Bibliography Tag: pregnancy and heartland region

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Diepietro Mager, 2020

DiPietro Mager, Natalie Ann. (2020). Preconception and Interconception Health and Routine Health Service Use Among Women in a Rural Midwestern County (Doctor of Philosophy), Indiana University.

ABSTRACT:

Advancement of preconception and interconception health is a key element to improve women’s health as well as pregnancy outcomes. Little is known about the preconception and interconception health status of rural Midwestern populations in the United States. The primary objective of this study was to determine the preconception and interconception health status as well as behaviors of reproductive age women living in a rural Midwestern area. Secondary objectives were to quantify process measures of health care access and barriers to care, as well as determine disparities in preconception and interconception health status among women in this rural area as compared to statewide estimates. As existing national or state secondary data sources often have limitations in data derived from areas with low population densities or insufficient sample sizes to generate reliable estimates, a cross-sectional study was performed using a 34item survey. Data were collected from February to May 2019 from 315 non-pregnant women ages 18-45 years in a rural county in northwestern Ohio. Nearly all women surveyed had at least one risk factor associated with poor pregnancy outcomes, many of which were modifiable. Nearly half of all respondents reported at least one barrier to receipt of health care services. Women in this rural county fared worse for several preconception and interconception health measures when compared to statewide estimates derived from Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey data. These findings illustrate the need for continued development of interventions to improve preconception and interconception health for rural women as well as improved methods to capture and analyze data on important subpopulations at risk.

Casey et al., 2004

Casey, Michelle M., Blewett, Lynn A., & Call, Kathleen T.; “Providing Health Care to Latino Immigrants: Community-Based Efforts in the Rural Midwest;” American Journal of Public Health, 2004, 94(10), 1709-1711; DOI: 10.2105/AJPH.94.10.1709.

ABSTRACT:

We examined case studies of 3 rural Midwestern communities to assess local health care systems response to rapidly growing Latino populations. Currently, clinics provide free or low-cost care, and schools, public health, social services, and religious organizations connect Latinos to the health care system. However, many unmet health care needs result from lack of health insurance, limited income, and linguistic and cultural barriers. Targeted safety net funding would help meet Latino health care needs in rural communities with limited resources.  FULL TEXT

Askelson et al., 2020

Askelson, N., Ryan, G., Pieper, F., Bash-Brooks, W., Rasmusson, A., Greene, M., & Buckert, A.; “Perspectives on Implementation: Challenges and Successes of a Program Designed to Support Expectant and Parenting Community College Students in Rural, Midwestern State;” Maternal Child Health Journal, 2020, 24(Suppl 2), 152-162; DOI: 10.1007/s10995-020-02879-6.

ABSTRACT:

OBJECTIVES: Expectant and parenting students (EPS) at community colleges are an underserved and often under-resourced group. In a rural, Midwestern state, the department of public health was awarded the Pregnancy Assistance Fund (PAF) grant to assist this population. This paper outlines the results of the implementation evaluation and offers suggestions for programs and evaluators working with this population in the community college setting.

METHODS: We conducted a multicomponent evaluation utilizing quantitative and qualitative methods. Evaluation activities included tracking activities/services, surveys and interviews with participants, and interviews with community college staff implementing grant activities. The research team calculated frequencies for quantitative data and coded qualitative data for themes.

RESULTS: Data from the community colleges and students’ self-reports revealed that EPS most commonly received concrete support from the program, often in the form of stipends or gift cards. Students reported that concrete support was beneficial and helped to relieve financial stress during the semester. Students’ major barriers to participation were lack of knowledge about the program and busy schedules that prevented them from accessing PAF services. Staff reported that difficulty identifying EPS and the short one-year project period were major implementation challenges.

CONCLUSIONS FOR PRACTICE: We recommend that community colleges work to identify EPS, use fellow EPS to recruit program participants, and implement programming that works with the students’ schedules.

FULL TEXT

Winchester et al., 2019

Winchester, Paul, Reiter, Jill L., Proctor, Cathy, Gerona, Roy R., Avery, Kayleigh D., Bromm, Jennifer R., Elsahy, Deena A, Hadley, Emily A., McGraw, Sara N., & Jones, Dana D., “Glyphosate in 1st Trimester of Pregnancy: Herbicides in the Womb,” 2019, Presented at the Pediatric Academic Societies (PAS) Meeting 2019, 4/24-5/1/2019, Baltimore, MD.

ABSTRACT:

BACKGROUND: Our previous study demonstrated that >90% of pregnant Midwest women had detectable glyphosate (GLY) in their urine. Most glyphosate exposure occurs through food & certain beverages but not through drinking water. Shorter pregnancies, rural address and caffeinated beverages were associated with higher GLY levels. The cohort was small and predominantly Caucasian. The current study was needed to confirm high rates of GLY detection in a racially more diverse high risk population.
OBJECTIVE: Will GLY be detected in a majority of pregnancies regardless of race/ethnicity? Are GLY levels associated with adverse pregnancy outcomes? Do GLY levels vary by season of collection in pregnancy?
DESIGN/METHODS: Prospective observation study. Discarded urine from 1st trimester pregnancies were collected prospectively from a high risk University obstetrical clinic. All pregnancy outcomes and neonatal outcomes were abstracted. Urines were frozen, shipped to analytical lab (USCF, RG) for analysis. Urine GLY (Glyphosate (N(phosphomethyl) glycine) was analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS), limit of quantification of 0.1 ng/mL. GLY measured as independent variable was compared to multiple variables using bivariate analysis.
RESULTS: GLY was detected in 99% (186 of 187) pregnancies. Levels varied from 1.004 to 10.31ng/mL with geometric mean 3.264ng/mL. Mean maternal age was 30, with 69% white, 4.2% Hispanic, 12% Black, 3.7% Asian and one “other”. GLY levels did not differ significantly by racial/ethnic group. GLY levels were not significantly difference between preterm and term outcomes, multiple/singleton or between fetal loss and live births. GLY levels were higher with increasing gestation at enrollment with 4-8 weeks GLY 2.73 vs 9-13 weeks 3.51(p=.0098). Significantly higher GLY levels were found in April-July pregnancies vs other months(3.64 vs 3.07 p=.03). NICU admission rates were 85% for preterm and 35% for term. Birth defect rate was12% and 37% had intrauterine drug exposure or NAS. Preterm birth rate was 31%. CONCLUSIONS: Glyphosate was found in virtually all of these high risk pregnancies in the first trimester regardless of race/ethnicity, plurality, fetal loss or gestation at birth. GLY levels rose with increasing gestation in the first trimester suggesting that gestation at measurement impacts GLY levels. Dietary sources contribute to GLY but we did find April-July are associated with higher GLY levels than other months. The fetal epigenetic consequences of 1st trimester GLY exposure remains unknown. FULL TEXT

Sathyanarayana et al., 2010

Sheela Sathyanarayana MD MPH, Olga Basso PhD, Catherine J. Karr MD PhD MS, Paula Lozano MD MPH, Michael Alavanja PhD, Dale P. Sandler PhD & Jane A. Hoppin ScD, “Maternal Pesticide Use and Birth Weight in the Agricultural Health Study,” Journal of Agromedicine, 15:2, 2010, DOI: 10.1080/10599241003622699

ABSTRACT:

Studies examining the association between maternal pesticide exposure and low birth weight yield conflicting results. The authors examined the association between maternal pesticide use and birth weight among women in the Agricultural Health Study, a large study of pesticide applicators and their spouses in Iowa and North Carolina. The authors evaluated self-reported pesticide use of 27 individual pesticides in relation to birth weight among 2246 farm women whose most recent singleton birth occurred within 5 years of enrollment (1993–1997). The authors used linear regression models adjusted for site, preterm birth, medical parity, maternal body mass index, height, and smoking. The results showed that mean infant birth weight was 3586 g (± 546 g), and 3% of the infants were low birth weight (<2500 g). First-trimester pesticide-related tasks were not associated with birth weight. Ever use of the pesticide carbaryl was associated with decreased birth weight (−82 g, 95% confidence interval [CI] = −132, −31). This study thus provides limited evidence about pesticide use as a modulator of birth weight. Overall, the authors observed no associations between birth weight and pesticide-related activities during early pregnancy; however, the authors have no data on temporal specificity of individual pesticide exposures prior to or during pregnancy and therefore cannot draw conclusions related to these exposure windows. Given the widespread exposure to pesticide products, additional evaluation of maternal pregnancy exposures at specific time windows and subsequent birth outcomes is warranted.

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