Digital Commons Network^™

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 …

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 …

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 …

Indirect Screening: Enhancing Identification Of Illicit Drug Use During Pregnancy, Courtney Smith

Theses and Dissertations

OBJECTIVE: Most drug use screening measures rely on and are validated against self-report. Fear of negative consequences often promotes denial of drug use. For pregnant women, social stigma and fear of legal consequences make underreporting of drug use even more likely. An indirect screener that could effectively identify pregnant women at risk for illicit drug use without reliance on disclosure would be clinically significant. The purpose of the current study was to develop and validate an indirect measure of prenatal drug use by comparing correlates of prenatal drug use to urinalysis results. METHOD: Pregnant women attending an OB appointment at …

Of Woman Born? Technology, Relationship, And The Right To A Human Mother, Jennifer S. Hendricks

College of Law Faculty Scholarship

This article explores the legal implications of a scientific fantasy: the fantasy of building artificial wombs that could gestate a human child from conception. It takes as its touchstone a claim by sociologist Barbara Katz Rothman, who writes, “Every human child has a right to a human mother.”

While the article discusses the legal principles that would apply to artificial wombs, it is skeptical about the technological possibility of artificial wombs in the foreseeable future. Accordingly, the focus of the article is the effect that the fantasy of artificial gestation has on the legal discourse around pregnancy and reproduction today. …

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 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 …

Religious Commitment As A Predictor Of Lower Blood Pressure In High-Risk Pregnancies Of Southern Appalachia., Anna Vadimovna Ermakova

Electronic Theses and Dissertations

Extensive literature review inspired a mediational model of the relationship between Religiosity/Spirituality (R/S) and Blood Pressure (BP) tested through secondary analyses of data from the TIPS program. Participants included 205 (92.1% Caucasian; age M=23.72, SD=5.33) pregnant Southern Appalachian women drawn from the region's at-risk pregnancy population. The only variables correlated with BP were women's weight (r=.430, r=.467, p<.01, for diastolic and systolic BP, respectively) and prenatal care use (r=.138, p<.05, with diastolic BP), but not R/S. Multiple regression analyses confirmed participant weight as the only significant independent predictor of BP. Previous findings of health benefits of R/S cannot be assumed to generalize to pregnant women without further study. Limitations of this study and possible explanations for the findings are discussed.

The Relationship Between Physical Activity Recommendations And Diabetes Risk Factors In Pregnant Women, Kelly Mattran

Masters Theses, 2010-2019

BACKGROUND: Changes in maternal insulin sensitivity throughout pregnancy may help supply nutrients to a growing fetus; however, the changes may concomitantly increase the mother and child’s risk for diabetes and chronic diseases. Regular physical activity (PA) positively impacts precursors for diabetes, but the impact of PA throughout gestation is less studied. The purpose of this study was to examine the relationship between meeting PA recommendations and diabetes risk in pregnant women. METHODS: A total of 23 pregnant women were recruited for participation. Venous blood samples, questionnaires, and anthropometric measurements (height, weight, and hip/waist circumferences) were ascertained during a single session. …

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 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 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 …

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) …

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 …

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 …

Vitamin D Status In Pregnant Omanis A Disturbingly High Proportion Of Patients With Low Vitamin D Stores, Moza Al Kalbani, Omayma Elshafie, Mohammed Al-Mamari, Ali, Abdullah Al-Zakwani, Nicholas Woodhouse

Sultan Qaboos University Medical Journal

Objectives: The objective of this study was to determine the vitamin D status of pregnant Omanis by measurement of their circulating 25 hydroxy vitamin D levels. Methods: Blood samples were obtained from a cohort of 103 consecutive healthy pregnant Omanis at the Armed Forces Hospital, Muscat, on their first antenatal visit. The study took place in May, June and July 2010. Results: Vitamin D deficiency was present in 34 (33%) of patients (25OHD3 <25 nmol/L), ‘at risk’ levels were found in 67 (65%) patients (25OHD3 25–50 nmol/L); two patients (1.9%) had values between 50 and 75 nmol/L, and no patients in the optimal range >75 nmol/L. Conclusion: If confirmed, these findings indicate the need for vitamin D replacement during pregnancy and lactation. Although not evidence based we recommend at least 1000 …

Screening For Cytomegalovirus During Pregnancy, Stuart P. Adler

Pediatrics Publications

The epidemiology and pathogenesis of CMV infections among pregnant women have been intensely studied over the last three decades. This paper highlights recent developments that make either universal or limited serologic screening for CMV during pregnancy potentially attractive. The developments include an understanding of the pathogenesis of CMV infections, a knowledge of high-risk women, the availability of accurate methods for the serologic diagnosis of a primary CMV infection using either single or serial blood samples, accurate methods for the diagnosis of fetal infection via amniotic fluid, sensitive fetal and placental indicators for neonatal outcomes, and the availability of potentially effective …

It Takes At Least Two: Male Partner Factors, Racial/Ethnic Disparity, And Chlamydia Trachomatis Among Pregnant Women, Jessica Weisz, Sara Lozyniak, Sandra D. Lane, Robert Silverman, Kathy Demott, Martha A. Wojtowycz

Falk College Research Center

Chlamydia trachomatis (CT), the most prevalent sexually transmitted infection in the United States, disproportionately infects women and people of color. This study aimed to identify risk factors for racial and ethnic disparities for CT infection, re-infection, and persistent infection among pregnant women. We present a secondary analysis of births from a retrospective cohort study in Syracuse, NY from January 2000 through March 2002. African American women [OR 3.35 CI (2.29, 4.92)], Latin American women [OR 4.35 CI (2.52, 7.48)], unmarried women [OR 7.57 CI (4.38, 13.10)], and teen mothers [OR 3.87 CI (2.91, 5.16)] demonstrated statistically significant increased risk for …

The Effects Of Smoking On Pregnant Women, Meir Cohen

The Science Journal of the Lander College of Arts and Sciences

Smoking during pregnancy is accepted as the most significant avoidable risk factor for an unsuccessful pregnancy result. Smoking is linked with fetal growth restriction, and increasing evidence also suggests that smoking can cause stillbirth, preterm birth, placental abruption, and possibly sudden infant death syndrome. Smoking during pregnancy is also associated with enhanced risks of spontaneous abortions, ectopic pregnancies, and placenta previa, and it might increase risks of behavioral disorders in childhood. Studies have shown with randomized controlled trials, that smoking intervention during pregnancy has had limited success. Smoking during pregnancy continues to be an important risk factor for maternal and …

Capacity-Building And Participatory Research Development Of A Community-Based Nutrition And Exercise Lifestyle Intervention Program (Nelip) For Pregnant And Postpartum Aboriginal Women: Information Gathered From Talking Circles, Michelle F. Mottola, Maggie M. Sopper, Lindsay Doxtator, Katie Big-Canoe, Harry Prapavessis, Stewart Harris, Anthony Hanley

Paediatrics Publications

Objectives were to gather information from Talking Circles of Aboriginal women who participated in a maternal Nutrition and Exercise Lifestyle Intervention Program (NELIP) to identify strategies to bring NELIP into the community. Twelve First Nations women participated. Several main themes were identified regarding health: balance, knowledge/education and time management. Benefits of the NELIP were improvement in health, stamina, stress, and a healthy baby, no gestational diabetes and a successful home birth, with social support as an important contributing factor for success. Suggestions for improvement for the NELIP included group walking, and incorporating more traditional foods into the meal plan. The …

Aryl Hydrocarbon Receptor Activation During Pregnancy, And In Adult Nulliparous Mice, Delays The Subsequent Development Of Dmba-Induced Mammary Tumors, Tao Wang, Heather M. Gavin, Volker M. Arlt, B. Paige Lawrence, Suzanne E. Fenton, Daniel Medina, Beth A. Vorderstrasse

United States Environmental Protection Agency: Publications

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), the prototypic ligand for the aryl hydrocarbon receptor (AhR), promotes tumor formation in some model systems. However, with regard to breast cancer, epidemiological and animal studies are inconclusive as to whether exposure increases tumor incidence or may instead be protective. We have previously reported that mice exposed to TCDD during pregnancy have impaired differentiation of mammary tissue, including decreased branching and poor development of lobuloalveolar structures. Because normal pregnancy-induced mammary differentiation may protect against subsequent neoplastic transformation, we hypothesized that TCDD-treated mice would be more susceptible to chemical carcinogenesis after parturition. To test this, mice were …

Birth Outcomes Of Intended Pregnancies Among Women Who Used Assisted Reproductive Technology, Ovulation Stimulation, Or No Treatment, Denise V. D’Angelo, Nedra Whitehead, Kristen Helms, Wanda Barfield, Indu B. Ahluwalia

United States Public Health Resources

Objective: To study birth outcomes among live born infants conceived by women who used infertility treatment.

Design: Population-based surveillance of women who recently delivered a live infant.

Setting: The birth outcomes among infants whose mothers used assisted reproductive technology (ART) or ovulation stimulation medications alone were compared with the outcomes of infants conceived without treatment.

Patient(s): Stratified random sample of women who were attempting conception and gave birth to a live infant in six US states (n = 16,748).

Intervention(s): Assisted reproductive technology and ovulation stimulation.

Main Outcome Measure(s): Adjusted odds ratios for perinatal outcomes.

Result(s): The prevalence of infertility …

Development And Psychometric Evaluation Of An Instrument To Assess The Treatment Fidelity Of A Brief Opportunistic Intervention To Reduce Substance Use Among Pregnant Women, Antonia Torrey

Electronic Theses and Dissertations

Although abstinence from alcohol, tobacco, and other drugs (ATOD) among pregnant women is a leading national objective, prenatal use has not decreased. Evidence-based interventions that can be replicated in practice are critically needed and brief interventions have shown promise in reducing prenatal ATOD use. The "I Am Concerned" (IAC) brief opportunistic intervention is currently being implemented by frontline primary prenatal care staff members in several areas of the United States. Evaluation of treatment fidelity, to determine if behavioral interventions are delivered as intended, is essential to controlled research. This study constituted the first step in the development and psychometric evaluation …

The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Not Of Woman Born: A Scientific Fantasy, Jennifer S. Hendricks

Publications

This Article explores the legal implications of a scientific fantasy: building artificial wombs that could gestate a human child from conception to birth. Because claims about the technological possibility of artificial wombs in the foreseeable future are likely overstated, the focus of the Article is the effect that the fantasy of artificial gestation has on the legal discourse about pregnancy and reproduction today.

The Article first places the fantasy of artificial gestation in the context of theories about reproduction that western science has propounded. The history of scientific theorizing about reproduction is a history of scientists emphasizing the male contribution …

Prenatal Programming Of Human Neurological Function, Curt A. Sandman, Elyssia Poggi Davis, Claudia Buss, Laura M. Glynn

Psychology Faculty Articles and Research

The human placenta expresses the genes for proopiomelanocortin and the major stress hormone, corticotropin-releasing hormone (CRH), profoundly altering the "fight or flight" stress system in mother and fetus. As pregnancy progresses, the levels of these stress hormones, including maternal cortisol, increase dramatically. These endocrine changes are important for fetal maturation, but if the levels are altered (e.g., in response to stress), they influence (program) the fetal nervous system with long-term consequences. The evidence indicates that fetal exposure to elevated levels of stress hormones (i) delays fetal nervous system maturation, (ii) restricts the neuromuscular development and alters the stress response of …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

A Comparison Of Latina Women In Centeringpregnancy And Individual Prenatal Care, Tara E. Trudnak

USF Tampa Graduate Theses and Dissertations

CenteringPregnancy is a model of group prenatal care that replaces routine, individual prenatal care. The program brings women together into small groups to receive their care and prenatal education, and is based on three components: risk assessment, education, and support. The model is client-centered, designed to empower pregnant women and support persons, and involves the woman in small group discussions of 8-10 other women of similar gestational age. The group discussions provide support, help women educate each other, and invoke self-monitoring. Currently, there have been few publications that closely examined maternal weight and obesity and associated outcomes in women involved …

Milk Composition And Yield Changes With Advancing Pregnancy In Dairy Buffaloes (Bubalus Bubalis), Sarzamin Khan, Muhammad Subhan Qureshi, Ifthiar Ahmed, Syed Mirajullah Shah

Turkish Journal of Veterinary & Animal Sciences

The changes in the composition of milk with advancing pregnancy were investigated in Nili-Ravi dairy buffaloes. Forty lactating buffaloes were used, within 2-3 months postpartum. The animals were grouped as high, moderate, and low yielders; synchronized for estrus; and inseminated artificially. Milk yield was recorded daily and sampled fortnightly for analysis. The data were analyzed using the univariate weighted mean and general linear model. Decline in milk yield became significant after the 8th week post-conception. The high yielders had the lowest fat contents. Milk fat increased significantly during succeeding weeks post-conception. The highest fat level (8.5%) was observed in week …