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McCormick, Marie

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McCormick

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Marie

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McCormick, Marie

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Now showing 1 - 6 of 6
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    The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit
    (BioMed Central, 2017) Lakshmanan, Ashwini; Agni, Meghana; Lieu, Tracy; Fleegler, Eric; Kipke, Michele; Friedlich, Philippe S.; McCormick, Marie; Belfort, Mandy
    Background: Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. Methods: We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression. Results: Median (inter-quartile range) infant gestational age was 28 (26–31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid. Conclusions: Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0602-3) contains supplementary material, which is available to authorized users.
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    Brief Parenteral Nutrition Accelerates Weight Gain, Head Growth Even in Healthy VLBWs
    (Public Library of Science, 2014) Morisaki, Naho; Belfort, Mandy; McCormick, Marie; Mori, Rintaro; Noma, Hisashi; Kusuda, Satoshi; Fujimura, Masanori
    Introduction: Whether parenteral nutrition benefits growth of very low birth weight (VLBW) preterm infants in the setting of rapid enteral feeding advancement is unclear. Our aim was to examine this issue using data from Japan, where enteral feeding typically advances at a rapid rate. Methods: We studied 4005 hospitalized VLBW, very preterm (23–32 weeks' gestation) infants who reached full enteral feeding (100 ml/kg/day) by day 14, from 75 institutions in the Neonatal Research Network Japan (2003–2007). Main outcomes were weight gain, head growth, and extra-uterine growth restriction (EUGR, measurement <10th percentile for postmenstrual age) at discharge. Results: 40% of infants received parenteral nutrition. Adjusting for maternal, infant, and institutional characteristics, infants who received parenteral nutrition had greater weight gain [0.09 standard deviation (SD), 95% CI: 0.02, 0.16] and head growth (0.16 SD, 95% CI: 0.05, 0.28); lower odds of EUGR by head circumference (OR 0.66, 95% CI: 0.49, 0.88). No statistically significant difference was seen in the proportion of infants with EUGR at discharge. SGA infants and infants who took more than a week until full feeding had larger estimates. Discussion Even in infants who are able to establish enteral nutrition within 2 weeks, deprivation of parenteral nutrition in the first weeks of life could lead to under nutrition, but infants who reached full feeding within one week benefit least. It is important to predict which infants are likely or not likely to advance on enteral feedings within a week and balance enteral and parenteral nutrition for these infants.
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    Disparities in antidepressant use in pregnancy
    (2014) Yamamoto, Ayae; McCormick, Marie; Burris, Heather H.
    Background: The American College of Obstetricians and Gynecologists and the American Psychiatric Association both recommend pharmacotherapy for perinatal depression when the benefits outweigh the risks. While minority adults are less likely to use antidepressant medications compared to Non-Hispanic Whites, whether this pattern occurs among pregnant women is unclear. Objective: We sought to determine the frequency of antidepressant medication use reported during ambulatory care visits for pregnant women and whether these rates varied by race. Methods: We combined the 2006–2010 National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) to obtain nationally representative estimates of outpatient preventive care visits for pregnant women. We then obtained estimates of the prevalence of reported depression and antidepressant use during outpatient visits for pregnant women. To determine whether these estimates varied by race, we used multivariable logistic regression analyses accounting for survey design using SAS 9.2 (PROC SURVEYLOGISTIC) to estimate odds ratios of reported antidepressant use after adjustment for age, insurance status and region of the country. Results: Antidepressant use was reported during 2.2% of all outpatient visits for pregnant women. Providers indicated a depression diagnosis in 4.5% of visits. Among visits for depressed pregnant women, providers reported antidepressant use 25.4% of the time for all visits. Antidepressant use during pregnancy varied significantly by race/ethnicity. Among visits for Non-Hispanic White women, 3.1% included a code for antidepressant use vs. just 1.0% for Non-White women (P<0.0001). After adjustment for age, insurance status, and region of the country, this association persisted with Non-Hispanic White (vs. Non-White) pregnant women having higher odds of antidepressant use (adjusted OR 3.3, 95% CI 2.1, 5.3). Conclusion: Non-Hispanic White women were more likely than Non-White women to be using antidepressants during pregnancy. Whether differences in antidepressant use by race/ethnicity indicates over-treatment of non-Hispanic White women or under-treatment of minorities remains unclear. This disparity warrants investigation with the goal of optimizing maternal mental health while minimizing potential adverse sequelae of antidepressants on developing fetuses.
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    Prenatal and perinatal predictors of blood pressure at school age in former preterm, low birth weight infants
    (2015) Belfort, Mandy; Gillman, Matthew; McCormick, Marie
    Objective: To investigate prenatal and perinatal determinants of school age blood pressure (BP) in former preterm, low birth weight infants Study Design We studied 694 participants in the Infant Health and Development Program, an 8-center longitudinal study of children born ≤37 weeks and ≤2500 grams. We obtained information about prenatal and perinatal factors by interview and medical record review and measured BP 3 times at age 6.5 years. Result Adjusting for sex, age, sociodemographic variables, and height z-score, for each z-score birth weight for gestational age – which represents fetal growth – systolic BP at 6.5 years was 0.7 mmHg higher (95% CI −0.1, 1.6). Maternal age, pre-pregnancy weight, gestational weight gain, smoking, preeclampsia, gestational diabetes; and child gestational age and neonatal complications were also not associated with BP. Conclusion: In contrast to full term infants, slower fetal growth was not associated with higher BP in former preterm, low birth weight infants.
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    The Impact of Maternal Characteristics on the Moderately Premature Infant: An Antenatal Maternal Transport Clinical Prediction Rule
    (Nature Publishing Group, 2012) Dukhovny, Dmitry; Dukhovny, Stephanie; Pursley, Dewayne; Escobar, Gabriel J.; McCormick, Marie; Mao, WenYang; Zupancic, John
    Background: Moderately premature infants, defined here as those born between 30 \(\frac{0}{7}\) and 34 \(\frac{6}{7}\) weeks gestation, comprise 3.9% of all births in the United States and 32% of all preterm births. While long-term outcomes for these infants are better than for less mature infants, morbidity and mortality are still substantially increased in comparison to infants born at term. There is an added survival benefit resulting from birth at a tertiary neonatal care center, and although many of these infants require tertiary level care, delivery at lower level hospitals and subsequent neonatal transfer are still common. Objective: Our primary aim was to determine the impact of maternal characteristics and antenatal medical management on the early neonatal course of the moderately premature infant. The secondary aim was to create a clinical prediction rule to determine which infants require intubation and mechanical ventilation in the first 24 hours of life. Such a prediction rule could inform the decision to transfer maternal-fetal patients prior to delivery to a facility with a Level III Neonatal Intensive Care Unit (NICU), where optimal care could be provided without the requirement for a neonatal transfer. Methods: Data for this analysis came from the cohort of infants in the Moderately Premature Infant Project (MPIP) database, a multi-center cohort study of 850 infants born at gestational age 30 \(\frac{0}{7}\) to 34 \(\frac{6}{7}\) weeks, who were discharged home alive. We built a logistic regression model to identify maternal characteristics associated with need for tertiary care, as measured by administration of surfactant. Using statistically significant covariates from this model, we then created a numerical decision rule to predict need for tertiary care. Results: In multivariate modeling, 4 factors were associated with reduction in the need for tertiary care, including, surfactant administration, including non-White race (OR=0.5, [0.3, 0.7], older gestational age, female gender (OR=0.6 [0.4, 0.8]) and use of antenatal corticosteroids (OR=0.5, [0.3, 0.8]). The clinical prediction rule to discriminate between infants who received surfactant, versus those who did not, had an area under the curve of 0.77 [0.73, 0.8]. Conclusions: Four antenatal risk factors are associated with a requirement for Level III NICU care as defined by the need for surfactant administration. Future analyses will examine a broader spectrum of antenatal characteristics and revalidate the prediction rule in an independent cohort.
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    Predictors of Compliance with the Postpartum Visit among Women Living in Healthy Start Project Areas
    (Springer Nature, 2006) Bryant, Allison; Haas, Jennifer; McElrath, Thomas; McCormick, Marie
    Objectives: Few studies have examined factors associated with compliance with a postpartum visit (PPV). The identification of such factors is of particular importance in populations with high rates of unintended pregnancies and medical complications of pregnancy. This study seeks to determine factors associated with compliance with a PPV among low-income women in the population served by fourteen Healthy Start sites. Methods: Data from the Healthy Start Survey of Postpartum Women were reviewed to identify variables associated with compliance with a PPV at or beyond 6 weeks. Multiple logistic regression models were created, based on a sociobehavioral model of health services use, to examine which types of factors (demographic, social, enabling or need) are most strongly associated with the use of a PPV. Results: The study population consisted of survey respondents interviewed six weeks or more following delivery. Eighty-five percent of respondents had had a PPV at time of interview. In a multiple regression analysis, enabling factors such as multiple moves (OR (95% CI)=0.34 (0.18, 0.67)), trouble understanding the provider (OR (95% CI)=0.65 (0.43, 0.99)) and appointment reminders (OR (95% CI)=2.37 (1.40, 4.02)) were most strongly associated with a PPV. Conclusions: This work finds that women with unstable housing, transportation barriers, and difficulties communicating with providers are at risk for not receiving a PPV. This suggests that access to postpartum health services in the Healthy Start communities studied may not be entirely equitable. Policies aimed at improving interconception care will need to address these barriers to accessing health services.