Reproductive Health, Essay Example

El-Mohandes, A., Kiely, M., Gantz, M., & El-Khorazaty, M. (2011). Very preterm birth is reduced in women receiving an integrated behavioral intervention: A randomized controlled trial. Maternal Child Health Journal, 15, 19-28.

Type

This was a randomized controlled quantitative study that used logistic regression modeling and was performed to examine whether an integrated behavioral intervention with proven efficacy in decreasing behavioral risks such as smoking, direct exposure to tobacco, depression, and intimate partner violence in African-Americans has an association with an increase in positive pregnancy outcomes. Two groups were chosen for this study: a random controlled group that was tested in order to gather data for the four risk factors discussed and the second group which was a control group used as a base model for comparison of the statistical data.

Method

Study participants were initially screened via a telephone self-interview for each of the four risk factors. Study participants were African-American women of childbearing age who were currently pregnant and in the first trimester during the time of the first interview. As stated, these were smoking, direct tobacco exposure, depression, and intimate partner violence. After the initial screening, mothers who met the inclusion criteria were scheduled for a follow-up interview via telephone. The initial screening process was conducted during the first trimester and data collection was taken during the second and third trimesters of pregnancy. Any needed interventions were continued until July 2004. The total number of women reached for the telephone interview was 1,070. The depression intervention was based on the cognitive behavioral theory program proven to be successful with low income minority women.

Results

Study results showed significant differences between women based on sociodemographic, behavioral, or reproductive characteristics during baseline interviews or anytime data was being collected. There was a significant difference reported in women who were exposed to smoking, direct exposure to tobacco, depression, and intimate partner violence versus those who were not when comparing pregnancy outcomes.  Actual results showed a depression correlation with low birth weight of 1.71 per 100 patients. Intimate partner violence was associated with preterm birth rates at a level of 1.64 patients per 100 births and very pre term birth rates of 2.94 births per 100 patients. These statistics were reduced significantly in the control group of patients and there was no clinical difference noted in any category. All results met the 95% confidence levels of the study thus validating the results obtained.

Implications

The study correlates with the findings of previous researchers which have shown associations between psycho-behavioral risks and decreased levels of low term birth weights and very pre term birth weights. These results indicate the importance of interventions that target pregnancy risks due to their simultaneous occurrence. The increased risks of infant mortality continue to be important causes of health disparities in the United States.

Implications of increased infant mortality has direct links to preterm and low birth weights in African-American women because it has been found to be double the rate that is reported in the entire United States population. Infants at the lower end of the scale when speaking in terms of weight and gestation are normally those at the highest risk for death and are more often the infants who succumb to mortality during the first few weeks of life.