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Treatments For Opioid Use Disorder Among Pregnant And Reproductive-Aged Women., Dennis J. Hand, Vanessa L. Short, Diane J. Abatemarco

Department of Obstetrics and Gynecology Faculty Papers

The increased prevalence of opioid use disorder and access to medical insurance is subsequently increasing the likelihood that medical professionals will encounter individuals with opioid use disorder. Sharp increases in opioid use disorder among women mean that obstetricians, gynecologists, and other reproductive medicine providers may be especially likely to encounter such patients. Medical professionals' understanding of treatment for opioid use disorder and their roles in their patients' treatment may increase referrals to treatment, reduce stigma, and improve the quality of medical care. Treatment for opioid use disorder falls into four overlapping domains: medication management, medical care, behavioral/mental health care, and …

Maternal Choline Supplementation Alters Fetal Growth Patterns In A Mouse Model Of Placental Insufficiency, Julia H. King, Sze Ting (Cecilia) Kwan, Jian Yan, Kevin C. Klatt, Xinyin Jiang, Mark S. Roberson, Marie A. Caudill

Publications and Research

Impairments in placental development can adversely affect pregnancy outcomes. The bioactive nutrient choline may mitigate some of these impairments, as suggested by data in humans, animals, and human trophoblasts. Herein, we investigated the effects of maternal choline supplementation (MCS) on parameters of fetal growth in a Dlx3+/− (distal-less homeobox 3) mouse model of placental insufficiency. Dlx3+/− female mice were assigned to 1X (control), 2X, or 4X choline intake levels during gestation. Dams were sacrificed at embryonic days E10.5, 12.5, 15.5, and 18.5. At E10.5, placental weight, embryo weight, and placental efficiency were higher in 4X versus 1X choline. Higher concentrations …

Developmental Origins Of The Human Hypothalamic-Pituitary-Adrenal Axis, Mariann A. Howland, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Introduction: The developmental origins of disease or fetal programming model predicts that intrauterine exposures have life-long consequences for physical and psychological health. Prenatal programming of the fetal hypothalamic-pituitary-adrenal (HPA) axis is proposed as a primary mechanism by which early experiences are linked to later disease risk.

Areas covered: This review describes the development of the fetal HPA axis, which is determined by an intricately timed cascade of endocrine events during gestation and is regulated by an integrated maternal-placental-fetal steroidogenic unit. Mechanisms by which stress-induced elevations in hormones of maternal, fetal, or placental origin influence the structure and function …

Birth Record Analysis Of Gestational Diabetes: Applications For Intervention Planning, Elizabeth L. Macquillan

Dissertations

Gestational diabetes (GDM) rates in the U.S. and in Michigan have increased over the past several decades, along with the increases in Type 2 Diabetes Mellitus and obesity. GDM is associated with adverse health outcomes for mothers and their offspring. Many current maternal-infant health (MIH) programs in Michigan do not target women with GDM. This study aims to assess state-level rates of GDM in pregnancy with a combination of statistical and spatial analyses using Geographic Information Systems (GIS) for the purpose of informing content and location of public health interventions.

Existing data from 2013 Michigan birth records (107,743 births) were …

Immunology Of The Gray Short-Tailed Opossum During Pregnancy And Prenatal Development, Victoria L. Hansen

Biology ETDs

Vertebrate species that bear live young have overcome the evolutionary challenge of maintaining both a functional adaptive immune system and viviparous life cycle. In normal pregnancy, viviparous mothers are able sustain and nourish a fetus that is genetically half non-self without mounting an immunological attack. In 1953 Sir Peter Medawar brought attention to the “enigma of the fetal graft” and immunologists have been puzzling out the intricacies of fetal tolerance ever since. Although viviparity has evolved in all jawed vertebrate lineages aside from Aves, the vast majority of reproductive immunology research has been limited to eutherian mammals. There are insights …

Sex-Specific Associations Of Maternal Birthweight With Offspring Birthweight In The Omega Study., Collette N Ncube, Amelia R Gavin, Michelle A Williams, Chunfang Qiu, Tanya K Sorensen, Daniel A Enquobahrie

Articles, Abstracts, and Reports

PURPOSE: We investigated nonlinear and offspring sex-specific associations of maternal birthweight (BW) with offspring BW among participants of the Omega study, a pregnancy cohort.

METHODS: Maternal BW was modeled as a continuous variable, linear spline and binary variable indicating low birthweight (LBW;≥2500 grams). Offspring BW was modeled as a continuous and binary variable in regression models. Nonlinearity was assessed using likelihood ratio tests (LRTs) in marginal linear spline models.

RESULTS: For every 100-gram increase of maternal BW, offspring BW increased by 22.29 (95% CI: 17.57, 27.02) or 23.41 (95% CI: 6.87, 39.96) grams among mothers with normal BW or born …

Predicting The Onset Of Parturition By Determining Calcium In Prepartum Milk Of Sheep, Lensey Watson

Animal Science Undergraduate Honors Theses

Multiple methods of pregnancy detection can be used in sheep production. The gestation period for sheep is usually between 144 and 150 days; however, depending on the breed and age of the ewes, this number can vary. A breeding marker, such as a breeding crayon, is used to detect when the ewe is bred by the ram, and the date the ewe will lamb is typically calculated based on an average 145-day gestation. Unfortunately, this method provides only a rough estimate of when the ewe could lamb. In addition, because sheep routinely give birth to multiples (twins, triplets, and, sometimes, …

Impact Of Maternal Respiratory Infections On Low Birth Weight - A Community Based Longitudinal Study In An Urban Setting In Pakistan, Asad Ali, Umber Zaman, Sadia Mahmud, Gul-E-Shehwar Zahid, Momin Kazi, William A. Petri, Zulfiqar Bhutta, Anita Zaidi, Molly A. Hughes

Department of Paediatrics and Child Health

Background: The health of mothers and their newborns is intricately related. The weight of the infant at birth is a powerful predictor of infant growth and survival, and is considered to be partly dependent on maternal health and nutrition during pregnancy. We conducted a longitudinal study in an urban community within Karachi to determine maternal predictors of newborn birth weight.Methods: Four hundred pregnant women were enrolled in the study during the period 2011-2013. Data related to symptoms of acute respiratory illness (fever, cough, difficulty breathing, runny nose, sore throat, headache, chills, and myalgia/lethargy) in the pregnant women were collected weekly …

¿Querías Salir Embarazada?: La Cultura Y La Salud De Las Embarazadas En Puerto Bello / Did You Want To Get Pregnant?: The Culture And Health Of Pregnant Women In Puerto Bello, Jessie Malone Friedman

Independent Study Project (ISP) Collection

Las mujeres embarazadas ya son, según la perspectiva del médico, pacientes en riesgo. Hay diferentes niveles de riesgo: con algunas clasificadas “en bajo riesgo obstétrico, algunas en alto riesgo obstétrico; incluso, bajo riesgo obstétrico evoluciona a alto riesgo obstétrico.” Por eso, ambos a nivel del médico de alguna embarazada y a nivel nacional de la salud pública, las embarazadas son un enfoque especial de la atención médica, en cualquier caso. En Nicaragua, hay muchas mujeres embarazadas y aún más mujeres que podrían salir embarazadas en cualquier momento. En 2005, las mujeres con capacidad fértil representaron el 41.5% de la población …

A Prospective Study Of Maternal, Fetal And Neonatal Outcomes In The Setting Of Cesarean Section In Low- And Middle-Income Countries., Margo S. Harrison, Omrana Pasha, Sarah Saleem, Sumera Ali, Elwyn Chomba, Waldemar A. Carlo, Ana L. Garces, Nancy F. Krebs, K. Michael Hambidge, Shivaprasad S. Goudar, Bhala Kodkany, Sangappa Dhaded, Richard J. Derman, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Janet L. Moore, Dennis Wallace, Elizabeth M. Mcclure, Menachem Miodovnik, Marion Koso-Thomas, Jose Belizan, Antoinette K. Tshefu, Melissa Bauserman, Robert L. Goldenberg

Global Health Articles

INTRODUCTION: Cesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality associated with CS compared with vaginal delivery (VD) both within and across sites in low- and middle-income countries.

MATERIAL AND METHODS: A prospective population-based study including home and facility births in 337 153 women with a VD and 47 308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia and Democratic Republic of Congo. Women were enrolled during pregnancy; delivery and 6-week follow-up data were collected. …

Changes In Underlying Determinants Explain Rapid Increases In Child Linear Growth In Alive & Thrive Study Areas Between 2010 And 2014 In Bangladesh And Vietnam, Phuong Hong Nguyen, Derek Headey, Edward A. Frongillo Jr., Lan Mai Tran, Rahul Rawat, Marie T. Ruel, Purnima Menon

Faculty Publications

Background: Child linear growth sometimes improves in both intervention and comparison groups in evaluations of nutrition interventions, possibly because of spillover intervention effects to nonintervention areas or improvements in underlying determinants of nutritional change in both areas.

Objective: We aimed to understand what changes in underlying socioeconomic characteristics and behavioral factors are important in explaining improvements in child linear growth.

Methods: Baseline (2010) and endline (2014) surveys from the Alive & Thrive impact evaluation were used to identify the underlying determinants of height-for-age z scores (HAZs) among children aged 24–48 mo in Bangladesh (n = 4311) and 24–59 mo …

Risk Factors Of Premature Rupture Of Membrane, Maryuni Maryuni, Dedeh Kurniasih

Kesmas

Angka kematian ibu di Indonesia berdasarkan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 sebanyak 359 per 100.000 kelahiran hidup. Penyebab kematian ibu tersebut masih didominasi oleh pendarahan, pre-eklampsia/eklampsia, dan infeksi. Salah satu penyebab infeksi adalah ketuban pecah dini (KPD). KPD dapat meningkatkan morbiditas dan mortalitas pada ibu dan anak. Insiden kejadian KPD sekitar 10,7% dari seluruh persalinan. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian KPD di Rumah Sakit Ibu dan Anak (RSIA) ANNISA Citeureup, Kabupaten Bogor tahun 2014. Penelitian ini merupakan penelitian analitik dengan rancangan penelitian kasus kontrol. Sampel terdiri dari 114 orang kasus ibu yang mengalami KPD …

Group B Streptococcus Induces Neutrophil Recruitment To Gestational Tissues And Elaboration Of Extracellular Traps And Nutritional Immunity, Visheh Kothary, Ryan S. Doster, Lisa M. Rogers, Leslie A. Kirk, Kelli L. Boyd, Joann Romano-Keeler, Kathryn Haley, Shannon D. Manning, David M. Aronoff, Jennifer A. Gaddy

Peer Reviewed Articles

Streptococcus agalactiae, or Group B Streptococcus (GBS), is a gram-positive bacterial pathogen associated with infection during pregnancy and is a major cause of morbidity and mortality in neonates. Infection of the extraplacental membranes surrounding the developing fetus, a condition known as chorioamnionitis, is characterized histopathologically by profound infiltration of polymorphonuclear cells (PMNs, neutrophils) and greatly increases the risk for preterm labor, stillbirth, or neonatal GBS infection. The advent of animal models of chorioamnionitis provides a powerful tool to study host-pathogen relationships in vivo and ex vivo. The purpose of this study was to evaluate the innate immune response …

Gestational Diabetes Mellitus And The Predisposing Factors, Syeda Sadia Fatima, Rehana Rehman, Faiza Alam, Sarosh Madhani, Bushra Chaudhry, Taseer Ahmed Khan

Department of Biological & Biomedical Sciences

Objective: To evaluate the occurrence of gestational diabetes mellitus and its association with demographic and anthropometric variables in pregnant women.
Methods: This cross-sectional study was conducted at the Aga Khan University Hospital, Abbasi Shaheed Hospital and Memon Hospital in Karachi, from February 2014 to December 2015, and comprised pregnant women who were screened by 75-g 2-hour oral glucose tolerance test, (24-28 weeks of gestation) and classified as per the criteria of the International Association of Diabetes and Pregnancy Study Group. Weight, body mass index and serum glycated haemoglobin levels were measured. Women with pre-gestational diabetes were excluded. SPSS 21 was …

Placental Genetic Variations In Vitamin D Metabolism And Birthweight., Tsegaselassie Workalemahu, Sylvia E Badon, Michal Dishi-Galitzky, Chunfang Qiu, Michelle A Williams, Tanya Sorensen, Daniel A Enquobahrie

Articles, Abstracts, and Reports

INTRODUCTION: Vitamin D has pleiotropic functions that regulate fetal growth and development. We investigated associations of common placental genetic variations in vitamin D metabolism with birthweight.

METHODS: The study was conducted among participants (506 maternal-infant pairs) of a pregnancy cohort study. Data were collected using interviewer-administered questionnaires and post-delivery medical record abstraction. DNA, extracted from placental samples collected at delivery, was genotyped for eight single nucleotide polymorphisms (SNPs) in five vitamin D metabolism genes (CUBN, LRP2, VDR, GC, and CYP2R1). Linear and logistic regression models were used to evaluate associations of SNPs with birthweight and risk of low birthweight, respectively. …

Antiemetic Use Among Pregnant Women In The United States: The Escalating Use Of Ondansetron, Lockwood G. Taylor, Steven T. Bird, Leyla Sahin, Melissa S. Tassinari, Patty Greene, Marsha E. Reichman, Susan E. Andrade, Katherine Haffenreffer, Sengwee Toh

United States Food and Drug Administration: Publications

Purpose To examine ondansetron use in pregnancy in the context of other antiemetic use among a large insured United States population of women delivering live births.

Methods We assessed ondansetron and other antiemetic use among pregnant women delivering live births between 2001 and 2015 in 15 data partners contributing data to the Mini-Sentinel Distributed Database. We identified live birth pregnancies using a validated algorithm, and all forms of ondansetron and other available antiemetics were identified using National Drug Codes or procedure codes. We assessed the prevalence of antiemetic use by trimester, calendar year, and formulation.

Results In over 2.3 million …

A Mixed Methods Examination Of Pregnancy Attitudes And Hiv Risk Behaviors Among Homeless Youth: The Role Of Social Network Norms And Social Support, Stephanie J. Begun

Electronic Theses and Dissertations

Homeless young women become pregnant at exceptionally high rates, and such pregnancies often pose serious emotional, social, and physical health concerns. Perhaps surprisingly, many homeless youth intentionally seek to become pregnant or involved in pregnancy, as pregnancy and parenthood are viewed as conduits toward accessing social services and meaningful social connections to others that this group often lacks. However, most prevention efforts focus solely on young females' pregnancy attitudes and behaviors at the individual level. Such approaches fail to acknowledge contextual factors, such as desired pregnancy and pregnancy ambivalence, the influence of youths' social networks and perceived social norms regarding …

Associations Between Pre-Pregnancy Weight Status And/Or Gestational Weight Gain And Obesity In Older Children, Marisa P. Hammond

Honors Undergraduate Theses

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status …

Prevalence And Potential Reproductive Health Impacts Of Phthalates And Phthalate Alternatives In Pregnant Women In Charleston, South Carolina, Abby Goodson Wenzel

MUSC Theses and Dissertations

Phthalates are plasticizers commonly detected in humans due to widespread exposure from PVC plastics, food packaging, and personal care products. Several phthalates are known antiandrogens, raising concern for prenatal exposures during critical windows of fetal development. The goal of the research presented here is to 1) Determine if certain demographics have greater or lesser phthalate concentrations, 2) Evaluate associations between prenatal phthalate exposure and AGD, a marker of in utero androgen exposure, in newborns, and 3) Investigate the prevalence and bioactivity of a novel phthalate replacement, DINCH. We sampled urine from 378 pregnant women during the second trimester of pregnancy …

The Rules Of Maternity, Dara Purvis

Faculty Scholarship

A diverse body of laws and regulations speaking to reproductive rights, healthcare, criminal punishment of drug use, termination of parental rights, and more creates the rules of maternity. These rules are guidance provided both obliquely and explicitly by the law's coercive power telling women both how to and who should mother. Rule one begins in pregnancy, with the message that "your body is your child's vessel." During pregnancy, women are counselled that doctor knows best. After the child's birth, the mother remains responsible for the people who enter a child's life, leading to rule 3: "mothers must always protect." …

Risk Of Glucose Intolerance And Gestational Diabetes Mellitus In Relation To Maternal Habitual Snoring During Early Pregnancy., Chunfang Qiu, Wayne Lawrence, Bizu Gelaye, Lee Stoner, Ihunnaya O Frederick, Daniel A Enquobahrie, Tanya K Sorensen, Michelle A Williams

Articles, Abstracts, and Reports

BACKGROUND: Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM).

METHODS: A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy. Results from screening and diagnostic tests for IGT and GDM were abstracted from medical records. Multivariate logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% …

Effects Of In Utero Nicotine Exposure On Immune Cell Disposition After P. Aeruginosa Lung Infection, Nayon Kang

Theses and Dissertations--Pharmacy

Current smoking cessation guidelines recommend nicotine replacement therapy (NRT) to assist pregnant smokers to quit, but this is without strong evidence for effectiveness and safety. Nicotine, the main addictive component of tobacco, is known to exert physiological effects by binding to its receptor, the nicotinic acetylcholine receptor (nAChR). Recent studies have identified the presence of nAChRs in non-neuronal cells, and in macrophages, functional alteration upon stimulation with nicotine has been documented.

To understand the impact of in utero nicotine exposure on various immune cell disposition and function, we designed preliminary studies using an in vivo model of P. aeruginosa infection. …

Fibroblast Growth Factor 21 Is A Novel Protein Sensor In Pregnancy, Elizabeth Frost Sutton

LSU Doctoral Dissertations

The twenty-first century has experienced a shift in cause of death worldwide from communicable diseases to noncommunicable diseases. Interestingly, many of these implicated chronic diseases, such as cancer, diabetes, and cardiovascular disease, have been shown to be programmed in the womb. As first posited by the Barker Hypothesis, adverse exposures in utero can increase an individual’s risk for chronic disease later in life. Therefore, pregnancy is an opportune time for intervention to improve the health of future generations. Studies of exposures known to negatively impact infant health, e.g. states of overnutrition (obesity, diabetes, excess gestational weight gain) and undernutrition (starvation, …

Maternal Fatty Acid And Inflammatory Status During Pregnancy Are Related To Infant Heart Rate And Heart Rate Variability, Merritt Leanne Drewery

LSU Doctoral Dissertations

Early life heart rate (HR) and heart rate variability (HRV) reflect autonomic maturation. Intervention with n-3 long chain polyunsaturated fatty acids (LCPUFAs) during pregnancy favorably affects fetal HR and HRV; similar observations have been reported with infant n-3 LCPUFA intake. Infant HR and HRV have not been assessed in relation to maternal fatty acid status during pregnancy. Further, exposure to intrauterine inflammation may underlie these observations, although this hypothesis has not been tested. The aim of this observational study was to explore associations between maternal fatty acid and inflammatory status during pregnancy and infant HR and HRV. Simple linear and …

Development Of An Educational Package Regarding Reproductive Environmental Health For Nurses And Patients, Donna Ammons Msn, Rn.

Doctor of Nursing Practice (DNP)

Objectives: To identify common behaviors, attitudes, and practices that expose pregnant women to indoor air pollutants. Design: A mixed method study was conducted. Setting: Data was collected from the South Georgia Outpatient Obstetrical Practice. Participants: Prenatal low-risk OB antepartum/ postpartum patients. Methods: Participants were selected through convenience sampling method and from the preliminary study that had measured the level of indoor air pollutants in the home. The participants completed phone interview that asked 12 open ended questions, which addressed the patient’s knowledge, practice and attitudes/behaviors about indoor air pollutants and their sources. Results: Twenty pregnant women were interviewed. 70% had …

The Skin Microbiome: Impact Of Modern Environments On Skin Ecology, Barrier Integrity, And Systemic Immune Programming, Susan Prescott, Danica-Lea Larcombe, Alan Logan, Christina West, Wesley Burks, Luis Caraballo, Michael Levin, Eddie Van Etten, Pierre Horwitz, Anita Kozyrskyj, Dianne Campbell

Research outputs 2014 to 2021

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which …

The Benefits And Concerns Of Veganism In Women's Health, Elisa R. Hester

Senior Honors Theses

There are many health benefits of consuming a vegan diet. It is associated with a decreased incidence of obesity, cardiovascular disease, type two diabetes, and a variety of cancers. Despite its numerous benefits, there are several concerns for consumers of a vegan diet, including nutrient deficiency and cardiovascular risk associated with consumption of coconut oil. However, many nutrients of highest concern, such as calcium and protein, are not needed in as high amounts as is commonly believed and recommended. Moreover, it is possible for vegans to obtain adequate nutrition with proper education despite restriction of animal products. Coconut oil consumption …

Maternal Nutrient Intakes From Food And Drinks Consumed In Early Pregnancy In Ireland, Laura Mullaney, Shona Cawley, Rachel Kennedy, Amy C. O'Higgins, Daniel Mccartney, Michael J. Turner

Articles

Background: The aim of this observational study was to measure food, macronutrient and micronutrient intakes of women presenting for antenatal care and assess compliance with current nutritional recommendations.

Duration Of Periconceptual Folic Acid Supplementation In Women Booking For Antenatal Care, Shona Cawley, Laura Mullaney, Rachel Kennedy, Maria Farren, Daniel Mccartney, Michael J. Turner

Articles

Objective: To provide accurate estimates of the commencement time, duration and dosage of folic acid (FA) supplementation taken by Irish women in the periconceptional period. The study also aimed to establish the factors associated with optimal FA supplementation practices. Design: Cross-sectional observational study. Women’s clinical and sociodemographic details were computerised. Maternal weight and height were measured before calculating BMI. Detailed FA supplementation questionnaires were completed under the supervision of a trained researcher. Setting: A large university maternity hospital, Republic of Ireland, January 2014–April 2016. Subjects: Women (n 856) recruited at their convenience in the first trimester. Results: While almost all …

Maternal Physical Activity And Cardiorespiratory Fitness During Pregnancy And Its Relation To Infant Size, Samantha M. Mcdonald

Theses and Dissertations

Recent evidence indicates that U.S.-born infants are larger today compared to 20 years ago. A strong determinant of neonatal size is maternal body mass, where larger mothers deliver larger infants. Consistent evidence indicates that higher levels of maternal physical activity (PA) during pregnancy reduce the risk of delivering a larger infant. However, this protective effect has only been demonstrated in normal weight pregnant women. Little is known about the relationship between maternal PA and neonatal size in overweight or obese pregnant women. Moreover, no studies have examined the association between maternal cardiorespiratory fitness (CRF), an indicator of habitual PA, on …