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National Maternal (national + maternal)
Selected AbstractsMaternal health: does prenatal care make a difference?HEALTH ECONOMICS, Issue 5 2006Karen Smith Conway Abstract This research attempts to close an important gap in health economics regarding the efficacy of prenatal care and policies designed to improve access to that care, such as Medicaid. We argue that a key beneficiary , the mother , has been left completely out of the analysis. If prenatal care significantly improves the health of the mother, then concluding that prenatal care is ,ineffective' or that the Medicaid expansions are a ,failure' is premature. This paper seeks to rectify the oversight by estimating the impact of prenatal care on maternal health and the associated cost savings. We first set up a joint maternal,infant health production framework that informs our empirical analysis. Using data from the National Maternal and Infant Health Survey, we estimate the effects of prenatal care on several different measures of maternal health such as body weight status and excessive hospitalizations. Our results suggest that receiving timely and adequate prenatal care may increase the probability of maintaining a healthy weight after the birth and, perhaps for blacks, of avoiding a lengthy hospitalization after the delivery. Given the costs to society of obesity and hospitalization, these are benefits worth exploring before making conclusions about the effectiveness of prenatal care , and Medicaid. Copyright © 2006 John Wiley & Sons, Ltd. [source] The efficacy of the non-stress test in preventing fetal death in post-term pregnancyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2001Tong Li Summary We conducted a case,control study to examine the efficacy of non-stress testing in preventing fetal death in post-term pregnancy. The analysis was based on data from the 1988 National Maternal and Infant Health Survey, which was a nationally representative sample of live births, fetal deaths and infant deaths that occurred in 1988. Information on whether a woman had non-stress testing was obtained from a questionnaire sent to prenatal care providers and hospitals. Cases were post-term women (with 42 weeks or more gestation) who had fetal deaths. Three post-term controls, who had live births and who delivered at the same time or later than the cases, were randomly chosen and individually matched to each case by maternal race. The proportion of women who had one or more non-stress tests during pregnancy was compared between cases and controls. Non-stress testing was used in 30.9% of the 126 cases and in 28.5% of the 375 controls. The race-adjusted odds ratio for exposure to non-stress test was 1.12 [95% CI 0.72, 1.75]. After controlling for other important confounding variables the odds ratio was 1.05 [95% CI 0.57, 1.91]. These results do not support the efficacy of non-stress testing in post-term pregnancies. A more detailed evaluation of this widely used screening procedure is needed. [source] Taiwan's High Rate of Cesarean Births: Impacts of National Health Insurance and Fetal Gender PreferenceBIRTH, Issue 2 2007Tsai-Ching Liu PhD ABSTRACT: Background: Taiwan has a high rate of cesarean section, approximately 33 percent in the past decade. This study investigates and discusses 2 possible factors that may encourage the practice, one of which is fetal gender difference and the other is Taiwan's recently implemented National Health Insurance (NHI). Methods: A logistic regression model was used with the 1989 and 1996 National Maternal and Infant Health Survey and with the 2001 to 2003 NHI Research Databases. Results: Using survey data, we found a statistically significant 0.3 percent gender difference in parental choice for cesarean section. However, no statistically significant difference was found in the rate of cesarean section before and after NHI implementation. Conclusions: Taiwan's high cesarean section rate is not directly related to financial incentives under NHI, indicating that adjusting policy to lower financial incentives from NHI would have only limited effect. Likewise, focusing effort on the small gender difference is unlikely to have much impact. Effective campaigns by health authorities might be conducted to educate the general population about risks associated with cesarean section and the benefits of vaginal birth to the child, mother, and society. (BIRTH 34:2 June 2007) [source] Effects of Poverty and Maternal Depression on Early Child DevelopmentCHILD DEVELOPMENT, Issue 6 2001Stephen M. Petterson Researchers have renewed an interest in the harmful consequences of poverty on child development. This study builds on this work by focusing on one mechanism that links material hardship to child outcomes, namely the mediating effect of maternal depression. Using data from the National Maternal and Infant Health Survey, we found that maternal depression and poverty jeopardized the development of very young boys and girls, and to a certain extent, affluence buffered the deleterious consequences of depression. Results also showed that chronic maternal depression had severe implications for both boys and girls, whereas persistent poverty had a strong effect for the development of girls. The measures of poverty and maternal depression used in this study generally had a greater impact on measures of cognitive development than motor development. [source] | ||||||||||