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Measurement Webinar - "Data Linkage" featuring Kimberlyn McGrail, PhD (Scientific Director, Population Data BC) and Anne Gadermann, PhD (Assistant Professor, Human Early Learning Partnership, School of Population and Public Health). August 1, 2019, 11am-noon PT. REGISTER HERE.

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From infant to mother: early disease environment and future maternal health

By Douglas Almond, Janet Currie and Mariesa Herrmann

This paper examines the links between the disease environment around the time of a woman’s birth and her health at the time she delivers her own infant. Our results suggest that exposure to disease in early childhood significantly increases the incidence of diabetes in the population of future mothers. The exposed mothers are less likely to be married, have fewer years of education, are more likely to gain over 60 pounds while pregnant and are more likely to smoke while pregnant. Not surprisingly then, exposure increases the probability of low birth weight in the next generation, at least among whites. Among whites, this effect remains when we control for maternal …

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Prenatal exposure to a natural disaster increases risk for obesity in 5½-year-old children

By Kelsey Needham Dancause, David P. Laplante, Sarah Fraser, Alain Brunet, Antonio Ciampi, Norbert Schmitz and Suzanne King

An adverse environment in utero, including exposure to prenatal maternal stress (PNMS), can result in poor birth outcomes such as low birth weight, which increases risk of later cardiometabolic diseases such as hypertension and obesity. It is unclear to what extent PNMS influences obesity risk independent of its impact on birth characteristics, especially among humans. Our objective was to determine whether PNMS resulting from a natural disaster influenced risk of childhood obesity. Read full article

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Closing the black-white gap in birth outcomes: a life course approach

By Michael C. Lu, Milton Kotelchuck, Vijaya Hogan, Loretta Jones, Kynna Wright and Neal Halfon

In the United States, Black infants have significantly worse birth outcomes than White infants. Over the past decades, public health efforts to address these disparities have focused primarily on increasing access to prenatal care, however, this has not led to closing the gap in birth outcomes. We propose a 12-point plan to reduce Black-White disparities in birth outcomes using a life course approach. The first four points (increase access to interconception care, preconception care, quality prenatal care and healthcare throughout the life course) address the needs of African American women for quality healthcare across the lifespan. The next four points (strengthen father involvement, systems integration, reproductive social capital and community …

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Effect of in utero and early-life conditions on adult health and disease

By Peter D. Gluckman, Mark A. Hanson, Cyrus Cooper and Kent L. Thornburg

A long latency period between an environmental trigger and the onset of subsequent disease is widely recognized in the etiology of certain cancers, yet this phenomenon is not generally considered in the etiology of other conditions such as cardiovascular disease, metabolic disease or osteoporosis. However, many lines of evidence, including epidemiologic data and data from extensive clinical and experimental studies, indicate that early life events play a powerful role in influencing later susceptibility to certain chronic diseases. An increased understanding of developmental plasticity (defined as the ability of an organism to develop in various ways, depending on the particular environment or setting) provides a conceptual basis for these observations. Developmental plasticity …

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Achieving safe motherhood: applying a life course and multiple determinants perinatal health framework in public health

By Dita P. Misra and Holly Grason

Safe motherhood has begun to be identified as a priority for the health of American women. We argue that safe motherhood can be achieved through application of a life course and multiple determinants framework. This framework, with its focus on the preconception period, poses a dilemma in that it links together periods of life and domains of activities that have traditionally not been linked with maternal health. The interests of women and children have often been juxtaposed in the making of policy. Further, the domains of women’s health, maternal and child health, and family planning have often clashed over policy priorities and funds. This framework shows that the research literature …

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Psychosocial stress and neuroendocrine mechanisms in preterm delivery

By JW Rich-Edwards and TA Grizzard

This review focuses on the contribution of psychosocial stress to the racial/ethnic disparities in preterm delivery in the United States and addresses the subset of psychosocial stressors that are disproportionately prevalent among minority women. We argue that chronic exposure to poverty, racism, and insecure neighborhoods may condition stress responses and physiologic changes in ways that increase the risk of preterm delivery. Cumulative stressors may impact pregnancy outcomes through several intersecting pathways, which include neuroendocrine, behavioral, immune, and vascular mechanisms. Many of these pathways also lead to chronic disease. It may be useful to consider preterm delivery as a chronic disease with roots in childhood, adolescence, and early adulthood. Like other …

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Integrated perinatal health framework: a multiple determinants model with life span approach

By Dita Misra, Bernard Guyer and Adam Allston

Despite great strides in improving prenatal care utilization among American women, key perinatal indicators have remained stagnant or worsened in the past decade and the United States continues to rank near the bottom compared to other developed countries.  A new approach is needed if we are to achieve improvements in perinatal health. The authors propose a new framework that integrates a “life span” approach with a multiple determinants model. Read full article

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Racial and ethnic disparities in birth outcomes

By Michael Lu and Neal Halfon

In the United States, Black infants have significantly worse birth outcomes than do White infants. The cause of these persisting racial disparities remains unexplained. Most extant studies focus on differential exposures to protective and risk factors during pregnancy, such as current socioeconomic status, maternal risky behaviors, prenatal care, psychosocial stress or perinatal infections. These risk factors during pregnancy, however, do not adequately account for the disparities. We conducted a literature review for longitudinal models of health disparities and presented a synthesis of two leading models using a life-course perspective. Traditional risk factors during pregnancy are then reexamined within their life course context. We conclude with a discussion of the limitations …

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Programming and reproductive function

By MJ Davies and RJ Norman

Here, we explore the influence of fetal programming and early life exposures on lifelong reproductive health through modification of the hypothalamic-pituitary-gonadal axis. A range of programming issues are considered with examples from the literature demonstrating that environmental or nutritive exposures have a crucial role in reproductive performance, fetal growth, postnatal development and reproduction-related disease risk. We pay particular attention to recent research on associations between indicators of fetal and postnatal growth and the etiology of polycystic ovary syndrome in women. We conclude that the concept of programming can be applied to reproductive development and related health outcomes, and that the complex potential for interactions between parameters controlling fetal development and …

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Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis

By AT Geronimus

This study seeks to explore if early health deterioration (‘weathering’) among young adult African American women contributes to observed increases with maternal age in the black/white disparity in birth outcome. Theoretically, ‘weathering’ is constructed as being a physical consequence of social inequality. Thus, we also examine whether African American mothers vary in their age trajectories of poor birth outcome with respect to social class. Black or white singleton first births to Michigan residents aged 15-34 in 1989 (N = 54,888 births) are analyzed, using data drawn from linked birth and infant death certificates augmented with census-based economic information. We find among blacks, but not whites, advancing maternal age above 15 …

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