Medicine and Health Sciences Commons^™

The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner

Doctoral Dissertations

Cardiovascular disease and type 2 diabetes are global epidemics affecting approximately 127 and 21 million people in the U.S., respectively. Women who are overweight, obese or who develop glucose intolerance during pregnancy represent high-risk groups for the development of cardiovascular disease and type 2 diabetes. Hispanic women are both more likely to begin their pregnancies as overweight or obese and have a higher prevalence of type 2 diabetes, compared to non-Hispanic whites. However, prior lifestyle interventions have largely been limited to non-Hispanic whites. Therefore, this research assessed how culturally tailored lifestyle modification may affect cardiovascular disease and type 2 diabetes …

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 …

Improving Intimate Partner Violence Screening Practices Among Postpartum Nurses, Robin Mills-Humphreys

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and Review of the Literature: Intimate partner violence (IPV) during pregnancy is a global public health issue that has negative outcomes on both an individual and a societal level. Health care providers play a pivotal role in providing services to women experiencing violence during pregnancy. Regardless of the setting, barriers to IPV screening exist among healthcare providers. Review of the literature examined the existing IPV screening practices and screening barriers among healthcare providers to better understand the relationship between barriers and frequency of screening for IPV. Purpose: The purpose of this DNP project was to enhance …

The Lived Experience And Factors Affecting Disclosure Of Pregnant Victims Of Domestic Violence, Pedro Vargas Ortiz

Doctoral Dissertations

Domestic violence is defined as a pattern of assaultive and coercive behaviors that includes the threat or infliction of physical, sexual, or psychological abuse that is used by perpetrators for the purpose of intimidation and control over the victim. The lived experience and meaning of domestic violence in Puerto Rican pregnant women has not been well researched. This study described pregnant women’s lived experience of domestic violence and examined the factors influencing the process of disclosure of domestic violence among pregnant women in the southern region of Puerto Rico. A phenomenological method was used where women who have experienced domestic …

Foki Vitamin D Receptor Gene Polymorphisms And Metabolic Health In Pregnant Saudi Women, Maysa Alzaim

Doctoral Dissertations

Lifestyles have been dynamically changing in the past few years in Saudi Arabia, and the prevalence of non-communicable diseases (NCDs), such as obesity, diabetes, hypertension, high cholesterol, and other cardiovascular diseases (CVD), is notably increasing. In fact, NCDs are affecting a growing number of people in SA, especially women of childbearing age. Vitamin D deficiency has also become pandemic and a major public health concern among the Saudi population despite the abundance of sunlight. The most vulnerable groups are pregnant women and their newborns. Previous studies have correlated low vitamin D status with a higher risk of adverse short- and …

Improving Pertussis Education For Postpartum Women And Their Family Members, Marlene Unisa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background:The purpose of this DNP project was to synthesize evidenced based-research related to Tdap vaccination against pertussis for family members of pregnant and postpartum women in order to provide protection from pertussis for newborn infants through cocooning. Cocooning refers to the vaccination of family members and caregivers in close contact with the infant to protect the infant by lowering risk of acquiring pertussis from close contact through an infected family member.

Methods: This project utilized the Health Belief Model to understand perceptions and predict behaviors related to the pertussis vaccination of family members who may come in contact …

Gestational Weight Gain And Maternal Health Among Hispanic Women, Megan W. Harvey

Doctoral Dissertations

More than 70% of women do not gain within their target range of gestational weight gain (GWG), as recommended by the Institute of Medicine (IOM) in 2009. Risks associated with inadequate GWG include small-for-gestational age, low birthweight, pre-term birth, and difficulty establishing breastfeeding. Risks associated with excessive GWG include large-for-gestational-age, macrosomia, and delivery complications. There are also long-term consequences for maternal and fetal metabolic processes. Higher pre-pregnancy BMI, lower education level, and higher parity are known risk factors for excessive GWG. There are also possible racial / ethnic differences, and Hispanic women, in particular, may be at high risk for …

Pre-Pregnancy Bmi And Preterm Birth Among Hispanic Teens, Allison C. Hope

Masters Theses

Preterm birth affects 12% of infants in the United States annually and is the main contributor to infant deaths and long-term neurological disabilities in offspring. Obesity is a growing problem in the U.S., and is increasingly being considered a major risk factor for adverse health outcomes. Puerto Rican teenagers have disproportionately high rates of preterm birth and obesity when compared to non-Hispanic White teenagers. Studies evaluating risk factors for preterm birth among adolescents are sparse, have inconsistent findings, and were conducted among predominantly non-Hispanic populations. Therefore, we investigated the association between BMI and preterm birth among the 419 teenage (ages …

Psychosocial Factors Affecting Pregnant Hispanic Women, Marushka L. Silveira

Doctoral Dissertations

Prenatal psychosocial stress, anxiety, and depression are common, with higher rates among Hispanic women. While evidence supports an adverse effect of psychosocial factors on glucose intolerance and oral health, studies during pregnancy are sparse, particularly among Hispanic women. Therefore, we examined correlates of psychosocial factors and their associations with glucose intolerance and oral health among pregnant women. The first project examined correlates of high stress among 1,426 pregnant Hispanic participants in Proyecto Buena Salud, a prospective cohort study. Cohen’s Perceived Stress Scale was administered in early, mid- and late pregnancy. Using multivariable logistic regression, we found that increasing age, pre-pregnancy …

Modifiable Risk Factors For Hypertensive Disorders Of Pregnancy Among Latina Women, Shannon Renee Turzanski Fortner

Open Access Dissertations

Hypertensive disorders of pregnancy affect approximately 8% of pregnancies, and can lead to serious complications for both mother and child. While Latinas are at two-fold increased risk of preeclampsia relative to non-Latina white women, little research on hypertension in pregnancy has been conducted in this population. Furthermore, there are few modifiable risk factors for hypertensive pregnancy. Therefore, we examined associations between psychosocial stress, physical activity, and pre-pregnancy BMI and gestational weight gain and hypertensive disorders of pregnancy using data from the Latina GDM Study, a prospective cohort study of 1,231 women. The first study evaluated the association between perceived stress …

Weight Gain In Pregnancy And Risk Of Maternal Hyperglycemia, Sharon J. Herring, Emily Oken, Sheryl L. Rifas-Shiman, Janet W. Rich-Edwards, Alison M. Stuebe, Ken P. Kleinman, Matthew W. Gillman

Public Health Department Faculty Publication Series

OBJECTIVE:

The purpose of this study was to examine associations of weight gain from prepregnancy to glycemic screening with glucose tolerance status.

STUDY DESIGN:

Main outcomes were failed glycemic screening (1-hour glucose result >or= 140 mg/dL) with either 1 high value on 3-hour oral glucose tolerance testing (impaired glucose tolerance in pregnancy) or >or= 2 high values on 3-hour oral glucose tolerance testing (gestational diabetes mellitus). We performed multinomial logistic regression to determine the odds of these glucose intolerance outcomes by quartile of gestational weight gain among 1960 women in Project Viva.

RESULTS:

Mean gestational weight gain was 10.2 +/- …

Gestational Weight Gain And Child Adiposity At Age 3 Years, Emily Oken, Elsie M. Taveras, Ken P. Kleinman, Janet W. Rich-Edwards, Matthew W. Gillman

Public Health Department Faculty Publication Series

OBJECTIVE

The purpose of this study was to examine the associations of gestational weight gain with child adiposity.

STUDY DESIGN

Using multivariable regression, we studied associations of total gestational weight gain and weight gain according to 1990 Institute of Medicine guidelines with child outcomes among 1044 mother-child pairs in Project Viva.

RESULTS

Greater weight gain was associated with higher child body mass index z-score (0.13 units per 5 kg [95% CI, 0.08, 0.19]), sum of subscapular and triceps skinfold thicknesses (0.26 mm [95% CI, 0.02, 0.51]), and systolic blood pressure (0.60 mm Hg [95% CI, 0.06, 1.13]). Compared with inadequate …