Introduction: The maternal mortality crisis in the United States disproportionately affects women who are Black, especially those living in the Gulf South. These disparities result from a confluence of healthcare, policy, and social factors that systematically place Black women at greater risk of maternal morbidities and mortality. This study protocol describes the Southern Center for Maternal Health Equity (SCMHE), a research center funded by the National Institutes of Health in 2023 to reduce preventable causes of maternal morbidity and mortality while improving health equity.
View Article and Find Full Text PDFObjective: This study of pregnant people with obesity examined two aims in testing the hypothesis that the COVID-19 pandemic widened racial disparity in maternal health in high-risk pregnancies; it compared by race both (1) gestational weight gain (GWG) patterns and (2) patterns of preexisting conditions and adverse pregnancy outcomes.
Methods: This retrospective chart review included birth certificate and delivery records from a large women's specialty hospital in Louisiana between 2018 and 2022. Differences in preexisting conditions, GWG, and adverse pregnancy outcomes were explored across early-, peak-, and late-pandemic periods using log-linear regression and robust Poisson models.
Purpose: To demonstrate the process and results of an equity analysis of a reproductive health association.
Description: A series of quantitative surveys and qualitative interviews were conducted with employees of Planned Parenthood League of Massachusetts (PPLM), assessing different aspects of equity. Amaka Consulting and Evaluation Services, LLC, an external consulting agency, analyzed the results and provided recommendations for improvements.
Background: Stressful large-scale events, such as the COVID-19 pandemic and natural disasters, impact birthing individuals' postpartum experiences and their mental health. Resultant changes in government assistance, housing, and employment may further exacerbate these impacts, with differences experienced by varying income levels and races. This study aimed to examine maternal depression and anxiety in postpartum individuals by income and race during a stressful large-scale event, and the mediating role of government assistance, housing, and employment.
View Article and Find Full Text PDFAim: To investigate metabolic risk factors (RFs) that accumulated over 20 years related to left ventricular mass index (LVMI), relative wall thickness (RWT) and LV remodelling patterns in participants with versus without early-onset type 2 diabetes (T2D) or prediabetes (pre-D).
Methods: A total of 287 early-onset T2D/pre-D individuals versus 565 sociodemographic-matched euglycaemic individuals were selected from the Coronary Artery Risk Development in Young Adults (CARDIA) study, years 0-25. We used the area under the growth curve (AUC) derived from quadratic random-effects models of four or more repeated measures of RFs (fasting glucose [FG], insulin, triglycerides [TG], low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-c), total cholesterol (total-c), blood pressure and body mass index) to estimate the cumulative burden, and their associations with LV outcomes.
We investigated sexual orientation disparities in several obstetric and perinatal outcomes in Louisiana and examined whether these disparities differed among Black, Latine, and White populations. We analyzed cross-sectional vital records data on singleton live births in Louisiana (2016-2022). Same-sex relationships (SSR) vs.
View Article and Find Full Text PDFPhotogramm Eng Remote Sensing
July 2023
Post-hurricane damage assessments are often costly and time-consuming. Remotely sensed data provides a complementary method of data collection that can be completed comparatively quickly and at relatively low cost. This study focuses on 15 Florida counties impacted by Hurricane Michael (2018), which had category 5 strength winds at landfall.
View Article and Find Full Text PDFPurpose: To examine the impact of medically assisted fertility treatments on the risk of developing perinatal and cardiometabolic complications during pregnancy and in-hospital deliveries.
Methods: We conducted a retrospective cohort study using medical health records of deliveries occurring in 2016-2022 at a women's specialty hospital in a southern state of the Unites States (US). Pregnancies achieved using medically assisted reproductive (MAR) techniques were compared with unassisted pregnancies using propensity score matching (PSM), based on demographic, preexisting health, and reproductive factors.
Environ Health Perspect
December 2023
Background: The exposome serves as a popular framework in which to study exposures from chemical and nonchemical stressors across the life course and the differing roles that these exposures can play in human health. As a result, data relevant to the exposome have been used as a resource in the quest to untangle complicated health trajectories and help connect the dots from exposures to adverse outcome pathways.
Objectives: The primary aim of this methods seminar is to clarify and review preprocessing techniques critical for accurate and effective external exposomic data analysis.
Background: Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results.
Methods: We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit.
Background: The metabolic changes that ultimately lead to gestational diabetes mellitus (GDM) likely begin before pregnancy. Cannabis use might increase the risk of GDM by increasing appetite or promoting fat deposition and adipogenesis.
Objectives: We aimed to assess the association between preconception cannabis use and GDM incidence.
Importance: Average gestational weight gain (GWG) increased during the COVID-19 pandemic, but it is not known whether this trend has continued.
Objective: To examine patterns of GWG during the COVID-19 pandemic by delivery and conception timing through the second year of the pandemic.
Design, Setting, And Participants: This cohort study is a retrospective review of birth certificate and delivery records from 2019 to 2022.
Goal: Body mass index (BMI) in early pregnancy is a critical risk factor for hypertensive disorders of pregnancy (HDP). The pathobiology of the interplay between BMI and HDP is not fully understood and represents the focus of this investigation.
Methods: BMI and 1st-trimester serum samples were obtained from the Global Alliance to Prevent Prematurity and Stillbirth repository for 154 women (105 without HDP and 49 with HDP).
Background: Life course patterns of change in risk-trajectories-affect health.
Objectives: To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes.
Methods: Data from two cohort studies participating in the International Childhood Cardiovascular Consortium-The Bogalusa Heart Study (BHS; started in 1973, N = 903 for this analysis) and the Cardiovascular Risk in Young Finns Study (YFS; started in 1980, N = 499) were used.
The Preconception Period Analysis of Risks and Exposures Influencing Health and Development (PrePARED) Consortium creates a novel resource for addressing preconception health by merging data from numerous cohort studies. In this paper, we describe our data harmonization methods and results. Individual-level data from 12 prospective studies were pooled.
View Article and Find Full Text PDFIncreased occurrences of harmful algal blooms (HAB) in the Gulf of Mexico, and even worldwide, yield concern for increases in brevetoxin exposure leading to respiratory illness or even death, highlighting the need for extensive scientific research and human health monitoring. It is known that major events such as tropical storms and hurricanes are followed by periods of increased red tides caused by HABs; however, the nature by which phytoplankton blooms proliferate following major events remains a topic of great interest and research. The impact of Hurricane Michael on October 10, 2018 on HABs in the Florida panhandle was examined by analyzing data from the Florida Fish and Wildlife Conservation Commission in coordination with Normalized Fluorescence Line Height (nFLH) data from the University of South Florida College of Marine Science.
View Article and Find Full Text PDFBackground: The effect of social distancing due to the COVID-19 pandemic on the mental health of pregnant women is of particular concern, given potential effects on physical health, family functioning, and child development.
Methods: Pregnant women were recruited for the "Implications of and Experiences Surrounding being Pregnant during the COVID-19 Pandemic" study at Woman's Hospital in Baton Rouge, Louisiana. Participants enrolled at any point during their pregnancy and surveys were delivered weekly until the participant indicated that she had delivered her baby; a postpartum survey followed four weeks after delivery.
Objective: To evaluate the potential for adverse health outcomes among infants born to US Coast Guard (USCG) responders to the Deepwater Horizon (DWH) oil spill disaster.
Methods: Department of Defense Birth and Infant Health Research programme data identified a cohort of singleton infants born 2010-2011 to USCG personnel in the DWH Oil Spill Coast Guard Cohort study. Infants were included if their military parent ('sponsor') responded to the oil spill during a selected reproductive exposure window (ie, 3 months preconception for male sponsors and periconception through pregnancy for female sponsors), or if their sponsor was a non-responder.
Background: Studies of effects of hurricanes on perinatal outcomes often rely on approximate measures of exposure. This study aims to use observed damage from aerial imagery to refine residential building damage estimates, evaluate the population changes post landfall, and assess the associations between the extent of residential building damage and adverse perinatal outcomes and access to prenatal care (PNC) services. METHODS: Vital statistics data from the Florida Department of Health's Office of Vital Statistics were used to align maternal geocoded address data to high-resolution imagery (0.
View Article and Find Full Text PDFAccess to housing is an important manifestation of structural racism and discrimination, and birth outcomes show wide health disparities, but few studies have examined eviction and birth outcomes. This multilevel study merged data from the Eviction Lab on 2015 eviction judgements and records with the National Center for Health Statistics natality dataset. The analytic sample included 2,950,965 births across 5924 counties in 45 states.
View Article and Find Full Text PDFTo assess the epigenetic effects of exposure to maternal infection. We performed an epigenome-wide association study to compare the DNA methylation patterns of umbilical cord blood cells from uninfected babies from chagasic and uninfected mothers. DNA methylation was measured using Infinium EPIC arrays.
View Article and Find Full Text PDFIn a recent issue of the Journal, Wesselink et al. (Am J Epidemiol. 2022;191(8):1383-1395) presented findings that indicate that the coronavirus disease 2019 (COVID-19) vaccine does not cause any reduction in fertility in either men or women, while COVID-19 infection may reduce fertility temporarily among men.
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