US Health final exam - maternal & child health Flashcards
Maternal and child
where is this on the list of priorities of PH?
what do they want to assure
what does the evidence say about the connection of conditions in utero/early life to later in life?
The health of pregnant women and children is one of the highest priorities of public health
Want to assure the best possible start to life
Evidence shows conditions in utero and during early life play an important role later in life in regards to susceptibility to chronic diseases
what is IMR
what is Infant Mortality
what number is the rate out of
factors that affect the health of the entire population also impact what
Infant Mortality Rate (IMR)
Infant mortality is considered the death of an infant before their first birthday
The rate is given per 1000 live births
Factors that affect the health of the entire population can also impact the mortality rate of infants
IMR is low in industrialized countries but high in developing places
high IMR = PH & infrastructure and life is really difficult and not conducive to having healthy children
color of skin and zip code can determine health outcome
Importance of infant and child health
what do fetal and infant stages provide
who are the most vulnerable group in society
what is IMR an indicator of
how does infant mortality in blacks compare to white and is this indicative of
Fetal and infant stages of development provide the foundations of good health throughout life
Children are the most vulnerable group in society
Infant mortality rate (IMR) is an indicator of the health status of a population
Infant mortality rate is more than double for US blacks than whites, indicative of a health disparity
Key birth statistics in USA
which state in the U.S has the highest IMR
The current infant mortality rate for the U.S. in 2023 is5.480deaths per 1000 live births, a1.21% declinefrom 2022.
States with the highest IMR:
Mississippi (poorest state): 9.39
Arkansas: 8.59
MA- 3.23 and NH 3.96
chart
when comparing different races
there is a difference between ethnicity and infant mortality
Social Factors in infant mortality
what is the #1 risk factor/cause for infant mortality
Why does low SES increase the risk? because there are:
- what kind of hazards
- is there good food
- who’s behavior imposes a risk
- what 3 things are prevalent
- what kind of factors
- who is young, is it safe, are they married
- is there prenatal care
Number one risk factor/cause is poverty
Why does low SES increase the risk? because there are:
Environmental hazards
Poor nutrition
Maternal risk behaviors
Smoking, alcohol, illegal drugs
Social factors
Young maternal age, violence, out of wedlock birth, stress, lack of social support
Lack of prenatal care
How does poverty affect women and infants
is there enough money to have a good diet for a healthy baby
is there access to fresh fruits and veggies, are they cheap
do women know how to make healthy meals
do these women often breast feed
Not enough money to have a nutritious diet to nourish fetus
Access to fresh fruits and vegetables are not readily available –or too expensive
Lack of knowledge of how to prepare nutritious meals
Breastfeeding is not commonly practiced in women of lower SES
Top reasons for infant mortality in the US
defects in what
are they full term and do they have the normal weight
do they get hurt and if so what in what way
does the mom ever have complications with pregnancy
Birth defects
Preterm birth & low birth weight
Injuries (i.e. suffocation, MV accidents)
Sudden Infant Death Syndrome (SIDS)
Maternal pregnancy complications
Prenatal Care
where does it rank in the public health-oriented kind of care
what does it give to women
poor women are linked with who
who collects prenatal care data
Prenatal care is the most public health-oriented kind of care the medical professional provides
It provides women with information
Problems are diagnosed early
Poor women are often linked with social services
State and federal governments collect prenatal care data
CDC recommends screening and treatment of all pregnant women for common infections
Outreach programs are needed for women who do not seek early prenatal care
Preventing birth defects
what kind of testing is done
what does the FDA regulate
reduction in medication for who and why
who is immunized and against what kind of disease
dietary supplements with what
Genetic and newborn testing
FDA regulation of teratogenic drugs
Warning against alcohol for pregnant women
Reduction of prescribed pain medications during pregnancy
- They may increase risk of congenital heart defects and neural tube defects in fetus
Immunization of all children against rubella
Dietary supplements with folic acid
Preventing low birth weight
are causes of low birth weight understood
what kind of disease is associated with preterm births
what could the recent increase in low brth weight be due to
what are the two preventative measures
Causes of low birth weight are not well understood
Recent evidence suggests that gum disease is associated with preterm births
Periodontal treatment may reduce risk
Recent increase in low birth weight may be due to multiple births-IVF
Preventative measures:
Prenatal care
Reduction of adolescent pregnancy
Sudden Infant Death Syndrome (SIDS)
who is SIDs common in
what campaign led to the dramatic decline in SIDS
IN 2013, SIDS fell to less than how much of what it was in 1990s
SIDS is also listed as the cause of death when what and is the term for this
SIDS is common in infants of low birth weight and in infants of smokers or drug users
“Back to Sleep” campaign led to dramatic decline in SIDS
By 2013, SIDS fell to less than one third of what it was in 1990’s
SIDS is listed as cause of death only if no other explanation is found - diagnosis of EXCLUSION
sleep diagram
don’t overheat or overdress them
Environmental Issues
where was there a mercury contamination
where is lead common in
what were pesticides known to cause and what did where does the result rank in IMR
where can organic solvents be absorbed and what can this cause
Mercury contamination - contamination of bay in Japan
Lead-common in American inner cities-lead paint and older plumbing
Pesticides-identified as causing birth defects one of the leading causes of infant mortality
Organic solvents-can be absorbed through the skin - cause of birth defects
no mercury while pregnant!
Environmental exposures include and what does each cause
Tobacco smoke—increase
Viruses- rubella—
Heavy metals –
brain development
Drugs: legal drugs
The FDA has identified certain teratogen drugs (phenytoin, thalidomide, Accutane. etc…)- these tend to be Category X drugs
Environmental exposures include:
Tobacco smoke—increase risk of cleft palate/lip
Viruses- rubella—deafness, mental retardation
Heavy metals – increase risk of miscarriage, brain development
Drugs: legal drugs
The FDA has identified certain teratogen drugs (phenytoin, thalidomide, Accutane. etc…)- these tend to be Category X drugs
Environmental exposures:Maternal behaviors
what do drugs lead to
- what do infants suffer from
- what is permanently impaired
what is alcohol considered to be
- what kind of syndrome can it cause in fetuses
all of these behaviors are not limited in what
Drugs: illegal drugs:
-“crack babies”
-Infants suffer from withdrawal
-Permanent neurological impairments
Alcohol:
-A teratogen
-Fetal alcohol syndrome
All of these behaviors are not limited by SES
face of crack baby
Social Factors
In poorer neighborhoods:
- are the mothers young or old
- are they educated
- are they married when they give birth
- is their environment safe
- lack of what care has been linked with high risk of mortality in who
In poorer neighborhoods:
Young maternal age
Low maternal education
Out-of-wedlock births - really hard for single moms
Violence
Lack of prenatal care has been linked with a high risk of infant mortality
Barriers to seeking prenatal care
- do they have info about services
- are the hours convenient
- how long do they have to wait in the clinic
- do they have transportation
- can they find child care
- in some states, are they allowed prenatal care
Lack of information about available services
Inconvenient hours of service
Long waits at clinic
Inadequate transportation
Lack of child care for older children
Denial of prenatal care for immigrants in some states
Congenital Malformations
- what is it a factor in
- how much % of infant deaths
- through what method can genetic screening be done and for what diseases
A factor in infant mortality
20% of infant deaths
Genetic screening may be done via amniocentesis for:
Tay-Sachs disease
Hemophilia
Down Syndrome
