Medical Specialties Commons^™

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

Venoarterial Extracorporeal Membrane Oxygenation And Implantable Cardioverter-Defibrillator Implantation In A Hemodynamically Unstable Infant With Ventricular Tachycardia From Multiple Cardiac Rhabdomyomas, Victor Kieu, Richard J. Czosek, Timothy K. Knilans, James A. Quintessenza, Roosevelt Bryant Iii, Shaun Mohan

Pediatrics Faculty Publications

Tuberous sclerosis complex (TSC) is a neurocutaneous disorder characterized by benign tissue hamartomas in multiple organ systems, including cardiac rhabdomyomas. Though prevalent in TSC, cardiac tumors are rare in children, occurring in about 0.03%–0.17%. Rhabdomyomas are the most common, accounting for 45%. When present, they are multiple and in the ventricular myocardium. Frequently, they regress and surveillance is all that is required until spontaneous regression. Intervention is necessary when life-threatening obstruction or hemodynamically significant refractory arrhythmias occur. This case highlights the course of a 6-month-old infant with TSC and cardiac rhabdomyomas who presented in refractory ventricular tachycardia (VT) with decompensation …

A New Paediatric Diabetes Knowledge Test - M-Wikad Development And Factor Analysis., Sarah Tsai, Susana Patton, Stephen Delurgio, David D. Williams, Kavitha Dileepan, Alexander Karmazin, Melinda Storm, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. …

Identification Of Inadvertent Azygous Vein Cannulation Using Transthoracic Echocardiography During Venoarterial Extracorporeal Membrane Oxygenation Initiation., Bethany Runkel, Jason D. Fraser, John Daniel, Karina M. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

It is well known that optimal cannula positioning during initiation of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is directly related to ECMO circuit function. Malpositioned cannulae can have deleterious effects on clinical outcomes, and inadvertent cannulation of the azygous vein during initiation of ECMO is a rare but potentially devastating complication that has been reported only a few times in the literature. Here we report a case of azygous vein cannulation in a neonate that was not identified on chest radiography but was recognized and corrected expeditiously with the use of transthoracic echocardiography.

Improving Communication Of Asthma Related Care Between Pediatric Primary Care Providers And Schools, Jessica N. Heichel

Doctoral Projects

Introduction: Asthma is a life-altering chronic disease that affects many children throughout the state of Michigan. Evidence-based guidelines recommend a written asthma action plan (AAP) be given to all caregivers of children with asthma. This would include schools, but the plans are not making it there. This project focused on collecting school asthma data and designing a process change at a local clinic to send the plans directly to the schools.

Objectives: The goal of this project was to improve communication between healthcare providers and schools for children with asthma. The objectives were to increase the percentage of children with …

Final Defense: Sepsis Screening Tool Assessment At A Freestanding Children’S Hospital In The Midwest, Cassandra Cummings

Doctoral Projects

Pediatric sepsis is a major contributor to childhood morbidity and mortality. Tools for predicting sepsis in pediatric patients have had poor predictive ability nor been validated. Risk assessment screening tools are effective at earlier detection of sepsis. The implementation of an evidence-based pediatric sepsis screening tool could reduce time to detect and diagnose severe sepsis so that patient treatment could occur earlier. This was a quality improvement project that evaluated a sepsis screening tool predictive validity at a children’s hospital.

Health Effects Of A Vegan Diet And Pediatric Cancer Prevention, Lindsay Wisehart

Senior Honors Theses

Veganism is a diet which excludes consumption of all animal products. With proper planning and vitamin supplementation to ensure adequate intake of protein, fat, calcium, zinc, iron, and vitamins D and B12, a vegan diet is widely accepted as suitable for growing and developing children. The decreased levels of dairy, red and processed meats, fat, and protein, and increased levels of fruits and vegetables characteristic of a vegan diet have been shown to reduce risk of mortality and a number of diseases including adult and childhood cancer. Childhood cancer is the second leading cause of childhood death in Western society. …

Retrospective Study Of Patients With Hyperphenylalaninemia: Experience From A Tertiary Care Center In Pakistan, Sibtain Ahmed, Hafsa Majid, Lena Jafri, Aysha Habib Khan, Zeba Zulfiqar Ali, Bushra Afroze

Department of Pathology and Laboratory Medicine

Objective: To assess the clinical and biochemical features as well as outcome of perphenylalaninemia patients.
Methods: The descriptive retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from January 2013 to February 2017 of plasma amino acid analysed at the Biochemical Genetic Laboratory of patients with phenylalanine levels >120 umol/L. Medical charts of patients registered with the Metabolic Clinics were reviewed, while outside referrals were contacted by telephone to collect data on a pre-structured questionnaire. Data was analysed using SPSS 21.
Results: Of the 18 patients, 13(72%) were males. Overall median age was 606 days …

Contextual Design Choices And Partnerships For Scaling Early Child Development Programmes, Kate M. Milner, Raquel Bernal Salazar, Sunil Bhopal, Alexandra Brentani, Pia Rebello Britto, Tarun Dua, Melissa Gladstone, Esther Goh, Jena Hamadani, Muneera Rasheed

Department of Paediatrics and Child Health

Translating the Nurturing Care Framework and unprecedented global policy support for early child development (ECD) into action requires evidence-informed guidance about how to implement ECD programmes at national and regional scale. We completed a literature review and participatory mixed-method evaluation of projects in Saving Brains®, Grand Challenges Canada® funded ECD portfolio across 23 low- and middle-income countries (LMIC). Using an adapted programme cycle, findings from evaluation related to partnerships and leadership, situational analyses, and design for scaling ECD were considered. 39 projects (5 'Transition to Scale' and 34 'Seed') were evaluated. 63% were delivered through health and 84% focused on …

The Incidence Of Pregnancy Hypertension In India, Pakistan, Mozambique, And Nigeria: A Prospective Population-Level Analysis., Laura A. Magee, Sumedha Sharma, Hannah L. Nathan, Olalekan O. Adetoro, Mrutynjaya B. Bellad, Shivaprasad Goudar, Rahat Qureshi, Andrew H. Shennan, Zulfiqar A. Bhutta, Peter Von Dadelszen

Department of Paediatrics and Child Health

Background:
Most pregnancy hypertension estimates in less-developed countries are from cross-sectional hospital surveys and are considered overestimates. We estimated population-based rates by standardised methods in 27 intervention clusters of the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials.
Methods and findings:
CLIP-eligible pregnant women identified in their homes or local primary health centres (2013–2017). Included here are women who had delivered by trial end and received a visit from a community health worker trained to provide supplementary hypertension-oriented care, including standardised blood pressure (BP) measurement. Hypertension (BP ≥ 140/90 mm Hg) was defined as chronic (first detected at <20 weeks gestation) or gestational (≥20 weeks); pre-eclampsia was gestational hypertension plus proteinuria or a pre-eclampsia-defining complication. A multi-level regression model compared hypertension rates and types between countries (p < 0.05 …

Eeg Findings In Infants With Neonatal Abstinence Syndrome Presenting With Clinical Seizures, Murali Reddy Palla, Gulam Q. Khan, Zahra M. Haghighat, Henrietta S. Bada

Pediatrics Faculty Publications

Neonatal abstinence syndrome (NAS) refers to a constellation of signs occurring in newborn infants who were exposed to opioids or opiates in utero. These manifestations include poor feeding, gastrointestinal disorders, abnormal sleep patterns, and neurological signs such as jitteriness, tremors, and seizures (1, 2). Myoclonus, jitteriness, and tremors often may be interpreted as seizures and therefore treated as epileptic seizures.

Objective: To determine whether seizure like activity observed in infants with NAS correlate with electroencephalogram (EEG) findings.

Design/ Method: We reviewed the standard EEG or video electroencephalogram (VEEG) of infants with NAS who were admitted because of seizure-like clinical …

Sport Participation And Specialization Characteristics Among Pediatric Soccer Athletes, Tamara Valovich Mcleod, Michael Israel, Melissa A. Christino, Jane S. Chung, Scott D. Mckay, Pamela J. Lang, David R. Bell, Charles M. Chan, Allison Crepeau, Elizabeth Davis, Amanda L. Fletcher, Jessica Laniak, Kelsie Mccaffrey, Donna M. Pacicca, Mark Riederer, Katherine Rizzone, Jeremy K. Rush, Tracy Zaslow

Manuscripts, Articles, Book Chapters and Other Papers

© The Author(s) 2019.

Background: Soccer is an increasingly popular sport for children and adolescents in the United States. Little is known about participation patterns related to sport specialization.

Purpose: To investigate soccer participation levels and sport specialization characteristics among youth soccer athletes.

Study Design: Cross-sectional study. Methods: Adolescent athletes aged between 12 and 18 years completed an online survey addressing participant demographics, sports and soccer participation history, and level of specialization. Descriptive analyses characterized participation, while chi-square and Kruskal-Wallis tests assessed the influence of specialization, sex, and grade on survey variables.

Results: Overall, 83.7% of 746 respondents participated in …

A Mixed Method Multi-Country Assessment Of Barriers To Implementing Pediatric Inpatient Care Guidelines, Kirkby D. Tickell, Dorothy I. Mangale, Stephanie N. Tornberg-Belanger, Celine Bourdon, Johnstone Thitiri, Molline Timbwa, Jenala Njirammadzi, Wieger Voskuijl, Ali Faisal Saleem, Zaubina Kazi

Department of Paediatrics and Child Health

Introduction: Accelerating progress in reducing child deaths is needed in order to achieve the Sustainable Development Goal child mortality target. This will require a focus on vulnerable children-including young children, those who are undernourished or with acute illnesses requiring hospitalization. Improving adherence to inpatient guidelines may be an important strategy to reduce child mortality, including among the most vulnerable. The aim of our assessment of nine sub-Saharan African and South Asian hospitals was to determine adherence to pediatric inpatient care recommendations, in addition to capacity for and barriers to implementation of guideline-adherent care prior to commencing the Childhood Acute Illness …

Dr. Warady Wins 2019 Karl D. Nolph Lifetime Achievement Award In Dialysis, Children's Mercy Hospital

Our Story Continues

Bradley Warady, MD, Division Director-Pediatric Nephrology and Director-Dialysis and Transplantation, recently was presented with the 2019 Karl D. Nolph Lifetime Achievement Award in Dialysis at the 39th Annual Dialysis Conference in Dallas.

The Nolph award recognizes individuals whose academic achievements exemplify the academic life of Dr. Nolph and have contributed to unique and broader understanding and application of renal replacement therapies, including peritoneal dialysis.

Global Variation Of Nutritional Status In Children Undergoing Chronic Peritoneal Dialysis: A Longitudinal Study Of The International Pediatric Peritoneal Dialysis Network., Franz Schaefer, Laura Benner, Dagmara Borzych-Dużałka, Joshua Zaritsky, Hong Xu, Lesley Rees, Zenaida L Antonio, Erkin Serdaroglu, Nakysa Hooman, Hiren Patel, Lale Sever, Karel Vondrak, Joseph Flynn, Anabella Rébori, William Wong, Tuula Hölttä, Zeynep Yuruk Yildirim, Bruno Ranchin, Ryszard Grenda, Sara Testa, Dorota Drożdz, Attila J. Szabo, Loai Eid, Biswanath Basu, Renata Vitkevic, Cynthia Wong, Stephen J. Pottoore, Dominik Müller, Ruhan Dusunsel, Claudia Gonzalez Celedon, Marc Fila, Lisa Sartz, Anja Sander, Bradley A. Warady, International Pediatric Peritoneal Dialysis Network (Ippn) Registry

Manuscripts, Articles, Book Chapters and Other Papers

While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was …

Great Save! Old Chapel Pews Find New Homes, Children's Mercy Hospital

Our Story Continues

Discusses the preservation of historical artifacts from Children's Mercy Hospital in Kansas City, specifically the restoration of three chapel pews circa 1917 that have new homes in the hospital's marketing and fund-raising departments, and in the new Children's Research Institute building.

Association Of Slco1b1 *14 Allele With Poor Response To Methotrexate In Juvenile Idiopathic Arthritis Patients, Laura B. Ramsey, Halima Moncrieffe, Chelsey Smith, Marc Sudman, Miranda C. Marion, Carl D. Langefeld, Mara L. Becker, Susan D. Thompson

Manuscripts, Articles, Book Chapters and Other Papers

Objective: Variants in the SLCO1B1 gene, encoding a hepatic methotrexate (MTX) transporter, affect clearance of high-dose MTX. We tested whether in the *14 and *15 alleles of SLCO1B1 influenced the response to low-dose MTX in juvenile idiopathic arthritis (JIA) patients.

Methods: The study included 310 JIA patients genotyped for three single nucleotide polymorphisms (SNPs) in SLCO1B1 (rs4149056, rs2306283, and rs11045819). A patient's SLCO1B1 diplotype was determined by combining the SNPs into the *1a, *1b, *4, *5, *14, and *15 alleles. Number of active joints at follow-up (visit closest to 6 months of treatment and prior …

Protecting Women And Children In Conflict Settings, Zulfiqar Ahmed Bhutta, Michelle F. Gaffey, Karl Blanchet, Ron Waldman, Kamran Abbasi

Department of Paediatrics and Child Health

No abstract provided.

Watchful Waiting And Antibiotic Stewardship: A Quality Improvement Project, Rebecca Couper

Seton Hall University DNP Final Projects

Antibiotic misuse and overuse are major contributors to antibiotic resistance which is responsible for the death of 23,000 American’s annually. There is a growing body of evidence that antibiotic stewardship programs are successful in reducing antibiotic prescribing rates while maintaining safe patient care. Research supports a multifaceted approach with an ongoing commitment to antibiotic stewardship. This quality improvement project aimed to reduce the overuse of antibiotics in pediatric acute respiratory tract infections (ARTIs), improve the percentage of children who received laboratory confirmation for the diagnosis and treatment of streptococcal pharyngitis, and to implement and measure the efficacy of watchful waiting …

Edwardsiella Tarda Infection Triggering Acute Relapse In Pediatric Crohn’S Disease, A K Li, M Barton, J A Delport, D Ashok

Paediatrics Publications

Crohn's disease exacerbations can often be associated with bacterial infections causing gastroenteritis. We report a child who experienced exacerbation of his Crohn's disease associated with a positive stool culture for

Pain Management Practices Surrounding Lumbar Punctures In Children: A Survey Of Canadian Emergency Physicians., Naveen Poonai, Victoria Brzozowski, Antonia S Stang, Amy L Drendel, Philippe Boisclair, Michael Miller, Stuart Harman, Samina Ali

Paediatrics Publications

OBJECTIVES:
Lumbar punctures (LPs) are painful for children, and analgesia is recommended by academic societies. However, less than one-third of pediatric emergency physicians (EPs) adhere to recommendations. We assessed the willingness to provide analgesia among pediatric and general EPs and explored patient and provider-specific barriers.

METHODS:
We surveyed physicians in the Pediatric Emergency Research Canada (PERC) or Canadian Association of Emergency Physicians (CAEP) databases from May 1 to August 1, 2016, regarding hypothetical scenarios for a 3-week-old infant, a 3-year-old child, and a 16-year-old child requiring an LP. The primary outcome was the willingness to provide analgesia. Secondary outcomes included …

A Pilot Study Identifying Brain-Targeting Adaptive Immunity In Pediatric Extracorporeal Membrane Oxygenation Patients With Acquired Brain Injury, Sterling B. Ortega, Poornima Pandiyan, Jana Windsor, Vanessa O. Torres, Uma M. Selvaraj, Amy Lee, Michael Morriss, Fenghua Tian, Lakshmi Raman, Ann M. Stowe

Neurology Faculty Publications

OBJECTIVES: Extracorporeal membrane oxygenation provides short-term cardiopulmonary life support, but is associated with peripheral innate inflammation, disruptions in cerebral autoregulation, and acquired brain injury. We tested the hypothesis that extracorporeal membrane oxygenation also induces CNS-directed adaptive immune responses which may exacerbate extracorporeal membrane oxygenation-associated brain injury.

DESIGN: A single center prospective observational study.

SETTING: Pediatric and cardiac ICUs at a single tertiary care, academic center.

PATIENTS: Twenty pediatric extracorporeal membrane oxygenation patients (0-14 yr; 13 females, 7 males) and five nonextracorporeal membrane oxygenation Pediatric Logistic Organ Dysfunction score matched patients.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Venous blood samples were …

Early Neonatal Vitamin A Supplementation And Infant Mortality: An Individual Participant Data Meta-Analysis Of Randomised Controlled Trials, Rajiv Bahl, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Biannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.
Methods: Investigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of …

Effectiveness Of 10-Valent Pneumococcal Conjugate Vaccine Against Vaccine-Type Invasive Pneumococcal Disease In Pakistan, Atif Riaz, Syed Mohiuddin, Sara Husain, Mohammad Tahir Yousafzai, Muhammad Sajid, Furqan Kabir, Najeeb Rehman, Waseem Mirza, Basit Salam, Naila Naila, Khatidja Pardhan, Anita K. M. Zaidi, Syed Asad Ali

Department of Paediatrics and Child Health

Objective: To assess the effectiveness of 10-valent pneumococcal conjugate vaccine (PCV10) against invasive pneumococcal disease (IPD) due to vaccine serotypes of Streptococcus pneumoniae post introduction of the vaccine into the routine immunization program in Pakistan.
Methods: A matched case-control study was conducted at 16 hospitals in Sindh Province, Pakistan. Children aged (eligible to receive PCV10) who presented with radiographically confirmed pneumonia and/or meningitis were enrolled as cases. PCR for the lytA gene was conducted on blood (for radiographic pneumonia) and cerebrospinal fluid (for meningitis) samples to detect S. pneumoniae. The proportion of IPD due to vaccine serotypes (including vaccine-related serogroups) …

Prevalence Of Bacteremia And Bacterial Meningitis In Febrile Neonates And Infants In The Second Month Of Life: A Systematic Review And Meta-Analysis., Eric A. Biondi, Brian R. Lee, Shawn L. Ralston, Jared M. Winikor, Justin F. Lynn, Angela Dixon, Russell Mcculloh

Manuscripts, Articles, Book Chapters and Other Papers

Importance: Febrile neonates (persons in the first month of life) are believed to be at higher risk for bacteremia or bacterial meningitis than infants in their second month of life. However, the true prevalence is unclear.

Objective: To determine modern rates of bacteremia and bacterial meningitis in febrile neonates and infants in the second month of life presenting to an ambulatory setting.

Data Sources: A comprehensive, no-limit search was conducted in PubMed using previously published search terms in February 2015 and repeated in September 2016.

Study Selection: Abstracts and full texts were reviewed independently by several investigators. Studies were included …

Neutralizing Antibody Against Enterovirus D68 In Children And Adults Before 2014 Outbreak, Kansas City, Missouri, Usa, Christopher J. Harrison, William C. Weldon, Barbara A. Pahud, Mary Anne Jackson, M. Steven Oberste, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

© 2019, Centers for Disease Control and Prevention (CDC). All rights reserved. We evaluated enterovirus D68 seroprevalence in Kansas City, Missouri, USA, from samples obtained during 2012-2013. Neutralizing antibodies against Fermon and the dominant 2014 Missouri isolate were universally detected. Titers increased with age. Widespread circulation of enterovirus D68 occurred before the 2014 outbreak. Research is needed to determine a surrogate of protection.

Considerations For Implementing Precision Therapeutics For Children., Matthew J. Mclaughlin, Jonathan B. Wagner, Valentina Shakhnovich, Bruce Carleton, J Steven Leeder

Manuscripts, Articles, Book Chapters and Other Papers

Improving the utilization of pharmacologic agents in the pediatric population yields significant, perhaps life-long, benefits. Genetic factors related to the disposition of a medication or an alteration at the target receptor site contributes to the observed variability of exposure and response between individuals. An additional source of this variability specific to the pediatric population is ontogeny, where age-specific changes during development may require dose adjustments to obtain the same levels of drug exposure and response. With significant improvements in characterizing both the ontogeny and genetic contributions of drug metabolizing enzymes, the time is right to begin placing more emphasis on …

Improving Rural Pediatric Patient Management Through Streamlined High-Volume Patient Clinical Pathways Enhanced By Standardized Nursing Education For Care Confidence, Marie-Cassandre O. Macdonnell

Doctoral Projects

Rural America creates a challenging, poorly financed environment for pediatric health. More than 20 million Americans live in areas with physician shortages too great to meet basic health need (Petlz et al., 2013). In comparing rural versus urban data, rural population experience a 7% higher rate of chronic health conditions (44% versus 37%), increased inpatient costs ($8, 507 versus $7, 174) and higher odds ratios for pediatric 30-day readmission. Findings from Khan et al., (2015) note that hospital readmission rates have higher odds ratios in pediatric patients (95% CI); of Caucasian ethnicity 0.74 [0.65–0.84] to 0.88 [0.79–0.99]); when admitted to …

Description Of An Innovative Pediatric Individualized Therapeutics Clinic: Working Toward Precision Drug Therapy., Tracy L. Sandritter, Jean C. Dinh, Jennifer A. Wagner, Jennifer Lowry

Manuscripts, Articles, Book Chapters and Other Papers

The GOLDILOKs® (Genomic and Ontogeny-Linked Dose Individualization and cLinical Optimization for KidS) Clinic aims to provide families and physicians with data to make more informed decisions with regard to pharmacological therapy by using innovative therapy and genomic technologies. The objectives are two-fold: (1) To describe the utility of the GOLDILOKs® Clinic to referring prescribers by evaluating the type of referrals made to the GOLDILOKs® Clinic and (2) to assess the most often utilized technologies (e.g., genotyping) completed to formulate therapy recommendations. Patient data from July 2010 to June 2016 was retrospectively reviewed following Institutional Review Board (IRB) approval. The GOLDILOKs® …

Maternal And Gestational Influences On Childhood Blood Pressure., Bonita Falkner

Department of Medicine Faculty Papers

Exposures that contribute to a sub-optimal intrauterine environment can have an effect on the developing fetus. Impaired fetal growth that results in low birth weight is an established risk factor for cardio-metabolic disorders later in life. Recent epidemiologic and prospective cohort studies that include the maternal and gestational period have identified maternal and gestational conditions that confer increased risk for subsequent cardio-metabolic disorders in the absence of low birth weight. Maternal pre-conception health status, including chronic obesity and type 2 diabetes, increase risk for childhood obesity and obesity-related higher blood pressure (BP) in child offspring. Maternal gestational exposures, including gestational …