Disposition and health outcomes among infants born to mothers with no prenatal care
Disposition and health outcomes among infants born to mothers with no prenatal care
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DOI：
10.1016/j.chiabu.2008.05.009
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发表时间：
2009-02-01
影响因子：
4.8
通讯作者：
Rosenthal, Miriam
中科院分区：
文献类型：
--
作者：
Friedman, Susan Hatters;Heneghan, Amy;Rosenthal, Miriam
目的：这项研究评估了没有产前护理的母亲所生后代的婴儿性格和健康结果，基于母亲的特征和缺乏产前护理的原因（即，否认怀孕、隐瞒怀孕、主要药物使用、经济障碍和多产）。受试者是妇女谁在分娩或产后立即没有产前护理的历史（N = 211），和他们的infants.Results：婴儿的母亲与物质使用问题的转介率最高的儿童保护服务和出院时的家庭安置，虽然母亲与其他原因没有产前护理也经历了转介和安置。使用物质的母亲所生的婴儿经历了新生儿重症监护病房入院率最高，平均出生体重最低。结论：虽然那些没有产前护理经历了各种不良后果，物质使用的问题是最常见的不良婴儿结局相关。失去对其他孩子的监护权或有吸毒问题的母亲失去对婴儿监护权的风险最高。那些谁否认或隐瞒自己的怀孕仍然经常returned custouse.Practice影响：在没有产前护理的母亲，那些有物质使用问题的最不可能保留监护权的婴儿出院。母亲的其他子女的监护权状况也与婴儿监护权独立相关。否认或隐瞒怀孕的母亲仍然常常保留监护权。没有产前护理的母亲很少被转介进行精神病评估，尽管转介到社会工作是经常的。儿童保护机构有时不调查拒绝和隐瞒群体中的转介情况。卫生保健提供者应该意识到这一弱势群体的婴儿和母亲的医疗和心理需求。(C)2009爱思唯尔有限公司保留所有权利。
Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity).Methods: A retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N = 211), and their infants.Results: Infants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight.Conclusions: Though those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody.Practice implications: Among mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers. (C) 2009 Elsevier Ltd. All rights reserved.