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Government policies often target vulnerable communities on the premise of their socioeconomic status, race, gender, etc., and hinder their ability to attain proper resources. These discriminatory practices can have consequences that span generations when enforced upon expecting mothers that lack access to preventative care. Whether it be for education, basic needs, or even health, access is undoubtedly disproportionate. Redlining is a specific policy that has seeped its way into communities and continues to affect the socioeconomic status of hundreds of thousands of families. One aspect of health that is especially impacted is maternal and fetal health. Findings show increased health risks for mothers and an increase in potential fetal mortality in these areas. Expanding research on the topic is crucial to promoting policies and the expansion of programs that will help subside these harmful effects that pose a risk to these communities. Our environments, both physical and social, are determinants of our health and in reviewing existing literature, it is clear that where we live is vital to our livelihoods.

Omega (n)-3 fatty acids are vital to neonatal maturation, and recent investigations reveal n-3 fatty acids serve as substrates for the biosynthesis of specialized pro-resolving lipid mediators (SPM) that have anti-inflammatory and immune-stimulating effects. The role SPM play in the protection against negative maternal-fetal health outcomes is unclear, and there are no current biomarkers of n-3 fatty acid sufficiency. We sought to ascertain the relationships between n-3 fatty acid intake, SPM levels, and maternal-fetal health outcomes. We obtained n-3 fatty acid intake information from 136 mothers admitted for delivery using a food frequency questionnaire and measured docosahexaenoic acid (DHA)-derived SPMs resolvin D1 (RvD1) and RvD2 in maternal and cord plasma. We found significantly elevated SPM in maternal versus cord plasma, and increased SPM levels were associated with at-risk outcomes. We also identified that increased DHA intake was associated with elevated maternal plasma RvD1 (p = 0.03; R² = 0.18) and RvD2 (p = 0.04; R² = 0.20) in the setting of neonatal intensive care unit (NICU) admission. These findings indicate that increased n-3 fatty acid intake may provide increased substrate for the production of SPM during high-risk pregnancy/delivery conditions, and that increased maternal plasma SPM could serve as a biomarker for negative neonatal outcomes.

In today’s medical field, doctors rely on electrocardiograms (ECG) to monitor fetal heart rate and overall fetal health during labor. ECG readings, although accurate, tend to be very difficult to interpret and consequently tell doctors very little in terms of fetal distress levels during labor. Due to this lack of specificity, physicians often turn to emergency intervention by performing Cesarean sections (C-sections). Nearly half of these C-sections are unnecessary which poses extreme risks to the fetus and the mother, and is a financial burden on insurance companies as well. To combat these issues, our team proposes pHetal Meter, a handheld device that can give a rapid, bedside reading of fetal blood pH. Fetal blood pH levels are currently the gold standard for early detection of fetal distress during labor. The device will be able to quickly and accurately detect whether or not the fetus is in distress. Our device will be nurse-operable, cause little to no pain or discomfort to the mother, and allow for faster and more direct results. When used alongside current technology, physicians will no longer need to guess whether an emergency C-section is necessary, and will be able to rapidly determine fetal distress levels. pHetal Meter uniquely bridges an unmet medical need by quickly and accurately determining intrapartum fetal health, and drastically lowering the risks and costs incurred by unnecessary C-sections. Advisors: Christine King, Ph.D. Department of Biomedical EngineeringDinh Vu, MD, MBA, Department of Obstetrics and Gynecology, Saddleback Medical CenterDepartment of Biomedical engineering and material Science Engineering, University of California Irvine

We examine birth order differences in health of newborns and follow the children throughout childhood using high-quality administrative data on individuals born in Denmark between 1981 and 2010. Family fixed effects models show a positive and robust effect of birth order on health at birth; firstborn children are less healthy at birth. During earlier pregnancies, women are more likely to smoke, receive more prenatal care, and are more likely to suffer a medical pregnancy complication, suggesting worse maternal health. We further show that the health disadvantage of firstborns persists in the first years of life, disappears by age seven, and becomes a health advantage in adolescence. In contrast, later-born children are throughout childhood more likely to suffer an injury. The results on health in adolescence are consistent with previous evidence of a firstborn advantage in education and with the hypothesis that postnatal investments differ between first- and later-born children.

Health monitoring has become widespread these past few years. Such applicationsinclude from exercise, food intake and weight watching, to specific scenarios like monitoringpeople who suffer from chronic diseases. More and more we see the need to also monitorthe health of new-born babies and even fetuses. Congenital Heart Defects (CHDs) are themain cause of deaths among babies and doctors do not know most of these defects. Hence,there is a need to study what causes these anomalies, and by monitoring the fetus daily therewill be a better chance of identifying the defects in earlier stages. By analyzing the datacollected, doctors can find patterns and come up with solutions, thus saving peoples’ lives.In many countries, the most common fetal monitor is the ultrasound and the use of it isregulated. In Sweden for normal pregnancies, there is only one ultrasound scan during thepregnancy period. There is no great evidence that ultrasound can harm the fetus, but manydoctors suggest to use it as little as possible. Therefore, there is a demand for a new non-ivultrasound device that can be as accurate, or even better, on detecting the FHR and notharming the baby. The problems that are discussed in this thesis include how can accuratefetus health be monitored non-invasively at home and how could a fetus health monitoringsystem for home use be designed. The first part of the research investigates differenttechnologies that are currently being used on fetal monitoring, and techniques andparameters to monitor the fetus. The second part is a qualitative study held in Swedenbetween April and May 2016. The data for the qualitative study was collected throughinterviews with 21 people, 10 mothers/mothers-to-be and 11obstetricians/gynecologists/midwives. The questions were related to the Swedish pregnancyprotocol, the use of technology in medicine and in particular during the pregnancy process,and the use of an ECG based monitoring device. The results show that there is still, Validerat; 20160818 (global_studentproject_submitter)

Nel, S., & Geraghty, S. (2017). Amphetamine use in pregnancy: Perinatal approaches to improve maternal and neonatal outcomes. British Journal of Midwifery, 25(9), 522-555. Available here.