Medicine and Health Sciences Commons^™

Evidence-Based Public Health Practices For Screening For Postpartum Depression, Roula Hilli

Master of Public Health Program Student Publications

Background: Five to 20 percent of the women worldwide suffer from Post Partum depression (PPD) which has serious negative impacts on the mother and her newborn. Although PPD is a preventive disease thorough screening using different tools, half of its cases are left undetected.

Purpose of the study: Is to find the best practice for PPD screening, which includes the best screening tool, best setting for screening, best administration period and the best cut-off score.

Methods: It is an Evidence-based Public Health (EBPH) review through a comparative study of 82 studies since 2005 that screened women for PPD in the …

Evaluation Of Rubella, Toxoplasma Gondii, And Cytomegalovirus Seroprevalences Among Pregnant Women In Denizli Province, Aysun Karabulut, Yusuf Polat, Meral Türk, Yasemi̇n Işik Balci

Turkish Journal of Medical Sciences

There is no national screening program for rubella, Toxoplasma gondii, and cytomegalovirus (CMV) infections for pregnant women in Turkey. The purpose of this study was to determine the prevalence of these infections among pregnant women in Denizli province, and to review seroprevalences reported from different regions of Turkey. Materials and methods: Between April 2008 and April 2009, 1268 women were investigated for rubella, 1102 for toxoplasma, and 1000 women for CMV seroprevalences in the first trimester of pregnancy. Toxoplasma and rubella IgM and IgG antibodies were assayed by the automated Vitros ECiQ system based on an immunometric technique. Cytomegalovirus IgM …

Serum Paraoxonase And Arylesterase Activities In Iron Deficiency Anemia During Pregnancy, Hakan Camuzcuoğlu, Harun Toy, Mehmet Vural, Aysun Camuzcuoğlu, Abdullah Taşkin, Haki̇m Çeli̇k

Turkish Journal of Medical Sciences

To investigate serum paraoxonase and arylesterase activities, and lipid hydroperoxide levels in pregnant women with iron deficiency anemia. Materials and methods: Paraoxonase and arylesterase activities, and lipid hydroperoxide levels were assessed for pregnant women with iron deficiency anemia (n = 50) and controls (n = 70). Serum basal and salt-stimulated paraoxonase, and arylesterase activities were measured spectrophotometrically. The lipid hydroperoxide levels were measured by ferrous ion oxidation xylenol orange assay. In addition, lipid parameters were determined by routine laboratory methods. Results: Basal and salt-stimulated paraoxonase, and arylesterase activities were significantly lower (P = 0.026, P = 0.031, and P = …

A Comparison Of Intravenous General Anesthesia And Paracervical Block For In Vitro Fertilization: Effects On Oocytes Using The Transvaginal Technique, Sevi̇l Bümen, İlkben Günüşen, Vi̇cdan Firat, Semra Karaman, Ayşi̇n Akdoğan, Ege Nazan Tavmergen Göker

Turkish Journal of Medical Sciences

To compare the effects of 2 different anesthetic techniques used for oocyte retrieval. Comparison was made based on the number of retrieved and fertilized oocytes, metaphase 2 (M2, mature) oocytes, and transferred embryos, as well as fertilization, pregnancy, and live birth rates. Ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization is one of the most common minor surgical procedures. Despite this, it is stressful and painful for the patient; most patients request sedation and/or pain relief. Propofol, which is frequently used for general anesthesia in such procedures, has been suspected to damage oocytes. Materials and methods: Results from 70 patients …

Icsi Outcome In Severely Oligoasthenozoospermic Patients And Its Relationship To Prewash Progressive Sperm Motility*, Ni̇lgün Turhan, Aslihan Pekel, Ayli̇n Ayrim, Ömer Bayrak

Turkish Journal of Medical Sciences

To investigate the association between prewash progressive sperm motility and pregnancy rate in cases of severely oligoasthenozoospermic patients in intracytoplasmic sperm injection (ICSI) cycles. Materials and methods: The study included 80 infertile couples who were treated by ICSI due to severe oligoasthenozoospermia (

Factors Associated With Tobacco Use Among Rural And Urban Pregnant Women, Whitney Jeanne Katirai

University of Kentucky Doctoral Dissertations

The purpose of this study was to investigate the influences of smoking on rural and urban pregnant women. More specifically, the variables of the knowledge of health effects, health provider recommendations, subscores from the Health Belief Model (HBM), and social support were explored in relation to the smoking behavior of pregnant women. A secondary purpose was to investigate the accuracy of self-reported smoking during pregnancy using biochemical validation. Pregnant women (N=71) completed an anonymous questionnaire, designed by the researcher, to identify variables that predicted smoking for urban and rural women. Participants also gave a saliva sample for cotinine testing.

Approximately …

Gestational Diabetes, Depression, And The Impact On Maternal Child Health Outcomes, Mary Alice Byrn

Dissertations

Antenatal depression occurs in about 20% of all pregnancies and gestational diabetes occurs in up to 14% of all pregnancies. Although there is sufficient information on (1) depression during pregnancy and (2) depression and diabetes, there is little information about depression and gestational diabetes. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression. The study aims were the following: (1) to determine whether women with gestational diabetes had more depression than women without gestational diabetes, (2) to determine whether factors predictive of depression in pregnant women with gestational diabetes were different from …

Prenatal Programming Of Human Neurological Function, Curt A. Sandman, Elyssia Poggi Davis, Claudia Buss, Laura M. Glynn

Psychology Faculty Articles and Research

The human placenta expresses the genes for proopiomelanocortin and the major stress hormone, corticotropin-releasing hormone (CRH), profoundly altering the "fight or flight" stress system in mother and fetus. As pregnancy progresses, the levels of these stress hormones, including maternal cortisol, increase dramatically. These endocrine changes are important for fetal maturation, but if the levels are altered (e.g., in response to stress), they influence (program) the fetal nervous system with long-term consequences. The evidence indicates that fetal exposure to elevated levels of stress hormones (i) delays fetal nervous system maturation, (ii) restricts the neuromuscular development and alters the stress response of …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

Development Of Fetal Movement Between 26 And 36 Weeks’ Gestation In Response To Vibroacoustic Stimulation, Marybeth Grant-Beuttler, Laura M. Glynn, Amy L. Salisbury, Elyssia Poggi Davis, Carol Holliday, Curt A. Sandman

Psychology Faculty Articles and Research

BACKGROUND: Ultrasound observation of fetal movement has documented general trends in motor development and fetal age when motor response to stimulation is observed. Evaluation of fetal movement quality, in addition to specific motor activity, may improve documentation of motor development and highlight specific motor responses to stimulation.

AIM: The aim of this investigation was to assess fetal movement at 26 and 36-weeks gestation during three conditions (baseline, immediate response to vibro-acoustic stimulation (VAS), and post-response).

DESIGN: A prospective, longitudinal design was utilized.

SUBJECTS: Twelve normally developing fetuses, eight females and four males, were examined with continuous ultrasound imaging.

OUTCOME MEASURES: …

Tdp-43 Potentiates Alpha-Synuclein Toxicity To Dopaminergic Neurons In Transgenic Mice., Tian Tian, Cao Huang, Jianbin Tong, Ming Yang, Hongxia Zhou, Xugang Xia

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

TDP-43 and α-synuclein are two disease proteins involved in a wide range of neurodegenerative diseases. While TDP-43 proteinopathy is considered a pathologic hallmark of sporadic amyotrophic lateral sclerosis and frontotemporal lobe degeneration, α-synuclein is a major component of Lewy body characteristic of Parkinson's disease. Intriguingly, TDP-43 proteinopathy also coexists with Lewy body and with synucleinopathy in certain disease conditions. Here we reported the effects of TDP-43 on α-synuclein neurotoxicity in transgenic mice. Overexpression of mutant TDP-43 (M337V substitution) in mice caused early death in transgenic founders, but overexpression of normal TDP-43 only induced a moderate loss of cortical neurons in …

A Comparison Of Latina Women In Centeringpregnancy And Individual Prenatal Care, Tara E. Trudnak

USF Tampa Graduate Theses and Dissertations

CenteringPregnancy is a model of group prenatal care that replaces routine, individual prenatal care. The program brings women together into small groups to receive their care and prenatal education, and is based on three components: risk assessment, education, and support. The model is client-centered, designed to empower pregnant women and support persons, and involves the woman in small group discussions of 8-10 other women of similar gestational age. The group discussions provide support, help women educate each other, and invoke self-monitoring. Currently, there have been few publications that closely examined maternal weight and obesity and associated outcomes in women involved …

Milk Composition And Yield Changes With Advancing Pregnancy In Dairy Buffaloes (Bubalus Bubalis), Sarzamin Khan, Muhammad Subhan Qureshi, Ifthiar Ahmed, Syed Mirajullah Shah

Turkish Journal of Veterinary & Animal Sciences

The changes in the composition of milk with advancing pregnancy were investigated in Nili-Ravi dairy buffaloes. Forty lactating buffaloes were used, within 2-3 months postpartum. The animals were grouped as high, moderate, and low yielders; synchronized for estrus; and inseminated artificially. Milk yield was recorded daily and sampled fortnightly for analysis. The data were analyzed using the univariate weighted mean and general linear model. Decline in milk yield became significant after the 8th week post-conception. The high yielders had the lowest fat contents. Milk fat increased significantly during succeeding weeks post-conception. The highest fat level (8.5%) was observed in week …

Addressing The Fertility Needs Of Hiv-Seropositive Males, Brian A. Levine, Sahadat K. Nurudeen, Jennifer T. Gosselin, Mark V. Sauer

Psychology Faculty Publications

An increasing number of serodiscordant couples are utilizing advanced reproductive technologies to address their reproductive needs. Recent literature has demonstrated that it is not only technically possible but also safe to utilize sperm-washing techniques to allow for the creation of embryos, thereby preventing both horizontal and vertical transmission of HIV. This article addresses the strengths and weakness of various reproductive techniques and discusses our experience at Columbia University (NY, USA), the location of the largest HIV-focused fertility program in the USA.

Prenatal Diagnosis And Risk Factors For Preoperative Death In Neonates With Single Right Ventricle And Systemic Outflow Obstruction: Screening Data From The Pediatric Heart Network Single Ventricle Reconstruction Trial(∗)., Andrew M. Atz, Thomas G. Travison, Ismee A. Williams, Gail D. Pearson, Peter C. Laussen, William T. Mahle, Amanda L. Cook, Joel A. Kirsh, Mark Sklansky, Svetlana Khaikin, Caren Goldberg, Michele Frommelt, Catherine Krawczeski, Michael D. Puchalski, Jeffrey P. Jacobs, Jeanne M. Baffa, Jack Rychik, Richard G. Ohye, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this analysis was to assess preoperative risk factors before the first-stage Norwood procedure in infants with hypoplastic left heart syndrome and related single-ventricle lesions and to evaluate practice patterns in prenatal diagnosis, as well as the role of prenatal diagnosis in outcome.

METHODS: Data from all live births with morphologic single right ventricle and systemic outflow obstruction screened for the Pediatric Heart Network's Single Ventricle Reconstruction Trial were used to investigate prenatal diagnosis and preoperative risk factors. Demographics, gestational age, prenatal diagnosis status, presence of major extracardiac congenital abnormalities, and preoperative mortality rates were recorded.

RESULTS: …

An Exploration Of "The 'Wild West' Of Reproductive Technology": Ethical And Feminist Perspectives On Sex-Selection Practices In The United States, Meredith Leigh Birdsall

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

A Case Study In Unethical Transgressive Bioethics: "Letter Of Concern From Bioethicists" About The Prenatal Administration Of Dexamethasone., Laurence B Mccullough, Frank A Chervenak, Robert L Brent, Benjamin Hippen

Department of Pediatrics Faculty Papers

On February 3, 2010, a "Letter of Concern from Bioethicists," organized by fetaldex.org, was sent to report suspected violations of the ethics of human subjects research in the off-label use of dexamethasone during pregnancy by Dr. Maria New. Copies of this letter were submitted to the FDA Office of Pediatric Therapeutics, the Department of Health and Human Services (DHHS) Office for Human Research Protections, and three universities where Dr. New has held or holds appointments. We provide a critical appraisal of the Letter of Concern and show that it makes false claims, misrepresents scientific publications and websites, fails to meet …

Lybarger, Shaunn Maree (Fa 115), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

"Menstruation: Childbirth and Child-rearing." Independent study compiled for a Western Kentucky University Folk Studies class. Utilizing existing Folklife Archives collections, Lybarger referenced beliefs, customs, and cures associated with fertility, families, child-rearing, and menstruation.

The Perils Of The Imperfect Expectation Of The Perfect Baby., Frank A Chervenak, Laurence B Mccullough, Robert L Brent

Department of Pediatrics Faculty Papers

Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine's control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care of pregnant women with expectations for a perfect baby. We use Nathaniel Hawthorne's classic short story, "The Birthmark," to illustrate the perils of the logic of control and perfection through science and then identify possible contemporary sources of the expectation of the perfect baby. We propose that the informed consent …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Experiences With Infant Mortality As Reported By Middle Class Black Women In Their Own Words, Lisa Paisley-Cleveland

Dissertations, Theses, and Capstone Projects

Black Middle-Class Women and Pregnancy Loss: A Qualitative Inquiry is the first qualitative research case study of its kind on Black Infant Mortality (BIM) to focus on a target group of black American-born middle-class professional married women who have all lived through the experience of infant loss. This target group allows Lisa Paisley-Cleveland to examine the BIM phenomenon outside the poverty paradigm and issues attached to teenage pregnancy, as well as to explore contributing factors attached to the persistent black and white disparity in infant mortality rates, which according to CDC’s January 2013 report are 12.40 and 5.35 respectively.

This …

The Association Between Prenatal Care Content And Quality With Preterm Birth And Maternal Postpartum Health Behaviors, Susan Cha

Theses and Dissertations

Background: Health policies that seek to improve pregnancy outcomes focus on increasing the availability and access to prenatal care (PNC) services based on studies that support an association between insufficient PNC and adverse birth outcomes. These studies employ PNC utilization indices that measure the adequacy of PNC use, but these indices fail to account for the content or specific components of PNC. Objectives: The purpose of this study was to utilize PRAMS and birth certificate data to evaluate the content and quality of PNC in Virginia, and its impact on preterm birth and maternal postpartum health behaviors. Methods: Data was …

The Effects Of Motivational Interviewing In Pregnancy On Knowledge And Retention Of Infant Oral Health Information, Andrew Zima

Theses and Dissertations

THE EFFECTS OF MOTIVATIONAL INTERVIEWING IN PREGNANCY ON KNOWLEDGE AND RETENTION OF INFANT ORAL HEALTH INFORMATION By Andrew D. Zima, Jr., B.S., M.S., D.D.S. A thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2010 Major Director: Tegwyn H. Brickhouse, D.D.S., Ph.D Associate Professor, Department of Pediatric Dentistry Purpose: The purpose was to examine the effect of motivational counseling in pregnancy with readiness and acceptance of infant oral health information. Methods: The study used a prospective cohort design to examine the effect of prenatal education …

Parity-Induced Decrease In Systemic Growth Hormone Alters Mammary Gland Signaling: A Potential Role In Pregnancy Protection From Breast Cancer, Robert K. Dearth, David A. Delgado, Jill K. Hiney, Thushangi Pathiraja, Steffi Oesterreich, Dan Medina, W. Les Dees, Adrian V. Lee

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

Early full-term pregnancy is an effective natural protection against breast cancer in both humans and experimental rodents. The protective effect of an early pregnancy is in part linked to changes in circulating hormones that are involved in both normal breast development and breast cancer. For example, a reduction in circulating growth hormone (GH) has been shown to protect rats from carcinogen-induced mammary tumors. We examined the ability of a full-term pregnancy to alter the endocrine GH/IGF-I axis and how this change affected normal mammary gland function in two commonly used rat models (Sprague-Dawley and Wistar-Furth). Circulating GH and IGF-I were …

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

Factor Vii Deficiency And Pregnancy: A Case Report And Review Of Literature, Syed Mohammad Asad Zaidi, Rahat Qureshi, Salman Naseem Adil

Department of Obstetrics & Gynaecology

Factor VII deficiency is one of the 'rare inherited disorders of coagulation.' Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures. Delivery was carried out via Caesarean section due to non-reassuring foetal heart monitoring. Patient was treated with Fresh Frozen Plasma (FFPs) and Factor VII concentrates, however, the patient developed bleeding postoperatively. Literature indicates that whilst Factor VII levels rise during pregnancy in normal women, no increase is seen in …

Pregnancy Associated Breast Cancer: An Analysis Of Fetal Treatment Risk, Melissa Barnett

The Science Journal of the Lander College of Arts and Sciences

There are several viable treatment options for patients with PABC considered un-harmful to fetal development. Trastusumab, or Herceptin, targets HER2 protein and successfully combats aggressive breast cancer. In standard doses, it appears to be safe to the fetus even when administered during the first trimester. A likely side effect of Herceptin is anhydramnios, which can be monitored for throughout the stages of a pregnancy (Shrim et al. 2008). Anthracyclines, commonly used in chemotherapy, appear to be non-toxic, and have been used to successfully cure PABC patients in their second and third trimester. However, first trimester spontaneous abortions are documented to …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Periodontal Disease And Adverse Pregnancy Outcomes: Treatment Recommendations For The Pregnant Patient, Tabitha Price

ETSU Faculty Works

No abstract provided.