Medicine and Health Sciences Commons^™

Bed Rest And Its Continued Use In Women With High-Risk Pregnancy: A Review Of Literature, Irene De Los Reyes

Senior Theses

Bed rest is defined as confinement to bed and restriction of activity. In the clinical setting bed rest includes strict bed rest, strict bed rest in Trendelenburg position, bed rest with bathroom privileges, and up ad lib (Irion, Irion, Lewis & Giglio, 2012). Bed rest has been the standard treatment for over the past 30 years in preventing preterm birth and complications arising from high-risk pregnancy despite the lack of evidence to support its safety and effectiveness for the mother and fetus (Maloni, 2010). The purpose of this literature review and critique is to provide information about the adverse physiologic …

Sleep Disordered Breathing And Pregnancy: Prevalence And Outcomes At Delivery, Ryan Lyle Nations

Dissertations

Introduction
Sleep Disordered Breathing (SDB) during pregnancy is associated with maternal and neonatal morbidity, and in-hospital mortality. A recent prevalence study using the Nationwide Inpatient Sample reported an obstructive sleep apnea (OSA) prevalence of 7.3 per 10,000 in 2013, a rate of 24% per year over the last decade. The rise in prevalence mirrors the rise in obesity. Military Treatment Facilities (MTF) have seen an increase in obesity and related co-morbidities with an unknown prevalence of SDB. Most studies have been conducted in high-risk populations; the general prevalence of SDB and its association with adverse pregnancy outcomes in a military …

Disaster Preparedness Education And Resource Needs For Pregnant And Post-Partum Families, Ellen A. Erickson Bonner

Nursing Theses and Dissertations

Hurricane Katrina in 2005 heightened awareness of the need to educate vulnerable populations on disaster preparedness. However, little has been written specifically on the preparedness needs of the pregnant and post-partum families. Only one article explores disaster preparedness education for this population. To fill this gap. An interprofessional sample (n=115) rated the relevance of the educational topics and birthing kit items proposed by the panel from the previous Delphi study. The education topics were reduced to four themes that explained 66.80% of the variance and the birthing kit items were reduced to six themes that explained 70.99% of the variance.

Smoking Cessation During Pregnancy: An Evidence Based Practice Protocol, Katherine J. Ruhlman

Master of Science in Nursing Evidence-Based Practice Projects

Intrauterine exposure to nicotine is one of the largest modifiable risk factors for infant morbidity and mortality. Previous progress toward decreasing the number impacted by intrauterine nicotine exposure has recently plateaued. While guidelines for assisting pregnant women to stop smoking are available, few providers have a formalized protocol in place. This project will evaluate most current research evidence regarding smoking cessation during pregnancy in order to develop a formalized protocol for implementation in an obstetric clinic in Southwest Ohio. Reviewed literature was summarized and level of evidence was established. Recommendations were made and categorized as strong, moderate, and weak. The …

Pre-Pregnancy Bmi And Preterm Birth Among Hispanic Teens, Allison C. Hope

Masters Theses

Preterm birth affects 12% of infants in the United States annually and is the main contributor to infant deaths and long-term neurological disabilities in offspring. Obesity is a growing problem in the U.S., and is increasingly being considered a major risk factor for adverse health outcomes. Puerto Rican teenagers have disproportionately high rates of preterm birth and obesity when compared to non-Hispanic White teenagers. Studies evaluating risk factors for preterm birth among adolescents are sparse, have inconsistent findings, and were conducted among predominantly non-Hispanic populations. Therefore, we investigated the association between BMI and preterm birth among the 419 teenage (ages …

Maternal Fat Intake During Pregnancy And Breastfeeding Initiation, Rachel Man

Electronic Thesis and Dissertation Repository

Introduction: Breast milk provides health benefits for both mother and child. Prominent reasons for not initiating breastfeeding include lactation problems and perceived insufficient milk supply. Animal studies have shown that a high fat diet is associated with negative changes in the lactation process, while omega-3 supplementation appears to have positive effects. Hypothesis: 1. High maternal fat intake during pregnancy is associated with breastfeeding non-initiation. 2. Long-chain omega-3 fatty acid intake (EPA+DHA) is associated with breastfeeding initiation. 3. Maternal EPA+DHA intake modifies the relationship between total fat intake during pregnancy and breastfeeding initiation. Materials and Methods: The data for this study …

Sle And Pregnancy, Patricia Graham

Nursing Student Class Projects (Formerly MSN)

Systemic lupus erythematosus (SLE) is a life-long, life-threatening autoimmune disease which can affect any organ in the body (Marks & Tullus, 2011). SLE disproportionately affects women in a ratio of 9:1 compared to men with most women being affected during child-bearing age (15-50 years) (Ferenkeh-Koroma, 2012). Pregnancy represents a challenge for the patient with SLE. Pregnant patients with SLE are considered high-risk for multiple medical and obstetric complications, as flares are related to increased irreversible organ damage (Ateka- Barrutia & Khamashta, 2013). Severe flares are also associated with poor fetal outcomes (Peart & Clowse, 2014). Successful pregnancies happen in 67% …

Smoking Cessation In Pregnancy And Gestational Weight Gain In South Carolinian Mothers, 2009-2011, Laquenta Latreese Weldon

Theses and Dissertations

Purpose: To determine if smoking cessation during pregnancy is associated with excessive gestational weight gain (GWG).

Methods: Data came from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing population-based survey of live births in South Carolina (n=2,603). Participant smoking status was classified as nonsmoker (did not smoke before or during pregnancy), persistent smoker (smoked before and throughout pregnancy), or quitter (smoked before but quit during pregnancy). Multinomial logistic regression model was estimated to examine the association between smoking status and meeting the 2009 Institute of Medicine guidelines, while linear regression model was used for the continuous outcomes such …

Maternal Obesity And Incidence Of Depression, Caroline A. Habjan

Honors Capstone Projects - All

Obesity is a national epidemic in the United States, which both directly and indirectly affects the social productivity of individuals, the American macro economy and individuals’ personal health and well being. Depression often interferes with an individual’s ability to work, sleep, study, eat, and enjoy life. A maternal state of both obesity and depression may cause serious adverse medical conditions in the mother’s child. Taking steps to treat depression and obesity are critical in the construct of modern medicine. This project yields results that have the potential to make treatment options better tailored, more efficient, effective and economically-sound for the …

Influence Of Maternal Prior Life Adversity On The Psycho-Neuroendocrine-Immune Profile During Pregnancy, Karen J. Kotz

Dissertations

Pregnancy is accompanied by a multitude of physical and psychological changes. Adaptation to these changes through reduced anxiety and attenuated stress responsiveness is necessary across gestation and into the postpartum period for optimal maternal-infant health. In contrast, exposure to higher amounts of stressors during pregnancy can disrupt neuroendocrine-immune processes required for successful pregnancy outcomes. Evolving evidence demonstrates that exposure to adversity early in life has long-lasting effects on stress response systems that alter stress reactivity during adulthood. Given this evidence, it is posited that women who experience greater pre-pregnancy adversity during their childhood are at greater risk for negative maternal-infant …

The Effect Of Education On Folic Acid In Women On Childbearing Age And Low Socioeconomic Status, Macey I. Bentley, Anna R. Goetsch, Courtney L. Perpich

All Electronic Theses and Dissertations

The purpose of this study was to investigate the effect of education to women of lower socioeconomic status about the importance of folic acid use before and during pregnancy. Previous research has shown the significance of folic acid in preventing neural tube defects; however, research has shown that women of lower socioeconomic status are not equipped with proper education regarding folic acid usage periconceptionally. An educational session was provided to three women’s shelters regarding folic acid, and questionnaires were used to gauge knowledge on folic acid before and after the sessions. The statistical analysis was consistent with our hypothesis in …

Toward Enhancing Treatment For Pregnant Smokers: Laying The Groundwork For The Use Of Complementary And Alternative Medicine Approaches, Amy Michele Loree

Wayne State University Dissertations

Tobacco is the most widely used drug of abuse during pregnancy. Despite efforts to reduce perinatal tobacco use, its prevalence has remained steady over at least the past decade, suggesting that efforts to reduce smoking prevalence before and during pregnancy have not been effective. Although a range of effective treatments exist, most pregnant smokers neither seek nor receive any kind of treatment. Complementary and alternative medicine (CAM) treatments may be ideal as alternative, low-cost approaches capable of reaching and assisting a greater proportion of pregnant women with smoking cessation. This study examined characteristics and treatment utilization practices of pregnant smokers …

Relationships Between A Prenatal Nutrition Education Intervention And Maternal Nutrition In Ethiopia, Divya Lakshmi Selvakumar

Walden Dissertations and Doctoral Studies

In Ethiopia, 17% of pregnant women ages 18-49 are malnourished and have low awareness of prenatal nutrition, which may relate to increasingly high rates of maternal and infant mortality. The purpose of this mixed methods research study was to determine the effects of a community-based prenatal nutrition education intervention program on maternal nutrition knowledge and attitudes in the Alaje district of Ethiopia. The theoretical framework was Sen's capability theory of poverty, in which opportunities can lead to well-being and promote economic development. Research questions focused on the relationships among 8 independent variables-age, income source, degree of program implementation, marital status, …

Screening And Intervention For Women With Hyperglycemia During Pregnancy, Ladonna Lynn Williams

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus occurs in up to 10% of pregnancies and often leads to labor and delivery complications for both the mother and the baby. Early identification of gestational diabetes and educational intervention are needed to improve the self-management and knowledge among pregnant women. The purpose of the project was to implement newly established national guidelines to ensure that women with gestational diabetes are identified during the first trimester of pregnancy and begin diabetes education early in gestation. Lewin's planned change theory was selected as the theoretical framework, and the six sigma approach was used to facilitate the change process. …

Mechanisms Of Seizure During Pregnancy And Preeclampsia, Abbie Chapman Johnson

Graduate College Dissertations and Theses

Eclampsia is defined as de novo seizure in a woman with the hypertensive complication of pregnancy known as preeclampsia (PE), and is a leading cause of maternal and fetal morbidity and mortality worldwide. The pathogenesis of eclamptic seizure remains unknown, but is considered a form of hypertensive encephalopathy where an acute rise in blood pressure causes loss of cerebral blood flow (CBF) autoregulation and hyperperfusion of the brain that results in vasogenic edema formation and subsequent seizure. However, eclamptic seizure can occur during seemingly uncomplicated pregnancies, in the absence of hypertension and PE, suggesting that normal pregnancy may predispose the …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

Case Study: Breastfeeding Facilitation And Initiation Within One Prison Nursery Program, Jessica Wallace

Master's Theses and Doctoral Dissertations

Breastfeeding rates of incarcerated women in the U.S. are unknown. As the female prison population rises, little to no data exists on breastfeeding initiation within prison nursery programs. The purpose of this case study was to assess breastfeeding facilitation and initiation within one prison nursery program. An interview was conducted with a nursery program administrator from one of nine active prison nurseries here in the U.S. Constructs from the Social Cognitive Theory including reciprocal determination, facilitation, observational learning, and incentive motivation were assessed. Through an administrative perspective, the results provided a better understanding of prison nursery programs and shed light …

Pregnant Obese Women And Factors Which Impact Their Social And Physiological Well-Being, Stephanie Denise Morgan Frye

Walden Dissertations and Doctoral Studies

For more than 50 years, researchers have recognized complications associated with obesity and pregnancy as a problem for mothers and their unborn children. Despite this recognition, the rates of obesity and mortality in pregnant women have continued to rise. Using the health belief model, the transtheoretical model of behavior change, and the social cognitive theory as the theoretical frameworks, this phenomenological study examined barriers that might hinder the health of obese pregnant women and their unborn children. Semi-structured interviews were conducted with 12 women who had a body mass index of 30 to 50, were between the ages of 18-55, …

Treatment Outcomes For Opiate Addicted Pregnant Women, Jennifer L. Roth Parr

DNP Projects

The problem of opiate addiction is complex enough but compounded when the patient is pregnant. Substance use during pregnancy produces harmful and costly effects to both the mother and the fetus (Veilleux, Colvin, Anderson, York & Hines, 2010). The rate of opiate addiction among pregnant women in the U.S. has been increasing in epidemic numbers since the beginning of the 21st century. This paper looks at research on the origin of the problem, the demographics of the average pregnant opiate addicted patient, the effects on the woman and her unborn child, and available treatment options.

Temporality Of Risk Factors And The Gender Differential Related To Autism Spectrum Disorder Diagnosis, Donna L. Sullivan

Walden Dissertations and Doctoral Studies

Autism spectrum disorders (ASD) constitute life-long neurodevelopmental conditions. Globally, ASD risk for males remains 2 to 4 times greater than for females. Critical exposure mechanisms, their timing on ASD risk, and associations with the ASD gender differential remain elusive. The purpose of this study was to describe the relationship between preconception, pregnancy, recalled lactation practice, and infant traits, on ASD risk and the gender differential of ASD. A recently published temporal framework was adapted to study effects of maternal smoking and vitamin use, and recalled lactation practice on offspring ASD diagnosis with adjustment for preconception health and infant breathing traits. …

Antenatal Clinic: Using Ethnographic Methods To Listen To The Voices Of Pregnant Adolescents, Deborah Ireson

Theses: Doctorates and Masters

Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice.

Research design: Using ethnographic methods, this …