Medicine and Health Sciences Commons^™

Adult-Onset Still’S Disease Triggered By Pregnancy, Saleem Abdulkarim, Fredrick Otieno, Sayed Karar

Internal Medicine, East Africa

Adult-onset Still’s disease (AOSD) is an inflammatory disorder with arthritis, quotidian fever, evanescent rash, elevated white cell count, elevated ferritin, and abnormal liver function tests. The diagnosis requires the exclusion of other inflammatory, infectious, and malignant conditions. Onset of AOSD, though rare, has been known to occur in pregnancy. We present a 28-year-old woman diagnosed with AOSD at 3 months gestation.

National Policies And Care Provision In Pregnancy And Childbirth For Twins In Eastern And Southern Africa: A Mixed-Methods Multi-Country Study, Claudia Hanson, Stephen Munjanja, Agnes Binagwaho, Bellington Vwalika, Andrea B. Pembe, Elsa Jacinto, George K. Chilinda, Kateri B. Donahoe, Sikolia Wanyonyi, Peter Waiswa, Muchabayiwa F. Gidiri, Lenka Benova

Obstetrics and Gynaecology, East Africa

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods and findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and …

A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield

The Qualitative Report

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …

Association Between Hypertensive Disorders And Fetal Growth Abnormalities In Class Ii And Iii Obese Women, Mary Ferrante, Bs, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: Studies have shown that hypertension in pregnancy can lead to small for gestational age newborns while obesity can lead to large for gestational age newborns. However, little research has been done to study the influence of both disorders on birthweight.

Objective: To assess the effect of both maternal obesity and a hypertensive disorder on neonatal birthweight and to identify the specific growth abnormality(s) present if a discrepancy exists. We hypothesize that obese women diagnosed with hypertensive disorders are more likely to deliver neonates with growth abnormalities compared to obese women without hypertensive disorders.

Methods: This is a …

A Multicountry Randomized Controlled Trial Of Comprehensive Maternal Nutrition Supplementation Initiated Before Conception: The Women First Trial., K. Michael Hambidge, Jamie E. Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S. Goudar, Sangappa M. Dhaded, Omrana Pasha, Sumera A. Ali, Antoinette Tshefu, Adrien Lokangaka, Richard J. Derman, Robert L. Goldenberg, Carl L. Bose, Melissa Bauserman, Marion Koso-Thomas, Vanessa R. Thorsten, Amaanti Sridhar, Kristen Stolka, Abhik Das, Elizabeth M. Mcclure, Nancy F. Krebs

Global Health Articles

Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited.

Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3).

Methods: Women First was a 3-arm individualized randomized controlled trial (RCT). The intervention was a lipid-based micronutrient supplement; a protein-energy supplement was also provided if maternal body mass index (kg/m2) was(DRC), Guatemala, India, and …

Effects Of Prenatal Exercise On Fetal Heart Rate, Umbilical And Uterine Blood Flow: A Systematic Review And Meta-Analysis, Rachel J. Skow, Margie H. Davenport, Michelle Mottola, Gregory A. Davies, Veronica J. Poitras, Casey E. Gray, Alejandra Jaramillo Garcia, Nick Barrowman, Victoria L. Meah, Linda G. Slater, Kristi B. Adamo, Ruben Barakat, Stephanie-May Ruchat

Anatomy and Cell Biology Publications

Objective To perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics.

Design Systematic review with random-effects meta-analysis and meta-regression.

Data sources Online databases were searched up to 6 January 2017.

Study eligibility criteria Studies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other …

An Exploration Of The Lived Experience Of Women Who Had Abortions And The Effects Of The Abortion Secret On Their Relationships: An Interpretive Phenomenological Analysis, Marckdaline Johnson

Department of Family Therapy Dissertations and Applied Clinical Projects

The United States Supreme Court decision in the Roe v. Wade (1973) case provides women with a right to privacy and the liberty to make decisions concerning their reproductive lives. With this, women who become pregnant are offered the right to choose between keeping their pregnancy and terminating the pregnancy by way of abortion. Since Roe v. Wade (1973), many women have exercised their reproductive liberties, as evidenced by the termination of over 60 million pregnancies via legal abortion in the United States. Still, secrecy among women with a history of abortion remains a common phenomenon. Studies conducted on abortion …

Maternal Characteristics Associated With Injury-Related Infant Death In West Virginia, 2010-2014, Wilson A. Koech, Toni M. Rudisill, Ian R. H. Rockett

Faculty & Staff Scholarship

Although injury-related deaths have been documented among children and adult populations, insufficient attention has been directed towards injury-related infant deaths. The objective of this retrospective study was to investigate maternal and infant characteristics associated with injury-related infant deaths in West Virginia. Birth and infant mortality data for 2010–2014 were sourced from the West Virginia Bureau for Public Health, Charleston. Relative risk was calculated using log-binomial regression utilizing generalized estimating equations. Maternal characteristics associated with injury-related infant mortality in West Virginia were race/ethnicity ( = 7.48, p = .03), and smoking during pregnancy (, p < .00). Risk of a Black Non-Hispanic infant suffering an injury-related death was 4.0 (95% CL 1.7, 9.3) times that of infants of other races/ethnicities. Risk of an infant dying from an injury-related cause, if the mother smoked during pregnancy, was 2.9 (95% CL 1.6, 5.0) times the risk of such a death if maternal smoking status during pregnancy is unknown or no smoking, controlling for race/ethnicity. This study provides important information to public health stakeholders at both the state and local levels in designing interventions for partial reduction or prevention of injury-related infant mortality in West Virginia.

A Comparison Of Pharmacologic Interventions In Pregnant Women With Opioid Use Disorder, Catherine K. Bopp

Physician Assistant Scholarly Project Posters

The purpose of this research and systematic literature review is to determine which pharmacotherapeutic agent, methadone or buprenorphine, leads to better outcomes in cases of pregnant mothers with opioid use disorder (OUD).

Outcomes considered are maternal compliance, neonatal abstinence syndrome severity, and neonatal length of hospital stay. In the review, PubMed, Clinical Key, Cochrane Database of Systematic Reviews, and DynaMed Plus were searched. Key terms searched were “methadone, buprenorphine, pregnancy”, “opioids, pregnancy”, “neonatal abstinence syndrome” and “medication assisted treatment, pregnancy”. Several studies were excluded, as their study population was not specified to have diagnosed OUD in pregnancy. The drawbacks to …

Effect Of Abo Blood Group On Asymptomatic, Uncomplicated And Placental Plasmodium Falciparum Infection: Systematic Review And Meta-Analysis, Abraham Degarege, Merhawi T. Gebrezgi, Consuelo M. Beck-Sague, Mats Wahlgren, Luiz Carlos De Mattos, Purnima Madhivanan

Journal Articles: Epidemiology

BACKGROUND: Malaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear. We explored effects of ABO blood group on asymptomatic, uncomplicated and placental falciparum infection in the published literature.

METHODS: A systematic review and meta-analysis was performed using the preferred reporting items for systematic reviews and meta-analyses guidelines. Articles in Pubmed, Embase, Web of Science, CINAHL and Cochrane Library published before February 04, 2017 were searched without restriction. Studies were included if they reported P. falciparum infection incidence or prevalence, …

Fertility Options For Women With Endometriosis: In Vitro Fertilization Versus Surgical Excision Or Ablation, Jenny L. Brown

Oral History Posters

Endometriosis negatively affects the fertility of many women of reproductive age worldwide. Some women with endometriosis are able to conceive without reproduction assistance, while others require medical intervention. In vitro fertilization and surgical management are available and widely used in the treatment of endometriosis associated infertility. In vitro fertilization has been found to be effective in women with stages I-IV endometriosis, with varying degrees of success at each stage. These varying results may be due to oocyte quality and availability as well as endometriosis location. Surgical excision and/or surgical ablation of endometriosis/endometriomas may also improve chance of successful pregnancy but …

Screening For Depression During The Early Perinatal Period, Loretta Ann Donnelly-Moreno

Walden Dissertations and Doctoral Studies

The clinical practice guideline (CPG) is the implementation of a depression screening tool to be used in the early perinatal period. The practice change occurred in a rural Obstetrical and Gynecological (OBGYN) practice in the southern United States. The CPG change has been guided by recommendations from both the American Congress of Obstetrics and Gynecology and the American College of Nurse Midwives. Implementation of this CPG change addresses the gap in practice of not doing depression screening during the perinatal period, and only screening during the postpartum period, which was being done at the OBGYN office. Theorist Lewin’s ‘change theory’ …

A Comparison Of The Safety And Efficacy Of Three Medical Abortion Protocols, Dhammika Perera

Walden Dissertations and Doctoral Studies

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers.

A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study.

A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- …

Nutrition Interventions Integrated Into An Existing Maternal, Neonatal, And Child Health Program Reduce Food Insecurity Among Recently Delivered And Pregnant Women In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Tina Sanghvi, Zeba Mahmud, Bachera Aktar, Silvia Alayon, Purnima Menon

Faculty Publications

Background

Antenatal care may be a means to reduce food insecurity in pregnancy and postpartum periods.

Objective

With the use of a cluster-randomized design, we tested whether participation in nutrition-focused antenatal care intending to improve household knowledge about the importance of nutrition for pregnant and lactating women and encourage allocation of household resources to ensure sufficient quality and quantity of foods, without providing food assistance, would reduce household food insecurity.

Methods

Alive & Thrive integrated nutrition interventions into an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. The nutrition-focused MNCH package was delivered in 10 subdistricts through antenatal …

Comparing Screening And Treatment Of Bacterial Vaginosis And Pregnancy Outcomes, Stephanie Severson

Physician Assistant Scholarly Project Posters

Evidence shows that bacterial vaginosis (BV) can lead to poor perinatal outcomes.

• The goal of this project is to answer the question of which pregnant patients should be screened for BV and does identification and treatment of BV during pregnancy improve perinatal outcomes.

• Due to variability in a multitude of factors, a generalized recommendation is difficult to make. Lack of recommendations are largely due to harm of treatment in those who were misdiagnosed.

• The development of polymerase chain reaction (PCR) has the capability to reduce misdiagnosis.

• Newer studies have shown benefit of early screening and treatment …

Epidemiology Of Self-Reported Maternal Depression During Pregnancy And Association With Adverse Birth Outcomes In New York State, 2012-2017, Solita Julianna Jones

Legacy Theses & Dissertations (2009 - 2024)

Background

The Effect Of Maternal Dietary Habits During Pregnancy On Neonate Leptin Methylation Patterns And Gestational Age, Sean Fitzpatrick

Legacy Theses & Dissertations (2009 - 2024)

The health of a newborn baby is inextricably linked to the health status of its mother and in turn the mother’s diet during pregnancy. Leptin (LEP) is an adipokine hormone involved in metabolism regulation and has been linked fetal development through the hypothalamic-pituitary-adrenal axis (HPA). Prior work suggests that gestational epigenetic alterations the LEP gene may be sensitive to adverse exposures during pregnancy, which in turn could explain variation in neonate outcomes. However, no prior work has examined this possibility explicitly. The objective of this study was to investigate the association between dietary patterns of mothers during pregnancy and their …

Risk Factors For Gestational Diabetes In Upstate New York Women & Implications For Practice, Margaret Versteegen

Legacy Theses & Dissertations (2009 - 2024)

Gestational diabetes mellitus (GDM) is a form of diabetes, or abnormal blood glucose (sugar) metabolism, diagnosed during pregnancy. Pregnant, non-diabetic women who are initially noted to experience high blood glucose levels during their pregnancy are considered to have GDM (ADA, 2016b). GDM has significant implications for infant and maternal morbidity and mortality, with adverse pregnancy outcomes such as infant macrosomia, difficult birth requiring cesarean section, and postpartum hemorrhage (Kamana, Shakya, & Zhang, 2015). In the majority of cases, GDM goes away once the baby is born, but around 5-10% of women with GDM go on to have type 2 diabetes …

Retrospective Evaluation Of Anesthetic Techniques In Pregnant Women With Renal Transplantation, Asuman Sargin, Semra Karaman, Şeyda Ceylan Ari, Ali̇ Akdemi̇r, İsmet Hortu

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to evaluate anesthesia management in cesarean operation of pregnant women who underwent renal transplantation and the effects on postoperative renal function, retrospectively.Materials and methods: After obtaining the approval of the ethics committee of our hospital, the records of pregnant women who underwent kidney transplantation and cesarean section between 2007 and 2017 were retrospectively analyzed. The patients' demographic data, concomitant disease history, the treatment received, and type of anesthesia were retrospectively evaluated and recorded in the follow-up form.Results: It was found that a total of 47 women who underwent renal transplantation had 47 live …

A Randomized Trial Of Prenatal N-3 Fatty Acid Supplementation And Preterm Delivery, Maria Makrides, Karen Best, Lisa Yelland, Andrew Mcphee, Shao Zhou, Julie Quinlivan, Jodie Dodd, Elinor Atkinson, Huda Safa, Jacqueline Van Dam, Gustaaf Dekker, Monika Skubisz, Amanda Anderson, Beth Kean, Anneka Bowman, Carly Mccallum, Kara Cashman, Robert Gibson

Health Sciences Papers and Journal Articles

Background: Previous studies have suggested that maternal supplementation with n−3 long-chain polyunsaturated fatty acids may reduce the incidence of preterm delivery but may also prolong gestation beyond term; however, more data are needed regarding the role of n−3 long-chain polyunsaturated fatty acids in pregnancy.

Methods: We performed a multicenter, double-blind, randomized trial in which women who were pregnant with single or multiple fetuses were assigned to receive either fish-oil capsules that contained 900 mg of n−3 long-chain polyunsaturated fatty acids (n−3 group) or vegetable-oil capsules that contained trace n−3 long-chain polyunsaturated fatty acids (control group) daily, beginning before 20 weeks …

Assessment Of Presumed Sterility Of The Human Placenta And Maternal Bladder, Ali Alhousseini

Wayne State University Dissertations

Introduction

Preterm birth is the number one cause of neonatal morbidity and mortality. A causal link has been established between infection and preterm birth. Urinary tract infection is the number one infection in pregnancy. Evaluating the existence of a placental and maternal bladder microbiome is a major scientific and clinical milestone in perinatal medicine.

Methodology and Results

Chapter 2: This is a prospective case control study. 69 placentas were collected in a sterile fashion from six groups of women without infection: Term cesarean not in labor (n=18), term cesarean in labor (n=9), term vaginal (n=21), preterm cesarean not in labor …

Differential Dynamics Of The Maternal Immune System In Healthy Pregnancy And Preeclampsia, Xiaoyuan Han, Mohammad Sajjad Ghaemi, Kazuo Ando, Laura S. Peterson, Edward A. Ganio, Amy S. Tsai, Dyani K. Gaudilliere, Ina A. Stelzer, Jakob Einhaus, Basile Bertrand, Natalie Stanley, Anthony Culos, Athena Tanada, Julien Hedou, Eileen S. Tsai, Ramin Fallahzadeh, Ronald J. Wong, Amy E. Judy, Virginia D. Winn, Maurice L. Druzin, Yair J. Blumenfeld, Mark A. Hlatky, Cecele C. Quaintance, Ronald S. Gibbs, Brendan Carvalho, Gary M. Shaw, David K. Stevenson, Martin S. Angst, Nima Aghaeepour

All Dugoni School of Dentistry Faculty Articles

Preeclampsia is one of the most severe pregnancy complications and a leading cause of maternal death. However, early diagnosis of preeclampsia remains a clinical challenge. Alterations in the normal immune adaptations necessary for the maintenance of a healthy pregnancy are central features of preeclampsia. However, prior analyses primarily focused on the static assessment of select immune cell subsets have provided limited information for the prediction of preeclampsia. Here, we used a high-dimensional mass cytometry immunoassay to characterize the dynamic changes of over 370 immune cell features (including cell distribution and functional responses) in maternal blood during healthy and preeclamptic pregnancies. …

Developmental Expression Of Monocarboxylate Transporter 1 And 4 In Rat Liver, Michael Ng, Justin Louie, Jieyun Cao, Melanie A. Felmlee

School of Pharmacy Faculty Articles

PURPOSE: Monocarboxylate transporters (MCT) are proton-coupled integral membrane proteins that control the influx and efflux of endogenous monocarboxylates such as lactate, acetate and pyruvate. They also transport and mediate the clearance of drugs such as valproate and gamma-hydroxybutyrate. CD147 functions as ancillary protein that chaperones MCT1 and MCT4 to the cell membrane. There is limited data on the maturation of MCT and CD147 expression in tissues related to drug distribution and clearance. The objective of the present study was to quantify hepatic MCT1, MCT4, and CD147 mRNA, whole cell and membrane protein expression from birth to sexual maturity.

METHODS: Liver …

Impact Of Socioeconomic Status And Health-Seeking Behavior On Malaria In Pregnancy, Ifeanyi Livinus Udenweze

Walden Dissertations and Doctoral Studies

Malaria in pregnancy remains a public health challenge in Nigeria despite the fund appropriation for malaria control. The health challenges of malaria in pregnancy vary with populations and there is limited knowledge on the impact of the socioeconomic status and health-seeking behavior on malaria in pregnancy in Nigeria. The objective of this cross-sectional quantitative survey was to examine whether socioeconomic status and health-seeking behavior predict malaria in pregnancy in Nigeria using the social cognitive theoretical model. The data from a 2015 Nigeria Malaria Indicator Survey was used in this study. Data were analyzed using chi-square, binary, and multivariate logistics regression …

Associations Between Mindful Eating Techniques And Gestational Weight Gain, Yuqing Shang

Public Health Theses

Abstract

Objective: To investigate the extent to which the use of mindful eating techniques is associated with gestational weight gain among a clinic-based sample of pregnant women.

Methods: Four hundred and forty-eight pregnant women in their second trimester of pregnancy participated in the Expect With Me group care study and were selected for this secondary analysis. Sociodemographic and general health data was collected at baseline. Mindfulness practice was measured based on frequency of performing mindful thinking and mindful eating techniques in the third trimester. The main outcome was excessive average weekly gestational weight gain, which was determined using the guidelines …

Racial Disparities, Fragmentation Of Care, And Adverse Outcomes Associated With Ectopic Pregnancy, Angela Rosa Jourdain

Walden Dissertations and Doctoral Studies

Ectopic pregnancy (EP) is a rare condition that occurs in 1% of all pregnancies. However, women of lower socioeconomic status (SES) and ethnic minority groups are at greater risk of adverse outcomes associated with EP than White women. The purpose of this study was to examine data from the 2014 National Inpatient Sample to identify predictors of complications from EP in 2,626 females ages 15-44 in the United States. The theoretical framework used to guide this study was the theory of fundamental causes to explain why the association between SES and mortality has persisted despite progressive advances in the diseases …

Five-Year Follow Up Of A Low Glycaemic Index Dietary Randomised Controlled Trial In Pregnancy—No Long-Term Maternal Effects Of A Dietary Intervention, E.C. O'Brien, Aisling A. Geraghty, Elizabeth O'Sullivan, J.A. Riordan, Mary K. Horan, Elizabeth Larkin, John Mehegan, P.J. Twomey, Fionnuala M. Mcauliffe

Articles

Objective: To determine whether a dietary intervention in pregnancy had a lasting effect on maternal outcomes of diet, HbA1c and weight retention 5 years post-intervention; and to establish whether modifiable maternal behaviours were associated with these outcomes. Design: Randomised control trial of low glycaemic index (GI) diet in pregnancy with longitudinal follow up to 5 years post-intervention. Setting: Dublin, Ireland (2007–2016). Population: In all, 403 women of 759 (53.1%) were followed up at 5 years. A total of 370 (intervention n = 188; control n = 182) were included in this analysis. Methods: Fasting glucose was measured at 13 and …

The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds

Walden Dissertations and Doctoral Studies

Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15 —19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and …

Improving Interdepartmental Care Collaboration For Pregnant Patients, Michelle Anne Ott

Walden Dissertations and Doctoral Studies

Communication is vital to improve patient care outcomes, especially with high acuity patients. Pregnant patients differ from other patient populations because their care involves 2 entities: the patient (mother-to-be) and her unborn fetus. There has been a noted gap in communication and care collaboration between the emergency department (ED) and obstetric (OB) teams at the project site, resulting in delays for patients and lack of appropriate maternal/fetal assessment and contributing negatively to patients' experiences. Using transitions theory and the Rosswurm and Larrabee model, a clinical practice guideline (CPG) inclusive of an obstetrically focused algorithm was developed and presented for use …

The Impact Of Mandatory Iodine Fortification And Supplementation On Pregnant And Lactating Women In Australia, Stephen Hurley, Creswell J. Eastman, Gisselle Gallego

Medical Papers and Journal Articles

Background and Objectives: In Australia, two public health measures were introduced between 2009 and 2010 to reduce iodine deficiency. However there has been a shortage of information regarding their effectiveness and the ongoing prevalence of iodine deficiency in Australia. The primary aim of this study was to assess the extent to which these public health measures have reduced rates of iodine deficiency among pregnant and lactating women.

Methods and Study Design: A review was conducted to identify all studies published since January 2010 that quantitatively measured the iodine status of pregnant and/or lactating women in Australia.

Results: We found 25 …