Maternal and Child Health Commons^™

Perceptions, Careseeking, And Experiences Pertaining To Non-Cephalic Births In Rural Sarlahi District, Nepal: A Qualitative Study., Naoko Kozuki, Luke C Mullany, Subarna K Khatry, James M Tielsch, Steven C Leclerq, Caitlin E Kennedy, Joanne Katz

Global Health Faculty Publications

BACKGROUND: In low-resource settings, a significant proportion of fetal, neonatal, and maternal deaths can be attributed to intrapartum-related complications. Certain risk factors, such as non-cephalic presentation, have a particularly high risk of complications. This qualitative study describes experiences around non-cephalic births and highlights existing perceptions and care-seeking behavior specific to non-cephalic presentation in rural Sarlahi District, Nepal.

METHODS: We conducted in-depth interviews with 34 individuals, including women who recently gave birth to a non-cephalic infant and female decision-makers in their households. We also conducted two focus groups with mothers (have two or more children, with at least one child under …

Moderate Prenatal Alcohol Exposure Impairs Performance In An Object-Place-Paired-Associate Task, Lilliana May Sanchez

Psychology ETDs

Memory impairments, including spatial and object processing, are often observed in individuals with Fetal Alcohol Spectrum Disorder. Much attention has been directed towards the hippocampus, which displays significant alterations after moderate prenatal alcohol exposure (PAE). In the present study, we tested a moderate PAE rat model in an object-place-paired-associate (OPPA) task, previously shown to require hippocampal processing. The OPPA task was composed of training rats to discriminate between an identical pair of objects presented in 180° opposite arms of a radial arm maze. Animals were given a total of 10 trials per day over 14 consecutive days of training and …

Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Addressing Extreme Vulnerability: Remaining Barriers To Neonatal Healthcare Delivery In Conflict Areas, Olivia Palmer

Independent Study Project (ISP) Collection

Global statistics show that world-wide neonatal mortality rates are not yet within the target range set by Sustainable Development Goals and reflect persistent violations of the fundamental right to health for newborns around the world. While there is a wide base of knowledge on the main causes of death and minimum standards of care for neonatal health in stable and low-resource settings, there is a significant gap in knowledge regarding the unique circumstances of neonatal healthcare situated in conflict settings. The main objectives of this research are to elaborate on the current state of neonatal healthcare in conflict areas and …

Violencia Obstétrica: Los Derechos De Autonomía Reproductiva, Tratamiento Justo Y Accesibilidad En El Ámbito De La Salud Maternal En San Carlos, Salta / Obstetric Violence: The Rights To Reproductive Autonomy, Fair Treatment, And Accessibility Of Maternal Health Services In San Carlos, Salta, Emily Gleason

Independent Study Project (ISP) Collection

In Argentina, there exists a national legislature (Ley N° 25.929 and 26.485) that is intended to ensure women’s rights to maternal and reproductive healthcare services free from obstetric violence; that is, the right to autonomy, fair treatment, and accessibility of maternal healthcare services. Women have the inherent right to receive fair and equitable maternal healthcare and receive humanized births, or partos humanizados. Despite the existence of these laws, however, there is still a rampant amount of obstetric violence that women in Argentina experience. Their rights to autonomous, accessible, and just maternal health services are often ignored or outright denied. …

Breastfeeding As A Predictor Of Serum Concentrations Of Per- And Polyfluorinated Alkyl Substances In Reproductive-Aged Women And Children: A Rapid Systematic Review, Brianna N. Vannoy, Juleen Lam, Ami R. Zota

GW Research Days 2016 - 2020

Purpose of Review: Per- and polyfluorinated alkyl substances (PFASs) are synthetic chemicals widely detected in human serum, and at low levels in breast milk. We conducted a rapid systematic review on breastfeeding practices and serum concentrations of PFASs – specifically PFOS and PFOA - among reproductive-aged women and young children using the Navigation Guide systematic review methodology.

Recent Findings: We included 14 studies examining associations between breastfeeding and PFASs in infants/toddlers or pregnant/postnatal women. Breastfeeding was significantly associated with lower PFASs exposure among women and higher PFASs exposure among children. Summary: We concluded there was “sufficient” evidence supporting an association …

(Video) Outreach Services To Treat Women Living With Obstetric Fistula: A Systematic Review, Pauline Pamela Pratt, Rashida Muhammad

GW Research Days 2016 - 2020

Background: Obstetric fistula is a condition experienced by women who because of prolonged labor become incontinent forming one or more holes in between the rectum and the vagina or the vagina and the bladder (Heller, A., 2017). The hole causes uncontrollable stool and urine to leak from the woman. For most women with obstetric fistula, the duration of the labor leading to fistula varied between 5 hours and 9 days, averaging 3.0 days long (Heller, A., 2017). Women who suffer from this from this condition are do not have access to quality medical care. While prevention is the priority and …

Etiology And Management Of Hospitalized And Outpatient Diarrhea Among Children Less Than 5 Years Of Age In Lambaréné, Gabon, Christina Pugliese, Natalie Byrne, Frederique Nguema, Kafui Vodounou, Mirabeau Mbong Ngwese, Gedeon Manouana, Jean Edoa, Bayode Adegbite, Jeannot Zinsou, Ayola Adegnika, Martin Grobusch, David Diemert

GW Research Days 2016 - 2020

Objectives: Diarrhea remains a significant cause of global under-5 mortality, particularly in SubSaharan Africa (SSA). To reduce morbidity and mortality, the World Health Organization (WHO) recommends oral rehydration salts (ORS), zinc supplementation, and continued feeding or breastfeeding for all children with diarrhea to prevent dehydration and malnutrition; antibiotics only for bloody diarrhea (i.e. probable shigellosis), suspected cholera, or severe non-intestinal infections (e.g. pneumonia or sepsis); and avoidance of antidiarrheals and antiemetics owing to lack of benefit and potential for harm in young children. Gabon is an upper-middle income country in SSA for which there is a lack of recent, high …

What To Expect When You’Re Expecting: The Impacts China’S Maternal And Child Health Care Law Has Had On Tibetan Birthing Practices In The Diqing Tibetan Autonomous Prefecture, Hannah Mishriky

Independent Study Project (ISP) Collection

While childbirth is universal, it is undeniable that class, culture, ethnicity, and the scientific and political state of medicine all influence how women experienced it. The Tibetan ethnic minority of the People’s Republic of China (PRC) is a culture that exemplifies the uniqueness of each birth. Due to both their distinctive childbirth beliefs and practices, as well as the swift changes China has undergone, Tibetan birthing experiences are asking to be explored.

This study will focus on two major factors influencing Tibetan women's birthing experiences. To begin, research will be done to understand the Buddhist influences surrounding pregnancy and childbirth, …

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.

Utilization Of Prevention Of Mother-To-Child Transmission (Pmtct) Services Among Pregnant Women In Hiv Care In Uganda: A 24-Month Cohort Of Women From Pre-Conception To Post-Delivery., Rhoda K Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Jolly Beyeza-Kashesya, Deborah Mindry, Josephine Birungi, Mahlet Woldetsadik, Glenn J Wagner

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: We assessed the uptake of prevention of mother-to-child transmission (PMTCT) services in a cohort of HIV infected women in care at The AIDS Support Organization Jinja and Kampala in Uganda, who were trying to conceive, over a period of 24 months, to inform the strengthening of PMTCT service access for women in care.

RESULTS: Of the 299 women 127 (42.5%) reported at least one pregnancy within 24 months; 61 women (48.0%) delivered a live child. Of the 55 who had a live birth at the first pregnancy, 54 (98.2%) used antenatal care (ANC) starting at 15.5 weeks of gestation …

Women's Experiences Of Mistreatment During Childbirth: A Comparative View Of Home- And Facility-Based Births In Pakistan, Waqas Hameed, Bilal Iqbal Avan

Community Health Sciences

Introduction: Respectful and dignified healthcare is a fundamental right for every woman. However, many women seeking childbirth services, especially those in low-income countries such as Pakistan, are mistreated by their birth attendants. The aim of this epidemiological study was to estimate the prevalence of mistreatment and types of mistreatment among women giving birth in facility- and home-based settings in Pakistan in order to address the lack of empirical evidence on this topic. The study also examined the association between demographics (socio-demographic, reproductive history and empowerment status) and mistreatment, both in general and according to birth setting (whether home- or facility-based). …

Addressing Hydrocephaly In Viet Nam: A Plausible Prevention And Intervention Medical Support Program Proposal, Chelle Mcintyre-Brewer

UNO Student Research and Creative Activity Fair

Families affected by hydrocephalus in Viet Nam have few options for sustainable treatment for a myriad of reasons, primarily centering on barriers to care prevalent to minority, underserved, and economically disadvantaged populations. High morbidity and abandonment rates often result from these circumstances. An interdisciplinary examination of the factors contributing to causal concerns reveals unique cultural considerations, language and literacy barriers, ethnic and geographic differences, as well as economic and governmental issues greatly impacting patient outcome for this condition. The author contends that a program that addresses sociological concerns, along with the medical treatment of the patient, proffers the opportunity for …

Cortical Thinning And Neuropsychiatric Outcomes In Children Exposed To Prenatal Adversity: A Role For Placental Crh?, Curt A. Sandman, Megan M. Curran, Elyssia Poggi Davis, Laura M. Glynn, Kevin Head, Tallie Z. Baram

Psychology Faculty Articles and Research

Exposure to early life adversity may disrupt the development and maturation of neurons and brain circuits, which, in turn, underlie neurodevelopment and mental illnesses. During fetal life, maternal adversity is conveyed to the developing brain via several molecular signals, including the stress hormone corticotropin releasing hormone (CRH). Employing a large well characterized prospective cohort, we find that fetal exposure to placental-origin CRH levels predicts structural and functional brain outcomes in children. Specifically, elevated placental CRH levels portend thinning of selective cortical regions of exposed individuals, with commensurate cognitive and emotional deficits. Notably, the relations of placental-origin CRH to cortical thinning …

Perinatal Depression: Investing In Our Mothers Before It's Too Late, Katelin Dietel, Anna Garbers, Kailee Hrubetz

Master of Social Work Student Policy Advocacy Briefs

Currently, there is no consistent, universal screening process within the United States healthcare system that considers the mental health of a new mother. Mandatory screening for perinatal depressive symptoms would improve the lives of new mothers, children, and their families nationwide. Home-visiting programs, such as the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program supported by Healthy Families America, should be universal and available in every locale in the U.S. Individual state policies within these programs should be tailored to meet the needs of each unique mother, child, and family. Early, nurturing relationships are critical to a child's development. …

Uterine Arteriovenous Malformations After Suction Evacuation Of Missed Miscarriage, Arshia Javed, Reeta Chander, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is an uncommon but life-threating source of bleeding. AVM is an abnormal connection between uterine arteries and veins. Patients typically present with vaginal bleeding following miscarriage (medical/surgical) or cesarean section. The treatment of choice depends on the symptoms, age, desire of fertility, localization and size of the lesion. Uterine artery embolization is the first choice in symptomatic patients of reproductive age group. We report a case of AVM presenting after dilation and evacuation with extensive lesion, which was successfully treated with bilateral uterine artery embolization.

Relationships Among Common Illness Symptoms And The Protective Effect Of Breastfeeding In Early Childhood In Mal-Ed: An Eight-Country Cohort Study, Stephanie A. Richard, Benjamin J. J. Mccormick, Jessica C. Seidman, Zeba Rasmussen, Margaret N. Kosek, Elizabeth T. Rogawski, William Petri, Anurahda Bose, Zulfiqar Ahmed Bhutta, Ali Turab

Department of Paediatrics and Child Health

Children in low-income countries experience multiple illness symptoms in early childhood. Breastfeeding is protective against diarrhea and respiratory infections, and these illnesses are thought to be risk factors of one another, but these relationships have not been explored simultaneously. In the eight-site MAL-ED study, 1,731 infants were enrolled near birth and followed for 2 years. We collected symptoms and diet information through twice-weekly household visits. Poisson regression was used to determine if recent illness history was associated with incidence of diarrhea or acute lower respiratory infections (ALRI), accounting for exclusive breastfeeding. Recent diarrhea was associated with higher risk of incident …

A Meta-Analysis Of Interventions To Reduce Repeat Pregnancy And Birth Among Teenagers, Lee Smithbattle, Chutima Chantamit-O-Pas, Joanne Schneider

Journal of Adolescent and Family Health

Almost 20% of teen mothers have more than one child before age 20. Researchers have implemented many interventions to prevent subsequent births. The purpose of this study was to examine their effectiveness in preventing repeat pregnancy/birth. We searched nine electronic databases for eligible studies conducted through September, 2014; 47 primary studies met our criteria and provided 52 comparisons. We coded the primary studies for characteristics related to study source, participants, interventions, methods, and outcomes. Using meta-analytic techniques, we calculated intervention effect sizes (ESs) on repeat pregnancy/birth within three time periods: <15 months after the first>birth, 15-35 months, and after 36-60 months. Primary studies included …

American Indian Youth: A Residential Camp Program For Wellness, Francine C. Gachupin, Jennie R. Joe

Journal of Health Disparities Research and Practice

The American Indian Youth Summer Wellness Camp strives to increase physical activity and healthful eating among at-risk southwest American Indian youth. The Wellness Camp is one week in duration and involves youth, aged 10-15 years. Youth who attend camp are self-selected or referred by local tribal health programs. In any given summer, 35-60 youth attend camp. Approximately 20%-33% of youth return from one year to the next. We describe our program to increase healthy lifestyles among American Indian youth at risk for overweight, obesity, diabetes and cardiovascular disease. The Wellness Camp Program includes five primary components: (1) cultural capital, (2) …

Health Insurance Enrollment Of Children And Young Adults In Wayne County, Michigan: A Qualitative Evaluation, Kristin Kan, Richard Lichtenstein, Michelle Famulare, Alison Jensen, Theresa Kowalski-Dobson, Joslyn Pettway, Erminia Ramirez, Madiha Tariq, Minal Patel

Journal of Health Disparities Research and Practice

Since the Affordable Care Act went into effect, community outreach to increase health insurance enrollment of young adults and children in low-income families of color has been a priority in Wayne County, Michigan. Our objective was to inform community efforts for improved outreach, we explored perceptions around the importance of health insurance and barriers to enrollment for children and young adults through a qualitative research study. We conducted a focus group with enrollment assisters and nine focus groups with Arab American, Latino/Hispanic, and African American community members. Several themes emerged about community members’ perceptions and experiences: they believe that children …

Stigma Gets In My Way: Factors Affecting Client-Provider Communication Regarding Childbearing Among People Living With Hiv In Uganda., Jolly Beyeza-Kashesya, Rhoda K. Wanyenze, Kathy Goggin, Sarah Finocchario-Kessler, Mahlet Atakilt Woldetsadik, Deborah Mindry, Josephine Birungi, Glenn J. Wagner

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Many HIV-affected couples living in sub-Saharan Africa desire to have children, but few quantitative studies have examined support for their childbearing needs. Our study explored client-provider communication about childbearing and safer conception among HIV clients in Uganda.

METHODS: 400 Ugandan HIV clients in committed relationships and with intentions to conceive were surveyed. Knowledge, attitudes and practices related to childbearing, and use of safer conception methods were assessed, including communication with providers about childbearing needs, the correlates of which were examined with bivariate statistics and logistic multivariate analysis.

RESULTS: 75% of the sample was female; 61% were on antiretroviral therapy; …

Pregnancy Outcomes Among Women With An Unintended Pregnancy: Findings From A Prospective Registry In Rural Pakistan, Sumera Aziz Ali, Shiyam Sunder Tikmani, Margo S. Harrison, Sarah Saleem, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Background: Unintended pregnancies are an important public health issue in both developed and developing countries. An unintended pregnancy may affect maternal health seeking behavior during the antenatal and postpartum periods, which can adversely affect perinatal outcomes. Aim: The specific aim of our study was to measure antepartum, intrapartum, and postpartum pregnancy outcomes among women with unintended pregnancies in a rural Pakistani population.
Methods: Using a prospective maternal and newborn health registry in Thatta Pakistan, we evaluated temporal associations between unintended pregnancy and several dimensions of health seeking behavior including: antenatal care, preference for private versus government facility for antenatal care, …

Economic And Health Predictors Of National Postpartum Depression Prevalence: A Systematic Review, Meta-Analysis And Meta-Regression Of 308 Studies From 56 Countries, Jennifer Hahn-Holbrook, Taylor Cornwell-Hinrichs, Itzel Anaya

Psychology Faculty Articles and Research

Background: Postpartum depression (PPD) poses a major global public health challenge. PPD is the most common complication associated with childbirth and exerts harmful effects on children. Although hundreds of PPD studies have been published, we lack accurate global or national PPD prevalence estimates and have no clear account of why PPD appears to vary so dramatically between nations. Accordingly, we conducted a meta-analysis to estimate the global and national prevalence of PPD and a meta-regression to identify economic, health, social, or policy factors associated with national PPD prevalence.

Methods: We conducted a systematic review of all papers reporting …

The Associations Among Maternal Resiliency, Perceptions Of Touch, And Reports Of Infant Touch, Lisa D'Agostino

The Pegasus Review: UCF Undergraduate Research Journal

This research study measures how mothers perceive and use touch with their infants, and its association with maternal resiliency, a measure of coping ability. This is important because the inability to cope causes increased stress, which increases negative perceptions of life events, making it even more difficult to cope. In addition, research has yet to uncover whether resiliency is increased in mothers by the same touch and interactions that have been proven to enhance development, attachment, and resiliency in infants. This study asked participants (mothers of infants < 1 year of age) to complete demographic information and a survey composed of three questionnaires: the Mother-Infant Touch Survey, the Physical Contact Assessment, and the Resilience Scale. Although there were no statistically significant correlations among reported perceptions of touch, mother-infant touch, and maternal resiliency, some findings warrant further investigation. Hispanic mothers scored higher on the Resiliency Scale (RS-14) than Non-Hispanic mothers, and a linear trend was detected between mothers in the < 25 years of age group and higher scores on the RS- 14. These findings may influence future research on the correlations between mother-infant touch and maternal coping ability.

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

Zika, Pregnancy, And The Law, Sam F. Halabi

Arkansas Law Review

The public health emergency surrounding the spread of the Zika virus has resurrected and brought into sharp relief some of the most vexing questions surrounding the relationship between pregnancy and law: the appropriate circumstances, if any, in which fetal tissue research is permissible; when and how the government may sponsor statements intended to influence reproductive decisions; and how to balance the health and rights of both women and their unborn children when health threats target both.

Effectiveness Of A Federal Healthy Start Program In Reducing Infant Mortality, Ronee E. Wilson, Hamisu M. Salihu, Jason L. Salemi, Priyanshi Patel, Rana Daas, Estrellita "Lo" Berry

Journal of Health Disparities Research and Practice

Objective: Infant mortality is an important indicator of the health status of a community. In this analysis, we aimed to evaluate temporal changes in infant mortality rates (IMR) in the Central Hillsborough Healthy Start (CHHS) program service area in Tampa, Florida compared to rates in the rest of Hillsborough County and the state.

Method: We conducted a five-year (2010-2014) trends analysis using birth and infant death data extracted from the Florida Community Health Assessment Resource Tool Set (CHARTS). The number of infant deaths and live births were used to calculate and compare IMRs in the CHHS catchment area to those …

Randomized Trial To Reduce Air Particle Levels In Homes Of Smokers And Children, Suzanne C. Hughes, John Belletierre, Benjamin Nguyen, Sandy Liles, Neil E. Klepeis, Penelope J.E. Quintana, Vincent Berardi, Saori Obayashi, Savannah Bradley, C. Richard Hofstetter, Melbourne F. Hovell

Psychology Faculty Articles and Research

Introduction

Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children.

Design

A randomized trial with two groups—intervention and control.

Setting/participants

A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012–2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites.

Intervention

The multicomponent intervention consisted of continuous lights and …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …