Women's Health Commons^™

Maternal Respiratory Syncytial Virus Vaccination And Preterm Birth A Utah Statewide Retrospective Cohort Study, Amy Solsman, Torri Metz, Josh Benton, Shana Godfred-Cato

Knowledge and Creativity Expo

We conducted a statewide, retrospective cohort study to evaluate the association between maternal receipt of the respiratory syncytial virus (RSV) vaccine and preterm birth. All individuals who delivered a singleton neonate in Utah and were between 32 0/7 and 36 6/7 weeks of gestation from September 2023 to February 2024 were included and followed up until delivery. Overall, 2,733 of 24,213 individuals (11.3%) received the vaccine. Vaccine receipt was associated with lower odds of preterm birth (5.5% vaccinated group vs 6.8% unvaccinated group, adjusted odds ratio 0.80, 95% CI, 0.67–0.95). Receipt of the RSV vaccine was not associated with any …

Quantification Of Illicit And Prescription Drug Residues In Pasteurized Donor Human Milk: A Comprehensive Analytical Approach, Michelle Brenner, Kaytlin Krutsch, Ashlynn Baker, Dhavalkumar Patel, Palika Datta

Department of Pediatrics Faculty Publications

Objective

To assess the risk of infant exposure to illicit and prescription drug residues, from infant-ready, pooled, pasteurized donor human milk (PDHM) provided by healthy, screened, voluntary non-remunerated donors to a not-for-profit milk bank.

Study Design

A total of 150 pooled samples, representing 742 donor contributions, were analyzed for 15 illicit and prescription drug analytes using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Detected concentrations were evaluated for clinical significance.

Result

All 150 PDHM samples tested negative for residues of marijuana, amphetamines, benzodiazepines, fentanyl, hydrocodone, and morphine. Three samples (2%) contained trace amounts of oxycodone (< 0.6 parts per billion), yielding exposures over 455 times lower than established standards for infant safety (Relative Infant Dose: < 0.022%; standard safety threshold 10%).

Conclusion

Comprehensive analysis detected no clinically …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Artificial Intelligence And Machine Learning In Smart Vaginal Formulation Development, Deborah A. Ogundemuren, Vivek Agrahari, Andrew P. Wong, Carolina Herrera, Margaret O. Ilomuanya, Gustavo F. Doncel

CONRAD Publications

Vaginal drug delivery in women's health remains underutilized and insufficiently studied, largely due to the complexity and dynamic nature of the vaginal microenvironment. Variations in vaginal pH, hormonal levels, and microbiota composition introduce significant biological variability, complicating formulation design and contributing to inconsistent therapeutic outcomes and poor patient adherence. Conventional vaginal formulations often fail to account for these individual differences, highlighting the need for more adaptive and predictive approaches. Emerging advances in artificial intelligence (AI) and machine learning (ML) offer promising strategies to address these challenges by enabling multi-parameter, data-driven formulation development that explicitly considers biological variability. Despite their transformative …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

Estetrol (E4) For The Treatment Of Moderate To Severe Vasomotor Symptoms In Postmenopausal Women - Efficacy And Safety Results From The Phase 3 E4comfort I Multicenter, Placebo-Controlled Study, Tommaso Simoncini, Céline Bouchard, Marie Cloes, Mélanie Taziaux, Santiago Palacios, Sebastião Freitas De Medeiros, Valeriu Vrabii, David F. Archer, Nick Panay

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the efficacy and safety of estetrol in reducing moderate to severe vasomotor symptoms in postmenopausal women.

Methods

Multicenter, randomized, parallel group (1:1:1), placebo-controlled, double-blind, phase 3 study in hysterectomized and non-hysterectomized participants aged 40-65 years. A total of 640 participants with seven or more moderate to severe hot flashes daily or 50 weekly received estetrol 15 mg, estetrol 20 mg, or placebo for 12 weeks. Co-primary endpoints were the change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12. Comparisons versus placebo were made using a mixed-effects model for …

Medical Image Feature Extraction And Selection Based On Inception V3 And Gini Index For Cervical Cancer Cells Identification, Rachida Assawab, Mounir Ouzir, Badreddine Benyacoub, Abderrahim Electrochemical Sensor For Tenofovir Allati, Ismail El Moudden

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

Background: Cervical cancer remains the fourth most common cancer in women globally, with 604,000 new cases annually. Early detection through cytological screening is critical, but manual interpretation suffers from high false negative rates and requires expert pathologists often unavailable in resource-limited settings.

Methods: We developed a novel hybrid framework combining InceptionV3-based deep feature extraction with Gini Index feature selection for automated cervical cancer cell classification. Using the Herlev dataset (917 Pap smear images: 242 normal, 675 abnormal), we extracted 2048 deep features and applied systematic feature selection to identify optimal discriminative subsets. Comprehensive clustering analysis (K-means, K-medoid, Fuzzy clustering) validated …

Neurotensin Drives Theca Cell Migration During Ovulation In Primates, Jessica S. Miller, Megan A. G. Sage, Thomas E. Curry Jr., Diane M. Duffy

Department of Biomedical and Translational Sciences Faculty Publications

Theca cells are a critical steroidogenic cell type of the ovarian follicle and corpus luteum. The ovulatory luteinizing hormone (LH) surge (or human chorionic gonadotropin (hCG)) stimulates theca cell relocation from the stroma surrounding the dominant follicle to full integration into the developing corpus luteum. Luteinizing hormone/human chorionic gonadotropin also stimulates granulosa cells to produce local mediators of ovulation, including the peptide neurotensin (NTS). To determine if hCG-stimulated NTS regulates theca cell relocation within the ovulatory follicle, vehicle or an NTS receptor antagonist was injected into a macaque dominant follicle, and ovaries were removed 48 h after hCG administration. Additional …

Skeletal Muscle Myofiber Development In Non-Human Primate Offspring Deprived Of Estrogen In Utero, Phillip J. Gauronskas, Terrie J. Lynch, Eugene D. Albrecht, Gerald J. Pepe

Department of Biomedical and Translational Sciences Faculty Publications

Introduction: We previously showed that baboon offspring born to mothers deprived of estrogen during the second half of gestation exhibited insulin resistance prior to and after the onset of puberty. Moreover, the size of skeletal muscle myofibers and the number of microvessels important for delivery of insulin/glucose to myofibers were lower in near-term fetuses deprived of estrogen during pregnancy, and myofiber capillarization remained reduced in post-pubertal offspring deprived of estrogen in utero. However, it remains to be determined whether skeletal muscle size is restored to normal in animals deprived of estrogen in utero after the onset of puberty/gonadal estrogen production. …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

The Taper Sign: Sonographic Representation Of Uterine Dehiscence In Severe Cases Of Placenta Accreta Spectrum, Uma Deshmukh, Anna M. Modest, Alfred Abuhamad, Alireza A. Shamshirsaz, Jonathan L. Hecht, Scott A. Shainker

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Prenatal diagnosis of placenta accreta spectrum (PAS) depends on reliable ultrasound markers and skilled image interpretation. Existing PAS markers emphasize placental features suggestive of abnormal adherence and require advanced image optimization. However, emerging hypotheses suggest that uterine dehiscence—not placental invasion—is the central mechanism underlying PAS, particularly in severe (Grade 3) disease. Despite this, few established ultrasound markers address this uterine dehiscence. We describe a novel ultrasound marker, the taper sign, which uniquely represents the uterine dehiscence in severe PAS with anterior placenta previa, and outline a standardized technique for image acquisition and interpretation.

Methods: This descriptive report details the …

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …

Assessing The Impact Of Maternal Oral Health On The Risk Of Adverse Birth Outcomes, May Amr Salama

Health Services Research Dissertations

Preterm birth (PTB) and low birth weight (LBW) are leading causes of neonatal morbidity and mortality. Maternal periodontal disease (PD) has been increasingly linked to these adverse birth outcomes (ABOs), yet questions about causality and treatment effectiveness persist due to study design heterogeneity and potential unmeasured confounding. These gaps hinder the development of clear clinical and public health guidelines. This dissertation addresses these gaps through three interconnected studies assessing the relationship between maternal oral health and ABOs.

The first study employed a meta-epidemiological analysis of 62 original studies from nine systematic reviews to evaluate the impact of unmeasured confounding on …

Exploring Differences In Cannabis Use And Harm Perceptions Among Sexual Minority And Heterosexual Females: A Brief Report, Sarah J. Ehlke, Samantha A. Fitzer, Kendra Rigney

Psychology Faculty Publications

Objective: Sexual minority women (SMW) have higher rates of cannabis use compared to heterosexual women, which may be partially attributed to lower harm perceptions. However, no study has examined if the association between harm perceptions and cannabis use is stronger for SMW than heterosexual women. This study examined if sexual identity (SMW vs. heterosexual woman) moderated the association between harm perceptions and past 30-day cannabis use among a sample of female young adults (18-25 years old). Method: Participants were 949 (29.8% SMW; Mean age = 24.33; 92.1% non-Hispanic White) females (99.3% cisgender) recruited from Amazon Mechanical Turk who reported weekly …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

Frequency And Perceived Influence Of Menopausal Symptoms On Training And Performance In Female Endurance Athletes, Heather M. Hamilton, Natalie M. Yarish, Kristin E. Heron

Rehabilitation Sciences Faculty Publications

Menopause is associated with several negative health concerns and common menopausal symptoms. Physical activity is essential to mitigate these negative effects, but menopausal symptoms may interfere with participation in physical activity. The purpose of this study was to determine the frequency and the perceived negative effect of menopausal symptoms among female endurance athletes. Female runners, cyclists, swimmers, and triathletes 40–60 years of age were recruited (N = 187). Participants completed an online, anonymous survey that included self-reported menopausal status; the Menopausal Rating Scale (MRS), a validated measure for assessing menopausal symptoms; and the perceived effect of menopausal symptoms on …

'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. …

Therapy-Based Strategies To Support Tummy Time In Infants Post-Hospital Discharge: A Scoping Review Protocol, Ketaki Inamdar, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Tummy time is essential for infant development, yet many caregivers face significant challenges with adherence due to behavioral and contextual barriers. While numerous tummy time interventions exist, a limited understanding of their behavioral components hinders effective replication and implementation. This scoping review aims to identify multidisciplinary interventions used to promote tummy time in infants aged 0–12 months, evaluate their impact on adherence, developmental and health outcomes, and examine the behavior change techniques employed using the Theoretical Domains Framework (TDF). Following the Joanna Briggs Institute (JBI) methodology, a comprehensive search will be conducted in MEDLINE (PubMed), Web of Science Core Collection, …

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. …

Inflammatory Mediators And The Rage Pathway In Placental Tissues Of Pregnancies Complicated By Severe Preeclampsia, Neelima Chandra, Thomas D. Kimble, Kathleen R. Heim, Sharon M. Anderson, Andrew P. Wong, Andrea R. Thurman, Gustavo F. Doncel

CONRAD Publications

Introduction: Preeclampsia (PE) is a complex multisystem disorder of pregnancy associated with abnormal placentation, vascular anomalies, and systemic inflammation and hypertension. Previous research assessing inflammatory triggers of the condition used plasma, amniotic fluid, or explant samples. Studies using placental tissue from either vaginal or cesarean deliveries are confined to semiquantitative analysis using subjective scoring methods and generally involve a small sample size.

Methods: In this study, we have quantified the expression of inflammatory mediators by immunohistochemical image analysis of archived placental tissues obtained from cesarean delivery of preeclamptic, chorioamnionitic, and normal pregnancies.

Results: Among the inflammatory mediators, we found a …

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 …

The Role Of Doulas In The Health Care Continuum For Pregnant People With Substance Use Disorder: Perspectives Of Patients, Doulas, And Healthcare Providers, Dashaunda Taylor, Derek A. Chapman, Caitlin E. Martin, Cynthia C. F. Romero, Gerard Moeller

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives/Goals: The goals of this research are to 1) determine the prevalence of perinatal doula services use in Virginia, with a focus on individuals with substance use disorders (SUD), 2) evaluate awareness of doulas among pregnant and postpartum people with SUD, and 3) assess provider knowledge and interaction with doulas for the care of this population. Methods/Study Population: Both quantitative and qualitative methods will be used to evaluate patient and healthcare provider knowledge regarding doula services and the patient–doula–healthcare provider relationship. Surveys and semi-structured interviews will be administered to doulas, pregnant and postpartum women, and healthcare providers in this mixed-methods …

The Use Of Motivational Interviewing In Preventing Dental Caries Among Young Children, Denise C. Mckinney, Melissa L. Sullivan, Futun Alkhalifah

Dental Hygiene Faculty Publications

Dental caries is a complex, preventable disease that remains a global health burden. The burden of this disease has been shown to impact young children before the age of 6 years. Discussing dental caries prevention with the mother/caregiver(s) prior to childbirth is an ideal time to influence positive oral health behaviors. Motivational interviewing (MI) is a person-centered, goal-oriented, collaborative communication style that has been used to help individuals modify behaviors. The interrelated principles of partnership, acceptance, compassion, and evocation underpin the MI approach while utilizing communication skills such as asking open-ended questions, affirmation, reflective listening, and summarizing (OARS) to engage …

Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] We read with interest the recent study by Rosenfeld et al.¹ However, we have several clinical and methodological concerns about this study.¹

First, this study's propensity score matching (PSM) lacked key clinical confounders, including perinatal risk factors and the highest systolic/diastolic blood pressures. Smoking, alcohol use, and multifetal gestation, which influence blood pressure during pregnancy,²,³ potentially affect both primary and secondary outcomes. Additionally, the authors did not report standardized mean differences before and after PSM, which are essential for assessing balance.⁴

Longitudinal Assessment Of Intravillous Arterioles In Normal Pregnancy Using Superb Microvascular Imaging, R. Horgan, E. Sinkovskaya, G. Saade, E. Kalafat, A. Heeze, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

To use superb microvascular imaging (SMI) to longitudinally evaluate blood flow in intravillous arterioles (IVA) in pregnancy, and to develop reference ranges for IVA pulsatility index (PI) and peak systolic velocity (PSV) from 12 to 38 weeks' gestation.

Methods

The data for this study were obtained from the National Institutes of Health-funded Human Placenta Project. Eligible for inclusion were women aged 18-35 years, with a body mass index of <  30 kg/m², without comorbidities, with a singleton pregnancy conceived spontaneously and a gestational age of ≤ 13 + 6 weeks. Exclusion criteria were maternal or neonatal complications, fetal or umbilical cord anomalies, abnormal placental implantation and delivery <  37 weeks. Each participant underwent eight ultrasound examinations during pregnancy. Using SMI technology, the total number of IVA identified was recorded in a sagittal placental section at the level of cord insertion. The PI and PSV were measured in a total of six IVA (two in the central portion of the placenta, two peripherally towards the uterine fundal portion and two peripherally towards the lower uterine segment). Umbilical artery (UA)-PI was also obtained. Multilevel regression models were used to create reference ranges for IVA-PI and IVA-PSV at 12-38 weeks' gestation.

Results

A total of 90 women fulfilled the study criteria. IVA-PI decreased throughout pregnancy from a mean ± SD of 1.04 ± 0.23 in the first trimester (at 12-13 weeks) …

Group Antenatal Care Positively Transforms The Care Experience: Results Of An Effectiveness Trial In Malawi, Crystal L. Patil, Kathleen F. Noor, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafuulafula, Elizabeth T. Abrams, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa

Department of Medicine Faculty Publications

Background

We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes.

Methods

We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, …