Pregnant American Women Research Articles

Preventive Care-Seeking Among Inner-City African American Pregnant Women

Preventive Care-Seeking Among Inner-City African American Pregnant Women

Resource Loss, Resource Gain, and Communal Coping During Pregnancy Among Women with Multiple Roles

We investigated stress, coping, and employment status in 92, mostly European American pregnant women. Conservation of Resources (COR) theory (Hobfoll, 1988, 1989) was applied as a specification of role-quality theory to examine the stressful influences of women's multiple roles. Women's resource loss predicted psychological distress better than either their resource gains or their employment status (i.e., multiple versus single roles). Full-time employed women were significantly more distressed under high loss conditions than were part-time or nonemployed women. Examining women's coping strategies based on a communal model of coping, we found that active, prosocial coping was associated with better emotional outcomes. A significant interaction was found for the effects of loss × cautious action such that loss was related to greater depression, but only among women who did not employ cautious action.

Nursing case management and its role in perinatal risk reduction: development, implementation, and evaluation of a culturally competent model for African American women.

The authors outline the need for comprehensive perinatal services management for African American pregnant women, based on social/environmental stressors, and propose a workable model for delivery of services based on case management principles. The implications of case management as an intervention to ameliorate these stressors are discussed. Data from 5 years of comprehensive case management are included to support the effectiveness of case management as an intervention among high-risk women. Steps utilized to develop, implement, and evaluate case management are also discussed.

A randomized trial of an empirically-derived social support intervention to prevent low birthweight among African American women

Previous clinical trials of social support interventions to reduce low birthweight (LBW) have not fully capitalized on findings from social science research, and therefore have not used empirically-derived criteria to define a low social support population or to develop the intervention. To overcome limitations of previous studies, this randomized clinical trial tested the hypothesis that an empirically-derived social support intervention would reduce LBW among African American women. Based on prior work, African American women were identified as at-risk for LBW due to inadequate social support if they lacked support from their mothers or male partners. Focus groups were used in this study to develop a culturally-relevant intervention. Adult low-income African American pregnant women ( n = 319) were tested for inadequate social support in mid-pregnancy. Of these, 114 (36%) low-support women were identified and randomly assigned to the intervention group ( n = 56) or control group ( n = 58). The intervention was designed to provide the support usually provided by the pregnant woman's mother or male partner. It consisted of four standardized face-to-face sessions at two week intervals and telephone contact in the intervening weeks. Birthweight was obtained blinded from charts or birth certificates, with 99% follow-up. The rate of LBW (below 2500 grams) was 9.1% in the intervention group compared to 22.4% in the control group ( P < 0.05). Contrary to previous studies, this social support intervention was effective in reducing the rate of LBW. It is promising that this intervention was successful for African Americans because the rate of LBW is twice as high among African Americans than among Caucasians.

Relationships of Substance Abuse to Dietary Intakes and Anthropometric Measurements in Urban African American Pregnant Women.

LEARNING OUTCOME: Through the use of anthropometric measurements, examine the impact of alcohol and substance abuse on the nutritional status of pregnant women.Relationships of illicit and licit drugs to dietary intakes and anthropometric measurements were examined in 163 urban African American pregnant women. Socio-demographic and dietary data were collected via questionnaires. Maternal anthropometric measurements were determined from the participants’ medical records. Fasting blood samples were screened for marijuana, heroin, opiate and phencyclidine (PCP). The participants were designated as drug users, trace drug users and non-drug users based on screening threshold concentrations. Drug use was determined by self reports and biochemical analysis. Prevalence of self reported drug use was lower than the prevalence based on biochemical analysis. Chi-square analysis showed significant relationships between smoking and use of alcoholic beverages (P<0.05). No significant differences were noted when the soda-demographic characteristics were compared. Kilocalories, protein, vitamin A, ascorbic acid, thiamin, riboflavin, niacin, vitamin B12 and phosphorus were consumed consistently in amounts equal to or exceeding 100% of the Recommended Dietary Allowances (RDA). Vitamin B6, calcium, folate, iron, magnesium and zinc were consumed in amounts below the RDA. No significant differences in food energy and nutrient intakes were found among the groups (P>0.05). The maternal anthropometric measurements though similar among the three groups, were mainly highest among the drug using group.

Weight, self-esteem, ethnicity, and depressive symptomatology during pregnancy among inner-city women.

The relationship of weight and self-esteem to depressive symptomatology was examined among 36 African American and 96 European American pregnant inner-city women. Lower self-esteem and higher deviations from medically ideal weight predicted increased dysphoria during the 3rd trimester for European American women, but only lower self-esteem predicted increased dysphoria for African American women. These results support the hypothesis that African Americans are less likely than European Americans to experience negative psychological repercussions of greater weight. Consistent with findings among nonpregnant middle-class samples, these results extend the association between heavier weight and increased risk for psychological distress to pregnant women of European American descent.

Time series analyses reveal differential impact of the Alcohol Warning Label by drinking level

This paper uses time series analysis to examine the impact of the Alcoholic Beverage Warning Label on the attitudes and drinking behavior of 3,572 African American pregnant women. The results indicate that knowledge of the Warning Label increased 3 months after the implementation of the law. Drinking during pregnancy declined after a 7 month lag only among non-risk drinkers, although birthweight showed no trends. This analysis illustrates the importance of controlling for timing, history and behavior of subgroups when studying the impact of a natural experiment.

Mineral status and blood pressure levels in African American pregnant and non-pregnant women

Mineral status and blood pressure levels in African American pregnant and non-pregnant women

Another look at the Dalkon Shield: Meta-analysis underscores its problems

Numerous non-comparative clinical trials of the Dalkon Shield appear to provide ample evidence that the Dalkon Shield was an effective IUD; they seem to yield little evidence that it was a dangerous device, nor markedly different from its contemporaries. Equating the performance of the Dalkon Shield IUD to that of the Lippes Loop or of Copper IUDs is erroneous, however, with respect to rates of pregnancy, expulsion, pelvic infection, septic abortion, death with the device in situ, and tubal infertility. Randomized studies show the Dalkon Shield had approximately double the pregnancy rates of the Lippes Loop D or Copper IUDs (P < .05) and a significantly lower expulsion rate. These differences coupled together with the distinguishing multifilament tail of the Dalkon Shield underlay the higher rates of pregnancy complications, including septic abortions with the device in situ and deaths, associated with the Shield. A five-fold increased risk of hospitalized pelvic infection among Dalkon Shield users found in the Women's Health Study resulted not from ascertainment bias, but was related to the fact that Dalkon Shield users had more severe hospitalized PID than did other hospitalized women with PID and IUD use. Following cessation of distribution and of use of the Dalkon Shield, and following the FDA's recommendation to remove IUDs in case of pregnancy, there have been no deaths reported among pregnant American women with an IUD in situ in a 5-year period. Neither the IUDs of today nor those in use during 970–974 are equatable to the Dalkon Shield.

Nicotine Replacement Therapy During Pregnancy

CIGARETTE smoking is a major preventable cause of fetal death and injury, yet many women continue to smoke cigarettes throughout pregnancy. The most effective pharmacologic adjunct to smoking cessation therapy is nicotine replacement, including nicotine chewing gum or transdermal nicotine. However, the use of nicotine replacement therapy is contraindicated during pregnancy. The analysis presented herein suggests that the benefits of nicotine replacement therapy to aid smoking cessation in pregnant women who cannot stop smoking without such therapy substantially outweigh the risks of continued smoking or the risks of nicotine replacement per se. <h3>PREVALENCE OF CIGARETTE SMOKING DURING PREGNANCY</h3> Although the prevalence of smoking has declined in recent years and many women quit smoking when they become pregnant, 20% to 25% of pregnant American women continue to smoke throughout pregnancy; many of these women are heavy smokers. The National Health Interview survey of women pregnant in 1985 or with a birth

Determination of Numbers of Lead-Exposed Women of Childbearing Age and Pregnant Women: An Integrated Summary of a Report to the U.S. Congress on Childhood Lead Poisoning

In a Congressionally mandated study carried out under the aegis of the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) and summarized in this article, the authors have provided estimates of the numbers of American women of childbearing age and the numbers of American pregnant women whose lead exposure is sufficiently elevated to pose an intrauterine toxicity risk. Exposures associated with such risk were defined as blood lead (PbB) levels greater than 10, greater than 15, greater than 20, and greater than 25 micrograms/dL. Using PbB prevalence projection techniques based on the Second National Health and Nutrition Examination Survey (NHANES II), we first generated projected 1984 prevalences of these PbB levels in white and black women of childbearing age, ages 15 to 19 and 20 to 44. White women in the two age bands had rates of PbBs greater than 10 micrograms/dL of 9.2 and 9.7%, respectively. For black women, the corresponding rates were 8.2 and 19.7%, respectively. Combining these rates with standard metropolitan statistical areas (SMSAs) based 1980 Census and other population enumerations show, for example, that 4.4 million U.S. women of childbearing age are estimated to have had PbBs greater than 10 micrograms/dL. Pregnant black and white women in U.S. SMSAs are approximately 9% of the U.S. black and white childbearing age total, i.e. 3.6 million out of a 41.3 million SMSA total. Of these, 403,200 pregnant women were estimated to have PbB levels greater than 10 micrograms/dL.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of numbers of lead-exposed women of childbearing age and pregnant women: an integrated summary of a report to the U.S. Congress on childhood lead poisoning.

In a Congressionally mandated study carried out under the aegis of the U.S. Agency for Toxic Substances and Disease Registry (ATSDR) and summarized in this article, the authors have provided estimates of the numbers of American women of childbearing age and the numbers of American pregnant women whose lead exposure is sufficiently elevated to pose an intrauterine toxicity risk. Exposures associated with such risk were defined as blood lead (PbB) levels greater than 10, greater than 15, greater than 20, and greater than 25 micrograms/dL. Using PbB prevalence projection techniques based on the Second National Health and Nutrition Examination Survey (NHANES II), we first generated projected 1984 prevalences of these PbB levels in white and black women of childbearing age, ages 15 to 19 and 20 to 44. White women in the two age bands had rates of PbBs greater than 10 micrograms/dL of 9.2 and 9.7%, respectively. For black women, the corresponding rates were 8.2 and 19.7%, respectively. Combining these rates with standard metropolitan statistical areas (SMSAs) based 1980 Census and other population enumerations show, for example, that 4.4 million U.S. women of childbearing age are estimated to have had PbBs greater than 10 micrograms/dL. Pregnant black and white women in U.S. SMSAs are approximately 9% of the U.S. black and white childbearing age total, i.e. 3.6 million out of a 41.3 million SMSA total. Of these, 403,200 pregnant women were estimated to have PbB levels greater than 10 micrograms/dL.(ABSTRACT TRUNCATED AT 250 WORDS)

Consequences of Prenatal Exposure to Diethylstilbestrol

Exposure to the drug diethylstilbestrol (DES) during the first 18 weeks of prenatal life can have many results ranging from benign misconfigurations of the reproductive organs to adenocarcinoma. Since the drug was routinely administered to pregnant American women from 1940 to 1970, a large population of Americans are involved. The key factor is early awareness to the exposure and careful follow-up. Since many of those exposed are unaware that they received DES, the health care profession must be attuned to the signs and symptoms predisposed by the exposure and be able to provide adequate follow-up and education concerning this medical problem.

Genital infection with TRIC agents in Taiwan

Agents of the trachoma-inclusion conjunctivitis type (TRIC agents) have been recovered from the ocular and genital tracts of men and women. This study is an attempt to define the prevalence of cervical TRIC agents in Taipei. Two of 86 pregnant Chinese women yielded TRIC agents one or more times. One infant developed inclusion conjunctivitis. None of 33 pregnant American women and one of 29 American and Chinese women attending family planning clinics in Taipei harbored cervical TRIC agents. Two of 59 prostitutes yielded the same cervical organisms. Only the pregnant women had significant cervicitis. None of the genital strains recovered were of the same two types of TRIC agent recovered on numerous occasions from ocular trachoma in Taiwan. The possibility that endemic ocular trachoma and genital TRIC agent infections are distinct etiologic entities is discussed.