Thursday, May 15, 2025
5/15/2025
R42 MCH Secondary Data Analysis Research - PROBLEM: Although the United States (U.S) infant mortality hit historic low in 2020, it is worse than other comparable nations (America’s Health Rankings, 2022). Racial disparities remain in infant mortality and birth outcomes, especially for non-Hispanic Black women (Ely & Driscoll, 2022). Poor birth outcomes have been associated with prenatal behaviors such as smoking, alcohol consumption, and late or no prenatal care (Liu et al., 2022). Healthy People 2030’s goal is for 80.5% of women to initiate prenatal care (PNC) within the first trimester. A major obstacle to timely PNC is that it cannot be initiated until a woman recognizes that she is pregnant (Ayoola et al., 2010). The time of pregnancy recognition is crucial to fetal development, initiation of PNC, and birth outcomes. This project is in line with MCHB program’s goal to promote access to high quality and equitable health services (adequate PNC) to optimize health and well-being of mothers and their children. GOAL(S) AND OBJECTIVES: This study examines the relationship between time of pregnancy recognition, time of PNC initiation, and number of PNC visits in the U.S. The focus of this study is: 1) To determine the extent to which early recognition of a pregnancy (confirmed pregnancy within 6 weeks of conception) predicts early initiation of PNC (start PNC within 12 weeks of conception) and the number of PNC visits. 2) To explore how early pregnancy recognition affects birth outcomes such as gestational age at birth, birth weight, rates of admission to NICUs and infant mortality in the general population and among racial minority groups such as Non-Hispanic Black, Native American/Alaskan native and other minority groups. PROPOSED DATA SETS AND TARGET POPULATION(S): The proposed study is a secondary analysis of phase 8 (2016 to 2020) multi-state data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) program. PRAMS is a population-based survey that is part of the Centers for Disease Control and Prevention (CDC) initiative to reduce infant mortality and low birth weight and promote safe motherhood. PRAMS is an on-going state-based surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy (CDC (c), 2022). The PRAMS sample is drawn from the jurisdiction’s birth certificate file. Each participating site samples between 1,000 and 3,000 women per year (CDC (c), 2022). States stratify their sample by characteristics of public health interest such as maternal age, race/ethnicity, geographic area of residence, and infant birth weight (Shulman et al., 2018). PRODUCTS: This research will provide an opportunity to mentor two junior investigators in secondary data analysis. At least two manuscripts will be published based on the findings of this secondary analysis in peer reviewed journals with relatively high impact factors. There will be presentations of the findings of this study at local, regional, national and international conferences. EVALUATION: We will focus on assessing the following: 1. Completing PRAMS analysis within the specified timeframe 2. Disseminating findings as specified and within the expected timeframe at local, regional, international conferences and in peer review journals with high impact factor. 3. Examining how the two mentees plan to use the skills of secondary data analysis to promote maternal and child health research beyond the project period. KEY TERMS: Project: Access to Health Care, Health Disparities, Cost Effectiveness, Low Birthweight, Prenatal Care, Preterm, Infant Illness & Hospitalization, Mortality, Smoking, Social Determinants of Health Targeted Populations: African American, Hispanic/Latino, Indigenous/Native American/Alaskan Native, Other Persons of Color Age Ranges: Women’s Health & Well-being (Preconception/Interconception/Prenatal), Prenatal (until 28th week of gestation), Perinatal (28th week of gestation to 4 weeks after birth)
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