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Barriers To Identifying Eating Disorders In Pregnancy And In The Postnatal Period: A Qualitative Approach., Amanda Bye, Jill Shawe, Debra Bick, Abigail Easter, Megan Kash-Macdonald, Nadia Micali

School of Nursing and Midwifery

BACKGROUND: Eating Disorders (ED) are mental health disorders that typically effect women of childbearing age and are associated with adverse maternal and infant outcomes. UK healthcare guidance recommends routine enquiry for current and past mental illness in antenatal and postnatal care for all women, and that pregnant women with a known ED are offered enhanced monitoring and support. Midwives and health visitors are ideally placed to identify and support women with ED as they are often the primary point of contact during the antenatal and postnatal periods. However, research on the barriers to identifying ED in the perinatal period is …

Vitamin D Deficiency And Supplemental Use In Pregnancy: A Systematic Review And Meta-Analysis, Christine Rogers-Kelly

Theses and Dissertations

Vitamin D inadequacy is highly prevalent among pregnant women worldwide. Inadequacy or deficiency of vitamin D can lead to adverse outcomes during pregnancy such as pre-eclampsia, gestational diabetes, and caesarian section. A systematic review and meta-analysis were conducted to examine the effectiveness of vitamin D supplementation on serum vitamin D status during pregnancy in randomized controlled trials (RCTs). A search was conducted in PubMed, Scopus, ProQuest, EBSCO, Cochrane CENTRAL Database of Controlled Clinical Trials, PsycINFO, CINAHL, and Google Scholar, in addition to searching reference lists in published reviews. A comprehensive list of RCTs of vitamin D status and supplemental use …

Dietary Diversity Predicts The Adequacy Of Micronutrient Intake In Pregnant Adolescent Girls And Women In Bangladesh, But Use Of The 5-Group Cutoff Poorly Identifies Individuals With Inadequate Intake, Phuong Hong Nguyen, Lieven Huybregts, Tina G. Sanghvi, Lan Mai Tran, Edward A. Frongillo Jr., Purnima Menon, Marie T. Ruel

Faculty Publications

Background: The Minimum Dietary Diversity for Women (MDD-W) indicator based on a 10-food group women dietary diversity score (WDDS-10) has been validated to assess dietary quality in nonpregnant women. Little is known about its applicability in pregnant women, and specifically pregnant adolescent girls with higher nutrient requirements. Objectives: This study aimed to 1) compare the adequacy of micronutrient intakes between pregnant adolescent girls and women, 2) examine the performance of WDDS-10 in predicting the mean probability of adequacy (MPA) of 11 micronutrients, and 3) assess how well the MDD-W cutoff of 5 groups performed in pregnant adolescent girls and women. …

Informing Consent: Medical Malpractice And The Criminalization Of Pregnancy, Laura Beth Cohen

Michigan Law Review

Since the early 1990s, jurisdictions around the country have been using civil child abuse laws to penalize women for using illicit drugs during their pregnancies. Using civil child abuse laws in this way infringes on pregnant women’s civil rights and deters them from seeking prenatal care. Child Protective Services agencies are key players in this system. Women often become entangled with the Child Protective Services system through their health care providers. Providers will drug test pregnant women without first alerting them to the potential negative consequences stemming from a positive drug test. Doing so is a breach of these providers’ …

Implications Of Early Pregnancy Obesity On Maternal, Fetal And Neonatal Health: Retrospective Cohort Study From Oman, Anita Zutshi, Jayasree Santhosh, Julie Naeem, Fareeha, Ahmed Al-Hamedi, Shahla Khan, Eishthiag Al-Said

Sultan Qaboos University Medical Journal

Objectives: This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal complications among such women in comparison to women of normal weight. Methods: This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients’ electronic medical records were reviewed for antenatal, intrapartum and postpartum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications …

Women’S Lived Experience Of Pregnancy And Child Birth: Narratives From Pakistan, Rabia Ali, Ume Habiba, Hazir Ullah

The Qualitative Report

In Pakistan there are unique socio-cultural factors that contribute to women’s experiences of pregnancy and childbirth. This study explores Pakistani women’s experiences of pregnancy and childbirth an area that remains under researched in the country. Qualitative research was employed for data collection by using an un-structured interview guide. The informants included twelve women who had recently been through the childbirth process for the first and second time. The collected data reveals that women were unaware of the use of multi vitamins during pregnancy. They delayed physical check-ups with a gynaecologist. Women encountered challenges at work during pregnancy and encountered work …

Household Chores As The Main Source Of Physical Activity: Perspectives Of Pregnant Pakistani Women, Zahra Hoodbhoy, Rahat Qureshi, Romaina Iqbal, Qamarunissa Muhabat

Department of Paediatrics and Child Health

Objective: To understand the level of physical activity in pregnant women and to identify perceived facilitators and barriers faced by them.
Methods: This cross-sectional study was conducted from January to June 2016 at Aga Khan Maternity and Child Care Centre, Hyderabad, Pakistan, and comprised pregnant women attending the antenatal clinics. They were administered the pregnancy physical activity questionnaire while additional questions were asked to assess perceived barriers and facilitators in pregnancy. SPSS 19 was used for data analysis.
Results: Of the 455 subjects, 179(36%) were physically active. Their median metabolic equivalent of task hours per week was 14.65 (interquartile …

Assessment Of Maternal And Infant Outcomes Of Moderately Malnourished Pregnant Adolescents In Malawi, Alyssa Marie Friebert

Master's Theses

Background: Adolescent childbearing and maternal malnutrition are common in low- and middle-income countries and are associated with increased risk for poor maternal and infant outcomes. Adolescent pregnancy compounded with moderate malnutrition exacerbates outcomes common to both individually. Supplementary foods may be a way to improve outcomes in malnourished adolescent pregnant women.

Objective: To retrospectively assess maternal and infant outcomes in moderately malnourished pregnant young adolescents (16-17 YO), older adolescents (18-19 YO), and adults (≥20 YO) in response to one of three nutritional interventions and in a pooled treatment group analysis, and to assess differences in infant outcomes by infant gender. …

How To Nourish Mom And Baby Alike: Nutrition During Pregnancy, Marianne Olsen, Mateja R. Savoie-Roskos, Carrie Durward

All Current Publications

This fact sheet offers weight gain and nutrition suggestions that can improve the health of you and your baby during and after pregnancy.

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Are Children Of A Diabetic Mother In Comparison To Children Of A Nondiabetic Mother At An Increased Risk For Developing Obesity In The First 10 Years Of Life?, Chhorn Pho

Theses and Graduate Projects

Body weight, glucose, insulin, and leptin were studied in children of mothers with gestational diabetes, type 1 or type 2 diabetes. Breast milk of diabetic mothers was also analyzed to study its relationship to childhood obesity. In the first 2 years of life, infants of mothers with gestational diabetes have no significant difference in weight gain but by the age of 10, most of the children birthed by any diabetic mothers were either overweight or obese. Children of mothers diagnosed with diabetes mellitus type 2 have higher resistance to insulin than children of mothers with other diabetes types. Leptin was …

Triennial Reproduction Symposium: Looking Back And Moving Forward—How Reproductive Physiology Has Evolved, Deb L. Hamernik, Andrea S. Cupp, John S. Davis

Department of Animal Science: Faculty Publications

In honor of the 50th anniversary of the Society for the Study of Reproduction (SSR), a Triennial Reproduction Symposium was cosponsored by SSR and the American Society of Animal Science (ASAS). The Society for the Study of Reproduction was formed in 1967 when a group of reproductive biologists that were members of ASAS met with physician scientists and decided to organize a new scientific society. The goal of SSR was to promote the study of reproduction by fostering interdisciplinary communication among scientists, holding conferences, and publishing meritorious studies. Today after its 50th anniversary, the mission for SSR is to harness …

Birth Conflicts: Leveraging State Power To Coerce Health Care Decision-Making, Elizabeth Kukura

University of Baltimore Law Review

No abstract provided.

The Effects Of Pre-Pregnancy Tobacco Use On Food Cravings And Weight Gain In Pregnancy, Lauren E. Blau

Legacy Theses & Dissertations (2009 - 2024)

Smoking cessation is associated with greater frequency of food cravings, even when controlling for body mass index. Recent studies have indicated similarities between obese women and women who smoke tobacco in mood states and food craving frequency. This is consistent with the common substrate hypothesis, which postulates that shared neural pathways mediate craving across multiple domains, and could explain why it is common for women attempting to quit smoking to gain weight. Smoking cessation prior to pregnancy is strongly encouraged due to the adverse effects of tobacco use on the developing fetus. Studies have shown that women who quit smoking …

Cravings And Gestational Weight Gain : Predictors Of Weight-Related Health In Pregnancy And The Postpartum, Natalia Christine Orloff

Legacy Theses & Dissertations (2009 - 2024)

More than half of all pregnancies result in excess gestational weight gain (GWG), which is one of the most common high-risk obstetric conditions and is associated with health complications in the mother and the fetus. We have conceptualized excess GWG within the Elaboration Intrusion framework and developed studies to test this theory and identify predictors of excess GWG. These studies sought to 1) establish the appropriateness of existing measures related to the constructs of the EI Theory, 2) establish a causal effect of food craving on excess GWG, 3) examine the role of knowledge as a predictor in excess GWG, …

Investigating The Pubertal Effects Of High Advanced Glycation End Product (Age) Consumption On Mammary Gland Development, Jamie F. Randise

MUSC Theses and Dissertations

The mammary gland continues to develop postnatally through puberty, pregnancy, lactation and involution. Evidence supports the notion that critical events in mammary development permanently alter developmentally regulated programs which influence the breast microenvironment to increase breast cancer risk. Advanced glycation end-products (AGEs) are highly reactive metabolites that irreversibly accumulate in tissues as we grow older. The pathogenic effects of AGEs include tissue degeneration, protein dysfunction, aberrant cell signaling and reduced genetic fidelity. AGE accumulation can contribute to pro-inflammatory and -oxidant phenotypes when signaling through the receptor for advanced glycation end-products. AGEs form during normal metabolism but critically, lifestyle factors such …

The Effect Of Breastfeeding And Rooming-In Care On Neonatal Abstinence Syndrome, Rachel Boyer, Lindsay Gal, Mahaylie Cline

Williams Honors College, Honors Research Projects

Concurrent with a rise in opioid abuse during pregnancy is an increase in the number of babies born with Neonatal Abstinence Syndrome (NAS). Despite this crisis, no single treatment has been identified for NAS. This paper sought to analyze and synthesize research evaluating the effectiveness of breastfeeding and rooming-in care on the need and length of pharmacologic treatment and length of hospital stay for neonates with NAS. Twenty-six peer reviewed research articles published between 2006 and 2017 were selected from PubMed and CINAHL for analysis. The studies focused on neonates with NAS born to mothers addicted to opioids or undergoing …

Preconceptional Health Behavior Change In Women With Overweight And Obesity: Prototype For Smart Strong Healthy Women Intervention, Frank T. Materia, Joshua M. Smyth, Kristin E. Heron, Marianne Hillemeier, Mark E. Feinberg, Patricia Fonzi, Danielle Symons

Psychology Faculty Publications

Background: The prevalence of maternal perinatal obesity is rising, and in turn, increases health risks and morbidity for both mother and child. Past evidence suggests the preconceptional Strong Healthy Women (SHW) intervention can reduce multiple biobehavioral risk factors for adverse perinatal health. The SHW intervention, however, was time- and resource-intensive to deliver. Mobile health (mHealth) technologies provide an opportunity to expand intervention reach while reducing implementation cost and burden. Previous research suggests that preconceptional women are broadly supportive of using smartphones for behavior change, yet few studies have elicited their specific preferences for a targeted mHealth intervention. The objective of …

The Timing And Composition Of Gestational Weight Gain And The Impact On Neonatal Anthropometry, Kathy Redfern

Other Faculty of Health Theses

Background: Numerous maternal factors, such as body mass index (BMI), gestational weight gain (GWG), diet and physical activity (PA) have been shown to impact infant birth weight. In the UK, antenatal care tends to be based on pre-pregnancy BMI and women are not weighed routinely during pregnancy nor are there guidelines for GWG. However, it is widely acknowledged that maternal obesity and GWG in excess of the American Institute of Medicine guidelines are associated with increased risk of foetal macrosomia and recent studies have suggested a role of the timing and composition of GWG beyond that of BMI. The purpose …

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

Uterine Prolapse In A Pregnant Cat, Zeynep Günay Uçmak, Meli̇h Uçmak, Ali̇ Can Çeti̇n, Çağatay Tek

Turkish Journal of Veterinary & Animal Sciences

A 3-year-old, 2.5-kg British shorthair cat with dystocia and protrusion of a mass through the vulva was presented to the Obstetrics and Gynaecology Clinic, Faculty of Veterinary Medicine, İstanbul University. Upon clinical examination, a complete uterine prolapse was diagnosed. Because of a blood blister and oedema in the uterine horns, ovariohysterectomy treatment was decided. During laparotomy, one foetus was detected in the cranial portion of the left uterine horn. After manual reduction and intraabdominal withdrawal of the prolapsed uterus, a caesarean section was performed to deliver the foetus. The last litter and the queen were discharged from the clinic in …

Physical Exercise During Pregnancy And Its Related Factors: An Observational Study In Japan, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Seonae Yeo

Asian/Pacific Island Nursing Journal

This study aimed to investigate the exercise habits of pregnant women in the third trimester (N = 303). We assessed participation in physical activities, including exercise or sports, using the Japanese version of the Pregnancy Physical Activity Questionnaire. A total of 183 (60.4%) pregnant Japanese women participated in some form of exercise and 87 (28.7%) exercised for 2 hours or more, per week, in the third trimester. Multiple logistic regression analyses indicated that women who set themselves a gestational weight gain target (adjusted odds ratio [AOR] = 8.10, 95% CI [2.82, 23.4], p< .001), were more likely to participate in exercise or sports. In contrast, multiparous women (AOR = 0.44, 95% CI [0.26, 0.72], p = .001), and those whose …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

Do Neonatal Nurses Caring For Newborns With Neonatal Abstinence Syndrome (Nas) Whose Mothers Used Illicit Substances During Pregnancy Experience Moral Distress? A Pilot Study, Valarie Artigas

Doctoral Dissertations

Maternal substance misuse/abuse during pregnancy may lead to adverse neonatal outcomes, including neonatal abstinence syndrome (NAS). NAS is a constellation of withdrawal symptoms exhibited in newborns in response to the discontinuance of in-utero exposure to licit and illicit substances. The incidence of NAS is directly related to the increasing rates of maternal substance use/abuse. The United States has experienced a five-fold increase of newborns born with NAS. The care of the newborn with NAS is one of the most challenging conditions for the neonatal nurse. Management of newborns with NAS requires knowledge that has not been traditionally partnered within care …

Integrating Nutrition Interventions Into An Existing Maternal, Neonatal, And Child Health Program Increased Maternal Dietary Diversity, Micronutrient Intake, And Exclusive Breastfeeding Practices In Bangladesh: Results Of A Cluster-Randomized Program Evaluation, Phuong Hong Nguyen, Sunny S. Kim, Tina Sanghvi, Zeba Mahmud, Lan Mai Tran, Sadia Shabnam, Bachera Aktar, Raisul Haque, Kaosar Afsana, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. We used a cluster-randomized design with cross-sectional surveys at baseline (2015) …

Increased Birth Weight Is Associated With Altered Gene Expression In Neonatal Foreskin, Leryn J. Reynolds, Rebecca I. Pollack, Richard J. Charnigo, Cetewayo S. Rashid, Arnold J. Stromberg, Shu Shen, John O'Brien, Kevin J. Pearson

Pharmacology and Nutritional Sciences Faculty Publications

Elevated birth weight is linked to glucose intolerance and obesity health-related complications later in life. No studies have examined if infant birth weight is associated with gene expression markers of obesity and inflammation in a tissue that comes directly from the infant following birth. We evaluated the association between birth weight and gene expression on fetal programming of obesity. Foreskin samples were collected following circumcision, and gene expression analyzed comparing the 15% greatest birth weight infants (n = 7) v. the remainder of the cohort (n = 40). Multivariate linear regression models were fit to relate expression levels on differentially …

Assessing The Effect Of Nutritional Interventions On Body Composition Changes During Pregnancy In Moderately Malnourished Malawian Women, Megan K. Kitagawa

Master's Theses

Background: Malnutrition can affect the body composition changes that occur in healthy pregnancy, resulting in adverse effects to both the mother and infant. Supplementary foods with high quality protein may result in more favorable changes in lean mass and fat mass in pregnant malnourished women.

Objective: To retrospectively assess changes in body composition in moderately malnourished pregnant Malawian women in response to one of three nutritional interventions.

Methods: Height, weight, MUAC, and TSF were measured in pregnant women with MUAC >20.6 cm and19) were compared using ANOVA. If differences were detected, differences between groups were tested using the Tukey HSD …

The Effects Of Poor Maternal Nutrition On Offspring Growth And Maternal And Offspring Inflammatory Status During Gestation, Amanda Jones

Doctoral Dissertations

Breeding and management of pregnant females are essential components of livestock production. Improper gestational management creates maternal stressors which negatively affect prenatal and postnatal offspring development. We hypothesized that 1) using transabdominal ultrasound, pregnancy diagnosis would be accurate during early gestation in ewes and measure fetal growth patterns during mid-gestation, and 2) inflammation may be a mechanism contributing to suboptimal offspring performance when maternal nutrition is poor during gestation. To investigate, 99 ewes were scanned three times per wk between d26 and d40 of gestation. The sensitivity and specificity of pregnancy diagnoses were >90% from d33 onward, coinciding with visualization …

The Oral Microbiome And Adverse Pregnancy Outcomes., Charles M. Cobb, Patricia J. Kelly, Karen B. Williams, Shilpa Babbar, Mubashir Angolkar, Richard J. Derman

Department of Obstetrics and Gynecology Faculty Papers

Significant evidence supports an association between periodontal pathogenic bacteria and preterm birth and preeclampsia. The virulence properties assigned to specific oral pathogenic bacteria, for example, Fusobacterium nucleatum, Porphyromonas gingivalis, Filifactor alocis, Campylobacter rectus, and others, render them as potential collaborators in adverse outcomes of pregnancy. Several pathways have been suggested for this association: 1) hematogenous spread (bacteremia) of periodontal pathogens; 2) hematogenous spread of multiple mediators of inflammation that are generated by the host and/or fetal immune response to pathogenic bacteria; and 3) the possibility of oral microbial pathogen transmission, with subsequent colonization, in the vaginal microbiome resulting from sexual …

Using Neonatal Skin To Study The Developmental Programming Of Aging, Leryn J. Reynolds, Brett J. Dickens, Benjamin B. Green, Carmen J. Marsit, Kevin J. Pearson

Pharmacology and Nutritional Sciences Faculty Publications

Numerous studies have examined how both negative and positive maternal exposures (environmental contaminants, nutrition, exercise, etc.) impact offspring risk for age-associated diseases such as obesity, type 2 diabetes, hypertension, and others. The purpose of this study was to introduce the foreskin as a novel model to examine developmental programming in human neonates, particularly in regard to adipogenesis and insulin receptor signaling, major contributors to age-associated diseases such as obesity and diabetes. Neonatal foreskin was collected following circumcision and primary dermal fibroblasts were isolated to perform adipocyte differentiation and insulin stimulation experiments. Human neonatal foreskin primary fibroblasts take up lipid when …