Browsing by Author "Peaceman, Alan M."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Prescription and Other Medication Use in Pregnancy
    (Wolters Kluwer, 2018-05) Haas, David M.; Marsh, Derek J.; Dang, Danny T.; Parker, Corette B.; Wing, Deborah A.; Simhan, Hyagriv N.; Grobman, William A.; Mercer, Brian M.; Silver, Robert M.; Hoffman, Matthew K.; Parry, Samuel; Iams, Jay D.; Caritis, Steve N.; Wapner, Ronald J.; Esplin, M. Sean; Elovitz, Michal A.; Peaceman, Alan M.; Chung, Judith; Saade, George R.; Reddy, Uma M.; Obstetrics and Gynecology, School of Medicine
    OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured. Additionally, reasons the medications were taken were recorded. Trends in medications taken across pregnancy and in the first trimester were determined. RESULTS: Of the 9,546 study participants, 9,272 (97.1%) women took at least one medication during pregnancy with 9,139 (95.7%) taking a medication in the first trimester. Polypharmacy, defined as taking at least five medications, occurred in 2,915 (30.5%) women. Excluding vitamins, supplements, and vaccines, 73.4% of women took a medication during pregnancy with 55.1% taking one in the first trimester. The categories of drugs taken in pregnancy and in the first trimester include the following: gastrointestinal or antiemetic agents (34.3%, 19.5%), antibiotics (25.5%, 12.6%), and analgesics (23.7%, 15.6%, which includes 3.6%; 1.4% taking an opioid pain medication). CONCLUSION: In this geographically and ethnically diverse cohort of nulliparous pregnant women, medication use was nearly universal and polypharmacy was common.
  • Thumbnail Image
    Item
    Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women
    (Elsevier, 2017-06) Bodnar, Lisa M.; Simhan, Hyagriv N.; Parker, Corette B.; Meier, Heather; Mercer, Brian M.; Grobman, William A.; Haas, David M.; Wing, Deborah A.; Hoffman, Matthew K.; Parry, Samuel; Silver, Robert M.; Saade, George R.; Wapner, Ronald; Iams, Jay D.; Wadhwa, Pathik D.; Elovitz, Michal; Peaceman, Alan M.; Esplin, Sean; Barnes, Shannon; Reddy, Uma M.; Obstetrics and Gynecology, School of Medicine
    BACKGROUND: The significance of periconceptional nutrition for optimizing offspring and maternal health and reducing social inequalities warrants greater understanding of diet quality among US women. OBJECTIVE: Our objective was to evaluate racial or ethnic and education inequalities in periconceptional diet quality and sources of energy and micronutrients. DESIGN: Cross-sectional analysis of data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort. PARTICIPANTS AND SETTING: Nulliparous women (N=7,511) were enrolled across eight US medical centers from 2010 to 2013. MAIN OUTCOME MEASURES: A semiquantitative food frequency questionnaire assessing usual dietary intake during the 3 months around conception was self-administered during the first trimester. Diet quality, measured using the Healthy Eating Index-2010 (HEI-2010), and sources of energy and micronutrients were the outcomes. STATISTICAL ANALYSES: Differences in diet quality were tested across maternal racial or ethnic and education groups using F tests associated with analysis of variance and χ2 tests. RESULTS: HEI-2010 score increased with higher education, but the increase among non-Hispanic black women was smaller than among non-Hispanic whites and Hispanics (interaction P value <0.0001). For all groups, average scores for HEI-2010 components were below recommendations. Top sources of energy were sugar-sweetened beverages, pasta dishes, and grain desserts, but sources varied by race or ethnicity and education. Approximately 34% of energy consumed was from empty calories (the sum of energy from added sugars, solid fats, and alcohol beyond moderate levels). The primary sources of iron, folate, and vitamin C were juices and enriched breads. CONCLUSIONS: Diet quality is suboptimal around conception, particularly among women who are non-Hispanic black, Hispanic, or who had less than a college degree. Diet quality could be improved by substituting intakes of refined grains and foods empty in calories with vegetables, peas and beans (legumes), seafood, and whole grains.