OverviewImproving the well-being of mothers, infants, and children is an important public health goal for the United States. Their well-being determines the health of the next generation and can help predict future public health challenges for families, communities, and the health care system.
Why It's ImportantPregnancy can provide an opportunity to identify existing health risks in women and to prevent future health problems for women and their children. These health risks may include:
- Hypertension and heart disease
- Genetic conditions
- Sexually transmitted diseases (STDs)
- Tobacco use and alcohol abuse
- Inadequate nutrition
- Unhealthy weight
Who Is at Risk
Many factors can affect pregnancy and childbirth, including:
- Preconception health status
- Access to appropriate preconception and interconception health care
Infant and child health are similarly influenced by sociodemographic factors, such as family income, but are also linked to the physical and mental health of parents and caregivers.
There are racial and ethnic disparities in mortality and morbidity for mothers and children, particularly for African Americans. These differences are likely the result of many factors.
Social Determinants of Maternal Health
Physical Determinants of Maternal Health
Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and during pregnancy. In addition, environmental factors can shape a woman's overall health status before, during, and after pregnancy by:
- Affecting her health directly.
- Affecting her ability to engage in healthy behaviors
Social Determinants of Infant and Child Health
The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial and ethnic disparities in infant mortality exist, particularly for African American infants. Child health status varies by both race and ethnicity, as well as by family income and related factors, including educational attainment among household members and health insurance coverage.
Physical Determinants of Infant and Child Health
The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and development. Furthermore, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other social adversities, are more likely to have better outcomes as adults.
Emerging Issues in Maternal, Infant, and Child Health
Recent efforts to address persistent disparities in maternal, infant, and child health have employed a "life course" perspective to health promotion and disease prevention. At the start of the decade, fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives have been aimed at improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.
The life course perspective also supports the examination of quality of life, including the challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44 have received infertility services (including counseling and diagnosis) in their lifetime. Infertility is an area where health disparities are large, particularly among African American women, and may only continue to increase as childbearing practices change over time.
How It's Tracked
Maternal and Child Health is tracked at the national and state levels primarily through:
- Pregnancy Risk Assessment and Monitoring System (PRAMS)
- Birth certificates
- Death certificates