First name
Kate
Last name
Wallis

Title

Risk of Extreme, Moderate and Late Preterm Birth by Maternal Race, Ethnicity and Nativity.

Year of Publication

2021

Date Published

2021 Sep 27

ISSN Number

1097-6833

Abstract

<p><strong>OBJECTIVES: </strong>To explore the relative risks of preterm birth-both overall and stratified into three groups (late, moderate and extreme prematurity)-associated with maternal race, ethnicity and nativity (ie, birthplace) combined.</p>

<p><strong>STUDY DESIGN: </strong>This was a retrospective cross-sectional cohort study of women delivering a live birth in Pennsylvania from 2011-2014 (n=4,499,259). Log binomial and multinomial regression analyses determined the relative risks of each strata of preterm birth by racial/ethnic/native category, after adjusting for maternal sociodemographic, medical comorbidities and birth year.</p>

<p><strong>RESULTS: </strong>Foreign-born women overall had lower relative risks of both overall preterm birth and each strata of prematurity when examined en bloc. However, when considering maternal race, ethnicity and nativity together, the relative risk of preterm birth for women in different racial/ethnic/nativity groups varied by preterm strata and by race. Being foreign-born appeared protective for late prematurity. However, only foreign-born White women had lower adjusted relative risks of moderate and extreme preterm birth compared with reference groups. All ethnic/native sub-groups of Black women had a significantly increased risk of extreme preterm births compared with US born non-Hispanic White women.</p>

<p><strong>CONCLUSIONS: </strong>Race, ethnicity and nativity contribute differently to varying levels of prematurity. Future research involving birth outcome disparities may benefit by taking a more granular approach to the outcome of preterm birth and considering how nativity interacts with race and ethnicity.</p>

DOI

10.1016/j.jpeds.2021.09.035

Alternate Title

J Pediatr

PMID

34592259

Title

Caregiver Strengths, Attitudes, and Concerns About Reading and Child Development in the Dominican Republic.

Year of Publication

2020

Number of Pages

2333794X20942661

Date Published

2020

ISSN Number

2333-794X

Abstract

<p><strong>Background.</strong> Parents' beliefs about and engagement in reading aloud to young children and other positive parenting practices have been associated with early childhood development (ECD) and later achievement. <strong>Aim.</strong> This exploratory study sought to assess parental attitudes and self-reported practices regarding ECD in a rural, low-income community in the Dominican Republic with many risk factors for ECD delays, including high rates of poverty, iron-deficiency anemia, and malnutrition. <strong>Methods.</strong> We used the Parent Reading Belief Inventory and open-ended questions to evaluate parental beliefs regarding reading, self-efficacy in promoting child development, current positive parenting practices, and parents' concerns about the development of their 0- to 5-year-old children in Consuelo, Dominican Republic. We explored associations between demographic factors and strength of positive parenting beliefs and practices. <strong>Results.</strong> Overall participants had positive attitudes toward reading and their own importance in promoting their children's development. Participants with at least some high school education had significantly higher Parent Reading Belief Inventory scores ( = .03) than those with less formal education. Participants reported frequently singing, talking, and playing with their children, but less frequently reading with them. Few participants had access to reading materials for young children. Parental interest in programs to support ECD was high. Parents raised concerns about their children's behavior, personal and educational attainment, and early literacy. <strong>Conclusion.</strong> Children whose parents have less formal education may benefit most from interventions to promote beliefs and practices likely to improve ECD. In this community, there is high interest in learning more about ECD.</p>

DOI

10.1177/2333794X20942661

Alternate Title

Glob Pediatr Health

PMID

32743027

Title

Accuracy of Autism Screening in a Large Pediatric Network.

Year of Publication

2019

Date Published

2019 Oct

ISSN Number

1098-4275

Abstract

<p><strong>BACKGROUND: </strong>Universal screening is recommended to reduce the age of diagnosis for autism spectrum disorder (ASD). However, there are insufficient data on children who screen negative and no study of outcomes from truly universal screening. With this study, we filled these gaps by examining the accuracy of universal screening with systematic follow-up through 4 to 8 years.</p>

<p><strong>METHODS: </strong>Universal, primary care-based screening was conducted using the Modified Checklist for Autism in Toddlers with Follow-Up (M-CHAT/F) and supported by electronic administration and integration into electronic health records. All children with a well-child visit (1) between 16 and 26 months, (2) at a Children's Hospital of Philadelphia site after universal electronic screening was initiated, and (3) between January 2011 and July 2015 were included ( = 25 999).</p>

<p><strong>RESULTS: </strong>Nearly universal screening was achieved (91%), and ASD prevalence was 2.2%. Overall, the M-CHAT/F's sensitivity was 38.8%, and its positive predictive value (PPV) was 14.6%. Sensitivity was higher in older toddlers and with repeated screenings, whereas PPV was lower in girls. Finally, the M-CHAT/F's specificity and PPV were lower in children of color and those from lower-income households.</p>

<p><strong>CONCLUSIONS: </strong>Universal screening in primary care is possible when supported by electronic administration. In this "real-world" cohort that was systematically followed, the M-CHAT/F was less accurate in detecting ASD than in previous studies. Disparities in screening rates and accuracy were evident in traditionally underrepresented groups. Future research should focus on the development of new methods that detect a greater proportion of children with ASD and reduce disparities in the screening process.</p>

DOI

10.1542/peds.2018-3963

Alternate Title

Pediatrics

PMID

31562252

WATCH THIS PAGE

Subscription is not available for this page.