Public Health Commons^™

Neighbourhood Social Vulnerability And Preterm Birth Risk Among Infants With Trisomy 21: A Statewide Analysis, Fatima R Sheriff, Renata H Benjamin, Qian Xiao, Jenil Patel, Charles Shumate, Alejandra Fernandez, A J Agopian

Faculty, Staff and Student Publications

Background: Residing in socioeconomically vulnerable areas is known to be associated with increased preterm birth (PTB) risk in the general population. However, the relationship between social vulnerability and PTB remains unexplored among infants with trisomy 21, who experience more than twice the PTB rate of the general population.

Objectives: The primary objective was to examine the association between maternal socioeconomic vulnerability, as measured by the SVI, and PTB among infants with trisomy 21.

Methods: We conducted a retrospective cohort study among infants with trisomy 21 born in Texas (1999-2018). We examined the association between neighbourhood vulnerability, measured by Social Vulnerability …

Maternal Mental Health: What Utahns Need To Know, Brie Sparks, Susan R. Madsen

Marketing and Strategy Faculty Publications

Pregnancy and the transition to motherhood are often portrayed as joyful and fulfilling experiences, yet many women face significant emotional and psychological challenges. Maternal mental health conditions, including depression and anxiety, are among the most common complications of pregnancy and the postpartum period. Despite growing awareness, stigma, screening gaps, and limited access to care persist. In Utah, where rates are similar to or higher than national averages, expanding screening and resources will create a clearer path to better support mothers and families.

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Global, Regional And National Burden Of Maternal Haemorrhage (2000–2021) And Projections To 2050 In 204 Countries And Territories, Mulat Ayele, Bereket Duko, Tenaw Tiruye, Paul R. Ward, Lillian Mwanri, Gavin Pereira, Tegene Atamenta Kitaw, Biruk Beletew Abate, Eyob Shitie Lake, Abebaw Alamrew, Aynalem Yetwale, Gizachew Yilak, Befkad Derese Tilahun, Chalie Mulugeta, Tadele Emagneneh, Amanuel Tesfay Gebremedhin

Research outputs 2022 to 2026

Objective: To estimate the global, regional and national burden of maternal haemorrhage (2000–2021) and its 2050 projections in 204 countries and territories. Design: This study systematic analysis of the burden of maternal haemorrhage sourced data from the Global Burden of Disease (GBD) 2021 study. We estimated the incidence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs) and years of life lost (YLLs) due to maternal haemorrhage. Changes in the burden from 2000 to 2021 were computed using AAPC. To detect statistically notable changes in the trends of maternal haemorrhage metrics between 2000 and 2021, Joinpoint regression analysis using …

Terminal Digit Preference And Threshold Avoidance In Digital Blood Pressure Measurements During Pregnancy: Secondary Analysis Of Data From The Clip And Precise Cohorts, Peter Dadelszen, Akshdeep Sandhu, Jeffrey Bone, Rahat Qureshi, Olukayode Dada, Ashalata Mallapur, Marleen Temmerman, Marie-Laure Volvert, Joseph Waiswa, Moses Mukhanya, Angela Koech

Centre of Excellence in Women and Child Health

Background:Screening for, detecting, and managing pregnancy hypertension is a core function of antenatal care. To reduce both training requirements and the risks of measurement error in blood pressure (BP) values, automated and semiautomated BP devices have been validated in pregnant women with normal BP and pregnant women with hypertension and introduced for serial antenatal measurement of BP.

Objectives:The study aimed to (1) determine whether or not repeated BP measurements reduced the presence of terminal digit preference and (2) discern whether or not there was evidence of threshold avoidance in the Community-Level Interventions for Preeclampsia (CLIP) trials compared with …

Managing Maternal Anemia In Pregnancy: The Role Of Iron-Rich Foods And Supplementation, Carli Dibler

InnovateHER Meeting 2026

Anemia during pregnancy is a large public health concern, which often leads to independent risk factors for fetal and maternal outcomes including postpartum hemorrhaging, cesarean sections, blood transfusions during and after the labor process, hysterectomies, preterm birth, and infectious diseases. Six level I-III studies were analyzed using the John Hopkins nursing evidence-based practice model. Findings showed that by using a combined approach of dietary intake and supplementation overall leads to better fetal and maternal outcomes compared to supplementation alone.

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

The Intersection Between Adolescent Pregnancy, Mental Health Concerns, Stigma, And Sex Education, Madelon Cox

Honors Program: Senior Projects (Public)

This thesis discusses research from the past two decades focused on factors contributing to an increased risk of adolescent pregnancy and the lasting impact of that pregnancy. The consequences of being a pregnant adolescent can be compounded by race, gender, socioeconomic class, and access to education. Adolescent pregnancy also carries significant physical and mental health risk for the adolescent and the child. Awareness and various interventions can help pregnant adolescents or those who may be at risk for adolescent pregnancy to support them, prevent isolation, and reduce further negative mental health conditions, such as depression and anxiety.

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

A Bilingual Ai-Based Chatbot For Nutrition Education In A Food Is Medicine Intervention For High-Risk Pregnant Women: Design And Development Study, Lorena Macias-Navarro, Nalini Ranjit, Gregory W Bounds, Brendon A Providence, Yesmeena Shmaitelly, Naomi M Tice, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use.

Objective: This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM …

Leading With Hope: A Clinical Communication Campaign To Promote Partner Hiv Testing In Assisted Partner Notification And Antenatal Care Programs In Uganda., Emily A. Hurley, Violet Gwokyala, Linda Kisaakye Nabitaka, Jolly Beyeza Kashesya, Mercylynn Agasha, Florence Namaganda, Nikolaus Schuetz, J Nalubega Ross, Joseph K B Matovu, Rhoda Wanyenze, Glenn Wagner, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

Among heterosexual couples in sub-Saharan Africa, fears of relationship dissolution and inability to bear healthy children following an HIV-positive result remain barriers to HIV testing. Recently expanded availability of pre-exposure prophylaxis (PrEP) affords a critical opportunity to promote HIV testing with reassuring communication that highlights use for relationship preservation and healthy childbearing. We aimed to develop a theoretically-grounded communication intervention to promote partner HIV testing within assisted partner notification (APN) and antenatal care (ANC) programs in Uganda. Through an 18-month iterative co-creation process, we developed the HOPE Clinical Communication Campaign (HOPE-CCC) in collaboration with a project advisory board (PAB) of …

Identifying Delays Impacting Maternal And Perinatal Deaths Using A Facility-Based Death Audit Review System Integrated With Community Engagement: A Mixed Methods Study, Zahid Memon, Wardah Ahmed, Shah Muhammad, Sajid Soofi, Shanti Chouhan, Arjumad Rizvi, Paul Barach, Zulfiqar A. Bhutta

College of Population Health Faculty Papers

BACKGROUND: Pakistan's persistently high maternal (178 per 100 000 livebirths) and neonatal (41 per 1000 livebirths) mortality ratios are compounded by lack of reliable data on the root causes and preventable risk factors, which hinders their effective use in improving care and progress toward safe, high-quality services. We sought to identify system delays impacting maternal and perinatal deaths using a facility-based death audit review system integrated with community engagement for implementing actionable solutions.

METHODS: We used a mixed methods, concurrent parallel study design at three secondary level healthcare facilities in District Matiari, Sindh, Pakistan. We reviewed 319 cases that included …

Occupational Therapy For Maternal Pelvic Floor And Mental Health: A Holistic Approach To Recovery, Diana S. Theodore

Student Capstone Papers

Maternal pelvic floor dysfunction (PFD) is highly prevalent yet often underrecognized in occupational therapy practice, despite its significant impact on mental health, daily function, and quality of life. Many postpartum women experience symptoms such as urinary incontinence, pain with intimacy, and pelvic organ prolapse, which are frequently normalized or left untreated. Occupational therapy practitioners often have limited training in addressing the complex relationship between pelvic floor function and maternal mental health, contributing to gaps in care. The purpose of this capstone project was to develop a comprehensive handbook for occupational therapy students and practitioners integrating pelvic floor function and maternal …

First Covid-19 Vaccination Rates Among Pregnant Tennessee Women By Month Of Conception And Urbanization Level: March 2021 – November 2021, Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate

Journal of Appalachian Health

Introduction: Throughout the pandemic, COVID-19 vaccination coverage was lower for the general population living in rural counties than in urban counties. In Tennessee (TN), COVID-19 vaccinations became available to pregnant women in March 2021. Little is known about rates of COVID-19 vaccination in pregnancy during the pandemic, or whether these rates changed or differed by urbanization level.

Purpose: The purpose of this study is to describe COVID-19 vaccination rates among pregnant women in TN by month of conception and urbanization level.

Methods: COVID-19 vaccination data from the TN Immunization Information System and the TN Surveillance for Emerging Threats to Mothers …

Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

Psychosocial Mediators Of A Physical Activity And Dietary Intervention In Pregnant Women With Overweight Or Obesity, Meghan Baruth, Sarah Wilcox, Jihong Liu, Rebecca Schlaff

Faculty Publications

Background

Mediation analyses provide insight into both ‘pieces’ of the mediation chain; they allow us to look into the ‘black box’ that is behavior change. They allow researchers to better understand the ‘how’ of an intervention’s effects and/or the ‘why’ behind why an intervention worked or did not work. The lack of publications in pregnant populations highlights the need for additional studies to be conducted and published. The purpose of this study is to examine the psychosocial mediators of physical activity and dietary outcomes in a sample of pregnant women with overweight or obesity participating in the Health in Pregnancy …

Maternal Infection At Delivery And Risk Of Stillbirth And Early Neonatal Death: Nested Case-Control Studies In East African Pregnancy Cohorts, Anna Seale, Meron Kebede, Rosanna Glazik, Mussie Brhane, Mulu Berihun, Zelalem Teklemariam, Dadi Marami, Joseph Oundo, Tadesse Gure, Angela Koech

Centre of Excellence in Women and Child Health

Background Stillbirths and early neonatal deaths remain common in low- and middle-income countries. Maternal infections are likely contributors, but data are extremely limited. We aimed to describe maternal infections at delivery and their association with perinatal death.

Methods We investigated maternal infections at delivery in two hospitals in East Africa: in Kilifi County Hospital (2011–2017), Kenya, and Hiwot Fana Comprehensive Specialised Hospital (2019–2020), Ethiopia. We compared 642 mothers delivering stillbirths/newborns dying in the first 24 h after birth (cases) and 855 mothers with newborns surviving ≥ 24 h (controls) from pregnancy cohorts. We tested maternal blood with molecular diagnostic panels …

Low-Dose Aspirin For Preventing Intrauterine Growth Restriction And Pre-Eclampsia In Sickle Cell Pregnancy, Lydia Pecker, Sophie Lanzkron

Cardeza Foundation for Hematologic Research

No abstract provided.

Bridging Ipv And Sud For Pregnant And Postpartum Women: A Case Report Of Interdisciplinary Programming In Mississippi, Catherine Poehling, Masoumeh Karimi, Chinedu Chukwu, Jerome R. Kolbo, Xiaoshan Gordy, Saijun Zhang, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsanee Davis, Sonja Fuqua, Mary M. Wesley, Lei Zhang

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Stumping The Federal Effort: Southern States’ Contributions To The United States’ Leading Maternal Mortality Rate, Natalie A. Snook

Arkansas Law Review

Maternal care has reached a terrifying deficit in the United States. Masses of women throughout this nation are dying preventable deaths resulting from extremely lacking prenatal, birthing, delivery, and postnatal care. This is a silent epidemic. Why is the United States failing so miserably in comparison to its fellow developed countries? Why does the gap appear to be widening more and more each day? Various factors lend themselves to an explanation: general factors like the overall shortage of maternal care providers, as well as specific ones such as the not-so surprising fact that the United States is the only developed …

Group Antenatal Care Model As An Innovative And Sustainable Maternal And Child Health Service Delivery In A Northern Nigerian State, Pius I. Christopher-Izere, Abiola Ajibola, Abimbola Phillips, Dorcas Magbadelo, Ibidun Jolaoso, Obioma Azurunwa, Francis Ogirima, Collins Imarhiagbe, Anthony Onwuegbusi, David Udanwojo, Emmanuel Udeh, Victor Obagunlu, Adebola Adekogbe, Sunday Joseph, Hamza Abubakar, Neyu Iiyasu, Adetosoye Adebanjo, Barlarbe Gaya, Olayiwola Jaiyeola, Damilola Olaniyan, Bankole Olatosi Ph.D., Deborah Lynn Billings Ph.D., Et. Al.

Faculty Publications

The maternal and child health situation in developing countries remains critical and deeply concerning, These regions account for 99% of global maternal and under-five deaths. In Nigeria, uptake of critical life-saving maternal, neonatal and child health (MNCH) services, delivered through antenatal care (ANC), are sub-optimal, leading to poor outcomes. Group antenatal care (G-ANC) is an evolving antenatal care delivery model in low and medium-income countries. G-ANC models can improve quality and uptake of maternal health services.G-ANC model was implemented across 255 primary health facilities (PHFs) to ensure pregnant women receive components of a well-defined package of MNCH services at regular …

“My Heart Was In My Stomach”: Texas-Based Obstetricians’ And Gynecologists’ Experiences Post Anti-Abortion Legislation, Chelsey Kanipe, Precious Chiamaka Anunobi, Anupria D Davenport, Sheryl A Mccurdy, Marie A Brault

Faculty, Staff and Student Publications

Background

The purpose of this study is to investigate the downstream effects of anti-abortion legislation on the practice of obstetrics and gynecology in urban Texas.

Methods

We conducted semi-structured interviews until saturation with eleven obstetricians/gynecologists (OBGYNs) to explore the effects of Texas’s abortion laws. Analysis consisted of inductive and deductive approaches.

Results

We identified three main themes regarding the downstream effects of Texas abortion laws: the conflicting role of colleagues as a support system and a source of frustration and distrust for OBGYNs, the lowered standard of care for those with a desired pregnancy, and concerns that anti-abortion legislation will …

Fathers, Futures, And Fragile Contexts: Men’S Intergenerational Perspectives On Pregnancy In A Low-Income South African Setting, Urlridge A. Thompson, Johanni Beukes, Michelle Leal, Stephanie Alcock, Stephen Lye, Shane A. Norris, Catherine Draper

Journal of Social, Behavioral, and Health Sciences

Men’s involvement in their partner’s pregnancy in low-income South African settings is influenced by a complex interplay of contextual factors that influence the nature and extent of their participation. The confluence of these factors contributes to limiting men’s adoption of an intergenerational perspective of their partner’s pregnancy. The adoption of an intergenerational perspective by men may enhance outcomes for maternal and child health, but it remains understudied. This qualitative study explored intergenerational perspectives of men in Soweto, South Africa, regarding their partners’ pregnancies. An exploratory descriptive qualitative approach was employed. We conducted in-depth individual interviews with 19 male partners (fathers …

Qualitative Exploration Of Factors Associated With Covid-19 Vaccination Among Pregnant Women In Kenya, Violet Naanyu, Ferdinand Okwaro, Ingrid Gichere, Mandeep Sura, Prachi Singh, Berhaun Fesshaye, Marleen Temmerman

Centre of Excellence in Women and Child Health

The COVID-19 pandemic significantly disrupted societies worldwide, and COVID-19 vaccination has been identified as instrumental in the fight against the pandemic. While studies have examined uptake of COVID-19 vaccination, more research is needed to gain a better understanding of the factors influencing pregnant women’s decisions to get vaccinated. In this study, we used a cross-sectional descriptive qualitative study to explore the attitudes, beliefs, and behaviors related to COVID-19 vaccination during pregnancy in Kenya. A total of 50 in-depth interviews were conducted between October 2023 to March 2024 with a purposively drawn sample of 25 pregnant and 25 postpartum women during …

Women With Moderate Anaemia Prior To Conception Benefited Most From Nutrition Interventions: A Secondary Analysis Of The Women First Preconception Maternal Nutrition Trial, Sumera Aziz Ali, Ka Kahe, Jeanine Genkinger, Linda Valeri, Sarah Saleem, Saleem Jessani, Robert Goldenberg, Jamie Westcott, Jennifer Kemp, Ana Garces, Lester Figueroa, Shivaprasad Goudar, Sangappa Dhaded, Richard Derman, Antoinette Tshefu Kitoto, Adrien Lokangaka, Melissa Bauserman, Elizabeth Mcclure, Marion Koso-Thomas, Louise Kuhn, Nancy Krebs

Global Health Articles

INTRODUCTION: The Women First (WF) Preconception Maternal Nutrition trial found greater benefits of small-quantity lipid-based nutrient supplements (SQ-LNS) for intrauterine growth among anaemic versus non-anaemic women at preconception. We investigated whether the benefits of SQ-LNS in improving markers of intrauterine growth occurred evenly across the mild to moderate spectrum of pre-pregnancy anaemia.

METHODS: We analysed WF data (n=2443 maternal-newborn dyads) from Pakistan, India, Guatemala and the Democratic Republic of Congo. Women received SQ-LNS either ≥3 months preconception through pregnancy (Arm 1); starting in the late first trimester (Arm 2); or not at all (Arm 3: control), with all supplementations discontinued …

Characteristics And Effectiveness Of Maternal Health Interventions To Prevent Mother-To-Child Transmission (Pmtct) Of Syphilis In A Global Setting: A Scoping Review Using Intervention Mapping As A Framework, Jinni Tang, Anusha Sajja, Christine Markham, Emily T Hebert, Irene Stafford, Sheryl Dacso, Melissa F Peskin

Faculty, Staff and Student Publications

Background: Despite the availability of cost-effective treatments, maternal syphilis continues to contribute significantly to preventable stillbirths and congenital syphilis cases worldwide. This scoping review aimed to identify and characterize maternal health interventions designed to prevent mother-to-child transmission (PMTCT) of syphilis globally, using a modified Intervention Mapping (IM) framework.

Methods: We conducted a scoping review of maternal health interventions targeting PMTCT of syphilis published between January 2010 and August 2023. Searches were performed in PubMed, Medline Ovid, and Embase, supplemented by manual reference screening. Eligible studies described at least one maternal health intervention addressing syphilis PMTCT and were analyzed using a …

M-O-M-S On The Bayou: Implementation Of An Intervention To Improve Mental Health After Disaster, E. W. Harville, Gloria Giarratano, M. Patterson, M. Schultheis, K. S. Dorans, S. Turner, S. Harris, S. Longo, K. Weis

School of Nursing Faculty Publications

Pregnant women are a vulnerable population after disaster. Their health may be improved through community-based support programs in addition to their standard prenatal care. We conducted a prenatal peer support program, Mentors Offering Maternal Support (M-O-M-S), focused on improving mental health in hurricane-affected areas in southern Louisiana. M-O-M-S consists of six biweekly sessions covering pregnancy acceptance, maternal role identification, family and partner relationships, preparation for labor/fears around labor, well-being/safety of self and baby, and post-delivery health and maternal-infant bonding. The program is led by a “mentor”, an experienced mother but not necessarily a clinician or social worker, who guides the …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …