Public Health Commons^™

Real-Time Experiences Of Racism And Stress In Association With Postpartum Weight Retention: A Longitudinal Ecological Momentary Assessment Study, Dara M Méndez, Amanda L Tapia, Sarah A Sanders, Andrea D Casas, Marquita Smalls, Esa M Davis, Stephen L Rathbun, Tiffany L Gary-Webb, Lora E Burke, Serwaa S Omowale, Linda A Adodoadji, John J Gianakas, Y Lai, Maisa Feghali, Meredith L Wallace

Faculty, Staff and Student Publications

Racial inequities in postpartum weight have been documented with limited studies on the influences of racism and other forms of discrimination. In a prospective longitudinal study applying ecological momentary assessment (EMA) and ambulatory assessment of weight, we measured the association between discrimination, stress, and postpartum weight change. The Postpartum Mothers Mobile Study is a cohort of 313 pregnant and birthing individuals who were followed during their second and third trimesters through 1 year postpartum. They were recruited in clinical settings between 2017 and 2020 in a major city center in Pennsylvania. Measures of racism and gender-based discrimination were collected via …

Anesthetic Management For Delivery In Parturients With Heart Disease: A Narrative Review, Shahab Ahmadzadeh, Drake P. Duplechin, Paris D. Bailey, Dillon T. Duplechan, Alexia J. Enache, Peyton Moore, Sahar Shekoohi

School of Medicine Faculty Publications

Cardiac disease remains a leading cause of maternal morbidity and mortality, particularly in developed countries where improved survival has increased the number of pregnant patients with congenital heart disease. The physiological changes of pregnancy, such as increased blood volume, cardiac output, and hypercoagulability, can exacerbate preexisting cardiac conditions, posing significant anesthetic challenges during cesarean delivery. This review outlines anesthetic strategies for parturients with structural or functional cardiac disease, emphasizing individualized, multidisciplinary care. We examine general and regional anesthesia approaches, intraoperative monitoring, and hemodynamic goals, including fluid balance, venous return optimization, and myocardial oxygen demand reduction. Preoperative risk stratification and coordination …

Systemic Exogenous Progestins With Or Without Estrogens Are Associated With Decreased Rates Of Venous Procedures For Varicose Veins, Paarth Jain, Adam M. Ostrovsky, Paul J Dimuzio, Luis H. Eraso, Michael Nooromid, Dawn Salvatore, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVES: Risk factors for varicose veins (VVs) such as female sex, pregnancy, and obesity are high estrogen states, yet the role of systemic progestins with or without estrogens (SPEs) in VV management is not well characterized. This study investigates how SPE use affects rates of venous procedures for patients with VV.

METHODS: The TriNetX database was queried for subjects with International Classification of Diseases, 10th edition, diagnoses of asymptomatic VV, chronic venous insufficiency, and complicated VV (inflammation or ulceration). Patients were divided into a control cohort with no subsequent SPE use, a progestin-only cohort, and a combined estrogen-progestin (CEP) cohort. …

Immediate Skin-To-Skin Contact And Postpartum Hemorrhagic Morbidity, Rachel L Wiley, Ipsita Ghose, Dana R Canfield, Minhazur R Sarker, Hector Mendez-Figueroa, Suneet Chauhan

Faculty, Staff and Students Publications

Objective: To examine rates of postpartum hemorrhagic (PPH) morbidity among patients who did and did not have immediate skin-to-skin contact (SSC).

Methods: This study was a retrospective cohort of all non-anomalous, term singleton vaginal births at a Level IV center over 2 years. Exclusion criteria included COVID-19. Immediate SSC was defined as at least 60 min of direct contact initiated between parturient and neonate within 10 min of birth. The primary outcome was a composite of maternal morbidity related to PPH compared among those with and without immediate SSC. We used multivariable Poisson regression adjusted for possible confounders with robust …

Bibliometric Analysis Of Congenital Toxoplasmosis: A Ten-Year (2013-2023) Review Of Research Publications, Festus Mulakoli, Horatius Musembi, Ann Kimani

School of Nursing & Midwifery, East Africa

Background:Toxoplasma gondii, an obligate intracellular protozoan, infects more than one-third of the global population and causes toxoplasmosis, which can lead to severe fetal complications in pregnant women. The global prevalence of latent toxoplasmosis in pregnant women is 33.8%, with regional variations and risk factors, including the consumption of undercooked meat, exposure to cat feces, and consumption of contaminated water. Pregnant women lack sufficient awareness of these risk factors, necessitating enhanced education, regular screening, and counseling during antenatal care for early detection and management.

Aim: This study performed a comprehensive bibliometric analysis of research on congenital toxoplasmosis published between 2013 …

Contribution Of Maternal Adherence To The Effect Of Multiple Micronutrient Supplementation During Pregnancy: A Systematic Review And Individual Participant Data Meta-Analysis, Emily R. Smith, Filomena Gomes, Seth Adu-Afarwuah, Victor M. Aguayo, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Ellen C. Caniglia, Parul Christian, Arjumand Rizvi, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Multiple micronutrient supplements (MMS) in pregnancy reduces risk of infant low birthweight (LBW) and improves other maternal and infant outcomes compared with iron and folic acid (IFA) supplements alone. However, the impact of timing of initiation and adherence on the MMS effectiveness in real-world programs remains unclear. To address this, we conducted a 2-stage individual participant data meta-analysis that included 15 randomized trials (61,204 pregnant women) and assessed whether the relative effect of MMS differed by the following: adherence alone; adherence in combination with gestational age at initiation; and the total number of tablets taken. We also evaluated the observational …

The Relationship Between Prenatal Stressful Life Events And Breastfeeding Initiation Among Mississippi Mothers, Candon Garbo, Katie C. Hall, Disha Jhaveri, Jung Hye S. Lee, Deanna Howington, Mina Qobadi, Mary Wesley

Journal of Public Health in the Deep South

Background: Early initiation of breastfeeding increases the likelihood of exclusive breastfeeding, which can be linked to improving both the mother’s and infant’s health. However, breastfeeding rates in Mississippi continue to be one of the lowest in the United States, with infant mortality and morbidity rates at the highest. Purpose: This study aims to explore the impact SLEs may have on initiating breastfeeding, as research is limited. Methods: Analyzed data from 2016 to 2021 Pregnancy Risk Assessment and Monitoring System (PRAMS) was used to determine a correlation between life stressor experiences during pregnancy and initiation of exclusive breastfeeding with a sample …

A Retrospective Descriptive Study Of Maternal Morbidity Based On Mississippi Poison Control Center Data, Laura Lee S. Beneke, Zariad Saran, Mallory Pullman, Jenna Davis, David Vearrier

Journal of Public Health in the Deep South

Maternal morbidity and mortality remain significant public health concerns in the United States, but particularly in Mississippi, which has one of the highest maternal mortality rates in the country. This study analyzes data from the Mississippi Poison Control Center (MPCC) from January 2020 through December 2024 to assess trends in exposures among pregnant women. A total of 168 cases were identified. Exposures were categorized as unintentional, intentional, adverse reactions, or unknown, with unintentional exposures (47.6%) being the most common, often due to medication misuse. Intentional exposures, often linked to suspected self harm (31.5% of cases), represented 39.9% of the total. …

Respectful Patient-Provider Communication And Patient Portal Usage In Pregnant People Of Color, Amy H. Goh, Christopher Lee, Chisolum Nkenke, Joyce K. Edmonds

College of Health Professions Faculty Papers

BACKGROUND: Patient-provider communication (PPC) increasingly occurs in online patient portals. Variations in portal usage might worsen communication inequities for pregnant people of color (POC), widening the digital divide. The objective of this study was to examine the relationships between respectful PPC, patient portal usage, and digital health literacy (DHL) in pregnant POC.

METHODS: A multimethod cross-sectional survey design was used. Ordered logistic regression was performed to determine the relationship between PPC and portal use, controlling for trimester prenatal care was initiated, insurance type, age, gestational age, and parity. The moderating effect of Digital Health Literacy Instrument (DHLI) was tested on …

Risk And Protective Factors Associated With Teenage Pregnancy And Intergenerational Interventions: A Scoping Review Protocol, Zamasomi Luvuno, Wilbroda Hlolosile Chiya, Silingene Joyce Ngcobo, Deshini Naidoo, Serwaa Omowale, Tracy Zhandire, Elizabeth Musili Joseph-Shehu, Busisiwe Purity Ncama, Sinegugu E Duma

Faculty, Staff and Student Publications

Introduction: Teenage pregnancy remains a critical global health issue, particularly in low- and middle-income countries. The intergenerational transmission of teenage pregnancy underscores the need for targeted interventions. Existing research on intergenerational approaches is fragmented, with varying methodologies and outcomes. This scoping review seeks to address this gap by answering the following research questions: What are the available intergenerational interventions for teenage pregnancy, and what are the associated risks and protective factors for early and late teenage pregnancy?

Methods and analysis: This study does not involve primary data collection and therefore does not require ethical approval. The review will be conducted …

Implementation Of An Opt-Out And Rapid Point-Of-Care Syphilis Testing Program For Pregnant Patients Presenting To The Emergency Department, Irene Stafford, Carrie Bakunas, Joe Haydamous, Ana Mosqueda, Jeffrey D Klausner, Leandro Mena, Sean C Blackwell

Faculty, Staff and Student Publications

Background: Adult and congenital syphilis rates are rising in the United States. The aim of this pre- and post-implementation study was to determine whether implementation of an opt-out laboratory-based and rapid syphilis point-of-care testing program in the emergency department (ED) improves the detection and treatment of syphilis during pregnancy in a high-prevalence region.

Methods: This pre- and post-implementation study was conducted at the University of Texas Health Science Center, Houston, TX. During the pre-implementation phase (November 1, 2023-February 29, 2024), pregnant patients presenting to the ED underwent laboratory-based syphilis testing using the reverse algorithm only when clinically indicated. In the …

Cenobamate Use In Pregnancy: A Case Report, Tiara Paul, Maromi Nei

Department of Neurology Faculty Papers

No abstract provided.

A Comparative, Quantitative Analysis Of Birth Outcomes Among Women With Intellectual Or Developmental Disabilities, Jocelyn T. Reddix

MUSC Theses and Dissertations

Women who are pregnant or planning to give birth deserve equitable resources, respect, and assurances to ensure a healthy and safe pregnancy, including women of childbearing age who are diagnosed with intellectual or developmental disabilities (IDD). These women are more likely to experience negative perinatal, delivery, and postpartum health outcomes (Tarasoff et al., 2020). Healthcare providers, clinicians, and the family and friends of those with IDD must understand the impact and implications of the prenatal and postpartum journey for this group of women. This comparative research examined 2021 birth outcomes of women in the United States with IDD compared to …

Relationship Between Maternal Iron Indices In The Second Trimester With Cord Blood Iron Indices And Pregnancy Outcomes: A Prospective Cohort Study, J.P. Akshaykirthan, Manjunath S. Somannavar, M.S. Deepthy, Umesh Charantimath, S. Yogeshkumar, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: Iron deficiency anemia in pregnancy poses risks to mothers and infants. This study aimed to correlate maternal iron indices in the second trimester with cord blood indices and pregnancy outcomes.

Methods: This prospective cohort study was nested within the RAPIDIRON Trial (Reducing Anaemia in Pregnancy in India) at Jawaharlal Nehru Medical College, Karnataka, India. A total of 292 pregnant women with moderate anemia who received oral iron supplementation were enrolled from April 2021 to May 2023. Maternal iron indices were measured at multiple time points and correlated with cord blood indices and pregnancy outcomes.

Results: Increased hemoglobin levels were …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Relationship Between Maternal Mortality And Zip Code In New Jersey, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality remains a pressing public health concern in the United States, with significant disparities influenced by geography and social determinants of health. This study investigates the relationship between zip code-level factors and maternal mortality rates (MMR) in New Jersey (NJ), a state with demographic and socioeconomic diversity. Using data from the NJ Department of Health, CDC, and recent literature, I identified patterns correlating higher MMR with areas experiencing poverty, limited access to healthcare, and predominantly minority populations. Counties such as Essex, Union, and Cumberland—classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)—exhibited particularly high vulnerability. These …

Musculoskeletal Changes In Pregnancy: Implications For Long-Term Bone & Joint Health, Jaylyn Thompson, Clarence Julian Clark Ii, Nayarith Lopez, Aziza Ndaw

Rowan-Virtua Research Day

Pregnancy and lactation represent significant physiological challenges to maternal skeletal health, with substantial implications for both short and long-term musculoskeletal integrity. Research emphasizes that lactation induces notable skeletal adaptations, with up to 10% bone mineral density loss occurring in trabecular-rich regions such as the spine and hip (1,5). While most women experience substantial recovery post-weaning, the research indicates that recovery patterns vary significantly, with some women experiencing incomplete restoration of bone mass, potentially compromising long-term skeletal strength (3).

The underlying mechanisms driving these changes are primarily hormonal, with elevated parathyroid hormone-related protein (PTHrP) and decreased estrogen levels during lactation facilitating …

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Havcr1-Centric Host Factor Network Drives Zika Virus Vertical Transmission, Wenzhe Yu, Jun Tao, Hongmin Cao, Wanshan Zheng, Beiang Zhang, Yue Zhang, Peiqun Xu, Yiwei Zhang, Xuan Liu, Yinan Wang, Han Cai, Gang Liu, Fan Liu, Haibin Wang, Haiyan Zhao, Indira U Mysorekar, Xiaoqian Hu, Bin Cao

Center on Aging Staff Publications

Zika virus (ZIKV) vertical transmission results in devastating congenital malformations and pregnancy complications; however, the specific receptor and host factors facilitating ZIKV maternal-fetal transmission remain elusive. Here, we employ a genome-wide CRISPR screening and identify multiple placenta-intrinsic factors modulating ZIKV infection. Our study unveils that hepatitis A virus cellular receptor 1 (HAVCR1) serves as a primary receptor governing ZIKV entry in placental trophoblasts. The GATA3-HAVCR1 axis regulates heterogeneous cell tropism in the placenta. Notably, placenta-specific Havcr1 deletion in mice significantly impairs ZIKV transplacental transmission and associated adverse pregnancy outcomes. Mechanistically, the immunoglobulin variable-like domain of HAVCR1 binds to ZIKV via …

The Art Of Resiliency: Patient Stories Of Maternal Mental Health Experiences, Sara Santarossa, Becca Austin, Molly A. Bell, Samantha C. Henry, Ashley Inclima, Hailey Maddox, Tara G. Smith, Leah Copeland, Dana Murphy, Ashley Redding, Amy Loree

Journal of Patient-Centered Research and Reviews

As part of a Patient-Centered Outcomes Research Institute Eugene Washington Engagement Award aimed at improving capacity to address maternal mental health in research, this collection of stories describes experiences from six unique patient perspectives. Using motherhood as a common thread, these six stories weave together the patients’ challenges and barriers juxtaposed with their hopes and dreams. Exploring such topics as infant loss, expectations versus the reality of the postpartum experience, grief, loss of identity, loss of physical or emotional safety, advocacy, and perseverance through challenging maternal mental health experiences, these tales of resiliency leverage the voices and lived experiences of …

Progesterone Signaling In Oviductal Epithelial Cells Modulates The Immune Response To Support Preimplantation Embryonic Development, Emily A Mcglade, Jiude Mao, Kalli K Stephens, Ryan M Marquardt, Feyza Nur Arguc, Peter F Lais, San-Pin Wu, Sarayut Winuthayanon, Haval Shirwan, Esma S Yolcu, Mark I Hunter, James K Pru, John P Lydon, Francesco J Demayo, Wipawee Winuthayanon

Faculty, Staff and Students Publications

More than 60% of pregnancy losses occur during the first trimester, highlighting the need to understand the role of the oviduct in early pregnancy. In this study, we conditionally ablated the classical progesterone receptor (Pgr) in oviductal epithelial cells, called the Pgrd/d mouse model. We found that 40% of embryos collected from Pgrd/d females were nonviable or developmentally delayed, indicating that epithelial PGR expression is crucial for embryonic development. Single-cell RNA sequencing revealed up-regulation of proinflammatory genes, including interleukin-22 (IL-22), in the epithelial cells of Pgrd/d females. Pharmacological inhibition of inflammation using nonsteroidal anti-inflammatory drugs …

Patient And Healthcare Provider Knowledge Of Exercise During Pregnancy., Robert J. Leone, Dr. Shihyun Kim, Vidhi Sharma, Monique Swain

Medical Student Research Symposium

Title: Patient and Healthcare Provider Knowledge of Exercise During Pregnancy.

Authors: Leone, R., Kim, S., Sharma, V., Swain, M.

Introduction:

Physical activity before and during pregnancy can significantly improve pregnancy outcomes. ACOG’s evidence-based recommendations help healthcare providers (HCPs) educate patients regarding the benefits of exercise during pregnancy. However, many patients do not engage in regular physical activity. We aim to determine how provider counseling on exercise per ACOG recommendations impacts patients’ exercise and perception of exercise during pregnancy.

Methods:

This is a survey study of HCPs offering prenatal and postpartum care, and pregnant patients. HCPs were given surveys …

Standardization And Quality Control Of The Introduction Of A Noninvasive Cardiac Output Monitor For Pregnancy Measurements In A Low- And Middle-Income Country, Helen Perry

Centre of Excellence in Women and Child Health

Introduction :There is increasing awareness of the role of the maternal cardiovascular system in complicated pregnancies. Despite the high disease burden, noninvasive cardiac output monitors have not been used extensively in low- and middle-income countries. The aim of this study was to evaluate the quality control of the use of the ultrasonic cardiac output monitor (USCOM) 1A® in a LMIC.

Material and Methods This was a quality assessment study of the introduction of the USCOM 1A® to measure maternal hemodynamic indices. Inter-observer agreement was assessed across all four study sites by intraclass correlation coefficient. Quality control was assessed using pre-defined …

Cell-Free Dna Results Indicating Mosaic Monosomy X Of Likely Maternal Origin: Impact On Genetic Counseling Practices And Patient Experiences, Audrey Mcbride, Ashley Cannon, Siddharth Prakash, Aaron W Roberts, Angela Seasely, Anna C E Hurst, Laura Hendon

Faculty, Staff and Student Publications

Objective: To investigate the current genetic counseling practices involving a cfDNA result indicating mosaic monosomy X of likely maternal origin, and to better understand the perspectives of patients who have received this result.

Method: A total of 60 prenatal genetic counselors completed surveys about their experiences with this result, cfDNA consenting practices, and management practices. In addition, qualitative interviews were conducted with 5 patients to gain insight into their experiences with result disclosure and follow-up care.

Results: 95% of genetic counselors reported feeling prepared to counsel on these results. However, responses to current practices varied. Of the genetic counselors surveyed, …

Single-Nucleus Transcriptional Profiling Of The Placenta Reveals The Syncytiotrophoblast Stress Response To Covid-19, Rachel A Keuls, Scott A Ochsner, Mary B O'Neill, Diana R O'Day, Akihiko Miyauchi, Kadeshia M Campbell, Natalie Lanners, Jeffery A Goldstein, Connor Yee, Neil J Mckenna, Ronald J Parchem, Jacqueline G Parchem

Faculty, Staff and Students Publications

Background: COVID-19 in pregnancy is associated with placental immune activation, inflammation, and vascular malperfusion, but its impact on syncytiotrophoblast biology and function is unclear.

Objective: This study aimed to determine the effects of maternal COVID-19 on placental syncytiotrophoblasts using single-nucleus transcriptional profiling and to compare placental stress responses in COVID-19 and preeclampsia.

Study design: For transcriptional characterization of syncytiotrophoblasts, we used the single-nucleus RNA sequencing platform, single-cell combinatorial indexing RNA sequencing (sci-RNA-seq3), to profile placental villi and fetal membranes from unvaccinated patients with symptomatic COVID-19 at birth (n = 4), gestational age-matched controls (n = 4), and a case of …

Liver Transplantation In 3 Cholestatic Infants With History Of Covid Exposure, Shruti Sakhuja, Kalyani R Patel, Matthew Goss, Flor M Munoz, Garrett Wortham, Megan Crawford, John A Goss, Nhu Thao Galvan

Faculty, Staff and Students Publications

The COVID-19 pandemic presents several challenges during pregnancy including thromboembolic complications, direct placental infection, transplacental transmission, and systemic hyperinflammatory state. The liver is the second most commonly affected organ in SARS-CoV-2 infection after the lungs. Mechanisms of liver injury in COVID-19 patients can include: direct viral cytopathic effect, worsening of underlying liver disease, cytokine storm, hypoxic ischemic injury, and cholangiopathy leading to persistent marked cholestasis. Here we describe 3 infants at Texas Children's Hospital with perinatal SARS-CoV-2 exposure with persistent cholestasis and histologic evidence of extrahepatic biliary obstruction suggesting underlying biliary atresia (BA) with some atypical features possibly exacerbated by …

Cost-Effectiveness Of Intrapartum Azithromycin To Prevent Maternal Infection, Sepsis, Or Death In Low-Income And Middle-Income Countries: A Modelling Analysis Of Data From A Randomised, Multicentre, Placebo-Controlled Trial, Jackie K. Patterson, Simon Neuwahl, Sydney Kirsch, Janet L. Moore, Alan T.N. Tita, Waldemar A. Carlo, Adrien Lokangaka, Antoinette Tshefu, Musaku Mwenechanya, Elwyn Chomba, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osa A. Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam S. Tikmani, Sarah Saleem, Blair J. Wylie, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William A. Petri, Manolo Mazariegos, Nancy F. Krebs, Jennifer J. Hemingway-Foday, Denise Babineau, Marion Koso-Thomas, Elizabeth M. Mcclure, Melissa Bauserman

Global Health Articles

BACKGROUND: Sepsis is one of the leading causes of maternal mortality globally. In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin for women planning a vaginal birth reduced the risk of maternal sepsis or death and infection. We aimed to evaluate the cost-effectiveness of intrapartum azithromycin for pregnant people planning a vaginal birth in low-income and middle-income countries (LMICs) using A-PLUS trial data.

METHODS: We compared the benefits and costs of intrapartum azithromycin versus standard care across 100 000 model simulations using data from the A-PLUS trial and a probabilistic decision tree model that included 24 …

The Autophagy Protein Atg14 Safeguards Against Unscheduled Pyroptosis Activation To Enable Embryo Transport During Early Pregnancy, Pooja Popli, Arin K Oestreich, Vineet K Maurya, Marina N Rowen, Yong Zhang, Michael J Holtzman, Ramya Masand, John P Lydon, Shizuo Akira, Kelle Moley, Ramakrishna Kommagani

Faculty, Staff and Students Publications

Recurrent pregnancy loss, characterized by two or more failed clinical pregnancies, poses a significant challenge to reproductive health. In addition to embryo quality and endometrial function, proper oviduct function is also essential for successful pregnancy establishment. Therefore, structural abnormalities or inflammation resulting from infection in the oviduct may impede the transport of embryos to the endometrium, thereby increasing the risk of miscarriage. However, our understanding of the biological processes that preserve the oviductal cellular structure and functional integrity is limited. Here, we report that autophagy-related protein ATG14 plays a crucial role in maintaining the cellular integrity of the oviduct by …