Maternal and Child Health Commons^™

Postpartum Physical Activity And Sleep Levels In Overweight And Normal Weight Mothers, Shane Warehime

UNO Student Research and Creative Activity Fair

Objective: Objectively examine postpartum mothers’ physical activity (PA) and sleep. Compare PA and sleep of overweight/obese and normal weight postpartum mothers. Setting: A mid-sized city in the Midwestern United States. Participants: Twenty-one mothers who had an infant at least three months old. Participants were classified as normal weight (n = 8) or overweight (n = 13). Methods: PA and sleep levels were gathered for four days at three time intervals in the six months following childbirth. Wrist-worn Actigraph accelerometers were used to collect data. Results: All participants increased PA over time, especially from visit two to visit three. When separated …

Waiting 2 Minutes After Sucrose Administration—Unnecessary?, Naomi Meesters, Sinno Simons, Joost Van Rosmalen, Irwin Reiss, John Van Den Anker, Monique Van Dijk

Pediatrics Faculty Publications

Background Worldwide, oral sucrose is standard of care in many neonatal intensive care units to relieve procedural pain in neonates. This study aims to determine if time interval between sucrose administration and heelstick correlates with pain scores.

Methods Neonates were prospectively studied with variable time intervals and assessed with the Premature Infant Pain Profile-Revised (PIPP-R).

Results 150 neonates were included with a median gestational age of 30⁺⁶ (IQR 27⁺⁶–33⁺²) weeks and a median time interval of 72 (IQR 39–115) seconds between sucrose administration and heelstick. In multiple regression analysis, this time interval was not significantly …

{Ace}Ing Early Childhood In Minnesota, Bailey Alston, Casie Devos, Alisha Field, Renee Gasner

Master of Social Work Student Policy Advocacy Briefs

Too many young children are facing ACEs that are detrimentally impacting their development and contributing to negative outcomes that persist into adulthood. There are no current policies using the ACE questions to drive mental health interventions. The Governor’s Task Force on Mental Health made nine recommendations that, if implemented, will greatly improve the mental health and well-being of children and their parents. Improving early childhood prevention and intervention programs helps ALL Minnesota’s families build healthy and rich experiences for their children.

1. Expand the Early Childhood Mental Health Grant program statewide to increase early childhood mental health specialists.
2. Create a Governor’s …

The Use Of Vital Statistics Data For Research Of Consequence: Birth Outcomes And Population Health In A Rural Region, Claudia Kozinetz, Shimin Zheng, Eunice Mogusu

ETSU Faculty Works

Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes.

Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. …

Comprehensive Neighborhood Portraits And Child Asthma Disparities Introduction, Ashley W. Kranjac, Rachel T. Kimbro, Justin T. Denney, Kristin M. Osiecki, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to …

The Association Between Electronic Bullying And School Absenteeism Among High School Students In The United States, Erin Grinshteyn, Y. Tony Yang

Nursing and Health Professions Faculty Research and Publications

BACKGROUND: This study examines the relationship between exposure to electronic bullying and absenteeism as a result of being afraid. METHODS: This multivariate, multinomial regression analysis of the 2013 Youth Risk Behavior Survey data assessed the association between experiencing electronic bullying in the past year and how often students were absent in the last month due to feeling unsafe at/in transit to school. The model controlled for other predictors of school absence including demographics, physical / behavioral health, and risk factors. Missing data were multiply imputed. RESULTS: Electronic bullying was significantly associated with absences. Controlling for model covariates, the relative risk …

Bridging The Divide White Paper: Pregnant Women And Substance Use: Overview Of Research & Policy In The United States, Darla Bishop, Liz Borkowski, Megan Couillard, Amy Allina, Susanna Baruch, Susan Wood

Jacobs Institute of Women's Health

This paper examines the current literature and policy implications of substance use and substance use disorders among pregnant and parenting women. While this is not meant to serve as an exhaustive literature review on this topic, it seeks to describe: current research on health effects of substance use and substance use disorders on pregnant women1 and their children; policies and programs that help ensure that pregnant women who use substances have access to the highest quality healthcare, including prenatal care; the current barriers to accessing treatment for substance use disorders for pregnant women, including those who are incarcerated; and the …

Reproductive History Before And After Hiv Diagnosis: A Cross-Sectional Study In Hiv-Positive Women In Spain, Victoria Hernando, Belen Alejos, Marta Montero, M Jesús Pérez-Elias, José Ramón Blanco, Livia Giner, Juan Luis Gómez-Sirvent, Jose Antonio Iribarren, Enrique Bernal, Francisco Bolumar

Publications and Research

The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.

A cross-sectional study was performed among women within reproductive ages (18–49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women’s serostatus at the moment of pregnancy and association of women’s characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models.

Overall, 161 …

Self-Reported Tobacco Use And Correlation With Umbilical Cord Blood Cotinine Levels At Delivery Among Appalachian Gravidas, Jesse Cottrell, Brenda L. Mitchell, Pooja N. Sangani, D'Andrea S. Thomas, Monica A. Valentovic

Marshall Journal of Medicine

The detrimental effects of cigarette use during pregnancy are well documented. Studies have shown that cigarette smoking while pregnant is associated with multiple adverse outcomes including: pre-term birth, placental abruption, placenta previa, fetal growth restriction, stillbirth, increased rate of birth defects, and increased risk of sudden infant death syndrome. Cotinine is the primary metabolite of nicotine and allows for measurement of active as well as passive exposure. Cotinine freely cross the placental barrier and maternal concentrations are closely correlated with newborn plasma levels. The aim of this study was to compare maternally reported rates of tobacco use to fetal umbilical …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

State-Level Immunization Information Systems: Potential For Childhood Immunization Data Linkages., Jill E. Fuller, Emmanuel B. Walter Jr., Nancy Dole, Richard O'Hara, Amy H. Herring, Maureen S. Durkin, Bonny Specker, Betty Wey

Ethel Austin Martin Program Publications

Objectives Sources of immunization data include state registries or immunization information systems (IIS), medical records, and surveys. Little is known about the quality of these data sources or the feasibility of using IIS data for research. We assessed the feasibility of collecting immunization information for a national children's health study by accessing existing IIS data and comparing the completeness of these data against medical record abstractions (MRA) and parent report. Staff time needed to obtain IIS and MRA data was assessed. Methods We administered a questionnaire to state-level IIS representatives to ascertain availability and completeness of their data for research …

Trinidad & Tobago : Hiv Epidemic, Madison Caldwell

Global Public Health

Trinidad and Tobago are twin islands located in the Caribbean off the coast of Venezuela. In the recent years since about 1990, citizens of this country have been greatly affected by the HIV epidemic. HIV stands for human immunodeficiency virus and is spread through infected seman, blood, or vaginal fluids usually through sexual intercourse. As this virus continues to progress in the body, it will eventually turn into AIDS, which stands for acquired immunodeficiency syndrome. Once HIV progresses to AIDS, the outcome is ultimately fatal, hence why there is a dire need to promote awareness and methods of intervention to …

Belize : Maternal Mortality And Morbidity, Kelsey Snodgrass

Global Public Health

In this report, we discuss infant and maternal mortality/morbidity rates in Belize. While the problem is getting better, there is still a lot of work that needs to be done to fix it. Those in rural areas are still not being reached and are the most at risk for maternal and infant mortality due to lack of transportation and hospitals in the region.

Spain : Childhood Obesity, Emily Haygood

Global Public Health

Throughout the world, obesity is increasing as a public health issue. Specifically, in Spain, which is on the rise for childhood obesity. It is reported that around 1/3 of children in Spain have an excess of weight. Part of this high rate of obesity can be attributed to the high income status. This exposes the population to activities and habits that may lead to poor lifestyle choices. For example, the access to television can decrease activity in children as well as access to fast food can allow for poor nutritional habits.

Puerto Rico : Zika Virus, Rachel Cybulski

Global Public Health

Puerto Rico has had an epidemic of Zika virus within the past few years. Considering the close distance to America, the U.S. has been up-to-date in stopping the spread of Zika from Puerto Rico to the states. In 2016 particularly, the United States declared Puerto Rico to be in a state of emergency due to the heavy presence of the virus. Although this specific outbreak has been terminated, the likelihood of another such occurrence is high, so it is important to learn about the effects of Zika and ways to prevent the spread. The major result of having the virus …

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Conventional Early Infant Diagnosis In Lesotho From Specimen Collection To Results Usage To Manage Patients: Where Are The Bottlenecks?, Appolinaire Tiam, Michelle M Gill, Heather J Hoffman, Anthony Isavwa, Mafusi Mokone, Matokelo Foso, Jeffrey T Safrit, Lynne M Mofenson, Thorkild Tylleskär, Laura Guay

Epidemiology Faculty Publications

Introduction

Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade.

Methods

We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means …

Pregnancy Intendedness And Birth Control Use: Data From The South Dakota 2014 Pregnancy Risk Assessment Monitoring System (Prams)-Like Survey, Wei Bai, Bonny Specker

Ethel Austin Martin Program Publications

The health status of South Dakotans is commonly reported from public health surveillance surveys. Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) provide information that is used by policy makers, public health professionals, advocacy groups, health care organizations, and others to develop initiatives to improve the health of the population. South Dakota has one of the highest infant mortality rates in the U.S., ranking in the bottom half of states, yet there are little data available on factors that influence health behaviors and attitudes of mothers that can ultimately influence birth outcomes. The Pregnancy Risk Assessment Monitoring System …

Evaluation Of The Volunteer Doula Program At Brookings Health System, Jenn Anderson, Rebecca A. Kuehl

Communication Studies Publications

The 12-month research project included interviews and focus groups with key stakeholders, as well as an evaluation of promotional materials. An interdisciplinary team of researchers from South Dakota State University (SDSU) partnered with OB and PR/Marketing staff at Brookings Health System (BHS) to evaluate the volunteer doula program. The team collaboratively recruited participants and developed interview questions for key stakeholders, including: OB nurses and doctors, volunteer doulas, expectant parents, and mothers. Promotional materials were also evaluated by a persuasion expert. Our findings are drawn from interviews with 15 BHS staff, 9 doulas,

The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study Of Ultrasound Biometric Measurements And Estimated Fetal Weight., Torvid Kiserud, Gilda Piaggio, Guillermo Carroli, Mariana Widmer, José Carvalho, Lisa Neerup Jensen, Sameera A Talegawkar, +Several Additional Authors

Exercise and Nutrition Sciences Faculty Publications

BACKGROUND: Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable diseases in adulthood. Against this background, WHO made it a high priority to provide the present fetal growth charts for estimated fetal weight (EFW) and common ultrasound biometric measurements intended for worldwide use.

METHODS AND FINDINGS: We conducted a multinational prospective observational longitudinal study of fetal growth in low-risk singleton pregnancies of women of high or middle …

Midwives’ And Patients’ Perspectives On Disrespect And Abuse During Labor And Delivery Care In Ethiopia: A Qualitative Study, Sahai Burrowes, Sarah Jane Holcombe, Dube Jara, Danielle Carter, Katheryn Smith

Background: It is increasingly recognized that disrespect and abuse of women during labor and delivery is a violation of a woman’s rights and a deterrent to the use of life-saving, facility-based labor and delivery services. In Ethiopia, rates of skilled birth attendance are still only 28% despite a recent dramatic national scale up in the numbers of trained providers and facilities. Concerns have been raised that women's perceptions of poor quality of care and fear of mistreatment might contribute to this low utilization. This study examines the experiences of disrespect and abuse in maternal care from the perspectives of …

Risk And Burden Of Adverse Intrapartum-Related Outcomes Associated With Non-Cephalic And Multiple Birth In Rural Nepal: A Prospective Cohort Study, Naoko Kozuki, Joanne Katz, Subarna Khatry, James M. Tielsch, Steven Leclerq, Luke C. Mullany

Global Health Faculty Publications

Objectives Intrapartum-related complications are the second leading cause of neonatal death worldwide. We estimate the community-level risk and burden of intrapartum-related fetal/neonatal mortality and morbidity associated with non-cephalic and multiple birth in rural Sarlahi District, Nepal.

Design Community-based prospective cohort study.

Setting Rural Sarlahi District, Nepal.

Participants Pregnant women residing in the study area.

Methods We collected data on maternal background characteristics, conditions during labour and delivery, fetal presentation and multiple birth during home visits. We ran log-binomial regression models to estimate the associations between non-cephalic/multiple births and fresh stillbirth, early neonatal mortality and signs of neonatal encephalopathy, respectively, and …

Preventing Pediatric Tuberculosis: A Randomized Trial Of Symptom-Based Screening Of South African Children Exposed To Tuberculosis, Population Council

HIV and AIDS

In South Africa, a country with one of the highest levels of HIV prevalence, HIV-positive adults are the source case for a large proportion of pediatric tuberculosis (TB) cases. Unfortunately, TB index cases are not consistently asked about their child contacts, not all child contacts present to the clinic for TB screening, and it remains unknown what proportion of child contacts receive isoniazid preventive therapy (IPT)—a highly effective treatment for preventing TB in these children, long recommended by the World Health Organization. Project SOAR is assessing whether a symptom-based screening approach by TB nurses in community health clinics is more …

The Role Of Breastfeeding In Mother-To-Child Transmission Of Hiv/Aids: A Comparative Case Study Of Three Countries, Anjali Cherukuri

Honors Undergraduate Theses

The HIV pandemic has affected millions of people around the world both medically and socially, since there is a stigma associated with this disease. Common methods of transmission include sexual intercourse and sharing needles, but there are other lesser known methods through which people can contract this disease. One such way is mother-to-child transmission (MTCT), in which a mother could transmit the virus to her child either during pregnancy, childbirth, or through breastfeeding. This paper focuses on the role of breastfeeding in the transmission of HIV from mother to child. Many studies have investigated how breastfeeding results in the transmission …

Predictors Of Modern Contraceptive Usage Among Women In Rural Pakistan: Physical Access To Services Stills A Major Barrier, Sumera Aziz Ali, Zafar Fatmi

Community Health Sciences

Background: The predictors of contraceptive use may vary in urban and rural areas. Studies have largely focused on the factors predicting contraceptive usage in urban areas. We studied the predictors of contraceptives in one of the rural districts of Pakistan.
Methods: A nested case-control design was used on The Global Network’s Maternal Newborn Health Registry (MNHR) in district Thatta Pakistan between June 2011 to July 2012. Pregnant women before their index pregnancy, who did not use (n = 200 cases) and those used any modern contraceptive method (n = 600 controls), were compared. Logistic regression was used to as certain …

Expanding Access To Integrated Family Planning Intervention Packages For Married Adolescent Girls In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Hassan Rushekh Mahmood, Sadia Afrin, Anisuddin Ahmed, Nafis Al Haque, Bidhan Krishna Sarker

Reproductive Health

This research report describes an intervention study conducted among married adolescent girls aged 15–19 years in four urban slums of Dhaka, Bangladesh. Objectives of the study were to examine the acceptability and feasibility of forming married adolescent girls’ clubs, and involving community health volunteers (Shasthya Skebikas) and marriage registrars to increase access to family planning (FP) information and services, to promote the uptake of long-acting reversible contraceptive methods, and to provide FP information to newlywed couples at the time of marriage registration. The study findings revealed that a noteworthy number of married adolescent girls received FP-related information, mostly from the …

Global Health Experience In Swaziland, Anik Patel

Posters

Describes a global health learning experience at the Baylor Center of Excellence in Swaziland, where diagnosis and treatment of HIV/AIDS and TB, along with maternal health, women's health, and adolescent care are provided.

Universal Coverage In Developing Countries: A Summative Evaluation Of Maternal Policies In Ghana And Burkina Faso, Kiswendsida Aida Sawadogo

College of Graduate Studies: Theses & Dissertations

The Word Health Organization (WHO) has declared health to be a fundamental human right, yet more than 400 million people around the world do not have access to essential health services. Millions of Africans are unable to access or afford needed services without sustaining economic hardship. Sub-Saharan Africa is behind the rest of the world on coverage of essential health services such as planning, immunization, and sanitation and continues to grapple with higher rates of child mortality, maternal death, and communicable diseases. Despite bearing 25 percent of the world’s disease burden, the region only retains 3 percent of its doctors. …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …