Medicine and Health Sciences Commons^™

Rice Consumption Contributes To Arsenic Exposure In Us Women, Diane Gilbert-Diamond, Kathryn L. Cottingham, Joann F. Gruber, Tracy Punshon, Vicki Sayarath, A. Jay Gandolfi, Emily R. Baker, Brian P. Jackson, Carol L. Folt, Margaret R. Karagas

Dartmouth Scholarship

Emerging data indicate that rice consumption may lead to potentially harmful arsenic exposure. However, few human data are available, and virtually none exist for vulnerable periods such as pregnancy. Here we document a positive association between rice consumption and urinary arsenic excretion, a biomarker of recent arsenic exposure, in 229 pregnant women. At a 6-mo prenatal visit, we collected a urine sample and 3-d dietary record for water, fish/seafood, and rice. We also tested women's home tap water for arsenic, which we combined with tap water consumption to estimate arsenic exposure through water. Women who reported rice intake (n …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Sexuality Education, Eva Goldfarb, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Sexuality education comprises the lifelong intentional processes by which people learn about themselves and others as sexual, gendered beings from biological, psychological, and sociocultural perspectives. It takes place through a potentially wide range of programs and activities in schools, community settings, religious centers, as well as informally within families, among peers, and through electronic and other media. Sexuality education for adolescents occurs in the context of the biological, cognitive, and social-emotional developmental progressions and issues of adolescence. Formal sexuality education falls into two main categories: behavior change approaches, which are represented by abstinence-only and abstinence-plus models, and healthy sexual development …

Obstetricians And Violence Against Women, Sonya Charles

Philosophy and Religious Studies Department Faculty Publications

I argue that the American Congress of Obstetricians and Gynecologists (ACOG), as an organization and through its individual members, can and should be a far greater ally in the prevention of violence against women. Specifically, I argue that we need to pay attention to obstetrical practices that inadvertently contribute to the problem of violence against women. While intimate partner violence is a complex phenomenon, I focus on the coercive control of women and adherence to oppressive gender norms. Using physician response to alcohol use during pregnancy and court-ordered medical treatment as examples, I show how some obstetrical practices mirror the …

Culture Medium, Gas Atmosphere And Mapk Inhibition Affect Regulation Of Rna-Binding Protein Targets During Mouse Preimplantation Development., Michele D Calder, Patricia H Watson, Andrew J Watson

Obstetrics & Gynaecology Publications

During oogenesis, mammalian oocytes accumulate maternal mRNAs that support the embryo until embryonic genome activation. RNA-binding proteins (RBP) may regulate the stability and turnover of maternal and embryonic mRNAs. We hypothesised that varying embryo culture conditions, such as culture medium, oxygen tension and MAPK inhibition, affects regulation of RBPs and their targets during preimplantation development. STAU1, ELAVL1, KHSRP and ZFP36 proteins and mRNAs were detected throughout mouse preimplantation development, whereas Elavl2 mRNA decreased after the two-cell stage. Potential target mRNAs of RBP regulation, Gclc, Slc2a1 and Slc7a1 were detected during mouse preimplantation development. Gclc mRNA was significantly elevated in embryos …

Effect Of Percutaneous Mitral Vavuloplasty On Pregnant Mother And Foetus--A Tertiary Care Hospital Experience From A Developing Country, Syed Haider Imam, Abbas Haider Zaidi, Sana Shoukat, Sajid H. Dhakam

Section of Cardiology

This study evaluated the short and long-term consequences of Percutaneous Mitral Valvuloplasty (PMV) in pregnant patients and their offspring, in a tertiary care setting, Karachi, Pakistan. The hospital database was used to retrieve all patients who underwent PMV during pregnancy in the period 1998-2007. The follow up data of the patients and the born children were obtained from the hospital records and also by contacting the patients via phone. Six patients underwent PMV but follow-up was available for 5 patients only. All 5 patients were admitted due to severe mitral stenosis with symptoms of dyspnea and palpitation. Mean age was …

Human Glial-Restricted Progenitor Transplantation Into Cervical Spinal Cord Of The Sod1 Mouse Model Of Als., Angelo C Lepore, John O'Donnell, Andrew S Kim, Timothy Williams, Alicia Tuteja, Mahendra S Rao, Linda L Kelley, James T Campanelli, Nicholas J Maragakis

Department of Neuroscience Faculty Papers

Cellular abnormalities are not limited to motor neurons in amyotrophic lateral sclerosis (ALS). There are numerous observations of astrocyte dysfunction in both humans with ALS and in SOD1(G93A) rodents, a widely studied ALS model. The present study therapeutically targeted astrocyte replacement in this model via transplantation of human Glial-Restricted Progenitors (hGRPs), lineage-restricted progenitors derived from human fetal neural tissue. Our previous findings demonstrated that transplantation of rodent-derived GRPs into cervical spinal cord ventral gray matter (in order to target therapy to diaphragmatic function) resulted in therapeutic efficacy in the SOD1(G93A) rat. Those findings demonstrated the feasibility and efficacy of transplantation-based …

The Effect Of Intermittent Umbilical Cord Occlusion On Elastin Composition In The Ovine Fetus., Jennifer A Thompson, Sarah A Gimbel, Bryan S Richardson, Robert Gagnon, Timothy Regnault

Paediatrics Publications

This study aimed to determine the effect of varying degrees of intermittent umbilical cord occlusion (UCO) on arterial elastin composition. Over 4 days, chronically catheterized late gestation fetal sheep received 5 total UCO per day lasting 1 min/h (mild group: n = 6), 2 min/h (moderate group: n = 4), 3 min/h (severe group; n = 6); or no occlusion (control group: n = 7). Each group was evaluated for elastin content of the carotid and superior mesenteric artery (SMA), the arterial pressure response to UCO, and plasma cortisol concentration. Elastin content of the carotid artery was significantly increased by …

From Numbers To Knowledge : A Social Network Analysis Of Information Sharing And Trust In A Family Medicine Network, Tirzah J. Creel

MPA Capstone Projects 2006 - 2015

The IMPLICIT Network consists of 20 family residencies located across the Eastern United States. Ten of these residencies are actively implementing the IMPLICIT ONE Project, which provides pregnant women with health interventions associated with a decrease in preterm rates and/or birth of low birth weight infants. Each site tracks its intervention rates and enters performance information into an online database accessible to the organization that leads the network.

Severe Propylthiouracil-Induced Hepatotoxicity In Pregnancy Managed Successfully By Liver Transplantation: A Case Report, Evan Sequeira, Sikolia Wanyonyi, Raj Dodia

Obstetrics and Gynaecology, East Africa

Introduction: Propylthiouracil-induced severe hepatotoxicity is a relatively rare occurrence, with very few cases reported in the literature. The management of this complication in pregnancy can be a challenge because of the effects of the various treatment options on the fetus.

Case presentation: We report a rare case of fulminant hepatic failure in a 36-year-old gravida 2 black woman of African descent that occurred at 17 weeks gestation following propylthiouracil treatment for Graves’ disease. Her liver failure was managed by liver transplantation and thyroidectomy. Her pregnancy was continued to term, though with not so favorable early childhood sequelae.

Conclusion: This case …

Alpha-Defensins 1-3 Release By Dendritic Cells Is Reduced By Estrogen, Maria M. Escribese, Marta Rodríguez-García, Rhoda Sperling, Stephanie M. Engel

Dartmouth Scholarship

During pregnancy the immune system of the mother must protect any activation that may negatively affect the fetus. Changes in susceptibility to infection as well as resolution of some autoimmune disorders represent empirical evidence for pregnancy related alterations in immunity. Sex hormones reach extremely high levels during pregnancy and have been shown to have direct effects on many immune functions including the antiviral response of dendritic cells. Among the immunologically active proteins secreted by monocyte derived DCs (MDDC) are the alpha-defensins 1-3. This family of cationic antimicrobial peptides has a broad spectrum of microbicidal activity and has also been shown …

Polycyclic Aromatic Hydrocarbons In Maternal And Umbilical Cord Blood From Pregnant Hispanic Women Living In Brownsville, Texas, Ken Sexton, Jennifer J Salinas, Thomas J Mcdonald, Rose M Z Gowen, Rebecca P Miller, Joseph B Mccormick, Susan P Fisher-Hoch

Journal Articles

Venous blood was drawn from 35 pregnant Hispanic women living in Brownsville, Texas, and matched cord blood was collected at birth. Gas chromatography/mass spectrometry was used to measure concentrations of 55 individual PAHs or groups of PAHs. Results indicate that these women and their fetuses were regularly exposed to multiple PAHs at comparatively low concentrations, with levels in cord blood generally exceeding levels in paired maternal blood. While the possibility of related adverse effects on the fetus is uncertain, these exposures in combination with socioeconomically-disadvantaged and environmentally-challenging living conditions raise legitimate public health concerns.

Prenatal Maternal Anxiety And Early Childhood Temperament, Megan M. Blair, Laura M. Glynn, Curt A. Sandman, Elysia Poggi Davis

Psychology Faculty Articles and Research

The consequences of exposure to prenatal maternal anxiety for the development of child temperament were examined in a sample of 120 healthy, 2-year-old children. Prenatal maternal state and pregnancy-specific anxiety (PSA) were measured five times during pregnancy, and maternal state anxiety was measured again at 2 years post partum. Child temperament was measured at 2 years using the Early Childhood Behavior Questionnaire. The relationship between the trajectory of maternal anxiety across gestation and negative affectivity was evaluated using hierarchical linear growth curve modeling. Higher maternal PSA between 13 and 17 weeks of gestation was associated with increased negative temperament …

Smoking Cessation And Relapse Among Pregnant African-American Smokers In Washington, Dc, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kieley, Marie G. Gantz

Publications and Research

Smoking is the single most preventable cause of perinatal morbidity. This study examines smoking behaviors during pregnancy in a high risk population of African Americans. The study also examines risk factors associated with smoking behaviors and cessation in response to a cognitive behavioral therapy (CBT) intervention. This study is a secondary analysis of data from a randomized controlled trial addressing multiple risks during pregnancy. Five hundred African-American Washington, DC residents who reported smoking in the 6 months preceding pregnancy were randomized to a CBT intervention. Psycho-social and behavioral data were collected. Self-reported smoking and salivary cotinine levels were measured prenatally …

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

Interventions For Trichomoniasis In Pregnancy, A. Metin Guelmezoglu, Maimoona Azhar

Woman and Child Health

Background: Vaginitis due to Trichomonas vaginalis is one of the most common of sexually transmitted diseases. Trichomoniasis affects women during pregnancy as well but it is not clearly established whether it causes preterm birth and other pregnancy complications.
Objectives: The objective of this review was to assess the effects of various treatments for trichomoniasis during pregnancy.
Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register ( 14 January 2011).
Selection criteria: Randomized trials comparing anti-trichomonas agents during pregnancy. Trials including symptomatic or asymptomatic women with trichomoniasis were eligible.
Data collection and analysis: Two review authors assessed …

Domestic Violence And Pregnancy: The Challenge Of Framing A European-Wide Research Question., Caroline Andries, Nicola Buckley, Kristien Roelens, Ingunn Studsrød, Marleen Temmerman, An-Sofie Van Parys, Elisabeth Willumsen

Obstetrics and Gynaecology, East Africa

No abstract provided.

Health Needs Of Hiv-Infected Women In The United States: Insights From The Women Living Positive Survey., Kathleen E Squires, Sally L Hodder, Judith Feinberg, Dawn Averitt Bridge, Staats Abrams, Stephen P Storfer, Judith A Aberg

Department of Medicine Faculty Papers

The objective of this study was to describe attitudes, opinions, and perceived health needs of HIV-infected women in the United States. In this cross-sectional study, women were invited to participate in the Women Living Positive survey, a structured interview instrument with 45 questions. Collected data were deidentified and the margin of error was calculated as four percentage points. Incoming toll-free phone interviews were conducted from December 21, 2006, through March 14, 2007 among subjects recruited from a U.S. national network of AIDS counseling centers. Seven hundred HIV-infected women (43% African American, 28.5% Hispanic, 28.5% Caucasian; median age, 42.5 years) receiving …

Role Of Calcium Supplementation During Pregnancy In Reducing Risk Of Developing Gestational Hypertensive Disorders: A Meta-Analysis Of Studies From Developing Countries, Aamer Imdad, Afshan Jabeen, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Hypertension in pregnancy stand alone or with proteinuria is one of the leading causes of maternal mortality and morbidity in the world. Epidemiological and clinical studies have shown that an inverse relationship exists between calcium intake and development of hypertension in pregnancy though the effect varies based on baseline calcium intake and pre-existing risk factors. The Purpose of this review was to evaluate preventive effect of calcium supplementation during pregnancy on gestational hypertensive disorders and related maternal and neonatal mortality in developing countries.
Methods: A literature search was carried out on PubMed, Cochrane Library and WHO regional databases. Data …

The Effect Of Folic Acid, Protein Energy And Multiple Micronutrient Supplements In Pregnancy On Stillbirths, Aamer Imdad, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Pregnancy is a state of increased requirement of macro-and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes including stillbirths. Many nutritional interventions have been proposed during pregnancy according to the nutritional status of the mother and baseline risk factors for different gestational disorders. In this paper, we have reviewed three nutritional interventions including peri-conceptional folic acid supplementation, balanced protein energy supplementation and multiple micronutrients supplementation during pregnancy. This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST) …

Effect Of Balanced Protein Energy Supplementation During Pregnancy On Birth Outcomes, Aamer Imdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR). Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST) model.

Methods:

A literature search …

Effect Of Multiple Micronutrient Supplementation During Pregnancy On Maternal And Birth Outcomes, Batool Azra Haider, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives/Background:Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron-folate alone, could be of potential benefit to the mother and the fetus. These benefits could relate to prevention of maternal complications and reduction in other adverse pregnancy outcomes such as small-for-gestational age (SGA) births, low birth weight, stillbirths, perinatal and neonatal mortality. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron-folate supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST). Data sources/review methods: A systematic review …

Effect Of Routine Iron Supplementation With Or Without Folic Acid On Anemia During Pregnancy, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction:Iron deficiency is the most prevalent nutrient deficiency in the world, particularly during pregnancy. According to the literature, anemia, particularly severe anemia, is associated with increased risk of maternal mortality. It also puts mothers at risk of multiple perinatal complications. Numerous studies in the past have evaluated the impact of supplementation with iron and iron-folate but data regarding the efficacy and quality of evidence of these interventions are lacking. This article aims to address the impact of iron with and without folate supplementation on maternal anemia and provides outcome specific quality according to the Child Health Epidemiology Reference Group …

Effect Of Screening And Management Of Diabetes During Pregnancy On Stillbirths, Madiha Syed, Hasan Javed, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Diabetes during pregnancy is associated with significant risk of complications to the mother, fetus and newborn. We reviewed the potential impact of early detection and control of diabetes mellitus during pregnancy on stillbirths for possible inclusion in the Lives Saved Tool (LiST).

Methods:

A systematic literature search up to July 2010 was done to identify all published randomized controlled trials and observational studies. A standardized data abstraction sheet was employed and data were abstracted by two independent authors. Meta-analyses were performed with different sub-group analyses. The analyses were graded according to the CHERG rules using the adapted GRADE criteria …

Effectiveness Of Interventions To Screen And Manage Infections During Pregnancy On Reducing Stillbirths: A Review, Sidra Ishaque, Mohammad Yawar Yakoob, Aamer Imdad, Robert L. Goldenberg, Thomas P. Eisele, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Infection is a well acknowledged cause of stillbirths and may account for about half of all perinatal deaths today, especially in developing countries. This review presents the impact of interventions targeting various important infections during pregnancy on stillbirth or perinatal mortality.
Methods: We undertook a systematic review including all relevant literature on interventions dealing with infections during pregnancy for assessment of effects on stillbirths or perinatal mortality. The quality of the evidence was assessed using the adapted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach by Child Health Epidemiology Reference Group (CHERG). For the outcome of interest, namely …

Primary Hyperparathyrodism In Pregnancy And Review Of Literature, Tahira Naru, Rozilla Sadia Khan, Mohammed Ataullah Khan

Department of Obstetrics & Gynaecology

hyperparathyroidism (PHPT) is rare condition during pregnancy; however, it can carry significant risks to both mother and foetus during and after the pregnancy. The definitive treatment is parathyroidectomy undertaken preferably in the second or early third trimester. A case of asymptomatic PHPT diagnosed and treated by parathyroidectomy in the third trimester is described.

An Evaluation Of Hospital Breastfeeding Policies In The Philadelphia Metropolitan Area 1994-2009: A Comparison With The Baby-Friendly Hospital Initiative Ten Steps., Andrea Crivelli-Kovach, Esther K Chung

Department of Pediatrics Faculty Papers

OBJECTIVE: The purpose of this study was to describe current breastfeeding policies and practices among Philadelphia, PA metropolitan hospitals and changes in their policies and practices over time.

METHODS: In-person group interviews were conducted to obtain a composite picture of actual breastfeeding policies and practices. One questionnaire per hospital was completed based on responses from group consensus. Twenty-five hospitals providing maternity care were contacted. Information was obtained from personnel representing different areas of maternity services. Hospitals were classified according to the degree to which they were implementing the Ten Steps to Successful Breastfeeding.

RESULTS: Mean breastfeeding rates at suburban hospitals …

Food For Thought: Eathing For The Baby & You, Cassandra Fernandes Faria

Institute for Educational Development, Karachi

No abstract provided.

Identifying Postpartum Intervention Approaches To Preventing Type 2 Diabetes In Women With A History Of Gestational Diabetes, Jacinda M. Nicklas, Chloe A. Zera, Ellen W. Seely, Zainab S. Abdul-Rahim, Noelle D. Rudloff, Sue E. Levkoff

Faculty and Staff Publications

Background: Women who develop gestational diabetes mellitus (GDM) have an increased risk for the development of type 2 diabetes. Despite this "window of opportunity," few intervention studies have targeted postpartum women with a history of GDM. We sought perspectives of women with a history of GDM to identify a) barriers and facilitators to healthy lifestyle changes postpartum, and b) specific intervention approaches that would facilitate participation in a postpartum lifestyle intervention program.

Methods: We used mixed methods to gather data from women with a prior history of GDM, including focus groups and informant interviews. Analysis of focus groups relied on …

Does Treatment Of Premature Labor With Terbutaline Increase The Risk Of Autism Spectrum Disorders?, Patricia Rodier, Richard K Miller, Robert L Brent

Department of Pediatrics Faculty Papers

Beta-adrenergic agents have been used in pregnant women for the treatment of premature labor and for the treatment of asthma. Concerns have been expressed that exposure to terbutaline, a beta-2 adrenergic agonist, may increase the risk of autism spectrum disorders (ASDs) in the offspring. This hypothesis deserves critical review, given the number of patients exposed to the drug in the last two decades. The results are important to both the obstetricians and patients who weigh the risks and benefits of interventions and to the pediatricians who counsel the families of affected children.