Biostatistics Commons^™

Psychosocial Mediators Of A Physical Activity And Dietary Intervention In Pregnant Women With Overweight Or Obesity, Meghan Baruth, Sarah Wilcox, Jihong Liu, Rebecca Schlaff

Faculty Publications

Background

Mediation analyses provide insight into both ‘pieces’ of the mediation chain; they allow us to look into the ‘black box’ that is behavior change. They allow researchers to better understand the ‘how’ of an intervention’s effects and/or the ‘why’ behind why an intervention worked or did not work. The lack of publications in pregnant populations highlights the need for additional studies to be conducted and published. The purpose of this study is to examine the psychosocial mediators of physical activity and dietary outcomes in a sample of pregnant women with overweight or obesity participating in the Health in Pregnancy …

Short-Term Preeclampsia Prediction: Cutoff Variations For Sflt-1/Plgf In U.S. Patients With Or Without Hypertensive Disorders, Yaxin Li, Kristen Cagino, Jim Yee, Caroline Andy, Dajana Borova, Ayush Shah, Isla Racine, Tracy Grossman, Zhen Zhao

Student Papers, Posters & Projects

BACKGROUND: Preeclampsia (PE) is a complex disorder with significant maternal and fetal risks. The soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio shows promise as a diagnostic tool, but its adoption in the U.S. remains limited due to the lack of accessible testing platforms, U.S.-based studies, and evidence-based implementation guidelines.

PATIENTS/MATERIALS AND METHODS: We conducted a cohort study to evaluate the sFlt-1/PlGF ratio for predicting PE within two weeks among pregnant individuals ≥18 years, ≥20 weeks gestation. Serum samples were obtained from routine prenatal visits or triage evaluations. sFlt-1/PlGF ratios were measured using Roche Elecsys assays, and …

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …

Maternal Care Utilization And Provision During The Covid-19 Pandemic: Voices From Minoritized Pregnant And Postpartum Women And Maternal Care Providers In Deep South, Ran Zhang, Tiffany Byrd, Shan Qiao Ph.D., Myriam E. Torres Phd, Msph, Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background

The COVID-19 pandemic has significantly affected maternal care services especially for minoritized individuals, creating challenges for both service users (i.e., African American and Hispanic pregnant/postpartum women) and maternal care providers (MCPs). Guided by a socioecological framework, this study aims to investigate the experiences of African American and Hispanic pregnant and postpartum women, as well as MCPs, in accessing and providing maternal care services during the COVID-19 pandemic in the Deep South.

Methods

We conducted semi-structured interviews with 19 African American women, 20 Hispanic women, and 9 MCPs between January and August 2022. Participants were recruited from Obstetrics and Gynecology …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Effects Of A Behavioral Intervention On Physical Activity, Diet, And Health-Related Quality Of Life In Pregnant Women With Elevated Weight: Results Of The Hipp Randomized Controlled Trial, Sarah Wilcox Phd, Jihong Liu, Gabrielle Turner-Mcgrievy Ph.D., Rd, Alycia K. Boutte, Ellen Wingard Msph, Rd, Ld

Faculty Publications

Background

Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight.

Methods

Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based …

Process Evaluation Methods And Results From The Health In Pregnancy And Postpartum (Hipp) Randomized Controlled Trial, Sarah Wilcox Phd, Alicia A. Dahl, Alycia K. Boutté, Jihong Liu Sc.D., Kelsey Day, Gabrielle Turner-Mcgrievy Ph.D., Rd, Ellen Wingard

Faculty Publications

Background

Excessive gestational weight gain has increased over time and is resistant to intervention, especially in women living with overweight or obesity. This study described the process evaluation methods and findings from a behavioral lifestyle intervention for African American and white women living with overweight and obesity that spanned pregnancy (≤ 16 weeks gestation) through 6 months postpartum.

Methods

The Health in Pregnancy and Postpartum (HIPP) study tested a theory-based behavioral intervention (vs. standard care) to help women (N = 219; 44% African American, 29.1 ± 4.8 years) living with overweight or obesity meet weight gain guidelines in pregnancy and …

Metabolome-Wide Associations Of Gestational Weight Gain In Pregnant Women With Overweight And Obesity, Jin Dai, Nansi S. Boghossian, Mark Sarzynski Ph.D., Faha, Facsm, Feng Luo, Xiaoqian Sun, Jian Li, Oliver Fiehn, Jihong Liu Sc.D., Liwei Chen

Faculty Publications

Excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. This metabolome-wide association study aimed to identify metabolomic markers for GWG. This longitudinal study included 39 Black and White pregnant women with a prepregnancy body mass index (BMI) of ≥ 25 kg/m². Untargeted metabolomic profiling was performed using fasting plasma samples collected at baseline (mean: 12.1 weeks) and 32 weeks of gestation. The associations of metabolites at each time point and changes between the two time points with GWG were examined by linear and least absolute shrinkage and selection operator (LASSO) regression analyses. Pearson correlations between the …

Correcting For Measurement Error In The Outcome When Estimating The Distribution Of Time To Pregnancy With The Current Duration Approach, Nicole Nasrallah

Theses and Dissertations

The current duration approach to modeling time-to-pregnancy (TTP) models the length of pregnancy attempt for women that are currently attempting pregnancy. There is a scarcity of studies, let alone TTP studies, that account for measurement error in the outcome. Previously, the benefits of a piecewise constant model with regards to bias in estimates of the survival function with measurement error and the parametric modelling of TTP was shown. In this thesis, correcting for measurement error in the outcome with the current duration approach is explored through piecewise constant models with log-normal measurement error. Five different methods are compared to determine …

Maternal Methylmercury Exposure Through Rice Ingestion And Child Neurodevelopment In The First Three Years: A Prospective Cohort Study In Rural China, Sarah E. Rothenberg, Susan A. Korrick, Jihong Liu, Yanfen Nong, Chuan Hong, Eva P. Trinh, Xu Jiang, Fred J. Biasini, Fengxiu Ouyang

Faculty Publications

Background

Rice is an important dietary source for methylmercury; however, rice does not contain the same beneficial nutrients as fish. Our main objective was to assess associations of prenatal methylmercury exposure through rice ingestion with child neurodevelopment in rural China.

Methods

Eligible peripartum women were enrolled (n = 391), provided peripartum hair samples, and children’s neurodevelopment was assessed at 12 months (n = 264, 68%) and 36 months (n = 190, 48%) using the Bayley Scales of Infant Development, 2nd Edition, including the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI). Associations between prenatal methylmercury …

Validation Of Icd-10-Cm Codes For Injuries Complicating Pregnancy, Childbirth And The Puerperium: A Medical Record Review, Anna Hansen, Dana Quesinberry, Peter Akpunonu, Julia Martin, Svetla Slavova

Kentucky Injury Prevention and Research Center Faculty Publications

INTRODUCTION: The purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.

METHODS: A medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to …

Maternal Dietary Quality, Inflammatory Potential And Childhood Adiposity: An Individual Participant Data Pooled Analysis Of Seven European Cohorts In The Alphabet Consortium, Ling-Wei Chen, Adrien M. Aubert, Nitin Shivappa, Jonathan Y. Bernard, Sara M. Mensink-Bout, Aisling A. Geraghty, John Mehegan, Matthew Suderman, Kinga Polanska, Wojciech Hanke, Agnieszka Jankowska, Caroline L. Relton, Sarah R. Crozier, Nicholas C. Harvey, Cyrus Cooper, Mark Hanson, Keith M. Godfrey, Romy Gaillard, Liesbeth Duijts, Barbara Heude, James Hébert Scd, Fionnuala M. Mcauliffe, Cecily Kelleher, Catherine M. Phillips

Faculty Publications

Background

Mounting evidence suggests that maternal diet influences pregnancy and birth outcomes, but its contribution to the global epidemic of childhood obesity has not as yet been definitively characterized. We investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity.

Methods

We harmonized and pooled individual participant data from 16,295 mother-child pairs in seven European birth cohorts. Maternal pre-, early-, late-, and whole-pregnancy (any time during pregnancy) dietary quality and inflammatory potential assessed with the Dietary Approaches to Stop Hypertension (DASH) score and the energy-adjusted Dietary Inflammatory Index (E-DII™) score, respectively. Primary outcome was childhood overweight and obesity …

Dietary Quality And Dietary Inflammatory Potential During Pregnancy And Offspring Emotional And Behavioral Symptoms In Childhood: An Individual Participant Data Meta-Analysis Of Four European Cohorts, Kinga Polanska, Pawel Kaluzny, Adrien M. Aubert, Liesbeth Duijts, Hanan El Marroun, Wojciech Hanke, James R. Hébert, Barbara Heude, Agnieszka Jankowska, Giulia Mancano, Sara M. Mensink-Bout, Caroline Relton, Nitin Shivappa Mbbs, Mph, Ph.D., Matthew Suderman, Elzbieta Trafalska, Ewelina Wesolowska, Raquel Garcia-Esteban, Mònica Guxens, Maribel Casas, Catherine M. Phillips

Faculty Publications

Background

The impact of maternal diet during pregnancy on child neurodevelopment is of public health and clinical relevance. We evaluated the associations of dietary quality based on the Dietary Approaches to Stop Hypertension (DASH) score and dietary inflammatory potential based on the energy-adjusted Dietary Inflammatory Index (E-DII) score during pregnancy with emotional and behavioral symptoms of offspring at 7 to 10 years of age.

Methods

Individual participant data for 11,870 mother–child pairs from four European cohorts participating in the ALPHABET project were analyzed. Maternal antenatal DASH and E-DII scores were generated from self-completed food frequency questionnaires. Symptoms of depression …

The Effect Of Maternal Dietary Habits During Pregnancy On Neonate Leptin Methylation Patterns And Gestational Age, Sean Fitzpatrick

Legacy Theses & Dissertations (2009 - 2024)

The health of a newborn baby is inextricably linked to the health status of its mother and in turn the mother’s diet during pregnancy. Leptin (LEP) is an adipokine hormone involved in metabolism regulation and has been linked fetal development through the hypothalamic-pituitary-adrenal axis (HPA). Prior work suggests that gestational epigenetic alterations the LEP gene may be sensitive to adverse exposures during pregnancy, which in turn could explain variation in neonate outcomes. However, no prior work has examined this possibility explicitly. The objective of this study was to investigate the association between dietary patterns of mothers during pregnancy and their …

Blood Transfusions In Preterm Infants: Changes On Perfusion Index And Intermittent Hypoxemia, Katrina T. Ibonia, Henrietta S. Bada, Philip M. Westgate, Enrique Gomez Pomar, Prasad Bhandary, Abhijit R. Patwardhan, Elie G. Abu Jawdeh

Pediatrics Faculty Publications

BACKGROUND

Red blood cell (RBC) transfusion decreases intermittent hypoxemia (IH) events beyond the first week of life. This benefit may be related to improved perfusion to the respiratory control network. Perfusion index (PI) is a perfusion measure provided by the pulse oximeter. We hypothesized that the benefit in IH after RBC transfusion is associated with an increase in PI. In addition, we assessed the value of PI and clinical measures in predicting the effect of RBC transfusion on IH.

STUDY DESIGN AND METHODS

We prospectively enrolled infants less than 30 weeks' gestation age. PI and oxygen saturation (SpO₂) …

Increased Birth Weight Is Associated With Altered Gene Expression In Neonatal Foreskin, Leryn J. Reynolds, Rebecca I. Pollack, Richard J. Charnigo, Cetewayo S. Rashid, Arnold J. Stromberg, Shu Shen, John O'Brien, Kevin J. Pearson

Pharmacology and Nutritional Sciences Faculty Publications

Elevated birth weight is linked to glucose intolerance and obesity health-related complications later in life. No studies have examined if infant birth weight is associated with gene expression markers of obesity and inflammation in a tissue that comes directly from the infant following birth. We evaluated the association between birth weight and gene expression on fetal programming of obesity. Foreskin samples were collected following circumcision, and gene expression analyzed comparing the 15% greatest birth weight infants (n = 7) v. the remainder of the cohort (n = 40). Multivariate linear regression models were fit to relate expression levels on differentially …

Risk Factors Of Premature Rupture Of Membrane, Maryuni Maryuni, Dedeh Kurniasih

Kesmas

Angka kematian ibu di Indonesia berdasarkan Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012 sebanyak 359 per 100.000 kelahiran hidup. Penyebab kematian ibu tersebut masih didominasi oleh pendarahan, pre-eklampsia/eklampsia, dan infeksi. Salah satu penyebab infeksi adalah ketuban pecah dini (KPD). KPD dapat meningkatkan morbiditas dan mortalitas pada ibu dan anak. Insiden kejadian KPD sekitar 10,7% dari seluruh persalinan. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian KPD di Rumah Sakit Ibu dan Anak (RSIA) ANNISA Citeureup, Kabupaten Bogor tahun 2014. Penelitian ini merupakan penelitian analitik dengan rancangan penelitian kasus kontrol. Sampel terdiri dari 114 orang kasus ibu yang mengalami KPD …

Conventional Early Infant Diagnosis In Lesotho From Specimen Collection To Results Usage To Manage Patients: Where Are The Bottlenecks?, Appolinaire Tiam, Michelle M Gill, Heather J Hoffman, Anthony Isavwa, Mafusi Mokone, Matokelo Foso, Jeffrey T Safrit, Lynne M Mofenson, Thorkild Tylleskär, Laura Guay

Epidemiology Faculty Publications

INTRODUCTION: Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade.

METHODS: We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means …

Mekanisme Hubungan Sosial Ekonomi, Pemanfaatan Pelayanan Kesehatan Dan Kehamilan Risiko Tinggi Terhadap Prevalensi Panjang Badan Lahir Pendek, Demsa Simbolon, Wahyu Dwi Astuti, Lusi Andriani

Kesmas

Prevalensi panjang badan lahir pendek di Indonesia masih tinggi dan menjadi masalah kesehatan masyarakat yang disebabkan oleh pelbagai faktor secara langsung dan tidak langsung serta berdampak luas dan berkelanjutan dalam siklus kehidupan. Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 dengan pendekatan potong lintang bertujuan mengetahui mekanisme hubungan berbagai variabel laten terhadap prevalensi panjang badan lahir pendek. Sampel adalah 497 kabupaten yang diagregat dari data individu, yaitu anak lahir dari ibu berusia 15 hingga 49 tahun dengan kriteria anak kandung dan lahir tunggal. Pemodelan menggunakan Structural Equation Modelling. Kehamilan berisiko tinggi berhubungan positif langsung dengan prevalensi panjang badan lahir pendek …

Genetic Risk Of Progression To Type 2 Diabetes And Response To Intensive Lifestyle Or Metformin In Prediabetic Women With And Without A History Of Gestational Diabetes Mellitus., Shannon D Sullivan, Kathleen A. Jablonski, Jose C Florez, Dana Dabelea, Paul W Franks, Sam Dagogo-Jack, Catherine Kim, William C Knowler, Costas A Christophi, Robert Ratner, Diabetes Prevention Program Research Group.

GW Biostatistics Center

OBJECTIVE The Diabetes Prevention Program (DPP) trial investigated rates of progression to diabetes among adults with prediabetes randomized to treatment with placebo, metformin, or intensive lifestyle intervention. Among women in the DPP, diabetes risk reduction with metformin was greater in women with prior gestational diabetes mellitus (GDM) compared with women without GDM but with one or more previous live births.

RESEARCH DESIGN AND METHODS We asked if genetic variability could account for these differences by comparing β-cell function and genetic risk scores (GRS), calculated from 34 diabetes-associated loci, between women with and without histories of GDM.

RESULTS β-Cell function was …

Progestogens To Prevent Preterm Birth In Twin Pregnancies: An Individual Participant Data Meta-Analysis Of Randomized Trials., Ewoud Schuit, Sarah Stock, Rolf H.H. Groenwold, Kimberly Maurel, C. Andrew Combs, Thomas Garite, Catherine Y. Spong, Elizabeth A. Thom, Dwight J. Rouse, Steve N. Caritis, George Saade, Julia M. Zachary, Jane E. Norman, Line Rode, Katharina Klein, Ann Tabor, Elcin Cetingoz, John C. Morrison, Everett F. Magann, Christian M. Briery, Vicente Serra, Alfredo Perales, Juan Meseguer, Anwar Nassar, Arianne C. Lim, Karel G.M. Moons, Anneke Kwee, Ben W.J. Mol

Epidemiology Faculty Publications

Background

Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix) or to determine adverse effects for rare outcomes such as intrauterine death.

Methods/design

We propose an individual participant data meta-analysis of high quality randomized, double-blind, placebo-controlled trials of progestogen treatment in women with a twin pregnancy. The …