Dissertations / Theses on the topic 'Birthweight'
To see the other types of publications on this topic, follow the link: Birthweight.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Birthweight.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Hodgson, Theresa Paula. "Stories about low birthweight." Thesis, Lancaster University, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.418865.
Full text
2
Bellingham-Young, Denise Anne. "Birthweight and minor illness." Thesis, University of Wolverhampton, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.418884.
Full text
3
Peacock, Janet Lesley. "Birthweight and cigarette smoking." Thesis, St George's, University of London, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.434249.
Full textAbstract:
Recent research has shown an association between smoking in pregnancy and low birthweight. Many authors have concluded that the relationship is causal but some have argued that it is the smoker rather than the smoke which is responsible. This thesis examines the relationship between the smoking habit in pregnancy and birthweight corrected for gestational age using data from the St. George's Hospital Birthweight Study. Adjustment is made for confounding factors so that the effect of smoking can be estimated. The statistical problem of adjusting birthweight for gestational age when very early births are included is discussed and a solution presented in the form of a birthweight ratio. The relationship is examined between birthweight ratio and many socioeconomic and psychological factors and shows that few are associated with reduced birthweight. Those associations which are observed can be explained by smoking. Alcohol and caffeine are only related to birthweight in smokers. When the smoking habit is analysed in terms of quantity and constituents, a threshold is observed whereby women smoking a low number of low yield cigarettes have mean birthweight similar to non-smokers. For women smoking higher numbers of cigarettes but a low yield brand mean birthweight is reduced by the same amount (6% or more) as women smoking high yield brands. The effect on birthweight of alcohol and caffeine in smokers only is adjusted for smoking by using this threshold. This shows that smoking, alcohol and caffeine are all associated with reduced birthweight. For alcohol and caffeine consumption this relationship is strongest in early pregnancy and weakest near delivery. The association between smoking and birthweight is not explained by any of the wide range of confounding factors examined. This provides evidence that the relationship is a causal one.
4
Doyle, Wendy. "Maternal nutrition and low birthweight." Thesis, Brunel University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267895.
Full text
5
Mathai, Matthews. "Fetal growth in India : studies on antenatal prediction of low birthweight and some factors that determine birthweight /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3421-5/.
Full text
6
Headley, La Tosha. "Effects of Maternal Obesity on Preterm Birth and Birthweight." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7661.
Full textAbstract:
Obesity is one of the major risk factors for neonate low birthweight among reproductive women. The purpose of this quantitative study was to examine the association between 3 categories of obese status (moderate, severe, and very severe) and low neonate birthweight and preterm birth among women ages 18 to 39 years at all socioeconomic levels. Secondary data were obtained from 141,859 women ages 18-39 years living in the United States who had participated in the 2012-2015 Pregnancy Risk Assessment Monitoring System. Social-ecological theory was used to guide the study, and binary logistic regression was used for the analyses adjusting for age, education, ethnicity, income, marital status, and race confounders. Without accounting for the confounders, moderate, severe, and very severe obesity were associated with preterm birth. However, after adjusting for confounders, the obese categories were no longer associated with preterm birth. The estimated prevalence of preterm birth was higher among moderate, severe, and very severe obesity categories combined (56 preterm births per 1,000 live births) than among normal weight women (43 preterm births per 1,000 live births). Women of moderate obesity had a 10% statistically significant higher odds (p = .046, OR = 1.095) of neonate low birthweight when compared with very severely obese women. Severely obese women were not associated with neonate low birthweight when compared to women with very severe obese status (p = 0.159, OR = 1.056). Findings may be used to promote healthy lifestyle changes that could reduce the prevalence of preterm birth among obese women.
7
Corey, William Frederick. "A Preschool-Age Neurodevelopmental Comparison Between Normal-Birthweight Infants and Low-BirthWeight Infants With and Without Intraventricular Hemorrhage." DigitalCommons@USU, 1989. https://digitalcommons.usu.edu/etd/6000.
Full textAbstract:
Advances in medical technology have provided the mechanisms for sustaining life in premature and low-birthweight infants, resulting in the survival of more of these infants. Low-birthweight (LBW) and preterm infants are placed at risk by a number of medical complications, including intraventricular hemorrhage (IVH).
The outcome of low-birthweight infants with intraventricular hemorrhage has been the subject of a great deal of research and continues to be a much-discussed topic in the medical and psychological communities. As more data become available, it appears that more questions arise concerning the later neuodevelopmental and neuropsychological outcome of these infants.
For this reason, research concerning the later status of infants born with intraventricular hemorrhage is needed. The purpose of this study was to determine if there are differences in cognitive and motor functioning among infants with intraventricular hemorrhage (IVH), infants who were low birthweight (LBW), and normal-birthweight (NBW) infants.
Forty-four subjects (10 with mild IVH, 9 with severe IVH, 12 LBW, and 13 NBW), who were born between January 1, 1984, and June 1, 1985, and were either patients in the neonatal intensive care unit at University of Utah Medical Center (the IVH and LBW infants) or were residents of the well-baby nursery (the NBW infants) at University of Utah Medical Center, served as the sample population. The subjects were tested at 3 to 4.5 years of age using the Stanford-Binet Intelligence Scales (Fourth Edition) and the motor section of the McCarthy Scales of Children's Abilities. In addition, infant medical data were obtained from medical records, and demographic data were collected including mother's age at time of birth, family income, mother's and father's education level, and birth order of the infant.
The MIVH, SIVH, and LBW groups had significantly lower gestational ages and birthweights and significantly more medical complications than did the NBW group. The MIVH and SIVH groups also had significantly lower birthweight and gestational ages than did the LBW group, but approximately equivalent numbers of medical complications.
Significant group differences were found only between the MIVH and NBW groups on the McCarthy motor score, with the MIVH group appearing to outperform the NBW group following statistical manipulation with analysis of covariance. No other significant group differences were found. Further research with a larger sample is recommended in order to more fully understand the later outcome following LBW and IVH.
8
Lyttle, Steven. "Temperament in very-low-birthweight preterm infants." Thesis, Queen's University Belfast, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295416.
Full text
9
Roberts, B. Lynne. "Very low birthweight children in primary school." Thesis, University of Liverpool, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317215.
Full text
10
Blair, Lisa M. "Cognitive Risk Mapping in Low Birthweight Children." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu153202738375901.
Full text
11
RondoÌ, PatriÌcia Helen de Carvalho. "The influence of maternal nutritional factors on intrauterine growth retardation." Thesis, University of London, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248112.
Full text
12
Leary, Samantha Dawn. "Geographical variation in neonatal size and shape, and relationships with maternal and paternal body composition." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274471.
Full text
13
Snyder, Jennifer. "Nutritional predictors of infant birthweight in gestational diabetes." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=60724.
Full textAbstract:
The predictors of birthweight (scBWT) in normal pregnancy are well established. The objectives of this study were to characterize and determine predictors of scBWT among women diagnosed with scGDM. A cohort of 436 scGDM full-term pregnancies (followed 1978-1989) were examined using data abstracted from the Royal Victoria Hospital Antenatal Diabetic Clinic charts and McGill Obstetric and Neonatal Database. Women were treated with insulin and/or diet. Dietary treatment (mean 2047 kcal/d) significantly decreased the rate of weight gain and mean fasting plasma glucose (scFPG). Regression analysis identified several predictors of scBWT (mean 3520 g): prepregnancy body mass, height, smoking, pre-diagnostic rate of weight gain, scFPG, gestational age, infant gender, and length of treatment. Stratification by body mass indicated that among non-obese women with scGDM, scFPG and length of treatment were not significant predictors of scBWT. In conclusion, since women with normal pregravid mass and prediagnostic weight gain are at lower risk of high scBWT, these require consideration, in addition to plasma glucose criteria, when treating scGDM.
14
Murray, Barbara A. "A statistical analysis of low birthweight in Glasgow." Thesis, University of Glasgow, 1999. http://theses.gla.ac.uk/2988/.
Full textAbstract:
The percentage of singleton livebirths resulting in low birthweight deliveries has remained constant in the last 20 years, with between 6 and 10% of singleton pregnancies resulting in such a delivery. Low birthweight infants have been shown to develop medical problems in infancy and childhood, such as visual impairment, lower IQs and neuromotor problems, and as such it is important to identify those pregnancies that may result in low birthweight infants. This thesis considers factors that may be related to low birthweight, and uses these factors in the construction of a model to predict the probability of a woman delivering a low birthweight infant in order to identify high risk mothers. One factor that may be thought of as being related to low birthweight is deprivation. In this thesis a new deprivation measure is proposed which updates previous work in the area by using the 1991 small area census data to create a continuous deprivation measure, based on postcode area of residence, within the Greater Glasgow Health Board. This new measure of deprivation is included in the model referred to above. As there are many possible risk factors involved in modelling the probability of delivering a low birthweight infant multiple comparisons are involved in the production of the model and it is important to produce a model that incorporates most of the relevant factors and relatively few of the unimportant factors. The first order Bonferroni bound is one method used to correct for multiple comparisons by giving an upper bound on the actual p-value. This thesis considers the second order Bonferroni bound which gives a lower bound on the p-value and, when used in conjunction with the first order bound, gives a better correction method than the first order bound alone. These two bounds are then extended into logistic regression models.
15
Terry, Peter Brian. "Perinatal mortality and birthweight in a multiracial population." Thesis, University of Edinburgh, 1987. http://hdl.handle.net/1842/30824.
Full text
16
Kumaran, K. "Relation of fetal growth to adult coronary heart disease : a study of left ventricular mass and arterial compliance in South Indian adults : retrospective cohort study of men and women bom in Mysore, South India during 1934-53." Thesis, University of Southampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274436.
Full text
17
Chan, Kwok-Ning. "Long term pulmonary outcome in children of low birthweight." Thesis, Imperial College London, 1990. http://hdl.handle.net/10044/1/47798.
Full text
18
Laing, Ian A. "Studies of nutrition of the very low birthweight infant." Thesis, University of Edinburgh, 1992. http://hdl.handle.net/1842/19909.
Full textAbstract:
The perinatal mortality rate has decreased in Scotland from 15.4 per 1,000 total births in 1978 to 8.7 per 1,0000 total births in 1989. This improvement is largely accounted for by a decrease in mortality of infants weighing less than 1500g at birth. It has become important to learn more about the nutrition of these infants in an effort to decrease their mortality rate still further, to optimise their ability to combat the diseases of prematurity, and to allow them to achieve their potential in both growth and development. Most infants weighing less than 1500g at birth are unable to establish full oral feeds immediately. Total parenteral nutrition, transpyloric feedings or gastric feedings must be given to provide the infant with adequate calories for growth and development. This thesis contains a study in which very low birthweight infants were randomly allocated to nasoduodenal or nasogastric routes of milk administration. The nasoduodenal route proved to be more complex, more time-consuming, and offered no advantages to the infants. Gastric feedings are recommended as the best method of providing calories enterally to the very low birthweight infant. Rickets of prematurity continues to be described in the 1990's, involving diffuse demineralisation of the skeleton and even bone fractures. Elevation of plasma alkaline phosphatase activity is a commonly used biochemical marker of this condition. Since large doses of vitamin D do not prevent the disease, it may be that the problem is one of substrate deficiency. Included in this thesis is an examination of the effects of adding extra calcium and then extra phosphorus to the milk given to cohorts of very low birthweight infants. The addition of calcium alone reduced radiological evidence of rickets, while the addition of both calcium and phosphorus maintained plasma alkaline phosphatase activity within normal limits throughout the study period.
19
Novelli, Lauren. "Racism and Infant Mortality: Links Between Racial Stress and Adverse Birth Outcomes for African American Women and their Infants." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439305228.
Full text
20
Wilson, David Charles. "Studies of nutrition in the sick very low birthweight infant." Thesis, Queen's University Belfast, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.282045.
Full text
21
Quiery, Nuala Patricia Josephine. "Mother - child interaction in very low and normal birthweight infants." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337027.
Full text
22
Thompson, Shannon G. "Intraventricular Hemorrhage Sequelae in Low Birthweight Infants: A Meta-analysis." DigitalCommons@USU, 1993. https://digitalcommons.usu.edu/etd/6066.
Full textAbstract:
Technological advances in neonatal care have dramatically improved the survival and disability rates among low birthweight infants (LBW). One common factor associated with later problems among these babies is intraventricular hemorrhage (IVH). A meta-analysis was conducted among LBW infants with and without IVH to determine developmental outcome. More than 450 studies were located. Only 125 studies met inclusion criteria.
Mean effect sizes were computed by comparing the LBW group to either a fullterm children, LBW children scored worse in all areas except gross motor skills.
Cognitive assessment was done commonly up to 6 years of age. LBW infants scored about 1/2 standard deviation below their comparison group. A positive linear trend was found for severity of IVH: those children without an IVH scored comparably to fullterm children, while those with severe bleeds were about one standard deviation behind.
Assessment of academic skills was done with the 8- to 11-year olds. There was no information given on presence/severity of IVH. Very few assessments were done. On general academic measures, the LBW children scored about 1/2 standard deviation behind the comparison group.
Over 80% of the language assessments were done at 15- to 38-months of age. LBW children tended to score 1/2 to 3/4 of a standard deviation below the comparison group. The severity of hemorrhage did not mediate these results.
Fine motor assessments were performed on children 9 months to 11 years old. LBW children were about 2/3 of a standard deviation behind the comparison group. These skills were not affected by severity of IVH.
Gross motor abilities were typically measured before the children were 24 months old. LBW children showed more deficits in this area than in any other: almost 90% of a standard deviation behind. Gross motor skills appear to be strongly impacted both by being low birthweight and by the severity of IVH.
Results indicate that IVH is a mediating factor in outcome among LBW infants. More research needs to be conducted on these children when they are school age, so long-term effects of low birthweight can be determined.
23
Pickering, R. M. "Analysis of categorical data on pregnancy outcome." Thesis, University of Glasgow, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.280012.
Full text
24
Chiswick, Carolyn. "Obesity and metformin in pregnancy." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/29598.
Full textAbstract:
Obesity is the most common antenatal comorbidity, affecting one in five of the antenatal population in the UK. It is associated with adverse outcomes for mother and baby in both the short and long term. Increasing data suggest that maternal obesity may programme offspring later life obesity and premature mortality, with high birth weight being a marker for increased risk. The mechanism by which maternal obesity causes excessive neonatal birth weight is incompletely understood but considerable evidence implicates insulin resistance and/or hyperglycaemia. There are currently no effective interventions to mitigate the effects of obesity during pregnancy. In this thesis, we present the findings from a randomised, double blind, placebo controlled trial designed to examine the efficacy of metformin, an insulin-sensitising agent, in obese pregnant women. The aim of the trial was to determine whether giving metformin to obese pregnant women from between 12 and 16 weeks’ gestation until birth, would improve maternal and fetal outcomes. The primary outcome measure was birth weight of the baby, using this as a surrogate marker for the future life risk of the child developing obesity. Nested within this large clinical trial were a series of mechanistic sub-studies. To examine the effect of metformin on maternal insulin resistance at 36 weeks’ gestation, we used the hyperinsulinaemic euglycaemic clamp with concomitant use of stable isotope tracers. This enabled us to characterise in greater detail insulin sensitivity, endogenous glucose production and lipolysis. To determine the effect of metformin on maternal and fetal body composition we used magnetic resonance imaging and spectroscopy. This allowed us to quantify subcutaneous and intra-abdominal adipose tissue deposition and hepatic and skeletal muscle ectopic lipid deposition in the mother; and to measure subcutaneous adipose tissue deposition, hepatic lipid and hepatic volume in the fetus. To determine the effect of metformin on maternal endothelial function, we measured endothelium-dependent flow-mediated dilatation at the beginning and end of pregnancy. Change in diameter of the brachial artery in response to a flow stimulus created by arterial occlusion was measured using ultrasound imaging. We found no significant effect of metformin on birth weight. Mean birth weight was 3463 g (SD 660) in the placebo group and 3462 g (SD 548) in the metformin group (adjusted mean difference in z score –0·029, 95% CI –0·217 to 0·158; p=0·7597). Subjects taking metformin did demonstrate increased insulin sensitivity (M/I difference between means during high dose insulin of 0.02 [95% CI 0.001 to 0.03] milligrams per kilogram fat free mass per minute per pmol/L, p=0.04) but also enhanced endogenous glucose production (difference between means 0.54 [95% CI 0.08 to 1.00] milligrams per kilogram fat free mass per minute, p=0.02), compared with those taking placebo. We did not demonstrate any differences between treatment groups in maternal subcutaneous and intra-abdominal adipose tissue, or ectopic lipid deposition, or in fetal body fat distribution and liver volume. Participants in both treatment groups demonstrated a decline in endothelium-dependent flow-mediated dilatation between early and late pregnancy but there were no differences in the magnitude of that decline between the treatment groups. In conclusion, metformin, administered to obese, non-diabetic pregnant women, does not have any significant effect on birth weight of the baby. Our clamp studies demonstrated that subjects taking metformin were indeed more insulin-sensitive than those taking placebo, but the higher endogenous glucose production in this group suggests a reduced ability to suppress hepatic glucose production in response to insulin. This increased glucose flux may in part explain the lack of effect of metformin on fetal nutrition and growth. We can conclude that metformin, should not be used as an intervention in obese pregnant women to prevent excess birth weight. The global obesity epidemic is one of the greatest public health challenges we face and the cycle of disadvantage continues to be perpetuated to the next generation. The lack of any effective interventions for this high-risk group remains a significant concern and an important area for further research.
25
Botting, Nicola Fay. "Psychological and educational outcome of Very Low Birthweight children at 12yrs." Thesis, University of Liverpool, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266195.
Full text
26
Williams, Catherine. "The East London study of periodontal disease and preterm low birthweight." Thesis, Queen Mary, University of London, 2001. http://qmro.qmul.ac.uk/xmlui/handle/123456789/25127.
Full textAbstract:
Establishment of risk factors, and mechanisms involved in preterm (premature) birth is important for society. Despite efforts to find the cause(s), a significant proportion of preterm birth is of unknown aetiology. Maternal infection has been implicated and oral infection in the form of periodontal (gum) disease has also been suggested as a risk factor for preterm birth (OPenbacher et at, 1996). The aim of this study was to examine the possible relationship between maternal periodontal disease and the delivery of preterm infants with associated low birthweight in East London. This was an unmatched case-control study with 187 cases (mothers whose infant weighed < 2500g, gestational age < 37 weeks (preterm low birthwieght (PLBW)), and 532 controls (mothers whose infant weighed z 2500g, gestational age z 37 weeks). Risk factor information for prematurity and low birthweight were collected from Maternity notes and a structured questionnaire. Maternal periodontal disease levels were measured by: Community Periodontal Index, periodontal probing pocket depths and a bleeding index. Analysis was by logistic regression. The study population was derived from a multiethnic inner city population the predominant groups being Bangladeshi (51.9%) and white Caucasian (25.9%). No differences were found between the periodontal status of the case and control mothers for any of the periodontal indices. The risk for PLBW decreased significantly (p=0.02) with increasing mean periodontal probing pocket depth (crude OR 0.83[95% CI 0.68, 1.00]). After controlling for pre-pregnancy hypertension, smoking, alcohol consumption, maternal age, ethnic group and mother's education this risk decreased further (OR 0.78[95% CI 0.63, 0.96]). No evidence was found for increased risk of PLBW with maternal periodontal disease as measured in this study population. Promotion of oral health by healthcare workers is important, but these results did not support a specific drive to improve the periodontal health of pregnant women as a means of decreasing adverse pregnancy outcomes.
27
Mena, Melisa A. "The Dose-Response of Maternal Exercise Volume on Newborn and Placental Outcomes." Scholarly Repository, 2007. http://scholarlyrepository.miami.edu/oa_dissertations/9.
Full textAbstract:
Current ACOG guidelines recommend exercise during a low-risk pregnancy for 30 minutes on most, if not all days of the week. However, little is known about how the volume of exercise performed during pregnancy affects fetoplacental size. In addition, the confounding effects of maternal nutrient intake and weight gain, and how they interact with exercise volume to influence fetoplacental size have not been appropriately addressed. Therefore, the purpose of this study was to examine the effects of varying maternal exercise volumes on neonatal birthweight and placental volume, while addressing the influence of maternal nutrient intake and weight gain. Subjects evaluated for this study included pregnant women who walked during gestation (n=26), performed non-walking aerobic exercise during gestation (n=30), or remained as sedentary controls (n=32). At 16, 20, 24, 28, 32, 36 weeks gestation, women recorded their nutrient intake for 3 consecutive days. Additionally, they kept monthly exercise logs indicating the type and duration of their exercise. Nutrient variables calculated included average daily Calorie intake, average daily carbohydrate intake, average daily protein intake, average daily fat intake, and average daily fiber intake. Exercise volume was calculated as the average number of minutes per week spent performing exercise. Latent growth modeling was the statistical procedure used to analyze how change in maternal exercise volume and nutrient intake throughout gestation affects neonatal outcomes. Neonatal outcomes measured were birthweight, corrected birthweight for gestational age, sex, race, and socioeconomic status, and placental volume at delivery. Maternal walking volume had no effect on newborn birthweight or corrected birthweight, while it was inversely related to placental size at birth. Maternal non-walking aerobic exercise volume was inversely related with newborn birthweight, while there was a trend toward an inverse relationship with corrected birthweight and placental volume. Controlling for Calorie intake strengthened the relationship between any form of exercise volume and infant birthweight. Calorie intake, carbohydrate intake, and protein intake were all positively related to infant birthweight. Fiber intake was significantly inversely related to placental volume. Finally, maternal exercise volume and nutrient intake were not related to maternal weight gain. This data suggests that neonatal outcome will be affected by variations in exercise protocol. In addition, nutrient intake is a potentially confounding variable that should be examined when undertaking studies addressing the role of maternal exercise on neonatal outcome.
28
Chowdhury, Morseda. "Prevention of Low Birthweight Infants Among Pregnant Women in Rural Bangladesh: A Cluster Randomized Controlled Trial." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20073.
Full textAbstract:
The low birthweight (LBW) prevalence in Bangladesh varies between 22-50%, which positioned Bangladesh 4th globally among the countries having highest burden of LBW. LBW imposes greater risk of mortality and morbidities among children under five and creates a long-term negative impact on development and wellbeing in adolescence and adulthood. Therefore, the objective of the research was to investigate the effects of ‘balanced plate nutrition education’ (nutrition education on balanced diet with practical demonstration of balanced plate) in combination with engagement of family decision makers, to reduce incidences of LBW infants among pregnant women by increasing birthweight. The specific objectives included developing the ‘balanced plate nutrition education’ intervention for rural pregnant women and measuring the effect of the intervention on birthweight of infants and incidences of LBW, and exploring the barriers of and household coping strategies related to compliance. It also examined the association of household food insecurity and size of infants at birth. Both quantitative and qualitative methods were applied for this research. For the quantitative analysis, primary data were derived from a randomized controlled trial conducted in rural Bangladesh (Chapter 4) and secondary data from Bangladesh Demographic and Health Survey 2011 (Chapter 6). Statistical analyses were performed using multivariable linear and binomial regression with log link function. We adjusted for the clustered randomisation using generalised estimating equations (GEE). We constructed survey-weighted logistic regression models for BDHS data to account for different sampling probabilities and different response rate. A qualitative study was conducted in the trial area among the balanced plate nutrition education intervention recipients. We conducted in-depth interviews (n=10) with mothers of infants (0-6 months), focus group discussions (n=2) with their husbands and older women in the family and key informant interviews (n=4) with Shasthya Kormi (community health workers) of BRAC (an NGO in Bangladesh, formerly known as Bangladesh Rural Advancement Committee). Interviews were audio-recorded during collection, later transcribed in Bangla, and translated into English. The transcripts were manually coded and analysed using the thematic approach. Chapter 4 demonstrated that pregnant women who received balanced plate nutrition education had heavier infants compared to those received standard nutrition education. The incidence of low birthweight (LBW) was also lower among women in the balanced plate group compared to the latter. The mean birthweight increased by 125.3 g (95% confidence interval (CI) 5·7, 244·9; p=0·04) and the risk of LBW was reduced by 54% (relative risk (RR) 0·46; 95% CI 0·28, 0·78; p=0·004) in the intervention compared to the comparison group. The effect of intervention was greater among adolescent mothers in terms of birthweight and incidence of LBW than the non-adolescent mothers mean difference 297·3 g; 95% CI 85·0, 509·6; p=0·006 and RR 0·31; 95% CI 0·12, 0·77; p=0·01). Chapter 5 exhibited that accessing animal source food was the greatest barrier in practicing balanced diet. Perceived gap in understanding appropriate portion size and importance of diversified food for a pregnant woman were the other reported barriers. Mothers-in-law’s authority and control over pregnant women’s diet led to intrahousehold food mal-distribution with less nutritious food share for them. Active engagement of the family decision makers (husbands and elderly women in the family) in the nutrition counseling and demonstration session created an agreement on balanced diet for pregnant women. Husbands were inclined to finance more for purchasing nutritious foods such as cheap fishes, milk and fruits. Women were selfmotivated to increase consumption of vegetables and animal source foods with right proportion of rice. Mothers-in-law’s approval and husbands’ voluntary contribution enabled women to practice the balanced diet. Chapter 6 showed an inverse association between household food insecurity and perceived birth size of infants in Bangladesh. Infants from food insecure household were 36% more at risk of being small at birth compared to infants born in food secure households, which was aggravated by less utilization of antenatal care and first birth. There was an obvious regional variation of prevalence of smaller infants in geographically hard to reach areas; women in Sylhet and Chittagong districts were more vulnerable to give birth to smaller infants than mothers living in Barisal. In conclusion, balanced plate nutrition education in pregnancy impacted on the birthweight of infants and incidence of LBW in rural Bangladesh. Practical demonstration of making balanced plate in combination with family engagement can create an enabling environment for pregnant women to adopt a balanced diet with self-motivation. Household food insecurity is major driver in determining fetal growth and subsequent size of infants at birth. The insights from this research will help to design nutrition behaviour change communications for pregnant women and target household with greatest need to improve perinatal nutrition for better child survival, growth, development and productivity in Bangladesh and other LMICs.
29
Magasiner, Vivien Adele. "The development of posture in very low birthweight infants (<1500 grams)." Master's thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/26598.
Full textAbstract:
The aims of the study were to examine postural development in very low birthweight and normal birthweight infants and to determine whether deviant postures were predictive of adverse neurodevelopmental outcome. In the first part of the study the 7 postural responses selected by Vojta to evaluate neuromotor development were applied to 69 very low birthweight (VLBW < 1 500 grams) infants and to 28 healthy full-term infants of normal birthweight (> 2500 grams). Of the 69 VLBW infants, 43 were small for gestational age and 26 appropriate for gestational age. All infants were examined at term and 4 months corrected age. They were all later assessed on the Griffiths Mental Development Scale at 12 and 18 months corrected age. There were significant differences in postural reactions between the 2 groups which confirmed the lower tone and greater extension previously described in VLBW infants. An important finding in the study was that poor head and trunk righting noted at 4 months corrected age in VLBW infants, was associated with less developed locomotion at 12 and 18 months as assessed by the Griffiths Mental Development Scale. Thus, a delay in maturation in VLBW infants which was apparent from the assessment of postural responses was still identifiable on the locomotor sub-scales at 12 and 18 months. Five of Vojta's responses were shown to be useful as part of the neurological assessment of high risk infants. In the second part of the study, the 5 useful Vojta responses were incorporated into the Infant Neurodevelopmental Assessment (INA) which was used to assess 76 high risk VLBW infants. The 76 infants consisted of 34 infants with intracranial lesions on ultrasound and 42 without intracranial lesions. All infants were assessed at term and 4 % months corrected age using the INA. At 12 months corrected age they were all assessed on the Griffiths Mental Development Scale. Six infants were diagnosed as having cerebral palsy, all of whom had intracranial lesions. Several clinical signs indicative of cerebral palsy were significant at 4 % months corrected age and will be useful in future studies to diagnose cerebral palsy early. The association between lack of head and trunk control at 4 % months corrected age and a lower locomotor score at 12 months corrected age proved to be significant again and reinforces the finding that early delay in maturation is identifiable on the locomotor scale at 12 months corrected age.
30
Moleti, Carole Ann. "Centering Pregnancy Implementation and its Effect on Preterm Birth and Low Birthweight." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/241.
Full textAbstract:
Preterm birth (PTB) and low birthweight (LBW) babies are the source of a large burden of infant, neonatal, and childhood morbidity. The purpose of this project was to expand the use of the CenteringPregnancyTM Group Prenatal Care Model as an evidence-based intervention for management of both medical and psychosocial risk in low-income, ethnic and racial minorities in New York City. The standardized model developed by Schindler Rising decreases the incidence of preterm birth and low birthweight and increases the rate of breastfeeding. A CenteringPregnancyTM program implementation plan, customized to meet the needs of a multisite urban hospital system, was coordinated with the Centering Healthcare Institute to ensure method fidelity while allowing for an individual site's needs based upon patient demographics and provider mix. Program evaluation showed that the logic models supported implementation and expansion of Centering Groups at 2 federally qualified health centers, with adequate progress toward site approval, method fidelity scores, and favorable patient and staff satisfaction ratings using the CenteringCountsTM data collection system. After a total of 4 Centering group cohorts with 26 women, 7 at high medical risk, 4 delivered preterm (11.5%), 2.3% less than the institutional average PTB rate of 13.8%. One out of 26 women delivered a LBW infant. Twenty-two of 24 women (92%) initiated breastfeeding compared to the institutional average of 89%. To foster a change in policy toward Centering as the default option for prenatal care, ongoing evaluation is required to assess the reduction of and fiscal impact on preterm and low birthweight rates to offset the cost of implementation.
31
Dahlqwist, Elisabeth. "Birthweight-specific neonatal health : With application on data from a tertiaryhospital in Tanzania." Thesis, Uppsala universitet, Statistiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-227531.
Full textAbstract:
The following study analyzes birthweight-specific neonatal health using a combination of a mixture model and logistic regression: the extended Parametric Mixture of Logistic Regression. The data are collected from the Obstetric database at Muhimbili National Hospital in Dar es Salaam, Tanzania and the years 2009 -2013 are used in the analysis. Due to rounding in the birthweight data a novel method to adjust for rounding when estimating a mixture model is applied. The influence of rounding on the estimates is then investigated. A three-component model is selected. The variables used in the analysis of neonatal health are early neonatal mortality, if the mother has HIV, anaemia, is a private patient and if the neonate is born after 36 completed weeks of gestation. It can be concluded that the mortality rates are high especially for low birthweights (2000 or less) in the estimated first and second components. However, due to wide confidence bounds it is hard to draw conclusions from the data.
32
Hutcheon, Jennifer. "Birthweight charts in the study of fetal growth: current limitations and potential alternatives." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=40778.
Full textAbstract:
Birthweight-for-gestational-age charts have long been used to identify infants at increased risk of adverse perinatal outcomes due to fetal growth restriction. Despite their widespread use, conventional birthweight charts have several important limitations. Although the pathological process of interest is the longitudinal process of poor fetal growth, birthweight charts classify infants based only on the cross-sectional measure of weight. As a result, infants that are small, but healthy, can be inappropriately identified as being at increased risk of adverse outcomes. Further, most conventional birthweight charts are created from the weights of livebirths at each completed week of gestation. Since the weights of livebirths at preterm ages are known to be smaller than the weights of ongoing pregnancies of similar gestational age, conventional birthweight charts are not representative of the total cohort at early gestational ages. Given these known limitations, the goals of this thesis were 1) to evaluate the potential for bias arising from the use of conventional birthweight-for-gestational-age percentiles in epidemiologic studies of fetal growth restriction and, 2) to evaluate two alternatives to conventional birthweight-for-gestational-age percentiles: “customized” birthweight percentiles and “conditional” fetal growth percentiles. This thesis first outlines the theoretical bias created by the classification of “small-for-gestational-age” (SGA, a weight below the 10th percentile for gestational age) of conventional birthweight charts at preterm gestational ages. Using simulations, the impact of this theoretical bias on studies of risk factors for fetal growth restriction is quantified and shown to be of sufficient magnitude to impact substantive conclusions. Next, the use of “customized” percentiles, birthweight percentiles that have been adjusted to account for maternal influences on fetal growth such as height, parity, ethnicity or pre-pregnLes graphiques de poids à la naissance pour l’âge gestationnel ont longtemps été utilisés afin d’identifier les nouveau nés à risque élevé de mortalitée et à morbidité périnatale en raison d’hypotrophie foetale. Malgré leur utilisation étendue, les graphiques de poids à la naissance pour l’âge gestationnel conventionnel ont plusieurs restrictions importantes. Bien que le processus pathologique d'intérêt soit le processus longitudinal de la pauvre croissance foetale, les graphiques de poids à la naissance classifient les nouveau-nés seulement par la mesure de poids. Conséquemment, les nouveau-nés qui sont petits, mais en bonne santé, peuvent être inopportunément identifiés comme étant à risque augmenté de mortalité/morbidité. De plus, les graphiques de poids à la naissance conventionnels sont créés avec seulement les poids des nouveau-nés à chaque semaine complète de gestation. Puisqu’il est connu que le poids d’un nouveau-né à l’âge préterme est plus petit que le poids de grossesse en cours d'âge gestationnel semblable, les graphiques de poids à la naissance pour l’âge gestationnel conventionnel ne sont pas représentatifs de la cohorte totale à l’âges gestationnel préterme. Étant donné ces restrictions connues, les objectifs de cette thèse étaient 1) évaluer le potentiel pour la partialité avec l'utilisation de centiles de poids à la naissance conventionnels dans les études épidémiologique d’hypotrophe foetale et, 2) évaluer deux alternatives aux graphiques de poids à la naissance conventionnels : les centiles de poids à la naissance “personnalisés” et les centiles de croissance foetaux "conditionnels".Cette thèse débute en décrivant la partialité théorique créée par la classification de "Poids à la naissance faible" (un poids au-dessous du 10ème centile pour l'âge gestationnel) des graphiques de poids à la naissance pour l’âge gestationnel préterme. En utilis
33
Darlow, B. A. "Retinopathy of prematurity in very low birthweight New Zealand infants : an epidemiological study." Thesis, University of Cambridge, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598281.
Full text
34
Lum, Sook-Yuen. "Influence of low birthweight for gestational age on airway function in early infancy." Thesis, University College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398863.
Full text
35
Fall, Caroline H. D. "Birthweight, weight in infancy and risk of coronary heart disease in adult life." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299292.
Full text
36
James, Tiffany. "Assessing Racial Differences in U.S. Prenatal Care, Gestational Weight Gain, and Low Birthweight." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5205.
Full textAbstract:
The benefits of prenatal care (PNC) are extensively documented; however, controversy surrounds the extent to which benefits are experienced among different racial groups. Determining whether PNC influences positive birth outcomes and if advantages differ by race is pertinent to attaining positive health outcomes. The purpose of this study was to examine the relationship between gestational weight gain (GWG), low birthweight (LBW), and PNC while weighing racial differences. The theoretical foundation was the motivation-facilitation theory of PNC access. Research questions were designed to (a) determine if there was a significant association between GWG and LBW, (b) determine if PNC had a mediating role if GWG was found to be associated with LBW, and (c) determine if PNC was a mediator and if that role differed between races. A quantitative, deductive correlational analysis was carried out using a retrospective observational approach. Spearman correlation showed that the relationship between GWG and LBW was significant (rs = 0.14, p < .001). Binary logistic regression was used for analysis and showed that the overall model was significant, Ï?2(12) = 50.29, p < .001, and that maternal age, race, marital status, GWG, education, body mass index (BMI), cigarette use, and gestational diabetes significantly affected the chances of LBW. Baron and Kenny's mediation analysis supported partial mediation for American Indian or Alaskan Native and Asian or Pacific Islander races and showed that PNC was significantly associated with birthweight. Based on these findings, providers can aim to implement motivational factors to increase the facilitation and use of PNC to decrease adverse birth outcomes and increase population health.
37
Müller, Doris. "Emotionale Verfügbarkeit in der Mutter-Kind-Interaktion bei Very Low Birthweight Frühgeborenen im Grundschulalter." Diss., Ludwig-Maximilians-Universität München, 2014. http://nbn-resolving.de/urn:nbn:de:bvb:19-176721.
Full text
38
McKay, Mary Ana. "Neighborhood Composition, Immigrant Status, and the Risk of Low Birthweight amongBlack Women in Ohio." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1478526771566044.
Full text
39
Frennborn, Lena C. "Race and Birthweight: The Influence of Socio-Economic Status and Utilization of Prenatal Care." VCU Scholars Compass, 1997. http://scholarscompass.vcu.edu/etd/4546.
Full textAbstract:
The purpose of this research was to determine how much of the variance in birthweight can be explained by socio-economic status and utilization of prenatal care in Blacks and Whites. Rather than defining race in genetic terms, race was understood here as a social construction. The methodological approach was an analysis of the National Survey of Family Growth Cycle IV, 1988. The first, singleton, live birth for each interviewed woman was included, resulting in a sample of 911 women, of whom 313 were Black women and 598 White women.
Consistent with previous research, Black mothers were twice as likely to have a low birthweight infant (11.8%) compared to White women (6%). In the total sample race, marital status, and income were correlated with birthweight. Multiple regression analysis was used to examine how much of the variance in birthweight is explained by socioeconomic factors and utilization of prenatal care. The model explained 5% of the variance in birthweight. Race and education were the only two factors that significantly explained variance in birthweight in this model. The findings failed to support the hypothesis that socioeconomic status and utilization of prenatal care would explain a significant amount of the variance in birthweight. The variables included in the model did not explain variance in birthweight for either Black women, or White women.
40
Bethel, Jeffrey W. "Low birthweight deliveries to Hispanic women in California : the role of occupation and data quality /." For electronic version search Digital dissertations database. Restricted to UC campuses. Access is free to UC campus dissertations, 2005. http://uclibs.org/PID/11984.
Full text
41
Miskelly, Margaret. "Teen pregnancy and low birthweight infants, an analysis of three regions in northern British Columbia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0029/MQ62484.pdf.
Full text
42
Feeley, Nancy. "Infant, mother and contextual factors related to mothers' interactions with their very-low-birthweight infants." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=37888.
Full textAbstract:
While there is evidence that the interactions that occur in the early years of life between very-low-birthweight (VLBW) infants and their mothers affects later child development, little is known about the factors that are associated with responsive and sensitive mother-VLBW infant interaction. Belsky's (1984) model of the determinants of parenting proposes that multiple child, parent, and contextual factors influence parenting behaviour. This prospective study examined the combined influence of a set of infant (i.e., birthweight and perinatal illness severity), mother (i.e., state anxiety and parenting sense of competence), and contextual variables (i.e., maternal received and perceived helpfulness of support, and marital adjustment) on mother-infant interaction, and assessed which factors were associated with sensitive and responsive interaction.The participants were 72 mothers and their VLBW infants (<1500 grams). Infant, mother, and contextual variables were assessed at 3- and 9-months of age (corrected). At 9 months, mother-infant teaching interactions were observed in the home and later coded using the Nursing Child Assessment Teaching Scale (NCATS).
Hierarchical multiple regression analyses were used to examine the relationship between mother-infant interaction and the infant, mother and contextual variables. The prospective model explained 33% of the variance in the interactive behaviour of the dyad. Dyads whose interaction was more sensitive and responsive at 9 months included mothers who were better-educated, less anxious at 3 months, and reported higher perceived support at 3 months. The concurrent model explained 29% of the variance in the interactive behaviour of the dyad. Dyads whose interaction was more sensitive and responsive included mothers who were better-educated and reported higher perceived support at 9 months. The hypothesis that the mother variables would be more important than the contextual variables in explaining mother-infant interaction was not supported. The findings highlight the importance of examining multiple infant, parent, and contextual variables to explain mother-VLBW infant interaction.
43
Casson, Karen. "Socio-demographic Inequalities in Low Birthweight, Stillbirth and Infant Mortality in Northern Ireland 1991-2002." Thesis, University of Ulster, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.516438.
Full text
44
Samms-Vaughan, Maureen Elaine. "Factors associated with low birthweight growth retardation and preterm birth in Jamaica : an epidemiological analysis." Thesis, University of Bristol, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294549.
Full text
45
Monterosso, Leanne. "The effect of nursing interventions on thermoregulation and neuromotor function in very low birthweight infants." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1222.
Full textAbstract:
The prone position is used routinely in neonatal intensive care units worldwide in the nursing of preterm infants because of reported beneficial psychological effects This position can, however, lead to development of flattened posture very low birthweight (VLBW) infants and contributes to both short and longer term implications for functional motor development of upper and lower extremities. To date limited research has been undertaken to investigate methods of reducing flattened posture and its related negative outcomes temperature instability is also a problem for VLBW infants and no nappy exists that meets postural size and thermoregulation requirements. The purpose of this study was to demonstrate the effect of a nursing care model designed for the primary prevention of neuromotor problems and temperature instability in VLBW infants. The theoretical framework was based on two bodies of knowledge thermoregulation and neuromotor development. A two phase study was used to test two hypotheses: (1) use of a cloth postural support nappy (N) with an inner absorbent nappy liner would improve temperature stability in VLBW infants nursed in incubators on infant servo control (ISC): and (2) use of a postural support roll (R) with or without a N would improve neuromotor development in the short and longer term. In Phase1 a sample of 23 infants < 31 weeks gestation nursed in incubators on ISC was recruited over two months to a randomised, observer blind, crossover trial infants were randomised to commence wearing either a N with or without an inner absorbent liner and alternated wearing each nappy for a 24 hour period over four days. Eight hourly per axilla (PA) temperatures and hourly measurements of infant handling, skin and incubator temperatures were recorded. lnfants in both groups were well matched for birth and postnatal variables. Findings showed that nursing infants in a N with an inner absorbent liner experienced clinically and statistically significant higher skin and lower incubator temperatures. In addition, a prediction model for PA temperature was developed that showed it was possible to predict PA temperatures from skin temperatures. In Phase 2. a sample of 123 infants < 31 weeks gestation was recruited to a randomised, observer blind, controlled trial. Infants were randomised to one of three treatment groups (i.e., N only, N and R, or R only). Measurements of neuromotor development were performed at three assessment periods (i.e., from birth to term conceptional age, then at four and eight months conceptional age). Randomisation was effective. Findings confirmed previous study findings that use of a N improves hip posture up to term conceptional age. The major finding was that use of a R while VLBW infants are nursed in the prone position in a NICU improved hip and shoulder posture up to eight months conceptional age. In addition, an Infant Posture Evaluation Tool (IPAT) was developed that will enhance the clinical skills of health Professionals involved in the care of these infants. The findings contribute to neonatal nursing theory development in thermoregulation and neuromotor development and function in VLBW infants. Practice implications focus on promoting temperature stability and normal neuromotor function in VLBW infants up until eight months conceptional age. Longer term research will determine the effect of postural interventions on gait and foot progression angles. Testing and validation of the IPAT will facilitate future research related to infant posture.
46
Paulukaitis, Jennifer J. "Risk factors in the prenatal environment and later cognitive abilities of very low birth weight premature infants in northern Nevada /." abstract and full text PDF (free order & download UNR users only), 2006. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1437659.
Full textAbstract:
Thesis (M.S.)--University of Nevada, Reno, 2006."August, 2006." Includes bibliographical references (leaves 89-94). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2006]. 1 microfilm reel ; 35 mm.
47
Lira, Pedro Israel Cabral de. "Impact of zinc supplementation on the morbidity and growth of low birthweight infants in northeast Brazil." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321777.
Full text
48
Mutch, L. M. M. "Secular changes in two year survival and rehospitalisation rates in very low birthweight and heavier infants." Thesis, University of Aberdeen, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.370111.
Full text
49
Simcox, Louise. "Identification and validation of ultrasound parameters to predict birthweight and identify late-onset fetal growth restriction." Thesis, University of Manchester, 2018. https://www.research.manchester.ac.uk/portal/en/theses/identification-and-validation-of-ultrasound-parameters-to-predict-birthweight-and-identify-lateonset-fetal-growth-restriction(6e9a8b30-3f3b-4b32-98f2-19f9684c1ed2).html.
Full textAbstract:
Background: Single estimates of fetal size are poor at detecting growth restricted infants, especially in the late third trimester. Current guidelines recommend comparing EFW on scans to fetal intra-uterine birth weight charts generated from cross-sectional studies that do not account for each individual fetuses growth potential. Individualised growth assessment (IGA) methods using 3D ultrasound provide a means for evaluating true growth restriction which may result in earlier detection of fetal growth abnormalities. Hypothesis, Aims and Objectives: We tested the hypothesis that ultrasound parameters obtained longitudinally through the second and third trimesters can be used to assess fetal growth and identify fetuses deviating from their early pregnancy growth trajectory. Methods: New Ultrasound Parameters in Pregnancy (NUPS) is a prospective, longitudinal cohort study of an unselected normal pregnancy population. Measurements of 2D and 3D fetal size parameters, as well as fetal Doppler measurements were obtained at scan intervals of 6-8 weeks from 14 weeks gestation until 36 weeks gestation. Automated volume measurements were obtained using 4Dview software (GE Healthcare). Individualised growth assessment (IGA) using the iGAP software (http://iGAP.research.bcm.edu) was used to predict third trimester growth trajectories and birthweight. Additionally, multiple linear regression analysis and multi-level mixed effects model were used to identify predictors of birthweight at different scan intervals. Repeatability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman Plots. Results: 3D fractional thigh volume has low measurement error and ICC values in the third trimester of 0.943-0.992. There was a modest improvement in the detection of both SGA and FGR using TVol derived measures compared to standard 2D measurements at 34-36 weeks (AUC= 0.86 (95% CI 0.79-0.94,), and 0.92 (95% CI 0.85-0.99), respectively. IGA using the iGAP online computer program can be used reliably to identify growth restricted fetuses that are deviating from their third trimester growth trajectories. Both gestational age and the presence of SGA (EFW < 10th centile)/FGR (EFW < 3rd centile) independently affect uterine artery pulsatility index (UtA-PI) values and the effect of SGA/FGR over time appears to be constant. Discussion: This series of studies demonstrates that enhanced detection of late-onset FGR is possible and there is potential with individualised growth assessment methods to improve perinatal outcomes.
50
Shah, Darshan, Beth A. Bailey, David Wood, Emmitt Turner, and Kathryn Duvall. "Does Marijuana Use In Opioid Exposed Pregnancies Increase the Risk of Preterm Birth and Low Birthweight." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7669.
Full textAbstract:
Background: Opioid maintenance therapy has been advocated by American College of Obstetrics and Gynecology (ACOG) along with American Society of Addiction Medicine (ASAM) for opioid use disorder in pregnancy. Marijuana use has been increasing with legalization of marijuana in many states along with reported benefit of antiemetic effect in pregnancy. Both have been independently implicated in adverse neonatal outcome but they haven't been studied for concurrent use in pregnancy.
Objective: Objective of the study was to look in to the use of opioid and marijuana in pregnancy related with neonatal outcomes; birth weight, Apgar scores,low birth weight, preterm birth along with social determinant of opioid and marijuana use in pregnancy.
Design/Methods: A retrospective chart review from July 2011 to June 2016 of all births from 6 delivery hospitals in South-Central Appalachia was conducted to determine pregnancy and neonatal outcomes of pregnancies exposed to any form of opioid and positive urine drug screen (UDS) for marijuana(THC) at the time of delivery. Inclusion criteria were UDS positive for THC at delivery and exposure to opioid during pregnancy.18730 births were identified during the study period, 2638 pregnancy were opioid exposed, and 2375 pregnancies met the inclusion criteria were included for analysis with 108 pregnancies positive for THC in UDS at the time of delivery.
Maternal characteristics, delivery and perinatal outcome were studied. Student t-test and Chi-Square test were used for group comparison for presence and absence of marijuana. Logistic regression was done for significant confounding variables like parity, maternal status, tobacco, and benzodiazepine to find aOR for marijuana exposure for NAS diagnosis, premature birth, and low birth weight (LBW).
Results: Among opioid using women, marijuana positive women were more likely to be unmarried, nulliparous, and use tobacco and benzodiazepines. Infants born to the marijuana users were likely to be of earlier gestational age (3 days), lower birth weight, and preterm; with preterm birth and low birth weight (mean difference = 265 gms) increased two fold even after controlling for parity, marital status, tobacco and benzodiazepine use with aOR of 2.35 (1.30-4.23) and 2.02 (1.18-3.47) respectively.
Conclusion(s): In view of ACOG and ASAM guidelines for continuing opioid for opioid use disorder during pregnancy, finding of increased prematurity along with LBW carries significance of advocating counseling against use of marijuana in pregnancy exposed to opioids.