Maternal and Child Health Commons^™

Adverse Childhood Experiences And Their Connection To Autoimmune Disease In Adulthood, Emma J. Molden

Honors Theses

Everyday in the United States, a child experiences a traumatic event. Autoimmune disease is one of the top two leading causes of death in the United States. Can these two horrifying events be connected? Autoimmune diseases currently affect millions of Americans and are considered an epidemic because of their prevalence within the adult population. Even with a high number of cases, this possible connection has been largely ignored and under researched for the history of modern medicine. However, two studies have begun to make the connection between adverse childhood experiences and how that affects the onset of autoimmune diseases in …

Fine Particulate Matter And Low Weight Births In Mexico City, Mexico, Kennedy Cohn

Honors Theses

Fine particulate matter (PM2.5) exposure has been associated with several negative health consequences, and recent studies suggest a potential relationship between PM2.5 exposure and adverse birth outcomes, including low birth weight (LBW). This thesis investigated a potential relationship between fine particulate matter concentration and low birth weight in Mexico City, Mexico between 2008-2016. Maternal pollution exposure was estimated at the city-wide level by averaging PM2.5 measurements from various monitoring stations. Birth weight was collected from the SINAC database. Logistic regression models were run for different temporal scales (by trimester, and 10-month periods); however, there were no significant relationships found between …

How Covid-19 Has Fundamentally Changed Clinical Research In Global Health, Jay J H. Park, Robin Mogg, Gerald E. Smith, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Craig R. Rayner, Jeanine Condo, Eric H. Decloedt, Jean B. Nachega, Gilmar Reis, Edward J. Mills

Department of Paediatrics and Child Health

COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response …

Urgently Seeking Efficiency And Sustainability Of Clinical Trials In Global Health, Jay J H. Park, Rebecca F. Grais, Monica Taljaard, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Jean B. Nachega, Nathan Ford, Denis Xavier, Andre P. Kengne, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current …

Tiny Tusks Internship: The Importance Of Breastfeeding Education In The Workplace, Gianna Hogan

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Breastfeeding education in public, especially in the workplace, is a concept that has a multitude of different perspectives. Research has shown that breastfeeding has many positive effects on mother and baby, that can be lessened due to the lack of breastfeeding support in various organizations. In this literature review, barriers to breastfeeding in the workplace were analyzed in order to understand the effects these barriers have on breastfeeding duration. In addition, this review helped emphasize the need for policies to be enacted in the workplace to better support breastfeeding mothers, and the impact these policies have on employee retention rates …

Tiny Tusks Internship: An Analysis Of Exclusive Breastfeeding In Low Income Women, Brittany Jones

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Due to the fact that formula feeding is often seen as the “easier” option for some women, this literature analysis was conducted to gain an understanding about factors which influence the perception of breastfeeding in low-income populations. This literature review analyzed the factors which influence reduced rates of breastfeeding in lower income populations and the importance of breastfeeding education to this population. A search through CINAHL and PubMed for journal articles dating from 2016 to 2021 was conducted. The search generated 46 studies, 40 from CINAHL and 6 from PubMed. Study eligibility was determined by looking for articles involving low …

Determinants Of Short Birth Intervals Among Married Women: A Cross-Sectional Study In Karachi, Pakistan, Sidrah Nausheen, Maria Asif Bhura, Kristy Hackett, Imtiaz Hussain, Zainab Shaikh, Arjumand Rizvi, Uzair Ansari, David Canning, Iqbal Shah, Sajid Bashir Soofi

Department of Obstetrics & Gynaecology

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.
Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Parenting In Poor Health: Examining Associations Between Parental Health, Prescription Drug Use, And Child Maltreatment, Jennifer Price Wolf, Bridget Freisthler, Karla Shockley Mccarthy

Faculty Research, Scholarly, and Creative Activity

Rationale
Child maltreatment and problematic parenting are related to negative outcomes for children. Poor parental health could be a risk factor for problematic parenting through several mechanisms: 1) inadequate emotional regulation and coping; 2) impairment of parental capacity; and, 3) impairment of the parent-child relationship.
Objective
This study examines relationships between self-rated parental health, prescription drug use, and a broad array of negative parenting outcomes.
Methods
A sample of general population parents of children aged ten and younger was recruited from 30 mid-sized cities in California (n = 681). Weighted mixed-effects negative binomial and logistic regression models were used to …

Multiple-Micronutrient Supplementation In Pregnant Adolescents In Low- And Middle-Income Countries: A Systematic Review And A Meta-Analysis Of Individual Participant Data, Emily C. Keats, Nadia Akseer, Pravheen Thurairajah, Simon Cousens, Zulfiqar Ahmed Bhutta, Global Young Women’S Nutrition Investigators’ Group

Woman and Child Health

Context: Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.
Objective: The aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN …

Hyperglycemia During The First Three Days Of Life Increases The Risk Of Retinopathy Of Prematurity In Extremely Low Birth Weight Infants, Jihan M. Esmail, Ramasubbareddy Dhanireddy Md

Longitudinal Scholar's Project

Background: The association between hyperglycemia and ROP has been inconsistent in previous studies. Extremely low birth weight (ELBW) infants are at high risk for ROP. They also experience hypoglycemia initially and hyperglycemia while receiving IV glucose infusion. The effect of initial hypoglycemia on hyperglycemia associated ROP risk is unknown.

Objective: To study the effect of initial hypoglycemia and subsequent hyperglycemia during the first three days of life on the incidence of ROP and severe ROP in ELBW (birth weight ≤1000g) infants.

Methods: Clinical and demographic data were collected from 227 ELBW infants born during the years 2017-2019 at the Regional …

The Effects Of The Use Of Medical Interpreters Amongst The Latina Population In The Context Of Sexual And Reproductive Health, Carson Collins

Senior Theses

The Latino population in the United States is large and consistently growing. These individuals, due to cultural and systemic factors, are at greater risk for a variety of health problems, especially in the context of sexual and reproductive health. Many of these patients may not speak English as their first language and thus need to access interpretative services to receive care. This study sought to examine whether medical facilities using certified medical interpreters and requiring cultural competency training for their staff could reduce the cultural and communication barriers LEP Latinas experience when receiving sexual and reproductive health care services. An …

Examining Factors Associated With Bcg And Poliomyelitis Vaccination Coverage In Tanzanian And Kenyan Children Aged 12 To 23 Months Using Dhs Surveys, Ognyan Simeonov

Independent Study Project (ISP) Collection

The rapid spread of infectious diseases in eastern Africa has made vaccination a major health factor in the region. This study aims to evaluate the factors affecting vaccination coverage with the BCG and Poliomyelitis vaccines in Tanzanian and Kenyan children aged 12 to 23 months. In May 2021, we collected data from the Demographic and Health Surveys (DHS) from 2014-2016 for Kenya and Tanzania and evaluated how different variables such as the sex of the child, maternal age, maternal educational level, availability of health facilities, access to electricity in the household, and birth order affect the vaccination coverage. We used …

The Financing Need For Expanding Paid Maternity Leave To Support Breastfeeding In The Informal Sector In The Philippines, Valerie Gilbert Ulep, Paul Zambrano, Janice Datu-Sanguyo, Mireya Vilar-Compte, Graciela Materuel Belismelis, Rafael Pérez-Escamilla, Grace J. Carrol, Roger Mathisen

Department of Public Health Scholarship and Creative Works

In low- and middle-income countries, almost three-fourths of women in the labour force lack maternity protection. In the Philippines, current laws do not guarantee paid maternity leave to workers in the informal economy. A non-contributory maternity cash transfer to informal sector workers could be used to promote social equity and economic productivity and could provide health benefits by helping mothers meet their breastfeeding goals. The objective of the study is to provide a realistic cost estimate and to assess the financial feasibility of implementing a publicly financed, non-contributory maternity cash transfer programme to the informal sector in the Philippines. Using …

Prenatal Maternal Mood Entropy Is Associated With Child Neurodevelopment, Mariann A. Howland, Curt A. Sandman, Elysia Poggi Davis, Hal S. Stern, Michael Phelan, Tallie Z. Baram, Laura M. Glynn

Psychology Faculty Articles and Research

Emerging evidence indicates that the predictability of signals early in life may influence the developing brain. This study examines links between a novel indicator of maternal mood dysregulation, mood entropy, and child neurodevelopmental outcomes. Associations between prenatal maternal mood entropy and child neurodevelopment were assessed in 2 longitudinal cohorts. Maternal mood was measured several times over pregnancy beginning as early as 15 weeks’ gestation. Shannon’s mood entropy was applied to distributions of mothers’ responses on mood questionnaires. Child cognitive and language development were evaluated at 2 and 6–9 years of age. Higher prenatal maternal mood entropy was associated with lower …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

Evidence-Based Practice: Delaying Infant Bathing, Gabrielle Wadle, Grace Frankland

Scholars Week

A hospital's policy regarding infant bathing is currently not congruent with best nursing practice. The hospital’s current policy is to bathe an infant once they are stable and their rectal temperature is at or above 98.6 °F. Although the infant may become stable within the first 24-hours of birth, the World Health Organization recommends that, “Bathing should be delayed until 24 hours after birth.” (2013, p. 4). Research has been completed to support delaying infant bathing until 24 hours post-delivery, suggesting potential modifications to current policy.

Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Objectives: Paediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.
Design: Prospective qualitative study using semistructured interviews SETTING: Two referral hospitals in Mozambique and Pakistan PARTICIPANTS: A total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.
Results: HCPs …

Heterogeneous Contributions Of Change In Population Distribution Of Body Mass Index To Change In Obesity And Underweight, Ncd Risk Factor Collaboration (Ncd-Risc), Maria Lc Iurilli, Bin Zhou, James E. Bennett, Rodrigo M. Carrillo-Larco, Marisa K. Sophiea, Andrea Rodriguez-Martinez, Honor Bixby, Bethlehem D. Solomon, Zulfiqar Ahmed Bhutta

Woman and Child Health

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape …