Publications by authors named "Margaret H Blabey"

3 Publications

  • Page 1 of 1

Infant bed-sharing practices and associated risk factors among births and infant deaths in Alaska.

Public Health Rep 2009 Jul-Aug;124(4):527-34

Alaska Division of Public Health, Anchorage, AK 99524-0249, USA.

Objective: The Alaska Division of Public Health has stated that infants may safely share a bed for sleeping if this occurs with a nonsmoking, unimpaired caregiver on a standard, adult, non-water mattress. Because this policy is contrary to recent national recommendations that discourage any bed sharing, we examined 13 years of Alaskan infant deaths that occurred while bed sharing to assess the contribution of known risk factors.

Methods: We examined vital records, medical records, autopsy reports, and first responder reports for 93% of Alaskan infant deaths that occurred between 1992 and 2004. We examined deaths while bed sharing for risk factors including sleeping with a non-caregiver, prone position, maternal tobacco use, impairment of a bed-sharing partner, and an unsafe sleep surface. We used Pregnancy Risk Assessment Monitoring System data to describe bed-sharing practices among all live births in Alaska during 1996-2003.

Results: Thirteen percent (n=126) of deaths occurred while bed sharing; 99% of these had at least one associated risk factor, including maternal tobacco use (75%) and sleeping with an impaired person (43%). Frequent bed sharing was reported for 38% of Alaskan infants. Among these, 60% of mothers reported no risk factors; the remaining 40% reported substance use, smoking, high levels of alcohol use, or most often placing their infant prone for sleeping.

Conclusions: Almost all bed-sharing deaths occurred in association with other risk factors despite the finding that most women reporting frequent bed sharing had no risk factors; this suggests that bed sharing alone does not increase the risk of infant death.
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August 2009

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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August 2009

Three maternal risk factors associated with elevated risk of postneonatal mortality among Alaska native population.

Matern Child Health J 2009 Mar 4;13(2):222-30. Epub 2008 Apr 4.

Alaska Division of Public Health, Maternal and Child Health Epidemiology Unit, Anchorage, AK 99524-0249, USA.

Objective: Compared to non-Natives in Alaska, the Alaska Native population has a postneonatal mortality rate 2.3 times higher (95% CI 1.9, 2.7). The objective of the study was to identify variables that account for this elevated risk.

Methods: The dataset used included birth and death certificate records for all Alaska-resident live births and infant deaths occurring during 1992-2004. Race was defined as Alaska Native or non-Native. The association between race and postneonatal mortality was examined using univariate, stratified and regression analyses. Variables were considered confounding if they resulted in a change of at least 10% in the odds ratio between race and postneonatal mortality when added to a bivariate model, or when removed from a multivariate model.

Results: In stratified analysis, race remained associated with postneonatal mortality within most categories of marital status, maternal education, maternal age, prenatal tobacco or alcohol use, prenatal care utilization, parity and residence. The odds ratio between race and postneonatal mortality was reduced to 1.3 (95% CI 1.0, 1.6) by controlling for education, a composite variable of marital status and the presence of father's name on the birth certificate, and prenatal tobacco or alcohol use.

Conclusions: A small number of potentially modifiable factors explain most of the postneonatal mortality disparity between Alaska Natives and non-Natives, leaving a relatively small increase in risk. These findings suggest that by targeting Alaska Native women who display these characteristics, the postneonatal mortality gap may be reduced.
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March 2009