Placental dysfunction is implicated in the pathogenesis of preeclampsia. Chemical signals between the placenta and maternal circulation are a suspect cause of endothelial dysfunction and maternal hypertension. This study examined select lipid mediators of inflammation produced by the placenta. Patients were recruited from Virginia Commonwealth University’s pregnancy clinics and placentas were collected at delivery. Forty-eight-hour explant cultures of villous placental tissue were used to model lipid production. Electrospray ionization mass spectrometry was used to quantify concentrations of free lipids in the culture media. Bicinchoninic acid assays were performed to quantify protein in each culture for normalization of lipid data. After analysis, it was found that severity of preeclampsia was correlated with a unique lipid profile. Pro-inflammatory hydroxyeicosatetraenoic acids and sphingolipids were elevated. Aspirin usage in patients who developed preeclampsia was found to attenuate accumulation of isoprostane oxidative stress markers and thromboxane production while preserving omega-3-fatty acid and increasing prostacyclin levels.

Australia has a lower teenage fertility rate than other industrialised English-speaking countries. However, with over 11,000 births and 12,000 abortions to teenagers each year, the resolution of teenage pregnancy is an issue faced by many young Australian women. ¶ This research seeks to explore the factors that discriminate between those who terminate and those who continue a teenage pregnancy. To achieve this aim a survey was conducted on young ever-pregnant women throughout New South Wales and the Australian Capital Territory. The survey sought information on young women’s characteristics on three different levels: individual; institutional; and societal or cultural. ¶ The findings suggest that, at each of the three levels proposed, there are factors that discriminate between young women who choose abortion and those who choose motherhood. At the individual level, attitudes to abortion and career aspirations were found to affect pregnancy resolution. At the institutional level factors relating to education, family, relationships and religion were found to discriminate between the two groups. Finally, at the cultural level, ethnicity and area of residence were found to be associated with pregnancy resolution, in addition to modifying the effect of characteristics at other levels.

Source: Masters Abstracts International, Volume: 47-06, page: 3556. Adviser: Robert E. Roberts. Includes bibliographical references.

Thesis (M.N.)--Memorial University of Newfoundland, 2002. / Bibliography: leaves 143-152.

Advanced maternal age (AMA) is linked to several adverse pregnancy outcomes, hence these pregnancies are considered to be "high risk." Risk perception impacts pregnant women’s health care use, health behaviors, and adherence to medical recommendations. Yet, a gap remains in the understanding of perception of pregnancy risk and its contributing factors. This mixed methods research study was developed to address this gap, using a conceptual framework based on a literature review and the Psychometric Model of risk perception. The specific objectives of this study were to compare risk perception in nulliparous women of AMA with younger women, determine the factors influencing perception of pregnancy risk, and gain an understanding of women’s perspectives of risks associated with AMA. Between December 2009 and January 2011, a sample of 159 participants (105 women aged 20-29 years and 54 women aged 35 years or older) was recruited from a variety of settings in Winnipeg, Manitoba. Several questionnaires were completed by participants. Descriptive statistics, chi square, t tests, Pearson's r correlations, and stepwise multivariate linear regressions were used to analyze data. Fifteen women of AMA were chosen purposefully to participate in individual and semi-structured interviews. Interviews were audio-taped and transcribed verbatim, and content analysis was used to identify themes. Results revealed that pregnancy-related anxiety, maternal age, medical risk, perceived control (internal), and gestational age were significant predictors of perception of pregnancy risk accounting for 47-49% of the variance in risk perception. Maternal age interacted in a synergistic manner with pregnancy-related anxiety to increase perception of pregnancy risk levels. In the qualitative component, four main themes emerged from the data: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals. Women of AMA perceived higher pregnancy risk for both themselves and their fetuses than younger women. However, they were not a homogenous group in their pregnancy risk appraisal. This study contributed to the field by proposing pregnancy-related anxiety as a pregnancy dread factor in risk perception theories. Risk communication is an important element of developing care plans for women of AMA and should be integrated into prenatal care visits.

Advanced maternal age (AMA) is linked to several adverse pregnancy outcomes, hence these pregnancies are considered to be "high risk." Risk perception impacts pregnant women’s health care use, health behaviors, and adherence to medical recommendations. Yet, a gap remains in the understanding of perception of pregnancy risk and its contributing factors. This mixed methods research study was developed to address this gap, using a conceptual framework based on a literature review and the Psychometric Model of risk perception. The specific objectives of this study were to compare risk perception in nulliparous women of AMA with younger women, determine the factors influencing perception of pregnancy risk, and gain an understanding of women’s perspectives of risks associated with AMA. Between December 2009 and January 2011, a sample of 159 participants (105 women aged 20-29 years and 54 women aged 35 years or older) was recruited from a variety of settings in Winnipeg, Manitoba. Several questionnaires were completed by participants. Descriptive statistics, chi square, t tests, Pearson's r correlations, and stepwise multivariate linear regressions were used to analyze data. Fifteen women of AMA were chosen purposefully to participate in individual and semi-structured interviews. Interviews were audio-taped and transcribed verbatim, and content analysis was used to identify themes. Results revealed that pregnancy-related anxiety, maternal age, medical risk, perceived control (internal), and gestational age were significant predictors of perception of pregnancy risk accounting for 47-49% of the variance in risk perception. Maternal age interacted in a synergistic manner with pregnancy-related anxiety to increase perception of pregnancy risk levels. In the qualitative component, four main themes emerged from the data: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals. Women of AMA perceived higher pregnancy risk for both themselves and their fetuses than younger women. However, they were not a homogenous group in their pregnancy risk appraisal. This study contributed to the field by proposing pregnancy-related anxiety as a pregnancy dread factor in risk perception theories. Risk communication is an important element of developing care plans for women of AMA and should be integrated into prenatal care visits.

Unintended pregnancy remains to be a public health priority for adolescents as there are a myriad of negative social and developmental consequences for both young mothers and their children. The goal of this study was to examine associations of individual-level determinants of health with sexual risk behaviors and protective factors among a sample of African American female adolescents. African American adolescent females were recruited from sexual health clinics to participate in a cross-sectional survey at 18 months post-participation in a STD/HIV prevention trial. Surveys were administered using Audio Computer Assisted Self Interview (ACASI). Statistical analyses were run to determine associations of protective and sexual risk behaviors with age, education, household income status, sexual history, other contraception use and knowledge of emergency contraception (EC). A total of 410 surveys were included in the analyses. (N=410; mean age=19.06) Almost sixteen percent (n=65) of participants reported ever using emergency contraception. Bivariate analyses indicated that EC use among African American female adolescents was significantly associated with age, education level, job status, receipt of government assistance, age at first sex, knowledge of EC availability and number of average condom errors. The findings in this study are consistent with previous studies exploring social determinants and their relationship to sexual health practices among high risk populations. The findings of this study could be used to design effective pregnancy prevention initiatives including EC education and promotion targeting specific segments of the African American adolescent female population that may be at a greater risk for unintended pregnancies.

The labour pain experienced by 101 women giving birth in a Scottish hospital was assessed by the McGill Pain Questionnaire and Visual Analogue Scales during active first stage labour and post-natally. Labour pain was found to be on average severe, but not intensely negatively affective. Its intensity varied considerably and was related to parity and the duration of the first stage of labour reflecting underlying differences in levels of noxious stimulation. Other obstetric and pharmacological factors which might affect noxious stimulation were not significantly related to pain scores. Induction was related to higher,and complications of pregnancy, to lower levels of pain attributable to psychological modulation. The desirability of pregnancy, positive and accurate expectations of birth, ante-natal training and the welcomed presence of the husband at the birth were associated with significantly lower levels of labour pain, particularly of non-sensory pain. A few subjects had very minimal previous experience of pain. These subjects had the lowest levels of pain in childbirth, perhaps because they were relatively insensitive to noxious stimulation. Subjects whose previous experience of pain had been extensive had significantly lower levels of labour pain than subjects whose previous pain experience had been more limited. Subjects who had extensive experience of pain used a larger number of strategies to cope with that pain than subjects whose experience had been more moderate. They used more strategies during labour, a greater proportion of which they had used previously. The use of a number of strategies in labour, either in combination or in sequence was related to lower levels of labour pain but not to painless childbirth. So too was the use of strategies which had been previously utilised. The relationship between previous pain experience and levels of labour pain was mediated by the differential use of coping strategies.

This study focused on perceptions and experiences of pregnant women who opted in against those who opted out of voluntary antenatal HIV counseling and testing. The pregnant women's perceptions and experiences were assessed in order to gain insight into their views towards voluntary antenatal counseling and testing.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.