Medicine and Health Sciences Commons^™

Down-Regulation Of Placental Neuropilin-1 In Fetal Growth Restriction., Dev Maulik, Alok De, Louis Ragolia, Jodi Evans, Dmitry Grigoryev, Kamani Lankachandra, David Mundy, Jolene Muscat, Mary M. Gerkovich, Shui Qing Ye

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Fetal growth restriction (FGR) is associated with adverse outcomes extending from fetal to adult life, and thus, constitutes a major health care challenge. Fetuses with progressive growth restriction show increasing impedance in the umbilical artery flow, which may become absent during end-diastole. Absent end-diastolic flow (AEDF) is associated with adverse perinatal outcomes including stillbirths and perinatal asphyxia. Placentas from such pregnancies demonstrate deficient fetoplacental vascular branching. Current evidence, moreover, indicates an antiangiogenic state in maternal circulation in several pregnancy complications including preeclampsia, small-for-gestational-age births, fetal death, and preterm labor. The angiogenic mediators in maternal circulation are predominantly of placental …

Identifying Intimate Partner Violence During Pregnancy In Prenatal Care Settings, Tifani R. Fletcher, Andrea D. Clements, Beth Bailey

International Journal of Health Sciences Education

More than 324,000 women each year are estimated as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms and severity of IPV is necessary to inform the implementation of interventions to prevent and treat IPV. This can optimally be accomplished with data from accurate screening instruments. The United States Preventative Services Task force has recently recommended that all women who are pregnant should be screened for IPV over the course of their pregnancy and postnatal visits. Currently, clinical practice and research are hindered by the lack of validated IPV screening measurements for a pregnant population. …

The Potential Benefits And Risks Of Antidepressant, Antipsychotic And/Or Mood Stabilizing Medications Use In Pregnancy: A Critical Review Of The Literature, Brittany Kaye Schultz

All Electronic Theses and Dissertations

Background: Medication use in pregnancy walks a fine line between safety of the mother and adverse effects in the developing fetus. Medications are prescribed to either help the mother maintain mental stability or they are discontinued out of fear of fetal harm. Many providers hope that the shift in hormones during pregnancy will fulfill the medications requirement in the non-pregnant state but this is not always the case. Is a discontinuation in medications upon a positive pregnancy test warranted? Purpose: To determine if antipsychotics, mood stabilizers, and antidepressants should be continued or discontinued during pregnancy or if they negatively impact …

The Use Of Supplemental Progesterone In Preventing Preterm Birth In High-Risk Women: A Critical Review Of The Literature, Leah Marie Schroeder

All Electronic Theses and Dissertations

Background: Twelve percent of births in the United States occur before 37 weeks of gestation and therefore are considered preterm births (Norwitz, 2015). While the ability to identify women at risk for preterm birth has improved dramatically over the past three decades, the application of primary and secondary interventions has failed to reduce the incidence of preterm delivery, which has actually been on the rise (Norwitz, 2015). Preterm birth is a phenomenon that needs to be reduced not only in the United States, but also across the world. Purpose: To determine to what extent the use of supplemental progesterone in …

Non-Antibiotic Alternatives For Reducing Antepartum Group B Streptococcus Colonization, Rebecca M. Smith

All Electronic Theses and Dissertations

Background: Streptococcus agalactiae (known as Group B strep, or GBS) is a bacterium that resides in the gastrointestinal tract and/or vaginal canal and is typically benign, but during pregnancy and birth it can potentially colonize the neonate, causing early-onset group B streptococcal disease (EOGBSD) of the neonate. The use of antibiotics has reduced the morbidity and mortality associated with neonatal infections, but it is not an entirely effective means of preventing the infections and the development of antibiotic resistance may render antibiotics ineffective for this purpose. Alternative methods of preventing GBS colonization are in use by consumers and out-of-hospital birth …

Teenage Pregnancy With Catecholaminergic Polymorphic Ventricular Tachycardia And Documented Icd Discharges, Aziez Ahmed, John R. Phillips

Faculty & Staff Scholarship

We report the first case of pregnancy in a pediatric patient with catecholiminergic polymorphic ventricular tachycardia (CPVT). Pregnant adolescents with CPVT are at high risk for NSVT and malignant VT during pregnancy, despite antiarrhythmic medication. They may receive multiple implantable cardioverter defibrillator (ICD) therapies. Such patients require close monitoring with special care during the first trimester.

Traditional Practices Of Konya Women During Pregnancy, Birth, The Postpartumperiod, And Newborn Care, Berri̇n Okka, Yasemi̇n Durduran, Nesli̇han Değerli̇ Kodaz

Turkish Journal of Medical Sciences

Background/aim: The purpose of the present study was to identify traditional practices and the extent to which they are practiced by mothers during pregnancy, birth, the postpartum period, and newborn care. Materials and methods: This study was conducted in the city center of Konya (Turkey). Data were collected through questionnaires completed by volunteers. The research sample comprised 450 mothers, all of whom had given birth to at least one live baby. The forms were completed during face-to-face interviews. Results: Some traditional pregnancy practices were followed by 70.7% of the participants. Of the women who performed these practices, 57.4% consciously chose …

First Trimester Vaginal Microbiome As Pregnancy Outcome Predictor, Sarah K. Rozycki, Jennifer M. Fettwis

MD Student Summer Research Fellowship Program Posters

• We have developed clinical definiKons of healthy and complicated pregnancies based on pathologies that will be used in future VaHMP studies.

• Although one study7 found dysbioKc vagitypes in all three semesters of women who had PPROM, none of our PPROM subjects had a BVAB1 vagitype, and there were equal Gardnerella vaginalis vagitypes in both the controls and subjects who had PPROM (Fig. 2).

• While there were more PPROM subjects with Lactobacillus iners vagitypes, this Lactobacillus is less protecKve as it can coexist with pathogenic anaerobic bacteria.

• “Candidatus Mycoplasma girerdii”, Lactobacillus jensenii, and Ureaplasma were significantly associated …

Case No. 21 - Trauma In Pregnancy, New York Law School

Anonymous Closed Medical Liability Cases

Anonymous Closed Medical Liability Case - Trauma in Pregnancy

Maternal Surgery Or Anesthesia Use During Pregnancy And The Risk Of Adverse Birth Outcomes In The National Birth Defects Prevention Study, 1997-2009, Youjung Byun

Legacy Theses & Dissertations (2009 - 2024)

Background: 50,000 to 75,000 pregnant women are estimated to undergo surgery during pregnancy. This number comprises of 1.5 to 2 percent of the total confirmed pregnancies. Considering most pregnancies are unintended (49%), the number of women undergoing surgery unaware of the pregnancy is expected to be higher than the historical estimate. This study objective is to identify the characteristics of mothers who undergo surgery and assess the association between surgery or anesthesia exposure and the risk of adverse birth outcomes.

Use Of A Web-Based Dietary Assessment Tool In Early Pregnancy, Laura Mullaney, Amy C. O'Higgins, Shona Cawley, R. Kennedy, Daniel Mccartney, M.J. Turner

Articles

Background Maternal diet is critical to fetal development and lifelong health outcomes. In this context, dietary quality indices in pregnancy should be explicitly underpinned by data correlating food intake patterns with nutrient intakes known to be important for gestation.

Aims Our aim was to assess the correlation between dietary quality scores derived from a novel online dietary assessment tool (DAT) and nutrient intake data derived from the previously validated Willett Food Frequency Questionnaire (WFFQ).

Methods 524 women completed the validated semiquantitive WFFQ and online DAT questionnaire in their first trimester. Spearman correlation and Kruskal–Wallis tests were used to test associations …

Influence Of Thyroid Disorders On Pregnancy Outcomes, Brittany Sullivan

Theses and Dissertations

Objective: The objective of this thesis is to investigate the effects of maternal thyroid dysfunction on maternal pregnancy outcomes.

Setting and Participants: The NICHD Consecutive Pregnancy data set contains information on a total of 114,679 pregnancies from 51,086 women who delivered ≥ 20 weeks of gestation. The data come from 20 different hospitals throughout the state of Utah and were collected between the years of 2002 to 2010.

Main Outcomes: Main outcomes of interest included: breech presentation, chorioamnionitis, gestational diabetes, gestational hypertension, hemorrhage, inductions, placental abruption, placental previa, preterm birth, premature rupture of membranes (PROM), preeclampsia, and …

Relationship Between Gestational Transient Thyrotoxicosis And Vitamin D, Feri̇t Keri̇m Küçükler, Yasi̇n Şi̇mşek, Ümi̇t Görkem, Berçem Ayçi̇çek Doğan, Serdar Güler

Turkish Journal of Medical Sciences

Background/aim: Gestational transient thyrotoxicosis (GTT) is a transient, mild hyperthyroidism that occurs early in pregnancy and is due to human chorionic gonadotropin. There is no clear information about why only some pregnant women develop GTT. Previous papers stated that vitamin D plays a role in thyroid functions. We aimed to evaluate the relationship between vitamin D and GTT. Materials and methods: Fifty-three patients diagnosed with GTT at the 6th to 10th weeks of gestation were included in the study (GTT group). Thirty-five pregnant women with normal thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels served as a …

Disturbed Body Perception, Reduced Sleep, And Kinesiophobia In Subjects With Pregnancy-Related Persistent Lumbopelvic Pain And Moderate Levels Of Disability: An Exploratory Study, Darren Beales, Alison Lutz, Judith Thompson, Benedict M. Wand, Peter O'Sullivan

Physiotherapy Papers and Journal Articles

Background: For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep impairments, body perception or mindfulness as potential factors associated with disability post-partum.

Objectives: To compare women experiencing no pain post-pregnancy with those experiencing pregnancy-related persistent lumbopelvic pain (either low- or high-level disability) across multiple biopsychosocial domains.

Design: Cross-sectional

Methods: Participants completed questionnaires for thorough profiling of factors thought to be important in pregnancy-related lumbopelvic pain. Specific measures were the Urinary Distress Inventory, Medical Outcomes Study Sleep Scale, Back Beliefs Questionnaire, Tampa …

Does Aerobic Exercise During Pregnancy Prevent Cesarean Sections?, Kait Lassen

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aerobic exercise in pregnant women prevents cesarean sections (“C-sections”).

STUDY DESIGN: Review of two English articles and one English/Portuguese article, two of which were randomized control trials (RCTs) and one was a prospective study, all published after 2011.

DATA SOURCES: Two RCTs and one prospective study found via PubMed and Cochrane Database.

OUTCOMES MEASURED: The main clinical outcome in all studies measured the incidence of C-section as compared to vaginal delivery. The outcomes were measured by method of delivery which was categorized as either vaginally or …

Does Oral Gabapentin Administered Prior To Scheduled Cesarean Delivery Decrease Pain With Movement In Adult Women At 24 Hours As Compared To Placebo?, Ashley E. Boller

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not oral gabapentin administered prior to scheduled cesarean delivery decreases pain with movement in adult women at 24 hours postpartum as compared to placebo.

STUDY DESIGN: Review of three English language, peer-reviewed, primary studies published after 2000.

DATA SOURCES: Three randomized, placebo-controlled trials comparing the efficacy of oral gabapentin to a lactose placebo in adult women undergoing elective cesarean delivery. Sources were selected from PubMed, Medline, Ovid, and the Cochrane Database to include all studies matching the keywords that were published in peer-reviewed, English language …

Life Events, Initial Sexual Behaviors, And Teenage Pregnancy Among African American Females, Yonzetta Brook Tillman

Walden Dissertations and Doctoral Studies

Teenage pregnancy is disproportionate between African American and Caucasian females. This disproportion is notable because African American teenagers are 3 times more likely to become pregnant than their Caucasian counterparts are. The purpose of this study was to determine whether a relationship exists among major life events, sexual behaviors, and resultant teenage pregnancy among African American females in the United States. The theoretical framework for this study was social learning theory. Three key research questions focused on relationships among (a) major life events and initial sexual behavior, (b) ethnicity, and (c) teenage pregnancy. Independent variables were life event and ethnicity, …

Referral And Treatment Settings For Pregnant Women, Linda D. O'Daniel

Walden Dissertations and Doctoral Studies

Drug and alcohol addiction in pregnant women is a significant public health issue. The purpose of this study was to assess drug and alcohol addiction in pregnant women and the setting in which they sought service or treatment to determine whether U.S. census regions and race data could predict the type of addiction service or treatment that pregnant addicts chose. The theories of self-efficacy, cognitive behavioral therapy, and rational emotive behavioral therapy were used as the theoretical framework for this study. The research questions were used to examine whether there was a relationship between the source of addiction treatment referral …

Contraceptive Provision To Adolescent Females Prescribed Teratogenic Medications., Stephani L. Stancil, Melissa K. Miller, Holley Briggs, Daryl Lynch, Kathy Goggin, Gregory Kearns

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population.

METHODS: A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic …

Whole-Genome Sequencing And Disability In The Nicu: Exploring Practical And Ethical Challenges., Michael J. Deem

Manuscripts, Articles, Book Chapters and Other Papers

Clinical whole-genome sequencing (WGS) promises to deliver faster diagnoses and lead to better management of care in the NICU. However,several disability rights advocates have expressed concern that clinical use of genetic technologies may reinforce and perpetuate stigmatization of and discrimination against disabled persons in medical and social contexts. There is growing need, then, for clinicians and bioethicists to consider how the clinical use of WGS in the newborn period might exacerbate such harms to persons with disabilities. This article explores ways to extend these concerns to clinical WGS in neonatal care. By considering these perspectives during the early phases of …

Crp, Hba1c, Lipid, And Biochemical Parameters And Their Relation With Maternal Visceral Adipose Tissue And Subcutaneous Fat Tissue Thickness, Müzeyyen Duran, Aydin Köşüş, Nermi̇n Köşüş, Ni̇lgün Turhan

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to find whether maternal visceral tissue (VAT) or subcutaneous fat tissue (SCFT) thicknesses are associated with CRP, HbA1c, lipid, and biochemical parameters in the first trimester of pregnancy. Materials and methods: Ninety pregnant women were enrolled. Body mass index (BMI), VAT, and SCFT were measured. The best cut-off points for grouping subjects were found to be 4 cm for VAT and 2 cm for SCFT. Venous blood samples were collected. Results: VAT was higher than 4 cm in all cases with high BMIs. High CRP and HbA1c were found in 45.5% and 18.2% …

Early Life Events And Motor Development: A Longitudinal Study, Tegan Grace

Theses

Longitudinal studies are important to fully understand the processes of neurological development during gestation and how risk factors present during this time impact motor development outcomes, yet few to date have focused on this critical time period.

The purpose of this study was to identify modifiable risk factors influencing motor development during the prenatal period. Of particular interest was finding out whether these risk factors differed between the sexes.

Participants (N=2900) were from the Western Australian Pregnancy Cohort (Raine) Study. The Raine Study began in May 1989 and women were recruited between 16-20 weeks gestation (m = 18 weeks) from …

Placental Epigenetics In Children’S Environmental Health, Carmen Marsit

Dartmouth Scholarship

There is a growing interest in understanding the mechanisms that drive the developmental origins of health and disease, and the role of epigenetic regulation has risen to the forefront of these studies. In particular, the placenta may be a model organ to consider as a mediator of the impact of the environment on developmental programming of children's health, as this organ plays a critical role in directing development and regulating the fetal environment. Several recent studies have begun to examine how environmental toxicant exposures can impact the placental epigenome, focusing on studies of DNA methylation and microRNA expression. This review …

Relationship Between Fasting Plasma Glucose Levels And Maternal Food Group And Macronutrient Intakes In Pregnancy, Laura Mullaney, Aisling Brennan, Shona Cawley, Amy C. O'Higgins, Daniel Mccartney, Michael J. Turner

Articles

Aim Increased maternal body mass index (BMI) has been consistently associated with elevated blood glucose levels during pregnancy. Studies to date investigating the relationship between maternal blood glucose levels and dietary intake have shown mixed results. We investigated the association between maternal fasting plasma glucose (FPG) levels and food group and macronutrient intakes in the first trimester of pregnancy, after adjustment for maternal bodyweight.

Methods Women were recruited after sonographic confirmation of an ongoing singleton pregnancy in the first trimester. Dietary information was collected using the validated Willett Food Frequency Questionnaire. Maternal height and weight were measured and BMI calculated. …

Implementation And Evaluation Of Dietary Modification With Gestational Diabetes, Celia T. Ojeaga

Walden Dissertations and Doctoral Studies

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff …

Malaria, Changes In Angiogenesis Factors, Cytokine Profiles And Birth Outcomes, John A. Keenan

All ETDs from UAB

Malaria remains an important public health problem, with over three billion people at risk of infection and as many as 214 million new cases each year. Of particular concern is the effect Plasmodium falciparum malaria has on reproductive health. Malaria is responsible for a wide array of adverse birth outcomes including infant death, low birth weight, preterm delivery and small for gestational age. The mechanism by which malaria influences adverse birth outcomes remains poorly understood. Cross-sectional data from 291 women delivering infants in Ghana are used to investigate whether malaria during pregnancy was associated with select cytokines or angiogenesis factors …

Does Cardiotocography Have A Role In The Antenatal Management Of Pregnancy Complicated By Gestational Diabetes Mellitus?, T Jeffery, R Petersen, J Quinlivan

Medical Papers and Journal Articles

Background: Controversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).

Aim: The aim was to investigate whether antenatal CTG aids the management in pregnancy complicated by GDM. Materials and Methods: A prospective audit of 1404 consecutive antenatal CTGs in women diagnosed with GDM. Outcomes for all CTGs were audited to determine if the CTGs altered pregnancy management.

Results: In women requiring combination therapy (diet and medication), 43 CTGs were required to change management of a pregnancy. In women managed by diet alone with a secondary pregnancy complication, 161 CTGs …

Review Of Diabetes Among Aboriginal And Torres Strait Islander People, Samantha Burrow, Kathy Ride

Research outputs 2014 to 2021

Diabetes is the world’s fastest growing chronic disease. Type 2 diabetes in particular, has reached epidemic proportions globally and in Australia, and poses a challenge for public health systems everywhere. The greatest burden tends to fall on socially disadvantaged groups and Indigenous peoples Aboriginal and Torres Strait Islander Australians experience disproportionately high levels of diabetes. They are three times more likely to have diabetes than non-Indigenous Australians and Aboriginal and Torres Strait Islander women are almost twice as likely to develop gestational diabetes as non-Indigenous women. There is also evidence that Aboriginal and Torres Strait Islander children are eight times …

Racial Disparities In The Association Between Stress And Preterm Birth, Saba W. Masho, Sarah Kye Price, Patricia Anne Kinser, Nancy Jallo

Journal of Health Disparities Research and Practice

Background: High levels of maternal stress have been linked to preterm births. However, findings from previous studies are inconsistent due to the varied use of stress measures. This study examined the effect of maternal stress on preterm birth, using both psychosocial and physiological measures.

Methods: This study was conducted among 231 pregnant women enrolled during their first prenatal care visit. Presence of stress was assessed at enrollment using the Perceived Stress Scale (PSS) and Stressful Life Events Inventory (SLEI). Samples of maternal salivary cortisol were obtained during the first trimester and birth outcomes were ascertained at delivery. Multiple …

Ethnic Differences In Maternal Adipokines During Normal Pregnancy, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African …