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Objective. Term infants ([greater than or equal to] 37 weeks' gestation) who weigh Methods. We analyzed data from a survey of California mothers aged [greater than or equal to] 15 years with term live births in 1999 and 2000 (N = 5961). Mothers were asked about pregnancy intendedness before pregnancy, initial happiness about becoming pregnant, and maternal sense of control, assessed by a standardized scale. We examined the association of having an infant with IUGR and these factors in univariate and multivariate analyses. Results. Mothers with low sense of control (3.0%) and average sense of control (2.7%) were more likely to have an infant with IUGR than mothers with high sense of control (1.8%; odds ratio: 1.8; 95% confidence interval: 1.2-2.9; and odds ratio: 1.6; 95% confidence interval: 1.02.5). After multivariate analysis, we found no significant association between sense of control and IUGR. We also found no significant association between IUGR and pregnancy intendedness and happiness about becoming pregnant. Conclusions. We found no statistically significant association between IUGR and maternal pregnancy intendedness, initial happiness about becoming pregnant, and maternal sense of control. Although research should continue to explore associations between psychosocial factors and IUGR, prenatal care programs should focus on known risk factors for IUGR. Pediatrics 2003;111:1171-1175; low birth weight, infant, small for gestational age, pregnancy, psychology., ABBREVIATIONS. LBW, low birth weight; IUGR, intrauterine growth restriction; PTD, preterm delivery; MIHA, Maternal Infant Health Assessment; PNC, prenatal care; OR, odds ratio; CI, confidence interval. Infants who are born [...]

Byline: Katherine E. Heck (1,2), Jennifer D. Parker (1), C. Jane McKendry (3), Gilberto F. Chavez (2) Keywords: trends; vital statistics; methods; ethnic groups Abstract: Objectives: To examine the effects of proposed methods of redistributing multiple-race mothers to single-race categories when computing trend data from birth certificates. Methods: Low birthweight and multiple (twin and higher-order) birthrates for California were calculated for non-Hispanic mothers from birth certificate data for 2000. Births to the 1.9% of mothers identified as multiple-race were reassigned to single-race groups according to 12 "bridging" methods. Bridge methods utilized population-based whole allocation, fractional allocation, and other methods, primarily depending on first race listed. Results: For large race groups, there was little difference in low birthweight and multiple birth rates regardless of the bridge method employed. For smaller groups such as Native Hawaiians and other Pacific Islanders and American Indians/Alaska Natives, there was substantial variation by bridge method in observed rates. Conclusions: Tracking trends in birth outcomes across the change indata collection will challenge public health researchers. This paper outlines advantages and disadvantages of various bridge methods. Author Affiliation: (1) Infant and Child Health Studies Branch, National Center for Health Statistics, Hyattsville, Maryland (2) Maternal and Child Health Branch, California Department of Health Services, Sacramento, California (3) Center for Health Statistics, California Department of Health Services, Sacramento, California Article History: Registration Date: 07/10/2004

Byline: Anand Chabra (1), Gilberto F. Chavez (1,2), Elizabeth J. Adams (1,3), Don Taylor (1) Keywords: asthma; readmission; hospitalization; children; pediatric Abstract: Objectives: We undertook this population-based study to describe the characteristics of poor children with multiple asthma hospitalizations and to discern if poor minority children have a greater risk for these events than poor white children. Methods: We conducted a retrospective analysis of 1994 California hospital discharge data for asthma hospitalizations among 1 to 12-year-old Medicaid patients (N = 6844 discharges). Risk factors for multiple Medicaid asthma hospitalizations were calculated by using logistic regression procedures. Results: In 1994, asthma hospitalizations accounted for 11.6% of Medicaid-funded hospitalizations for 1 to 12-year-olds in California. These hospitalizations had a mean length of 2.7 days and a mean hospital charge of $6532. After we controlled for source of admission and length of stay, African American children (OR, 1.93 95% CI 1.49--2.49) and Latino children (OR, 1.34 95% CI 1.04--1.72) had a higher risk of multiple Medicaid-paid hospitalizations for asthma than did white children. Adjusted odds ratios for multiple asthma hospitalizations were 1.35 (CI, 1.05--1.74) for children with emergency room admissions, and 1.16 (CI, 0.97--1.39) for children having hospital stays of at least 5 days duration. Conclusions: Among children with Medicaid-paid hospitalizations for asthma, the risk for multiple asthma hospitalizations within a year was greater among African Americans and Latinos than among whites. Programs attempting to decrease repeat hospitalizations for asthma may benefit by focusing on these populations. Author Affiliation: (1) Maternal and Child Health Branch, California Department of Health Services, Sacramento, California (2) California Department of Health Services, Maternal and Child Health Branch, Berkeley, California, 94704-1011 (3) Pregnancy and Infant Health Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (4) Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Article History: Registration Date: 30/09/2004

ABSTRACT. Objectives. To evaluate changes in the rates and epidemiologic patterns of sudden infant death syndrome (SIDS) after implementation of public health campaigns to promote back sleeping and reduce exposure [...]

To examine differences in perinatal health among nine Asian ethnic subgroups, a descriptive epidemiological study was conducted using linked birth/infant death certificates for 1982 to 1987. When compared with Whites, Asians had a lower proportion of young mothers, unmarried mothers, and women who received first trimester prenatal care; a higher proportion of foreign-born mothers; and a different birthweight distribution. A great deal of heterogeneity was found in risk factors and infant mortality rates among the various Asian ethnic subgroups. Paradoxically, although Asian ethnic subgroups had a higher perinatal risk profile, they had more favorable birth outcomes than did Whites. (Am J Public Health. 1994;84:1497-1500), Asian Americans may have some higher risk factors for infant mortality than other ethnic and racial groups. In addition, Asian American groups may differ among themselves on these factors. Forty percent of Asian American births occur in California. Data from the California Birth Cohort files for 1982 through 1987 were analyzed for nine Asian American groups. Generally, Asian Americans have fewer teenage births, fewer unwed mothers, more births to older mothers over age 35, less prenatal care and more low-birth-weight infants. These differences were not uniform across different Asian groups, however. While the percentage of teenager births was 0.7% for Chinese compared to 8.8% for whites, it was 14.2% for Laotians. About four percent of the white babies were of low birth weight, while 5.2% of the Asian American babies were. However, Koreans had only 2.9% low-birth-weight infants, while the percentage for Filipinos and Cambodians was 6.2%. Despite these factors, most Asian American groups had lower infant mortality rates than whites.

Rh hemolytic disease of the newborn (RhHDN) is caused by the passage of antibodies from the mother to the fetus, usually as a result of blood group incompatibility; for example, when a mother with Rh-negative blood is carrying a child with Rh-positive blood. Symptoms of RhHDN in the newborn include anemia, jaundice, enlarged liver and spleen, and edema (the swelling of tissues as a result of too much fluid). The incidence of RhHDN was declining until the late 1970s. About 90 percent of all cases of RhHDN would be eliminated if an adequate dose of Rh immune globulin (RhIg) were given to all pregnant women with a potential blood type incompatibility. If RhIg treatments were administered prenatally and after birth, up to 99 percent of all cases of RhHDN could be prevented. There has been debate about the benefits and costs of this practice, even though it has been shown to substantially lower incidence of RhHDN. Nine hundred sixty cases of RhHDN were listed in the Birth Defects Monitoring Program (BDMP) during 1986, and records were obtained for 828 of them. The estimated incidence rate was 10.6 per 10,000 total births. Regional variations may be accounted for by differences in medical practice or in racial patterns; the incidence of RhHDN is low in blacks and Asians. Neonatal mortality was lower than expected, perhaps because infants who were transferred to other hospitals and later died were not counted. Many of the mothers lacked insurance, suggesting that adequate and early prenatal care that would have prevented the condition was lacking. About half of the cases listed as RhHDN were misclassified, leading to overestimation of incidence rates. It was not possible to determine how many cases of RhHDN were misdiagnosed, but the number is probably small. Risk factors for RhHDN should be identified to determine the reasons for its continued high rate in the US. (Consumer Summary produced by Reliance Medical Information, Inc.)

The relationship between maternal cocaine use early in pregnancy and urogenital birth defects in infants was studied in a group of 276 infants with urinary anomalies and 791 infants with genital anomalies. The control group for each of these subgroups consisted respectively of 2,835 and 2,973 babies without birth defects, randomly selected through birth certificates. There was a significant link between urinary tract defects and maternal cocaine use during the period one month before pregnancy through the third month of pregnancy. There were no links between cocaine and genital birth defects. These findings were consistent with earlier studies performed on humans and animals., ABSTRACT: To study the association of maternal cocaine use during early pregnancy with the occurrence of congenital urogenital anomalies, we analyzed data from the population-based Atlanta Birth Defects Case-Control Study. We identified 276 and 791 case-babies with urinary and genital anomalies, respectively, who were live born and stillborn to residents of metropolitan Atlanta from 1968 through 1980. There were 2835 and 2973 respective control-babies born without birth defects randomly selected through birth certificates. Maternal cocaine use during early pregnancy was defined as reported use at any time from 1 month before the pregnancy began through the first 3 months of pregnancy. We found a statistically significant association of reported cocaine use with an increased risk for urinary tract defects (crude odds ratio, 4.39; 95% confidence interval, 1.12 to 17.24) and no statistically significant association with genital organ defects (odds ratio, 2.26; confidence interval, 0.67 to 7.62). The findings from this study were consistent with a previously reported association of maternal cocaine use and urinary tract anomalies in animal and clinical studies.

Presents a reply to a letter to the editor about postpartum length of stay and breastfeeding duration, published in the March 1, 2004 issue of the journal "Birth 31:1."