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1.
J Investig Allergol Clin Immunol ; 20(6): 469-75, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21243930

RESUMEN

BACKGROUND: The prevalence of atopic dermatitis (AD), a chronic skin disease, has increased substantially in recent decades, and different factors have been implicated in its etiology. Although dietary habits are being investigated, few conclusive findings have been reported. Nevertheless, increased consumption of polyunsaturated fatty acids (PUFA) and a diet poor in antioxidants have been related to AD. OBJECTIVES: The objectives of this study were to investigate the association between AD, the intake of different foods, and the effect of a Mediterranean diet among Spanish schoolchildren aged 6 to 7. METHODS: We performed a cross-sectional study with 20 106 schoolchildren aged 6-7 years from 10 different areas of Spain. The participation rate was 76.50%. The prevalence of AD was assessed using the International Study of Asthma and Allergies in Childhood questionnaire and the criteria of the Spanish Academy of Dermatology. To calculate the Mediterranean diet score, we classified food into 2 groups: Mediterranean food, including fruit, seafood, vegetables, pulses, cereals, pasta, rice, and potatoes; and non-Mediterranean food, including meat, milk, and fast food. RESULTS: Milk was negatively associated with AD. Butter and nuts also were negatively associated, although statistical significance was only reached when these foods were consumed 3 or more times a week. CONCLUSIONS: We found no association between the Mediterranean diet score and AD and a positive association between AD and obesity.


Asunto(s)
Dermatitis Atópica/epidemiología , Dieta , Niño , Estudios Transversales , Dieta Mediterránea , Femenino , Humanos , Masculino , Obesidad/complicaciones , Prevalencia , España/epidemiología
2.
Pediatrics ; 102(1 Pt 1): 25-30, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9651409

RESUMEN

OBJECTIVE: To explore the association between adequacy of prenatal care utilization and subsequent pediatric care utilization. DESIGN: A longitudinal follow-up of a nationally representative sample of infants born in 1988. PARTICIPANTS: Nine thousand four hundred forty women who had a live birth in 1988, and whose child was alive at the time of interview, and 8285 women from the original sample who were reinterviewed in 1991. MAIN OUTCOME MEASURE: There were four outcome measures: number of well-child visits; adequate immunization for diphtheria, tetanus, and pertussis; adequate immunization for polio; and continuity of a regular source of care, as measured by the number of sites for pediatric care. RESULTS: Children whose mothers had less than adequate prenatal care utilization had significantly fewer well-child visits, and were significantly less likely to have adequate immunizations, even after income, health insurance coverage, content of prenatal care, wantedness of child, sites of prenatal and pediatric care, and maternal and pregnancy risk characteristics were taken into account. Less than adequate prenatal care utilization was not associated with having more than one pediatric care site. CONCLUSIONS: Prenatal care utilization can be used to identify and target interventions to women who are at risk for not obtaining well-child care or complete immunizations for their children.


Asunto(s)
Servicios de Salud del Niño/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Embarazo , Vacunación/estadística & datos numéricos
3.
Int J Epidemiol ; 17(1): 39-43, 1988 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-3384547

RESUMEN

Information from death certificates and veterans' bonuses identified 840 Vietnam veterans and 2515 Vietnam-era veterans who died in Massachusetts during 1972-1983. Causes of death among Vietnam veterans were compared to Vietnam-era veterans and other male decedents. Standardized PMRs and MORs were both elevated for soft tissue sarcoma compared to Vietnam-era veterans [sPMR = 880, sMOR = 5.16, 95% Cl = (2.4, 11.1)], as well as non-veteran males.


Asunto(s)
Sarcoma/mortalidad , Neoplasias de los Tejidos Blandos/mortalidad , Veteranos , Adulto , Causas de Muerte , Humanos , Masculino , Massachusetts , Vietnam
4.
Am J Prev Med ; 11(2): 99-104, 1995.
Artículo en Inglés | MEDLINE | ID: mdl-7632457

RESUMEN

We used data from the 1991 Longitudinal Follow-up to the National Maternal and Infant Health Survey to examine cumulative risk of injury among children from birth to three years old and to provide national-level cause-specific estimates of medically attended nonfatal injuries for this age group. Almost 25% of the 8,145 children reportedly received care for an injury between birth and three years old. Among the children with injuries, 25.4% reportedly had more than one medically attended injury. Risk of reported injury was higher for boys and upper level socioeconomic groups. Falls were the most frequently reported injury (51%), followed by burns (11.7%), striking or cutting injuries (9.8%), poisonings (9.8%), and injuries from devices not intended for the child's use (7.9%). Nonfatal injuries for preschool-age children present a pattern strikingly different from that of fatal injuries among this age group, and the need for this data is important in targeting prevention strategies.


Asunto(s)
Heridas y Lesiones/terapia , Causas de Muerte , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Estudios Longitudinales , Masculino , Riesgo , Factores Socioeconómicos , Estados Unidos/epidemiología , Heridas y Lesiones/clasificación , Heridas y Lesiones/epidemiología
5.
Am J Prev Med ; 11(2): 79-85, 1995.
Artículo en Inglés | MEDLINE | ID: mdl-7632454

RESUMEN

This study examines the association between maternal sociodemographic characteristics and the receipt of different levels of prenatal care use (no care, inadequate, intermediate, adequate) in order to determine different patterns in the relationships between maternal characteristics and these distinct categories of prenatal care use. Using the 1979-1992 Hawaii live birth vital record file, single live births to Hawaii resident mothers of white, Hawaiian/part-Hawaiian, Filipino, or Japanese ethnicity, who did not indicate on the birth certificate that either parent was active duty military, were selected. Over one quarter of this study population did not initiate prenatal care in the first trimester. Given the high level of insurance coverage found in Hawaii, this finding is disconcerting, particularly in relation to the U.S. Year 2000 Objective of 90% initiation in the first trimester. Overall, the factors that predicted receipt of any prenatal care predicted more adequate use of prenatal care as well. Noteworthy exceptions were maternal age and ethnicity. Identifying these exceptions is important for the development of a more detailed understanding of risk factors related to use of prenatal care to better target program responses aimed at improving prenatal care use. In addition, these data suggest that removing financial barriers to access to care does not guarantee universal use of disease prevention and health promotion services.


Asunto(s)
Promoción de la Salud , Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , Tasa de Natalidad , Etnicidad , Femenino , Hawaii , Humanos , Paridad , Embarazo , Análisis de Regresión , Factores Socioeconómicos
6.
Public Health Rep ; 109(5): 637-46, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-7938384

RESUMEN

The Public Health Service's Expert Panel on the Content of Prenatal Care Report in 1989 provided detailed guidelines for the components of each prenatal visit. However, the extent to which women were receiving the recommended care when the guidelines were being formulated has yet to be determined. The 1988 National Maternal and Infant Health Survey results permit an examination of the proportion of women who reported receiving some of the recommended procedures. Women were asked if they received six of the recommended procedures (blood pressure measurement, urine test, blood test, weight and height taken, pelvic examination, and pregnancy history) in the first two visits, and whether they received seven types of advice or counseling (nutrition; vitamin use; smoking, alcohol, and drug use cessation; breastfeeding; and maternal weight gain) any time during their pregnancy. Only 56 percent of the respondents said they received all of the recommended procedures in the first two visits, and only 32 percent of the respondents said they received advice in all of the areas. Logistic regression analysis indicated that women receiving their care from private offices were significantly less likely to receive all the procedures and advice than women at publicly funded sites of care. This study suggests that recommendations of the Public Health Service's expert panel were not being met.


Asunto(s)
Guías como Asunto , Madres/estadística & datos numéricos , Atención Prenatal/normas , Calidad de la Atención de Salud/estadística & datos numéricos , Distribución de Chi-Cuadrado , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Análisis Multivariante , Embarazo , Atención Prenatal/estadística & datos numéricos , Factores Socioeconómicos , Estados Unidos , United States Public Health Service
7.
J Perinatol ; 13(1): 14-21, 1993.
Artículo en Inglés | MEDLINE | ID: mdl-8445441

RESUMEN

The purpose of this study was to examine potential racial disparities in the use of prenatal care beyond what could be measured by the Kessner Index. The data were obtained from the 1986 Massachusetts Prenatal Care Survey, a follow-back study of 2587 postpartum women, which had as its primary objective the identification of barriers to adequate use of prenatal care. This investigation examined the number of prenatal visits reported for each month of pregnancy and found that white women reported significantly more visits than black women only in the eighth and ninth months of pregnancy. This racial difference remained after we controlled for gestational age, sociodemographic factors, reported barriers to care, payor status, and access to care. This study suggests that racial differences in use of late prenatal visits need direct attention if the gaps in use of prenatal care and adverse birth outcomes are to be lessened.


Asunto(s)
Negro o Afroamericano , Atención Prenatal/estadística & datos numéricos , Población Blanca , Adolescente , Adulto , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo , Análisis de Regresión , Factores Socioeconómicos
8.
J Perinatol ; 17(4): 283-7, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9280092

RESUMEN

OBJECTIVES: The objectives of this study are to examine the influence of paternal and maternal education and marital status on the initiation and adequate use of prenatal care services. METHODS: Data were obtained from the 1990-1991 Minnesota Live Birth file. Single live births to white resident mothers who were 21 years of age or older were selected for investigation. After these selections 102,798 cases were analyzed. RESULTS: Logistic regression was used to examine the association of parental characteristics on the following three measures of poor prenatal care use: (1) receiving no prenatal care; (2) initiating care later than the first trimester; and (3) given a first trimester start of care, receiving less than the recommended number of prenatal care visits. Within each maternal education stratum, an increased risk of delayed initiation and less efficient use of prenatal care were observed for lower paternal educational attainment. Unmarried women, regardless of educational level, exhibited more than a tenfold risk of receiving no prenatal care, and unmarried women of low educational attainment exhibited the highest risk of delayed care. CONCLUSIONS: A persistent positive effect of increasing paternal education on the level of adequacy of prenatal care utilization within all maternal marital status and educational attainment groups poses further challenges to our understanding of the factors that influence prenatal care use.


Asunto(s)
Padre , Madres , Atención Prenatal/estadística & datos numéricos , Adulto , Educación , Femenino , Humanos , Estado Civil , Pacientes Desistentes del Tratamiento , Embarazo , Segundo Trimestre del Embarazo , Análisis de Regresión , Factores de Riesgo
9.
J R Soc Med ; 88(11): 611-5, 1995 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-8544143

RESUMEN

The manifest importance of reducing the incidence of low birth weight is most obvious for the first year of life: low birth weight is the single most important factor affecting infant morbidity and mortality. However, there is growing evidence that the adverse consequences of low birth weight continue throughout the life cycle. This review deals primarily with social causes of low birth weight.


Asunto(s)
Recién Nacido de Bajo Peso , Clase Social , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo , Factores de Riesgo
10.
J Fam Pract ; 47(1): 33-8, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9673606

RESUMEN

BACKGROUND: A preconception care program has the potential to assist women who want to become pregnant by advising these women about risk factors, healthy lifestyles, and assessing readiness for pregnancy. We conducted a randomized controlled trial to determine whether comprehensive preconception risk assessment at the time of a negative pregnancy test followed by referral to primary care services is effective in initiating treatment for women with preconception risk factors. METHODS: One hundred seventy women were offered preconception risk assessment following a negative pregnancy test. Women were assigned randomly either to a usual care group or an intervention group. Women in the latter group were informed about the risks identified and received an appointment with a primary care clinician who was also informed. Women in the usual care group and their clinicians received no feedback. All charts were reviewed and the women were contacted by telephone to determine if interventions to reduce risk were offered by clinicians during the year following the assessment. RESULTS: An average of 8.96 risks were identified per woman. The proportion of women having risks in each of 12 risk categories studied ranged from 19% to 71%. One hundred women (59%) made at least one visit during the subsequent year, thus allowing the opportunity for preconception care. The proportion of these women who had a risk addressed ranged from 18% for psychosocial risks to 48% for those with fetal exposures (smoking, alcohol, and drug use). There was no difference between groups in the percentage of risks addressed. CONCLUSIONS: The notification of women and their clinicians of identified preconception risks did not improve intervention rates. A more organized intervention system including office-based protocols is needed.


Asunto(s)
Atención Perinatal , Atención Preconceptiva , Pruebas de Embarazo , Embarazo de Alto Riesgo , Adolescente , Adulto , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Complicaciones del Embarazo/prevención & control , Atención Primaria de Salud , Medición de Riesgo
11.
Allergol Immunopathol (Madr) ; 36(6): 336-42, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-19150033

RESUMEN

BACKGROUND AND AIMS: Atopic eczema (AE) is the most frequent inflammatory skin disease in childhood in the western world. Several studies have reported a significant increase of prevalence in recent decades and the environmental factors implicated in its aetiology, including environmental tobacco smoke. This study aims to investigate the possible association of AE prevalence in Spanish schoolchildren aged 6-7 and 13-14 years in relation to their parents' smoking habits. METHODS: We conducted a cross-sectional population-based study with 6-7 year-old (n = 27805) and 13-14 year-old (n = 31235) schoolchildren from 10 Spanish centres. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and the Spanish Academy of Dermatology criteria, used in Spain to diagnose AE. RESULTS: An association was found in school-children aged 6-7 (adjusted for gender, presence of asthma, presence of rhinitis, siblings and mother's level of education) between AE being clinically diagnosed with the mother's smoking habit (RPRa 1.40, 1.10-1.78) and there being more than 2 smokers at home (RPRa 1.34, 1.01-1.78). Regarding the presence of itchy rash, an association was observed with fathers who smoke (RPRa 1.40, 1.13-1.72). Among the 13-14 year-olds, no association was observed in relation to either clinically diagnosed AE or the appearance of itchy rash with parents' smoking habit. CONCLUSIONS: Our results indicate the risk for children of being exposed to environmental tobacco smoke in terms of AE, especially when they are younger.


Asunto(s)
Dermatitis Atópica/epidemiología , Fumar/efectos adversos , Adolescente , Estudios de Casos y Controles , Niño , Estudios Transversales , Dermatitis Atópica/inmunología , Femenino , Humanos , Masculino , Padres , Prevalencia , España/epidemiología , Encuestas y Cuestionarios
12.
Fam Plann Perspect ; 22(3): 128-30, 1990.
Artículo en Inglés | MEDLINE | ID: mdl-2379570

RESUMEN

PIP: Records of the 21 Maternal and Infant Care (MIC) offices run by the Massachusetts Department of Public Health located in community-based facilities in high-risk areas provided data for the period 1985-87. MIC services include a postpartum visit within 2-6 weeks after birth. 24% of the deliveries in the MIC program were to teenagers. Unmarried women, high school dropouts, and minority group members were greatly overrepresented in the MIC program. 78% (10,854) of the women who received MIC care returned for a postpartum visit. Maternal age, educational status, parity, ethnicity, primary language, adequacy of prenatal care, length of maternal hospitalization, transfer of the infant to a neonatal intensive care unit, length of pregnancy, birth outcome, type of delivery, and birth weight were factors studied. The largest effect appeared to be correlated with adequacy of prenatal care utilization (the Kessner Index is used). Only 63% of women with inadequate utilization returned, compared with 76% of those with intermediate care and 86%, adequate care. The higher the women's level of education, the more likely she was to have a postpartum visit. The more children she had, the less likely she was to return. 82% of those with 1st births returned and 70% of those with 4 or more children. Women who did not speak English were more likely to return, (82%) than those who did (78%). NonEnglish speaking Asian women had the highest return rate (92%). Women under age 26 were likely to return than older ones. Factors associated with postpartum care were analyzed by year of delivery, so time trends could be seen. In 1985 and 1986, 78.9% returned for postpartum care; in 1987, the figure decreased to 76.4%. The % with adequate prenatal care who returned for postpartum care declined each year, from 87.4% in 1985 to 85.9% in 1986, and 83.8% in 1987. This was statistically significant. The % of Blacks who received postpartum care also declined, significantly. There was no change in the proportion getting adequate postpartum care among nonBlack groups. Factors associated with the lack of postpartum care in the multivariate analysis included Hispanic ethnicity, or later birth, and having a repeat cesarean section. The findings were shown to be stable across the years. In 1986 and 1987, women on the Healthy Start (a state-funded reimbursement program that pays for obstetric care of women with incomes between 100 and 185% of the poverty level) were less likely to miss their postpartum visit than those with commercial insurance.^ieng


Asunto(s)
Servicios de Salud Materna/estadística & datos numéricos , Atención Posnatal/estadística & datos numéricos , Periodo Posparto , Adolescente , Adulto , Femenino , Humanos , Recién Nacido , Massachusetts , Servicios de Salud Materna/economía , Análisis Multivariante , Atención Posnatal/economía , Análisis de Regresión
13.
Pediatrics ; 100(5): E4, 1997 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-9346998

RESUMEN

OBJECTIVE: To estimate the prevalence of recent supplement use in a national sample of preschool children and to examine the relationship of maternal and child characteristics, past maternal supplement use practices, familial, health services, and child health factors associated with supplement use. METHODS: We used data on 8285 preschool children whose mothers were interviewed for the 1991 Longitudinal Follow-up to the 1988 National Maternal and Infant Health Survey. Data collection was conducted either by telephone or personal interview. The sample is representative of the estimated 3. 8 million US born children in 1988 and alive in 1991. The outcome measures are whether the child was given any vitamin and mineral supplements at least 3 days a week in the 30 days before the interview and the type of supplement received. Statistical techniques included bivariate and weighted multiple logistic regression analysis. RESULTS: More than half of all US 3-year-olds (54.4%) were given some vitamin and mineral supplement. The most common supplements consumed were multivitamin-mineral with iron (59% of supplement users) and multivitamin-mineral without iron (26.4%). Children who received any supplements tended to have mothers who are non-Hispanic White, older, more educated, married, insured, receiving care from a private health care provider, have greater household income, and took supplements during pregnancy. Child health characteristics associated with supplement use included first birth order and having eating problems or poor appetites. CONCLUSIONS: More than half of US preschool children used vitamin and mineral supplements. The sociodemographic and health predictors identified for supplement use suggest that groups at risk for nonuse are likely the same groups whose circumstances may predispose a need for supplementation.


Asunto(s)
Suplementos Dietéticos/estadística & datos numéricos , Minerales/administración & dosificación , Vitaminas/administración & dosificación , Anciano , Preescolar , Humanos , Modelos Logísticos , Factores Socioeconómicos , Estados Unidos
14.
Matern Child Health J ; 3(4): 225-31, 1999 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-10791363

RESUMEN

OBJECTIVES: Establishing and comparing race, ethnic, and gender-specific birth weight percentiles for gestational age is requisite for investigating the determinants of variations in fetal growth. In this study, we calculate percentiles of birth weight for gestational age for the total 1994-1996 U.S. population and contrast these percentiles by racial/ethnic and gender groups. METHODS: Single live births to U.S. resident mothers were selected from the 1994-1996 U.S. Natality Files. After exclusions, 5,973,440 non-Hispanic Whites, 1,393,908 non-Hispanic African Americans, 1,683,333 Hispanics, 80,187 Native Americans, and 510,021 other racial/ethnic groups were used to calculate distribution percentiles of birth weight for each gestational age for which there were at least 50 cases to calculate the 50th percentile and 100 cases to calculate the 10th percentile. RESULTS: Fetal growth patterns among the four U.S. racial/ethnic groups varied markedly and, across the gestational age range, there was considerable oscillation in the relative ranking of any one group's birth weight percentile value in comparison to the others. Males had relatively higher birth weight percentile values than females. The proportion of infants with a birth weight value less than 1994-1996 U.S. population's 10th percentile value of birth weight for their corresponding gestational age was 7.87 for non-Hispanic Whites, 15.43 for non-Hispanic African Americans, 9.30 for Hispanics, and 8.81 for Native Americans. CONCLUSIONS: While the factors underlying trends and population subgroup differences in fetal growth are unclear, nutrition, smoking habits, health status, and maternal morbidity are possible precursors for part of the variations in patterns of fetal growth. As prenatal care has been touted as a means to reduce the risk of fetal growth restriction at term, assuring the availability and accessibility of comprehensive prenatal care services is viewed as an essential corollary in the effort to improve fetal growth patterns in the United States.


Asunto(s)
Peso al Nacer , Negro o Afroamericano/estadística & datos numéricos , Retardo del Crecimiento Fetal/etnología , Edad Gestacional , Hispánicos o Latinos/estadística & datos numéricos , Indígenas Norteamericanos/estadística & datos numéricos , Caracteres Sexuales , Población Blanca/estadística & datos numéricos , Femenino , Retardo del Crecimiento Fetal/etiología , Estado de Salud , Humanos , Recién Nacido , Masculino , Morbilidad , Valores de Referencia , Características de la Residencia/estadística & datos numéricos , Factores de Riesgo , Estados Unidos/epidemiología
15.
Am J Public Health ; 90(2): 245-50, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10667186

RESUMEN

OBJECTIVES: Recurrent and persistent otitis media is often treated by tympanostomy tube insertion to ventilate the middle ear and restore hearing. This study examined the factors that predict which children are most likely to receive tympanostomy tubes through 3 years of age. METHODS: Multiple logistic regression was conducted on data from a nationally representative sample of children (N = 8285). RESULTS: By 3 years of age, 6.8% of US children had tubes inserted. Logistic regression indicated that after control for number of ear infections, children without any gaps in health insurance, who attended a day-care center, who were White, whose birth-weight was less than 1500 g, and who lived in the Midwest or South were significantly more likely to have tympanostomy tubes. CONCLUSIONS: These data suggest that differences exist as to who receives tubes. Of particular concern are differences by race/ethnicity and continuity of health insurance coverage. With expansions in health care coverage to larger proportions of uninsured children, it will be important to monitor these programs to ensure that all children who may need tympanostomy tubes have access to them.


Asunto(s)
Ventilación del Oído Medio/estadística & datos numéricos , Otitis Media/cirugía , Preescolar , Humanos , Cobertura del Seguro , Modelos Logísticos , Oportunidad Relativa , Otitis Media/epidemiología , Factores Socioeconómicos , Estados Unidos/epidemiología
16.
Am J Public Health ; 91(11): 1865-8, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11684617

RESUMEN

OBJECTIVES: This study examined the predictors of 3 patterns of prenatal care use (no care, late initiation of care, and inadequate use after early initiation) for 4 Asian American ethnic groups in the United States. METHODS: Single live births to US resident mothers of Chinese, Japanese, Korean, and Vietnamese ancestry (n = 273 604) were selected from the 1992-1996 US natality files. Logistic regression was used to analyze the effects of maternal characteristics on the 3 use measures. RESULTS: Korean Americans and Vietnamese Americans had the lowest levels of prenatal care use. Young or single motherhood, high parity for age, and low educational attainment were the main risk factors for low use. CONCLUSIONS: Considerable variability exists in prenatal care use among Asian American ethnic groups.


Asunto(s)
Etnicidad/estadística & datos numéricos , Aceptación de la Atención de Salud/etnología , Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , China/etnología , Comparación Transcultural , Femenino , Humanos , Japón/etnología , Corea (Geográfico)/etnología , Modelos Logísticos , National Center for Health Statistics, U.S. , Cooperación del Paciente/etnología , Embarazo , Trimestres del Embarazo , Estados Unidos/epidemiología , Vietnam/etnología
17.
JAMA ; 271(17): 1340-5, 1994 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-8158819

RESUMEN

OBJECTIVE: Numerous studies have found a relationship between the quantity of prenatal care received and birth outcomes. Few studies have had the opportunity to examine the content of prenatal care. This study examined the relationship between two components of the content of prenatal care: maternal reports of health behavior advice received and initial prenatal care procedures performed during the first two visits and low birth weight in a national sample of women. Advice and initial procedures were categorized based on the recommendations of the US Public Health Service Expert Panel on the Content of Prenatal Care. DESIGN: Interview survey of a nationally representative sample of women who had live births in 1988. PARTICIPANTS: A total of 9394 women, with data from the National Maternal and Infant Health Survey. MAIN OUTCOME MEASURE: Low birth weight (< 2500 g) as reported on the birth certificate. RESULTS: After controlling for other sociodemographic, utilization, medical, and behavioral factors, women who reported not receiving all the types of advice recommended by the Expert Panel on the Content of Prenatal Care were more likely to have a low-birth-weight infant compared with women who reported receiving the optimal level of advice (odds ratio = 1.38; 95% confidence interval, 1.18 to 1.60). There were no differences between women who reported receiving all the recommended initial prenatal care procedures and those who reported not receiving all recommended prenatal care (odds ratio = 1.00; 95% confidence interval, 0.87 to 1.14). CONCLUSION: These data suggest that women who report receiving sufficient health behavior advice as part of their prenatal care are at lower risk of delivering a low-birth-weight infant.


Asunto(s)
Conductas Relacionadas con la Salud , Recién Nacido de Bajo Peso , Educación del Paciente como Asunto , Atención Prenatal , Femenino , Encuestas Epidemiológicas , Humanos , Recién Nacido , Educación del Paciente como Asunto/estadística & datos numéricos , Embarazo , Atención Prenatal/normas , Atención Prenatal/estadística & datos numéricos , Riesgo
18.
JAMA ; 272(13): 1025-30, 1994 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-8089884

RESUMEN

OBJECTIVE: To estimate the prevalence of recent over-the-counter (OTC) medication use in a national sample of preschool-age children. DESIGN: Follow-up survey of a nationally representative sample of 3-year-old children in the US population by telephone or personal interview. PARTICIPANTS: A total of 8145 children whose mothers were interviewed for the 1991 Longitudinal Follow-up to the National Maternal and Infant Health Survey. MAIN OUTCOME MEASURES: Report of any OTC medications given in the past 30 days and the type of medications that the child received. RESULTS: During the past 30 days, 53.7% of all 3-year-old children in the United States were given some OTC medications. Among OTC medication users, the most common medications reported were Tylenol (66.7%) and cough or cold medicine (66.7%). Most respondents reported that recent child illness episodes (70%) were treated with OTC medications. After adjustment for recent child illness, women who were white (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.13 to 1.55), were more educated (OR, 1.58; 95% CI, 1.24 to 2.00), and had higher incomes (OR, 1.75; 95% CI, 1.33 to 2.30) were more likely to have given their child OTC medications. Women without health insurance were also more likely to have given OTC medications (OR, 1.27; 95% CI, 1.04 to 1.55). Provider visits, but not telephone calls, were associated with a reduction in OTC medication usage. CONCLUSIONS: Over-the-counter medications are an important component of health care for treating illness in US preschool-age children. The high prevalence of use has occurred despite the dearth of scientific proof for the effectiveness of certain classes of OTC medications and the risks associated with improper use.


Asunto(s)
Madres/estadística & datos numéricos , Medicamentos sin Prescripción/uso terapéutico , Automedicación/estadística & datos numéricos , Enfermedad Aguda , Adulto , Preescolar , Demografía , Femenino , Encuestas Epidemiológicas , Humanos , Seguro de Salud , Modelos Logísticos , Masculino , Conducta Materna , Prevalencia , Automedicación/tendencias , Factores Socioeconómicos , Estados Unidos
19.
Am J Public Health ; 84(1): 82-8, 1994 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8279618

RESUMEN

OBJECTIVES: The relationship between certain maternal behaviors and adverse pregnancy outcomes has been well documented. One method to alter these behaviors is through the advice of women's health care providers. Advice from providers may be particularly important in minority populations, who have higher rates of infant mortality and prematurity. This study examines racial disparities according to women's self-report of advice received from health care providers during pregnancy in four areas: tobacco use, alcohol consumption, drug use, and breast-feeding. METHODS: Health care providers' advice to 8310 White non-Hispanic and Black women was obtained from the National Maternal and Infant Health Survey. RESULTS: After controlling for sociodemographic, utilization, and medical factors, Black women were more likely to report not receiving advice from their prenatal care providers about smoking cessation and alcohol use. The difference between Blacks and Whites also approached significance for breast-feeding. No overall difference was noted in advice regarding cessation of drug use, although there was a significant interaction between race and marital status. CONCLUSIONS: These data suggest that Black women may be at greater risk for not receiving information that could reduce their chances of having an adverse pregnancy outcome.


Asunto(s)
Población Negra , Conductas Relacionadas con la Salud/etnología , Educación en Salud , Atención Prenatal , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Lactancia Materna , Femenino , Humanos , Oportunidad Relativa , Preparaciones Farmacéuticas , Embarazo , Fumar , Población Blanca
20.
Matern Child Health J ; 1(1): 25-34, 1997 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10728223

RESUMEN

OBJECTIVE: To assess whether site of prenatal care influences the content of prenatal care for low-income women. DESIGN: Bivariate and logistic analyses of prenatal care content for low-income women provided at five different types of care sites (private offices, HMOs, publicly funded clinics, hospital clinics, and other sites of care), controlling for sociodemographic, behavioral, and maternal health characteristics. PARTICIPANTS: A sample of 3405 low-income women selected from a nationally representative sample of 9953 women surveyed by the National Maternal and Infant Health Survey, who had singleton live births in 1988, had some prenatal care (PNC), Medicaid participation, or a family income less than $12,000/year. OUTCOME MEASURES: Maternal report of seven initial PNC procedures (individually and combined), six areas of PNC advice (individually and combined), and participation in the Women Infant Children (WIC) nutrition program. RESULTS: The content of PNC provided for low-income women does not meet the recommendations of the U.S. Public Health Service, and varies by site of delivery. Low-income women in publicly funded clinics (health departments and community health centers) report receiving more total initial PNC procedures and total PNC advice and have greater participation in the WIC program than similar women receiving PNC in private offices. CONCLUSIONS: Publicly funded sites of care appear to provide more comprehensive prenatal care services than private office settings. Health care systems reforms which assume equality of care across all sites, or which limit services to restricted sites, may foster unequal access to comprehensive PNC.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Bienestar Materno/estadística & datos numéricos , Pobreza , Atención Prenatal/estadística & datos numéricos , Atención Prenatal/normas , Ubicación de la Práctica Profesional/estadística & datos numéricos , Adolescente , Adulto , Escolaridad , Femenino , Encuestas de Atención de la Salud , Humanos , Modelos Logísticos , Educación del Paciente como Asunto , Participación del Paciente , Embarazo , Atención Prenatal/economía , Atención Prenatal/tendencias , Medición de Riesgo , Muestreo , Estados Unidos
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