Research Notes – Use of behavioral intervention to reduce infant mortality rates

It is the first study to evaluate behavioral interventions and their effectiveness in reducing the number of preterm births in a high-risk patient population.

As part of the National Institutes of Health (NIH)- DC Initiative to Reduce Infant Mortality in Minority Populations, researchers led by College of Public Health Dean Ayman El-Mohandes, M.D., M.B.B.Ch., M.P.H., examined several risk factors that are often interconnected yet contribute to the health disparities in infant mortality rates.

“Much of the current research is focused on medical risks (such as maternal age, hypertension and inter-pregnancy spacing) or cause and effect correlations,”Dr. El-Mohandes said. “Our research work evaluated a behavioral intervention to improve pregnancy outcomes.”

Ayman El-Mohandes, M.B.B.Ch., M.D., M.P.H.

Dr. El-Mohandes’ team studied the following risk factors, which have all been associated with poor pregnancy outcomes:

• Smoking;
  
• Environmental tobacco smoke exposure;
  
• Depression; and
  
• Intimate partner violence.

Data indicated that it was unusual for a woman to have just one risk factor. Therefore, individually designed counseling sessions were offered to participants during their prenatal visits. They learned coping skills and received interventions — such as smoking patches or cessation counseling — to improve their pregnancy outcomes.

In several studies published recently, results indicated the women benefited from the counseling. In addition, the studies confirmed a link between therapy interventions and a reduction of birth rates in high-risk categories such as preterm and low birth weight.

Recent publications Dr. El-Mohandes’ research was published recently in the following journals: Pediatrics – March 2010 Obstetrics & Gynecology – February 2010 Maternal Child Health – January 2010

“It is a simple intervention that could be carried out in the clinical setting,” Dr. El-Mohandes said. “Our recommendations include asking health care providers to go beyond screening for risk factors to provide behavioral interventions to address risk factors during prenatal visits. We think the potential cost savings with reduction of high risk births should become a heath policy priority.”

Other institutions that contributed to this research include:

• Children’s National Medical Center;
  
• Georgetown University;
  
• George Washington University;
  
• Howard University;
  
• The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD);
  
• The National Center for Minority Health and Health Disparities; and
  
• RTI International.