Women's Health Commons^™

Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim

Rowan-Virtua Research Day

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …

Demographic Disparities In Contraceptive Use: Insights From Female Nsfg Respondents, 2015–2023, Adira Brenner

Rowan-Virtua Research Day

Disparities in contraceptive use persist in the United States despite expanded access to family planning services. Historical policies and ongoing social determinants of health (SDOH) are significant drivers of the continued inequality in reproductive healthcare access and utilization. This study examines demographic trends in contraceptive use using data from the National Survey of Family Growth (NSFG) between 2015 and 2023.

Data were obtained from the NSFG and the National Center for Health Statistics (NCHS) datasets. A cross-comparison was conducted, focusing on variables such as age, race/ethnicity, and educational attainment.

The consensus was that contraceptive use increased to approximately 65% in …

What Are The Correlations Between The Severity Of A Woman's Major Menopausal Symptoms And Their Eating Habits?, Kiely Hoyt, Philip Collins, Do

Rowan-Virtua Research Day

BACKGROUND

Menopause is a naturally occurring process during a woman’s life that is associated with a variety of symptoms that can significantly impact daily life.  Although hormone based therapies are available, they are not always effective or appropriate for all women.  As a result, there is growing interest in diet as a potential non-pharmacologic method to manage symptoms, though current evidence is limited.

HYPOTHESIS

Dietary habits are associated with menopause symptom severity, with certain dietary patterns potentially influencing symptom burden.

METHODS

A cross-sectional, survey study was conducted using an online questionnaire distributed through social media. A total of 129 menopausal …

Determining The Impact Fitness Training Has On Cardiovascular Health Program For New Jersey Women With Socioeconomic Disadvantages, Aishwarya Muppoor, Amy Glasofer, Lisa Rosenberry, Emma Palma, Dawn Mcmath

Rowan-Virtua Research Day

WISEWOMAN is a 3-year federally funded program offered through Virtua Health to address lifestyle changes in women age 35-64 at risk for heart disease. The purpose of this project was to evaluate the additional of a fitness program to the standard nutrition program offered through Virtua Health’s WISEWOMAN program. Nutrition programming occurred during years 1 and 2 of the WISEWOMAN program, and fitness programming was offered to women in program year 3. Women who received nutrition + exercise (intervention) will have improved outcomes compared to those who receive nutrition programming only (control). We conducted a retrospective chart review to compare …

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

De-Epithelialization Versus Pedicle De-Skinning In Reduction Mammoplasty: Comparative Outcomes From The Literature, Samantha Fry, Karina Vizzoni

Rowan-Virtua Research Day

Background- Reduction mammoplasty treats symptomatic macromastia. A key step involves pedicle preparation before breast mound reconstruction. Two main techniques include: De-epithelialization: Removes epidermis, preserves dermis, De-skinning: Excises both epidermal and dermal layers. Evidence comparing surgical outcomes between these techniques is limited.

Hypothesis- De-epithelialization will result in fewer vascular complications but longer operative times than de-skinning; thus, superiority depends on case selection.

Methods- A literature review identified studies on skin removal techniques in breast reduction mammoplasty.

Results- De-skinning was faster than de-epithelialization, though energy-assisted modalities were fastest. Nipple–areola complex (NAC) ischemia and necrosis rates were low across all methods. Superficial de-epithelialization …

Hormonal Contraceptives And Menstrual Symptom Severity Among Women With Elevated Cardiovascular Disease Risk: Global And Daily Assessment, Maria Cox, Danielle Arigo, Gabrielle M. Salvatore

Rowan-Virtua Research Day

Hormonal contraceptive (HC) use is primarily for pregnancy prevention and may reduce menstrual symptoms in some individuals, though evidence is inconsistent. The aim of the study was to examine differences in symptom presence and severity among 64 menstruating women with ≥1 CVD risk factor (e.g., hypertension), including HC users (20.63%) and non-users (79.37%; sample M_age= 31.88 ± 9.89, M_bmi= 31.79 ± 7.6). Participants completed the global Premenstrual Screening Tool at baseline and then reported the presence and severity of 16 menstrual symptoms (1=Not Present to 4 = Severe) in end-of-day surveys over 45 days. In a …

Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group

Cooper Rowan Medical Journal

Background: In June 2022, the Dobbs v Jackson Women’s Health Organization ruling overturned the previously upheld constitutional right to abortion. The resulting impact on medical training and student decision-making remains uncertain. This study aims to assess the nationwide impact of the Dobbs decision on medical students’ geographic residency preferences, specialty selection, and level of concern regarding civil and criminal charges for physicians providing abortion and fertility care.

Methods: An anonymous IRB-approved REDCap survey was distributed to American accredited medical schools across the United States and Israel between December 2022 and May 2023. Participants indicated specialty interests and geographic preferences for …

A Qualitative Analysis Of The Lived Experience Of Active-Duty Servicewomen Receiving Perinatal Care Within The Military Health System., Caitlin Russell, Emily Balog, Anne Teitelman, Rosemary Polomano

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.

STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.

RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications …

The Impact Of Obesity On The Risk Of Venous Thromboembolism In Users Of Combined Oral Contraceptives: A Comprehensive Literature Review, Adeena Javed

Rowan-Virtua Research Day

Background: Combined oral contraceptives (COCs) are a widely used method of birth control in the U.S., particularly among women aged 15–44. COCs are known to increase the risk of venous thromboembolism (VTE). Obesity, which affects over 40% of adult women in the U.S., is also a recognized independent risk factor for VTE. However, the compounded risk posed by the simultaneous presence of obesity and COC use has not been thoroughly explored.

Hypothesis: Obesity significantly elevates the risk of VTE in women using COCs, demonstrating a synergistic interaction between these two factors.

Methods: A systematic literature review was conducted using PubMed, …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Children Born To Mothers With Inflammatory Bowel Disease: A Review Of Pediatric Outcomes, Simran Gandhi, Kush Patel, Harmann Singh

Rowan-Virtua Research Day

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies.

Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation.

Methods: A literature review was conducted using PubMed and Google Scholar. Search terms …

The Physical And Mental Health Implications On Patients Of Childbearing Age Following The Dobbs Deicison, Jaclyn M. Schultz, Mariana A. Sales, Amy C. Nguyen, Chloe M. Triolo, Melissa K. Crisci

Rowan-Virtua Research Day

Background: In June 2022, the Supreme Court ruled to overturn Roe v. Wade in the Dobbs v. Jackson case which allowed for individual states to determine the legality of abortion. Thirteen states had “trigger” laws in place that immediately restricted abortion access. Since then, many states have enacted laws restricting access to abortion, increasing the total number of states where abortion is outlawed or heavily restricted.

Hypothesis: The goal of this review was to examine the potential implications of restricted access to abortion care on the physical and mental health of patients of childbearing age, which was hypothesized to be …

Relationship Between Maternal Mortality And Zip Code In New Jersey, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality remains a pressing public health concern in the United States, with significant disparities influenced by geography and social determinants of health. This study investigates the relationship between zip code-level factors and maternal mortality rates (MMR) in New Jersey (NJ), a state with demographic and socioeconomic diversity. Using data from the NJ Department of Health, CDC, and recent literature, I identified patterns correlating higher MMR with areas experiencing poverty, limited access to healthcare, and predominantly minority populations. Counties such as Essex, Union, and Cumberland—classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs)—exhibited particularly high vulnerability. These …

Screening And Prevention Of The Female Athlete Triad, Lia Summer Goldberg, Kate Whelihan

Rowan-Virtua Research Day

Background The Female Athlete Triad—a syndrome of low energy availability, menstrual dysfunction, and decreased bone mineral density—poses a significant risk to female athletes, particularly those in sports emphasizing leanness or endurance. Despite its potential to impair both performance and long-term health, the Triad remains frequently underdiagnosed due to stigma, nonspecific symptoms, and limited screening practices. This review investigates current strategies for screening and preventing the Triad, aiming to identify best practices and areas needing improvement.

Methods A literature review was conducted using PubMed, focusing on studies published after 2005. Keyword searches included “female athlete triad screening,” “prevention,” “education,” and “awareness.” …

Musculoskeletal Changes In Pregnancy: Implications For Long-Term Bone & Joint Health, Jaylyn Thompson, Clarence Julian Clark Ii, Nayarith Lopez, Aziza Ndaw

Rowan-Virtua Research Day

Pregnancy and lactation represent significant physiological challenges to maternal skeletal health, with substantial implications for both short and long-term musculoskeletal integrity. Research emphasizes that lactation induces notable skeletal adaptations, with up to 10% bone mineral density loss occurring in trabecular-rich regions such as the spine and hip (1,5). While most women experience substantial recovery post-weaning, the research indicates that recovery patterns vary significantly, with some women experiencing incomplete restoration of bone mass, potentially compromising long-term skeletal strength (3).

The underlying mechanisms driving these changes are primarily hormonal, with elevated parathyroid hormone-related protein (PTHrP) and decreased estrogen levels during lactation facilitating …

Addressing Pain Management Practices And Potential Under-Medication Of Women During Iud Insertion Procedures, Malgorzata Zembrzuska

Rowan-Virtua Research Day

Intrauterine devices (IUDs) are among the most effective and safe contraceptive options available to women, yet their utilization often remains limited due in part to fear of pain, lack of adequate pain management during insertion, and absence of standardized clinical guidelines. This literature review explores current pain management strategies for IUD insertion and examines the potential under-medication of women during this procedure. Ten sources were reviewed, including randomized controlled trials, a clinical trial, linear regression analyses, and meta-analyses, with inclusion criteria focusing on pain interventions for IUD insertion in women over the past decade. Findings reveal that commonly used interventions—such …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

Abortion Training In Family Medicine: A Post-Dobbs Examination, Innes Tounkel, Lauren Kasoff, Brittany Macdonald, Krys Foster, Allison Casola, Glen Atlas

Cooper Rowan Medical Journal

No abstract for this article type.

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

Effects Of Sex And Estrous Cycle On Extended-Access Oxycodone Self-Administration And Cue-Induced Drug Seeking Behavior, Bhumiben P Patel, Jessica A Loweth

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Increasing evidence indicates that sex is a factor that impacts the abuse liability and relapse vulnerability of prescription opioids like oxycodone. However, while women are more likely than men to be prescribed and to use these drugs, the impact of sex and ovarian hormones on prescription opioid use and relapse vulnerability remains unclear. Accurately assessing these measures is complicated by the fact that chronic opioid exposure can lower ovarian hormone levels and cause cycle irregularities.

METHODS: Adult male and female Sprague-Dawley rats self-administered oxycodone (0.1 mg/kg/infusion) under extended-access conditions (6 h/day, 10 days) followed by forced abstinence. Separate groups …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

Unplanned Pregnancy As An Independent Risk Factor For Antepartum Si In A Post Roe Vs. Wade World, Rianna Mcnamee

Rowan-Virtua Research Day

Abstract: The objective of this literature review is to determine whether unplanned pregnancy is an independent risk factor for developing antepartum SI. Background: The Supreme Court of the United States of America recently ruled that the constitution of the United States does not confer a right to abortion to its citizens. As of October 2023, twenty-one states had developed full or partial bans on abortion, resulting in millions of Americans residing in areas where terminating unplanned pregnancy is not a viable option. There is evidence that indicates antepartum suicidal ideation (SI) is higher than that of the general population, however …

Investigating Patient Barriers In Receiving Mammography Screenings Following The Covid-19 Pandemic, Nicole Clarke, Tara Pellegrino

Rowan-Virtua Research Day

Current literature shows reduced breast cancer mortality is associated with compliance of mammographic screenings (Duffy, 2020), specifically increasing the survival rate an estimated 1-2% every year for the past thirty years (Giordano, 2004). However, during the Covid-19 pandemic, rates of basic cancer screenings, including breast cancer, all declined (Chen, 2021). Unfortunately, even in a “post-pandemic” world, years after the height of the pandemic, the Rowan-Virtua School of Osteopathic Medicine Family Medicine Office has noticed many female patients still have not kept up with their routine basic healthcare screenings. While there are many barriers in access to healthcare, this survey-based study …

Use Of Point-Of-Care Ultrasound In The Diagnosis Of Postpartum Cardiomyopathy, Muhammad Noman, Frank A. Wheeler, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy is a rare form of heart failure (HF) that occurs in the late stages of pregnancy or in the early postpartum period. For it to be classified as PPCM, it must occur in the absence of another identifiable cause for HF and have left ventricular (LV) systolic dysfunction with an LV ejection fraction (LVEF) less than 45%. Here we present the case of a 46-year-old female G3P2 presented 5 days postpartum cesarean section delivery in acute respiratory distress where point of care ultrasound was used for assessment of the lungs to visualize …

Dermoid Cyst – Presenting With Llq Abdominal Pain, Mohammad A. Rattu, James A. Espinosa

Rowan-Virtua Research Day

Ovarian cysts are fluid-filled structures that may be defined as simple or complex and are often discovered incidentally on imaging. Their etiology can range from physiologically normal (such as follicular or luteal cysts) to ovarian malignancies. They are more common in the reproductive years secondary to endogenous hormonal production however may also occur at any age. Simple cysts more commonly occur among all age groups; mixed cystic and solid and completely solid ovarian lesions however have rates of increased malignancy. The most independent risk factor is age; therefore, post-menopausal women should have proper follow-up secondary to this risk. Some risk …