Maternal and Child Health Commons^™

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. …

Women In Health And Their Economic, Equity And Livelihood Statuses During Emergency Preparedness And Response (Wheeler) Protocol: A Mixed Methods Study In Kenya., Evaline Chepchirchir Langat, Bilali Yusuf Mazoya, Pauline Oginga, Ferdinand Okwaro, Norah Matheka, Irene Kibara, Rhoda Otieno, Michaela Mantel, Robert Lorway, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction: Kenya reported its first COVID-19 case on 13 March 2020. Pandemic-driven health system changes followed and unforeseen societal, economic and health effects reported. This protocol aims to describe the methods used to identify the gender equality and health equity gaps and possible disproportional health and socioeconomic impacts experienced by paid and unpaid (community health volunteer) female healthcare providers in Kilifi and Mombasa Counties, Kenya during the COVID-19 pandemic.

Methods and analysis: Participatory mixed methods framed by gender analysis and human-centred design will be used. Research implementation will follow four of the five phases of the human-centred design approach. Community …

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 …

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 …

Facilitators To Cervical Cancer Screening In A Minority, Urban, Underserved Population, Noel Higgason, Linh Nguyen, Yen-Chi Le, Ogochukwu Juliet Ezeigwe, Tong Han Chung, Natalia Williams, Xochitl K Olguin, Abigail S Zamorano

Faculty, Staff and Student Publications

OBJECTIVES: Cervical cancer has markedly declined due to widespread use of screening, but Hispanic women continue to bear a disproportionate amount of the cervical cancer burden due to under-screening. Previous studies have explored barriers to screening but have failed to identify targetable facilitators in this group. We aimed to assess facilitators to cervical cancer screening among a predominantly urban, Hispanic population who presented to a no-cost, community-based clinic.

METHODS: Patients completed demographic and health information, a validated social determinants of health (SDOH) screen, and a self-reported facilitators survey on factors which enabled them to present to clinic. Descriptive statistics were …

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 …

Prenatal Cocaine Exposure And Its Influence On Pediatric Epigenetic Clocks And Epigenetic Scores In Humans, Thiago Wendt Viola, Christina Danzer, Victor Mardini, Claudia Szobot, João Henrique Chrusciel, Laura Stertz, Joy M Schmitz, Consuelo Walss-Bass, Gabriel R Fries, Rodrigo Grassi-Oliveira

Faculty, Staff and Student Publications

The investigation of the effects of prenatal cocaine exposure (PCE) on offspring has been inconsistent, with few studies investigating biological outcomes in humans. We profiled genome-wide DNA methylation (DNAm) of umbilical cord blood (UCB) from newborns with (n = 35) and without (n = 47) PCE. We used DNAm data to (1) assess pediatric epigenetic clocks at birth and (2) to estimate epigenetic scores (ES) for lifetime disorders. We generated gestational epigenetic age estimates (DNAmGA) based on Knight and Bohlin epigenetic clocks. We also investigated the association between DNAmGA and UCB serum brain-derived neurotrophic factor (BDNF) levels. Considering the large-scale …

Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das

Centre of Excellence in Women and Child Health

No abstract provided.

Lipid Genetics In Pregnant Women: Maneuvering The Challenges Of Using Degraded Samples, Kylee Meece

Mahurin Honors College Capstone Experience/Thesis Projects

The results of this project will explore a novel approach to lipid metabolism in pregnant women by exploring the relationship between maternal gene expression of genes critical for fat metabolism, protein expression, and maternal and neonatal outcomes. The study will also examine gene expression in lean pregnant women compared to obese pregnant women, shedding light into the adverse pathology of obesity during pregnancy. These findings may uncover a mechanism related to gene-expression that connects unfavorable maternal fat metabolism to inflammation and/or insulin resistance, which may help to uncover future targets for interventions.

The analysis of lipid gene expression requires the …

The Effects Of Adverse Childhood Experiences And Racism On The Risk For Poor Birth Outcomes In Women Of Color, Audrey Hermosura

Nursing | Senior Theses

Background: Adverse childhood experiences, or ACEs, are traumatic challenges experienced before the age of 18. These adversities have lifelong effects on physiologic and mental health. A relationship has been made between the number of ACEs and occurrences of poor birth outcomes. The toxic stress that accumulates from ACEs compounded by racism increases the risk for poor birth outcomes in women of color. Understanding the importance of screening for these events can mitigate the negative effects on women’s health during and after gestation. Purpose: This current paper, in addition to a literature review, proposes a research design to validate the feasibility …

Doulas In Modern Health Care, Gabriella J. Lawrence

Soaring: A Journal of Undergraduate Research

This paper looks into whether the implementation of doulas by all hospitals would benefit mothers before, during, and after childbirth. Through previous research it is shown how traumatizing birth can be for mothers who don't feel that they have control within the labor and delivery room. High rates of augmentation, epidural anesthesia, and cesarean sections within hospitals are all causes of postpartum anxiety and depression among new mothers. By researching who a doula is and what they can do for mothers during childbirth, we can get a better understanding on how to prevent mental health disorders that are caused by …

Primary Care Physician Trust: The Importance Of Early Medical Intervention For African American Children With Asthma, Harrish Ganesh

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Asthma is a prevalent condition characterized by an individual’s airway becoming inflamed, constricted, and leads to the formation of mucus and difficulty breathing. Nearly 27 million individuals are currently diagnosed with Asthma in the United States, and African Americans are 40% more likely to be diagnosed with asthma than Caucasians. This literature review analyzed multifaceted barriers that restrict African American asthmatic children from gaining consistent asthma treatment. Some of these barriers range from historical racial discrimination that leads to parental mistrust to financial and educational barriers that result in inconsistent pediatric care for asthmatic children. The combination of the above …

Inequalities In Use Of Hospitals For Childbirth Among Rural Women In Sub-Saharan Africa: A Comparative Analysis Of 18 Countries Using Demographic And Health Survey Data., Manuela Straneo, Claudia Hanson, Thomas Van Den Akker, Bosede Afolabi, Anteneh Asefa, Alexandre Delamou, Mardieh Dennis, Luis Gadama, Nyika Mahachi, Welcome Mlilo

Centre of Excellence in Women and Child Health

Introduction; Rising facility births in sub-Saharan Africa (SSA) mask inequalities in higher-level emergency care— typically in hospitals. Limited research has addressed hospital use in women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom hospital care is essential. We aimed to address this gap, by comparatively assessing hospital use in rural SSA by wealth and parity.

Methods; Countries in SSA with a Demographic and Health Survey since 2015 were included. We assessed rural hospital childbirth stratifying by wealth (wealthier/poorer) and parity (nulliparity/high parity≥5), and their combination. We computed percentages, 95% CIs and …

Understanding Social Dynamics In Toxic Conversations And Public Health Intervention Acceptance On Social Media, Ana Aleksandric

Computer Science and Engineering Dissertations - Archive

Social media is now central to daily life, offering users a space to share content and opinions. However, these platforms also facilitate the spread of hate speech and misinformation, which can negatively impact public health. This dissertation develops methodologies to analyze social media data for insights that could inform health interventions. The research first examines user responses to toxic content, focusing on behavioral and emotional reactions, as well as group dynamics and bystander effects in toxic interactions. Another key focus is public opinion toward health interventions, particularly COVID-19 vaccination, using geolocated posts and analyzing factors such as race, ethnicity, and …

Clinical Characteristics And Outcomes Of Patients With Idiopathic Intracranial Hypertension In East Africa: A Retrospective Cross-Sectional Study, Zian Muikamba

Master of Internal Medicine

Introduction; Idiopathic intracranial hypertension (IIH) is a neurological condition characterized by elevated intracranial cerebrospinal fluid (CSF) pressure without demonstratable evident causes. The mechanisms leading to a particular predilection for women of childbearing age who are overweight and obese or who have recent rapid weight changes remain imprecisely described. The Modified Dandy criteria is used for diagnosis and includes-clinical symptoms, papilledema, lumbar puncture (LP) opening pressure, and neuroimaging. If undiagnosed, it can progress to disabling irreversible visual loss. Weight loss is useful in addition to medical therapy in treating the condition. Data in Sub-Saharan Africa is scarce.

Methods; This study described …

Too Hot To Thrive: A Qualitative Inquiry Of Community Perspectives On The Effect Of High Ambient Temperature On Postpartum Women And Neonates In Kilifi, Kenya., Adelaide Lusambili, Sari Kovats, Britt Nakstad, Veronique Filippi, Peter Khaemba, Nathalie Roos, Cherie Part, Stanley Luchters, Matthew Chersich, Jeremy Hess

Institute for Human Development, East Africa

Objectives; To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi.

Design; Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16).

Settings; We conducted our research in Kilifi County in Kenya’s Coast Province. The area is largely rural and during …

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Identifying Youth Appeals In Alcohol Alternative Social Media Content Through Framing, Melina Oneal

West Chester University Master’s Theses

Proposed regulations for alcohol advertising prevent beverage companies from targeting people under the legal drinking age. However, similar regulations for alcohol alternative beverages are less explored, which could allow alcohol alternative products to create awareness for alcoholic beverages among youth. Alcohol alternatives beverages, including no-alcohol and low-alcohol products, are increasing in popularity and can function as compliments to alcoholic products to decrease the total alcohol volume consumed or as substitutes for alcoholic products. Framing theory can be operationalized through the Content Appealing to Youth Index, an index of content elements found in research literature to be appealing to youth, to …