Medicine and Health Sciences Commons^™

A Case Study Of Pregnant Migrants In Detention, Abby Wheatley, Samantha Nabaty

Biennial Conference: The Social Practice of Human Rights

No abstract provided.

Effects Of Provider Support And Psychosocial Stressors On Maternal Health-Promoting Behaviors, Mary Catherine Jessen

Theses and Dissertations

ABSTRACTEFFECTS OF PROVIDER SUPPORT AND PSYCHOSOCIAL STRESSORS ON MATERNAL HEALTH-PROMOTING BEHAVIORS

Despite technological and structural advances in the organization and delivery of health care services to pregnant women and infants, the U.S. ranks low on perinatal outcomes with profound disparities. Engagement in health-promoting behaviors during pregnancy is critical in improving birth outcomes. Women, particularly women of color, continue to experience unmet needs for emotional support with providers. Women of color experience being treated differently based on their race. The purpose of this study was to 1) examine the relationships between stress, provider support, and specific maternal health promoting behaviors (MHPB) …

Exclusive Breastfeeding And Professionals From The Family Health Strategy, Marialda Moreira Christoffel, Ana Leticia Monteiro Gomes, Cássia Leoneuza Augusto Julio, Julia Florentino De Barros, Elisa Da Conceição Rodrigues, Fernanda Garcia Bezerra Góes, Ana Maria Linares

Nursing Faculty Publications

OBJECTIVES: to analyze the perception of health professionals about exclusive breastfeeding in Family Health Strategy units in the city of Macaé.

METHODS: qualitative study carried out in four units of the Family Health Strategy in the city of Macaé, Rio de Janeiro. Thirty health professionals were interviewed from March to May 2019. Textual contents were processed in the IRaMuTeQ^® software by the Descending Hierarchical Classification.

RESULTS: professionals use different strategies for actions to promote, protect and support breastfeeding in prenatal consultations, but social and cultural determinants are important issues that interfere in this process, the involvement of the family …

The Contribution Of Racism-Related Stress And Adversity To Disparities In Birth Outcomes: Evidence And Research Recommendations, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including …

Treating A Public Health Crisis For Rural Moms – A Comparative Analysis Of Four Rural States Addressing Maternal Opioid Misuse With Medicaid Innovation Models, Jason Semprini

Online Journal of Rural Research & Policy

Objective As we enter the third decade of the opioid crisis, opioid misuse continues its devastating toll on young women, specifically mothers on Medicaid in rural areas. The evolving Medicaid policy landscape has led to coverage and benefit expansion, yet gaps remain for pregnant women with opioid misuse. Further, the myriad of state specific policy decisions related to maternal eligibility and substance abuse benefits have created a seemingly disjoint policy arena for tackling a specific subgroup’s unmet needs. This policy scan aims to investigate the newly implemented 1115 demonstration model for Maternal Opioid Misuse by comparing the approaches of four …

The Efficacy Of A Personalized Mhealth Coaching Program During Pregnancy On Maternal Diet, Supplement Use, And Physical Activity: Protocol For A Parallel-Group Randomized Controlled Trial, Rozina Nuruddin, Khadija Vadsaria, Nuruddin Badruddin Mohammed, Saleem Sayani

Community Health Sciences

Background: Adequate intake of macro- and micronutrients and adoption of an active lifestyle during pregnancy are essential for optimum maternal and fetal health and offspring development. Dietary counseling and advice regarding adequate physical activity are integral components of antenatal care. Personalized coaching through the use of mobile health (mHealth) that supports behavior modification is an innovative approach that needs exploration.
Objective: Our primary aim is to assess the efficacy of an mHealth program in improving diet, supplement use, and physical activity during pregnancy. Secondary objectives include evaluation of the program's effect on maternal and offspring health outcomes and assessment of …

Shifts In Unaids Ethics Guidance And Implications For Ethics Review Of Preventive Hiv Vaccine Trials., Catherine Slack, Paul Ndebele, Mary Allen, Jessica Salzwedel

Global Health Faculty Publications

INTRODUCTION: A major change in the ethics framework for preventive HIV vaccine trials worldwide is the release of the UNAIDS 2021 ethical considerations in HIV prevention trials. This new guidance comes at an exciting time when there are multiple HIV vaccine efficacy trials in the field. Research Ethics Committees (RECs) or Institutional Review Boards are a most likely audience for these guidelines. Our objective is to highlight shifts in ethics recommendations from the earlier 2012 UNAIDS guidance.

DISCUSSION: We review recommendations related to four key issues, namely standard of prevention, post-trial access to safe and effective vaccines, enrolment of adolescents …

A Mixed Methods Case Study Of Food Shopping In A Community With High Infant Mortality, Sarah Evenosky, Eleanor Lewis, Katherine Isselmann Disantis

College of Population Health Faculty Papers

In the U.S., preterm birth disproportionately impacts certain racial/ethnic groups, with Black women experiencing preterm birth at a rate 50% higher than other groups. Among the numerous factors that likely contribute to these increased rates are neighborhood characteristics, such as food environment. In this mixed-methods case study, we evaluated how pregnant women living in a predominately minority, lower income community with high preterm birth rates navigate and perceive their food environment. Qualitative interviews were performed to assess perceptions of food environment (n = 7) along with geographic and observational assessments of their food environment. Participants traveled an average of 2.10 …

Factors Associated With Pregnancy-Induced Hypertension In Women Living At High Altitudes, Jenny Mendoza-Vilcahuaman, Rossibel Juana Muñoz- De La Torre, Anibal Valentin Diaz-Lazo

Revista de la Facultad de Medicina Humana

Objective: To determine the factors associated with pregnancy-induced arterial hypertension (HIE) in people living at high altitude. Methods: The research was observational, cross-sectional, analytical study of cases and controls. It was held at the El Carmen de Huancayo Regional Teaching Maternal and Child Hospital, Peru located at 3,259 m.a.s.l. The calculation of the sample was Epidat 3.0. 80% power level, with frequency of 27% for cases, 17% for controls, precision of 5% and odds ratio (OR) = 2. X2 squared, binomial and multivariate logistic regression were used for statistical analysis. Results: 960 (100%) pregnant women were included, with a mean …

Sleep, Reproduction, And Pregnancy, Joshua R. Freeman

Doctoral Dissertations

Sleep, and particularly sleep timing, prior to conception may be important for reproductive and pregnancy health. Evidence of a biological mechanism relating sleep to reproductive health from laboratory studies suggests that sleep may influence the hypothalamic-pituitary-ovarian (HPO) axis. The role of sleep in the HPO axis may also impact many reproductive outcomes including reproductive hormones, ovulation, pregnancy, live birth, pregnancy loss, and adverse pregnancy outcomes. However, epidemiological evidence for associations between sleep, especially sleep timing, and these reproductive health endpoints is limited with most studies typically assessing shift work, and not sleep patterns directly. To address these gaps, we evaluated …

Characteristics And Quality Of Mobile Apps Containing Prenatal Genetic Testing Information: Systematic App Store Search And Assessment, Ko Lin Wu, Rebeca Alegria, Jazzlyn Gonzalez, Harrison Hu, Haocen Wang, Robin Page, Patricia Robbins-Furman, Ping Ma, Tung-Sung Tseng, Lei Shih Chen

School of Public Health Faculty Publications

Background: Prenatal genetic testing is an essential part of routine prenatal care. Yet, obstetricians often lack the time to provide comprehensive prenatal genetic testing education to their patients. Pregnant women lack prenatal genetic testing knowledge, which may hinder informed decision-making during their pregnancies. Due to the rapid growth of technology, mobile apps are a potentially valuable educational tool through which pregnant women can learn about prenatal genetic testing and improve the quality of their communication with obstetricians. The characteristics, quality, and number of available apps containing prenatal genetic testing information are, however, unknown. Objective: This study aims to conduct a …

Pregnancy And Childbirth Expectations During Covid-19 In A Convenience Sample Of Women In The United States, Tishra Beeson, Amy Claridge, Amie Wojtyna, Debra Rich, Gracie Minks, Adrienne Larson

All Faculty Scholarship for the College of Education and Professional Studies

The COVID-19 pandemic has transformed the health care landscape and shifted individuals’ expectations for and interactions with essential health services, including pregnancy-related care. This study explores alterations to individuals’ pregnancy and childbirth decisions during an infectious disease pandemic. A convenience sample of 380 pregnant individuals with an expected delivery date between April and December 2020 consented to enroll and complete an online questionnaire on their pregnancy and childbirth expectations during the COVID-19 pandemic; a subset of respondents (n = 18) participated in semi-structured phone interviews. Survey data were analyzed quantitatively while interview data were analyzed using a thematic content …

Causes And Circumstances Of Maternal Death: A Secondary Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials Cohort, Annet M. Aukes, Kristina Arion, Jeffrey N. Bone, Jing Li, Marianne Vidler, Mrutyunjaya B. Bellad, Zahra Hoodbhoy, Rahat Qureshi, Sana Sheikh, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Incomplete vital registration systems mean that causes of death during pregnancy and childbirth are poorly understood in low-income and middle-income countries. To inform global efforts to reduce maternal mortality, we compared physician review and computerised analysis of verbal autopsies (interpreting verbal autopsies [InterVA] software), to understand their agreement on maternal cause of death and circumstances of mortality categories (COMCATs) in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials.
Methods: The CLIP trials took place in India, Pakistan, and Mozambique, enrolling pregnant women aged 12-49 years between Nov 1, 2014, and Feb 28, 2017. 69 330 pregnant women were …

Cohort Profile: The Alliance For Maternal And Newborn Health Improvement (Amanhi) Biobanking Study, Fahad Aftab, Salahuddin Ahmed, Aneeta Hotwani, Muhammad Ilyas, Mohammad Javaid, Fyezah Jehan, Farah Khalid, Usma Mehmood, Muhammad Imran Nisar, Muhammad Sajid

Department of Paediatrics and Child Health

No abstract provided.

Dietary Blueberry And Soluble Fiber Improve Serum Antioxidant And Adipokine Biomarkers And Lipid Peroxidation In Pregnant Women With Obesity And At Risk For Gestational Diabetes, Arpita Basu, Jeannette Crew, Jeffrey L. Ebersole, Jefferson W. Kinney, Arnold M. Salazar, Petar Planinic, James M. Alexander

Kinesiology and Nutrition Sciences Faculty Publications

Pregnancies affected by obesity are at high risk for developing metabolic complications with oxidative stress and adipocyte dysfunction contributing to the underlying pathologies. Few studies have examined the role of dietary interventions, especially those involving antioxidants including polyphenolic flavonoids found in fruits and vegetables on these pathologies in high-risk pregnant women. We conducted an 18 gestation-week randomized controlled trial to examine the effects of a dietary intervention comprising of whole blueberries and soluble fiber vs. control (standard prenatal care) on biomarkers of oxidative stress/antioxidant status and adipocyte and hormonal functions in pregnant women with obesity (n = 34). Serum samples …

Maternal Diet During Pregnancy And Lactation And Child Food Preferences, Dietary Patterns, And Weight Outcomes: A Review Of Recent Research, Alison K. Ventura, Suzanne Phelan, Karina Silva Garcia

Kinesiology and Public Health

Purpose of Review Efforts to promote children’s preferences for healthy foods hold much potential for improving diet quality and preventing obesity. The purpose of this review was to summarize recent evidence for associations between maternal diet during pregnancy and lactation and child food preferences, dietary patterns, and weight outcomes.

Recent Findings Recent research illustrates greater maternal vegetable intakes during pregnancy and lactation predict greater child preferences for and intakes of vegetables. Recent randomized clinical trials to improve maternal weight outcomes during the perinatal period via behavioral lifestyle interventions that included dietary components have yielded mixed findings for effects on child …

Assessing Sleep Efficiency Of Nulliparous Women In The Third Trimester Of Pregnancy, Ran Hu

Dissertations & Theses (Open Access)

Objectives: Pregnant women in the third trimester are more likely to experience sleep disorders, resulting in adverse effects on fetal health. This study aimed to evaluate the sleep efficiency (SE) of nulliparous women in their late pregnancy.

Methods: Data was extracted from the National Sleep Research Resource focusing on nulliparous women (n = 1,803) in their third trimester of pregnancy. The two-sample Wilcoxon test for continuous variables and the Chi-square test for categorical variables were used based on a normal SE cut-off of 0.85. The least absolute shrinkage and selection operator (Lasso) was used to find the risk …

Blood Pressure Thresholds In Pregnancy For Identifying Maternal And Infant Risk: A Secondary Analysis Of Community-Level Interventions For Pre-Eclampsia (Clip) Trial Data, Jeffrey N. Bone, Laura A. Magee, Joel Singer, Hannah Nathan, Rahat Qureshi, Charfudin Sacoor, Esperança Sevene, Andrew Shennan, Mrutyunjaya B. Bellad, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings.
Methods: We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10). We included pregnant women aged 15-49 years (12-49 years in Mozambique), identified in their …

Associations Between Physiological Biomarkers And Psychosocial Measures Of Pregnancy-Specific Anxiety And Depression With Support Intervention, Karen L Weis, Tony T Yuan, Katherine C Walker, Thomas F Gibbons, Wenyaw Chan

Journal Articles

Stress and anxiety significantly impact the hypothalamic-pituitary axis, and in pregnancy, the subsequent maternal-fetal response can lead to poor outcomes. The objective of this study was to assess the association between psychosocial measures of pregnancy-specific anxiety and physiologic inflammatory responses. Specifically, to determine the effectiveness of the Mentors Offering Maternal Support (M-O-M-S

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented …

Role Of Community Engagement In Maternal Health In Rural Pakistan: Findings From The Clip Randomized Trial, Zahra Hoodbhoy, Sana Sadiq Sheikh, Rahat Qureshi, Javed Memon, Farrukh Raza, Mai-Lei Woo Kinshella, Jeffrey N. Bone, Marianne Vidler, Sumedha Sharma, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Community-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women's knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.
Methods: The CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. CE activities engaged pregnant women at their homes …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Pregnancy And Substance Use, Elise Withers, Krista Thompson, Emily Hamilton, Maren Wright Voss

All Current Publications

The use of alcohol and other harmful substances, such as cocaine, opioids, and marijuana during pregnancy has increased over the last decades (Sebastiani et al., 2018). Using these substances can be very harmful to the unborn baby and mother (Viteri et al., 2015). This fact sheet covers (1) the consequences of substance use and (2) the current recommendations for substance use during pregnancy.

Identifying Mediators, Moderators And High-Risk Latent Classes Of Preterm Birth And Low Birth Weight Among Pregnant Women In Rural Mysore, India, Sandra Kiplagat

FIU Electronic Theses and Dissertations

This dissertation examined the mediators, moderators, and high-risk latent classes of preterm birth (PTB) and low birth weight (LBW) among pregnant women in rural Mysore District, India. Secondary data analyses of a prospective cohort study conducted between 2011-2014 among 1540 women was performed to complete this dissertation.

In the first study, we examined the association between socioeconomic status (SES) and PTB and LBW. Latent class analysis (LCA) was performed to assess sociodemographic patterns of high-risk pregnant women based on education, income, marital status, primigravida status and number of children. We identified four distinct classes, Class 1 “low SES/early marriage/multigravida/1 child …

Perceptions Of Autism Spectrum Disorder (Asd) Etiology Among Parents Of Children With Asd, Wei-Ju Chen, Zihan Zhang, Haocen Wang, Tung-Sung Tseng, Ping Ma, Lei-Shih Chen

School of Public Health Faculty Publications

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and restricted or repetitive behaviors. Parental perceptions of the etiology of their child’s ASD can affect provider–client relationships, bonding between parents and their children, and the prognosis, treatment, and management of children with ASD. Thus, this study sought to examine the perceptions of ASD etiology of parents of children with ASD. Methods: Forty-two parents of children diagnosed with ASD were recruited across Texas. Semi-structured interviews were conducted individually. All interviews were recorded and later transcribed verbatim for content analysis utilizing NVivo 12.0 (QSR International, Doncaster, Australia). …

Maternal Sociodemographic Factors And Antenatal Stress, Maheshwari Andhavarapu, James Orwa, Marleen Temmerman, Wangira Musana

Obstetrics and Gynaecology, East Africa

Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We conducted a secondary analysis of data from 150 pregnant women attending antenatal care services at a rural referral hospital in Kenya. The participants completed a sociodemographic and clinical questionnaire, the Cohen’s Perceived Stress Scale (PSS) and gave a hair sample for cortisol and cortisone analysis. The association between selected sociodemographic predictors (age, …

Improved First Trimester Maternal Iodine Status With Preconception Supplementation: The Women First Trial, Amy E. Young, Jennifer F. Kemp, Charis Uhlson, Jamie L. Westcott, Sumera Aziz Ali, Sarah Saleem, Ana Garcès, Lester Figueroa, Manjunath S. Somannavar, Shivaprasad S. Goudar

Community Health Sciences

Maternal iodine (I) status is critical in embryonic and foetal development. We examined the effect of preconception iodine supplementation on maternal iodine status and on birth outcomes. Non-pregnant women in Guatemala, India and Pakistan (n ~ 100 per arm per site) were randomized ≥ 3 months prior to conception to one of three intervention arms: a multimicronutrient-fortified lipid-based nutrient supplement containing 250-μg I per day started immediately after randomization (Arm 1), the same supplement started at ~12 weeks gestation (Arm 2) and no intervention supplement (Arm 3). Urinary I (μg/L) to creatinine (mg/dl) ratios (I/Cr) were determined at 12 weeks …

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …