Maternal and Child Health Commons^™

Stillbirth Mortality By Robson Ten-Group Classification System: A Cross-Sectional Registry Of 80 663 Births From 16 Hospital In Sub-Saharan Africa, Claudia Hanson, Kristi Annerstedt, Maria Alsina, Muzdalfat Abeid, Hussein Kidanto, Helle Alvesson, Andrea Pembe, Peter Waiswa, Jean-Paul Dossou, Effie Chipeta

Centre of Excellence in Women and Child Health

Objective To assess stillbirth mortality by Robson ten-group classification and the usefulness of this approach for understanding trends.

Design Cross-sectional study.

Setting Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.

Population All women aged 13–49 years who gave birth to a live or stillborn baby weighting >1000 g between July 2021 and December 2022.

Methods We compared stillbirth risk by Robson ten-group classification, and across countries, and calculated proportional contributions to mortality.

Main outcome measures Stillbirth mortality, defined as antepartum and intrapartum stillbirths.

Results We included 80 663 babies born to 78 085 women; …

Investigating The Influence Of Prenatal Metals Exposures On Childhood Mitochondrial Biomarkers, Z'Dhanne Williams

Molloy Multidisciplinary Undergraduate Research Conference

Note: Z'Dhanne is a current Molloy student and conducted this research while studying at Columbia University - Mailman School of Public Health

Abstract

Background and Purpose: Mitochondrial health plays a vital role in the development of chronic health conditions, including neurodegenerative and cardiovascular diseases. Mitochondria have the unique ability to independently control replication of mitochondrial DNA (mtDNA) depending on conditions of cellular stress, including oxidative stress. Exposure to environmental metals affects a variety of health outcomes via oxidative stress pathways. Our objective was to determine the association between prenatal exposure to metals on two biomarkers of mtDNA in child blood: …

Prognostic Values Of Serum Lactate-To-Bicarbonate Ratio And Lactate For Predicting 28-Day In-Hospital Mortality In Children With Dengue Shock Syndrome, Thanh Nguyen Tat, Nhu Vo Hoang-Thien, Dat Nguyen Tat, Phuc Hoang Nguyen, Lien Thi Ho, Duong Hung Doan, Dung Tuan Phan, Yen Nguyen-Hoang Duong, Truc Huynh Nguyen, Tuyet Kim Nguyen, Ha Thi-Thu Dinh, Thuy Thi-Diem Dinh, Anh Thi-Mai Pham, Viet Do Chau, Tung Huu Trinh, Luan Vo Thanh

Faculty, Staff and Student Publications

This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of …

Reproductive Justice In Mississippi: A Call For Reform And Acknowledgement, Andie Udziela

Honors Theses

In this thesis, I apply the values of the Reproductive Justice Movement to reproductive healthcare resources in Mississippi to advocate for reproductive policy reform. I begin by navigating the historic racial discrimination in gynecology and how it manifested in Mississippi. Dr Sim’s abusive experimentation on Anarcha, Betsy, and Lucy depict how Anti-Black racism took root in gynecology and obstetrics and was later expanded on by the eugenic goals of white supremacy and the feminist movement through Margaret Sanger and the Mississippi Appendectomy. Then I discuss the current availability of reproductive care in Mississippi to low-income individuals to emphasize socioeconomic and …

The Mental Health Impact Of Aortic Dissection, Elaine Symanski, Kristina W Whitworth, Hector Mendez-Figueroa, Kjersti M Aagaard, Iman Moussa, Juan Alvarez, Adrien Chardon Fabian, Kurunthachalam Kannan, Cheryl L Walker, Cristian Coarfa, Melissa A Suter, Hamisu M Salihu

Faculty, Staff and Student Publications

INTRODUCTION: The Maternal and Infant Environmental Health Riskscape (MIEHR) Center was established to address the interplay among chemical and non-chemical stressors in the biological, physical, social, and built environments that disproportionately impact perinatal health among Black pregnant people in a large and diverse urban area with documented disparities in the U.S.

METHODS: The MIEHR cohort is recruiting non-Hispanic Black and non-Hispanic white pregnant people who deliver their infants at major obstetric hospitals in Houston, Texas. At enrollment, all participants are asked to provide urine samples for chemical [metals, cotinine, and polycyclic aromatic hydrocarbons (PAHs)] analyses and blood samples. A subset …

Improving Patients’ Perception Of Provider Trust And Communication With Birth Plans, Christelle Reeves, Nicole Tenzel, Timothy Kremer

North Texas GME Research Forum 2024

Objective: Birth plans are an effective tool for a pregnant person to express their desires and expectations for labor and postpartum. Shortcomings of birth plans can be found whenever there is a lapse in communication between provider and patient. In the management of labor and emergent situations, it has been observed by patients that obstetric providers can communicate in authoritarian and dismissive manners. In response to this, birth plans were developed to serve as a guide in these scenarios. Birth plans allow a pregnant person to design a thoughtful plan of action with their healthcare provider before giving birth, rather …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

Preparatory Program For Women During Pregnancy/Postpartum And Transitioning Back To Work Or School, Bria Runnels, Rebecca King

Spring 2024 Virtual OTD Capstone Symposium

Despite the importance of maternal health during the prenatal, postnatal, and parenting stages, there is a lack of research on the role of occupational therapists (OTs) in addressing the occupational challenges faced by women during this transitional phase. This dissertation aims to develop a program that raises awareness of the role of occupational therapy in maternal health and promotes occupational therapists as part of an interdisciplinary team within the scope of maternal health care. By adapting co-occupation for mothers, occupational therapists can play an important role in individualizing occupations for enhanced transitioning and overall quality of life. The study highlights …

‘Joining The Dots: Linking Prenatal Drug Exposure To Childhood And Adolescence’ – Research Protocol Of A Population Cohort Study, Kate Lawler, Mithilesh Dronavalli, Andrew Page, Evelyn Lee, Hannah Uebel, Barbara Bajuk, Lucinda Burns, Michelle Dickson, Charles Green, Lauren Dicair, John Eastwood, Ju Lee Oei

Faculty, Staff and Student Publications

INTRODUCTION: Prenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. The

METHODS AND ANALYSIS: Information from routinely collected administrative databases was linked for all births registered in New South Wales (NSW), Australia between 1 July 2001 and 31 December 2020 (n=1 834 550). Outcomes for seven mutually exclusive groups of children with varying prenatal exposure to maternal substances of addiction, including smoking, alcohol, prescription/illicit drugs and neonatal abstinence syndrome will be assessed. Key exposure measures include maternal drug use type, maternal …

Pharmacologic Management Of Postpartum Hemorrhage In An Urban Hospital, Jessica Summer Martin Bsn, Rn, Alison Brubaker Doyle Bsn, Rn, Lacey Camille Ballard Bsn, Rn, Stephanie Marie Maupin Bsn, Rn, Kate Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

This retrospective chart review examined female patients (N=25) who had a postpartum hemorrhage. Electronic medical records from Regional One Health were queried for ICD-10 072 related codes from January 1, 2021-October 31, 2023. Of those, a maximum of 25 charts were identified and the information was deidentified. All data was de-identified, coded, encrypted, housed, and locked securely. Selected records that met the above criteria were then queried for the following: Baseline demographics, gravida, para, amount of blood loss, pharmacological and non-pharmacological interventions, and timing of tranexamic acid (TXA) administration. Data was imported into MS Excel and statistical analysis was conducted …

Impact Of Fads Genotype On Polyunsaturated Fatty Acid Content In Human Milk Extracellular Vesicles: A Genetic Association Study, John J. Miklavcic, Natalie Paterson, Jennifer Hahn-Holbrook, Laura M. Glynn

Food Science Faculty Articles and Research

Background

Extracellular vesicles in human milk are critical in supporting newborn growth and development. Bioavailability of dietary extracellular vesicles may depend on the composition of membrane lipids. Single-nucleotide polymorphisms (SNPs) in the fatty acid desaturase gene cluster impact the content of long-chain polyunsaturated fatty acids in human milk phospholipids. This study investigated the relation between variation in FADS1 and FADS2 with the content of polyunsaturated fatty acids in extracellular vesicles from human milk.

Methods

Milk was obtained from a cohort of mothers (N = 70) at 2–4 weeks of lactation. SNPs in the FADS gene locus were determined using …

Neonatal Outcomes In The Surgical Management Of Placenta Accreta Spectrum Disorders: A Retrospective Single-Center Observational Study From 468 Vietnamese Pregnancies Beyond 28 Weeks Of Gestation, Phuc Nhon Nguyen, Anh Dinh Bao Vuong, Xuan Trang Thi Pham

Faculty, Staff and Student Publications

BACKGROUND: Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes.

METHODS: This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation …

Voices, Stories And Experiences Of Black Women Phase Ii: Community Engagement Activity Report Informing The Establishment Of A Trenton-Based Maternal & Infant Health Innovation Center, John S. Watson Institute For Urban Policy And Research, Tirzah Spencer, Phd, Mph, Barbara George Johnson

Center for Urban Policy Research

As an extension of our 2022 study Voices, Stories and Experiences of Black Women (Phase 1), the John S. Watson Institute for Urban Policy and Research at Kean University’s Maternal and Child Health Equity Team was asked to share information about the planned Maternal and Infant Health Innovation Center (MIHIC) with Trenton residents as a part of Nurture NJ’s community engagement efforts. The Team implemented the following community engagement activities: Communication: Community engagement through social media outreach and in-person outreach were used as approaches to inform Trenton residents about the MIHIC. Dissemination of Findings: Community cafés were designed to share …

Los Determinantes Sociales Y El Acceso A La Salud De Las Mujeres Migrantes: Desde La Perspectiva De Las Usuarias Y Los Trabajadores De Salud, Vanessa Gutiérrez

Independent Study Project (ISP) Collection

For the past few years, Chile has developed laws and programs, such as the Program for Access to Healthcare for Immigrants, Decree N° 67, and recently Law N° 21.235, to improve the access that migrants have, however, there has been a failure to comply with these regulations. In this qualitative and descriptive investigation, the main objective is to find out how accessible, adequate, and effective the health resources offered by clinics are for migrant women. In order to carry out the investigation, eight semi-structured interviews were held with five primary healthcare workers who frequently work with the migrant population and …

Bridging The Gap: Strategies For Enhancing Wic Participation Rates In South Dakota, Melissa K. Wyum

Honors Thesis

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a national program administered by the USDA to State agencies for low-income women and nutritionally at-risk infants and children. South Dakota WIC provides services related to breastfeeding, healthcare referrals, and accessibility/knowledge of nutritious foods. Successes of WIC include improved birth outcomes, decreased healthcare costs, regular immunization rates, establishment of a primary care provider, and improved nutrition status. Although WIC has shown positive health outcomes for mothers and children, the relationship between the barriers of WIC access and resulting health outcomes in South Dakota is unknown. According to the …

Digital Health Technologies For High-Risk Pregnancy Management: Three Case Studies Using Digilego Framework, Sahiti Myneni, Alexandra Zingg, Tavleen Singh, Angela Ross, Amy Franklin, Deevakar Rogith, Jerrie Refuerzo

Faculty, Staff and Student Publications

OBJECTIVE: High-risk pregnancy (HRP) conditions such as gestational diabetes mellitus (GDM), hypertension (HTN), and peripartum depression (PPD) affect maternal and neonatal health. Patient engagement is critical for effective HRP management (HRPM). While digital technologies and analytics hold promise, emerging research indicates limited and suboptimal support offered by the highly prevalent pregnancy digital solutions within the commercial marketplace. In this article, we describe our efforts to develop a portfolio of digital products leveraging advances in social computing, data science, and digital health.

METHODS: We describe three studies that leverage core methods from

RESULTS: Scalable social computing models using deep learning classifiers …

Clinical Epidemiological Characteristics And Risk Factors For Severity Of Sars-Cov-2 Pneumonia In Pediatric Patients: A Hospital-Based Study In Vietnam, Sang N Nguyen, Lam T Vu, Ha T Nguyen, Giang H Dao, Anh Ngoc T Nguyen

Faculty, Staff and Student Publications

Introduction Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2, which can cause organ failure in several organs, cardiac problems, or acute respiratory distress syndrome (ARDS). Identifying clinical epidemiological characteristics and risk factors for complications of COVID-19 allows clinicians to diagnose and treat promptly. Objectives This study aims to describe the clinical epidemiological characteristics of COVID-19 and assess risk factors for the severity of SARS-CoV-2 pneumonia in children treated at Haiphong Children's Hospital. Methods A descriptive cross-sectional study was conducted in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from January 1, 2022, to December 31, 2022. Results In …

A Comparative Analysis Of Births For Women Aged 20-25 Vs. 35-39: An Examination Of Longitudinal Trends Of Volume And Outcomes, Kristy Hampton

MUSC Theses and Dissertations

Maternal health impacts the well-being of society as it is commonly viewed as an indicator of public health welfare. Childbirth at an advanced maternal age (AMA) increases the likelihood of less favorable birth outcomes. As births to AMA women have increased over time, it is important to understand the impact age has on birth methods and birth outcomes. This research examined the proportion of births to women aged 20-25 years in comparison to AMA women aged 35-39 years in North Carolina from 2002-2017. The proportions of births to AMA women have increased over time despite increased risk and birth outcomes. …

The Ethics And Practice Of Periviability Care, Alex C Vidaeff, Joseph W Kaempf

Faculty, Staff and Students Publications

Since the 1960s, the gestational age at which premature infants typically survive has decreased by approximately one week per decade [1]. Survival is now reported at remarkably early gestational ages. In 2022, the Vermont Oxford Network reported neonatal intensive care unit (NICU) survival rates of 21%, 46%, and 63% at 22, 23, and 24 weeks’ gestation [2]. Presently, in industrialized nations, the so-called periviability interval refers to the gestational age period of possible survival that extends from approximately 22 to 25 weeks’ gestation. Newborns born within this period are distinguished by their need for extraordinarily complex …

Effect Of Russian Current And Structured Exercise Program On Postpartum Diastasis Recti Abdominis: A Case Series, Nagma Khan, Ashwini Bulbuli

Internet Journal of Allied Health Sciences and Practice

Background: Diastasis recti abdominis (DRA) is the most common complication occurring post-delivery that limits the functional well-being of the affected individuals. Management of diastasis recti can include an abdominal binder, core strengthening, taping, and various surgical procedures. There is limited evidence to support the Russian current and structured exercise intervention in managing patients with DRA. Methodology: Three patients identified with DRA underwent a multi-modal treatment regimen including a hot moist pack, Russian current, abdominal binder, transverse abdominus activation exercises, treadmill training, and stationary cycling training. Outcomes were assessed using the visual analogue scale, abdominal girth, Ranney DRA scale, Oswestry …