Public Health Commons^™

Patient Perspectives On Noninvasive Prenatal Testing Among Black Women In The United States: A Scoping Review, Shameka P. Thomas, Madison A. Keller, Tiara Ranson, Rachele E. Willard

School of Medicine Faculty Publications

Advances in reproductive health technologies such as noninvasive prenatal testing (NIPT) are changing the landscape of prenatal care and maternal health. NIPT, made clinically available in the United States (US) in 2011, is a screening test that utilizes cell-free DNA (cfDNA) to detect for aneuploidies and genetic characteristics in fetal DNA. In September 2020, the American College of Obstetricians and Gynecologists (ACOG) recommended NIPT for all pregnant patients regardless of age or risk factors. We examined peer-reviewed, empirical studies published from January 2011 to February 2022, assessing NIPT studies with patient perspectives in the US and what is known about …

Accuracy Of The Drug-Dependency Checkbox On The Maine Birth Certificate For Medicaid-Covered Births, 2016-2020, Julia Dudley Ba, Catherine Mcguire Bs, Apsara Kumarage Ba, Chinonye Anumaka Mph, Katherine Ahrens Phd

Journal of Maine Medical Center

Introduction: The accuracy of the drug-dependency checkbox on Maine birth certificates is unknown. Our objective was to compare the drug-dependency checkbox with information on substance use disorders (SUDs) documented in Medicaid claims.

Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to Maine birth-record data between 2016 and 2020 (N = 58 584). Among the linked records (n = 27 448), we identified maternal SUD diagnoses during the 280 days before through 7 days after delivery using ICD-CM-9/10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without …

Hereditary Angioedema And Covid-19 During Pregnancy: Two Case Reports, Amanda Salih, Aaron Chin, Manisha Gandhi, Amir Shamshirsaz, Hennie Lombaard, Joud Hajjar

Faculty, Staff and Students Publications

No abstract provided.

In Utero Exposure To Antiemetic And Risk Of Adult-Onset Colorectal Cancer, Caitlin C Murphy, Piera M Cirillo, Nickilou Y Krigbaum, Amit G Singal, Barbara A Cohn

Faculty, Staff and Student Publications

BACKGROUND: Incidence rates of colorectal cancer (CRC) are increasing among adults born in and after the 1960s, implicating pregnancy-related exposures introduced at that time as risk factors. Dicyclomine, an antispasmodic used to treat irritable bowel syndrome, was initially included in Bendectin (comprising doxylamine, pyridoxine, and dicyclomine), an antiemetic prescribed during pregnancy in the 1960s.

METHODS: We estimated the association between in utero exposure to Bendectin and risk of CRC in offspring of the Child Health and Development Studies, a multigenerational cohort that enrolled pregnant women in Oakland, CA, between 1959 and 1966 (n = 14 507 mothers and 18 751 …

Role Of Biomarkers (Sflt-1/Plgf) In Cases Of Covid-19 For Distinguishing Preeclampsia And Guiding Clinical Management, Guilherme M Nobrega, Jose P Guida, Juliana M Novaes, Larissa M Solda, Luciana Pietro, Adriana G Luz, Giuliane J Lajos, Carolina C Ribeiro-Do-Valle, Renato T Souza, Jose G Cecatti, Indira U Mysorekar, Tabata Z Dias, Maria Laura Costa

Faculty, Staff and Students Publications

OBJECTIVES: To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS).

STUDY DESIGN: The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed.

MAIN OUTCOME MEASURES: Serum measurements of sFlt-1 and PlGF; obstetrics …

Transabdominal Cerclage During Pregnancy: A Retrospective Single Operator Series Over A Quarter Century, David R Hall, Mari Van De Vyver

Faculty, Staff and Student Publications

OBJECTIVE: To describe the pregnancy outcomes and complications observed in a series of cases of transabdominal cerclage (TAC), which is reserved for highly selected women with recurrent mid-trimester pregnancy loss, due to cervical insufficiency.

METHODS: A retrospective audit covering 25 years (January 1, 1997 to December 31, 2021) was performed at the Obstetric Special Care division, Tygerberg Academic Hospital in Cape Town, South Africa. All 118 pregnancies from 94 procedures, operated and managed by the principal author were included for descriptive analysis.

RESULTS: Eighty-four (91.3%) of the 92 first pregnancies after first insertion had successful outcomes. All second and third …

Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Testing And Detection During Peripartum Hospitalizations Among A Multicenter Cohort Of Pregnant Persons: March 2020-February 2021, Miranda J Delahoy, Flor Munoz, De-Kun Li, Carmen Sofia Arriola, Nanette Lee Bond, Michael Daugherty, Jeannette Ferber, Nickolas Ferguson, Louise Hadden, Jillian T Henderson, Stephanie A Irving, Mary Juergens, Venkatesh Kancharla, Mara Greenberg, Roxana Odouli, Gabriella Newes-Adeyi, Erin G Nicholson, Lawrence Reichle, Momodou Sanyang, Margaret Snead, Fatimah S Dawood, Allison L Naleway

Faculty, Staff and Students Publications

BACKGROUND: Identifying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections during peripartum hospitalizations is important to guide care, implement prevention measures, and understand infection burden.

METHODS: This cross-sectional analysis used electronic health record data from hospitalizations during which pregnancies ended (peripartum hospitalizations) among a cohort of pregnant persons at 3 US integrated healthcare networks (sites 1-3). Maternal demographic, medical encounter, SARS-CoV-2 testing, and pregnancy and neonatal outcome information was extracted for persons with estimated delivery and pregnancy end dates during March 2020-February 2021 and ≥1 antenatal care record. Site-stratified multivariable logistic regression was used to identify factors associated with testing …

Disparities In The Use Of Assisted Reproductive Technologies After Breast Cancer: A Population-Based Study, Clare Meernik, Kirsten Jorgensen, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Paula C Brady, Roni Nitecki, Hazel B Nichols, J Alejandro Rauh-Hain

Faculty, Staff and Student Publications

PURPOSE: Equitable access to oncofertility services is a key component of cancer survivorship care, but factors affecting access and use remain understudied.

METHODS: to describe disparities in assisted reproductive technology (ART) use among women with breast cancer in California, we conducted a population-based cohort study using linked oncology, ART, and demographic data. We identified women age 18-45 years diagnosed with invasive breast cancer between 2000 and 2015. The primary outcome was ART use-including oocyte/embryo cryopreservation or embryo transfer-after cancer diagnosis. We used log-binomial regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) to identify factors associated with ART …

Disparities In Fertility-Sparing Treatment And Use Of Assisted Reproductive Technology After A Diagnosis Of Cervical, Ovarian, Or Endometrial Cancer, Kirsten Jorgensen, Clare Meernik, Chi-Fang Wu, Caitlin C Murphy, Valerie L Baker, Peiton Jarmon, Paula C Brady, Roni Nitecki, Hazel B Nichols, Jose Alejandro Rauh-Hain

Faculty, Staff and Student Publications

OBJECTIVE: to assess the presence of sociodemographic and clinical disparities in fertility-sparing treatment and assisted reproductive technology (ART) use among patients with a history of cervical, endometrial, or ovarian cancer.

METHODS: We conducted a population-based cohort study of patients aged 18-45 years who were diagnosed with cervical cancer (stage IA, IB), endometrial cancer (grade 1, stage IA, IB), or ovarian cancer (stage IA, IC) between January 1, 2000, and December 31, 2015, using linked data from the CCR (California Cancer Registry), the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. The primary outcome …

First- Or Second-Trimester Sars-Cov-2 Infection And Subsequent Pregnancy Outcomes, Brenna L Hughes, Grecio J Sandoval, Torri D Metz, Rebecca G Clifton, William A Grobman, George R Saade, Tracy A Manuck, Monica Longo, Amber Sowles, Kelly Clark, Hyagriv N Simhan, Dwight J Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer Bailit, Maged M Costantine, Harish M Sehdev, Alan T N Tita, George A Macones

Faculty, Staff and Student Publications

BACKGROUND: SARS-CoV-2 infection during pregnancy is associated with adverse pregnancy outcomes, including fetal death and preterm birth. It is not known whether that risk occurs only during the time of acute infection or whether the risk persists later in pregnancy.

OBJECTIVE: This study aimed to evaluate whether the risk of SARS-CoV-2 infection during pregnancy persists after an acute maternal illness.

STUDY DESIGN: A retrospective cohort study of pregnant patients with and without SARS-CoV-2 infection delivering at 17 hospitals in the United States between March 2020 and December 2020. Patients experiencing a SARS-CoV-2-positive test at or before 28 weeks of gestation …

The Sflt-1/Plgf Ratio In Pregnant Patients Affected By Covid-19, Katarzyna Kosinska-Kaczynska, Ewa Malicka, Iwona Szymusik, Norbert Dera, Michal Pruc, Stepan Feduniw, Zubaid Rafique, Lukasz Szarpak

Faculty, Staff and Students Publications

COVID-19 in pregnant women increases the risk of adverse pregnancy outcomes, including preeclampsia. This meta-analysis aimed to examine the effect of SARS-CoV-2 infection on sFlt-1/PIGF ratio during pregnancy. The study was designed as a systematic review and meta-analysis. PubMed, Web of Science, Embase and Cochrane Library were searched for relevant studies reporting the sFlt-1/PlGF ratio in pregnant women with COVID-19. Results were compared using meta-analysis by the Mantel-Haenszel method. A total of 7 studies were included in the analysis. sFlt-1/PlGF ratios between COVID-19 positive vs. negative women were 45.8 ± 50.3 vs. 37.4 ± 22.5, respectively (SMD = 1.76; 95% …

Substrate Electronics Dominate The Rate Of Reductive Dehalogenation Promoted By The Flavin-Dependent Iodotyrosine Deiodinase, Jeffrey M Carlson, Ayzsa Tannis, Kate R Woodworth, Megan R Reynolds, Neha Shinde, Breanne Anderson, Keivon Hobeheidar, Aisha Praag, Kristen Campbell, Cynthia Carpentieri, Teri Willabus, Elizabeth Burkhardt, Elizabeth Torrone, Kevin P O'Callaghan, Kathryn Miele, Dana Meaney-Delman, Suzanne M Gilboa, Emily O'Malley Olsen, Van T Tong

Faculty, Staff and Student Publications

Despite universal prenatal syphilis screening recommendations and availability of effective antibiotic treatment, syphilis prevalence during pregnancy and the incidence of congenital syphilis have continued to increase in the United States (1,2). Concurrent increases in methamphetamine, injection drug, and heroin use have been described in women with syphilis (3). CDC used data on births that occurred during January 1, 2018-December 31, 2021, from two states (Arizona and Georgia) that participate in the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) to describe the prevalence of substance use among pregnant persons with syphilis by congenital syphilis pregnancy outcome (defined …

Impact Of Treating Maternal Periodontal Disease On The Risk Of Preterm Birth And Low Birth Weight: An Umbrella Review Of Systematic Reviews, May Salama, Abdullah Al-Taiar

College of Health Sciences Posters

Pregnancy involves complex physical and hormonal changes that significantly impact almost every organ system, including the oral cavity. The presence of oral disease in women has consequences for both their child and their health. The two main oral conditions linked to pregnancy are gingivitis and periodontal disease. Several studies have demonstrated that there is a positive association between periodontal disease and adverse pregnancy outcomes such as preterm birth (PTB) and low birth weight (LBW). PTB and LBW are among the leading causes of perinatal mortality and morbidity. It has been hypothesized that periodontal disease may cause PTB and/or LBW either …

Contraception And Healthcare Utilization By Reproductive-Age Women Who Use Drugs In Rural Communities: A Cross-Sectional Survey., Ximena A. Levander, Canyon A. Foot, Sara L. Magnusson, Ryan R. Cook, Jerel M. Ezell, Judith Feinberg, Vivian F. Go, Kathryn E. Lancaster, Elizabeth Salisbury-Afshar, Gordon S. Smith, Ryan P. Westergaard, April M. Young, Judith I. Tsui, P. Todd Korthuis

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: Women who use drugs (WWUD) have low rates of contraceptive use and high rates of unintended pregnancy. Drug use is common among women in rural U.S. communities, with limited data on how they utilize reproductive, substance use disorder (SUD), and healthcare services.

OBJECTIVE: We determined contraceptive use prevalence among WWUD in rural communities then compared estimates to women from similar rural areas. We investigated characteristics of those using contraceptives, and associations between contraceptive use and SUD treatment, healthcare utilization, and substance use.

DESIGN: Rural Opioids Initiative (ROI) - cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions …

Perspective: Organic Food Consumption During Pregnancy And The Potential Effects On Maternal And Offspring Health, Cynthia L. Curl, Annica Balentine

Public and Population Health Faculty Publications and Presentations

Pregnancy represents a critical window for both maternal and child health. Previous studies have shown that the consumption of an organic diet during pregnancy can reduce pesticide exposure compared with the consumption of a conventional diet. It is possible that this could, in turn, improve pregnancy outcomes, because maternal pesticide exposure during pregnancy has been associated with increased risk of pregnancy complications. Organic foods are produced by methods that comply with organic standards, generally restricting the use of agrochemicals, such as synthetic pesticides. In the past few decades, the global demand for organic foods has increased drastically, driven in large …

Maternal Educational Attainment In Pregnancy And Epigenome-Wide Dna Methylation Changes In The Offspring From Birth Until Adolescence, Priyanka Choudhary, Giulietta S. Monasso, Ville Karhunen, Justiina Ronkainen, Giulia Mancano, Caitlin G. Howe, Zhongzheng Niu, Xuehuo Zeng, Weihua Guan, John Dou, Jason I. Feinberg, Charles Mordaunt, Giancarlo Pesce, Nour Baïz, Rossella Alfano, Dries S. Martens, Congrong Wang, Elena Isaevska, Elina Keikkala, Sanna Mustaniemi, Chris H. L. Thio, Eliza Fraszczyk, Elmar W. Tobi, Anne P. Starling, Marta Cosin-Tomas, Jose Urquiza, Stefan Röder, Thanh T. Hoang, Christian Page, Dereje D. Jima, John S. House, Rachel L. Maguire, Raffael Ott, Xenia Pawlow, Lea Sirignano, Lea Zillich, Anni Malmberg, Sebastian Rauschert, Phillip Melton, Tong Gong, Robert Karlsson, Ruby Fore, Wei Perng, Zachary M. Laubach, Darina Czamara, Gemma Sharp, Carrie V. Breton, Enrique Schisterman, Edwina Yeung, Sunni L. Mumford, M. Daniele Fallin, Janine M. Lasalle, Rebecca J. Schmidt, Kelly M. Bakulski, Isabella Annesi-Maesano, Barbara Heude, Tim S. Nawrot, Michelle Plusquin, Akram Ghantous, Zdenko Herceg, Lorenza Nisticò, Marina Vafeiadi, Manolis Kogevinas, Marja Vääräsmäki, Eero Kajantie, Harold Snieder, Eva Corpeleijn, Regine P. M. Steegers-Theunissen, Ivana V. Yang, Dana Dabelea, Serena Fossati, Ana C. Zenclussen, Gunda Herberth, Maria Magnus, Siri E. Håberg, Stephanie J. London, Monica C. Munthe-Kaas, Susan K. Murphy, Cathrine Hoyo, Anette-G Ziegler, Sandra Hummel, Stephanie H. Witt, Fabian Streit, Josef Frank, Katri Räikkönen, Jari Lahti, Rae-Chi Huang, Catarina Almqvist, Marie-France Hivert, Vincent W. V. Jaddoe, Marjo-Riitta Järvelin, Marko Kantomaa, Janine F. Felix, Sylvain Sebert

Research outputs 2022 to 2026

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was …

Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany B. Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Human Movement Studies & Special Education Faculty Publications

Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 µmole PCB126 per kg of body weight via oral gavage on postnatal …

Virtual Home Visits During Covid-19 Pandemic: Mothers' And Home Visitors' Perspectives, Abdullah Al-Taiar, Michele A. Kekeh, Stephanie Ewers, Amy L. Prusinski, Kimberly J. Alombro, Nancy Welch

Community & Environmental Health Faculty Publications

Background

The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation.

Methods

Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received …

Sleep Aid Use During Early Pregnancy And The Risk Of Birth Defects, Meredith M. Howley

Legacy Theses & Dissertations (2009 - 2024)

This dissertation examines the validity of maternal self-reported medication exposures and then explores the associations between self-reported sleep aid use, including zolpidem specifically, and birth defects using data from three population-based case-control studies conducted within the United States. The first aim of this dissertation was to explore agreement between two sources of prescription medication use in early pregnancy: medical records and self-reported interview data from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS). We observed that agreement of prescription data between self-report and medical records varies by whether the medication is used chronically or episodically. While self-reported medication information …

Researching Covid To Enhance Recovery (Recover) Pregnancy Study: Rationale, Objectives And Design, Torri D Metz, Rebecca G Clifton, Richard Gallagher, Rachel S Gross, Leora I Horwitz, Vanessa L Jacoby, Susanne P Martin-Herz, Myriam Peralta-Carcelen, Harrison T Reeder, Carmen J Beamon, James Chan, A Ann Chang, Maged M Costantine, Megan L Fitzgerald, Andrea S Foulkes, Kelly S Gibson, Nick Güthe, Mounira Habli, David N Hackney, Matthew K Hoffman, M Camille Hoffman, Brenna L Hughes, Stuart D Katz, Victoria Laleau, Gail Mallett, Hector Mendez-Figueroa, Vanessa Monzon, Anna Palatnik, Kristy T S Palomares, Samuel Parry, Christian M Pettker, Beth A Plunkett, Athena Poppas, Uma M Reddy, Dwight J Rouse, George R Saade, Grecio J Sandoval, Shannon M Schlater, Frank C Sciurba, Hyagriv N Simhan, Daniel W Skupski, Amber Sowles, Tanayott Thaweethai, Gelise L Thomas, John M Thorp, Alan T Tita, Steven J Weiner, Samantha Weigand, Lynn M Yee, Valerie J Flaherman

Faculty, Staff and Student Publications

IMPORTANCE: Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy may also have long-term ramifications for exposed offspring, and it is critical to evaluate the health outcomes of exposed children. The National Institutes of Health (NIH) Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC aims to evaluate the long-term sequelae of SARS-CoV-2 infection in various populations. RECOVER-Pregnancy was designed specifically to address long-term outcomes in maternal-child dyads.

METHODS: RECOVER-Pregnancy cohort is a …

Effect Of Positive Emotion Intervention During Late Pregnancy On Improving Colostrum Secretion: A Randomised Control Trial Protocol, Kechen Xu, Ying Xie, Xiujun Han, Ying Yu, Suqing Liu, Suliu Wu, Qian Yang, Qi Zhang

Community & Environmental Health Faculty Publications

Introduction Though evidence has revealed the beneficial effects of cognitive improvement interventions on breastfeeding, the effect of psychological interventions has rarely been studied. This study aims to test whether promoting a positive emotion intervention, 'Three Good Things' intervention, during the last trimester of pregnancy can enhance early colostrum secretion and breastfeeding behaviours by modulating the hormones associated with lactation (prolactin and insulin-like growth factor I). We will attempt to promote exclusive breastfeeding by using physiological behavioural measures.

Methods and analysis This study is designed as a randomised controlled trial conducted in the Women's Hospital School of Medicine at Zhejiang University …

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Black Midwives For Black Mothers: Ameliorating Racial Disparities In The Quality Of Maternal Healthcare, Kimberly Navarro

Theses and Dissertations

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women …

Calcitonin Gene-Related Peptide Protects From Soluble Fms-Like Tyrosine Kinase-1-Induced Vascular Dysfunction In A Preeclampsia Mouse Model, Akansha Mishra, Ancizar Betancourt, Vipin Alukkal Vidyadharan, Chellakkan Selvanesan Blesson, Michael Belfort, Chandra Yallampalli, Madhu Chauhan

Faculty, Staff and Students Publications

Introduction: Preeclampsia (PE) is a hypertensive disorder during pregnancy associated with elevated levels of soluble FMS-like tyrosine kinase (sFLT-1) and increased vascular sensitivity to angiotensin II (ATII). Calcitonin gene-related peptide (CALCA) is a potent vasodilator that inhibits the ATII-induced increase in blood pressure and protects against ATII-induced increases in oxidative stress through a mitochondrial-dependent pathway in male mice. In rodent pregnancy, CALCA facilitates pregnancy-induced vascular adaptation. Most of the vascular effects of CALCA are mediated by vascular smooth muscle cells (VSMCs). We recently reported that CALCA treatment inhibits sFLT-1-induced decreases in cAMP synthesis in omental artery smooth muscle cells (OASMCs) …

A Pregnant Patient Presents With Leakage Of Vaginal Fluid In The Second Trimester, Alison N Goulding, Jennifer R Mckinney, Diana Crabtree Sokol, Anitra D Beasley

Faculty, Staff and Students Publications

Morning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient’s chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case.

This report examines the story of a 43-year-old (gravida 3, para 2) woman who sought evaluation for leakage of vaginal fluid at 15 weeks of gestation. Using questions, physical examination, and testing, an illness script for the presentation emerges. As her …

Versican Provides The Provisional Matrix For Uterine Spiral Artery Dilation And Fetal Growth, Yusuke Sagae, Akihito Horie, Akihiro Yanai, Tsutomu Ohara, Baku Nakakita, Yoshimi Kitawaki, Asuka Okunomiya, Hirohiko Tani, Ken Yamaguchi, Junzo Hamanishi, John P Lydon, Takiko Daikoku, Hideto Watanabe, Masaki Mandai

Faculty, Staff and Students Publications

The extracellular matrix (ECM) in the endometrium plays a crucial role in mammalian pregnancy. We have shown that versican secreted from the endometrial epithelium promotes embryo implantation. Versican is a proteoglycan, a major player in the provisional matrix, and versikine, its N-terminal fragment cleaved by ADAMTS proteinases, serves as a bioactive molecule. Here, since versican expression in the placenta was dynamically altered in humans and mice, we investigated the role of versican in pregnancy using uterine-specific Vcan deletion mice (uKO mice) and ADAMTS-resistant versican expressing mice (V1R mice). uKO mice exhibited insufficient spiral artery dilation, followed by fetal growth restriction …

Covid-19 And Pregnancy: Clinical Outcomes; Mechanisms, And Vaccine Efficacy, Deepak Kumar, Sonam Verma, Indira U Mysorekar

Faculty, Staff and Students Publications

As the COVID-19 pandemic continues into its third year, emerging data indicates increased risks associated with SARS-CoV-2 infection during pregnancy, including pre-eclampsia, intrauterine growth restriction, preterm birth, stillbirth, and risk of developmental defects in neonates. Here, we review clinical reports to date that address different COVID-19 pregnancy complications. We also document placental pathologies induced by SARS-CoV-2 infection, entry mechanisms in placental cells, and immune responses at the maternal-fetal interface. Since new variants of SARS-CoV-2 are emerging with characteristics of higher transmissibility and more effective immune escape strategies, we also briefly highlight the genomic and proteomic features of SARS-CoV-2 investigated to …

Susceptible Windows Of Exposure To Fine Particulate Matter And Fetal Growth Trajectories In The Spanish Inma (Infancia Y Medio Ambiente) Birth Cohort, Wei-Jen Chen, Alison M Rector, Monica Guxens, Carmen Iniguez, Michael D Swartz, Elaine Symanski, Jesús Ibarluzea, Albert Ambros, Marisa Estarlich, Aitana Lertxundi, Isolina Riano-Galán, Jordi Sunyer, Ana Fernandez-Somoano, Suneet P Chauhan, Jennifer Ish, Kristina W Whitworth

Faculty, Staff and Student Publications

While prior studies report associations between fine particulate matter (PM

Cerebral Venous Thrombosis In Pregnancy : A Case Report, Dr Sumuk M S Sr, Dr Anupama Marnal B A Sr, Dr Mamatha S Professor And Head Of The Department, Poornima M Associate Professor

Digital Journal of Clinical Medicine

Cerebral venous thrombosis (CVT) is a rare complication encountered in pregnancy. Symptoms of CVT include headache, limb paresis, seizures , disturbed consciousness , visual disturbances. We present our 25 years old pregnant patient who presented with unsteadiness of gait , weakness and numbness of all four limbs, vomiting headache , giddiness due to which it was difficult for her to perform her daily activities. After the differential diagnostic examinations, we recognised cerebral venous thrombosis. After anti-coagulant treatment , the symptoms resolved. We would like to convey that such symptoms in pregnant women we should always think of CVT.

Relationships Among Pregnancy, Substance Use, Social Determinants Of Health And Assessment, Referral, And Utilization Of Treatment: A Secondary Analysis Of Nsduh Data, Heather Lynn Coddington

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment …