Maternal and Child Health Commons^™

Risk And Protective Factors For Sudden Infant Death Syndrome (Sids) In Low-Resource Communities In Kolkata India: A Mixed Methods Exploratory Study Of Semi-Structured Interviews And Survey Data, Susan Samreth, Alexandra Leader, Jillian Kiely, Turja Chakrabarti, Rupa Kapoor

Department of Pediatrics Faculty Publications

Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and infant sleep practices are widely documented and studied in high-resource countries. Knowledge of SUID/SIDS occurrence, risk factors and protective factors in low or middle-resource countries such as India is lacking. This was an exploratory study using a mixed methods (qualitative and quantitative) approach to better understand infant sleep practices and the various factors that may influence them amongst caregivers in 5 low-income communities in Kolkata, India. Twenty-eight and 22 caregivers of infants < 12 months old were recruited using a convenience sampling approach to participate in semi-structured interviews (phase 1) and a survey (phase 2), respectively. This research was conducted in partnership with Pratit International, a locally based NGO dedicated to providing comprehensive health care to disenfranchised communities in Kolkata. Analysis of qualitative and quantitative data found that infant caregivers frequently described risk factors (e.g., bedsharing, soft sleep surface, infant sleep position, objects in sleep area, environmental smoke exposure, low rates of pacifier use) and protective factors (e.g., breastfeeding, routine immunization/prenatal care, low rates of caregiver substance use) that have been associated with SIDS in high resource communities. Qualitative data revealed that certain caregivers' reasons for infant sleep position were rooted in cultural beliefs. Prenatal and postnatal sleep education given by a healthcare professional were limited and awareness of safer sleep advice in the community was low. These study findings suggest the need to provide safer sleep education resources in a culturally appropriate manner and can help guide future research on potential interventions such as the baby box.

The Effects Of Medical Misinformation About Vaccines On Parents Of Pediatric Patients, Mya Izabela B. Emelia

Nursing | Student Research Posters

No abstract provided.

Barriers To Postpartum Depression Treatment: Availability And Accessibility Of Maternal Behavioral Health-Inclusive Support Groups For Low-Income Populations, Radhika S. Venkatesan

Honors Undergraduate Theses

The maternal health crisis is a prevalent and concerning issue in the United States. The lack of efficient availability and accessibility to health care services plays a significant role in augmenting this problem. One health care service that is often understudied is support groups, for prevalent issues like postpartum depression. Considering the socioeconomic burdens of low-income mothers, this paper analyzed the accessibility and availability of maternal health support groups across counties in Florida, with varying amounts of individuals below the federal poverty level (%BPL). Essentially, Florida counties were divided into one of four categories depending on their %BPL. A Fisher’s …

The Relationship Between Food Insecurity And Low Birthweight Across Us Counties And Related Racial Disparities, Marissa A. Beldon, Shondra L. Clay, M. Courtney Hughes, Kathryn Mazurek

Faculty Articles, Papers, and Other Scholarship

Objective

To explore the relationship between low birthweight (LBW) and food insecurity across US counties and determine whether this relationship differs between Black and White women.

Methods

LBW data was derived from the 2013–2019 National Center for Health Statistics and National Vital Statistics System Birth Files. Food insecurity data was derived from Feeding America’s 2013–2019 Map the Meal Gap project. Analyses included descriptive statistics and regression models.

Results

Data were available for 3037 US counties. Food insecurity significantly predicted county-level LBW (t(3035) = 44.48, P <  .001) and explained 39.46% of the variance in LBW (F(13,035) = 1978.03, P <  .001, R = .63). Food insecurity predicted LBW for …

Women’S Health In Rural American Communities, Leandra Moukoudi Ndoko, Stephanie Zeszutek Do, Renee Reijo Pera Phd

Touro College of Osteopathic Medicine (Great Falls) Publications and Research

Limited data have been published on the status of women’s health in rural areas, particularly pertaining to women of color and rural women in the United States. The aim of this review is to briefly describe the trends in women’s health in rural areas, the factors contributing to poor health outcomes and potential ways to focus improvements most effectively. To provide this overview, approximately 310 articles were screened by full text on the database PubMed. Of these, 27 articles are described in more detail in this piece. Data focus on women’s health in the United States and include information bulletin …

London's Murderous Mothers: How Charitable And Medical Advancement Influenced Infanticide Indictments During The Long 18th Century, Brandon Gamman

EWU Masters Thesis Collection

No abstract provided.

Challenges And Opportunities Of Universal Health Coverage In Africa: A Scoping Review, Evaline Chepchirchir Langat, Paul Ward, Hailay Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

Background: Universal health coverage (UHC) is a global priority, with the goal of ensuring that everyone has access to high-quality healthcare without suffering financial hardship. In Africa, most governments have prioritized UHC over the last two decades. Despite this, the transition to UHC in Africa is seen to be sluggish, with certain countries facing inertia. This study sought to examine the progress of UHC-focused health reform implementation in Africa, investigating the approaches utilized, the challenges faced, and potential solutions.

Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we scoped the literature …

Approval Of Parent-Child Aggression As A Mediator Of Intergenerational Child Abuse Risk: An Evaluation Of Racial Differences, Casie H. Morgan, Christina M. Rodriguez, Doris F. Pu, Zoe O. Elkins

Psychology Faculty Publications

Purpose

Personal history of parent-child aggression (PCA) can predict future parenting behavior, but some effects may differ between racial groups. Black parents in the U.S. are more likely to encounter discrimination and personally experience and approve of PCA, which may account for previously reported group differences. This study examined whether personal PCA history predicted later parental child abuse risk mediated by PCA approval across the transition to parenthood, and whether effects differed by race.

Methods

Expectant parents (non-Hispanic White sample: 95 mothers with 86 fathers; Black sample: 94 mothers with 85 fathers) participated in a prospective longitudinal study, assessed prenatally …

A Multilevel Framework For The Promotion Of Maternal Mental Health And Well-Being During The Perinatal Period, Jenn A. Leiferman, Jessica Walls Wilson, Charlotte V. Farewell, Chelsea Walker-Mao, James F. Paulson

Psychology Faculty Publications

Background: Depression and anxiety are prevalent in the perinatal period and may contribute to adverse maternal and child health outcomes. A focus on multilevel protective factors may be effective in promoting well-being and increasing quality of life (QOL) in the perinatal period while simultaneously reducing or preventing depression and anxiety symptoms. We tested a conceptual model that posits specific personal, social, and community factors affecting depression, anxiety, and QOL among pregnant and postpartum individuals.

Methods: Four hundred and thirty-eight pregnant or postpartum individuals completed a 121-item cross-sectional survey composed of validated tools that assessed multilevel protective factors, health behaviors, and …

'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced By Parents While Implementing Early Intervention For Their Preterm Infants-A Qualitative Perspective, Manasa Kolibylu Raghupathy, Selim Jahangir, Sonia Khurana, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Background

Preterm birth is a highly stressful experience for both parents and infants. Parental participation in care enhances developmental outcomes, fosters parent-infant interactions and builds parental confidence. However, low parental adherence has always been a challenge in the successful implementation of intervention programs both in the NICU and at home. It is imperative to understand parents' perspectives and view the challenges that they experience through their lens while providing early intervention to their infants born preterm. This study is aimed at identifying new parents' challenges when implementing early intervention programs for their infants during the transition from hospital to home. …

Disparities In Maternal Healthcare: Examining The Impact Of Social Determinants Of Health On Provider Care Quality, Rishita Anumukonda

Honors Undergraduate Theses

Poor maternal health outcomes among racially and socioeconomically marginalized populations are a major public health concern in the United States. Effective clinician discussions during prenatal and postpartum care play an essential role in promoting maternal and infant well-being. However, the content of provider-patient discussions in maternal care and how it varies for patients exposed to different social determinants of health has not yet been well explored. This study aims to examine whether healthcare provider discussions about key maternal health topics, including preventative health tips, risk factors, and available resources, differ based on social factors such as income level and race. …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To evaluate the association of longitudinal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in early pregnancy with later development of superimposed preeclampsia with severe features in pregnancies complicated by mild chronic hypertension.

METHODS: This secondary analysis used data from the CHAP (Chronic Hypertension and Pregnancy) trial, a multicenter randomized controlled trial that involved pregnant individuals with chronic hypertension. Participants were categorized based on the development of superimposed preeclampsia with severe features. Longitudinal blood pressure measurements from enrollment to the development of superimposed preeclampsia with severe features or delivery were assessed using regression models. …

Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although spectral tissue Doppler imaging is recognized as the optimal method for assessing the fetal myocardial performance index (MPI), longitudinal reference ranges for fetal MPI measured using spectral tissue Doppler have not been established. Our objective was to use spectral tissue Doppler data to establish gestational-age-specific reference ranges from 12–33 weeks for left and right ventricular fetal MPI.

Methods

This was a prospective longitudinal study of women aged 18–35 years, with a body mass index below 30 kg/m² and a singleton pregnancy conceived spontaneously. Fetal MPI measurements were obtained in the first, second and third trimesters and MPI was …

Maternal Mortality According To State Abortion Legislative Climate Following The Us Supreme Court's Dobbs V. Jackson Women's Health Organization Ruling, Emily Nuss, Mari Iwasaki, Lindsay Robbins, Peggy Ye, Misa Hayasaka, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to evaluate how maternal mortality rates have evolved across US states following the Dobbs ruling, while accounting for the confounding influence of the coronavirus disease 2019 (COVID-19) pandemic.

Study Design

We conducted a retrospective analysis of publicly available data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database from January 2018 to December 2024. This study period was divided into three intervals: (1) pre-COVID (January 2018 to February 2020), (2) pandemic (March 2020 to September 2022), and (3) post-Dobbs (October 2022 to December 2024). Using the Kaiser Family Foundation …

Consumption Of The Food Groups With The Revised Benefits In The New Wic Food Package: A Scoping Review, Qi Zhang, Priyanka T. Patel, Bidusha Neupane, Caitlin M. Lowery, Futun Alkhalifah, Faezeh Mahdavi, Esther May Sarino

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: On 18 April 2024, the United States Department of Agriculture (USDA) published the first food package changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in over a decade, which reduced some food benefits (juice, milk, canned fish, and infant fruits and vegetables) and offered substitutes (cash-value vouchers (CVVs) or cash-value benefits (CVBs) to redeem for fruits and vegetables, cheese, soymilk, or other dairy products). Methods: To assess the impact of the changes on the consumption and redemption of these food groups, a systematic search was conducted, identifying 23 peer-reviewed publications between 2010 and 2024. …

Espad Ireland 2024 Supplementary Analysis Report: A Closer Look At Teenager Substance Use And Gambling Through Family, Peer, And School Data, Joan Hanafin, Salome Sunday, Helen Fitzmarice, Luke Clancy

Reports

No abstract provided.

Espad Ireland 2024. European School Survey Project On Alcohol And Other Drugs, Joan Hanafin, Salome Sunday, Helen Fitzmarice, Luke Clancy

Reports

No abstract provided.

Beyond Diagnostic Thresholds: Measures Of The Maternal Cardiometabolic Health Continuum And Their Association With Placental Function, Elizabeth Cook Anderson

Dartmouth College Ph.D Dissertations

Diabetes and hypertension during pregnancy adversely impact maternal and offspring health. Altered placental function is hypothesized to be involved, but impacts of elevated glucose and blood pressure (BP) within the subclinical range are unknown. The objective of this thesis is to evaluate how elevated glucose and BP, above and below diagnostic thresholds, impact measures of placental development and function including gross morphology (Aim 1), histopathology (Aim 2), and maternal circulating miRNAs (Aim 3), many of which originate in the placenta. Gross morphology and histopathology data from the New Hampshire Birth Cohort Study were used for Aims 1 and 2, and …

Proximity And Density Of Tobacco Retail Locations To Kentucky Schools And The Relationship To Youth Perceptions Of Harm And Susceptibility To E-Cigarette Use, Hannah Cardona

Theses and Dissertations--Kinesiology and Health Promotion

Purpose: To explore the potential relationship between tobacco retailer proximity/density around Kentucky elementary, middle, and high schools, and students’ perceptions, perceived norms, susceptibility to, and use of e-cigarettes. Design: A mixed-methods analysis of youth’s self-reported survey results and geographical data. Setting: 106 Kentucky elementary, middle, and high schools which participated in #iCANendthetrend’s tobacco education program between September 2023 and May 2024. Subjects: Convenience sample of students from Ky schools (N = 7,823) Measures: Items assessing e-cigarette use, susceptibility, perceptions, and perceived norms. Analysis: ANOVA tests used to compare responses of elementary, middle, and high school students. Chi-squared tests were used …

Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

Timing Of Delivery In Preeclampsia: Time To Reconsider?, Rebecca Horgan, Ahmed S. Z. Moustafa, Mackenzie Mchugh, Tetsuya Kawakita, Baha Sibai, George Saade

Department of Obstetrics & Gynecology Faculty Publications

The article discusses the need to reassess the timing of delivery in cases of preeclampsia, a condition affecting 2%–8% of pregnancies and linked to significant maternal and neonatal risks. It highlights that existing guidelines, primarily based on older studies, may not adequately reflect current clinical practices and advancements in neonatal care. The authors suggest that planned delivery at 34–36 weeks of gestation may offer maternal benefits without increasing short-term neonatal morbidity, while also emphasizing the importance of considering long-term outcomes for both mothers and infants. They advocate for further research, including large-scale randomized trials, to better understand the implications of …

Effectiveness And Safety Of Intravenous Iron Therapy In Outpatient Obstetrical Clinic For Treatment Of Iron-Deficiency Anemia During Pregnancy, Ellen M. Murrin, Olivia S. Lebeau, Lillian Singer, Mark A. Kassab, Peyton Kalan, Julie Costanzo, Scott A. Sullivan, George L. Maxwell, George R. Saade, Antonio F. Saad

Department of Obstetrics & Gynecology Faculty Publications

Background

Iron-deficiency anemia (IDA) affects over one-third of pregnant patients globally, contributing to severe maternal morbidity and adverse neonatal outcomes. Oral iron supplementation, while cost-effective, is limited by poor absorption, significant gastrointestinal side effects, and poor adherence. The use of intravenous (IV) iron addresses many of these concerns, including eliminating GI side effects and the need for daily therapy. However, administration of IV iron in pregnant patients is typically restricted to specialized infusion centers or hospitals due to concerns about acute side effects, cost, resource utilization, the need for fetal heart rate monitoring, and extended infusion times.

Methods

This descriptive …