Infant Health Outcomes Research Articles

Effects of Nurse-Led Intervention for Mother-Infant Dyads on Breastfeeding, Infant Health Outcomes.

This study aimed to investigate the efficacy of nurse-led interventions in enhancing breastfeeding women's knowledge and practices and in preventing diarrhea among their infants. The study was conducted in rural areas of Haryana, India, and used the survey design and pre-experimental research design in Phase I and Phase II, respectively. Mothers who had recently delivered a baby were identified using the birth register at the panchayat office, and 200 mothers who met the inclusion criteria were chosen using purposive sampling technique. The data were collected by interview approach using the knowledge questionnaire on breastfeeding, observational checklist on practice of breastfeeding, diarrhea assessment tool, and the duration of data collection was between May to August 2022. In Phase I, exclusive and non-exclusive breastfeeding mothers were surveyed regarding the occurrence of diarrhea among infants. In Phase II, non-exclusive breastfeeding mothers' knowledge and practice were assessed, and then nurseled intervention on breastfeeding was administrated and on 30th, 60th, and 90th days, post-test was done. The study's findings demonstrate that the knowledge and practice scores varied significantly across different tests, from pre-test 1 (6.73 ± 1.94) to post-test 3 (16.19 ± 3.04), (F=294.11, p < .000) for knowledge, and for practice pre-test 1 (23.41 ± 8.90) to post-test 3 (101.81 ± 22.4), (F=535.98, p < .000) in the intervention group. Further, in the intervention group, there was decrease in diarrhea occurrence among various observations (Q=60.609, p < .000). The nurse-led intervention of breastfeeding is an effective teaching technique to improve the knowledge and practice of mothers, as well as it helps to reduce the occurrence of diarrhea among infants, there by it can contribute to reducing the infant mortality rate.

The potential utility of cord blood DNA methylation in pediatric clinical practice.

Our understanding of the origins of noncommunicable diseases has evolved over the years with greater consideration given to the lasting influence exposures and experiences during the preconceptional and prenatal periods can have. Research highlights the associations of parental exposures (e.g., diet, obesity, gestational diabetes, lipid profile, toxic exposures and microbiome) with the infant/fetal methylome and suggest associations with infant, child and/or adolescent chronic health outcomes. Thus, epigenetics and specifically cord blood DNA methylation may have utility as biomarkers for disease risk identification and stratification in pediatrics. However, for cord blood DNA methylation analyses to be leveraged as biomarkers of disease risk in pediatric clinical practice, the results must be replicable, validated and clinically meaningful. Challenges and opportunities to this prospect are herein discussed.

Evaluating Educational Patterns and Methods in Infant Sleep Care: Trends, Effectiveness, and Impact in Home Settings—A Systematic Review

Background: Sleep care is crucial for the health and development of infants, with proper sleep patterns reducing the risk of sudden infant death syndrome (SIDS) and other sleep-related incidents. Educational interventions targeting caregivers are essential in promoting safe sleep practices. Methods: This systematic review adhered to PRISMA guidelines, searching databases such as PubMed, MEDLINE, Scopus, and the Cochrane Library. Inclusion criteria focused on studies involving home-based interventions for infants aged 0–12 months, including parental education and behavioral interventions. Exclusion criteria included studies in clinical settings and non-peer-reviewed articles. Data extraction and synthesis were performed by two independent reviewers, using a narrative approach to categorize interventions and outcomes. Results: Twenty-three studies met the inclusion criteria. Key findings indicate that home-based educational interventions, including hospital-based programs, home visits, and mobile health technologies, significantly improve parental knowledge and adherence to safe sleep practices. These interventions also enhance parental satisfaction and contribute positively to infant health outcomes. Conclusions: Educational interventions have demonstrated effectiveness in promoting safe sleep practices among caregivers, particularly in home settings. These interventions, including hospital-based programs, home visits, and digital tools, improve parental knowledge, adherence to guidelines, and overall satisfaction. The impact is evident in the reduction of unsafe sleep behaviors and enhanced infant health outcomes. However, variability in the intervention methods and delivery, cultural contexts, and geographic focus suggest a need for more tailored, long-term, and comprehensive studies. Future research should standardize outcome measures and assess the sustained impact of these educational strategies on infant sleep patterns and caregiver practices over time. This will provide deeper insights into the trends and long-term effectiveness of educational patterns and methods in diverse home environments.

Breast milk sharing practices in emergency settings

Abstract Background In emergencies, breast milk sharing becomes essential to sustain infant nutrition when access to maternal breastfeeding is disrupted. This study examines donor motivations and assesses the impact of such initiatives on infant health outcomes during wartime. Methods This qualitative study investigated a community of breast milk donors on a Facebook platform for the month following the start of the war on October 7, 2023. We investigated two main groups participating in breast milk sharing through reflective thematic analysis of social media messages. Results A count of posts one month before and after October 7 revealed a doubling in post frequency post-7/10, emphasizing the surge in war-related posts. Two main themes emerged concerning the war: 1. Infant needs: Posts addressed various infant needs, including general necessities and those specific to war-related situations. Requests for milk sharing emerged from the second day of the war, particularly for infants whose mothers were missing or injured. Government information from the National Human Milk Bank was shared within these Facebook groups, encouraging donations for these infants. 2. Donor Motivation: Posts reflected both non-war-related and war-related motivations, with a notable emphasis on the latter. Authors, including both women and men, actively promoted the donation of human milk to conflict-affected areas. Suggestions included pumping milk specifically for war-affected infants or offering frozen human milk. Some posts also offered to collect and deliver human milk to needy infants within the affected regions. Conclusions Post frequency doubled in both Facebook groups compared to the previous month, mainly focusing on war-related topics, indicating an increased drive to share human milk with those affected by the conflict. Key messages • Breast milk sharing, crucial in emergencies, analyzed via social media, sheds light on donor motivations and impacts on infant health during conflicts. • This qualitative study investigated a community of breast milk donors on a Facebook platform for the month following the start of the war on October 7, 2023.

Antibiotic use in the first 1000 days and maternal-infant outcomes: results from the MAMI-MED cohort

Abstract Introduction Antibiotic use within the initial thousand days of life could potentially lead to a range of negative health outcomes for both mothers and infants. This study seeks to identify the primary factors influencing antibiotic use and examine the associations with adverse neonatal outcomes, specifically focusing on neonatal intensive care unit (NICU) admissions. Methods Data were gathered from pregnant women and their offspring enrolled in the ‘MAMI-MED’ study at ARNAS Garibaldi Nesima in Catania (Italy), from December 2020 to January 2024. Information regarding antibiotic exposure and maternal-infant health outcomes was collected through follow-up questionnaires administered at birth, one year, and two years postpartum. Results Among 1492 women (average age: 31 years) included in the study, 20.4% reported using antibiotics during pregnancy. The mean age of antibiotic users during pregnancy was significantly higher compared to non-users (p = 0.008). Among the 304 women who used antibiotics during pregnancy, 45.5% did so during the third trimester, 41.4% during the second trimester, and 13.1% during the first trimester. Furthermore, 47.1% of women reported antibiotic use at delivery or postpartum. Of the 904 children studied, 63% were administered at least one antibiotic between birth and the first year of age. A greater proportion of newborns admitted to the NICU were born to mothers who used antibiotics during the second trimester of pregnancy compared to those who used antibiotics during other trimesters (p = 0.013). Conclusions Comprehensive research is needed to delve deeper into the intricate factors influencing maternal antibiotic use. This should thoroughly explore socio-demographic variables, such as income level, education, and access to healthcare. Understanding these multifaceted influences can provide valuable insights into designing tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy. Key messages • Different factors influence maternal antibiotic use. • Tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy are needed.

A Case for a Maternal Culturally Tailored Smoking Cessation Research Agenda

Background/Objectives: Despite national efforts, smoking rates during pregnancy remain high among certain demographics, particularly American Indian/Alaska Native and younger women. This study examines the causal link between maternal smoking, maternal and fetal mortality, and social determinants of health, highlighting disparities faced by Black, Indigenous, and People of Color (BIPOC) and American Indian/Alaskan Native (AIAN) pregnant persons. Methods: Data from various sources, including national reports and committee findings, were analyzed to assess trends in maternal smoking, mortality rates, and associated factors. While smoking rates among all groups have declined, disparities persist. Young women, BIPOC, and American Indian/Alaska Native women, and those with lower educational attainment, have higher smoking rates. Black women exhibit significantly higher maternal mortality rates, often linked to cardiac/coronary conditions. Stress, exacerbated by social determinants of health like poverty and housing insecurity, emerges as a key factor driving smoking behavior, particularly among African Americans. The leading causes of pregnancy-related deaths vary by race and ethnicity, with preventability noted in 80% of cases. Perinatal exposure to cigarette smoking is also identified as a leading cause of poor infant health outcomes, emphasizing the importance of addressing smoking behavior during and after pregnancy. Results: This report advocates for a comprehensive approach to reducing maternal and fetal mortality rates, with a focus on adapting existing smoking cessation programs to adopt culturally tailored agendas in order to address social and political determinants of health as well as behavioral drivers of tobacco use among pregnant persons.

The maternal and infant health consequences of restricted access to abortion in the United States

Since the recent US Supreme Court decision in Dobbs v. Jackson Women's Health Organization, people across the country have experienced large sudden changes in their access to abortion care. In this paper, I look to the history of abortion access in the United States to inform predictions for this new future. I study the effects of targeted regulations on abortion providers (TRAP laws) on a variety of maternal and infant health outcomes, using variation in the timing of policy adoption across states and a direct measure of the distance to an abortion provider. I implement difference-in-differences techniques across outcomes from restricted-use microdata on the universe of US births. I find that TRAP laws lead to 11–16 % increased rates of hypertensive disorders of pregnancy. Additionally, I find evidence that TRAP laws widen existing disparities in adverse infant health outcomes across parental race. These results demonstrate the potentially wide-ranging health effects of restricting access to abortion.

Exploring the effects of mental health on bonding and caregiving among pregnant and postpartum persons with likely depression and/or PTSD in South Africa: A qualitative analysis.

Perinatal mental health disorders place a particularly high public health burden on South Africa (SA) via negative health outcomes for the birthing parent and adverse health outcomes for infants (e.g., low birth weight, preterm deliveries, malnourishment) as well as emotional and behavioral problems in children. Depression, posttraumatic stress disorder (PTSD), and other mental health disorders may also compromise engagement in HIV prevention behaviors during the perinatal period, when HIV acquisition risk increases. This is particularly important in SA, where almost a quarter of women between ages 15 to 49 have HIV. There is little research exploring the anticipated impacts mental health symptoms have on one's ability to emotionally connect or caregive after delivery; this critical information will enable providers to support women and their mental health during the transition from pregnancy to postpartum. HIV-negative pregnant persons were recruited from an antenatal clinic in Cape Town as a part of a larger study investigating mental health barriers to pre-exposure prophylaxis (PrEP) uptake during pregnancy. Participants qualified for an in-depth interview based on elevated symptoms of depression and/or PTSD. The interviews explored the likely impact of their mental health symptoms on their baby's wellbeing, their ability to bond with their baby, and their ability to meet their baby's needs. Following the principles of thematic analysis, we identified three main themes that described these relationships: (1) a strong perceived connection between maternal mental health and baby's wellbeing; (2) perceived strains on bonding with the baby; and (3) negative impact of mental health on likelihood of completing parenting tasks. This study will inform future mental health programming to prepare pregnant persons with mental health symptoms for a successful postpartum period with respect to bonding and caring for their infant.

Utilization Postnatal Care Services in Hyolmo Community

Postnatal care (PNC) utilization among the Hyolmo community highlights significant gaps in existing literature and underscores the critical need for targeted healthcare interventions in remote and ethnically distinct populations. This study reveals that, while considerable attention is given to urban and accessible rural populations, remote communities face unique challenges that can impede access to essential maternal health services. The results demonstrate that age, education, and socio-economic factors significantly influence PNC uptake, suggesting disparities that are compounded in remote areas like the Helambu Rural Municipality of Sindhupalchowk District. This study shows that younger mothers, often less aware or hindered by accessibility barriers, are less likely to utilize PNC services compared to their older counterparts. This disparity highlights the necessity for community-specific educational programs that can enhance understanding and encourage the use of PNC services among younger women. Additionally, the influence of education and socio-economic status on PNC utilization points to the broader implications of systemic inequities in healthcare access. Moreover, the study brings to light the role of cultural practices and beliefs in shaping healthseeking behaviors, which varies significantly across different communities. In the traditional beliefs may conflict with modern healthcare practices, there is a clear need for culturally sensitive health interventions that respect and integrate local customs and practices. This research not only contributes to a deeper understanding of the factors affecting PNC service uptake in a specific Nepalese community but also calls for comprehensive policy responses. By addressing the multifaceted challenges faced by the Hyolmo community ranging from geographic isolation to cultural and educational barriers the study advocates for a holistic approach to healthcare. This should include the development of policies that ensure equitable access to health services, enhance community health education, and promote cultural competence among healthcare providers. Ultimately, such efforts are essential for improving maternal and infant health outcomes in remote communities, ensuring that every individual, regardless of their socio-economic or cultural background, has access to the necessary postnatal care.

Male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia

Male involvement in infant care is an effective intervention to improve infant health outcomes. However, evidence regarding male involvement in infant care and its associated factors is limited in Ethiopia. To assess the male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia. A community-based cross-sectional study was conducted among 606 participants from April 1–30/2023. A systematic sampling technique was used to select each study participant. Data was collected using interviewer-administered questionnaires. Data were entered into Epi data 4.6 and analyzed using statistical Product Service and Solution (SPSS) version 2 5. Both descriptives, mean, frequency and analytical statistics were employed. Variables with a p-value of less than 0.25 in bivariate logistic regression were entered into a multivariate logistic regression to identify associated factors. Statistical significance was declared at p < 0.05. The prevalence of male involvement in infant care was 42.2% with a 95% CI (38.26–46.12). Male who did not attend formal education (AOR = 0.24, 95% CI = 0.14–0.43), having one child (AOR = 5.66, 95%CI = 2.94–10.88), having male infants (AOR = 2.51, 95% CI = 1.60–3.95), first infant order (AOR = 2.70, 95% CI = 1.36–5.39), having adequate knowledge towards infant care (AOR = 5.56,95% CI = 0.12–0.28), and having favorable attitude towards infant care (AOR = 1.70,95% CI = 0.34–0.99) were factors associated with male involvement in infant care. Less than 50% ( 50%) of males are involved in their infant care. Educational status of males, number of infants, male infants, male knowledge, and attitude towards infant care were significantly associated with involvement in infant care. Therefore, efforts should be directed at improving males’ educational status, knowledge, and attitude to improve their engagement in caring for their infants.

Geographical disparities in temporal trends of low birth weight in Saskatchewan from 2002/2003 to 2021/2022: insights from a joinpoint regression analysis.

Low birth weight (LBW) is an important public health indicator that is associated with various negative health outcomes in infants. To effectively implement interventions that would improve health outcomes in children, it is important to understand both the historical trends and current levels of LBW rates. In this study, trends and regional differences in LBW rates in Saskatchewan from 2002/2003 to 2021/2022 were assessed. A joinpoint regression analysis was conducted using historical LBW rates, obtained from the Canadian Institute for Health Information database. Data were analysed using average percent change and average annual percent change. Spatial patterns and trends were identified using a choropleth map. From a provincial and national rate of 5.2% in 2002/2003, the LBW rate in Saskatchewan increased to 6.5% in 2021/2022, approaching the national rate of 6.8%. Over the 20-year period, average annual changes for Canada were 1.4% and 1.0% for Saskatchewan. There was a turning point in the study: 2004/2005 for Canada and 2011/2012 for Saskatchewan. Initially, Saskatchewan had stable LBW rates, increasing yearly by 0.1%, while the national rate was 5.7%. However, in recent years, Saskatchewan's rate increased to 1.8% annually, surpassing the national rate of 0.9%. Geographical differences were also observed within Saskatchewan, with the Far North region having the highest LBW rate (9.2%), and the Central West region having the lowest rate (4.3%) in 2021/2022. The Central East, Regina Qu'Appelle, and southern Saskatchewan saw significant upwards trends in LBW rates between 2015/2016 and 2021/2022. There is an increasing trend in LBW rates in Canada and Saskatchewan, as well as geographical disparities within the province. The geographical disparities in LBW rates underscore the need for tailored interventions in high-risk regions in the province.

KNOWLEDGE, PRACTICES, AND CONSTRAINTS AMONG BREASTFEEDING EMPLOYEES TOWARDS IMPLEMENTATION OF LACTATION AREA

Breastfeeding empowers women and children and working mothers who revolutionize the workplace globally, specifically in carrying mutual roles as employees delivering quality service to humanity and mothers nurturing their children. This study explored the knowledge, practices, and constraints among breastfeeding working mothers in Region III, Philippines, towards implementing lactation areas. A mixed-methods approach combined a quantitative survey with a qualitative semi-structured interview component. Findings showed a high prevalence of breastfeeding among working mothers, coupled with a good level of knowledge about breastfeeding practices. However, constraints such as lack of lactation areas in offices, heavy workload, and limited support were revealed, thus foregrounding the need for institutionalized policies and guidelines to establish lactation areas in offices, promote breastfeeding, and support working mothers and their welfare, anchored on sustainable development goals (SDGs). By addressing these issues, workplaces position a more conducive environment for breastfeeding mothers, contributing to improved maternal and infant health outcomes. Further, this research provides valuable insights for policymakers, employers, and healthcare providers in initiating more effective strategies to support breastfeeding working women. Through the documented findings and by providing concrete recommendations for policy and infrastructure, this research advances the shaping of a more breastfeeding-friendly environment, promotion of maternal and infant health, supporting SDG 3-good health and well-being, and enhancement of workplace productivity towards achieving SDG 8-decent work and economic growth and SDG 5-gender equality.

Part II: Enhancing Breastfeeding Experience and Self-Efficacy in Opioid-Dependent Breastfeeding Mothers—Results From the PeriWell Intervention

Objective:The PeriWell project integrates the Positive Direction Model and the Tri-Core Breastfeeding Model into a virtual support program tailored to peripartum mothers in substance use recovery. PeriWell addresses the unique challenges this population faces by offering tailored, wraparound support. This manuscript, part of a two-part series, highlights the project’s outcomes, demonstrating significant implications for maternal health practices by fostering an environment of empowerment and lactation wraparound support.Methods:This longitudinal quality improvement (QI) project spanned 24 months (2019–2021) during the COVID-19 pandemic. It involved 15 peripartum mothers in substance use recovery engaging in a virtual, single-site program. The project was approved as a QI initiative by the Institutional Review Board (IRB reference 2018-19, #89), ensuring ethical adherence and participant safety. Participants provided voluntary consent and were recruited from obstetrics and gynecology offices in Upstate New York. To evaluate participants’ confidence and belief in their breastfeeding abilities, we received author permission and utilized the validated Breastfeeding Self-Efficacy Scale-Short Form (Dennis &amp; Faux, 1999; Dennis, 2010), guiding the tailored support provided.Results:Results indicated a significant increase in prenatal breastfeeding confidence correlated with the PeriWell approach (r= .782,n= 14,p&lt; .001). Participants reported improved self-confidence in latching techniques and a greater appreciation of the time commitment required for successful breastfeeding. Correlational relationships provided valuable insight to enhance and amplify breastfeeding support. The findings advocate for the inclusion of targeted specialized interventions in maternal care to better meet the needs of expecting individuals.Conclusion:Cultivating a supportive peripartum environment is fundamental to maternal-child healthcare, and the PeriWell project demonstrated the efficacy of integrating tailored, virtual peripartum and breastfeeding support for expecting and postpartum mothers in substance use recovery. This quality improvement project improved maternal and infant health outcomes, such as breastfeeding self-efficacy, and highlighted the importance and value of specialized, wraparound lactation support for vulnerable populations. These findings underscore the need for continued innovation in maternal health services, particularly through empowerment and promoting breastfeeding success in recovery settings.

Optimization of timing for maternal immunization to protect newborns from influenza infection

Objectives The primary objective of this systematic review was to identify the optimal timing for immunizing pregnant women to confer the most protection by reducing the incidence of laboratory-confirmed influenza or influenza-like illness in infants less than 6 months of age. Currently, there are gaps in research regarding the timing of administration during the gestational period to provide maximum immunogenicity to the infant. The research question being addressed is: ‘When considering immunization of pregnant mothers with the influenza vaccine, implementing a vaccination program during which trimester in pregnancy would optimize benefits for infants less than 6 months of age in terms of the incidence of laboratory-confirmed influenza and influenza-like illness?’ Design Systematic review/Meta-analysis Methods Randomized controlled trials (RCT’s) and observational studies comparing health outcomes of infants and children up to 6 months of age born to women who received inactivated influenza vaccine during pregnancy with mothers who did not receive the vaccine or received a control vaccine. The primary outcome was laboratory-confirmed influenza infection in infants. Secondary outcome measures included influenza –like illness diagnosed by a clinician and acute respiratory illness. Results 7 studies were included: 2 primary RCT’s and 5 observational studies (prospective and retrospective cohort studies).5 of the 7 studies were suitable to be included in the quantitative synthesis part and and were compared. Forrest plot analysis revealed that vaccinating pregnant mothers in the second and third trimester when compared with any trimester (1,2 and 3) (OR 0.18 vs. 0.65) conferred less protection, promoting vaccination in the first trimester. Conclusions Vaccinating pregnant mothers in the first trimester conferred greater protection to infants than any other trimester.

Application of time series analysis in predicting postpartum depression: integrating data from the hospitalization period and early postpartum weeks.

This study aimed to explore the dynamic changes in postpartum depressive symptoms from the hospitalization period to 4-8 weeks postpartum using time series analysis techniques. By integrating depressive scores from the hospital stay and the early postpartum weeks, we sought to develop a predictive model to enhance early identification and intervention strategies for Postpartum Depression (PPD). A longitudinal design was employed, analyzing Edinburgh Postnatal Depression Scale (EPDS) scores from 1,287 postpartum women during hospitalization and at 4, 6, and 8 weeks postpartum. Descriptive statistics summarized demographic characteristics. Time Series Analysis using the Auto-Regressive Integrated Moving Average (ARIMA) model explored temporal trends and seasonal variations in EPDS scores. Correlation analysis examined the relationships between EPDS scores and demographic characteristics. Model validation was conducted using a separate dataset. EPDS scores significantly increased from the hospitalization period to 4-8 weeks postpartum (p < .001). The ARIMA model revealed seasonal and trend variations, with higher depressive scores in the winter months. The model's fit indices (AIC = 765.47; BIC = 774.58) indicated a good fit. The Moving Average (MA) coefficient was - 0.69 (p < .001), suggesting significant negative impacts from previous periods' errors. Monitoring postpartum depressive symptoms dynamically was crucial, particularly during the 4-8 weeks postpartum. The seasonal trend of higher depressive scores in winter underscored the need for tailored interventions. Further research using longitudinal and multi-center designs was warranted to validate and extend these findings. Our predictive model aimed to enhance early identification and intervention strategies, contributing to better maternal and infant health outcomes.

Impacts of Different Perinatal Factors on Faecal Immune Compounds in Infants: Determination of Normal Values.

The gut microbiota is a key and primary stimulus for the development of a host's immune system. The early establishment of the gut microbiota is affected by several perinatal factors but little is known about their influence on shaping normal immune development and, consequently, on the programming of future health. The analysis of different immune compounds is well-documented in serum samples; however, their presence in faecal samples has not been studied, and this information could be valuable in early life. In this context, the authors of this study aimed to both describe the immunological faecal profile of a cohort of one-month-old infants and describe the impact of different perinatal factors, exploring possible associations between immune compounds and gut microbiota in faecal samples. Clear differences in immune profile were observed between full-term and premature infants. Breastfeeding increases IgG2, IgG4, and IgA; in addition, male babies showed some increased Igs, among other observations. Overall, the findings of this study reinforce the hypothesis that microorganisms and immune compounds interact with each other in the early neonatal gut and that understanding these interactions in depth will help us comprehend the influence of the gut microbiota on short- and long-term infant health outcomes.

Australian women’s experiences and perceptions of interconception care: a qualitative descriptive study

BackgroundInterconception, the time between pregnancies, is an opportunity to improve the health outcomes of women, infants and subsequent pregnancies. Interconception care involves the assessment of previous pregnancy outcomes, management of...

How do physicians respond to new medical research?

What happens when the findings of a prominent medical study are overturned? Using a medical trial on breech births, we estimate the effect of the reversal of such a medical study on physician choices and infant health outcomes. Using the United States Birth Certificate Records from 1995 to 2010, we employ a difference-in-differences estimator for C-sections, low Apgar, and low birth weight measures. We find that the reversal of a multi-site, high profile, randomized control trial on the appropriate delivery of term breech births, the Term Breech Trial, led to a 15%-23% decline in C-sections for such births at a time when the overall trend in C-sections was rising. We find our largest estimated effects amongst traditionally disadvantaged groups (i.e., non-white, and minimal education). However, we do not find that such a change in practice had significant impacts on infant health. Contrary to prior studies, we find that physicians updated their beliefs quickly, and do indeed adjust to new medical research, particularly young physicians, prior to mandatory policy or professional guidelines.

Impact of Digital Health Interventions on Birth Equity: A Review.

The rise in smartphone utilization and technology uptake has popularized digital health interventions as a means of supporting healthy pregnancies and optimizing maternal and child health. Digital health interventions include several modalities, such as telemedicine, remote patient monitoring, smartphone applications, web-based interventions, wearables, and health information technology. However, the impact of these interventions on improving maternal and infant health outcomes by race and socioeconomic status to achieve birth equity is unknown. This review summarizes current literature on the impact of digital health interventions on the outcomes of communities of color and lower socioeconomic status in the United States. We demonstrate there is emerging evidence of the impact of digital health interventions on maternal health outcomes, particularly for telemedicine, but evidence specifically focused on assessing outcomes by race and ethnicity and for other modalities, like mHealth apps or wearables, is limited. Digital health interventions may play a part in birth equity initiatives, but should not be considered a standalone solution, and instead should be integrated into other existing efforts to achieve birth equity, like diversifying the clinician workforce, expanding access to high-quality prenatal and postpartum care, or delivering respectful maternity care.

Improving Maternal and Infant Outcomes through Enhanced Midwifery Practices

Improving maternal and infant health outcomes remains a critical challenge in healthcare systems worldwide. This study investigates the role of enhanced midwifery practices in improving these outcomes by examining various interventions and approaches that midwives can implement. Using a mixed-methods approach, data were collected from 150 midwives across different healthcare settings, including urban and rural areas, over a six-month period. The research focused on key factors such as the application of evidence-based care, continuity of care, patient education, and culturally sensitive practices. The results show that midwifery practices emphasizing patient-centered care, continuous monitoring, and active collaboration with other healthcare professionals significantly improved maternal outcomes, such as reduced rates of complications during labor and delivery, as well as lower instances of postpartum hemorrhage. Moreover, infants born under these enhanced practices showed better health metrics, including higher Apgar scores and reduced neonatal mortality rates. One notable finding was the positive impact of culturally sensitive practices in communities with diverse populations, where understanding and integrating cultural beliefs into care plans led to increased patient satisfaction and improved health outcomes. Despite these findings, the study also highlights certain limitations, such as the restricted geographical scope and the need for further research to explore the long-term effects of these enhanced practices. Nevertheless, this research provides evidence that by adopting comprehensive and patient-centered midwifery approaches, maternal and infant health outcomes can be significantly improved. Future studies with larger sample sizes and broader geographical coverage are recommended to further validate these results.