Maternal and Child Health Commons^™

Maternal And Newborn Health Risks Of Climate Change: A Call For Awareness And Global Action, Nathalie Roos, Sari Kovats, Shakoor Hajat, Veronique Filippi, Matthew Chersich, Stanley Luchters, Fiona Scorgie, Britt Nakstad, Olof Stephansson, Chamnha Consortium

Population Health, East Africa

Climate change represents one of the largest global health threats of the 21st century with immediate and long‐term consequences for the most vulnerable populations, especially in the poorest countries with the least capacity to adapt to climate change. Pregnant women and newborns are increasingly being recognized as vulnerable populations in the context of climate change. The effects can be direct or indirect through heat stress, extreme weather events and air pollution, potentially impacting both the immediate and long‐term health of pregnant women and newborns through a broad range of mechanisms. In 2008, the World Health Organization passed a resolution during …

Impact Of Long-Term Doula Services On Maternal And Fetal Health Outcomes In Women In Treatment For Opioid Use Disorder, Saloni Parikh, Meghan Gannon, Phd, Msph

Phase 1

This study analyzed the impact of doula services on maternal and fetal health outcomes in pregnant women seeking treatment for opioid use disorder. Understanding the impact of doula services is critical in reducing inequities in health outcomes experienced by this vulnerable population. Retrospective and prospective data was collected from surveys, focus groups, and maternal and infant birth data from 100 women in treatment for opioid use disorder, with fifty utilizing doulas and fifty not utilizing doulas. Standardized data abstraction of quantitative and qualitative measures were collected into an SPSS database and Nvivo, respectively, and analyzed using SPSS. Measures of importance …

Évaluation De La Performance Des Agents De Santé Communautaires En Haïti: Principales Conclusions D’Une Étude À Méthodologie Mixte, Frontline Health Project, Zanmi Lasante

Reproductive Health

Ce document résume les principales conclusions qualitatives et quantitatives de l'étude de référence du projet Frontline Health en Haïti. Les résultats révèlent que les ASC en Haïti sont des membres hautement fiables et appréciés de leurs communautés et fournissent des liens cruciaux vers les services d'orientation ; cependant, davantage de formation et de soutien concernant les références sont nécessaires.

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This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, …

Assessing The Performance Of Community Health Workers In Haiti: Key Findings From A Mixed-Methods Study, Frontline Health Project, Zanmi Lasante

Reproductive Health

This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, more training and support around referrals is needed.

A Scoping Review: Overview Of Current Respectful Maternity Care Research By Research Approach And Study Location, Hannah L. Shuman, Annika M. Grupp, Lauren A. Robb, Gurbani Bedi, Miloni Shah, Andrea Janis, Caroline G. Caldart, Ryan Melikian, Urvashi Gupta, Janki K. Vaghasia, Aishwarya Panneerselvam, Aisha Kazeem, Ndidiamaka N. Amutah-Onukagha, Diane L. Levine

Medical Student Research Symposium

Introduction: Disrespectful care during childbirth contributes to poor health outcomes, perpetuates disparities, and encourages childbirth outside of healthcare facilities. To measure disrespectful care, investigators use many research approaches. Most research has focused on low/low-middle income countries. This scoping review aims to 1) summarize current research and research approaches to analyze whether these approaches identify the same types of mistreatment and 2) identify gaps in current research analyzing disrespectful care during childbirth.

Methods: Following PRISMA guidelines, this review utilized search terms to filter articles from the Pubmed database. Using specific criteria, articles were then excluded by title and abstract, then full …

Meropenem-Induced Pancytopenia In A Preterm Neonate: A Case Report, Kashif Hussain, Muhammad Sohail Salat, Naureen Mohammad, Ambreen Mughal, Sidra Idrees, Javaid Iqbal, Gul Ambreen

Department of Biological & Biomedical Sciences

Background: A post-marketing surveillance study has reported an association between meropenem use and the incidence of hematologic abnormalities, including leukopenia, thrombocytopenia, hemolysis, and neutropenia, but the precise incidence in neonates is unknown. Here, we report meropenem-induced pancytopenia in a preterm neonate.
Case presentation: A preterm newborn Pakistani received intravenous meropenem 40 mg/kg every 8 hours to treat Klebsiella pneumoniae in blood cultures and suspected meningitis. The baby developed severe thrombocytopenia, with a platelet count of 22 × 10³ cells/mm³, low hemoglobin level of 9.7 g/dl, and low absolute neutrophil count (ANC) of 816 cells/mm³ on days …

Mucosal Genomics Implicate Lymphocyte Activation And Lipid Metabolism In Refractory Environmental Enteric Dysfunction, Najeeha Talat Iqbal, Najeeb Rahman, Kamran Sadiq, Zubair Ahmad, Romana Idress, Junaid Iqbal, Sheraz Ahmed, Aneeta Hotwani, Fayyaz Umrani, Sana Syed, Syed Asad Ali

Department of Paediatrics and Child Health

Background & aims: Environmental enteric dysfunction (EED) limits the Sustainable Development Goals of improved childhood growth and survival. We applied mucosal genomics to advance our understanding of EED.
Methods: The Study of Environmental Enteropathy and Malnutrition (SEEM) followed 416 children from birth to 24 months in a rural district in Pakistan. Biomarkers were measured at 9 months and tested for association with growth at 24 months. The duodenal methylome and transcriptome was determined in 52 undernourished SEEM participants and 42 North American controls and celiac disease patients.
Results: After accounting for growth at study entry, circulating IGF-1 and ferritin predicted …

Preferred Incentives For Improving Ugandan Community Health Worker Job Satisfaction And Retention, Frontline Health Project

Reproductive Health

This research brief summarizes key quantitative and qualitative results from the Frontline Health project's discrete choice experiment in Uganda. This study was implemented in two phases, and revealed that community health workers in Uganda are motivated by a mix of financial and non-financial incentives to perform.

Silent Epidemic Of Childhood Bronchiectasis In Pakistan: An Infectious Disease Physician's Perspective, Fatima Mir

Department of Paediatrics and Child Health

No abstract provided.

Characteristics Of Salmonella Recovered From Stools Of Children Enrolled In The Global Enteric Multicenter Study, Irene N. Kasumba, Caisey V. Pulford, Blanca M. Perez-Sepulveda, Sunil Sen, Nurulla Sayed, Jasnehta Permala-Booth, Sofie Livio Sofie Livio, Darren Heavens Darren Heavens, Ross Low Ross Low, Shahida Qureshi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Background: The Global Enteric Multicenter Study (GEMS) determined the etiologic agents of moderate-to-severe diarrhea (MSD) in children under 5 years old in Africa and Asia. Here, we describe the prevalence and antimicrobial susceptibility of non-typhoidal Salmonella (NTS) serovars in GEMS and examine the phylogenetics of Salmonella Typhimurium ST313 isolates.
Methods: Salmonella isolated from children with MSD or diarrhea-free controls were identified by classical clinical microbiology and serotyped using antisera and/or whole genome sequence data. We evaluated antimicrobial susceptibility using the Kirby-Bauer disk diffusion method. Salmonella Typhimurium sequence types were determined using multi-locus sequence typing and whole genome sequencing was performed …

Food Insecurity Experiences Of Idaho Head Start Families, Sherry Deiter, Yitza A. Arcelay-Rojas

Journal of Social, Behavioral, and Health Sciences

Using the social-ecological model, this basic interpretive qualitative study sought to examine the phenomenon of food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. A total of 11 interviews were conducted with parents who had children enrolled in five Idaho Head Start programs. The data were coded and analyzed and are reflective of how individual, interpersonal, community, and organizational levels factors are reflected in participants’ decisions to access available nutrition assistance programs. Participants reported feelings of stigma and shame and transportation concerns as individual barriers as well as the interpersonal …

A Pathogenic Ufsp2 Variant In An Autosomal Recessive Form Of Pediatric Neurodevelopmental Anomalies And Epilepsy, Min Ni, Bushra Afroze, Chao Xing, Chunxiao Pan, Yanqiu Shao, Ling Cai, Brandi L. Cantarel, Jimin Pei, Nick V. Grishin, Stacy Hewson

Department of Paediatrics and Child Health

Purpose: Neurodevelopmental disabilities are common and genetically heterogeneous. We identified a homozygous variant in the gene encoding UFM1-specific peptidase 2 (UFSP2), which participates in the UFMylation pathway of protein modification. UFSP2 variants are implicated in autosomal dominant skeletal dysplasias, but not neurodevelopmental disorders. Homozygosity for the variant occurred in eight children from four South Asian families with neurodevelopmental delay and epilepsy. We describe the clinical consequences of this variant and its effect on UFMylation.
Methods: Exome sequencing was used to detect potentially pathogenic variants and identify shared regions of homozygosity. Immunoblotting assessed protein expression and post-translational modifications in patient-derived fibroblasts. …

An Evaluation Of A Maternal Health And Extreme Heat Exposure Training, Adelle Dora Monteblanco, Jennifer K. Vanos, Sarah Leroy, Patricia M. Juarez, Gregg M. Garfin

Journal of Social, Behavioral, and Health Sciences

Growing empirical evidence documents the potential risk of extreme heat exposure to pregnant individuals. These risks include adverse birth outcomes, such as preterm birth and low birth weight. Climate change will exacerbate extreme heat exposures to a large portion of the global population, and pregnant individuals need to understand the risks and protective measures needed. Maternal health workers are a key mechanism for conveying this information to pregnant individuals. The authors assess a training of maternal health workers in El Paso, Texas, through two research instruments. First, eight maternal health workers completed an educational workshop and consented to participation; pre- …

Prenatal Maternal Psychological Distress And Fetal Developmental Trajectories: Associations With Infant Temperament, Mariann A. Howland, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Associations between prenatal maternal psychological distress and offspring developmental outcomes are well documented, yet relatively little research has examined links between maternal distress and development in utero, prior to postpartum influences. Fetal heart rate (FHR) parameters are established indices of central and autonomic nervous system maturation and function which demonstrate continuity with postnatal outcomes. This prospective, longitudinal study of 149 maternal–fetal pairs evaluated associations between prenatal maternal distress, FHR parameters, and dimensions of infant temperament. Women reported their symptoms of psychological distress at five prenatal visits, and FHR monitoring was conducted at the last three visits. Maternal report of infant …

Direct And Indirect Effect Of 10 Valent Pneumococcal Vaccine On Nasopharyngeal Carriage In Children Under 2 Years Of Age In Matiari, Pakistan, Muhammad Imran Nisar, Sheraz Ahmed, Fyezah Jehan, Shahira Shahid, Sadia Shakoor, Furqan Kabir, Aneeta Hotwani, Sahrish Munir, Sajid Muhammad, Farah Khalid, Syed Asad Ali, Anita K. M. Zaidi, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

Background: Pakistan introduced Ten-valent pneumococcal-conjugate-vaccine PCV10 in 2012 as a 3 + 0 schedule without catch-up.
Methods: Children <2 years old in Matiari, Sindh provided nasopharyngeal swabs between 2014 and 2018, which were cultured for pneumococcus and serotyped through multiplex PCR at the Aga Khan University Hospital. Carriage rates over time for Vaccine-Type (VT) and Non-VT (NVT) serotypes were used to estimate direct, indirect, total and overall effects of vaccination. Regression analysis was used to determine factors associated with VT carriage.
Results: Pneumococcus was detected in 2370/3140 (75%). VT carriage decreased overall, 16.1-9.6% (p-trend <0.001); vaccinated (all 3 doses of PCV10 received) 11.3-8.1% (p-trend 0.031) and unvaccinated (no PCV10 dose received) 17.4-10.3% (p-trend 0.003) with a decline in serotypes 6B, 9V/9A and 19F. Immunization increased from 41.0% to 68.4% (p-trend 0.001). Direct effect of vaccine was 32.8% (95% CI 14.7-47.0%) and indirect effect 44.6%(95% CI 40.6-48.6%). Factors associated with decreased VT colonization were education 1-5 years (aOR 0.7, 95%CI 0.6-1.0), history of difficulty breathing (aOR 0.7, 95%CI 0.5-1.0), exposure to smoke (aOR 0.8, 95% CI 0.6-1.0), child fully immunized (aOR 0.7, 95%CI 0.5-1.0) and enrolled in 3rd (aOR 0.6, 95%CI 0.4-0.8) and 4th (aOR 0.6, 95%CI 0.5-0.9) year of the study whereas history of runny nose (aOR 1.5, 95% CI 1.2-1.9) was positively associated.
Conclusions: Decrease in VT pneumococcal carriage in vaccinated and unvaccinated children indicates herd immunity. Sustained increase in vaccine coverage and close long-term surveillance is warranted.

Trends In Diagnoses Of Neonatal Abstinence Syndrome At Newborn Hospitalization In Maine, 2009-2018, Emily C. Bauer Mph, Katherine Ahrens Phd, Jenny L. Carwile Mph, Scd

Journal of Maine Medical Center

Introduction: Incidence rates of neonatal abstinence syndrome (NAS) have increased in Maine, but whether this increase can be explained by use of different diagnosis codes over time is unknown. Our objective was to estimate trends in diagnoses of NAS at newborn hospitalization in Maine using different NAS case definitions.

Methods: We used International Classification of Diseases (ICD) diagnosis codes to identify newborns diagnosed with NAS in Maine between 2009 and 2018 using state-level hospital discharge data (n = 123 519). First, we considered only ICD-9 and ICD-10 codes used for confirmed NAS. Then we used an expanded ICD-10 NAS case …

Characterization Of Cardiovascular Function In Adult Offspring Following Prenatal Exposure To Methamphetamine, Hasitha Chavva

Theses, Dissertations and Capstones

Methamphetamine (meth) is a synthetic stimulant, and its abuse is a significant public health concern in the United States and all over the world. Methamphetamine is a highly addictive drug, and its abuse is widespread among women of child-bearing age. The consequences of methamphetamine abuse are not only of relevance to pregnant women, but also their unborn children, as amphetamine type substances can cross the placental barrier and effect the fetus during gestation. Most previous studies investigating the impact of prenatal methamphetamine exposure on the offspring have focused on neurological and behavioral effects. The goal of this study was to …

The Impacts Of Terrorism On Maternal Health In Afghanistan, Kyla Rocanello-Snow

Global Sustainable Development Projects

Terrorism is both directly and indirectly harmful to maternal health. Terrorist attacks targeted at healthcare workers, hospitals and maternity wards are a direct impediment of maternal healthcare. Other terrorist activity and conflict produce overall instability, aggravating insecurity in the country. Attacks that disrupt functions within a community and a country at large indirectly impact maternal health as they target specific social determinants of health, including infrastructure for transportation, education, and healthcare. Terrorism and the influence of Islamic militia groups in Afghanistan continue to threaten the power and stability of the national government, making it difficult for policy enactment to improve …

Parents' Attitudes As Mediators Between Knowledge And Behaviours In Unintentional Injuries At Home Of Children Aged 0-3 In Shanghai, Eastern China: A Cross-Sectional Study, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Huiping Wang, Qinghua Xia, Jicui Zheng, Wei Deng, Fengshui Chang, Xiaohong Li

Community & Environmental Health Faculty Publications

Objective: Parental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours.

Design: Cross-sectional study.

Setting: Eastern China

Participants: Participants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0–3 years participated in the study and 476 (97.5%) valid questionnaires were recovered.

Primary outcome measures: Parents’ knowledge, attitudes (including injury attribution, preventability and responsibility) …

A Qualitative Systemic Review On Maternal Health Disparities In Haitian Women, Alexandra Jean-Louis

Honors Undergraduate Theses

Background: It is universally known that pregnancy is a vulnerable time for a woman's health. Women of all backgrounds endure significant physiological and anatomical changes during pregnancy and after childbirth. But the latest research studies have called attention to the unique experience of Black mothers. Compared to other racial and ethnic groups, Black women encounter health disparities at an all-time higher rate. According to research studies conducted in Haiti and the United States, Haitian women are amongst the community of Black women who are experiencing disproportionate maternal outcomes.

Research Aims: The aim of this systematic review is to …