Medicine and Health Sciences Commons^™

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 …

Current State Of Preeclampsia Mouse Models: Approaches, Relevance, And Standardization, Christopher A. Waker, Melissa R. Kaufman, Thomas L. Brown

Neuroscience, Cell Biology & Physiology Faculty Publications

Preeclampsia (PE) is a multisystemic, pregnancy-specific disorder and a leading cause of maternal and fetal death. PE is also associated with an increased risk for chronic morbidities later in life for mother and offspring. Abnormal placentation or placental function has been well-established as central to the genesis of PE; yet much remains to be determined about the factors involved in the development of this condition. Despite decades of investigation and many clinical trials, the only definitive treatment is parturition. To better understand the condition and identify potential targets preclinically, many approaches to simulate PE in mice have been developed and …

Pregnant Women's Experiences With Gastrointestinal Discomforts And Strategies They Use To Cope, Heidi Jo Paquette

Dissertations (1934 -)

Problem The experience of gastrointestinal (GI) discomforts of pregnancy is almost universal. Heartburn, constipation, nausea and/or vomiting are the most common, with variation in frequency and intensity by trimester. GI discomforts of pregnancy are understudied. Most research on GI discomforts of pregnancy has employed quantitative instruments, before and after specific therapeutic approaches. Little research has focused on women’s experiences of GI discomforts of pregnancy and self-management strategies. Women are experts in their experience of their own pregnancies and their voices are rich sources of data, but have been largely ignored in the study of GI discomforts of pregnancy. Methodology The …

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.

Comprehensive And Compassionate Responses For Opioid Use Disorder Among Pregnant And Parenting Women., Dennis J. Hand, Alice C. Fischer, Meghan L. Gannon, Kimberly A. Mclaughlin, Vanessa L. Short, Diane J. Abatemarco

Department of Obstetrics and Gynecology Faculty Papers

Pregnant and parenting women with opioid use disorder face multiple challenges to recovery. Trauma histories, poverty, stigma and discrimination, and lack of access to treatment intersect to marginalise this population. It is important that pregnant and parenting women with opioid use disorder receive comprehensive care to improve their health, the health of their child(ren), and prevent the intergenerational transmission of opioid and other substance use disorders. For nearly 50 years the Maternal Addiction Treatment, Education, and Research program has provided an evolving and expanding range of comprehensive services for treating opioid and other substance use disorders in this population. In …

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). …

Endometrial Receptivity And Implantation Require Uterine Bmp Signaling Through An Acvr2a-Smad1/Smad5 Axis., Diana Monsivais, Takashi Nagashima, Renata Prunskaite-Hyyryläinen, Kaori Nozawa, Keisuke Shimada, Suni Tang, Clark Hamor, Julio E Agno, Fengju Chen, Ramya P Masand, Steven L Young, Chad J Creighton, Francesco J Demayo, Masahito Ikawa, Se-Jin Lee, Martin M Matzuk

Faculty Research 2021

During early pregnancy in the mouse, nidatory estrogen (E2) stimulates endometrial receptivity by activating a network of signaling pathways that is not yet fully characterized. Here, we report that bone morphogenetic proteins (BMPs) control endometrial receptivity via a conserved activin receptor type 2 A (ACVR2A) and SMAD1/5 signaling pathway. Mice were generated to contain single or double conditional deletion of SMAD1/5 and ACVR2A/ACVR2B receptors using progesterone receptor (PR)-cre. Female mice with SMAD1/5 deletion display endometrial defects that result in the development of cystic endometrial glands, a hyperproliferative endometrial epithelium during the window of implantation, and impaired apicobasal transformation that prevents …

Water-Fat Magnetic Resonance Imaging Of Adipose Tissue Compartments In The Normal Third Trimester Fetus, Stephanie A Giza, Tianna L Koreman, Simran Sethi, Michael R Miller, Debbie A Penava, Genevieve D Eastabrook, Charles A Mckenzie, Barbra De Vrijer

Obstetrics & Gynaecology Publications

BACKGROUND: Assessment of fetal adipose tissue gives information about the future metabolic health of an individual, with evidence that the development of this tissue has regional heterogeneity.

OBJECTIVE: To assess differences in the proton density fat fraction (PDFF) between fetal adipose tissue compartments in the third trimester using water-fat magnetic resonance imaging (MRI).

MATERIALS AND METHODS: Water-fat MRI was performed in a 1.5-T scanner. Fetal adipose tissue was segmented into cheeks, thorax, abdomen, upper arms, forearms, thighs and lower legs. PDFF and R2* values were measured in each compartment.

RESULTS: Twenty-eight women with singleton pregnancies were imaged between 28 and …

Translating Developmental Origins Of Health And Disease In Practice: Health Care Providers' Perspectives., Monica L Molinaro, Marilyn Evans, Timothy Regnault, Barbra De Vrijer

Paediatrics Publications

Currently, there is limited knowledge on how health care providers perceive and understand the Developmental Origins of Health and Disease (DOHaD), which may impact how they inform patients and their families throughout the perinatal period. This qualitative descriptive study explored if and how health care providers counsel on in utero programming and future health outcomes with parents, both preconception and during pregnancy. One-on-one, semi-structured interviews were conducted with 23 health care providers from varying health disciplines including obstetrics and gynaecology, midwifery, paediatrics, endocrinology and internal medicine. Audiotaped interviews were transcribed verbatim and analysed using inductive thematic analysis. Three themes were …

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, …

Defining Vdr Expression In The Brain Using A Novel Vdrcre Mouse, Hailan Liu, Yang He, Jessie Beck, Silvania Da Silva Teixeira, Keisha Harrison, Yong Xu, Stephanie Sisley

Children’s Nutrition Research Center Staff Publications

Vitamin D action has been linked to several diseases regulated by the brain including obesity, diabetes, autism, and Parkinson’s. However, the location of the vitamin D receptor (VDR) in the brain is not clear due to conflicting reports. We found that two antibodies previously published as specific in peripheral tissues are not specific in the brain. We thus created a new knockin mouse with cre recombinase expression under the control of the endogenous VDR promoter (VDRCre). We demonstrated that the cre activity in the VDRCre mouse brain (as reported by a cre-dependent tdTomato expression) is highly overlapping with endogenous VDR …

Air Pollution Exposure And Risk Of Adverse Obstetric And Neonatal Outcomes Among Women With Type 1 Diabetes, Andrew D. Williams, Jenna Kanner, Katherine Grantz, Marion Ouidir, Shanshan Sheehy, Seth Sherman, Candace Robledo, Pauline Mendola

School of Medicine Publications

Aims/Hypothesis:

Women with type 1 diabetes have increased risk for poor obstetric outcomes. Prenatal air pollution exposure is also associated with adverse outcomes for women and infants. We examined whether women with type 1 diabetes are more vulnerable than other women to pollution-associated risks during pregnancy.

Methods:

In singleton deliveries from the Consortium on Safe Labor (2002-2008), obstetric and neonatal outcomes were compared for women with type 1 diabetes (n=507) and women without autoimmune disease (n=204,384). Preconception, trimester, and whole pregnancy average air pollutant exposure (ozone (O3), carbon monoxide (CO), particulate matter >10 microns (PM10), PM >2.5 microns (PM2.5), sulfur …

Evaluation Of Sleep Quality And Duration In Pregnancy And Risk Of Gestational Diabetes Mellitus: A Prospective Follow-Up Study, Saloumeh Peivandi, Ali Habibi, Seyed Hamzeh Hosseini, Mohammad Khademloo, Mohammad Raisian, Hedieh Pournorouz

BioMedicine

Background and Objectives: Sleep disorders during pregnancy may be linked with increased risk of adverse pregnancy outcomes. This study aimed to evaluate the relationship between sleep quality and duration in pregnancy and risk of gestational diabetes mellitus (GDM).

Materials and Methods: This prospective follow-up study was performed on 240 pregnant women with a gestational age between 20 to 24 weeks, who were referred to Imam Khomeini Hospital in Sari from 2018 to 2019 for prenatal care. The sleep quality of all eligible women were evaluated with the Pittsburgh Sleep Quality Index (PSQI). During the 26 to 28 weeks of …

Digital Technology Needs In Maternal Mental Health: A Qualitative Inquiry, Alexandra Zingg, Laura Carter, Deevakar Rogith, Amy Franklin, Sudhakar Selvaraj, Jerrie Refuerzo, Sahiti Myneni

Faculty, Staff and Student Publications

Digital technologies offer many opportunities to improve mental healthcare management for women seeking pre- and-postnatal care. They provide a discrete, practical medium that is well-suited for the sensitive nature of mental health. Women who are more prone to experiencing peripartum depression (PPD), such as those of low-socioeconomic background or in high-risk pregnancies, can benefit the most from such technologies. However, current digital interventions directed towards this population provide suboptimal support, and their responsiveness to end user needs is quite limited. Our objective is to understand the digital terrain of information needs for low-socioeconomic status women with high-risk pregnancies, specifically within …

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 …

Substance Use Screening, Brief Intervention, And Referral To Treatment (Sbirt) In Pregnant Women Living With Hiv, Whitney Markowitz

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Substance Use Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Pregnant Women Living with Human Immunodeficiency Virus (HIV)

BACKGROUND: According to the 2018 National Survey on Drug Use and Health, 5.4%, 9.9%, and 11.1% of pregnant women reported use of illicit drugs, alcohol, and tobacco, respectively, in the past month. In the same year, Centers for Disease Control reported 19% of new HIV diagnoses were among women. Substance use in pregnant women living with HIV increases risk of adverse outcomes for both mother and child including neonatal viral transmission and obstetrical complications. Universal screening for substance use …

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 …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Case Report: Post-Partum Headache, Alaleh Ebrahimi

Rowan-Virtua Research Day

Cerebral venous sinus thromboses are rare and occur in 5 people/1,000,000, more commonly in women that are pregnant at about 202/100,000 deliveries with an 11.63% mortality rate. It is believed that pregnancy being a hypercoagulable state is one of the main reasons that it is more common in pregnant and post-partum women. Common symptoms include sudden onset headache, blurry vision, focal neuro deficits, seizures and altered mental status.

Perceived Stress May Mediate The Relationship Between Antenatal Depressive Symptoms And Preterm Birth: A Pilot Observational Cohort Study, Sharifa Bashir Lalani, Aliyah Dosani, Ntonghanwah Forcheh, Shahirose Sadrudin Premji, Sana Siddiqui, Kiran Shaikh, Ayesha Mian, Ilona S Yim Ilona S Yim, Maternal-Infant Global Health Team (Might) Collaborators In Research

School of Nursing & Midwifery

Background: Screening for changes in pregnancy-related anxiety and depressive symptoms during pregnancy may further our understanding of the relationship between these two variables and preterm birth.
Objectives: To determine whether changes in pregnancy-related anxiety and depressive symptoms during pregnancy influence the risk of preterm birth among Pakistani women; explore whether perceived stress moderates or mediates this relationship, and examine the relationship between the various components of pregnancy-related anxiety and preterm birth.
Methods: A prospective cohort study design was used to recruit a diverse sample of 300 low-risk pregnant women from four centers of Aga Khan Hospital for Women and Children …

Intradural Extramedullary Primary Central Nervous System Melanoma Of The Craniovertebral Junction During Pregnancy: Observations And Outcomes, Fabiola Valenzuela, Sohum Desai

School of Medicine Publications

Background: Primary central nervous system (CNS) melanoma is a rare lesion derived from neural crest precursors. While its management is analogous to metastatic spinal melanoma, the literature does not describe this entity clearly in pregnant patients and the unique implications it presents. Here, we describe the case of a pregnant patient who presented with primary CNS melanoma of the cervical spine.

Case Description: A 27-year-old pregnant patient presented with a 3-month history of neck and interscapular pain. MRI of the cervical spine demonstrated a ventral intradural extramedullary mass adjacent to the C2-C3 vertebral bodies causing severe cord compression. The patient …

Predictors Of Iron Consumption For At Least 90 Days During Pregnancy: Findings From National Demographic Health Survey, Pakistan (2017-2018), Sumera Aziz Ali, Savera Aziz Ali, Shama Razzaq, Nayab Khowaja, Sarah Gutkind, Fazal Ur Rehman, Nadir Suhail

Section of Internal Medicine

Background: Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan.
Methods: We analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017-2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy …

Effectiveness Of Diet/Exercise In Prevention Of Gestational Diabetes Mellitus And Associated Cesarean Section Delivery, Jonathyn Andrew Marx

Physician Assistant Scholarly Project Papers

Gestational diabetes mellitus (GDM) is becoming a more common diagnosis during pregnancy. GDM is defined as glucose intolerance diagnosed during pregnancy. Women diagnosed with GDM during pregnancy are at an increased risk for emergent or planned cesarean section delivery and the development of overt diabetes mellitus post pregnancy. Complications related to GDM include eclampsia, macrosomia, shoulder dystocia, stillbirth, and cesarean section delivery. Initial treatment consists of diet and exercise and if glucose can not be controlled then pharmacotherapy is introduced. A literature review was performed utilizing scientific databases, mesh terms, and keywords to gather statistically relevant research to analyze the …

Differences In Obstetric Care Between Japan And The Us: A Qualitative Analysis Of Blogs, Rei Yamada, Maki Kano-Lueckerath, Walter K. Kraft

Student Papers, Posters & Projects

Aim

To investigate patient-reported differences in obstetric care between Japan and the US by characterizing the information Japanese immigrants and expatriates share online.

Gardnerella Vaginalis Promotes Group B Streptococcus Vaginal Colonization, Enabling Ascending Uteroplacental Infection In Pregnant Mice, Nicole M Gilbert, Lynne R Foster, Bin Cao, Yin Yin, Indira U Mysorekar, Amanda L Lewis

2020-Current year OA Pubs

BACKGROUND: Group B Streptococcus is a common vaginal bacterium and the leading cause of invasive fetoplacental infections. Group B Streptococcus in the vagina can invade through the cervix to cause ascending uteroplacental infections or can be transmitted to the neonate during vaginal delivery. Some studies have found that women with a "dysbiotic" polymicrobial or Lactobacillus-depleted vaginal microbiota are more likely to harbor group B Streptococcus. Gardnerella vaginalis is often the most abundant bacteria in the vaginas of women with dysbiosis, while being detected at lower levels in most other women, and has been linked with several adverse pregnancy outcomes. Mouse …

Relationships Between Intimate Partner Violence, Pregnancy, Maternal Mental Health And Infant Care Behaviors, Brooke Ambrose

Boise State University Theses and Dissertations

Background: Intimate Partner Violence (IPV) is a public health issue that is known to have deleterious health effects for pregnant women and their babies. Women who experience IPV during pregnancy are also likely to develop and exacerbate already existing mental health conditions. Experiences with IPV are thought to impact health behaviors, particularly how a mother copes or cares for her baby. The objective of this study is to explore the potential relationships between experiencing IPV (before and/or during pregnancy), maternal mental health, and health-related infant care behaviors (i.e., breastfeeding initiation, breastfeeding duration, well-child visits).

Methods: Data from phases 6 (years …

Recurrent Spontaneous Pneumothorax During Pregnancy; A Case Report, Andrew J. Weaver, Wai Hau, Mark H. Cooper

Marshall Journal of Medicine

Spontaneous pneumothorax is a rare but potentially life-threatening condition during pregnancy. We discuss a case of recurrent spontaneous pneumothorax during a single pregnancy. The pneumothorax occurred twice during the pregnancy, first in the second trimester and again in the third trimester with both times being managed conservatively. Due to the low prevalence of this condition management guidelines are few. We report our management of recurrent spontaneous pneumothorax during pregnancy to support the literature and current guidelines.