Journal of the National Medical Association最新文献

{"title":"Developing Pre-Surgical Dental Algorithms for Enhanced Patient Care","authors":"Arushi Gupta MSN,&nbsp;Janice F. Hernandez DNP, RN, FNP-C,&nbsp;Jose Reyes DDS","doi":"10.1016/j.jnma.2024.07.014","DOIUrl":"10.1016/j.jnma.2024.07.014","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this project is to identify major health risk factors among Latino patients and develop pre-surgical algorithms based on the most common risk factors to prevent complications before, during and after dental surgery.</p></div><div><h3>Methods</h3><p>A thorough literature review was conducted using CINAHL and PubMed to identify scholarly articles that address health risk factors in the Latino population, and to identify Evidence-based protocols used at outpatient surgery center. The top-ranked health risk factors associated with dental surgery were identified.</p></div><div><h3>Results and Findings</h3><p>The literature review yielded five evidence-based articles identifying the top health-risk factors: patients on anticoagulation therapy, heart valve replacement, active atrial fibrillation, and medications associated with delayed gastrointestinal emptying such as Semaglutide. Four pre-surgical algorithms were developed after review. The pre-surgical algorithms will guide surgical protocols and procedures at Alamo City Dental.</p></div><div><h3>Conclusion and Implications for Practice</h3><p>As dentists continue to provide preventative and emergency dental services, the need for addressing health risk factors related to the decrease in access to primary care by their patients is increasing. This added workload and responsibility in becoming the first point of contact for patients with undiagnosed chronic conditions can become overwhelming. In addition, with the decrease in dental service and access to primary care in underserved areas, it is vital to reinforce and improve interprofessional collaboration and education regarding preventive dental hygiene in patients among medical professionals. With the collaboration and creation of these pre-surgical algorithms, dentist may now have the ability to enhance patient care, safety, and decrease emergency complications before, during and after dental surgery.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 416"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Association of Hidradenitis Suppurativa and Hyperthyroidism","authors":"Krina V Patel BS,&nbsp;Lisa R Patel BS,&nbsp;Sunaina V Addanki BS","doi":"10.1016/j.jnma.2024.07.034","DOIUrl":"10.1016/j.jnma.2024.07.034","url":null,"abstract":"<div><h3>Introduction</h3><p>Hidradenitis Suppurativa (HS) is an inflammatory disease affecting pilosebaceous skin units that has been linked with several autoimmune conditions. Hyperthyroidism is most commonly seen in Grave's Disease, an autoimmune condition that results in a hypermetabolic state. The aim of this study is to explore and establish the relationship between HS and hyperthyroidism in order to investigate the potential implications in patient care.</p></div><div><h3>Methods</h3><p>Data from the National Institute of Health (NIH) All of Us Researcher Program (AoU), was used to evaluate the relationship between hyperthyroidism and HS. A cross-sectional study was performed to evaluate the prevalence of HS in individuals with and without a history of hyperthyroidism matched by age ranges and health surveys. Significance and relative risk were obtained using standard statistical procedures.</p></div><div><h3>Results</h3><p>A total of 407,333 patients were matched by age range and health surveys in both the experimental and control groups. Amongst patients with a history of hyperthyroidism, the prevalence of HS was 1.40% compared to 0.38% in the control group. This difference was statistically significant by p&lt;0.0001 with an OR=3.717, 95% CI 3.038-4.548.</p></div><div><h3>Conclusion</h3><p>The study shows a statistically significant correlation between hyperthyroidism and increased prevalence of HS. These results warrant further research regarding hyperthyroidism's role in HS and the potential screening tools and lifestyle management techniques that may be prevalent for both conditions. Implementation of patient education in those with hyperthyroidism about the signs and symptoms of HS may prompt earlier seeking of medical care and improved timelines for diagnosis and management.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 425"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Research Representation in Anxiety, MDD, PTSD for Disenfranchised Groups","authors":"Mayenha E Guerrier MD","doi":"10.1016/j.jnma.2024.07.097","DOIUrl":"10.1016/j.jnma.2024.07.097","url":null,"abstract":"<div><h3>Introduction</h3><p>The underrepresentation of disenfranchised communities in clinical research on the top three mental health disorders—anxiety, major depressive disorder (MDD), and post-traumatic stress disorder (PTSD)—presents significant challenges to the development of effective and inclusive mental health interventions. This study aims to identify barriers to diverse participation and propose actionable strategies to improve representation in clinical research.</p></div><div><h3>Methods</h3><p>To address these issues, a comprehensive review of existing literature and analysis of current clinical research practices was conducted. The study examined the extent of underrepresentation across various demographic groups and explored the systemic, cultural, and logistical barriers that prevent equitable participation.</p></div><div><h3>Results</h3><p>The findings reveal persistent disparities in clinical research, with marginalized groups (including but not limited to racial and ethnic minorities and low-income individual populations) often underrepresented in studies. Barriers to inclusion include limited access to healthcare and research opportunities, language and cultural differences, and mistrust of the medical system. To combat these issues, the study proposes several strategies, such as community engagement initiatives, culturally sensitive recruitment practices, and partnerships with local organizations to build trust and awareness. Additionally, providing resources such as transportation, translation services, and financial compensation can help facilitate participation.</p></div><div><h3>Conclusion</h3><p>In conclusion, this research underscores the importance of implementing inclusive practices in clinical research on anxiety, MDD, and PTSD. By addressing barriers to participation and promoting equitable representation, the research community can ensure that findings are applicable to diverse populations and improve mental health outcomes for all individuals.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 454"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keeping it real: A descriptive analysis of HIV testing history, PrEP awareness, and PrEP use among Black cisgender women in Middle Tennessee, 2018","authors":"Leah R. Alexander ,&nbsp;Vanisha L. Brown ,&nbsp;John R. Koethe ,&nbsp;Bryan E. Shepherd ,&nbsp;Michael Green ,&nbsp;Hector F. Myers ,&nbsp;Cristian J. Chandler","doi":"10.1016/j.jnma.2024.07.002","DOIUrl":"10.1016/j.jnma.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>HIV disproportionately affects Black/African American women in the United States, particularly in the southern states, including Tennessee. Despite this, limited research and intervention are targeting this population, especially regarding biomedical prevention technologies such as pre-exposure prophylaxis (PrEP). This study aims to describe the HIV testing history of a sample of Black women in middle Tennessee, assess their awareness and potential for adopting modern HIV prevention technologies like PrEP, and explore the dyadic and social factors that influence their HIV prevention awareness and use.</p></div><div><h3>Theory</h3><p>The Precaution Adoption Process Model (PAPM) is employed to understand how individuals progress through decision-making stages when adopting new health behaviors, especially related to novel interventions.</p></div><div><h3>Methods</h3><p>For survey development and deployment, this cross-sectional survey study engaged the Nashville Health Disparities Coalition and the Resident Association for the Metropolitan Developmental Housing Association in Nashville. Eligible participants included African American and Black women aged 18 and above. The survey collected demographic information, HIV testing history, reasons for testing or not testing, dyadic HIV risk factors, awareness, and use of rapid HIV testing and PrEP, and social norms related to these prevention technologies.</p></div><div><h3>Results and discussion</h3><p>Age significantly influenced HIV testing history, emphasizing the importance of regular screening, especially among older women. Dyadic factors such as concurrency and having a shared male partner were associated with differences in testing behavior. Awareness of both rapid HIV testing and PrEP was limited among participants, highlighting the need for increased education and awareness campaigns specifically highlighting benefits to Black women. Social norms, particularly recommendations from healthcare providers, played a crucial role in influencing women's willingness to adopt these prevention technologies. [Increasing routine HIV testing and awareness of PrEP, especially among women in non-monogamous relationships, is essential in reducing HIV disparities among Black women.]</p></div><div><h3>Implications</h3><p>Healthcare providers play a crucial role in initiating and recommending HIV testing and PrEP among Black women, emphasizing the importance of patient-provider relationships and ongoing conversations about prevention strategies. This study underscores the importance of community-engaged research in addressing HIV disparities and highlights the potential for partnerships between medical centers and community organizations in the fight against HIV.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Pages 338-350"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S002796842400083X/pdfft?md5=b11e0a1caceadac9d2a405c7cac0c3fd&pid=1-s2.0-S002796842400083X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Healthcare Disparities: Exploring the Barrier of Medical School Admissions in Texas","authors":"Joshua E Lewis BS,&nbsp;Lornee C. Pride BS,&nbsp;Kafayat Oyejide BS,&nbsp;Kelsey H. Bassey BS,&nbsp;Mary W. Maina BS,&nbsp;Adedamola Ashade BSA,&nbsp;Wei-Chen Lee PhD","doi":"10.1016/j.jnma.2024.07.027","DOIUrl":"10.1016/j.jnma.2024.07.027","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite efforts by medical school admissions committees to promote diversity and inclusion, underrepresented in Medicine (URiM) minorities remain inadequately represented in medicine. While holistic admission criteria have been introduced, URiM enrollment rates continue to lag behind the demand for diverse physicians. This study examines trends in URiM epresentation at Texas medical schools, focusing on Hispanic/Latino, African American/Black, and male/female demographics.</p></div><div><h3>Method</h3><p>Racial, ethnic, and gender demographic data were collected from the Texas Medical and Dental Schools Application Services (TMDSAS) from 2013 to 2023. Data analysis excluded 2024 due to unavailable matriculation data. Statistical significance was set at p&lt; 0.05.</p></div><div><h3>Results</h3><p>Between 2013 and 2023, Texas MD and DO schools received 71,716 applicants, with 19,478 (27.2%) matriculants. Of these, 5.8% were African American/Black (n=1128) and 16.9% were Hispanic/Latino (n=3293). Gender did not significantly affect applicant or matriculation rates (p=0.113). While overall applicant and matriculation rates increased, URiM representation remained disproportionately low compared to non-URiM minorities (p=0.002).</p></div><div><h3>Conclusions</h3><p>Further research is needed to assess recruitment efforts for URiM at Texas medical schools. Initiatives like pipeline programs and free MCAT prep courses have not effectively bridged the gap between URiM and non-URiM matriculants. Texas medical school admissions processes require reevaluation to ensure increased URiM representation, addressing healthcare disparities in lower socioeconomic areas and specific minority groups.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 422"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education & Communication to Improve Healthcare Outcomes Academy (ECHO Academy)","authors":"Tia Baulckim Degrees Ph.D., MPH","doi":"10.1016/j.jnma.2024.07.028","DOIUrl":"10.1016/j.jnma.2024.07.028","url":null,"abstract":"<div><h3>Background</h3><p>Mayo Clinic's Department of Laboratory Medicine and Pathology conducted a climate survey in 2022, revealing the need for enhanced workforce education in areas such as psychological safety, DEI, and handling sensitive healthcare topics. The department recognized to facilitate change, increase ACGME scores related to educational offerings on things like Psychological Safety, and ensure clinical and business impact were supported, traditional training alone would be insufficient. This led to the creation of the DLMP's Education &amp; Communication to Improve Healthcare Outcomes Academy. This academy utilizes a Hub and Spoke Model, offering practical case studies and presentations to facilitate knowledge sharing and application in difficult conversations.</p></div><div><h3>Methods</h3><p>The DLMP-ECHO Academy offers 2 cohorts annually with 25 slots each, spanning 5 months. Participants can earn up to 5 CE credits through Mayo Clinic Continuing Education by attending monthly classes. These courses are also available upon request outside the academy framework.</p></div><div><h3>Results</h3><p>Attendance includes clinicians, future leaders, and allied health staff, showcasing a significant impact on healthcare outcomes. Postsession surveys reveal increased empowerment and preparedness to address sensitive subjects, particularly noted by ResidentPhysicians who aim to strengthen their residency communities and patient care practices.</p></div><div><h3>Conclusions</h3><p>Prioritizing knowledge management enhances organizational values and competitive advantage, fostering equal opportunities for better healthcare outcomes. The direct positive outcomes include improved patient care practices and increased empowerment among healthcare professionals. Furthermore, the indirect positive outcomes encompass enhanced staff satisfaction, innovation, and retention.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Pages 422-423"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocating for perinatal medication treatment of opioid use disorder","authors":"Michelle R Lofwall MD, MS,&nbsp;Frankie K. Kropp MS,&nbsp;Anna-Maria South MD,&nbsp;Laura C. Fanucchi MD,&nbsp;T. John Winhusen PhD","doi":"10.1016/j.jnma.2024.07.072","DOIUrl":"10.1016/j.jnma.2024.07.072","url":null,"abstract":"<div><h3>Purpose</h3><p>Best practices for pregnant, breastfeeding and parenting persons with opioid use disorder (OUD) include standard of care medications - buprenorphine and methadone, but may not be allowed in some settings, which can violate the Americans with Disabilities Act (ADA). We review best practice guidance and the ADA as an advocacy tool to help improve access to Food and Drug Administration (FDA)-approved medication treatments.</p></div><div><h3>Methods</h3><p>Best practice documents are identified from: 1) Substance Abuse and Mental Health Services Administration (SAMHSA), 2) national physician organizations in addiction medicine, obstetrics/gynecology, pediatric, addiction psychiatry, and 3) expert clinicians participating in a National Institute on Drug Abuse Clinical Trials Network study evaluating buprenorphine sublingual and subcutaneous injectable formulations in pregnant and post-partum persons. The ADA is explained through patient examples and case law.</p></div><div><h3>Results</h3><p>Best practice guidance consistently recommends buprenorphine and methadone treatment through pregnancy and postpartum, including while breastfeeding. A person on medication treatment who is not allowed to continue medication may experience miscarriage and increased risk for overdose. The Department of Justice has made clear that policies within public health care entities, including jails and prisons, not allowing for FDA-approved medication treatments of OUD, are an ADA violation. Reports of potential ADA violations may be made to the assistant United States attorney (<span><span>https://www.justice.gov/usao/find-your-united-states-attorney</span><svg><path></path></svg></span>) and to non-profits such as the Legal Action Center.</p></div><div><h3>Conclusion</h3><p>The audience will have improved health literacy around best medical practice for this special population and understand how to identify and report possible ADA violations to improve public health.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Pages 442-443"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Barriers to Annual CT Scanning for Lung Cancer Detection","authors":"Ashley Villa-Rangel BA,&nbsp;Nabill Munshi BS,&nbsp;Shahrzad Bazargan-Hejazi PhD,&nbsp;Deyu Pan BS,&nbsp;Vishal Roa BS,&nbsp;Ashley Villa-Rangel BA","doi":"10.1016/j.jnma.2024.07.100","DOIUrl":"10.1016/j.jnma.2024.07.100","url":null,"abstract":"<div><h3>Background</h3><p>Only 5.8% of eligible Americans were screened for lung cancer, according to the 2022 ‘State of Lung Cancer’ report. Lung cancer screening is essential for early diagnosis, better health outcomes, and prognosis.</p></div><div><h3>Objective(s)</h3><p>This study examines the association of social determinants of health (SDoH) in obtaining annual low-dose Computed Tomography (CT) screening for lung cancer.</p></div><div><h3>Methods</h3><p>This retrospective study used telephone survey data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) (N=42725). The analytical data included adults between the ages of 50-79 (n=19599). Data analysis included descriptive, bivariate (Chi-Square test), and multivariate analysis (adjusted logistic regression). Data was analyzed using SAS, and statistical significance was determined by p&lt;0.05.</p></div><div><h3>Results</h3><p>Of the sample, 10.1% received low dose CT for lung cancer screening. Ethnicity breakdown included white (64.7%), black (11.7%), Hispanic (18.1%) and other (5.5%). Adjusted logistic regression analysis revealed that unemployment, the presence of five or more chronic conditions, the existence of depressive disorders, and reporting fair or poor general health were associated with an increased likelihood of undergoing a CT scan for lung cancer screening compared to reference groups. Additionally, access to a personal physician and health plan coverage positively correlated with the likelihood of receiving a CT scan. However, having college and above education—as opposed to high school and below—and having concerns about medical care costs were associated with a decreased probability of participating in lung cancer screening.</p></div><div><h3>Conclusions</h3><p>Our initial findings underscore the multifaceted nature of annual CTs.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 455"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating Cadaveric Models for Training in Ocular Ultrasonography","authors":"Jacob B. Morgan BS,&nbsp;Katia M Castillo BS","doi":"10.1016/j.jnma.2024.07.079","DOIUrl":"10.1016/j.jnma.2024.07.079","url":null,"abstract":"<div><h3>Introduction</h3><p>The purpose of this paper is to create a cadaveric model which can be utilized in the training and practice of ocular ultrasonography. Ultrasonography has become a mainstay in diagnostic medicine due to its versatility and availability. One use of this modality is the rapid, non-invasive detection of acute intraocular pathologies such as retinal detachment. A retinal detachment is the pathologic separation of the retina from underlying structures. During this period of separation, the retina is devoid of oxygen and nutrition which may subject the eye to permanent visual loss. There are many ocular offenses which lead to detachment including diabetic retinopathy and trauma. In all cases, this disorder requires rapid diagnosis and treatment for best long-term vision.</p></div><div><h3>Methods</h3><p>To create the retinal detachment model, a lateral canthotomy and sclerotomy is performed to access the choroid and retinal layers in the posterior pole of the eye. A normal saline solution is then injected with a micropipette into the subretinal space, causing the retina to detach.</p></div><div><h3>Results</h3><p>We hypothesize that this model will be an effective tool in teaching ocular ultrasonography to healthcare professionals due to the simplicity of the procedure and availability of cadavers in academic settings such as medical schools.</p></div><div><h3>Conclusion</h3><p>Ocular ultrasonography has been recognized as a reliable tool in the diagnosis of retinal detachments with improvement in overall prognosis. Large groups of healthcare professionals trained in ocular ultrasonography will mitigate permanent visual loss in underserved populations through expedited time to diagnosis.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Pages 445-446"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142088089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction of Diet and Pregnancy Outcomes in High-Income Countries","authors":"Daniel P Ashley MPA, BSc,&nbsp;Severine Navarro PhD, MSc, BSc","doi":"10.1016/j.jnma.2024.07.044","DOIUrl":"10.1016/j.jnma.2024.07.044","url":null,"abstract":"<div><h3>Introduction</h3><p>The Western diet – embodied by consumption of ultra-processed food, decreased nutritional content, and excessive caloric intake – has increased in First-World countries resulting in a higher prevalence of obesity and chronic inflammatory diseases. Evidence suggests that the onset of these immune-mediated diseases is strongly correlated with the early life microbiome, which is directly influenced by maternal diet and mode of delivery. This review covers the role of diet during preconception and pregnancy on delivery outcomes.</p></div><div><h3>Methods</h3><p>This narrative review reviewed and summarized 86 references from the existing literature, which demonstrate the association between maternal western dietary patterns and adverse pregnancy outcomes.</p></div><div><h3>Results</h3><p>Diet directly affects the gut microbiome and, in turn, plays an important role in maintaining metabolic homeostasis and health. Environmental stresses during the fetal stages of life can influence health throughout the life of an individual. Evidence suggests maternal fertility, weight gain, gestational diabetes, preeclampsia, and cesarean section rates may all be associated with maternal diet. Furthermore, maternal diet may influence organogenesis, gestational weight, preterm birth, offspring obesity, cardiometabolic disorders, allergies, and neurodevelopmental complications.</p></div><div><h3>Conclusion</h3><p>This data suggests that maternal diet composition is important to the healthy function of multiple systems involved in energy metabolism and fetal health. As the childhood period is sensitive to the programming effect of diet in pregnancy, future intervention studies should explore the role of dietary patterns in pregnancy on offspring growth, feeding behaviors, and cardiometabolic health. This evidence will help improve educational resources supporting the importance of maternal and infant nutrition.</p></div>","PeriodicalId":17369,"journal":{"name":"Journal of the National Medical Association","volume":"116 4","pages":"Page 430"},"PeriodicalIF":2.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}