Maternal and Child Health Commons^™

Syphilis And Congenital Syphilis Among Women In San Bernardino County, Valerie Alfaro

Electronic Theses, Projects, and Dissertations

Background: Syphilis is a sexually transmitted infection that mostly affects individuals from a lower income status. San Bernardino County has a high poverty rate and a high rate of Congenital Syphilis. Pregnant women who test positive for Syphilis run the risk of passing the infection on to the fetus. Babies born with Congenital Syphilis may experience many complications, and therefore, the treatment is more intense. The best prevention for Congenital Syphilis is regular screening during pregnancy.

Methods: This study used quantitative research based on secondary data collected from San Bernardino County, Department of Public Health. Data were gathered by an …

Adverse Birth Outcomes: Investigating The Role Of Nativity And Perceived Racial Discrimination Among Black Mothers Enrolled In Des Moines, Iowa Healthy Start., Kendria Kelly-Taylor

Electronic Theses and Dissertations

Birth outcomes for Black women in the United States (US) are disproportionately worse in comparison to non-Black women, even when controlling for potential confounders. Existing studies suggest foreign-born (FB) Black women present better birth outcomes in comparison to US-born (USB) Black women. Also, the longer FB Black women live in the US, the more their perinatal health advantage diminishes. Racial discrimination has been hypothesized as a potential reason for this decline. This dissertation investigates the relationship between nativity and adverse birth outcomes while also exploring how the reporting of racial discrimination impacts birth outcomes among FB and USB Black mothers …

The Ethical Dilemmas Epigenetic Editing In Utero Presents To Christians, Victoria Hendrix

Senior Honors Theses

The development of CRISPR epigenetic editing technology was initially impactful due to its potential for disease treatment. However, despite the potential benefits of epigenetic technology, there exist ethical dilemmas surrounding its use in utero. The review of the ethical dilemmas of epigenetic editing in utero from a Christian perspective showed that research in epigenetic editing is promising, yet fraught with peril. The basic ethical issues of epigenetic editing in utero stem from its inaccuracy, lack of research concerning its effects on offspring, an incomplete understanding of gene interactions, and its connection to eugenics. The ethical concerns particularly relevant to Christians …

Investigation Of Teratogenic Concerns In The Covid-19 Era, Emily Daykin

Dissertations and Theses (Open Access)

In the United States, Coronavirus disease 19 (COVID-19) has disproportionately impacted vulnerable populations, including pregnant people, who were shown to be at higher risk of severe illness from COVID-19 infection and pregnancy complications. Research on the teratogenicity of COVID-19 is still ongoing, but overall neither COVID-19 infection nor vaccination appear to increase the risk of birth defects. Numerous studies have investigated healthcare providers’ opinions on whether and when pregnant people should get vaccinated, as well as pregnant people’s perceptions of COVID-19 vaccines and psychosocial impacts of the pandemic. However, more research is needed to identify the most common concerns regarding …

Socio-Demographic, Maternal, And Infant Characteristics Associated With Pacifier Use Among Six-Months Old Infants In Clark County, Nevada, Kaelia Lynn Saniatan, Smriti Neupane, Chad L. Cross, Gabriela S. Buccini

Epidemiology & Biostatistics Faculty Research

Background

Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.

Method

Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial …

The Impact Of The Covid-19 Pandemic On Maternal Health Outcomes, Jaiden Outten, Afekwo Mary Ukuku Ph.D.

Symposium of Student Scholars

Title: The Impact of the COVID-19 Pandemic on Maternal Health Outcomes

Abstract

The COVID-19 Pandemic has disrupted access to maternal health services. Lockdowns, fear of contracting the disease, and limited access to healthcare services may have affected the overall well-being of expectant mothers and their newborns. Studies from previous infectious disease outbreaks have shown that adverse maternal outcomes have increased. Research is needed to determine the indirect impact the pandemic had on various areas of maternal health. The purpose of this study is to conduct a systematic literature review to understand the impact of COVID-19 on maternal health. A systematic …

Possible Effects Of Sexual Health Education On Health Behaviors And Indicators, Chloe Lafosse

Honors Scholar Theses

Sexual health education has long been evolving, and while a mountain of research has built a compelling case for continuing its improvement, the authors of the present paper were interested in evaluating the efficacy of state education standards in 2009, 2014, and 2019 on a multitude of sexual health outcomes in 2019. We concluded that throughout all three years, states with higher educational requirements could in fact produce better health outcomes, but those outcomes were heavily targeting delaying pregnancy. The educational requirements appeared to have neglected all other aspects of sexual health, including STD prevention, even though STD-based education was …

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

Positive Parenting With Guyanese Children, Parthener Pinder

NYMC Student Theses and Dissertations

During the earliest years of life, a child has rapid neurological development. In low- and middle-income countries (LMICs), such as Guyana, there continues to be a struggle to educate all children, especially those in rural or isolated areas leading to concerns about young children's development, particularly those under five. LMICs have little research on how caregiver positive parenting in the household affects early childhood development as well as how other sociodemographic factors influence positive parenting. This study answers the question: Does positive parenting in the household improve learning development in Guyanese children? This study used Guyana’s Multiple Indicator Cluster Survey …

Structural Foundations Of Potassium Selectivity In Channelrhodopsins, Sukyeong Lee, Sang Bum Lee, Nuri Sung, Wendy W Xu, Changsoo Chang, Hyun-Eui Kim, Andre Catic, Francis T F Tsai

Faculty, Staff and Student Publications

Mitochondria are critical to cellular and organismal health. To prevent damage, mitochondria have evolved protein quality control machines to survey and maintain the mitochondrial proteome. SKD3, also known as CLPB, is a ring-forming, ATP-fueled protein disaggregase essential for preserving mitochondrial integrity and structure. SKD3 deficiency causes 3-methylglutaconic aciduria type VII (MGCA7) and early death in infants, while mutations in the ATPase domain impair protein disaggregation with the observed loss-of-function correlating with disease severity. How mutations in the non-catalytic N-domain cause disease is unknown. Here, we show that the disease-associated N-domain mutation, Y272C, forms an intramolecular disulfide bond with Cys267 and …

A Process Evaluation Of The Green Period Pantry Project, Gabi Wiggill

Honors College Theses

Introduction: The Green Period Pantry (GPP) was a health promotion initiative that was implemented in collaboration with the Office of Student Wellness and Health Promotion. It was created using $48,000 in grant money applied for and received from Sustain Southern as part of the Sustainability Fee Grants at Georgia Southern University. The purpose of the project was to supply students who experienced menstruation with reusable menstrual hygiene products. Another purpose was to describe the process from idea inception to implementation through collaboration with the Office of Student Wellness and Health Promotion. Results: A total of 3,506 units of reusable Menstrual …

Essays On The Economics Of Health And Education, Thao Bui

LSU Doctoral Dissertations

This dissertation consists of three chapters on the economics of health and education. In Chapter 2, I examine the effect of prenatal exposure to Agent Orange, a dioxin- contaminated herbicide that was dispersed on a large scale in South Vietnam for military operations during the Vietnam War, on educational attainment of Vietnamese civilians. The identification strategy exploits province-by-cohort variation in the intensity of Agent Orange sprayed. I find that controlling for conventional bombing, cohorts exposed in utero to Agent Orange (who were born between 1962 and 1971) have lower educational attainment compared to other birth cohorts. The same inference is …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investigating Interactive Methods In Remote Chestfeeding Support For Lactation Consulting Professionals In Brazil, Jessica De Souza, Cinthia Calsinski, Kristina Chamberlain, Franceli L. Cibrian, Edward Jay Wang

Engineering Faculty Articles and Research

Objective: Lactation consultants (LCs) positively impact chestfeeding rates by providing in-person support to struggling parents. In Brazil, LCs are a scarce resource and in high demand, risking chestfeeding rates across many communities nationwide. The transition to remote consultations during the COVID-19 pandemic made LCs face several challenges to solve chestfeeding problems due to limited technical resources for management, communication, and diagnosis. This study investigates the main technological issues LCs have in remote consultations and what technology features are helpful for chestfeeding problem-solving in remote settings.

Methods: This paper implements qualitative investigation through a contextual study (n = 10) and …

Examination Of Explicit And Implicit Emotions And Relationship With The Intention To Support Breastfeeding In Public: A Descriptive Study, Kaitlin Overgaard, Lauren M. Dinour, Adrian Kerrihard, Yeon K. Bai

Department of Nutrition and Food Studies Scholarship and Creative Works

Objectives

Current social norms in the United States do not favor breastfeeding in public. This study examined associations between college students’ explicit and implicit emotions of breastfeeding in public and their intention to support public breastfeeding.

Methods

Twenty-two student participants viewed images of a breastfeeding woman with a fully-covered, fully-exposed, or partially-exposed breast in a public setting. After viewing each image, participants’ explicit emotions (self-reported) of the image were measured using a questionnaire and their implicit emotions (facial expression) were measured using FaceReader technology. We examined if a relationship exists between both emotions [toward images] and intention to support breastfeeding …

El Empoderamiento De Personas Embarazadas Y Posparto En Arica, Chile: Perspectivas Indígenas Y Biomédicas, Abby Perce

Independent Study Project (ISP) Collection

El parto, sin importar las tradiciones o los procedimientos utilizados, es un proceso transformador tanto para quien da a luz como para el bebé. Si bien los procesos de embarazo, parto y posparto son experiencias individualizadas, el apoyo de la comunidad y la atención médica cuidadosa pueden marcar una gran diferencia en los sentimientos de empoderamiento y satisfacción en la vida de los pacientes. Este estudio exploratorio cualitativo tiene como objetivo comprender los contextos culturales que influyen en el apoyo disponible para las personas embarazadas y puérperas en Arica, Chile, así como investigar las formas en que este apoyo conduce …

Validation Of A Brief Measure For Complicated Grief Specific To Reproductive Loss, Cara Buskmiller, Kathryn R Grauerholz, Jennifer Bute, Maria Brann, Michaelene Fredenburg, Jerrie S Refuerzo

Faculty, Staff and Student Publications

Objective

Complicated grief reactions follow some pregnancy outcomes, like miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. Stigma can delay treatment and worsen outcomes. Screening tools such as the Edinburgh Postnatal Depression Scale detect complicated grief poorly, and specific tools for prolonged or complicated grief after a reproductive loss are cumbersome. In this study, a five-item questionnaire to detect complicated grief after reproductive loss of any type was designed and preliminary validated.

Methods

A questionnaire patterned after the extensively validated Brief Grief Questionnaire (BGQ) was created by a group of physicians and lay advocates to employ …

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …

Maternal Healthcare Access And Obstetric Complications: A Cause And Effect Relationship?, Lena Sharara

Independent Study Project (ISP) Collection

Poverty-stricken migrant women, named ‘Kayayei or Kayayo’ because of the nature of their job in the informal sector, have high birth rates and are said to have many barriers affecting their access to maternal health resources. In this study, Kayayei in Madina Market were interviewed and both quantitative and qualitative data were gathered to determine whether a relationship exists between access to maternal health and the obstetric complications and outcomes experienced by Kayayei. A Chi-Squared Test of Independence and a Qualitative Content Analysis were both used to analyze the data. Due to a non-significant p-value, it was found that the …

The Intersectionality Of Race And Rurality In Polysubstance Use During Pregnancy In The United States: A Study Of National Survey On Drug Use And Health, Sophia Tavakol

Senior Theses

Importance: Though detrimental consequences, many pregnant individuals are still binging alcohol, smoking, and/or using illicit drug. Yet, little is known regarding variations in such behaviors across pregnant people in the United States.

Objective: To examine alcohol, tobacco, and drug use during pregnancy in 2015-2020 and assess their racial, ethnic, and rural disparities.

Design: This cross-sectional descriptive study derived maternal characteristics and self-reported prenatal substance use data from 2015 and 2020 National Survey on Drug Use and Health, considering the complex sampling weight per participant per year produced by NSDUH.

Setting: United States.

Participants: A scientific random sample of non-institutionalized residents …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Long-Term Maternal Metabolic And Cardiovascular Phenotypes After A Pregnancy Complicated By Mild Gestational Diabetes Mellitus Or Obesity, Ashley N Battarbee, Lisa Mele, Mark B Landon, Michael W Varner, Brian M Casey, Uma M Reddy, Ronald J Wapner, Dwight J Rouse, John M Thorp, Edward K Chien, George Saade, Beth A Plunkett, Sean C Blackwell

Faculty, Staff and Student Publications

Objective:

To evaluate the association of mild gestational diabetes (GDM) and obesity with metabolic and cardiovascular markers 5-10 years after pregnancy.

Study Design:

This was a secondary analysis of 5-10 year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/HOMA-IR, and cardiovascular markers VEGF, VCAM-1, CD40L, GDF-15, and ST-2. Multivariable linear regression estimated the association of GDM and obesity …

Short-Term Neonatal Outcomes Of Pregnancies Complicated By Maternal Obesity, Mara J Dinsmoor, Lynda G Ugwu, Jennifer L Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

BACKGROUND: Maternal obesity complicates a high number of pregnancies. The degree to which neonatal outcomes are adversely affected is unclear.

OBJECTIVE: This study aimed to evaluate neonatal outcomes of pregnancies complicated by maternal obesity.

STUDY DESIGN: This study was a secondary analysis of a cohort of deliveries occurring on randomly selected days at 25 hospitals from 2008 to 2011. Data were collected by certified abstractors. This analysis included singleton deliveries between 24 and 42 weeks of gestation. Body mass index was calculated on the basis of maternal height and most recent weight before delivery. Normal and overweight (reference group; body …

The Association Of Smoking And Coffee Consumption With Occurrence Of Upper Gastrointestinal Symptoms In Patients With Active Helicobacter Pylori Infection In Jazan City: A Cross-Sectional Study, Anna Palatnik, Paula Mcgee, Jennifer L Bailit, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units (Mfmu) Networ

Faculty, Staff and Student Publications

Objective:

To examine whether there are racial disparities in severe maternal morbidity in patients with hypertensive disorder of pregnancy (HDP).

Study Design:

Secondary analysis of an observational study of 115,502 patients who had a live birth at ≥ 20 weeks in 25 hospitals in the US from 2008 to 2011. Only patients with HDP were included in this analysis. Race and ethnicity were categorized as non-Hispanic White, non-Hispanic Black and Hispanic and were abstracted from the medical charts. Patients of other races and ethnicities were excluded. Associations were estimated between race and ethnicity and the primary outcome of severe maternal …

International Society For Prenatal Diagnosis 2022 Debate 3-Fetal Genome Sequencing Should Be Offered To All Pregnant Patients, Ignatia B Van Den Veyver, Yuval Yaron, Zandra C Deans

Center for Medical Ethics and Health Policy Staff Publications

Prenatal trio exome sequencing (ES) has become integrated into the care for pregnant women when the fetus has structural anomalies. Details regarding optimizing indications for prenatal exome sequencing, its detection rates with different categories of fetal anomalies, and principles of interpretation of pathogenicity of sequence variants are still under investigation. However, there is now growing consensus about its benefits for finding the cause of fetal structural anomalies. What is not established, is whether exome or genome sequencing (GS) has a place in the care of all pregnant women. This report is a summary of the debate on this topic at …

Renal-Hepatic-Pancreatic Dysplasia Type 2: Perinatal Lethal Condition Or A Multisystemic Disorder With Variable Expressivity, Kathryn Gunther, Essam M Imseis, Joyce P Samuel, Elizabeth A Hillman, Tiina H Ojala, Timo Jahnukainen, Paul R Hillman

Faculty, Staff and Student Publications

BACKGROUND: Renal-hepatic-pancreatic dysplasia type 2 (RHPD2) is a rare condition that has been described in the literature disproportionately in perinatal losses. The main features of liver and kidney involvement are well described, with cardiac malformations and cardiomyopathy adding additional variation to the phenotype. Many patients reported are within larger cohorts of congenital anomalies of kidney and urinary tract (CAKUT) or liver failure, and with minimal phenotypic and clinical course data.

METHODS: An independent series of phenotypes and prognosis was aggregated from the literature. In this literature review, we describe an additional patient with RHPD2, provide a clinical update on the …

Evaluation Of A Portable Gynecological Examination Table On Increasing Access To Cervical Cancer Screenings, Brennan Burrows, Giuliana Motta, Vibhasri Davuluri, Urvee Deo, Aman Tahir, Brindha Rajakumar, Jacob Blumenstein, Eliza Steinberg, Mariam Tobia, Asmita Tuladhar, Abigail Ahn

Medical Student Research Symposium

Introduction: Cervical cancer is a preventable disease affecting millions of women worldwide, with higher prevalence and mortality in developing countries. One explanation of this disparity is due to reduced access to screenings, especially in rural communities where mobile health clinics are limited by what medical equipment they can bring. To address these barriers, an engineering team called Project MESA (Making Examinations Safe and Accessible) designed a gynecological examination table that is portable, lightweight, and easily sanitizable.

Objective: This study aims to (1) evaluate whether the implementation of this device improves the clinician’s ability to perform pap smears as opposed to …

Effects Of Armed Conflict On Maternal And Infant Health: A Case Study Of Armenia And The 2020 Nagorno-Karabakh War, Lara Rostomian

Medical Student Research Symposium

Introduction: Armed conflict is a major cause of ill health and mortality which disproportionately impacts women and children. The 2020 War between Armenia and Azerbaijan over the territory of Nagorno-Karabakh occupied by ethnically Armenian population, provides an example of how conflict impacted health during COVID-19. We hypothesize that exposure to crises will correspond to decreased healthcare utilization rates and worse health outcomes of the maternal and infant population in Armenia, and that these trends will be compounded during the pandemic period.

Methods: Following a historic case study approach, we used ecological level data from 1980-2020 to evaluate trends in battle …

What Is The Effect Of Opioid Use During Pregnancy On Infant Health And Wellbeing At Birth?, Jessica Pac, Christine Durrance, Lawrence Berger, Deborah Ehrenthal

Population Health Research Brief Series

The opioid epidemic has severe consequences for pregnant women and their infants. Opioid use during pregnancy increases the risk of numerous poor outcomes at birth, including Neonatal Abstinence Syndrome (NAS), preterm birth, and low birth weight. Opioid use during pregnancy can also lead to child protective services reports and foster care entry. This brief summarizes the findings from a recent study that used linked administrative data from Wisconsin from 2010-2019 and child protective service reports to evaluate the effects of exposure to prescription and illicit opioids during pregnancy on infant health and wellbeing at birth.

How Has The Opioid Overdose Crisis Affected Child Maltreatment In The U.S.?, Alexander Chapman

Population Health Research Brief Series

This brief summarizes results from a study examining the association between U.S. county-level opioid mortality rates and child maltreatment rates from 2007 to 2017. Places with higher opioid overdose mortality rates have higher rates of child maltreatment. Poverty makes this problem worse - where the proportion of families in poverty increases, the association between fatal opioid overdose rates and child maltreatment also increases. Findings suggest that intervening in opioid use by reducing poverty has the potential to markedly decrease the incidence of child maltreatment.