Medicine and Health Sciences Commons^™

Socioecological Factors Associated With The Timing Of Prenatal Care Initiation In Kentucky And Beyond: An Exploratory Study., Melissa B. Eggen

Electronic Theses and Dissertations

Objectives: Early prenatal care is initiated in the first twelve weeks of pregnancy and is a known contributor to improved short- and long-term outcomes for women and infants. Despite its known benefits, many women do not initiate early prenatal care. The purpose of this dissertation was to explore the socioecological factors associated with the timing of prenatal care initiation in the United States and in Kentucky. Methods: Chapter Two of this dissertation used a scoping review methodology to identify barriers and facilitators related to first-trimester prenatal care initiation among women in the United States. Chapter Three of this dissertation used …

Environmental Ozone Exposure, Gestational Health, And The Lung-Placental Axis, Russell Hunter

Biomedical Sciences ETDs

Adverse gestational outcomes of pregnancy are a globally occurring threat to fetomaternal health, with limited clinical prognostic and intervention strategies aside from premature labor induction. Epidemiological data shows strong correlations between gestational exposure to air pollution and the incidence of adverse gestational outcomes. The research presented here was designed to evaluate potential murine models of gestational exposure, as well as quantify maternal cardiovascular damage therein. These studies employ radiotelemetry, echocardiography, single cell RNA-sequencing, and untargeted lipidomic analyses in efforts to study these effects. Results implicate cardiovascular responses to mid-gestational ozone exposure as evidenced by decreased maternal cardiac output and increased …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Facility-Based Audit System With Integrated Community Engagement To Improve Maternal And Perinatal Health Outcomes In Rural Pakistan: Protocol For A Mixed Methods Implementation Study, Zahid Memon, Wardah Ahmed, Shah Muhammad, Sajid Bashir Soofi, Shanti Chohan, Arjumand Rizvi, Paul Barach, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Maternal and newborn mortality in Pakistan remains as a major public health challenge. Pakistan faces significant infrastructure challenges and inadequate access to quality health care, exacerbated by sociocultural factors. Facility-based audit systems coupled with community engagement are key elements in achieving improved health system performance. We describe an implementation approach adapted from the World Health Organization audit cycle in real-world settings, with a plan to scale-up through mixed methods evaluation plan.
Objective: This study aims to implement a locally acceptable and relevant audit system and evaluate its feasibility within the rural health system of Pakistan for scale-up.
Methods: The …

Maternal, Child, And Parenting Factors Associated With Obesity Among Pre-Kindergarten Children In Mississippi, Jerome R. Kolbo

Journal of Public Health in the Deep South

Background: Obesity among children and youth has been consistently assessed among public school students in Mississippi since 2005. Significant declines in the prevalence of obesity among elementary students over the past decade suggest that changes may be occurring prior to entry into public school. Purpose: The purpose was to collect anthropometric data on a weighted, representative sample of children ages 3 to 5 years in licensed childcare facilities across Mississippi, and to correlate maternal, child, and parenting characteristics to obesity. Methods: The Body Mass Index was calculated using measured height and weight data. Results: A total of 14.12% of the …

An Occupation Based Program: Supporting Mothers Through Pregnancy And Postpartum, Precious Barnett, Monica Watford, La'shandra Russell

Summer 2023 Virtual OTD Capstone Symposium

This capstone project aimed to discover the effects of occupational therapy services with women who may experience or who are at risk for postpartum depression. Supporting Mothers Through Pregnancy and Postpartum is the developed capstone program. This program included occupation-based activities and resources to encourage occupational participation and engagement. This program used an integrative approach to support the participants of this project. This poster presentation includes background information regarding this population, the methods used to develop the program, program topic themes and goals, and links to view the program’s deliverables.

Educating Labor And Delivery Nurses On Evidence-Based Birthing Positions To Promote Fetal Descent During First And Second Stage Labor, Sophia Nguyen

Master's Projects and Capstones

The goal of this project was to increase confidence of labor and delivery nurses in utilizing evidence-supported birth positions during the first and second stages of labor in order to aid in fetal descent and labor progression. Current statistics demonstrate climbing trends in cesarean deliveries, which have been associated with increased maternal morbidity and mortality. One nurse intervention that can reduce failure to progress, a main contributor to cesarean sections, is the use of various evidence-supported maternal birth positions such as ambulation, assisted squat, sitting, backwards sitting, lunging, throne, side-lying with peanut ball, hands-and-knees, and throne position. This evidence-based practice …

Occupational Therapy's Role In Infant Feeding & Postpartum Support, Megan Gallagher

Occupational Therapy Doctoral Student Capstone Posters

A smooth transition to parenthood requires education and preparation on what to expect and new roles, responsibilities, and occupations. This capstone, in collaboration with Nurture Columbus, developed educational resources for new parents to help meet their infant feeding goals and facilitate a smooth transition throughout the postpartum period. In addition, education for healthcare professionals on the distinct value of occupational therapy during the perinatal period is included.

Impact Of Elective Induction Of Labor At 39 Weeks' Gestational Age On Maternal And Neonatal Risk, Alaa E. F. Elhalaby, Ibrahim A. S. Elnasr, Mohamed E. H. Elsheikh

Menoufia Medical Journal

Objectives To compare elective induction of labor at 39 weeks' gestational age in uncomplicated pregnancies with expectant management of up to 41 weeks' gestation and induction of labor in undelivered mothers. Background Late-term and postterm pregnancies are associated with increased maternal and fetal risks, thus several studies have considered induction of labor between 39 and 41 weeks' gestational age. Patients and methods This study was a randomized case–control study on 194 pregnant women at 39 weeks for labor induction at Menoufia University Hospitals and Elsalam Specialized Hospital during the period between December 2020 and June 2022. Results In the present …

Assessing The Impact Of Pregnancy And Birth Factors On The Maternal And Infant Microbiota, Kait F. Al, Laura Allen, Samantha Bedell, Jeremy P. Burton, Barbra De Vrijer

Obstetrics & Gynaecology Publications

Background: The microbiota acquired at birth is known to play an intimate role in later life health and disease and has been shown to be affected by the mode of birth. There has been recent interest in microbiota correction by maternal vaginal seeding in Cesarean section-born infants; however, the safety of this practice has been debated. The aim of this study was to assess how other factors, such as timing of sampling, maternal obesity, vaginal Group B Streptococcus colonization (GBS), and antibiotic exposure, affect the maternal and infant microbiota.

Methods: Maternal vaginal and saliva samples were collected at three time …

Vaping With Nicotine During Pregnancy Affects Aortic Structure And Function In Rat Offspring, Sydney Alexis Nassabeh

Graduate Theses, Dissertations, and Problem Reports

Electronic cigarette (E-cig) use during pregnancy has grown in popularity due to the marketing of these devices as safer alternatives to traditional cigarettes. However, nicotine is a constituent in cigarettes that is cause for concern and is also present in a majority of E-cig devices. Little has been reported regarding the implications of E-cig use with nicotine during pregnancy on offspring health outcomes. This study tested the hypothesis that in-utero exposure to nicotine-containing E-cig aerosol would result in a wattage-dependent increase in vascular endothelial dysfunction and arterial stiffening that would persist throughout the lifespan of the offspring. Pregnant Sprague-Dawley rats …

Mothers Of Children With Disabilities: Perceptions Of Online Peer Mentoring Support, April S. Felder

Walden Dissertations and Doctoral Studies

There has been a trend of increased diagnoses of childhood disabilities in the United States. Mothers who care for a child diagnosed with disabilities typically experience increased parental obligations and maternal mental health deficits that often go undiagnosed or untreated, resulting in adverse events. Researchers found that peer mentoring is an effective, nonclinical resource for addressing these mothers’ intervention needs but have not established alternative ways to increase access and delivery. The purpose of this generic, qualitative study was to explore how mothers of children with disabilities perceive online peer mentoring as an intervention resource for stress and coping. Lazarus’s …

Views And Opinions Of Mass Media Key Informants On Coverage Of Issues Related To Maternal, Newborn And Child Health In Lake Zone, Tanzania, Violeth A. Mbuni, Nyagwegwe Wango, Elias C. Nyanza

Institute for Educational Development, East Africa

In Tanzania, the mass media is a primary means of communicating health information to urban and rural populations. While unsafe abortion is the leading cause of maternal deaths and complications in Tanzania, this has increased the high unintended pregnancy rate. Journalists, editors, program managers and producers play a significant role in determining the health-related issues reported. In the present study, the views, and opinions of mass media key informants on coverage of issues related to maternal, newborn and child health in Lake Zone were investigated. This qualitative study was conducted with key informants from 24 mass media outlets that covered …

What Impact Does The Ability To Access Healthcare Have On Maternal Outcomes In Africa?, Helena Harris

Nursing | Senior Theses

Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: …

Access To Prenatal Care And Mental Health In Pregnant Women During Covid-19: A Systematic Review, Chloe Feezel, Marin Kahoun, Kaija Kunttu

Williams Honors College, Honors Research Projects

COVID-19 affected the world in many ways. Pregnant women were greatly impacted by a change in their access to prenatal care, from in-person care to telehealth methods, and social support being limited by social isolation. Compared with prevalence of anxiety and depression in pregnant women pre-COVID-19, pregnant women during COVID-19 reported higher levels of anxiety and depression symptoms due to the stress of circumstantial changes. The purpose of this systematic review is to review and critically appraise the evidence about access to prenatal care and mental health in pregnant women during the COVID-19 pandemic. The following PICOT formatted question will …

Adverse Maternal, Fetal, And Newborn Outcomes Among Pregnant Women With Sars-Cov-2 Infection: An Individual Participant Data Meta-Analysis, Emily R. Smith, Erin Oakley, Gargi Wable Grandner, Kacey Ferguson, Fouzia Farooq, Yalda Afshar, Mia Ahlberg, Homa Ahmadzia, Victor Akelo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Introduction: Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.

Methods: We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.

Results: We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.

Pregnant women with …

Voices, Stories And Experiences Of Black Women: Informing The Establishment Of A Trenton-Based Maternal And Infant Health Innovation And Research Center, Tirzah R. Spencer Phd, Mph, Barbara George Johnson Mph, J.D., Consuelo Bonillas

Center for Health Policy Development

The establishment of a Maternal and Infant Health Innovation and Research Center is one of nine recommendations outlined by the 2021 Nurture NJ Strategic Plan to reduce maternal and infant mortality and morbidity and ensure equity in care and in outcomes for mothers and infants of all ethnic groups. The purpose of this environmental scan is to provide input for the design of a Maternal and Infant Health Innovation and Research Center within Trenton.

Building on the Nurture NJ Initiative, this project is a deeper dive in its focus on Black and Latina women living in Trenton and surrounding areas. …

Acceptability And Feasibility Of A Low-Cost Device For Gestational Age Assessment In A Low-Resource Setting: Qualitative Study, Angela Koech, Peris Muoga Musitia, Grace Mwashigadi, Mai-Lei Woo Kinshella, Marianne Vidler, Marleen Temmerman, Rachel Craik, J. Alison Noble, Peter Dadelszen Von Dadelszen, Aris T . Papageorghiou

Obstetrics and Gynaecology, East Africa

Background: Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated measurements of the fetal transcerebellar diameter and head circumference.

Objective: The aim of this study was to assess the perceptions of pregnant women, their families, and health care workers regarding the feasibility and acceptability of the TraCer device in an appropriate setting.

Methods: A descriptive study using qualitative methods was conducted in …

Decreasing Black Maternal Mortality Rate, Gabriella J. Bermeo, Kate Bragg, Jessica Duranko, Susannah Gaines

Non-Thesis Student Work

Abstract

The drastic difference in Black maternal mortality rates (MMR) compared to White MMR has begged the question: For pregnant Black women, how does access to quality prenatal care and screenings for common pregnancy complications, such as pregnancy induced hypertension (PIH), affect the maternal mortality rate compared to pregnant Black women of childbearing age that do not receive quality prenatal care and screenings? Studies have shown the Black MMR to be 3.55 times that of the White MMR, with three in five maternal deaths being preventable. A correlation exists between poor use of prenatal care services and adverse maternal outcomes. …

Association Between Fetal Abdominal Growth Trajectories, Maternal Metabolite Signatures Early In Pregnancy, And Childhood Growth And Adiposity: Prospective Observational Multinational Interbio-21st Fetal Study, Jose Villar, Roseline Ochieng, Robert B. Gunier, Aris T. Papageorghiou, Stephen Rauch, Rose Mcgready, Julia M. Gauglitz, Fernando C. Barros, Manu Vatish, Michelle Fernandes

Paediatrics and Child Health, East Africa

Background: Obesity predominantly affects populations in high-income countries and those countries facing epidemiological transition. The risk of childhood obesity is increased among infants who had overweight or obesity at birth, but in low-resource settings one in five infants are born small for gestational age. We aimed to study the relationships between: (1) maternal metabolite signatures; (2) fetal abdominal growth; and (3) postnatal growth, adiposity, and neurodevelopment.

Methods: In the prospective, multinational, observational INTERBIO-21st fetal study, conducted in maternity units in Pelotas (Brazil), Nairobi (Kenya), Karachi (Pakistan), Soweto (South Africa), Mae Sot (Thailand), and Oxford (UK), we enrolled women …

Association Between Fetal Abdominal Growth Trajectories, Maternal Metabolite Signatures Early In Pregnancy, And Childhood Growth And Adiposity: Prospective Observational Multinational Interbio-21st Fetal Study, Jose Villar, Roseline Ochieng, Robert B. Gunier, Aris T. Papageorghiou, Stephen Rauch, Rose Mcgready, Julia M. Gauglitz, Fernando C. Barros, Manu Vatish, Shama Munim

Department of Obstetrics & Gynaecology

Background: Obesity predominantly affects populations in high-income countries and those countries facing epidemiological transition. The risk of childhood obesity is increased among infants who had overweight or obesity at birth, but in low-resource settings one in five infants are born small for gestational age. We aimed to study the relationships between: (1) maternal metabolite signatures; (2) fetal abdominal growth; and (3) postnatal growth, adiposity, and neurodevelopment.
Methods: In the prospective, multinational, observational INTERBIO-21st fetal study, conducted in maternity units in Pelotas (Brazil), Nairobi (Kenya), Karachi (Pakistan), Soweto (South Africa), Mae Sot (Thailand), and Oxford (UK), we enrolled women (≥18 years, …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Reducing The Stigma Associated With Maternal Substance Use Disorder In A Rural Midwest Hospital And Clinic, Jami Vineyard

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to determine if an educational resource provided to maternal healthcare providers, more specifically, providers in a Midwest regional hospital and clinic, would reduce the stigma associated with maternal substance use disorder (SUD). This project also aimed at increasing provider knowledge on the disease process of maternal SUD and current treatment guidelines.

A quantitative research design was used for this study. There was no control group; therefore, it is a quasi-experimental study. Qualtrics were utilized to design a pre-test and post-test. An email including a brief description of the study, an invitation to participate, and …

Postpartum Depression Screening In The Neonatal Intensive Care Unit: Maternal And Provider Perspectives, Candice Triulzi

Dissertations & Theses (Open Access)

Objective: Although mothers of preterm infants are at increased risk for postpartum depression (PPD), PPD screening conducted by neonatal providers in the Neonatal Intensive Care Unit (NICU) is currently not a standard of care. The purpose of this study was to explore maternal and provider perceptions of neonatal providers conducting PPD screening in the NICU.

Design: This study was conducted with a qualitative approach.

Setting: A 24-bed Level III NICU in Houston, TX acted as the study site.

Participants: Participants were purposively sampled (N=31) and included mothers of NICU infants (n=15) and NICU providers (n=16).

Methods: Semi-structured individual and paired …

Testing For Transferred Immunity Of A Universal Influenza Vaccine In Pigs, Rachel Marie Sestak

Honors Thesis

Influenza causes high numbers of illnesses and deaths annually (CDC, 2020). Influenza vaccines prevent these complications by reducing the risk of flu illness between 40-60% (CDC, 2021). However, no vaccination exists for infants under six months old so other methods, such as passive immunity, must be explored. To determine how infants can be protected, we tested the passive transfer of a universal influenza vaccine using a pig model and researched the mechanism of transfer. Four pregnant pigs were vaccinated one time with PBS and one time with HA-129 vaccine and four were vaccinated twice with the HA-129 vaccine. After farrowing, …

Testing For Transferred Immunity Of A Universal Influenza Vaccine In Pigs, Rachel Marie Sestak

Honors Thesis

Influenza causes high numbers of illnesses and deaths annually (CDC, 2020). Influenza vaccines prevent these complications by reducing the risk of flu illness between 40-60% (CDC, 2021). However, no vaccination exists for infants under six months old so other methods, such as passive immunity, must be explored. To determine how infants can be protected, we tested the passive transfer of a universal influenza vaccine using a pig model and researched the mechanism of transfer. Four pregnant pigs were vaccinated one time with PBS and one time with HA-129 vaccine and four were vaccinated twice with the HA-129 vaccine. After farrowing, …

Matrilateral Bias Of Grandparental Investment In Grandchildren Persists Despite The Grandchildren’S Adverse Early Life Experiences, Samuli Helle, Antti O. Tanskanen, David A. Coall, Mirkka Danielsbacka

Research outputs 2022 to 2026

Evolutionary theory predicts a downward flow of investment from older to younger generations, representing individual efforts to maximize inclusive fitness. Maternal grandparents and maternal grandmothers (MGMs) in particular consistently show the highest levels of investment (e.g. time, care and resources) in their grandchildren. Grandparental investment overall may depend on social and environmental conditions that affect the development of children and modify the benefits and costs of investment. Currently, the responses of grandparents to adverse early life experiences (AELEs) in their grandchildren are assessed from a perspective of increased investment to meet increased need. Here, we formulate an alternative prediction that …

Preventing Maternal Falls, Blair Burkhart

Master's Projects and Capstones

Patient falls are unfortunate events in healthcare that are an essential quality improvement focus during patients’ hospital stays. At Hospital X, a private institution located in the suburbs of a large city, there had been 23 maternal falls within the last three years. This increase in maternal fall rate puts this hospital’s maternity unit above the average of other hospital’s fall rates according to the National Database of Nursing Quality Indicators. This quality improvement project aimed to reduce the rate of maternal falls on postpartum units through various forms of staff education. Education included Morse Fall Scale scoring, Sara Stedy …

Reducing Postpartum Maternal Falls: A Quality Improvement Project, Sarah L. Iroz

Master's Projects and Capstones

Falls are an unfortunate, common occurrence in the healthcare system and are often not thought to be a problem in the obstetrics population. Key stakeholders in a Northern California hospital brought the issue of maternal falls to leaders of the quality improvement team on the maternity unit. In the last three years, there have been 23 falls on the maternity floor, making their fall rate above the national average. It is the purpose of this project to aid the quality improvement team in reducing postpartum maternal falls over the next three years. After conducting a unit assessment, performing a literature …

Neonatal Outcomes And Congenital Anomalies In Pregnancies Affected By Hypothyroidism, Zareen Kiran,, Aisha Sheikh, Khadija N Humayun, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Maternal hypothyroidism has been reported to have concerns over neonatal outcomes, not only in the context of neurocognitive development but also in the short term as birth weight and neonatal jaundice.
Patients and methods: We conducted a cross-sectional retrospective study on 638 cases who delivered live births in the Aga Khan University Hospital after ethical approval. Data were collected on hypothyroid pregnant females who were diagnosed before conception or during their antenatal visits during the year 2008-2016. Neonatal outcomes were noted for birth weight, maturity, and neonatal jaundice, neonatal hypothyroidism, neonatal respiratory distress syndrome, sepsis, hypocalcaemia, congenital anomalies, need …