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Introduction: There are limited and conflicting data regarding the impact of hepatitis C in pregnancy on adverse birth outcomes. Methods: Using the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET), a large surveillance cohort, we describe birth outcomes among a cohort of people with HCV in pregnancy in total and by reported substance use. Results: Among 1418 infants, 89% were born to people with reported substance use during pregnancy. The proportion born preterm was 20%, 13% were small-for-gestational age and 34% of term infants required intensive care. Conclusions: Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. Significance: Incidence of hepatitis C in pregnancy is increasing. Prematurity, small-for-gestational age, and intensive care unit admission were common among this surveillance cohort of infants born to people with hepatitis C in pregnancy with high frequency of substance use. Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine the number and characteristics of US State Registrars of Vital Statistics (Vital Registrars) and State Systems Development Initiative (SSDI) Coordinators that link birth certificate and hospital discharge data as well as using linkage processes. Methods: Vital Registrars and SSDI Coordinators in all 52 vital records jurisdictions (50 states, District of Columbia, and New York City) were asked to complete a 41-question survey. We examined frequency distributions among completed surveys using SAS 9.3. Results: The response rate was 100 % (N = 52) for Vital Registrars and 96 % (N = 50) for SSDI Coordinators. Nearly half of Vital Registrars (n = 22) and SSDI Coordinators (n = 23) reported that their jurisdiction linked birth certificate and hospital discharge records at least once in the last 4 years. Among those who link, the majority of Vital Registrars (77.3 %) and SSDI Coordinators (82.6 %) link both maternal and infant hospital discharge records to the birth certificate. Of those who do not link, 43 % of the Vital Registrars and 55 % of SSDI Coordinators reported an interest in linking birth certificate and hospital discharge data. Reasons for not linking included lack of staff time, inability to access raw data, high cost, and unavailability of personal identifiers to link the two sources. Conclusions: Results of our analysis provide a national perspective on data linkage practices in the US. Our findings can be used to promote further data linkages, facilitate sharing of data and linkage methodologies, and identify uses of the resulting linked data. [ABSTRACT FROM AUTHOR]

There is limited data on prepregnancy obesity trends specifically among low-income women, a population at high risk for obstetric complications. Using the Pregnancy Nutrition Surveillance System, we assessed prepregnancy obesity [body mass index (BMI) ≥ 30 kg/m] trends among women who participated in the Supplemental Nutrition Program for Women, Infants, and Children in 1999, 2004, and 2008. Prepregnancy BMI was calculated using measured height and self-reported prepregnancy weight. We report unadjusted contributor (state, territory or Indian tribal organization) specific trends, and both unadjusted and adjusted overall trends, to account for changes in maternal age and race-ethnic distributions, using 1999 as the referent. Of the 27 contributors in 1999, 2 had a prepregnancy obesity prevalence <20%, and 1 had a prevalence ≥30%. Of the 35 contributors in 2008, none had a prepregnancy obesity prevalence <20%, and 14 had a prevalence ≥30%. From 1999 to 2008, the overall prevalence of prepregnancy obesity increased among all racial-ethnic groups, except among American Indian/Alaskan Natives, where it remained high, but stable. Overall prepregnancy obesity increased most rapidly among Hispanics, and remained stable from 2004 to 2008 among non-Hispanic blacks. In 2008, prevalence was highest among American Indian/Alaskan Natives (36.1%) and lowest among Asians/Pacific Islanders (10.8%). The adjusted prepregnancy obesity prevalence increased from 24.8% in 1999 to 28.3% in 2008, a relative increase of 14.1%. Prepregnancy obesity among low-income women increased from 1999 to 2008 and varied by race-ethnicity. These data can be used by obesity prevention programs to better target high-risk women. [ABSTRACT FROM AUTHOR]