Maternal and Child Health Commons^™

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Neonatal Jaundice And Developmental Impairment Among Infants In Kilifi, Kenya, Dorcas N. Magai, Michael Mwaniki, Amina Abubakar, Shebe Mohammed, Anne L. Gordon, Raphael Kalu, Paul Mwangi, Hans M. Koot, Charles R. Newton

Institute for Human Development, East Africa

Background: Neonatal jaundice (NNJ) is common in sub‐Saharan Africa (SSA), and it is associated with sepsis. Despite the high incidence, little has been documented about developmental impairments associated with NNJ in SSA. In particular, it is not clear if sepsis is associated with greater impairment following NNJ.

Methods: We followed up 169 participants aged 12 months (57 cases and 112 controls) within the Kilifi Health Demographic Surveillance System. The diagnosis of NNJ was based on clinical laboratory measurement of total serum bilirubin on admission, whereas the developmental outcomes were assessed using the Developmental Milestones Checklist and Kilifi Development …

Factors Influencing Infant Death Due To Respiratory Syncytial Virus, Michelle Adamczyk

Scholarship in Medicine - All Papers

Objective: Determine what factors are associated with increased mortality in infants <1 year old due to respiratory syncytial virus. Methods: Using publicly accessible infant mortality data from CDC Wonder, I used z-scores to compare infant death rates due to RSV between different groups including levels of prematurity, birth weight, and race. Results: When compared by race, mortality rates were highest for infants with mothers who are American Indian or Alaska Natives, followed by infants with Black mothers, and lowest for infants with White or Asian mothers. Infants born with lower weight at birth had higher mortality rates by RSV than infants with higher birth weights. Infants born prematurely, especially at <28 weeks gestation had higher RSV mortality rates. When compared by geographic region, RSV mortality rates were highest in the Southern U.S.. Sorting by mother’s age, infants born to younger mothers, especially mothers <20 years old had higher mortality rates due to RSV. These findings align with previous research focusing on RSV mortality and overall trends in epidemiological factors influencing infant mortality.

The Effects Of Centering Pregnancy On Attitudes Towards Breastfeeding Among Women With Opioid Use Disorder, Francesca Mancuso, Vanessa Short, Phd, Mph

Phase 1

Introduction: Breastfeeding has been found to decrease severity of neonatal abstinence syndrome (NAS), however, breastfeeding rates among women with opioid use disorder (OUD) are significantly lower than national averages. CenteringPregnancy, a group prenatal care model, increases exposure to education regarding breastfeeding, making it more likely that patients breastfeed in traditional populations.

Objective: This project’s purpose was to identify and understand current infant feeding attitudes among mothers with OUD and explore whether participation in the CenteringPregnancy “Breastfeeding Session” positively impacted knowledge and attitudes towards breastfeeding.

Methods: Data were collected from 12 women in treatment for OUD who participated in CenteringPregnancy. A …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

An Environmental Assessment Of Barriers To Hpv Vaccination In Lira, Uganda, Mary Ryan, Amy Leader, Phd

Phase 1

Introduction: Vaccination against HPV is a global concern, given that cervical cancer is the most common cancer among women in developing countries, such as Uganda. Uganda has launched a national program to vaccinate girls 9-13 with Gardasil^â for HPV prevention, yet areas like Lira in northern Uganda are well below the 80% coverage goal. While there is infrastructure at a national level to vaccinate girls against HPV, this project aimed to assess barriers to vaccination at a local level.

Methods: Semi-structured interviews with individuals in Lira, providers at Ayira Health Services, and a stakeholder at the Uganda Ministry of …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: Breastfeeding is essential for health and bonding within the mother-child dyad. Most guidelines, therefore, suggest women continue breastfeeding up to twelve months post-partum. Discrepancies in achieving this exist across zip codes and race in Philadelphia, despite high overall rates of breastfeeding. Our research goal is to understand these discrepancies and the relationship between attitudes and practices of breastfeeding Philadelphian women, in order to target them with breastfeeding resource.

Methods: General population data was collected via an online survey taken by residents of Philadelphia and the surrounding counties, whereas the focus group survey was taken in-person by Maternity Care Coalition …

Territorial Inequality In Health Service Delivery: Lessons From Latin America’S Federations, Agustina Giraudy, Jennifer Pribble

Political Science Faculty Publications

Access to quality healthcare varies across the national territory inside Latin American countries, with some subnational units enjoying higher-quality care than others. Such territorial inequality is consequential, as residents of particular regions face shorter life spans and an increased risk of preventable disease. This article analyzes trajectories of territorial healthcare inequality across time in Argentina, Brazil, and Mexico. The data reveal a large decline in Brazil, a moderate decline in Mexico, and low levels of change followed by a moderate decline in Argentina. The article argues that two factors account for these distinct trajectories: the nature of the coalition that …

Culturally Competent Interventions To Reduce Sids Rates Among Native American/Alaska Native Nations, Kathleen Hynes

Capstone Showcase

ABSTRACT:

Introduction: Environmental factors can increase the risk of SIDS for infants. These environmental factors have been targeted by educational campaigns in the past in an effort to reduce SIDS rates. Such educational campaigns have been effective in reducing SIDS among the white population but not Native American/Alaska Native (NAAN) populations in the United States. This paper aims to study whether educational campaigns that incorporate NAAN traditions and take socioeconomic factors into account will more effectively reduce SIDS rates for these communities.

Methods: To obtain scholarly articles, a literature search was performed using Pubmed, Academic Search Ultimate, and Google scholar. …

Project Adkeyso: Addressing Female Genital Mutilation And Cutting In Somaliland, Ayanna Joyner

Capstone Showcase

Project Adkeyso: Addressing Female Genital Mutilation and Cutting in Somaliland

Ayanna Joyner

Faculty Advisor: Dr. Comfort Olorunsaiye

Female Genital Mutilation or Cutting (FGM/C) is the procedure of intentionally causing injury and altering the vulva of a young girl or woman for non-medical reasons. There are four types of FGM/C however, type III or infibulation, remains the most dangerous because the procedure consists of the narrowing of the vaginal opening by creating a seal with the labia majora through stitching. With infibulation, there will be a need for further surgeries or re-infibulation, which requires reopening of the stitches covering the vagina …

Grant Proposal For Thrive: Targeting Malnutrition In Children Under-Five In Bolivia’S Indigenous Population, Leah Mccaskey

Capstone Showcase

Thrive: Targeting Malnutrition in Children Under-Five in Bolivia’s Indigenous Population

Leah McCaskey BSPH(c)

Faculty Advisor: Comfort Olorunsaiye, PhD

Malnutrition is a serious public health issue that has been linked to an increase in morbidity and mortality¹. Poor nutrition can lead to severe health issues, including stunted growth, developmental disabilities, immune deficiency, chronic fatigue, and in the most severe cases, death¹. Children under the age of five are the most vulnerable to malnutrition because of the immense nutrition requirements for physical and mental development. Bolivia has the highest prevalence of under-five malnutrition in South America, with 25 …

Oxidative Stress Analysis Of Placental Tissue In The Rupp Pregnant Rat, Natalie Ganios

Williams Honors College, Honors Research Projects

Preeclampsia is a disease associated with a vasoconstrictive phenotype due to disrupted signaling in the vascular endothelial growth factor (VEGF) relaxation pathway. The purpose of these studies is to determine the level of oxidative damage that is occurring in the placenta of the reduced uterine perfusion pressure (RUPP) rat, which serves as a common model for preeclampsia. RUPP and SHAM placenta tissue will be examined for oxidative stress as an indicator of tissue damage associated with the pathologically induced ischemia. Oxidative stress in the placental tissue will be measured by performing the following oxidative stress assays: 8-isoprostane test, TBARS assay, …

Altered Growth Trajectory In Children Born To Mothers With Gestational Diabetes Mellitus And Preeclampsia, Yonglin Huang, Wei Zhang, Karen Go, Kenji J. Tsuchiya, Jianzhong Hu, Daniel W. Skupski, Sheow Yun Sei, Yoko Nomura

Publications and Research

Purpose: Gestational diabetes mellitus (GDM) and preeclampsia are leading causes of mortality and morbidity in mothers and children. High childhood body mass index (BMI) is among their myriad of negative outcomes. However, little is known about the trajectory of the child BMI exposed to GDM and co-occurring preeclampsia from early to mid-childhood. This study examined the independent and joint impact of GDM and preeclampsia on childhood BMI trajectory.

Methods: A population-based sample of 356 mothers were recruited from OB/GYN clinics in New York. Their children were then followed annually from 18 to 72 months. Maternal GDM and preeclampsia status were …

Examining The Associations Between Addiction Severity And Prior Adverse Childhood Experiences In Pregnant Women Receiving Treatment For Opioid Addiction, Julia Gong, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Opioid use during pregnancy poses risk to both the mother and fetus, including fetal loss and pre-term birth. Prior research suggests that adverse childhood experiences (ACEs) are a plausible antecedent to opioid abuse. However, there is insufficient understanding of the association between prior ACEs, familial history of substance use, and treatment outcomes in pregnant women receiving treatment for opioid addiction.

Methods: A retrospective chart review will be used to review data from 167 MATER patients who entered treatment between 1997 and 2017. Descriptive statistics will be utilized to characterize the study population. Regression and chi-square analyses will be conducted …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: It is recommended that women breastfeed for twelve months because breastfeeding is an important part of infant development and maternal bonding. Research shows that despite high overall breastfeeding rates, discrepancies exist in breastfeeding rates across zip codes and race in Philadelphia. The research goal is to develop a community resource to promote breastfeeding in Philadelphia and to understand the impact race and zip code have on breastfeeding attitudes and practices.

Methods: Data was collected from residents of Philadelphia and neighboring counties through an online general population survey and focus group survey. Both surveys addressed demographics and the women’s attitudes …

Perceptions Of Centering Pregnancy At Jefferson’S Maternal Addiction Treatment, Education & Research (Mater) Program, Lindsay Caldarone, Ms, Vanessa Short, Phd, Mph

Phase 1

Introduction: Opioid use and misuse, including during pregnancy, is prevalent across the United States. Many women with opioid use disorder (OUD) face multiple barriers to care, including prenatal care. Group prenatal care, as compared to individual prenatal care, may lead to beneficial outcomes such as reduced odds of preterm birth.

Objective: This study aimed to assess the perceptions of Centering Pregnancy (CP), a group prenatal care program, among women in treatment for OUD.

Methods: The target population included women who participated in the CP program at MATER. Participants (N=6) completed a survey after the last CP session. Survey questions assessed …

Disparities In The Prevalence And Risk Factors Of Anaemia Among Children Aged 6–24 Months And 25–59 Months In Ethiopia, Tafere Gebreegziabher Belay, Nigatu Regassa, Micaela Wakefield, Kelly Pritchett, Susan Hawk

All Faculty Scholarship for the College of Education and Professional Studies

Despite global efforts made to address anaemia, the prevalence remains high in most Sub-Saharan African countries. In Ethiopia, anaemia poses a very strong public health concern. The purpose of the present study was to examine the key risk factors related to anaemia among children aged 6–24 months (younger age group) and 25–59 months (older age group). We used the 2016 Ethiopian Demographic and Health Survey data, collected from 11 023 mothers with under five children. Ordered logistic regression modelling was used for assessing risk factors of childhood anaemia. The results suggest that the prevalence of anaemia was 72 % in …

Parenting Styles, Parenting Practices, And Dietary Intakes Of Preschoolers And Their Parents, Biyi Chen

Electronic Theses and Dissertations

Emerging research efforts have focused on the role of parents in the development of dietary behaviors of their children. Parental influences play a particularly important role in determining the children’s weight and shaping children’s dietary behaviors, especially during early childhood. Parent-related determinants can be classified as two types—general parenting (parenting style) and specific parenting practices (e.g, food parenting practices). Examining the interactions between parental influences and preschoolers’ and their parental dietary behaviors and may reveal important insights into how parents influence children’s dietary behaviors. Therefore, the goal of this research is to examine the associations between parenting styles, food parenting …