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The mission of the Centers for Disease Contol's Division of Reproductive Health, Applied Sciences Branch, Research and Evaluation Team (RET) is to improve the health of mothers and infants by—

• Monitoring chronic disease and related risk factors among women of reproductive age.
   
• Developing and evaluating innovative interventions, policies, and integrated services that promote healthy behaviors among women of reproductive age and improve reproductive health outcomes for women and infants.

The RET aims to achieve its mission by conducting the following activities:

• Evaluating state quit lines to help pregnant and postpartum smokers to quit
  Telephone-based counseling via tobacco quit lines has proven to be an effective method for delivering cessation counseling to the general adult population. Quit lines are now available in all 50 states and, therefore, have the potential of reaching diverse populations. In FY 2009, CDC's Division of Reproductive Health (DRH) and CDC's Office of Smoking and Heath (OSH) are co-funding three states to evaluate the referral patterns and use of quit lines among pregnant women and their health care providers. The evaluation results may help to develop several clinic-based models for promoting quit lines and referring pregnant and postpartum smokers to them. The three grantees include The Translational Tobacco Reduction Research Program at the West Virginia University, The University of Wisconsin’s Center for Tobacco Research and Intervention, and University of Medicine and Dentistry of New Jersey.

Preventing Smoking and Exposure to Secondhand Smoke Before, During, and After Pregnancy

For more information about tobacco and pregnancy, please visit http://www.cdc.gov/reproductivehealth/TobaccoUsePregnancy/

• Quality improvement project to increase postpartum diabetes testing rates among women with gestational diabetes
  The RET team in collaboration with the Maternal and Infant Health Team in CDC's DRH are funding a quality improvement project at the Kaiser Permanente Northwest (KPNW) to increase postpartum diabetes testing rates among women with gestational diabetes. An initial study found that postpartum diabetes testing rates at KPNW increased from 56% in 1999 to 68% in 2006. The quality improvement project will focus on provider education and feedback for current postpartum testing rates, as well as system changes to remind providers to order the lab test and patients to complete it.
   
  
• Collaboration between Maternal and Child Health and Chronic Disease Programs
  DRH supports collaboration between state maternal and child health (MCH) departments and state chronic disease departments through a cooperative agreement with the National Association of Chronic Disease Directors. This project monitors and encourages collaboration between MCH and Chronic Disease state staff to address issues such as prenatal smoking and preventing type 2 diabetes among women with gestational diabetes and to use Pregnancy Risk Assessment Monitoring System (PRAMS) data to identify needs and evaluate programs.
   
• Cooperative agreement with the Association of Maternal and Child Health Programs
  CDC supports a cooperative agreement with the Association of Maternal and Child Health Programs (AMCHP)* to support prenatal smoking cessation programs in states. AMCHP’s members consist of all state Maternal and Child Health (MCH) program directors and their staff. AMCHP is partnering with the American College of Obstetricians and Gynecologists (ACOG)* and the Planned Parenthood Federation of America (PPFA)* to strengthen knowledge, partnerships, and capacity among state MCH and tobacco professionals, OB–GYNs, and community clinicians regarding effective tobacco programs for women of reproductive age.
   
• Maternal Child Health Smoking Attributable Mortality, Morbidity, and Economic Costs
  MCH SAMMEC is an online tool to estimate annual smoking-attributable medical expenditures, deaths, and years of potential life lost for infants exposed to tobacco in the United States.
   
• Ongoing analyses of the Pregnancy Risk Assessment Monitoring System to help guide and prioritize RET team intervention efforts. A few examples include the following:
  • Describing the burden of chronic disease conditions and risk factors among low-income women. The results of this analysis can be used to increase certain types of screenings and referrals for low-income women accessing publicly funded family planning clinics.
  • The 1990 Institute of Medicine recommendations for weight gain during pregnancy are currently being reviewed. Two analyses are being conducted to evaluate associations between recommended weight gain and pregnancy outcomes. In addition, trends in weight gain during pregnancy are being explored.

Publications

Allen AM, Prince CB, Dietz PM. Postpartum Depressive Symptoms and Smoking Relapse. Am J Prev Med 2009;36(1):9–12.

Allen AM, Dietz PM, Tong VT, England LJ, Prince CB. Prenatal Smoking Prevalence Ascertained from Two Population-Based Data Sources: Birth Certificates and PRAMS Questionnaires, 2004. Public Health Rep 2008;123(5):586–592.

Tong VT, England LJ, Dietz PM, Asare LA. Smoking Patterns and Use of Cessation Interventions During Pregnancy. Am J Prev Med 2008;35(4):327c333.

Dietz PM, Vesco KK, Callaghan WM, Bachman DJ, Bruce FC, Berg CJ, England LJ, Hornbrook MC. Postpartum Screening for Diabetes After a Gestational Diabetes Mellitus-Affected Pregnancy. Obstet Gynecol 2008;112(4):868–874.

Kuhlmann AK, Dietz PM, Galavotti C, England LJ.  Weight-Management Interventions for Pregnant or Postpartum Women.  Am J Prev Med 2008;34(6):523–528. Review.

Dietz PM, Adams MM, Kendrick JS, Mathis MP. Completeness of ascertainment of prenatal smoking using birth certificates and confidential questionnaires: variations by maternal attributes and infant birth weight. Am J Epidemiol 1998;148(11):1048–54.

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Page last reviewed: 4/15/09
Page last modified: 4/15/09
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion