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Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Complementary Medicines And Therapies In Clinical Guidelines On Pregnancy Care: A Systematic Review, Carolyn Ee, Kate Levett, Caroline Smith, Mike Armour, Hannah G. Dahlen, Prakshi Chopra, Paulette Maroun, Vibhuti S. Rao, Nicole Avard, Suzanne Grant, Hazel Keedle, Susanne Armour, Susan Arentz, Adele E. Cave, Kerry Sutcliffe, Kate Templeman

Medical Papers and Journal Articles

Background: There is a need for evidence-based guidance on complementary medicines and therapies (CMT) use during pregnancy due to high prevalence of use and lack of guidance on the balance of benefit and harms.

Aim: Evaluate the extent to which current clinical practice guidelines relevant to Australian healthcare professionals make clear and unambiguous recommendations about CMT use in pregnancy, and synthesise these recommendations.

Methods: The search included EMBASE, PubMed, the National Health and Medical Research Council’s Clinical Practice Guidelines Portal, and websites of Australian maternity hospitals and professional/notfor-profit organisations for published guidelines on pregnancy care. Data were synthesised narratively. Guidelines …

Urate Genetic Assessment In Asian And Pacific Islander Subgroups Of Pregnant Women: Implications For Personalized Medicine And Means To Reduce Health Disparities, Ali Alghubayshi

Theses and Dissertations

Gout is one of the most common rheumatic conditions and appears to have a higher prevalence in certain populations. Risk factors for gout and its precursor, hyperuricemia, are also significant risk factors for preeclampsia, major pregnancy-related morbidity. A retrospective cross-sectional study was conducted on 1059 pregnant women from different populations whom 100% reported their ethnicities from the Asian, Native Hawaiian, and Pacific Islander populations. Numerous uric acid (UA) genes and clinical conditions were addressed, and all study details were reviewed and exempted by the University of Hawaii human Studies Program (Protocol Number: 2018-00225). In this project, we hypothesized that UA …

Feasibility Of Online Nutritional Counseling And/Or Remote Self Weighing In Pregnant Women With Obesity, Rebecca Mattson

Dissertations

Purpose

The purpose of this feasibility study is to determine the magnitude of effect using a combination of weekly weights and an online registered dietician to control excessive gestational weight gain in pregnant women with obesity using a pilot randomized controlled trial.

Specific Aims

There are three specific aims. Aim 1: Describe the study population in terms of sociodemographic influences (e.g., ethnicity, age, weight, and height) and obstetrical influences (i.e., parity and pregnancy weight). Aim 2: Measure participant satisfaction with the study interventions of weekly weighing and online nutrition counselling. Aim 3: (a) Explore the differences in gestational weight …

Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem

Community Health Sciences

Background: Preconceptional maternal small-quantity lipid-based nutrient supplementation (SQLNS) improved intrauterine linear growth in low-resource countries as demonstrated by the Women First Preconception Maternal Nutrition Trial (WF). Fetal growth is dependent on nutrient availability and regulated by insulin-like growth factor 1 (IGF-1) through changes in placental transfer capacity, mediated by the mechanistic target of rapamycin (mTOR) pathway.
Objectives: Our objective was to evaluate the role of placental mTOR and IGF-1 signaling on fetal growth in women from 2 low-resource countries with high rates of stunting after they received preconceptional SQLNS.
Methods: We studied 48 women from preconception through delivery who were …

Cotrimoxazole Prophylaxis Increases Resistance Gene Prevalence And Α-Diversity But Decreases Β-Diversity In The Gut Microbiome Of Human Immunodeficiency Virus-Exposed, Uninfected Infants, Alaric W D'Souza, Eshia Moodley-Govender, Bertram Berla, Tejas Kelkar, Bin Wang, Xiaoqing Sun, Brodie Daniels, Anna Coutsoudis, Indi Trehan, Gautam Dantas

2020-Current year OA Pubs

BACKGROUND: Prophylactic cotrimoxazole treatment is recommended in human immunodeficiency virus (HIV)-exposed, uninfected (HEU) infants, but the effects of this treatment on developing HEU infant gut microbiotas and resistomes are largely undefined.

METHODS: We analyzed whole-metagenome sequencing data from 163 longitudinally collected stool samples from 63 HEU infants randomized to receive (n = 34; CTX-T) or to not receive (n = 29; CTX-N) prophylactic cotrimoxazole treatment. We generated taxonomic, functional pathway, and resistance gene profiles for each sample and compared microbiome signatures between the CTX-T and CTX-N infants.

RESULTS: Metagenomic analysis did not reveal significant differences in taxonomic or functional pathway …

Preterm Premature Rupture Of Membranes And The Value Of Serum Ferritin During Pregnancy, Maha Al Bayati, Baidaa Mohammed

Iraqi Postgraduate Medical Journal

BACKGROUND: Preterm premature rupture of membranes occurring from 24-37 weeks gestation. Ferritin is an acute phase reactant as it increases during inflammation that inflammation can predispose to preterm premature rupture of membranes during pregnancy. OBJECTIVE: To investigate the value of serum ferritin as a marker for preterm premature rupture of membrane. PATIENTS AND METHODS: The study includes 150 pregnant women attending the department of Obstetrics and Gynecology with a gestational age ranging from 28+0 – 36+6 weeks. 50 of them presented with Preterm premature rupture of membrane (group A), 50 women were presented with spontaneous preterm labor (group B), and …

Effect Of A Mobile Phone Intervention For Female Sex Workers On Unintended Pregnancy In Kenya (Whisper Or Shout): A Cluster-Randomised Controlled Trial, Frances H. Ampt, Megan S. C. Lim, Paul A. Agius, Kelly L'Engle, Griffins Manguro, Caroline Gichuki, Peter Gichangi, Walter Jaoko, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background: Female sex workers in low-income and middle-income countries face high risks of unintended pregnancy. We developed a 12-month, multifaceted short messaging service intervention (WHISPER) for female sex workers in Kenya who had the potential to become pregnant, to improve their contraceptive knowledge and behaviours. The aim of this study was to assess the effectiveness of the intervention to reduce the incidence of unintended pregnancy among sex workers in Kenya compared with an equal-attention control group receiving nutrition-focused messages (SHOUT).

Methods: Our two-arm, cluster-randomised controlled trial was done in sex-work venues in two subcounties of Mombasa, Kenya (Kisauni and Changamwe). …

Implementation Fidelity Of Nutritional Counselling, Iron And Folic Acid Supplementation Guidelines And Associated Challenges In Rural Uasin Gishu County Kenya, Roselyter Riang’A, Anne Nangulu, Jacqueline Broerse

Population Health, East Africa

Background: Implementation fidelity which is defined as the degree to which programmes are implemented as intended is one of the factors that affect programme outcome, thus requiring careful examination. This study aims to acquire insight into the degree to which nutritional counselling and Iron and Folic Acid supplementation (IFAs) policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity.

Methods: Data were collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among intervention recipients (n = 188) and semi-structured interviews with programme implementers (n = 6). …

The Cortico-Limbo-Thalamo-Cortical Circuits: An Update To The Original Papez Circuit Of The Human Limbic System, Jochen Profit, Paul J Sharek, Xin Cui, Courtney C Nisbet, Eric J Thomas, Daniel S Tawfik, Henry C Lee, David Draper, J Bryan Sexton

Faculty, Staff and Student Publications

OBJECTIVES: Key validated clinical metrics are being used individually and in aggregate (Baby-MONITOR) to monitor the performance of neonatal intensive care units (NICUs). The degree to which perceptions of key components of safety culture, safety climate, and teamwork are related to aspects of NICU quality of care is poorly understood. The objective of this study was to test whether NICU performance on key clinical metrics correlates with caregiver perceptions of safety culture.

STUDY DESIGN: Cross-sectional study of 6253 very low-birth-weight infants in 44 NICUs. We measured clinical quality via the Baby-MONITOR and its nine risk-adjusted and standardized subcomponents (antenatal corticosteroids, …

A Quality Improvement Project To Facilitate A Human Trafficking Screening Protocol At A Maternal Resource Center, Jessica Mcdow

Doctor of Nursing Practice

Human trafficking is a global, criminal industry that negatively impacts the health of victims. Most U.S. victims of human trafficking are young females. Many female sex trafficking victims will seek health care services for unplanned pregnancies and sexually transmitted infections. Healthcare professionals fail to identify human trafficking victims due to lack of standardized screening. The aim of the project was to initiate a sustainable, standardized human trafficking screening protocol at a Maternal Resource Center in order to improve human trafficking identification.

This 10-week quality improvement project provided the staff and volunteers at a Maternal Resource Center with the necessary tools …

The Effects Of Covid-19 On Pregnancy, Madison R. Cerda

Honors Capstones

On March 11, 2020, the World Health Organization declared a pandemic of a new strain of SARS-CoV-2, now officially named COVID-19. As a future nurse in labor and delivery I decided to focus on how coronavirus affects pregnancy. Pregnancy is considered a state of immune suppression, which makes this population especially vulnerable. The purpose of this literature review is to explore the health effects coronavirus has on the mother and fetus, while at the same time research possible treatment plans. The paper will highlight coronavirus’s history, pathophysiology, diagnosis, treatment, obstetric workflow, how it affects the placenta, and breastfeeding recommendations. I …

Maternal Altitude And Risk Of Low Birthweight: A Systematic Review And Meta-Analyses, Lin Yang, Veronika Helbich-Poschacher, Chao Cao, Katrin Klebermass-Schrehof, Thomas Waldhoer

2020-Current year OA Pubs

BACKGROUND: Previous studies conducted in high altitude regions showed that maternal altitude was associated with low birth weight. The effect size of birth weight reduction is inclusive with unknown effects due to preterm birth. We systematically reviewed the literature and synthesize evidence on associations between altitude elevation from sea level and birth weight.

METHOD: We searched MEDLINE/PubMed, Embase, Scopus, Web of Science, and Cochrane database, from inception to May 5, 2020 for studies that reported maternal altitude and birth weight. Bayesian multilevel effect models were employed to estimate the effect size on birth weight (and gestational age) associated with altitude. …

Interview Transcript Participant #02, Auriluz Pacheco

New York City Maternal Health Oral History Project

No abstract provided.

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

National Nutrition Strategies That Focus On Maternal, Infant, And Young Child Nutrition In Southeast Asia Do Not Consistently Align With Regional And International Recommendations, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Jennifer Cashin, Mellissa Withers, Roger Mathisen, Karin Lapping, Timothy D. Mastro, Edward A. Frongillo Jr.

Faculty Publications

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy …

Modification Of Irisin Level In Overweight/Obese Women During Pregnancy And Its Association With Some Metabolic Risk Factors, Mohammad Ahmad Hamza, Yassar Yahya Al Tamer, Omar Abdulmajeed Al Habib

Baghdad Science Journal

Irisin is a novel myokine and adipokine, its role during pregnancy and its association with some metabolic risk factors especially pre-pregnancy body mass index (pre-BMI) need more evaluation. The aim of the study is to find whether the pre-BMI could predict irisin levels during normal pregnancy and to clarify associations of irisin with some pathological parameters. Irisin levels were estimated by ELISA in sera of 59 normal pregnant women who enrolled from December 2016 to May 2017 at Maternity Hospital, Zakho city, Kurdistan region (Iraq). Thirty-two normal-weight pregnant (pre-BMI≤24.9 kg/m2, Age=24.03 mean±3.7standard deviation) and 27 overweight/obese-pregnant (pre-BMI>25 kg/m2, Age=27.6 …

Connecting Vitamin D To Gene Expression In Pregnant African Americans, Sheila L. Jordan, Anne Dunlop, Alicia Smith, Carolyn Reilly, Vin Tangpricha

International Nursing Research Congress (INRC)

Vitamin D potentially plays a role in maternal health outcomes partly through the regulation of genes linked to vital physiologic processes. This study investigates the relationship between serum vitamin D and gene expression in peripheral blood mononuclear cells of pregnant African Americans in the southeastern United States.

Patient And Provider Communication Regarding Exercise During Pregnancy In A Rural Setting, Maire M. Blankenship, Kim Link, Samantha Henry, Rachel A. Tinius

International Journal of Exercise Science

International Journal of Exercise Science 13(3): 1228-1241, 2020. Women in rural settings are at increased risk for adverse pregnancy outcomes. One potential way to improve pregnancy outcomes in rural settings is through physical activity promotion. However, given the disparities in prenatal care, women in rural areas may not receive information from their health care provider regarding physical activity during pregnancy. Therefore, the purpose of this study was to examine patient and provider communication in a rural setting (both patients’ and providers’ perspectives) regarding physical activity during pregnancy. A mixed methods study was performed among patients and providers in an obstetrical …

Multiomic Immune Clockworks Of Pregnancy, Laura S. Peterson, Ina A. Stelzer, Amy S. Tsai, Mohammad S. Ghaemi, Xiaoyuan Han, Kazuo Ando, Virginia D. Winn, Nadine R. Martinez, Kevin Contrepois, Mira N. Moufarrej, Stephen Quake, David A. Relman, Michael P. Snyder, Gary M. Shaw, David K. Stevenson, Ronald J. Wong, Petra Arck, Martin S. Angst, Nima Aghaeepour, Brice Gaudilliere

All Dugoni School of Dentistry Faculty Articles

Preterm birth is the leading cause of mortality in children under the age of five worldwide. Despite major efforts, we still lack the ability to accurately predict and effectively prevent preterm birth. While multiple factors contribute to preterm labor, dysregulations of immunological adaptations required for the maintenance of a healthy pregnancy is at its pathophysiological core. Consequently, a precise understanding of these chronologically paced immune adaptations and of the biological pacemakers that synchronize the pregnancy “immune clock” is a critical first step towards identifying deviations that are hallmarks of peterm birth. Here, we will review key elements of the fetal, …

Transcriptional Profiling Reveals Altered Biological Characteristics Of Chorionic Stem Cells From Women With Gestational Diabetes, Liyun Chen, Chung-Teng Wang, Nicholas R Forsyth, Pensee Wu

Open Access Publications

BACKGROUND: Gestational diabetes (GDM) is a common complication of pregnancy. The impact of pregnancy complications on placental function suggests that extraembryonic stem cells in the placenta may also be affected during pregnancy. Neonatal tissue-derived stem cells, with the advantages of their differentiation capacity and non-invasive isolation processes, have been proposed as a promising therapeutic avenue for GDM management through potential cell therapy approaches. However, the influence of GDM on autologous stem cells remains unclear. Thus, studies that provide comprehensive understanding of stem cells isolated from women with GDM are essential to guide future clinical applications.

METHODS: Human chorionic membrane-derived stem …

Rationale And Study Design For Lifestyle Intervention In Preparation For Pregnancy (Lipp): A Randomized Controlled Trial, M. L. Erickson, J. T. Mey, C. L. Axelrod, D. Paul, L. Gordesky, K. Russell, H. Barkoukis, P. O'Tierney-Ginn, R. A. Fielding, J. P. Kirwan, P. M. Catalano

Division of Basic Science Faculty Publications

Introduction: Maternal obesity increases neonatal risk for obesity and metabolic syndrome later in life. Prior attempts to break this intergenerational obesity cycle by limiting excessive gestational weight gain have failed to reduce neonatal adiposity. Alternatively, pre-conception lifestyle interventions may improve the in utero metabolic milieu during early pregnancy leading to improved fetal outcomes. This randomized controlled trial (RCT) is evaluating whether a lifestyle intervention to reduce weight and improve maternal metabolism in preparation for pregnancy (LIPP) attenuates neonatal adiposity, compared to standard medical advice. Material and methods: Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for …

Advancing Human Health In The Decade Ahead: Pregnancy As A Key Window For Discovery: A Burroughs Wellcome Fund Pregnancy Think Tank., Yoel Sadovsky, Sam Mesiano, Graham J Burton, Michelle Lampl, Jeffrey C Murray, Rachel M Freathy, Anita Mahadevan-Jansen, Ashley Moffett, Nathan D Price, Paul H Wise, Derek E Wildman, Ralph Snyderman, Nigel Paneth, John Anthony Capra, Marcelo A Nobrega, Yaacov Barak, Louis J Muglia

Articles, Abstracts, and Reports

Recent revolutionary advances at the intersection of medicine, omics, data sciences, computing, epidemiology, and related technologies inspire us to ponder their impact on health. Their potential impact is particularly germane to the biology of pregnancy and perinatal medicine, where limited improvement in health outcomes for women and children has remained a global challenge. We assembled a group of experts to establish a Pregnancy Think Tank to discuss a broad spectrum of major gestational disorders and adverse pregnancy outcomes that affect maternal-infant lifelong health and should serve as targets for leveraging the many recent advances. This report reflects avenues for future …

Experiences And Satisfaction Of High-Risk Mothers Who Gave Birth In Select Facilities In Legazpi City, Philippines, Maria Stephanie Fay S. Cagayan, Veincent Christian F. Pepito, Rita Mae Ang-Bon, Erlidia F. Llamas-Clark

Ateneo School of Medicine and Public Health Publications

Among the interventions implemented to curb maternal mortality in the Philippines, service delivery networks (SDNs) have been one of the most important. However, due to their recent implementation, frameworks to assess the quality of care they provide have not yet been established. To address this need, we had formulated the Integrated Patient-Centered Health Service Framework and used it to explore the satisfaction of mothers who gave birth in select facilities Legazpi City Philippines. We conducted key-informant interviews with 14 mothers. We found out that they were satisfied with the quality of care during pre-pregnancy, pregnancy, and post-partum; however, the quality …

Maternal Viral Load Monitoring: Coverage And Clinical Action At 4 Kenyan Hospitals., Matthew Sandbulte, Melinda Brown, Catherine Wexler, May Maloba, Brad Gautney, Kathy Goggin, Elizabeth Muchoki, Shadrack Babu, Nicodemus Maosa, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Kenya's guidelines for prevention of mother-to-child transmission of HIV (PMTCT) recommend routine viral load (VL) monitoring for pregnant and breastfeeding women.

METHOD: We assessed PMTCT VL monitoring and clinical action occurring between last menstrual period (LMP) and 6 months postpartum at 4 Kenyan government hospitals. Pregnant women enrolled in the HIV Infant Tracking System from May 2016-March 2018 were included. We computed proportions who received VL testing within recommended timeframes and who received clinical action after unsuppressed VL result.

RESULTS: Of 424 participants, any VL testing was documented for 305 (72%) women and repeat VL testing was documented for …

Determining The Knowledge And Practices Of Obstetrics Healthcare Professionals Regarding Maternal Intrapartum Pertussis Vaccination Administration, Kristie Mattix

Doctor of Nursing Practice Scholarly Project

Pertussis is a contagious respiratory disease that can occur in all age groups. Signs and symptoms of pertussis, however, are worse in infants and young children; likewise, the rates of severe cases, hospitalizations, and deaths are higher in this group as well. Vaccination against pertussis is the most effective way to combat this illness. In the last 15 years, there have been a number of changes in the recommendations regarding vaccination against pertussis. In order for these recommendations to be followed, healthcare professionals must be aware of the guidelines as well as be knowledgeable about the condition they are trying …

Creating Attunement In Utero: Dance/Movement Therapy For Women Who Are Incarcerated While Pregnant, Meaghan Wilson

Expressive Therapies Capstone Theses

This thesis reviews the experience of pregnancy in prisons; pregnancy in bonding, attachment, and attunement; and pregnancy in dance movement therapy. Every woman deserves the help and guidance to connect with their baby as much as possible: during pregnancy and after. For women whom are incarcerated, the time to connect is shortened. For most women, they do not have access to their babies after delivery. I have researched the living conditions for women who are pregnant while incarcerated; this includes accommodations, possible health risks, and programs set up for pregnant women. Also researched is the importance to have connections made …

The Harms Of Willful Ignorance: Maternal Healthcare Providers’ Insight On Racial Disparities, Cara Marisa Cancelmo

Master's Theses

Black women in the United States die in pregnancy and childbirth at alarmingly high rates. According to The Center for Disease Control, black women are two to three times more likely to die from pregnancy-related causes than white women. The black-white racial disparity is even greater in New York City, and The NYC Department of Health has found that black mothers in NYC still face higher rates of harm even when accounting for risk factors like educational attainment, obesity, and neighborhood poverty level. Drawing on 18 interviews with NYC-based Obstetricians, Labor and Delivery Nurses, and Midwives, this study examines how …

The Nightmare Before Delivery: A Study Of Nightmares, Depressive Symptoms, And Suicidality In Pregnant Women, Denise Frantz

Honors Theses

Pregnancy is notoriously a time of immense changes. Some of which are characterized by disturbances in sleep such as trouble falling asleep, trouble staying asleep, waking after sleep onset, snoring, leg discomfort, and nightmares (Foley, Ancoli-Israel, Britz, and Walsh, 2004; Lee and Gay, 2004; Köthe & Pietrowsky, 2001). Nightmares specifically have been associated with depressive symptoms and suicidality in non-pregnant individuals (Cukrowicz et al., 2006; Tanskanen et al., 2001), but these relations are not as well understood in the pregnant population. The aim of this study was to assess any potential relation between nightmares and depressive symptoms and suicidality in …

Socioeconomic Status And Symptoms Of Anxiety And Depression In Pregnant Women, Meagan Mandabach

Honors Theses

Pregnancy is a period of great change in a woman’s body as her baby develops. During this period, women commonly experience symptoms of anxiety (Dennis et al., 2017) and depression (Shidhaye & Giri, 2014). Literature has suggested that socioeconomic status (SES) can contribute to the severity at which pregnant women experience anxiety and depression (Arora & Aeri, 2019; Field et al., 2008; Shagufta & Shams, 2019), and women of low socioeconomic status may be more likely to experience symptoms of anxiety and depression during pregnancy (Field et al., 2008). The present study aimed to assess the relationships between household income …