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BackgroundPregnancy and the postpartum period provide windows of opportunity to impact perinatal and lifelong preventive health behavior for women and their families, but these opportunities are often missed. Understanding racial/ethnic differences in information and communication technology (ICT) use could inform technology-based interventions in diverse populations. ObjectiveThe objective of the study was to evaluate differences in the use of ICT between racial and ethnic groups as well as by English language proficiency. MethodsWe conducted a cross-sectional study of 246 women who were aged 18 years or older and pregnant or within 1 year of delivery. They were recruited from 4 hospital-based outpatient clinics and completed a self-administered survey. We used multivariate regression analysis to evaluate the association between race/ethnicity and ICT (mobile phone/short message service [SMS] text message, Internet, and social network) usage by race/ethnicity and perceived English language proficiency after adjusting for age, income, marital status, and insurance status. ResultsIn all, 28% (69/246) of participants were Latina, 40% (98/246) were African American, 23% (56/246) were white, and 9% (23/246) from other racial/ethnic groups. Of the Latinas, 84% (58/69) reported limited English language proficiency and 59% (41/69) were uninsured. More than 90% of all participants reported mobile phone use, but more than 25% (65/246) had changed phone numbers 2 or more times in the past year. Compared to white women, African American women were less likely to SMS text message (OR 0.07, 95% CI 0.01-0.63) and Latinas were less likely to use the Internet to find others with similar concerns (OR 0.23, 95% CI 0.08-0.73). Women with limited English language proficiency were less likely to use the Internet overall (OR 0.30, 95% CI 0.09-0.99) or use email (OR 0.22, 95% CI 0.08-0.63) compared to women with adequate English language proficiency. ConclusionsMobile phones are widely available for the delivery of health interventions to low-income, racially diverse pregnant and postpartum women, but disparities in Internet use and SMS text messaging exist. Interventions or programs requiring Web-based apps may have lower uptake unless alternatives are available, such as those adapted for limited English proficiency populations.

Background: HIV services in Tanzania are facility‐based but facilities are often overcrowded. Differentiated care models (DCM) have been introduced into the National Guidelines. We piloted a Community Health Worker (CHW)‐led HIV treatment club model (CHW‐DCM) in an urban region, and assessed its effectiveness in comparison to the standard of care (SoC, facility‐based model), in terms of stability in care, loss to follow‐up (LTFU) and treatment adherence. Methods: In two clinics in the Shinyanga region, clients established on ART (defined as stable clients by national guidelines as on first‐line ART >6 months, undetectable viral load, no opportunistic infections or pregnancy, and good adherence) were offered CHW‐DCM. This prospective cohort study included all stable clients who enrolled in CHW‐DCM between July 2018 and March 2020 (CHW‐DCM) and compared them to stable clients who remained in SoC during that period. Multivariable Cox regression models were used to analyse factors associated with continued stability in care and the risk of LTFU during 18 months of follow‐up; treatment adherence was assessed by pill count and compared using Chi‐square tests. Results: Of 2472 stable clients, 24.5% received CHW‐DCM and 75.5% SoC. CHW‐DCM clients were slightly older (mean 42.8 vs. 37.9 years) and more likely to be female (36.2% vs. 32.2%). Treatment adherence was better among CHW‐DCM than SoC: 96.6% versus 91.9% and 98.5% versus 92.2%, respectively (both p = 0.001). SoC clients were more likely to not remain stable over time than CHW‐DCM (adjusted Hazard ratio [AHR] = 2.68; 95% CI: 1.86–3.90). There was no difference in LTFU (adjusted hazard ratio [AHR] = 1.54; 95%CI: 0.82–2.93). Conclusion: Clients attending CHW‐DCM demonstrated better stability in care and treatment adherence than SoC, and the risk of LTFU was not increased. These findings demonstrate the potential of CHW in delivering community‐based HIV services in the local Tanzanian context. These results could be used to extend this CHW‐DCM model to similar settings. [ABSTRACT FROM AUTHOR]

Fetal neurobehavioral development was modeled longitudinally using data collected at weekly intervals from 24 to 38 weeks gestation in a sample of 112 healthy pregnancies. Predictive associations between 3 measures of fetal neurobehavioral functioning and their developmental trajectories to neurological maturation in the first weeks after birth were examined. Prenatal measures included fetal heart rate (FHR) variability, fetal movement, and coupling between fetal motor activity and heart rate patterning; neonatal outcomes include a standard neurologic examination (n = 97) and brainstem auditory evoked potential (BAEP; n = 47). Optimality in newborn motor activity and reflexes was predicted by fetal motor activity, FHR variability, and somatic-cardiac coupling predicted BAEP parameters. Maternal pregnancy-specific psychological stress was associated with accelerated neurologic maturation. (Contains 4 tables and 2 figures.)

Longitudinal neurobehavioral development was examined in 237 fetuses of low-risk pregnancies from 2 distinct populations-Baltimore, Maryland, and Lima, Peru-at 20, 24, 28, 32, 36, and 38 weeks gestation. Data were based on digitized Doppler-based fetal heart rate (FHR) and fetal movement (FM). In both groups, FHR declined while variability, episodic accelerations, and FM-FHR coupling increased, with discontinuities evident between 28 and 32 weeks gestation. Fetuses in Lima had higher FHR and lower variability, accelerations, and FM-FHR coupling. Declines in trajectories were typically observed 1 month sooner in Lima, which magnified these disparities. Motor activity differences were less consistent. No sex differences in fetal neurobehaviors were detected. It is concluded that population factors can influence the developmental niche of the fetus.

Investigated associations between maternal psychological and fetal neurobehavioral functioning with data provided at 24, 30, and 36 weeks gestation. Found that fetuses of women who were more affectively intense, appraised their lives as more stressful, and reported more pregnancy-specific hassles were more active across gestation. Fetuses of women who perceived their pregnancy to be more uplifting and had positive emotional value toward pregnancy were less active. (Author/KB)

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8624.2007.01099.x Byline: Janet A. DiPietro (1), Marc H. Bornstein (2), Chun-Shin Hahn (2), Kathleen Costigan (3), Aristide Achy-Brou (4) Abstract: Stability in cardiac indicators before birth and their utility in predicting variation in postnatal development were examined. Fetal heart rate and variability were measured longitudinally from 20 through 38 weeks gestation (n = 137) and again at age 2 (n = 79). Significant within-individual stability during the prenatal period and into childhood was demonstrated. Fetal heart rate variability at or after 28 weeks gestation and steeper developmental trajectories were significantly associated with mental and psychomotor development at 2 years (n = 82) and language ability at 2.5 years (n = 61). These data suggest that the foundations of individual differences in autonomic control originate during gestation and the developmental momentum of the fetal period continues after birth. Author Affiliation: (1)Johns Hopkins University (2)National Institutes of Health (3)Johns Hopkins Medical Institutions (4)Johns Hopkins University Article note: Correspondence concerning this article should be addressed to Janet DiPietro, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E4531, Baltimore, MD 21205. Electronic mail may be sent to jdipietr@jhsph.edu.

There is increasing evidence that psychosocial factors may affect dietary intakes and health. The current analysis examined the association of six indices of psychosocial wellbeing with dietary intake during pregnancy. One hundred thirty-four women with low-risk, normal pregnancies participated in a cross-sectional, observational study that assessed dietary intake at 28 weeks' gestation. Psychosocial characteristics, including anxiety, depressed mood, anger, fatigue, social support, and stress were assessed between 24 and 32 weeks' gestation. Pearson product-moment correlations were calculated to determine the relationships between psychosocial factors and diet. Findings suggest that pregnant women who were more fatigued, stressed, and anxious consumed more foods, as evidenced by their increased macronutrient intakes, while appearing to have decreased intakes of some micronutrients. Psychosocial factors should be considered when counseling women regarding diet during pregnancy. J Am Diet Assoc. 2005;105:963-966.