Maternal and Child Health Commons^™

The Lifecourse Perspective Theory As A Strategy For Improving Maternal Mortality In Georgia, Joanne Chopak-Foss, Alisha Riggins

Georgia Public Health Association Annual Meeting & Conference

Background: Maternal mortality and morbidity outcomes in Georgia are among the highest in the United States, with women of color experiencing higher rates of morbidity and mortality compared to their White counterparts. Public health policies such as Medicaid expansion have been suggested as one method for improving maternal mortality. In addition, the Life Course Perspective or Theory approach to maternal and child health suggests a complex interplay of biological, behavioral, psychological and social protective factors contributes to health outcomes across the span of a person’s life.

Methods: Using the Lifecourse Theory Perspective/Theory along with current maternal health policies the presenters …

Knowledge Of Pregnancy And Postpartum Complications Up To One Year Postpartum Compared By Rurality, Evelyn Frances Fagan, Alisha Riggins, Ariel A. Alston, Mario Keko, Ana M. Palacios, Helen Bland, Joanne Chopak-Foss

Georgia Public Health Association Annual Meeting & Conference

Introduction: Georgia has one of the highest maternal mortality rate in the U.S. at 46.2 maternal deaths per 100,000 live births, disproportionately affecting Black and rural populations. This study sought to 1) assess knowledge of Georgian adults about complications and urgent warning signs both during pregnancy and up to 1-year postpartum, and 2) characterize knowledge within rural and urban population.

Methods: As part of a larger study, an online survey with previously validated questions was distributed to Georgia residents through social media and email. Data was grouped into 2 different categories: 1) pregnancy warning signs and 2) post-partum warning signs. …

Health Behavior And Outlooks In An Altered Microbial Diversity: Changes In Parental Attitudes On ‘Building Immunity’ Throughout The Covid-19 Pandemic, Jennifer Vidal

Pitzer Senior Theses

The Covid-19 Pandemic in a short amount of time put into action disease control measures. Current literature has sought to address the long-term effects of sanitization efforts and social isolation on the diversity of the microbiome and the future of infectious diseases. Microbes – microorganisms such as bacteria, protozoa, algae, fungi, and viruses – inhabit the natural environment and human microbiome with our immune system, playing an essential role in immune regulation. The interplay between humans and microbes forms early immune development that has impacted parents’ attitudes toward microbes shown through their participation in Covid-19 preventative health practices. Using the …

Evaluating The Impact Of Mental Health Needs And Services Disruption: Covid-19 & Wisconsin Children’S Welfare Services, Gavin Rienne

Theses and Dissertations--Epidemiology and Biostatistics

Children’s traumatic experiences have lifelong impacts on their mental health and quality of life, therefore mental health services are a critical part of necessary community resources. The increased frequency and severity of natural disasters such as hurricanes, tornadoes, and pandemics reinforces the need to examine and understand the importance of mental health and child services in response to disaster events. This research assesses the relationship between disasters and subsequent health service utilization amongst children and adolescents. We investigated current research on the relationship between children’s mental health and community mental health resource efficacy and accessibility after a major disaster by …

Maternal Occupation And Pediatric Brain Cancer In Kentucky, Mary Elizabeth Begley

Theses and Dissertations--Epidemiology and Biostatistics

Pediatric brain cancer is a rare and potentially deadly diagnosis that affects children in Kentucky at a higher incidence than those nationally. Limited exposures in children early in life to warrant the development and progression of brain cancer point to the role parental exposures experienced in the period prior to conception and throughout pregnancy may play in its development. Many of these exposures may be experienced through occupation.

Data on a subset of pediatric brain cancer cases in Kentucky was compared to all cases diagnosed in the state from 1995 to 2019. Survey data of the study sample was collected …

Comparison Of Midwifery And Obstetric Care Among American Indian And Alaska Native Birthing People, Trista Barnhart

All Master's Theses

Despite making up only 3% of the U.S. population, American Indian/Alaska Native (AI/AN) individuals have the second highest maternal mortality rate in the United States, and the leading cause of maternal mortality and morbidity among AI/AN is postpartum hemorrhage. Many interventions used during childbirth have been identified as common causes of hemorrhage, such as lacerations of the vagina and cervix, operative vaginal deliveries, & augmentation of labor. Research has found that individuals who had midwives as their care providers have been found to be less likely to experience instrumental deliveries, epidural analgesia, labor augmentation, episiotomy or perineal lacerations, cesarean sections, …

The Expected Risks And Exacerbations Of Poverty, Mental Health Disorders, And Maternal Mortality From Abortion Bans: A Comparative Literature Analysis, Daniel J. Francisco

All Master's Theses

Background. Early termination of a pregnancy (hereinafter referred to as an “abortion”) has been debated in the United States (U.S.) for decades, without much regard to the negative outcomes that forced pregnancies have for those assigned female at birth regarding poverty, mental health and maternal mortality. In 1973, access to safe abortions was protected so long that the procedure was done within the legal gestational period and/or was necessary for the health and safety of the patient (Blackmun, 1972). Unfortunately, in 2022, the Supreme Court took that protection away and made it legal for states to determine the reproductive rights …

Abortion Decisions As Humanizing Acts: The Application Of Ambivalent Sexism And Objectification To Women-Centered Anti-Abortion Rhetoric, Rachel L. Dyer, Olivia R. Checkalski, Sarah Gervais

Department of Psychology: Faculty Publications

Women-centered anti-abortion rhetoric, grounded in ostensibly positive beliefs that pregnant people are precious objects who must be protected from having abortions, has proliferated anti-abortion activism and legislation. However, abortion stigma, marked by negative perceptions of people who terminate pregnancies, is the most widely used theoretical tool for understanding the social and psychological implications of abortion. In this article, we first integrate these two seemingly contradictory perspectives on abortion through the lens of ambivalent sexism theory. We then argue that ambivalent sexism paves the way for objectifying perceptions and treatment of pregnant people; specifically, our typology of reproductive objectification provides a …

Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany B. Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Human Movement Studies & Special Education Faculty Publications

Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 µmole PCB126 per kg of body weight via oral gavage on postnatal …

A Qualitative Analysis Of Women’S Postnatal Experiences Of Breastfeeding Supports During The Perinatal Period In Ireland, Niamh Lawlor, Lucia Prihodova, Deborah Byrne, Megan Etherton, Felicienne Rahill, Catie Wilson, Elizabeth O'Sullivan

Articles

Ireland has among the lowest rates of breastfeeding worldwide. Despite policies to support breastfeeding, breastfeeding initiation and exclusivity remain low in Ireland. Greater knowledge about support received in the maternity unit may—in part—shed light on why this is so. Our aim was to analyse women’s experiences of the breastfeeding supports available in the early postnatal period in Ireland. We conducted an analysis of an open-ended question on a cross-sectional survey about breastfeeding support conducted in the Republic of Ireland in 2022. Participants were asked to provide comments about the breastfeeding support they received in the maternity unit or during your …

Stuffed Animals For Coping And Communication In The Hospital: A Child Life Perspective, Becca Scobee

EWU Masters Thesis Collection

No abstract provided.

Pregnancy And Diabetic Ketoacidosis: Fetal Jeopardy And Windows Of Opportunity, Ankia Coetzee, David R Hall, Eduard J Langenegger, Mari Van De Vyver, Magda Conradie

Faculty, Staff and Student Publications

BACKGROUND: Diabetic ketoacidosis (DKA) during pregnancy poses significant risks to both the mother and fetus, with an increased risk of fetal demise. Although more prevalent in women with Type I diabetes (T1D); those with Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) can also develop DKA. A lack of information about DKA during pregnancy exists worldwide, including in South Africa.

OBJECTIVE: This study examined the characteristics and outcomes associated with DKA during pregnancy.

METHODS: The study took place between 1 April 2020 and 1 October 2022. Pregnant women with DKA, admitted to Tygerberg Hospital's Obstetric Critical Care Unit (OCCU) …

Exosomal Lipid Biomarkers Of Oligodendrocyte Pathology To Predict Scoliosis In Children With Cerebral Palsy, Nune Darbinian, Emily C Sparks, Armine Darbinyan, Nana Merabova, Tamara Tatevosian-Geller, Katie Calaku, Sarah Bachman, Huaqing Zhao, Shohreh Amini, Laura Goetzl, Solomon P Samuel, Amer Samdani, Michael E Selzer

Faculty, Staff and Student Publications

INTRODUCTION: Cerebral Palsy (CP), the most common cause of disability in children, is phenotypically heterogeneous. Approximately 20% of cases develop severe scoliosis. A pathological hallmark of CP is periventricular leukomalacia (PVL), which is due to dysmyelination, suggesting the possibility of a lipidomic abnormality. Risk factors for CP include perinatal hypoxia, prematurity, multiple gestation, ischemia, infection, and maternal alcohol consumption. There is evidence for low serum levels of omega-3 (ω-3) fatty acids in CP patients, and separately in idiopathic scoliosis. Many effects of free fatty acids (FFAs) are mediated via specific G protein-coupled free fatty acid receptors (FFARs), which play essential …

Maternal Blood Lipid Biomarkers Of Oligodendrocyte Pathology To Predict Fetal Alcohol Spectrum Disorders, Nune Darbinian, Emily C Sparks, Armine Darbinyan, Nana Merabova, Gabriel Tatevosian, Ekaterina Vadachkoria, Huaqing Zhao, Shohreh Amini, Laura Goetzl, Michael E Selzer

Faculty, Staff and Student Publications

INTRODUCTION: Up to 9.9% of children have fetal alcohol spectrum disorders (FASD), the most frequent cause of intellectual disability in the US. FASD may involve abnormal brain development, including dysmyelination, suggesting abnormal development of oligodendrocytes (OLs), which make myelin and are rich in lipids. Indeed, low serum levels of omega-3 fatty acids (ω-3) have been reported in FASD. Free fatty acids bind to specific receptors (FFARs). We have isolated cell type-specific fetal brain-derived exosomes (FB-E) from maternal blood and sampled their contents to search for lipid-related biomarkers that predict FASD.

METHODS: Blood samples were collected from two groups of pregnant …

Dna Release From Plant Tissue Using Focused Ultrasound Extraction (Fuse), Alexia Stettinius, Hal Holmes, Qian Zhang, Isabelle Mehochko, Misa Winters, Ruby Hutchison, Adam Maxwell, Jason Holliday, Eli Vlaisavljevich

Faculty, Staff and Student Publications

PREMISE: Sample preparation in genomics is a critical step that is often overlooked in molecular workflows and impacts the success of downstream genetic applications. This study explores the use of a recently developed focused ultrasound extraction (FUSE) technique to enable the rapid release of DNA from plant tissues for genetic analysis.

METHODS: FUSE generates a dense acoustic cavitation bubble cloud that pulverizes targeted tissue into acellular debris. This technique was applied to leaf samples of American chestnut (

RESULTS: We observed that FUSE can extract high quantities of DNA in 9-15 min, compared to the 30 min required for control …

Association Between Giving Birth During The Early Coronavirus Disease 2019 (Covid-19) Pandemic And Serious Maternal Morbidity, Torri D Metz, Rebecca G Clifton, Brenna L Hughes, Grecio J Sandoval, William A Grobman, George R Saade, Tracy A Manuck, Monica Longo, Amber Sowles, Kelly Clark, Hyagriv N Simhan, Dwight J Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer L Bailit, Maged M Costantine, Harish M Sehdev, Alan T N Tita, George A Macones

Faculty, Staff and Student Publications

OBJECTIVE: To evaluate whether delivering during the early the coronavirus disease 2019 (COVID-19) pandemic was associated with increased risk of maternal death or serious morbidity from common obstetric complications compared with a historical control period.

METHODS: This was a multicenter retrospective cohort study with manual medical-record abstraction performed by centrally trained and certified research personnel at 17 U.S. hospitals. Individuals who gave birth on randomly selected dates in 2019 (before the pandemic) and 2020 (during the pandemic) were compared. Hospital, health care system, and community risk-mitigation strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in response to the early …

Population-Based Linked Longitudinal Surveillance Of Pregnant People And Their Infants: A Critical Resource For Emerging, Re-Emerging, And Persistent Threats, Van T Tong, Kate R Woodworth, Erin Blau, Neha Shinde, Amanda Akosa, Suzanne M Gilboa, Dana Meaney-Delman

Faculty, Staff and Student Publications

Public health emergencies, from Zika to COVID-19, have underscored the importance of addressing the needs of pregnant people and their infants. Recent events have underlined the critical role of mother-infant-linked longitudinal surveillance to characterize and assess the impacts of emerging, re-emerging, and persistent threats, including infectious diseases, on these populations. In partnership with state, local, and territorial health departments, CDC's National Center on Birth Defects and Developmental Disabilities activated the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) to capture information about pregnant people with laboratory-confirmed infection with SARS-CoV-2 (the virus that causes COVID-19) and their infants. SET-NET …

Evaluation Of The Loving Support Peer Counseling Program On Breastfeeding Duration Rates Among African American Women Enrolled In The Program (2017-2018), Nancy S. Jeffery

College of Graduate Studies: Theses & Dissertations

Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”-World Health Organization. The aim of this study was to evaluate the effectiveness of the Loving Support Peer Counseling (LSPC) program, under the WIC program in the state of Georgia, on breastfeeding duration rates among African American postpartum primiparas women. This observational study analyzed state-level data from January 2017 through December 2018. A cross-sectional design was used to evaluate the effectiveness of the Loving Support Peer Counseling Program (LSPC) in six of the …

Medical Providers' Use Of Maternal Mental Health Screening Tools During Prenatal Appointments In Southeast Georgia, Andreka Ewing

College of Graduate Studies: Theses & Dissertations

In the United States, maternal mental health disorders are the most common comorbidities experienced during pregnancy and after childbirth. In particular, the state of Georgia reports that 1 in 7 Georgian mothers experience depression, anxiety, obsessive-compulsive disorders, or psychosis related to these disorders. Research suggests that untreated maternal mental health can have adverse effects on the mother and unborn child. Conditions such as autism, mixed handedness, reduced cognitive ability, and affective disorders can develop while the child is in the womb of a depressed mother. Routine maternal mental health screening using a validated screening tool has been recommended to help …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

College of Graduate Studies: Theses & Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Black Midwives For Black Mothers: Ameliorating Racial Disparities In The Quality Of Maternal Healthcare, Kimberly Navarro

Theses and Dissertations

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women …

In Utero Ethanol Exposure Induces Mitochondrial Dna Damage And Inhibits Mtdna Repair In Developing Brain, Nune Darbinian, Armine Darbinyan, Nana Merabova, Myrna Kassem, Gabriel Tatevosian, Shohreh Amini, Laura Goetzl, Michael E Selzer

Faculty, Staff and Student Publications

Introduction

Mitochondrial dysfunction is postulated to be a central event in fetal alcohol spectrum disorders (FASD). People with the most severe form of FASD, fetal alcohol syndrome (FAS) are estimated to live only 34 years (95% confidence interval, 31 to 37 years), and adults who were born with any form of FASD often develop early aging. Mitochondrial dysfunction and mitochondrial DNA (mtDNA) damage, hallmarks of aging, are postulated central events in FASD. Ethanol (EtOH) can cause mtDNA damage, consequent increased oxidative stress, and changes in the mtDNA repair protein 8-oxoguanine DNA glycosylase-1 (OGG1). Studies of molecular mechanisms are limited by …

Evaluating The Relationship Of In Utero Nicotine Exposure With Hypoglycemia After Delivery: An Observational Study, Mary G Johnson, Robert Suchting, Lisa M Scheid, Lindsay N Holzapfel, Aditi Chalise, Angela L Stotts, John C Chapman, Amir M Khan, Thomas F Northrup

Faculty, Staff and Student Publications

BACKGROUND: Hypoglycemia in neonates is common and contributes to 4.0-5.8% of neonatal intensive care unit (NICU) admissions. In utero nicotine exposure is underexplored as a potential contributor to neonatal hypoglycemia. Rat models have shown that in utero nicotine exposure can be associated with a reduction in pancreatic beta cell mass, leading to glucose dysregulation. The primary aim of this work is to study the risk of developing hypoglycemia after birth in a population of in utero nicotine-exposed neonates.

METHODS: We conducted a retrospective matched cohort study that augmented an existing dataset of neonates admitted to a level IV NICU with …

Understanding The Effects Of The Covid-19 Pandemic On West Virginia Students In Secondary School, Hannah Mckenzye Layman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract 1

Background: The COVID-19 pandemic negatively impacted the mental health of young people. Mental health disparities among youth are abundant, so understanding how the pandemic may have affected specific sub-groups to develop tailored interventions to mitigate variations in health disparities is essential. Methods: School-based survey data from the Young Mountaineer Health Study (YMHS) was used to create generalized estimating equations models predicting anxiety and depression among early adolescents. The cohort sample included 2,322 students. Waves 1, 2, and 3 were collected ~6 months apart. Independent variables included COVID-19-related emotional impact (scale range: 5-25) and social support. Results: Average age …

Exploring Prenatal Care In A Rural Appalachian State: A Project Watch Study Of Barriers And Facilitators In All Births From May 2018 To March 2022, Madelin Gardner

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: PNC is essential in protecting the health of birthing person and infant. Teenage and advanced maternal age (AMA) birthing persons are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC. Births to teenagers continue to be of concern in rural areas however, little is known about the association between inadequate PNC and poor infant outcomes in teenage populations. Previous studies have determined that greater risk of inadequate PNC has been linked to more rural areas compared to more urban areas. WV is the third most rural state …

Relationships Among Pregnancy, Substance Use, Social Determinants Of Health And Assessment, Referral, And Utilization Of Treatment: A Secondary Analysis Of Nsduh Data, Heather Lynn Coddington

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Relationships Among Pregnancy, Substance Use, Social Determinants of Health and Assessment, Referral, and Utilization of Treatment: A Secondary Analysis of NSDUH Data

Heather Coddington

Background: Assessment and referral for substance use disorder during pregnancy is crucial to improving outcomes for mothers and newborns during the antepartum and postpartum period. Healthcare professionals are essential during the entirety of the pregnancy during each trimester to provide effective communication when assessing for substance use early and throughout each trimester of pregnancy. The purpose of this study was to determine if there was a relationship between assessment, referral, and utilization of treatment …

Exploring Disparities In Prenatal Smoking And The Role Of Adverse Childhood Experiences, Patricia Da Rosa

Electronic Theses and Dissertations

Cigarette smoking is the most common cause of premature death, killing half of its users. During pregnancy, smoking continues to be the leading cause of premature death for both mothers and newborns. Research has consistently demonstrated smoking is not randomly distributed across populations; it is, instead, socially patterned. Women from lower socioeconomic backgrounds, those experiencing mental health issues, and rural area residents are disproportionately affected. The life course framework emphasizes the impact of exposures in early life on shaping health inequities. Eliminating health inequities, including risky behaviors such as smoking, requires an understanding of the pathways that generate these inequities. …

Adverse Maternal, Fetal, And Newborn Outcomes Among Pregnant Women With Sars-Cov-2 Infection: An Individual Participant Data Meta-Analysis, Emily R. Smith, Erin Oakley, Gargi Wable Grandner, Kacey Ferguson, Fouzia Farooq, Yalda Afshar, Mia Ahlberg, Homa Ahmadzia, Victor Akelo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Introduction: Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.

Methods: We screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.

Results: We screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.

Pregnant women with …

Understanding Maternity Care Providers’ Use Of Data In Southern Tanzania, Regine Unkels, Fadhlun Alwy Al-Beity, Zamoyoni Julius, Elibariki Mkumbo, Andrea B. Pembe, Claudia Hanson, Helle Molsted-Alvesson

Obstetrics and Gynaecology, East Africa

Introduction: Health information management system data is collected for national planning and evaluation but is rarely used for healthcare improvements at subnational or facility-level in low-and-middle-income countries. Research suggests that perceived data quality and lack of feedback are contributing factors. We aimed to understand maternity care providers’ perceptions of data and how they use it, with a view to co-design interventions to improve data quality and use.

Methods: We based our research on constructivist grounded theory. We conducted 14 in-depth interviews, two focus group discussions with maternity care providers and 48 hours of observations in maternity wards to understand …