142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

312292
Understanding Predictors of Maternal and Child Health in Rural Western India: An International Prospective Study

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 9:15 AM - 9:30 AM

Apurv Soni, BA , School of Medicine/ Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Nisha Fahey, BA , College of Osteopathic Medicine, Des Moines University, Des Moines, IA
Nitin Raithatha, MD , Obstetrics and Gynaecology, Charutar Arogya Mandal, Karamsad, Gujarat, India
Anusha Prabhakaran, MD , Psychiatry, Charutar Arogya Mandal, Karamsad, Gujarat, India
Sowmya Rao, PhD , Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worchester, MA
Tiffany Moore Simas, MD, MPH, MEd, FACOG
Nancy Byatt, DO, MBA , Psychiatry and Obstetrics & Gynecology / Psychosomatic Medicine and Women's Mental Health, University of Massachusetts Medical School/UMass Memorial Medical Center, Worcester, MA
Milagros Rosal, PhD , Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Ajay Phatak, MSc, MPH , Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
Somashekhar Nimbalkar, MD , Central Research Services, Charutar Arogya Mandal, Karamsad, Gujarat, India
Jeroan J. Allison, MD, MSc , Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Background: Efforts by the Indian government to improve maternal and child health (MCH) outcomes have failed to have significant impact, calling for a more evidence-based approach. This study stems from an Indo-US collaboration led by two U.S. medical students designed to address critical gaps in knowledge about the underlying causes of adverse MCH outcomes.

Methods: The pilot longitudinal study will enroll 150 pregnant women between the ages of 18-45 and spans from first trimester of a pregnancy to six months post-partum and includes eight visits at a tertiary healthcare center in rural Western India. Participants receive clinical evaluations, ultrasound imaging studies, and serum biomarker measurements. Trained research coordinators manage their visits and conduct standardized interview surveys in the local language.

Results: Currently, 86 participants are enrolled, with enrollment projected to conclude in May 2014. To date, 53 participants reported a previous pregnancy, with only half (51.6%) resulting in a live childbirth. Of the participants, 76.7% were anemic (Hgb < 12g/dL) and 41.1% were Vitamin B12 deficient (< 120 pmol/L). Only one of the 17 participants who have completed their third trimester visit was aware of the government MCH program.

Conclusions: Preliminary evidence reveals important insight into the nutritional, psychosocial, and clinical problems affecting pregnancy in rural Western India. Additionally, our findings suggest lack of patient engagement in large government-operated MCH programs. Findings from the full data set will guide future interventions to be developed by ongoing cohorts of medical students in collaboration with academic partners and the existing local public health infrastructure.

Learning Areas:

Advocacy for health and health education
Biostatistics, economics
Diversity and culture
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Identify predictors of maternal and child health in rural Western India Define the prevalence of physical abnormalities, under-nutrition, and depression during pregnancy in rural western India Discuss the role of validated tools for screening physical and mental health during pregnancy in low and middle income countries

Keyword(s): International MCH, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a second year MD/PhD student and a co-founder of Research and Health Advocacy in India (RAHI). Additionally, I am a co-investigator of the study "Understanding Predictors of Maternal and Child Health in Rural Western India." I have played a leading role in the research study design, implementation, and development of data analysis plan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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