Medicine and Health Sciences Commons^™

Early Invitation To Food And/Or Multiple Micronutrient Supplementation In Pregnancy Does Not Affect Body Composition In Offspring At 54 Months: Follow-Up Of The Minimat Randomized Trial, Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Sophie Hawkesworth, Eva‐Charlotte Ekström, Shams Arifeen, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

Growth patterns in early life are associated with later health.The effect of nutrition duringin uterodevelopmenton later body composition is unclear. We evaluated whether prenatal early invitation to food and/or multiplemicronutrient supplementation (MMS) in pregnancy has an effect on offspring body composition at 54 monthsof age. In Maternal and Infant Nutrition Interventions in Matlab trial (ISRCTN16581394) in Bangladesh, 4436pregnant women were randomised into six equally sized groups: double-masked supplementation with capsulesof either 30 mg Fe and 400mg folic acid, or 60 mg Fe and 400mg folic acid, or MMS (15 micronutrients), wascombined with a randomised early invitation (around 9 weeks) or …

A Randomized Controlled Trial Investigating The Effects Of A Low-Glycemic Index Diet On Pregnancy Outcomes In Gestational Diabetes Mellitus, Jennie Brand-Miller, Jimmy Chun Yu Louie, Peter Petocz, Tania Markovic, Nimalie Perera, Deborah Foote, Glynis Ross

Jimmy Chun Yu Louie

OBJECTIVE: The prevalence of gestational diabetes mellitus (GDM) is rising. There is little evidence to demonstrate the effectiveness of one dietary therapy over another. We aimed to investigate the effect of a low-glycemic index (LGI) versus a conventional high-fiber diet on pregnancy outcomes, neonatal anthropometry, and maternal metabolic profile in GDM.RESEARCH DESIGN AND METHODS: Ninety-nine women (age 26-42 years; mean ± SD prepregnancy BMI 24 ± 5 kg/m²) diagnosed with GDM at 20-32 weeks' gestation were randomized to follow either an LGI (n = 50; target glycemic index [GI] ~50) or a high-fiber moderate-GI diet (HF) (n = 49; target …

Glycemic Index And Pregnancy: A Systematic Literature Review, Jimmy Chun Yu Louie, Jennie C. Brand-Miller, Tania P. Markovic, Glynis P. Ross, Robert G. Moses

Jimmy Chun Yu Louie

Background/Aim. Dietary glycemic index (GI) has received considerable research interest over the past 25 years although its application to pregnancy outcomes is more recent. This paper critically evaluates the current evidence regarding the effect of dietary GI on maternal and fetal nutrition. Methods. A systematic literature search using MEDLINE, EMBASE, CINAHL, Cochrane Library, SCOPUS, and ISI Web of Science, from 1980 through September 2010, was conducted. Results. Eight studies were included in the systematic review. Two interventional studies suggest that a low-GI diet can reduce the risk of large-for-gestational-age (LGA) infants in healthy pregnancies, but one epidemiological study reported an …

Male Gender Promotes An Increased Inflammatory Response To Lipopolysaccharide In Umbilical Vein Blood., Shunaha Kim-Fine, Timothy Regnault, James S Lee, Sarah A Gimbel, Jill A Greenspoon, Jonathan Fairbairn, Kelly Summers, Barbra De Vrijer

Paediatrics Publications

OBJECTIVES: To establish gender-specific differences in maternal and fetal immune response in healthy human fetuses at term.

METHODS: Forty-five women with elective caesarean sections for uncomplicated singleton pregnancies were recruited for two studies. Using a multiplex biomarker immunoassay system, unstimulated maternal and fetal plasma concentrations of interleukin (IL)-1β, IL-1ra, IL-6, IL-8, macrophage inflammatory protein (MIP)-1α, and tumor necrosis factor (TNF)-α were measured from one study population. Lipopolysaccharide (LPS)-stimulated cytokine response was measured in a second study.

RESULTS: There were no significant gender differences in either maternal or fetal unstimulated plasma cytokine concentrations, but concentrations of the proinflammatory cytokines IL-1β and …

Antenatal Physical Activity Counseling Among Healthcare Providers, Jenn Leiferman, Margaret Gutilla, James Paulson, Jim Pivarnik

Psychology Faculty Publications

Objective: Pregnant women often report a lack of knowledge concerning the safety of exercising during pregnancy. Healthcare providers play an integral role in providing pregnant women with the necessary knowledge to promote antenatal physical activity. Thus, the objective of this study was to assess healthcare providers’ beliefs, attitudes, knowledge and practices related to antenatal physical activity counseling.

Study Design: 188 Providers (i.e. obstetricians, midwives, and family medicine physicians) completed a 39 closed-item survey. Characteristics among healthcare providers’ physical activity counseling practices as well as belief, attitudes and knowledge were explored.

Results: The majority of all providers agreed that physical activity …

In Utero Exposures, Infant Growth, And Dna Methylation Of Repetitive Elements And Developmentally Related Genes In Human Placenta, Charlotte S. Wilhelm-Benartzi, E. Andres Houseman, Matthew A. Maccani, Graham M. Poage, Devin C. Koestler, Scott M. Langevin, Luc A. Gagne, Carolyn E. Banister, James F. Padbury, Carmen J. Marsit

Dartmouth Scholarship

BACKGROUND:

Fetal programming describes the theory linking environmental conditions during embryonic and fetal development with risk of diseases later in life. Environmental insults in utero may lead to changes in epigenetic mechanisms potentially affecting fetal development.

OBJECTIVES:

We examined associations between in utero exposures, infant growth, and methylation of repetitive elements and gene-associated DNA in human term placenta tissue samples.

METHODS:

Placental tissues and associated demographic and clinical data were obtained from subjects delivering at Women and Infants Hospital in Providence, Rhode Island (USA). Methylation levels of long interspersed nuclear element-1 (LINE-1) and the Alu element AluYb8 were determined in …

Cabergoline Therapy For Macroprolactinoma During Pregnancy: A Case Report., Hira Shahzad, Aisha Sheikh, Lumaan Sheikh

Department of Medicine

Background: We assessed the safety of Cabergoline therapy during pregnancy in a lady with hyperprolactinemia intolerant to Bromocriptine.

Case presentation: We report the case of a 31 year old lady who presented to us with uncontrolled hyperprolactinemia. A pituitary Macroadenoma was demonstrated by MRI. Due to intolerance to Bromocriptine, Cabergoline was started. The patient improved and subsequently conceived. MRI in the second trimester demonstrated further reduction in the tumor size. It was decided to continue Cabergoline throughout pregnancy to ensure further reduction in tumor size until delivery and to hold Cabergoline during postpartum period to allow for an adequate interval …

Maternal Concentrations Of Polyfluoroalkyl Compounds During Pregnancy And Fetal And Postnatal Growth In British Girls, Mildred Maisonet, Metrecia L. Terrell, Michael A. Mcgeehin, Krista Yorita Christensen, Adrianne Holmes, Antonia M. Calafat, Michele Marcus

Mildred Maisonet

The Differential Effects Of Maternal Age, Race/Ethnicity And Insurance On Neonatal Intensive Care Unit Admission Rates., Beatriz E De Jongh, Robert Locke, David A Paul, Matthew Hoffman

Department of Pediatrics Faculty Papers

BACKGROUND: Maternal race/ethnicity, age, and socioeconomic status (SES) are important factors determining birth outcome. Previous studies have demonstrated that, teenagers, and mothers with advanced maternal age (AMA), and Black/Non-Hispanic race/ethnicity can independently increase the risk for a poor pregnancy outcome. Similarly, public insurance has been associated with suboptimal health outcomes. The interaction and impact on the risk of a pregnancy resulting in a NICU admission has not been studied. Our aim was, to analyze the simultaneous interactions of teen/advanced maternal age (AMA), race/ethnicity and socioeconomic status on the odds of NICU admission.

METHODS: The Consortium of Safe Labor Database (subset …

The Study Of Hiv And Antenatal Care Integration In Pregnancy In Kenya: Design, Methods, And Baseline Results Of A Cluster-Randomized Controlled Trial, Janet M. Turan, Rachel L. Steinfeld, Maricianah Onono, Elizabeth A. Bukusi, Meghan Woods, Starley B. Shade, Sierra Washington, Reson Marima, Jeremy Penner, Marta L. Ackers, Dorothy Mbori-Ngacha, Craig R. Cohen

Pathology, East Africa

Background: Despite strong evidence for the effectiveness of anti-retroviral therapy for improving the health of women living with HIV and for the prevention of mother-to-child transmission (PMTCT), HIV persists as a major maternal and child health problem in sub-Saharan Africa. In most settings antenatal care (ANC) services and HIV treatment services are offered in separate clinics. Integrating these services may result in better uptake of services, reduction of the time to treatment initiation, better adherence, and reduction of stigma.

Methodology/Principal Findings: A prospective cluster randomized controlled trial design was used to evaluate the effects of integrating HIV treatment into ANC …

Common Respiratory Issues In Ambulatory Obstetrics., Kelly M Orzechowski, Richard C Miller

Department of Obstetrics and Gynecology Faculty Papers

This article reviews the diagnosis and management of the most common respiratory conditions complicating pregnancy--asthma and influenza. We also review strategies for smoking cessation in pregnancy as, in addition to exacerbating all other pulmonary conditions, smoking is the most modifiable risk factor for poor pregnancy outcome. Moreover, the obstetrician frequently encounters each of these conditions in the ambulatory setting. A thorough knowledge of the normal pregnancy-induced physiological respiratory changes combined with a comprehensive understanding of how to manage these conditions, will provide the obstetrician with the armamentarium needed to optimize health outcomes for mothers and their fetuses.

Atovaquone Ameliorate Gastrointestinal Toxoplasmosis Complications In A Pregnancy Model, Helieh S. Oz, Thomas Tobin

Physiology Faculty Publications

Background: Toxoplasma is an important source of foodborne hospitalization with no safe and effective therapy against chronic or congenital Toxopalsmosis. Atovaquone is a drug of choice but not approved for use in congenital Toxoplasmosis. We hypothesized atovaquone to be safe and effective against feto-maternal Toxoplasmosis.

Material/Methods: Programmed pregnant mice were i.p. infected with 50–2400 Tachyzoites from Type II strain (clone PTG). Dams were treated daily with atovaquone or sham and monitored for pain, and complications.

Results: Dams developed pain related abdominal hypersensitivity (allodynia) to mechanical stimuli in a Tachyzoites dose dependent manner. Infected dams were anemic and exhibited ascities and …

Population-Based Placental Weight Ratio Distributions And Determinants Of Placental Weight Ratios, Erin M. Macdonald

Erin M Macdonald

The placental weight ratio (PWR) is a common proxy for the balance between fetal and placental growth, and is defined as the placental weight over the birth weight. The objectives were (1a) to establish PWR distributions by gestational age for the overall population and (1b) for small, average and large for gestational age infants (SGA, AGA, LGA) and (2) to determine what pregnancy related conditions were associated with the PWR. The data were obtained using a hospital based retrospective cohort. Nonparametric quantile regression was used for the first and multinomial logistic regression for the second objective. The results show how …

Are Maternal Child Health Outcomes Affected By Adequacy Of Prenatal Care In Montgomery County, Oh?, Amy Rouse

Master of Public Health Program Student Publications

Background: Prenatal Care has been recommended by the World Health Organization for all pregnant women in order to improve health outcomes of the mother and the child. However, recommendations for the number of visits required to provide adequate health care and improve outcomes continue to be debated. Understanding if adequate prenatal care is improving maternal child outcomes is essential before making these recommendations. This research aims to determine if in Montgomery County, OH the adequacy of prenatal care influenced gestational age at birth, birth weight, breastfeeding rate, rate of cesarean sections, and smoking cessation rates.

Methods: De-indentified birth data was …

Population-Based Placental Weight Ratio Distributions And Determinants Of Placental Weight Ratios, Erin M. Macdonald

Electronic Thesis and Dissertation Repository

The placental weight ratio (PWR) is a common proxy for the balance between fetal and placental growth, and is defined as the placental weight over the birth weight. The objectives were (1a) to establish PWR distributions by gestational age for the overall population and (1b) for small, average and large for gestational age infants (SGA, AGA, LGA) and (2) to determine what pregnancy related conditions were associated with the PWR. The data were obtained using a hospital based retrospective cohort. Nonparametric quantile regression was used for the first and multinomial logistic regression for the second objective. The results show how …

The Effect Of A Low Glycemic Index Diet During Pregnancy On Obstetric Outcomes, Robert G. Moses, M J. Luebcke, Warren S. Davis, K J. Coleman, Linda C. Tapsell, Peter Petocz, Jennie C. Brand-Miller

L. C. Tapsell

Abstract presented at The 2006 Annual Scientific Meeting of the Nutrition Society of Australia, 29 November - 2 December, Sydney, Australia

The Impact Of Anaemia And Malaria Parasite Infection In Pregnant Women, Nigerian Perspective., Ifeyinwa M. Okafor Dr., M Mbah, E A. Usanga

Okafor Ifeyinwa M Dr.

Malaria and anaemia during pregnancy is still a major health problem in endemic countries with clinical consequences including death of both mother and child. In Nigeria, statistics shows that as many as 300,000 lives especially those of children and pregnant women are lost annually due to malaria. This study was aimed at assessing the impact of malaria and anaemia among pregnant women living in Calabar South Local Government Area of Cross River State, Nigeria, which is characterized by unstable transmission of malaria. .A total of 664 subjects were enrolled in the study made up of 414 pregnant women attending antenatal …

The Ethics Of Vaginal Birth After Cesarean, Sonya Charles

Philosophy and Religious Studies Department Faculty Publications

The decline in providers and facilities that will allow a trial of labor after cesarean forces many women to choose a repeat cesarean. The choice is frequently not much of a choice, however, since the full range of options are often not on the table. This limited 'choice' violates obstetricians' obligations both to respect patients' autonomy and to offer them good care. There has been a vigorous but so far not very fruitful debate in the last few years about the lack of access to a trial of labor after cesarean. Some recently released documents express concern about the limited …

Konsumsi Jamu Ibu Hamil Sebagai Faktor Risiko Asfiksiabayi Baru Lahir, Dewi Purnamawati, Iwan Ariawan

Kesmas

Jamu merupakan obat tradisional yang dibuat dengan cara mengolah bahan alamiah yang mempunyai khasiat obat dengan beberapa bahan campuran. Efektivitas dan efek samping pengobatan tradisional sebagai upaya pelayanan kesehatan masih perlu dibuktikan, khususnya jika digunakan oleh ibu yang sedang hamil. Penelitian ini bertujuan untuk mengetahui pengaruh konsumsi jamu pada ibu hamil terhadap kejadian asfiksia pada bayi baru lahir di Bekasi tahun 2008. Desain penelitian adalah kasus kontrol dengan metode kuantitatif dan kualitatif. Hasil penelitian menunjukkan hubungan yang signifikan antara konsumsi jamu terhadap kejadian asfiksia pada bayi baru lahir (nilai p = 0,005; odds ratio (OR) = 7,1; 95% CI = …

Ginseng Extract Treatment Influences On Preimplantation Development In Vitro, And Pregnancy And Post-Partum Development In The Mouse, Danyka D. Belanger

Electronic Thesis and Dissertation Repository

Ginseng is one of the most commonly consumed herbal medicines in the world. Consumption is highest in females, thus my purpose was to define the concentration responsive effects of North American alcoholic and aqueous ginseng extracts on preimplantation development in vitro and on pregnancy and post-partum development in the mouse. 2-cell embryos from female mice were cultured with 5 different concentrations of both extracts, ginsenosides Rb1, Rg1 and Re, a combinatorial ginsenoside solution and a polysaccharide fraction. Embryonic development and recovery from treatment was assessed. To investigate in vivo effects of ginseng extracts, females were gavaged with 50 mg/kg and …

Effects Of Low-Dose Drinking Water Arsenic On Mouse Fetal And Postnatal Growth And Development, Courtney D. Kozul-Horvath, Fokko Zandbergen, Brian P. Jackson, Richard I. Enelow, Joshua W. Hamilton

Dartmouth Scholarship

Background: Arsenic (As) exposure is a significant worldwide environmental health concern. Chronic exposure via contaminated drinking water has been associated with an increased incidence of a number of diseases, including reproductive and developmental effects. The goal of this study was to identify adverse outcomes in a mouse model of early life exposure to low-dose drinking water As (10 ppb, current U.S. EPA Maximum Contaminant Level). Methodology and Findings: C57B6/J pups were exposed to 10 ppb As, via the dam in her drinking water, either in utero and/or during the postnatal period. Birth outcomes, the growth of the F1 offspring, and …

Evaluation Of A Tobacco Educational Intervention For Pregnant Alaska Native Women, Christi A. Patten, Carrie Enoch, Caroline C. Renner, Karin Larsen, Paul A. Decker, Kari J. Anderson, Caroline Nevak, Ann Glasheen, Kenneth P. Offord, Anne Lanier

Journal of Health Disparities Research and Practice

Tobacco cessation interventions developed and evaluated for Alaska Native women do not exist. As part of routine clinical care provided at a prenatal visit, a brief tobacco educational intervention for Alaska Native pregnant women (N=100; mean ± SD age = 25.9±6.2 years; mean 6.3± 2.6 months gestation) was piloted at the Y-K Delta Regional Hospital in Bethel, Alaska. This retrospective study reports on the evaluation of this clinical program. The intervention was consistent with the clinical practice guidelines (i.e., 5 A’s – ask, advise, assess, assist, arrange), with an average duration of 20.2 ± 6.8 minutes. The self-reported tobacco abstinence …

The Benefits Of Exercise During Pregnancy, Nikelle Holbrook Hunsaker

Undergraduate Honors Capstone Projects

People are often confused about the effects and recommendations of exercise during pregnancy. A review of the literature demonstrates that regular physical activity provides benefits to both mother and fetus during pregnancy. These benefits range from decreasing the risk of gestational diabetes mellitus to improving the mother's psychological well-being and can be obtained without causing harm to the fetus. The recommendations for physical activity during pregnancy include thirty minutes of physical activity on most, if not all, days of the week. These recommendations are the same as those for non-pregnant individuals. Contrary to popular opinion, a sedentary lifestyle during pregnancy …

Early Term Infant Care: Hospital Utilization And Breastfeeding Practices, Debra Craighead

Nursing Theses and Dissertations

Early term infants (ETI), with gestational ages from 37 to 38 weeks, have higher morbidity and mortality rates when compared with later term infant counterparts born at 39 to 41 weeks. Although this newly identified term infant subcategory is gaining attention, the immediate and long term health outcomes and care needs of ETI remain largely unexplored. The purpose of this research project was to examine the current research documenting ETI health and explore care practices that are currently utilized to promote ETI health. The original research study describes care practices used to promote health for ETIs born in Louisiana in …

Predictors Of Sexual Relationship Power, Communication And Sexual Decision Making Among Latino Couples, Yui Matsuda

Theses and Dissertations

Unintended pregnancy (UP) is increasing among Latinos in the United States. Unintended pregnancy contributes to many negative consequences for infants, mothers and families. Concurrently, various factors affect Latino couples’ sexual relationship power, communication and decision making about family planning, including sexual relationship power, relationship commitment, dyadic adjustment, individual background, and cultural characteristics. Previous research has not focused on understanding the factors that affect Latino couples’ sexual relationship power, communication and sexual decision making from each partner’s perspective. The purpose of this study was to examine the association between sexual relationship power, communication, and sexual decision making from each partner’s perspective …

Violence During Pregnancy Among Young Married Women In Nepal, Prakrity Silwal

Master's Theses

No abstract provided.

Progesterone And Preterm Birth Prevention: Translating Clinical Trials Data Into Clinical Practice, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE:

We sought to provide evidence-based guidelines for using progestogens for the prevention of preterm birth (PTB).

METHODS:

Relevant documents, in particular randomized trials, were identified using PubMed (US National Library of Medicine, 1983 through February 2012) publications, written in English, which evaluate the effectiveness of progestogens for prevention of PTB. Progestogens evaluated were, in particular, vaginal progesterone and 17-alpha-hydroxy-progesterone caproate. Additionally, the Cochrane Library, organizational guidelines, and studies identified through review of the above were utilized to identify relevant articles. Data were evaluated according to population studied, with separate analyses for singleton vs multiple gestations, prior PTB, or short …

Understanding The Experience Of Weight Gain And Body Image During Adolescent Pregnancy, Jessica L. Hinkley, Liana J. Newcombe

Honors Theses and Capstones

This qualitative descriptive study explores the experience of adolescent pregnancy and the influence of body image and other factors on weight gain. It identified three main themes through content analysis: Continuity of Care, Adolescent Investment in a Healthy Pregnancy, and the Impact of Pregnancy Symptoms.

Factors And Health Promoting Behaviors That Influence Maternal And Infant Outcomes In Older Pregnant Thai Women, Supawadee Thaewpia Phd, Msn, Rn

Dissertations

This dissertation summarizes research conducted in partial fulfillment of the program requirements for the Doctor of Philosophy in Nursing degree from the Hahn school of Nursing and Health Sciences, University of San Diego. The results of the dissertation research are organized as three discrete papers. Article one is entitled; "Reliability and Validity of Thai Translations of Instruments Measuring Psychosocial Factors and Health Promoting Behaviors among Older Pregnant Thai Women." This article describes the dissertation research study in which the selected instruments were piloted at an antenatal clinic in Thailand. The article determines the instruments' ability to examine perceived benefits, perceived …

A Descriptive Study Of Undergraduate Contraceptive Attitudes Among Students At The University Of New Hampshire, Katrina Heisler, Danielle M. Van Eron

Honors Theses and Capstones

PURPOSE: The purpose of this study was to examine and to understand undergraduate students’ contraceptive attitudes and its effects on contraceptive use to further enhance the education regarding unwanted pregnancies and sexually transmitted diseases (STDs). DESIGN AND METHODS: A descriptive study to understand contraceptive attitudes while exploring demographics and sexual behaviors as well as the incorporation of the Contraceptive Attitude Scale (CAS). The researchers utilized an online survey system to distribute surveys electronically. RESULTS: Most students had a positive attitude regarding contraception. IMPLICATIONS: Nurses at college health facilities can focus on educating the college population since their age group is …