outcomes among disadvantaged resource-poor populations. The objective of this study was to apply the positive deviance concept to explore the characteristics of positive deviants for breastfeeding among WIC-enrolled first-time mothers in Louisiana. The cross sectional study included data on 2,036 WIC-enrolled first time mothers (52.6% black) from the LaPRAMs, 2000-2004. Chi-square test was used to compare groups. Multivariable logistic regression was applied to calculate adjusted OR and 95% CI by breastfeeding initiation status. The average age was 21.3 years, 31.5% had less than 12 years of education, and 44.6% of the sample reported having initiated breastfeeding. Black mothers were less likely to initiate breastfeeding than their white counterparts (OR 0.39 (95% CI: 0.31, 0.48)). Among 641 WIC-enrolled first time mothers with less than 12 years of education, 28.4% were identified as positive deviants for breastfeeding initiation. Among the black mothers 19.8% were positive deviants compared to 40.3% of the white mothers. Breastfeeding in the hospital after delivery ( P < 0.0001) and having received help on how to breastfeed in the hospital ( P < 0.0001) were significantly associated with breastfeeding initiation in white and black mothers. In addition, the black positive deviants were more likely, OR 2.80 (95% CI: 1.20, 6.56) to have initiated breastfeeding if their baby was low birth weight. Breastfeeding practices shortly after delivery including assistance and education from staff in the hospital, are related to breastfeeding initiation among less educated WIC-enrolled mothers. [ABSTRACT FROM AUTHOR]