BEGIN:VCALENDAR
VERSION:2.0
CALSCALE:GREGORIAN
PRODID:iCalendar-Ruby
BEGIN:VEVENT
CATEGORIES:Defenses
DESCRIPTION:Impact of Preconception Cardiometabolic and Thyroid Dysfunction
  on Preterm Birth\n\nPublic Health/Epidemiology\n\nCommittee: \nCatherine L
 . Haggerty\, Department of Epidemiology (advisor)\nJanet M. Catov\, Departm
 ents of Epidemiology and Obstetrics\, Gynecology & Reproductive Sciences\nG
 ong Tang\, Department of Biostatistics\nEmma Barinas-Mitchell\, Department 
 of Epidemiology\nMaisa Feghali\, Department of Obstetrics\, Gynecology & Re
 productive Sciences\n\nAbstract: \n\nBackground  Cardiometabolic markers su
 ch as blood pressure and other clinical factors such as thyroid dysfunction
  during pregnancy have been associated with preterm birth but less is known
  about the impact of preconception health factors.  Research is needed to d
 etermine the effect of preconception health on preterm birth among reproduc
 tive-age women.\n\nObjective  This dissertation is comprised of three paper
 s with the following objectives:  1) To conduct a systematic review to asse
 ss the quality and breath of current literature on preconception cardiometa
 bolic markers and risk of preterm birth (Manuscript 1).  The purpose of thi
 s systematic review was to identify gaps in the literature that can serve t
 o inform future research.  2) To evaluate the association between thyroid d
 ysfunction and risk of preterm birth in reproductive-age women (Manuscript 
 2).  3) To determine the trajectory of blood pressure changes from the peri
 od prior to conception through pregnancy and its association with the risk 
 of preterm birth (Manuscript 3).\n\nMethods  For the systematic review\, we
  conducted a search in PubMed (including Medline with In-Process & Other No
 n-Indexed Citations)\, PubmMed Central (PMC)\, Embase\, and ClinicalTrials.
 gov to identify original research articles published between 1950 and July 
 2020.  We included articles that included analyses of preconception lipids\
 , glucose\, or blood pressure\, and preterm birth.  For Manuscripts 2 and 3
 \, women from the Longitudinal Indian Family hEalth Study (LIFE\; n=539\; m
 ean age 21.60±2.83) who were recruited preconception and had measures both 
 on the exposures of interest (blood pressure and thyroid hormones) and outc
 ome of interest (preterm birth) were included.  For Manuscript 2\, we used 
 multivariable logistic models to assess the association between preconcepti
 on thyroid dysfunction and risk of preterm birth.  Additionally\, we assess
 ed mediation by hypertensive disorders of pregnancy between thyroid dysfunc
 tion and preterm birth.  For Manuscript 3\, we modeled blood pressure traje
 ctories over time (preconception\, first and third trimesters\, and postpar
 tum) and used mixed-effects models with splines to assess the longitudinal 
 change over time in blood pressure among women experiencing preterm birth v
 ersus those delivering at full-term.  Additionally\, we used logistic regre
 ssion and generalized additive models at three time points (preconception\,
  first and third trimesters) to assess the association between blood pressu
 re and risk of preterm birth. \n\nResults  The systematic review showed con
 siderable heterogeneity in the assessment of the exposures and none of the 
 studies assessed all cardiometabolic markers of interest.  Given the sparsi
 ty of the studies\, we were unable to draw meaningful conclusions regarding
  the risk of these markers prior to conception and their association with p
 reterm birth.  The second manuscript showed that preconception hyperthyroid
 ism increases the risk of preterm birth\, after adjusting for maternal age 
 at conception\, pre-pregnancy BMI\, time between pre-pregnancy thyroid meas
 urement and conception\, education level\, and hypertensive disorders of pr
 egnancy.  However\, were not able to conclude that thyroid dysfunction and 
 risk of preterm birth is mediated by hypertensive disorders of pregnancy.  
 In the third manuscript\, we showed that blood pressure trajectories change
  over time as a woman transitions from preconception to pregnancy to postpa
 rtum.  We were not able to determine an association between blood pressure 
 increase during preconception\, first or third trimesters and increased odd
 s of preterm birth. \n\nConclusions  Our systematic review highlights the n
 eed for additional studies assessing preconception measures so that future 
 healthcare recommendations can be formulated.  Our data suggest that women 
 diagnosed with hyperthyroidism during the preconception period may have a h
 igher risk of preterm birth in a subsequent pregnancy.  The period prior to
  conception may be a critical window to identify women at risk for preterm 
 birth who may benefit from interventions to address abnormal thyroid functi
 on.  Additionally\, our data indicate that the level of change in blood pre
 ssure and rate of that change is different among women with preterm births 
 compared to women with term births.  Sufficiently powered studies with more
  time points are needed to better understand blood pressure trajectories be
 fore and during the course of pregnancy in association with the risk of pre
 term birth.
DTEND:20220408T163000Z
DTSTAMP:20260511T124807Z
DTSTART:20220408T143000Z
LOCATION:
SEQUENCE:0
SUMMARY:Dissertation Defense: Fouzia Farooq
UID:tag:localist.com\,2008:EventInstance_39546105829207
URL:https://calendar.pitt.edu/event/dissertation_defense_fouzia_farooq
END:VEVENT
END:VCALENDAR