Maternal and Child Health

PROGRAMS

Baltimore City FIMR/HIV Prevention Project

The Center for a Healthy Maryland has been selected as a project site for the FIMR/HIV Prevention Methodology, a collaborative project of the CDC, CityMatCH, ACOG and NFIMR. This project looks at cases of prenatal HIV exposure using the Fetal and Infant Mortality Review methodology of case review and community action. During the first year of the project, October 2009 to September 2010, the Center partnered with Sinai Hospital’s Women, Children, and Youth HIV Program. During the second year, October 2010 to September 2011, the goal is to identify cases at additional birthing hospitals that more broadly represent women in Baltimore City who give birth to infants with prenatal HIV exposure.

Similar to FIMR, FIMR/HIV case review will look at systems issues and identify opportunities for improvement within health and human service systems within the city of Baltimore. Project findings and recommendations will be shared with the Baltimore City FIMR Community Action Team and the Department of Health and Mental Hygiene.

For more information on the FIMR/HIV Prevention Methodology, please visit the FIMR/HIV National Resource Center.

Maryland Maternal Mortality Review

The Maternal Mortality Review Program examines deaths among resident women while pregnant or within one year of having been pregnant, in order to identify opportunities to reduce maternal morbidity and mortality. The Program is conducted in collaboration with MedChi’s Maternal and Child Health Subcommittee, the Center for Maternal and Child Health, and the Maryland Department of Health and Mental Hygiene.

The Program develops recommendations and identifies strategies to reduce maternal morbidity and mortality, taking into account both medical and non-medical factors contributing to the death, while examining quality and content of care. For the past several years, the Program has reviewed an average of 38 cases per year.

During 2011-2012 the committee completed the review of the 2010 deaths. Click here for the 2012 Annual Report.

For more information, please visit the Maryland State Department of Health and Mental Hygiene.

HIV/AIDS – Preventing Perinatal HIV Transmission

In past years, an estimated 92% of AIDS cases reported among children less than 13 years old in the US were attributed to perinatal or mother-to-child transmission of HIV. Transmission can occur during pregnancy, labor, delivery or breastfeeding. Recent reductions in perinatal transmission are attributed to routine screening of pregnant women to identify those infected with HIV and the use of anti-retroviral drugs for treatment and prophylaxis. Rates of HIV transmission from an infected mother to her infant have been reduced to less than 2%, compared to 25%-30% with no interventions.

The Center for a Healthy Maryland (Maryland State Medical Society) partnered with the Infectious Disease and Environmental Health Administration (former Maryland AIDS Administration) to work to pass legislation that changed Maryland law to meet the CDC recommendations for universal HIV testing. A critical part of which dealt with HIV testing in pregnant women. As a result of these changes the Center now participates in a collaborative partnership between the Infectious Disease and Environmental Health Administration and the University of Maryland Institute for Human Virology. The Perinatal HIV Education and Consultation Team (PHECT) provide technical assistance through education and practice consultation at Maryland Hospitals on implementing Rapid HIV Testing.

Please click here for more information on the Center for a Healthy Maryland’s activities on HIV/AIDS, including the 2007 changes to the HIV/AIDS reporting law.

Regional Perinatal Advisory Group

The Center for a Healthy Maryland is an active member of the Regional Perinatal Advisory Group whose goal is to optimize the health of pregnant women and newborn infants in the Baltimore region through education, advocacy, and information sharing. RPAG members are public and private sector clinicians, and public health officials from Baltimore County, Baltimore City, Carroll County, Frederick County, Harford County, and Howard County. The Center has worked with RPAG to develop materials for Perinatal HIV Transmission, Pertussis, and Perinatal Infections.

RESOURCES

Baltimore City Health Department, B’more for Healthy Babies

Click here for more information.

Maryland Fetal and Infant Mortality Review

Maryland’s Infant Mortality Rate has consistently ranked above the national average, even though Maryland is one of the wealthiest states in the country. The Maryland Fetal and Infant Mortality Review (FIMR) is a statewide effort to better understand the issues associated with fetal and infant mortality and morbidity, and to develop strategies to improve perinatal systems of care, both at the local and state level.

For more information about Fetal and Infant Mortality Review, visit www.NFIMR.org.

For more information about Maternal and Perinatal Health Programs in Maryland, please visit the Family Health Administration.

Perinatal HIV

The Baltimore Regional Perinatal Advisory Group (RPAG) works to optimize the health of pregnant women and newborn infants in the Baltimore region through education, advocacy and information sharing. RPAG has developed “Preventing Perinatal HIV Transmission: A Clinician’s Toolkit for Testing Counseling and Referral,” which can be accessed at www.baltimorecountymd.gov/go/perinatal.

For more information about HIV/AIDS, please visit the Centers for Disease Control and Prevention.

Maternal Depression – Improving Diagnosis and Treatment in Maryland

Maternal depression occurs anywhere from pregnancy up to 12 months following delivery, and is the most common complication of pregnancy, affecting 10–15 percent of all women. With support from the Aetna Foundation, the Center for a Healthy Maryland is building on previous efforts to enable clinicians to diagnose and manage maternal depression by increasing their awareness of the disorder and providing them with tools for use with their pregnant and postpartum patients.

Improved diagnosis and treatment of maternal depression will result in more women getting the necessary care to better care for themselves, their infants and family.

Resources
Postpartum Depression Helpline: 1-800-773-6667 available 24 hours, 7 days a week.

FASD – Preventing Alcohol Use During Pregnancy

Fetal Alcohol Spectrum Disorder (FASD) is a broad term that describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible life-long implications. FASD is also one of the leading-known preventable causes of mental retardation and birth defects.

The Center applied the Fetal and Infant Mortality Review approach to examine why some women drink during pregnancy, the current services and resources available, and opportunities for working with the community to assist at-risk women in avoiding alcohol use during pregnancy.

The Maryland FASD Coalition is working to increase awareness of the effects of alcohol use during pregnancy among health and social services professionals, substance abuse treatment program staff, juvenile services agency staff, the faith community, businesses and industry. Please visit the Maryland FASD Coalition for more information.

Center for Infant and Child Loss

The Center for Infant & Child Loss works with Maryland families and communities facing the sudden unexpected death of their infant or child as they learn to live with their loss. The Center is committed to increasing the understanding of sudden infant and child death, risk reduction practices, grief, and compassionate intervention.

Their website offers resources on counseling and support services, outreach and education, risk reduction and current research.

Contact Information

For more information on Maternal and Child Health Programs, please contact:

Erin Johnson Patton , MPH, CHES
Program Director
Phone: 410-539-0872 or 800-492-1056, ext. 3342
Fax: 410-649-4131
Email: ejohnson@medchi.org