Spring 2015
PUBH 718.185
MATERNAL CHILD HEALTH EPIDEMIOLOGY
SPRING 2015
FACULTY:
Kesha Baptiste-Roberts PhD, MPH
Office Location: Portage Campus, Room 212
Office hours: Thurs 3:30-4:30pm and by appointment
Telephone:
Google voice
E-mail:
Skype:
(443) 885-4013
(717) 473-7387 kesha.baptisteroberts@morgan.edu
baptika725
CREDIT HOURS 3 Semester Credits
COURSE DESCRIPTION :
This course is an introduction to the epidemiology of maternal, child and related family and community health issues using a life course perspective. Factors contributing to pregnancy decision making, adverse pregnancy outcomes, and early and late childhood growth and development will be systematically discussed. The course will include the discussion of relevant methodologic issues and measurement challenges in maternal and child health epidemiology and will incorporate examples in both domestic and international settings. In addition to obtaining a more in-depth understanding of the epidemiologic issues related to maternal and child health, student will develop skills in critically reading the MCH epidemiology literature.
COURSE OBJECTIVES :
Upon completion of the course, the student will be able to:

To learn and apply the terminology and definitions underlying MCH epidemiology

To apply epidemiologic methods and principles within the context of maternal and child health

To discuss challenges in measurement of key maternal and child health variables.

To apply epidemiologic knowledge and skills necessary for critical analysis of published research article.
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Spring 2015
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To describe the long-term impact of pre-conceptual and pre-natal factors on infant growth and development
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To describe and discuss health disparities within the context of maternal and child health

To discuss strategies to improve pregnancy outcomes based using community based best practices
REQUIRED TEXTBOOK
There is no required textbook for the course. There will be selected reading assignments.
TEACHING METHODS & ASSIGNMENTS
This course will employ a combination of learner-centered and instructor-led strategies. The course will be include in-class lectures, guest presenters, in-class discussion, videocasts, case studies, readings, discussion forum participation, homework assignments and a final project.

All assignments are due on the assigned due date at 11:00pm

Assignments submitted late will receive a deduction of 5% per day and will not be accepted 48 hours past the due date and time . If there are extenuating circumstances, these must be brought to the attention of the instructor prior to the due date.

It is expected that all discussion posts and e-mail correspondence be professional with good grammar, proper formatting and appropriate use of citations
.

All assignments should be double spaced in 12 point font in Arial or Times New
Roman unless otherwise indicated in the assignment details.

Blackboard will be used as the communication tool for all course materials. All students registered have access to this course through the blackboard website. All class notes and assignments are posted in Blackboard and students will use Blackboard to post assignments and participate in online discussions. Blackboard is located at the following
URL: http://www.morgan.blackboard.com
The various formats of the assignments are chosen to: 1) provide regular feedback; 2) require repetition of core techniques necessary for mastery of epidemiologic thinking and analysis; 3) challenge students to tackle both straightforward and difficult applications of epidemiologic methods to practical maternal and child health problems; and 4) incorporate epidemiologic analysis into a written presentation, emphasizing proper use of language and effective communication.
Activity
Class participation (in class exercises, discussions, presentations)
Discussions (5, 10 points each; 50 points total)
Percentage (%)
10
15
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Spring 2015
Homework assignments (5 assignments, 20 points each; 100 points total)
Final Project
ASSESSMENT AND GRADING POLICY
50
25
Course grades will be based on the course instructor’s evaluation of each student’s or group’s performance on the required components of the course according to the following scale:
90 – 100% A
80 – 89% B
70 – 79% C
<70% F
ACADEMIC PERFORMANCE EXPECTATIONS

All assignments are to be completed on time unless other arrangements have been made with the instructor at least one week in advance of the due date.

Students are expected to be fully prepared to discuss all required readings and actively participate in all class sessions.

Students will be held accountable for all material assigned/covered in the course.
ATTENDANCE EXPECTATIONS

Students are expected to be regular and punctual in class attendance. Should a student need to miss class for any reason, it is expected that he/she inform the course instructor – by phone, email or in person – prior to the class (only emergency situations will be exempt from this expectation).
INSTRUCTOR’S INCLEMENT WEATHER POLICY:
 In case of inclement weather, your instructor will follow the University’s inclement weather guidelines. In addition, please check your Morgan email account and
Blackboard prior to the beginning of class for possible updates on class cancellation. If I need to cancel class, I will do my best to let you know ahead of time. If class is cancelled, expect to have class via our course website on Blackboard. Consult our course website for details. Failure to do so will count as an unexcused absence.
PROFESSIONAL BEHAVIOR EXPECTATIONS


Students are expected to show respect for the instructor, each other.
Students are expected to check their Morgan e-mail and Blackboard regularly for course



 correspondence.
Only e-mails received from your Morgan e-mail address will be opened and read. Use only your Morgan e-mail for all course communications.
Please check your email daily for class changes or updates .
Any improprieties will be dealt with according to University Regulations
Every MSU student is responsible for upholding the provisions of the Policy on
Academic Dishonesty, as published in the Undergraduate and Graduate Catalogs. This
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Spring 2015

 policy addresses issues such as plagiarism and cheating, misrepresentation/falsification of academic work, abuse of academic materials, disrespectful or reckless behavior towards faculty and other students, stealing and lying. Incidents of alleged academic misconduct will be handled through the established procedures of the University, which includes an initial review by the MSU SCHP Academic Advisory Committee, the student’s academic advisor and affected parties, which may result in a grade adjustment and reprimand letter, or a formal hearing procedure, which may subject a student to disciplinary probation, suspension, or expulsion from the University.
Morgan State University has an account with an automated plagiarism detection service
(SafeAssign), which allows instructors and students to submit student assignments to be checked for plagiarism. I (the instructor) reserve the right to 1) request that assignments be submitted as electronic files and 2) submit students’ assignments to SafeAssign, or 3) request students to submit their assignments to SafeAssign through Blackboard.
Assignments are compared automatically with a database of journal articles, web articles, the internet and previously submitted papers. The instructor receives a report showing exactly how a student’s paper was plagiarized. There are a number of free online packages that you may utilize independently. Seek advice from your academic advisor and your instructors on how to write original work if you need assistance.
Please review the revised Code of Student Conduct using the following link http://www.morgan.edu/current_students/code_of_student_conduct.html
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Spring 2015
PUBH 718.185
MATERNAL CHILD HEALTH EPIDEMIOLOGY
SPRING 2015
COURSE SCHEDULE
Week / date
Week 1
Jan 28
TOPICS
-Review course syllabus
-Determine course operational priorities
-Course expectations
-MCH Surveillance Overview
Readings and activities to be completed prior to class
(will be posted on Blackboard)

Patel, D.A., Burnett, N.M., Curtis, K.M.
(2003). Reproductive Health
Epidemiology Series-Module 2. (pp. 1-
46). U.S. Department of Health and
Human Services, Centers for Disease
Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Division of
Reproductive Health, Atlanta, GA

Wilcox, L.S., Marks, J.S. (1994) From
Data to Action: CDC’s Public Health
Surveillance for Women, Infants and
Children. (pp. 9-20). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,
Atlanta GA
ASSESSMENT
Discussion 1
(due Feb 3 @
11:00pm)
Week 2
Feb 4
Week 3
Feb 11
Week 4
Feb 18
MCH epidemiological concepts and definitions
MCHB – its historical context and future directions
Title V and the life-course
Library Skills
Fertility & Fecundity

Conceptual paradigm for human fertility and fecundity

Measuring fecundity

Determinants of male and female fecundity

Measuring human

 fertility
Conception Delays
Pregnancy Loss
Yvette McEachern- State Title V – office

Buck Louis, G.M. (2011). Fecundity and Fertility. In G. Buck Louis & R.
W. Platt (Eds.), Reproductive and
Perinatal Epidemiology (pp. 30-
61). New York, NY: Oxford
University Press.

Buck Louis GM, Sundaram R,
Schisterman EF, Sweeney A, Lynch
CD, Kim S, et al. Semen quality and time to pregnancy: the
Longitudinal Investigation of
Assignment 1
(due Feb 10
@11:00pm)
Assignment 2
(due Feb 17 @
11:00pm)
Discussion 2
(due Feb 17
@11:00pm)
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Spring 2015
Week 5
Feb 25
Infecundity
Preconception & Prenatal
Care

Prenatal care and its utilization

Indices of prenatal care adequacy

Gestational weight gain (GWG)

2009 IOM recommendations
Fertility and the Environment
Study. Fertil Steril. 2014
Feb;101(2):453-62.

Martinez G, Daniels K, Chandra A.
Fertility of men and women aged
15-44 years in the United States:
National Survey of Family Growth,
2006-2010. Natl Health Stat
Report. 2012 Apr 12(51):1-28.

Stephen EH, Chandra A. Declining estimates of infertility in the
United States: 1982-2002. Fertil
Steril. 2006 Sep;86(3):516-23.

Torrealday S. Is the fertility treatment itself a risk factor for early pregnancy loss? Curr Opin
Obstet Gynecol. 2014
Jun;26(3):174-80.
Wise LA, Palmer JR, Rosenberg L.
Body size and time-to-pregnancy in black women. Hum Reprod.
2013 Oct;28(10):2856-64

Adams, M.A. , Alexander, G.R.,
Kirby, R.S. & Wingate, M.S. (2009).
Reproductive Health Issues. In
Perinatal Epidemiology for Public
Health Practice (pp. 19-26 and 39-
42). New York, NY: Springer
Science +Business Media.

Alexander GR, Cornely DA.
Prenatal care utilization: its measurement and relationship to pregnancy outcome. Am J Prev
Med. 1987 Sep-Oct;3(5):243-53.

Alexander GR, Kotelchuck M.
Quantifying the adequacy of prenatal care: a comparison of indices. Public Health Rep. 1996
Sep-Oct;111(5):408-18; discussion
19.

Fiscella K. Does prenatal care improve birth outcomes? A critical review. Obstet Gynecol. 1995
Mar;85(3):468-79.
Assignment 3
(due Mar 3
@11:00pm)
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Spring 2015
Week 6
Mar 4
Pregnancy & Complications

Pregnancy and obesity

Pregnancy
Complications o Asthma o Gestational
Diabetes o Preeclampsia
Obstetric Interventions

Gunderson EP, Abrams B.
Epidemiology of gestational weight gain and body weight changes after pregnancy.
Epidemiol Rev. 2000;22(2):261-74.

Kotelchuck M. An evaluation of the Kessner Adequacy of Prenatal
Care Index and a proposed
Adequacy of Prenatal Care
Utilization Index. Am J Public
Health. 1994 Sep;84(9):1414-20.

Phelan ST. Components and timing of prenatal care. Obstet Gynecol
Clin North Am. 2008
Sep;35(3):339-53, vii.

Siega-Riz AM, Gray GL. Gestational weight gain recommendations in the context of the obesity epidemic. Nutr Rev. 2013 Oct;71
Suppl 1:S26-30.

Stringer M. Issues in determining and measuring adequacy of prenatal care. J Perinatol. 1998
Jan-Feb;18(1):68-73.

Williams, M.A. Buck Louis, G.M.
(2011). Pregnancy Complications.
In G. Buck Louis & R. W. Platt
(Eds.), Reproductive and Perinatal
Epidemiology (pp. 105-115). New
York, NY: Oxford University Press.

Ben-Haroush A, Yogev Y, Hod M.
Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes.
Diabet Med. 2004 Feb;21(2):103-
13.

Carty DM, Delles C, Dominiczak AF.
Preeclampsia and future maternal health. J Hypertens. 2010
Jul;28(7):1349-55.

Enriquez R, Griffin MR, Carroll KN,
Assignment 4
(due Mar 17
@11:00pm)
Start thinking about topic for final project
Ideas will be presented and discussed in class on Mar
18.
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Spring 2015
Week 7
Pregnancy & Complications

Pregnancy and obesity
Wu P, Cooper WO, Gebretsadik T, et al. Effect of maternal asthma and asthma control on pregnancy and perinatal outcomes. J Allergy
Clin Immunol. 2007
Sep;120(3):625-30.

Glantz JC, Guzick DS. Can differences in labor induction rates be explained by case mix? J
Reprod Med. 2004 Mar;49(3):175-
81.

Grobman WA. Elective induction:
When? Ever? Clin Obstet Gynecol.
2007 Jun;50(2):537-46.

Guy ES, Kirumaki A, Hanania NA.
Acute asthma in pregnancy. Crit
Care Clin. 2004 Oct;20(4):731-45, x.

Holt RI. The Hyperglycemia and
Adverse Pregnancy Outcomes trial: answers but still more questions about the management of gestational diabetes. Diabet
Med. 2008 Sep;25(9):1013-4.

Jeyabalan A. Epidemiology of preeclampsia: impact of obesity.
Nutr Rev. 2013 Oct;71 Suppl
1:S18-25.

Kjos SL, Buchanan TA. Gestational diabetes mellitus. N Engl J Med.
1999 Dec 2;341(23):1749-56.

Metzger BE, Lowe LP, Dyer AR,
Trimble ER, Chaovarindr U,
Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes.
N Engl J Med. 2008 May
8;358(19):1991-2002.
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Spring 2015
Mar 11
Week 8
Mar 18

Pregnancy
Complications o Asthma o Gestational
Diabetes o Preeclampsia
Obstetric Interventions
Fetal Growth & Development



Pregnancy dating
Preterm birth
Measurement of fetal growth

Risk factors for abnormal fetal growth

Alexander GR, Himes JH, Kaufman
RB, Mor J, Kogan M. A United
States national reference for fetal growth. Obstet Gynecol. 1996
Feb;87(2):163-8.

Hunter LA. Issues in pregnancy dating: revisiting the evidence. J
Midwifery Womens Health. 2009
May-Jun;54(3):184-90.
 Mayer C, Joseph KS. Fetal growth: a review of terms, concepts and issues relevant to obstetrics.
Ultrasound Obstet Gynecol. 2013
Feb;41(2):136-45.

Salafia CM, Charles AK, Maas EM.
Placenta and fetal growth restriction. Clin Obstet Gynecol.
2006 Jun;49(2):236-56.
 Zhang J, Merialdi M, Platt LD,
Kramer MS. Defining normal and abnormal fetal growth: promises and challenges. Am J Obstet
Gynecol. 2010 Jun;202(6):522-8.
Complete literature search for final project.
Week 9
Mar 25
Week 10
Apr 1
Infant Morbidity & Mortality
SPRING BREAK

Ananth CV, Liu S, Joseph KS, Kramer
MS. A comparison of foetal and infant mortality in the United States and Canada. Int J Epidemiol. 2009
Apr;38(2):480-9.

MacDorman MF, Hoyert DL,
Mathews TJ. Recent declines in infant mortality in the United States,
2005-2011. NCHS Data Brief. 2013
Apr(120):1-8.
Discussion 3
(due Apr 7
@11:00pm)
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Spring 2015
Week 11
Apr 8
Childhood Growth &
Development
Week 12
Apr 15
Intimate Partner Violence

Hamilton BE, Hoyert DL, Martin JA,
Strobino DM, Guyer B. Annual summary of vital statistics: 2010-
2011. Pediatrics. 2013

Mar;131(3):548-58.
Horon IL. Underreporting of maternal deaths on death certificates and the magnitude of the problem of maternal mortality. Am J
Public Health. 2005 Mar;95(3):478-
82.

Howell EM, Blondel B. International infant mortality rates: bias from reporting differences. Am J Public
Health. 1994 May;84(5):850-2.

Lawn JE, Blencowe H, Pattinson R,
Cousens S, Kumar R, Ibiebele I, et al.
Stillbirths: Where? When? Why?
How to make the data count?
Lancet. 2011 Apr

23;377(9775):1448-63.
Zhang X, Kramer MS. Variations in mortality and morbidity by gestational age among infants born at term. J Pediatr. 2009
Mar;154(3):358-62, 62 e1.

Garcia-Moreno C, Jansen HA,
Ellsberg M, Heise L, Watts CH et al.
Prevalence of intimate partner violence: findings form WHO multicountry study on women’s health and domestic violence. Lancet.
2006;368: 1260-9
Urquia ML, O’Campo PJ, Heaman MI,
Discussion 4
(due Apr 14
@11:00pm)
Submit draft of final project to peer reviewer
April 14
Discussion 5
(due April 21
@11:00pm)
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Spring 2015
Week 13
Apr 22
Week 14
Apr 29
Adolescent Health
Health Disparities in MCH
Peer review of final projects
Janssen PA, Thiessen KR. Experiences of violence before and during pregnancy and adverse pregnancy outcomes: an analysis of the
Canadian Maternity Experiences
Survey. BMC Pregnancy Childbirth
2011;11:42
Dr. Donald Shell
Director, Cancer and Chronic Disease Bureau
Maryland Department of Health & Mental
Hygiene

Alio AP, Richman AR, Clayton HB,
Jeffers DF, Wathington DJ, Salihu
HM. An ecological approach to understanding black-white disparities in perinatal mortality.

Almeida J, Mulready-Ward C,
Bettegowda VR, Ahluwalia IB.
Racial/Ethnic and nativity differences in birth outcomes among mothers in new york city: the role of social ties and social support. Matern Child
Health J. 2014 Jan;18(1):90-100.

Flores ME, Simonsen SE, Manuck TA,
Dyer JM, Turok DK. The "Latina epidemiologic paradox": contrasting patterns of adverse birth outcomes in U.S.-born and foreign-born
Latinas. Womens Health Issues. 2012
Sep;22(5):e501-7.

Rowley DL, Hogan V. Disparities in infant mortality and effective, equitable care: are infants suffering from benign neglect? Annu Rev
Public Health. 2012 Apr;33:75-87.

Spong CY, Iams J, Goldenberg R,
Hauck FR, Willinger M. Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortality.
Obstet Gynecol. 2011
Apr;117(4):948-55.Matern Child
Health J. 2010 Jul;14(4):557-66.
Assignment 5
(due April 28
@ 11:00pm)
Week 15
May 6
Health Disparities in MCH
Week 16 Critical MCH Issues
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Spring 2015
May 13
NOTE : Any adjustments to the schedule or assignments will be announced and posted on the website. It is the student’s responsibility to note any changes.
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