Community stigma, victimization, and coping strategies among gay, bisexual, and other cis-gender men who have sex with men in slum communities in Ghana. BSGH-003.

BACKGROUND: Gay, bisexual, and cis-gender men who have sex with men (GBMSM) face severe consequences, especially within stigmatized environments. However, very little is known about the experiences of GBMSM living in slums in SSA and Ghana. This study investigates the experiences of stigma, victimization, and coping strategies and proposes some interventional approaches for combating stigma facing GBMSM in slum communities. METHODS: We engaged GBMSM living in slums in two major Ghanaian cities. We used a time-location sampling and collected data through in-depth individual interviews. Two major themes emerged from the study: (1) insecurities and criminalization of GBMSM activity, and (2) GBMSM coping strategies. RESULTS: Findings show GBMSM experienced negative attitudes from the community due to their sexual behavior/orientation. GBMSM also developed coping strategies to avert negative experiences, such as hiding their identities/behavior, avoiding gender non-conforming men, and having relationships with persons outside their communities. CONCLUSION: We propose interventions such as HIV Education, Empathy, Empowerment, Acceptance, and Commitment Therapy as possible measures to improve the experiences of GBMSM living in Ghanaian slum communities.

A Community Collaborative for the Exploration of Local Factors Affecting Black Mothers' Experiences with Perinatal Care.

OBJECTIVES: Black women face disparities in maternal morbidity and mortality when compared to White women. Multiple factors contribute to these disparities. This study examines the perspectives of Black women who have given birth in the last 5 years, to understand their pregnancy and birth experiences as a means of ascertaining factors that may be contributing to these disparities. METHODS: The Consortium to End Black Maternal Mortality was established as a collaborative table of cross-sector stakeholders and Black mothers to effectively conduct community-based participatory research focused on Black maternal health. Between January and March 2020, Black mothers who had given birth in the last 5 years facilitated Listening Sessions (LS) with other Black mothers in Rochester, NY. Participants reported on details of their pregnancy and delivery, including interaction with providers, personal relationships and their individual experience. The qualitative data captured during these sessions were coded to draw out key themes which were validated with LS participants and the Consortium. RESULTS: The key themes that emerged clustered into four groups, including: (1) Mother-Provider Communication; (2) Social Support; (3) Systemic factors and (4) Maternal Emotional & Mental Health. Mother-provider communication was the most salient factor affecting the maternal experience and was found to be influenced primarily by maternal health literacy and provider discriminatory attitudes and behaviors. CONCLUSIONS FOR PRACTICE: As a result of the Listening Sessions conducted with Black women, we identified mother-provider communication as the most important factor influencing the maternal experience.

They call us goor-jigeen: a qualitative exploration of the experiences of Senegalese Muslim men who have sex with men living with HIV.

Men who have sex with men living with HIV in majority Muslim communities face discrimination based on multiple forms of stigma at socio-cultural and legislative levels. This study aimed to explore qualitatively the experiences of men who have sex with men living with HIV in Dakar, Senegal. In-depth individual interviews were conducted with 30 Senegalese men aged 18 to 55 years, who self-reported as same-sex practising, Muslim, and receiving HIV treatment at health centres in Dakar. Interview data were analysed using an ethnographic phenomenological approach to explore their life experiences. Primary themes included: the self-discovery process; the social, religious and health ramifications of being same-sex practising; and stigma. Within the theme of stigma issues described included shame, blame (of self and others), and violence resulting from being a man who has sex with other men and/or being HIV seropositive. Those with undetectable viral load reported how HIV related stigma and burden diminished as their health improved. Disclosure of being men who have sex with men and/or HIV status, whether voluntary or not, affected experiences of violence and/or isolation. Addressing stigma at healthcare institutions and improving access to HIV treatment can help mitigate the burden of stigma affecting such men. Interventions to address their physical and psychosocial wellbeing require the engagement of multiple stakeholders, including religious and political leaders.

A quasi-experimental design to assess the effectiveness of the federal healthy start in reducing preterm birth among obese mothers.

We assessed the impact of Central Hillsborough Healthy Start (CHHS), a federally-funded program dedicated to improving maternal and infant outcomes in a population of high-risk obese mothers in the socio-economically challenged community of East Tampa in Florida on preterm birth and very preterm birth (VPTB). We utilized hospital discharge records linked to vital statistics data in Florida (2004-2007) to study obese women with a singleton birth, matching mothers in the CHHS catchment area with those from the rest of Florida. We conducted conditional logistic regression with the matched data. Obese mothers in the CHHS service area had a 61% lower likelihood of having a VPTB infant than obese mothers in the rest of the state (AOR = 0.39, 95% CI 0.21-0.70). Obese women of reproductive age may benefit from services from federal Healthy Start programs. Study findings underscore the need for further research to explore the impact of such programs.

Theoretical model of critical issues in informed consent in HIV vaccine trials.

The informed consent process (ICP) for HIV vaccine trials poses unique challenges and would benefit from improvements to its historically based structure and format. Here, we propose a theoretical framework that provides a basis for systematically evaluating and addressing these challenges. The proposed framework follows a linear pathway, starting with the precondition of voluntariness, three main variables of valid decision-making (competency, provision of information and understanding) and then the consequential outcome of either refusal or consent to participate. The existing literature reveals that culturally appropriate provision of information and resultant understanding by the vaccine trial participant are among the most significant factors influencing the authenticity of valid decision-making, though they may be overridden by other considerations, such as individual altruism, mistrust, and HIV-related stigma. Community collaborations to foster bidirectional transmission of information and more culturally tailored consenting materials, therefore, represent a key opportunity to enhance the ICP. By providing a visual synopsis of the issues most critical to IC effectiveness in a categorical and relational manner, the framework provided here presents HIV vaccine researchers a tool by which the ICP can be more systematically evaluated and consequently improved.

Assessing the economic impact of paternal involvement: a comparison of the generalized linear model versus decision analysis trees.

Lack of paternal involvement has been shown to be associated with adverse pregnancy outcomes, including infant morbidity and mortality, but the impact on health care costs is unknown. Various methodological approaches have been used in cost minimization and cost effectiveness analyses and it remains unclear how cost estimates vary according to the analytic strategy adopted. We illustrate a methodological comparison of decision analysis modeling and generalized linear modeling (GLM) techniques using a case study that assesses the cost-effectiveness of potential father involvement interventions. We conducted a 12-year retrospective cohort study using a statewide enhanced maternal-infant database that contains both clinical and nonclinical information. A missing name for the father on the infant's birth certificate was used as a proxy for lack of paternal involvement, the main exposure of this study. Using decision analysis modeling and GLM, we compared all infant inpatient hospitalization costs over the first year of life. Costs were calculated from hospital charges using department-level cost-to-charge ratios and were adjusted for inflation. In our cohort of 2,243,891 infants, 9.2% had a father uninvolved during pregnancy. Lack of paternal involvement was associated with higher rates of preterm birth, small-for-gestational age, and infant morbidity and mortality. Both analytic approaches estimate significantly higher per-infant costs for father uninvolved pregnancies (decision analysis model: $1,827, GLM: $1,139). This paper provides sufficient evidence that healthcare costs could be significantly reduced through enhanced father involvement during pregnancy, and buttresses the call for a national program to involve fathers in antenatal care.

Impact of a federal healthy start program on feto-infant morbidity associated with absent fathers: a quasi-experimental study.

The absence of fathers during pregnancy increases the risk of feto-infant morbidities, including low birth weight (LBW), preterm birth (PTB), and small-for-gestational age. Previous research has shown that the Central Hillsborough Healthy Start project (CHHS)-a federally funded initiative in Tampa, Florida-has improved birth outcomes. This study explores the effectiveness of the CHHS project in ameliorating the adverse effects of fathers' absence during pregnancy. This retrospective cohort study used CHHS records linked to vital statistics and hospital discharge data (1998-2007). The study population consisted of women who had a singleton birth with an absent father during pregnancy. Women were categorized based on residence in the CHHS service area. Propensity score matching was used to match cases (CHHS) to controls (rest of Florida). Conditional logistic regression was employed to generate odds ratios (OR) and 95 % confidence intervals (CI) for matched observations. Women residing in the CHHS service area were more likely to be high school graduates, black, younger (<35 years), and to have adequate prenatal care compared to controls (p < 0.01). These differences disappeared after propensity score matching. Mothers with absent fathers in the CHHS service area had a reduced likelihood of LBW (OR 0.76, 95 % CI 0.65-0.89), PTB (OR 0.72, 95 % CI 0.62-0.84), very low birth weight (OR 0.50, 95 % CI 0.35-0.72) and very preterm birth (OR 0.48, 95 % CI 0.34-0.69) compared to their counterparts in the rest of the state. This study demonstrates that a Federal Healthy Start project contributed to a significant reduction in adverse fetal birth outcomes in families with absent fathers.

Study protocol: Examining sexual and reproductive health literacy in Mexican American young women using a positive deviance approach.

Health literacy is generally low in marginalized groups, leading to delays in accessing care, poor health outcomes, and health disparities. Yet, some individuals in these groups demonstrate higher health literacy and better health outcomes. These exceptional cases exemplify 'positive deviance' because they have found ways to be successful where others have not. Identifying the methods, practices, and resources that these individuals have used to gain health literacy and healthcare access may have generalized application to improve health literacy, access to care, and health outcomes. Using the Integrated Model of Health Literacy, the main objectives of this study are to (1) identify facilitators, barriers, and strategies to gain sexual and reproductive health literacy and healthcare access and (2) to explore each of the core domains of health literacy as they relate to successful access of sexual and reproductive healthcare services among individuals identified as positive deviants. For the purposes of this mixed methods community engaged study, positive deviants are defined as Mexican American young women aged 18-29 years old living in Rural Western New York who have accessed sexual and reproductive healthcare within the past year. A community advisory committee will be formed to provide community-engaged guidance and support for the recruitment of participants. Positive deviants will participate in a survey and semi-structured interview. Data collection and analysis will be simultaneous and iterative. Results will provide evidence of positive deviant methods, practices, and strategies to gain health literacy and access to sexual and reproductive healthcare. Findings may reveal characteristics and patterns in the relationship of health literacy and healthcare access that can inform interventions to improve health literacy and make healthcare more accessible for this demographic group and context.

A community perspective on the role of fathers during pregnancy: a qualitative study.

BACKGROUND: Defining male involvement during pregnancy is essential for the development of future research and appropriate interventions to optimize services aiming to improve birth outcomes. STUDY AIM: To define male involvement during pregnancy and obtain community-based recommendations for interventions to improve male involvement during pregnancy. METHODS: We conducted focus groups with mothers and fathers from the National Healthy Start Association program in order to obtain detailed descriptions of male involvement activities, benefits, barriers, and proposed solutions for increasing male involvement during pregnancy. The majority of participants were African American parents. RESULTS: The involved "male" was identified as either the biological father, or, the current male partner of the pregnant woman. Both men and women described the ideal, involved father or male partner as present, accessible, available, understanding, willing to learn about the pregnancy process and eager to provide emotional, physical and financial support to the woman carrying the child. Women emphasized a sense of "togetherness" during the pregnancy. Suggestions included creating male-targeted prenatal programs, enhancing current interventions targeting females, and increasing healthcare providers' awareness of the importance of men's involvement during pregnancy. CONCLUSIONS: Individual, family, community, societal and policy factors play a role in barring or diminishing the involvement of fathers during pregnancy. Future research and interventions should target these factors and their interaction in order to increase fathers' involvement and thereby improve pregnancy outcomes.

Infant mortality and the risk of small size for gestational age in the subsequent pregnancy: a retrospective cohort study.

To examine the association between prior infant mortality and subsequent risk for small for gestational age (SGA). This population-based, retrospective cohort study used the Missouri maternally linked, longitudinal dataset (1989-2005). Analyses were restricted to women who had two singleton pregnancies during the study period. Logistic regression was conducted to obtain adjusted odds ratios (AOR) and 95 % confidence intervals (CI) for the association between infant mortality in the first pregnancy and SGA in the second pregnancy. Women with a prior occurrence of infant death were more likely to be black and obese and had lower educational levels and had higher rates of pregnancy-related complications (p < 0.01). White women with previous infant mortality were at 1.46 times greater risk for SGA in the subsequent pregnancy (AOR = 1.46, 95 % CI = 1.24-1.71). For black women with prior infant death, the risk for SGA increased to 2.77 times (AOR = 2.77, 95 % CI = 2.19-3.51). White mothers who experienced infant mortality coupled with SGA in the first pregnancy had a nearly threefold heightened risk for SGA in the second pregnancy (AOR = 2.89, 95 % CI = 2.21-3.78), whereas black women with this history were more than four times as likely to have an infant with SGA (AOR = 4.60 95 % CI = 3.05-6.96). Prior occurrence of infant mortality is associated with increased risk for subsequent SGA. This finding has important implications for health professionals, as targeted inter-conception strategies for women who have experienced infant death, as well as SGA, may be warranted.

An assessment of essential maternal health services in Kwara State, Nigeria.

The objective of this study is to evaluate the levels of emergency obstetrics care (EOC) signal functions in health facilities in a developing setting with high maternal morbidity and mortality indices and to determine if there are differences between public and private health facilities in terms of availability of these signal functions. A survey of health facilities was carried out in six of the 16 Local Government Areas (LGAs) of Kwara State Nigeria. All health facilities in these LGAs including public and private health facilities offering some services to pregnant women were surveyed using an interviewer- administered, facility-assessment questionnaire adapted from the WHO/UNFPA/UNICEF international guidelines for monitoring the availability and use of obstetric services. Frequency tables, percentages and charts were used for presenting the data. Comparing public and private facilities was done using chi-square tests. A total of 258 health facilities that provide maternal health services were surveyed in this study, out of which 76 (29.5%) were private facilities and 182 (70.5%) were public sector facilities. Most of the UN indicators were not met by the health facilities in Kwara state. The availability of EOC facilities was more among the private sector and this was statistically significant. This study shows that all stakeholders involved in reducing maternal mortality have a big challenge in the areas of availability, inequity in geographical distribution of EOC facilities and poor utilisation of these EOC services by women.

Particulate pollutants and racial/ethnic disparity in feto-infant morbidity outcomes.

We sought to assess the association between air particulate pollutants and feto-infant morbidity outcomes across racial/ethnic subgroups. This is a retrospective cohort study from 2000 through 2007 based on three linked databases: (1) The Florida Hospital Discharge database; (2) The vital statistics records of singleton live births in Florida; (3) Air pollution and meteorological data from the Environmental Protection Agency. Using computerized mathematical modeling, we assigned exposure values of the air pollutants of interest (PM(2.5), PM(10) and the PM coarse fraction [PM(10) - PM(2.5)]) to mothers over the period of pregnancy based on Euclidean minimum distance from the air pollution monitoring sites. The primary outcomes of interest were: low birth weight, very low birth weight, preterm birth, very preterm birth, and small for gestational age (SGA). We used adjusted odds ratios to approximate relative risks. We observed increased risk for overall feto-infant morbidity outcome in women exposed to any of the three particulate pollutants (values above the median). Exposed women had increased odds for low birth weight, very low birth weight and preterm birth with the greatest risk being that for very low birth weight (AOR = 1.27, 95% CI = 1.08-1.49). Black women exposed to any particulate pollutant had the greatest odds for all the morbidity outcomes, most pronounced for very low birth weight (AOR = 3.32, 95% CI = 2.56-4.30). Environmental particulate pollutants are associated with adverse feto-infant outcomes among exposed women, especially blacks. Black-white disparity in adverse fetal outcomes is widened in the presence of these pollutants, which provide a target for intervention.

The impact of birth spacing on subsequent feto-infant outcomes among community enrollees of a federal healthy start project.

Numerous studies have shown an association between shorter birth intervals, and several adverse fetal outcomes, including low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). However, there is little evidence on the effectiveness of interconception care on fetal outcomes associated with sub-optimal interpregnancy interval (IPI). The purpose of this study is to examine the influence of the Federal Healthy Start's interconception care services on IPI and fetal growth outcomes. This is a retrospective cohort study used records from the Central Hillsborough Healthy Start program in Tampa, Florida linked to Florida vital statistics data covering the period 2002-2009. Only first and second pregnancies were considered, and interpregnancy interval (IPI), the exposure of interest, was categorized in months as 0-5, 6-17, 18-23, and ≥24. The following feto-infant morbidities were considered as primary outcomes: LBW, PTB, and SGA. A composite variable coding the presence of any of the aforementioned adverse fetal events was also created. Multivariate logistic regression modeling was applied Overall, mothers with the shortest IPI (0-5 months: AOR = 1.39, 95% CI 1.23-1.56) and longest IPI (≥60 months: AOR = 1.13, 95% CI 1.03-1.23) were at a greater risk for adverse fetal growth outcomes, compared to the referent category (18-23 months). Our findings support the need for inter conception care that addresses IPI and delayed childbearing among women.

Effectiveness of a federal healthy start program in reducing the impact of particulate air pollutants on feto-infant morbidity outcomes.

We sought to assess (1) the relationship between air particulate pollutants and feto-infant morbidity outcomes and (2) the impact of a Federal Healthy Start program on this relationship. This is a retrospective cohort study using de-identified hospital discharge information linked to vital records, and air pollution data from 2000 through 2007 for the zip codes served by the Central Hillsborough Federal Healthy Start Project in Tampa, Florida. Mathematical modeling was employed to compute minimal Euclidean distances to capture exposure to ambient air particulate matter. The outcomes of interest were low birth weight (LBW), very low birth weight (VLBW), small for gestational age, preterm (PTB), and very preterm birth. We used odds ratios to approximate relative risks. A total of 12,356 live births were analyzed. Overall, women exposed to air particulate pollutants were at elevated risk for LBW (AOR = 1.24; 95% CI = 1.07-1.43), VLBW (AOR = 1.58; 95% CI = 1.09-2.29) and PTB (AOR = 1.18; 95% CI = 1.03-1.34). Analysis by race/ethnicity revealed that the adverse effects of air particulate pollutants were most profound among black infants. Infants of women who received services provided by the Central Hillsborough Federal Healthy Start Project experienced improved feto-infant morbidity outcomes despite exposure to air particulate pollutants. Environmental air pollutants represent important risk factors for adverse birth outcomes, particularly among black women. Multi-level interventional approaches implemented by the Central Hillsborough Federal Healthy Start were found to be associated with reduced likelihood for feto-infant morbidities triggered by exposure to ambient air particulate pollutants.

Fetal sex and differential survival in preeclampsia and eclampsia.

PURPOSE: We investigate sex differences in the incidence of stillbirth, neonatal mortality, and perinatal mortality among singletons born to mothers with preeclampsia or eclampsia. METHODS: Retrospective cohort analysis of a population-based sample of singleton births covering the period 1989 through 2005 (n = 56,313). RESULTS: The study population comprised 26,931 female (47.8%) and 29,382 male infants (52.2%; referent group). Overall, the prevalence of stillbirth, neonatal mortality and perinatal mortality were 0.68, 0.52 and 1.2%, respectively. There was no sex difference in the incidence of stillbirth, neonatal or perinatal mortality among offspring of mothers in this study. CONCLUSION: Although there was a preponderance of male infants among mothers with preeclampsia or eclampsia, we did not observe any sex-associated differences in fetal or neonatal survival among offspring of mothers with preeclampsia or eclampsia.

Previous cesarean section, gestational age at first delivery and subsequent risk of pre-eclampsia in obese mothers.

PURPOSE: We examine the association between prior C-section and subsequent pre-eclampsia; and describe the effect of gestational age at prior C-section, and obesity status on this association. METHODS: The study population included women with two subsequent singleton births in Missouri between 1998 and 2005. The risk for pre-eclampsia/eclampsia was assessed among women with and without prior cesarean delivery. The two groups were followed to their second pregnancy and the occurrence of pre-eclampsia was documented. Additionally, the history of pre-eclampsia, prior cesarean at preterm, and obesity status were examined for their differential effects on the risk of pre-eclamsia. RESULTS: Women with prior C-section were 28% more likely to have pre-eclampsia in their subsequent pregnancy [OR = 1.28; 95% CI = 1.20-1.37]. However, this result was not significant when women with pre-eclampsia in their first pregnancy were excluded. After this exclusion, a more than threefold increased risk for subsequent pre-eclampsia was observed in women with prior early C-section [OR = 3.15; 95% CI= 2.43-4.08], while the level of risk did not change in the prior late C-section group [OR = 0.90; 95% CI= 0.82-1.00]. Subgroup analysis suggested that obesity status modified the risk of prior early C-section but did not affect the risk for prior late C-section. CONCLUSION: Preterm C-section in the first pregnancy may be associated with subsequent pre-eclampsia regardless of prior pre-eclampsia status.

Impact of prior bariatric surgery on maternal and fetal outcomes among obese and non-obese mothers.

PURPOSE: To assess the association between bariatric surgery and pregnancy-related outcomes among obese and non-obese women in the state of Florida. METHODS: We conducted a population-based, retrospective cohort analysis using vital records and hospital discharge data in Florida during 2004-2007. Women were categorized based on prior bariatric surgery and pre-pregnancy obesity status. Maternal complications (i.e., anemia, pre-eclampsia, gestational diabetes, chronic hypertension, endocrine disorders, cesarean section, prolonged hospital stay) and fetal morbidities [macrosomia, preterm birth, small for gestational age (SGA)] were the outcomes of interest. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were computed. RESULTS: Mothers with a prior history of bariatric surgery, regardless of obesity status, were more likely to have anemia, chronic hypertension, endocrine disorders, and SGA infants. Classification based on prior history of bariatric surgery and obesity status showed that non-obese mothers with prior bariatric surgery were more likely to have anemia, chronic hypertension, endocrine disorders, and SGA infants, whereas obese mothers without prior bariatric surgery were at greater risk of having gestational diabetes, chronic hypertension, macrosomic infants (AOR = 1.69, 95% CI = 1.65-1.73), and prolonged hospital stay as compared to non-obese mother without prior bariatric surgery. CONCLUSIONS: Although prior bariatric surgery is associated with multiple negative maternal and fetal outcomes, it is protective against infant macrosomia in obese mothers. Our findings support the need for preconception/interconception services tailored for former bariatric surgery patients to improve maternal and feto-infant health outcomes.

Assessing the impact of paternal involvement on racial/ethnic disparities in infant mortality rates.

We sought to assess the contribution of paternal involvement to racial disparities in infant mortality. Using vital records data from singleton births in Florida between 1998 and 2005, we generated odds ratios (OR), 95% confidence intervals (CI), and preventative fractions to assess the association between paternal involvement and infant mortality. Paternal involvement status was based on presence/absence of paternal first and/or last name on the birth certificate. Disparities in infant mortality were observed between and within racial/ethnic subpopulations. When compared to Hispanic (NH)-white women with involved fathers, NH-black women with involved fathers had a two-fold increased risk of infant mortality whereas infants born to black women with absent fathers had a seven-fold increased risk of infant mortality. Elevated risks of infant mortality were also observed for Hispanic infants with absent fathers (OR = 3.33. 95%CI = 2.66-4.17). About 65-75% of excess mortality could be prevented with increased paternal involvement. Paternal absence widens the black-white gap in infant mortality almost four-fold. Intervention programs to improve perinatal paternal involvement may decrease the burden of absent father-associated infant mortality.

Addressing policy barriers to paternal involvement during pregnancy.

Efforts to reduce infant mortality in the United States have failed to incorporate paternal involvement. Research suggests that paternal involvement, which has been recognized as contributing to child development and health for many decades, is likely to affect infant mortality through the mother's well-being, primarily her access to resources and support. In spite of that, systemic barriers facing the father and the influence on his involvement in the pregnancy have received little attention. The Commission on Paternal Involvement in Pregnancy Outcomes (CPIPO) has identified the most important social barriers to paternal involvement during pregnancy and outlined a set of key policy priorities aimed at fostering paternal involvement. This article summarizes the key recommendations, including equitable paternity leave, elimination of marriage as a tax and public assistance penalty, integration of fatherhood initiatives in MCH programs, support of low-income fathers through employment training, father inclusion in family planning services, and expansion of birth data collection to include father information.

Alcohol consumption during pregnancy and risk of placental abruption and placenta previa.

The purpose of this study was to examine the association between prenatal alcohol consumption and the occurrence of placental abruption and placenta previa in a population-based sample. We used linked birth data files to conduct a retrospective cohort study of singleton deliveries in the state of Missouri during the period 1989 through 2005 (n = 1,221,310). The main outcomes of interest were placenta previa, placental abruption and a composite outcome defined as the occurrence of either or both lesions. Multivariate logistic regression was used to generate adjusted odd ratios, with non-drinking mothers as the referent category. Women who consumed alcohol during pregnancy had a 33% greater likelihood for placental abruption during pregnancy (adjusted odds ratio (OR), 95% confidence interval (CI) = 1.33 [1.16-1.54]). No association was observed between prenatal alcohol use and the risk of placenta previa. Alcohol consumption in pregnancy was positively related to the occurrence of either or both placental conditions (adjusted OR [95% CI] = 1.29 [1.14-1.45]). Mothers who consumed alcohol during pregnancy were at elevated risk of experiencing placental abruption, but not placenta previa. Our findings underscore the need for screening and behavioral counseling interventions to combat alcohol use by pregnant women and women of childbearing age.