Maternal and Child Health Commons^™

The Koolungar Moorditj Healthy Skin Project: Elder And Community Led Resources Strengthen Aboriginal Voice For Skin Health, Bernadette M. Ricciardo, Jacinta Walton, Noel Nannup, Dale Tilbrook, Heather-Lynn Kessaris, Carol Michie, Brad Farrant, Roni Forrest, Annette Garlett, Joanne Hill, Larissa Jones, Natasha Kickett, Sally Smith, Delys Walton, Taleah Ugle, Nadia Rind, Richelle Douglas, Jodie Ingrey, Brenda Carter, Ainslie Poore, Ingrid Amgarth-Duff, Hannah Thomas, Prasad S. Kumarasinghe, Jonathan R. Carapetis, Asha C. Bowen

Journal of the Australian Indigenous HealthInfoNet

In partnership with local Aboriginal Community Controlled Health Organisations, the Elder-led co-designed Koolungar Moorditj Healthy Skin project is guided by principles of reciprocity, capacity building, respect, and community involvement. Through this work, the team of Elders, community members, clinicians and research staff have gained insight into the skin health needs of urban-living Aboriginal koolungar (children); and having identified a lack of targeted and culturally appropriate health literacy and health promotion resources on moorditj (strong) skin, prioritised development of community-created healthy skin resources. Community members self-appointed to Aboriginal Community Advisory Groups (CAG) on Whadjuk (Perth) …

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data., Miguel A. Lopez, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

South Texas is a predominantly Hispanic region with high rates of chronic illness, poor healthcare access, and a history of birth defect clusters. Between 1986 and 1991, 47 cases of anencephaly in Cameron County were linked to elevated fumonisins in the region’s corn-based diet, prompting a series of ongoing public health efforts. This paper aims to identify changes in prevalence for CNS defects, in addition to cardiac, circulatory, gastrointestinal, and genitourinary defects in South Texas within the last two decades. Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and …

Sex Differences In Revascularization, Treatment Goals, And Outcomes Of Patients With Chronic Coronary Disease: Insights From The Ischemia Trial, Harmony R Reynolds, Derek D Cyr, C Noel Bairey Merz, Leslee J Shaw, Bernard R Chaitman, William E Boden, Karen P Alexander, Yves D Rosenberg, Sripal Bangalore, Gregg W Stone, Claes Held, John Spertus, Kaatje Goetschalckx, Olga Bockeria, Jonathan D Newman, Jeffrey S Berger, Ahmed Elghamaz, Renato D Lopes, James K Min, Daniel S Berman, Michael H Picard, Raymond Y Kwong, Robert A Harrington, Boban Thomas, Sean M O'Brien, David J Maron, Judith S Hochman, Ischemia Research Group

Faculty, Staff and Student Publications

BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management.

METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

Policy Brief: Decreasing Unintended Pregnancy Rates In Mississippi, Jaycee S. Pilcher

Honors Theses

On June 24th, 2022, the U.S. Supreme Court’s decision to reverse Roe v. Wade marked a pivotal moment, eliminating the federal right to pregnancy termination. This thesis examines the challenges of restricted abortion access and emphasizes preventative strategies for unintended pregnancies. Analyzing both pre- and post-pregnancy interventions, such as enhanced sex education, hormonal contraceptives, insurance coverage, prescribers, and post-pregnancy policies, this thesis urges Mississippi residents and legislators to consider policy adjustments for reducing the occurrence of unintended pregnancies.

This research includes an analysis of literature, legislative records, and statistical data. It takes a comparative approach to evaluate the effectiveness of …

Identifying Rural Health Clinics Within The Transformed Medicaid Statistical Information System (T-Msis) Analytic Files, Katherine Ahrens Mph, Phd, Zachariah Croll, Yvonne Jonk Phd, John Gale Ms, Heidi O'Connor Ms

Rural Health Clinics

Researchers at the Maine Rural Health Research Center describe a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.

Background: There is limited information on the extent to which Rural Health Clinics (RHC) provide pediatric and pregnancy-related services to individuals enrolled in state Medicaid/CHIP programs. In part this is because methods to identify RHC encounters within Medicaid claims data are outdated.

Methods: We used a 100% sample of the 2018 Medicaid Demographic and Eligibility and Other Services Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files for 20 states …

Dhea: A Neglected Biological Signal That May Affect Fetal And Child Development, Natasha A. Bailey, Elysia Poggi Davis, Curt A. Sandman, Laura M. Glynn

Psychology Faculty Articles and Research

The stress-sensitive maternal hypothalamic–pituitary–adrenal (HPA) axis through the end-product cortisol, represents a primary pathway through which maternal experience shapes fetal development with long-term consequences for child neurodevelopment. However, there is another HPA axis end-product that has been widely ignored in the study of human pregnancy. The synthesis and release of dehydroepiandosterone (DHEA) is similar to cortisol, so it is a plausible, but neglected, biological signal that may influence fetal neurodevelopment. DHEA also may interact with cortisol to determine developmental outcomes. Surprisingly, there is virtually nothing known about human fetal exposure to prenatal maternal DHEA and offspring neurodevelopment. The current study …

A Systematic Review Of Measures Of Healthcare Workers’ Vaccine Confidence, Kofoworola Akinsola, Ayobami Bakare, Elisa Gobbo, Carina King, Claudia Hanson, Adegoke Falade, Sibylle Herzig Van Wees

Centre of Excellence in Women and Child Health

Healthcare workers (HCW) perceptions toward vaccines influence patient and community vaccine decision making. In an era of rising vaccine hesitancy, understanding HCW vaccine confidence is critical. This systematic review aims to review instruments that have been validated to measure HCW vaccine confidence. We conducted a search in five databases in June 2023. Data was descriptively synthesized. Twelve articles describing 10 different tools were included. Most tools included dimensions or items on vaccine knowledge (n = 9), safety (n = 8), vaccine usefulness (n = 8), recommendation behavior (n = 8), and self-vaccination practice (n = 7). All, except one study, …

Breastfeeding Initiation, Duration, And Associated Factors Among People With Hepatitis C Virus Infection, Jennifer L Grasch, Jessica A De Voest, George R Saade, Brenna L Hughes, Uma M Reddy, Maged M Costantine, Edward K Chien, Alan T N Tita, John M Thorp, Torri D Metz, Ronald J Wapner, Vishakha Sabharwal, Hyagriv N Simhan, Geeta K Swamy, Kent D Heyborne, Baha M Sibai, William A Grobman, Yasser Y El-Sayed, Brian M Casey, Samuel Parry, Eunice Kennedy Shriver National Institute Of Child Health And Human Development (Nichd) Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

OBJECTIVE: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection.

METHODS: We conducted a secondary analysis of a multicenter observational cohort of pregnant people with singleton gestations and HCV seropositivity. This analysis includes individuals with data on breastfeeding initiation and excludes those with human immunodeficiency virus (HIV) co-infection. The primary outcome was self-reported initiation of breastfeeding or provision of expressed breast milk. Secondary outcomes included duration of breastfeeding. Demographic and obstetric characteristics were compared between those who initiated breastfeeding and those who did not to identify associated factors. Univariable and …

Enhancing Pastoralist Women's Knowledge Of Danger Signs Through Home-Based Life-Saving Skills Intervention In Northern Kenya: A Quasi Experimental Study, Dabo Galgalo Halake, Elijah Isinta Maranga, Japheth Mativo Nzioki, John Gachohi

Faculty Publications

Background: Maternal recognition of obstetric danger signs is crucial for reducing maternal mortality and delays in seeking emergency care. However, there is insufficient knowledge about obstetric danger signs among women in rural Kenya, especially in the hard-to-reach pastoralist communities. This study aimed to determine whether home-based life-saving skills intervention improves knowledge about obstetric danger signs among women in Marsabit County, Kenya. Methods: We conducted a quasi-experimental study with pre-posttests among 256 pregnant women, allocated to intervention and control groups. We implemented sensitization of pregnant women on obstetric danger signs and basic life-saving actions as components of home-based life-saving skills intervention. …

Covid-19 Prevalence And Trends Among Pregnant And Postpartum Persons In Maine By Rurality And Pregnancy Conditions, Charlie O. Grantham, Christina M. Ackerman-Banks Md, Heather S. Lipkind Md, Ms, Kristin Palmsten Scd, Katherine A. Ahrens Mph, Phd

Journal of Maine Medical Center

No abstract provided.

Infant Mortality Rates Vary Substantially Across Regions Of The United States, Marissa Merrifield

Population Health Research Brief Series

Infant mortality rates are higher in the United States than in its high-income peer countries. Additionally, infant mortality rates vary within the U.S., with much higher rates in some geographic regions compared to others. This data slice uses data from the U.S. Centers for Disease Control and Prevention to compare infant mortality rates by geographic region in the U.S. between 2017-2021. The results show that the infant mortality rate was the highest in the South and lowest in the Northeast and West.

Uterine Leiomyomata As A Cause Of Abdominal Compartment Syndrome In The Postpartum Period, Mason Hui, Baha Sibai, Alvaro Montealegre, Mateo G Leon

Faculty, Staff and Student Publications

Uterine leiomyomas are common benign smooth muscle tumors that often occur during the reproductive years. Although many cases may not result in significant complications, negative pregnancy outcomes have been associated with the size and location of the fibroids. Degeneration of fibroids can occur as early as the late first trimester when they undergo significant volumetric growth, contributing to pain during pregnancy. While myomectomy is typically avoided during pregnancy, conservative management with anti-inflammatory medications may be effective. Surgical removal or preterm delivery may be necessary if symptoms persist. Abdominal compartment syndrome (ACS) is a rare condition characterized by sustained elevated intra-abdominal …

Black Women Have The Highest Maternal Mortality Rate In The United States, Tori-Ann Haywood

Population Health Research Brief Series

The U.S. maternal mortality rate is consistently higher than its high-income peer countries. Since 2018 maternal mortality rates in the U.S. have steadily increased for all ethnoracial groups. This data slice uses data from the U.S. National Center for Health Statistics to describe U.S. maternity mortality rates for women ages 15-45 across different ethnoracial groups between 2018-2022. Results show that, except for non-Hispanic (NH) Asian women, ethnoracial minority women have higher maternal death rates than NH White women.

Impact Of An Integrated Health, Nutrition, And Early Child Stimulation And Responsive Care Intervention Package Delivered To Preterm Or Term Small For Gestational Age Babies During Infancy On Growth And Neurodevelopment: Study Protocol Of An Individually Randomized Controlled Trial In India (Small Babies Trial), Ranadip Chowdhury, Rukman Manapurath, Ingvild Fossgard Sandøy, Ravi Prakash Upadhyay, Neeta Dhabhai, Saijuddin Shaikh, Harish Chellani, Tarun Shankar Choudhary, Abhinav Jain, Jose Martines, Nita Bhandari, Tor A Strand, Sunita Taneja

Faculty, Staff and Student Publications

BACKGROUND: Preterm and term small for gestational age (SGA) babies are at high risk of experiencing malnutrition and impaired neurodevelopment. Standalone interventions have modest and sometimes inconsistent effects on growth and neurodevelopment in these babies. For greater impact, intervention may be needed in multiple domains-health, nutrition, and psychosocial care and support. Therefore, the combined effects of an integrated intervention package for preterm and term SGA on growth and neurodevelopment are worth investigating.

METHODS: An individually randomized controlled trial is being conducted in urban and peri-urban low to middle-socioeconomic neighborhoods in South Delhi, India. Infants are randomized (1:1) into two strata …

Running Biomechanics Differ During And After Pregnancy Compared To Females Who Have Never Been Pregnant, Jennifer J. Bagwell, Elizabeth Avila, Nicholas Reynolds, Jo Armour Smith, Kevin Valenzuela, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

Perinatal running participation has increased recently; however, pregnancy related symptoms can limit activity. Perinatal running biomechanics could inform interventions to help perinatal individuals maintain an active lifestyle.

Research question

Are perinatal running biomaechanics and muscle activation different compared to nulligravida females?

Methods

Sixteen pregnant participants completed self-selected velocity running during second trimester (2 T), third trimester (3 T), and postpartum (PP) and 16 matched controls completed these procedures once in this case control study. Kinematic, kinetic, and electromyography (EMG) data were collected using a motion capture system, force plates, and EMG electrodes. Peak trunk, pelvis, hip, knee, and ankle …

Neonatal Intensive Care Unit Resource Use For Infants At 22 Weeks' Gestation In The Us, 2008-2021, Matthew A Rysavy, Monica M Bennett, Kaashif A Ahmad, Ravi M Patel, Zubin S Shah, Dan L Ellsbury, Reese H Clark, Veeral N Tolia

Faculty, Staff and Student Publications

IMPORTANCE: During the past decade, clinical guidance about the provision of intensive care for infants born at 22 weeks' gestation has changed. The impact of these changes on neonatal intensive care unit (NICU) resource utilization is unknown.

OBJECTIVE: To characterize recent trends in NICU resource utilization for infants born at 22 weeks' gestation compared with other extremely preterm infants (≤28 weeks' gestation) and other NICU-admitted infants.

DESIGN, SETTING, AND PARTICIPANTS: This is a serial cross-sectional study of 137 continuously participating NICUs in 29 US states from January 1, 2008, through December 31, 2021. Participants included infants admitted to the NICU. …

Limited Independent Follow-Up With Germline Testing Of Variants Detected In Brca1 And Brca2 By Tumor-Only Sequencing, Carol J Nowlen, Molly Daniels, Burak Uzunparmak, Ecaterina E Ileana Dumbrava, Ying Yuan, Keyur P Patel, Nadine Rayes, Jacqueline Harkenrider, Chetna Wathoo, Jennifer Veazie, Krystle A Luna, Wanlin Wang, Chacha Horombe, Milind Javle, Jordi Rodon Ahnert, Timothy A Yap, Banu Arun, Karen H Lu, Funda Meric-Bernstam

Faculty, Staff and Student Publications

Introduction

Genomic profiling is performed in patients with advanced or metastatic cancer, in order to direct cancer treatment, often sequencing tumor-only, without a matched germline comparator. However, because many of the genes analyzed on tumor profiling overlap with those known to be associated with hereditary cancer predisposition syndromes (HCPS), tumor-only profiling can unknowingly uncover germline pathogenic (P) and likely pathogenic variants (LPV). In this study, we evaluated the number of patients with P/LPVs identified in BRCA1 and BRCA2 (BRCA1/2) via tumor-only profiling, then determined the germline testing outcomes for those patients.

Methods

A retrospective chart review was performed …

Challenges And Opportunities For Improving Access To Adolescent And Youth Sexual And Reproductive Health Services And Information In The Coastal Counties Of Kenya: A Qualitative Study., Evaline Chepchirchir Langat, Abdu Mohiddin, Flaura Kidere, Anisa Omar, Job Akuno, Violet Naanyu, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Globally, adolescents and youth experience high unmet need for sexual and reproductive health (SRH) information and services. In Kenya, evidence shows that more than half of teenage pregnancies are unintended and that half of all new HIV infections occur in people ages 15-24-year-olds, with the majority of those being female. The coastal counties in Kenya record a relatively high adolescent pregnancy rate and higher rates of unmet need for contraception for all women of reproductive age compared to the national average. This study focused on gaining a deeper understanding of the existing challenges to and opportunities for accessing SRH …

Invisible Hand Of Socioeconomic Factors In Rising Trend Of Maternal Mortality Rates In The U.S., Disha Kanada

Dissertations, Theses, and Capstone Projects

Maternal death is a tragedy with devastating effect on families and serves as an important indicator of the quality of a health system. Worldwide, the maternal mortality rate has fallen; however, the maternal mortality rate is increasing in the United States in comparison to other wealthy developed countries. The United States spends a lot of resources on healthcare funds and therefore, the increasing maternal mortality rate is alarming. Apart from this, the birth rates are decreasing, so, it is hard to understand the relationship between declining birth rates (and fertility rates) and inclining mortality rates – logically, this does not …