The Building Respectful Integrated Doula Support as a Gateway for Enhanced Maternal Health Outcomes and Experiences Conceptual Framework for Integrating Doula Support in the Pregnancy Continuum.

Doulas, non-clinical companions trained to provide emotional, informational, and physical support throughout the pregnancy continuum, have emerged as cost-effective interventions to enhance maternal health. This article aims to review existing definitions, roles, outcomes, and theoretic frameworks surrounding doula support, culminating in the development of the Building Respectful Integrated Doula Support as a Gateway for Enhanced Maternal Health Outcomes and Experiences (BRIDGE) conceptual framework. The BRIDGE conceptual framework provides a comprehensive understanding of doula support and its potential to improve maternal health outcomes, underscoring the importance of integrating doula support into standard maternal health care practices.

Collaborative Training as a Conduit to Build Knowledge in Black Birth Workers.

Background: Black women have worse birthing outcomes in part due to perceived racism. Therefore, mistrust between Black birthing people and their obstetric providers is profound. Black birthing people may use doulas to support and advocate throughout their pregnancy.

Vascular alterations impede fragile tolerance to pregnancy in type 1 diabetes.

Objective: To determine the impact of autoimmunity in the absence of glycemic alterations on pregnancy in type 1 diabetes (T1D).

Design: Because nonobese diabetic (NOD) mice experience autoimmunity before the onset of hyperglycemia, we studied pregnancy outcomes in prediabetic NOD mice using flow cytometry and enzyme-linked immunosorbent assays. Once we determined that adverse events in pregnancy occurred in euglycemic mice, we performed an exploratory study using electronic health records to better understand pregnancy complications in humans with T1D and normal hemoglobin A1c levels.

Bronchopulmonary dysplasia is associated with polyhydramnios in a scan for novel perinatal risk factors.

Background: The pathogenesis of bronchopulmonary dysplasia (BPD) is multifactorial, and there are limited data about prenatal exposures and risk of BPD.

Study Design: Our study performed parallel analyses using a logistic regression model in a cohort of 4527 infants with data from a curated registry and using a phenome wide association study (PheWAS) based on ICD9/10-based phecodes. We examined 20 prenatal exposures from a neonatal intensive care unit (NICU) curated registry database related to pregnancy and maternal health as well as 94 maternal diagnosis phecodes with a PheWAS analysis.

Maternal Hyperglycemia Induces Changes in Gene Expression and Morphology in Mouse Placentas.

Background: Pregestational diabetes complicates one million pregnancies in the United States and is associated with placental dysfunction. Placental dysfunction can manifest as stillbirth, spontaneous abortions, fetal growth restriction, and preeclampsia in the mother. However, the underlying mechanisms of placental dysfunction are not well understood.

Black Box Warning: Cardiovascular Complications Make Motherhood Unsafe for African American Women.

Background: In the United States, cardiovascular disease and its complications in pregnancy is the leading killer in mothers. The black maternal mortality rate is quadruple the rate among white women.

Main Body: The reasons for this staggering discrepancy hinge on two central issues: First, black women are more likely to have pre-existing cardiovascular morbidity that increase the risk of maternal mortality.

Ovarian Stimulation Increases the Risk of Fetal Cardiac Defects of Pups Exposed to Severe Maternal Hyperglycemia.

Objectives: To study the incidence of congenital heart defects (CHD) in offspring born to hyperglycemic mothers with and without ovarian stimulation.

Design: Reproductive biology.

Setting: Mouse model.

Black Maternal Mortality-The Elephant in the Room.

Maternal mortality is on the rise in the United States and it disproportionately affects black women. The reasons for this staggering discrepancy hinge on three central issues: First, black women are more likely to have pre-existing cardiovascular morbidity that increase the risk of maternal mortality. Second, black women are more likely to experience adverse pregnancy outcomes which puts them at risk for developing long-term cardiovascular disease.

Intrauterine Programming of Diabetes Induced Cardiac Embryopathy.

Background: Maternal hyperglycemia is a well-recognized risk factor for fetal congenital heart disease. However, the underlying cellular and molecular mechanisms are not well characterized. We hypothesize that maternal hyperglycemia leading to congenital heart are linked to abnormal DNA methylation and mRNA expression at cardiac specific loci.

DNA methylation is developmentally regulated for genes essential for cardiogenesis.

Background: DNA methylation is a major epigenetic mechanism altering gene expression in development and disease. However, its role in the regulation of gene expression during heart development is incompletely understood. The aim of this study is to reveal DNA methylation in mouse embryonic hearts and its role in regulating gene expression during heart development.