Maternal and Child Health Commons^™

Health Care Workers’ Perspectives Of The Influences Of Disrespectful Maternity Care In Rural Kenya, Adelaide Lusambili, Stefania Wisofschi, Constance Shumba, Jerim Obure, Kennedy Mulama, Lucy Nyaga, Terrance J. Wade, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HCWs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identified four areas …

Prenatal Depression And Risk Of Short Interpregnancy Interval In A Predominantly Puerto Rican Population, Sami Backley, Alex Knee, Penelope Pekow, Glenn Markenson, Katharine O White, Corina Schoen, Lisa Chasan-Taber

Faculty, Staff and Student Publications

Background: Short interpregnancy interval (IPI) is associated with risk of adverse pregnancy outcomes; however, few studies have evaluated the role of depression as a risk factor for short IPI. Puerto Rican women in the United States experience disparities in adverse birth outcomes and have the highest birth rates.

Methods: We analyzed the association between prenatal depressive symptoms and IPI in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women in Western Massachusetts (2006–2011). Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) in early, mid, and late pregnancy. We calculated follow-up time as the difference between the …

J Mich Dent Assoc November 2020

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Feature articles on how “Routine Blood Lead Testing During Pregnancy Empowers Future Dental Caries and Neurotoxicity Research”, how to “Recoup Your Dues and More with MDA-Endorsed Programs”, and your “2021 MDA Membership Benefits Guide”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, 10-Minute EBD, Headquarters …

Characterizing Prenatal Maternal Distress With Unique Prenatal Cortisol Trajectories, Gage Peterson, Emma V. Espel, Elyssia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

Objective: It is widely assumed that glucocorticoids represent a primary mechanism through which exposure to adversity and maternal psychological distress shape prenatal developmental trajectories of both mother and fetus. However, despite repeated investigations and the fact that prenatal cortisol has been reliably linked to developmental outcomes, the empirical evidence supporting an association between prenatal cortisol and maternal distress is scarce. In this study, a novel approach to assessing links between maternal prenatal psychological distress and gestational cortisol profiles, general growth mixture modeling (GGMM), was applied. Method: Measures of pregnancy anxiety, perceived stress, and state anxiety and depressive symptoms as well …

Frontline Health: Harmonizing Metrics, Advancing Evidence, Accelerating Policy—Project Overview Brief, Frontline Health Project

Reproductive Health

Despite decades of technological and medical progress globally, half the world’s population still lacks access to essential health care due to insufficient numbers and types of health workers, especially in remote settings. There is growing recognition that well-supported community health workers (CHWs) are essential for effective delivery of primary health care (PHC). Despite broad consensus on the importance of CHWs, few countries have successfully integrated them as part of PHC at scale, and many lack official statistics on the performance of CHW programs. USAID, UNICEF, and the Bill & Melinda Gates Foundation developed a Memorandum of Understanding to collaborate on …

Revisiting Child And Adolescent Health In The Context Of The Sustainable Development Goals, Zulfiqar Ahmed Bhutta, Kathryn M. Yount, Quique Bassat, Artur A. Arikainen

Woman and Child Health

No abstract provided.

Machine Learning Model Demonstrates Stunting At Birth And Systemic Inflammatory Biomarkers As Predictors Of Subsequent Infant Growth - A Four-Year Prospective Study, Elizabeth Harrison, Sana Syed, Lubaina Ehsan, Najeeha Talat Iqbal, Kamran Sadiq, Fayyaz Umrani, Sheraz Ahmed, Najeeb Rahman, Sadaf Jakhro, Jennie Z. Ma, Molly Hughes, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Stunting affects up to one-third of the children in low-to-middle income countries (LMICs) and has been correlated with decline in cognitive capacity and vaccine immunogenicity. Early identification of infants at risk is critical for early intervention and prevention of morbidity. The aim of this study was to investigate patterns of growth in infants up through 48 months of age to assess whether the growth of infants with stunting eventually improved as well as the potential predictors of growth.
Methods: Height-for-age z-scores (HAZ) of children from Matiari (rural site, Pakistan) at birth, 18 months, and 48 months were obtained. Results …

Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara

Woman and Child Health

The prevalence of “toxic stress” and huge downstream consequences in disease, suffering, and financial costs make prevention and early intervention crucial, say Charles A Nelson and colleagues.

Outcomes After In Utero Myelomeningocele Repair Based On Delivery Location, Eric P Bergh, Kuojen Tsao, Mary T Austin, Stephen A Fletcher, Suzanne M Lopez, Kenneth J Moise, Anthony Johnson, Ramesha Papanna

Faculty, Staff and Student Publications

Maternal and pediatric delivery outcomes may vary in patients who underwent open fetal myelomeningocele repair and elected to deliver at the fetal center where their fetal intervention was performed versus at the referring physician’s hospital. A prospective cohort study of 88 patients were evaluated following in utero open fetal myelomeningocele repair at a single fetal center between the years 2011–2019. Exclusion criteria included patients that delivered within two weeks of the procedure (n = 6), or if a patient was lost to follow-up (n = 1). Of 82 patients meeting inclusion criteria, 36 (44%) patients were delivered at …

Outcomes After In Utero Myelomeningocele Repair Based On Delivery Location, Eric P Bergh, Kuojen Tsao, Mary T Austin, Stephen A Fletcher, Suzanne M Lopez, Kenneth J Moise, Anthony Johnson, Ramesha Papanna

Faculty, Staff and Student Publications

Maternal and pediatric delivery outcomes may vary in patients who underwent open fetal myelomeningocele repair and elected to deliver at the fetal center where their fetal intervention was performed versus at the referring physician’s hospital. A prospective cohort study of 88 patients were evaluated following in utero open fetal myelomeningocele repair at a single fetal center between the years 2011–2019. Exclusion criteria included patients that delivered within two weeks of the procedure (n = 6), or if a patient was lost to follow-up (n = 1). Of 82 patients meeting inclusion criteria, 36 (44%) patients were delivered at …

Dancing During Labor: Are Women Down To Boogie?, Drew A. Horter, Kayla Heslin, Marie Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Recent social media trends have demonstrated increased interest in dancing during the final weeks of pregnancy and labor. However, there is limited evidence about dancing during labor and its impact on labor pain and duration as well as patient satisfaction. Before conducting a prospective study, given that enrollment is often challenging, our feasibility study aimed to assess the willingness of pregnant women to participate in a future study evaluating low-impact dance during labor. We anonymously surveyed a convenience sample of English-speaking/reading pregnant women who presented for prenatal care at 1 of 3 clinics from June 2019 to July 2019. Questions …

Use Of Smokeless Tobacco Before Conception And Its Relationship With Maternal And Fetal Outcomes Of Pregnancy In Thatta, Pakistan: Findings From Women First Study, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Brandi Vollmer, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Introduction: Smokeless tobacco (SLT) consumption during pregnancy has adverse consequences for the mother and fetus. We aimed to investigate the effects of maternal pre-pregnancy SLT consumption on maternal and fetal outcomes in the district of Thatta, Pakistan.
Methods: We conducted a secondary data analysis of an individual randomized controlled trial of preconception maternal nutrition. Study participants were women of reproductive age residing in the district of Thatta, Pakistan. Participants were asked questions regarding the usage of commonly consumed SLT known as gutka (exposure variable). Study outcomes included maternal anemia, miscarriage, preterm births, stillbirths, and low birth weight. We performed a …

Intergenerational Associations Of Adverse Birth Outcomes: A Surveillance Report, Dong Liu, Ge Lin, Dejun Su, James M. Alexender, Xiaoting Sun, Ming Qu

School of Medicine Faculty Research

Nebraska births between 1995 and 2005 were followed until 2018 to look for intergenerational associations of low birth weight (LBW) and preterm birth (PTB). Results from generalized estimating equations revealed that mothers born LBW preterm were more likely to deliver LBW (adjusted OR 1.94, 95% CI 1.39–2.71) or preterm (adjusted OR 1.65, 95% CI 1.20–2.27) than mothers born with normal weight or at term. In addition, mothers who had an LBW sibling were 44% more likely to have an LBW infant (OR 1.44, 95% CI 1.04–2.00). A consistent finding was also observed for mothers who had a PTB sibling (OR …

Accuracy Of Rn Visual Quantification Of Emesis Volumes In The Neonatal Intensive Care Unit, Stephen Stoever

Seton Hall University DNP Final Projects

An important component of nursing assessment of feeding tolerance in the neonatal intensive care unit (NICU) for both low-risk and high-risk babies, is the quantification of emesis volumes. While some nurses attempt to weigh the items saturated in emesis in order to quantify volume loss (QEV), there is no or limited consistency in this practice across nurses in this unit. Rather, volumes are “best-guessed” or estimated (EEV) and reported to the practitioner for decision-making. Often feed advances are paused or limited due to perceived feeding intolerance connected to emesis events in neonates.

For this project, 158 NICU nurses at a …

Evaluating Implementation Of "Management Of Possible Serious Bacterial Infection (Psbi) When Referral Is Not Feasible" In Primary Health Care Facilities In Sindh Province, Pakistan, Maria Asif Bhura, Shabina Ariff, Shamim Ahmad Qazi, Zaitoon Qazi, Imran Ahmed, Yasir Bin Nisar, Zamir Suhag, Abdul Wahab Soomro, Sajid Bashir Soofi

Woman and Child Health

Background: The World Health Organization (WHO) launched a guideline in 2015 for managing Possible Serious Bacterial Infection (PSBI) when referral is not feasible in young infants aged 0-59 days. This guideline was implemented across 303 Basic Health Unit (BHU) Plus primary health care (PHC) facilities in peri-urban and rural settings of Sindh, Pakistan. We evaluated the implementation of PSBI guideline, and the quality of care provided to sick young infants at these facilities.
Methods: Thirty (10%) out of 303 BHU Plus facilities were randomly selected for evaluation. A survey team visited each facility for one day, assessed the health system …

Weight Status Of Children Aged 2-5 Years Old, Attending A Paediatric Outpatient Clinic And Its Association With Parental Feeding Style And Parental Perceptions Of Weight Status, Aisling Lee, Helen Callaghan, Dara Gallagher Dr, Annette Lalor, Louise Rattigan, Hilary Greaney, Laura Keaver

SURE Journal: Science Undergraduate Research Experience Journal

Background: A child’s weight status can allow health care professionals to assess their developmental growth. A child having a low or high weight for height could be due to an imbalance in nutrient intake occurring. It is important to balance dietary intake and physical activity to maintain a healthy weight status. Excessive consumption of food can lead to an overweight/obese weight status which is linked to non-communicable diseases. Parental feeding style can directly impact a child’s set of eating behaviours. Therefore, parents have a strong influence over a child’s growth pattern. In addition, parental awareness of childhood obesity is reported …

Chronic Inflammation Was A Major Predictor And Determinant Factor Of Anemia In Lactating Women In Sidama Zone Southern Ethiopia: A Cross-Sectional Study, Tafere Gebreegziabher Belay, Taylor Roice, Barbara J. Stoecker

All Faculty Scholarship for the College of the Sciences

Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socio-economic factors were assessed. From each, a blood sample was collected …

Cesarean Delivery And Infant Cortisol Regulation, Leticia D. Martinez, Laura M. Glynn, Curt A. Sandman, Deborah A. Wing, Elysia Poggi Davis

Psychology Faculty Articles and Research

Background:
Cesarean delivery reduces the risk of infant and maternal morbidity and mortality when medically indicated, however, the cesarean delivery rate is estimated to be two to three times higher than medically necessary. The World Health Organization and American College of Obstetricians and Gynecologists have expressed concern over the high rates of cesarean delivery, citing evidence that cesarean delivery has negative short- and long-term consequences for the health of the infant, mother, and for future pregnancies. Infants delivered by cesarean are at an increased risk of metabolic disease and immune dysfunction throughout the lifespan. Preliminary research suggests that the …

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

High Impact Practices—Detecting And Managing Hypertension In The Extended Postnatal Period: Preventing Postnatal Pre-Eclampsia And Eclampsia, Charlotte E. Warren

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: detecting and managing hypertension in the extended postnatal period. Key points presented are: the extended postnatal period provides an opportunity to monitor a woman’s blood pressure (BP) and check for persistent hypertension; if BP is measured routinely at any contact with the health system during the extended postnatal period, hypertension is more likely to be detected and managed appropriately; women with pre-eclampsia have a 3.7-fold …

Overview Of High Impact Practices For Improved Prevention, Detection, And Management Of Hypertensive Disorders In Pregnancy, Population Council

Reproductive Health

As part of the Ending Eclampsia Project and supported by the Pre-eclampsia Technical Working Group, the Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving the prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). HDPs affect 10 percent of women globally and are major contributors to maternal and newborn mortality, morbidity, and disability. Providing essential services and health education for women at all levels of the health system is necessary to improve survival rates and quality of life for those who experience HDPs and their newborns. Inspired by Family Planning HIPs, …

High Impact Practices—Task Sharing For Hypertensive Disorders In Pregnancy: Improving Early Detection And Management Of Hypertensive Disorders In Pregnancy, Karen Kirk

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: task sharing, which is the expansion of the levels of health providers who can appropriately deliver health services. Key points presented in this brief are: optimizing available human resources through task sharing can be an effective strategy to increase access to health services; task sharing key services for the prevention, detection, and management of hypertensive disorders in pregnancy can help prevent maternal and newborn morbidity …

High Impact Practices—Encouraging Empowerment And Self-Care Through Participatory Women’S Groups And Group Antenatal Care: Supporting Women To Be At The Center Of Their Own Care As Active Participants, Tracy Mcclair

Reproductive Health

The Population Council developed High Impact Practice (HIP) briefs for three strategies that show promise for improving prevention, detection, and management of Hypertensive Disorders in Pregnancy (HDPs). This brief focuses on one of those strategies: encouraging empowerment and self-care through participatory women’s groups and group antenatal care. Key points presented are: highly participatory, group-based interventions—such as community-based women’s groups and group antenatal and postnatal care (ANC/PNC)—provide opportunities for women to share their experiences and knowledge with others, discuss the local context for challenges and how to address them, and promote empowerment and agency; participation in these groups is associated with …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Operability, Usefulness, And Task-Technology Fit Of An Mhealth App For Delivering Primary Health Care Services By Community Health Workers In Underserved Areas Of Pakistan And Afghanistan: Qualitative Study, Shehla Zaidi, Abdul Momin Kazi, Atif Riaz, Ammarah Ali, Rabia Najmi Taha, Rawshan Jabeen, Umerdad Khudadad, Saleem Sayani

Community Health Sciences

Background: The recent proliferation of digital health technology in low- and middle-income countries has made it possible for community health workers (CHWs) to use mobile health (mHealth) to perform tasks such as data collection and training. Although most studies focus on the prospect of digital apps to motivate and connect CHW, only a few have captured end-user experiences with mobile-based apps. We examined the experience of frontline health workers with a move towards digitalized real-time data to record maternal and childcare services in remote areas of Afghanistan and Pakistan.
Objective: Our study aimed to explore CHW perceptions on the operability …

Fertility Awareness And Parenting Intentions Among Mexican Undergraduate And Graduate University Students, J. M. Place, Brennan D. Peterson, B. Horton, M. Sanchez

Marriage and Family Therapy Faculty Articles and Research

An online, cross-sectional survey was carried out between November 2017 and January 2018 to assess fertility awareness among students attending the National Autonomous University of Mexico (UNAM) in Mexico City. A total of 371 students participated in the survey (n = 228 females, 143 males). 75% of females and 74% of males believed a woman’s fertility begins to decline markedly after age 40. Over 75% of all participants overestimated the probability of couples having a live birth after undergoing one cycle of IVF. With regard to parenting intentions, only 48% of females wished to have children compared to 59% …

Neonatal Lead (Pb) Exposure And Dna Methylation Profiles In Dried Bloodspots, Luke Montrose

Public and Population Health Faculty Publications and Presentations

Lead (Pb) exposure remains a major concern in the United States (US) and around the world, even following the removal of Pb from gasoline and other products. Environmental Pb exposures from aging infrastructure and housing stock are of particular concern to pregnant women, children, and other vulnerable populations. Exposures during sensitive periods of development are known to influence epigenetic modifications which are thought to be one mechanism of the Developmental Origins of Health and Disease (DOHaD) paradigm. To gain insights into early life Pb exposure-induced health risks, we leveraged neonatal dried bloodspots in a cohort of children from Michigan, US …

A Case Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project—Brief, Population Council

HIV and AIDS

The ZAMFAM program aims to improve the care and resilience of orphans and vulnerable children (OVC) as well as young people living with HIV in Zambia by providing support and protection and by strengthening the capacity of children, families, and the community to better manage the socioeconomic shocks of the HIV/AIDS epidemic. A case study approach was employed to understand actors and perceptions, and to document best practices by the program. This brief summarizes the case study findings. The ZAMFAM program utilized several approaches to improving the well-being of OVC. Services or referrals were provided to beneficiaries through home visitation …

A Case-Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project, Lyson Phiri, Drosin Mulenga, Nancy Choka, Caila Brander, Nachela Chelwa, Nkomba Kayeyi

HIV and AIDS

Zambia’s HIV prevalence is estimated at 11% among adults aged 15–49 years and 1% among children younger than 15 years. An estimated 10% of Zambia’s population is at high risk of being orphaned or vulnerable due to the HIV epidemic. The Zambia Family (ZAMFAM) project aims to improve the care and resilience of vulnerable populations while supporting HIV epidemic control. ZAMFAM used a case management approach that tracks beneficiaries from identification to graduation. The Population Council conducted a qualitative case study to understand actors and perceptions, and document best practices. Program beneficiaries viewed the ZAMFAM program as having made a …

Frequency And Outcome Of Meconium Aspiration Syndrome In Babies Born With Meconium-Stained Liquor At Secondary Care Hospital In Pakistan: A Case Series Study, Abdul Moeed, Heeramani Lohana, Sarwat Urooj, Sheraz Ahmed, Khalil Ahmed, Khadija N Humayun

Department of Paediatrics and Child Health

Background: Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome; in terms of hospital stay, complications, and mortality.
Methods: The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled …