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At least 19 recordsLinked to original sources
PubMed2006

Critical role of the March of Dimes in the expansion of newborn screening.

Expansion of newborn screening (NBS) has been driven primarily by a combination of advances in technology and medical treatment, and the sustained advocacy efforts of consumers and voluntary health organizations. The longstanding leadership of the March of Dimes has been credited by many as a critical factor in the expansion and improvement of state NBS programs. From the historic vantage point of four decades of March of Dimes involvement with newborn screening, this report reviews the unique origin of the first newborn screening test, and identifies from this point of origin several of the elements which still define the evolution of advocacy for NBS today. It also documents activities at the federal level and in seven states that have lead to expanded screening for newborns. Advances in NBS technology and medical treatment have informed policy development. Mobilization of volunteers and focused advocacy activities have brought about expansion of screening opportunities for newborns across the United States. But more work is needed. Continued application of the effective strategies identified in this report will help assure that all families have the best possible chance of assuring that their newborns do not have to suffer the complications of conditions that we know can be treated effectively.

Financing, Government↗
PubMed2005

Research agenda for preterm birth: recommendations from the March of Dimes.

Preterm birth (PTB) is a common, serious, and costly health problem affecting nearly 1 in 8 births in the United States. Burdens from PTB are especially severe for the very preterm infant (<32 weeks' gestation), comprising 2% of all US births. Successful prevention needs to include newly focused and adequately funded research, incorporating new technologies and recognition that genetic, environmental, social, and behavioral factors interact in complex pathogeneses and multiple pathways leading to PTB. The March of Dimes Scientific Advisory Committee created this prioritized research agenda, which is aimed at garnering serious attention and expanding resources to make major inroads into the prevention of PTB, targeting six major, overlapping categories: epidemiology, genetics, disparities, inflammation, biologic stress, and clinical trials. Analogous to other common, complex disorders, progress in prevention will require incorporating multipronged risk reduction strategies that are based on sound scientific discovery, as well as on effective translation into clinical care.

Charities↗
PubMed1994

The effect of corticosteroid therapy in the very premature infant. March of Dimes Multicenter Study Group.

OBJECTIVE: Our purpose was to determine the efficacy of maternal corticosteroid therapy between 26 and 31 weeks' gestation. STUDY DESIGN: The data in this study were derived from 32,658 women who participated in the March of Dimes-sponsored multicenter prematurity prevention program. Of the 432 women who were delivered at 26 to 31 weeks, 67 received betamethasone before delivery and 365 did not. The frequency and relative risks of adverse outcomes, including respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death were compared for each of two gestational age periods by means of univariate and multivariate techniques. RESULTS: When betamethasone was administered > or = 2 days before delivery (n = 45), there was a lower incidence of respiratory distress syndrome in both the 26 to 28 week group (53.9% vs 86.5%, p = 0.008) and the 29 to 31 week group (25.0% vs 59.1%, p = 0.0003). The rate of intraventricular hemorrhage was less in the betamethasone group at 26 to 28 weeks (15.4% vs 32.3%, p = 0.17), but the difference reached statistical significance only at 29 to 31 weeks (3.1% vs 16.5%, p = 0.029). Neonatal death occurred significantly less often in infants who were delivered at 26 to 28 weeks when their mothers received betamethasone compared with infants of the same gestational age whose mothers did not receive betamethasone treatment (0% vs 34.6%, p = 0.01). In a regression analysis of infants born between 26 and 31 weeks in which birth weight, gestational age, race, infant sex, and tocolytic use were controlled, the odds ratio for respiratory distress syndrome associated with betamethasone use was 0.20 (0.10, 0.42), for intraventricular hemorrhage 0.26 (0.08, 0.90), and for neonatal death 0.14 (0.02, 1.09). Insufficient numbers of women were given betamethasone before 26 weeks for analysis. CONCLUSION: Betamethasone appears to significantly reduce neonatal death and the morbidity between 26 and 31 weeks' gestation.

Betamethasone↗
PubMed2006

Trends in folic Acid awareness and behavior in the United States: the Gallup Organization for the March of Dimes Foundation surveys, 1995-2005.

OBJECTIVE: To summarize changes in folic acid awareness, knowledge, and behavior among women of childbearing age in the United States since the U.S. Public Health Service (USPHS) 1992 folic acid recommendation and later fortification. METHODS: Random-digit dialed telephone surveys were conducted of approximately 2000 women (per survey year) aged 18-45 years from 1995-2005 in the United States. RESULTS: The percentage of women reporting having heard or read about folic acid steadily increased from 52% in 1995 to 84% in 2005. Of all women surveyed in 2005, 19% knew folic acid prevented birth defects, an increase from 4% in 1995. The proportion of women who reported learning about folic acid from health care providers increased from 13% in 1995 to 26% in 2005. The proportion of all women who reported taking a vitamin supplement containing folic acid increased slightly from 28% in 1995 to 33% in 2005. Among women who were not pregnant at the time of the survey in 2005, 31% reported taking a vitamin containing folic acid daily compared with 25% in 1995. CONCLUSIONS: The percentage of women taking folic acid daily has increased modestly since 1995. Despite this increase, the data show that the majority of women of childbearing age still do not take a vitamin containing folic acid daily. Health care providers and maternal child health professionals must continue to promote preconceptional health among all women of childbearing age, and encourage them to take a vitamin containing folic acid daily.

Adolescent↗
PubMed2005

Electrophoresis: the march of pennies, the march of dimes.

The present review encompasses ca. 65 years of history of developments in electrokinetic separations, taking as a starting point the year 1937, i.e. the official launching of Tiselius' moving boundary electrophoresis (MBE). The 1950s have been particularly rich in introducing novel methodologies in zone electrophoresis (ZE), thus bringing about the decline of MBE. Among them of extraordinary importance was the development of electrophoresis on agar gels coupled to immuno-diffusion at right angles, which brought a big revolution not only in biochemistry but also in clinical chemistry. Also the by now forgotten paper electrophoresis was a landmark in separation science, in that it implemented, in its "fingerprinting" version, the first genuine two-dimensional (2D) map, coupling orthogonally a charge to a hydrophobic scale separation, while permitting for the first time the detection of spot mutations, i.e. single amino acid replacements in a polypeptide chain, that paved the way to modern genetic analysis. Equally important was the introduction of starch-block electrophoresis, that brought about the notion of sieving and the first discontinuous buffers, refined, in the 1960s, by Ornstein and Davies with their classical papers combining multiphasic buffer systems to polyacrylamide gels, that went down to history as disc-electrophoresis. The 1960s also contributed with two fundamental techniques, isoelectric focusing (IEF) and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) that permitted to discriminate proteins solely on the basis of surface charge and molecular mass, respectively. The 1970s gave other fundamental contributions, such as isotachophoresis, the first example of a fully instrumental approach to electrophoresis, both in its analytical and preparative version (Tachophor and Tachofrac), 2D maps combining IEF to SDS-PAGE at right angles and silver staining techniques, that incremented sensitivity by 3 orders of magnitude. The 1980s generated immobilized pH gradients and capillary zone electrophoresis (CZE), two big players that dominated the electrokinetic horizon for all the 1990s and still in vigorous use in present days. The review terminates with a glimpse, in the third millennium, onto microchip technology and hyphenated techniques, notably direct interfacing of various electrophoretic separation methods with mass spectrometry (MS).

Electrophoresis↗
PubMed1992

Neonatal periventricular-intraventricular hemorrhage after maternal beta-sympathomimetic tocolysis. The March of Dimes Multicenter Study Group.

OBJECTIVE: Our objective was to determine if the rate of periventricular-intraventricular hemorrhage is increased in the offspring of women who received a beta-sympathomimetic agent as part of the management of preterm labor. STUDY DESIGN: This retrospective study consists of 2827 women who were delivered of a singleton, live infant free of congenital neurologic anomalies between 25 and 36 completed weeks of gestation during a multicenter preterm birth prevention trial. The data were analyzed, adjusting for type of tocolytic agent, race, infant sex, gestational age, birth weight, health care center, route of delivery, indication for delivery, intrapartum fetal distress, respiratory distress syndrome, and neonatal sepsis. RESULTS: The overall incidence of periventricular-intraventricular hemorrhage in this population was 5.6%. In a univariate analysis in which no adjustment was made for potentially confounding variables, beta-sympathomimetic tocolysis was found to be associated with nearly a fourfold increase in the incidence of periventricular-intraventricular hemorrhage when compared with the use of either magnesium sulfate or no tocolytic agent. The results of a multivariate regression analysis revealed that beta-sympathomimetic agents were associated with a statistically significant increase in the overall incidence of periventricular-intraventricular hemorrhage (odds ratio 2.47, 95% confidence interval 1.34 to 4.56, p = 0.004) and a similar, but not significant, increase in the incidence of grades 3 and 4 periventricular-intraventricular hemorrhage (odds ratio 2.50, 95% confidence interval 0.96 to 6.48, p = 0.06). CONCLUSION: beta-Sympathomimetic tocolytic therapy may be associated with a more than twofold increase in the incidence of neonatal periventricular-intraventricular hemorrhage.

Birth Weight↗
PubMed1999

Factors relating to readmission of term and near-term neonates in the first two weeks of life. Early Discharge Survey Group of the Health Professional Advisory Board of the Greater New York Chapter of the March of Dimes.

AIMS: A multisite study of term and near term infants readmitted in the first two weeks of life to 9 New York City area hospitals in 1995 was conducted to evaluate factors related to readmission, including length of newborn stay. RESULTS: Of the 30,884 infants born at the 9 study hospitals 391 newborns were readmitted. The major admission diagnoses were infection, 40.7%, hyperbilirubinemia, 39.1%, and feeding and/or gastrointestinal problems, 10.5%. In the first week, 65.1% of readmissions were for hyperbilirubinemia and 19.1% were for infection or suspected sepsis. In the second week, 67.8% of readmissions were for infection and 7.6% were for hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while infection was most frequent for African-American and Hispanic infants. Age at readmission was younger and the interval from discharge was shorter for infants with hyperbilirubinemia. Abnormalities which should have precluded early discharge included feeding difficulties, cyanotic congenital heart defects, hemolytic disease of the newborn, early jaundice or early high bilirubin levels. CONCLUSION: Attention to identification of infants at risk and programs such as lactation counseling and universal screening for bilirubin (with appropriate interpretation) prior to discharge could have reduced the necessity for readmission regardless of the newborn length of stay.

Adolescent↗
PubMed2002

The March of Dimes.

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Congenital Abnormalities↗