Publications by authors named "Katherine A Perham-Hester"

7 Publications

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Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study.

Drug Alcohol Depend 2018 06 29;187:72-78. Epub 2018 Mar 29.

Alaska Department of Health and Social Services, 3601C Street, Suite 358, Anchorage, AK, 99503, USA.

Background: We sought to describe the correlates of marijuana use during and after pregnancy, and to examine the independent relationship between prenatal marijuana use and infant outcomes.

Study Design: We used state-specific data from the Pregnancy Risk Assessment Monitoring System (N = 9013) to describe correlates of self-reported prenatal and postpartum marijuana use. We estimated differences in mean infant birth weight and gestational age among prenatal marijuana users and nonusers, controlling for relevant covariates (i.e., cigarette smoking).

Results: Respectively, 4.2% (95% CI: 3.8-4.7) and 6.8% (95% CI: 6.0-7.7) of women reported using marijuana during and after pregnancy. Compared to nonusers, prenatal marijuana users were more likely to be ≤24 years; non-Hispanic white, not married, have <12 years of education, have Medicaid/IHS/Other insurance, be on WIC during pregnancy, have annual household income <$20,000, cigarette smokers, and alcohol drinkers during pregnancy (p-values < 0.05). After adjustment, no differences in gestational age or birthweight were observed. Postpartum users were more likely to smoke cigarettes (48.7% vs. 20.3%), experience postpartum depressive symptoms (14.0% vs. 9.0%), and breastfeed for <8 weeks (34.9% vs. 18.1%).

Conclusion: Co-use of substances was common among prenatal and postpartum marijuana users. Prenatal marijuana use was not independently associated with lower average birthweight or gestational age. Postpartum marijuana use was associated with depressive symptoms and shorter breastfeeding duration. Surveillance of marijuana use among pregnant and postpartum women is critical to better understanding the relationship of marijuana use with birth outcomes, and postpartum experiences such as depression and breastfeeding.
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http://dx.doi.org/10.1016/j.drugalcdep.2018.02.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479809PMC
June 2018

Risk factors for obesity at age 3 in Alaskan children, including the role of beverage consumption: results from Alaska PRAMS 2005-2006 and its three-year follow-up survey, CUBS, 2008-2009.

PLoS One 2015 20;10(3):e0118711. Epub 2015 Mar 20.

Agence de Medicin Preventive, Paris, France.

Background: Prenatal and early life risk factors are associated with childhood obesity. Alaska Native children have one of the highest prevalences of childhood obesity of all US racial/ethnic groups.

Methods: Using the Pregnancy Risk Assessment Monitoring System (PRAMS) and the follow-up survey at 3 years of age (CUBS), we evaluated health, behavioral, lifestyle and nutritional variables in relation to obesity (95th percentile for body mass index (BMI)) at 3 years of age. Multivariate logistic regression modeling was conducted using Stata 12.0 to evaluate independent risk factors for obesity in non-Native and Alaska Native children.

Results: We found an obesity prevalence of 24.9% in all Alaskan and 42.2% in Alaska Native 3 year olds. Among Alaska Native children, obesity prevalence was highest in the Northern/Southwest part of the state (51.6%, 95%CI (42.6-60.5)). Independent predictive factors for obesity at age 3 years in Alaska non-Native children were low income (<$10,000 in the year before the child was born (OR 3.94, 95%CI 1.22--17.03) and maternal pre-pregnancy obesity (OR 2.01, 95%CI 1.01-4.01) and longer duration of breastfeeding was protective (OR 0.95, 95%CI 0.91-0.995). Among Alaska Native children, predictive factors were witnessing domestic violence/abuse as a 3 year-old (OR 2.28, 95%CI 1.17-7.60). Among obese Alaska Native children, there was an increased daily consumption of energy dense beverages in the Northern/Southwest region of the state, which may explain higher rates of obesity in this part of the state.

Conclusions: The high prevalence of obesity in Alaska Native children may be explained by differences in lifestyle patterns and food consumption in certain parts of the state, specifically the Northern/Southwest region, which have higher consumption of energy dense beverages.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118711PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368660PMC
December 2015

Identifying risk factors for child maltreatment in Alaska: a population-based approach.

Am J Prev Med 2011 Jun;40(6):666-73

Alaska Division of Public Health, Maternal and Child Health Epidemiology Unit, 3601 C Street, Anchorage, AK 99503, USA.

Background: Child maltreatment has been linked to multiple negative health outcomes and many leading causes of death. Statewide population-based evaluations are needed to identify high-risk populations early in life for targeted interventions.

Purpose: To assess the utility of combining Pregnancy Risk Assessment Monitoring System (PRAMS) data with child protective services (CPS) records to identify risk factors associated with Protective Services Reports (PSR) suggestive of child maltreatment.

Methods: This was a retrospective population-based cohort study conducted in the spring of 2010 using weighted survey data from Alaska PRAMS for birth years 1997-1999. PRAMS responses were linked with CPS records for the sampled child. The outcome of interest was any PSR made to CPS after the survey was returned through 48 months after birth. Validation of the PRAMS data set occurred through direct comparison between the total population and PRAMS weighted sample for birth certificate factors. Multivariate logistic regression models were constructed to identify risk groups.

Results: In the final multivariate model among the main effect variables, three of the top five strongest associated factors were derived all or in part from PRAMS. Public aid as a source of income had a significant interaction with Alaska Native status, and among Alaska non-Natives had an AOR of 3.37 (95% CI=2.2, 5.1). Six significant modifiable factors were identified in the multivariate model. Three quarters (75%) of the maltreatment cases occurred among children with two or more of these factors, despite being found in about one third (32%) of the total population.

Conclusions: Although birth certificates remained a valuable source of risk factor information for child maltreatment, PRAMS identified additional risk factors not available from birth certificates.
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http://dx.doi.org/10.1016/j.amepre.2011.02.022DOI Listing
June 2011

Experience of a controlling or threatening partner among mothers with persistent symptoms of depression.

Am J Obstet Gynecol 2009 Aug 18;201(2):173.e1-9. Epub 2009 Jun 18.

Maternal and Child Health Epidemiology Unit, Section of Women's, Children's, and Family Health, Division of Public Health, Department of Health and Social Services, State of Alaska, Anchorage, Alaska, USA.

Objective: We evaluated the prevalence of symptoms of maternal depression (SMD) that continue beyond the postpartum period and the association between persistent SMD and reporting a controlling or threatening partner.

Study Design: We combined data from a survey of mothers 2-6 months after delivery and its 2-year follow-up survey and analyzed the responses of 444 women who responded to both surveys. We focused on exposure to a controlling partner because this was the sole factor that was associated with persistent SMD in preliminary analysis.

Results: Postpartum SMD was reported by 23% of the women. Among these women, 46% also reported SMD 2 years later. In bivariate analysis, a controlling partner was associated with persistent SMD (odds ratio, 6.9; 95% confidence interval, 1.5-31.8; P = .014).

Conclusion: Almost one-half of women with postpartum SMD continue to have symptoms 2 years later. Further research is needed to measure the strength of the association between controlling partners and persistent depression.
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http://dx.doi.org/10.1016/j.ajog.2009.04.025DOI Listing
August 2009

Patterns of cigarette and smokeless tobacco use before, during, and after pregnancy among Alaska native and white women in Alaska, 2000-2003.

Matern Child Health J 2010 May 13;14(3):365-72. Epub 2009 Jan 13.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS K-23, Atlanta, GA 30341, USA.

Objective: To examine patterns of cigarette and smokeless tobacco use before, during, and after pregnancy among Alaska Native (AN) and white women living in Alaska.

Methods: We used data from the 2000-2003 population-based Pregnancy Risk Assessment Monitoring System to describe patterns of self-reported prenatal tobacco use among AN and white women. We used multiple variable logistic regression analysis to identify maternal factors associated with quitting and relapse. The final sample included 5,458 women.

Results: During 2000-2003, the prevalence of any tobacco use before pregnancy was twofold higher among AN women than among white women (60.0 vs. 27.5%), and the prevalence of any tobacco use during pregnancy and after pregnancy were each nearly threefold higher. Of the 25.8% (SE 0.9) of white women who smoked before pregnancy, 49.0% (SE 2.1) reported that they quit during pregnancy and of those, 41.1% (SE 2.9) relapsed postpartum. Of the 38.5% (SE 0.9) of AN women who smoked before pregnancy, 35.7% (SE 1.4) quit, and of those 57.0% (SE 2.4) relapsed. Of the 14.2% of AN women who chewed tobacco before pregnancy, 15.7% (SE 1.7) quit, and of those, 52.9% (SE 5.9) relapsed.

Conclusion: During 2000-2003, the prevalence of tobacco use was two to three times higher among AN women than among white women before, during, and after pregnancy. In addition, AN women had lower quit rates and higher relapse rates than white women. Comprehensive, culturally appropriate tobacco control approaches targeting AN women are needed to increase cessation during pregnancy and to decrease relapse.
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http://dx.doi.org/10.1007/s10995-009-0444-7DOI Listing
May 2010

Prenatal cigarette smoking and smokeless tobacco use among Alaska native and white women in Alaska, 1996-2003.

Matern Child Health J 2009 Sep 19;13(5):652-9. Epub 2008 Aug 19.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

Objective: To examine trends in prenatal cigarette smoking and smokeless tobacco use among Alaska Native (AN) and white women in Alaska.

Methods: Using 1996-2003 data from the population-based Pregnancy Risk Assessment Monitoring System, we determined trends in self-reported prenatal tobacco use among AN and white women and used chi-square tests and multiple variable logistic regression analysis to identify maternal factors associated with prenatal tobacco use.

Results: Over the study period, prevalence of any tobacco use during pregnancy declined by 27% among AN women (from 55.8 to 40.9%) (P < 0.0001) and by 17% among white women (from 18.8 to 15.6%) (P < 0.0001). In 2003, among AN women the prevalence of self-reported smokeless tobacco use was 16.9%, cigarette smoking was 25.7%, and any tobacco use was 40.9%; corresponding values for white women were 0.4, 15.0, and 15.6%, respectively. Western Alaska had the highest prevalence of tobacco use.

Conclusion: The prevalence of tobacco use decreased between 1996 and 2003, but remained higher among AN women than white women, especially for smokeless tobacco. Support for cessation interventions targeting pregnant women should be made a public health priority in Alaska.
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http://dx.doi.org/10.1007/s10995-008-0402-9DOI Listing
September 2009

The impact of perceived barriers on primary care physicians' screening practices for female partner abuse.

Women Health 2002 ;35(2-3):55-69

Alaska Family Violence Prevention Project, Section of Maternal, Child and Family Health, Department of Health and Social Services, Anchorage 99524-0249, USA.

Objectives: Our purpose was to examine primary care physicians' screening practices for female partner abuse in different clinical situations and to investigate the relationship between perceived barriers and screening practices.

Methods: A cross-sectional survey was mailed to Alaska physicians practicing in the following specialties: family practice, internal medicine, obstetrics/gynecology and general practice.

Results: The survey response rate was 80 percent (305/383). The majority (85.7%) of primary care physicians screened often or always when a female patient presents with an injury, but they rarely screened at initial visits (6.2%) or annual exams (7.5%). More than one-third of respondents estimated that 10% or more of their female patients had experienced some type of intimate partner abuse. Several barriers to screening described in the literature were not predictive of physicians' screening practice patterns. Physicians' perceptions that abuse is prevalent among their patients and physicians' beliefs that they have a responsibility to deal with abuse were the only variables independently associated with screening at initial visits and annual exams. The only variable predictive of screening when a patient presents with an injury was physicians' perceived prevalence of abuse.

Conclusion: Primary care physicians have not integrated screening for partner abuse into routine care. Strategies to increase awareness of the high prevalence of abuse in the primary care setting and to educate providers on the negative health effects of victimization can help physicians to acknowledge their responsibility in addressing abuse and the importance of screening at routine visits. Further rigorous studies are needed to identify and evaluate predictors of screening for abuse.
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http://dx.doi.org/10.1300/J013v35n02_04DOI Listing
October 2002
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