Medicine and Health Sciences Commons^™

Prenatal Diagnosis And Risk Factors For Preoperative Death In Neonates With Single Right Ventricle And Systemic Outflow Obstruction: Screening Data From The Pediatric Heart Network Single Ventricle Reconstruction Trial(∗)., Andrew M. Atz, Thomas G. Travison, Ismee A. Williams, Gail D. Pearson, Peter C. Laussen, William T. Mahle, Amanda L. Cook, Joel A. Kirsh, Mark Sklansky, Svetlana Khaikin, Caren Goldberg, Michele Frommelt, Catherine Krawczeski, Michael D. Puchalski, Jeffrey P. Jacobs, Jeanne M. Baffa, Jack Rychik, Richard G. Ohye, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this analysis was to assess preoperative risk factors before the first-stage Norwood procedure in infants with hypoplastic left heart syndrome and related single-ventricle lesions and to evaluate practice patterns in prenatal diagnosis, as well as the role of prenatal diagnosis in outcome.

METHODS: Data from all live births with morphologic single right ventricle and systemic outflow obstruction screened for the Pediatric Heart Network's Single Ventricle Reconstruction Trial were used to investigate prenatal diagnosis and preoperative risk factors. Demographics, gestational age, prenatal diagnosis status, presence of major extracardiac congenital abnormalities, and preoperative mortality rates were recorded.

RESULTS: …

An Exploration Of "The 'Wild West' Of Reproductive Technology": Ethical And Feminist Perspectives On Sex-Selection Practices In The United States, Meredith Leigh Birdsall

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

A Case Study In Unethical Transgressive Bioethics: "Letter Of Concern From Bioethicists" About The Prenatal Administration Of Dexamethasone., Laurence B Mccullough, Frank A Chervenak, Robert L Brent, Benjamin Hippen

Department of Pediatrics Faculty Papers

On February 3, 2010, a "Letter of Concern from Bioethicists," organized by fetaldex.org, was sent to report suspected violations of the ethics of human subjects research in the off-label use of dexamethasone during pregnancy by Dr. Maria New. Copies of this letter were submitted to the FDA Office of Pediatric Therapeutics, the Department of Health and Human Services (DHHS) Office for Human Research Protections, and three universities where Dr. New has held or holds appointments. We provide a critical appraisal of the Letter of Concern and show that it makes false claims, misrepresents scientific publications and websites, fails to meet …

Lybarger, Shaunn Maree (Fa 115), Manuscripts & Folklife Archives

FA Finding Aids

"Menstruation: Childbirth and Child-rearing." Independent study compiled for a Western Kentucky University Folk Studies class. Utilizing existing Folklife Archives collections, Lybarger referenced beliefs, customs, and cures associated with fertility, families, child-rearing, and menstruation.

The Perils Of The Imperfect Expectation Of The Perfect Baby., Frank A Chervenak, Laurence B Mccullough, Robert L Brent

Department of Pediatrics Faculty Papers

Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care of pregnant women with expectations for a perfect baby. We use Nathaniel Hawthorne's classic short story, "The Birthmark," to illustrate the perils of the logic of control and perfection through science and then identify possible contemporary sources of the expectation of the perfect baby. We propose that the informed consent …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Experiences With Infant Mortality As Reported By Middle Class Black Women In Their Own Words, Lisa Paisley-Cleveland

Dissertations, Theses, and Capstone Projects

Black Middle-Class Women and Pregnancy Loss: A Qualitative Inquiry is the first qualitative research case study of its kind on Black Infant Mortality (BIM) to focus on a target group of black American-born middle-class professional married women who have all lived through the experience of infant loss. This target group allows Lisa Paisley-Cleveland to examine the BIM phenomenon outside the poverty paradigm and issues attached to teenage pregnancy, as well as to explore contributing factors attached to the persistent black and white disparity in infant mortality rates, which according to CDC’s January 2013 report are 12.40 and 5.35 respectively.

This …

The Association Between Prenatal Care Content And Quality With Preterm Birth And Maternal Postpartum Health Behaviors, Susan Cha

Theses and Dissertations

Background: Health policies that seek to improve pregnancy outcomes focus on increasing the availability and access to prenatal care (PNC) services based on studies that support an association between insufficient PNC and adverse birth outcomes. These studies employ PNC utilization indices that measure the adequacy of PNC use, but these indices fail to account for the content or specific components of PNC. Objectives: The purpose of this study was to utilize PRAMS and birth certificate data to evaluate the content and quality of PNC in Virginia, and its impact on preterm birth and maternal postpartum health behaviors. Methods: Data was …

Sp441-C-Smart Choices...How Your Baby Grows - The Last Trimester, The University Of Tennessee Agricultural Extension Service

Health, and Fitness

During the last three months, your baby grows very fast. It is important that you eat enough food so you will gain weight. Much of the weight you gain goes to the baby. Alcohol, drugs and tobacco can cause your baby to come too early and be too small. Sexually transmitted diseases can also hurt your baby.

Sp441-B-Smart Choices...How Your Baby Grows - The Second Trimester, The University Of Tennessee Agricultural Extension Service

Health, and Fitness

Your body goes through many changes in the 4th, 5th and 6th months of pregnancy. For example, you will make a lot of blood. Your uterus (womb) and breasts grow larger. You will store extra body fat.

Sp441-A-Smart Choices...How Your Baby Grows - The First Trimester, The University Of Tennessee Agricultural Extension Service

Health, and Fitness

The first three months are a very important time for you and your baby. Most of your baby's organs are forming early in pregnancy. Alcohol, drugs and tobacco can cause birth defects and miscarriages.

The Effects Of Motivational Interviewing In Pregnancy On Knowledge And Retention Of Infant Oral Health Information, Andrew Zima

Theses and Dissertations

THE EFFECTS OF MOTIVATIONAL INTERVIEWING IN PREGNANCY ON KNOWLEDGE AND RETENTION OF INFANT ORAL HEALTH INFORMATION By Andrew D. Zima, Jr., B.S., M.S., D.D.S. A thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2010 Major Director: Tegwyn H. Brickhouse, D.D.S., Ph.D Associate Professor, Department of Pediatric Dentistry Purpose: The purpose was to examine the effect of motivational counseling in pregnancy with readiness and acceptance of infant oral health information. Methods: The study used a prospective cohort design to examine the effect of prenatal education …

Parity-Induced Decrease In Systemic Growth Hormone Alters Mammary Gland Signaling: A Potential Role In Pregnancy Protection From Breast Cancer, Robert K. Dearth, David A. Delgado, Jill K. Hiney, Thushangi Pathiraja, Steffi Oesterreich, Dan Medina, W. Les Dees, Adrian V. Lee

Biology Faculty Publications and Presentations

Early full-term pregnancy is an effective natural protection against breast cancer in both humans and experimental rodents. The protective effect of an early pregnancy is in part linked to changes in circulating hormones that are involved in both normal breast development and breast cancer. For example, a reduction in circulating growth hormone (GH) has been shown to protect rats from carcinogen-induced mammary tumors. We examined the ability of a full-term pregnancy to alter the endocrine GH/IGF-I axis and how this change affected normal mammary gland function in two commonly used rat models (Sprague-Dawley and Wistar-Furth). Circulating GH and IGF-I were …

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Journal Articles

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

A Longitudinal Study Of The Effect Of Pregnancy On Rising To Stand From A Chair, Wendy L. Gilleard, Jack Crosbie, Richard Smith

Wendy L Gilleard

Rising to stand from a chair becomes more difficult to perform as pregnancy progresses, which may lead to altered biomechanics affecting the musculoskeletal demands on the body segments. The kinematic and kinetic adaptations in the lower limbs and trunk as pregnancy progresses are unknown. Nine maternal subjects were investigated using an eight-camera motion analysis system and two force plates, four times throughout pregnancy and once post-birth during rising to stand. Twelve nulliparous female subjects were used to establish natural variation with retesting over the time period. The maternal subjects used temporal–spatial, kinematic and kinetic strategies to widen the base of …

Factor Vii Deficiency And Pregnancy: A Case Report And Review Of Literature, Syed Mohammad Asad Zaidi, Rahat Qureshi, Salman Naseem Adil

Department of Obstetrics & Gynaecology

Factor VII deficiency is one of the 'rare inherited disorders of coagulation.' Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures. Delivery was carried out via Caesarean section due to non-reassuring foetal heart monitoring. Patient was treated with Fresh Frozen Plasma (FFPs) and Factor VII concentrates, however, the patient developed bleeding postoperatively. Literature indicates that whilst Factor VII levels rise during pregnancy in normal women, no increase is seen in …

Pregnancy Associated Breast Cancer: An Analysis Of Fetal Treatment Risk, Melissa Barnett

The Science Journal of the Lander College of Arts and Sciences

There are several viable treatment options for patients with PABC considered un-harmful to fetal development. Trastusumab, or Herceptin, targets HER2 protein and successfully combats aggressive breast cancer. In standard doses, it appears to be safe to the fetus even when administered during the first trimester. A likely side effect of Herceptin is anhydramnios, which can be monitored for throughout the stages of a pregnancy (Shrim et al. 2008). Anthracyclines, commonly used in chemotherapy, appear to be non-toxic, and have been used to successfully cure PABC patients in their second and third trimester. However, first trimester spontaneous abortions are documented to …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Dietary Behaviours During Pregnancy: Findings From First-Time Mothers In Southwest Sydney, Australia, Li Ming Wen, Judy Simpson, Christopher Rissel, Victoria M. Flood, Louise Baur

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background: Limited prevalence data are available for nutrition related health behaviours during pregnancy. This study aimed to assess dietary behaviours during pregnancy among first-time mothers, and to investigate the relationships between these behaviours and demographic characteristics, so that appropriate dietary intervention strategies for pregnant women can be developed. Method: An analysis of cross-sectional survey was conducted using data from 409 first-time mothers at 26-36 weeks of pregnancy, who participated in the Healthy Beginnings Trial conducted in southwestern Sydney, Australia. Dietary behaviours, including consumption of vegetables, fruit, water, milk, soft drinks, processed meat products, fast foods/take away and chips, were assessed …

Glycemic Index And Pregnancy: A Systematic Literature Review, Jimmy Chun Yu Louie, Jennie C. Brand-Miller, Tania P. Markovic, Glynis P. Ross, Robert G. Moses

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background/Aim. Dietary glycemic index (GI) has received considerable research interest over the past 25 years although its application to pregnancy outcomes is more recent. This paper critically evaluates the current evidence regarding the effect of dietary GI on maternal and fetal nutrition. Methods. A systematic literature search using MEDLINE, EMBASE, CINAHL, Cochrane Library, SCOPUS, and ISI Web of Science, from 1980 through September 2010, was conducted. Results. Eight studies were included in the systematic review. Two interventional studies suggest that a low-GI diet can reduce the risk of large-for-gestational-age (LGA) infants in healthy pregnancies, but one epidemiological study reported an …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Periodontal Disease And Adverse Pregnancy Outcomes: Treatment Recommendations For The Pregnant Patient, Tabitha Price

ETSU Faculty Works

No abstract provided.

Prenatal Beta-Endorphin As An Early Predictor Of Postpartum Depressive Symptoms In Euthymic Women, Ilona S. Yim, Laura M. Glynn, Christine Dunkel Schetter, Calvin J. Hobel, Aleksandra Chicz-Demet, Curt A. Sandman

Psychology Faculty Articles and Research

After delivery, many women experience symptoms of postpartum depression (PPD), and early identification of women at risk is therefore important. The opioid peptide [beta]-endorphin has been implicated in non-puerperal depression but its role in the development of PPD is unknown.

Association Between Birth Outcomes And Aflatoxin B1-Biomarker Levels Among Pregnant Women In Kumasi, Ghana, Faisal Mohammed Barbas Shuaib

All ETDs from UAB

Aflatoxins are fungal metabolites that contaminate staple food crops in many developing countries. Although studies have linked these toxins to adverse health outcomes, few studies have investigated the association between birth outcomes and aflatoxin B1-lysine adduct levels among pregnant women. The objective of this dissertation was to investigate the association between birth outcomes and aflatoxin B1- lysine adduct levels among pregnant women in Kumasi, Ghana. In a cross-sectional study of 755 pregnant women, Aflatoxin B1-lysine adduct (AF-ALB) levels were determined by High Performance Liquid Chromatography. AF-ALB associations were assessed as both continuous and categorical values. Analysis of variance (ANOVA) was …

Socio-Cultural Factors Influencing Male Involvement In Reproductive Health During Pregnancy, Childbirth And The Postnatal Period In Rural Districts Of Malawi, Jane Dzumbila-Namasasu

Theses: Doctorates and Masters

This thesis focuses on socio cultural factors influencing male involvement in reproductive health during pregnancy, childbirth and the postnatal period in rural districts of Malawi. This research stems from my fourteen years of experience in designing and overseeing the implementation of reproductive health services in Malawi, which led me to question why men as partners/husbands are not considered in the design and implementation of such services. Men as partners/husbands bear witness to most of the reproductive health problems that women go through and they are in a position of power, making decisions for their families‟ welfare. In addition to men‟s …