Maternal Child Health and Maternal Child Health and Maternal Child Health and Chronic Disease Chronic Disease Chronic Disease The Odd Couple The Odd Couple The Odd Couple or or or A Marriage Made in Heaven? A Marriage Made in Heaven? A Marriage Made in Heaven? AMCHP Women and Perinatal Health Information Series AMCHP Women and Perinatal Health Information Series July 17, 2008 July 17, 2008 July 17, 2008 Joan Ware, MSPH, RN, Consultant, Women’ ’s Health Council, National Association of Chroni s Health Council, National Association of Chronic Joan Ware, MSPH, RN, Consultant, Women Joan Ware, MSPH, RN, Consultant, Women’s Health Council, National Association of Chroni Disease Directors Disease Directors Disease Directors ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Outline Outline Outline • What is NACDD? What is NACDD? • • Why chronic disease and MCH? Why chronic disease and MCH? • • Why gestational diabetes? Why gestational diabetes? • • What is the Gestational Diabetes What is the Gestational Diabetes • Collaborative Project Collaborative Project • What can MCH programs do? What can MCH programs do? • ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Collaborators Collaborators ����� ����� ���������������������������� ���������������������������� �!���!����������� �!���!����������� ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ���������������� ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Who is NACDD? Who is NACDD? Who is NACDD? • The The “ “AMCHP AMCHP” ” for Chronic Disease for Chronic Disease • • More than 800 members from every US More than 800 members from every US • state and territory state and territory • 16 Councils and special interest groups 16 Councils and special interest groups • supporting state public health activities supporting state public health activities focusing on specific chronic disease focusing on specific chronic disease and health promotion areas and health promotion areas ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Councils and Special Councils and Special Councils and Special Interest Groups Interest Groups Interest Groups • Obesity Obesity • Asthma Asthma • • • Healthy Aging Healthy Aging • Arthritis Arthritis • • • Health Disparities Health Disparities • Cancer Cancer • • Physical Activity Physical Activity • Diabetes Diabetes • • • • Vision and Eye Vision and Eye • Heart Disease and Heart Disease and • • Health Health Stroke Stroke • Tobacco Use Tobacco Use • School Health School Health • • Prevention Prevention • Women Women’ ’s Health s Health • • Depression Depression • • Osteoporosis Osteoporosis • ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Why Link MCH and Chronic Why Link MCH and Chronic Why Link MCH and Chronic �� �� Disease/Health Promotion? Disease/Health Promotion? Disease/Health Promotion? � � � � " " � � ! ! � � � � � � � � � � � � � � � � � � � � • Preconception care is important, especially for Preconception care is important, especially for • women with chronic diseases women with chronic diseases – Risk factors and conditions can be identified Risk factors and conditions can be identified – early and addressed early and addressed • Pregnancy can unmask a potential for chronic Pregnancy can unmask a potential for chronic • diseases diseases • Pregnancy is an entry point into health care and Pregnancy is an entry point into health care and • an opportunity for primary prevention of chronic an opportunity for primary prevention of chronic diseases diseases ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Why Chronic Disease? Why Chronic Disease? Why Chronic Disease? Among women of child bearing age: Among women of child bearing age: • Asthma (medication risk) Asthma (medication risk) 6.1% 6.1% • • Hypertension/CVD Hypertension/CVD 6.4% 6.4% • • Diabetes Diabetes 9.3% 9.3% • • Smoke during pregnancy Smoke during pregnancy 11.4% 11.4% • • Overweight or obese Overweight or obese 55.0% 55.0% • • 250,000 breast cancer 250,000 breast cancer • survivors under age 40 survivors under age 40 ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
Why Chronic Disease? Why Chronic Disease? Why Chronic Disease? Of women who are pregnant: Of women who are pregnant: 3- -8% will develop gestational diabetes 8% will develop gestational diabetes 3 • • 10- -15% will develop postpartum depression 15% will develop postpartum depression 10 • • If overweight prior to pregnancy, her offspring is 3 times more If overweight prior to pregnancy, her offspring is 3 times more • • likely to be overweight by age 7 likely to be overweight by age 7 If preeclampsia developed in pregnancy there is an increased If preeclampsia developed in pregnancy there is an increased • • lifetime risk of metabolic syndrome, ischemic heart disease and lifetime risk of metabolic syndrome, ischemic heart disease and stroke stroke Postpartum state confers 5- -fold risk of new fold risk of new- -onset rheumatoid onset rheumatoid Postpartum state confers 5 • • arthritis, especially after first pregnancy arthritis, especially after first pregnancy ����������������������� ����������������������� ������������������������� ������������������������� ������ ����� ����������������� ����������������
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