Shorter pregnant women restrained in the rear seat of a car are at risk for serious neck injuries: Biomechanical analysis using a pregnant crash test dummy

Abstract Objectives Nutrition during pregnancy is a critical dimension not only for women’s heath, but also for the offspring’s lifelong health. Very limited national data exist on the usual dietary intakes of pregnant women. The objective of this study was to estimate total usual nutrient intakes (from foods and dietary supplements) of pregnant women in the U.S. Methods Cross-sectional analysis of a nationally-representative sample of pregnant U.S. women, ages 20-40 years (n = 1,003) from NHANES 2001-2014. Total usual dietary intakes were estimated using the National Cancer Institute (NCI) method to adjust 2, 24-hour dietary recalls for within-person variation. Adherence with the Dietary Reference Intakes were used to assess the proportion at risk of inadequacy by the Estimated Average Requirement (%< EAR), assumed to be adequate by the Adequate Intake (% >AI), and at risk of excess by the Tolerable Upper Intake Level (% >UL). Results About 70% of pregnant women use a dietary supplement. Less than 5% of pregnant women have usual diets that are at risk for inadequate intakes of riboflavin (3%), niacin (1%), vitamin B12 (1%), iron (2%), phosphorus (< 0.5%), and selenium (< 0.5%). More pregnant women have usual intakes < EAR for vitamins A (15%), B6 (11%), folate (16%), C (11%), D (46%), E (43%), and minerals including copper (5%), calcium (13%), magnesium (47%) and zinc (11%). Few pregnant females have usual intakes >AI for potassium (2%) and choline (8%), whereas only 48% have vitamin K intakes >AI. The majority of pregnant women (95%) exceed the UL for sodium, while folic acid (34%), iron (28%), calcium (3%), and zinc (7%) were also of concern for intakes >UL. Conclusions Many U.S. pregnant women ( >10% < EAR or < 10% >AI) do not consume enough of key nutrients during pregnancy specifically vitamins A, C, D, E, K, B6, folate, and choline and minerals including potassium, calcium, magnesium, and zinc, while almost all are at risk of excessive consumption of sodium, and many at risk of excessive consumption of folic acid and iron. Improved dietary guidance to help pregnant women meet and not exceed dietary recommendations is warranted. Funding Sources Nestle Nutrition.

Download Full-text

Automobile crash simulation with the first pregnant crash test dummy

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(96)80036-6 ◽

1996 ◽

Vol 175 (4) ◽

pp. 977-981 ◽

Cited By ~ 65

Author(s):

Mark D. Pearlman ◽

David Viano

Keyword(s):

Crash Test ◽

Crash Simulation ◽

Crash Test Dummy ◽

Automobile Crash

Download Full-text

On estimation of occupant safety in vehicular crashes into roadside obstacles using non-linear dynamic analysis

MATEC Web of Conferences ◽

10.1051/matecconf/201928500022 ◽

2019 ◽

Vol 285 ◽

pp. 00022

Author(s):

Krzysztof Wilde ◽

Arkadiusz Tilsen ◽

Stanisław Burzyński ◽

Wojciech Witkowski

Keyword(s):

Direct Method ◽

Passive Safety ◽

Crash Test ◽

European Standard ◽

Head Injury Criterion ◽

Linear Dynamic ◽

Passive Safety System ◽

Crash Test Dummy ◽

Safety Estimation ◽

Vehicular Crashes

The article describes a comparison of two general methods of occupants safety estimation based on a numerical examples. The so-called direct method is mainly based on the HIC (Head Injury Criterion) of a crash test dummy in a vehicle with passive safety system while the indirect method uses a European standard approach to estimate impact severity level.

Download Full-text

Maternal and Infant Death and the rVSV-ZEBOV Vaccine Through Three Recent Ebola Virus Epidemics-West Africa, DRC Équateur and DRC Kivu: 4 Years of Excluding Pregnant and Lactating Women and Their Infants from Immunization

Current Tropical Medicine Reports ◽

10.1007/s40475-019-00195-w ◽

2019 ◽

Vol 6 (4) ◽

pp. 213-222 ◽

Cited By ~ 9

Author(s):

David A. Schwartz

Keyword(s):

At Risk ◽

Clinical Trials ◽

West Africa ◽

Pregnant Women ◽

Ebola Virus ◽

Disease Outbreaks ◽

Case Fatality ◽

Viral Disease ◽

Lactating Women ◽

Health Communities

Abstract Purpose of Review Ebola virus infection has one of the highest overall case fatality rates of any viral disease. It has historically had an especially high case mortality rate among pregnant women and infants—greater than 90% for pregnant women in some outbreaks and close to 100 % in fetuses and newborns. The Merck recombinant vaccine against Ebola virus, termed rVSV-ZEBOV, underwent clinical trials during the 2013–2015 West Africa Ebola epidemic where it was found to be 100% efficacious. It was subsequently used during the 2018 DRC Équateur outbreak and in the 2018 DRC Kivu Ebola which is still ongoing, where its efficacy is 97.5 %. Pregnant and lactating women and their infants have previously been excluded from the design, clinical trials, and administration of many vaccines and drugs. This article critically examines the development of the rVSV-ZEBOV vaccine and its accessibility to pregnant and lactating women and infants as a life-saving form of prevention through three recent African Ebola epidemics—West Africa, DRC Équateur, and DRC Kivu. Recent Findings Pregnant and lactating women and their infants were excluded from participation in the clinical trials of rVSV-ZEBOV conducted during the West Africa epidemic. This policy of exclusion was continued with the occurrence of the DRC Équateur outbreak in 2018, in spite of calls from the public health and global maternal health communities to vaccinate this population. Following the onset of the DRC Kivu epidemic, the exclusion persisted. Eventually, the policy was reversed to include vaccination of pregnant and lactating women. However, it was not implemented until June 2019, 10 months after the start of the epidemic, placing hundreds of women and infants at risk for this highly fatal infection. Summary The historical policy of excluding pregnant and lactating women and infants from vaccine design, clinical trials, and implementation places them at risk, especially in situations of infectious disease outbreaks. In the future, all pregnant women, regardless of trimester, breastfeeding mothers, and infants, should have access to the Ebola vaccine.

Download Full-text

Plague and Pregnancy: Why Special Considerations Are Needed

Clinical Infectious Diseases ◽

10.1093/cid/ciz1232 ◽

2020 ◽

Vol 70 (Supplement_1) ◽

pp. S27-S29

Author(s):

Dana Meaney-Delman ◽

Nadia L Oussayef ◽

Margaret A Honein ◽

Christina A Nelson

Keyword(s):

Public Health ◽

United States ◽

At Risk ◽

Pregnant Women ◽

Yersinia Pestis ◽

The United States ◽

Highly Pathogenic ◽

Pathogenic Organism ◽

Public Health Emergencies ◽

Life Threatening

Abstract Pregnant women are an important at-risk population to consider during public health emergencies. These women, like nonpregnant adults, may be faced with the risk of acquiring life-threatening infections during outbreaks or bioterrorism (BT) events and, in some cases, can experience increased severity of infection and higher morbidity compared with nonpregnant adults. Yersinia pestis, the bacterium that causes plague, is a highly pathogenic organism. There are 4 million births annually in the United States, and thus the unique needs of pregnant women and their infants should be considered in pre-event planning for a plague outbreak or BT event.

Download Full-text