Public Health Commons^™

Maternal Diet During Pregnancy And Lactation And Child Food Preferences, Dietary Patterns, And Weight Outcomes: A Review Of Recent Research, Alison K. Ventura, Suzanne Phelan, Karina Silva Garcia

Kinesiology and Public Health

Purpose of Review Efforts to promote children’s preferences for healthy foods hold much potential for improving diet quality and preventing obesity. The purpose of this review was to summarize recent evidence for associations between maternal diet during pregnancy and lactation and child food preferences, dietary patterns, and weight outcomes.

Recent Findings Recent research illustrates greater maternal vegetable intakes during pregnancy and lactation predict greater child preferences for and intakes of vegetables. Recent randomized clinical trials to improve maternal weight outcomes during the perinatal period via behavioral lifestyle interventions that included dietary components have yielded mixed findings for effects on child …

Assessing Sleep Efficiency Of Nulliparous Women In The Third Trimester Of Pregnancy, Ran Hu

Dissertations and Theses (Open Access)

Objectives: Pregnant women in the third trimester are more likely to experience sleep disorders, resulting in adverse effects on fetal health. This study aimed to evaluate the sleep efficiency (SE) of nulliparous women in their late pregnancy.

Methods: Data was extracted from the National Sleep Research Resource focusing on nulliparous women (n = 1,803) in their third trimester of pregnancy. The two-sample Wilcoxon test for continuous variables and the Chi-square test for categorical variables were used based on a normal SE cut-off of 0.85. The least absolute shrinkage and selection operator (Lasso) was used to find the risk …

Blood Pressure Thresholds In Pregnancy For Identifying Maternal And Infant Risk: A Secondary Analysis Of Community-Level Interventions For Pre-Eclampsia (Clip) Trial Data, Jeffrey N. Bone, Laura A. Magee, Joel Singer, Hannah Nathan, Rahat Qureshi, Charfudin Sacoor, Esperança Sevene, Andrew Shennan, Mrutyunjaya B. Bellad, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings.
Methods: We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10). We included pregnant women aged 15-49 years (12-49 years in Mozambique), identified in their …

Associations Between Physiological Biomarkers And Psychosocial Measures Of Pregnancy-Specific Anxiety And Depression With Support Intervention, Karen L Weis, Tony T Yuan, Katherine C Walker, Thomas F Gibbons, Wenyaw Chan

Faculty, Staff and Student Publications

Stress and anxiety significantly impact the hypothalamic-pituitary axis, and in pregnancy, the subsequent maternal-fetal response can lead to poor outcomes. The objective of this study was to assess the association between psychosocial measures of pregnancy-specific anxiety and physiologic inflammatory responses. Specifically, to determine the effectiveness of the Mentors Offering Maternal Support (M-O-M-S

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented …

Role Of Community Engagement In Maternal Health In Rural Pakistan: Findings From The Clip Randomized Trial, Zahra Hoodbhoy, Sana Sadiq Sheikh, Rahat Qureshi, Javed Memon, Farrukh Raza, Mai-Lei Woo Kinshella, Jeffrey N. Bone, Marianne Vidler, Sumedha Sharma, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Community-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women's knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.
Methods: The CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. CE activities engaged pregnant women at their homes …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Pregnancy And Substance Use, Elise Withers, Krista Thompson, Emily Hamilton, Maren Wright Voss

All Current Publications

The use of alcohol and other harmful substances, such as cocaine, opioids, and marijuana during pregnancy has increased over the last decades (Sebastiani et al., 2018). Using these substances can be very harmful to the unborn baby and mother (Viteri et al., 2015). This fact sheet covers (1) the consequences of substance use and (2) the current recommendations for substance use during pregnancy.

Perceptions Of Autism Spectrum Disorder (Asd) Etiology Among Parents Of Children With Asd, Wei-Ju Chen, Zihan Zhang, Haocen Wang, Tung-Sung Tseng, Ping Ma, Lei-Shih Chen

School of Public Health Faculty Publications

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits and restricted or repetitive behaviors. Parental perceptions of the etiology of their child’s ASD can affect provider–client relationships, bonding between parents and their children, and the prognosis, treatment, and management of children with ASD. Thus, this study sought to examine the perceptions of ASD etiology of parents of children with ASD. Methods: Forty-two parents of children diagnosed with ASD were recruited across Texas. Semi-structured interviews were conducted individually. All interviews were recorded and later transcribed verbatim for content analysis utilizing NVivo 12.0 (QSR International, Doncaster, Australia). …

Maternal Sociodemographic Factors And Antenatal Stress, Maheshwari Andhavarapu, James Orwa, Marleen Temmerman, Wangira Musana

Obstetrics and Gynaecology, East Africa

Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We conducted a secondary analysis of data from 150 pregnant women attending antenatal care services at a rural referral hospital in Kenya. The participants completed a sociodemographic and clinical questionnaire, the Cohen’s Perceived Stress Scale (PSS) and gave a hair sample for cortisol and cortisone analysis. The association between selected sociodemographic predictors (age, …

Improved First Trimester Maternal Iodine Status With Preconception Supplementation: The Women First Trial, Amy E. Young, Jennifer F. Kemp, Charis Uhlson, Jamie L. Westcott, Sumera Aziz Ali, Sarah Saleem, Ana Garcès, Lester Figueroa, Manjunath S. Somannavar, Shivaprasad S. Goudar

Community Health Sciences

Maternal iodine (I) status is critical in embryonic and foetal development. We examined the effect of preconception iodine supplementation on maternal iodine status and on birth outcomes. Non-pregnant women in Guatemala, India and Pakistan (n ~ 100 per arm per site) were randomized ≥ 3 months prior to conception to one of three intervention arms: a multimicronutrient-fortified lipid-based nutrient supplement containing 250-μg I per day started immediately after randomization (Arm 1), the same supplement started at ~12 weeks gestation (Arm 2) and no intervention supplement (Arm 3). Urinary I (μg/L) to creatinine (mg/dl) ratios (I/Cr) were determined at 12 weeks …

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Predictors Of Iron Consumption For At Least 90 Days During Pregnancy: Findings From National Demographic Health Survey, Pakistan (2017-2018), Sumera Aziz Ali, Savera Aziz Ali, Shama Razzaq, Nayab Khowaja, Sarah Gutkind, Fazal Ur Rehman, Nadir Suhail

Section of Internal Medicine

Background: Iron supplementation is considered an imperative strategy for anemia prevention and control during pregnancy in Pakistan. Although there is some evidence on the predictors of iron deficiency anemia among Pakistani women, there is a very limited understanding of factors associated with iron consumption among Pakistani pregnant women. Thus, this study aimed to investigate the predictors of iron consumption for at least ≥90 days during pregnancy in Pakistan.
Methods: We analyzed dataset from the nationally representative Pakistan Demographic Health Survey 2017-2018. The primary outcome of the current study was the consumption of iron supplementation for ≥90 days during the pregnancy …

Relationships Between Intimate Partner Violence, Pregnancy, Maternal Mental Health And Infant Care Behaviors, Brooke Ambrose

Boise State University Theses and Dissertations

Background: Intimate Partner Violence (IPV) is a public health issue that is known to have deleterious health effects for pregnant women and their babies. Women who experience IPV during pregnancy are also likely to develop and exacerbate already existing mental health conditions. Experiences with IPV are thought to impact health behaviors, particularly how a mother copes or cares for her baby. The objective of this study is to explore the potential relationships between experiencing IPV (before and/or during pregnancy), maternal mental health, and health-related infant care behaviors (i.e., breastfeeding initiation, breastfeeding duration, well-child visits).

Methods: Data from phases 6 (years …

Determinants Of Postnatal Care Service Utilization In Indonesia: A Secondary Analysis Using The Indonesian Health And Demographics Survey, Haerawati Idris, Willyana Syafriyanti

Makara Journal of Health Research

Background: The postnatal complication that occurs in the first week after childbirth is one of the causes of maternal death in Indonesia. However, it can be prevented with postnatal care (PNC). This study aims to analyze the determinants of PNC service utilization in Indonesia.

Methods: This quantitative study employed a cross-sectional study design and used secondary data from the Indonesian Health and Demographics Survey of 2017. The sample consisted of 14,724 women aged 15–49 years. We assessed the predictors of PNC service utilization using multivariate logistic regression models.

Results: About 78.4% of the respondents utilized PNC services. …

Obstetric Patients And Healthcare Providers Perspectives To Inform Mobile App Design For Physical Activity And Weight Control During Pregnancy And Postpartum In A Rural Setting, Rachel Tinius, Cathryn Duchette, Sia Beasley, Maire Blankenship, Nancy Schoenberg

Behavioral Science Faculty Publications

Background: Mobile health technology offers the opportunity for women to engage with physical activity promotion programs without many of the barriers commonly associated with exercise during and after pregnancy (eg, childcare concerns, rigid schedules, fear of doing harm to fetus or self, access to fitness facilities, uncomfortable with body in front of others) which may be particularly useful in under-resourced rural environments. We conducted the first known study on perspectives of pregnant women, postpartum women, and obstetric healthcare providers in a rural setting on needs related to the development of a mobile app designed to increase physical activity during pregnancy …

Maternal Methylmercury Exposure Through Rice Ingestion And Child Neurodevelopment In The First Three Years: A Prospective Cohort Study In Rural China, Sarah E. Rothenberg, Susan A. Korrick, Jihong Liu, Yanfen Nong, Chuan Hong, Eva P. Trinh, Xu Jiang, Fred J. Biasini, Fengxiu Ouyang

Faculty Publications

Background

Rice is an important dietary source for methylmercury; however, rice does not contain the same beneficial nutrients as fish. Our main objective was to assess associations of prenatal methylmercury exposure through rice ingestion with child neurodevelopment in rural China.

Methods

Eligible peripartum women were enrolled (n = 391), provided peripartum hair samples, and children’s neurodevelopment was assessed at 12 months (n = 264, 68%) and 36 months (n = 190, 48%) using the Bayley Scales of Infant Development, 2nd Edition, including the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI). Associations between prenatal methylmercury …

Are Underprivileged And Less Empowered Women Deprived Of Respectful Maternity Care: Inequities In Childbirth Experiences In Public Health Facilities In Pakistan, Waqas Hameed, Mudassir Uddin, Bilal Iqbal Avan

Community Health Sciences

Background: Attainment of healthcare in respectful and dignified manner is a fundamental right for every woman regardless of the individual status. However, social exclusion, poor psychosocial support, and demeaning care during childbirth at health facilities are common worldwide, particularly in low- and middle-income countries. We concurrently examined how women with varying socio-demographic characteristics are treated during childbirth, the effect of women's empowerment on mistreatment, and health services factors that contribute to mistreatment in secondary-level public health facilities in Pakistan.
Methods: A cross-sectional survey was conducted during August-November 2016 among 783 women who gave birth in six secondary-care public health facilities …

Deep Learning Of Epidemiological And Omics Data Of Covid-19 Using N3c Data Enclave, Pranay Patodi, Ranojoy Chatterjee, Vishesh Javangula, Haegi Oh

GW Research Showcase 2021-2026

No abstract provided.

Validation Of Icd-10-Cm Codes For Injuries Complicating Pregnancy, Childbirth And The Puerperium: A Medical Record Review, Anna Hansen, Dana Quesinberry, Peter Akpunonu, Julia Martin, Svetla Slavova

Kentucky Injury Prevention and Research Center Faculty Publications

INTRODUCTION: The purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.

METHODS: A medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to …

Maternal Dietary Quality, Inflammatory Potential And Childhood Adiposity: An Individual Participant Data Pooled Analysis Of Seven European Cohorts In The Alphabet Consortium, Ling-Wei Chen, Adrien M. Aubert, Nitin Shivappa, Jonathan Y. Bernard, Sara M. Mensink-Bout, Aisling A. Geraghty, John Mehegan, Matthew Suderman, Kinga Polanska, Wojciech Hanke, Agnieszka Jankowska, Caroline L. Relton, Sarah R. Crozier, Nicholas C. Harvey, Cyrus Cooper, Mark Hanson, Keith M. Godfrey, Romy Gaillard, Liesbeth Duijts, Barbara Heude, James Hébert Scd, Fionnuala M. Mcauliffe, Cecily Kelleher, Catherine M. Phillips

Faculty Publications

Background

Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity.

Methods

We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity …

Vulvar Lichen Sclerosus In Women Of Reproductive Age, Elysha Kolitz, Laura Gammon, Melissa Mauskar

Faculty, Staff and Students Publications

Vulvar lichen sclerosus (vLS) is an inflammatory skin condition that predominantly affects the vulvar and perianal regions. Approximately 50% of cases present prior to menopause; however, there is a paucity of data on vLS in women of reproductive age as well as during their pregnancies. A retrospective review was performed at two tertiary referral centers to better describe cases of vLS in women of reproductive age. Thirty-three patients with a mean age of 40 years met inclusion criteria. In this group, vulvar pruritus was the most common presenting symptom (52%); 61% had biopsy-proven vLS, 42% had at least one autoimmune …

Dietary Quality And Dietary Inflammatory Potential During Pregnancy And Offspring Emotional And Behavioral Symptoms In Childhood: An Individual Participant Data Meta-Analysis Of Four European Cohorts, Kinga Polanska, Pawel Kaluzny, Adrien M. Aubert, Liesbeth Duijts, Hanan El Marroun, Wojciech Hanke, James R. Hébert, Barbara Heude, Agnieszka Jankowska, Giulia Mancano, Sara M. Mensink-Bout, Caroline Relton, Nitin Shivappa Mbbs, Mph, Ph.D., Matthew Suderman, Elzbieta Trafalska, Ewelina Wesolowska, Raquel Garcia-Esteban, Mònica Guxens, Maribel Casas, Catherine M. Phillips

Faculty Publications

Background

The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age.

Methods

Individual participant data for 11,870 mother–child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression …

Maternal Stress And Breastfeeding Intention In Pregnant Women With Opioid Use Disorder, Yassamin Jamshidian, Vanessa Short, Phd, Mph, Diane J. Abatemarco

Phase 1

Introduction: Breastfeeding rates are low among women in treatment for opioid use disorder (OUD). Information on determinants of breastfeeding intention can help inform the design of breastfeeding promotion interventions for this population. The objective of the study was to examine associations between maternal characteristics, including stress, and breastfeeding intention among pregnant women in treatment for OUD.

Methods: Fifty-six pregnant women who were receiving treatment for OUD at Thomas Jefferson University’s Maternal Addiction Treatment Education & Research (MATER) program completed a survey, which included questions on demographics, psychosocial characteristics, breastfeeding history, and breastfeeding intention. Maternal stress was measured using the Perceived …

Does Delay In The Diagnosis Of Rudimentary Horn Pregnancy In Patients With Unicornuate Uteri Impact Treatment Outcomes?, Victoria Webber, Megan Fee, Damla Gonullu, Jessica Rausch, Omosalewa Itauma, Chidinma Abara, Awoniyi Awonuga

Medical Student Research Symposium

OBJECTIVE: Rudimentary horn pregnancy (RHP) is a very rare form of ectopic pregnancy (EP) that tends to rupture in the second trimester. Similar to other EPs, the treatment of RHPs is excision, hence delay in diagnosis (DID) can be detrimental. Our objective is to determine whether DID of RHP in patients with unicornuate uteri (UCU) impacts the treatment outcome.

DESIGN: Retrospective cohort study of published case reports in PubMed database.

MATERIALS AND METHODS: A computerized PubMed search of case reports of RHP from 2007 to 2020 was performed using the key words; unicornuate uterus, rudimentary horn, pregnancy, case. Data was …

Disparities In Cardiovascular Disease Outcomes Among Pregnant And Post-Partum Women, Mohamed M Gad, Islam Y Elgendy, Ahmed N Mahmoud, Anas M Saad, Toshiaki Isogai, Isadora Sande Mathias, Rabel Misbah Rameez, Johnny Chahine, Hani Jneid, Samir R Kapadia

Faculty, Staff and Students Publications

Background

The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited.

Methods and Results

Pregnant and post‐partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample. The outcomes of interest included: in‐hospital mortality, myocardial infarction, stroke, pulmonary embolism, and peripartum cardiomyopathy. Multivariate regression analysis was used to assess the independent association between race and in‐hospital outcomes. Among 46 700 637 pregnancy‐related hospitalizations, 21 663 575 (46.4%) were White, 6 302 089 (13.5%) were Black, and 8 914 …

Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott

Walden Dissertations and Doctoral Studies

Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …