What helps or hinders midwives to implement physical activity guidelines for obese pregnant women? A questionnaire survey using the Theoretical Domains Framework.

PubMed

McParlin, Catherine; Bell, Ruth; Robson, Stephen C; Muirhead, Colin R; Araújo-Soares, Vera

2017-06-01

to investigate barriers and facilitators to physical activity (PA) guideline implementation for midwives when advising obese pregnant women. a cross-sectional, self-completion, anonymous questionnaire was designed using the Theoretical Domains Framework. this framework was developed to evaluate the implementation of guidelines by health care professionals. A total of 40 questions were included. These were informed by previous research on pregnant women's and midwives views, knowledge and attitudes to PA, and supported by national evidence based guidelines. Demographic information and free text comments were also collected. three diverse NHS Trusts in the North East of England. all midwives employed by two hospital Trusts and the community midwives from the third Trust (n=375) were invited to participate. mean domain scores were calculated. Factor and regression analysis were performed to describe which theoretical domains may be influencing practice. Free text comments were analysed thematically. 192 (53%) questionnaires were returned. Mean domain scores were highest for social professional role and knowledge, and lowest for skills, beliefs about capabilities and behaviour regulation. Regression analysis indicated that skills and memory/attention/decision domains had a statistically significant influence on midwives discussing PA with obese pregnant women and advising them accordingly. Midwives comments indicated that they felt it was part of their role to discuss PA with all pregnant women but felt they lacked the skills and resources to do so effectively. midwives seem to have the necessary knowledge about the need/importance of PA advice for obese women and believe it is part of their role, but perceive they lack necessary skills and resources, and do not plan or prioritise the discussion regarding PA with obese pregnant woman. designing interventions that improve skills, promote routine enquiry regarding PA and provide resources (eg. information, referral

A new threat to pregnant women's autonomy.

PubMed

Johnsen, D

1987-01-01

Courts and legislatures are increasingly being called upon to restrict the autonomy of pregnant women by requiring them to behave in ways that others determine are best for the fetuses they carry. The state should not attempt to transform pregnant women into ideal baby-making machines. Pregnant women make decisions about their behavior in the context of the rest of their lives, with all the attendant complexities and pressures. Our interest in helping future children by improving prenatal care would best be furthered by helping pregnant women to make informed, less constrained choices, not by punishing women or depriving them of choices altogether.

[Assessment of iodine nutritional status and thyroxine levels in pregnant women from different geographic areas of the Castile and Leon].

PubMed

González Mateo, M Carmen; Fernández Fernández, Marta; Valdazo Revenga, Vega; García Menéndez, Luis; Díez Hernández, Alberto; Rodríguez Rodríguez, Rosario

2011-10-01

Iodine nutritional status in pregnant women is important for neuronal development of the fetus, and may vary depending on the geographic area. Thyroid function and urinary iodine excretion were therefore assessed in pregnant women from three different provinces of a large Spanish autonomous community. A descriptive study was conducted in the three healthcare areas of Burgos, Avila, and Ponferrada on 1,200 women in the first trimester of pregnancy The study consisted of a survey and thyroid hormone and urinary iodine measurements. Use of iodized salt and iodine-containing pharmacological compounds was reported by 40% and 17% of pregnant women respectively. Median urinary iodine excretion in the total group was 121 mcg/L, with lower values in Burgos (117 mcg/L) and Ponferrada (118 mcg/L) and higher levels in Avila (130 mcg/L). Urinary iodine excretion was less than 100 mcg/L in 34% of women and was undetectable in 3.3%. Excretion levels lower than 150 mcg/L were found in 69.8% of women. Low thyroxine levels were detected in 1.1%, and thyrotropin levels were increased in 4.7%. Iodine deficiency currently exists in pregnant women from different areas of our large autonomous community. Consumption of iodized salt and iodine-containing pharmacological compounds is not widely established. It would be of great interest to conduct studies in other geographic areas and to advise an increased iodine intake in women who plan to become pregnant and in pregnant women from the very start of pregnancy. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

Pregnant women models analyzed for RF exposure and temperature increase in 3T RF shimmed birdcages.

PubMed

Murbach, Manuel; Neufeld, Esra; Samaras, Theodoros; Córcoles, Juan; Robb, Fraser J; Kainz, Wolfgang; Kuster, Niels

2017-05-01

MRI is increasingly used to scan pregnant patients. We investigated the effect of 3 Tesla (T) two-port radiofrequency (RF) shimming in anatomical pregnant women models. RF shimming improves B 1 + uniformity, but may at the same time significantly alter the induced current distribution and result in large changes in both the level and location of the absorbed RF energy. In this study, we evaluated the electrothermal exposure of pregnant women in the third, seventh, and ninth month of gestation at various imaging landmarks in RF body coils, including modes with RF shimming. Although RF shimmed configurations may lower the local RF exposure for the mother, they can increase the thermal load on the fetus. In worst-case configurations, whole-body exposure and local peak temperatures-up to 40.8°C-are equal in fetus and mother. Two-port RF shimming can significantly increase the fetal exposure in pregnant women, requiring further research to derive a very robust safety management. For the time being, restriction to the CP mode, which reduces fetal SAR exposure compared with linear-horizontal polarization modes, may be advisable. Results from this study do not support scanning pregnant patients above the normal operating mode. Magn Reson Med 77:2048-2056, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

A qualitative investigation of alcohol use advice during pregnancy: experiences of Dutch midwives, pregnant women and their partners.

PubMed

van der Wulp, Nickie Y; Hoving, Ciska; de Vries, Hein

2013-11-01

two studies aimed to explore the advice Dutch midwives give and the information Dutch pregnant women and partners of pregnant women receive about alcohol consumption in pregnancy. study 1 included individual semi-structured interviews with midwives. Study 2 involved focus groups and individual semi-structured interviews with pregnant women and partners. Interview content was based on the I-Change Model. study 1 was conducted nation-wide; Study 2 was conducted in the central and southern regions of the Netherlands. 10 midwives in Study 1; 25 pregnant women and nine partners in Study 2. study 1 showed that midwives intended to advise complete abstinence, although this advice was mostly given when women indicated to consume alcohol. Midwives reported to lack good screening skills and sufficient knowledge about the mechanisms and consequences of antenatal alcohol use and did not involve partners in their alcohol advice. In Study 2, the views of pregnant women and partners were congruent to the findings reported in Study 1. In addition, pregnant women and partners considered midwives as an important source of information on alcohol in pregnancy. Partners were interested in the subject, had a liberal view on antenatal alcohol use and felt ignored by midwives and websites. Pregnant women indicated to receive conflicting alcohol advice from their health professionals. midwives' alcohol advice requires improvement with regard to screening, knowledge about mechanisms and consequences of antenatal alcohol use and the involvement of the partners in alcohol advice during pregnancy. training should be given to Dutch midwives to increase their screening skills and their alcohol related knowledge to pregnant women. Research is needed to determine how the midwife's alcohol advice to the partner should be framed in order to optimise the partner's involvement concerning alcohol abstinence in pregnancy. More attention to the topic at a national level, for example via mass media

Depression in perinatally HIV-infected pregnant women compared to non-perinatally HIV-infected and HIV-uninfected pregnant women.

PubMed

Angrand, Ruth C; Sperling, Rhoda; Roccobono, Kinga; Osborne, Lauren M; Jao, Jennifer

2018-05-18

"Depression (as noted in chart by a physician)" was compared between HIV infected pregnant women and controls. Perinatally HIV-infected (PHIV), non-perinatally HIV-infected (NPHIV), and HIV-uninfected (HIV-U) pregnant women were all compared using a logistic regression model. Overall, HIV-infected women had higher rates of depression than HIV-U, with PHIV women demonstrating a clinically and statistically significant increased risk compared to HIV-U women [adjusted OR: 15.9, 95% CI = 1.8-143.8]. Future studies in larger populations are warranted to confirm these findings and further elucidate mental health outcomes of PHIV and NPHIV pregnant women.

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

PubMed Central

2014-01-01

Background This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. Results A retrospective case–control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. Conclusion We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the

Research with pregnant women: a call to action.

PubMed

Little, Margaret Olivia; Wickremsinhe, Marisha N

2017-12-14

Despite a global need for the use of medication during pregnancy, the medical research community lacks robust evidence for safety and efficacy of treatments and preventives often taken by pregnant women. Given the biological differences between pregnant women and the rest of the population, the need to gather data on the ways in which medications behave in the pregnant body is critical to the health of pregnant women and their offspring. Three ethical reasons are central to this need: 1. Pregnant women deserve access to effective treatment, 2. Pregnant women deserve access to safe treatment, and 3. Pregnant women deserve equitable access to trials carrying the prospect of direct benefit. In this paper, we introduce and frame this Supplement Issue, which presents important conference proceedings of the 2016 Global Forum on Bioethics in Research meeting held in Buenos Aires, Argentina, on the 3rd and 4th of November.

Pregnant Enlisted Women in Navy Work Centers

DTIC Science & Technology

1991-03-01

effect of pregnancy on the workplace . Data were collected from pregnant enlisted women receiving medical care at San Diego and Tidewater area Navy...14 12. Effect of Pregnancy-related Events on the Workplace as Perceived by Pregnant Women (W) and Their Supervisors (S...detailed the following limitations for pregnant women in the workplace : women assigned to ships must be put ashore by the 20th week of pregnancy

Comparison of rocuronium-induced neuromuscular blockade in second trimester pregnant women and non-pregnant women.

PubMed

Jun, I J; Jun, J; Kim, E M; Lee, K Y; Kim, N; Chung, M H; Choi, Y R; Choi, E M

2018-05-01

This study set out to compare the onset and duration of rocuronium-induced neuromuscular blockade in second trimester pregnant women and non-pregnant women receiving general anesthesia. Forty-seven pregnant (Group P) and forty-seven non-pregnant (Group C) women were enrolled. Anesthesia was induced with propofol 2.0 mg/kg and rocuronium 0.6 mg/kg, and neuromuscular blockade was assessed with an accelerometric sensor using train-of-four stimulation (TOF-Watch® SX). Tracheal intubation was performed at maximum depression of the first twitch (T1) and anesthesia was maintained with sevoflurane 1.5-2.5% and 50% oxygen in air. We recorded the times to maximum T1 depression and 5% and 25% T1 recovery, as well as the mean arterial pressure and heart rate at baseline, injection of rocuronium, intubation, and 5% and 25% T1 recovery. The onset of rocuronium-induced neuromuscular blockade (time to maximum T1 depression) did not differ significantly between the groups. The duration (time to 25% T1 recovery) was significantly longer in Group P than in Group C (45.7 ± 12.9 min vs 40.6 ± 10.4 min, P <0.037). During the recovery period from the blockade, the mean arterial pressure was significantly lower in Group P than in Group C. Our data showed that the rocuronium-induced neuromuscular blockade did not significantly differ in onset but lasted significantly longer in second trimester pregnant women compared with non-pregnant women. Copyright © 2018 Elsevier Ltd. All rights reserved.

Tobacco cessation intervention for pregnant women in Argentina and Uruguay: study protocol

PubMed Central

2013-01-01

Background Argentina and Uruguay are among the countries with the highest proportion of pregnant women who smoke. The implementation of an effective smoking cessation intervention would have a significant impact on the health of mothers and infants. The “5 A’s” (Ask, Advise, Assess, Assist, Arrange) is a strategy consisting of a brief cessation counseling session of 5–15 minutes delivered by a trained provider. The “5 A’s” is considered the standard of care worldwide; however, it is under used in Argentina and Uruguay. Methods We will conduct a two-arm, parallel cluster randomized controlled trial of an implementation intervention in 20 prenatal care settings in Argentina and Uruguay. Prenatal care settings will be randomly allocated to either an intervention or a control group after a baseline data collection period. Midwives’ facilitators in the 10 intervention prenatal clinics (clusters) will be identified and trained to deliver the “5 A’s” to pregnant women and will then disseminate and implement the program. The 10 clusters in the control group will continue with their standard in-service activities. The intervention will be tailored by formative research to be readily applicable to local prenatal care services at maternity hospitals and acceptable to local pregnant women and health providers. Our primary hypothesis is that the intervention is feasible in prenatal clinics in Argentina and Uruguay and will increase the frequency of women receiving tobacco use cessation counseling during pregnancy in the intervention clinics compared to the control clinics. Our secondary hypotheses are that the intervention will decrease the frequency of women who smoke by the end of pregnancy, and that the intervention will increase the attitudes and readiness of midwives towards providing counseling to women in the intervention clinics compared to the control clinics. Trial registration ClinicalTrials.gov. Identifier: NCT01852617 PMID:23971512

[Eating habits of pregnant and non-pregnant women: are there differences?].

PubMed

Gomes, Caroline de Barros; Malta, Maíra Barreto; Martiniano, Ana Carolina de Almeida; Di Bonifácio, Luiza Pereira; Carvalhaes, Maria Antonieta de Barros Leite

2015-07-01

To determine the eating behavior of pregnant women assisted by primary health care and to compare it with women at childbearing age in Brazilian capitals. A cross-sectional study conducted on 256 pregnant women in the second trimester of gestation, selected by drawing lots from those assisted by primary health care units of a municipality in the state of São Paulo in 2009/2010. Eating habits were investigated via a questionnaire adapted from the VIGITEL system, consisting of questions about eating habits in general and the frequency and consumption characteristics of food groups/specific foods. For tis comparison, we used the indicators reported by the VIGITEL system for women at childbearing age in Brazilian capitals in 2010. The analyses involved the presentation of frequency distribution and descriptive statistics with comparisons according to the age group. Most patients had breakfast every day (86.7%) and 45.7% habitually exchanged a main meal for a snack once or twice a week. A daily consumption of fruit, raw salad and vegetables was not reported by 48.8%, 41.8% and 55.1% of the women, respectively. Fish was reported to never or almost never be consumed by 64.4% of the pregnant women. At least once a week, 69.9% of them reported the consumption of soda, and 86.4% of wafers/cookies. The comparison between the pregnant women and women at childbearing age in capitals showed a close similar prevalence of overweight, and no difference in the regular consumption of fruit and vegetables. Meat containing excess of fat and whole milk were more consumed by pregnant women, with differences reported in all the age groups analyzed. On the other hand, the pregnant women reported a less regular intake of soft drinks. The actions that need to be performed in prenatal care are various and very important, promoting the consumption of specific foods and providing guidelines about eating behavior, while reinforcing healthy eating habits already present.

Dental caries and gingivitis among pregnant and non-pregnant women in Chiang Mai, Thailand.

PubMed

Rakchanok, Noochpoung; Amporn, Dejpitak; Yoshida, Yoshitoku; Harun-Or-Rashid, Md; Sakamoto, Junichi

2010-02-01

The aims of this study were to identify dental caries and gingivitis among pregnant women, and to compare it with those in non-pregnant women in Chiang Mai, Thailand. Data were collected from 197 women (94 pregnant and 103 non-pregnant) from June to August, 2008. Dental caries and gingivitis was defined clinically according to the World Health Organization (WHO) diagnostic criteria. Over 74.0% of pregnant women had caries, and 86.2% had gingivitis. There were significant differences between pregnant and non-pregnant women with regard to dental caries (p < 0.001) and gingivitis (p = 0.021). The pregnant women were 2.9 times more likely to suffer from dental caries (95% confidence intervals (CI), 1.6-5.4), and 2.2 times more (95% CI, 1.1-4.7) from gingivitis compared to non-pregnant women. Farmers (Odd ratio (OR), 7.0; 95% CI, 1.8-26.3), high school graduation (OR, 3.0; 95% CI, 1.2-7.3), and universal health insurance coverage (OR, 2.1; 95% CI, 1.0-4.3) were significant predictors for gingivitis. Only high school graduates were found to be significant predictors of dental caries with an OR of 2.8 (95% CI, 1.2-6.3). Poor oral hygiene (OR, 2.2; 95% CI, 0.8-6.5), lack of knowledge (OR, 2.0; 95% CI, 0.6-6.3), and poor oral hygiene habits (OR, 3.0; 95% CI, 1.1-8.6) were important risk factors for dental caries. Similarly, inadequate oral hygiene status (OR, 24.8; 95% CI, 5.5-112.2), and poor oral health habits (OR, 5.2; 95% CI, 1.1-25.2) were found to be significant risk factors for gingivitis among pregnant women indicating, that most women should be trained in proper oral hygiene practices. Community awareness programs should be conducted to increase women's awareness of such hygienic practices.

Demographic and substance abuse trends among pregnant and non-pregnant women: eleven years of treatment admission data.

PubMed

McCabe, Jennifer E; Arndt, Stephan

2012-11-01

The objective of this study was to identify demographic and substance abuse trends among pregnant women entering treatment over eleven years. This study compiled the publicly available Treatment Episode Datasets from the Substance Abuse Mental Health Services Administration from 1998 to 2008. Subjects included 1,724,479 women entering publicly funded substance abuse treatment for the first time, 81,818 of whom were pregnant. Compared to non-pregnant women, pregnant women were more likely to be younger, minority, never married, less educated, homeless, and on public-assistance or have no income. Referrals from health care providers (HCPs) among pregnant women entering treatment have stayed consistently low while referrals from the criminal justice system accounted for the largest portion of pregnant women entering treatment. Over the past eleven years, there has been a general decline in alcohol abuse and an increase in drug abuse among women entering treatment; this trend was more pronounced in pregnant women. Unlike their non-pregnant counterparts, pregnant women were more likely to report marijuana, not alcohol, as their primary problem substance as well as other drugs like methamphetamine and cocaine. Over the past eleven years, trends in the demographics and patterns of substance abuse among women have changed; some of these trends were unique to pregnant women. A large proportion of pregnant women entering treatment are referred by the criminal justice system. Knowledge surrounding the demographics and abuse patterns of pregnant women entering treatment can inform HCPs and community programs in their screening and outreach efforts.

Pharmacokinetics of Doxorubicin in Pregnant Women

PubMed Central

Ryu, Rachel J.; Eyal, Sara; Kaplan, Henry G.; Akbarzadeh, Arezoo; Hays, Karen; Puhl, Kristin; Easterling, Thomas R.; Berg, Stacey L.; Scorsone, Kathleen A.; Feldman, Eric M.; Umans, Jason G.; Miodovnik, Menachem; Hebert, Mary F.

2014-01-01

Purpose Our objective was to evaluate the pharmacokinetics (PK) of doxorubicin during pregnancy compared to previously published data from non-pregnant subjects. Methods During mid- to late-pregnancy, serial blood and urine samples were collected over 72 hours from 7 women treated with doxorubicin for malignancies. PK parameters were estimated using noncompartmental techniques. Pregnancy parameters were compared to those previously reported non-pregnant subjects. Results During pregnancy, mean (± SD) doxorubicin PK parameters utilizing 72 hour sampling were: clearance (CL), 412 ± 80 mL/min/m2; steady-state volume of distribution (Vss), 1132 ± 476 L/m2; and terminal half-life (T1/2), 40.3 ± 8.9 hr. The BSA-adjusted CL was significantly decreased (p < 0.01) and T1/2 was not different compared to non-pregnant women. Truncating our data to 48 hours, PK parameters were: CL, 499 ± 116 ml/min/m2; Vss, 843 ± 391 L/m2; and T1/2, 24.8 ± 5.9 hr. The BSA-adjusted CL in pregnancy compared to non-pregnant data was significantly decreased in 2 of 3 non-pregnant studies (p < 0.05, < 0.05, NS). Vss and T1/2 were not significantly different. Conclusions In pregnant subjects, we observed significantly lower doxorubicin CL in our 72 hour and most of our 48 hour sampling comparisons with previously reported non-pregnant subjects. However, the parameters were within the range previously reported in smaller studies. At this time, we cannot recommend alternate dosage strategies for pregnant women. Further research is needed to understand the mechanism of doxorubicin pharmacokinetic changes during pregnancy and optimize care for pregnant women. PMID:24531558

Online Medicine for Pregnant Women

PubMed Central

Davidesko, Sharon; Segal, David

2014-01-01

Objective. To assess the use of cell phones and email as means of communication between pregnant women and their gynecologists and family physicians. Study Design. A cross-sectional study of pregnant women at routine followup. One hundred and twenty women participated in the study. Results. The mean age was 27.4 ± 3.4 years. One hundred nineteen women owned a cell phone and 114 (95%) had an email address. Seventy-two women (60%) had their gynecologist's cell phone number and 50 women (42%) had their family physician's cell phone number. More women contacted their gynecologist via cell phone or email during pregnancy compared to their family physician (P = 0.005 and 0.009, resp.). Most preferred to communicate with their physician via cell phone at predetermined times, but by email at any time during the day (P < 0.0001). They would use cell phones for emergencies or unusual problems but preferred email for other matters (P < 0.0001). Conclusions. Pregnant women in the Negev region do not have a preference between the use of cell phones or email for medical consultation with their gynecologist or family physician. The provision of the physician's cell phone numbers or email address together with the provision of guidelines and resources could improve healthcare services. PMID:25132848

Online medicine for pregnant women.

PubMed

Davidesko, Sharon; Segal, David; Peleg, Roni

2014-01-01

Objective. To assess the use of cell phones and email as means of communication between pregnant women and their gynecologists and family physicians. Study Design. A cross-sectional study of pregnant women at routine followup. One hundred and twenty women participated in the study. Results. The mean age was 27.4 ± 3.4 years. One hundred nineteen women owned a cell phone and 114 (95%) had an email address. Seventy-two women (60%) had their gynecologist's cell phone number and 50 women (42%) had their family physician's cell phone number. More women contacted their gynecologist via cell phone or email during pregnancy compared to their family physician (P = 0.005 and 0.009, resp.). Most preferred to communicate with their physician via cell phone at predetermined times, but by email at any time during the day (P < 0.0001). They would use cell phones for emergencies or unusual problems but preferred email for other matters (P < 0.0001). Conclusions. Pregnant women in the Negev region do not have a preference between the use of cell phones or email for medical consultation with their gynecologist or family physician. The provision of the physician's cell phone numbers or email address together with the provision of guidelines and resources could improve healthcare services.

Treatment of sexually transmitted bacterial diseases in pregnant women.

PubMed

Donders, G G

2000-03-01

twice daily for 7 days as earlier fears of teratogenesis in humans have not been confirmed by recent data. Bacterial vaginosis is also associated with preterm delivery in certain risk groups, such as women with a history of preterm birth or of low maternal weight. Such an association is yet to be convincingly proven in other women. The current advice is to treat only women diagnosed with bacterial vaginosis who also present other risk factors for preterm delivery. The treatment of choice is oral metronidazole 1 g/day for 5 days. The possible reduction of preterm birth by vaginally applied metronidazole or clindamycin is still under investigation. In general, both test of cure and re-testing after several weeks are advisable in most pregnant patients with STDs, because partner notification and treatment are likely to be less efficient than outside pregnancy and the impact of inadequately treated or recurrent disease is greater because of the added risk to the fetus. Every diagnosis of an STD warrants a full screen for concomitant genital disease. Most ulcerative genital infections, as well as abnormal vaginal flora and bacterial vaginosis, increase the sexual transmission efficiency of HIV, necessitating even more stringent screening for and treating of STD during pregnancy.

Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women

PubMed Central

2011-01-01

Background Overweight and obesity during pregnancy raise the risk of gestational diabetes and birth complications. Lifestyle factors like physical activity may decrease these risks through beneficial effects on glucose homeostasis. Here we examined physical activity patterns and their relationships with measures of glucose homeostasis in late pregnancy compared to non-pregnant women. Methods Normal weight and overweight women without diabetes (N = 108; aged 25-35 years) were studied; 35 were pregnant (in gestational weeks 28-32) and 73 were non-pregnant. Insulin sensitivity and β-cell response were estimated from an oral glucose tolerance test. Physical activity was measured during 10-days of free-living using a combined heart rate sensor and accelerometer. Total (TEE), resting (REE), and physical activity (PAEE) energy expenditure were measured using doubly-labeled water and expired gas indirect calorimetry. Results Total activity was associated with reduced first-phase insulin response in both pregnant (Regression r2 = 0.11; Spearman r = -0.47; p = 0.007) and non-pregnant women (Regression r2 = 0.11 Spearman; r = -0.36; p = 0.002). Relative to non-pregnant women, pregnant women were estimated to have secreted 67% more insulin and had 10% lower fasting glucose than non-pregnant women. Pregnant women spent 13% more time sedentary, 71% less time in moderate-to-vigorous intensity activity, had 44% lower objectively measured total activity, and 12% lower PAEE than non-pregnant women. Correlations did not differ significantly for any comparison between physical activity subcomponents and measures of insulin sensitivity or secretion. Conclusions Our findings suggest that physical activity conveys similar benefits on glucose homeostasis in pregnant and non-pregnant women, despite differences in subcomponents of physical activity. PMID:21679399

Plasminogen activator activity in tears of pregnant women.

PubMed

Csutak, Adrienne; Steiber, Zita; Tőzsér, József; Jakab, Attila; Berta, András; Silver, David M

2017-01-01

Plasminogen activator activity (PAA) in tears of pregnant women was investigated at various gestation times to assess the availability of plasminogen activator for aiding potential corneal wound healing processes during pregnancy. PAA was measured by a spectrophotometric method. The analysis used 91 tear samples from pregnant and non-pregnant women, supplemented with 10 additional tear PAA measurements from non-pregnant women obtained in a previous study. Tear levels of PAA in pregnant women formed a bimodal distribution. Either the tear PAA level was zero or non-zero during pregnancy. When non-zero, the tear PAA level was dissociated from gestation time and not different than non-pregnant and post-pregnant levels. The frequency of occurrence of zero level tear PAA increased with gestation: 16%, 17% and 46% had zero tear PAA in samples taken from women in the first, second and third trimester, respectively. Overall, of the tear samples taken from women during pregnancy, a total of 26% were at zero tear PAA. The remaining tear samples had non-zero tear PAA values throughout gestation equivalent to non-pregnant tear PAA values, suggesting local control of the source of PAA in tears. Given the importance of the plasminogen activator system in tears to wound healing in the cornea, and the high occurrence of zero tear PAA in our sample of pregnant women, elective corneal surgery would be contraindicated. If corneal surgery is nevertheless necessary, the tear PAA level would be worth checking and patients with low level should be closely observed during the postoperative period.

Alcohol consumption among pregnant women in Northern Tanzania 2000-2010: a registry-based study.

PubMed

Isaksen, Alexander Blaauw; Østbye, Truls; Mmbaga, Blandina Theophil; Daltveit, Anne Kjersti

2015-09-03

intake and favourable perinatal outcomes remained significant after maternal factors were adjusted for. Information on diet, lifestyle factors and maternal health might give further insight into this unexpected observation. The proportion of pregnant women consuming alcohol in Northern Tanzania is high, and greater awareness of health outcomes associated with alcohol consumption is advised.

[The vitamin status of pregnant women in Moscow: effect of multivitamin-mineral supplements].

PubMed

Beketova, N A; Sokolnikov, A A; Kodentsova, V M; Pereverzeva, O G; Vrzhesinskaya, O A; Kosheleva, O V; Gmoshinskaya, M V

2016-01-01

Examination of the vitamin status of 102 pregnant women (19-41 years old) from Moscow (gestational age 6-38 weeks) in winter and spring 2015 has been conducted. The lack of vitamin B2 (blood serum level of riboflavin <5 ng/ml), D (25(OH)D level <30 ng/ml) and β-carotene (<20 mg/dL) occurred in 49-66% of pregnant women. The percentage of persons with reduced serum levels of vitamin B6 (<4.8 mg/l), folic acid (<3 mg/l), vitamin A (<30 mg/dL), and E (<0.8 mg/dl) was insignificant and amounted 6-8%. All of the women had an adequate supply with vitamins C (>0.4 mg/dL) and B12 (>150 ng/L). The frequency of the combined deficiency of two vitamins was 29%, of three vitamins - 21%, four - 10%, five - 5%. Only 8% of women were sufficiently supplied with all 8 studied vitamins and β-carotene. A positive correlation (p<0.001) between the concentration of vitamin E and gestation term occurred. β-Carotene blood serum level raised with increasing gestation term in women receiving multivitamin-mineral supplements (VMS) and directly correlated (p<0.05) with vitamin E serum level. In 63 women who were not taking VMS, blood serum level of vitamins A, D, C, B2, B6, B12, folic acid and β-carotene was lower, and the frequency of inadequate supply, on the contrary, was significantly higher, compared to 39 women receiving VMS. Blood serum concentration of vitamins C, A, D, B6 and folic acid in women who were not taking VMS was significantly reduced (p<0.05) with increasing gestation term, whereas in women consuming VMS vitamin blood serum level was maintained at a constant level. The data obtained demonstrate advisability of VMS intake during pregnancy to maintain vitamin status of pregnant women at a satisfactory level and to reduce the risk of birth defects in infants.

Breastfeeding knowledge among working pregnant women in Turkey.

PubMed

Karanci, Gülsah; Yenal, Kerziban

2014-04-01

The purpose of this study was to examine the breastfeeding knowledge of pregnant working women and explore factors that affected their knowledge. This Turkish study included 260 healthy, working women in the last trimester of pregnancy. Two separate questionnaires developed by the researcher were used to collect data. The average knowledge score of pregnant women respondents for all questions were 6.03 ± 2.99 (range: 0 to 14). Pregnant women had the least knowledge about duration of expressing breast milk (21.9%) and safe storage conditions for breast milk (27.2%). They knew the most about methods to express breast milk (87.3%) and features of containers used to store expressed milk (80%). Study results indicated that working pregnant women need better prenatal education to continue safe breastfeeding after returning to work. Occupational health nurses should inform working pregnant women about expression and storage of breast milk during prenatal education. Copyright 2014, SLACK Incorporated.

45 CFR 46.204 - Research involving pregnant women or fetuses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Research involving pregnant women or fetuses. 46... PROTECTION OF HUMAN SUBJECTS Additional Protections for Pregnant Women, Human Fetuses and Neonates Involved in Research § 46.204 Research involving pregnant women or fetuses. Pregnant women or fetuses may be...

45 CFR 46.204 - Research involving pregnant women or fetuses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Research involving pregnant women or fetuses. 46... PROTECTION OF HUMAN SUBJECTS Additional Protections for Pregnant Women, Human Fetuses and Neonates Involved in Research § 46.204 Research involving pregnant women or fetuses. Pregnant women or fetuses may be...

45 CFR 46.204 - Research involving pregnant women or fetuses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Research involving pregnant women or fetuses. 46... PROTECTION OF HUMAN SUBJECTS Additional Protections for Pregnant Women, Human Fetuses and Neonates Involved in Research § 46.204 Research involving pregnant women or fetuses. Pregnant women or fetuses may be...

45 CFR 46.204 - Research involving pregnant women or fetuses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Research involving pregnant women or fetuses. 46... PROTECTION OF HUMAN SUBJECTS Additional Protections for Pregnant Women, Human Fetuses and Neonates Involved in Research § 46.204 Research involving pregnant women or fetuses. Pregnant women or fetuses may be...

45 CFR 46.204 - Research involving pregnant women or fetuses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Research involving pregnant women or fetuses. 46... PROTECTION OF HUMAN SUBJECTS Additional Protections for Pregnant Women, Human Fetuses and Neonates Involved in Research § 46.204 Research involving pregnant women or fetuses. Pregnant women or fetuses may be...

Characteristics of pregnant women in motor vehicle crashes

PubMed Central

Weiss, H; Strotmeyer, S

2002-01-01

Objectives: Motor vehicle crashes are the leading cause of hospitalized trauma during pregnancy. Maternal injury puts the fetus at great risk, yet little is known about the incidence, risks, and characteristics of pregnant women in crashes. Setting and methods: Police reported crashes were analyzed from the National Automotive Sampling System Crashworthiness Data System. Since 1995, this system recorded pregnancy/trimester status. Pregnant and non-pregnant women 15–39 years of age were compared by age, driver status, seat belt use, and treatment. Belt use and seating position were examined by trimester. Results: There were 427 pregnant occupants identified (weighted n=32 810, 2.6%, SE 12 585, rate 13/1000 person years). The mean age was 24.9 compared with 24.8 years (pregnant v non-pregnant). Cases were distributed by trimester as follows: first 29.8%, second 36.4%, and third 33.8%. Pregnant women were drivers 70% of the time compared with 71% for non-pregnant women. No belt use was 14% compared with 13% (pregnant v non-pregnant). Mean injury severity was lower for pregnant women but they were more likely to transported or hospitalized. Improper belt use decreased after the first trimester and there was little change in driver proportion by trimester. Third trimester hospitalization rates increased. Conclusions: Pregnant occupants in crashes have similar profiles of restraint use, driver status, and seat position but different treatment indicators compared to non-pregnant occupants. Trimester status has relatively little impact on crash risk, seating position or restraint use. Undercounting of pregnant cases was possible, even so, 1% of all births were reported to be involved in utero in crashes. Little research has focused on developmental outcomes to infants and children previously involved in exposure to these crashes. PMID:12226117

Racial Discrimination and Psychological Wellbeing of Pregnant Women.

PubMed

Giurgescu, Carmen; Zenk, Shannon N; Engeland, Christopher G; Garfield, Lindsey; Templin, Thomas N

African American women are more likely to be exposed to racial discrimination and to experience psychological distress compared with white women. Although studies have shown that social support is positively related to psychological wellbeing, little is known about the potential buffering effect of social support on the relationship between racial discrimination and psychological wellbeing of pregnant women. The purpose of this study was to determine if social support moderates effects of racial discrimination on psychological wellbeing among pregnant African American women. Using a cross-sectional design, 107 African American women between 15 and 26 weeks gestation from an urban university-based midwifery practice completed questionnaires. Women who reported more experiences of racial discrimination also reported lower levels of social support and psychological wellbeing (p <.05). Maternal child nurses should be aware that experiences of racial discrimination have negative effects on psychological wellbeing of pregnant African American women regardless of their levels of social support. However, social support can reduce psychological distress and improve wellbeing of pregnant women. Therefore, nurses need to provide pregnant women with positive and supportive experiences that may improve their psychological wellbeing.

Environmental odor intolerance in pregnant women.

PubMed

Nordin, Steven; Broman, Daniel A; Wulff, Marianne

2005-02-15

Previous findings indicating that pregnant women experience a shift in odor sensitivity and hedonics raise the question of whether these changes evoke adverse reactions to odorous and pungent environmental substances in daily activities, to a larger extent in pregnant than in nonpregnant women. Forty-four women in pregnancy weeks 21-23 and 44 nonpregnant women were therefore compared with respect to affective reactions to and behavioral disruptions by odorous/pungent daily environments by means of the questionnaire-based, 21-item Chemical Sensitivity Scale (CSS). This scale refers to neurasthenic and sensory/somatic symptoms and includes the 11 items of the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR). This latter scale refers predominantly to sensory/somatic symptoms. To investigate whether there is a general environmental hypersensitivity during pregnancy, the Noise Sensitivity Scale (NSS) was used that is analogous to the CSS (including 11 NSS items corresponding to those of the CSS-SHR; "NSS-SHR"). Results show that the two groups were similar with respect to scores on both the CSS and NSS, whereas the pregnant women had higher scores than the nonpregnant women on the CSS-SHR, but not on the "NSS-SHR". These results suggest that pregnant women to a larger extent than nonpregnant women manifest an odor intolerance that affects their daily activities, with predominantly sensory/somatic symptoms, which appears not to be due to a general environmental hypersensitivity. This behavior may have embryo- and maternal-protective functions.

Kurdish pregnant women's feelings: a qualitative study.

PubMed

Shahoei, Roonak; Riji, Haliza Mohd; Saeedi, Zhila Abed

2011-04-01

to gain a deeper understanding of how Kurdish pregnant women feel about their pregnancy. a qualitative study analysed by a grounded theory approach. the study was conducted among women in the third trimester of their pregnancy in either their homes or the health-care centres in Sanandaj in the western part of Iran. 22 pregnant women were recruited and interviewed. during pregnancy, women experienced a variety of feelings: 'satisfied and happy', 'unpleasant' and 'ambivalent'. it is important for midwives to ask pregnant women about their feelings concerning their current pregnancy, childbirth and future motherhood. If they express negative or ambivalent feelings, these should be discussed in greater detail and their causes identified. Special consideration should be given to primiparous women and multiparous women with negative experiences of previous pregnancies. Copyright © 2009 Elsevier Ltd. All rights reserved.

Toxoplasmosis in pregnant Sudanese women.

PubMed

Elnahas, Amir; Gerais, Abd S; Elbashir, Mustafa I; Eldien, Eltoum S; Adam, Ishag

2003-08-01

The aim of this study was to conduct a sero-epidemiological survey of toxoplasmosis in pregnant Sudanese women. Four hundred and eighty-seven pregnant women attending antenatal clinics in Khartoum and Omdurman, Maternity Hospitals, Sudan during the period June through to December 2000 were counselled for socio-demographic and obstetrical risk factors for toxoplasmosis, and screened for immunoglobin G (IgG) and IgM anti-toxoplasma antibodies using enzyme linked immunoassay. Immunoglobin G anti-toxoplasma antibodies were positive (titre > 11 IU/ml) in 166/487 (34.1%), while 321/487(65.9%) were sero-negative. The sera of 35 women showed very high titres (>100 IU/ml), 5/35 (14.3%) were IgM-positive. The risk factors for IgG anti-toxoplasma seropositivity were; Southern ethnic origin and consumption of raw meat. Thirty (18.1%) out of 166 women who were IgG anti-toxoplasma seropositive gave history of intrauterine fetal death, while 31 (9.7%) out of 321 women who were sero-negative gave history of intrauterine fetal death, the difference was statistically significant (P < 0.05). Over 65% Sudanese women screened for anti-toxoplasma IgG antibodies were sero-negative and they were at risk of sero-conversion during pregnancy. Southers and eating raw meat were the risk factors for toxoplasmosis in Sudanese pregnant women.

[Frequency of atypical squamous cells of undetermined significance (ASCUS) for pregnant and non-pregnant women].

PubMed

Dufloth, Rozany Mucha; Vieira, Luiz Fernando Fonseca; Xavier Júnior, José Candido Caldeira; Vale, Diama Bhadra; Zeferino, Luiz Carlos

2015-05-01

To compare the frequency of an ASCUS Pap Smear result in pregnant and non-pregnant women, stratified by age group. We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed between 2000 and 2009 (ten years) with the purpose of screening for cervical carcinoma. Comparisons were made between pregnant and non-pregnant women, and the sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The χ2 test was used and the magnitude of association was determined by the by Odds Ratio (OR) with the 95% confidence interval (95%CI). A Total of 447,489 samples were excluded on the basis of the criteria adopted, for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women. An ASCUS result was detected in 1.2% of cases, with a significant difference between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85; 95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03). This study suggested that non-pregnant women have a higher frequency of ASCUS, most evident in the age group of 20 to 29 years. The collection of cervical cancer screening should not be a compulsory part of the prenatal routine.

Clinical malaria in African pregnant women.

PubMed

Bardají, Azucena; Sigauque, Betuel; Bruni, Laia; Romagosa, Cleofé; Sanz, Sergi; Mabunda, Samuel; Mandomando, Inacio; Aponte, John; Sevene, Esperança; Alonso, Pedro L; Menéndez, Clara

2008-01-30

There is a widespread notion, based on limited information, that in areas of stable malaria transmission most pregnant women with Plasmodium falciparum infection are asymptomatic. This study aim to characterize the clinical presentation of malaria in African pregnant women and to evaluate the adequacy of case management based on clinical complaints. A hospital-based descriptive study between August 2003 and November 2005 was conducted at the maternity clinic of a rural hospital in Mozambique. All women attending the maternity clinic were invited to participate. A total of 2,330 women made 3,437 eligible visits, 3129 were analysed, the remainder were excluded because diagnostic results were unavailable or they were repeat visits. Women gave a standardized clinical history and had a medical exam. Malaria parasitaemia and haematocrit in capillary blood was determined for all women with signs or symptoms compatible with malaria including: presence and history of fever, arthromyalgias, headache, history of convulsions and pallor. Outcome measure was association of malaria symptoms or signs with positive blood slide for malaria parasitaemia. In 77.4% of visits pregnant women had symptoms suggestive of malaria; 23% (708/3129) were in the first trimester. Malaria parasitaemia was confirmed in 26.9% (842/3129) of visits. Headache, arthromyalgias and history of fever were the most common symptoms (86.5%, 74.8% and 65.4%) presented, but their positive predictive values for malaria parasitaemia were low [28% (27-30), 29% (28-31), and 33% (31-35), respectively]. Symptoms suggestive of malaria were very frequent among pregnant women attending a rural maternity clinic in an area of stable malaria transmission. However, less than a third of them were parasitaemic. In the absence of microscopy or rapid diagnostic tests, a large proportion of women, including those in the first trimester of gestation, would be unnecessarily receiving antimalarial drugs, often those with unknown

Rubella seroprevalence among pregnant women in Beijing, China.

PubMed

Meng, Qinghong; Luo, Jie; Li, Lijun; Shi, Wei; Yu, Jinqian; Shen, Yingjie; Li, Li; Wang, Yajuan; Yao, Kaihu

2018-03-15

Rubella infection in pregnant women can result in serious effects, such as miscarriages, stillbirths, and congenital rubella syndrome (CRS). However, very little is known about the rubella seroprevalence among pregnant women in China. This is a cross-sectional and hospital-based study. From June 2016 through March 2017, a total of 324 serum samples from healthy pregnant women were collected in the Shunyi Women and Children's Hospital of Beijing Children's Hospital. Rubella-specific IgG antibody was determined by ELISA (Euroimmun, Lübeck, Germany) kits. International assigned cut-off values of ≥10 IU/ml were used to assess the percentage of pregnant women with protective IgG concentrations. The total rate of protected individuals was 83.3% (95% CI: 78.9%-87.0%). The protective rates of pregnant women in 17-26 years group, 27-36 years group and 37-46 years group were 84.0% (95% CI: 75.3%-90.1%), 81.9% (95% CI: 74.9%-87.4%) and 84.9% (95% CI: 75.8%-90.9%) respectively. No significant difference in protective rates among the three age groups was found (P = 0.83). There were also no statistically significant correlations between protective rates and gravidity (P = 0.84), parity (P = 0.84), birth place (P = 0.16), residence area (P = 0.58), education (P = 0.40) or occupation (P = 0.65). Despite the generally low vaccination coverage for rubella, most of Chinese pregnant women had potent rubella immunity. However, at least 16.7% of pregnant women were susceptible to rubella, which suggested rubella immunization in Chinese women at or before child-bearing age.

Happiness and related factors in pregnant women.

PubMed

Jayasvasti, Kanthika; Kanchanatawan, Buranee

2005-09-01

Pregnancy is a crisis in the human life cycle as an important turning point in aspects of anatomical, physiological and psychosocial changes. An unhappy pregnanus could influence the fetal growth and development and sense of maternal competence as well as bonding with the fetus which profoundly affect the nurture of the infant after delivery. The authors'purposes were to study happiness and related factors in pregnant women having antenatal care at King Chulalongkorn Memorial Hospital. Four hundred and thirty-eight pregnant women from the antenatal clinic at King Chulalongkorn Memorial Hospital were randomly selected to complete a set of questionnaires that consisted of personal information, pregnant information, The Oxford Happiness Questionnaire (OHQ), The Maudsley Personality Inventory (MPI) and The Marital Satisfaction Scale (MSS). Prevalence of happiness level was classified by descriptive analysis. Unpaired t-test, ANOVA and Pearson's Product Moment Correlation analyzed related factors to happiness in pregnant woman. Also Stepwise Multiple Regression Analysis was used to define predictive factors for happiness in pregnant women. The sample had a high level of happiness of 57.3%. Significant related factors to happiness were age between 31-35 years, high education level, high individual and family income, having saving deposition, no drug abuse, improved marital relationship, no conflict with relatives, extrovert and stable personality types and no concerns about post-partum body image. Four predictive factors for happiness in pregnant women were extrovert personality, stable personality, high family income and improved marital relationship. Level of happiness in pregnant women could be predicted by type of personality, family income and marital relationship.

Evaluation of sexual functions of the pregnant women.

PubMed

Tosun Güleroğlu, Funda; Gördeles Beşer, Nalan

2014-01-01

Pregnant women may avoid sexual intercourse or may unavoidably undergo problems in their sexual lives because of various complaints they suffer from. The study aims to evaluate sexual functions of the pregnant women and to determine the factors that negatively affect their sexual health. This is a descriptive research study conducted to evaluate sexual functions of pregnant women. Three hundred six pregnant women admitted to the Women Birth Polyclinics within the Women Birth and Children's Hospital between October 1, 2010 and March 31, 2011 were included in the study. The data were gathered using a personal information form and the Female Sexual Function Index (FSFI). Kruskall-Wallis variance analysis and Mann-Whitney U-tests were used for the statistical analysis. The main outcome is an assessment of the FSFI domains in pregnancy and relationships between pregnancy complaints and sexual functions. The results indicated that the mean age of the pregnant women was 25.6 ± 5.4 and their length of marriage was 5.93 ± 5.4 years. The study revealed that 88.9% of the pregnant women had sexual desire disorders, 86.9% had sexual arousal disorder, 42.8% had lubrication disorders, 69.6% had orgasm disorders, and 48% had sexual satisfaction disorders. Statistically significant differences were found in correlations between FSFI medians and the characteristics of the pregnant women in terms of age, educational level, length and type of marriage, and gestational week. There were also statistically significant differences in correlations between the pregnancy characteristics in terms of backache, constipation, respiratory difficulty, leg ache, and cramp problems (P < 0.05). It was determined that the sexual lives of the pregnant women were negatively affected not only by factors such as old age, low educational status, arranged marriages lasting for more than 10 years, undesired pregnancy, and gestational week but also by health problems such as backache

Reference Values for TSH and Free Thyroid Hormones in Healthy Pregnant Women in Poland: A Prospective, Multicenter Study.

PubMed

Kostecka-Matyja, Marta; Fedorowicz, Anna; Bar-Andziak, Ewa; Bednarczuk, Tomasz; Buziak-Bereza, Monika; Dumnicka, Paulina; Górska, Maria; Krasnodębska, Małgorzata; Niedźwiedzka, Beata; Pach, Dorota; Ruchała, Marek; Siewko, Katarzyna; Solnica, Bogdan; Sowiński, Jerzy; Szelachowska, Małgorzata; Trofimiuk-Müldner, Małgorzata; Wachowiak-Ochmańska, Katarzyna; Hubalewska-Dydejczyk, Alicja

2017-04-01

The diagnosis and treatment of thyroid diseases in pregnant women remains a challenge. Various medical associations recommend establishing the reference intervals for thyroid hormones by a local laboratory. Considering differences within geophysical, socioeconomic conditions, and iodine prophylaxis in various populations, it is advisable to assess reference intervals for thyroid hormones specific to a region of residence. The objective was to assess trimester-specific reference intervals for TSH, fT 3 , and fT 4 for pregnant women in the Polish population. We conducted a prospective study in 4 centers representing different regions of Poland (Krakow, Warsaw, Poznan, and Bialystok). Our study included consecutive, healthy pregnant women (172 patients), with an age range of 27-47 years. All women had a negative history for thyroid diseases, normal thyroid peroxidase antibody levels, and proper iodine prophylaxis. All newborns had TSH levels in the appropriate reference range. Serum TSH, fT 3 , fT 4 , and thyroid-peroxidase antibodies were measured in each trimester. The reference intervals were calculated using the percentile method, as recommended by the International Federation of Clinical Chemistry. The reference values calculated were 0.009-3.177, 0.05-3.442, and 0.11-3.53 mIU/L for TSH; 3.63-6.55, 3.29-5.45, and 3.1-5.37 pmol/L for fT 3 ; and 11.99-21.89, 10.46-16.67, and 8.96-17.23 pmol/L for fT 4 in consecutive trimesters of pregnancy. Reference intervals for pregnant women when compared to the general population showed a lower concentration of TSH in every trimester of pregnancy and lower fT 4 in the 2nd and 3rd trimesters. Using appropriate trimester-specific reference intervals may improve care of pregnant women by preventing misdiagnosis and inadequate treatment.

Circumstances of tobacco smoking by pregnant women.

PubMed

Zołnierczuk-Kieliszek, Dorota; Chemperek, Ewa; Koza, Matylda

2004-01-01

The aim of the paper was to determine the frequency and intensity of tobacco smoking by pregnant women as well as to find out the relationship between tobacco smoking during pregnancy and socioeconomic variables (education, marital status, professional career, smoking partner, number of children) as well as health variables (severe ailments during pregnancy period, taking medicines, using medical care). The research was carried out at the department of gynecology and obstetrics of the Specialist Hospital in Jasło as well as at the Women's Outpatient Clinic of the Public Independent Health Service Institution in Skołyszyn (Podkarpackie Voivodship). The research was conducted by means of the questionnaire distributed from July to September 2002 among 100 pregnant women. The results of the analysis indicate that 18% of the women under survey smoked cigarettes during pregnancy, including 6% daily smokers and 12% occasional smokers. 18% of women quitted smoking when they found out that they were pregnant, and 18% of them limited smoking. Exposure to passive smoking at their family home was declared by more than a half of the pregnant women, while 14% of the surveyed women mentioned passive exposure to smoke at their workplace. The socioeconomic variables that most clearly showed positive correlation with active smoking by pregnant women were: smoking tobacco by a husband or steady partner, smoking tobacco in the presence of a pregnant woman in her workplace and at home, as well as taking advantage of a family doctor's advice. Smoking tobacco during pregnancy was also enhanced by: the lower level of education, extramarital pregnancy, permanent residence in a town or a city, poor living conditions, not working professionally during pregnancy, having two or more children, abnormal course of pregnancy, suffering from such ailments as: weepiness, problems with relaxation, lack of appetite and taking no medicines during pregnancy.

Cognitive behavioral therapy and pharmacotherapy for anxiety: treatment preferences and credibility among pregnant and non-pregnant women.

PubMed

Arch, Joanna J

2014-01-01

Relatively little is known about women's anxiety-related treatment preferences and no studies have examined potential differences between pregnant versus non-pregnant women. Treatment credibility and willingness are particularly important to understand regarding exposure-based cognitive behavioral therapy (CBT) and pharmacotherapy, the leading evidence-based treatments. A large U.S. sample of pregnant (n = 377) and matched non-pregnant (n = 399) women (total N = 776) rated overall treatment preferences and treatment credibility, concerns, and willingness to have CBT and pharmacotherapy if suffering from anxiety. Women preferred anxiety-related treatment that included psychotherapy. Preference for psychotherapy alone was stronger among pregnant (74%) than non-pregnant (47%) women, p < .001. In response to treatment descriptions, both groups rated CBT more favorably than pharmacotherapy on treatment willingness, credibility, and concerns, ps < .001, with the magnitude of this preference significantly greater among pregnant than non-pregnant women, ps < .001. Pregnancy status was unrelated to CBT ratings. Treatment credibility and to a lesser extent total concerns mediated the relationship between pregnancy status and pharmacotherapy willingness. Non-pregnant and especially pregnant women rated exposure-based CBT for anxiety more favorably than pharmacotherapy. Pregnancy status predicted general treatment preferences and pharmacotherapy, but not CBT, ratings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Domestic Violence Among Pregnant Women.

PubMed

Habib, Sadia; Abbasi, Nasreen; Khan, Bushra; Danish, Nargis; Nazir, Quratulain

2018-01-01

Domestic violence during pregnancy is an important social & health issue in all societies. In Muslim world and particularly underdeveloped countries, domestic violence is often under reported. It is the need of hour to encourage reporting of such events & implementation of research-based policies for prevention of women abuse & support of the victims of domestic violence (DV). The objective of this study was to highlight this neglected social problem of our society & to identify at risk population. This is a cross sectional study conducted at Ayub Teaching Hospital & Benazir Bhutto Shaheed Teaching Hospital, Abbottabad (January 2014 to December. 2016). Pregnant women were inquired regarding history of abuse by husband and sociodemographic characteristics were noted in a Performa to analyse the risk factors for domestic violence. The overall prevalence was found to be 35%. Out of 1000 pregnant women, 270 (27%) suffered from simple violence and 60 (6%) were victims of grievous assault. Violence among pregnant women is found to be more prevalent among residents of urban areas, women of older age being uneducated & belonging to poor socioeconomic status. Domestic violence during pregnancy is a common & often neglected psychosocial health problem. High risk population needs to be identified so that preventive strategies can be planned & implemented.

Characteristics of pregnant Jordanian women dissatisfied with life: A comparison between satisfied and dissatisfied women's demographics.

PubMed

Abujilban, Sanaa; Abuidhail, Jamila; Mrayan, Lina; Hatamleh, Reem

2017-06-01

Dissatisfied pregnant women who are at higher risk of negative outcomes perinatally have not been identified in Jordan. The purposes of the researchers were to identify and compare sociodemographic characteristics of satisfied pregnant women with dissatisfied pregnant women. A non-experimental, descriptive, comparative design was employed. Jordanian pregnant women (n =203) were consecutively selected. We found that younger, better educated pregnant women with a high economic status and a small number of children were more satisfied with their lives. Practitioners can identify dissatisfied women and develop an educational and interventional package that focuses on improving satisfaction with life for pregnant mothers.

[Iodine supply of pregnant women in the Czech Republic].

PubMed

Bílek, Radovan; Kaňová, Nataša; Mindžáková, Veronika; Neumann, David; Jiskra, Jan; Ryšavá, Lydie; Zamrazil, Václav

Iodine deficiency is a global public health problem which is particularly noticeable in pregnant or breastfeeding women and their children. Even mild iodine deficiency during pregnancy can lead to damage to the developing brain and thus affecting the fetus intelligence, his cognitive and neurological function, embryogenesis and growth. In the period 2010-2015 was determined by spectrophotometry at the Institute of Endocrinology the basal urinary iodine in 532 pregnant women at the age of 32 ± 5 (18-44) years, which came from Prague, Hradec Kralove and Mlada Boleslav. It was located 349 women in the first trimester, 112 in the second trimester, and 71 women in the third trimester. In the monitoring of pregnant women in the first trimester 218 basal urine samples of women were determined by mass spectrometry with inductively coupled plasma (ICP MS) in The National Institute of Public Health (NIPH). Women came from the 6 areas in the Czech Republic. Development of urinary iodine in the general population in the period 1994-2015 was observed in patients who underwent Institute of Endocrinology and from population studies conducted in 7 regions of the Czech Republic. It performed 52 648 spectrophotometric analysis of urinary iodine in the general population. Urinary iodine was determined by alkali melting of urine samples, followed by spectrophotometric determination of iodine in the form of iodide using the Sandell-Kolthoff reaction in the Institute of Endocrinology or determination was performed by ICP-MS in the laboratory of NIPH. On average, only 21.8 % of pregnant women had urinary iodine values determined by spectrophotometry higher than 150 μg/L. The results of iodine nutrition of pregnant women in the first trimester analyzed using ICP-MS are better, but even so, only 50.5 % of pregnant women have urinary iodine higher than 150 μg/L. The results of iodine nutrition of pregnant women are alarming, on average, only 30 % of the total of 750 examined women have

Nutritional status and weight gain in pregnant women.

PubMed

Sato, Ana Paula Sayuri; Fujimori, Elizabeth

2012-01-01

This study described the nutritional status of 228 pregnant women and the influence of this on birth weight. This is a retrospective study, developed in a health center in the municipality of São Paulo, with data obtained from medical records. Linear regression analysis was carried out. An association was verified between the initial and final nutritional status (p<0.001). The mean of total weight gain in the pregnant women who began the pregnancy underweight was higher compared those who started overweight/obese (p=0.005). Weight gain was insufficient for 43.4% of the pregnant women with adequate initial weight and for 36.4% of all the pregnant women studied. However, 37.1% of those who began the pregnancy overweight/obese finished with excessive weight gain, a condition that ultimately affected almost a quarter of the pregnant women. Anemia and low birth weight were uncommon, however, in the linear regression analysis, birth weight was associated with weight gain (p<0.05). The study highlights the importance of nutritional care before and during pregnancy to promote maternal-infant health.

Dream-associated Behaviors Affecting Pregnant and Postpartum Women

PubMed Central

Nielsen, Tore; Paquette, Tyna

2007-01-01

Study objectives: Evaluate the prevalence and phenomenology of dream-associated behaviors affecting pregnant and postpartum mothers. Episodes consist of anxious dreams and nightmares about the new infant that are accompanied by complex behaviors (motor activity, speaking, expressing emotion). Design: Three-group design (postpartum, pregnant, null gravida), self-report, and repeated measures. Setting: Pregnancy and postpartum groups: completion of questionnaires in hospital room within 48 hours of giving birth and home telephone interviews; null gravida group: completion of questionnaires and interview in person or by telephone. Participants: Two hundred seventy-three women in 3 groups: postpartum: n = 202 (mean age = 29.7 ± 4.94 years; 95 primiparas, 107 multiparas); pregnant: n = 50 (mean age = 31.1 ± 5.44 years); null gravida: n = 21 (mean age = 28.5 ± 6.34 years). Interventions: Subjects completed questionnaires about pregnancy and birth factors, personality, and sleep and participated in interviews concerning the prevalence of recent infant dreams and nightmares, associated behaviors, anxiety, depression, and other psychopathologic factors. Measurements and Results: Most women in all groups recalled dreams (88%-91%). Postpartum and pregnant women recalled infant dreams and nightmares with equal prevalence, but more postpartum women reported they contained anxiety (75%) and the infant in peril (73%) than did pregnant women (59%, P < 0.05 and 42%, P < 0.0001). More postpartum (63%) than pregnant (40%) women reported dream-associated behaviors (P < 0.01), but neither group differed from null gravida women (56%). This was due to different distributions over groups of the behavior subtypes. Motor activity was present in twice as many postpartum (57%) as pregnant (24%) or null gravida (25%) women (all P < 0.0001). Expressing emotion was more prevalent among null gravida (56%) than postpartum women (27%) (P < 0.05) but was not different from pregnant women (37

[An innovative policy for supporting pregnant women].

PubMed

Perz, Stéphanie

2015-04-01

Improving working conditions for pregnant women can boost their feeling of wellbeing in their job. As a result of its innovative work in this area, Seclin general hospital, in the north of France, has received special recognition for its policy in supporting pregnant women. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Oral hygiene in pregnant women versus cigarette smoking].

PubMed

Nakonieczna-Rudnicka, Marta; Gogacz, Małgorzata; Kobyłecka, Elzbieta; Bachanek, Teresa

2013-01-01

Proper oral hygiene is an essential element of dental caries prophylaxis and periodontitis. The aim of the study was evaluation of the oral health state and the state of periodontal in pregnant women in relation to the status of cigarette smoking. Survey and clinical studies were conducted in the group of 100 women--80% pregnant women and 20% in the first week of puerperium remaining at the gynaecological and obstetric hospital wards in Lublin and its region. The mean age of the investigated was 27.94. Study results revealed no correlation between the frequency of pregnant women tooth-brushing and the status of cigarette smoking or non-smoking. The average oral hygiene evaluated on the basis of API index was stated essentially more frequently in the group of non-smoking women (50%) in comparison with the smoking women (24.14%),, whereas improper oral hygiene was stated essentially more frequently in the group of smoking women (31.03%) in comparison with non-smokers (11.29%) (chi = 7.82, p < 0.05). No correlation was stated between the state of periodontal in smoking and non-smoking pregnant women.

Factors that influence physical activity for pregnant and postpartum women and implications for primary care.

PubMed

Doran, Frances; Davis, Kierrynn

2011-01-01

Many pregnant women and women of child-bearing age do not engage in the recommended levels of physical activity despite the well known benefits. Pregnancy and the postpartum period can be a time when inactivity actually increases. Women who experience gestational diabetes mellitus (GDM) during their pregnancy are often advised to become more active in order to ameliorate their increased risk of developing type 2 diabetes. Health professionals have an influential role in promoting physical activity, which would be enhanced with an understanding of the factors that positively and negatively influence women's participation in physical activity during pregnancy and in the postpartum period. This research sought to explore these factors with pregnant and postpartum women including those who had experienced GDM and the attention given to physical activity during pregnancy. A survey was developed after a critical review of factors identified from previous studies. Women were recruited from the antenatal clinic, community health centres and the local media. Results from 72 women are reported from a predominately well educated, Caucasian population. Overall, the results were confirmatory of factors previously identified. Lack of child care, time constraints, no time and feeling unwell during pregnancy hindered activity and factors that facilitated activity included family support, enjoyment of activity and to prevent later health problems. It was also found that non-GDM women are given minimal advice about exercise during pregnancy. A checklist has been developed for health professionals, in partnership with women, to direct attention to the factors that enable and hinder participation in physical activity during and after pregnancy.

Sexually transmitted diseases in pregnant women in Lusaka.

PubMed

Ratnam, A V; Chatterjee, T K; Mulenga, R C

1980-01-01

The prevalance of sexually transmitted diseases has been known to be high in many African countries and preliminary investigations in Lusaka revealed a similar trend in Zambia. This paper presents an analysis of diagnoses made in 170 symptomatic pregnant women referred to the sexually transmitted diseases clinic and the screening results of 163 pregnant women in a routine antenatal examination. A high prevalance of gonococcal infection as well as syphilis was discovered in pregnant women. The implications of these findings on the possible complications and outcome of pregnancy are discussed and remedial measures suggested.

Sympathetic baroreflex gain in normotensive pregnant women

PubMed Central

Usselman, Charlotte W.; Skow, Rachel J.; Matenchuk, Brittany A.; Chari, Radha S.; Julian, Colleen G.; Stickland, Michael K.; Davenport, Margie H.

2015-01-01

Muscle sympathetic nerve activity is increased during normotensive pregnancy while mean arterial pressure is maintained or reduced, suggesting baroreflex resetting. We hypothesized spontaneous sympathetic baroreflex gain would be reduced in normotensive pregnant women relative to nonpregnant matched controls. Integrated muscle sympathetic burst incidence and total sympathetic activity (microneurography), blood pressure (Finometer), and R-R interval (ECG) were assessed at rest in 11 pregnant women (33 ± 1 wk gestation, 31 ± 1 yr, prepregnancy BMI: 23.5 ± 0.9 kg/m2) and 11 nonpregnant controls (29 ± 1 yr; BMI: 25.2 ± 1.7 kg/m2). Pregnant women had elevated baseline sympathetic burst incidence (43 ± 2 vs. 33 ± 2 bursts/100 heart beats, P = 0.01) and total sympathetic activity (1,811 ± 148 vs. 1,140 ± 55 au, P < 0.01) relative to controls. Both mean (88 ± 3 vs. 91 ± 2 mmHg, P = 0.4) and diastolic (DBP) (72 ± 3 vs. 73 ± 2 mmHg, P = 0.7) pressures were similar between pregnant and nonpregnant women, respectively, indicating an upward resetting of the baroreflex set point with pregnancy. Baroreflex gain, calculated as the linear relationship between sympathetic burst incidence and DBP, was reduced in pregnant women relative to controls (−3.7 ± 0.5 vs. −5.4 ± 0.5 bursts·100 heart beats−1·mmHg−1, P = 0.03), as was baroreflex gain calculated with total sympathetic activity (−294 ± 24 vs. −210 ± 24 au·100 heart beats−1·mmHg−1; P = 0.03). Cardiovagal baroreflex gain (sequence method) was not different between nonpregnant controls and pregnant women (49 ± 8 vs. 36 ± 8 ms/mmHg; P = 0.2). However, sympathetic (burst incidence) and cardiovagal gains were negatively correlated in pregnant women (R = −0.7; P = 0.02). Together, these data indicate that the influence of the sympathetic nervous system over arterial blood pressure is reduced in normotensive pregnancy, in terms of both long-term and beat-to-beat regulation of arterial pressure

Seroepidemiology of cytomegalovirus infection in pregnant women in Durango City, Mexico.

PubMed

Alvarado-Esquivel, Cosme; Hernández-Tinoco, Jesús; Sánchez-Anguiano, Luis Francisco; Ramos-Nevárez, Agar; Cerrillo-Soto, Sandra Margarita; Estrada-Martínez, Sergio; Martínez-Ramírez, Lucio; Pérez-Álamos, Alma Rosa; Guido-Arreola, Carlos Alberto

2014-09-05

Cytomegalovirus causes congenital infections all around the world. The seroepidemiology of cytomegalovirus infection in pregnant women in Mexico is largely unknown. We sought to determine the seroprevalence of cytomegalovirus infection in pregnant women in Durango City, Mexico; and to determine seroprevalence association with socio-demographic, clinical and behavioral characteristics of pregnant women. Through a cross-sectional study design, 343 pregnant women were examined for anti-cytomegalovirus IgG and IgM antibodies in Durango City, Mexico. We used a standardized questionnaire to obtain the general characteristics of the pregnant women. Multivariate analysis was performed to determine the association of cytomegalovirus infection with the characteristics of the pregnant women. Anti-CMV IgG and IgM antibodies were detected in 225 (65.6%) and in none of the 343 pregnant women studied, respectively. Multivariate analysis showed that CMV exposure was associated with increasing age (OR = 1.67; 95% CI: 1.01-2.76; P = 0.04). Other women characteristics including socioeconomic status, education, blood transfusion, transplantation, sexual promiscuity and number of previous pregnancies or deliveries did not show an association with CMV exposure. This is the first seroepidemiology study of CMV infection in pregnant women in Mexico. A number of known factors associated with CMV infection were not associated with CMV exposure in the women studied. Further studies to determine routes of CMV infection in pregnant women in Mexico are needed.

The management of HCV-infected pregnant women.

PubMed

Valladares, Guillermo; Chacaltana, Alfonso; Sjogren, Maria H

2010-01-01

Hepatitis C is, at present, a worldwide health problem and is the most common cause of liver transplantation. Its prevalence in pregnant women is similar to that of the general population. In the absence of cirrhosis and portal hypertension, most HCV-infected pregnant women do not have obstetric complications. Screening of pregnant women that are asymptomatic and do not have risk factors is not cost effective. A high hepatitis C viral load reportedly increases vertical transmission and is higher in women who are coinfected with HIV or who are intravenous drug users. Prolonged rupture of the membrane for more than 6 h, amniocentesis, and perineal lacerations increase the potential risk of perinatal transmission. Although the hepatitis C virus can be transmitted intrapartum, prevention by caesarean delivery is not generally indicated. The HCV virus can be found in maternal milk; however, breast feeding is not contraindicated. In conclusion, there are no antiviral treatment recommendations for HCV-infected women during pregnancy, or guidelines for the prevention of vertical transmission.

Tuberculosis care for pregnant women: a systematic review.

PubMed

Nguyen, Hang Thanh; Pandolfini, Chiara; Chiodini, Peter; Bonati, Maurizio

2014-11-19

Tuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care, especially for women who have limited access to health services. The aim of this review was to gather and evaluate studies on TB care for pregnant women. We used a combination of the terms "tuberculosis" and "pregnancy", limited to human, to search for published articles. Studies reflecting original data and focusing on TB care for pregnant women were included. All references retrieved were collected using the Reference Manager software (Version 11). Thirty five studies were selected for review and their data showed that diagnosis was often delayed because TB symptoms during pregnancy were not typical. TB prophylaxis and anti-TB therapy appeared to be safe and effective for pregnant women and their babies when suitable follow up and early initiation were present, but the compliance rate to TB prophylaxis is still low due to lack of follow up and referral services. TB care practices in the reviewed studies were in line in principle with the WHO International Standards for Tuberculosis Care (ISTC). Integration of TB care within prenatal care would improve TB diagnosis and treatment for pregnant women. To improve the quality of TB care, it is necessary to develop national level guidelines based on the ISTC with detailed guidelines for pregnant women.

Thiol/disulfide homeostasis in pregnant women with obstructive sleep apnea syndrome.

PubMed

Üstündağ, Yasemin; Demirci, Hakan; Balık, Rifat; Erel, Ozcan; Özaydın, Fahri; Kücük, Bilgen; Ertaş, Dilber; Ustunyurt, Emin

2017-11-27

Repetitive episodes of hypoxia and reoxygenation during sleep in patients with obstructive sleep apnea syndrome (OSAS) resemble an ischemia-reperfusion injury. We aimed to test the hypothesis that oxidative stress occurs in pregnant women with OSAS. We also aimed to compare thiol/disulfide homeostasis with ischemia-modified albumin (IMA) and total antioxidant capacity (TAC) as markers of ischemia-reperfusion injury in pregnant women with and without OSAS and healthy control. This study included 29 pregnant women with OSAS, 30 women without OSAS in the third trimester applying for periodic examinations, and 30 healthy women. Serum IMA and TAC (using the ferric reducing power of plasma method) were measured. Serum thiol/disulfide homeostasis was determined by a novel automated method. The mean age of the pregnant women with OSAS was 31.0 ± 4.7 years with a mean gestational age of 36.5 ± 3.0 weeks. The mean age of pregnant women without OSAS was 29.8 ± 4.9 years with a mean gestational age of 36.9 ± 2.7 weeks. The mean age of the nonpregnant control group was 29.7 ± 6.4 years. Both native thiol (291 ± 29 μmol/L versus 314 ± 30 μmol/L; p = .018) and total thiol (325 ± 32 versus 350 ± 32, p = .025) levels were lower in pregnant women with OSAS compared to pregnant women without OSAS, respectively (p < .01). This is the first study demonstrating the thiol/disulfide homeostasis in pregnant women with OSAS. Native thiol and total thiol levels were lower in pregnant women with OSAS compared to those without OSAS. However, dynamic thiol/disulfide homeostasis parameters cannot provide valuable information to discriminate OSAS in pregnant women.

Intestinal Parasitic Infections among Pregnant Women in Venezuela

PubMed Central

Rodríguez-Morales, Alfonso J.; Barbella, Rosa A.; Case, Cynthia; Arria, Melissa; Ravelo, Marisela; Perez, Henry; Urdaneta, Oscar; Gervasio, Gloria; Rubio, Nestor; Maldonado, Andrea; Aguilera, Ymora; Viloria, Anna; Blanco, Juan J.; Colina, Magdary; Hernández, Elizabeth; Araujo, Elianet; Cabaniel, Gilberto; Benitez, Jesús; Rifakis, Pedro

2006-01-01

Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P < .01). Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered. PMID:17093349

[Functional limitations associated with lumbosacral spine pain in pregnant women].

PubMed

Brylewska-Pinda, Magdalena; Kemicer-Chmielewska, Ewa; Pierzak-Sominka, Joanna; Mosiejczuk, Hanna

Lower back pain affects most pregnant women. Pain is often associated with varying degrees of functional limitations, causing a problem for pregnant women in the performance of many everyday activities. The aim of the study was to assess the extent to which lumbosacral spine pain caused limitations in the daily functioning of pregnant women, and the relationship between reported restrictions and analysed variables. The study was conducted in the city of Szczecin in Poland among 81 pregnant women. Data were collected using a standardized Oswestry questionnaire survey (The Oswestry Lower Back Pain Disability Questionnaire). Results were analysed using the χ² test of independence. The signiicance level was adopted at p < 0.05. The majority of women pregnant for the second time (n = 38) had mild disability. The relationship between the degree of disability and the order of pregnancies was statistically signi icant (χ² = 40.457, p = 0.0000000085). The majority of pregnant women had minor functional limitations due to pain in the lumbosacral spine region. The degree of functional limitations depends on the trimester of pregnancy and the order of pregnancies.

Assessment of dietary intake and mineral status in pregnant women.

PubMed

Kocyłowski, Rafał; Lewicka, Iwona; Grzesiak, Mariusz; Gaj, Zuzanna; Sobańska, Anna; Poznaniak, Joanna; von Kaisenberg, Constantin; Suliburska, Joanna

2018-06-01

To evaluate the dietary intake of pregnant women and their nutritional status of Ca, Mg, Fe, Zn, and Cu, as the nutritional status of pregnant women is an important factor for the proper progression of a pregnancy and the development and health of the foetus. The study was conducted on 108 pregnant women ages 18-42, at 6-32 weeks of gestation. We used a questionnaire and a 24-h recall nutrition interview. Hair samples were taken for testing and the level of each mineral was assessed using atomic absorption spectrometry. The results were analysed using the Dietetyk and Statistica 10 software. Low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid intake were seen in the pregnant women, with the use of dietary supplements significantly increasing their intake of Fe, Zn, and folic acid. The concentration of zinc and magnesium in the women's hair was shown to be affected by their age and, in the case of magnesium, by the week of pregnancy. It was observed that the diet of pregnant women is characterised by low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid. Dietary supplementation with vitamins and minerals significantly increases the daily Fe and folic acid intake in pregnant women. The concentration of Zn and Mg in hair depends on the age of pregnant women and Mg level in the hair of women decreases during pregnancy.

Fair inclusion of pregnant women in clinical trials: an integrated scientific and ethical approach.

PubMed

van der Graaf, Rieke; van der Zande, Indira S E; den Ruijter, Hester M; Oudijk, Martijn A; van Delden, Johannes J M; Oude Rengerink, Katrien; Groenwold, Rolf H H

2018-01-29

Since pregnant women are severely underrepresented in clinical research, many take the position that the exclusion of pregnant women from research must be justified unless there are compelling "scientific reasons" for their exclusion. However, it is questionable whether this approach renders research with pregnant women fair. This paper analyzes and evaluates when research with pregnant women can be considered as fair and what constitutes scientific reasons for exclusion. Conceptual ethical and methodological analysis and evaluation of fair inclusion. Fair inclusion of pregnant women means (1) that pregnant women who are eligible are not excluded solely for being pregnant and (2) that the research interests of pregnant women are prioritized, meaning that they ought to receive substantially more attention. Fairness does not imply that pregnant women should be included in virtually every research project, as including only a few pregnant women in a population consisting only of women will not help to determine the effectiveness and safety of a treatment in pregnant women. Separate trials in pregnant women may be preferable once we assume, or know, that effects of interventions in pregnant women differ from the effects in other subpopulations, or when we assume, or know, that there are no differences. In the latter case, it may be preferable to conduct post-marketing studies or establish registries. If there is no conclusive evidence indicating either differences or equivalence of effects between pregnant and non-pregnant women, yet it seems unlikely that major differences or exact equivalence exist, the inclusion of pregnant women should be sufficient. Depending on the research question, this boils down to representativeness in terms of the proportion of pregnant and non-pregnant women, or to oversampling pregnant women. Fair inclusion of pregnant women in research implies that separate trials in pregnant women should be promoted. Inclusion of pregnant women has to

Vitamin D levels among pregnant and lactating women.

PubMed

Sharif, Saima; Farasat, Tasnim; Shoaib, Hamna; Saqib, Muhammad; Fazal, Sabiha

2013-12-01

To assess the serum level of vitamin D in pregnant and lactating women. Case-control study. Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. A total of 100 women comprised of three groups: pregnant (n = 40), lactating (n = 40) and control (n = 20) groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS (version 13). The values were considered significant at 0.05 level of significance. The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 ± 17.1 nmol/L and 21.4 ± 16.3 nmol/L respectively and in control group was 33.8 ± 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 ± 1.2 mg/dL, 9.7 ± 1.3 mg/dL and 9.7 ± 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 ± 0.76 mg/dl, in lactating was 3.3 ± 0.76 mg/dl and in control was 3.5 ± 0.92 mg/dl. Significant difference (p = 0.041 and p = 0.037 respectively) in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group.

Skewed risk perceptions in pregnant women: the case of influenza vaccination.

PubMed

Bödeker, Birte; Betsch, Cornelia; Wichmann, Ole

2015-12-29

Pregnant women and their newborns have an increased risk of developing severe influenza and influenza-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. However, little is known about pregnant women's vaccination-related knowledge and attitudes, as well as their risk perceptions. This study therefore assessed pregnant women's vaccination-related knowledge, risk perceptions related to influenza disease and influenza vaccination during pregnancy, and aimed to identify determinants of influenza vaccination uptake during pregnancy in Germany. Between 2012 and 2014, a nationwide web-based prospective cohort study with follow-up interviews was conducted in initially pregnant women who gave birth over the study period. Control groups were set up in a cross-sectional fashion during the follow-up interviews. Women who participated in both, the baseline interview before giving birth and in the 1st interview after giving birth were included in the analysis. Univariate and multiple logistic regression were used to identify associations between influenza vaccination uptake and sociodemographic characteristics as well as items assessing attitude and knowledge. In total, 838 women were included in the analyses. Pregnant women had a positive attitude towards vaccination in general, but only modest vaccination knowledge. Overall, 10.9 % of women were vaccinated against seasonal influenza during pregnancy. While pregnant women perceived classical childhood diseases to be more risky than the respective vaccinations, this relation reversed for influenza: The risk of vaccination was perceived higher than the risk of the disease. These two types of risk perceptions independently determined influenza vaccination uptake-higher perception of disease risk and lower perceptions of vaccination-related risks increased uptake. Additionally, knowledge about the vaccination recommendation for pregnant women and a positive gynaecologist

The Effect of Media on Body Image in Pregnant and Postpartum Women.

PubMed

Coyne, Sarah M; Liechty, Toni; Collier, Kevin M; Sharp, Aubrey D; Davis, Emilie J; Kroff, Savannah L

2018-07-01

Much research has found that exposure to certain types of media portrayals of women can be related to body image concerns among women. The current paper focuses on the impact of certain messages on pregnant and postpartum women. These women are rarely examined in a media research context but are particularly vulnerable to body image concerns. This experimental study involved 192 pregnant or postpartum women who read a magazine containing glamorized media portrayals of pregnant/postpartum women or a control magazine. Pregnant women reported lower body image after only five minutes of exposure to the magazine with pregnant/postpartum women compared to the control group. There was no immediate effect on postpartum women. Implications for the media industry, health professionals, and women are discussed.

Activity Behaviours in Lean and Morbidly Obese Pregnant Women.

PubMed

Fazzi, Caterina; Mohd-Shukri, Nor; Denison, Fiona C; Saunders, David H; Norman, Jane E; Reynolds, Rebecca M

2018-05-17

Interventions to increase physical activity in pregnancy are challenging for morbidly obese women. Targeting sedentary behaviours may be a suitable alternative to increase energy expenditure. We aimed to determine total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. We administered the Pregnancy Physical Activity Questionnaire PPAQ (non-objective) and the Actical accelerometer (objective) to morbidly obese (BMI≥40kg/m²) and lean (BMI≤25Kg/M²) pregnant women recruited in early (<24 weeks), and late (≥24 weeks) gestation. Data are mean (SD). Morbidly obese pregnant women reported expending significantly more energy per day in early (n=140 vs 109; 3198.4 (1847.1) vs 1972.3 (10284.8) Kcal/day, p<0.0001) and late (n=104 vs 64; 3078.2 (1356.5) vs 1947.5 (652.0) Kcal/day, p<0.0001) pregnancy, and expended significantly more energy in sedentary activities, in early (816.1 (423.5) vs 540.1 (244.9) Kcal/day, p<0.0001) and late (881.6 (455.4) vs 581.1 (248.5) Kcal/day, p<0.0001) pregnancy, than lean pregnant women. No differences were observed in the proportion of energy expended sedentary between lean and morbidly obese pregnant women. The greater total energy expenditure in morbidly obese pregnant women was corroborated by Actical accelerometer in early (n=14 per group, obese 1167.7 (313.6) Kcal; lean 781.1 (210.1) Kcal, p<0.05), and in late (n=14 per group, obese 1223.6 (351.5) Kcal; lean 893.7 (175.9) Kcal, p<0.05) pregnancy. In conclusion, non-objective and objective measures showed morbidly obese pregnant women expended more energy per day than lean pregnant. Further studies are needed to determine whether sedentary behaviours are a suitable target for intervention in morbidly obese pregnancy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Rubella Immune Status in Pregnant Women in a Northern Mexican City

PubMed Central

Alvarado-Esquivel, Cosme; Hernandez-Tinoco, Jesus; Sanchez-Anguiano, Luis Francisco; Ramos-Nevarez, Agar; Cerrillo-Soto, Sandra Margarita; Salas-Pacheco, Jose Manuel; Sandoval-Carrillo, Ada Agustina; Martinez-Ramirez, Lucio; Antuna-Salcido, Elizabeth Irasema; Guido-Arreola, Carlos Alberto

2016-01-01

Background The seroepidemiology of rubella virus infection in pregnant women in northern Mexico is largely unknown. We sought to determine the seroprevalence of rubella virus infection in pregnant women in the northern Mexican city of Durango, Mexico. Seroprevalence association with the socio-demographic, clinical and behavioral characteristics of the pregnant women was also investigated. Methods Through a cross-sectional study, we determined the seroprevalence of IgG and IgM anti-rubella virus in 279 pregnant women (mean age 29.17 ± 5.96 years; range 15 - 43 years) attending in a clinic of family medicine using enzyme-linked fluorescent assays. A questionnaire was used to obtain the socio-demographic, clinical and behavioral characteristics of the pregnant women. The association of rubella seropositivity and characteristics of the women was assessed by bivariate and multivariate analyses. Results Anti-rubella IgG antibodies (≥ 15 IU/mL) were found in 271 (97.1%) of the 279 pregnant women examined. None of the 279 pregnant women were positive for anti-rubella IgM antibodies. Multivariate analysis of socio-demographic, clinical and behavioral variables showed that seroreactivity to rubella virus was positively associated with national trips (OR = 7.39; 95% CI: 1.41 - 38.78; P = 0.01), and negatively associated with age (OR = 0.26; 95% CI: 0.06 - 0.99; P = 0.04). Conclusions Rate of rubella immunity in pregnant women in the northern Mexican city of Durango is high. However, nearly 3% of pregnant women are susceptible to rubella in our setting. Risk factors associated with rubella seropositivity found in this study may be useful for optimal design of preventive measures against rubella and its sequelae. PMID:27540439

Oral Health-Related Quality of Life and Periodontal Status of Pregnant Women.

PubMed

Geevarghese, Amrita; Baskaradoss, Jagan Kumar; Sarma, P Sankara

2017-08-01

Aim The purpose of this study was to assess the difference in the oral health related quality of life (OHRQoL) and the oral health status between pregnant and non-pregnant women. Methods This cross-sectional study included 150 pregnant women (mean age 23.8 ± 3.01) and 150 non-pregnant women (mean age 25.2 ± 3.35). Data were collected through a self-administered structured questionnaire, followed by an oral examination. Oral health impact profile-49 (OHIP-49) questionnaire was used to capture the individual's perceived OHRQoL. The periodontal disease assessment was based on the pocket depth (PD) and clinical attachment loss (CAL) measured with the cemento-enamel junction as the reference point. Decayed (D), Missing(M) and Filled (F) teeth (DMFT) index was used to measure the caries experience. Results The overall OHIP score for pregnant women (47.33 ± 8.56) was significantly (p = 0.03) higher, when compared to non-pregnant women (37.87 ± 9.61). Higher scores indicate a poorer OHRQoL among the pregnant women. Fourteen items of the OHIP-49 were higher for pregnant women and the subgroups that were significantly different between the two groups were: 'functional limitation', 'physical pain', 'psychological discomfort', 'psychological disability' and 'handicap'. The mean PD and CAL for pregnant women was significantly higher than that of non-pregnant women (p < 0.01). Dichotomized DMFT scores (≤6 and >6) showed significant difference (p < 0.01) between the two groups. Multivariate regression model showed that periodontitis (p = 0.01) and pregnancy status (p < 0.01) had a positive linear relationship with OHIP-49 scores after adjusting for all other variables. Conclusion The periodontal health and OHRQoL of pregnant women was poorer than non-pregnant women.

[Partner violence against pregnant women in Mexico City].

PubMed

Doubova Dubova, Svetlana Vladislavovna; Pámanes-González, Verónica; Billings, Deborah L; Torres-Arreola, Laura del Pilar

2007-08-01

To assess factors related to partner violence against pregnant women. Data were collected from 383 pregnant women eligible attending five family medicine units of the Mexican institute of social security in Mexico City, Mexico, between September 2003 and August 2004. Data collection was carried out using a questionnaire developed for the study. Of all women interviewed, 120 (31.1%) reported that they had been exposed to psychological and/or physical and/or sexual violence perpetrated by their partners during the current pregnancy; 10% reported combined violence and 21% isolated violence. Psychological violence was most frequently reported (in 93% of the "experienced violence" group). As for their perception of violence there was not found any significant differences between those women who had experienced versus those who did not experience violence. Only about 20% of women had knowledge of centers for women victims of violence. The factors significantly associated with partner violence among pregnant women included: being single (OR=3.02; 95% CI: 1.17;7.83), being unmarried and living with a partner (OR=2.22; 95% CI: 1.11;4.42), history of violence during childhood (OR= 3.08; 95% CI: 1.62;5.85), alcohol consumption by the partner (OR=1.87; 95% CI: 1.02;3.42) and emotional distress among women (OR=4.17; 95% CI: 1.12;15.51). The study results stress other research findings that violence against pregnant Mexican women is still common.

[The expectancy-stress factor in pregnant refugee women].

PubMed

Gogol', K N; Gotsiridze, E G; Guruli, Z V; Kintraia, N P; Tsaava, F D

2006-09-01

Our study revealed that refugee status increases the risks and worsens the outcome of pregnancy among Georgian refugees. 125 Georgian refugee women participated in this study. The study included examinations of the psychological status of expecting mothers, clinical development of pregnancy, complications of labor, functional status of the fetus, and EEG and neuro-ultrasound data of newborns. The control group comprised 125 pregnant women who experienced no stress during pregnancy. An examination of the psycho-emotional status of pregnant refugee women revealed high percentage indicators (82%) for hypochondria, depression, psychopathy, hysteria and psychoastenia in contrast to the control group. The deterioration of psycho-emotional status and biochemical indicators in pregnant refugee women was directly proportional to the worsening of functional and clinical conditions in fetuses. Prolonged stress is the cause of increased morbidity and mortality during pregnancy and child birth in refugee women. Infants born to refugee women also faced increased risks and belong to the group of special premature care and observation.

Nutritional behaviours of pregnant women in rural and urban environments.

PubMed

Suliga, Edyta

2015-01-01

Monitoring of the environmental differences in the mode of nutrition is especially important in pregnant women, for whom normal body weight gain is especially important for both the course of pregnancy and the normal development of the foetus, and is inseparably associated with rational nutrition. The objective of the study was evaluation of the mode of nutrition of pregnant women according to the place of residence. The investigation comprised 704 women. Information was collected by means of an anonymous survey concerning place of residence, consumption of selected products and beverages, and taking folic acid and other vitamin and/or mineral dietary supplements. In the urban environment, pregnant women more frequently consumed vegetables, milk and dairy products, sea fish and wholemeal cereal products, drank more liquids, as well as more fruit and/or vegetable juices, and more often used the supplementation with folic acid, even before becoming pregnant. No significant differences were found in the consumption of fruits, pulses, products which are the source of complete proteins, confectionery products and sweets, according to the place of residence. The diet of pregnant women from the rural environment compared to that of women from urban areas, was characterized by worse quality. It is necessary to carry out health education in the area of adequate nutrition among pregnant women, and those who plan pregnancy, directed primarily to all women from the rural environment.

D-dimer concentration outliers are not rare in at-term pregnant women.

PubMed

Wang, Yu; Gao, Jie; Du, Juan

2016-06-01

To determine the D-dimer levels in pregnant women at term and the differences between pregnant women with different D-dimer levels. The plasma D-dimer concentrations in pregnant women at term were identified in a cross-sectional study. The clinical indicators that are potentially relevant to D-dimer levels were compared between the pregnant women with different D-dimer levels (i.e., normal, mildly increased, and severely increased). There were always some D-dimer concentration outliers in the pregnant women at term regardless of the presence or absence of complications, and there were no significant differences in maternal age, gestational age, gravidity, parity, blood count, blood coagulation, or liver function between the pregnant women with different D-dimer levels. D-dimer levels may vary significantly during pregnancy for unknown reasons. This variation, particularly in pregnant women at term, might lead to questionable diagnostic information regarding coagulation. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Dental awareness and oral health of pregnant women in Poland.

PubMed

Gaszyńska, Ewelina; Klepacz-Szewczyk, Justyna; Trafalska, Elżbieta; Garus-Pakowska, Anna; Szatko, Franciszek

2015-01-01

The level of dental awareness of a pregnant woman affects the sanitary condition of her own teeth and the health of the child to be born. Poor oral health is considered to be a probable risk factor for the pre-term birth or low birth weight. The aim of this work was to assess the level of oral health knowledge that determines oral health condition of pregnant women in Poland. Empirical data were obtained from the National Monitoring of Oral Health and Its Determinants, financed by the Ministry of Health. This socio-epidemiological study assessed oral health status and dental health awareness, which affects that status. Study subjects included 1380 pregnant women at the age ranging from 15 to 44, randomly-selected from urban and rural environments. Dental health status was recorded in the clinical examination sheets supplied by the World Health Organization, and the socio-medical data were recorded in the questionnaire interview sheets. Almost 3/4 of the pregnant women evaluated their dental health as unsatisfactory or poor. Over 60% of the pregnant women rated their knowledge and practical skills concerning care of their own teeth and of the child to be born as limited, inadequate or none. Only 40% of the pregnant women provided right answers to the questions about dental issues. Low oral health awareness results in poor oral health status of the study subjects. A statistical pregnant woman has a total of 13 teeth showing the symptoms of tooth decay or caries. Over 70% of the pregnant women developed gingivitis or periodontitis. There is an urgent need in Poland to make the European principle of treating pregnant women as a dentally vulnerable group obligatory. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Pregnant Women's perceptions of exposure to brominated flame retardants.

PubMed

Lane, A; Goodyer, C G; Rab, F; Ashley, J M; Sharma, S; Hodgson, A; Nisker, J

2016-12-01

Recent media reports on human studies associating brominated flame retardants (BFRs) in household products in pregnancy with urogenital anomalies in boys and endocrine disruption in both sexes. We sought to explore the perceptions of pregnant women of brominated flame retardant (BFR) exposure, in light of recent media reports on the adverse health effects of BFR exposure prenatally. Pregnant women were recruited for interviews through posters and pamphlets in prenatal clinics, prenatal fairs and community centres. Interviews were audiotaped and transcribed verbatim for Charmaz-based qualitative analysis supported by NVIVO 10™. Theoretical sufficiency was reached after analyzing the interviews of 23 pregnant women. Themes co-constructed were: I-Lack of Awareness of BFRs; II-Factors Influencing BFR Exposure; III-Responsibility; IV-Informed Choice. Almost all participants felt it was difficult to make informed choices to avoid BFRs, and wanted communication from clinicians and regulation from governments regarding decreasing BFR exposure. Pregnant women in Canada may be unaware of the potential risks of exposure to BFRs. Professional organizations and governments should further study risk associated with BFR exposure in pregnancy and provide educational materials for pregnant women and clinicians regarding BFR exposure.

Asymptomatic malaria correlates with anaemia in pregnant women at Ouagadougou, Burkina Faso.

PubMed

Douamba, Zoenabo; Bisseye, Cyrille; Djigma, Florencia W; Compaoré, Tegwinde R; Bazie, Valérie Jean Telesphore; Pietra, Virginio; Nikiema, Jean-Baptiste; Simpore, Jacques

2012-01-01

Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission of Plasmodium falciparum causing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence of Plasmodium falciparum asymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT) and microscopy, respectively. The prevalence of P. falciparum asymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected with P. falciparum compared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.

[Low back pain in pregnant women].

PubMed

Majchrzycki, Marian; Mrozikiewicz, Przemysław M; Kocur, Piotr; Bartkowiak-Wieczorek, Joanna; Hoffmann, Marcin; Stryła, Wanda; Seremak-Mrozikiewicz, Agnieszka; Grześkowiak, Edmund

2010-11-01

Pain of lumbosacral segment of the vertebral column and the pelvis concerns about 45% of all pregnant women. The change of the body posture during pregnancy is the result of gravity centre relocation, which affects the musculosceletal system. Development of the joint, ligament and myofascial dysfunctions, as well as the pain in the lumbosacral segment and the pelvis, are the most common reasons of spine pain. The aim of this review is to present the current state of knowledge about lumbar spine pain in pregnant women with special focus on the pain connected with muscular, joint and ligament disorders. Pregnancy is a serious burden for the female osteo-skeletal system. Lumbar pain with different location and intensification is the negative consequence of the position changes during pregnancy. Pharmacotherapy could be useful only in cases of intensive low back pain, with possible application of small spectrum of drugs that are safe during pregnancy. Physical therapy including manual therapy exercises, massage and techniques of local anesthesia are alternative methods in case of low back pain in pregnant women.

Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

PubMed

Legault, Anik; Marquis, Marie

2014-01-01

Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

Epidemiology and Risk Factors of Functional Constipation in Pregnant Women.

PubMed

Shi, Wenjun; Xu, Xiaohang; Zhang, Yi; Guo, Sa; Wang, Jing; Wang, Jianjun

2015-01-01

To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors. We searched hospital databases for women who were 37-41 weeks pregnant (1698 cases) from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software. Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history. The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population.

Pregnant Women and Influenza (Flu)

MedlinePlus

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Psychophysiology and posttraumatic stress disorder symptom profile in pregnant African-American women with trauma exposure.

PubMed

Michopoulos, Vasiliki; Rothbaum, Alex O; Corwin, Elizabeth; Bradley, Bekh; Ressler, Kerry J; Jovanovic, Tanja

2015-08-01

While female sex is a robust risk factor for posttraumatic stress disorder (PTSD), pregnant women are an understudied population in regards to PTSD symptom expression profiles. Because circulating hormones during pregnancy affect emotionality, we assessed whether pregnant women would have increased expression of the intermediate phenotypes of hyperarousal and fear-potentiated startle (FPS) compared to non-pregnant women. We examined PTSD symptom profiles in pregnant (n = 207) and non-pregnant women (n = 370). In a second study, FPS responses were assessed in 15 pregnant and 24 non-pregnant women. All participants were recruited from the obstetrics and gynecology clinic at a public hospital serving a primarily African-American, low socioeconomic status, inner-city population. Our results indicate that overall PTSD symptoms were not different between the groups of women. However, pregnant women reported being more hypervigilant (p = 0.036) than non-pregnant women. In addition, pregnant women showed increased FPS to a safety signal compared to non-pregnant women (p = 0.024). FPS to a safety signal in pregnant women was significantly correlated with PTSD hyperarousal symptoms (r = 0.731, p < 0.001). Furthermore, discrimination between danger and safety signals was present in non-pregnant women (p = 0.008), but not in pregnant women (p = 0.895). Together, these data suggest that pregnant women show clinical and psychophysiological hyperarousal compared to non-pregnant women, and support screening for PTSD and assessment of PTSD risk in pregnant women.

Recent HIV prevalence trends among pregnant women and all women in sub-Saharan Africa: implications for HIV estimates.

PubMed

Eaton, Jeffrey W; Rehle, Thomas M; Jooste, Sean; Nkambule, Rejoice; Kim, Andrea A; Mahy, Mary; Hallett, Timothy B

2014-11-01

National population-wide HIV prevalence and incidence trends in sub-Saharan Africa (SSA) are indirectly estimated using HIV prevalence measured among pregnant women attending antenatal clinics (ANC), among other data. We evaluated whether recent HIV prevalence trends among pregnant women are representative of general population trends. Serial population-based household surveys in 13 SSA countries. We calculated HIV prevalence trends among all women aged 15-49 years and currently pregnant women between surveys conducted from 2003 to 2008 (period 1) and 2009 to 2012 (period 2). Log-binomial regression was used to test for a difference in prevalence trend between the two groups. Prevalence among pregnant women was age-standardized to represent the age distribution of all women. Pooling data for all countries, HIV prevalence declined among pregnant women from 6.5 [95% confidence interval (CI) 5.3-7.9%] to 5.3% (95% CI 4.2-6.6%) between periods 1 and 2, whereas it remained unchanged among all women at 8.4% (95% CI 8.0-8.9%) in period 1 and 8.3% (95% CI 7.9-8.8%) in period 2. Prevalence declined by 18% (95% CI -9-38%) more in pregnant women than nonpregnant women. Estimates were similar in Western, Eastern, and Southern regions of SSA; none were statistically significant (P>0.05). HIV prevalence decreased significantly among women aged 15-24 years while increasing significantly among women 35-49 years, who represented 29% of women but only 15% of pregnant women. Age-standardization of prevalence in pregnant women did not reconcile the discrepant trends because at older ages prevalence was lower among pregnant women than nonpregnant women. As HIV prevalence in SSA has shifted toward older, less-fertile women, HIV prevalence among pregnant women has declined more rapidly than prevalence in women overall. Interpretation of ANC prevalence data to inform national HIV estimates should account for both age-specific fertility patterns and HIV-related sub-fertility.

Where Does Your State Stand on Shackling of Pregnant Incarcerated Women?

PubMed

Ferszt, Ginette G; Palmer, Michelle; McGrane, Christine

2018-02-01

Pregnant incarcerated women have been identified as a particularly high-risk group and among the most vulnerable women in the United States. The use of shackling or restraints poses health risks to pregnant women and their fetuses. Currently, only 22 states have legislation prohibiting or limiting the shackling of pregnant women. Here we provide an overview of the potential negative health outcomes that can result from shackling pregnant women, especially during labor and birth, and suggest strategies for nurses who wish to promote optimal health care for incarcerated women and to advocate for anti-shackling legislation in their states. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

HIV Risk Factors among Pregnant and Non-Pregnant High-Risk Women in New York City.

ERIC Educational Resources Information Center

Deren, Sherry; And Others

1993-01-01

Compared high-risk pregnant (n=55) and nonpregnant (n=598) women from Harlem on human immunodeficiency virus-related drug and sexual risk behaviors. Found higher percentage of intravenous drug users (IVDUs) among nonpregnant women and no significant differences between pregnant and nonpregnant IVDUs in terms of needle risk behaviors. Pregnant…

Intimate partner violence among pregnant women in Rwanda

PubMed Central

Ntaganira, Joseph; Muula, Adamson S; Masaisa, Florence; Dusabeyezu, Fidens; Siziya, Seter; Rudatsikira, Emmanuel

2008-01-01

Background Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV) against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be made available. PMID

Asymptomatic plasmodial infection in Colombian pregnant women.

PubMed

Carmona-Fonseca, Jaime; Agudelo, Olga M; Arango, Eliana M

2017-08-01

Information about asymptomatic plasmodial infection is scarce in the world, and the current antimalarial program goals (control, elimination, and eradication) demand this evidence to be well documented in different populations and malaria transmission settings. This study aimed to measure the prevalence of API in Colombian pregnant women at delivery. A retrospective prevalence survey was used. Women were recruited at hospital obstetric facility in each of the municipalities of Turbo, Necoclí in Antioquia department, and Puerto Libertador in Córdoba department. Malaria infection was tested by thick blood smear (TBS) and real-time quantitative PCR (qPCR). Ninety-six pregnant women at delivery were studied: 95% were asymptomatic (91/96), 45% had asymptomatic plasmodial infection (API) by qPCR (41/91), and only 8% (7/91) had API by microscopy. The prevalence of submicroscopic infections (TBS negative and qPCR positive) was very high, 37% (34/91) in asymptomatic women and 41% (39/96) in total women studied (91 asymptomatic and 5 symptomatic). The prevalence of API in Colombian pregnant women is much higher than which is expected for a country that does not have the level of malaria transmission as Sub-Saharan African countries. Copyright © 2017 Elsevier B.V. All rights reserved.

Advancing HIV research with pregnant women: navigating challenges and opportunities.

PubMed

Krubiner, Carleigh B; Faden, Ruth R; Cadigan, R Jean; Gilbert, Sappho Z; Henry, Leslie M; Little, Margaret O; Mastroianni, Anna C; Namey, Emily E; Sullivan, Kristen A; Lyerly, Anne D

2016-09-24

Concerns about including pregnant women in research have led to a dearth of evidence to guide safe and effective treatment and prevention of HIV in pregnancy. To better understand why these evidence gaps persist and inform guidance for responsible inclusion of pregnant women in the HIV research agenda, we aimed to learn what HIV experts perceive as barriers and constraints to conducting this research. We conducted a series of group and one-on-one consultations with 62 HIV investigators and clinicians to elicit their views and experiences conducting HIV research involving pregnant women. Thematic analysis was used to identify priorities and perceived barriers to HIV research with pregnant women. Experts discussed a breadth of needed research, including safety, efficacy, and appropriate dosing of: newer antiretrovirals for pregnant women, emerging preventive strategies, and treatment for coinfections. Challenges to conducting research on pregnancy and HIV included ethical concerns, such as how to weigh risks and benefits in pregnancy; legal concerns, such as restrictive interpretations of current regulations and liability issues; financial and professional disincentives, including misaligned funder priorities and fear of reputational damage; and analytical and logistical complexities, such as challenges recruiting and retaining pregnant women to sufficiently power analyses. Investigators face numerous challenges to conducting needed HIV research with pregnant women. Advancing such research will require clearer guidance regarding ethical and legal uncertainties; incentives that encourage rather than discourage investigators to undertake such research; and a commitment to earlier development of safety and efficacy data through creative trial designs.

Changes in exhaled breath condensate pH in healthy and asthmatic pregnant women.

PubMed

Eszes, Noémi; Bikov, András; Lázár, Zsófia; Bohács, Anikó; Müller, Veronika; Stenczer, Balázs; Rigó, János; Losonczy, György; Horváth, Ildikó; Tamási, Lilla

2013-05-01

Asthma is a common chronic disease complicating pregnancy with a risk for perinatal complications. Control of airway inflammation in the asthmatic pregnancy improves pregnancy outcomes. Our aim was to evaluate pH of exhaled breath condensate (EBC), a non-invasive method for the assessment of asthmatic airway inflammation, in healthy and asthmatic pregnancies. Cross-sectional study. Hungarian university clinics. Seventeen healthy pregnant women, 21 asthmatic pregnant women, 23 healthy non-pregnant women and 22 asthmatic non-pregnant women. EBC samples were collected using a portable condenser, EBC pH was measured after argon deaeration. EBC pH. EBC pH (mean ± SD) of healthy non-pregnant and asthmatic non-pregnant women was similar (7.75 ± 0.27 vs. 7.54 ± 0.57; p = 0.118), probably indicating an optimal control of airway inflammation in asthmatic women. On the other hand, EBC pH was higher in healthy pregnant women compared with healthy non-pregnant women (8.02 ± 0.43 vs. 7.75 ± 0.27; p = 0.017). Higher EBC pH accompanying healthy pregnancy was absent in asthmatic pregnant patients whose EBC pH was lower (7.65 ± 0.38) than that of healthy pregnant women (p = 0.006), and it was similar to that in asthmatic and healthy non-pregnant women (p = 0.470 and p = 0.300, respectively). The EBC pH in asthmatic pregnant women correlated positively with birthweight (r = 0.49, p = 0.047) and negatively with forced vital capacity (r = 0.45, p = 0.039). EBC pH was not related to blood pH. EBC pH is higher in healthy pregnant women but not in asthmatic pregnant women compared with data from healthy non-pregnant women, indicating that oxidative inflammatory processes induced by asthma may compromise the regulatory mechanisms causing alkaline pH in the airways during pregnancy. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

The Physical Activity Patterns of Pregnant Taiwanese Women.

PubMed

Lee, Ching-Fang; Hwang, Fang-Ming; Lin, Hsien-Ming; Chi, Li-Kang; Chien, Li-Yin

2016-12-01

Physical activity reduces the risk of maternal disorders during pregnancy. However, many pregnant women reduce their levels of physical activity while pregnant. The purpose of this study was to examine and compare the physical activity (total amount, intensity, type) of Taiwanese women during each trimester. This cross-sectional survey used purposive sampling to enroll 581 Taiwanese women as participants. The physical activity of participants was measured using the Mandarin version of the Pregnancy Physical Activity Questionnaire. The levels of household/caregiving activity and occupational activity differed significantly across trimesters. Household/caregiving (43.2%-54.5%) and occupational activity (42.0%-54.0%) accounted for the largest percentages of total energy expenditure for all three trimesters. In terms of total and household/caregiving activities, multiparous women had significantly higher mean energy expenditures than their primiparous peers. Moreover, income had a pervasive influence on all types and amounts of physical activity and energy expenditures, respectively, with the exception of sports/exercise. Further careful assessment of the types and intensities of physical activity that are suitable for pregnant women in different parity and income categories in Taiwan is necessary. Furthermore, healthcare providers should encourage pregnant women to use strategies that promote their more regular participation in enjoyable physical activities. One of these potential strategies is to do activities together with children, family members, or friends.

Do pregnant women exercise their pelvic floor muscles?

PubMed

Bø, Kari; A H Haakstad, Lene; Voldner, Nanna

2007-07-01

The aims of the present study were to assess the number of women performing pelvic floor muscle training (PFMT) during pregnancy and to compare the background variables in those exercising and in those who did not. Four hundred and sixty-seven pregnant women (response rate 84%), mean age 31.5 years (range 20-49), answered a questionnaire on general physical activity level during pregnancy including PFMT. The questionnaire was sent out in week 32 of gestation and answered within week 36. Twenty-four percent reported problems with urinary incontinence and 9% flatus/fecal incontinence. The percentages of pregnant women performing PFMT at least once a week before pregnancy and during trimesters 1, 2, and 3 were 7, 12.9, 17.6, and 17.4%, respectively. More women with lower prepregnancy BMI and with present and past pelvic girdle pain were performing regular PFMT. No significant differences were found in any other background variables. It is concluded that relatively few women perform regular PFMT during pregnancy. In conclusion, only 17% of pregnant Norwegian women reported performing PFMT during pregnancy.

Effects of an oral health education program for pregnant women.

PubMed

Cardenas, Lina M; Ross, Damon D

2010-01-01

The purpose of this study was to evaluate the gain in knowledge of oral health after education to pregnant women on dental anticipatory guidance and to determine how much of this information pregnant women retain over time. The study consisted of 40 pregnant women. Inclusion criteria included: (1) between the ages of 21-40; (2) in 12-40th week of pregnancy; and (3) spoke English. During the first visit, all subjects were asked to complete a pre-test (24 questions), watch a ten minute presentation and complete the post-test (24 questions). During the second visit (4 weeks/1 month after the first visit), all subjects were asked to complete the follow-up test (24 questions). All of the tests (pre, post and follow-up) were scored and used to determine the changes in knowledge of the pregnant women after the presentation. The mean age for all 40 pregnant women was 26.88 (SD +/- 4.3) years and the mean number of weeks pregnant was 25.2 at the first visit. The mean overall correct scores for the pre-test was 12.9 (53.75%), post-test was 20.9 (87.08%) and follow-up test was 20.17 (84.05%). These overall scores show an improvement of 8 (33.33%, p<0.05) questions correct from the first to second test, and a digression of 0.73 (3.08%) questions correct from the second to third test. These observations indicate that in this study population pregnant women's knowledge improved after a presentation on dental anticipatory guidance. These observations also indicate that after four weeks, pregnant women were able to retain most of the information, as only a slight digression in overall scores was noticed from the follow-up test to the post-test.

PHQ-8 minor depression among pregnant women: association with somatic symptoms of depression.

PubMed

McMahon, Adrienne B; Arms-Chavez, Clarissa J; Harper, Bridgette D; LoBello, Steven G

2017-06-01

It was recently reported that pregnant women were more likely to have minor depression as measured by the Patient Health Questionnaire-8 depression scale (PHQ-8), (as reported by Kroenke and Spitzer (Psychiatr Ann 32(9):1-7, 2002), and Kroenke et al. (J Affect 114(1-3):163-173, 2009)) compared to women who were not pregnant (as reported by Ashley et al. (Arch Womens Ment Health 19(2):395-400, 2015)). The present study is designed to investigate if somatic symptoms (energy level, appetite, sleep) associated with both pregnancy and depression were responsible for this increased prevalence of minor depression. A sample of pregnant women (n = 404) was compared to women who were not pregnant (n = 6754). Both groups scored within the minor depression range on the PHQ-8 and comparisons were based on participants' responses to PHQ-8 items. Results indicate that of the somatic symptoms of depression, only changes in energy level accounted for the elevated prevalence of minor depression among pregnant women compared to women who are not pregnant. Removing the decreased energy item from the score determination reduces the prevalence of minor depression among pregnant women to a level significantly below that of women who are not pregnant. Emotional symptoms such as feeling down and feeling like a failure were less likely to be reported by pregnant women compared to women who were not pregnant. Implications for depression screening during pregnancy are discussed.

Molecular Characterization of Streptococcus agalactiae Isolates From Pregnant and Non-Pregnant Women at Yazd University Hospital, Iran.

PubMed

Sadeh, Maryam; Firouzi, Roya; Derakhshandeh, Abdollah; Bagher Khalili, Mohammad; Kong, Fanrong; Kudinha, Timothy

2016-02-01

Streptococcus agalactiae (Group B streptococcus, GBS) that colonize the vaginas of pregnant women may occasionally cause neonatal infections. It is one of the most common causes of sepsis and meningitis in neonates and of invasive diseases in pregnant women. It can also cause infectious disease among immunocompromised individuals. The distribution of capsular serotypes and genotypes varies over time and by geographic era. The serotyping and genotyping data of GBS in Iranian pregnant and non-pregnant women seems very limited. The aim of this study was to investigate the GBS ‎molecular capsular serotype ‎and genotype distribution of pregnant and non-pregnant carrier ‎women at Yazd university hospital, in Iran.‎. In this cross-sectional study, a total of 100 GBS strains isolated from 237 pregnant and 413 non-pregnant women were investigated for molecular capsular serotypes and surface protein genes using the multiplex PCR assay. The Chi-square method was used for statistical analysis. Out of 650 samples, 100 (15.4%) were identified as GBS, with a predominance of capsular serotypes III (50%) [III-1 (49), III-3 (1)], followed by II (25%), Ia (12%), V (11%), and Ib (2%), which was similar with another study conducted in Tehran, Iran, but they had no serotype Ia in their report. The surface protein antigen genes distribution was rib (53%), epsilon (38%), alp2/3 (6%), and alpha-c (3%). The determination of serotype and surface proteins of GBS strains distribution would ‎be ‎relevant ‎for the future possible formulation of a GBS vaccine.

Midwifery Management of Pregnant Women Who Are Obese.

PubMed

Reither, Margi; Germano, Elaine; DeGrazia, Michele

2018-05-19

Obesity is associated with increased risks for adverse health outcomes during and after pregnancy in both the woman with obesity and her infant. This study was designed to investigate midwifery management of pregnant women with obesity. Certified midwives and certified nurse-midwives who were members of the American College of Nurse-Midwives were sent a survey. The survey instrument was divided into 4 sections: demographic characteristics; practice guidelines and protocols; the role of the 2015 Levels of Maternal Care guidelines for referral, including transfer to a higher level of care; and factors that influence management of pregnant women with obesity. Descriptive statistics were used to analyze data. In a sample of 546 midwives, 87% of respondents reported observing an increase in perinatal complications associated with obesity. Midwives reported increasing discomfort with the care of pregnant women with obesity as body mass index (BMI) increased. For pregnant women with extreme obesity, the respondents reported less frequent use of physiologic birth guidelines only and increased use of interventions, referral to physician care, and transfer to a higher level of care. Approximately half (270, 49.5%) reported having a guideline that addressed the care of women with obesity. Of these, 145 midwives (53.7%) reported that extreme obesity was the BMI threshold for identifying an increased or high risk for perinatal complications. Sixty percent (339) of midwives who participated requested guidance for management of laboring women who are obese. This study provides a greater understanding of midwifery management practices when caring for women with obesity and opportunities to improve care. The results suggest that midwifery management alters with increased BMI, specifically in the care of women with extreme obesity. Suggestions for future study include research on management of pregnant women with obesity and extreme obesity with outcome data examining management

Epidemiology and Risk Factors of Functional Constipation in Pregnant Women

PubMed Central

Zhang, Yi; Guo, Sa; Wang, Jing; Wang, Jianjun

2015-01-01

Aim To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors. Methods We searched hospital databases for women who were 37–41 weeks pregnant (1698 cases) from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software. Results Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history. Conclusion The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population. PMID:26208169

[Sexuality of pregnant women].

PubMed

Malarewicz, Andrzej; Szymkiewicz, Jadwiga; Rogala, Jerzy

2006-09-01

Over the time when the sexual intercourse has been considered merely one of a number of forms of sexual contact, views on sexuality during pregnancy have undergone considerable transformation. A great many of authors emphasise, that the pregnancy is a stimulus for partners to search for ways to maintain mutual emotional bond, close physical affinity and satisfy sexual needs not necessarily finished with an intercourse. The fact, that one of the two partners is pregnant, imposes some restrictions on sexual life. Not rarely, in particular in the first trimester of pregnancy, a female is little interested in sex. It is due to, inter alia, hormonal changes resulting in nausea, fatigue and increased nervosity. These symptoms contribute to general feebleness and reduction of the level of sexual needs and difficulty to become aroused and sexually ready. In spite of that, a lot of women have the need to keep physical and emotional contact with their partners. For a number of couples, pregnancy becomes a stimulus to search for new ways of pleasing each other in love play, that does not necessarily leads with an intercourse. Most studies concerning sexuality during pregnancy focus on observing sexual activity, physiological changes, mutual relationship of partners, analysis of sexual intercourses and investigation of so-called sexual satisfaction. Examination of sexual satisfaction ruchedes the frequency of sexual contacts, intercourses, foreplay, concurrence of orgasms in the two partners, partners' happiness, sexual satisfaction and mutual heartiness. In some researchers' opinion, sexual satisfaction correlates with the feeling of happiness resulting form being pregnant, pregnant woman's feeling still attractive and experience of orgasm. However, some researchers observe reduced sexual activity during pregnancy, except for the second trimester, when sexual activity is similar to the one outside pregnancy. Pregnant women prefer the following types of sexual activity: non

[Asymptomatic bacteriuria among pregnant women. An underestimated threat].

PubMed

Quiroga-Feuchter, Germán; Robles-Torres, Rosa Evangelina; Ruelas-Morán, Andrés; Gómez-Alcalá, Alejandro V

2007-01-01

Urinary tract infection is a common pregnancy complication. Asymptomatic bacteriuria (AB) can trigger the development of serious complications affecting both the mother and the fetus. Determine the frequency of AB among pregnant women attending to antenatal care at the family medicine clinic number 1 of the Instituto Mexicano del Seguro Social, located in Ciudad Obregón, Sonora. A longitudinal study was carried out from September to December 2004. Seventy-two 72 pregnant women with gestational age of 24 weeks or less were followed up during four months. All pregnant women were selected by a non-probabilistic method. Every patient had a monthly urine culture during the follow up period. Among the 72 pregnant women, 16.7% developed symptomatic urinary infections during the follow-up and 25% had at least one positive urine culture without urinary symptoms, being classified as AB, thus receiving treatment. Frequency of positive urine cultures was common at first and fourth months of follow-up. Urine culture is an important component of prenatal care, and helps in identifying a significant number of urinary tract infections that would go otherwise undetected.

Seroprevalence of toxoplasmosis in Korean pregnant women.

PubMed

Song, Kyoung-Ju; Shin, Jong-Chul; Shin, Ho-Joon; Nam, Ho-Woo

2005-06-01

This study was performed in order to evaluate the sero-epidemiological status of toxoplasmosis in pregnant Korean women. Among 5,175 sera and 750 amniotic fluid samples obtained from pregnant women, 41 serum samples (0.79%) and 10 (1.33%) amniotic fluid samples tested positive for IgG antibodies by ELISA. Fifty one cases showing a score more than 0.25 on ELISA were tested for PCR reaction against the SAG1 gene. Only one case of the 51 ELISA positive cases exhibited a positive reaction on all tests. This case had a history of acute nephropyelitis during early pregnancy, but fortunately, had delivered a phenotypically healthy baby. In this study, the seroprevalence of toxoplasmosis in pregnant women was found to be comparatively low, consistent with previous reports from Korea. However our trials, performed with a variety of diagnostic tools, were considered to be useful for the precise diagnosis of congenital toxoplasmosis.

Factors influencing brain natriuretic peptide levels in healthy pregnant women.

PubMed

Mayama, Michinori; Yoshihara, Masato; Uno, Kaname; Tano, Sho; Takeda, Takehiko; Ukai, Mayu; Kishigami, Yasuyuki; Oguchi, Hidenori

2017-02-01

The normal range of plasma brain natriuretic peptide (BNP) in pregnant women is still unclear. Moreover, pregnant women experience dynamic body weight changes and suffer from anemia, but effects on maternal BNP have not been investigated. This study aimed to reveal the normal plasma BNP range and examine the effects of physiological changes on BNP among pregnant women. Plasma BNP, hemoglobin, plasma creatinine and BMI were measured in 58 non-pregnant control women and in 773 normal pregnant women at late pregnancy, early postpartum and 1-month postpartum. Mean plasma BNP (in pg/mL) was 11.8 (95% confidence interval: 0-27.5) in non-pregnant women, 17.9 (0-44.7, p<0.001) at late pregnancy, 42.5 (0-112.6, p<0.001) early postpartum and 16.1 (0-43.9, p=0.001) 1-month postpartum. Multiple regression analysis revealed that pre-delivery BNP levels were negatively correlated with BMI (p<0.001) and hemoglobin (p=0.002) and positively correlated with creatinine (p<0.001). Post-delivery BNP was positively associated with body weight change during pregnancy (p=0.001) and post-delivery creatinine (p=0.010) but negatively associated with body weight loss at delivery (p<0.001) and post-delivery hemoglobin (p=0.004). Even normal pregnancy affects plasma BNP, particularly in the early postpartum period, indicative of cardiac stress. Plasma BNP levels are affected by BMI, body weight changes, creatinine and hemoglobin levels; therefore, these factors should be considered when analysing cardiac function and the physiological implications of BNP levels in pregnant women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Urinary angiotensinogen excretion in Australian Indigenous and non-Indigenous pregnant women.

PubMed

Pringle, Kirsty G; de Meaultsart, Celine Corbisier; Sykes, Shane D; Weatherall, Loretta J; Keogh, Lyniece; Clausen, Don C; Dekker, Gus A; Smith, Roger; Roberts, Claire T; Rae, Kym M; Lumbers, Eugenie R

2018-04-01

The intrarenal renin-angiotensin system (iRAS) is implicated in the pathogenesis of hypertension, chronic kidney disease and diabetic nephropathy. Urinary angiotensinogen (uAGT) levels reflect the activity of the iRAS and are altered in women with preeclampsia. Since Indigenous Australians suffer high rates and early onset of renal disease, we hypothesised that Indigenous Australian pregnant women, like non-Indigenous women with pregnancy complications, would have altered uAGT levels. The excretion of RAS proteins was measured in non-Indigenous and Indigenous Australian women with uncomplicated or complicated pregnancies (preeclampsia, diabetes/gestational diabetes, proteinuria/albuminuria, hypertension, small/large for gestational age, preterm birth), and in non-pregnant non-Indigenous women. Non-Indigenous pregnant women with uncomplicated pregnancies, had higher uAGT/creatinine levels than non-Indigenous non-pregnant women (P < 0.01), and levels increased as pregnancy progressed (P < 0.001). In non-Indigenous pregnant women with pregnancy complications, uAGT/creatinine was suppressed in the third trimester (P < 0.01). In Indigenous pregnant women with uncomplicated pregnancies, there was no change in uAGT/creatinine with gestational age and uAGT/creatinine was lower in the 2nd and 3rd trimesters than in non-Indigenous pregnant women with uncomplicated pregnancies (P < 0.03, P < 0.007, respectively). The uAGT/creatinine ratios of Indigenous women with uncomplicated or complicated pregnancies were the same. A decrease in uAGT/creatinine with advancing gestational age was associated with increased urinary albumin/creatinine, as is seen in preeclampsia, but it was not specific for this disorder. The reduced uAGT/creatinine in Indigenous pregnant women may reflect subclinical renal dysfunction which limits the ability of the kidney to maintain sodium balance and could indicate an increased risk of pregnancy complications and/or future renal

Screening for gestational diabetes mellitus in Germany: A qualitative study on pregnant women's attitudes, experiences, and suggestions.

PubMed

Görig, Tatiana; Schneider, Sven; Bock, Christina; Maul, Holger; Kleinwechter, Helmut; Diehl, Katharina

2015-11-01

to explore pregnant women's experiences with the recently implemented screening for gestational diabetes mellitus (GDM). qualitative study. Rhine-Neckar Metropolitan region, Germany. 20 pregnant women aged 27-41 years (mean: 32.6 years) who were at least in gestational week 29, i.e., those who should have already been screened for GDM. semi-structured interviews with open-ended questions were conducted via telephone between November 2013 and February 2014. All interviews were audiotaped, transcribed verbatim and subsequently analyzed using qualitative content analysis according to Mayring. The screening was seen as an important instrument to detect GDM and thus to prevent possible health problems in both mother and child. Some deviations from the recommended screening procedure were reported in the interviews, e.g., collecting capillary blood instead of venous blood during an oral glucose tolerance test (OGTT); offering an OGTT without a prior glucose challenge test (GCT); conducting a GCT after an overnight fast. Two women had to actively ask for the screening to be done. One woman reported that her gynaecologist advised her against the screening. this qualitative study reflects the women's experiences with the new screening for GDM. Our findings show that two years after the introduction of universal GDM screening in Germany the screening procedure does not always seem to meet the standards of the German maternity guidelines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Becoming pregnant: exploring the perspectives of women living with diabetes

PubMed Central

Griffiths, Frances; Lowe, Pam; Boardman, Felicity; Ayre, Catherine; Gadsby, Roger

2008-01-01

Background The risk of adverse pregnancy outcome for women with type 1 diabetes is reduced through tight diabetes control. Most women enter pregnancy with inadequate blood glucose control. Interview studies with women suggest the concept of ‘planned’ and ‘unplanned’ pregnancies is unhelpful. Aim To explore women's accounts of their journeys to becoming pregnant while living with type 1 diabetes. Design of study Semi-structured interviews with 15 women living with pre-gestational type 1 diabetes, between 20 and 30 weeks gestation and with a normal pregnancy ultrasound scan. Setting Four UK specialist diabetes antenatal clinics. Method Interviews explored women's journeys to becoming pregnant and the impact of health care. Analysis involved comparison of women's accounts of each pregnancy and a thematic analysis. Results Women's experiences of becoming pregnant were diverse. Of the 40 pregnancies described, at least one positive step towards becoming pregnant was taken by 11 women in 23 pregnancies but not in the remaining 17 pregnancies, with variation between pregnancies. Prior to and in early pregnancy, some women described themselves as experts in their diabetes but most described seeking and/or receiving advice from their usual health professionals. Three women described pre-conception counselling and the anxiety this provoked. Conclusion For women living with type 1 diabetes each pregnancy is different. The concept of planned and unplanned pregnancy is unhelpful for designing health care. Formal preconception counselling can have unintended consequences. Those providing usual care to women are well positioned to provide advice and support to women about becoming pregnant, tailoring it to the changing needs and situation of each woman. PMID:18318971

Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men

PubMed Central

Aliyu, Muktar H.; Blevins, Meridith; Megazzini, Karen M.; Parrish, Deidra D.; Audet, Carolyn M.; Chan, Naomi; Odoh, Chisom; Gebi, Usman I.; Muhammad, Mukhtar Y.; Shepherd, Bryan E.; Wester, C. William; Vermund, Sten H.

2015-01-01

Background We examined antiretroviral therapy (ART) initiation and retention by sex and pregnancy status in rural Nigeria. Methods We studied HIV-infected ART-naïve patients aged ≥15 years entering care from June 2009 to September 2013. We calculated the probability of early ART initiation and cumulative incidence of loss to follow-up (LTFU) during the first year of ART, and examined the association between LTFU and sex/pregnancy using Cox regression. Results The cohort included 3813 ART-naïve HIV-infected adults (2594 women [68.0%], 273 [11.8%] of them pregnant). The proportion of pregnant clients initiating ART within 90 days of enrollment (78.0%, 213/273) was higher than among non-pregnant women (54.3%,1261/2321) or men (53.0%, 650/1219), both p<0.001. Pregnant women initiated ART sooner than non-pregnant women and men (median [IQR] days from enrollment to ART initiation for pregnant women=7 days [0–21] vs 14 days [7–49] for non-pregnant women and 14 days [7–42] for men; p<0.001). Cumulative incidence of LTFU during the first year post-ART initiation was high and did not differ by sex and pregnancy status. Persons who were unemployed, bedridden, had higher CD4+ counts, and/or in earlier WHO clinical stages were more likely to be LTFU. Conclusions Pregnant women with HIV in rural Nigeria were more likely to initiate ART but were no more likely to be retained in care. Our findings underscore the importance of effective retention strategies across all patient groups, regardless of sex and pregnancy status. PMID:26012740

Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women.

PubMed

Hall, Helen; Lauche, Romy; Adams, Jon; Steel, Amie; Broom, Alex; Sibbritt, David

2016-02-01

Common discomforts of pregnancy experienced in the lower extremity include sciatica, leg cramps and varicose veins. Whilst research attention has focused on aetiology and outcomes, the health service utilisation of pregnant women suffering from these complaints has been largely overlooked. To examine the health status and health service utilisation profile of pregnant women experiencing sciatica, leg cramps or varicose veins. Linear and logistic regression was applied to a cross-sectional survey of a pregnant women drawn from the 1973 to 1978 cohort (aged 31-36 years in 2009), of the Australian Longitudinal Study on Women's Health (n=1835). Participant's demographics, health status and health service utilisation were compared for all three complaints based upon three subgroups (yes, sought help; yes, did not seek help; no). A number of women experienced sciatica (22.1%), leg cramps (18.2%) or varicose veins (9.4%). Of these, a greater proportion of women with sciatica (79.3%) or varicose veins (71.5%) sought help for their condition compared with women with leg cramps (46.7%). Comparisons between women with the conditions of interest who did seek help and those who did not only found that women with a university degree were 0.29 (95% CI: 0.10, 0.85) times less likely to seek help for their condition compared to women with a school only education. Further research examining all health seeking behaviour and treatment use of pregnant women who experience lower extremity problems is required in order to facilitate safe, effective and coordinated maternity care to further support these women during pregnancy. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Midwives' oral health recommendations for pregnant women, infants and young children: results of a nationwide survey in Germany.

PubMed

Wagner, Yvonne; Heinrich-Weltzien, Roswitha

2016-03-18

Studies suggest that poor oral health during pregnancy can lead to perinatal complications, such as low birth weight and preterm delivery as well as poor oral health in children. Aim of this study was to assess the German midwives knowledge about oral health and preventive recommendations for pregnant women, infants and young children. The nationwide online-survey was conducted with use of a self-developed, pretested and validated standardized questionnaire. The German association of midwives (Deutscher Hebammenverband e.V.) informed their members about the survey through email, newsletter, website and association journal (Hebammenforum) (n = 7.500). Data were analyzed using descriptive statistics. Response rate was 12.6 % (mean age 42.9 ± 9.3 years). The majority of midwives advised pregnant women about periodontal diseases (78.6 %). Of the midwives, 8.4 % mentioned the possible associations between periodontal diseases and perinatal complications. In general, half of the midwives (53.5 %) recommended a dental visit during pregnancy. A total of 65.5 % of midwives advised parents about early childhood caries. The majority of midwives recommended that oral hygiene starts with eruption of the first tooth (60.4 %) and the first dental visit of the child should be at age 2 or 3 years (51.6 %). Midwives recommendations regarding the implementation of oral hygiene and the referral to a dentist during pregnancy and childhood were highly variable. To increase oral awareness and to improve the oral health knowledge among midwives and all other health-care professionals, uniform guidelines should be developed in Germany. German Clinical Trial Register DRKS00008021.

Schistosomiasis among pregnant women in rural communities in Nigeria.

PubMed

Salawu, Oyetunde T; Odaibo, Alexander B

2013-07-01

To assess the epidemiology of urogenital schistosomiasis among pregnant women in rural communities of southwestern Nigeria. The present cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted during 2010-2011 among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically screened for infection with Schistosoma haematobium. Of 313 volunteer participants, 20.8% tested positive for S. haematobium infection. The prevalence of infection was highest (31.5%) among women aged 20-24years. The infection intensity did not differ significantly between age groups (t=1.848, P=0.71). Primigravidae and women in the first trimester of pregnancy had the highest intensity of infection with 33.1 and 27.7 eggs/10mL of urine, respectively. There was an association between disease prevalence and parasite intensity across the age groups (χ(2)=68.82, P=0.02). The prevalence of S. haematobium was not associated with age or pregnancy trimester (P=0.06), but associations existed between intensity of infection and gravidity (P=0.001). The prevalence of urogenital schistosomiasis among pregnant women in Nigeria was high, with younger women and primigravidae at the greatest risk. These data can be used to develop a schistosomiasis control program among pregnant women in the study area. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Estimation of daily energy expenditure in pregnant and non-pregnant women using a wrist-worn tri-axial accelerometer.

PubMed

van Hees, Vincent T; Renström, Frida; Wright, Antony; Gradmark, Anna; Catt, Michael; Chen, Kong Y; Löf, Marie; Bluck, Les; Pomeroy, Jeremy; Wareham, Nicholas J; Ekelund, Ulf; Brage, Søren; Franks, Paul W

2011-01-01

Few studies have compared the validity of objective measures of physical activity energy expenditure (PAEE) in pregnant and non-pregnant women. PAEE is commonly estimated with accelerometers attached to the hip or waist, but little is known about the validity and participant acceptability of wrist attachment. The objectives of the current study were to assess the validity of a simple summary measure derived from a wrist-worn accelerometer (GENEA, Unilever Discover, UK) to estimate PAEE in pregnant and non-pregnant women, and to evaluate participant acceptability. Non-pregnant (N = 73) and pregnant (N = 35) Swedish women (aged 20-35 yrs) wore the accelerometer on their wrist for 10 days during which total energy expenditure (TEE) was assessed using doubly-labelled water. PAEE was calculated as 0.9×TEE-REE. British participants (N = 99; aged 22-65 yrs) wore accelerometers on their non-dominant wrist and hip for seven days and were asked to score the acceptability of monitor placement (scored 1 [least] through 10 [most] acceptable). There was no significant correlation between body weight and PAEE. In non-pregnant women, acceleration explained 24% of the variation in PAEE, which decreased to 19% in leave-one-out cross-validation. In pregnant women, acceleration explained 11% of the variation in PAEE, which was not significant in leave-one-out cross-validation. Median (IQR) acceptability of wrist and hip placement was 9(8-10) and 9(7-10), respectively; there was a within-individual difference of 0.47 (p<.001). A simple summary measure derived from a wrist-worn tri-axial accelerometer adds significantly to the prediction of energy expenditure in non-pregnant women and is scored acceptable by participants.

Substance Use in Pregnant Women Using the Emergency Department: Undertested And Overlooked?

PubMed Central

Moyer, C. Leigh; Johnson, Sean; Klug, Marilyn G.

2018-01-01

Introduction The objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women. Methods We captured all ED visits over a six-year period (2010–2016) from a single community hospital and identified women of childbearing age, defined for our study as 11–50 years old. We collected demographic data including age in years, ethnicity, body mass index, marital status, disposition, last encounter department, method of arrival, and day of week. An independent binary variable was created based on whether the woman was tested for alcohol or drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, opioids) during her visit. We then compared rates of testing for substance use by pregnancy status. Results We identified 61,222 ED visits by women of childbearing age (range 11–50, mean 30.5, standard deviation 9.6) over a six-year period from 2010–2016. Of the 57,360 non-pregnant women, 4.14% were tested compared to 1.04% of the 3,862 pregnant women tested with a relative risk of 0.25 (p<0.001, 95% confidence interval [CI] [0.183–0.341]). The most highly tested chief complaints for all women – psychiatric or substance use concerns – showed pregnant women were still 37% and 54% less likely to be tested, respectively (risk ratio [RR] 0.46, 95% CI [0.19–1.13]; RR 0.63, 95% CI [0.41–0.96]). Beyond pregnancy status, we found no significant interaction between patient demographics and substance use testing. Conclusion Pregnant women presenting to the ED were 75% less likely to be tested for drug or alcohol use than non-pregnant women. Our study showed only pregnancy status as a statistically significant variable in drug- and alcohol-screening rates when pregnant and non-pregnant patient chief complaints and demographics were compared. Increased attention to the screening of pregnant women for substance use may be necessary to provide adequate care and intervention to

Vaccination knowledge and acceptability among pregnant women in Italy.

PubMed

D'Alessandro, Alessia; Napolitano, Francesco; D'Ambrosio, Antonio; Angelillo, Italo Francesco

2018-06-04

The aims of this survey were to ascertain pregnant women's level of knowledge and acceptability on the vaccinations and to identify their associations with several characteristics. A cross-sectional study was performed from December 2017 through March 2018 in the geographic area of Naples, Italy. The study used two stages cluster sampling method for selection and recruitment of participants. Data were collected through face-to-face interviews with pregnant women present at the Obstetrics outpatient clinic of the selected hospitals. A total of 358 respondents agreed to be interviewed out of the 405 pregnant women selected. One-fourth knew at least one of the vaccinations recommended during pregnancy and only 2.8% correctly identified all of these. Women who had received information about the vaccinations during pregnancy from general practitioners or gynecologists or other sources and those with at least one child were more likely to know at least one of the recommended vaccinations, whereas women with middle school education were less knowledgeable. None of the women had received tetanus, diphtheria, and acellular pertussis vaccine and only 1.4% the seasonal influenza vaccination. Only 27.9% reported a positive willingness to receive all the recommended vaccinations during pregnancy. Pregnant women would be willing to get all recommended vaccinations if they had at least one child and if they needed additional information, whereas the willingness was significantly lower among women who had reported high school as the highest level of education, who were in the second trimester of pregnancy, and who felt that the recommended vaccines administered during pregnancy were less dangerous for them and for the unborn child. This study suggests important focus points to be taking into account for informing and for implementing education activities on the benefits regarding vaccinations in order to increase the level of knowledge and the uptake in pregnant women.

Pregnant women in vehicles: Driving habits, position and risk of injury.

PubMed

Auriault, F; Brandt, C; Chopin, A; Gadegbeku, B; Ndiaye, A; Balzing, M-P; Thollon, L; Behr, M

2016-04-01

This study proposed to broadly examine vehicle use by pregnant women in order to improve realism of accident simulations involving these particular occupants. Three research pathways were developed: the first consisted in a questionnaire survey examining the driving habits of 135 pregnant women, the second obtained measurements of 15 pregnant women driving position in their own vehicle from the 6th to the 9th month of pregnancy by measuring distances between body parts and vehicle parts, and the third examined car accidents involving pregnant occupants. Results obtained indicate that between 90% and 100% of pregnant women wore their seat belts whatever their stage of pregnancy, although nearly one third of subjects considered the seat belt was dangerous for their unborn child. The measurements obtained also showed that the position of the pregnant woman in her vehicle, in relation to the various elements of the passenger compartment, changed significantly during pregnancy. In the studied accidents, no correlation was found between the conditions of the accident and the resulting fetal injury. Results reveal that pregnant women do not modify significantly the seat setting as a function of pregnancy stage. Only the distance between maternal abdomen and steering wheel change significantly, from 16 cm to 12 cm at 6 and 9 month respectively. Pregnant women are mainly drivers before 8 months of pregnancy, passengers after that. Car use frequency falls down rapidly from 6 to 9 months of pregnancy. Real crashes investigations indicate a low rate of casualties, i.e. 342 car accidents involving pregnant women for a period of 9 years in an approximately 1.7 million inhabitants area. No specific injury was found as a function of stage of pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hepatitis C virus and HIV co-infection among pregnant women in Rwanda.

PubMed

Mutagoma, Mwumvaneza; Balisanga, Helene; Sebuhoro, Dieudonné; Mbituyumuremyi, Aimable; Remera, Eric; Malamba, Samuel S; Riedel, David J; Nsanzimana, Sabin

2017-02-22

Hepatitis C virus (HCV) infection is a pandemic causing disease; more than 185 million people are infected worldwide. An HCV antibody (Ab) prevalence of 6.0% was estimated in Central African countries. The study aimed at providing HCV prevalence estimates among pregnant women in Rwanda. HCV surveillance through antibody screening test among pregnant women attending antenatal clinics was performed in 30 HIV sentinel surveillance sites in Rwanda. Among 12,903 pregnant women tested at antenatal clinics, 335 (2.6% [95% Confidence Interval 2.32-2.87]) tested positive for HCV Ab. The prevalence of HCV Ab in women aged 25-49 years was 2.8% compared to 2.4% in women aged 15-24 years (aOR = 1.3; [1.05-1.59]); This proportion was 2.7% [2.37-2.94] in pregnant women in engaged in non-salaried employment compared to 1.2% [0.24-2.14] in those engaged in salaried employment (aOR = 3.2; [1.60-6.58]). The proportion of HCV Ab-positive co-infected with HIV was estimated at 3.9% (13 cases). Women in urban residence were more likely to be associated with HCV-infection (OR = 1.3; 95%CI [1.0-1.6]) compared to those living in rural setting. HCV is a public health problem in pregnant women in Rwanda. Few pregnant women were co-infected with HCV and HIV. Living in urban setting was more likely to associate pregnant women with HCV infection.

Group B Streptococcal Colonization Among Pregnant Women in Delhi, India.

PubMed

Chaudhary, Manu; Rench, Marcia A; Baker, Carol J; Singh, Pushpa; Hans, Charoo; Edwards, Morven S

2017-07-01

Little is known regarding maternal group B streptococcal (GBS) colonization prevalence and capsular (CPS) serotype distribution among pregnant women in India. The objective of this prospective cohort study was to determine GBS recto-vaginal colonization prevalence in pregnant women at Dr. Ram Manohar Lohia Hospital in Delhi, India. Literature review identified reports from India assessing GBS colonization prevalence in pregnant women. Rectal and vaginal swabs were inoculated into Strep B Carrot Broth (Hardy Diagnostics, Santa Maria, CA) and subcultured onto GBS Detect plates (Hardy Diagnostics, Santa Maria, CA). Isolates were serotyped using ImmuLex Strep-B latex kits (Statens Serum Institut, Copenhagen, Denmark). Thirteen studies were identified citing GBS colonization prevalence during pregnancy as 0.47%-16%. Among 300 pregnant women (mean age: 26.9 years; mean gestation: 34 weeks) enrolled (August 2015 to April 2016), GBS colonization prevalence was 15%. Fifteen percent of women had vaginal only, 29% had rectal only and 56% had both sites colonized. CPS types were Ia (13.3%), Ib (4.4%), II (20%), III (22.2%), V (20%) and VII (6.7%); 13.3% were nontypable. Fetal loss in a prior pregnancy at ≥20-weeks gestation was more common in colonized than noncolonized women (15.6% vs. 3.5%; P = 0.004). Employing recent census data for the birth cohort and estimating that 1%-2% of neonates born to colonized women develop early-onset disease, at least 39,000 cases of early-onset disease may occur yearly in India. Using optimal methods, 15% of third trimester pregnant women in India are GBS colonized. A multivalent vaccine containing 6 CPS types (Ia, Ib, II, III, V and VII) would encompass ~87% of GBS carried by pregnant women in India.

Pregnant women with HIV in rural Nigeria have higher rates of antiretroviral treatment initiation, but similar loss to follow-up as non-pregnant women and men.

PubMed

Aliyu, Muktar H; Blevins, Meridith; Megazzini, Karen M; Parrish, Deidra D; Audet, Carolyn M; Chan, Naomi; Odoh, Chisom; Gebi, Usman I; Muhammad, Mukhtar Y; Shepherd, Bryan E; Wester, C William; Vermund, Sten H

2015-11-01

We examined antiretroviral therapy (ART) initiation and retention by sex and pregnancy status in rural Nigeria. We studied HIV-infected ART-naïve patients aged ≥15 years entering care from June 2009 to September 2013. We calculated the probability of early ART initiation and cumulative incidence of loss to follow-up (LTFU) during the first year of ART, and examined the association between LTFU and sex/pregnancy using Cox regression. The cohort included 3813 ART-naïve HIV-infected adults (2594 women [68.0%], 273 [11.8%] of them pregnant). The proportion of pregnant clients initiating ART within 90 days of enrollment (78.0%, 213/273) was higher than among non-pregnant women (54.3%,1261/2321) or men (53.0%, 650/1219), both p<0.001. Pregnant women initiated ART sooner than non-pregnant women and men (median [IQR] days from enrollment to ART initiation for pregnant women=7 days [0-21] vs 14 days [7-49] for non-pregnant women and 14 days [7-42] for men; p<0.001). Cumulative incidence of LTFU during the first year post-ART initiation was high and did not differ by sex and pregnancy status. Persons who were unemployed, bedridden, had higher CD4+ counts, and/or in earlier WHO clinical stages were more likely to be LTFU. Pregnant women with HIV in rural Nigeria were more likely to initiate ART but were no more likely to be retained in care. Our findings underscore the importance of effective retention strategies across all patient groups, regardless of sex and pregnancy status. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Dietary assessment of a population of pregnant women in Sheffield, UK.

PubMed

Mouratidou, Theodora; Ford, Fiona; Prountzou, Foteini; Fraser, Robert

2006-11-01

The present study examined the dietary intakes of a population of pregnant women living in the North of England. The objectives of the paper were to assess and describe the dietary intakes of the population and relate the findings to existing data on the diet of pregnant and non-pregnant women in the UK. A total of 250 pregnant women attending their first antenatal appointment at the Jessop Wing Hospital, Sheffield, UK were recruited. Information on their diet was assessed by an interviewer-administered semi-quantified food frequency questionnaire (FFQ). The mean intakes as assessed by the FFQ were similar to other studies of UK pregnant population; however Sheffield pregnant women had lower intakes of calcium and folate. Study findings were also related to the National Diet and Nutrition Survey and to the Estimated Nutrient Intakes (EAR). Of the study participants, 40 % did not meet the EAR for calcium, 67 % for iron and 69 % for folate. Subgroup comparisons suggested lower nutrient intakes of participants living in the 40 % most deprived electoral wards. The study findings suggest that the diet of pregnant women in Sheffield is characterised by low intakes of important nutrients for pregnancy such as folate and nutrient variations by electoral wards.

Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women.

PubMed

Andiappan, Hemah; Nissapatorn, Veeranoot; Sawangjaroen, Nongyao; Nyunt, Myat Htut; Lau, Yee-Ling; Khaing, Si Lay; Aye, Khin Myo; Mon, Nan Cho Nwe; Tan, Tian-Chye; Kumar, Thulasi; Onichandran, Subashini; bin Mat Adenan, Noor Azmi

2014-12-12

Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively. Anti-Toxoplasma IgG and IgM antibodies were screened by using standard commercial ELISA kits. The socio-demographic, obstetrics and risk factors associated with Toxoplasma infection data were compared between the two countries. The overall prevalence of Toxoplasma infection in Malaysian pregnant women (42.47%; 95% CI = 36.11-49.09) was significantly higher (p < 0.05) than Myanmar pregnant women (30.70%; 95% CI = 27.92-37.16). By univariate analysis, this study identified that age group, education, parity, awareness on toxoplasmosis and consumption of undercooked meat were significantly associated (p < 0.05) with Toxoplasma seropositive Malaysian pregnant women but none of these factors associated with Toxoplasma seropositive Myanmar pregnant women. In comparison using univariate analysis between the two countries, it was found that Toxoplasma seropositive Malaysian pregnant women was associated with aged 30 years and above, secondary or lower-secondary level of education, the third trimester of pregnancy, having one child or more, lacking awareness of toxoplasmosis, absence of bad obstetrics history, having no history of close contact with cats or soil, living on a farm and also consumption of undercooked meat, unpasterized milk or untreated water. Avidity measurement was used to confirm the stages of Toxoplasma infection in pregnant women who were positive for both IgG and IgM antibodies and found all were infected in the past. From our study, Toxoplasma screening and its risk measurement in pregnant women is firmly recommended for monitoring purposes and assisting proper management, including diagnosis and

[Studies of diet management and insulin resistance in obese pregnant women].

PubMed

Takeda, S; Saitoh, M; Kinoshita, K; Sakamoto, S

1992-02-01

In an attempt to determine the principles of diet management in obese pregnant women, the association between maternal weight gain during pregnancy (Group I; weight reduction, Group II; +0-4 kg, Group III; +5-9 kg, Group IV; +10 kg-) and the incidence of the complications was investigated in 151 obese pregnant women. Studies on glucose tolerance and insulin binding to erythrocytes were also undertaken. 1) In Group I, the incidences of C/S, forceps delivery, prolonged labor and complication of PIH were lower than those of other groups. There were no heavy-for-dates and light-for-dates babies in Group I, differing from the other three groups. 2) Plasma levels of glucose and insulin were high in obese pregnant women on 75 g OGTT in the second trimester. The binding sites of insulin to erythrocytes were significantly decreased in obese pregnant women. In conclusion, the risks of pregnancy complicated by obesity were high. Insulin resistance was a characteristic of obese pregnant women. The results of this study suggested that the nutritional requirements for very obese pregnant women should be restricted to maintaining the same weight or losing weight during the course of pregnancy to minimize maternal and perinatal risks.

Submicroscopic malaria infections in pregnant women from six departments in Haiti.

PubMed

Elbadry, Maha A; Tagliamonte, Massimiliano S; Raccurt, Christian P; Lemoine, Jean F; Existe, Alexandre; Boncy, Jacques; Weppelmann, Thomas A; Dame, John B; Okech, Bernard A

2017-08-01

To describe the epidemiology of malaria in pregnancy in Haiti. Cross-sectional study among pregnant women in six departments of Haiti. After obtaining informed consent, whole blood samples and demographic surveys were collected to investigate malaria prevalence, anaemia and socio-behavioural risk factors for infection, respectively. A total of 311 pregnant women were screened for Plasmodium falciparum infection using a rapid diagnostic test (RDT), microscopy and a novel, quantitative reverse transcriptase polymerase chain reaction method (qRT-PCR). Overall, 1.2% (4/311) of pregnant women were tested positive for malaria infection by both microscopy and RDT. However, using the qRT-PCR, 16.4% (51/311) of pregnant women were positive. The prevalence of malaria infection varied with geographical locations ranging between 0% and 46.4%. Additionally, 53% of pregnant women had some form of anaemia; however, no significant association was found between anaemia and submicroscopic malaria infection. The socio-behavioural risk factors identified to be protective of malaria infection were marital status (P < 0.05) and travel within one month prior to screening (P < 0.05). This study is the first to document the high prevalence of submicroscopic malaria infections among pregnant women in Haiti and identify social and behavioural risk factors for disease transmission. © 2017 John Wiley & Sons Ltd.

Maternal adjustment and maternal attitudes in adolescent and adult pregnant women.

PubMed

Figueiredo, Bárbara; Tendais, Iva; Dias, Cláudia C

2014-08-01

This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Occurrence of socransky red complex in pregnant women with and without periodontal disease.

PubMed

Lima, Daniela Pereira; Moimaz, Suzely Adas Saliba; Garbin, Cléa Adas Saliba; Sumida, Dóris Hissako; Jardim, Elerson Gaetti; Okamoto, Ana Cláudia

2015-01-01

To verify the presence of Socransky Red Complex (Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia) and P. intermedia using polymerase chain reaction (PCR) in periodontally healthy pregnant women and pregnant women with periodontal disease, as well as its relation to arterial blood pressure and capillary glycaemia. This case control study included 86 pregnant women, including 50 pregnant women with healthy periodontium, 27 with gingivitis and 9 with periodontitis. Arterial blood pressure and glycaemia were evaluated and recorded. Clinical specimens from the gingival crevice or periodontal pockets were gathered with sterile absorbent paper cones. DNA extraction was accomplished using the Easy-DNA Kit test and the presence of bacteria was detected by PCR with primers and specific probes for each microorganism. The arterial pressure of all pregnant women was found to be within normal levels and 51% presented with hyperglycaemia, these two variables were not associated with periodontal conditions and/or presence of microorganisms. Socransky Red Complex was not present in pregnant women with healthy periodontium; however, it was present in pregnant women with gingivitis (3.7%) and in a higher percentage of pregnant women with periodontitis (33.3%). Socransky Red Complex was found only in cases of periodontal diseases and is not related to blood pressure and/or high levels of blood glucose.

Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis.

PubMed

Sabour, Sahar; Arzanlou, Mohsen; Vaez, Hamid; Rahimi, Giti; Sahebkar, Amirhossein; Khademi, Farzad

2018-05-01

Bacterial vaginosis (BV) is a vaginal disorder which occurs either symptomatic or asymptomatic because of an imbalance between H 2 O 2 -producing Lactobacillus and Gardnerella vaginalis in the vagina. This systematic review and meta-analysis is the first to determine the prevalence of BV in pregnant and non-pregnant women in Iran. We used national (SID, Irandoc, Iranmedex and Magiran) and international (PubMed, Scopus, Google Scholar and ISI web of knowledge) electronic databases to systematically search and collect available studies using related keywords (up to 1 December 2017). Inclusion and exclusion criteria were defined to select eligible studies. The overall prevalence of BV among Iranian women was 18.9% (95% CI 14-25). Gardnerella vaginalis was the most prevalent isolated bacteria. The prevalence of BV in non-pregnant women was 28% (95% CI 15.1-45.9) which was higher compared with pregnant women who had a prevalence of 16.5% (95% CI 12.5-21.6). The present review revealed a high prevalence of BV in non-pregnant women. Given that BV is associated with a series of reproductive complications such as infertility, taking preventive measures such as awareness of patients as well as monitoring and controlling of syndrome are essential.

Examining the safety of dental treatment in pregnant women.

PubMed

Michalowicz, Bryan S; DiAngelis, Anthony J; Novak, M John; Buchanan, William; Papapanou, Panos N; Mitchell, Dennis A; Curran, Alice E; Lupo, Virginia R; Ferguson, James E; Bofill, James; Matseoane, Stephen; Deinard, Amos S; Rogers, Tyson B

2008-06-01

Although clinicians generally consider it safe to provide dental care for pregnant women, supporting clinical trial evidence is lacking. This study compares safety outcomes from a trial in which pregnant women received scaling and root planing and other dental treatments. The authors randomly assigned 823 women with periodontitis to receive scaling and root planing, either at 13 to 21 weeks' gestation or up to three months after delivery. They evaluated all subjects for essential dental treatment (EDT) needs, defined as the presence of moderate-to-severe caries or fractured or abscessed teeth; 351 women received complete EDT at 13 to 21 weeks' gestation. The authors used Fisher exact test and a propensity-score adjustment to compare rates of serious adverse events, spontaneous abortions/stillbirths, fetal/congenital anomalies and preterm deliveries (<37 weeks' gestation) between groups, according to the provision of periodontal treatment and EDT. Rates of adverse outcomes did not differ significantly (P> .05) between women who received EDT and those who did not require this treatment, or between groups that received both EDT and periodontal treatment, either EDT or periodontal treatment alone, or no treatment. Use of topical or local anesthetics during root planing also was not associated with an increased risk of experiencing adverse outcomes. EDT in pregnant women at 13 to 21 weeks' gestation was not associated with an increased risk of experiencing serious medical adverse events or adverse pregnancy outcomes. Data from larger studies and from groups with other treatment needs are needed to confirm the safety of dental care in pregnant women. This study provides evidence that EDT and use of topical and local anesthetics are safe in pregnant women at 13 to 21 weeks' gestation.

[Glucooxidative stress and spontaneous abortion in pregnant women with diabetes mellitus type 1].

PubMed

Todorova, K; Ivanov, S; Mazneĭkova, V; Genova, M

2005-01-01

The pregnancies in women with Diabetes mellitus are in condition of increased glucooxidative stress, which could be toxic for the developing embryo. END-POINTS: To evaluate the levels of selenium and glutation peroxidase in pregnant women with Diabetes mellitus type 1 in the first trimester of pregnancy and to establish whether there is a correlation between the diabetic glycemic control and occurrence of spontaneous abortions. Prospective study of 75 women for 1 year period. he pregnant women were divided in 3 groups as follows: 1st group--30 pregnant women with Diabetes mellitus type 1 with normal outcome; 2nd group--16 pregnant women with Diabetes mellitus type 1 with spontaneous abortion; 3rd group--29 healthy pregnant controls. The activity of GI-Px in red blood cells was measured in hemolysat of EDTA plasma in Germany. The levels of glucosylated haemoglobin were also evaluated. 1. In all pregnant women the levels of selenium were lower without significant difference between them 1st group--0.12 +/- 0.6 mmol/l, 2ndd group 0.13 +/- 0.1 mmol/l, 3rd group 0.13 +/- 0.7 mmol/l (P > 0.05). 2. There is an increase in the activity of GI-Px, which is statistically significant in the healthy pregnant women 47.8 +/- 13.3 U/g Hb and diabetic pregnant women with normal outcome 48. 6 +/- 8.4 U/g Hb. There is no statistically significant difference in the activity of GI-Px in diabetic pregnant women with spontaneous abortions and the healthy controls (P > 0. 05). 3. Negative correlation between the levels of selenium and the activity of GI-Px was proved in healthy pregnant women (r = - 0.4; P < 0.05). No correlation was found between the level of the selenium and the activity of GI-Px into the two groups of diabetic pregnant women. 4. There is a correlation in the levels of diabetic pregnant women with spontaneous abortions (r = -0.38; P < 0.001). The increased activity of GI-Px in diabetic pregnant women with spontaneous abortions is a result of increased antioxidative

The self-prescribed use of aromatherapy oils by pregnant women.

PubMed

Sibbritt, David W; Catling, Christine J; Adams, Jon; Shaw, Andrea J; Homer, Caroline S E

2014-03-01

While some studies have reported effectiveness of aromatherapy oils use during labour there is no reported evidence of efficacy or risks of aromatherapy oils use for pregnancy-related symptoms or conditions. A number of aromatherapy oils are unsafe for use by pregnant women yet there is currently no research examining the prevalence and characteristics of women who use aromatherapy oils during pregnancy. To conduct an empirical study of the prevalence and characteristics of women who use aromatherapy oils during pregnancy. The research was conducted as part of the Australian Longitudinal Study on Women's Health (ALSWH), focusing on the nationally representative sample of Australian women aged 31-36 years. Data were collected via a cross-sectional questionnaire (n=8200) conducted in 2009. Self-prescribed aromatherapy oils were used by 15.2% of pregnant women. Pregnant women were 1.57 (95% CI: 1.01, 2.43) times more likely to self-prescribe use of aromatherapy oils if they have allergies or hayfever, and 2.26 (95% CI: 1.34, 3.79) times more likely to self-prescribe use of aromatherapy oils if they have a urinary tract infection (UTI). Our study highlights a considerable use of aromatherapy oils by pregnant women. There is a clear need for greater communication between practitioners and patients regarding the use of aromatherapy oils during pregnancy, as well a need for health care practitioners to be mindful that pregnant women in their care may be using aromatherapy oils, some of which may be unsafe. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

[Multiple factors analysis of periodontal status in pregnant women in Shanghai].

PubMed

Chen, Lin; Lu, Hai-xia; Wei, Tian-you; Feng, Xi-ping

2014-08-01

To assess the periodontal health status of pregnant women in Shanghai, and to investigate the factors that may influence the periodontal health status of pregnant women, in order to provide theoretical evidence for the pointed oral health education and public health strategies in future. A cross-sectional study was carried out to recruit pregnant women (0 to 40 weeks) randomly selected from primary Maternal and Child Care Service Centers in Shanghai. The data collection included the questionnaire survey and clinical periodontal examination. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were assessed during the clinical examination. Chi-square test and logistic regression analysis were performed to analyze the data by SPSS 18.0 software package. A total of 561 pregnant women were surveyed. The mean age was (27.5 ± 4.0) years. The mean gestational age was (18.9 ± 8.1) weeks, ranged from 5 to 40 weeks. The prevalence of periodontal disease during pregnancy was 49.6%, of which the prevalence of gingivitis and periodontitis were 42.8% and 6.8%, respectively. The results of multiple logistic regression showed that pregnant women who were in the second and third trimesters, and whose place of residence was rural were significantly more likely to suffer periodontal disease. Gestational age and place of residence are the factors that are associated with the prevalence of periodontal disease among pregnant women in Shanghai. More oral health education and promotion should be targeted on these pregnant women at high-risk.

Seroprevalence of Anti-Toxoplasma gondii Antibodies Among Lebanese Pregnant Women.

PubMed

Nahouli, Hasan; El Arnaout, Nour; Chalhoub, Elias; Anastadiadis, Elie; El Hajj, Hiba

2017-12-01

Toxoplasma gondii, the causative agent of toxoplasmosis, is a zoonotic obligate intracellular protozoan parasite responsible for the infection of almost one-third of the world's population. T. gondii is particularly threatening for primo-infected pregnant women and may lead, following vertical transplacental transmission, to spontaneous abortion, miscarriage, or severe manifestations in the newborn. The aim of this study was to provide an updated estimate of the seroprevalence of anti-T. gondii antibodies among a group of Lebanese pregnant women and its seroconversion rate. This is a retrospective cohort study, in which medical records of 11,000 pregnant women were screened. These women visited a private Obstetrics and Gynecology clinic located in Beirut, the capital of Lebanon, during the period of January 1994 till September 2015. Serological results of anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) results of 2456 Lebanese pregnant women who fulfilled the inclusion criteria were included in the analysis. Seropositivity and seroconversion rates for women with repeated tests were reported according to age and area of residence. The overall anti-T. gondii IgG and IgM seropositivity among 2456 Lebanese pregnant women was 82.6% and 1.8% respectively. The highest IgG seropositivity is among the age group of 35-44 years (87.81%) and at the governorate of "Mount Lebanon" (82.95%). Sixty-four seroconversions were detected and two abortions due to T. gondii infection during pregnancy were recorded. The seroprevalence of anti-T. gondii IgG among the screened pregnant women in Lebanon is the highest in the Arab region. These results highlight the importance of running a national sample survey to estimate the real potential burden of this infection and its impact on maternal and fetal health.

Midwives' provision of antimalaria services to pregnant women in Uganda.

PubMed

Bbosa, Richard Serunkuma; Ehlers, Valerie Janet

2017-04-01

malaria causes complications during 80% of all pregnancies in Uganda. However, only 48% of Ugandan pregnant women took one dose of intermittent preventive therapy while merely 27% took the second dose during 2011. This study investigated midwives' provision of anti-malaria services in the Buikwe District of Uganda. a quantitative exploratory descriptive design was used. prenatal clinics (n=16) in the Buikwe District of Uganda RESPONDENTS: questionnaires were completed by 40 (out of a population of 45) midwives. midwives' provision of malaria-preventive services to pregnant women were associated with the midwives' education level and professional experience as well as by the availability of safe drinking water and drugs for intermittent preventive treatment. Midwives who provided frequent health education to pregnant women, cooperated with village health team members and received in-service training were likely to provide effective anti-malaria services to pregnant women. regular audits of midwives' records should identify strengths and weaknesses related to the prevention of malaria during pregnancy. Relevant in- service education should be provided. Drugs for intermittent preventive therapy and clean drinking water must be available at all prenatal clinics so that pregnant women can take these drugs under direct observation of the midwives. malaria-related health education should be provided during every prenatal clinic visit, and every pregnant women should take two doses of intermittent preventive therapy drugs during every pregnancy (as prescribed by Uganda's Ministry of Health) in order to reduce the reported impact of malaria on 80% of pregnancies in Uganda. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development of a Diet Quality Index Adapted for Pregnant Women

PubMed Central

Crivellenti, Lívia Castro; Zuccolotto, Daniela Cristina Candelas; Sartorelli, Daniela Saes

2018-01-01

ABSTRACT OBJECTIVE: To develop a Diet Quality Index Adapted for Pregnant Women (IQDAG) and to evaluate its relation with the characteristics of women treated at the Brazilian Unified Health System. METHODS: The data on food intake come from a cross-sectional study carried out with 785 adult pregnant women in the city of Ribeirão Preto, state of São Paulo, Brazil, between 2011 and 2012. The index was based on the recommendations of the Brazilian Ministry of Health, previous national dietary indexes, and the new Dietary Guidelines for the Brazilian Population. We used the ANOVA, Kruskal-Wallis, and chi-square tests to describe the quality of the diet according to the characteristics of the mother. RESULTS: The IQDAG has nine components, and it is represented by three food groups (in servings/1,000 kcal), five nutrients, and a moderator component. A high proportion of pregnant women reached the maximum score for the components of legumes and vegetables. However, few women reached the maximum score for consumption of fresh fruits, fiber, omega-3, calcium, folate, iron, and ultra-processed foods. We verified a better quality of diet among older and eutrophic pregnant women who reported practicing more physical activity and taking dietary supplements. We also observed the highest index score among women with higher intake of carbohydrates, proteins, vitamins C, E, and A, and minerals calcium, folate, and iron, as well as among those with lower intake of total fats and saturated fats. CONCLUSIONS: This dietary index is unprecedented in incorporating the recommendation of the new Dietary Guidelines for the Brazilian Population regarding the moderation of the consumption of ultra-processed foods. It was useful in evaluating the quality of the diet of pregnant women and we verified a higher score among older and eutrophic women who reported a healthy lifestyle. Strategies are needed to promote a higher consumption of fresh fruits, foods high in fiber, omega-3, calcium

[The influencing factors of anemia for pregnant women between 2010-2012 in China].

PubMed

Jiang, S; Pang, X H; Duan, Y F; Bi, Y; Wang, J; Yin, S A; Yang, L C; Yang, Z Y

2018-01-06

Objective: To investigate the prevalence of anemia and related risk factors for pregnant women in China. Method: Based on Chinese National Nutrition and Health Surveillance 2010-2012, a total of 3 501 pregnant women were investigated from 150 counties of 31 provinces, municipalities and autonomous regions in China, using a multi-stage stratified cluster randomization sampling method. General information of pregnant women, health status, and food intake during the gestation, was collected through a questionnaire investigation. 6 ml fasting venous blood was collected for the determination of hemoglobin concentration. Data were analyzed using multiple logistic regression to investigate the prevalence of anemia and the related influencing factors. Results: The 605 of 3 501 pregnant women had anemia. The prevalence of anemia was 17.2%; and mild anemia accounted for about 61.0% (369/605). Compared with the pregnant women living in the large cities, the OR (95% CI ) of those living in the poor rural areas was 1.46 (1.08-1.98). Compared with the pregnant women living in the south area of China, the OR (95% CI ) of those living in the north area of China was 1.39 (1.15-1.68); Compared with the pregnant women in the first trimester, the OR (95% CI ) of those in the second trimester and the third trimester were 1.79 (1.33-2.43) and 2.11 (1.56-2.85), respectively. The OR (95% CI ) of pregnant women who had used folic acid supplementation within the 6 months prior to gestation was 0.76 (0.63-0.93) compared with those who had not used. Conclusion: From 2010 to 2012, the epidemic characteristics of anemia was mild for the pregnant women in China, and pregnant women residential areas, periods of pregnancy and whether to take folic acid were related to anemia.

18 Percent of Pregnant Women Drink Alcohol during Early Pregnancy

MedlinePlus

National Survey on Drug Use and Health The NSDUH Report Data Spotlight September 9, 2013 18 Percent of Pregnant VA60 Women Drink Alcohol during Early Pregnancy Women who drink alcohol while pregnant increase the risk that their infants will have physical, learning, and/ ...

Detection of Fusobacterium nucleatum in chorionic tissues of high-risk pregnant women.

PubMed

Tateishi, Fumi; Hasegawa-Nakamura, Kozue; Nakamura, Toshiaki; Oogai, Yuichi; Komatsuzawa, Hitoshi; Kawamata, Kazuya; Douchi, Tsutomu; Hatae, Masayuki; Noguchi, Kazuyuki

2012-05-01

This study was undertaken to investigate the existence of a periodontopathic bacterium, Fusobacterium nucleatum, in chorionic tissues of pregnant women, and the effects of F. nucleatum on human chorion-derived cells. Oral and chorionic tissue samples were collected from 24 high-risk pregnant women and 15 normal pregnant women. The presence of F. nucleatum in the samples was detected using polymerase chain reaction. Chorion-derived cells and Toll-like receptor (TLR)-2 or TLR-4 gene-silenced chorion-derived cells were stimulated with F. nucleatum lipopolysaccharide (LPS). Interleukin (IL)-6 and corticotrophin-releasing hormone (CRH) levels in the culture supernatants were measured using ELISA. F. nucleatum was detected in all oral samples and seven chorionic tissues from the high-risk pregnant women, but was not detected in chorionic tissues from the normal pregnant women. F. nucleatum LPS significantly increased IL-6 and CRH secretion by chorion-derived cells. The F. nucleatum LPS-induced IL-6 and CRH levels were significantly reduced in TLR-2 or TLR-4 gene-silenced chorion-derived cells. We suggest that F. nucleatum is detected in chorionic tissues of high-risk pregnant women, but not in chorionic tissues of normal pregnant women, and that F. nucleatum induces IL-6 and CRH production via both TLR-2 and TLR-4 in chorion-derived cells. © 2012 John Wiley & Sons A/S.

Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital: a prospective study.

PubMed

Tansarli, G S; Skalidis, T; Legakis, N J; Falagas, M E

2017-02-01

Bacterial vaginosis (BV), candidiasis, and trichomoniasis were the three established types of vaginal conditions until aerobic vaginitis (AV) was defined in the early 2000s. We sought to study the prevalence of abnormal vaginal flora (AVF) with inflammation in our hospital and to correlate it with AV. We prospectively collected vaginal smear specimens originated from symptomatic women who were examined at Iaso Obstetrics, Gynecology and Children's Hospital of Athens from April 2014 until September 2015. Amsel's criteria were used for the diagnosis of BV. The presence of leukocytes and lactobacillary grade were evaluated to classify a condition as AVF with inflammation; subsequently, bacterial cultures were performed. A total of 761 women were included. Five hundred and seventy-nine women were diagnosed with candidiasis, BV, trichomoniasis, or other types of vaginitis in which no pathogenic bacterial growth occurred in cultures. One hundred and eighty-two women (23.9 %) were diagnosed with AVF with inflammation (116 non-pregnant, 66 pregnant). Escherichia coli was the most common pathogen among these women (non-pregnant: 45.7 %, pregnant: 34.8 %). Other common pathogens were Group-B-Streptococcus (non-pregnant: 20.7 %, pregnant: 22.7 % respectively), Enterococcus faecalis (14.7 %, 18.2 %), and Klebsiella pneumoniae (6.9 %, 12.1 %). The prevalence of AVF with inflammation may be high. Since inflammation criteria were applied, most cases of BV were eliminated and the majority of cases of AVF are AV. Therefore, clinicians should include AV in the differential diagnosis of vaginitis, while microbiologists should take into account the growth of aerobic bacteria in vaginal cultures originating from women with microscopic findings of AV.

Dental care for pregnant women: an assessment of North Carolina general dentists.

PubMed

Da Costa, Elizabeth Prada; Lee, Jessica Y; Rozier, R Gary; Zeldin, Leslie

2010-08-01

The authors conducted a study to examine factors associated with general dentists' provision of care for pregnant women and the extent to which they provide comprehensive dental care. The authors mailed an 86-item questionnaire to 1,000 practicing general dentists in North Carolina. Survey domains included provider knowledge about pregnancy and dental health, dental treatment practices, barriers to providing care, outcome expectancy, and personal and practice demographics. The primary dependent variables the authors analyzed were whether dentists provided any treatment to pregnant women and, among those who did, the extent to which they provided comprehensive services. The authors performed multivariate regression analyses to determine factors associated with dentists' provision of care to pregnant women (P < .05). A total of 513 surveys were returned (a response rate of 51.3 percent), of which 495 surveys had complete responses. The authors included the completed surveys in their analyses. The mean age of the respondents was 46 years. The results of multivariate analysis showed that respondents who perceived a lack of demand for services among pregnant women and provided preconception counseling were less likely to provide any treatment for pregnant patients than were those who perceived a demand for services and who did not provide preconception counseling, respectively. Dentists who were male, had a low knowledge score, provided preconception counseling and treated largely white populations of patients were less likely than female dentists, those who had moderate or high knowledge scores, and those who treated a population of minority patients to provide comprehensive care for pregnant women. Most general dentists in private practice provide care for pregnant women, but the authors found notable gaps in dental provider knowledge and comprehensive dental services available for pregnant women. Although many general dentists provide some dental care to pregnant

Identifying Pregnant Women Experiencing Domestic Violence in an Urban Emergency Department

ERIC Educational Resources Information Center

Datner, Elizabeth M.; Wiebe, Douglas J.; Brensinger, Colleen M.; Nelson, Deborah B.

2007-01-01

The article describes characteristics of pregnant women presenting to the Emergency Department (ED) who are experiencing current violence and presented a screening tool to identify pregnant women experiencing violence. Women completed an in-person interview regarding violence, sociodemo-graphic factors, health status, and drug use. Fifteen percent…

Improvement of perinatal outcome in diabetic pregnant women.

PubMed

Szilagyi, A; Szabo, I

2001-01-01

Obstetrical and perinatal outcomes in newborns of diabetic pregnant women depend on metabolic control and fetal surveillance during pregnancy. The effects of fetal surveillance on perinatal mortality and morbidity was analyzed in diabetic pregnant women with appropriate glucose control in our regional center for diabetes and pregnancy. 480 deliveries complicated by frank or gestational diabetes occurred in our Department in the period of 1988-1999. Perinatal mortality and morbidity, prevalence of premature deliveries, methods of fetal surveillance, options for respiratory distress syndrome (RDS) profilaxis, cesarean section rate, timing of delivery and its indications and occurrence of malformations have been analyzed. It was found that malformation rate and perinatal mortality may be reduced to even lower level than that of in healthy pregnant women by appropriate glucose control and by using the latest methods of intrauterine fetal surveillance including cardiotocography (non stress test and oxytocin challenge test), doppler fetal artery velocimetry and fetal pulse oximetry. Timing of delivery was needed in 35% of the cases with IDDM and 15% of gestational diabetes due to chronic placental insufficiency. If labour induction was needed before the 38 weeks, amniocentesis was performed to test fetal lung maturity. Direct fetal glucocorticoid administration was used to enhance fetal lung maturation in 14 cases. C-section rate was slightly higher than that of in non diabetic pregnant women. Our perinatal morbidity data (macrosomia, hyperbilirubinemia, hypoglycemia, injuries, infections) are comparable with the data from the literature. Although perinatal mortality with the help of thorough fetal surveillance is even better in diabetic pregnant women than in non diabetic patients, future eye should be focused on factors affecting perinatal morbidity, because it is still higher than in newborns of healthy mothers.

A qualitative study on acceptable levels of risk for pregnant women in clinical research.

PubMed

van der Zande, Indira S E; van der Graaf, Rieke; Oudijk, Martijn A; van Delden, Johannes J M

2017-05-15

There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members (RECs) and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals' individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient

Determinants of anaemia among pregnant women in rural Uganda.

PubMed

Mbule, Marjorie A; Byaruhanga, Yusuf B; Kabahenda, Magaret; Lubowa, Abdulrahman

2013-01-01

In spite of intervention efforts, in Uganda, as in other developing countries, high levels of anaemia among pregnant women continue. Anaemia among women of reproductive age (15-49 years) is a matter of national concern. This study was carried out to assess determinants of anaemia in Kiboga district. This was a single cross-sectional, descriptive survey. The anaemia status of the pregnant women was determined by measuring their haemoglobin levels. Possible determinant factors including socio-economic characteristics, knowledge, attitudes, practices and food intake were assessed using a structured questionnaire. Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough (63.1%) to be described as a severe public health problem. The uptake and utilisation of the public-health intervention package to combat anaemia in pregnancy was low, with iron/folic acid supplementation at 13.2%, use of intermittent preventive treatment of malaria 45.4%, and use of de-worming medicines 14.5%. Women from households without a functional radio were 2.07 times more likely be anaemic (95%CI, 1.08-3.00) compared with women from households where there was a functional radio. There was little awareness and functional knowledge about anaemia among pregnant women. The high prevalence of anaemia observed in Kiboga district can be attributed to poverty and limited access to nutrition and health education information which lead to low uptake and utilization of the public-health intervention package to combat anaemia in pregnancy.

HIV shedding in cervico-vaginal secretions in pregnant women.

PubMed

Gardella, Barbara; Roccio, Marianna; Maccabruni, Anna; Mariani, Bianca; Panzeri, Lucia; Zara, Francesca; Spinillo, Arsenio

2011-07-01

The purpose of this study was to evaluate the presence of HIV-1 in cervico-vaginal secretions of pregnant as compared to non-pregnant HIV-seropositive women. We compared 43 known HIV seropositive pregnant patients versus 241 age-matched (± 2 years) control non-pregnant HIV-seropositive subjects. In pregnant patients blood and cervico-vaginal samples were obtained during each trimester of pregnancy. In control subjects the same samples were obtained at enrolment. HIV-1 RNA was measured in plasma; proviral HIV-1 DNA, cell-associated and cell-free HIV-1 RNA in cervico-vaginal secretion by competitive polymerase chain reaction (cRT-PCR) and reverse transcriptase PCR. The genital shedding of HIV-DNA (22/43 as compared to 79/241, p = 0.02), and cell-free HIV-RNA detection (26/43 as compared to 72/241, p < .001) was more common in first-trimester pregnant than in non pregnant women. Pregnancy correlated with a significant positive trend in the cervico-vaginal load of HIV-DNA (Spearman Rho= 0.149, p= 0.012), and cell-free HIV-RNA (Spearman Rho= 0.253, p < .001), but not of HIV-RNA transcripts (Spearman Rho = 0.06, p= 0.31). After correction for potential confounders, first trimester pregnant women had increased rates of genital HIV- DNA (odds ratio = 1.94, 95% confidence interval = 1.01 3.78) and cell-free HIV-RNA (odds ratio = 4.07, 95% confidence interval = 1.97 8.41) detection compared to nonpregnant controls. The shedding of genital HIV was increased in pregnant compared to non pregnant subjects, even in patients with undetectable viremia. In this low-risk HIV-positive population the risks of vertical or horizontal transmissions should not be underestimated.

Health information needs of pregnant women: information sources, motives and barriers.

PubMed

Kamali, Sudabeh; Ahmadian, Leila; Khajouei, Reza; Bahaadinbeigy, Kambiz

2018-03-01

Pregnant women should be provided with relevant and useful information to manage this specific period of their lives. Assessing information needs of this group is a prerequisite for providing this information. The aim of this study was to assess the information needs of pregnant women during their pregnancy and childbirth. This descriptive study was conducted on the pregnant women who attended antenatal clinics and obstetricians/gynaecologists' offices in Kerman, Iran, in 2015. Data were collected using a self-administered, valid and reliable questionnaire. A total of 400 women participated in the study. Most pregnant women needed information about care of the foetus (n = 344, 86%), physical and psychological complications after delivery (n = 333, 83%), development and growth of the foetus (n = 330, 82.5%), pregnancy nutrition (n = 327, 82%) and special tests during pregnancy (n = 326, 81.5%). They mostly (n = 195, 49%) looked for information when they were suffering from a disease or pregnancy complications. As pregnant women need extensive information to be able to take care of themselves and their babies, their information needs should be identified and taken into consideration when planning educational programmes for this group of women. © 2017 Health Libraries Group.

Current status of syphilis in pregnant women in Japan.

PubMed

Suzuki, Shunji; Sekizawa, Akihiko; Tanaka, Masanobu; Okai, Takashi; Kinoshita, Katsuyuki; Kitamura, Tadaichi

2017-12-01

We examined the current status of syphilis-infected pregnant Japanese women, according to the results of syphilis screening and confirmation tests of women who gave birth in Japan between October, 2015 and March, 2016. We requested 2458 obstetrical facilities to provide information of syphilis screening tests and 78.1% of them responded. Considering the response rate and the rate of implementation of confirmation tests, the number of syphilis-infected pregnant Japanese women was estimated to be 250 (1/4022) per year.

Economic Evaluation of Health Services Costs During Pandemic Influenza A (H1N1) Pdm09 Infection in Pregnant and Non-Pregnant Women in Spain.

PubMed

Morales-Suárez-Varela, María; Llopis-González, Agustín; González-Candela, Fernando; Astray, Jenaro; Alonso, Jordi; Garin, Olatz; Castro, Ady; Galan, Juan Carlos; Soldevila, Nuria; Castilla, Jesús; Godoy, Pere; Delgado-Rodríguez, Miguel; Martin, Vicente; Mayoral, Jose María; Pumarola, Tomas; Quintana, José Maria; Tamames, Sonia; Rubio-López, Nuria; Dominguez, Angela

2016-04-01

The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15-44 yr old). We addressed this question with a longitudinal, observational, multicentre study. Inputs were the requirements in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and indirect (productivity loss) costs were considered. Unit of cost was attributed to the frequency of health service resources utilisation. The mean cost per patient was calculated in this group of women. We found that the influenza clinical pattern was worse in non-pregnant women as they had a high medical risk of 20.4% versus 6.1% of pregnant women. Non-pregnant required more antipyretics and antibiotics, and needed more health service resource utilisation (338 medical visits in non-pregnant women vs. 42 in pregnant women). The total cost of non-pregnant women was higher (€4,689.4/non-pregnant and €2,945.07/pregnant). Cost per (H1N1) pdm09 was lower for pregnant women, probably due to more preventive measures adopted for their protection in Spain. The highest costs were incurred by hospitalisations/day and work absenteeism for non-pregnant than for pregnant women. These data will allow better future pandemic influenza planning.

Protection for pregnant women in employment.

PubMed

Potrykus, C

1994-03-01

October 19 is the deadline for employers to implement improvements in maternity rights laid down by the Trade Union Reform and Employment Rights Act (TURERA) and the European directive to protect pregnant women's health and safety at work. Christina Potrykus outlines what the government and, separately, the general Whitley council have in store for women employees.

Working memory in pregnant women: Relation to estrogen and antepartum depression.

PubMed

Hampson, Elizabeth; Phillips, Shauna-Dae; Duff-Canning, Sarah J; Evans, Kelly L; Merrill, Mia; Pinsonneault, Julia K; Sadée, Wolfgang; Soares, Claudio N; Steiner, Meir

2015-08-01

This article is part of a Special Issue "Estradiol and cognition". Subjective changes in concentration and memory are commonly reported by women during the second or third trimesters of pregnancy, but the nature of the problem is poorly understood. We hypothesized that these self-reports might reflect difficulties in working memory (WM). It was further hypothesized that antepartum depression (depression arising during pregnancy) may play an etiological role, either on its own or due to secondary changes in endocrine function or sleep. Using WM tasks that emphasized executive control processes mediated by the prefrontal cortex (PFC) we compared pregnant women tested at 34-36 weeks of gestation (n = 28) with age- and education-matched non-pregnant controls (n = 26). All pregnant women were screened for depression. Evidence of a WM disturbance was found, and was evident only among pregnant women showing depressive symptoms. In contrast, pregnant women who were not depressed showed WM performance that equalled, or even significantly exceeded, non-pregnant controls. No significant differences were observed on control tests of other cognitive functions. Multiple regression revealed that serum estradiol concentrations, along with severity of depressive affect but not sleep disruption, significantly predicted variation in the WM scores. In agreement with studies of estradiol and WM in other contexts, higher estradiol was associated with better WM, while higher levels of depressive symptoms predicted poorer WM. We conclude that memory disturbance during gestation might not be as widespread as commonly believed, but can be seen among women experiencing antepartum depression. The high level of WM performance found in healthy, non-depressed, pregnant women is discussed from an adaptationist perspective. Copyright © 2015 Elsevier Inc. All rights reserved.

Pregnant women of South Asian ethnicity in Canada have substantially lower vitamin B12 status compared with pregnant women of European ethnicity.

PubMed

Schroder, Theresa H; Sinclair, Graham; Mattman, Andre; Jung, Benjamin; Barr, Susan I; Vallance, Hilary D; Lamers, Yvonne

2017-09-01

Maternal vitamin B12 (B12) status has been inversely associated with adverse pregnancy outcomes and positively with fetal growth and infant development. South Asians, Canada's largest ethnic minority, are prone to B12 deficiency. Yet, data are lacking on B12 status in South Asian pregnant women in North America. We sought to determine B12 status, using multiple biomarkers, in 1st and 2nd trimester pregnant women of South Asian and, for comparison, European ethnicity living in Vancouver, Canada. In this retrospective cohort study, total B12, holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine concentrations were quantified in two routinely collected (mean gestational week: 11·5 (range 8·3-13·9) and 16·5 (range 14·9-20·9)), banked serum samples of 748 healthy pregnant South Asian (n 371) and European (n 377) women. South Asian pregnant women had significantly lower B12 status than European pregnant women at both time points, as indicated by lower serum total B12 and holoTC concentrations, and higher MMA concentrations (all P≤0·001). The largest difference, which was substantial (Cohen's d≥0·5), was observed in mean serum total B12 concentrations (1st trimester: 189 (95 % CI 180, 199) v. 246 (95 % CI 236, 257) pmol/l; 2nd trimester: 176 (95 % CI 168, 185) v. 226 (95 % CI 216, 236) pmol/l). Further, South Asian ethnicity was a significant negative predictor of B12 status during pregnancy. South Asian women living in Vancouver have substantially lower B12 status during early pregnancy. Future research identifying predictors and health consequences of this observed difference is needed to allow for targeted interventions.

Research with Pregnant Women: New Insights on Legal Decision-Making

PubMed Central

Mastroianni, Anna C.; Henry, Leslie Meltzer; Robinson, David; Bailey, Theodore; Faden, Ruth R.; Little, Margaret O.; Lyerly, Anne Drapkin

2017-01-01

Although pregnant women rely on medical interventions to treat and prevent a wide variety of health conditions, they are frequently excluded or underrepresented in clinical research. The resulting dearth of pregnancy-specific evidence to guide clinical decisionmaking routinely exposes pregnant women, and their future offspring, to risk of uncertain harms for uncertain benefits. The two legal factors regularly cited as obstacles to such research are the federal regulatory scheme and fear of liability. This article reveals a far more nuanced and complex view of the legal context. First, legal professionals may—at any time from product conception to marketing—influence decisions about research with pregnant women. Second, factors not previously articulated in the literature may prompt legal professionals to slow or halt such research. They include: financial interests, regulatory ambiguity, obstacles to risk management, and site-specific laws unrelated to research. Any efforts to promote the ethical inclusion of pregnant women in research must acknowledge the role of legal decisionmakers and address their professional concerns. PMID:28543423

Reporting of HIV-infected pregnant women: estimates from a Brazilian study.

PubMed

Domingues, Rosa Maria Soares Madeira; Saraceni, Valéria; Leal, Maria do Carmo

2018-01-01

To estimate the coverage of the reporting of cases of HIV-infected pregnant women, to estimate the increase in the coverage of the reporting with the routine search of data in other Brazilian health information systems, and to identify missed opportunities for identification of HIV-infected pregnant women in Brazilian maternity hospitals. This is a descriptive study on the linkage of Brazilian databases with primary data from the "Nascer no Brasil" study and secondary database collection from national health information systems. The "Nascer no Brasil" is a national-based study carried out in 2011-2012 with 23,894 pregnant women, which identified HIV-infected pregnant women using prenatal and medical records. We searched for cases of HIV-infected pregnant women identified in the "Nascer no Brasil" study in the Information System of Notifiable Diseases, the Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count and HIV Viral Load Network, and the Logistics Control System for Medications. We used the OpenRecLink software for the linkage of databases. We estimated the notification coverage, with the respective confidence interval, of the evaluated Brazilian health information systems. We estimated the coverage of the reporting of HIV-infected pregnant women in the Information System of Notifiable Diseases as 57.1% (95%CI 42.9-70.2), and we located 89.3% of the HIV-infected pregnant women (95%CI 81.2-94.2) in some of the Brazilian health information systems researched. The search in other national health information systems would result in an increase of 57.1% of the reported cases. We identified no missed opportunities for the diagnosis of HIV+ in pregnant women in the maternity hospitals evaluated by the "Nascer no Brasil" study. The routine search for information in other Brazilian health information systems, a procedure carried out by the Ministry of Health for cases of AIDS in adults and children, should be adopted for cases of HIV in

Hepatitis B virus and HIV co-infection among pregnant women in Rwanda.

PubMed

Mutagoma, Mwumvaneza; Balisanga, Helene; Malamba, Samuel S; Sebuhoro, Dieudonné; Remera, Eric; Riedel, David J; Kanters, Steve; Nsanzimana, Sabin

2017-09-11

Hepatitis B virus (HBV) affects people worldwide but the local burden especially in pregnant women and their new born babies is unknown. In Rwanda HIV-infected individuals who are also infected with HBV are supposed to be initiated on ART immediately. HBV is easily transmitted from mother to child during delivery. We sought to estimate the prevalence of chronic HBV infection among pregnant women attending ante-natal clinic (ANC) in Rwanda and to determine factors associated with HBV and HIV co-infection. This study used a cross-sectional survey, targeting pregnant women in sentinel sites. Pregnant women were tested for hepatitis B surface antigen (HBsAg) and HIV infection. A series of tests were done to ensure high sensitivity. Multivariable logistic regression was used to identify independent predictors of HBV-HIV co-infection among those collected during ANC sentinel surveillance, these included: age, marital status, education level, occupation, residence, pregnancy and syphilis infection. The prevalence of HBsAg among 13,121 pregnant women was 3.7% (95% CI: 3.4-4.0%) and was similar among different socio-demographic characteristics that were assessed. The proportion of HIV-infection among HBsAg-positive pregnant women was 4.1% [95% CI: 2.5-6.3%]. The prevalence of HBV-HIV co-infection was higher among women aged 15-24 years compared to those women aged 25-49 years [aOR = 6.9 (95% CI: 1.8-27.0)]. Women residing in urban areas seemed having HBV-HIV co-infection compared with women residing in rural areas [aOR = 4.3 (95% CI: 1.2-16.4)]. Women with more than two pregnancies were potentially having the co-infection compared to those with two or less (aOR = 6.9 (95% CI: 1.7-27.8). Women with RPR-positive test were seemed associated with HBV-HIV co-infection (aOR = 24.9 (95% CI: 5.0-122.9). Chronic HBV infection is a public health problem among pregnant women in Rwanda. Understanding that HBV-HIV co-infection may be more prominent in younger women from urban

Pregnant Women in Louisiana Are Not Meeting Dietary Seafood Recommendations

PubMed Central

Lammi-Keefe, C. J.

2016-01-01

Background. The 2015–2020 Dietary Guidelines for Americans recommend that pregnant women and women of childbearing ages consume 8–12 oz. of seafood per week. Fish are the major dietary source of omega-3 long chain polyunsaturated fatty acids, which have benefits for the mother and fetus. Methods. In this observational study, we investigated dietary habits of pregnant women in Baton Rouge, Louisiana, USA, to determine if they achieve recommended seafood intake. A print survey, which included commonly consumed foods from protein sources (beef, chicken, pork, and fish), was completed by pregnant women at a single-day hospital convention for expecting families in October 2015. Women (n = 221) chose from six predefined responses to answer how frequently they were consuming each food. Results. Chicken was consumed most frequently (75% of women), followed by beef (71%), pork (65%), and fish (22%), respectively. Consumption frequency for the most consumed fish (catfish, once per month) was similar to or lower than that of the least consumed beef, chicken, and pork foods. Consumption frequency for the most consumed chicken and beef foods was at least once per week. Conclusion. Our data indicate that pregnant women in Louisiana often consume protein sources other than fish and likely fail to meet dietary seafood recommendations. PMID:27504202

[Clinical evaluation of periodontium in pregnant women with risk of preterm birth].

PubMed

Kurnatowska, Anna; Stankiewicz, Anna

2006-05-01

The aim of the study was to evaluate condition of the periodontium in pregnant women with pathological progress of the pregnancy, clinically and to compare it to periodontium in pregnant women in good health. Over the last years, the studies have described that periodontitis caused by dental plaque, could be the risk factor for preterm birth and low birth weight. This study was performed in 80 pregnant women, 40 with pathologic pregnancy and 40 with normal pregnancy in it. Periodontal Indexes were used to evaluate periodontium. In the searching group gingivitis gravidarum haemorrhagica diffusa and hyperplastica generalisata were dominating. In the control group gingivitis gravidatum simplex and hyperplastica localisata were observed. More severe manifestation of gingivitis gravidarum was noticed in pregnant women with risk of preterm low birth. We did not prove correlation between amount of bacterial dental plaque in pregnant women and risk of preterm low birth weight.

Risk factors related to asymptomatic bacteriuria in pregnant women.

PubMed

Kovavisarach, Ekachai; Vichaipruck, Maytina; Kanjarahareutai, Suwattana

2009-05-01

To determine the risk factors related to asymptomatic bacteriuria (ABU) in pregnant women. Three hundred and sixty asymptomatic pregnant women who attended their first antenatal appointment at Rajavithi Hospital from August 1 and October 31 2005 were enrolled. Those with symptoms of urinary tract infection within one month, those who had been prescribed antibiotics during the previous seven days, and those with medical or obstetric complications, vaginal bleeding, and history of urinary tract disease were excluded. Urine specimens were collected by clean-catched midstream urine technique for culture. Several risk factors related to ABU and obstetric and demographic characteristics were recorded. The prevalence of ABU in pregnant women was 10.0%. The significant risk factors related to ABU in pregnancy was lower education level < or = grade 6 (p < 0.05) with 2.17-time risk of ABU compared with higher education level > grade 6. Maternal and gestational age, occupation, monthly income, gravidity, previous history of urinary tract infection and anemia were not statistically associated with ABU. Lower education level (< or = grade 6) should be the only significant risk factor related to ABU in Thai pregnant women under limited sample size.

Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities.

PubMed

Nogayeva, Maral G; Tuleutayeva, Svetlana A

2015-01-01

Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up.

Health insurance, alcohol and tobacco use among pregnant and non-pregnant women of reproductive age.

PubMed

Brown, Qiana L; Hasin, Deborah S; Keyes, Katherine M; Fink, David S; Ravenell, Orson; Martins, Silvia S

2016-09-01

Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status. The women (n=97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010-2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR]=0.47; 95% confidence interval [CI]=0.27-0.82), but not associated with tobacco use (AOR=1.14; 95% CI=0.73-1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR=0.67; 95% CI=0.63-0.72), but higher odds of alcohol use (AOR=1.23; 95% CI=1.15-1.32). Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Assessment of dietary diversity and nutritional status of pregnant women in Islamabad, Pakistan. .

PubMed

Ali, Fatima; Thaver, Inayat; Khan, Shahzad Ali

2014-01-01

Maternal under-nutrition is one of the most important causes of maternal morbidity and mortality, particularly in the developing countries. Maternal nutrition has direct association with foetal nutrition. This study aimed to identify dietary diversity and determine any relationship of dietary diversity with nutritional status of pregnant women belonging to different socioeconomic conditions in Rawalpindi Islamabad region. It was a cross sectional survey involving 350 pregnant women in their second and third trimesters, conducted in outpatient department of Maternal and Child health centre at Pakistan Institute of Medical Sciences (PIMS) Islamabad. A semi qualitative questionnaire was used that contained structured questions regarding socio-demographic features, socioeconomic status, nutritional status, and three day dietary recall. A second section comprising of questions regarding dietary perceptions was also Out of total, 47% of pregnant women had normal pre-gestational BMI while, 22% were overweight, 17% obese, and only 12% of pregnant women were under weight. Similarly 28.1% were anaemic. Medium dietary diversity was observed in 89% of pregnant women, while only 5% showed low, and high dietary diversity. Dietary diversity was not associated with sociodemographic, or socioeconomic status of pregnant women. Even though weight gain during second (p=0.2) and third trimesters (p=0.049) had a positive relationship with dietary diversity, more than 74% of pregnant women gained less than recommended level of weight gain. No association could be proven between haemoglobin and dietary diversity (p=0.51). Dietary diversity is a good proxy indicator for micronutrient adequacy in pregnant women, however if quantity of food consumed is added it can give better indication of determinants of nutritional status of pregnant women.

Salivary flow rate, pH, and concentrations of calcium, phosphate, and sIgA in Brazilian pregnant and non-pregnant women

PubMed Central

Rockenbach, Maria I; Marinho, Sandra A; Veeck, Elaine B; Lindemann, Laura; Shinkai, Rosemary S

2006-01-01

Background Studies on salivary variables and pregnancy in Latin America are scarce. This study aimed to compare salivary flow rate, pH, and concentrations of calcium, phosphate, and sIgA of unstimulated whole saliva in pregnant and non-pregnant Brazilians. Methods Cross-sectional study. Sample was composed by 22 pregnant and 22 non-pregnant women attending the Obstetrics and Gynecology Clinics, São Lucas Hospital, in Porto Alegre city, South region of Brazil. Unstimulated whole saliva was collected to determine salivary flow rate, pH, and biochemical composition. Data were analyzed by Student t test and ANCOVA (two-tailed α = 0.05). Results No difference was found for salivary flow rates and concentrations of total calcium and phosphate between pregnant and non-pregnant women (p > 0.05). Pregnant women had lower pH (6.7) than non-pregnant women (7.5) (p < 0.001), but higher sIgA level (118.9 mg/L) than the latter (90.1 mg/L) (p = 0.026). Conclusion Some of the tested variables of unstimulated whole saliva were different between pregnant and non-pregnant Brazilians in this sample. Overall, the values of the tested salivary parameters were within the range of international references of normality. PMID:17132167

Soluble CD30 in normotensive pregnant women with isolated fetal intrauterine growth restriction: a comparison with preeclamptic women.

PubMed

Laskowska, Marzena; Laskowska, Katarzyna; Oleszczuk, Jan

2010-11-01

This study investigated the serum concentration of soluble CD30 (sCD30) in pregnant women with isolated fetal intrauterine growth restriction, in pregnancies complicated by preeclampsia with and without accompanying intrauterine growth restriction, and in normotensive healthy pregnant controls. Lower serum concentrations of sCD30 were observed in the group of normotensive pregnant women with a growth-restricted fetus in comparison with the group of healthy pregnant controls, and also in comparison with both preeclamptic groups of pregnant women with and without fetal growth restriction. The concentration of sCD30 in maternal serum from preeclamptic women did not differ in comparison with values from healthy controls or pregnancies complicated by isolated fetal intrauterine growth restriction. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Knowledge and attitude of pregnant women toward flu vaccination: a cross-sectional survey.

PubMed

Maurici, Massimo; Dugo, Valentina; Zaratti, Laura; Paulon, Luca; Pellegrini, Maria Grazia; Baiocco, Elisa; Rizzo, Giuseppe; Franco, Elisabetta

2016-10-01

The study was conducted to explore the knowledge of pregnant women about influenza, influenza vaccine during pregnancy and the attitudes regarding immunization. A questionnaire based on the model proposed by Yudin in 2009 was translated, adapted and administered to 309 pregnant women in the third trimester of pregnancy between October 1 and December 1, 2013 at San Giovanni Calibita Fatebenefratelli hospital of Rome (Italy). Most of the interviewed women (68.9%) answered that influenza is highly contagious, 34.6% of them believed that pregnant women have the same risk of complications as non-pregnant women. Only 5.8% were aware that the vaccine is recommended for women in the second and third trimester of pregnancy and only 14.2% of women answered that the vaccine is safe during pregnancy. Only 3/309 women reported recommendation and offer of vaccination during current pregnancy, but none of them was vaccinated. Overall, knowledge regarding influenza, implications during pregnancy and influenza vaccine was poor among pregnant women. In Italy, the National Vaccine Prevention Plan 2012-2014 recommends influenza vaccine during pregnancy, but only 18/309 were aware of this recommendation. These results suggest that in order to increase influenza vaccine acceptance it is necessary to improve pregnant women knowledge about influenza and to offer education to healthcare providers.

Pilates workouts can reduce pain in pregnant women.

PubMed

Oktaviani, Ika

2018-05-01

This study aims to evaluate the effects of Pilates exercises for a decreasing pain in pregnant women. A total of 40 pregnant women were divided into two groups, a control group (followed a standard pregnancy exercise regimen) and a Pilates group (completed a Pilates exercise regimen). A pain assessment was carried out after exercise, using a visual analog scale. The Pilates group workout program lasted 70-80 min per day, once a week, for 8 weeks. The reduction in the level of pain was found to be significantly greater in the group of pregnant women who completed the Pilates workout (p < 0.05). The results of this study indicated that Pilates is an effective, healthy, and feasible method of reducing pain in pregnancy, and is therefore a beneficial alternative workout for the suppression of pain in the third trimester of pregnancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Violence against pregnant women: prevalence and associated factors.

PubMed

Audi, Celene Aparecida Ferrari; Segall-Corrêa, Ana M; Santiago, Silvia M; Andrade, Maria da Graça G; Pèrez-Escamila, Rafael

2008-10-01

To identify the factors associated with domestic violence against pregnant women. Interviews were conducted with 1,379 pregnant women undergoing antenatal care in basic health care units of the Brazilian Health System, within the municipality of Campinas (Southeastern Brazil). A structured questionnaire on domestic violence, validated in Brazil, was applied between July 2004 and July 2006. The first and second interviews in a cohort study were analyzed. Descriptive and multiple logistic regression analysis of the data were conducted. Psychological violence was reported by 19.1% (n=263) of the total sample of pregnant women and physical/sexual violence was reported by 6.5% (n=89) of them. The factors associated to psychological violence were: adolescent intimate partner (p<0.019) and the pregnant woman had witnessed physical aggression before she was 15 years old (p<0.001). The factors associated to physical/sexual violence were: difficulties encountered by the pregnant woman in attending her antenatal appointments (p<0.014), intimate partner uses drugs (p<0.015) and does not work (p<0.048). The factors associated to psychological and physical/ sexual violence were: low level of education of the interviewee (p<0.013 and p<0.020, respectively), the pregnant woman being responsible for the family (p<0.001 and p=0.017, respectively) pregnant woman had suffered physical aggression during childhood (p<0.029 and p<0.038, respectively), presence of common mental disorder (p<0.001) and intimate partner consumes alcoholic beverage twice or more weekly. (p<0.001). A high prevalence of different categories of domestic violence by an intimate partner during pregnancy was found as well as different factors associated with them. Appropriate mechanisms are necessary, particularly in primary health care, to identify and deal with domestic violence during pregnancy.

Economic Evaluation of Health Services Costs During Pandemic Influenza A (H1N1) Pdm09 Infection in Pregnant and Non-Pregnant Women in Spain

PubMed Central

MORALES-SUÁREZ-VARELA, María; LLOPIS-GONZÁLEZ, Agustín; GONZÁLEZ-CANDELA, Fernando; ASTRAY, Jenaro; ALONSO, Jordi; GARIN, Olatz; CASTRO, Ady; GALAN, Juan Carlos; SOLDEVILA, Nuria; CASTILLA, Jesús; GODOY, Pere; DELGADO-RODRÍGUEZ, Miguel; MARTIN, Vicente; MAYORAL, Jose María; PUMAROLA, Tomas; QUINTANA, José Maria; TAMAMES, Sonia; RUBIO-LÓPEZ, Nuria; DOMINGUEZ, Angela

2016-01-01

Background: The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15–44 yr old). Methods: We addressed this question with a longitudinal, observational, multicentre study. Inputs were the requirements in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and indirect (productivity loss) costs were considered. Unit of cost was attributed to the frequency of health service resources utilisation. The mean cost per patient was calculated in this group of women. Results: We found that the influenza clinical pattern was worse in non-pregnant women as they had a high medical risk of 20.4% versus 6.1% of pregnant women. Non-pregnant required more antipyretics and antibiotics, and needed more health service resource utilisation (338 medical visits in non-pregnant women vs. 42 in pregnant women). The total cost of non-pregnant women was higher (€4,689.4/non-pregnant and €2,945.07/pregnant). Conclusions: Cost per (H1N1) pdm09 was lower for pregnant women, probably due to more preventive measures adopted for their protection in Spain. The highest costs were incurred by hospitalisations/day and work absenteeism for non-pregnant than for pregnant women. These data will allow better future pandemic influenza planning. PMID:27252911

Pregnant Women's Preferences for Men's Faces Differ Significantly from Nonpregnant Women.

PubMed

Limoncin, Erika; Ciocca, Giacomo; Gravina, Giovanni Luca; Carosa, Eleonora; Mollaioli, Daniele; Cellerino, Alessandro; Mennucci, Andrea; Di Sante, Stefania; Lenzi, Andrea; Jannini, Emmanuele A

2015-05-01

There is evidence that women's preferences for facial characteristics in men's faces change according to menstrual phase and sexual hormones. Literature indicates that the pregnancy is characterized by a specific sexual hormonal pattern with respect to all other physiological conditions concerning the sexual hormone status during the reproductive age, configuring this physiological condition as an excellent surrogate to study how the sexual hormones may affect many of the aspects concerning the sexual behavior. The aim of this study was to investigate pregnancy as a model of hormonal influence on women's facial preferences in short-term and long-term relationships and compare the choices of pregnant women with those of nonpregnant women. Measurement of women's preferences for synthetic men's faces, morphed from hyper-masculine to hypomasculine shape. Forty-six women in the third trimester of pregnancy, and 70 nonpregnant women took part in the study. All women were shown a composite male face. The sexual dimorphism of the images was enhanced or reduced in a continuous fashion using an open-source morphing program that produced a sequence of 21 pictures of the same face warped from a feminized to a masculinized shape. Pregnant women's choices differed significantly from those of nonpregnant women. In fact, in the context of both a hypothetical short- (M = -0.4 ± 0.11) and long-term relationship (M = -0.4 ± 0.07) pregnant women showed a clear preference for a less masculine man's face than the other group (short-term: M = 0.15 ± 0.13; long-term: M = -0.06 ± 0.15; P < 0.0001). Women in the third trimester of pregnancy clearly prefer more feminine men's faces, distancing themselves from the choices of women in other physiological conditions concerning the sexual hormonal status during the reproductive age. However, other psychosocial variables may explain this interesting finding. © 2015 International Society for Sexual Medicine.

Vaccination of HIV-infected pregnant women: implications for protection of their young infants.

PubMed

Dangor, Ziyaad; Nunes, Marta C; Kwatra, Gaurav; Lala, Sanjay G; Madhi, Shabir A

2017-01-01

The prevention of mother to child transmission of HIV has resulted in reduced burden of pediatric HIV-infection, but the prevalence of maternal HIV infection remains high in sub-Saharan African countries. HIV-exposed-uninfected infants have an increased risk of morbidity and mortality due to infectious diseases than HIV-unexposed infants, particularly during the first six months of life, which in part might be due to lower levels of pathogen-specific protective antibodies acquired transplacentally from their mothers. This could be mitigated by vaccinating pregnant women to boost antibody levels; although vaccine responses among HIV-infected pregnant women might differ compared to HIV-uninfected women. We reviewed studies that compared natural and vaccine-induced antibody levels to different epitopes between HIV-infected and HIV-uninfected pregnant women. Most studies reported lower baseline/pre-vaccination antibody levels in HIV-infected pregnant women, which may not be reversed by antiretroviral therapy during pregnancy. There were only few studies on vaccination of HIV-infected pregnant women, mainly on influenza virus and group B Streptococcus (GBS) vaccines. Immunogenicity studies on influenza vaccines indicated that HIV-infected pregnant women had lower vaccine induced hemagglutination inhibition antibody titers and a decreased likelihood of seroconversion compared to HIV-uninfected women; and while higher CD4+ T-lymphocyte levels were associated with better immune responses to vaccination, HIV viral load was not associated with responses. Furthermore, infants born to influenza vaccinated HIV-infected pregnant women also had lower antibody levels and a lower proportion of HIV-exposed infants had titers above the putative correlate of protection compared to HIV-unexposed infants. The immunogenicity of a CRM 197 -conjugated trivalent GBS vaccine was also lower in HIV-infected pregnant women compared to HIV-uninfected women, irrespective of CD4+ T

Predictors of childbirth fear among pregnant Chinese women: A cross-sectional questionnaire survey.

PubMed

Gao, Ling-Ling; Liu, Xiao Jun; Fu, Bai Ling; Xie, Wen

2015-09-01

to examine childbirth fear and identify its predictors among pregnant Chinese women. a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital in Guangzhou, China, between October and November 2013. 353 pregnant Chinese women who were at least 18 years old, with a singleton fetus, in the third trimester of pregnancy, not at high risk for complications of pregnancy, and not having had a previous caesarean section. a social-demographic data sheet; the Chinese version of the Childbirth Attitude Questionnaire and the Spielberger׳s State-Trait Anxiety Inventory; and the short form of 32-item Chinese Childbirth Self-Efficacy Inventory. the pregnant Chinese women reported moderate levels of childbirth fear. The pregnant Chinese women who were younger, with lower educational level, not satisfied with their husbands׳ support, and with previous experience of miscarriage reported higher level of childbirth fear. Pregnant women׳s childbirth self-efficacy, state anxiety and trait anxiety were correlated with childbirth fear. The best-fit regression analysis revealed four variables that explained 28% of variance in childbirth fear: trait anxiety, state anxiety, age and previous experience of miscarriage. this study highlighted the connection between childbirth fear, state and trait anxiety, childbirth self-efficacy, age, education and previous miscarriage among pregnant Chinese women. the CAQ was an appropriate method to measure childbirth fear in pregnant Chinese women. The health-care professionals should be sensitive toward issues that could affect levels of childbirth fear in pregnant Chinese women, including age, education and previous miscarriage. Copyright © 2015 Elsevier Ltd. All rights reserved.

M-cholinoreactivity of erythrocytes of non-pregnant and pregnant women evaluated by changes in the rate of erythrocyte agglutination under the influence of acetylcholine.

PubMed

Strelnikova, A I; Tsirkin, V I; Krysova, A V; Hlybova, S V; Dmitrieva, S L

2012-12-01

Acetylcholine (5.5×10(-10)-5.5×10(-6)M) accelerated erythrocyte agglutination in men, non-pregnant women in follicular phase of the menstrual cycle, and pregnant women in the first trimester. The effect was blocked with atropine (5.5×10(-6)M). Acetylcholine had no effect on the rate of erythrocyte agglutination in non-pregnant women in the luteal phase and pregnant women in the second and third trimesters, which coincided with the development of myometrium refractoriness to acetylcholine in pregnant women. The results indicate that erythrocytes can reflect M-cholinoreactivity of internal organs.

[Assessment of self-esteem in pregnant women using Rosenberg's Self-Esteem Scale].

PubMed

Maçola, Ligia; do Vale, Ianê Nogueira; Carmona, Elenice Valentim

2010-09-01

The objective of this descriptive, cross-sectional study was to evaluate the self-esteem of 127 pregnant women seen in a prenatal care program conducted in a public school hospital. Data collection was performed using the Rosenberg's Self-esteem Scale; unsatisfactory self-esteem was related to socio-demographic and health variables of the pregnant woman, and to the presence or absence of support systems. Descriptive and univariate statistical analysis were used to assess possible associations. Pregnant women who had low scores for self-esteem were 60% of all subjects. As for the sociodemographic data, women with fewer years of education presented higher frequency of lower self-esteem scores, which disagrees with other studies. Pregnant women who report having an unplanned pregnancy presented higher prevalence of low self-esteem than those who reported having planned their pregnancy. The lack of support from the partner to look after the baby was also associated to the pregnant women's low self-esteem. Other associations between variables were not statistically significant.

Pregnant Women Diet Quality and Its Sociodemographic Determinants in Southwestern Bangladesh.

PubMed

Shamim, Abu Ahmed; Mashreky, Saidur Rahman; Ferdous, Tarana; Tegenfeldt, Kathrin; Roy, Sumitro; Rahman, A K M Fazlur; Rashid, Iftekhar; Haque, Raisul; Rahman, Zakia; Hossen, Kabir; Siddiquee, Saydur Rahman; Rahman, Mosiqure; Sanghvi, Tina G; Shaheen, Nazma

2016-03-01

Diet diversity of pregnant women is associated with nutrition sufficiency, micronutrient adequacy, and pregnancy outcomes. However, the sociodemographic determinants of diet diversity among pregnant women in low-income countries are not well studied. The analysis was undertaken to study the determinants of high dietary diversity and consumption of micronutrient-rich foods by pregnant women from rural Bangladesh. Pregnant women (508) were randomly selected from southwestern Bangladesh and interviewed to collect data about diet and sociodemographic characteristics. A 24-hour recall was used to collect information about diet. Diet diversity score was calculated for 9 major food groups. All analyses were conducted using STATA SE 12. The overall mean diet diversity score was low at 4.28 and was significantly high among pregnant women who have higher educational achievement, whose husbands' occupation was business, who live in households of 4 or more family members, and who were dwelling in a house with more than 1 room. Highest gap on knowledge and consumption was reported for 3 food groups including dairy foods, eggs, and dark green leafy vegetables. Consumption of dairy and eggs was lower among women from low socioeconomic status, but no significant association was found between sociodemographic characteristics and consumption of leafy vegetables. Our analysis has shown that diet quality of pregnant women was poor and intake of micronutrient-rich foods was low despite having knowledge about the importance of these foods, underscoring the need for promoting the diet quality in developing countries through behavior change communication programs. © The Author(s) 2016.

Dietary Predictors of Urinary Cadmium among Pregnant Women and Childrena

PubMed Central

Moynihan, Meghan; Peterson, Karen E.; Cantoral, Alejandra; Song, Peter X.K.; Jones, Andrew; Solano-González, Maritsa; Meeker, John D.; Basu, Niladri; Tellez-Rojo, Martha Maria

2017-01-01

Background Cadmium is a toxic metal with modifiable exposure sources including diet. In pregnant women and children, unique dietary habits may contribute to DCd, and the relationship of diet to overall cadmium exposure can depend on specific factors during these transitional time periods. Objectives This study aimed to identify and quantify food sources of DCd, describe the distribution of UCd, and determine the relationship of DCd and intake of specific foods with UCd, stratified by maternal smoking history, among pregnant women and children in a well-characterized Mexico City birth cohort. Methods Our sample included 192 pregnant women (third trimester) and 223 children (7-15 years). DCd was calculated using FFQ and the U.S. TDS. We also measured UCd, maternal history of smoking, and additional covariates. Results Pregnant women and children had geometric mean UCd concentrations of 0.19±0.78 μg/L and 0.14±0.60 μg/L, respectively. On average, estimated daily DCd intake was 9.3±3.5 μg for women and 12.2±5.4 μg for children. Adjusted linear regression models showed a positive association between DCd and UCd among women (p=0.03) and children (p=0.03) without a maternal history of smoking. Intake of fruit and vegetables among women and potato consumption among children were positively associated with UCd. Conclusions Pregnant women and their children are exposed to cadmium at dietary and urinary levels similar to those previously reported. Higher estimated DCd for children than for women could be attributed to the different FFQs or related to dietary pattern changes between age groups. DCd contributed to UCd in those without a maternal smoking history. PMID:27707662

Risk factors for Chagas disease among pregnant women in El Salvador.

PubMed

Sasagawa, Emi; Aiga, Hirotsugu; Corado, Edith Y; Cuyuch, Blanca L; Hernández, Marta A; Guevara, Ana V; Romero, José E; Ramos, Hector M; Cedillos, Rafael A; Misago, Chizuru; Kita, Kiyoshi

2015-03-01

To determine the seroprevalence of Chagas disease among pregnant women and estimate the risk factors for Chagas disease during pregnancies. Community-based serological tests on Trypanosoma cruzi and structured interviews on socio-demographic and socio-economic status were conducted with pregnant women registered at three health centres in Sonsonate province, El Salvador. Of 797 pregnant women participating in the study, 29 (3.6%) were infected with Chagas disease. None had clinical symptoms. The results of bivariate analyses showed the significant association between seropositivity and maternal age ≥35 years, anaemia, illiteracy, having no formal school education and having knowledge on Chagas disease (P < 0.05). The results of multivariate analysis indicate that age ≥35 years and anaemia were significantly associated with being infected with Chagas disease among pregnant women (OR = 3.541 and 5.197, respectively). We recommend that the national Chagas disease control programme be better coordinated with the national maternal and child health programme to introduce blood screening for T. cruzi during antenatal visits. If financial constraint allows systematic blood screening to be only partially implemented, resources should be focused on pregnant women ≥35 years and women who have anaemia. © 2014 John Wiley & Sons Ltd.

Provision of smoking cessation support for pregnant women in England: results from an online survey of NHS stop smoking services for pregnant women

PubMed Central

2014-01-01

Background Smoking during pregnancy is a major public health concern and an NHS priority. In 2010, 26% of UK women smoked immediately before or during their pregnancy and 12% smoked continuously. Smoking cessation support is provided through free at the point of use Stop Smoking Services for Pregnant women (SSSP). However, to date, little is known of how these services provide support across England. The aim of this study was to describe the key elements of support provided through English SSSP. Methods SSSP managers were invited to participate in this survey by email. Data were then collected via an online questionnaire; one survey was completed for each SSSP. Up to four reminder emails were sent over a two month period. Results 86% (121 of 141) of services completed the survey. Responding services were, on average, larger than non-responding services in terms of the number of pregnant women setting quit dates and successfully quitting (p < 0.01). In line with the 2010 NICE guidelines, Stop Smoking in Pregnancy and following Childbirth, one in five SSSP identified pregnant smokers using carbon monoxide (CO) testing and refer via an opt-out pathway. All services offered nicotine replacement therapy (NRT) to pregnant women and 87% of services also offered dual therapy NRT, i.e. combination of a patch and short acting NRT product.. The 2010 NICE guidelines note that services should be flexible and client-centred. Consistent with this, SSSP offer pregnant women a range of support types (median 4) including couple/family, group (open or closed) or one-to-one. These are available in a number of locations (median 5), including in community venues, clinics and women’s homes. Conclusions English Stop Smoking Services offer behavioural support and pharmacotherapy to pregnant women motivated to quit smoking. Interventions provided are generally evidence-based and delivered in a variety of both social and health care settings. PMID:24593130

Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities

PubMed Central

Nogayeva, Maral G.; Tuleutayeva, Svetlana A.

2015-01-01

Urinary tract morbidity has increased by 7% in Kazakhstan between 2007 to 2011. Pregnant women with extragenital pathologies or kidney diseases had the greatest prevalence of morbidity. Asymptomatic bacteriuria (AB) is one of the most important risk factors of pyelonephritis development in pregnant women, and it can affect the course and outcome of pregnancy, delivery, and postnatal period. AB prevention requires prevention of pregnancy complications including early diagnostic of urinary tract infections, timely optimization of therapy at outpatient facilities, and dynamic follow-up. PMID:29138709

[Pregnancy-related and work-related sick leave of pregnant women].

PubMed

Tophøj, A; Mortensen, J T

1999-09-06

Pregnant women are allowed sick leave (SL) due to obstetrical or occupational risk factors. The aim was to describe reasons for SL during pregnancy. Pregnant women in a Danish county applying for SL were consecutively included in the study during 12 months in 1991-92. Data were obtained by questionnaires mailed to the women and their medical doctors. Of 1483 pregnant women on SL, 994 participated. Approximately 96% were on SL due to obstetrical risk factors. Occupational factors contributed to SL in at least 50% of the cases, mainly when working in a standing or walking position or when lifting. The women were rarely replaced in other jobs before leaving work. On average the women were absent for 83 days before official pregnancy leave started. Although SL during pregnancy is overwhelmingly due to obstetrical risk factors, occupational factors often contribute. Occupational Health and Safety Organizations are rarely involved at the workplace before issuing a sick leave certificate.

Knowledge about Iodine in Pregnant and Lactating Women in the Oslo Area, Norway.

PubMed

Garnweidner-Holme, Lisa; Aakre, Inger; Lilleengen, Anne Marie; Brantsæter, Anne Lise; Henjum, Sigrun

2017-05-13

Lack of knowledge about iodine may be a risk factor for iodine deficiency in pregnant and lactating women. The aim of this study was to assess knowledge about iodine and predictors of iodine knowledge scores among pregnant and lactating women. The study also examined whether iodine knowledge scores were associated with iodine status. A cross-sectional study was performed on 804 pregnant women and 175 lactating women from 18 to 44 years of age in 2016 in the Oslo area, Norway. Knowledge about iodine was collected through a self-administered, paper-based questionnaire. Iodine concentrations in urine and breast milk were measured using an inductively coupled plasma mass spectrometer (ICPMS). 74% of the pregnant women and 55% of the lactating women achieved none to low iodine knowledge scores. Higher educated pregnant women and those who had received information about iodine had significantly higher knowledge scores. In lactating women, increased age was associated with higher knowledge scores. Knowledge scores were not associated with participants' iodine status. This study revealed a lack of knowledge about the importance of iodine in pregnant and lactating women, as well as about the most important dietary sources. Public education initiatives are required to increase the awareness about iodine in these population groups.

Immunization of pregnant women: Future of early infant protection

PubMed Central

Faucette, Azure N; Pawlitz, Michael D; Pei, Bo; Yao, Fayi; Chen, Kang

2015-01-01

Children in early infancy do not mount effective antibody responses to many vaccines against commons infectious pathogens, which results in a window of increased susceptibility or severity infections. In addition, vaccine-preventable infections are among the leading causes of morbidity in pregnant women. Immunization during pregnancy can generate maternal immune protection as well as elicit the production and transfer of antibodies cross the placenta and via breastfeeding to provide early infant protection. Several successful vaccines are now recommended to all pregnant women worldwide. However, significant gaps exist in our understanding of the efficacy and safety of other vaccines and in women with conditions associated with increased susceptible to high-risk pregnancies. Public acceptance of maternal immunization remained to be improved. Broader success of maternal immunization will rely on the integration of advances in basic science in vaccine design and evaluation and carefully planned clinical trials that are inclusive to pregnant women. PMID:26366844

Comparative study of the nutritional status of vitamin A in pregnant women and in women who became pregnant or did not after Roux-en-Y gastric bypass.

PubMed

Cruz, Sabrina; Machado, Suzana; Cruz, Suelem; Pereira, Sílvia; Saboya, Carlos; Ramalho, Andréa

2018-01-18

the changes in digestive physiology after Roux-en-Y gastric bypass (RYGB), as well as pregnancy, maximizes the risk of vitamin A deficiency (VAD) and both can result in harm to the mother and child health. to compare the nutritional status of vitamin A among women who became pregnant or did not after RYGB and in pregnant women who did not undergo surgery, and to assess the impact of VAD on the mother and child health. this is a cross-sectional study of the analytical type. The women were divided into: group 1 (G1) with 80 pregnant women; group 2 (G2) with 40 pregnant women who had previously undergone RYGB, both in their third trimester of pregnancy; and group 3 (G3) with 77 non-pregnant women who had previously undergone RYGB. Serum concentrations of retinol and β-carotene, night blindness (NB), gestational and neonatal intercurrences were investigated. The significance level adopted was p < 0.05. RYGB, per se,had a greater impact on the inadequacy of retinol, β-carotene, and on the increased percentage of NB when compared to non-surgical pregnant women. When surgery was associated with pregnancy, more than 75% of inadequacy of retinol and β-carotene was noted, as well as a higher percentage of individuals with NB. G2 also showed increased prevalence ratio for developing gestational and neonatal intercurrences, when compared to G1. RYGB provides greater negative impact on the nutritional status of vitamin A compared to pregnancy, and surgery associated with pregnancy can create even greater risks.

[Streptococcus agalactiae in pregnant women. Prevalence at the Posadas Hospital].

PubMed

Di Bartolomeo, S; Gentile, M; Priore, G; Valle, S; Di Bella, A

2005-01-01

Streptococcus agalactiae (Lancefield group B Streptococcus), is the most frequent microorganism involved in neonatal infections through the mother-fetus vertical transmission. It is also responsible for infections in pregnant women, and adults with underlying diseases. The objective of this work was to know the S. agalactiae carrier prevalence in pregnant women who attended to Posadas Hospital, and to study the susceptibility pattern of the isolates to penicillin, erythromycin and clindamycin. From 1203 pregnant women studied, S. agalactiae was recovered in 113, which means a prevalence of 9.39%. Antimicrobial susceptibility was tested to 87 isolates. All of them were susceptible to penicillin, and only 2 isolates were resistant to erythromycin and clindamycin (constitutive MLS mechanism). We emphasize the importance of knowing these last resistance, in the case of beta-lactam antibiotics allergic women.

Melissa Rowland and the rights of pregnant women.

PubMed

Minkoff, Howard; Paltrow, Lynn M

2004-12-01

On March 11, 2004, the State of Utah charged Melissa Rowland with the murder of her stillborn fetus, claiming that the death resulted from her rejection of the advice of her physicians to have a cesarean delivery. Although Ms. Rowland avoided the homicide charge by pleading guilty to lesser child endangerment charges, the approach taken by the State raises important and troubling issues regarding the autonomy rights of pregnant women, as well as their right to speak on behalf their unborn children. We use this case to review relevant ethical principals and legal precedents. We conclude that if Ms. Rowland is to be judged legally culpable for the death of her fetus, then the courts must first create a new and significant exception to the doctrine of informed consent and the common law and constitutional principles upon which it is based. Such a precedent could introduce a substantial disparity between the rights of pregnant women and those of all other persons. We would argue that a better means of assuring the health interests of the pregnant woman and the fetus in similar circumstances is through advocacy by obstetricians for pregnant women's fully realized rights, including the right to informed consent.

Psychiatric disorders and treatment in low-income pregnant women.

PubMed

Cook, Cynthia A Loveland; Flick, Louise H; Homan, Sharon M; Campbell, Claudia; McSweeney, Maryellen; Gallagher, Mary Elizabeth

2010-07-01

This study estimated the prevalence of twenty-two 12-month and lifetime psychiatric disorders in a sample of 744 low-income pregnant women and the frequency that women with psychiatric disorders received treatment. To identify psychiatric disorders, the Diagnostic Interview Schedule (DIS) was administered to Medicaid or Medicaid-eligible pregnant women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The sample was stratified by the rural or urban location of the WIC sites in southeastern Missouri and the city of St. Louis. Eligible women were enrolled at each site until their numbers were proportional to the racial distribution of African American and Caucasian pregnant women served there. The 12-month prevalence of one or more psychiatric disorders was 30.9%. Most common were affective disorders (13.6%), particularly major depressive disorder (8.2%) and bipolar I disorder (5.2%). Only 24.3% of those with a psychiatric disorder reported that they received treatment in the past year. Lifetime prevalence of at least one disorder was 45.6%, with affective disorders being the most frequent (23.5%). Caucasian women were more likely than African Americans to have at least one 12-month disorder, with the difference largely accounted for by nicotine dependence. Higher prevalence of lifetime disorders was also found in Caucasian women, particularly affective disorders and substance use disorders. There were no differences in the prevalence of 12-month or lifetime psychiatric disorders by the urban or rural residence of subjects. With nearly one third of pregnant women meeting criteria for a 12-month psychiatric disorder and only one fourth receiving any type of mental health treatment, comprehensive psychiatric screening during pregnancy is needed along with appropriate treatment.

Administration of praziquantel to pregnant and lactating women.

PubMed

Olds, G Richard

2003-05-01

Praziquantel (PZQ) is the safest of all anti-helminthics and now forms the backbone for all national control programs against schistosomiasis (Med. Res. Rev. 3 (1983) 147-200; Bull. WHO 57 (1979) 767-771; Wegner, D.H.G, Therapeutic Drugs (1991), Churchill Livingstone; Adv. Intern. Med. 32 (1987) 193-206; Drugs 42 (1991) 379-405; Pharmac. Ther. 68 (1995) 35-85; Ann. Intern. Med. 110 (1989) 290-296). Despite its lack of known toxicity, the drug was not tested on pregnant or lactating women prior to release. It is currently listed as Pregnancy Category B by the US FDA, which is a drug presumed safe based in animal studies. Unfortunately, this has been interpreted by most national control programs and WHO (1998) to exclude lactating and pregnant women from treatment. In fact, some experts advocate excluding adolescent girls from mass treatment campaigns over this issue. As a result, a large number of women living in endemic countries are currently left untreated or have treatment significantly delayed. A review of the current known toxicology of PZQ, combined with over two decades of clinical experience with this drug, suggest very low potential for adverse effects on either the mother or her unborn child. In contrast, significant animal and human data are presented in this review that suggest both the pregnant woman and her unborn fetus suffer morbid sequella from schistosomiasis. A double-blind placebo-controlled trial that could resolve this issue would require a very large and expensive study and in light of the above facts might not now be ethically appropriate. The author concludes that pregnant women should be treated with PZQ, that women of childbearing age should be included in all mass treatment programs and that lactating women are not systematically excluded from treatment.

How have the lives of pregnant women changed in the last 30 years?

PubMed

Kingsbury, Ann M; Gibbons, Kristen; McIntyre, David; Tremellen, Anne; Flenady, Vicki; Wilkinson, Shelley; Mamun, Abullah; Najman, Jake M

2017-08-01

To what extent have the characteristics and needs of pregnant women changed over time? This cross-sectional, comparative study describes some socio-demographic, mental health and lifestyle characteristics of two samples of pregnant women assessed 30 years apart. We recruited two samples of pregnant women who were attending their first clinic visit at the same large Queensland maternity hospital 30 years apart between 1981 to 1984 (Sample A, N=6753) and 2011-2012 (Sample B, N=2156). The women were compared using the same survey tool. Descriptive statistics are presented. Pearson's chi-square tests were undertaken (significance at <0.05) to determine how the characteristics and needs of pregnant women may be changing over time. Women, recently sampled, were older, more highly-educated and were more likely to be living with, but not married to, their partners, as well as having their first baby, than were women 30 years ago. As well, recently sampled, pregnant women were more likely to be non-smokers, to have higher body mass indexes and more symptoms of anxiety, but were less likely to be having an unplanned pregnancy. This study found a number of differences between the socio-demographic characteristics, lifestyles and mental health of two samples of pregnant women assessed 30 years apart. Our findings suggest the need for ongoing monitoring of pregnant women to determine changing health priorities. Being more educated, today's women may be more amenable to health education interventions. Higher body mass indexes for recently sampled women, highlights an emerging problem that needs to be addressed. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Presence and resistance of Streptococcus agalactiae in vaginal specimens of pregnant and adult non-pregnant women and association with other aerobic bacteria.

PubMed

Numanović, Fatima; Smajlović, Jasmina; Gegić, Merima; Delibegović, Zineta; Bektaš, Sabaheta; Halilović, Emir; Nurkić, Jasmina

2017-02-01

Aim To determine the prevalence rate and resistance profile of Streptococcus agalactiae (S. agalactiae) in vaginal swabs of pregnant and adult non-pregnant women in the Tuzla region, Bosnia and Herzegovina (B&H), as well as its association with other aerobic bacteria. Methods This prospective study included 200 women, 100 pregnant and 100 adult non-pregnant. The research was conducted at the Institute of Microbiology, University Clinical Center Tuzla from October to December 2015. Standard aerobic microbiological techniques were used for isolation and identification of S. agalactiae and other aerobic bacteria. Antimicrobial susceptibility was determined by the disk diffusion and microdilution method(VITEK 2/AES instrument). Results Among 200 vaginal swabs, 17 (8.50%) were positive for S. agalactiae, e. g., 7% (7/100) of pregnant and 10% (10/100) of adult non-pregnant women. In the pregnant group, 71.4% (5/7) of S. agalactiae isolates were susceptible to clindamycin and 85.7%(6/7) to erythromycin. In the adult non-pregnant group, only resistance to clindamycin was observed in one patient (1/10; 10%). S. agalactiae as single pathogen was isolated in 57.14% (4/7) of pregnant and 60% (6/10) of adult non-pregnant S. agalactiae positive women. In mixed microbial cultures S. agalactiae was most frequently associated with Enterococcus faecalis and Escherichia coli. Conclusion The rate of S. agalactiae positive women in the population of pregnant and adult non-pregnant women of Tuzla Canton, B&H is comparable with other European countries. Large studies are needed to develop a common national strategy for the prevention of S. agalactiae infection in B&H, especially during pregnancy. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

Immediate Needs and Concerns among Pregnant Women During and after Typhoon Haiyan (Yolanda)

PubMed Central

Sato, Mari; Nakamura, Yasuka; Atogami, Fumi; Horiguchi, Ribeka; Tamaki, Raita; Yoshizawa, Toyoko; Oshitani, Hitoshi

2016-01-01

Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon. Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis. Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the

Stress and its predictors in pregnant women: a study in Saudi Arabia.

PubMed

Ahmed, Anwar E; Albalawi, Alhanouf N; Alshehri, Asmaa A; AlBlaihed, Rand M; Alsalamah, Majid A

2017-01-01

Although stress during pregnancy has negative effects on children's development and pregnant women's health, no study has assessed stress and its predictors among pregnant Saudi women. The aim of this study was to assess stress and identify its predictors in a sample of pregnant Saudi women. A correlational study was carried out at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia, on 438 pregnant women who attended the obstetrics/gynecology clinic. We collected data on their sociodemographic and oral health status. Stress was assessed using the Perceived Stress Scale (PSS). The sample mean age was 30.6±5.4 years, and 33.4% of the sample reported high stress levels (PSS ≥20). The study revealed significantly high stress levels in women with no or low income, chronic disease, sleep deprivation, no teeth brushing, irregular eating patterns, gestational diabetes, and no family support ( P <0.05). Self-reported oral health problems were significantly associated with high stress levels ( P <0.05). A multiple linear regression model showed that no teeth brushing, chronic disease, sleep deprivation, gestational diabetes, and gingival redness predicted an increase in stress by a score of 3.6, 2.4, 2.1, 1.4, and 1.4, respectively. It was estimated that three in ten pregnant women in King Abdulaziz Medical City reported high stress levels. Our study shed light on the relationship between healthy habits, oral health status, and perceived stress in pregnant women. This research may help health care practitioners who provide care to pregnant women, to educate them in regard to healthy habits, and to develop a program to reduce stress.

Are pregnant and postpartum women: at increased risk for violent death? Suicide and homicide findings from North Carolina.

PubMed

Samandari, Ghazaleh; Martin, Sandra L; Kupper, Lawrence L; Schiro, Sharon; Norwood, Tammy; Avery, Matt

2011-07-01

The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14-44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio= 0.27, 95% CI = 0.11-0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31-0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39-1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26-0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.

Need of tetraiodothyronine supplemental therapy in pregnant women

NASA Astrophysics Data System (ADS)

Stoian, Dana; Craciunescu, Mihalea; Timar, Romulus; Schiller, Adalbert; Pater, Liana; Craina, Marius

2013-10-01

Thyroid hormones are essential for fetal development. Normal thyroid function in pregnant women adjusts by itself in cases of pregnancy, phenomenon that is deficient in cases of previous maternal thyroid disease. The study group was represented by 120 females, with reproductive age, with known thyroid disease, that had a up to delivery pregnancy. Thyroid ultrasound parameters and functional parameters were follow-up during the 9-month of gestation. The study proposes a mathematical model of predicting the need and the amount of tetraiodothyronine treatment in pregnant women with prevalent thyroid disease.

An investigation into the exercise behaviours of regionally based Australian pregnant women.

PubMed

Hayman, Melanie; Short, Camille; Reaburn, Peter

2016-08-01

Regular exercise during pregnancy is a recommended prenatal care strategy with short and long-term health benefits to mother and child. Unfortunately, most pregnant women are insufficiently active to obtain health benefits and there is evidence that activity levels decrease overall during pregnancy. Physical activity among regionally based women is lower than that of urban-based women within Australia. However, little is currently known about exercise behaviours of regionally based Australian pregnant women. To successfully promote exercise among regionally based pregnant women, a greater understanding of exercise behaviours must first be explored. This study investigated exercise behaviours in a sample of regionally based Australian pregnant women. Regionally based Australian pregnant women (n=142) completed a modified version of the Godin Leisure-Time Exercise Questionnaire examining exercise behaviours before and during pregnancy. Women self-reported their exercise behaviours, including exercise frequency, intensity, time and type, before and during pregnancy. Chi-square analysis revealed significantly less (χ(2)=31.66, p<0.05) women participated in exercise during pregnancy (61%) compared to before pregnancy (87%). During pregnancy, respondents exercised at a significantly lower frequency (χ(2)=111.63, p<0.05), intensity (χ(2)=67.41, p<0.05), shorter time/duration (χ(2)=114.33, p<0.05), and significantly less (χ(2)=8.55, p<0.05) women (8%) are meeting 'exercise during pregnancy' guidelines compared to women before pregnancy (49%) meeting physical activity guidelines. Exercise during pregnancy decreases to levels significantly lower than what is currently recommended. Public health initiatives that promote exercise among Australian pregnant women should aim to increase frequency, intensity, time and type of exercise to be undertaken during pregnancy. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Determinants of sleep quality among pregnant women in China: a cross-sectional survey.

PubMed

Yang, Ying; Mao, Jing; Ye, Zhiying; Zeng, Xiaoli; Zhao, Huimin; Liu, Yueting; Li, Jie

2017-08-03

Sleep disturbances are common during pregnancy, yet few studies are currently available regarding the determinants of sleep quality among pregnant women in China. This study aimed to: (a) calculate the prevalence of sleep disorder during pregnancy, (b) examine the difference in sleep quality among three trimesters, and (c) identify determinants of sleep quality in pregnant women. This study was designed as a cross-sectional survey. Five hundred pregnant women were recruited at the outpatient department of obstetrics and gynecology of two teaching hospitals in central China. Five selfreport questionnaires were used for gathering data, including information of sample characteristics, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), prenatal depression (the Edinburgh Postnatal Depression Scale (EPDS)), perceived stress (Perceived Stress Scale (PSS)), and perceived social support (Multidimensional Scale of Perceived Social Support (MSPSS)). A total of 454 pregnant women participated in the study between September 2016 and April 2017. Eighty-seven percent pregnant women experienced sleep disorder (PSQI score >5). Poorer global sleep quality, subjective sleep quality, lower sleep efficiency and sleep disturbances were most prevalent during third trimester. The significant contributors to sleep quality for pregnant women were prenatal depression, maternal age, and gestational age. Sleep disorder is very common in pregnant women from China. Depressive symptoms, increased maternal age, and gestational age are determinants of sleep quality. These determinants can assist healthcare professionals in preventative intervention.

TB-HIV co-infection among pregnant women in Karnataka, South India: A case series.

PubMed

Suresh, Shastri; Sharath, Burugina N; Anita, Shet; Lalitha, Ravindra; Prasad, Tripathy J; Rewari, Bharat B

2016-01-01

Tuberculosis (TB) is a significant contributor to mortality in HIV-infected patients. Concurrent TB infection is also a significant contributing factor to maternal mortality in human immunodeficiency virus (HIV)-infected pregnant women. Studies addressing the outcomes of TB and HIV co-infection among pregnant women are generally infrequent. Although limited, the records maintained by the Revised National Tuberculosis Control Programme (RNTCP) and the National AIDS Control Programme (NACP) in Karnataka State, Southern India provide information about the numbers of pregnant women who are co-infected with TB and HIV and their pregnancy outcomes. We reviewed the data and conducted this study to understand how TB-HIV co-infection influences the outcomes of pregnancy in this setting. We sought to determine the incidence and treatment and delivery outcomes of TB-HIV co-infected pregnant women in programmatic settings in Karnataka State in southern India. The study participants were all the HIV-infected pregnant women who were screened for tuberculosis under the NACP from 2008 to 2012. For the purposes of this study, the program staff in the field gathered the data regarding on treatment and delivery outcomes of pregnant women. A total of seventeen pregnant women with TB-HIV co-infection were identified among 3,165,729 pregnant women (for an incidence of 5.4 per million pregnancies). The median age of these pregnant women was 24 years, and majority were primiparous women with WHO HIV stage III disease and were on a stavudine-based ART regimen. The maternal mortality rates were 18% before delivery and 24% after delivery. The abortion rate was 24%, and the neonatal mortality rate was 10%. The anti-tuberculosis treatment and anti-retroviral treatment outcome mortality rates were 30% and 53%, respectively. Although the incidence of TB among the HIV-infected pregnant women was marginally less than that among the non-HIV-infected women, the delivery outcomes were relatively

So near, yet so far: tobacco dependence treatment for pregnant women.

PubMed

Barker, Dianne; Orleans, Tracy; Halpin, Helen; Barry, Matthew

2004-04-01

Almost one-half million babies in the United States are born yearly to women who report smoking while pregnant. Almost all of these pregnant women have access to prenatal care, through federally financed health clinics, state and county health programs, or private providers. However, many pregnant smokers are unlikely to receive any type of counseling or assistance to help them stop smoking--despite the availability of evidence-based treatment and the considerable return on investment. This article recommends four next steps to ensure that tobacco dependence treatment is available for all pregnant women. These steps are (a). expanding Medicaid coverage for, and promotion of, effective counseling services for pregnant smokers, (b). improving health care systems by building the capacity of prenatal providers and health care systems to deliver effective treatments, (c). encouraging purchasers of private and public health benefit packages to demand coverage for, and promotion of, effective counseling services for pregnant smokers, and (d). redirecting state resources to ensure a statewide system of care for pregnant smokers. Implementation of these steps requires leadership, diligence, and action by the public health community--as well as ongoing monitoring to assess progress in improving coverage, capacity, and coordination.

An analysis of the feelings of pregnant women at risk of preterm labour.

PubMed

Sulima, Magdalena; Makara-Studzińska, Marta; Lewicka, Magdalena; Wiktor, Krzysztof; Kanadys, Katarzyna; Wiktor, Henryk

2014-01-01

The aim of the study was an analysis of the feelings of pregnant women at risk ofpreterm labour. 313 expectant mothers aged between 18 to 44 years (ranges: 18-25, 26-30 and 31-44 years) with no psychological disorders, hospitalized and treated due to the risk of preterm labour were surveyed. All the examined pregnant women expressed voluntary and informed consent for the participation in the survey. Each of the questionnaires given to the examined pregnant women contained: a questionnaire form devised by the authors, to establish the characteristics of the surveyed expectant mothers, and the following research standardized tool - Negative and Positive Feelings Scale by P. Brzozowski. The value of the mean level of positive feel- ings state in the group of patients aged 31-44 years with higher education was significantly higher (p < 0.05) than the mean value in the group of patients aged 26-30 years with secondary or primary/vocational education. Marital status and place of residence had no effect on the level of positive feelings as a condition of pregnant women in the study group (p > 0.05). There were no significant statistical differences (p > 0.05) between the level of negative feel- ings trait and age. It was found, however, that the level of negative feelings trait was significantly lower (p = 0.0009) in pregnant women with higher education than in pregnant women who had completed secondary education. 1. Among pregnant women at risk of pre- term labour, higher levels of positive feelings were found in pregnant women aged 31-44 years with higher education, being married and residents of a provincial city. 2. In order to reduce negative feelings in pregnant women at risk of preterm labour it seems important to implement appropriate psychological and prophylactic management, provide adequate care in the pregnancy pathology department, as well as support from the medical staff and the family. These activities should be targeted particularly at younger women with

Is Passive Smoking Associated With Sleep Disturbance Among Pregnant Women?

PubMed Central

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-01-01

Study Objective: Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Design: Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Setting: Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. Participants: 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. Intervention: N/A. Measurements and Results: Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Conclusion: Passive smoking is independently associated with increased sleep disturbance during pregnancy. Citation: Ohida T; Kaneita Y; Osaki Y; Harano S; Tanihata T; Takemura S; Wada K; Kanda H; Hayashi K; Uchiyama M. Is passive smoking associated with sleep disturbance among pregnant women? SLEEP 2007;30(9):1155-1161. PMID:17910387

[Analysis on iodine nutritional status and thyroid function in pregnant women].

PubMed

Li, Hongbo; Wang, Yanling; Zheng, Jing; Wang, Yancai; Huang, Dahong; Liang, Liping; Ren, Xudong; Dou, Yugui; Zhu, Xiaonan

2012-07-01

To investigate the iodine nutritional status and thyroid function of pregnant women during different periods of pregnancy, to provide evidence for guiding iodine supplementation for them. A cross-sectional survey was performed in 90 pregnant women in Wuwei City from April 2009 to January 2010. The morning blood samples and random urine samples were collected, and the thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroglobulin antibodies (TGAb), thyroid microsomal antibodies (TMAb) in blood samples and iodine in urine samples were detected. The medians of urinary iodine were 231.49, 158.25 and 328.35 microg/L for women in early, middle and late period of pregnancy, The ratio of urinary iodine below 150 microg/L were 39.29%, 45.16% and 25.81%, respectively. The FT3, FT4 levels in the first trimester were higher than those in the third trimester (P < 0.05) and TSH level was increased, but no significant difference (P > 0.05). The positive rate of TGAb and TMAb antibody of pregnant women in different period of time were not significantly different (P > 0.05). The incidence of thyroid function disorder was significantly different in different gestation periods. Generally, the iodine nutritional status of these pregnant women was appropriate, but there was a tendency towards hypothyroid in some women. Monitoring urinary iodine and thyroid function in pregnant women should be carried out regularly.

[POLYGYNAX IN THE TREATMENT OF VAGINAL INFECTIONS IN PREGNANT AND NON-PREGNANT WOMEN--CLINICAL EXPERIENCE].

PubMed

Popovski, N; Popovski, K; Nedelkovski, V

2016-01-01

Vaginal infections /VI/ represent some of the most common diseases by infection of FGS. The aim of this study is to analyze clinical and bacteriological efficacy of Polygynax in the treatment of vaginal infections and to take into account the correlation between the results of microbiological controls and reduction of clinical symptoms. The study included 100 patients, including 50 pregnant and non-pregnant 50 for a period of 3 months. All of them was diagnosed with vaginitis clinical examination, taken material from vagina for microbiological testing. The studied women was conducted targeted therapy Polygynax 12 capsules, in the form of vaginal capsules for 12 days, after which the sample control microbiology. Behind the subjective complaints of the patient and to reduce them as a result of treatment. The effective implementation of Polygynax 12 capsules is equally good as in non-pregnant and pregnant women. In a summary of the survey data to make relevant analyzes and conclusions from the results.

Protected to death: systematic exclusion of pregnant women from Ebola virus disease trials.

PubMed

Gomes, Melba F; de la Fuente-Núñez, Vânia; Saxena, Abha; Kuesel, Annette C

2017-12-14

For 30 years, women have sought equal opportunity to be included in trials so that drugs are equitably studied in women as well as men; regulatory guidelines have changed accordingly. Pregnant women, however, continue to be excluded from trials for non-obstetric conditions, though they have been included for trials of life-threatening diseases because prospects for maternal survival outweighed potential fetal risks. Ebola virus disease is a life-threatening infection without approved treatments or vaccines. Previous Ebola virus (EBOV) outbreak data showed 89-93% maternal and 100% fetal/neonatal mortality. Early in the 2013-2016 EBOV epidemic, an expert panel pointed to these high mortality rates and the need to prioritize and preferentially allocate unregistered interventions in favor of pregnant women (and children). Despite these recommendations and multiple ethics committee requests for their inclusion on grounds of justice, equity, and medical need, pregnant women were excluded from all drug and vaccine trials in the affected countries, either without justification or on grounds of potential fetal harm. An opportunity to offer pregnant women the same access to potentially life-saving interventions as others, and to obtain data to inform their future use, was lost. Once again, pregnant women were denied autonomy and their right to decide. We recommend that, without clear justification for exclusion, pregnant women are included in clinical trials for EBOV and other life-threatening conditions, with lay language on risks and benefits in information documents, so that pregnant women can make their own decision to participate. Their automatic exclusion from trials for other conditions should be questioned.

Trichomonas vaginalis and bacterial vaginosis. Coexistence in vaginal wet mount preparations from pregnant women.

PubMed

Franklin, T L; Monif, G R

2000-02-01

To identify how frequently trichomoniasis and characteristics of bacterial vaginosis (BV) occur concomitantly in wet mount preparations from pregnant women. Diagnosis of trichomoniasis was predicted on visualization of the organism. Diagnosis of BV required a positive volatile (whiff) test, presence of "clue cells" and one of two minor criteria: (1) absence of lactobacilli, or (2) a pH > 4.5. Pregnant women from January 1995 to July 1997 at our clinic had wet mount/KOH preparations performed as standard prenatal care. Corresponding medical charts were analyzed for symptoms, race, BV, sexually transmitted diseases, urinary tract infections and other infections. Of 191 pregnant women identified, 69 had trichomoniasis. Seventy-nine percent of the 69 were African American. Fifteen percent of pregnant women (17) had concomitant trichomoniasis and BV. Irrespective of race, 35-38% of pregnant women with trichomoniasis had another sexually transmitted disease or a urinary tract infection diagnosed in that pregnancy. BV, or bacteria excess syndrome, is a frequent coinfection in pregnant women harboring Trichomonas vaginalis.

[Caries and periodontal state of pregnant women. Part II. Periodontal state].

PubMed

Radnai, Márta; Gorzó, István; Nagy, Erzsébet; Urbán, Edit; Eller, József; Novák, Tibor; Pál, Attila

2005-06-01

A great number of clinical studies focused on the periodontal health of the pregnant women in the last decades, since an association has been presumed between the pregnant women's periodontal disease and the adverse pregnancy outcome. Altogether 161 healthy women were examined soon after delivery in Szeged/Hungary. The periodontal status of the patients was recorded by the Silness-Löe Plaque index (0.67), frequency of calculus (21.07%), mean probing pocket depth (1.67 mm) and the frequency of bleeding on probing (37.8%). A significant correlation was found between the state of the periodontium and the educational level and the pregnant women's profession. The periodontal state of women with higher education and the intellectuals was much better, than of the less educated patients and the manual workers.

Zika Virus Infection Among U.S. Pregnant Travelers - August 2015-February 2016.

PubMed

Meaney-Delman, Dana; Hills, Susan L; Williams, Charnetta; Galang, Romeo R; Iyengar, Preetha; Hennenfent, Andrew K; Rabe, Ingrid B; Panella, Amanda; Oduyebo, Titilope; Honein, Margaret A; Zaki, Sherif; Lindsey, Nicole; Lehman, Jennifer A; Kwit, Natalie; Bertolli, Jeanne; Ellington, Sascha; Igbinosa, Irogue; Minta, Anna A; Petersen, Emily E; Mead, Paul; Rasmussen, Sonja A; Jamieson, Denise J

2016-03-04

After reports of microcephaly and other adverse pregnancy outcomes in infants of mothers infected with Zika virus during pregnancy, CDC issued a travel alert on January 15, 2016, advising pregnant women to consider postponing travel to areas with active transmission of Zika virus. On January 19, CDC released interim guidelines for U.S. health care providers caring for pregnant women with travel to an affected area, and an update was released on February 5. As of February 17, CDC had received reports of nine pregnant travelers with laboratory-confirmed Zika virus disease; 10 additional reports of Zika virus disease among pregnant women are currently under investigation. No Zika virus-related hospitalizations or deaths among pregnant women were reported. Pregnancy outcomes among the nine confirmed cases included two early pregnancy losses, two elective terminations, and three live births (two apparently healthy infants and one infant with severe microcephaly); two pregnancies (approximately 18 weeks' and 34 weeks' gestation) are continuing without known complications. Confirmed cases of Zika virus infection were reported among women who had traveled to one or more of the following nine areas with ongoing local transmission of Zika virus: American Samoa, Brazil, El Salvador, Guatemala, Haiti, Honduras, Mexico, Puerto Rico, and Samoa. This report summarizes findings from the nine women with confirmed Zika virus infection during pregnancy, including case reports for four women with various clinical outcomes. U.S. health care providers caring for pregnant women with possible Zika virus exposure during pregnancy should follow CDC guidelines for patient evaluation and management. Zika virus disease is a nationally notifiable condition. CDC has developed a voluntary registry to collect information about U.S. pregnant women with confirmed Zika virus infection and their infants. Information about the registry is in preparation and will be available on the CDC website.

Safety and pharmacokinetics of dolutegravir in HIV-positive pregnant women: a systematic review.

PubMed

Hill, Andrew; Clayden, Polly; Thorne, Claire; Christie, Rachel; Zash, Rebecca

2018-04-01

The integrase strand transfer inhibitor dolutegravir (DTG) is being introduced into low- and middle-income countries (LMICs) as an alternative to first-line treatment with non-nucleoside reverse transcriptase inhibitors. However, DTG is not yet widely recommended for use in pregnant women. The aim of this systematic review was to analyse all available data on birth outcomes and congenital anomalies in the infants of pregnant women treated with DTG. A PubMed and Embase search was conducted using the terms "dolutegravir" or "DTG" and "pregnancy" or "pregnant" from the earliest available date on the database to 26 July 2017. Any reports involving women who were pregnant, HIV positive and taking DTG were included. The percentage of pregnant women with adverse birth outcomes or congenital anomalies in their infants after taking dolutegravir was compared with five historical control databases. There were six databases included in the main analysis of birth outcomes and congenital anomalies, with a total of 1200 pregnant women. The percentage of pregnant women taking DTG with adverse birth outcomes and congenital abnormalities was similar to results from historical control studies of HIV-positive women. However, there was significant heterogeneity among the six databases - the percentage of infants with congenital anomalies ranged from 0.0% in Botswana (0/116 infants) to 13.3% in IMPAACT P1026S (2/15 infants). Up to 15 million people could be on treatment with DTG in LMICs within the next 5 years, of whom a substantial percentage is likely to be women of child-bearing potential. In many countries with large HIV epidemics, unplanned pregnancies are common and access to antenatal clinic facilities may be limited. Continued pharmacovigilance is essential, but it is reassuring that no clear safety signals have been detected, to date, for pregnant women treated with DTG in terms of birth outcomes or congenital anomalies.

Distribution of Kell phenotype among pregnant women in Sokoto, North Western Nigeria.

PubMed

Osaro, Erhabor; Ladan, Malami Aisha; Zama, Isaac; Ahmed, Yakubu; Mairo, Hassan

2015-01-01

Kell antigen is highly immunogenic and is the common cause of antibody production in mismatched blood transfusions, haemolytic transfusion reaction (HTR) and maternal alloimmunization, which causes severe anaemia in neonates. The aim of this study is to determine the prevalence and ethnic variation of the Kell phenotype among pregnant women in Sokoto, Nigeria. Kell antigen status of 150 pregnant women aged 18-45 years and mean age 27.19 ±4.69 years attending antenatal clinic in UDUTH Sokoto Nigeria was determined using the conventional tube method and anti-Kell reagents (Lorne Laboratories, UK). Among the 150 subjects studied, 3 (2.0%) of subjects were positive and 147 (98.0) were negative for K antigen. Of the 150 pregnant subjects; 32 (21.3%) were primigravidae while 118 (78.7%) were multigravidae. Kell phenotype was more prevalent among primigravidae (3.1%) compared to multigravidae (1.7%) women. The distribution of Kell phenotype among the pregnant subjects was compared based on ethnicity. The prevalence of Kell antigen was significantly higher among the Hausa ethnic group (3.2%) compared to other ethnic groups which indicated zero prevalence (p = 0.001). Kell negative phenotype was ≥ 96.8% among all the ethnic groups. Our observed prevalence of Kell phenotype is consistent with previous studies among Blacks and Asians but significantly lower than values observed in previous studies among Caucasians. We recommend that all pregnant women should be screened for the presence clinically significant red cell antigens including Kell antigen on their first antenatal visit. Kell negative red cell should be routinely provided for all pregnant women and women with child bearing potential to reduce the risk of Kell-associated HDFN. There is need to introduce routine screening of pregnant women for clinically significant red cell antibodies to facilitate the effective management of HDFN as well as prevent HTR. There is also need for sustained health education of

[The National Board of Health's information pamphlet to pregnant women causes insecurity].

PubMed

Jensen, Puk; Brodersen, John

2010-06-07

Since 2004, all pregnant women in Denmark have been offered prenatal screening. The aim of this study was to investigate how the Danish National Board of Health's information pamphlet adressed to pregnant women was perceived by young female readers. Five women aged 23-26 years were interviewed. At the time of the interview, none of the women were pregnant or had previously been pregnant. The five individual interviews were carried out using a semi-structured interview guide. They were recorded, transcribed and analysed using Steinar Kvale's theory of meaning condensation. After reading the pamphlet, the informants became worried, anxious or frightened about the risk of giving birth to a seriously ill or handicapped child. They all wanted a risk estimation in order to be reassured that they were going to have a healthy child. The existence of a screening programme was perceived as an indication of risk. In its present form, the information pamphlet of the Danish National Board of Health suggests a yes rather than a no regarding participation in prenatal screening. This is reprehensible, partly because the aim of the pamphlet was to strengthen the self-determination of pregnant women, and partly because the benefits of participation in the screening programme do not clearly outweigh the corresponding drawbacks for the individual pregnant woman.

Punishing pregnant drug-using women: defying law, medicine, and common sense.

PubMed

Flavin, Jeanne; Paltrow, Lynn M

2010-04-01

The arrests, detentions, prosecutions, and other legal actions taken against drug-dependent pregnant women distract attention from significant social problems, such as our lack of universal health care, the dearth of policies to support pregnant and parenting women, the absence of social supports for children, and the overall failure of the drug war. The attempts to "protect the fetus" undertaken through the criminal justice system (as well as in family and drug courts) actually undermine maternal and fetal health and discourage efforts to identify and implement effective strategies for addressing the needs of pregnant drug users and their families. In this article, the authors seek to expose some of the flawed premises on which the arrests, detentions, and prosecutions are based. The authors highlight the inherent unfairness of a system that expects low-income and drug-dependent pregnant women to provide their fetuses with the health care and safety that these women themselves are not provided and have not been guaranteed.

Change of lifestyle habits - Motivation and ability reported by pregnant women in northern Sweden.

PubMed

Lindqvist, Maria; Lindkvist, Marie; Eurenius, Eva; Persson, Margareta; Mogren, Ingrid

2017-10-01

Pregnant women are generally more motivated to change their lifestyle habits compared with non-pregnant women. However, the ability to change these habits depends on the motivation to change. This study describes pregnant women's self-reported motivation and ability to change lifestyle habits and their relation to body mass index (BMI), self-rated health, educational level and country of origin. This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant residents in Västerbotten County (northern Sweden) between 2011 and 2012. Chi-square test, two independent samples t-test and univariate and multivariate logistic regression were performed. Most of the pregnant women (61.3%) were satisfied with their self-reported lifestyle habits irrespective of BMI, self-rated health, educational level, and country of origin. Many reported that they wanted to increase their physical activity, improve their dietary habits, and reduce their weight. In general, they estimated their ability to change their lifestyle habits as equal to their motivation of change. Women who reported a large or very large motivation to change their lifestyle habits were characterized by higher BMI and higher educational level. Most of the participating pregnant women were satisfied with their lifestyle habits, although they reported being further motivated to change some of them. Health care professionals encountering fertile and pregnant women may have a unique opportunity to support and promote lifestyle changes, taking into account women's motivation for change. Future research should focus on factors that motivate pregnant women to change their lifestyle, explore barriers for change of lifestyle and how support best may be provided to pregnant women. In addition, studies on lifestyle and motivation for lifestyle change from non-Nordic countries are called for. Copyright

Changes in hematologic indices in caucasian and non-caucasian pregnant women in the United States

PubMed Central

Harm, Sarah K.; Yazer, Mark H.

2012-01-01

Background The objective of this study was to determine if there are differences in common red blood cell (RBC) indices and platelet concentrations during pregnancy and to establish if any observed differences in these parameters were based on the patient's ethnicity. Methods From an electronic perinatal database which stores laboratory and clinical information on a large number of births at a regional hospital specializing in obstetrical care, RBC index and platelet concentration data were retrospectively analyzed at various time points throughout pregnancy. RBC index data was collected from 8,277 pregnant women (5,802 Caucasian pregnant women and 2,475 non-Caucasian pregnant women). Platelet concentration data was available from 8252 pregnant women (5,784 Caucasian pregnant women and 2,468 non-Caucasian pregnant women). Results Hemoglobin (HGB) levels were significantly higher amongst Caucasian women compared to non-Caucasian women (P at least <0.01) starting at 27 weeks gestation and proceeding until term. There was no significant difference in the mean PLT counts between Caucasian and non-Caucasian pregnant women at any point during gestation. Conclusion There are ethnic differences in HGB levels, but not the platelet concentrations, during pregnancy. Based on this finding it would be reasonable to conduct formal prospective studies to determine the clinical significance of this difference and to establish the threshold for diagnosing gestational anemia, especially in pregnant non-Caucasian women. PMID:22783361

Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1.

PubMed

Velkoska Nakova, V; Krstevska, B; Dimitrovski, Ch; Simeonova, S; Hadzi-Lega, M; Serafimoski, V

2010-01-01

The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during pregnancy in women with diabetes type 1 and gestational diabetes mellitus (GDM). The study group included 83 pregnant women who attended the Outpatient Department of the Endocrinology, Diabetes and Metabolic Disorders Clinic in the period from 05.2009 to 11.2009. The one hundred-g. oral glucose tolerance test (OGTT) was conducted on the pregnant women except for women with diabetes type 1. Thyroid functions were evaluated in all the pregnant women. After routine screening for GDM, thirty of the pregnant women were healthy and GDM was diagnosed in forty of them. The rest, thirteen women, had diabetes type 1. The women who developed GDM showed a mean free thyroxin concentration (fT4) significantly lower than that observed in the healthy pregnant women and women with diabetes type 1. Among the pregnant women with GDM, 10 women or 25% had fT4 concentrations below the lower cut-off with normal thyroid-stimulating hormone concentrations (TSH). A statistically significant difference was found in the prevalence of antithyroid antibodies (anti-TPO) between the (30%) women with diabetes type 1 and (10%) healthy pregnant women (p<0.05). In the women positive for anti-TPO, TSH was significantly higher (p<0.05). The significantly higher prevalence of hypothyroxinemia in GDM pregnancies and anti-TPO titres in pregnancies with diabetes type 1, than in healthy pregnant women warrants routine screening for thyroid abnormalities in these groups of pregnant women.

Comparative Evaluation of Oral Health Knowledge, Practices and Attitude of Pregnant and Non-Pregnant Women, and Their Awareness Regarding Adverse Pregnancy Outcomes

PubMed Central

Jain, Ashish; Mohan, Sugandha; Bhaskar, Nandini; Walia, Prabhjot Kaur

2015-01-01

Background Adverse pregnancy outcomes are undesirable events occurring during pregnancy and childbirth in mother or child, such as Preterm Low Birth Weight (PLBW) and preeclampsia. There is growing evidence that periodontitis may be a risk factor for preterm birth even after adjusting for known risk factors. Aim 1. To determine the knowledge and attitude of pregnant females about oral health. 2. To evaluate the oral hygiene practices of pregnant females. 3. To evaluate their awareness regarding effect of oral health on adverse pregnancy outcomes. 4. To assess whether there was any significant difference from their non pregnant counter parts. 5. To evaluate whether their awareness towards dental treatment had increased after conceiving. Materials and Methods 200 pregnant and 200 non-pregnant women filled up a validated questionnaire which comprised of questions on personal data, oral hygiene knowledge, attitude, oral hygiene practices and their awareness regarding the correlation of oral health to adverse pregnancy outcomes. Statistical Analysis Analyses were conducted using SPSS for Windows (version 15.0; SPSS Inc., Chicago, IL, USA). Results The results indicate no statistically significant differences in the variables assessed in both the groups, indicating that no further knowledge had been imparted to the women after they conceived. 96% women of both groups (p>0.05) had received no knowledge from the gynaecologist regarding the impact of oral health on pregnancy outcomes. 93.9% of pregnant women, and 89.5% of non pregnant women (p>0.05) did not go for routine dental check-ups. Only 3% of pregnant women were aware of oral health having a correlation with adverse pregnancy outcomes. Conclusion In our study, pregnancy did little to change future attitudes to dental care. To provide better oral health care, more knowledge needs to be made available to the pregnant women and the medical community. PMID:26674176

Pregnant and recently pregnant women's perceptions about influenza a pandemic (H1N1) 2009: implications for public health and provider communication.

PubMed

Lynch, Molly M; Mitchell, Elizabeth W; Williams, Jennifer L; Brumbaugh, Kelly; Jones-Bell, Michelle; Pinkney, Debra E; Layton, Christine M; Mersereau, Patricia W; Kendrick, Juliette S; Medina, Paula Eguino; Smith, Lucia Rojas

2012-11-01

The objective of this study was to explore pregnant and recently pregnant women's perceptions of influenza vaccine and antivirals during the 2009 H1N1 pandemic. We conducted 18 focus groups with pregnant and recently pregnant women in three US cities in September 2009. Participants were segmented into groups by insurance status (no or public insurance vs. private insurance), vaccine attitudes (higher vs. lower likelihood of acceptance of any vaccines, not only influenza vaccines), and parity (first child vs. other children in the home) based on information they provided on the screening questionnaire at the time of recruitment. We found that women are not well informed about influenza vaccinations and antiviral medicine and have significant concerns about taking them during pregnancy. An interest in their infant's well-being, however, can be strong motivation to adopt preventive recommendations, including vaccination. A woman's health care provider is a highly trusted source of information about the 2009 H1N1. Pregnant women have unique communication needs for influenza. Messages directing pregnant women to adopt public health recommendations, particularly for vaccination or prophylactic medication should include a detailed description of the benefits or lack of risk to the fetus and the safety of breastfeeding. Additionally, messages should recognize that pregnant women are taught to be selective about taking medication and provide a clear rationale for why the medicine or vaccine is necessary.

Effect of a gymnastics program on sleep characteristics in pregnant women.

PubMed

Kocsis, Ildikó; Szilágyi, Tibor; Turos, János; Bakó, Aliz; Frigy, Attila

2017-04-01

The quality and quantity of sleep represent important health issues in pregnant women. Sleep disturbances could be associated, beyond alteration of quality of life, with poor pregnancy outcome. Our aim was to investigate the effect of a regular, specific, medium-term physical training program on sleep characteristics in healthy pregnant women. A total of 132 healthy pregnant women, with gestational age between 18 weeks and 22 weeks, were enrolled in a prospective study. They were allocated into two groups; the first group involved 79 women (average age, 29.4 years) who performed a specific gymnastics program of 10 weeks, and the second group involved 53 pregnant women (average age, 27.9 years) who did not perform gymnastics. All participants completed a comprehensive questionnaire at baseline and after 10 weeks concerning general data, sleep characteristics, and psycho-emotional status. The changes arising within a diverse set of characteristics were followed and compared for the two groups using parametric and nonparametric statistics. In the control group, we observed significant worsening of 12 out of the 14 studied parameters during the 10-week period. In comparison with the women who did not perform gymnastics, women who performed specific gymnastics showed the following characteristics: (1) significantly less deterioration of psycho-emotional status (stress and anxiety levels); (2) the same general pattern of decrease in sleep quality, which is related to the progression of pregnancy; and (3) a significant attenuation of the worsening of several sleep characteristics, such as restless sleep, snoring, diurnal tiredness, and excessive daytime sleepiness. Nocturnal and diurnal sleep quantity increased significantly in both groups. The 10-week training program designed for pregnant women has an overall beneficial effect on sleep characteristics, not by improving them but by attenuating their general deterioration related to the progression of pregnancy. Our

Evaluation of rubella screening in pregnant women

PubMed Central

Gyorkos, T W; Tannenbaum, T N; Abrahamowicz, M; Delage, G; Carsley, J; Marchand, S

1998-01-01

BACKGROUND: The rationale for rubella vaccination in the general population and for screening for rubella in pregnant women is the prevention of congenital rubella syndrome. The objective of this study was to evaluate the effectiveness of the prenatal rubella screening program in Quebec. METHODS: A historical cross-sectional study was designed. Sixteen hospitals with obstetric services were randomly selected, 8 from among the 35 "large" hospitals in the province (500 or more live births/year) and 8 from among the 50 "small" hospitals (fewer than 500 live births/year). A total of 2551 women were randomly selected from all mothers of infants born between Apr. 1, 1993, and Mar. 31, 1994, by means of stratified 2-stage sampling. The proportions of women screened and vaccinated were ascertained from information obtained from the hospital chart, the physician's office and the patient. RESULTS: The overall (adjusted) screening rate was 94.0%. The rates were significantly different between large and small hospitals (94.4% v. 89.6%). Five large hospitals and one small hospital had rates above 95.0%. The likelihood of not having been screened was statistically significantly higher for women who had been pregnant previously than for women pregnant for the first time (4.8% v. 1.4%; p < 0.001). Of the 200 women who were seronegative at the time of screening (8.4%), 79 had been vaccinated postpartum, had a positive serological result on subsequent testing or did not require vaccination, and 59 had not been vaccinated postpartum; for 62, subsequent vaccination status was unknown. INTERPRETATION: Continued improvement in screening practices is needed, especially in small hospitals. Because vaccination rates are unacceptably low, it is crucial that steps be taken to address this issue. PMID:9835876

The use of hormones indicators in human saliva in diagnosing parodontitis in pregnant women

PubMed Central

Dolomatov, S. I.; Zukow, W.; Atmazhov, I. D.; Muszkieta, R.; Skaliy, A.

2012-01-01

AIMS: The purpose of this work– was to study the dynamics of biochemical parameters of human saliva and analyze the features of the chemical composition of the saliva of women with abnormal pregnancy and in periodontitis against pregnancy. MATERIALS AND METHODS: The study included four groups of women: a control group of nonpregnant women of childbearing age (10), pregnant women with physiological pregnancy (24-28 weeks) without any signs of periodontal disease (10), pregnant with a generalized periodontitis I--II degrees in remission (10), women with pathological pregnancy with no signs of periodontal inflammation (10). In each of the groups over two samples of saliva were collected, the first collection of saliva in the morning on an empty stomach. Then mouthwash 0.9% sodium chloride solution was assigned and after 30 minutes the second portion of saliva. By enzyme immunoassay in samples of saliva of control groups of nonpregnant and pregnant women, as well as women with signs of a pathological course of pregnancy, the content of estriol, testosterone, and dehydroepiandrosterone sulfate was determined. STATISTICAL ANALYSIS USED: Statistical data analysis was performed by the standard technique using Student's t-test. RESULTS: The results of biochemical analysis of saliva samples collected before rinsing the mouth with saline in groups of healthy nonpregnant and pregnant women were compared. It was established that during pregnancy the concentration of salivary estriol increases, but in pregnant women with periodontitis, the amount of this hormone in the saliva was significantly reduced. The highest content of testosterone in saliva samples, observed in healthy pregnant women, was significantly higher than nonpregnant women. In pregnant women with periodontitis concentration of testosterone in saliva is reduced, while remaining significantly higher than its level in the saliva of nonpregnant women. The highest concentration of testosterone is observed in the

Is passive smoking associated with sleep disturbance among pregnant women?

PubMed

Ohida, Takashi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Harano, Satoru; Tanihata, Takeo; Takemura, Shinji; Wada, Kiyoshi; Kanda, Hideyuki; Hayashi, Kenji; Uchiyama, Makoto

2007-09-01

Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy. Two cross-sectional questionnaire surveys conducted in 2002 and 2006. Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey. 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively. N/A. Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening. The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke. Passive smoking is independently associated with increased sleep disturbance during pregnancy.

Iron status in pregnant women and women of reproductive age in Europe.

PubMed

Milman, Nils; Taylor, Christine L; Merkel, Joyce; Brannon, Patsy M

2017-12-01

Understanding the iron status in pregnant women in Europe provides a foundation for considering the role of iron screening and supplementation. However, available reports and studies have used different approaches that challenge the devising of overall summaries. Moreover, data on pregnant women are limited, and thus, data on women of reproductive age provide useful background information including baseline iron stores in pregnant women. This review considered data that are available from >15 European countries including national surveys and relevant clinical studies. In European women of reproductive age, median or geometric mean serum ferritin (SF) concentrations were estimated at 26-38 μg/L. Approximately 40-55% of this population had small or depleted iron stores (i.e., SF concentration ≤30 μg/L), and 45-60% of this population had apparently replete iron stores. The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was 10-32% and 2-5%, respectively, depending on the cutoffs used. Approximately 20-35% of European women of reproductive age had sufficient iron stores (SF concentration >70 μg/L) to complete a pregnancy without supplementary iron. During pregnancy, European women in controlled supplementation trials who were not receiving iron supplements displayed increasing prevalences of ID and IDA during pregnancy, which peaked in the middle to late third trimester. Available evidence has suggested that, in gestational weeks 32-39, the median or geometric mean SF concentrations were 6-21 μg/L, and prevalences of ID and IDA were 28-85% and 21-35%, respectively. Women who were taking iron supplements had higher iron status and lower prevalences of ID and IDA, which were dependent on the dose of iron and compliance. The data suggest that, in Europe, the iron status of reproductive-aged women varies by region and worsens in pregnancy without iron supplementation. © 2017 American Society for Nutrition.

Acute headache diagnosis in pregnant women

PubMed Central

Farmakidis, Constantine; Dayal, Ashlesha K.; Lipton, Richard B.

2015-01-01

Objective: To characterize demographic and clinical features in pregnant women presenting with acute headache, and to identify clinical features associated with secondary headache. Methods: We conducted a 5-year, single-center, retrospective study of consecutive pregnant women presenting to acute care with headache receiving neurologic consultation. Results: The 140 women had a mean age of 29 ± 6.4 years and often presented in the third trimester (56.4%). Diagnoses were divided into primary (65.0%) and secondary (35.0%) disorders. The most common primary headache disorder was migraine (91.2%) and secondary headache disorders were hypertensive disorders (51.0%). The groups were similar in demographics, gestational ages, and most headache features. In univariate analysis, secondary headaches were associated with a lack of headache history (36.7% vs 13.2%, p = 0.0012), seizures (12.2% vs 0.0%, p = 0.0015), elevated blood pressure (55.1% vs 8.8%, p < 0.0001), fever (8.2% vs 0.0%, p = 0.014), and an abnormal neurologic examination (34.7% vs 16.5%, p = 0.014). In multivariate logistic regression, elevated blood pressure (odds ratio [OR] 17.0, 95% confidence interval [CI] 4.2–56.0) and a lack of headache history (OR 4.9, 95% CI 1.7–14.5) had an increased association with secondary headache, while psychiatric comorbidity (OR 0.13, 95% CI 0.021–0.78) and phonophobia (OR 0.29, 95% CI 0.09–0.91) had a reduced association with secondary headache. Conclusions: Among pregnant women receiving inpatient neurologic consultation, more than one-third have secondary headache. Diagnostic vigilance should be heightened in the absence of a headache history and if seizures, hypertension, or fever are present. Attack features may not adequately distinguish primary vs secondary disorders, and low thresholds for neuroimaging and monitoring for preeclampsia are justified. PMID:26291282

[IMPORTANCE OF SHEAR WAVE ELASTOGRAPHY OF LIVERS IN PRACTICALLY HEALTHY PREGNANT WOMEN].

PubMed

Sariyeva, E; Salahova, S; Bayramov, N

2017-01-01

Pulse-wave elastography (SWE) that is one of the mostly used methods in the recent years holds important place in assessment of liver fibrosis. However there is no exact information on the results of liver elastography in healthy pregnant women in the world literature. The aim of the study was to investigate theSWE parameters of liver elastography in practically healthy pregnant women. The subject of the research was 50 practically healthy pregnant women within 18-45 years old (mean age 27.7±0.7). The pregnant women with genital and extragenital diseases were not included to the research. The research work was executed in the II Department of Obstetrics and Gynecology of Azerbaijan Medical University. SWE of liver in pregnant women was conducted in the I Department of Surgical Diseases of Azerbaijan Medical University through Supersonic Aixplorer Multi Wave device presented by the Scientific Development Foundation under the President of the Azerbaijan Republic. The obtained tissue hardness indicators are assessed under METAVIR scale. The results of the research showed that the measures of liver in practically healthy pregnant women are normal, edges flat, its echogenicity mainly normal, echostructure of its parenchyma homogenous, hardness was F0-F1 (normal) under METAVIR scale, fibrosis not observed. The obtained results were processed by variational (power average, percentile distribution) and correlation (ρ-Spearman) analyzes using the statistical package SPSS-20. A statistical study of the distribution of liver density in healthy women showed that the average density was 4,43±0,01 with 95% confidence interval (4,23 - 4,63). The histogram of distribution of liver density in practically healthy women belongs to the family of normal distributions with coefficients of variation coefficient (16.3%), asymmetry (-0.861±0.337) and excess (-0.068±0.662). Correlation analysis in healthy women did not reveal a reliable relationship between age and liver density (ρ=0

"It's Just Not Very Realistic": Perceptions of Media Among Pregnant and Postpartum Women.

PubMed

Liechty, Toni; Coyne, Sarah M; Collier, Kevin M; Sharp, Aubrey D

2018-07-01

Although research has documented a connection between media and body image for women, little research has explored this connection among pregnant or postpartum women. The purpose of this study was to explore women's perceptions of media and body image during the perinatal period. Fredrickson's objectification theory provided a theoretical framework for the study. Data collection involved semi-structured in-depth interviews with 50 pregnant or postpartum women in which they were asked to describe their perceptions of media depictions of pregnant or postpartum women and its impact on their body image. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Four major themes emerged: (1) participants questioned the realism of media depictions of pregnant and postpartum women, (2) participants described complex reactions to media messages including negative impacts on body image and strategies for mitigating negative impacts, (3) participants desired changes in media messages to be more realistic and to depict a more complex portrayal of the life stage, and (4) participants discussed the unique and complex role of social media including both negative and positive impacts. Implications of the findings for pregnant and postpartum women, communication scholars, and healthcare professionals are discussed.

US provider-reported diet and physical activity counseling to pregnant and non-pregnant women of childbearing age during preventive care visits.

PubMed

Yamamoto, Ayae; McCormick, Marie C; Burris, Heather H

2014-09-01

Healthy diet, physical activity and appropriate weight gain during pregnancy contribute to healthy birth outcomes. The Institute of Medicine recommends that women receive counseling about diet and exercise during preconception, pregnancy and postpartum periods. We sought to determine how often healthcare providers report counseling women of childbearing age about diet or exercise and if such rates vary by pregnancy, overweight/obesity status or physician specialty. We combined the 2005-2010 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey to obtain nationally representative estimates of outpatient preventive care visits for women of child-bearing age (15-44 years). Accounting for survey design, we compared proportions of preventive visits that included diet/exercise counseling for pregnant women versus non-pregnant women and performed multivariable logistic regression models to estimate odds ratios. Providers reported counseling pregnant women about diet/exercise during 17.9 % of preventive care visits compared to 22.6 % of visits for non-pregnant women (P < 0.01, adj. OR 0.8, 95 % CI 0.7, 1.0). Overweight/obese pregnant (vs. non-pregnant) women were significantly less likely to receive diet/exercise counseling (adj. OR 0.7, CI 0.5, 0.9) as were women seen by OB/GYNs versus non-OB/GYNs (adj. OR 0.4, CI 0.3, 0.5). Our findings suggest that provider-reported diet/exercise counseling rates during preventive care visits for women of childbearing age vary by overweight/obesity and pregnancy statuses, as well as by provider specialty. Our data suggest that there may be missed opportunities to provide diet/exercise counseling and that increasing rates of counseling could result in improved maternal and infant health outcomes.

Fundamentals of Clinical Pharmacology With Application for Pregnant Women.

PubMed

Patil, Avinash S; Sheng, Jessica; Dotters-Katz, Sarah K; Schmoll, Maria S; Onslow, Mitchell; Pierson, Rebecca C

2017-05-01

Medication use is common in pregnancy, yet for most medications the optimal formulation and dosage have not been described specifically for pregnant women. Often, adverse effects are only discovered anecdotally or after extensive off-label use occurs. Since pharmacologic research that includes pregnant women is sparse and animal studies are often not applicable to the human fetus, providers must use knowledge of drug behavior and normal physiologic changes of pregnancy to personalize treatment for pregnant women. In this review, we present an overview of the basic concepts of clinical pharmacology: pharmacokinetics, pharmacodynamics, and pharmacogenomics. The normal physiologic changes of pregnancy are presented as a framework to understand alterations in drug behavior. A clinical vignette that addresses 4 pregnancy scenarios involving medications-preterm birth, vaccination, herpes simplex virus infection, and codeine toxicity-is provided to illustrate application of core clinical pharmacologic concepts. Discussion of relevant literature illustrates the challenges of offering individualized pharmacologic therapy in pregnancy. © 2017 by the American College of Nurse-Midwives.

Comparison of sVCAM-1 and sICAM-1 levels in maternal serum and vaginal secretion between pregnant women with preterm prelabour ruptures of membranes and healthy pregnant women.

PubMed

Sak, Sibel; Barut, Mert; Incebiyik, Adnan; Ağaçayak, Elif; Kirmit, Adnan; Koyuncu, Ismail; Sak, Muhammet

2017-11-02

The study aims to evaluate the maternal serum and the vaginal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecular (sICAM-1) in pregnant women complicated by preterm prelabour ruptures of membranes (PPROM). The prospective case control study included 34 pregnant women with PPROM and 34 healthy pregnant women. Patients with additional diseases, a smoking habit and vaginal bleeding, as well as those using antibiotics, during the study period were not included in the study. Cervicovaginal fluid and serum samples were taken during the patients' admission. The demographic data, maternal serum and vaginal fluid sVCAM-1 and sICAM-1, C reactive protein (CRP) and leukocyte counts were noted for all pregnant women included in the study. The sVCAM-1 and sICAM-1 levels were measured by enzyme-linked immunosorbent assay kits. In pregnant women with PPROM, the serum leukocyte (mean ± SD =11.41 ± 1.067 versus 9.18 ± 1.56, p < .0001), serum sVCAM-1 (median 771.20 versus 704.60 ng/ml, p < .001), sICAM-1 (mean ± SD 213.10 ± 35.59 ng/ml versus 188.11 ± 37.35 ng/ml, p = .06), vaginal sVCAM-1 (median 208.00 versus 140.20 ng/ml, p = .014) and sICAM-1 (mean ± SD 32.32 ± 6.49 ng/ml versus 24.87 ± 6.79 ng/ml, p < .001) values were found to be significantly higher in pregnant women with PPROM than in healthy pregnant women. A positive and significant correlation was observed between the leukocyte count and the vaginal sVCAM-1 level (r = 0.850; p < .001). To the best of our knowledge, this is the first study evaluating the levels of sICAM-1 in maternal serum in pregnant women with PPROM. The maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels can be used as biochemical markers supporting the PPROM diagnosis because of the increase in both maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels in pregnant women with PPROM.

The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza.

PubMed

Macias, Alejandro E; Precioso, Alexander R; Falsey, Ann R

2015-08-01

There is a heavy disease burden due to seasonal influenza in pregnant women, their fetuses, and their newborns. The main aim of this study was to review and analyze current evidence on safety, immunogenicity, and clinical benefits of the inactivated influenza vaccine (IIV) in pregnant women. Current evidence shows that in pregnant women, the seasonal and pandemic IIVs are safe and well tolerated. After vaccination, pregnant women have protective concentrations of anti-influenza antibodies, conferring immunogenicity in newborns. The best evidence, to date, suggests that influenza vaccination confers clinical benefits in both pregnant women and their newborns. Vaccination with either the seasonal or pandemic vaccine has been shown to be cost-effective in pregnancy. There are scarce data from randomized clinical trials; fortunately, new phase 3 clinical trials are under way. In the Northern and Southern Hemispheres, data suggest that the greatest clinical benefit for infants occurs if the IIV is administered within the first weeks of availability of the vaccine, at the beginning of the influenza season, regardless of the pregnancy trimester. The optimal timing to vaccinate pregnant women who live in tropical regions is unclear. Based on evaluation of the evidence, the Global Influenza Initiative (GII) recommends that to prevent seasonal influenza morbidity and mortality in infants and their mothers, all pregnant women, regardless of trimester, should be vaccinated with the IIV. For countries where vaccination against influenza is starting or expanding, the GII recommends that pregnant women have the highest priority. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Health risk factors and mental health among US women with and without chronic physical disabilities by whether women are currently pregnant.

PubMed

Iezzoni, Lisa I; Yu, Jun; Wint, Amy J; Smeltzer, Suzanne C; Ecker, Jeffrey L

2015-06-01

Growing numbers of reproductive-age US women with chronic physical disabilities (CPD) raise questions about their pregnancy experiences. Little is known about the health risks of women with versus without CPD by current pregnancy status. We analyzed cross-sectional, nationally-representative National Health Interview Survey data from 2006 to 2011, which includes 47,629 civilian, noninstitutionalized women ages 18-49. NHIS asks about specified movement difficulties, current pregnancy, and various health and health risk indicators, including tobacco use and body mass index (BMI). We used responses from eight movement difficulty and other questions to identify women with mobility difficulties caused by chronic physical health conditions. Across all women regardless of CPD, women reporting current pregnancy are significantly less likely to currently smoke tobacco and report certain mental health problems. Among currently pregnant women only, women with CPD are more likely to smoke cigarettes every day (12.2 %) versus 6.3 % for pregnant women without CPD (p ≤ 0.001). Among currently pregnant women, 17.7 % of women with CPD have BMIs in the non-overweight range, compared with 40.1 % of women without CPD (p ≤ 0.0001). Currently pregnant women with CPD are significantly more likely to report having any mental health problems, 66.6 % compared with 29.7 % among women without CPD (p ≤ 0.0001). For all women, currently pregnant women appear to have fewer health risks and mental health concerns than nonpregnant women. Among pregnant women, women with CPD have higher rates than other women of health risk factors that could affect maternal and infant outcomes.

"It's like a puzzle": Pregnant women's perceptions of professional support in midwifery care.

PubMed

Bäckström, Caroline A; Mårtensson, Lena B; Golsäter, Marie H; Thorstensson, Stina A

2016-12-01

Pregnant women are not always satisfied with the professional support they receive during their midwifery care. More knowledge is needed to understand what professional support pregnant women need for childbirth and parenting. Childbearing and the transition to becoming a parent is a sensitive period in one's life during which one should have the opportunity to receive professional support. Professional support does not always correspond to pregnant women's needs. To understand pregnant women's needs for professional support within midwifery care, it is crucial to further illuminate women's experiences of this support. To explore pregnant women's perceptions of professional support in midwifery care. A qualitative study using semi-structured interviews. Fifteen women were interviewed during gestational weeks 36-38. Data was analysed using phenomenography. The women perceived professional support in midwifery care to be reassuring and emotional, to consist of reliable information, and to be mediated with pedagogical creativity. The professional support facilitated new social contacts, partner involvement and contributed to mental preparedness. The findings of the study were presented in six categories and the category Professional support contributes to mental preparedness was influenced by the five other categories. Pregnant women prepare for childbirth and parenting by using several different types of professional support in midwifery care: a strategy that could be described as piecing together a puzzle. When the women put the puzzle together, each type of professional support works as a valuable piece in the whole puzzle. Through this, professional support could contribute to women's mental preparedness for childbirth and parenting. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Choline intake influences phosphatidylcholine DHA enrichment in nonpregnant women but not in pregnant women in the third trimester.

PubMed

West, Allyson A; Yan, Jian; Jiang, Xinyin; Perry, Cydne A; Innis, Sheila M; Caudill, Marie A

2013-04-01

Phosphatidylcholine (PC) produced via the S-adenosylmethionine-dependent phosphatidylethanolamine (PE) N-methyltransferase (PEMT) pathway is enriched with docosahexaenoic acid (DHA). DHA plays a critical role in fetal development and is linked to health endpoints in adulthood. It is unknown whether choline, which can serve as a source of S-adenosylmethionine methyl groups, influences PC-DHA or the PC:PE ratio in pregnant and nonpregnant women. This study tested whether choline intake affects indicators of choline-related lipid metabolism, including erythrocyte and plasma PC-DHA and PC:PE ratios, in pregnant women in the third trimester and nonpregnant women. Pregnant (n = 26) and nonpregnant (n = 21) women consumed 480 or 930 mg choline/d and a daily DHA supplement for 12 wk. Blood was collected at baseline and at the midpoint and end of the study. PC-DHA was analyzed as the proportion of total PC fatty acids. Pregnant women had greater (P = 0.002) PC-DHA concentrations than did nonpregnant women at baseline. The proportion of erythrocyte and plasma PC-DHA increased (P ≤ 0.002) in pregnant and nonpregnant women regardless of choline intake. However, in nonpregnant women, consumption of 930 mg choline/d led to greater (P < 0.001) erythrocyte PC-DHA and a more rapid increase (P < 0.001) in plasma PC-DHA. Lower (P = 0.001-0.024) erythrocyte and plasma PC:PE in pregnant women was not modified by choline intake. A higher choline intake may increase PEMT activity, resulting in greater PC-DHA enrichment of the PC molecule in nonpregnant women. Increased production of PC-DHA during pregnancy indicates elevated PEMT activity and a higher demand for methyl donors. This trial was registered at clinicaltrials.gov as NCT01127022.

Unintended pregnancy among HIV-positive pregnant women in Enugu, southeast Nigeria.

PubMed

Ezugwu, Euzebus C; Iyoke, Chukwuemeka A; Nkwo, Peter O; Ezegwui, Hygenius U; Akabueze, Jude C; Agu, Polycap U

2016-01-01

To determine the prevalence and factors associated with unintended pregnancy among HIV-positive pregnant women in Enugu, southeast Nigeria. A questionnaire-based cross-sectional study was performed of HIV-positive pregnant women receiving prenatal care at two tertiary health institutions in Enugu between March 1 and August 31, 2012. The women were interviewed with a pretested questionnaire. Overall, 180 HIV-positive pregnant women were recruited, 67 (37.2%) of whom declared that their pregnancy was unintended. Overall, 174 (96.7%) patients were receiving antiretroviral therapy and 99 (55.0%) had future fertility intensions. Participants with regular partners (married or cohabiting) had a significantly higher rate of unintended pregnancy than those with unstable partners (40.3%, n=64/159 vs 14.3%, n=3/21 P=0.029). Age, parity, educational level, and current treatment with antiretroviral therapy did not significantly affect the prevalence of unintended pregnancy. A substantial number of HIV-positive pregnant women declared their pregnancies to be unintended. Modern contraceptives should be made readily available and accessible to HIV-positive women to help eliminate mother-to-child transmission of HIV and subsequent new pediatric HIV infections. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Changes of insulin resistance and β-cell function in women with gestational diabetes mellitus and normal pregnant women during mid- and late pregnant period: a case-control study.

PubMed

Wang, Yun-Hui; Wu, Hui-Hua; Ding, Hong; Li, Yan; Wang, Zhen-Hua; Li, Feng; Zhang, Jian-Ping

2013-03-01

The aim of this study was to observe insulin resistance and β-cell function changes among women diagnosed with gestational impaired glucose tolerance or gestational diabetes mellitus (GDM) in mid-pregnancy. Sixty-four pregnant women receiving prenatal care underwent an oral glucose tolerance test at 20-24 weeks of gestation and an insulin release test. The GDM group included 34 pregnant women diagnosed with gestational impaired glucose tolerance or GDM, and the subjects with normal blood glucose were the control group. Insulin resistance and islet β-cell function changes were observed with the oral glucose tolerance test and insulin release test. The homeostatic model assessment-β levels in late pregnancy were higher than those in mid-pregnancy for both groups, and the primary time effect was statistically significant. The early insulin secretion index (ΔI(30)/ΔG(30)) values in mid- and late pregnancy were lower in the GDM group. The values of the area under the curve of blood glucose in mid- and late pregnancy were higher in the GDM group than those in the control group. Insulin resistance was higher in GDM patients than in normal pregnant women. Insulin resistance was aggravated, and β-cell's ability to compensate for the increased insulin resistance by modulating insulin secretion was aggravated, as gestational week increased in women with gestational diabetes and normal pregnant women. Insulin resistance in women with GDM is higher than in pregnant women with normal metabolism of glucose. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Seroprevalence of hepatitis E virus among pregnant women and control subjects in China.

PubMed

Cong, Wei; Sui, Jian-Chao; Zhang, Xiang-Yan; Qian, Ai-Dong; Chen, Jia; Zhu, Xing-Quan

2015-03-01

Hepatitis E infection, caused by the hepatitis E virus (HEV), is an important global public health concern, with particularly high mortality in pregnant women. China is generally judged to be an HEV-endemic area, but epidemiological data for HEV among pregnant women are limited. Between June 2011 and July 2013, a case-control study was conducted to estimate the seroprevalence and potential risk factors associated with the acquisition of HEV infection by pregnant women in China. Nine-hundred and ninety pregnant women who visited hospitals for antenatal follow-up or medication in Qingdao and Weihai and 965 control subjects matched by age, gender and residence were examined for the presence of anti-HEV IgG and IgM antibodies by enzyme immunoassays. Socio-demographic and behavioral characteristics from the study subjects were obtained. The overall prevalence of anti-HEV IgG in all 1,955 samples was 20.7%. In pregnant women, 16.2% of samples were anti-HEV IgG positive whereas, in control subjects 25.3% of samples were anti-HEV IgG positive, (P < 0.01). For anti-HEV IgM detection, 62 (3.2%) of the 1,955 serum samples were positive and the seroprevalence in pregnant women and control subjects was 2.6% and 3.6%, respectively. Age, contact with cats, contact with pigs and exposure to soil were found to be associated with HEV infection. These findings demonstrated the high prevalence of HEV and the considerable potential for the transmission of HEV infection in pregnant women in China. © 2014 Wiley Periodicals, Inc.

[Pathogenic mechanisms of proatherogenic changes in pregnant women with concomitant obesity].

PubMed

Tarasenko, K V; Mamontova, T V

2013-12-01

The concentration of insulin, high sensitivity C-reactive protein (CRP) and indices of lipid metabolism (concentrations of triacylglycerols, total cholesterol, cholesterol of low density lipoproteins and cholesterol of very low density lipoproteins) in women with concomitant obesity in the second trimester of pregnancy were studied. Changes of the lipid profile in the pregnant women with concomitant obesity indicate development of type IV hyperlipoproteinemia. Concentrations of insulin and CRP in the blood serum of the pregnant women with obesity were respectively 92.1% and 62.5% higher than in the control group. On the basis of literature data and our own research it was concluded that the complex of the metabolic changes (insulin resistance, dislipidemia, endothelial dysfunction, systemic inflammation) in pregnant women with obesity promotes development of proatherogenic changes.

Effect of betel chewing on the frequency of sister chromatid exchanges in pregnant women and women using oral contraceptives.

PubMed

Ghosh, P K; Ghosh, R

1988-06-01

The incidence of sister chromatid exchange (SCE) was investigated in the lymphocyte chromosomes of betel chewing and non-chewing normal women, pregnant women, and women using oral contraceptives. The frequency of SCE was found to be 7.82 +/- 0.24 and 8.27 +/- 0.27 in non-chewing pregnant women and women using oral contraceptives respectively, which were significantly higher than the mean value of 5.21 +/- 0.18 observed in non-chewing normal women. Betel chewing induced higher SCE in pregnant women and women using oral contraceptives, the frequencies being 11.79 +/- 0.38 and 12.51 +/- 0.44, respectively, which were significantly higher than the SCE frequency of 6.28 +/- 0.21 found in normal betel chewing females.

Mefloquine for preventing malaria in pregnant women

PubMed Central

González, Raquel; Pons-Duran, Clara; Piqueras, Mireia; Aponte, John J; ter Kuile, Feiko O; Menéndez, Clara

2018-01-01

Background The World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine for malaria for all women who live in moderate to high malaria transmission areas in Africa. However, parasite resistance to sulfadoxine-pyrimethamine has been increasing steadily in some areas of the region. Moreover, HIV-infected women on cotrimoxazole prophylaxis cannot receive sulfadoxine-pyrimethamine because of potential drug interactions. Thus, there is an urgent need to identify alternative drugs for prevention of malaria in pregnancy. One such candidate is mefloquine. Objectives To assess the effects of mefloquine for preventing malaria in pregnant women, specifically, to evaluate: the efficacy, safety, and tolerability of mefloquine for preventing malaria in pregnant women; and the impact of HIV status, gravidity, and use of insecticide-treated nets on the effects of mefloquine. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, Latin American Caribbean Health Sciences Literature (LILACS), the Malaria in Pregnancy Library, and two trial registers up to 31 January 2018. In addition, we checked references and contacted study authors to identify additional studies, unpublished data, confidential reports, and raw data from published trials. Selection criteria Randomized and quasi-randomized controlled trials comparing mefloquine IPT or mefloquine prophylaxis against placebo, no treatment, or an alternative drug regimen. Data collection and analysis Two review authors independently screened all records identified by the search strategy, applied inclusion criteria, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when required. Dichotomous outcomes were compared using risk ratios (RRs), count outcomes as incidence rate ratios (IRRs

Periodontal disease awareness among pregnant women and its relationship with socio-demographic variables.

PubMed

Alwaeli, H A; Al-Jundi, S H

2005-05-01

Certain conditions may have an affect on gingival status and may aggravate pre-existing disease, especially in persons with poor oral hygiene. Pregnancy is one of these conditions. In addition, there is evidence in the literature suggesting an association between periodontal diseases in pregnant women and giving birth to premature, low-birth infants. The purpose of this study was to evaluate the degree of periodontal health knowledge, and awareness, among pregnant women in Jordan. This was carried out by cross-sectional survey using self-administered, structured questionnaires distributed at six maternity care centres in Irbid City. Questionnaire items addressed personal and socio-demographic variables and periodontal health awareness and knowledge of pregnant women. Women (n = 300) were randomly chosen from attendants to these centres. Of the 300 questionnaires distributed, only 275 pregnant women ages 16-45 years with a mean of 29 year responded and were included in the study. Data were analysed by chi-squared test with the level of significance set at (P < 0.05). About one-third of the participants had secondary level of education; it appeared that a minority of the pregnant women had knowledge or ability to identify dental plaque (16.4%) and its harmful effects (22.5%), while most of them (88%) were aware that bleeding gums indicated the presence of periodontal disease. The differences in the responses to knowledge questions were only significant for question number one (What is plaque?) among different educational levels and groups. This study revealed that (71.6%) of the pregnant women knew the main cause of gum disease; however 56% of them do not believe that frequency of teeth brushing should be increased during pregnancy and only 5.1% believed there might be a relationship between gum diseases and premature labour. Knowledge and awareness for pregnant women about their teeth and gingival condition is generally poor. Pregnant women need accurate information

Breast-feeding intentions among low-income pregnant and lactating women.

PubMed

Hill, Gina Jarman; Arnett, Dennis B; Mauk, Eileen

2008-01-01

Provide a better understanding of the process used by low-income pregnant/postpartum women when deciding whether to breast-feed or not. Pregnant/postpartum women admitted to an obstetrics floor completed a survey to determine breast-feeding intention (n=88). Subjects were primarily Hispanic and African American women. Beliefs and referent other were related positively to attitude and subjective norm, respectively. Subjective norm was related positively to intention to breast-feed. Breast-feeding knowledge was low. Others' opinions clearly influence feeding intentions among this population of low-income women. Inclusion of these significant others, family, and friends within the breast-feeding education process is warranted.

Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

PubMed

Gómez, Mariel Fajer; Field, Catherine J; Olstad, Dana Lee; Loehr, Sarah; Ramage, Stephanie; McCargar, Linda J

2015-10-01

Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women. © 2013 John Wiley & Sons Ltd.

Potential unintended consequences of smoke-free policies in public places on pregnant women in China.

PubMed

Yao, Tingting; Lee, Anita H; Mao, Zhengzhong

2009-08-01

Smoke-free policies in public places have become more common in China. Little is known, however, about the potential unintended consequences of such policies on pregnant women. The study was conducted in 2006 in Chengdu, China. Nonsmoking pregnant women (N=55) whose husband were smokers participated in a study of their knowledge about secondhand smoke and smoke-free policies, their exposure to secondhand smoke, and their husbands' smoking status at home. This study presents descriptive statistics, analyses based on family income and pregnant women's education level, and the findings of focus group discussions that examined the potential unintended consequences of the smoke-free policies on pregnant women. Exposure to secondhand smoke at home was reported by 69.1% of the pregnant women. Both family income and the education level of the pregnant women had a significant (p<0.05) association with exposure to secondhand smoke. The four main potential unintended consequences of the smoke-free policies were: (1) increased exposure of pregnant women to secondhand smoke at home; (2) reduced work efficiency; (3) adverse effect on family harmony; and (4) poor air quality at home. Education is needed to increase knowledge of secondhand smoke among smokers and nonsmokers alike. When the smoking location is shifted from public places and workplaces to home, women, and in particular pregnant women, become the victims. Policymakers should recognize such potential unintended consequences and take necessary measures to increase awareness about the harms of secondhand smoke.

Perceptions of Electronic Cigarettes Among Medicaid-Eligible Pregnant and Postpartum Women.

PubMed

Fallin, Amanda; Miller, Alana; Assef, Sara; Ashford, Kristin

2016-01-01

To describe perceptions and beliefs about electronic cigarette (e-cigarette) use during pregnancy among pregnant and newly postpartum women. An exploratory, qualitative descriptive study. University-affiliated prenatal clinics. Twelve pregnant or recently postpartum women who reported use of tobacco and electronic cigarettes. Semistructured focus groups were audio recorded and professionally transcribed. The transcripts were coded to consensus and analyzed with MAXQDA software (version 11) using content analysis. Four overarching themes emerged: (a) Attraction to E-Cigarettes as a Harm Reduction Strategy, (b) Uncertainty Regarding the Health Effects of E-Cigarettes; (c) Ambivalence Regarding Novel Product Characteristics; and (d) Behaviors Reflected Dual Use and Often Complete Relapse to Traditional Cigarettes. Pregnant women are initially attracted to e-cigarettes as a harm reduction strategy, but they often return to traditional cigarettes in the postpartum period. Nurses should counsel pregnant women on the adverse effects of fetal exposure to nicotine. Evidence-based nursing interventions are needed to prevent relapse during the postpartum period. Copyright © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Serodiscordance and disclosure among HIV-positive pregnant women in the Southwestern United States.

PubMed

Nacius, Lori A; Levison, Judy; Minard, Charles G; Fasser, Carl; Davila, Jessica A

2013-04-01

The prevalence of HIV-positive pregnant women in relationships with HIV-negative men in the United States is unclear. The purpose of this study was to calculate the prevalence of HIV-positive pregnant women with a serodiscordant (HIV-negative) partner within a single clinic population, assess disclosure of their HIV status, and examine factors associated with disclosure. All HIV-positive pregnant women who received prenatal care at the Harris County Hospital District Women's Program at Northwest Health Center in Houston TX between 1/1/2006 and 4/1/2011 were identified. Data were obtained from electronic medical records. Prevalence of serodiscordance and disclosure was calculated, and predictors of disclosure were evaluated. We identified 212 HIV-positive pregnant women. About 40% had a serodiscordant partner, and 34% had a partner with an unknown HIV status. Disclosure occurred in over 90% of women with a serodiscordant partner and in 68% of women with partners whose HIV status was unknown. Among pregnant women who knew their HIV status prior to the current pregnancy and had a serodiscordant partner, 92% reported disclosing their status prior to conception. Our data indicated that serodiscordant relationships are common in our clinic population. Suboptimal disclosure rates were observed, especially among women who have a partner with an unknown HIV status. Further research is needed to evaluate the prevalence of serodiscordance and disclosure in other United States populations.

Dietary Intake and Food Habits of Pregnant Women Residing in Urban and Rural Areas of Deyang City, Sichuan Province, China

PubMed Central

Gao, Haoyue; Stiller, Caroline K.; Scherbaum, Veronika; Biesalski, Hans Konrad; Wang, Qi; Hormann, Elizabeth; Bellows, Anne C.

2013-01-01

Micronutrient deficiencies and imbalanced dietary intake tend to occur during the reproductive period among women in China. In accordance with traditional Chinese culture, pregnant women are commonly advised to follow a specific set of dietary precautions. The purpose of this study was to assess dietary intake data and identify risk factors for nutritional inadequacy in pregnant women from urban and rural areas of Deyang region, Sichuan province of China. Cross-sectional sampling was applied in two urban hospitals and five rural clinics (randomly selected) in Deyang region. Between July and October 2010, a total of 203 pregnant women in the third trimester, aged 19–42 years, were recruited on the basis of informed consent during antenatal clinic sessions. Semi-structured interviews on background information and 24-h dietary recalls were conducted. On the basis of self-reported height and pre-pregnancy weight, 68.7% of the women had a pre-pregnancy body mass index (BMI) within the normal range (18.5 ≤ BMI < 25), 26.3% were found to be underweight with a BMI <18.5 (20.8% in urban vs. 35.6% in rural areas), while only 5.1% were overweight with a BMI ≥30. In view of acceptable macronutrient distribution ranges (AMDRs) the women’s overall dietary energy originated excessively from fat (39%), was low in carbohydrates (49.6%), and reached the lower limits for protein (12.1%). Compared to rural areas, women living in urban areas had significantly higher reference nutrient intake (RNI) fulfillment levels for energy (106.1% vs. 93.4%), fat (146.6% vs. 119.7%), protein (86.9% vs. 71.6%), vitamin A (94.3% vs. 65.2%), Zn (70.9% vs. 61.8%), Fe (56.3% vs. 48%), Ca (55.1% vs. 41%) and riboflavin (74.7% vs. 60%). The likelihood of pregnant women following traditional food recommendations, such as avoiding rabbit meat, beef and lamb, was higher in rural (80%) than in urban (65.1%) areas. In conclusion, culturally sensitive nutrition education sessions are necessary for both

Hepatitis E virus exposure in pregnant women in rural Durango, Mexico.

PubMed

Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis F; Hernández-Tinoco, Jesús

2014-01-01

Hepatitis E virus (HEV) infection represents a risk for mortality in pregnant women. The seroepidemiology of HEV infection in rural pregnant women in the Americas is largely unknown. The aim of the study was to determine the seroepidemiology of anti-HEV IgG antibodies in rural pregnant women in Durango, Mexico. The presence of anti-HEV IgG antibodies was determined in 439 pregnant women in rural Durango, Mexico using an enzyme-linked immunoassay. Seroprevalence association with socio-demographic, clinical and behavioral characteristics of the women was also investigated. Twenty five (5.7%; 95% CI: 3.88-8.27) of the 439 women (mean age: 24.53 ± 6.1 years) had anti-HEV antibodies. Multivariate analysis showed that HEV seropositivity was associated with increasing age (OR = 1.11; 95% CI: 1.03-1.20; P = 0.004), consumption of unpasteurized cow milk (OR = 5.37; 95% CI: 1.17-24.63; P = 0.03), and overcrowding at home (OR = 2.36; 95% CI: 1.13-4.92; P = 0.02). In contrast, the variables educational level, occupation, socio-economic status, foreign travel, consumption of untreated water and raw or undercooked meat, and raising animals did not show associations with HEV seropositivity. Exposure to HEV was associated with the number of deliveries but not with the number of cesarean sections or miscarriages. This is the first report of seroprevalence and contributing factors for HEV infection in rural pregnant women in the Americas, and of an association of the consumption of unpasteurized cow milk with HEV exposure. Results of this study should be useful for designing optimal preventive measures against HEV infection. vg

A General Lack of IgG Against Pertussis Toxin in Chinese Pregnant Women and Newborns.

PubMed

Meng, Qing-Hong; Luo, Jie; Yang, Fan; Shen, Ying-Jie; Li, Li; Li, Li-Jun; Shi, Wei; Wang, Ya-Juan; Yao, Kai-Hu

2018-02-05

To investigate the level of pertussis-related antibodies in pregnant women and newborns. A total of 286 serum samples from healthy pregnant women and 221cord samples from newborns were collected in 2016 in Beijing. A routinely blood sample from pregnant women was obtained at 35 weeks of gestational age, and cord samples were collected in 20 min after delivery. The values from cord samples were used as the infant values. Anti-pertussis toxin (PT) IgG concentration was measured by ELISA (Euroimmun, Lübeck, Germany) using purified PT as a coating antigen. Newborns with anti-PT IgG ≤40 IU/ml in cord samples were considered to be unprotected against pertussis. Anti-PT IgG ≥100 IU/ml was considered to be indicative of a recent pertussis infection in pregnant women. The anti-PT IgG concentration below the lower limit of detection (< 5 IU/ml) occurred in 74.1% (212/286) of pregnant women and 66.5% (147/221) of newborns. Even with detectable anti-PT antibodies, the majority of pregnant women (79.7%, 59/74) and newborns (73.0%, 54/74) had antibody level of 5-<20 IU/ml, and 13.5% (10/74) of pregnant and 14.9% (11/74) of newborns had antibody level of 20-<40 IU/ml. The 75% percentiles for anti-PT IgG of pregnant women and newborns were 5.08 and 6.98 IU/ml, respectively. The prevalence of unprotected newborns as defined by anti-PT IgG ≤40 IU/ml was 95.9% (202/211). The prevalence of recent pertussis infection in pregnant women as defined by anti-PT IgG ≥100 was 0.7% (2/286). The pregnant women and newborns were generally lack of protective antibody and are vulnerable to pertussis in Beijing, China. Although acellular pertussis vaccine is administrated in infancy in China, a booster vaccination to pregnant women should be consider for protecting young infants who are too young to start pertussis vaccination.

Vaccines in pregnancy: The dual benefit for pregnant women and infants.

PubMed

Marshall, H; McMillan, M; Andrews, R M; Macartney, K; Edwards, K

2016-04-02

Maternal immunization has the potential to reduce the burden of infectious diseases in the pregnant woman and her infant. Many countries now recommend immunization against influenza at any stage of pregnancy and against pertussis in the third trimester. Despite evidence of the safety and effectiveness of these vaccines when administered during pregnancy, uptake generally remains low for influenza and moderate for pertussis vaccine. Enhancing confidence in both immunization providers and pregnant women by increasing the evidence-base for the safety and effectiveness of vaccines during pregnancy, improving communication and access by incorporating immunization into standard models of antenatal care are likely to improve uptake. Developing a framework for implementation of vaccines for pregnant women which is cognizant of local and national cultural, epidemiological, behavioral and societal factors will enable a smooth transition and high uptake for new vaccines currently in development for pregnant women.

Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

PubMed

Lee King, Patricia A; Duan, Lei; Amaro, Hortensia

2015-01-01

We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.

Listeriosis Prevention Knowledge Among Pregnant Women in the USA

DOE PAGES

Ogunmodede, Folashade; Jones, Jeffery L.; Scheftel, Joni; ...

2005-01-01

Background: Listeriosis is a food-borne disease often associated with ready-to-eat foods. It usually causes mild febrile gastrointestinal illness in immunocompetent persons. In pregnant women, it may cause more severe infection and often crosses the placenta to infect the fetus, resulting in miscarriage, fetal death or neonatal morbidity. Simple precautions during pregnancy can prevent listeriosis. However, many women are unaware of these precautions and listeriosis education is often omitted from prenatal care. Methods: Volunteer pregnant women were recruited to complete a questionnaire to assess their knowledge of listeriosis and its prevention, in two separate studies. One study was a national surveymore » of 403 women from throughout the USA, and the other survey was limited to 286 Minnesota residents. Results: In the multi-state survey, 74 of 403 respondents (18%) had some knowledge of listeriosis, compared with 43 of 286 (15%) respondents to the Minnesota survey. The majority of respondents reported hearing about listeriosis from a medical professional. In the multi-state survey, 33% of respondents knew listeriosis could be prevented by not eating delicatessen meats, compared with 17% in the Minnesota survey ( p = 0.01). Similarly, 31% of respondents to the multi-state survey compared with 19% of Minnesota survey respondents knew listeriosis could be prevented by avoiding unpasteurized dairy products (p = 0.05). As for preventive behaviors, 18% of US and 23% of Minnesota respondents reported avoiding delicatessen meats and ready-to-eat foods during pregnancy, whereas 86% and 88%, respectively, avoided unpasteurized dairy products. Conclusions: Most pregnant women have limited knowledge of listeriosis prevention. Even though most respondents avoided eating unpasteurized dairy products, they were unaware of the risk associated with ready-to-eat foods. Improved education of pregnant women regarding the risk and sources of listeriosis in pregnancy is needed.« less

Vaginal infections among pregnant women at Omdurman Maternity Hospital in Khartoum, Sudan.

PubMed

Abdelaziz, Zeinab A; Ibrahim, Mutasim E; Bilal, Naser E; Hamid, Mohamed E

2014-04-15

Microbial infections of the vagina in pregnant women are health problems that lead to serious medical complications and consequences. This study aimed to investigate and determine antimicrobial susceptibilities of the causative agents of vaginal infections in pregnant women. A cross-sectional study of pregnant women (n = 200) was conducted between August and December 2008 at Omdurman Maternity Hospital, Khartoum, Sudan. Vaginal and cervical swabs were obtained from each subject and processed for isolation and identification of pathogenic microorganisms using standard methods of wet mount preparation, direct Gram smear, Nugent scoring system, direct immunofluorescence, and cultural techniques. Antimicrobial susceptibility testing of bacterial isolates was performed using standard procedures. Statistical analysis was done using SPSS program version 12.0.1. A p value < 0.05 was considered statistically significant. Of the 200 pregnant women enrolled, BV was detected in 49.8%, followed by Chlamydia trachomatis (31.3%) and Candida albicans (16.6%), with low frequencies of Neisseria gonorrhoeae (1.8%) and Trichomonas vaginalis (0.5%). Higher infection rates were recorded among subjects in the third trimester (71.6%) than in the second trimester of gestation (28.4%). No significant association (p = 0.7) between history of abortions and C. trachomatis infections was found. Gentamicin was the most active agent against Gram-positive and Gram-negative bacteria. Clarythromycin was the most active against Mycoplasma species. Pregnant women with vaginal complaints revealed various positive microbiology results. Such cases may require specific medication. Routine culture of vaginal and cervical samples should be performed on all pregnant women during prenatal visits.

Internet Usage among Pregnant Women for Seeking Health Information: A Review Article.

PubMed

Javanmardi, Marzieh; Noroozi, Mahnaz; Mostafavi, Firoozeh; Ashrafi-Rizi, Hasan

2018-01-01

In recent years, the Internet has become one of the most popular sources of health information for users, and pregnant women are no exception. This study aimed to investigate Internet usage among pregnant women for achieving health information on the finding of related studies. This review study was conducted by searching databases such as IranMedex, Magiran, Scientific Information Database, Irandoc, PubMed, Science Direct, Cochrane, Google Scholar, and Scopus in December 2016. Restrictions were placed on publication to within 16 years and language of publication was restricted to English and Persian. Keywords used in the search included information-seeking behavior, information-seeking, information needs, access to information, pregnancy, and pregnant women. This search resulted in 106 related publications and among them sixteen articles met inclusion criteria. This review showed that the use of the Internet by pregnant women was driven by information needs, ease, and speed of access and finding people with the same situation. Fetal development, symptoms, and complications of pregnancy, prenatal tests and nutrition, activities during pregnancy, and stages of delivery were the most often mentioned topics of interest. The benefits of internet use include reduced anxiety, personal support, creating an emotional connection and an increased confidence. Health providers must have sufficient ability for interpreting the achieved information from the Internet and should allocate efficient amount of time for discussing information-seeking manners with pregnant women. Furthermore, they must try to respond to the doubts of pregnant women and provide valid and reliable online educational resources.

Changes in Cosmetics Use during Pregnancy and Risk Perception by Women.

PubMed

Marie, Cécile; Cabut, Sophie; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

2016-03-30

Cosmetic products contain various chemical substances that may be potential carcinogen and endocrine disruptors. Women's changes in cosmetics use during pregnancy and their risk perception of these products have not been extensively investigated. The main objective of this study was to describe the proportion of pregnant women changing cosmetics use and the proportion of non-pregnant women intending to do so if they became pregnant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics before and during pregnancy, and to describe among pregnant and non-pregnant women, the risk perception of these products. A cross-sectional study was carried out in a gynaecology clinic and four community pharmacies. One hundred and twenty-eight women (60 non-pregnant and 68 pregnant women) replied to a self-administered questionnaire. Cosmetics use was identified for 28 products. The results showed that few women intended to change or had changed cosmetics use during pregnancy. Nail polish was used by fewer pregnant women compared to the period before pregnancy (p < 0.05). Fifty-five percent of the women considered cosmetics use as a risk during pregnancy and 65% would have appreciated advice about these products. Our findings indicate that all perinatal health professionals should be ready to advise women about the benefits and risks of using cosmetics during pregnancy.

Knowledge and beliefs regarding oral health among pregnant women.

PubMed

Boggess, Kim A; Urlaub, Diana M; Moos, Merry-K; Polinkovsky, Margaret; El-Khorazaty, Jill; Lorenz, Carol

2011-11-01

Racial or ethnic and economic disparities exist in terms of oral diseases among pregnant women and children. The authors hypothesized that women of a racial or ethnic minority have less oral health knowledge than do women not of a racial or ethnic minority. Therefore, the authors conducted a study to assess and compare maternal oral health knowledge and beliefs and to determine if maternal race and ethnicity or other maternal factors contributed to women's knowledge or beliefs. The authors administered a written oral health questionnaire to pregnant women. The authors calculated the participants' knowledge and belief scores on the basis of correct answers or answers supporting positive oral health behaviors. They conducted multivariable analysis of variance to assess associations between oral health knowledge and belief scores and characteristics. The authors enrolled 615 women in the study, and 599 (97.4 percent) completed the questionnaire. Of 599 participants, 573 (95.7 percent) knew that sugar intake is associated with caries. Almost one-half (295 participants [49.2 percent]) did not know that caries and periodontal disease are oral infections. Median (interquartile range) knowledge and belief scores were 6.0 (5.5-7.0) and 6.0 (5.0-7.0), respectively. Hispanic women had median (interquartile range) knowledge and belief scores significantly lower than those of white or African American women (6.0 [4.0-7.0] versus 7.0 [6.0-7.0] versus 7.0 [6.0-7.0], respectively [P < .001]; and 5.0 [4.0-6.0] versus 6.0 [5.0-7.0] versus 6.0 [5.0-7.0], respectively [P < .001]). Multivariable analysis of variance results showed that being of Hispanic ethnicity was associated significantly with a lower knowledge score, and that an education level of eighth grade or less was associated significantly with a lower belief score. Pregnant women have some oral health knowledge. Knowledge varied according to maternal race or ethnicity, and beliefs varied according to maternal education

Preparedness of pregnant women for childbirth and the postpartum period: their knowledge and fear.

PubMed

Tugut, N; Tirkes, D; Demirel, G

2015-05-01

The aim of the study was to identify knowledge and fear related to childbirth and the postpartum period in pregnant women. The sample consisted of 114 pregnant women. It was determined that pregnant women had insufficient levels of knowledge related to childbirth and the postpartum period. The Fear of Childbirth and Postpartum Anxiety Scale score for childbirth and the postpartum period related to 'fear regarding the action of childbirth', was found to be the highest. The highest causes for concern were determined to be 'infant-related anxiety' and 'fear regarding infant and puerperal health'. No statistically significant correlation was observed between the perceived sufficiency of the knowledge of pregnant women in terms of maintaining their own health and care, and their mean childbirth and postpartum period concern score. These findings indicate that the level of concern among pregnant women with relation to the postpartum period and childbirth is rather high.

Anemia among pregnant women in Southeast Ethiopia: prevalence, severity and associated risk factors.

PubMed

Kefiyalew, Filagot; Zemene, Endalew; Asres, Yaregal; Gedefaw, Lealem

2014-11-03

Anemia is a significant public health problem in developing countries, particularly in pregnant women. It may complicate pregnancy, sometimes resulting in tragic outcomes. There is a lack of information on the magnitude of anemia among pregnant women in Southeast Ethiopia. The aim of this study is, therefore, to determine the prevalence of anemia and assess associated factors among pregnant women attending antenatal care (ANC) at Bisidimo Hospital in Southeast Ethiopia. A facility-based cross-sectional study, involving 258 pregnant women, was conducted from March to June 2013. Socio-demographic, medical and obstetric data of the study participants were collected using structured questionnaire. Hemoglobin was measured using a hematology analyzer and faecal specimens were examined to detect intestinal parasites. Anemia in pregnancy was defined as hemoglobin <11 g/dl. Overall, prevalence of anemia was 27.9%, of which 55% had mild anemia. Rural residence (AOR =3.3, 95% CI: 1.5-7.4), intestinal parasitic infection (IPI) (AOR = 2.5, 95% CI: 1.3-4.8) and history of heavy cycle (AOR =2.7, 95% CI: 1.3-1.7) were predictors of anemia. This study showed moderate prevalence of anemia among the pregnant women, with a sizable proportion having severe anemia. Routine testing of pregnant women for IPIs and creating awareness on factors predisposing to anemia is recommended.

Micronutrient intake inadequate for a sample of pregnant African American women

PubMed Central

Stewart, Patricia A.; Ossip, Deborah J.; Block, Robert C.; Wixom, Nellie; Fernandez, I Diana

2016-01-01

Background Micronutrient intake is critical for fetal development and positive pregnancy outcomes. Little is known about adequacy of micronutrient intake in pregnant African American women. Objective To describe nutrient sufficiency and top food groups contributing to dietary intake of select micronutrients in low-income pregnant African American women and determine if micronutrient intake varies with early pregnancy body mass index (BMI) and/or gestational weight gain. Design Secondary analysis of data collected in a cohort study of pregnant African American women. Participants/setting A total of 93 women 18–36 years old, < 20 weeks pregnant, with early pregnancy BMIs ≥ 18.5 kg/m2 and < 40.0 kg/m2. The study was conducted during 2008–2012 with participants from university affiliated obstetrical clinics in an urban setting in Northeast USA. Main outcome measures Proportion of women with dietary intakes below Estimated Average Requirement (EAR) or Adequate Intake (AI) for vitamin D, folate, iron, calcium, and choline throughout pregnancy. Top food groups from which women derived these micronutrients. Statistical analyses performed Descriptive statistics included means, standard deviations and percentages. Percent of women reaching EAR/AI was calculated. Chi-square test was used to assess micronutrient intake differences based on early pregnancy BMI and gestational weight gain. Results A large percentage of pregnant women did not achieve the EAR/AI from dietary sources alone; EAR for folate (66%), vitamin D (100%), iron (89%), and AI for choline (100%). Mean micronutrient intake varied throughout pregnancy. Top food sources included reduced fat milk, eggs and mixed egg dishes, pasta dishes, and ready to eat cereal. Conclusions The majority of study participants had dietary micronutrient intake levels below EAR/AI throughout pregnancy. Findings suggest that practitioners should evaluate dietary adequacy in women to avoid deficits in micronutrient intake during

Prevalence of anaemia among pregnant women in South-East China, 1993-2005.

PubMed

Jin, Lei; Yeung, Lorraine F; Cogswell, Mary E; Ye, Rongwei; Berry, Robert J; Liu, Jianmeng; Hu, Dale J; Zhu, Li

2010-10-01

To report the prevalence of anaemia by demographic characteristics and its secular trend over 13 years for south-east Chinese pregnant women, and to determine the focus of anaemia prevention in Chinese pregnant women. Prospective study of the data on Hb concentration and other demographic information from a large-scale population-based perinatal health surveillance system in south-east China. Fourteen cities or counties in Jiangsu and Zhejiang provinces. A total of 467 057 prenatal women who had participated in the perinatal health-care surveillance system and delivered babies from 1 January 1993 to 31 December 2005 and had a record of Hb in all three pregnancy trimesters. The overall prevalence of anaemia among pregnant women was 39.6 % from 1993 to 2005. Anaemia prevalence increased from the first (29.6 %) to the second (33.0 %) and third (56.2 %) trimesters. The prevalence of anaemia was higher in villagers, in women with less education and in women with higher gravidity or parity. The prevalence of anaemia in all of the trimesters was higher in the spring, summer and autumn and lower in the winter. The prevalence decreased from 1993 to 2005, from 53.3 % to 11.4 % for the first trimester, 45.6 % to 22.8 % for the second trimester and 64.6 % to 44.6 % for the third trimester. The prevalence of anaemia among pregnant women in Jiangsu and Zhejiang provinces decreased substantially from 1993 to 2005. However, anaemia in the third trimester is still a severe public health problem among pregnant women in these areas.

The relationship between women's characteristics and herbal medicines use during pregnancy.

PubMed

Abdollahi, Fatemeh; Yazdani Cherati, Jamshid

2018-01-16

The use of herbal medicines (HM) has been increasing worldwide. This cross-sectional study investigated the prevalence of and characteristics related to use of HM among 320 pregnant women. Participants were admitted to Mazandaran-based hospitals' postnatal wards from March to June 2015. Data were collected via a self-report questionnaire, including herbs used during pregnancy and demographic, socioeconomic and pregnancy-related factors. Nearly half (48.4%) of the women reported taking one or more HM during pregnancy. The most frequently used herbs were Sour orange (30.97%), Peppermint (19.81%) and Borage (19.46%). Most women (29.20%) were advised by their relatives to take these and did not disclose this use to their health care providers (50%) because they perceived their use as safe (39.7%). The use of herbs was greater among pregnant women with upper secondary level education, living in their own house and from higher socioeconomic classes. Most of the information sources for women were informal, indicating they were not knowledgeable about the herbs' safety and efficacy during pregnancy. Health care providers should be informed about HM and question pregnant women about their use of HM during pregnancy so that they can advise them about potential side effects and drug interactions.

Seroprevalence of hepatitis B virus serological markers among pregnant Nigerian women

PubMed Central

Aba, Henrietta Oneh; Aminu, Maryam

2016-01-01

Background: Chronic hepatitis B infection is a global problem; however, Asia and sub-Saharan Africa are most affected by it. Hepatitis B status of pregnant women is essential for the effective management of the disease and prevention of mother to child transmission. Materials and Methods: The study was conducted at the antenatal care unit of four hospitals within Kaduna Metropolis, Nigeria, between August and December 2011. After obtaining ethical clearance, blood samples were collected from 800 consenting pregnant women, the plasma were screened for hepatitis B surface antigen (HBsAg) using first response HBsAg card and the reactive sera were confirmed with enzyme-linked immunosorbent assay. Other serological markers of hepatitis B virus (HBV) were detected using the one-step HBV multi-5 test kit. Results: Of the 800 pregnant women screened, 31 (3.9%) tested positive for HBsAg. Only one of the 31 HBsAg positive women had developed the hepatitis B surface antibody, 16 (51.6%) had the envelop antibody, 18 (58.1%) had the hepatitis B core antibody (anti-HBc), and two (6.5%) had hepatitis B envelop antigen (HBeAg). The highest prevalence of HBsAg was recorded among women in age group 21–25 years old (P = 0.968). Similarly, married women (P = 0.772), women in their second trimester of pregnancy (P = 0.938), women with tertiary education (P = 0.972), women from the South-East geopolitical zone (P = 0.250) and those whose husbands were in polygamous relationships (P = 0.944) had the highest seroprevalence of HBsAg. Conclusion: HBV was detected with a prevalence of 3.9% among pregnant women in Kaduna Metropolis, Nigeria. About 96.8% (29) of the reactive women had HBeAg negative chronic hepatitis while 6.5% (2) had HBeAg positive chronic hepatitis B infection. About 58.1% of the women had anti-HBc, hence, did not have immunity and probably had chronic infection with reduced risk of vertical transmission. Pregnant women should be screened for HBsAg at the first antenatal

42 CFR 435.116 - Qualified pregnant women and children who are not qualified family members.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Qualified pregnant women and children who are not... Categorically Needy Mandatory Coverage of Pregnant Women, Children Under 8, and Newborn Children § 435.116 Qualified pregnant women and children who are not qualified family members. (a) The agency must provide...

42 CFR 435.116 - Qualified pregnant women and children who are not qualified family members.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Qualified pregnant women and children who are not... Categorically Needy Mandatory Coverage of Pregnant Women, Children Under 8, and Newborn Children § 435.116 Qualified pregnant women and children who are not qualified family members. (a) The agency must provide...

42 CFR 435.116 - Qualified pregnant women and children who are not qualified family members.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Qualified pregnant women and children who are not... Categorically Needy Mandatory Coverage of Pregnant Women, Children Under 8, and Newborn Children § 435.116 Qualified pregnant women and children who are not qualified family members. (a) The agency must provide...

Health behavior change in pregnant women: a two-phase study.

PubMed

Davis, Ann M; Wambach, Karen A; Nelson, Eve Lynn; Odar, Cathleen; Lillis, Teresa; McKinley, Amanda; Gallagher, Mia

2014-12-01

Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.

Coping with Stress among Pregnant Women with Gestational Diabetes Mellitus.

PubMed

Sürücü, Hamdiye Arda; Besen, Dilek Büyükkaya; Duman, Mesude; Yeter Erbil, Elif

2018-03-01

Introduction: The stress of pregnancy itself, gestational diabetes mellitus (GDM) that develops during pregnancy is also a stressor, because it can cause serious maternal and fetal health problems. The aim of this study was to examine the relationships between the characteristics of pregnant women with GDM and their styles of coping with stress. Methods: This descriptive cross-sectional study was conducted on 126 pregnant women with GDM. The sample consisted of patients who applied to the diabetes mellitus training polyclinic of a training and research and university hospital in southeastern Turkey, Data were evaluated using descriptive statistics, Kolmogorov-Smirnov normality tests, Spearman's rho and Pearson Correlation analysis, the Student's t-test, Mann-Whitney U-test and Kruskal-Wallis- test by SPSS software (version 13.0). Results: It was determined that a planned pregnancy, a high educational level, a first pregnancy and weight gain were important factors in the women with GDM in the study who coped effectively with stress during pregnancy. Unemployment and a second or subsequent pregnancy were important factors in the women with GDM< who coped ineffectively with stress during pregnancy. In addition, it was determined that the hemoglobin HbA1c levels of the pregnant women with GDM with "optimistic" and "submissive" approaches towards coping with stress were lower. Conclusion: It was determined that pregnant women with optimistic and submissive approaches towards coping with stress had lower HbA1c levels. It is suggested that randomized controlled studies be conducted to further determine the coping styles of patients with GDM.

Changes in Cosmetics Use during Pregnancy and Risk Perception by Women

PubMed Central

Marie, Cécile; Cabut, Sophie; Vendittelli, Françoise; Sauvant-Rochat, Marie-Pierre

2016-01-01

Cosmetic products contain various chemical substances that may be potential carcinogen and endocrine disruptors. Women’s changes in cosmetics use during pregnancy and their risk perception of these products have not been extensively investigated. The main objective of this study was to describe the proportion of pregnant women changing cosmetics use and the proportion of non-pregnant women intending to do so if they became pregnant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics before and during pregnancy, and to describe among pregnant and non-pregnant women, the risk perception of these products. A cross-sectional study was carried out in a gynaecology clinic and four community pharmacies. One hundred and twenty-eight women (60 non-pregnant and 68 pregnant women) replied to a self-administered questionnaire. Cosmetics use was identified for 28 products. The results showed that few women intended to change or had changed cosmetics use during pregnancy. Nail polish was used by fewer pregnant women compared to the period before pregnancy (p < 0.05). Fifty-five percent of the women considered cosmetics use as a risk during pregnancy and 65% would have appreciated advice about these products. Our findings indicate that all perinatal health professionals should be ready to advise women about the benefits and risks of using cosmetics during pregnancy. PMID:27043593

Impact of Vaccination History on Serological Testing in Pregnant Women.

PubMed

Desjardins, Michaël; Boucoiran, Isabelle; Paquet, Caroline; Laferrière, Céline; Gosselin-Brisson, Anne; Labbé, Annie-Claude; Martel-Laferrière, Valérie

2018-04-01

Serological testing guidelines for vaccine-preventable infectious diseases in pregnant women are heterogeneous. It is unclear how vaccination history influences health care workers' (HCWs) attitudes about testing. The aim of this study was to describe current practices in screening for rubella, hepatitis B, and varicella-zoster virus (VZV) in pregnant women in the province of Québec. In 2015, an electronic survey was distributed to HCWs who followed the case of at least one pregnant woman in the previous year and who could be contacted by email by their professional association. A total of 363 of 1084 (33%) participants were included in the analysis: general practitioners (57%), obstetrician-gynaecologists (20%), midwives (41%), and nurse practitioners (31%). For rubella, 48% of participants inquired about vaccination status, and of these, 98% offered serological testing for unvaccinated women versus 44% for vaccinated women. Similarly, of the 48% of participants who asked about hepatitis B vaccination status before offering testing, 96% ordered testing for hepatitis B surface antigen, 28% ordered testing for hepatitis B surface antibody, and 1% ordered no serological testing to unvaccinated women versus 72%, 46%, and 8%, respectively, for vaccinated women. Among the 81% of respondents who discussed VZV during prenatal care, 13% ordered serological testing if patients had a history of VZV infection, 87% if the VZV history was uncertain, and 19% if patients had a positive history of vaccination. Asking about vaccination status influences HCWs' attitudes about serological testing for rubella, hepatitis B, and VZV. In the context of increasing vaccination coverage in women of child-bearing age, it is important to clarify the impact of vaccination status in serological screening guidelines in pregnant women. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Variation in microbiologic profiles among pregnant women with bacterial vaginosis.

PubMed

Pereira, Leonardo; Culhane, Jennifer; McCollum, Kelly; Agnew, Kathy; Nyirjesy, Paul

2005-09-01

The purpose of this study was to determine if clinical findings and sociodemographic variables among bacterial vaginosis (BV)-positive pregnant women are associated with different microbiologic profiles. Pregnant women were assessed for BV by Nugent criteria. BV+ women were separated into 6 mutually exclusive microbiologic groups. In unadjusted analyses, we compared (1) sociodemographic and behavioral characteristics, and (2) 3 clinical characteristics among BV+ women with and without Mobiluncus (M+ vs M-). Unadjusted data were analyzed using the chi-square test. Multiple logistic regression was used to assess the likelihood of having clinical signs of BV in women with and without Mobiluncus spp while controlling for confounders. A total of 1756 BV+ pregnant women were followed. The M+ group (n=702) was significantly more likely than the M- group (n=1054) to be non-Hispanic black (80.9% vs 66.2%; P < .0001), older than 21 years (61.7% vs 48.7%; P < .0001), and to have had more than 3 lifetime sexual partners (66.4% vs 54.9%; P < .0001). The M+ group was also more likely to have clue cells on wet mount (63.9% vs 47.2%; P < .0001) and a positive amine odor after addition of KOH (57.2% vs 45.0%; P=.001). There was no difference in other demographic variables or physician diagnosis of abnormal vaginal discharge. In the adjusted analyses for each clinical outcome, all findings were consistent with the unadjusted analyses. BV+ pregnant women with Mobiluncus spp are more likely to have clue cells present on wet mount, a positive amine odor after KOH preparation, and to be older, non-Hispanic black, and have had more lifetime sexual partners compared to BV+ women without any Mobiluncus species.

Prophylaxis and treatment of pregnant women for emerging infections and bioterrorism emergencies.

PubMed

Cono, Joanne; Cragan, Janet D; Jamieson, Denise J; Rasmussen, Sonja A

2006-11-01

Emerging infectious disease outbreaks and bioterrorism attacks warrant urgent public health and medical responses. Response plans for these events may include use of medications and vaccines for which the effects on pregnant women and fetuses are unknown. Healthcare providers must be able to discuss the benefits and risks of these interventions with their pregnant patients. Recent experiences with outbreaks of severe acute respiratory syndrome, monkeypox, and anthrax, as well as response planning for bioterrorism and pandemic influenza, illustrate the challenges of making recommendations about treatment and prophylaxis for pregnant women. Understanding the physiology of pregnancy, the factors that influence the teratogenic potential of medications and vaccines, and the infection control measures that may stop an outbreak will aid planners in making recommendations for care of pregnant women during large-scale infectious disease emergencies.

HIV Surveillance Among Pregnant Women Attending Antenatal Clinics: Evolution and Current Direction

PubMed Central

Garcia Calleja, Jesus M; Marsh, Kimberly; Zaidi, Irum; Murrill, Christopher; Swaminathan, Mahesh

2017-01-01

Since the late 1980s, human immunodeficiency virus (HIV) sentinel serosurveillance among pregnant women attending select antenatal clinics (ANCs) based on unlinked anonymous testing (UAT) has provided invaluable information for tracking HIV prevalence and trends and informing global and national HIV models in most countries with generalized HIV epidemics. However, increased coverage of HIV testing, prevention of mother-to-child transmission (PMTCT), and antiretroviral therapy has heightened ethical concerns about UAT. PMTCT programs now routinely collect demographic and HIV testing information from the same pregnant women as serosurveillance and therefore present an alternative to UAT-based ANC serosurveillance. This paper reports on the evolution and current direction of the global approach to HIV surveillance among pregnant women attending ANCs, including the transition away from traditional UAT-based serosurveillance and toward new guidance from the World Health Organization and the Joint United Nations Programme on HIV/AIDS on the implementation of surveillance among pregnant women attending ANCs based on routine PMTCT program data. PMID:29208587

HIV testing for pregnant women: a rights-based analysis of national policies.

PubMed

King, Elizabeth J; Maman, Suzanne; Wyckoff, Sarah C; Pierce, Matthew W; Groves, Allison K

2013-01-01

Ethical and human rights concerns have been expressed regarding the global shift in policies on HIV testing of pregnant women. The main purpose of this research was to conduct a policy analysis using a human rights-based approach of national policies for HIV testing of pregnant women. We collected HIV testing policies from 19 countries including: Cambodia, China, Guyana, Haiti, India, Jamaica, Kenya, Moldova, Papua New Guinea, Russian Federation, South Africa, Sudan, Swaziland, Tanzania, Ukraine, United States, Uzbekistan, Zambia and Zimbabwe. We analysed the HIV testing policies using a standardised framework that focused on government obligations to respect, protect and fulfil. Our results highlight the need for more attention to issues of pregnant women's autonomy in consenting to HIV testing, confidentiality in antenatal care settings and provision of counselling and care services. We conclude with a discussion about potential implications of the current testing policies and provide recommendations for ways that HIV testing policies can more effectively uphold the human rights of pregnant women.

Frequency and predictors of anxiety and depression among pregnant women attending tertiary healthcare institutes of Quetta City, Pakistan.

PubMed

Ghaffar, Rahila; Iqbal, Qaiser; Khalid, Adnan; Saleem, Fahad; Hassali, Mohamed Azmi; Baloch, Nosheen Sikandar; Ahmad, Fiaz Ud Din; Bashir, Sajid; Haider, Sajjad; Bashaar, Mohammad

2017-07-25

Anxiety and depression (A&D) are commonly reported among pregnant women from all over the world; however, there is a paucity of workable data from the developing countries including Pakistan. The current study, therefore, aims to find out the frequency and predictors of A&D among pregnant women attending a tertiary healthcare institutes in the city of Quetta, in the Balochistan province, Pakistan. A questionnaire based, cross-sectional survey was conducted. The pre-validated Hospital Anxiety and Depression Scale (HADS) were used to assess the frequency of A&D among study respondents. Anxiety and depression scores were calculated via standard scoring procedures while logistic regression was used to identify the predictors of A&D. SPSS v. 20 was used for data analysis and p < 0.05 was taken as significant. Seven hundred and fifty pregnant women responded to the survey. The majority of the respondents belonged to age group of 26-35 year (424, 56.4%) and had no formal education (283, 37.6%). Furthermore, 612 (81.4%) of the respondents were unemployed and had urban residencies (651, 86.6%). The mean anxiety score was 10.08 ± 2.52; the mean depression score was 9.51 ± 2.55 and the total HADS score was 19.23 ± 3.91 indicating moderate A&D among the current cohort. Logistic regression analysis reported significant goodness of fit (Chi square = 17.63, p = 0.030, DF = 3), indicating that the model was advisable. Among all variables, age had a significant association when compared with HADS scores [adjusted OR (odds ratios) = 1.23, 95% CI = 1.13-1.62, p < 0.001]. Moderate A&D was reported among the study respondents. Furthermore, age was highlighted as a predictor of A&D. The evidence from this study provides a motion of support programs for anxious and depressed pregnant women. The benefits of implementing good mental health in antenatal care have long-lasting benefits for both mother and infant. Therefore, there is a need to incorporate

Use of Over-the-Counter Medication among Pregnant Women in Sharjah, United Arab Emirates

PubMed Central

Mustafa, Hafsa

2017-01-01

Background Over-the-counter medications are widely available in pharmacies Their safety profile, however, does not extend to pregnant women. Accordingly, there should be educational programs developed for pregnant women to protect them from the harms of the side effects. Aim This study was planned and designed with the aim of exploring the awareness and assessing the usage of OTC medications among pregnant women in Sharjah, UAE. Method A cross-sectional survey using a self-administered questionnaire. Results More than three-quarters (75.7%) reported that they are familiar with the term “over-the-counter drugs.” Interestingly, 40% of the respondents reported that they took OTC drugs during pregnancy, and the majority (94.2%) agreed with the survey statement “not all OTC medications are safe to be taken during pregnancy.” Constipation was the most frequent side effect that most of the participants reported during the study period. Folic acid (36%), calcium (28.6%), and iron (35.1%) were the most common supplements used by the pregnant women responding. Conclusion The reported 40% usage of OTC medications among pregnant women in this study is worrisome and calls for the need to educate, counsel, and increase awareness among pregnant women regarding the dangers of OTC drugs usage while pregnant in Sharjah, UAE. PMID:28804652

Self-monitoring Lifestyle Behavior in Overweight and Obese Pregnant Women: Qualitative Findings.

PubMed

Shieh, Carol; Draucker, Claire Burke

Excessive maternal gestational weight gain increases pregnancy and infant complications. Self-monitoring has been shown to be an effective strategy in weight management. Literature, however, is limited in describing pregnant women's engagement in self-monitoring. This qualitative study explored the experiences of overweight and obese pregnant women who self-monitored their eating, walking, and weight as participants in an intervention for excessive gestational weight gain prevention. Thirteen overweight and obese pregnant women participated in semistructured interviews. Reflexive iteration data analysis was conducted. Five themes were identified: making self-monitoring a habit, strategies for self-monitoring, barriers to self-monitoring, benefits of self-monitoring, and drawbacks of self-monitoring. The women viewed self-monitoring as a "habit" that could foster a sense of self-control and mindfulness. Visual or tracing aids were used to maintain the self-monitoring habit. Forgetting, defective tracking aids, complexities of food monitoring, and life events could impede self-monitoring. Being unable to keep up with self-monitoring or to achieve goals created stress. Self-monitoring is a promising approach to weight management for overweight and obese pregnant women. However, healthcare providers should be aware that, although women may identify several benefits to self-monitoring, for some women, consistently trying to track their behaviors is stressful.

Examining Intimate Partner Violence and Health Factors Among Rural Appalachian Pregnant Women.

PubMed

Shannon, Lisa; Nash, Shondrah; Jackson, Afton

2016-09-01

Among pregnant women, intimate partner violence (IPV) is recognized as a critical risk factor in adverse health outcomes for the mother and newborn alike. This pilot study examined IPV and health for rural Appalachian pregnant women, a particularly vulnerable high-risk and high-needs group. Participants were 77 rural, Appalachian pregnant women entering a hospital-based inpatient detoxification unit primarily for Opiate Dependence. Study participants gave informed consent to a face-to-face interview and secondary data abstraction from hospital medical records. IPV was measured via questions from the National Violence Against Women Survey, the Revised Conflict Tactics Scale (CTS2), and the Psychological Maltreatment of Women Inventory (PMWI). The majority of the sample reported lifetime psychological (89.6%) and physical (64.9%) violence. A little over three fourths (75.3%) experienced IPV in the past year. Furthermore, over one third (39.0%) experienced stalking, physical, or sexual violence in the past year. Most participants (71.4%) experienced psychological abuse in the past year. IPV experiences, in conjunction with pervasive substance use, mental and physical health problems, and poverty present in rural Appalachia, culminate in a particularly high-risk and high-needs group of pregnant women. These women present unique opportunities and challenges for prevention, intervention, and treatment. © The Author(s) 2015.

Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005-2009.

PubMed

Ko, Jean Y; Farr, Sherry L; Dietz, Patricia M; Robbins, Cheryl L

2012-08-01

Depression is often undiagnosed and untreated. It is not clear if differences exist in the diagnosis and treatment of depression among pregnant and nonpregnant women. We sought to estimate the prevalence of undiagnosed depression, treatment by modality, and treatment barriers by pregnancy status among U.S. reproductive-aged women. We identified 375 pregnant and 8,657 nonpregnant women 18-44 years of age who met criteria for past-year major depressive episode (MDE) from 2005-2009 nationally representative data. Chi-square statistics and adjusted prevalence ratios (aPR) were calculated. MDE in pregnant women (65.9%) went undiagnosed more often than in nonpregnant women (58.6%) (aPR 1.1, 95% confidence interval [CI] 1.0-1.3). Half of depressed pregnant (49.6%) and nonpregnant (53.7%) women received treatment (aPR 1.0, 95% CI 0.90-1.1), with prescription medication the most common form for both pregnant (39.6%) and nonpregnant (47.4%) women. Treatment barriers did not differ by pregnancy status and were cost (54.8%), opposition to treatment (41.7%), and stigma (26.3%). Pregnant women with MDE were no more likely than nonpregnant women to be diagnosed with or treated for their depression.

Knowledge, attitude and practice of oral and dental healthcare in pregnant women.

PubMed

Bamanikar, Sunita; Kee, Liew Kok

2013-07-01

Pregnant women are more susceptible to periodontal disease like gingivitis. Periodontal disease may be associated with adverse pregnancy outcomes. There is no published literature on dental health in pregnant women in Brunei, Darussalam. The objective of this study was to assess women's knowledge and attitude towards oral and dental health during pregnancy and to examine their self-care practices in relation to oral and dental health. This study was carried out at the maternal child health clinic, Jubli Perak Sengkurong Health Centre, Brunei, Darussalam. This was a cross-sectional descriptive and analytical study conducted at the maternal child health center in Brunei, Darussalam. The study group was comprised of 95 pregnant women attending the MCH clinic, Jubli Perak Sengkurong Health Centre, September 2010, using convenience sampling method. A self-administered questionnaire was used, after it was pre-tested and validated. Statistical analysis was done using SPSS version16. Of the total study group, 97.9% responded to the questionnaire and participated in the study. All the women brushed at least twice daily. However, only 40.9% flossed daily, 31.2% brushed after meals and 26.9% had a dental check-up at least twice a year. The knowledge related to dental care was also poor among the pregnant women. Though the majority of them (96.8%) agreed that women should have a dental check-up during pregnancy, only 55.9% actually practiced this. This raises serious concern since pregnant women may need extra oral and dental care due to susceptibility to gum diseases during pregnancy, which may contribute to low birth weight babies and premature births. This study highlights important gaps in dental knowledge and practices related to oral and dental healthcare among pregnant women in Brunei, Darussalam. More intense dental health education, including oral health promotion in maternal child health centers can lead to improved oral and dental health, and ultimately pregnancy

Analysis of German nutrition brochures for pregnant women with evidence-based patient information criteria.

PubMed

Küllenberg de Gaudry, Daniela; Grede, Nina; Motschall, Edith; Lins, Sabine

2015-02-01

To evaluate nutrition brochures for pregnant women in Germany based on evidence-based patient information (EBPI) criteria. Nutrition brochures for pregnant women in Germany were collected. Brochures addressing the risk of salmonellosis, toxoplasmosis or listeriosis were analyzed by two researchers independently. Fifty brochures reporting any information on the risk of infection were analyzed. Most brochures did not include literature citations and only few brochures gave a risk description, predominantly verbally, which usually leads to an overestimation of the actual risk. Advertisement was present in 22% of the brochures. German nutrition brochures for pregnant women should be adapted to comply with evidence-based patient information (EBPI) criteria for achieving a better quality of the disseminated information. The findings highlight the need of high quality nutrition brochures for pregnant women, which are relevant not only for pregnant women, but also to those responsible for creating brochures, and to physicians in charge of patient information. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Factors Associated with Periodontal Disease in Pregnant Diabetic Women.

PubMed

Anwar, N; Zaman, N; Nimmi, N; Chowdhury, T A; Khan, M H

2016-04-01

There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.

Ambient air pollution and annoyance responses from pregnant women

NASA Astrophysics Data System (ADS)

Llop, Sabrina; Ballester, Ferran; Estarlich, Marisa; Esplugues, Ana; Fernández-Patier, Rosalia; Ramón, Rosa; Marco, Alfredo; Aguirre, Amelia; Sunyer, Jordi; Iñiguez, Carmen; INMA-Valencia cohort

ObjectivesTo describe the degree of annoyance caused by air pollution and noise in pregnant women in a birth cohort; to determine the modifying factors and their relation with exposure to ambient nitrogen dioxide (NO 2). MethodsThe study population was 855 pregnant women in Valencia, Spain. Annoyance caused by air pollution and noise, and explanatory factors were obtained from 786 pregnant women through a questionnaire. NO 2 levels were determined combining measurements at 93 points within the area of study and using geostatistical techniques (kriging). ResultsIn all 7.9% of the women reported high annoyance caused by air pollution and 13.1% high annoyance caused by noise. There was a significant difference in the degree of annoyance due to both air pollution and noise depending on the area where the women lived and their working status. The degree of annoyance correlated better with measured NO 2 at the municipality level (air pollution: r=0.53; noise: r=0.44) than at the individual level (air pollution and noise: r=0.21). On multivariate analysis, being a housewife, higher NO 2 levels and high traffic density were associated with higher degrees of annoyance. ConclusionsThere was a high percentage of women who perceived medium-high annoyance due to noise and air pollution. Annoyance caused by environmental pollutants could lead to some psychological effects, which impair the quality of life, or even physiological ones, which affect prenatal development.

[Oral health and precariousness in pregnant women].

PubMed

Delemotte, M; Valcarcel, J; Tramini, P

2013-03-01

Systematic full-mouth dental examination during pregnancy is an official preventive measure recently advocated by the French Health policy. The aim of this study was firstly to evaluate the oral health related to some sociodemographic factors among pregnant women, and secondly to propose this dental examination together with the routine antenatal interview. This cross-sectional study combined several medical questionnaires with an oral examination. It concerned all pregnant women attending their routine antenatal interview in the maternity unit of the Montpellier hospital. Socioeconomic status was assessed by Epices index. So that two groups were determined : the deprived group (D), and the non-deprived group (ND). Oral examination revealed that 93% of the women were suffering from at least one oral disease, 74% had a periodontal disease (9% had a periodontitis), and 74% had at least one carious tooth. The mean Epices score was 30.5 and the mean number of carious teeth was significantly higher in the group D (3.4) than in the group ND (2.35), (p=0.02). The prevalence of periodontal disease or periodontitis were not significantly different between the two groups (p=0.81 and p=0.99 respectively). After stratification on the degree of dental hygiene knowledge, it was found that knowing about an adequate dental hygiene and specific preventive measures regarding pregnancy could reduce the gap between the oral health status of the two socioeconomic groups. This study showed that performing an oral examination, at the same time than the antenatal interview, could highly improve the knowledge about dental hygiene among pregnant women and the screening of oral diseases, especially for deprived population.

[Species and quantitative characteristics of pharyngeal mucosa microflora in pregnant women].

PubMed

Meshcheriakova, A K; Kostinov, M P; Magarshak, O O; Zaĭtseva, E V

2014-01-01

Species and quantitative characteristics of upper respiratory tract (URT) mucosa microflora in women at gestation period. The results of a bacteriological study of 68 samples of mucus from posterior pharyngeal wall in women at gestation period (from 14 weeks), 52 of those--from pregnant women with acute respiratory infection (ARI) symptoms and 16--from women without signs of disease, are presented. Qualitative and quantitative composition of microflora was studied by a generally accepted bacteriological method. During primary bacteriological study 111 microorganism cultures were isolated. 88 (79.3%) of strains belonged to Gram-positive flora, 20 (18.0%)--to Gram-negative, and Candida genus fungi constituted 3 (2.7%) isolates. Streptococcus pyogenes and Moraxella catarrhalis were isolated from pregnant women with ARI signs at 23.1% and 5.8% frequency of occurrence, respectively. A higher detectability of Staphylococcus aureus--in 31.3% and Candida spp.--in 6.3% of women who did not complain as opposed to patients with URT lesions (in 21.2 and 3.9%, respectively) was determined. In patients without ARI signs the amount of bacteria did not exceed 10(5)--10(6) CFU/ml, in pregnant women with ARI diagnosis in 8 of 52 cases semination of pharyngeal mucuswas observed--10(7)--10(8) CFU/ml. Prevalence of S. aureus, Streptococcus agalactiae, S. pyogenes, Streptococcus mutans in composition of pharyngeal mucus microflora of pregnant women both with URT lesion signs and without them was shown, however the degree of semination by pathogens in the groups was different that determined the severity of disease manifestations.

Quality of Life of Pregnant Women Living with HIV/AIDS.

PubMed

Silveira, Marysabel Pinto Telis; Silveira, Mariângela Freitas; Müller, Cristina Heloisa

2016-05-01

Objective to evaluate the quality of life of HIV positive (HIV+) pregnant women using the HIV/AIDS Target Quality of Life (HAT-QoL) instrument. Methods cross-sectional study, conducted between May 2014 and November 2015, with HIV+ pregnant women selected by convenience sampling. Sociodemographic and behavioral data were collected through interviews, and the HAT-QoL questionnaire was applied. Clinical and laboratorial data were collected from medical records. Results twenty-seven pregnant women participated in the study. Their mean age was 27 years (standard deviation - SD: 7.3). The majority (59%) had up to 8 years of education, 52% identified themselves as white, 56% were unemployed, and 59% had a household income higher than the minimum wage. The mean infection time by the virus was 68.4 months (5.7 years). The majority (74%) were contaminated with HIV through sexual intercourse, and 67% declared not having a HIV+ relative. Regarding the use of condoms, 41% reported using them sporadically, and the same number did not have proper knowledge about them. Only 23 patients (85%) reported having been prescribed antiretrovirals. Fourteen (64%) had a CD4 count higher than 500 cells/mm(3), and 13 pregnant women (59%) had an undetectable viral load. The scores from the quality of life questionnaire dimensions that were more affected are: infection "disclosure concerns" (mean: 39.8; SD: 27.1), followed by "financial concerns" (mean: 49.1; SD: 36), and "HIV acceptance" (mean: 49.1; SD: 35.8). The dimension with the best score was "medication concerns" (mean: 80.8; SD: 26.5). Conclusion quality of life has been increasingly used as a clinical outcome evaluation parameter. The results of this study contribute to the establishment of interventions based on the needs of HIV+ pregnant women. Thieme Publicações Ltda Rio de Janeiro, Brazil.

Psychosocial Adaptation and Depressive Manifestations in High-Risk Pregnant Women: Implications for Clinical Practice.

PubMed

Fiskin, Gamze; Kaydirak, Meltem Mecdi; Oskay, Umran Yesiltepe

2017-02-01

High-risk pregnancy research has focused primarily on psychological well-being. The aim is to determine psychosocial adaptation and depression levels of pregnant women who were admitted to hospital with diagnosis of high-risk pregnancy. This study was descriptive. Sampling was composed of 122 high-risk pregnant women who were hospitalized in the perinatology service of Istanbul University Medical School, Department of Obstetrics and Gynecology between January 1, 2014, and May 31, 2014, and met the study criteria. The Pregnant Introduction Form, Psychosocial Adjustment of Illness Scale-Self Report, and CES Depression Scale were used. Of high-risk pregnant women, 47% were found to have a poor level of psychosocial adaptation and 57% presented with depressive symptoms. There were statistically significant difference found between the levels of psychosocial adaptation and status of depressive manifestations. The difference between the average scores increased as the adaptation levels weaken and the pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. The results of this study indicate that, depending on the high-risk pregnancy status, pregnant women experience difficulty in adaptation to their current status and pregnant women with a poor level of psychosocial adaptation showed more depressive manifestations. Nurses should deliver care in high-risk pregnancies with the awareness of physiological needs as well the psychosocial needs of pregnant women, and information meetings should be held in order to increase the psychosocial support of their families and decrease their tendency toward depression. Nursing initiatives should be developed with further studies for the psychosocial adaptation of high-risk pregnancy and reduction of the depressive manifestations. © 2016 Sigma Theta Tau International.

Hostile and benevolent reactions toward pregnant women: complementary interpersonal punishments and rewards that maintain traditional roles.

PubMed

Hebl, Michelle R; King, Eden B; Glick, Peter; Singletary, Sarah L; Kazama, Stephanie

2007-11-01

A naturalistic field study investigated behavior toward pregnant (vs. nonpregnant) women in nontraditional (job applicant) and traditional (store customer) roles. Female confederates, who sometimes wore a pregnancy prosthesis, posed as job applicants or customers at retail stores. Store employees exhibited more hostile behavior (e.g., rudeness) toward pregnant (vs. nonpregnant) applicants and more benevolent behavior (e.g., touching, overfriendliness) toward pregnant (vs. nonpregnant) customers. A second experiment revealed that pregnant women are especially likely to encounter hostility (from both men and women) when applying for masculine as compared with feminine jobs. The combination of benevolence toward pregnant women in traditional roles and hostility toward those who seek nontraditional roles suggests a system of complementary interpersonal rewards and punishments that may discourage pregnant women from pursuing work that violates gender norms. (c) 2007 APA

[Interventions on the exposure of non-smoking pregnant women to passive smoking].

PubMed

Yao, Ting-ting; Chen, Xue-yun; Hu, De-wei; Mao, Zheng-zhong

2008-09-01

To investigate the extent of exposure of non-smoking pregnant women to passive smoking; to undertake interventions on the knowledge, attitudes and behaviors of those women toward passive smoking; and to evaluate the effectiveness of the interventions. A total of 128 non-smoking pregnant women participated in the survey. Their knowledge, attitudes and behaviors towards passive smoking were measured by a self-administered questionnaire. A sixteen-week intervention was undertaken. The knowledge and attitudes of the non-smoking pregnant women towards passive smoking improved significantly, as well as their attempts to avoid exposure to the passive smoking brought by their smoking husbands or other family members. Telephone counseling, booklets and doctors' advices were the most acceptable approaches of health education. The comprehensive interventions are effective for improving the knowledge, attitudes and behaviors of non-smoking women toward passive smoking.

Toxoplasmosis among pregnant women in Qualyobia Governorate, Egypt.

PubMed

El-Gozamy, Bothina R; Mohamed, Sabry Abdel-fattah; Mansour, Hadil Ahmad M

2009-08-01

This study was conducted between August 2007 and October 2008 to identify the sero-prevalence of Toxoplasma gondii among pregnant women of different ages and stages of gestation. Latex agglutination test was used as screening test. ELISA-IgG & IgM tests measured for the Toxo-Latex positive cases to identify toxoplasmosis clinical status. The results indicated that the prevalence of T. gondii among pregnant women was relatively high in the rural (57.6%) than urban (46.5%) areas. The positivity was correlated, in general, with age as it was higher in the older age groups. No specific clinical pictures were noticed in different patients with variable proportions, as well as a less marked correlation between Toxo-latex positive cases and having toxoplasmic congenital babies. But, neither correlation was detected between the history of congenital toxoplasmosis, or contact with cats and the Toxo-latex out-come results. An acute newly infected pregnant women during their first trimester of pregnancy that represents the rate of incidence of T. gondii in which ELISA-IgM positive and ELISA-IgG negative, was 23 cases (27.05%) and v.v. was 20 (23.54). The interpretation of IgM and IgG was given.

Epidemiological overview of HIV/AIDS in pregnant women from a state of northeastern Brazil.

PubMed

Silva, Claúdia Mendes da; Alves, Regina de Souza; Santos, Tâmyssa Simões Dos; Bragagnollo, Gabriela Rodrigues; Tavares, Clodis Maria; Santos, Amuzza Aylla Pereira Dos

2018-01-01

To learn the epidemiological characteristics of HIV infection in pregnant women. Descriptive study with quantitative approach. The study population was composed of pregnant women with HIV/AIDS residing in the state of Alagoas. Data were organized into variables and analyzed according to the measures of dispersion parameter relevant to the arithmetic mean and standard deviation (X ± S). Between 2007 and 2015, 773 cases of HIV/AIDS were recorded in pregnant women in Alagoas. The studied variables identified that most of these pregnant women were young, had low levels of education and faced socioeconomic vulnerability. It is necessary to include actions aimed at increasing the attention paid to women, once the assurance of full care and early diagnosis of HIV are important strategies to promote adequate treatment adherence and reduce the vertical transmission.

Barriers to receiving substance abuse treatment among rural pregnant women in Kentucky.

PubMed

Jackson, Afton; Shannon, Lisa

2012-12-01

Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services.

Early Phthalates Exposure in Pregnant Women Is Associated with Alteration of Thyroid Hormones

PubMed Central

Tsai, Chih-Hsin; Liang, Wei-Yen; Li, Sih-Syuan; Huang, Han-Bin

2016-01-01

Introduction Previous studies revealed that phthalate exposure could alter thyroid hormones during the last trimester of pregnancy. However, thyroid hormones are crucial for fetal development during the first trimester. We aimed to clarify the effect of phthalate exposure on thyroid hormones during early pregnancy. Method We recruited 97 pregnant women who were offered an amniocentesis during the early trimester from an obstetrics clinic in southern Taiwan from 2013 to 2014. After signing an informed consent form, we collected amniotic fluid and urine samples from pregnant women to analyze 11 metabolites, including mono-ethyl phthalate (MEP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(2-ethylhexyl) phthalate (MEHP), mono-butyl phthalate (MnBP), of 9 phthalates using liquid chromatography/ tandem mass spectrometry. We collected blood samples from each subject to analyze serum thyroid hormones including thyroxine (T4), free T4, and thyroid-binding globulin (TBG). Results Three phthalate metabolites were discovered to be >80% in the urine samples of the pregnant women: MEP (88%), MnBP (81%) and MECPP (86%). Median MnBP and MECPP levels in pregnant Taiwanese women were 21.5 and 17.6 μg/g-creatinine, respectively, that decreased after the 2011 Taiwan DEHP scandal. Results of principal component analysis suggested two major sources (DEHP and other phthalates) of phthalates exposure in pregnant women. After adjusting for age, gestational age, TBG, urinary creatinine, and other phthalate metabolites, we found a significantly negative association between urinary MnBP levels and serum T4 (β = –5.41; p-value = 0.012; n = 97) in pregnant women using Bonferroni correction. Conclusion We observed a potential change in the thyroid hormones of pregnant women during early pregnancy after DnBP exposure. Additional study is necessitated to clarify these associations. PMID:27455052

An evaluation of the automated assay of urinary oestrogens in pregnant women

PubMed Central

Muir, G. G.; Ryan, M.; Conaill, D. U.

1970-01-01

An automated assay suitable for estimating urinary oestrogens in pregnant women has been investigated. Fluorimetry was found to have considerable advantages over colorimetry. The fluorimetric assay was simpler, more precise, more sensitive, and eliminated the need for correction for non-specific chromogens; in the assay of oestriol in pregnant women there was no need for correction for non-specific fluorescence. Spectrofluorimetric and photometric analyses, recoveries, and reproducibility show that the method offers a robust means of providing values for urinary oestrogen in pregnant women on a scale of up to 100 tests a day, the time of the assay being one and a half hours. PMID:5476876

Development and validation of a new tool to measure Iranian pregnant women's empowerment.

PubMed

Borghei, N S; Taghipour, A; Roudsari, R Latifnejad; Keramat, A

2016-03-15

Empowering pregnant women improves their health and reduces maternal mortality, but there is a lack of suitable tools to measure women's empowerment in some cultures. This study aimed to design and validate a questionnaire for measuring the dimensions of empowerment among Iranian pregnant women. After a literature review, and face and content validity testing, a 38-item questionnaire was developed and tested on a sample of 161 pregnant women. Factor analysis grouped the items into 3 subscales: educational empowerment (e.g. prenatal training), autonomy (e.g. financial independency and mental ability) and sociopolitical empowerment (e.g. involvement in social and political activities). Criterion validity testing showed a strong positive correlation of the total scale and subscales scores with the Kameda and the Spritzer empowerment scales. Cronbach alpha was 0.92 for total empowerment. A total of 32 items remained in the Self-Structured Pregnancy Empowerment Questionnaire, which is a valid new tool to measure the dimensions of pregnant women's empowerment.

Serum urea and uric acid concentration in pregnant women in sub-urban commercial community in Africa.

PubMed

Ahaneku, J E; Adinma, J I; Ahaneku, G I; Nwosu, B O; Nwofor, P C; Okoli, C C

2009-06-01

Serum uric acid and urea levels were determined in 27 pregnant and 17 non-pregnant black African women. Uric acid levels for the pregnant women were significantly raised, and the relationship between uric acid elevation and gestational proteinuric hypertension was discussed. In conclusion, we recommend that uric acid estimation should be included during routine antenatal clinics in normal pregnancy. That the use of uric acid levels should be encouraged for the diagnosis and management of gestational proteinuric hypertension in African pregnant women. The above recommendation will help to reduce prenatal morbidity and mortality in African pregnant women.

Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women.

PubMed

Han, Seong-Min; Han, Jeong Hee; Park, Jina A; Quinn, Frank A; Park, Joonseok; Oh, Eunsuk

2013-12-01

Maternal thyroid dysfunction during pregnancy has been associated with adverse outcomes for both the mother and child. For this reason, it is important to understand thyroid status in pregnant women. However, there are relatively few published studies that examine thyroid function tests (TFT) and thyroid autoimmunity in non-Western pregnant women. Serum samples were longitudinally collected throughout pregnancy from 108 Korean women. TFT, thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) testing was performed. The impact of gestational age on TPO-Ab and Tg-Ab levels was evaluated and gestational age-specific reference intervals for TFT were established in antibody negative women. In the first trimester, TPO-Ab and Tg-Ab were positive in 13.9% and 16.7% of women, respectively. For antibody positive women, median autoantibody levels for TPO-Ab and Tg-Ab dropped from first trimester to near term (133.7-10.5 IU/mL, and 162.1-21.9 IU/mL, respectively). Antibody status influenced thyroid stimulating hormone (TSH) during the first trimester, and TSH, free T4 (FT4) and total T4 (TT4) in the early second trimester. Later in gestation, no significant differences in TFT were found based on antibody status. Gestational age-specific reference intervals for TFT were calculated in antibody negative women. Laboratory evidence of autoimmune thyroid disease (AITD) is common in this population of pregnant Korean women. Antibody status influences TFT values in the first and early second trimester. Thyroid autoantibody status and titer change in an individual-specific manner throughout pregnancy. Gestational age-specific reference intervals should be utilized for interpretation of TFT results in pregnant women.

High Prevalence of Vitamin D Deficiency among Pregnant Saudi Women.

PubMed

Al-Faris, Nora A

2016-02-04

Vitamin D deficiency has emerged as a public health problem worldwide due to its important role in health and disease. The present work is intended to examine prevalence of vitamin D deficiency among pregnant Saudi women and related risk factors. A cross-sectional study was carried out at King Fahad Medical City in Riyadh, Saudi Arabia. Serum 25-hydroxy vitamin D (25(OH)D) was measured by enzyme-linked immunosorbent assay in 160 pregnant women during the first trimester of pregnancy. Socio-demographic, lifestyle and maternal characteristics were collected and vitamin D intake was assessed using a 24-h dietary recall. Weight and height were measured using standardized methods. Vitamin D deficiency (25(OH)D < 50 nmol/L) and insufficiency (25(OH)D = 50-74 nmol/L) were reported in 50% and 43.8% of the study sample, respectively. Median serum 25(OH)D concentration was 49.9 nmol/L. Adequate vitamin D intake (≥600 IU/day) was reported among only 8.1% of pregnant women. Age group, educational level, sun exposure frequency and daytime and daily practice of exercise were significantly associated with vitamin D status. Overall, vitamin D deficiency was common among pregnant Saudi women in Riyadh. Steps should be taken to address the current situation, including increased sunlight exposure, consumption of fatty fish, and vitamin D supplements.

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China.

PubMed

Xu, Xianglong; Liu, Dengyuan; Zhang, Zhangyi; Sharma, Manoj; Zhao, Yong

2017-07-20

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1-3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future

Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China

PubMed Central

Liu, Dengyuan; Zhang, Zhangyi; Zhao, Yong

2017-01-01

Objectives: Good maternal health and fetal development require sufficient and good quality of sleep during pregnancy. This study investigated sleep duration and quality in pregnant women, assessing factors with possibly influence on sleep. Method: A cross-sectional survey was conducted on pregnant women between June and August in 2015 in 16 hospitals in five provinces in China. A total of 2345 pregnant women aged 18 years and older were surveyed. Insufficient sleeping duration was defined as sleeping of less than 7 h per day. Excessive sleep duration was defined as sleeping of more than 9 h per day. Results: A total of 561 (23.9%) participants reported insufficient sleeping duration, whereas 485 (20.9%) claimed excessive sleep duration. A total of 358 (15.2%) of pregnant women reported problems regarding sleep quality. Compared to pregnant women with sufficient sleeping duration, those with insufficient sleeping duration were prone to have poor sleep quality, whereas those with excessive sleeping duration featured low possibility of poor sleep quality. High-risk groups of insufficient sleep duration include women of Han nationality, with siblings, in their first trimester of pregnancy, receiving care in low-capacity/quality hospital settings, and with daily or 1–3 days of secondhand smoke exposure. High-risk groups of excessive sleep duration include women living in rural areas, unemployed, in their third trimester of pregnancy, and receiving care in medium-capacity/quality hospital settings. High-risk groups of poor sleep quality include women of non-Han nationality, low income level, in their third trimester of pregnancy, and with insufficient sleep duration. Conclusions: Insufficient/excessive sleep duration and poor sleep quality commonly occur during pregnancy in China. Findings provide a better understanding of the influencing factors of insufficient/excessive sleep duration and poor quality of sleep. These findings have some implications for future

Assessment of angiogenesis modulators in pregnant women with pre-eclampsia: a case-control study.

PubMed

Mundim, Guilhermo Justino; Paschoini, Marina Carvalho; Araujo Júnior, Edward; Da Silva Costa, Fabricio; Rodrigues Júnior, Virmondes

2016-02-01

This study aimed to evaluate the serum concentration of factors associated with placental angiogenesis in pre-eclamptic and normotensive pregnant women. This was a prospective, cross-sectional, case-control study in which the pro-angiogenic factors PlGF, VEGF and IL-10, and the anti-angiogenic factors IL-6, IL-17 and TNF-α of 55 pregnant women (31 with pre-eclampsia-PE and 24 normotensive), with gestational age ≥20 weeks, were measured in maternal blood through the enzyme-linked immunosorbent assay (ELISA). The Mann-Whitney and Kruskal-Wallis tests were used for comparison between groups. Serum PIGF was reduced in the group of pregnant women with PE when compared with the normotensive women (493.2 ± 55.1 pg/mL vs. 4.4 ± 26.5 pg/mL; p < 0.001). There was no significant difference in PlGF levels in the pre-eclamptic pregnant women in relation to gestational age or proteinuria levels (p > 0.05). The serum levels of VEGF, IL-17, IL-10 and TNF-α were lower in the pregnant women with PE when compared with their normotensive peers, while the IL-6 levels were higher; however, this difference was not statistically significant (p > 0.05). Serum PlGF levels were reduced in the pregnant women with PE and were unrelated to disease severity. Serum levels of VEGF, IL-17, IL-10 and TNF-α were reduced in the pre-eclamptic pregnant women when compared with their normotensive peers, without statistically significant differences.

Vitamin D Deficiency in Pregnant Women and Their Infants

PubMed Central

Özdemir, Abdurrahman Avar; Ercan Gündemir, Yasemin; Küçük, Mustafa; Yıldıran Sarıcı, Deniz; Elgörmüş, Yusuf; Çağ, Yakup; Bilek, Günal

2018-01-01

Objective: Vitamin D deficiency is a serious health problem despite a general improvement in socio-economic status in Turkey. The aim of this study was to evaluate maternal vitamin D status and its effect on neonatal vitamin D concentrations after a support programme for pregnant women was introduced. A second aim was to identify risk factors for vitamin D deficiency in a district of İstanbul. Methods: A total of 97 pregnant women and 90 infants were included in this study, conducted between January and October 2016. The demographic data, risk factors and daily vitamin intake were recorded. Serum levels of vitamin D, calcium, phosphorus and alkaline phosphatase in all subjects were measured. The mothers and newborns were divided into groups based on their vitamin D levels. The relationship between vitamin D levels and risk factors was analyzed. Results: Mean ± standard deviation vitamin D levels for the women and their infants were found to be 14.82±11.45 and 13.16±7.16 ng/mL, respectively. The number of mothers and infants was significantly higher in the deficient group, and their mean vitamin D levels significantly lower (9.02±1.34 and 8.80±1.06 ng/mL, respectively) (p<0.001, p<0.001). Only 14.4% of pregnant women took 1000-1200 IU/day of vitamin D. When the mother groups were evaluated in terms of risk factors, there were significant differences in daily vitamin intake and clothing style (p<0.001 and p<0.001 respectively). Conclusion: Vitamin D deficiency in pregnant women and their infants is still a serious health problem in Turkey, although a vitamin D support programme during pregnancy has been launched by the department of health. PMID:28901944

The prevalence of anemia in pregnant women and its associated risk factors in North Sumatera, Indonesia

NASA Astrophysics Data System (ADS)

Lestari, S.; Fujiati, I. I.; Keumalasari, D.; Daulay, M.; Martina, S. J.; Syarifah, S.

2018-03-01

The gestation period is the period that determines the quality of human resources in the future because the development of the child is determined from the time of the fetus in utero. The most common nutrition problems suffered by pregnant women in Indonesia is Chronic Energy Deficiency (CED) and anemia. The aim of this research to determine the prevalence of anemia in pregnant women and the risk factors associated with anemia in urban and rural areas of North Sumatera Province. This research is as descriptive analyticwith cross-sectional approach. Total sample 140 pregnant women from the Medan City, Langkat District and South Labuhan Batu District, and was from June to October 2016. Data collected by using interviews, hemoglobinometer tool and analyzed with Chi-square test. Anemia was in 40.7% of pregnant women, and the incidence of anemia is more common in pregnant women in urban areas than in rural areas. The factors associated with anemia in pregnant women is parity, knowledge of nutrition, diet and the risk of chronic energy deficiency (p <0.05). This study concludes that the prevalence of anemia in pregnant women in North Sumatra was higher than the national prevalence.

Knowledge and practice on Toxoplasma infection in pregnant women from Malaysia, Philippines, and Thailand.

PubMed

Andiappan, Hemah; Nissapatorn, Veeranoot; Sawangjaroen, Nongyao; Khaing, Si-Lay; Salibay, Cristina C; Cheung, Mary Mae M; Dungca, Julieta Z; Chemoh, Waenurama; Xiao Teng, Ching; Lau, Yee-Ling; Mat Adenan, Noor A

2014-01-01

Toxoplasma gondii, is one of the infectious agents of congenital TORCH infections, causes severe clinical outcomes in fetus and newborns. Nevertheless this life-threatening parasitic disease is preventable by simple preventive measures related to lifestyle during pregnancy. We aim to study on the knowledge about toxoplasmosis and practices that prevents this infection among the pregnant women. Total of 2598 pregnant women from Malaysia, Philippines, and Thailand were randomly surveyed to determine the knowledge and their practices on Toxoplasma infection. The questionnaire covered respondents' general information and knowledge on plausible risks factors, symptoms, timing of infection, prevention knowledge, and preventive behavior regarding Toxoplasma infection. Majority of these pregnant women were in their age group of 20-29 years (50.9%), completed secondary level of education (51.7%), in their second trimester of pregnancies (38.1%), non-parous (36.6%), and had no history of abortion (90.4%). Based on this survey, only 11% of these pregnant women had read, heard, or seen information regarding toxoplasmosis and 3.5% of them were aware of being tested for the infection. A small percentage of these pregnant women knew that T. gondii were shed in the feces of infected cats (19.4%) and sometimes found in the raw or undercooked meat (11.0%). There was 16.1% of responding women knew that toxoplasmosis is caused by an infection. Demographic profiles such as age group, level of education, pregnancy term, and number of children of the pregnant women showed significant association with their responses toward prevention knowledge and preventive behavior related questions (P < 0.05). Thus, it is suggested that health education on toxoplasmosis and primary behavioral practices should be consistently offered to reproductive age women in general and pregnant women in particular. This information could help to reduce vertical transmission of Toxoplasma infection during pregnancy.

Knowledge and practice on Toxoplasma infection in pregnant women from Malaysia, Philippines, and Thailand

PubMed Central

Andiappan, Hemah; Nissapatorn, Veeranoot; Sawangjaroen, Nongyao; Khaing, Si-Lay; Salibay, Cristina C.; Cheung, Mary Mae M.; Dungca, Julieta Z.; Chemoh, Waenurama; Xiao Teng, Ching; Lau, Yee-Ling; Mat Adenan, Noor A.

2014-01-01

Toxoplasma gondii, is one of the infectious agents of congenital TORCH infections, causes severe clinical outcomes in fetus and newborns. Nevertheless this life-threatening parasitic disease is preventable by simple preventive measures related to lifestyle during pregnancy. We aim to study on the knowledge about toxoplasmosis and practices that prevents this infection among the pregnant women. Total of 2598 pregnant women from Malaysia, Philippines, and Thailand were randomly surveyed to determine the knowledge and their practices on Toxoplasma infection. The questionnaire covered respondents' general information and knowledge on plausible risks factors, symptoms, timing of infection, prevention knowledge, and preventive behavior regarding Toxoplasma infection. Majority of these pregnant women were in their age group of 20–29 years (50.9%), completed secondary level of education (51.7%), in their second trimester of pregnancies (38.1%), non-parous (36.6%), and had no history of abortion (90.4%). Based on this survey, only 11% of these pregnant women had read, heard, or seen information regarding toxoplasmosis and 3.5% of them were aware of being tested for the infection. A small percentage of these pregnant women knew that T. gondii were shed in the feces of infected cats (19.4%) and sometimes found in the raw or undercooked meat (11.0%). There was 16.1% of responding women knew that toxoplasmosis is caused by an infection. Demographic profiles such as age group, level of education, pregnancy term, and number of children of the pregnant women showed significant association with their responses toward prevention knowledge and preventive behavior related questions (P < 0.05). Thus, it is suggested that health education on toxoplasmosis and primary behavioral practices should be consistently offered to reproductive age women in general and pregnant women in particular. This information could help to reduce vertical transmission of Toxoplasma infection during

Food insecurity and alcohol use among pregnant women at alcohol-serving establishments in South Africa.

PubMed

Eaton, Lisa A; Pitpitan, Eileen V; Kalichman, Seth C; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree; Cain, Demetria N

2014-06-01

South Africa has the highest rate of fetal alcohol syndrome (FAS) in the world. While efforts have been made to curb the high rate of FAS, little is known about situational factors that may contribute to alcohol use during pregnancy. In the current paper, we focus on the role of food insecurity and its relationship to alcohol use among pregnant women. Women completed computer-assisted interviews. Generalized linear modeling was used in all analyses. Women attending alcohol-serving establishments in a township in Cape Town, South Africa were recruited for the study. Five hundred sixty women were sampled and 95 women reported being pregnant. High levels of alcohol use were reported among pregnant women: 65 % of women consumed alcohol at least every month and 29 % consumed alcohol as often as two to three times per week. Thirty-four percent of the women reported having six or more drinks per occasion on at least a weekly basis. The majority (87 %) of pregnant women reported experiencing some form of food insecurity (e.g., food unavailable, eating less) in the past month. Alcohol use was significantly associated with food insecurity, even when controlling for relevant demographic variables. Intervention with pregnant women who consume alcohol is urgently needed. Future research should focus on understanding the intersection of food insecurity and alcohol, and how the experience of food insecurity may contribute to greater rates of alcohol use and abuse among pregnant women.

Pregnant women's navigation of information on everyday household chemicals: phthalates as a case study.

PubMed

Ashley, Justin M; Hodgson, Alexandra; Sharma, Sapna; Nisker, Jeff

2015-11-25

Current developments in science and the media have now placed pregnant women in a precarious situation as they are charged with the responsibility to navigate through information sources to make the best decisions for her pregnancy. Yet little is known regarding how pregnant women want to receive and use health information in general, let alone information regarding the uncertain risks to pregnancy in everyday household products such as phthalates found in cosmetics and canned food liners. Using phthalates as an example, this study investigated how pregnant women obtain, evaluate, and act on information regarding their pregnancy. Pregnant women were recruited using pamphlets and posters distributed in prenatal clinics, prenatal fairs and physician offices in Southwestern Ontario Canada. Research participants were engaged in 20 to 40 min semi-structured interviews regarding their use of information sources in pregnancy, particularly regarding phthalates in cosmetics and canned food liners. Interviews were transcribed verbatim and analyzed using constructivist grounded theory techniques supported by NVivo 9™ software. Theoretical sufficiency was reached after 23 pregnant women were interviewed and their transcripts analyzed. Three overlapping themes resulted from the co-constructed analysis: I-Strength of Information Sources; II-Value Modifiers; and III-Deciding to Control Exposure. The research participants reported receiving information from a wide range of sources that they perceived varying in strength or believability. They then described the strategies employed to increase the validity of the message in order to avoid risk exposure. Pregnant women preferred a strong source of information such as physician, government but frequently used weak sources such as the internet or the opinions of friends. A model was developed from the relationship between themes that describes how pregnant women navigate the multiple sources of information available to them. Our

Exposure to Secondhand Tobacco Smoke and Interventions Among Pregnant Women in China: A Systematic Review

PubMed Central

Hsia, Jason; Tu, Xiaoming; Xia, Yang; Zhang, Lihong; Bi, Zhenqiang; Liu, Hongyan; Li, Xiaoming; Stanton, Bonita

2015-01-01