Michigan Council for Maternal and Child Health Friday Notes

August 22, 2014
In this issue
State Seeking Innovative Approaches to Improving Health of Moms, Babies
ACOG: All Pregnant Women Should Get Flu Vaccine
For Kids, Risks of Prenatal Smoking Persist Long-Term, Study Finds
State Seeking Innovative Approaches to Improving Health of Moms, Babies

Improving health and early childhood outcomes for high-risk mothers and their babies are the first priorities of Michigan Partners for Success, a state program centered on government teaming up with service providers and investors from the philanthropic and private communities to fund new approaches to address persistent community health problems.

The program focuses on improving health and early childhood development for high-risk mothers and their babies through home-visitation, community programs and better coordination of care throughout pregnancy until the child's second birthday.

"Everyone benefits when mothers and families get the assistance they need to get children off to the best start possible," Governor Snyder said in a released statement. "It's important for parents to get support to keep mothers and their babies healthy. This new program will help find innovative approaches to provide this vital care."

Michigan was chosen in a national competition to work with Harvard University's Kennedy School on the project.

Using the model, investors from the philanthropic community and private sector provide upfront funding to expand or replicate proven programs. Governments cover the costs only if the program successfully meets its goals.

The state is issuing a formal request for proposals this month, with a public meeting and bidder's conference scheduled for Sept. 4. Interested parties, including investors, are encouraged to attend the bidder's conference. Bids will be due in October, with finalist interviews planned for November. Programs will start in 2015.

Groups interested in submitting proposals can receive additional information at: www.michigan.gov/pfs
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ACOG: All Pregnant Women Should Get Flu Vaccine

New data show the continued critical need for all pregnant women, regardless of trimester, to receive the influenza vaccination, according to an updated Committee Opinion released by the American College of Obstetricians and Gynecologists. Several studies released in recent years have increasingly demonstrated the safety and efficacy of influenza vaccine during pregnancy.

ACOG emphasizes that preventing the flu is an essential element of preconception, prenatal, and postpartum care. Moreover, physicians, healthcare organizations, and public health officials should improve their efforts to increase immunization rates among pregnant women, according to the Committee Opinion.

Prior to the H1N1 pandemic in 2009, influenza immunization rates for pregnant women were at only 15%. This rate increased to 50% in the 2009-2010 flu season and has been sustained or slightly increased every flu season since due to strong efforts by the College, the CDC and others. However, there is still room for significant improvement to increase influenza immunization rates for all pregnant women beyond 50%.

Flu vaccination is crucial for all pregnant women because the immune system changes during pregnancy, which puts women at increased risk of serious illness and complications if they get the flu. In addition, flu vaccination performs double duty by protecting both pregnant women and their fetuses; babies cannot be vaccinated against the flu until they are six months old, but they receive antibodies from their vaccinated mother, helping to protect them until they can be vaccinated directly.

"The flu virus is highly infectious and can be particularly dangerous to pregnant women, as it can cause pneumonia, premature labor, and other complications, " said Laura Riley, MD, chair of ACOG's Immunization Expert Work Group, which developed the Committee Opinion in conjunction with the Committee on Obstetric Practice. "Vaccination every year, early in the season and regardless of the stage of pregnancy, is the best line of defense."

Vaccination early in the flu season is optimal, regardless of the stage of pregnancy, but it can be done at any time during the season, which is October through May. ACOG advises that all women who are or who become pregnant during the annual flu season get the inactivated flu vaccine. Women can also receive the flu vaccine postpartum and while they are breastfeeding. The live attenuated version of the flu vaccine (the nasal mist) should not be given to pregnant women.

August is National Immunization Awareness Month. For more information see ACOG's hub on immunization for women: http://www.immunizationforwomen.org/

Committee Opinion #608, "Influenza Vaccination During Pregnancy," will be published in the September issue of Obstetrics & Gynecology.

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For Kids, Risks of Parental Smoking Persist Long-Term, Study Finds

HealthDay

Smoking while pregnant or around an infant has long been linked to development of asthma and allergies in young children. Now, researchers have found that the risk may persist into the teen years.

The study, which followed nearly 4,000 children in Sweden for 16 years, underscores the dangers of parental smoking, experts say.

"Exposure to second-hand smoke during pregnancy or infancy increases a child's risk of developing allergic disease even up to adolescence," said study researcher Jesse Thacher, a doctoral student at the Karolinska Institute in Stockholm.

Fetal exposure to cigarette smoking was linked with an overall 45 percent higher risk of getting asthma up until age 16, Thacher found.

For infants exposed to a parent's smoking, the risks of developing asthma and allergic rhinitis (stuffy or runny nose) in childhood or adolescence were 23 and 18 percent greater, respectively. The risk for eczema (inflamed, irritated skin) was 26 percent greater.

Previously, it wasn't clear whether the risks for asthma and allergies continued into the teen years, Thacher said.

The study, published online Aug. 18 in Pediatrics, only found an association between second-hand smoke and children's health problems, however. It wasn't designed to show a cause-and-effect relationship.

Thacher asked parents of children born from 1994 to 1996 about their smoking habits, other lifestyle information, and symptoms of allergic diseases in their children during the course of the study.

About 13 percent of the mothers smoked during pregnancy. Parental smoking during infancy was reported by more than 20 percent.

"Rates of parental smoking in the U.S. vary by state, but it's around 17 percent," he said.

Allergies aren't the only childhood concern related to second-hand smoking. Second-hand smoke contains about 4,000 chemicals, according to the American Academy of Pediatrics. More than 50 of those chemicals are known to cause cancer.

Smoking during pregnancy has also been linked with miscarriage, premature birth, lower birth weight, sudden infant death syndrome (SIDS) and learning problems.

The findings provide new information and also reinforce other research, said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, who wasn't involved in the study.

"There's no safe smoking," he said, "and there doesn't seem to be much safe second-hand smoking either."

People are less aware of the dangers of second-hand smoke compared to direct smoking, Horovitz said. "I don't think the message about second-hand smoke exposure has been hammered home," he said.

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Contributors to this Issue
American College of Obstetricians and Gynecologists (ACOG)
HealthDay
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Quick Links . . .

Webinar: Addressing Michigan's Obesity Problem, a CRC Report

In a new report,Addressing Michigan's Obesity Problem, the Citizens Research Council of Michigan explores

1. why high obesity rates are a problem,
2. the potential causes driving high rates in Michigan, and
3. the most effective solutions at the school, local, and state levels.

CRC will host a webinar on Wednesday, August 27, 2014 2:00 PM - 3:30 PM EDT to review this paper and answer questions.

Register to attend. Space is limited.
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Commission to Eliminate Child Abuse and Neglect Fatalities to Hold Public Meeting
The Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF), a federal advisory committee established by the Protect Our Kids Act of 2012 (P. L. 112-275), will hold an open meeting, 8am-4:30pm, Thursday, August 28, 2014, at The Inn at St. John's, Grande Ballroom, 44045 Five Mile Road, Plymouth, Michigan 48170.
To attend in person or listen to the teleconference, register by Tuesday, August 26.

CECANF was established to develop a national strategy and recommendations for reducing fatalities resulting from child abuse and neglect. The purpose of this meeting is for Commission members to gather national and state-specific information to better understand the extent of, and risks associated with, child abuse and neglect fatalities. The Commission will hear from researchers and experts from such disciplines as child welfare, law enforcement.
For further information: Visit the CECANF website or contact Patricia Brincefield, Communications Director, 1800 F St., NW, Room 7003D, Washington, DC 20006, 202-818-9596 or email.
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Early Elective Delivery Playbook: New NQF Publication

The National Quality Forum-convened Maternity Action Team developed the Playbook for the Successful Elimination of Early Elective Deliveries - or simply the "Playbook" - a document providing guidance and strategies for those still struggling to reduce their rates of early elective deliveries (EEDs). With the action team's focus on improving the health of mothers and babies through a model of sharing best practices and aligning public- and private-sector patient safety efforts, the Playbook offers support to all who are practicing and delivering care, and provides specific guidance for hospitals and hospital systems facing various barriers and challenges in their quality improvement (QI) efforts.

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Job Opening: Parent Consultant for CSHCS Family Center
The Family Center for Children and Youth with Special Health Care Needs has a job opening for a Parent Consultant. The Family Center is the parent-directed section of CSHCS; providing support to families statewide and serving as a voice for families who have children with special needs. All programs and services of the Family Center support family-centered, culturally competent, community-based, and coordinated care for families of children with special needs. Read the full job description here. Applications are due September 2, 2014.

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Next Michigan Health Endowment Fund Listening Tour Stop Announced
The Board of Directors of the Michigan Health Endowment Fund is conducting a listening tour to gain a better understanding of the health issues confronting Michigan residents, and to familiarize the public with the purpose of the Michigan Health Endowment Fund. The second session will be held from 10 a.m. to noon on September 4 in Marquette at Northern Michigan University. Four additional sessions will be scheduled in other regions of the state.

Register online for the September 4 session here.

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2014 Family Planning Update: Sept. 24-25
The 2014 Family Planning Update: Empowering Reproductive Health, will be held September 24-25 at the DoubleTree Hotel in Holland. This event brings together top policymakers and Family Planning forerunners from across the nation to provide quality training to the Michigan Family Planning Program. This two day, action packed event will provide you with all of the tools, resources, and best practices you need to accomplish your goals within your local community. This year, located near downtown Holland, the 2014 Family Planning Update offers a talented speaker lineup, and includes such names as Anita Nelson, Dr. Peter Gulick,, Dr. Brent Davidson, NFPHRA, Guttmacher and others. Online registration available here.

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