Study looks at pregnancy issues
For pregnant women, being around women who receive antenatal care is contagious. If your neighbors seek care, you are more likely to seek care and have a better birth outcome, said Dr. Anastasia Gage.
Gage, a professor of epidemiology at Tulane University, visited the UNT Health Science Center to give a presentation about barriers to the use of maternal health care.
While Gage was speaking specifically about women in Mali, a country in Africa where nearly 90 percent of women donÂ’t
go to school, she said, her ideas about
community education for expecting women are being tested in Fort Worth, where the infant mortality rate is still higher than in the rest of Texas or the United States.
The Health Science Center and the Fort Worth/Dallas Birthing Project are collaborating to study the effects of community guidance for pregnant women in a study funded by the National Institutes of Health.
Kim Parish Perkins, the executive director of the Fort Worth/Dallas Birthing Project, said a study had been contemplated for years because it was obvious that pairing a trained person with a pregnant woman gives mothers the support and resources necessary to have better, healthier pregnancies.
“We knew the benefits of it,” Parish Perkins said.
Kathryn Cardarelli, an assistant professor of epidemiology and director of the Center for Community Health, said that there has never been a similar study done in Fort Worth and Tarrant County and that there was a need for scientific data about what can affect birth outcomes.
“This is the conundrum about infant mortality — there’s so much we don’t know,” Cardarelli said.
What is known is that if a child is born with a poor birth outcome, such as born with a low birth weight, it can be an economic burden. The cost of care for an extremely low birth weight infant through the first two years of life is 25 times as much as the cost to care for an infant of normal weight, according to data from the September 2005 Tarrant County Infant Mortality Report.
Part of the puzzle is that overall, Texas has a low infant mortality rate — lower than the rate of the nation as a whole, according to the county’s report. The most recent data, which is for 2003, shows that the country averages 6.9 deaths per 1,000 live births, whereas Tarrant County averages 7.5 and Texas averages 6.6 deaths.
Part of the reason why Texas is so low is the “Hispanic paradox,” said Cardarelli. For unknown reasons, Hispanic women tend to have good birth outcomes, and the high number of Hispanic women in Texas is thought to contribute to the state’s low numbers.
However, high infant mortality rates in Tarrant County could indicate something about the overall health or well-being in a community, according to the report. It can also point to health disparities, like the fact that while white and Hispanic women in Texas have low infant mortality rates, black women had the infant mortality rate of 13.8 deaths per 1,000 live births in 2003.
Parish Perkins said most of the women served by the Fort Worth/Dallas Birthing Project are over the age of 18, black or Hispanic and educated, and yet the disparities persist. Scientifically tracking women can help community organizations like hers have an idea of how best to help women, she said.
“There’s so many things to look at,” said Parish Perkins.
The Fort Worth/Dallas Birthing Project was founded about 10 years ago with the SisterFriend program. In the SisterFriend program, a female volunteer is assigned to a high-risk pregnant woman. The volunteer accompanies the pregnant woman on her doctor visits, provides access to resources as needed and offers emotional and social support.
The Aintie-Tia program is the one that will be examined in the upcoming study, which is currently enrolling pregnant African-American women over 18 who are 10 to 29 weeks pregnant. Aintie-Tias are specially trained to help educate about pregnancy, childbirth, parenting and breast feeding, and they will also be available as resources to women until their children are a few months old.
Cardarelli said study participants will either be assigned an Aintie-Tia or go through regular antenatal care, and then the birth outcome data, such as birth weight of the infant and success with breastfeeding, will be compared.
Dorian Villegas, an epidemiologist and data analyst for the city of Fort WorthÂ’s health department, works with the Tarrant County Infant Mortality Network and he said the city is in the process of gather data about infant health and womenÂ’s health to better assess needs.
The most recent data Villegas said he has seen shows that the prime time to make an impact on infant mortality is before conception. By encouraging women to be healthy, thereÂ’s a better chance for healthy babies, he said.
“It’s a long-term project,” Villegas said. “Infant mortality depends on whatever resources are available at the local level.”
Contact Bassett at ebassett@bizpress.net
