Deanna Nardella | Brown University (original) (raw)
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Papers by Deanna Nardella
The Yale journal of biology & medicine/Yale journal of biology and medicine, Mar 29, 2024
Pregnant individuals and infants in the US are experiencing rising morbidity and mortality rates.... more Pregnant individuals and infants in the US are experiencing rising morbidity and mortality rates. Breastfeeding is a cost-effective intervention associated with a lower risk of health conditions driving dyadic morbidity and mortality, including cardiometabolic disease and sudden infant death. Pregnant individuals and infants from racial/ethnic subgroups facing the highest risk of mortality also have the lowest breastfeeding rates, likely reflective of generational socioeconomic marginalization and its impact on health outcomes. Promoting breastfeeding among groups with the lowest rates could improve the health of dyads with the greatest health risk and facilitate more equitable, person-centered lactation outcomes. Multiple barriers to lactation initiation and duration exist for families who have been socioeconomically marginalized by health and public systems. These include the lack of paid parental leave, increased access to subsidized human milk substitutes, and reduced access to professional and lay breastfeeding expertise. Breast pumps have the potential to mitigate these barriers, making breastfeeding more accessible to all interested dyads. In 2012, The Patient Protection and Affordable Care Act (ACA) greatly expanded access to pumps through the preventative services mandate, with a single pump now available to most US families. Despite their near ubiquitous use among lactating individuals, little research has been conducted on how and when to use pumps appropriately to optimize breastfeeding outcomes. There is a timely and critical need for policy, scholarship, and education around pump use given their widespread provision and potential to promote equity for those families facing the greatest barriers to achieving their personal breastfeeding goals.
International breastfeeding journal - Electronic Edition -, May 26, 2024
Current Developments in Nutrition
American Journal of Perinatology, 2019
Objective Given the paucity of contemporary data examining glucose challenge test (GCT), threshol... more Objective Given the paucity of contemporary data examining glucose challenge test (GCT), thresholds for gestational diabetes (GDM) screening in obese and overweight women, we sought to compare the sensitivity and testing characteristics of different screen positive GCT cut-offs in women with a prepregnancy body mass index (BMI) ≥ 25 kg/m2. Study Design This is a retrospective cohort study of obese and overweight women with singleton pregnancies who underwent GCT between 24 and 296/7 weeks and had a value between 130 and 199 mg/dL necessitating a 3-hour glucose tolerance test (GTT). Exclusion criteria were pregestational diabetes mellitus, multigestation, use of diabetes medications, and bariatric surgery. Results Between August 2015 and January 2016, 19% (n = 496) of women with a BMI ≥ 25 kg/m2 required a GTT to test for GDM, 27.8% (n = 138) of whom were diagnosed with GDM. Mean age was 30 years, mean BMI = 31.6 kg/m2, and 30.4% were Hispanic. The 130 mg/dL threshold compared with 1...
Med, 2021
Summary Background Early microbiota perturbations are associated with disorders that involve immu... more Summary Background Early microbiota perturbations are associated with disorders that involve immunological underpinnings. Cesarean section (CS)-born babies show altered microbiota development in relation to babies born vaginally. Here we present the first statistically powered longitudinal study to determine the effect of restoring exposure to maternal vaginal fluids after CS birth. Methods Using 16S rRNA gene sequencing, we followed the microbial trajectories of multiple body sites in 177 babies over the first year of life; 98 were born vaginally, and 79 were born by CS, of whom 30 were swabbed with a maternal vaginal gauze right after birth. Findings Compositional tensor factorization analysis confirmed that microbiota trajectories of exposed CS-born babies aligned more closely with that of vaginally born babies. Interestingly, the majority of amplicon sequence variants from maternal vaginal microbiomes on the day of birth were shared with other maternal sites, in contrast to non-pregnant women from the Human Microbiome Project (HMP) study. Conclusions The results of this observational study prompt urgent randomized clinical trials to test whether microbial restoration reduces the increased disease risk associated with CS birth and the underlying mechanisms. It also provides evidence of the pluripotential nature of maternal vaginal fluids to provide pioneer bacterial colonizers for the newborn body sites. This is the first study showing long-term naturalization of the microbiota of CS-born infants by restoring microbial exposure at birth. Funding C&D, Emch Fund, CIFAR, Chilean CONICYT and SOCHIPE, Norwegian Institute of Public Health, Emerald Foundation, NIH, National Institute of Justice, Janssen.
Reproductive sciences (Thousand Oaks, Calif.), Jul 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.
Reproductive sciences (Thousand Oaks, Calif.), Jul 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.
Reproductive sciences (Thousand Oaks, Calif.), Jan 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.
The Yale journal of biology & medicine/Yale journal of biology and medicine, Mar 29, 2024
Pregnant individuals and infants in the US are experiencing rising morbidity and mortality rates.... more Pregnant individuals and infants in the US are experiencing rising morbidity and mortality rates. Breastfeeding is a cost-effective intervention associated with a lower risk of health conditions driving dyadic morbidity and mortality, including cardiometabolic disease and sudden infant death. Pregnant individuals and infants from racial/ethnic subgroups facing the highest risk of mortality also have the lowest breastfeeding rates, likely reflective of generational socioeconomic marginalization and its impact on health outcomes. Promoting breastfeeding among groups with the lowest rates could improve the health of dyads with the greatest health risk and facilitate more equitable, person-centered lactation outcomes. Multiple barriers to lactation initiation and duration exist for families who have been socioeconomically marginalized by health and public systems. These include the lack of paid parental leave, increased access to subsidized human milk substitutes, and reduced access to professional and lay breastfeeding expertise. Breast pumps have the potential to mitigate these barriers, making breastfeeding more accessible to all interested dyads. In 2012, The Patient Protection and Affordable Care Act (ACA) greatly expanded access to pumps through the preventative services mandate, with a single pump now available to most US families. Despite their near ubiquitous use among lactating individuals, little research has been conducted on how and when to use pumps appropriately to optimize breastfeeding outcomes. There is a timely and critical need for policy, scholarship, and education around pump use given their widespread provision and potential to promote equity for those families facing the greatest barriers to achieving their personal breastfeeding goals.
International breastfeeding journal - Electronic Edition -, May 26, 2024
Current Developments in Nutrition
American Journal of Perinatology, 2019
Objective Given the paucity of contemporary data examining glucose challenge test (GCT), threshol... more Objective Given the paucity of contemporary data examining glucose challenge test (GCT), thresholds for gestational diabetes (GDM) screening in obese and overweight women, we sought to compare the sensitivity and testing characteristics of different screen positive GCT cut-offs in women with a prepregnancy body mass index (BMI) ≥ 25 kg/m2. Study Design This is a retrospective cohort study of obese and overweight women with singleton pregnancies who underwent GCT between 24 and 296/7 weeks and had a value between 130 and 199 mg/dL necessitating a 3-hour glucose tolerance test (GTT). Exclusion criteria were pregestational diabetes mellitus, multigestation, use of diabetes medications, and bariatric surgery. Results Between August 2015 and January 2016, 19% (n = 496) of women with a BMI ≥ 25 kg/m2 required a GTT to test for GDM, 27.8% (n = 138) of whom were diagnosed with GDM. Mean age was 30 years, mean BMI = 31.6 kg/m2, and 30.4% were Hispanic. The 130 mg/dL threshold compared with 1...
Med, 2021
Summary Background Early microbiota perturbations are associated with disorders that involve immu... more Summary Background Early microbiota perturbations are associated with disorders that involve immunological underpinnings. Cesarean section (CS)-born babies show altered microbiota development in relation to babies born vaginally. Here we present the first statistically powered longitudinal study to determine the effect of restoring exposure to maternal vaginal fluids after CS birth. Methods Using 16S rRNA gene sequencing, we followed the microbial trajectories of multiple body sites in 177 babies over the first year of life; 98 were born vaginally, and 79 were born by CS, of whom 30 were swabbed with a maternal vaginal gauze right after birth. Findings Compositional tensor factorization analysis confirmed that microbiota trajectories of exposed CS-born babies aligned more closely with that of vaginally born babies. Interestingly, the majority of amplicon sequence variants from maternal vaginal microbiomes on the day of birth were shared with other maternal sites, in contrast to non-pregnant women from the Human Microbiome Project (HMP) study. Conclusions The results of this observational study prompt urgent randomized clinical trials to test whether microbial restoration reduces the increased disease risk associated with CS birth and the underlying mechanisms. It also provides evidence of the pluripotential nature of maternal vaginal fluids to provide pioneer bacterial colonizers for the newborn body sites. This is the first study showing long-term naturalization of the microbiota of CS-born infants by restoring microbial exposure at birth. Funding C&D, Emch Fund, CIFAR, Chilean CONICYT and SOCHIPE, Norwegian Institute of Public Health, Emerald Foundation, NIH, National Institute of Justice, Janssen.
Reproductive sciences (Thousand Oaks, Calif.), Jul 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.
Reproductive sciences (Thousand Oaks, Calif.), Jul 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.
Reproductive sciences (Thousand Oaks, Calif.), Jan 27, 2015
Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of... more Mammals have evolved to nourish their offspring exclusively with maternal milk for around half of the lactation period, a crucial developmental window. In view of oral-breast contact during lactation and the differences in oral microbiota between cesarean section (C-section) and vaginally delivered infants, we expected differences in milk composition by delivery mode. We performed a cross-sectional study of banked human milk and found changes related to time since delivery in bacterial abundance and glycosylation patterns only in milk from women who delivered vaginally. The results warrant further research into the effects of delivery mode on milk microbes, milk glycosylation, and postpartum infant development.