Home visits by nurses may benefit new and expectant moms, children | Study assesses opioids prescriptions for women postpartum | Higher risk of serious childbirth complications seen in rural areas
December 5, 2019
ACNM SmartBrief
Quick e-news for midwives and other health professionals
Maternal Health
Home visits by nurses may benefit new and expectant moms, children
Low-income women with no previous live births who were visited at home by nurses who provided prenatal and infant care support had $17,310 lower public benefit costs at 18 years' follow-up, with even more cost savings among those who had greater psychological resources, researchers reported in Pediatrics. Another study in the same journal showed improved math achievement, receptive language and other secondary cognition-related outcomes among 18-year-olds whose mothers received home visits by nurses.
Physician's Briefing/HealthDay News (12/3) 
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Study assesses opioids prescriptions for women postpartum
A study published in the American Journal of Obstetrics & Gynecology Maternal-Fetal Medicine evaluated the EMRs of 4,248 patients who delivered at six US hospitals from January 2016 through March 2016 and found the percentage of women prescribed postpartum opioids varied significantly by hospital, ranging from 27.6% to 70.9%, with the median number of tablets prescribed ranging from 20 to 40. "The variation in prescribing found in our study illustrates the need for clear consensus guidelines for postpartum pain management," the researchers wrote.
Physician's Briefing/HealthDay News (12/4) 
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Higher risk of serious childbirth complications seen in rural areas
A study in Health Affairs that analyzed 6.8 million births from hospital discharge data between 2007 and 2015 found women in rural areas have a 9% greater chance of life-threatening complications during or after childbirth compared with women in urban areas. "In rural areas, where there is declining access to obstetric services, it is alarming that more and more people are facing severe maternal morbidity and mortality when giving birth," lead author Katy Kozhimannil said.
Medical Xpress (12/4) 
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Mental health screenings can promote resilience before and after birth
Cedars-Sinai Medical Center in Los Angeles designed a screening process for perinatal mood and anxiety disorders that connects women with social workers if they screen positive, with the goal of promoting resilience during pregnancy and beyond. Perinatal mental health screenings aren't yet universal but are becoming more common as five states require them and others mandate that providers give women information about them.
Quartz (tiered subscription model) (12/3) 
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Study links maternal diabetes to future CVD risk in children
Children born to mothers with diabetes had a 29% higher likelihood of developing cardiovascular disease, especially deep vein thrombosis, hypertensive disease and pulmonary embolism, during 40 years of follow-up, compared with those whose mothers didn't have diabetes, researchers reported in The BMJ. The study found the highest increase in risk of early CVD among those whose mothers both had diabetes and CVD.
MedPage Today (free registration) (12/4),  The New York Times (tiered subscription model) (12/4) 
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Are You Interested in Adding a Specialty or DNP?
Apply to one of FNU's distance education programs. We offer Post-Graduate Certificates in Nurse-Midwifery, Family Nurse Practitioner, Women's Health Care and Psychiatric-Mental Health NP specialties with the option to complete a DNP degree. Learn more.
Women's Health & Primary Care
37% of US adults will say no to flu shots this year, survey finds
Thirty-seven percent of US adults have no plans to be vaccinated against influenza this season because they worry about the side effects, they think the vaccine is ineffective or they mistakenly think they might get the flu from the vaccine itself, according to a survey conducted by NORC at the University of Chicago. The CDC recommends annual vaccines for those 6 months and older, and as of early last month, 44% percent of adults said they had gotten the vaccine, and 18% had plans to do so.
The Hill (12/3) 
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Oral hygiene linked to lower risk of AFib, heart failure
A study published in the European Journal of Preventive Cardiology, based on data from 161,286 individuals, found that people who brushed their teeth at least three times each day had a lower risk for heart failure and atrial fibrillation. The researchers said more study is needed.
Physician's Briefing/HealthDay News (12/2) 
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Study: Treating high cholesterol earlier may reduce CV risks
Beginning treatment to reduce cholesterol levels earlier in adulthood may decrease the risk of cardiovascular disease later, researchers reported in The Lancet. Data suggested that for adults under age 45 who had at least two heart disease risk factors, lowering non-HDL cholesterol reduced later CV risks from about 16% down to 4% for women and from 29% to 6% among men.
HealthDay News (12/4),  MedPage Today (free registration) (12/3) 
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Experimental monthly oral contraceptive effective in pigs, study finds
Researchers from Brigham and Women's Hospital and MIT have developed a monthly oral contraceptive that has proven effective in pigs, according to a study in Science Translational Medicine. The star-shaped capsule released levonorgestrel over four weeks at concentrations similar to those in pigs given immediate-release tablets, but it could be several years before the contraceptive is tested in people, the researchers said.
CNN (12/5),  Reuters (12/4),  BBC (12/4),  The Boston Globe (tiered subscription model) (12/4) 
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Infant Health
ICU holding intervention for intubated infants was well-tolerated
Babies younger than 6 months in the ICU with respiratory failure-related intubation who were held for a mean duration of 99 minutes had no urinary catheter removals, unplanned extubations or central catheter removals and only had one arterial catheter removal unrelated to holding, compared with an unplanned extubation and two arterial catheter removals among controls who were not held, according to a study in the journal Critical Care Nurse. Researchers also found that those in the intervention group had similar vital signs before and during ICU holding, as well as had similar intubation duration and ICU and hospital lengths of stay, compared with controls.
Physician's Briefing/HealthDay News (12/2) 
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National Influenza Vaccination Week is Dec. 1-7
CDC established National Influenza Vaccination Week in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond. Learn more.
Registration Now Open - 65th ACNM Annual Meeting & Exhibition!
The American College of Nurse-Midwives invites you to join us for the ACNM 65th Annual Meeting & Exhibition, May 29 – June 2, 2020 at the J.W. Marriott in Downtown Austin, TX. The theme of our meeting is: Midwives Caring for Mind, Body & Soul. Register now!
Webinar Hosted by Students and New Midwives Committee
Did you miss the Nov. 4th webinar for ACNM Students and New Midwives hosted by the ACNM Students and New Midwives Committee? The meeting featured an in depth Q&A with the authors of the ACNM publication, The Ultimate Survival Guide for New Midwives. The link to the recorded webinar will soon be posted on ACNM Connect. Learn more about The Ultimate Survival Guide for New Midwives and view the recorded webinar.
Join the Reducing Primary Cesarean Collaborative!
Encourage your facility to reduce its NTSV cesarean rate by applying for the multi-state, multi-hospital Reducing Primary Cesarean Collaborative. Interdisciplinary teams participating in RPC have reduced their NTSV rates an average of 8 percent in the first year and saved money while doing it! Applications are accepted on a rolling basis. Read more.
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