Medicine and Health Sciences Commons^™

Glad To Be Out. I Was Running Out Of Womb: A Study Of Omega-6 And Omega-3 Fatty Acid Metabolites At Delivery And Their Relationship To Infant Growth, Prematurity, And Admission To The Neonatal Intensive Care Unit, Maranda Thompson

Theses & Dissertations

Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled it can lead to poor infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and omega-6 fatty acids have been shown to be metabolized into bioactive metabolites that effect inflammation. The presence and importance of these metabolites at the time of delivery are not well understood. Therefore, the purpose of this dissertation was to first quantify omega-3 and omega-6 metabolites in maternal plasma, cord plasma, and placental tissue. Then the relationships between metabolites and infant outcomes, including birth weight percentile, length percentile, head circumferences …

The Association Of Maternal Sociodemographic Factors With Stress In Pregnancy, Maheshwari Andhavarapu

Theses & Dissertations

Introduction: Antenatal stress has been linked to maternal morbidity and preterm birth (PTB). One of the pathophysiological processes leading to PTB is thought to be via activation of the hypothalamus-pituitary-adrenal axis resulting in cortisol production. Hair cortisol has recently been shown to be a stress marker in the pregnant and non-pregnant population. Some determinants of hair cortisol have also been studied but more research is needed in this area, especially in pregnancy. Understanding the risk factors of antenatal stress may guide institution of preventative or screening measures to reduce the risk of adverse birth outcomes. As the effect of stress …

An Evaluation Of The Use Of A Clinical Research Data Warehouse And I2b2 Infrastructure To Facilitate Replication Of Research, Bret Gardner

Theses & Dissertations

Replication of clinical research is requisite for forming effective clinical decisions and guidelines. While rerunning a clinical trial may be unethical and prohibitively expensive, the adoption of EHRs and the infrastructure for distributed research networks provide access to clinical data for observational and retrospective studies. Herein I demonstrate a means of using these tools to validate existing results and extend the findings to novel populations. I describe the process of evaluating published risk models as well as local data and infrastructure to assess the replicability of the study. I use an example of a risk model unable to be replicated …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

The Use Of Electroacupuncture For Cervical Ripening In Pregnant Women, Becky A. Nauta

Theses & Dissertations

The purpose of this study was to compare cervical ripening outcomes, based on Bishop scoring methodology, of pregnant women receiving usual care treatment (UC) with those receiving electroacupuncture plus UC. A sample of 36 pregnant women completing their 39^th week of gestation was randomized into one of the two groups. The women in the UC group continued to meet with their provider on a weekly basis until delivery. The women in the electroacupuncture plus usual care group met with their provider on a weekly basis and also received electroacupuncture treatments: three in the 39th gestational week and two in …

Human Papillomavirus And Its Impact On Vulnerable Populations, Harpriya Kaur

Theses & Dissertations

Human papillomavirus (HPV) is the most common sexually transmitted infection. The infection is higher in certain racial/ethnic groups and those who are immunocompromised including pregnant women. Because immune system is suppressed during pregnancy, women are at higher risk of various types of infection including HPV, a known risk factor for pregnancy complications. However, its role in adverse pregnancy outcomes is unclear. Another high risk population is Northern Plain American Indian. In the Northern Plains region, American Indian women have significantly higher rate of HPV infection than white counterparts and are infected with different types of HPVs than the general population. …

Association Between Elevated Third Trimester Maternal Haemoglobin And Neonatal Gestational Age Adjusted Birth Weight, Bob Otieno Achila

Theses & Dissertations

Background: Women tend to have lower haemoglobin compared to men due to menstrual blood losses. This is often compounded by nutritional deficiencies. There is a further drop in haemoglobin during pregnancy due to red cell dilution. Pregnancy itself places a huge demand on maternal iron stores. High haemoglobin may reflect haemoconcentration due to a failure of the normal physiological expansion in plasma volume. Iron excess has also been associated with free-radical damage. In current practice, high maternal haemoglobin in pregnancy is often not given as much attention as anaemia. This study examines the association between high maternal haemoglobin in the …

Prevalence Of Vitamin D Deficiency In An Ethnic African Urban Obstetric Population In An Equatorial City Hospital, Raj Hasmukh Dodia

Theses & Dissertations

Introduction: Low Vitamin D levels in pregnancy have been associated with an increased risk of gestational diabetes, pre-eclampsia, bacterial vaginosis, preterm birth, disordered fetal skeletal homeostasis, and impaired offspring lung health. As a result, current public health advice in several countries is to universally supplement Vitamin D during pregnancy. Data regarding the Vitamin D levels of the ethnic obstetric population in Kenya are not available; hence recommendations for Vitamin D supplementation have no scientific basis.

Objectives of study: This research was carried out to determine the prevalence of deficiency of Vitamin D in ethnic African obstetric patients who had delivered …