At-risk Pregnant Women Research Articles

Psychosocial Correlates of Child Out-of-Home Living Arrangements among At-Risk Pregnant Women

The purpose of this study was to identify the maternal psychosocial factors associated with child out-of-home living arrangements among pregnant women living in poverty. One hundred and sixty women considered at psychosocial risk for child maltreatment were interviewed according to a structured questionnaire when they presented for prenatal care at a large urban hospital-based clinic. Mothers whose children were currently living with substitute caregivers were compared with mothers whose children resided with them. The policy and practice implications of the findings are discussed.

Bio-ethics yearbook, vol 1: theological developments in bio-ethics 1988-1990

<h3>Background</h3> Since the introduction of the Child Poverty Act (2017) in Scotland, all health visitors, midwives and family nurses in Scotland are expected to screen and offer a financial advice referral to at-risk pregnant women and parents/carers of families with children under five in Scotland. The so-called <i>‘Financial Inclusion Pathway’</i> (FIP) emerged in 2019 as one of a number of strategies intended to tackle child poverty. At this early implementation stage, little is known about parents’ perspectives about the acceptability or impact of this initiative in relation to its aim. <h3>Methods</h3> In 2020, low income parents with young children living in Aberdeen City were invited to take part in a qualitative study that aimed to determine any challenges they might face engaging with the FIP policy in practice, and their perspectives about financial discussions with professionals that could help to increase household incomes through this approach.One-to-one semi-structured telephone interviews lasting between 30–40 minutes took place during July and August 2020. Interviews were fully transcribed and thematically analysed. <h3>Results</h3> Ten women, ranging from ages 20–41 years. Each participant had between one and five child(ren), ranging in age from 2 to 18 years and all had one child under school-age. All lived in multiply deprived postcode areas within Aberdeen City. Three main themes emerged: i<i>. difficulties associated with discussing financial concerns</i>; ii. <i>how to talk about the issue</i>; iii. <i>intervention utility</i>. Within each of these three main themes, nine-sub themes were apparent, ranging from those indicating potential unintended negative consequences, as well as intervention benefits. <h3>Discussion</h3> Most participants considered health visitors to be a potentially good source of help about financial challenges; they were less clear about midwives’ role here. However, parents’ perceptions of the problems they may face associated with disclosing financial difficulties to health professionals, is a distinct barrier to conversations that could lead to a financial advice referral. Given the levels of unclaimed benefit in the UK, this is important to note. Establishing trust and rapport, careful and sensitive enquiry, and positive framing of financial maximisation were recommended to aid discussion of financial challenges. These findings are important given the current and predicted economic impact of the COVID-19. The study is limited by its sample size and recruitment site, but provides valuable insights to inform a larger scale investigation. The study also indicates the importance of understanding health professionals’ associated views and experiences.

Screening of the Mother During Early Pregnancy

Screening for the early diagnosis of sickle cell disease has been advocated as essential for reducing infant mortality and morbidity. The provision of comprehensive and preventive care optimizes the chance for a longer and more healthy life by minimizing the detrimental complications that often occur in early life. Accordingly, the goals of early identification and intervention include preventing complications through the anticipation of medical problems, educating the family so that they become knowledgeable about sickle cell disease and how it may affect their child, and assisting the family in identifying specialized medical centers where appropriate care and follow-up will occur. MATERIALS AND METHODS The target population in New Haven, CT, was defined as black and Puerto Rican gravida women giving birth at Yale Medical Center. Screening these at-risk pregnant women and the fathers permitted prior identification of the newborn at risk. This was perceived to be a method of decreasing the number of cord blood specimens to be screened as well as increasing the yield. Screening guidelines mandated education, informed consent, and appropriate follow-up for parents whose infants were identified to be heterozygous or homozygous for a sickle variant. The protocols for sample collection and sample testing were established. Hemoglobin electrophoresis was performed by the following two techniques: (1) cellulose acetate at pH 8.4 and (2) citrate agar gel at pH 6.2. The latter technique facilitates the identification of Hb S and Hb C in the presence of large amounts of Hb F3. The screening program was introduced to the medical community and support staff.

Newborn screening for hemoglobinopathies: the benefit beyond the target.

As a result of New York State's Newborn Screening Program 4,565 neonates with trait hemoglobinopathies were identified and 3,200 families were notified of the results of testing their infants in New York City in 1982. Of the 1,531 families (2,190 parents) tested and counseled, 22 parents were diagnosed with sickle cell disease and 39 couples were found to be at-risk for having a child with sickle cell disease. Amniocentesis was performed in 14 of the 28 at-risk pregnant women and three of the four affected pregnancies were terminated. MCH-331001-01 to 04