Maternal and Child Health Commons^™

Maternal Adverse Childhood Experiences And Infant Visual-Limbic White Matter Development, Catherine H. Demers, Benjamin L. Hankin, Mercedes Hoeflich Haase, Erin Todd, M. Camille Hoffman, C. Neill Epperson, Martin A. Styner, Elysia Poggi Davis

Psychology: Faculty Scholarship

Background

Maternal adverse childhood experiences (ACEs) are robust predictors of mental health for both the exposed individual and the next generation; however, the pathway through which such intergenerational risk is conferred remains unknown. The current study evaluated the association between maternal ACEs and infant brain development, including an a priori focus on circuits implicated in emotional and sensory processing.

Methods

The sample included 101 mother-infant dyads from a longitudinal study. Maternal ACEs were assessed with the Adverse Childhood Questionnaire dichotomized into low (0 or 1) and high (≥2) groups. White matter microstructure, as indexed by fractional anisotropy (FA), was assessed …

Disparities In The Pregnancy Experience: A Multi-Case Analysis, Tiffany C. Thomas, Lindsay Gietzen

Pacific Journal of Health

Racial disparities in maternal healthcare continue to be a significant issue, with Black women experiencing worse outcomes compared to White women. Despite improvements in healthcare, Black women are still 2.5 times more likely to die from pregnancy-related causes, and they face higher rates of preterm births, low birth weight, and insufficient prenatal care. This paper examines the experiences of three African American women from high socioeconomic backgrounds, focusing on where these negative experiences are most common throughout pregnancy, childbirth, and postnatal care. The study uses the Pregnancy and Maternity Care Patients' Experiences Questionnaire (PreMaPEQ) to explore different stages of care, …

Addressing The Public Health Concern Of Maternal Mortality In Houston, Texas, Lucy Couture

Dissertations and Theses (Open Access)

Maternal mortality remains a pressing public health concern in the United States, with disproportionate consequences for marginalized communities. Despite being a developed nation, the U.S. reports one of the highest maternal mortality rates among its peers, with approximately 80% of maternal deaths deemed preventable. Texas reflects this national crisis, particularly affecting Black women, whose maternal mortality rate is significantly higher than that of other racial and ethnic groups. This thesis explores maternal mortality trends in Houston, Texas, analyzing the roles of systemic inequities, social determinants of health, and disparities in access to quality care. Drawing on data from the Texas …

Faktor Kontributor Prevalensi Stunting: Studi Kasus Jawa Timur Tahun 2022, Sofiyulloh Sofiyulloh, Martya Rahmaniati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Malnutrisi, termasuk stunting, masih menjadi masalah kesehatan yang mempengaruhi kemajuan pembangunan berkelanjutan. Stunting, akibat kekurangan gizi berkepanjangan dan infeksi berulang, menghambat pertumbuhan anak. Di Indonesia, prevalensi stunting pada tahun 2022 adalah 21,6% dan masih belum mencapai target. Dan Jawa timur, angka stunting di 2022 adalah 19,2%, mendekati angka nasional pun masih belum mencapai target. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berkontribusi terhadap stunting di Jawa Timur, dengan fokus pada faktor soial ekonomi dan kesehatan. Data sekunder dari Kementerian Kesehatan, dan Dinas Kesehatan Jawa Timur dianalisis menggunakan uji korelasi. Hasil menunjukkan bahwa Indeks Pembangunan Manusia (IPM) dan rata-rata lama sekolah memiliki …

Community Perspectives Of Heat And Weather Warnings For Pregnant And Postpartum Women In Kilifi, Kenya, Adelaide Lusambili, Veronique Filippi, Britt Nakstad, Julian Natukunda, Cathryn Birch, John Marsham, Nathalie Roos, Peter Khaemba, Sari Kovats

Institute for Human Development, East Africa

Background: Extreme weather is a recognised risk factor for stillbirth and preterm birth, disrupts women’s access to healthcare during pregnancy and childbirth, and negatively affects the care of newborns. Reliable and accessible heat and weather warning systems are key in alerting individuals to undertake protective measures. There is a notable gap in understanding how women and caregivers in rural East Africa perceive and utilize weather information. We investigated community members’ heat and weather warning information-seeking behaviour, identified available sources, assessed their reliability and utility, and examined their influence on behaviour.

Settings: Our research was conducted in rural Kilifi County in …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Credentialing Care: Covid-19 And The Bureaucratization Of Doulas, Ellen Block, Julie Johnson Searcy, Angela N. Castañeda

Sociology Faculty Publications

Doulas in the United States offer embodied, informational, and continuous one-on-one care to birthing people. Doulas have historically sought certification to gain knowledge through training and to gain legitimacy for healthcare providers and clients. During the COVID-19 pandemic, hospitals required doulas to provide proof of certification. The COVID-19 pandemic, and the proliferation of state-sponsored doula programs, has sparked a shift in how doulas are viewed and regulated, enabling new forms of bureaucratic oversight and control. Based on participant observation, surveys, and semi-structured interviews, we examine the connection between certification and care including motivations doulas have for certification, the perceived value …

Barriers To Help-Seeking Behavior For Maternal Mental Health Disorders: Application Of The Health Belief Model, Tobi F. Oloyede, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Perinatal mood and anxiety disorders (PMADs) have become a leading cause of maternal mortality due to suicide among women in the first year following pregnancy. Although the profile for new mothers who die by suicide is predominantly white, disparities exist between Black and White women in their seeking help for perinatal and/or post-natal mood disorders. For Black, Indigenous, and People of Color (BIPOC), there are differences in the perceptions of the benefits of seeking help for PMADs. The COVID-19 pandemic exacerbated maternal mental health disorders in the United States particularly for women who live in communities with limited access to …

Maternal Cortisol Concentration Is Associated With Reduced Brain Activation To Infant Cry And More Intrusive Parenting Behavior, Andrew Erhart, Sarah Enos Watamura, Aviva K. Olsavsky, Alexander J. Dufford, Rebekah C. Tribble, Tom Yeh, Pilyoung Kim

Psychology: Faculty Scholarship

Previous research indicates that maternal cortisol function and maternal brain response to infant are each in turn related to variations in parenting behavior. However, little is known about how maternal cortisol and maternal brain function are associated, thus studying these two mechanisms together may improve our understanding of how maternal cortisol assessed during interactions with own infant is associated with brain response to infant cry. First-time mothers (N = 59) of infants aged 3-4 months old were recruited to participate. Mothers' cortisol concentration was measured during a naturalistic interaction with their infant and their behavior was coded for two parenting …

Interoception In Pregnancy: Implications For Peripartum Depression, Paul W. Savoca, Laura M. Glynn, Molly M. Fox, Misty C. Richards, Bridget L. Callaghan

Psychology Faculty Articles and Research

"In this perspective piece, we propose a novel mechanistic framework for peripartum depression in which improved interoceptive functioning in pregnancy and postpartum typically protects against depressive symptoms, but when there is a failure to improve interoception, the result is an inability to maintain metabolic efficiency, which ultimately poses risk for depression. First, we will review an emerging theory that links the modeling and predictive regulation of metabolic resources as central to the expression of many depressive symptoms. Then, focusing on the period of pregnancy to articulate the framework, we will discuss the physiological changes induced by pregnancy that place an …

Unraveling The Multilevel Dynamics Of Water, Sanitation, And Child Anthropometry In Indonesia, Rifa Kirana, Ahmad Komarulzaman

Makara Journal of Health Research

Background: Anthropometrics, reflecting nutritional status, growth, and development, are crucial elements that can predict a person’s health and well-being. However, low anthropometric measures among children under 5 years remain a significant issue in Indonesia, often influenced by various factors at the household and community levels. Access to clean water and adequate sanitation has been identified as major determinants of these adverse health outcomes. This study analyzes the relationship between anthropometric measures and access to water and sanitation at household and community levels using a multilevel analysis approach.

Methods: The study employs cross-sectional data from the Indonesian Family Life …

Leveraging The Science Of Early Life Predictability To Inform Policies Promoting Child Health, Laura M. Glynn, Sabrina R. Liu, Candice Taylor Lucas, Elysia Poggi Davis

Psychology Faculty Articles and Research

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for “why unpredictability?”, including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. …

Strategic Advocacy: Doula Care, Liminality, And Reproductive Justice, Julie Johnson Searcy, Ellen Block, Angela N. Castañeda

Sociology Faculty Publications

No abstract provided.

Five A Day, The Rainbow Way: A Nutrition Education Toolkit For Elementary School Aged Children, Sasha Menard

Department of Nutrition Student Projects

Learning Outcome: Develop a nutrition educational toolkit based on Social Cognitive Theory (SCT) for obesity prevention among elementary school-aged children by improving determinants of fruit and vegetable intake.

Background: Poor consumption of fruits and vegetables is a major contributing factor to childhood obesity, increasing the risk for chronic diseases later in life. There is a need for multicomponent nutrition educational tools to influence children to improve their eating behavior by increasing their awareness and self-efficacy. The current project describes the development of a 3-component toolkit for improving participants’ knowledge and values related to fruit and vegetable intake among 6-11-year-olds.

Methods: …

Maternal Decision Making And Children’S Nutritional Status: Evidence From Indonesia, Nadia Roswita, Teguh Dartanto

Jurnal Ekonomi Kependudukan dan Keluarga

Indonesia is encountering consecutive health problems caused by malnutrition. The latter poses long-term effects on children’s development. As this issue continue its prominence, using linear regression and binary logistic with time lag to analyze data from Indonesia Family Life Survey (IFLS) in 2007 and 2014 shall support the analysis of issue. Previous results from the models indicated that maternal decision-making in their share of food expenditure has a weak correlation for stunted children's experience. However, this study revealed different results. It suggested that involvement in from men in nutritional knowledge, skills, and financial backing to advance women's roles contributes to …

Parenting Identity And Parental Mental Health In Chinese Parents In Mainland China, Zhenqiao Yang

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

In the modern context of mainland China, parents of young children face unique parenting stressors, making parental mental health during the early stages of parenting a significant public concern. Increasing awareness of the role of self-concepts in mental health underscores the importance of exploring the relationships between parenting identity concepts, parenting stress, parental mental health, and familial factors. This study aims to examine the relationship between parenting identity and parental mental health, specifically depression and anxiety, in the context of early childhood parenting stress. Data were collected from 456 parents at four daycare centers and public spaces in an Eastern …

A Comparison Of Menstrual Health And Well-Being Among Adolescent Girls In Urban And Rural Areas Of The Belegavi District: A Crossectional Study, Arati Mahishale, Nagma Khan

Internet Journal of Allied Health Sciences and Practice

Background: Due to their relationship with several health hazards, menstrual hygiene management (MHM) and awareness are major public health concerns in both urban and rural settings. This study examined the awareness of MHM among adolescent girls in Belagavi and assessed their knowledge and understanding of menstruation and related taboos.

Methods: In the Belagavi District of Karnataka, India, a cross-sectional, community-based observational study was carried out. About 380 (as 8 were excluded) menstruating adolescent girls between the ages of 12 and 18 who attended different convent and government schools were included in the study. IBM SPSS version 20 was used to …

Cannabis Exposure During Pregnancy And Neural Mechanisms Of Parenting: Assessing Neural Responses To Infant Cues And Parenting Outcomes, Shannon Powers

Electronic Theses and Dissertations

As legalization of cannabis and cannabinoids spreads in the United States, access and use of cannabis during the prenatal period has increased. There is limited knowledge on the effects of prenatal cannabis use on the parental brain. One way to identify potential effects of cannabis on parenting is through studying parenting brain functions and behavior. Cannabis use disorder (CUD) has been shown to be associated with lower positive parenting and lower sensitivity to infants, but it is unclear by what mechanisms. The following two studies address this gap in knowledge by examining the association between cannabis use during the prenatal …

Exploring The Experiences Of Hiv Positive Pregnant Women On Prevention Of Vertical Transmission Of Hiv/Aids In Rural Malawi, Gertrude Finyiza

Electronic Theses and Dissertations

Mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) continues to be the primary conduct that HIV is transmitted to children worldwide. The problem of HIV/acquired immunodeficiency syndrome (AIDS) is having a great impact on the world's children. The prevalence of HIV/AIDS in Malawi continues to be a serious public health issue, especially for expectant mothers. The health outcomes of mothers and children remain significantly threatened by vertical HIV transmission, even with improvements in preventive and treatment efforts. The purpose of this thesis was to explore the experiences of HIV-positive pregnant women in Malawi. I conducted semi structured interviews with thirteen …

“I Had To Go There For My Own Safety” Negotiations Of Access And Autonomy Among Dc Birth Settings, Elizabeth Avery Borgmann

Geography Undergraduate Senior Theses

Childbirth experiences are shaped by spatial context. This study considers the relationships between access to, selection of, and experiences with labor and delivery care among Black birthing people in Washington, DC. Informed by Reproductive Justice and reproductive geographies frameworks, I employ a mixed methods GIS design that integrates mapping of potential spatial access with qualitative analysis of community members’ lived experiences. On the quantitative side, nearest-neighbor and 2-step floating catchment area analyses reveal an east-west gradient of potential spatial access to labor and delivery wards, with low access concentrated in predominantly Black and low-income census tracts of Wards 5, 7, …

Pediatric Obesity In The United States: Age–Period–Cohort Analysis, Ashley W. Kranjac, Dinko Kranjac, Roxanne I. Aguilera

Sociology Faculty Articles and Research

The rates of obesity among American children aged 2–5 years has reached a historic high. It is crucial to identify the putative sources of population-level increases in obesity prevalence among preschool-aged children because early childhood is a critical window for obesity prevention and thus reduction of future incidence. We used the National Health and Nutrition Examination Survey data and hierarchical age–period–cohort analysis to examine lifecycle (i.e., age), historical (i.e., period), and generational (i.e., cohort) distribution of age- and sex-specific body mass index z-scores (zBMI) among 2–5-year-olds in the U.S. from 1999 to 2018. Our current findings indicate that period effects, …

I See You! Play: A Therapeutic Playgroup For Caregivers And Their Intensive Care Group Infants, Mariana Cerqueira Aokalani

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper articulates a new therapeutic playgroup for caregivers of Intensive Care Unit (ICU) infants, named I See You! Play. This intervention is an adaptation of WePlay! (Gross et al., 2021), a cooperative learning and therapeutic playgroup for caregivers and their children from 6 to 36 months old. Dr, Tracy Vozar developed this program inspired by Saleem Penny’s program with the same name in Chicago. Parents of ICU infants face several challenges that can affect their experience of parenthood, their parenting skills, caregivers' sensitivity, their mental health, and their relationship with their premature infant. This in turn affects infant’s attachment …

Individual Longitudinal Changes In Dna-Methylome Identify Signatures Of Early-Life Adversity And Correlate With Later Outcome, Annabel K. Short, Ryan Weber, Noriko Kamei, Christina Wilcox Thai, Hina Arora, Ali Mortazavi, Hal S. Stern, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Adverse early-life experiences (ELA) affect a majority of the world's children. Whereas the enduring impact of ELA on cognitive and emotional health is established, there are no tools to predict vulnerability to ELA consequences in an individual child. Epigenetic markers including peripheral-cell DNA-methylation profiles may encode ELA and provide predictive outcome markers, yet the interindividual variance of the human genome and rapid changes in DNA methylation in childhood pose significant challenges. Hoping to mitigate these challenges we examined the relation of several ELA dimensions to DNA methylation changes and outcome using a within-subject longitudinal design and a high methylation-change threshold. …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Impact Of Temperature On Children’S Nutrition: A Comparative Study Of Three Ecological Regions Of Nepal, Prakriti Shakya

Master's Theses

Nutrition obtained during the growth period of childhood significantly influences long-term well-being and overall productivity, ultimately contributing to the economy of a society. However, weather shocks can wreak havoc by damaging crops, changing yields of important crops and disrupting market access, which directly impacts the food intake of both adults and children. When these adverse events occur during childhood, short term and long term inadequacy in nutrition as well as disease incidence can cause malnutrition leading to stunted growth and cognitive impairment that may persist into adulthood, affecting the labor market and increasing health expenditure. To address this issue, we …

Association Between Cultural Factors And Postpartum Depression, Usha Modukuru

Rowan-Virtua Research Day

Postpartum depression (PPD) is present in 17.22% of the world population. The negative physical and psychological impacts of PPD impact not only the mother, but also those around her. This raises the importance of identifying factors contributing to its onset. Studies have shown that PPD prevalence rates vary between non-Western and Western regions of the world. Cultural postpartum practices differed significantly region to region. Search terms including postpartum depression and cultures were used to find peer-reviewed articles, primary surveys, and patient interviews between 2013-2023. Qualitative analyses were performed on the results. Ethnokinship cultures, commonly present in non-Western countries, prioritized social …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

Rowan-Virtua Research Day

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …

Patient Interest In And Clinician Reservations On Polygenic Embryo Screening: A Qualitative Study Of Stakeholder Perspectives, D Barlevy, I Cenolli, T Campbell, R Furrer, M Mukherjee, K Kostick-Quenet, S Carmi, T Lencz, G Lázaro-Muñoz, S Pereira

Center for Medical Ethics and Health Policy Staff Publications

Purpose: We explored and compared perspectives of reproductive endocrinology and infertility specialists (REIs) and in vitro fertilization (IVF) patients regarding polygenic embryo screening (PES), a new type of preimplantation screening that estimates the genetic chances of developing polygenic conditions and traits in the future.

Methods: Qualitative thematic analysis of semi-structured interviews with US-based REIs and IVF patients.

Results: Clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians tended to temper their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more frequently than patients, who generally …

Breaking The Rule Of Silence: Childbirth And Gendered Power In Efuru And The Joys Of Motherhood, Sunday Elliott Uguru

Department of English: Dissertations, Theses, and Student Research

This study examines the thematic preoccupation of childbirth in the formative period of feminist discourse in African literature through a critical study of selected novels of Igbo women of southeastern Nigeria. The novels studied represent the earliest published African texts in English by women. The period under focus falls within the emerging stage of Nigerian literary tradition in its written form with a dominant presence of men. This study investigates the women novelists' perspective toward the failure of male authored works to represent women's childbirth experience. Through a critical reading of Flora Nwapa's Efuru and Buchi Emecheta's The Joys of …

Patient Understanding Of Fetal Sex Versus Gender In The Context Of Routine Cell-Free Dna Screening, Mindy Kolodziejski

Dissertations and Theses (Open Access)

Non-invasive prenatal testing (NIPT) is the current standard of care to screen for fetal aneuploidy using cell-free DNA (cfDNA). NIPT screens for sex chromosome aneuploidies (SCAs) and in doing so, can predict fetal chromosomal sex. Despite sex and gender being distinct concepts, many patients refer to NIPT as “the gender test” and elect testing in order to find out predicted fetal sex and assume gender. Our study aimed to evaluate and describe patient understanding of sex and gender in the context of receiving routine prenatal genetics education (PGE) on NIPT. A survey was developed with the goal of assessing patient …