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M&SIII > Infant and Maternal Mortality > Flashcards

Infant and Maternal Mortality Flashcards

1
Q

Infant Mortality

A

Death of an infant before 1st birthsay

Provides key information about state of intant and maternal health

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2
Q

Infant Mortality Rate (IMR)

A

annual number of infants death per 1000 live births (can be gestational age specific)

(US 6.1/1000)

Non-hispanic black have the highest rate

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3
Q

Why are babies dying?

A

Birth defects

Preterm and low birth weight

Maternal pregnancy complications

sudden infant death syndrome

Injuries (suffocation)

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4
Q

Birth rate

A

total nmber of live birhs per 1000 in a population (in a year or designated period)

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5
Q

premature delivery

A

delivery of neonate <37 weeks gestation

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6
Q

premature birth rate

A

number of live births to infants in a specific gestational age category divided by all live burths excluding those missing data on gestational age multiplied by 100

(getting worse by year)

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7
Q

Maternal mortality

A

women dies while pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

each year about 700 women die of pregnancy related causes

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8
Q

MAternal Mortality rate (MMR)

A

annual number of maternal deaths per 100,000 live births

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9
Q

Why are moms dying?

A

Inequalities in access to quality health care -> disparities

Nearly 75% of global maternal death are caused by

Severe bleeding

infetions

high blood pressure

delivery complication

unsafe abortion

undermanagement of chronic conditions - cardiac conditions, diabetes

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10
Q

African Americans are __________ more likely to die of pregnancy complication than white women

A

3 to 4 times

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11
Q

Women age ______ are almost _____ more likely to die of pregnancy complications vs women 20-24

A

age 35-39

2 x

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12
Q

Washington DC maternal mortality rate

A

41.6/100,000

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13
Q

Contributors to infant and maternal mortality

A

Obesity/Exercise (causes metabolic disease states that increase risk of preterm delivery)

Birth spacing (in us, 33.1% <18m, increase risk of premature birth and other adverse efects, ideal 1.5 years)

Maternal smoking (increase risk for preterm labor, ectopic pregnancy, placental patholog, miscaraige/stillbirth, baby at risk for birth defects, low birth weight, SIDS)

Insured or not

SUIDs (sudden unexpected infant death, sudden infant death syndrome, unknown, accidental suffocation and strangulation in bed)

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14
Q

Social Determinants of HEalth

A

Environment

Economis

Social

Health Care

Education

Food

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15
Q

Structural Determinants of Health Inequalities

A

Governance and Policies

Culture and Social Values

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16
Q

Governance and Policies

A

Education

Health Finance and Infrastructure

Social Protection

Law (gender equality, anti-violence)

reproductive health and rights

17
Q

Culture and Social values

A

Womens staus

gender norms

religion

health beliefs

social cohesion

18
Q

Intermediary Determinants of Health

A

Health Services

Community Context

Family and Peer Influence

Individual Attributes

19
Q

Health Services

A

Availability of relevant services

staff skills and technical competence

acceptability to the community

fees and related cost

20
Q

Community context

A

Rural/urban residence

social position class, wealth, ethnicity,

awarness of care

perceptions of quality

distance to facilities

social capital

21
Q

Family and peer influence

A

family structure and decision making

mental relationship

spousal communication

income

access to resources

support network

22
Q

Individual attributes

A

age

number of children

knowledge

self efficacy

(MATERNAL HEALTH OUTCOMES)

23
Q

How can we keep the babies from dying?

A

Improve pre-natal care

skilled practioners during birth

access to emergency obsterics and newborn care

postnatal visits

adequate nutrition and education

decrease number of unwanted pregnancies

24
Q

Pre-natal care

A

Preconception counseling

mom in best health possible (chronic condition management)

25
Q

Once they are pregnant

A

initiate in first trimester

doctor visist every 4 week until 28 weeks, then every 2 weeks until 36 week, then weekly untl delivery

anticipatory guidance

prep for social support

26
Q

Preconception care

A

Ideal time to identify risk to a person’s health

about people getting and staying healthy overall, throughout their lives

for babies, preconception health means their parents to steps to get healthy before preganncy (decrease in preterm and LBW babies)

Things considered:

  • manangement of chronic conditions

nutrition counseling - folic acid

immunizations

IPV and depression screening

tabacco cessation and substance abuse

27
Q

Prenatal care

A
  • CAre while baby is cooking
    • monitor mom and baby’s health
    • ideal time for teaching
    • anticipatory guidance: nutrition, healthy behaviors, substance abuse, IPV, denal care
    • delivery preperations
  • Ideal start ASAP (or earlier)
  • Routine testing and genetic screening
  • Inadequate care is linked to increased maternal and neonatal mortality
28
Q

Post partum care

A

2-6 weeks after delivery

anticipatory guidance: family planning, breastfeeding, management of family dynamics, depression

Also assessing baby’s life on earth

29
Q

Anticipatory guidance

2-4 weeks

A
  • Issues: sleep (position), feeding, crying, response, growth

–Safety: car seats, exposure to smoking, shaking baby

30
Q

Anticipatory guidance

2 mo

A

–Issues: sleep (position), feeding, growth

–Safety: burns, sun exposure, smoking, car seats, shaking baby

31
Q

Anticipatory guidance

4mo

A

–Issues: introducing food, sleep, talking to baby

–Safety: falling, car seats

32
Q

Anticipatory guidance

6mo

A

–Issues: food

–Safety: child-proofing house, poisons, walkers, car seats

33
Q

Anticipatory guidance

9mo

A

–Issues: table food, using cup, teeth

–Safety: drowning, burns, car seats

34
Q

Anticipatory guidance

A

–Issues: weaning, brushing teeth, lead screening, playing with baby

–Safety: child-proofing house, choking, car seats

35
Q

BRreastfeeding

A
  • AAP, AAFP & WHO recommend exclusively breastfeeding x6 months
  • Baby friendly initiatives
  • Initiate within one hour of birth
  • Lactation support is vital

Activities, attitudes and procedures during delivery impact breastfeeding

36
Q

Safe Sleep for baby

A

Place baby in prone position to sleep

  • baby sleeps in a crib, bassinet, or pack n play
  • baby sleeps alone
  • use a one piece sleeper
  • use firm matterss with fitted sheets
  • baby sleeps on his back
  • make a bare naked sleep area - no pillows, blankets, bumper pads or toys
37
Q

Increase risk of pre-term birth

A

Socioeconomic status at both the individual and community level (e.g., income/poverty, job status, education) as well as psychosocial factors (e.g., chronic stress, lack of social support

M&SIII (10 decks)

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