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Improving Maternal, Newborn, and Child Health

Tobacco Use During Pregnancy

Tobacco use during pregnancy is harmful to both the mother and the unborn child; however, smoking is a common practice in some countries, such as in Argentina and Uruguay where 15% and 20% of pregnant women smoke. Despite this high rate of tobacco use, brief counseling—which is effective in helping women quit smoking—is not a regular part of antenatal care in those countries.

CDC's Division of Reproductive Health funded a 4-year project to evaluate the effectiveness of having nurse midwives provide brief smoking cessation counseling in prenatal clinics in Buenos Aires, Argentina, and Montevideo, Uruguay. This project seeks to increase counseling delivered by clinic staff and to decrease smoking among pregnant women. Research is being led by Tulane University in collaboration with the Institute for Clinical Effectiveness and Health Policy and with the Montevideo Clinical and Epidemiological Research Unit. The study began in the spring of 2012 and follow-up data collection will be complete by the fall of 2013. If the program is found to be effective, the approach can be used in similar settings in other countries.

woman putting out cigaretteCDC's Division of Reproductive Health has funded the World Health Organization (WHO) to develop the first guidelines on treating tobacco dependence during pregnancy. These guidelines provide the state of the science on effective policies and interventions that reduce tobacco use and secondhand smoke exposure during pregnancy. CDC's Division of Reproductive Health conducted a systematic review of published studies on programs to reduce secondhand smoke exposure in prenatal care, and additional systematic reviews were commissioned by other researchers. An expert panel reviewed the evidence and developed recommendations for treatment. These guidelines are expected to be released in summer 2013. 

Another analysis led by CDC's Division of Reproductive Health has shown how great the need is for such tobacco cessation guidelines. CDC's Division of Reproductive Health looked at tobacco use and exposure to secondhand smoke among women of reproductive age in 14 low- and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay and Vietnam). In these countries, almost half of reproductive-aged women (470 million women) were exposed to secondhand smoke in the home, and an estimated 92 million women were current tobacco users. Source: (Current tobacco use and secondhand smoke exposure among women of reproductive age––14 countries, 2008–2010. MMWR. 2012;61(43):877–882.

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Border Maternal and Child Health (Border MACH)

Pregnany womanTo improve maternal and child health (MCH) along the U.S.-Mexico border, CDC's Division of Reproductive Health is working with health program staff at the local and regional levels helping them work collaboratively and increasing their use of MCH data to meet the health needs of the region.

Partnering with the Mexican Secretariat of Health, the U.S.-Mexico Border Health Commission and other United States and Mexican institutions, CDC's Division of Reproductive Health has established binational teams of program directors, epidemiologists, data managers, and other local health organization staff in sister cities along the border. These sister city pairs are Tijuana, Baja California—San Diego, California;  Nogales, Chihuahua—Santa Cruz County, Arizona; Ciudad Juarez, Chihuahua—El Paso,  Texas—Dona Ana, New Mexico; and Matamoros, Tamaulipas—Cameron County, Texas.

CDC's Division of Reproductive Health provides training and technical assistance to the teams to design and carry out MCH capacity-building projects in their communities. In CDC training workshops, the binational teams learn how to access and use available data to bring about local change, and learn how to work binationally to provide the needed maternal and child care on both sides of the border. These efforts are ongoing and teams that have received training are carrying out binational projects around shared MCH priorities.

CDC has assisted many nations with surveillance and research in maternal and infant health, and continues to provide global technical assistance.

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