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1

Pattern and outcome of antenatal care among women attending a Catholic mission hospital in Ibadan, Nigeria.  

PubMed

Antenatal care (ANC) services have the aim of monitoring the course of pregnancy, in order to promote favourable outcomes. In spite of the fact that its components have been found to improve pregnancy outcomes, maternal/infant morbidity and mortality still remain public health problems in most developing countries including Nigeria. These unacceptable health indicators form the basis of this study. The records of 581 women who attended ANC at the Catholic Hospital between October 2005 and September 2006 were accessed. The data collected with the aid of a checklist were processed using statistical package of social sciences (SPSS). The age range of the participants was 17-45; with the mean age of 30.3 (SD = 4.8). Three hundred and forty-seven (59.7%), sixty-nine (29.1%) of the women had tertiary and secondary education respectively. A total of 325 (55.9%) were nulliparous. Only 44 (7.6%) of the women began ANC at the first trimester. Out of 159 abortions recorded among the women, 72 (45%) were self-induced prior to marriage. Findings showed apparent low rate of first trimester booking, irregular antenatal clinic visits and initiation of ANC at the appearance of symptoms of illness among the women studied. Therefore the study recommends hospitals to adopt the WHO modified ANC with fewer visits to improve better compliance and coverage, provision of family life education especially on the benefits of early ANC booking and family planning services through available media. PMID:18982815

Aluko, J O; Oluwatosin, A

2008-09-01

2

Intestinal helminth infections in pregnant women attending antenatal clinic at kitale district hospital, kenya.  

PubMed

Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%). Ascariasis was the most prevalent 10 (6.5%), hookworm infection was 6 (3.9%), and trichuriasis was 2 (1.3%). Pregnant women aged below 29 years (OR = 3.63, CI = 0.87-11.75) and those with primary level of education (OR = 3.21, CI = 0.88-11.75) were at a higher risk of infection compared to those aged ? 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06-0.57). It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment. PMID:24971167

Wekesa, A W; Mulambalah, C S; Muleke, C I; Odhiambo, R

2014-01-01

3

Intestinal Helminth Infections in Pregnant Women Attending Antenatal Clinic at Kitale District Hospital, Kenya  

PubMed Central

Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%). Ascariasis was the most prevalent 10 (6.5%), hookworm infection was 6 (3.9%), and trichuriasis was 2 (1.3%). Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75) and those with primary level of education (OR = 3.21, CI = 0.88–11.75) were at a higher risk of infection compared to those aged ? 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57). It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment. PMID:24971167

Wekesa, A. W.; Mulambalah, C. S.; Muleke, C. I.; Odhiambo, R.

2014-01-01

4

Predicting Antenatal Class Attendance: Attitudes Of Self And Others  

Microsoft Academic Search

Attendance at antenatal classes has been found to improve birth outcomes, yet many women do not attend. This study investigates the extent to which we can predict attendance and whether women's expectations of classes are confirmed by their subsequent experiences. Intention to attend was the most predictive variable in the 529 primigravidas women studied. It was best predicted by women's

S. Michie; T. M. Marteau; J. Kidd

1992-01-01

5

Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania  

Microsoft Academic Search

BACKGROUND: Sentinel surveillance for HIV in ante-natal clinics (ANC) remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC) in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania.

Yusufu Kumogola; Emma Slaymaker; Basia Zaba; Julius Mngara; Raphael Isingo; John Changalucha; Patrick Mwidunda; Daniel Kimaro; Mark Urassa

2010-01-01

6

Plasmodium falciparum malaria in pregnancy: Prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria  

Microsoft Academic Search

This study evaluated malaria care-seeking behaviour, as well as the prevalence of parasitaemia and anaemia among pregnant women attending antenatal clinics of two tertiary healthcare facilities in Edo State, Nigeria. Malaria was highly prevalent in the study group (20%) by microscopy and estimated 25%, by PCR), but parasitaemia and incidence decreased with increasing number of pregnancies. Although the level of

E. F. O. Enato; P. F. Mens; A. O. Okhamafe; E. E. Okpere; E. Pogoson; H. D. F. H. Schallig

2009-01-01

7

Sero-positivity rate of rubella and associated factors among pregnant women attending antenatal care in Mwanza, Tanzania  

PubMed Central

Background Sero-positivity rates of the rubella virus among pregnant women vary widely throughout the world. In Tanzania, rubella vaccination is not included in the national immunization schedule and there is therefore no antenatal screening for this viral disease. So far, there are no reports on the sero-prevalence of rubella among pregnant women in Tanzania. As a result, this study was undertaken to establish the sero-positivity rate of rubella and rubella risk factors among pregnant women attending antenatal care clinics in Mwanza, Tanzania. Methods From November 2012 to May 2013 a total of 350 pregnant women were enrolled and their serum samples collected and analyzed using the AXSYM anti-rubella virus IgG/IgM-MEIA test. Demographic and clinical data were collected using a standardized data collection tool. Data analysis was done using STATA version 12. Results Of 342 pregnant women tested for rubella antibodies, 317 (92.6%) were positive for anti-rubella IgG while only 1 (0.3%) was positive for IgM. Higher sero-positivity rates were found in the age group of 25–44 years. Furthermore, it was observed that with each year increase in age, the risk of contracting rubella increases by 12% (OR?=?1.12, 95% CI: 1.02-1.22, P?=?0.019). Women involved in farming and business women were at a higher risk of contracting rubella infection compared to formally employed women (OR: 4.9, P?=?0.011; OR 7.1, p?=?0.003 respectively). In univariate analysis, the risk of contracting rubella virus infection was found to increase with gestational age with a statistical significance. Conclusions Sero-positivity rates of rubella are high in Mwanza and are significantly associated with an increase in age and being a farmer or a business woman. Screening of rubella and immunization of women at risk are highly recommended in this area with a high non-immune rate against rubella virus. PMID:24589180

2014-01-01

8

Survey of Women's Opinions on Female Genital Mutilation (FGM) in Southeast Nigeria: Study of Patients Attending Antenatal Clinic  

PubMed Central

Background: Female genital mutilation is known to exist especially in many third world countries including Nigeria with many women being victims of this harmful practice and its complications. The practice is rife in Southeast Nigeria and efforts have been made to discourage it. Objective: To determine women's views on aspects of female genital mutilation and the prevalence among the study population. Method: Women attending the antenatal clinics of two university teaching hospitals in Southeast Nigeria were interviewed by means of structured pre-tested interviewer- administered questionnaires. The data obtained were analysed using SPSS version 10.0 and the results expressed in descriptive statistics as percentages. Results: The prevalence of FGM was 42.1%. However, only 14.3% of the respondents circumcised their own daughters or showed willingness to circumcise their daughters indicating considerable reduction in uptake of the practice. A larger proportion (63.7%) would support legislation against FGM. Conclusion: There is a high opinion against the practice of FGM in Southeast Nigeria, with the majority of the women showing support for legislation against it. PMID:23209950

Ezenyeaku, CC; Okeke, TC; Chigbu, CO; Ikeako, LC

2011-01-01

9

High prevalence of hepatitis B virus infection among pregnant women attending antenatal care: a cross-sectional study in two hospitals in northern Uganda  

PubMed Central

Objective To determine the prevalence of the hepatitis B viral (HBV) infection and hepatitis B e antigen (HBeAg) positivity among pregnant women attending antenatal clinics in two referral hospitals in northern Uganda. Design Cross-sectional observational study. Setting Two tertiary hospitals in a postconflict region in a low-income country. Participants Randomly selected 402 pregnant women attending routine antenatal care in two referral hospitals. Five women withdrew consent for personal reasons. Data were analysed for 397 participants. Primary outcome Hepatitis B surface antigen (HBsAg) positivity. Results Of 397 pregnant women aged 13–43?years, 96.2% were married or cohabiting. 47 (11.8%) tested positive for HBsAg; of these, 7 (14.9%) were HBeAg positive. The highest HBsAg positivity rate was seen in women aged 20?years or less (20%) compared with those aged above 20?years (8.7%), aOR=2.54 (95% CI 1.31 to 4.90). However, there was no statistically significant difference between women with positive HBsAg and those with negative tests results with respect to median values of liver enzymes, haemoglobin level, absolute neutrophil counts and white cell counts. HIV positivity, scarification and number of sexual partners were not predictive of HBV positivity. Conclusions One in eight pregnant women attending antenatal care in the two study hospitals has evidence of hepatitis B infection. A significant number of these mothers are HBeAg positive and may be at increased risk of transmitting hepatitis B infection to their unborn babies. We suggest that all pregnant women attending antenatal care be tested for HBV infection; exposed babies need to receive HBV vaccines at birth. PMID:25387757

Bayo, Pontius; Ochola, Emmanuel; Oleo, Caroline; Mwaka, Amos Deogratius

2014-01-01

10

Parvovirus B19 antibodies and correlates of infection in pregnant women attending an antenatal clinic in central Nigeria.  

PubMed

Human parvovirus B19 infection is associated with spontaneous abortion, hydrops foetalis, intrauterine foetal death, erythema infectiosum (5th disease), aplastic crisis and acute symmetric polyarthropathy. However, data concerning Nigerian patients with B19 infection have not been published yet. The purpose of this study was to establish the prevalence of B19 IgG and IgM antibodies, including correlates of infection, among pregnant women attending an antenatal clinic in Nigeria. Subsequent to clearance from an ethical committee, blood samples were collected between August-November 2008 from 273 pregnant women between the ages of 15-40 years who have given their informed consent and completed self-administered questionnaires. Recombinant IgG and IgM enzyme linked immunosorbent assay kits (Demeditec Diagnostics, Germany) were used for the assays. Out of the 273 participants, 111 (40.7%) had either IgG or IgM antibodies. Out of these, 75 (27.5%) had IgG antibodies whereas 36 (13.2%) had IgM antibodies, and those aged 36-40 years had the highest prevalence of IgG antibodies. Significant determinants of infection (p < 0.05) included the receipt of a blood transfusion, occupation and the presence of a large number of children in the household. Our findings have important implications for transfusion and foeto-maternal health policy in Nigeria. Routine screening for B19 IgM antibodies and accompanying clinical management of positive cases should be made mandatory for all Nigerian blood donors and women of childbearing age. PMID:21537685

Emiasegen, Samuel E; Nimzing, Lohya; Adoga, Moses P; Ohagenyi, Adamu Y; Lekan, Rufai

2011-03-01

11

Prevalence and Public-health Significance of HIV Infection and Anaemia among Pregnant Women Attending Antenatal Clinics in South-eastern Nigeria  

Microsoft Academic Search

HIV infection and anaemia are major public-health problems in Africa and are important factors associated with an increased risk of adverse pregnancy outcomes. The objective of this study was to determine the prevalence of HIV infection and anaemia among pregnant women attending antenatal clinics in south- eastern Nigeria. To achieve this, a cross-sectional survey was conducted during July 2005-June 2006

C. J. Uneke; D. D. Duhlinska; E. B. Igbinedion

12

Declining HIV prevalence among women attending antenatal care in Pune, India  

Microsoft Academic Search

A declining prevalence of HIV among young women has been reported by the public sector implementing prevention of mother-to-child transmission (PMTCT) programmes, sentinel surveillance sites and research institutions in India. However, there are no reports evaluating such trends from the private healthcare sector. This study is a retrospective analysis of data collected by PRAYAS as a part of the PMTCT

Vinay Kulkarni; Smita Joshi; Nikhil Gupte; Ritu Parchure; Shrinivas Darak; Sanjeevani Kulkarni

2011-01-01

13

Utilization of folic acid and iron supplementation services by pregnant women attending an antenatal clinic at a regional referral hospital in Kenya.  

PubMed

To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4 days in a week were considered "highly compliant". The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6 % obtained antenatal care in the first trimester; 69.3 and 51.2 % received folic acid and iron supplements, respectively. However, only half (45-58 %) received any information about supplementation. Most women were initiated on folic acid (80.7 %) or iron (67.7 %) after 12 and 16 weeks of gestation, respectively, well after the recommended time period. However, more than 80 % of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels < 11 g/dl) was 7.8 %. Health workers need to better explain the importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem. PMID:22907273

Maina-Gathigi, L; Omolo, J; Wanzala, P; Lindan, C; Makokha, A

2013-09-01

14

Antenatal card for illiterate traditional birth attendants.  

PubMed

The training and use of trained birth attendants (TBAs) in Guinea Bissau was started in 1977 as part of the primary health care program. The majority of TBAs are illiterate, making accurate record-keeping of antenatal visits ineffective. This paper presents an antenatal card developed by the Ministry of Health and Social Affairs in use since 1982. The card was designed for several purposes: to help nurse-supervisors find and correct mistakes, to help TBAs remember what to look for during antenatal visits, and to enable them to identify at-risk pregnancies and refer them if necessary. The card requires no writing other than the initial visit, when it is suggested that a literate person assist the TBA in recording name, age, and village. Pictorial symbols are used on the rest of the card, which is retained by the patient between visits. The card is divided into 3 areas: a history (number of live children, number of dead children, number of abortions) recorded by placing the correct number of ticks in the proper column; examination (weight if possible, signs of anemia and edema indicated by a +or-, height of uterus, presence of fetal heart sounds); care (reminding TBAs to give nutritional advice, malaria prophylaxis, dispense iron tablets, determine if referral is necessary). The card needs to be field tested by nurses and midwives who will be training the TBAs, and then evaluated for its use in detecting at-risk pregnancies, making any additions or changes as necessary. PMID:3765084

Chabot, H T; Eggens, K H

1986-04-01

15

Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial  

PubMed Central

Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. Methods This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. Results The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. Conclusions The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care visits during pregnancy and there was a trend towards improved quality of care with more women receiving preventive health services, more women attending antenatal care late in pregnancy and more women with antepartum complications identified and referred. Mobile phone applications may contribute towards improved maternal and newborn health and should be considered by policy makers in resource-limited settings. Trial registration ClinicalTrials.gov, NCT01821222. PMID:24438517

2014-01-01

16

Comparative Haematological Screening of Urban and Rural Pregnant Women Attending Antenatal Clinics in Lagos and Its Environs.  

ERIC Educational Resources Information Center

Compared blood screening data for 200 urban and rural pregnant women in Nigeria. Found that rural subjects had a greater incidence of moderate anemia than did urban subjects, and corpuscular hemoglobin concentrations fell with increased gestational age. No relationship was found between hemoglobin counts and nutrition habits. (HTH)

Abidoye, R. O.; Olukoya, A. A.

1993-01-01

17

Use of Condoms among Human Immunodeficiency Virus Positive Women Attending Antenatal Clinic in Nnewi, South East Nigeria  

PubMed Central

Background: Consistent use of condom provides protection from transmission of human immunodeficiency virus (HIV) infection in couples with sero-discordant HIV status. It also protects against acquiring other strains in HIV positive concordant couples. Aim: This study evaluated the use of barrier method of contraception among HIV patients. Subjects and Methods: This was a descriptive cross-sectional study conducted among pregnant women in Nnamdi Azikiwe University Teaching Hospital Nnewi. An interviewer administered questionnaire was used to obtain relevant information from the subjects. Data was analyzed using SPSS software version 20.0 (Chicago, IL, USA, August 2011). Result: A total of 126 HIV positive pregnant women participated in this study. The mean age of the women was 30.4 (5) years while the mean parity was 2.6 (1). All the patients had at least primary education with 63.5% (80/126) having secondary education as the highest educational attainment while 87.3% (110/126) were in monogamous marriage. The partner's HIV status showed that 41.3% (52/126) tested negative to HIV antibodies while 42.8% (54/126) tested positive to HIV antibodies and 15.9% (20/126) do not know partner's HIV status. Only 61.9% (78/126) of the couples use condom during sexual intercourse. Further analysis showed that 26.2% (33/126) use condom consistently except during timed intercourse for conception. There was significant association between type of relationship and use of barrier method of contraception. There was no significant association between sero-discordant couples and highest educational status with use of barrier method of conception. Conclusion: Condom use among HIV positive couples is low and raises great concern on transmission of the virus to partners and babies born to positive mothers.

Udigwe, GO; Mbachu, II; Onyegbule, OA; Oguaka, V

2014-01-01

18

Why do women seek antenatal care late? Perspectives from rural South Africa  

Microsoft Academic Search

Despite the widespread availability of free antenatal care services, most women in rural South Africa attend their first antenatal clinic late in pregnancy and fail to return for any followup care, potentially leading to avoidable perinatal and maternal complications. Using interviews with pregnant women from the rural Hlabisa district of South Africa, we documented perceptions of health and health care

Landon Myer; Abigail Harrison

2003-01-01

19

Why don't some women attend antenatal and postnatal care services?: a qualitative study of community members' perspectives in Garut, Sukabumi and Ciamis districts of West Java Province, Indonesia  

Microsoft Academic Search

BACKGROUND: Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives

Christiana R Titaley; Cynthia L Hunter; Peter Heywood; Michael J Dibley

2010-01-01

20

Under-attending free antenatal care is associated with adverse pregnancy outcomes  

PubMed Central

Background Most pertinent studies of inadequate antenatal care concentrate on the risk profile of women booking late or not booking at all to antenatal care. The objective of this study was to assess the outcome of pregnancies when free and easily accessible antenatal care has been either totally lacking or low in number of visits. Methods This is a hospital register based cohort study of pregnancies treated in Kuopio University Hospital, Finland, in 1989 – 2001. Pregnancy outcomes of women having low numbers (1–5) of antenatal care visits (n = 207) and no antenatal care visits (n = 270) were compared with women having 6–18 antenatal visits (n = 23137). Main outcome measures were: Low birth weight, fetal death, neonatal death. Adverse pregnancy outcomes were controlled for confounding factors (adjusted odds ratios, OR: s) in multiple logistic regression models. Results Of the analyzed pregnant population, 1.0% had no antenatal care visits and 0.77% had 1–5 visits. Under- or non-attendance associated with social and health behavioral risk factors: unmarried status, lower educational level, young maternal age, smoking and alcohol use. Chorio-amnionitis or placental abruptions were more common complications of pregnancies of women avoiding antenatal care, and pregnancy outcome was impaired. After logistic regression analyses, controlling for confounding, there were significantly more low birth weight infants in under- and non-attenders (OR:s with 95% CI:s: 9.18 (6.65–12.68) and 5.46 (3.90–7.65), respectively) more fetal deaths (OR:s 12.05 (5.95–24.40) and 5.19 (2.04–13.22), respectively) and more neonatal deaths (OR:s 10.03 (3.85–26.13) and 8.66 (3.59–20.86), respectively). Conclusion Even when birth takes place in hospital, non- or under-attendance at antenatal care carries a substantially elevated risk of severe adverse pregnancy outcome. Underlying adverse health behavior and possible abuse indicate close surveillance of the newborn. PMID:17900359

Raatikainen, Kaisa; Heiskanen, Nonna; Heinonen, Seppo

2007-01-01

21

Factors affecting the quality of antenatal care provided to remote dwelling Aboriginal women in northern Australia.  

PubMed

Objective: there is a significant gap in pregnancy and birth outcomes for Australian Aboriginal and Torres Strait Islander women compared with other Australian women. The provision of appropriate and high quality antenatal care is one way of reducing these disparities. The aim of this study was to assess adherence to antenatal guidelines by clinicians and identify factors affecting the quality of antenatal care delivery to remote dwelling Aboriginal women. Setting and design: a mixed method study drew data from 27 semi-structured interviews with clinicians and a retrospective cohort study of Aboriginal women from two remote communities in Northern Australia, who gave birth from 2004-2006 (n=412). Medical records from remote health centres and the regional hospital were audited. Measurements and findings: the majority of women attended antenatal care and adherence to some routine antenatal screening guidelines was high. There was poor adherence to local guidelines for follow-up of highly prevalent problems including anaemia, smoking, urinary tract infections and sexually transmitted infections. Multiple factors influenced the quality of antenatal care. Key conclusions and implications for practice: the resourcing and organisation of health services and the beliefs, attitudes and practices of clinicians were the major factors affecting the quality of care. There is an urgent need to address the identified issues in order to achieve equity in women's access to high quality antenatal care with the aim of closing the gap in maternal and neonatal health outcomes. PMID:23809580

Bar-Zeev, Sarah; Barclay, Lesley; Kruske, Sue; Kildea, Sue

2014-03-01

22

Under-attending free antenatal care is associated with adverse pregnancy outcomes  

Microsoft Academic Search

BACKGROUND: Most pertinent studies of inadequate antenatal care concentrate on the risk profile of women booking late or not booking at all to antenatal care. The objective of this study was to assess the outcome of pregnancies when free and easily accessible antenatal care has been either totally lacking or low in number of visits. METHODS: This is a hospital

Kaisa Raatikainen; Nonna Heiskanen; Seppo Heinonen

2007-01-01

23

Factors Affecting Antenatal Care Attendance: Results from Qualitative Studies in Ghana, Kenya and Malawi  

PubMed Central

Background Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. Methods Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. Results Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care – checking the foetus’ position or monitoring its progress – motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women’s timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures – in spite of policies of free ANC – combined with ideas about the compulsory nature of follow-up appointments. Conclusion In these socially and culturally diverse sites, the findings suggest that ‘supply’ side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation. PMID:23335973

Pell, Christopher; Meñaca, Arantza; Were, Florence; Afrah, Nana A.; Chatio, Samuel; Manda-Taylor, Lucinda; Hamel, Mary J.; Hodgson, Abraham; Tagbor, Harry; Kalilani, Linda; Ouma, Peter; Pool, Robert

2013-01-01

24

Assessment of prescription profile of pregnant women visiting antenatal clinics  

PubMed Central

Managing medical complications in pregnancy is a challenge to clinicians. Objectives This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs) in Nigeria. A risk classification of the medicines was also determined. Methods Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The prescription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38%) was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13%) and gastrointestinal disturbances (GIT, 12%). The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43%) of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42%) were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8%) of the total medicines. Of all medicines prescribed, 984 (17%) were included in the foetal risk category C and 286 (5%) in category D. Conclusion The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent antimalarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.

Eze, Uchenna I.; Eferakeya, Adego E.; Oparah, Azuka C.; Enato., Ehijie F.

25

Effect of intimate partner violence on antenatal functional health status of childbearing women in Northeastern Thailand.  

PubMed

We investigated the effects of physical, psychological, and sexual violence on the health status of women attending antenatal clinics at two tertiary hospitals in rural Thailand. We asked 421 pregnant women at 32 weeks gestation or later to complete a survey questionnaire. Participants reported high rates of psychological abuse (53.7%); threats, acts of physical abuse, or both (26.6%); and sexual violence (19.2%). Women abused during pregnancy had poorer health compared with nonabused women, in role emotional functioning, vitality, bodily pain, mental health, and social functioning. Given the high prevalence of violence and poor health status, routine screenings by maternity services is urgently required. PMID:23790193

Saito, Amornrat; Creedy, Debra; Cooke, Marie; Chaboyer, Wendy

2013-01-01

26

Does traditional birth attendant training increase use of antenatal care? a review of the evidence  

Microsoft Academic Search

A combined narrative review and metanalytic review was conducted to summarize published and unpublished studies completed between 1970 and 2002 on the relationship between traditional birth attendant (TBA) training and increased use of professional antenatal care (ANC). Fifteen studies (n = 15) from 8 countries and 2 world regions were analyzed. There are, to varying degrees, positive associations between TBA

Lynn M. Sibley; Theresa Ann Sipe; Marge Koblinsky

2004-01-01

27

Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda  

Microsoft Academic Search

BACKGROUND: Male partner attendance of skilled Antenatal Care (ANC) is beneficial to improving maternal outcomes. This study investigated the level, perceived benefits and factors associated with male partner attendance of skilled ANC in a peri-urban community recovering from two decades of civil conflict. METHODS: This cross-sectional survey used multi-stage sampling in 12 villages of Omoro county to select 331 married

Raymond Tweheyo; Joseph Konde-Lule; Nazarius M Tumwesigye; Juliet N Sekandi

2010-01-01

28

Antenatal day care units versus hospital admission for women with complicated pregnancy  

PubMed Central

Background Antenatal day care units have been widely used as an alternative to inpatient care for women with pregnancy complications including mild and moderate hypertension, and preterm prelabour rupture of the membranes. Objectives The objective of this review is to compare day care units with routine care or hospital admission for women with pregnancy complications in terms of maternal and perinatal outcomes, length of hospital stay, acceptability, and costs to women and health services providers. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (February 2009). Selection criteria Randomised controlled trials comparing day care with inpatient or routine care for women with complicated pregnancy. Data collection and analysis Two review authors independently carried out data extraction and assessed studies for risk of bias. Main results Three trials with a total of 504 women were included. For most outcomes it was not possible to pool results from trials in meta-analyses as outcomes were measured in different ways. Compared with women in the ward/routine care group, women attending day care units were less likely to be admitted to hospital overnight (risk ratio 0.46, 95% confidence interval 0.34 to 0.62). The average length of antenatal admission was shorter for women attending for day care, although outpatient attendances were increased for this group. There was evidence from one study that women attending for day care were significantly less likely to undergo induction of labour, but mode of birth was similar for women in both groups. For other outcomes there were no significant differences between groups. The evidence regarding the costs of different types of care was mixed; while the length of antenatal hospital stays were reduced, this did not necessarily translate into reduced health service costs. While most women tended to be satisfied with whatever care they received, women preferred day care compared with hospital admission. Authors’ conclusions Small studies suggest that there are no major differences in clinical outcomes for mothers or babies between antenatal day units or hospital admission, but women may prefer day care. PMID:19821282

Dowswell, Therese; Middleton, Philippa; Weeks, Andrew

2014-01-01

29

Timing and reasons for coming late for the first antenatal care visit by pregnant women at Mulago hospital, Kampala Uganda  

PubMed Central

Background Mothers who attend antenatal care late miss the opportunity of early detection of HIV and STDs, malaria and anaemia prophylaxis, health education and treatment or prevention of complications. Whereas many women in Mulago hospital make their first antenatal care visit after 20 weeks of gestation, the reasons for coming late are not documented. The objectives were to determine the gestation age at which pregnant women make their first antenatal care visit and the reasons for late coming. Method The study was conducted in June 2012 among women with a gestation age of more than 20 weeks on their first antenatal care visit. We collected data on gestation age (from weeks of amenorrhea or based on ultrasound scan) and reasons for coming late. Results Four hundred women participated in the study. Their mean age was 25.2 years with a standard deviation of 5.2 years. The majority of the participants were Catholics (n?=?126, 31.5%), they lived in a distance of greater than five kilometers from the hospital (n?=?201, 50.3%) and had attained secondary education (n?=?220, 55.0%). The mean of their weeks of amenorrhea was 27.9 (± 4.6) weeks. The results showed that 291 (72.7%) of the study participants did not know the right gestation age at which a pregnant woman should start attending antenatal care. One hundred and ten (27.5%) agreed that they did not have money for transport to bring them to the hospital while 37 (9.3%) thought that they had to pay for the antenatal care services. Two hundred thirteen (53.3%) reported that they did not have any problem with their current pregnancy and so they saw no reason to come early for antenatal care, even though some of these knew the right gestation age at which they should make their first antenatal care visit. Conclusion Pregnant women who come late for antenatal care in Mulago hospital, Uganda are not well-informed about the right gestation age at which they should make their first antenatal care visit and/or of the importance of early attendance at antenatal care. PMID:23706142

2013-01-01

30

A qualitative study of women's experiences of communication in antenatal care: identifying areas for action.  

PubMed

To identify key features of communication across antenatal (prenatal) care that are evaluated positively or negatively by service users. Focus groups and semi-structured interviews were used to explore communication experiences of thirty pregnant women from diverse social and ethnic backgrounds affiliated to a large London hospital. Data were analysed using thematic analysis. Women reported a wide diversity of experiences. From the users' perspective, constructive communication on the part of health care providers was characterised by an empathic conversational style, openness to questions, allowing sufficient time to talk through any concerns, and pro-active contact by providers (e.g. text message appointment reminders). These features created reassurance, facilitated information exchange, improved appointment attendance and fostered tolerance in stressful situations. Salient features of poor communication were a lack of information provision, especially about the overall arrangement and the purpose of antenatal care, insufficient discussion about possible problems with the pregnancy and discourteous styles of interaction. Poor communication led some women to become assertive to address their needs; others became reluctant to actively engage with providers. General Practitioners need to be better integrated into antenatal care, more information should be provided about the pattern and purpose of the care women receive during pregnancy, and new technologies should be used to facilitate interactions between women and their healthcare providers. Providers require communications training to encourage empathic interactions that promote constructive provider-user relationships and encourage women to engage effectively and access the care they need. PMID:19554436

Raine, Rosalind; Cartwright, Martin; Richens, Yana; Mahamed, Zuhura; Smith, Debbie

2010-07-01

31

Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.  

PubMed Central

One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I. PMID:6091843

Mabey, D C; Lloyd-Evans, N E; Conteh, S; Forsey, T

1984-01-01

32

Male Antenatal Attendance and HIV Testing Are Associated with Decreased Infant HIV Infection and Increased HIV Free Survival  

PubMed Central

Objective To investigate the relationship between male involvement in prevention of mother-to-child HIV transmission (PMTCT) services and infant HIV acquisition and mortality a prospective cohort study was undertaken between 1999 and 2005 in Nairobi, Kenya. Methods HIV-infected pregnant women were enrolled and followed with their infants for 1 year with infant HIV DNA testing at birth, 1, 3, 6, 9 and 12 months postpartum. Women were encouraged to invite male partners for prevention counseling and HIV testing. Findings Among 456 female participants, 140 (31%) partners attended the antenatal clinic. Eighty-two (19%) of 441 infants tested were HIV infected by one year of age. Adjusting for maternal viral load, vertical transmission risk was lower among women with partner attendance compared to those without (Adjusted hazard ratio [aHR]=0.56, 95% CI 0.33–0.98; P=0.042) and among women reporting versus not reporting previous partner HIV testing (aHR=0.52, 95% CI 0.32–0.84; P=0.008). The combined risk of HIV acquisition or infant mortality was lower with male attendance (aHR=0.55, 95% CI 0.35–0.88; P=0.012) and report of prior male HIV testing (aHR=0.58, 95% CI 0.34–0.88; P=0.01) when adjusting for maternal viral load and breastfeeding. Conclusion Including men in antenatal PMTCT services with HIV testing may improve infant health outcomes. PMID:21084999

Aluisio, Adam; Richardson, Barbra A.; Bosire, Rose; John-Stewart, Grace; Mbori-Ngacha, Dorothy; Farquhar, Carey

2010-01-01

33

Antenatal depression and male gender preference in Asian women in the UK  

Microsoft Academic Search

Objectiveto identify the prevalence of antenatal depression among Asian women living in the UK in one antenatal clinic, and to investigate the possible association with a desire for a male child and other risk factors.

Navpreet Dhillon; Christine MacArthur

2010-01-01

34

Perception of pregnant women about antenatal care in a cottage hospital in Port Harcourt, Nigeria.  

PubMed

Antenatal care gives opportunity for care of women during pregnancy, prevention and treatment of diseases as well as behavioral change interventions. The perception of users about services influences service utilization. This study was performed to assess user satisfaction with antenatal care services at the centre and to identify constraints at service points. Women attending antenatal care at a cottage hospital In Nigeria were administered questionnaires to evaluate their satisfaction with services and their views about services at various points of care. Data analysis was made using Statistical Package for Social Science version 15.0. Statistical significance was set at P < 0.5. Four hundred correctly completed questionnaires were analysed. The mean age of the respondents was 29 years (SD of 4) and their parity ranged from 0 to 5 (mean 2.5 ± 1.9). The overall satisfaction with care was 94 % and it was highest (95.8 %) with health talks and least with medical consultations (64 %). Attributes valued at service points were educating nature of health talks, prompt attention, and friendly and polite staff. Reasons for dissatisfaction were unfriendly attitudes of staff and delay at service points. Additional care packages women would want were: more staff employed 61 (15.3 %), better organized services 34 (8.5 %) and routine ultrasound scans 25 (6.3 %). Women valued antenatal care and were highly satisfied with services received at the centre. Health education forums should be used to address issues with service delivery. Constraints at service points should be addressed to enhance better service delivery. PMID:23054423

Ekott, M I; Ovwigho, U; Ehigiegba, A; Fajola, A; Fakunle, B

2013-04-01

35

Seroprevalence of human immunodeficiency virus infection and its association with syphilis seropositivity among antenatal clinic attenders at Debretabor Rural Hospital, Ethiopia.  

PubMed

Sera collected for syphilis screening from pregnant women attending antenatal clinic at Debretabor rural hospital, north west Ethiopia were tested for HIV infection with the objective of assessing HIV prevalence and the relationship between syphilis and human immunodeficiency virus (HIV) seropositivity. A total of 270 pregnant women who visited antenatal clinics from June to September, 1994 were included in the study. Socio-demographic characteristics of the women were retrieved from antenatal care cards. Sera were screened for syphilis and HIV infection by VDRL and ELISA tests respectively. Twenty nine pregnant women (10.7%) were found to be HIV positive. Those living in other villages and rural towns appeared to have a low risk (odds ratio 0.3, 95% confidence interval 0.1-0.8) of acquiring HIV infection when compared to those living in Debretabor town. Women who were seropositive for syphilis were twice as likely to be positive for HIV. Prevention of HIV transmission to women and infants is a priority health and social concern. Prevention and early recognition and treatment of syphilis and other sexually transmitted diseases (STDs) will be important factors in the prevention and control of HIV transmission. PMID:7498045

Kidan, K G; Fantahun, M; Azeze, B

1995-09-01

36

Reduction in inequality in antenatal-care use and persistence of inequality in skilled birth attendance in the Philippines from 1993 to 2008  

PubMed Central

Objective To assess changes in the inequalities associated with maternal healthcare use according to economic status in the Philippines. Design An analysis of four population-based data sets that were conducted between 1993 and 2008. Setting Philippines. Participants Women aged 15–49?years who had a live-birth within 1?year in 1993 (n=1707), 1998 (n=1513), 2003 (n=1325) and 2008 (n=1209). Outcomes At least four visits of antenatal care, skilled birth attendance and delivery in a medical facility. Results The adjusted OR for antenatal-care use when comparing the highest wealth-index quintile with the lowest quintile declined from 1993 to 2008: 3.43 (95% CI 2.22 to 5.28) to 2.87 (95% CI 1.31 to 6.29). On the other hand, the adjusted OR for the other two outcome indicators by the wealth index widened from 1993 to 2008: 9.92 (95% CI 5.98 to 16.43) to 15.53 (95% CI 6.90 to 34.94) for skilled birth attendance and 7.74 (95% CI 4.22 to 14.21) to 16.00 (95% CI 7.99 to 32.02) for delivery in a medical facility. The concentration indices for maternal health utilisation in 1993 and 2008 were 0.19 and 0.09 for antenatal care; 0.26 and 0.24 for skilled birth attendance and 0.41 and 0.35 for delivery in a medical facility. Conclusions Over a 16-year period, gradients in antenatal-care use decreased and the high level of inequalities in skilled birth attendance and delivery in a medical facility persisted. The results showed a disproportionate use of institutional care at birth among disadvantaged Filipino women. PMID:23794551

Molina, Honey Faith; Nakamura, Keiko; Kizuki, Masashi; Seino, Kaoruko

2013-01-01

37

Women, forced caesareans and antenatal responsibilities.  

PubMed Central

In the UK in October 1992, Mrs S was forced to have a caesarean section despite her objections to such a procedure on religious grounds. The case once again called into question the obligations of women to the unborn, and also whether one person can be forced to undergo a medical procedure for the benefit of someone else. Re S, like the case of Angela Carder, is often discussed in terms of the conflict between maternal and fetal rights. This paper looks instead at our obligations to save life in general-whether or not we are pregnant- and at the obligations of mothers to their children-whether they are born or unborn. Drawing on Judith Jarvis Thomson's distinction, it argues that minimal decency informs the duties which are owed to strangers, but that parents can be expected to behave as Good Samaritans towards their children. Finally, it is argued that even if mothers are ethically obliged to consent to caesarean sections which will save the lives of their babies, this does not necessarily mean that others are at liberty, or even obliged, to proceed with such operations without their consent. PMID:8961116

Draper, H

1996-01-01

38

Pilot early intervention antenatal group program for pregnant women with anxiety and depression.  

PubMed

This study aims to examine the acceptability and effectiveness of an antenatal group intervention designed to reduce the severity of depression and anxiety symptoms and improve maternal attachment in pregnant women with current or emerging depression and anxiety. Women who participated in the program completed pre- and posttreatment measures of depression (Centre of Epidemiological Studies Depression Scale) and Edinburgh Postnatal Depression Scale), anxiety (State-Trait Anxiety Inventory) and maternal attachment (Condon Maternal Antenatal Attachment Scale). Participants also completed a satisfaction questionnaire and provided general feedback about the group intervention and experience. A total of 48 women (M?=?26 weeks of gestation) commenced and 37 (77 %) completed at least 80 % of the six session group intervention. Significant improvements with moderate to large effect sizes were observed for depression as measured on the Centre of Epidemiological Studies Depression Scale (CES-D) (p?attendance had improved their awareness of their partner's mental health issues and resources available to their family and would recommend the program to other fathers. These preliminary findings suggest that our antenatal group program is an effective and acceptable intervention for a clinical sample of women and partners. It is a feasible addition or alternative treatment option to perinatal mental health care. Future directions could involve more comprehensive randomised controlled trials (RCT) to examine the effectiveness of the group intervention. PMID:25074561

Thomas, Naomi; Komiti, Angela; Judd, Fiona

2014-12-01

39

Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies  

PubMed Central

Background Almost 50% of women in low- and middle-income countries (LMICs) don't receive adequate antenatal care. Women's views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. Methods and Findings Using a predetermined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMICs who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line-of-argument synthesis. We derived policy-relevant hypotheses from the findings. We included 21 papers representing the views of more than 1,230 women from 15 countries. Three key themes were identified: “pregnancy as socially risky and physiologically healthy”, “resource use and survival in conditions of extreme poverty”, and “not getting it right the first time”. The line-of-argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralised, risk-focused antenatal care programmes may be at odds with the resources, beliefs, and experiences of pregnant women who underuse antenatal services. Conclusions Our findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in LMICs. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences is likely to be underused, especially when attendance generates increased personal risks of lost family resources or physical danger during travel, when the promised care is not delivered because of resource constraints, and when women experience covert or overt abuse in care settings. Please see later in the article for the Editors' Summary PMID:23349622

Finlayson, Kenneth; Downe, Soo

2013-01-01

40

Rubella antibody status of patients attending a south-west London antenatal clinic, 2007-2012.  

PubMed

Mass vaccination with the measles-mumps-rubella (MMR) vaccine for children aged 12-15 months was introduced in 1988; schoolgirl vaccination was discontinued in 1996 and replaced by a second dose of MMR for preschool children and post-partum vaccination of susceptible women identified through antenatal testing. In the UK, declining uptake rates due to concerns about the MMR vaccine, and increasing numbers of cases in some European countries where rubella surveillance and preconceptional vaccination are inadequate, coupled with poor uptake rates, has started to show in the number of rubella-susceptible patients presenting at antenatal clinics (ANCs). In this study, samples were collected in serum separator tubes at the West Middlesex University Hospital (WMUH) ANC and sent to the laboratory. Rubella status was determined using a third-generation rubella IgG enzyme immunoassay. Any negative results were retested and confirmed using an alternative method. The concentrations were expressed as iu/mL (World Health Organization [WHO] standard). Over a five-year period, the number of rubella-susceptible patients increased from 4.1% to 6.8% of the total number of specimens tested. The current population susceptibility levels seem to be influenced by a number of factors: the target population, age at vaccination and the level of coverage, and exposure to wild virus. PMID:25265756

Mortlock, S; Farthing, S

2014-01-01

41

Antenatal care visit attendance, intermittent preventive treatment during pregnancy (IPTp) and malaria parasitaemia at delivery  

PubMed Central

Background The determinants and barriers for delivery and uptake of IPTp vary with different regions in sub-Saharan Africa. This study evaluated the determinants of ANC clinic attendance and IPTp-SP uptake among parturient women from Mount Cameroon Area and hypothesized that time of first ANC clinic attendance could influence uptake of IPTp-SP/dosage and consequently malaria parasite infection status at delivery. Methods Two cross sectional surveys were carried out at the Government Medical Centre in the Mutengene Health Area, Mt Cameroon Area from March to October 2007 and June 2008 to April 2009. Consented parturient women were consecutively enrolled in both surveys. In 2007, socio-demographic data, ANC clinic attendance, gestational age, fever history and reported use/dosage of IPTp-SP were documented using a structured questionnaire. In the second survey only IPT-SP usage/dosage was recorded. Malaria parasitaemia at delivery was determined by blood smear microscopy and placental histology. Results and discussion In 2007, among the 287 women interviewed, 2.2%, 59.7%, and 38.1% enrolled in the first, second and third trimester respectively. About 90% of women received at least one dose SP but only 53% received the two doses in 2007 and by 2009 IPTp-two doses coverage increased to 64%. Early clinic attendance was associated (P?=?0.016) with fever history while being unmarried (OR?=?2.2; 95% CI: 1.3-3.8) was significantly associated with fewer clinic visits (<4visits). Women who received one SP dose (OR?=?3.7; 95% CI: 2.0-6.8) were more likely not to have attended???4visits. A higher proportion (P?women with first visit during the third trimester received only one dose, meanwhile, those who had an early first ANC attendance were more likely (OR?=?0.4; 95% CI?=?0.2 - 0.7) to receive two or more doses. Microscopic parasitaemia at delivery was frequent (P?=?0.007) among women who enrolled in the third trimester and had received only one SP dose than in those with two doses. Conclusion In the study area, late first ANC clinic enrolment and fewer clinic visits may prevent the uptake of two SP doses and education on early and regular ANC clinic visits can increase IPTp coverage. PMID:24779545

2014-01-01

42

Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda  

PubMed Central

Background Maternal morbidity and mortality remains high in Uganda; largely due to inadequate antenatal care (ANC), low skilled deliveries and poor quality of other maternal health services. In order to address both the demand and quality of ANC and skilled deliveries, we introduced community mobilization and health facility capacity strengthening interventions. Methods Interventions were introduced between January 2010 and September 2011. These included: training health workers, provision of medical supplies, community mobilization using village health teams, music dance and drama groups and male partner access clubs. These activities were implemented at Kitgum Matidi health center III and its catchment area. Routinely collected health facility data on selected outcomes in the year preceding the interventions and after 21 months of implementation of the interventions was reviewed. Trend analysis was performed using excel and statistical significance testing was performed using EPINFO StatCal option. Results The number of pregnant women attending the first ANC visit significantly increased from 114 to 150 in the first and fourth quarter of 2010 (OR 1.72; 95% CI 1.39–2.12) and to 202 in the third quarter of 2011(OR 11.41; 95% CI 7.97–16.34). The number of pregnant women counselled, tested and given results for HIV during the first ANC attendance significantly rose from 92 (80.7%) to 146 (97.3%) in the first and fourth quarter of 2010 and then to 201 (99.5%) in the third quarter of 2011. The number of male partners counseled, tested and given results together with their wives at first ANC visit rose from 13 (16.7%) in the fourth quarter of 2009 to 130 (89%) in the fourth quarter of 2010 and to 180 (89.6%) in the third quarter of 2011. There was a significant rise in the number of pregnant women delivering in the health facility with provision of mama-kits (delivery kits), from 74 (55.2%) to 149 (99.3%) in the second and fourth quarter of 2010. Conclusions Combined community and facility systems strengthening interventions led to increased first ANC visits by women and their partners, and health facility deliveries. Interventions aimed at increasing uptake of maternal health services should address both the demand and availability of quality services. PMID:24134717

2013-01-01

43

Do Sociodemographic Characteristics of Pregnant Women Determine their Perception of Antenatal Care Quality?  

Microsoft Academic Search

Objectives To explore sociodemographic determinants of perceived quality of antenatal care (ANC) at the primary care level. Methods A survey of 452 randomly selected pregnant women accessing antenatal care at the primary healthcare facilities in Sagamu\\u000a Local Government Area (LGA) of Ogun State, southwest Nigeria. The relationships between 13 sociodemographic characteristics\\u000a of women and their overall perception of the quality

Olufemi T. Oladapo; Modinat O. Osiberu

2009-01-01

44

Use of antenatal services and delivery care among women in rural western Kenya: a community based survey  

Microsoft Academic Search

BACKGROUND: Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. METHODS: Population-based cross-sectional survey among women who had recently delivered. RESULTS: Of 635 participants, 90% visited the antenatal clinic (ANC) at least once during

Eijk M. van Anna; Bles M. Hanneke; Frank Odhiambo; Ayisi G. John; Blokland E. Ilse; Rosen H. Daniel; Kubaje Adazu; Laurence Slutsker; Lindblade A. Kim

2006-01-01

45

Urethritis in women attending an STD clinic  

Microsoft Academic Search

Of an unselected group of 159 women attending a sexually transmitted diseases (STD) clinic 20% (32) had symptoms of urethritis. A positive correlation existed between the finding of more than 10 polymorphonuclear leucocytes (PMNL) per high-power field in the Gram-stained urethral smear and the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis. Conversely, these organisms were rarely isolated if

J E Wallin; S E Thompson; A Zaidi; K H Wong

1981-01-01

46

Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis  

PubMed Central

Background Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya. Methods Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. ?2 test and Student’s t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, <4, ?4) on knowledge and practice scores, adjusting for maternal socio-demographic confounders, such as age, gestational age, education level and household wealth index. Results Among the 979 pregnant women in the survey, 59% had attended ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge. Conclusions Substantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices. PMID:23845074

2013-01-01

47

Competing Knowledge Claims in the Provision of Antenatal Care: A Qualitative Study of Traditional Birth Attendants in Rural Zimbabwe  

Microsoft Academic Search

In this article we examine the role of traditional birth attendants (TBAs) in their care of women during pregnancy and childbirth, and highlight their views on the training they receive and the application of knowledge they gain. We also discuss the ways women and men reason around the practices of TBAs. Data were generated using focus group discussions and individual

Thubelihle Mathole; Gunilla Lindmark; Beth Maina Ahlberg

2005-01-01

48

Factors Associated with Antenatal Care Utilization Among Rural Women in Lao People’s Democratic Republic  

Microsoft Academic Search

This study aims at exploring factors related to the antenatal care (ANC) utilization in rural areas of Lao PDR. A quantitative,\\u000a cross-sectional interview study was conducted in the Khammouane and Champasack provinces. The study population comprised all\\u000a currently pregnant women 15–45 years of age with a gestational period beyond 32 weeks plus all women who had given birth during\\u000a the last 12 months.

C. Manithip; A. Sihavong; K. Edin; R. Wahlstrom; H. Wessel

49

Intimate partner violence affects skilled attendance at most recent delivery among women in Kenya.  

PubMed

Delivery assistance by skilled health personnel is a key progress indicator for Millennium Development Goal 5, which aims to reduce the worldwide maternal mortality ratio by 75% between 1990 and 2015. The role of socio-demographic factors in determining skilled attendance at delivery has been widely explored, but relatively little attention has been paid to the effect of gender power relations on delivery care. This analysis investigated whether women's status in the household, as measured by their experience of intimate partner violence (IPV), affected skilled attendance at most recent delivery among women in Kenya. Cross-sectional data were obtained from the 2003 Kenya Demographic and Health Surveys (KDHS). 975 ever-married women who had given birth in the past year and completed the KDHS domestic violence module were included in the analysis. Logistic regression was used to assess the association between skilled attendance and IPV. In this sample, 46% reported having experienced any type of IPV, with 39% reporting physical violence, 21% emotional violence, and 13% sexual violence. After adjusting for demographic characteristics and number of antenatal visits, lifetime experience of emotional violence was found to decrease the odds of skilled attendance at most recent delivery by 40%, while lifetime experience of physical violence reduced the odds by 29%. Women's experience of IPV may influence receipt of skilled attendance during parturition, and should be addressed as national programs and their international partners align efforts to contribute to the achievement of Millennium Development Goal 5. PMID:21688110

Goo, Leslie; Harlow, Siobán D

2012-07-01

50

Antenatal Depressive Symptomatology, Family Conflict and Social Support Among Chengdu Chinese Women  

Microsoft Academic Search

To investigate the association between demo-socio-economic status, obstetric variables, family conflict, social support and\\u000a antenatal depressive symptoms among 1,609 Chinese women from four regional public hospitals during their second trimester\\u000a of pregnancy in Chengdu. The vulnerable factors of depressive symptoms were explored in terms of their demo-socio-economic,\\u000a obstetric, and Chinese family relational aspects, as well as in terms of social

Ying Lau; Lei Yin; Yuqiong Wang

51

Routine antenatal HIV testing: the responses and perceptions of pregnant women and the viability of informed consent. A qualitative study  

Microsoft Academic Search

This qualitative cross-sectional survey, undertaken in the antenatal booking clinics of a hospital in central London, explores pregnant women’s responses to routine HIV testing, examines their reasons for declining or accepting the test, and assesses how far their responses fulfil standard criteria for informed consent. Of the 32 women interviewed, only 10 participants were prepared for HIV testing at their

Paquita de Zulueta; Mary Boulton

2007-01-01

52

Women who decline antenatal screening for HIV infection in the era of universal testing: results of an audit of uptake in three London hospitals.  

PubMed

Universal screening for HIV in early pregnancy is strongly promoted policy in the United Kingdom with a target of 90 per cent uptake. We identified characteristics of women declining screening by conducting an audit at three hospitals in inner north London. In early 2002 midwives were asked to complete an audit form following first antenatal appointment. Of 2,710 women attending 401 (15 per cent) declined an HIV test. Of women who declined 38 per cent reported they had been tested for HIV in the past; 65 per cent accepted every other antenatal test. In multivariable analysis parity (OR: 1.19; 95 per cent CI 1.10-1.29 per additional child), declining other tests (OR: 3.10; 95 per cent CI 2.44-3.93 per test declined) and previous HIV testing (OR: 1.70; 95 per cent CI 1.30-2.23) were predictors of declining an HIV test. Women declining screening were not obviously from high-risk demographic groups: women from sub-Saharan Africa were not at greater risk of declining an HIV test than women from other regions. PMID:15637109

Conaty, S J; Cassell, J A; Harrisson, U; Whyte, P; Sherr, L; Fox, Z

2005-03-01

53

The impact of social factors on attendance at antenatal care services and the subsequent effect on mothers’ health, measured during the years of economic transition in Latvia  

Microsoft Academic Search

The goal of the study is to evaluate the risk factors having an impact on attendance at antenatal care services in Latvia\\u000a during the years of economic transition as well as the impact of those factors on mothers and newborns’ health. Based on Latvian\\u000a statistical data and published surveys, we analysed the possible impact of social and economic factors on

Dace Rezeberga; Gunta Lazdane; Gilbert G. G. Donders

2007-01-01

54

Antenatal corticosteroids impact the inflammatory rather than the antiangiogenic profile of women with preeclampsia.  

PubMed

Circulating antiangiogenic factors and proinflammatory cytokines are implicated in the pathogenesis of preeclampsia. This study was performed to test the hypothesis that steroids modify the balance of inflammatory and proangiogenic and antiangiogenic factors that potentially contribute to the patient's evolving clinical state. Seventy singleton women, admitted for antenatal corticosteroid treatment, were enrolled prospectively. The study group consisted of 45 hypertensive women: chronic hypertension (n=6), severe preeclampsia (n=32), and superimposed preeclampsia (n=7). Normotensive women with shortened cervix (<2.5 cm) served as controls (n=25). Maternal blood samples of preeclampsia cases were obtained before steroids and then serially up until delivery. A clinical severity score was designed to clinically monitor disease progression. Serum levels of angiogenic factors (soluble fms-like tyrosine kinase-1 [sFlt-1], placental growth factor [PlGF], soluble endoglin [sEng]), endothelin-1 (ET-1), and proinflammatory markers (IL-6, C-reactive protein [CRP]) were assessed before and after steroids. Soluble IL-2 receptor (sIL-2R) and total immunoglobulins (IgG) were measured as markers of T- and B-cell activation, respectively. Steroid treatment coincided with a transient improvement in clinical manifestations of preeclampsia. A significant decrease in IL-6 and CRP was observed although levels of sIL-2R and IgG remained unchanged. Antenatal corticosteroids did not influence the levels of angiogenic factors but ET-1 levels registered a short-lived increase poststeroids. Although a reduction in specific inflammatory mediators in response to antenatal steroids may account for the transient improvement in clinical signs of preeclampsia, inflammation is unlikely to be the major contributor to severe preeclampsia or useful for therapeutic targeting. PMID:24664292

Nayeri, Unzila A; Buhimschi, Irina A; Laky, Christine A; Cross, Sarah N; Duzyj, Christina M; Ramma, Wenda; Sibai, Baha M; Funai, Edmund F; Ahmed, Asif; Buhimschi, Catalin S

2014-06-01

55

Knowledge and Attitude of Nigerian Pregnant Women towards Antenatal Exercise: A Cross-Sectional Survey.  

PubMed

Background. Engagement in physical exercise in pregnancy is hamstrung by safety concerns, skepticism about usefulness, and limited individualized prescription guidelines. This study assessed knowledge and attitude of pregnant women towards antenatal exercises (ANEx). Methods. The cross-sectional study recruited 189 pregnant women from six selected antenatal clinics in Ile-Ife, South-West, Nigeria. Data were obtained on maternal characteristics, knowledge, and attitude towards ANEx. Results. Relaxation and breathing (59.8%), back care (51.3%), and muscle strengthening (51.3%) exercises were the most commonly known ANEx. Prevention of back pain risk (75.9%) and excess weight gain (69.1%) were perceived as benefits, while lower extremities swelling (31.8%) and extreme weight gain or loss (30.7%) were considered as contraindications to ANEx. 15.8% of the respondents had negative attitude towards ANEx resulting from insufficient information on exercise (83.3%) and tiredness (70.0%). Age significantly influences knowledge about contraindications to ANEx (P = 0.001), while attitude was influenced by age and occupation, respectively (P < 0.05). There was significant association between attitude and knowledge about benefits and contraindications to ANEx (P < 0.05). Conclusion. A majority of Nigerian pregnant women demonstrated inadequate knowledge but had positive attitude towards ANEx. Knowledge about benefits and contraindications to ANEx significantly influenced the attitude towards exercise in pregnancy. PMID:25006478

Mbada, Chidozie E; Adebayo, Olubukayomi E; Adeyemi, Adebanjo B; Arije, Olujide O; Dada, Olumide O; Akinwande, Olabisi A; Awotidebe, Taofeek O; Alonge, Ibidun A

2014-01-01

56

Knowledge and Attitude of Nigerian Pregnant Women towards Antenatal Exercise: A Cross-Sectional Survey  

PubMed Central

Background. Engagement in physical exercise in pregnancy is hamstrung by safety concerns, skepticism about usefulness, and limited individualized prescription guidelines. This study assessed knowledge and attitude of pregnant women towards antenatal exercises (ANEx). Methods. The cross-sectional study recruited 189 pregnant women from six selected antenatal clinics in Ile-Ife, South-West, Nigeria. Data were obtained on maternal characteristics, knowledge, and attitude towards ANEx. Results. Relaxation and breathing (59.8%), back care (51.3%), and muscle strengthening (51.3%) exercises were the most commonly known ANEx. Prevention of back pain risk (75.9%) and excess weight gain (69.1%) were perceived as benefits, while lower extremities swelling (31.8%) and extreme weight gain or loss (30.7%) were considered as contraindications to ANEx. 15.8% of the respondents had negative attitude towards ANEx resulting from insufficient information on exercise (83.3%) and tiredness (70.0%). Age significantly influences knowledge about contraindications to ANEx (P = 0.001), while attitude was influenced by age and occupation, respectively (P < 0.05). There was significant association between attitude and knowledge about benefits and contraindications to ANEx (P < 0.05). Conclusion. A majority of Nigerian pregnant women demonstrated inadequate knowledge but had positive attitude towards ANEx. Knowledge about benefits and contraindications to ANEx significantly influenced the attitude towards exercise in pregnancy. PMID:25006478

Mbada, Chidozie E.; Adebayo, Olubukayomi E.; Adeyemi, Adebanjo B.; Arije, Olujide O.; Dada, Olumide O.; Akinwande, Olabisi A.; Awotidebe, Taofeek O.; Alonge, Ibidun A.

2014-01-01

57

Men's Role in Women's Antenatal Health Status: Evidence From Rural Rajshahi, Bangladesh.  

PubMed

This study aimed to extend notions of men's role in women's antenatal care (ANC) status in rural Rajshahi, Bangladesh. The analyses were based on response of 480 men aged 15 to 54 years, living with at least 1 child younger than 3 years. Only 27% men accompanied their wives for ANC. Men's perception of actual roles for ANC services was low: 63% approved of women undergoing checkups; 33% discussed their wives' pregnancy with health professionals. Only 18% scored highly on the overall index of knowledge. From multivariate analysis, it was found that the number of men accompanying their wives for ANC was higher among those respondents who were married for the first time in the age-group 25 to 34 years and aged 35 years or more, had their last child at age-group 20 to 24 years or 25 to 34 years, had completed primary or secondary and higher education, and had mass media facilities. PMID:22426562

Rahman, Mosiur; Islam, Mohammad Touhidul; Mostofa, Md Golam; Reza, Md Shahin

2012-03-16

58

Predictors of women's attendance at cardiac rehabilitation programs.  

PubMed

This descriptive study was conducted to identify the factors that influence womens attendance at cardiac rehabilitation programs and womens adherence to risk factor modification following a cardiac event. Women (N=196) admitted to hospital for a cardiac event were followed-up at 12 weeks postdischarge. Despite eligibility, only 64% (n=112) had been referred to cardiac rehabilitation programs. By 12 weeks postdischarge only 32% of the total sample (n=57) attended programs and 12% of the total sample (n=21) had dropped out before completion. The odds of a woman attending cardiac rehabilitation were decreased by myocardial infarction diagnosis, lack of employment, <55 years or >70 years, and experiencing a personal stressful event during follow-up. Women were likely to adhere to smoking, medication, and stress modification guidelines but unlikely to adhere to modification guidelines for diet and exercise. PMID:12893973

Gallagher, Robyn; McKinley, Sharon; Dracup, Kathleen

2003-01-01

59

Neurodevelopmental outcome for offspring of women treated for antenatal depression: a systematic review.  

PubMed

The aim of this systematic review is to appraise existing literature on the effects of treatments for antenatal depression on the neurodevelopment outcomes of the offspring. We conducted a systematic review of the literature to identify studies on different kinds of treatments for antenatal depression (antidepressants and alternative therapies) and their effects on infants' neurodevelopment. After reading the title, abstract, or full text and applying exclusion criteria, a total of 22 papers were selected. Nineteen papers studied the effects of antidepressant drugs, one on docosahexanoic acid (DHA) (fish oil capsules) and two on massage therapy; however, no studies used a randomized controlled design, and in most studies, the control group comprise healthy women not exposed to depression. Comparisons between newborns exposed to antidepressants in utero with those not exposed showed significant differences in a wide range of neurobehavioral outcomes, although in many cases, these symptoms were transient. Two studies found a slight delay in psychomotor development, and one study found a delay in mental development. Alternative therapies may have some benefits on neurodevelopmental outcomes. Our review suggests that antidepressant treatment may be associated with some neurodevelopmental changes, but we cannot exclude that some of these effects may be due to depression per se. PMID:25212663

Previti, Giovanni; Pawlby, Susan; Chowdhury, Sahmina; Aguglia, Eugenio; Pariante, Carmine M

2014-12-01

60

Dieting behavior of Asian college women attending a US university.  

PubMed

Dieting behavior, body dissatisfaction, self-esteem, and food intake of 73 Asian women attending a US university were investigated and compared retrospectively with attitudes of 247 US-born female students at the same university. The Asian women reported restrained eating and body dissatisfaction only about half as often as the US women did. In both the Asian and US college women, body dissatisfaction scores were significantly correlated to body mass index and self-esteem scores. Fourteen percent of the Asian women in the restrained eating/body dissatisfied group, and 40% of the US students in that group reported intentional vomiting for weight control. Some of the Asian international students practiced undesirable dieting behaviors and reported body dissatisfaction levels similar to those of many US college women. College health professionals should recognize that disordered eating among Asian women must not be overlooked because of stereotypical perceptions about Asian women's body size and type. PMID:9519578

Tsai, C Y; Hoerr, S L; Song, W O

1998-01-01

61

Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina  

PubMed Central

Background The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina) are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country. Methods Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries. Results Three areas are particularly addressed in this paper: a) concepts about pregnancy and health care, b) experience with health services and health providers, and c) opinions about the modified Antenatal Care (ANC) programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period. Conclusion Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes. PMID:12756055

Nigenda, Gustavo; Langer, Ana; Kuchaisit, Chusri; Romero, Mariana; Rojas, Georgina; Al-Osimy, Muneera; Villar, Jose; Garcia, Jo; Al-Mazrou, Yagob; Ba'aqeel, Hassan; Carroli, Guillermo; Farnot, Ubaldo; Lumbiganon, Pisake; Belizan, Jose; Bergsjo, Per; Bakketeig, Leiv; Lindmark, Gunilla

2003-01-01

62

Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study.  

PubMed

Depression during pregnancy is a significant public health problem because of its negative effects on the health of both mother and infant. Data on its prevalence and determinants are lacking in Bangladesh. To estimate the prevalence of depression during pregnancy and to identify potential contributory factors among rural Bangladeshi women, a community-based study was conducted during 2005 in Matlab sub-district, a rural area of eastern Bangladesh. Three hundred and sixty-one pregnant women were identified through an existing health and demographic surveillance system covering a population of 110,000 people. The women were interviewed at home at 34-35 weeks of pregnancy. Information on risk factors was collected through structured questionnaires, with the Bangla version of the Edinburgh Postnatal Depression Scale (EPDS-B) used to measure their psychological status. Both univariate analysis and multivariate logistic regression were applied using the SPSS 15.0 statistical software. The prevalence of depression at 34-35 weeks pregnancy was 33% (95% CI, 27.6-37.5). After adjustment in a multivariate logistic regression model, a history of being beaten by her husband either during or before the current pregnancy had the highest association with depression followed by having an unhelpful or unsupportive mother-in-law or husband, and family preference for a male child. Of the antenatally depressed women, 17 (14%) admitted to thoughts of self-harm during the pregnancy. This paper further explores the reasons why women have considered some form of self-harm during pregnancy. Depression during pregnancy is common among Bangladeshi women, with about a third being affected. The study highlights the need to allocate resources and develop strategies to address depression in pregnancy. PMID:19468825

Gausia, Kaniz; Fisher, Colleen; Ali, Mohammed; Oosthuizen, Jacques

2009-10-01

63

Self-medication by women attending a genitourinary medicine clinic.  

PubMed

A questionnaire was completed by 103 symptomatic women attending a busy, walk-in genitourinary medicine clinic in London before seeing a doctor. This questionnaire asked about the patients' own diagnosis of symptoms, previous remedies and their source. The answers were compared to their past history and current diagnosis. Of symptomatic women 56% had used a self-administered remedy prior to attending the clinic. This was significantly associated with a history of a previous episode of genital infection which had produced similar symptoms to the current problem. Forty-three percent of those who used self-medication reported some improvement in symptoms and more than 50% tolerated longer than 10 days of symptoms before attending the clinic. PMID:2088538

Russell, J M; Barton, S E; Lawrence, A G

1990-07-01

64

Factors Associated with Women's Antenatal Plans to Use a Baby Walker: A Cross Sectional Study  

ERIC Educational Resources Information Center

Objective: The objective of these analyses was to explore maternal antenatal decisions about baby walker use, factors associated with these decisions and the relationship between antenatal plans to use a walker and postnatal walker use. Design: Cross sectional study. Setting: Mothers-to-be (n = 1174) participating in a cluster randomised…

Illingworth, Rachel; Kendrick, Denise; Collier, Jacqueline; Woods, Amanda; Wattse, Kim; Dewey, Michael; Chen, Chih-Mei

2006-01-01

65

Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.  

PubMed

Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies. PMID:23440491

Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

2014-01-01

66

Gestational Nightblindness among Women Attending a Public Maternity Hospital in Rio de Janeiro, Brazil  

Microsoft Academic Search

This study evaluated the prevalence of gestational nightblindness among postpartum women seen at the University Maternal Hospital of the Federal University in Rio de Janeiro, Brazil and the association of this symptom with a biochemical indicator (serum retinol levels) and sociodemographic, anthro- pometric and antenatal care variables. In total, 262 postpartum women, who did not receive vitamin A supplementation during

Cláudia Saunders; Maria do Carmo Leal; Mirian Martins Gomes; Luciana Ferreira Campos; Bianca Amaral; Ana Paula Pereira; Thiapó de Lima; Rejane Andréa Ramalho

2004-01-01

67

Black, White and Hispanic Women: Differences in College Attendance, Does the Rate of Return Matter?  

Microsoft Academic Search

In this paper, we focus our attention on the college attendance decisions of women by race and specifically whether they respond to the rate of return. Our results suggest that Hispanic women increase the probability of college attendance if they are faced with higher rates of return, as do white women when regional variation is considered. Black women do not

Michele C. McLennan; Susan L. Averett

68

Making friends at antenatal classes: a qualitative exploration of friendship across the transition to motherhood.  

PubMed

This study explored how friendships made at antenatal classes preserve new mothers' well-being, postnatally. Eight women from the United Kingdom who had attended antenatal classes in the third trimester were interviewed following the birth of their first baby. Transcripts were analyzed using a constant comparative method. Findings suggest that friendships made at antenatal classes are not only unique but also support women's mental health and enhance self-efficacy because the women give and gain reassurance that their babies are developing normally. Such friendships may reduce demands on overstretched social and health-care services. Childbirth educators, midwives, and nurses can be encouraged to capitalize on the opportunity provided by antenatal classes to facilitate the formation of friendships that can help mothers to find "a new equilibrium." PMID:23730129

Nolan, Mary L; Mason, Victoria; Snow, Sarah; Messenger, Wendy; Catling, Jonathon; Upton, Penney

2012-01-01

69

Spatial autocorrelation in uptake of antenatal care and relationship to individual, household and village-level factors: results from a community-based survey of pregnant women in six districts in western Kenya  

PubMed Central

Background The majority of maternal deaths, stillbirths, and neonatal deaths are concentrated in a few countries, many of which have weak health systems, poor access to health services, and low coverage of key health interventions. Early and consistent antenatal care (ANC) attendance could significantly reduce maternal and neonatal morbidity and mortality. Despite this, most Kenyan mothers initiate ANC care late in pregnancy and attend fewer than the recommended visits. Methods We used survey data from 6,200 pregnant women across six districts in western Kenya to understand demand-side factors related to use of ANC. Bayesian multi-level models were developed to explore the relative importance of individual, household and village-level factors in relation to ANC use. Results There is significant spatial autocorrelation of ANC attendance in three of the six districts and considerable heterogeneity in factors related to ANC use between districts. Working outside the home limited ANC attendance. Maternal age, the number of small children in the household, and ownership of livestock were important in some districts, but not all. Village proportions of pregnancy in women of child-bearing age was significantly correlated to ANC use in three of the six districts. Geographic distance to health facilities and the type of nearest facility was not correlated with ANC use. After incorporating individual, household and village-level covariates, no residual spatial autocorrelation remained in the outcome. Conclusions ANC attendance was consistently low across all the districts, but factors related to poor attendance varied. This heterogeneity is expected for an outcome that is highly influenced by socio-cultural values and local context. Interventions to improve use of ANC must be tailored to local context and should include explicit approaches to reach women who work outside the home. PMID:24314170

2013-01-01

70

Testing for the Endogenous Nature between Women's Empowerment and Antenatal Health Care Utilization: Evidence from a Cross-Sectional Study in Egypt  

PubMed Central

Women's relative lack of decision-making power and their unequal access to employment, finances, education, basic health care, and other resources are considered to be the root causes of their ill-health and that of their children. The main purpose of this paper is to examine the interactive relation between women's empowerment and the use of maternal health care. Two model specifications are tested. One assumes no correlation between empowerment and antenatal care while the second specification allows for correlation. Both the univariate and the recursive bivariate probit models are tested. The data used in this study is EDHS 2008. Factor Analysis Technique is also used to construct some of the explanatory variables such as the availability and quality of health services indicators. The findings show that women's empowerment and receiving regular antenatal care are simultaneously determined and the recursive bivariate probit is a better approximation to the relationship between them. Women's empowerment has significant and positive impact on receiving regular antenatal care. The availability and quality of health services do significantly increase the likelihood of receiving regular antenatal care. PMID:25140310

Hussein, Mohamed Ali

2014-01-01

71

Testing for the endogenous nature between women's empowerment and antenatal health care utilization: evidence from a cross-sectional study in Egypt.  

PubMed

Women's relative lack of decision-making power and their unequal access to employment, finances, education, basic health care, and other resources are considered to be the root causes of their ill-health and that of their children. The main purpose of this paper is to examine the interactive relation between women's empowerment and the use of maternal health care. Two model specifications are tested. One assumes no correlation between empowerment and antenatal care while the second specification allows for correlation. Both the univariate and the recursive bivariate probit models are tested. The data used in this study is EDHS 2008. Factor Analysis Technique is also used to construct some of the explanatory variables such as the availability and quality of health services indicators. The findings show that women's empowerment and receiving regular antenatal care are simultaneously determined and the recursive bivariate probit is a better approximation to the relationship between them. Women's empowerment has significant and positive impact on receiving regular antenatal care. The availability and quality of health services do significantly increase the likelihood of receiving regular antenatal care. PMID:25140310

Zaky, Hassan H M; Armanious, Dina M; Hussein, Mohamed Ali

2014-01-01

72

Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria  

PubMed Central

Background In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptions and utilization of traditional birth attendant (TBA) services in a rural Local Government Area (LGA) in Ogun State, southwest Nigeria. Methods A quantitative design was used to obtain information using a structured questionnaire from 250 pregnant women attending four randomly selected primary health care clinics in the LGA. Data were analyzed using Epi Info (v 3.5.1) statistical software. Results Almost half (48.8%) of the respondents were in the age group 26–35 years, with a mean age of 29.4 ± 7.33 years. About two-thirds (65.6%) of the respondents had been pregnant 2–4 times before. TBA functions, as identified by respondents, were: “taking normal delivery” (56.7%), “providing antenatal services” (16.5%), “performing caesarean section” (13.0%), “providing family planning services” (8.2%), and “performing gynaecological surgeries” (5.6%). About 6/10 (61.0%) respondents believed that TBAs have adequate knowledge and skills to care for them, however, approximately 7/10 (69.7%) respondents acknowledged that complications could arise from TBA care. Services obtained from TBAs were: routine antenatal care (81.1%), normal delivery (36.1%), “special maternal bath to ward off evil spirits” (1.9%), “concoctions for mothers to drink to make baby strong” (15.1%), and family planning services (1.9%). Reasons for using TBA services were: “TBA services are cheaper” (50.9%), “TBA services are more culturally acceptable in my environment” (34.0%), “TBA services are closer to my house than hospital services” (13.2%), “TBAs provide more compassionate care than orthodox health workers” (43.4%), and “TBA service is the only maternity service that I know” (1.9%). Approximately 8/10 (79.2%) of the users (past or current) opined that TBA services are effective but could be improved with some form of training (78.3%). More than three-quarters (77.1%) opposed the banning of TBA services. Almost 7/10 (74.8%) users were satisfied with TBA services. Conclusion Study findings revealed a positive perception and use of TBA services by the respondents. This underlines the necessity for TBAs’ knowledge and skills to be improved within permissible standards through sustained partnership between TBAs and health systems. It is hoped that such partnership will foster a healthy collaboration between providers of orthodox and traditional maternity services that will translate into improved maternal and neonatal health outcomes in relevant settings. PMID:22371657

Ebuehi, Olufunke M; Akintujoye, IA

2012-01-01

73

The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review  

Microsoft Academic Search

Background  Infant mortality has shown a steady decline in recent years but a marked socioeconomic gradient persists. Antenatal care is\\u000a generally thought to be an effective method of improving pregnancy outcomes, but the effectiveness of specific antenatal care\\u000a programmes as a means of reducing infant mortality in socioeconomically disadvantaged and vulnerable groups of women has not\\u000a been rigorously evaluated.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We conducted

Jennifer Hollowell; Laura Oakley; Jennifer J Kurinczuk; Peter Brocklehurst; Ron Gray

2011-01-01

74

Antenatal Depression in Anuradhapura, Sri Lanka and the Factor Structure of the Sinhalese Version of Edinburgh Post Partum Depression Scale among Pregnant Women  

PubMed Central

Background Mental health problems among women of reproductive age group contribute to 7% of Global Burden of Diseases of women of all ages. Purpose of this study was to determine the prevalence and correlates of antenatal depression among pregnant women in Anuradhapura, Sri Lanka, and to explore the factor structure of EPDS. Methods Pregnant women with gestational age of 24–36 weeks and residing in Anuradhapura district, Sri Lanka were recruited to the study using a two stage cluster sampling procedure. Sinhalese version of Edinburgh Post Partum Depression Scale (EPDS) and an interviewer administered questionnaire was use to collect data. A cut off value of 9 was used for the Sinhalese version of EPDS. Results A total of 376 pregnant women were studied. Median EPDS score among pregnant women was 5 (IQR 2–8). Prevalence of antenatal depression in this study sample was 16.2% (n?=?61). Thought of self harming (item number 10) was reported by 26 pregnant women (6.9%). None of the socio-demographic factors were associated with depression in this study sample. Having heart burn was significantly associated with depressive symptoms (p?=?0.041). Sri Lankan version of EPDS showed a two factor solution. Anxiety was not emerged as a separate factor in this analysis. Conclusions Prevalence of antenatal depression in Anuradhapura, Sri Lanka was relatively low. Anxiety was not emerged as a separate factor in the Sinhalese version of the EPDS. PMID:23922781

Agampodi, Suneth Buddhika; Agampodi, Thilini Chanchala

2013-01-01

75

Safety and efficacy of antenatal milk expressing for women with diabetes in pregnancy: protocol for a randomised controlled trial  

PubMed Central

Introduction Many maternity providers recommend that women with diabetes in pregnancy express and store breast milk in late pregnancy so breast milk is available after birth, given (1) infants of these women are at increased risk of hypoglycaemia in the first 24?h of life; and (2) the delay in lactogenesis II compared with women without diabetes that increases their infant's risk of receiving infant formula. The Diabetes and Antenatal Milk Expressing (DAME) trial will establish whether advising women with diabetes in pregnancy (pre-existing or gestational) to express breast milk from 36?weeks gestation increases the proportion of infants who require admission to special or neonatal intensive care units (SCN/NICU) compared with infants of women receiving standard care. Secondary outcomes include birth gestation, breastfeeding outcomes and economic impact. Methods and analysis Women will be recruited from 34?weeks gestation to a multicentre, two arm, unblinded randomised controlled trial. The intervention starts at 36?weeks. Randomisation will be stratified by site, parity and diabetes type. Women allocated to the intervention will be taught expressing and encouraged to hand express twice daily for 10?min and keep an expressing diary. The sample size of 658 (329 per group) will detect a 10% difference in proportion of babies admitted to SCN/NICU (85% power, ? 0.05). Data are collected at recruitment (structured questionnaire), after birth (abstracted from medical record blinded to group), and 2 and 12?weeks postpartum (telephone interview). Data analysis: the intervention group will be compared with the standard care group by intention to treat analysis, and the primary outcome compared using ?2 and ORs. Ethics and dissemination Research ethics approval will be obtained from participating sites. Results will be published in peer-reviewed journals and presented to clinicians, policymakers and study participants. Trial registration number Australian Controlled Trials Register ACTRN12611000217909. PMID:25358679

Forster, Della A; Jacobs, Susan; Amir, Lisa H; Davis, Peter; Walker, Susan P; McEgan, Kerri; Opie, Gillian; Donath, Susan M; Moorhead, Anita M; Ford, Rachael; McNamara, Catharine; Aylward, Amanda; Gold, Lisa

2014-01-01

76

Reduction in Preterm Delivery and Neonatal Mortality after the Introduction of Antenatal Cotrimoxazole Prophylaxis among HIV-Infected Women with Low CD4 Cell Counts  

PubMed Central

Background. Cotrimoxazole prophylaxis is recommended for subgroups of human immunodeficiency virus (HIV)-infected adults and children to reduce all-cause morbidity and mortality. We investigated whether antenatal cotrimoxazole prophylaxis begun during pregnancy for HIV-infected pregnant women with low CD4 cell counts would affect birth outcomes. Methods. Cotrimoxazole prophylaxis was introduced as a routine component of antenatal care for HIV-infected women with CD4 cell counts <200 cells/?L during the course of a trial of mother-to-child HIV transmission in Lusaka, Zambia. Rates of preterm delivery, low birth weight, and neonatal mortality were compared for women with low CD4 cell counts before and after its introduction. Results. Among 255 women with CD4 cell counts <200 cells/?L, the percentage of preterm births (?34 weeks of gestation) was lower (odds ratio [OR], 0.49 [95% confidence interval {CI}, 0.24-0.98]) after cotrimoxazole prophylaxis was introduced than before; there was a significant decrease in neonatal mortality (9% to 0%; P = .01) and a trend toward increased birth weight (? = 114 g [95% CI, -42 to 271 g]). In contrast, there were no significant changes in these parameters over the same time interval among women with CD4 cell counts ?200 cells/?L. Conclusion. Antenatal provision of cotrimoxazole for HIV-infected pregnant women with low CD4 cell counts may have indirect benefits for neonatal health. PMID:17083035

Walter, Jan; Mwiya, Mwiya; Scott, Nancy; Kasonde, Prisca; Sinkala, Moses; Kankasa, Chipepo; Kauchali, Shuaib; Aldrovandi, Grace M.; Thea, Donald M.; Kuhn, Louise

2006-01-01

77

Sentinel surveillance for HIV-1 infection: how representative are blood donors, outpatients with fever, anaemia, or sexually transmitted diseases, and antenatal clinic attenders in Mwanza Region, Tanzania?  

PubMed

When full-scale surveys of HIV-1 prevalence are not possible, sentinel surveillance is conducted at specific sites with specific population groups. In this study, 2 sentinel groups have been monitored since 1989 in the Mwanza region on the shores of Lake Victoria in Tanzania. The groups included blood donors in all hospitals of the region an prenatal clinic attenders in Mwanza Municipality. Also considered specifically for this study were outpatients from all 6 district hospitals (including 2 roadside hospitals) who had given blood samples. Population survey data on HIV prevalence between August 1990 and February 1991 were available for reference use. The sample included 1090 blood donors aged 15-54 years, 800 outpatients from district hospitals, and 1193 pregnant women attending a prenatal clinic. Blood donors (49%) were tested with enzyme immunosorbent assay (ELISA). Outpatients provided capillary blood samples collected on filter paper, of which 4605 samples were further tested with ELISA. 1866 were excluded because of age, inadequate samples, or missing data. The results of the comparison of HIV prevalence in the sentinel group and in the population survey showed that in both groups HIV-1 infection was more common in women, particularly those 15-34 years old, than in men, who were particularly affected in the 25-44 year old group. Blood donors, who were mostly male and related to the recipient, showed a crude HIV-1 prevalence of 6% (65 out of 1090). Rates were standardized, and standardized prevalence ratios were calculated. In the general population in both surveys, prevalence was 4.5%. Men had a higher prevalence in non-urban areas. Among outpatients with fever who gave blood for anemia, the crude prevalence was 9% (115 out of 1339). Prevalence was higher in the sentinel group. Of the 33 sexually transmitted diseases outpatients screened for syphilis, 33% (11) were seropositive. Prenatal clinic attenders had a HIV-prevalence of 12% (138 out of 1193). PMID:8507421

Borgdorff, M; Barongo, L; van Jaarsveld, E; Klokke, A; Senkoro, K; Newell, J; Nicoll, A; Mosha, F; Grosskurth, H; Swai, R

1993-04-01

78

Women's attitudes to and perceptions of oral health and dental care during pregnancy  

Microsoft Academic Search

Aims: To assess pregnant women's opinions on and percep- tions of oral health and their relationship to oral hygiene and dental care practices. Methods: Questionnaire survey on perceived oral health, oral hygiene and utilization of dental services among 649 nulliparae attending for antenatal care at all public antenatal clinics in Adelaide, South Australia. Results: Women rated their general health significantly

Marc J. N. C. Keirse; Kamila Plutzer

2010-01-01

79

Antenatal care and perinatal outcomes in Kwale district, Kenya  

PubMed Central

Background The importance of antenatal care (ANC) for improving perinatal outcomes is well established. However access to ANC in Kenya has hardly changed in the past 20 years. This study aims to identify the determinants of attending ANC and the association between attendance and behavioural and perinatal outcomes (live births and healthy birthweight) for women in the Kwale region of Kenya. Method A Cohort survey of 1,562 perinatal outcomes (response rate 100%) during 2004–05 in the catchment areas for five Ministry of Health dispensaries in two divisions of the Kwale region. The associations between background and behavioural decisions on ANC attendance and perinatal outcomes were explored using univariate analysis and multivariate logistic regression models with backwards-stepwise elimination. The outputs from these analyses were reported as odds ratios (OR) with 95% confidence intervals (CI). Results Only 32% (506/1,562) of women reported having any ANC. Women with secondary education or above (adjusted OR 1.83; 95% CI 1.06–3.15) were more likely to attend for ANC, while those living further than 5 km from a dispensary were less likely to attend (OR 0.29; 95% CI 0.22–0.39). Paradoxically, however, the number of ANC visits increased with distance from the dispensary (OR 1.46; 95% CI 1.33–1.60). Women attending ANC at least twice were more likely to have a live birth (vs. stillbirth) in both multivariate models. Women attending for two ANC visits (but not more than two) were more likely to have a healthy weight baby (OR 4.39; 95% CI 1.36–14.15). Conclusion The low attendance for ANC, combined with a positive relationship between attendance and perinatal outcomes for the women in the Kwale region highlight the need for further research to understand reasons for attendance and non-attendance and also for strategies to be put in place to improve attendance for ANC. PMID:18186921

Brown, Celia A; Sohani, Salim B; Khan, Khalid; Lilford, Richard; Mukhwana, Walter

2008-01-01

80

Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial  

PubMed Central

Background In 2001, the WHO Antenatal Care Trial (WHOACT) concluded that an antenatal care package of evidence-based screening, therapeutic interventions and education across four antenatal visits for low-risk women was not inferior to standard antenatal care and may reduce cost. However, an updated Cochrane review in 2010 identified an increased risk of perinatal mortality of borderline statistical significance in three cluster-randomized trials (including the WHOACT) in developing countries. We conducted a secondary analysis of the WHOACT data to determine the relationship between the reduced visits, goal-oriented antenatal care package and perinatal mortality. Methods Exploratory analyses were conducted to assess the effect of baseline risk and timing of perinatal death. Women were stratified by baseline risk to assess differences between intervention and control groups. We used linear modeling and Poisson regression to determine the relative risk of fetal death, neonatal death and perinatal mortality by gestational age. Results 12,568 women attended the 27 intervention clinics and 11,958 women attended the 26 control clinics. 6,160 women were high risk and 18,365 women were low risk. There were 161 fetal deaths (1.4%) in the intervention group compared to 119 fetal deaths in the control group (1.1%) with an increased overall adjusted relative risk of fetal death (Adjusted RR 1.27; 95% CI 1.03, 1.58). This was attributable to an increased relative risk of fetal death between 32 and 36 weeks of gestation (Adjusted RR 2.24; 95% CI 1.42, 3.53) which was statistically significant for high and low risk groups. Conclusion It is plausible the increased risk of fetal death between 32 and 36 weeks gestation could be due to reduced number of visits, however heterogeneity in study populations or differences in quality of care and timing of visits could also be playing a role. Monitoring maternal, fetal and neonatal outcomes when implementing antenatal care protocols is essential. Implementing reduced visit antenatal care packages demands careful monitoring of maternal and perinatal outcomes, especially fetal death. PMID:23577700

2013-01-01

81

Gap in the prevalence of neutralising antibodies to polioviruses in antenatal women in southern India  

Microsoft Academic Search

With the disappearance of circulating wild poliovirus and improved sanitation, protective antibody levels may wane over time following oral poliovirus vaccine (OPV) administration. This study evaluated the seroprevalence of neutralising antibodies to vaccine polioviruses among young Indian women who had received at least three doses of OPV as primary immunisation. Of 60 women studied, 27 (45%) had antibody titres of

Jacob John; Asha M. Abraham; Jayaprakash Muliyil; T. Jacob John; J. M. Deshpande; Gagandeep Kang

2011-01-01

82

Perception of quality of maternal healthcare services among women utilising antenatal services in selected primary health facilities in Anambra State, Southeast Nigeria  

PubMed Central

Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ?30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050

Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu

2014-01-01

83

Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai  

PubMed Central

Context: Depression affects about 20% of women during their lifetime, with pregnancy being a period of high vulnerability. Prevalence of depression during pregnancy ranges from 4% to 20%. Several risk factors predispose to depression during pregnancy including obstetric factors. Depression during pregnancy is not only the strongest risk factor for post-natal depression but also leads to adverse obstetric outcomes. Aims: To study the prevalence of depression during pregnancy and its associated obstetric risk factors among pregnant women attending routine antenatal checkup. Settings and Design: Cross-sectional observational survey done at the outpatient department (OPD) of the department of obstetrics of a tertiary care hospital in Navi Mumbai. Materials and Methods: One hundred and eighty-five pregnant women were randomly administered the Beck Depression Inventory (BDI) for detecting depression. Additional socio-demographic and obstetric history was recorded and analyzed. Results: Prevalence of depression during pregnancy was found to be 9.18% based upon BDI, and it was significantly associated with several obstetric risk factors like gravidity (P = 0.0092), unplanned pregnancy (P = 0.001), history of abortions (P = 0.0001), and a history of obstetric complications, both present (P = 0.0001) and past (P = 0.0001). Conclusions: Depression during pregnancy is prevalent among pregnant women in Navi-Mumbai, and several obstetric risk factors were associated to depression during pregnancy. Future research in this area is needed, which will clearly elucidate the potential long-term impact of depression during pregnancy and associated obstetric risk factors so as to help health professionals identify vulnerable groups for early detection, diagnosis, and providing effective interventions for depression during pregnancy. PMID:24459372

Ajinkya, Shaunak; Jadhav, Pradeep R.; Srivastava, Nimisha N.

2013-01-01

84

Use of antenatal care, maternity services, intermittent presumptive treatment and insecticide treated bed nets by pregnant women in Luwero district, Uganda  

Microsoft Academic Search

BACKGROUND: To reduce the intolerable burden of malaria in pregnancy, the Ministry of Health in Uganda improved the antenatal care package by including a strong commitment to increase distribution of insecticide-treated nets (ITNs) and introduction of intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP) as a national policy in 2000. This study assessed uptake of both ITNs and IPTp-SP

Mpungu S Kiwuwa; Patrobas Mufubenga

2008-01-01

85

The Prevalence of the Beta Thalassemia Trait among the Pregnant Women who attended the ANC Clinic in a PHC, by using the NESTROF Test in Bangalore, Karnataka  

PubMed Central

Contaxt: Every year in India 6000 to 8000 children are born with thalassaemia major. The birth of such a child produces considerable physical and economic strain on the affected child, its family and the community at large. Thus, the emphasis must shift from the treatment to the prevention of such births in the future. Aims: To find out the prevalence of the Beta Thalassaemia trait among the pregnant women who attended the antenatal clinics in a Primary Health Centre, by using the NESTROF test; to describe the socio-demographic characteristics of the study subjects, to find out the pregnancies which were ‘at risk’ of delivering babies with Thalassaemia major and to find out the ‘awareness’ of the pregnant women regarding Thalassaemia. Material and Methods: This exploratory study was conducted in a PHC which was attached to the Department of Community Medicine of a medical college which was situated in Bangalore, India, for a period of 3 months. All the pregnant women who attended the antenatal clinic and the husbands of the NESTROF positive women were included in the study. The details regarding the sociodemographic characteristics of the women were collected on a structured proforma and the NESTROF test was performed. Results: Out of the 210 pregnant women who were tested, 18 (8.5%) were thalassaemia carriers. 12 (66.6%) of them were between 20 – 25 years of age. 5 (27.7%) were born out of 2nd degree consanguineous marriages. 7 (38.8%) had a history of abortions, among which 6 (33.3%) were in the 1st trimesters of their pregnancies. Out of the 18 positive women, 9 (50%) had turned up with their husbands. All of the husbands were negative for the Thalassaemia carrier status. Thus, there was no pregnancy which was at a risk of delivering babies with thalassaemia major. None (100%) of the pregnant women were aware of the disease, thalassaemia. Conclusions: The prevalence of the Beta Thalassaemia trait among the pregnant women was 8.5%. PMID:23998078

Kulkarni, Praveen; Masthi, N R Ramesh; Niveditha, SR; Suvarna, R

2013-01-01

86

Urban ethnic minority women's attendance at health clinic vs. church based exercise programs.  

PubMed

Older, sedentary, urban-living, ethnic minority women are at high risk for preventable disease, but it is difficult to engage this population in health promotion efforts. This study tested two methods of engaging Hispanic and African American women, who were at high risk for cardiovascular disease, in a 10-week aerobic fitness program. The program was offered to 76 participants, in either a women's health clinic or a church. Attendance was the primary dependent variable and was recorded at each exercise session. Other variables, including the Baecke Questionnaire of Habitual Physical Activity, Fat Frequency Questionnaire, Self-Efficacy for Exercise Behaviors Scale, Social Support and Exercise Survey, and Psychological General Well-Being Schedule, were measured prior to the intervention, at the end of the 10-week program, and at 3-month follow-up. Age predicted attendance, independently of site. Women in the highest age quartile (50 - 70 years) attended more than twice as many exercise sessions compared to women in the lowest age quartile (17 - 27 years). The relationship between older age and attendance was particularly strong for Hispanic women. Church parishioners were primarily women over the age of 40, making it impossible to disentangle the relative effect of locale. These findings are relevant for clinicians who design exercise programs targeting older, ethnic, minority women. Administrators who design exercise programs for urban-living women should consider age of the target population when selecting the most conducive setting. PMID:17131182

Dornelas, Ellen A; Stepnowski, Roxanne R; Fischer, Edward H; Thompson, Paul D

2007-03-01

87

Effective Antenatal Education: Strategies Recommended by Expectant and New Parents  

PubMed Central

Antenatal education is a crucial component of antenatal care, yet practice and research demonstrate that women and men now seek far more than the traditional approach of a birth and parenting program attended in the final weeks of pregnancy. Indeed, women and men participating in this study recommended a range of strategies to be provided during the childbearing year, comparable to a “menu in a restaurant.” Their strategies included three program types: “Hearing Detail and Asking Questions,” “Learning and Discussing,” and “Sharing and Supporting Each Other.” The characteristics of each type of program are identified in this article. The actual learning methods the study participants recommended to be incorporated into the programs were “Time to Catch Up and Focus,” “Seeing and Hearing the Real Experience,” “Practicing,” and “Discovering.” PMID:19436529

Svensson, Jane; Barclay, Lesley; Cooke, Margaret

2008-01-01

88

Prevalence and determinants of genital shedding of herpes simplex virus among women attending Italian colposcopy clinics  

Microsoft Academic Search

Objectives: To determine the prevalence of herpes simplex virus (HSV) shedding among women attending Italian colposcopy clinics and describe their lifestyle, demographic characteristics, genital symptoms and signs. Study design: A cross-sectional study was performed to assess shedding of HSV among 4565 women requiring a gynecological consultation. An amplified enzyme immunoassay that detects an HSV type-common glycoprotein D was used to

Fausto Boselli; Giuseppe Chiossi; Marisa Bortolamasi; Andrea Gallinelli

2005-01-01

89

Widening Participation in Postgraduate Studies in Greece: Mature Working Women Attending an E-Learning Programme  

ERIC Educational Resources Information Center

This article examines issues relating to widening participation in postgraduate study programmes in Greece. It focuses on a group of mature women and examines their experiences from attending a novel postgraduate e-learning programme at the University of the Aegean. It presents findings from a study, which looked into mature women's decision to…

Vryonides, Marios; Vitsilakis, Chryssi

2008-01-01

90

Reported Frequency Of Domestic Violence: Cross Sectional Survey Of Women Attending General Practice  

Microsoft Academic Search

Objectives To determine exposure to violence by a partner or spouse among women attending general practice and its association with respondents' demographic and personal characteristics; frequency of inquiry about violence by general practitioners; and women's views on routine questioning about domestic violence by general practitioners. Design Cross sectional, self administered, anonymous survey. Setting 22 volunteer Irish general practices. Participants 1871

Fiona Bradley; Mary Smith; Jean Long; Tom O'Dowd

2002-01-01

91

Factors That Influence Women's Disclosures of Substance Use during Pregnancy: A Qualitative Study of Ten Midwives and Ten Pregnant Women  

Microsoft Academic Search

The present study was designed to examine the factors that motivate or act as barriers to disclosure of substance use by pregnant women. Participants included 10 midwives and 10 pregnant women who attended two ante-natal clinics at an Australian maternity hospital. One clinic specialized in women who were substance users and one clinic was specifically for young women (under 19

Diane Phillips; Kristina Thomas; Helen Cox; Lina A. Ricciardelli; Jan Ogle; Veronica Love; Angela Steele

2007-01-01

92

Women's social networks and birth attendant decisions: application of the network-episode model.  

PubMed

This paper examines the association of women's social networks with the use of skilled birth attendants in uncomplicated pregnancy and childbirth in Matlab, Bangladesh. The network-episode model was applied to determine if network structure variables (density/kinship homogeneity/strength of ties) together with network content (endorsement for or against a particular type of birth attendant) explain the type of birth attendant used by women above and beyond the variance explained by women's individual attributes. Data were collected by interviewing a representative sample of 246 women, 18-45 years of age, using survey and social network methods between October and December 2008. Logistic regression models were used to examine the associations. Results suggest that the structural properties of networks did not add to explanatory value but instead network content or the perceived advice of network members add significantly to the explanation of variation in service use. Testing aggregate network variables at the individual level extends the ability of the individual profile matrix to explain outcomes. Community health education and mobilization interventions attempting to increase demand for skilled attendants need to reflect the centrality of kinship networks to women in Bangladesh and the likelihood of women to heed the advice of their network of advisors with regard to place of birth. PMID:22196965

Edmonds, Joyce K; Hruschka, Daniel; Bernard, H Russell; Sibley, Lynn

2012-02-01

93

Antenatal survey for the seroprevalence of HTLV-1 infections in the West Midlands, England.  

PubMed Central

The sera of 3522 women who attended an antenatal clinic in Birmingham, England were tested anonymously for antibodies against HTLV-1. Samples from 5 women (0.14%) were positive, one serum showed indeterminate reactivity. Two of the women (0.06%) were born in the West Indies (of Afro-Caribbean ethnic origin), one (0.03%) in Africa (of African ethnic origin), and three (0.09%) were white Caucasian women born in the UK. Thus, HTLV-1 infection in pregnant women in the UK, though comparatively rare, is not negligible. As transmission of HTLV-1 to the newborn via breast milk has been observed and as seropositive mothers can be advised to refrain from breastfeeding or to treat their milk, the question of routine screening for HTLV-1 infection during antenatal care is discussed. PMID:8472781

Nightingale, S.; Orton, D.; Ratcliffe, D.; Skidmore, S.; Tosswill, J.; Desselberger, U.

1993-01-01

94

The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania  

Microsoft Academic Search

BACKGROUND: Although antenatal care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of postnatal care, by which we mean the care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe

Mwifadhi Mrisho; Brigit Obrist; Joanna Armstrong Schellenberg; Rachel A Haws; Adiel K Mushi; Hassan Mshinda; Marcel Tanner; David Schellenberg

2009-01-01

95

Urban - rural disparities in antenatal care utilization: a study of two cohorts of pregnant women in Vietnam  

Microsoft Academic Search

ABSTRACT: BACKGROUND: The use of antenatal care (ANC) varies between countries and in different settings within each country. Most previous studies of ANC in Vietnam have been cross-sectional, and conducted in rural areas before the year 2000. This study aims to compare the pattern and the adequacy of ANC used in rural and urban Vietnam following two cohorts of pregnant

Toan K Tran; Chuc TK Nguyen; Hinh D Nguyen; Bo Eriksson; Goran Bondjers; Karin Gottvall; Henry Ascher; Max Petzold

2011-01-01

96

College Attendance and Persistence among Hispanic Women: An Examination of Some Contributing Factors.  

ERIC Educational Resources Information Center

Examines the relationship of seven sociocultural, institutional, and psychological factors to college attendance and persistence in Hispanic women. Uses data taken from high school seniors in the 1982 first-year followup to the "High School and Beyond" survey. Educational aspiration, choosing nontraditional sex roles, college preparation, and…

Cardoza, Desdemona

1991-01-01

97

A Mixed-Method Analysis of African-American Women's Attendance at an HIV Prevention Intervention  

ERIC Educational Resources Information Center

Grounded in a model of service utilization, this study conceptualizes attendance of African-American women at an HIV prevention intervention as associated with influences across three ecological domains--individual, service (program), and social network. First, the texts of responses to semistructured, open-ended elicitation interviews were…

Pinto, R. M.; McKay, M. M.

2006-01-01

98

Reducing perinatal HIV transmission in developing countries through antenatal and delivery care, and breastfeeding: supporting infant survival by supporting women's survival.  

PubMed Central

In 1998, a joint UNAIDS/UNICEF/WHO working group announced an initiative to pilot test an intervention to reduce perinatal transmission of human immunodeficiency virus (HIV), based on new guidelines on HIV and infant feeding. This intervention for developing countries includes short-course perinatal zidovudine (AZT) treatment and advice to HIV-positive women not to breastfeed their infants, where this can be done safely. The present paper raises questions about the extent of the public health benefit of this intervention, even though it may be cost-effective, due to the limited capacity of antenatal and delivery services to implement it fully. It argues that it is necessary to provide universal access to replacement feeding methods and support in their safe use, not only for women who have tested HIV-positive during pregnancy, but also for untested women who may also decide not to breastfeed, some of whom may be infected with HIV or may acquire HIV during the breastfeeding period. It further argues that additional funding, more staff, staff training, and improved capacity and resources are also needed to integrate this intervention successfully into antenatal and delivery care. The intervention will prevent some infants from getting HIV even in the absence of many of these changes. However, a comprehensive approach to HIV prevention and care in developing countries that includes both women and infants would promote better health and survival of women, which would in turn contribute to greater infant health and survival. If combination antiretroviral therapy in the latter part of pregnancy and/or during the breastfeeding period can be shown to be safe for infants, preliminary evidence suggests that it might reduce perinatal HIV transmission as effectively as the current intervention and, in addition, might allow the practice of breastfeeding to be preserved. PMID:10612882

Berer, M.

1999-01-01

99

Factors associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999 and 2010.  

PubMed

In Tanzania, the coverage of four or more antenatal care (ANC 4) visits among pregnant women has declined over time. We conducted an exploratory analysis to identify factors associated with utilization of ANC 4 and ANC 4 decline among pregnant women over time. We used data from 8035 women who delivered within two years preceding Tanzania Demographic and Health Surveys conducted in 1999, 2004/05 and 2010. Multivariate logistic regression models were used to examine the association between all potential factors and utilization of ANC 4; and decline in ANC 4 over time. Factors positively associated with ANC 4 utilization were higher quality of services, testing and counseling for HIV during ANC, receiving two or more doses of SP (Sulphadoxine Pyrimethamine)/Fansidar for preventing malaria during ANC and higher educational status of the woman. Negatively associated factors were residing in a zone other than Eastern zone, never married woman, reported long distance to health facility, first ANC visit after four months of pregnancy and woman's desire to avoid pregnancy. The factors significantly associated with decline in utilization of ANC 4 were: geographic zone and age of the woman at delivery. Strategies to increase ANC 4 utilization should focus on improvement in quality of care, geographic accessibility, early ANC initiation, and services that allow women to avoid pregnancy. The interconnected nature of the Tanzanian Health System is reflected in ANC 4 decline over time where introduction of new programs might have had unintended effects on existing programs. An in-depth assessment of the recent policy change towards Focused Antenatal Care and its implementation across different geographic zones, including its effect on the perception and understanding among women and performance and counseling by health providers can help explain the decline in ANC 4. PMID:25036291

Gupta, Shivam; Yamada, Goro; Mpembeni, Rose; Frumence, Gasto; Callaghan-Koru, Jennifer A; Stevenson, Raz; Brandes, Neal; Baqui, Abdullah H

2014-01-01

100

Factors Associated with Four or More Antenatal Care Visits and Its Decline among Pregnant Women in Tanzania between 1999 and 2010  

PubMed Central

In Tanzania, the coverage of four or more antenatal care (ANC 4) visits among pregnant women has declined over time. We conducted an exploratory analysis to identify factors associated with utilization of ANC 4 and ANC 4 decline among pregnant women over time. We used data from 8035 women who delivered within two years preceding Tanzania Demographic and Health Surveys conducted in 1999, 2004/05 and 2010. Multivariate logistic regression models were used to examine the association between all potential factors and utilization of ANC 4; and decline in ANC 4 over time. Factors positively associated with ANC 4 utilization were higher quality of services, testing and counseling for HIV during ANC, receiving two or more doses of SP (Sulphadoxine Pyrimethamine)/Fansidar for preventing malaria during ANC and higher educational status of the woman. Negatively associated factors were residing in a zone other than Eastern zone, never married woman, reported long distance to health facility, first ANC visit after four months of pregnancy and woman's desire to avoid pregnancy. The factors significantly associated with decline in utilization of ANC 4 were: geographic zone and age of the woman at delivery. Strategies to increase ANC 4 utilization should focus on improvement in quality of care, geographic accessibility, early ANC initiation, and services that allow women to avoid pregnancy. The interconnected nature of the Tanzanian Health System is reflected in ANC 4 decline over time where introduction of new programs might have had unintended effects on existing programs. An in-depth assessment of the recent policy change towards Focused Antenatal Care and its implementation across different geographic zones, including its effect on the perception and understanding among women and performance and counseling by health providers can help explain the decline in ANC 4. PMID:25036291

Gupta, Shivam; Yamada, Goro; Mpembeni, Rose; Frumence, Gasto; Callaghan-Koru, Jennifer A.; Stevenson, Raz; Brandes, Neal; Baqui, Abdullah H.

2014-01-01

101

Surveillance of Transmitted Antiretroviral Drug Resistance among HIV1 Infected Women Attending Antenatal Clinics in Chitungwiza, Zimbabwe  

Microsoft Academic Search

The rapid scale-up of highly active antiretroviral therapy (HAART) and use of single dose Nevirapine (SD NVP) for prevention of mother-to-child transmission (pMTCT) have raised fears about the emergence of resistance to the first line antiretroviral drug regimens. A cross-sectional study was conducted to determine the prevalence of primary drug resistance (PDR) in a cohort of young (<25 yrs) HAART-naïve

Mqondisi Tshabalala; Justen Manasa; Lynn S. Zijenah; Simbarashe Rusakaniko; Gerard Kadzirange; Mary Mucheche; Seble Kassaye; Elizabeth Johnston; David Katzenstein

2011-01-01

102

Non-fistulous urinary leakage among women attending a Nigerian family planning clinic  

PubMed Central

Urinary leakage is an important gynecological challenge, which has a substantial impact on quality of life. The aim of this study was to determine the prevalence and types of non-fistulous urinary leakage among women attending the family planning clinic of the University of Ilorin teaching hospital, Ilorin, Nigeria. The study was a cross-sectional study carried out between January 3 and April 25 2009. One hundred and two women experienced urinary leakage out of 333 women interviewed, giving a prevalence rate of 30.6%. Stress incontinence was the most common urinary leakage (prevalence rate 12.0%). This is followed by urge incontinence (10.8%), urinary incontinence (4.8%), and overflow incontinence (3.0%). None of the women afflicted sought medical help. Conclusively, this study has demonstrated that non-fistulous urinary leakage is a common problem among women of reproductive age in this environment. PMID:22247626

Ijaiya, Munir'deen A; Raji, Hadijat O; Aboyeji, Abiodun P; Adesina, Kike T; Adebara, Idowu O; Ezeoke, Grace G

2011-01-01

103

Attitudes Towards the Role of Women in Cuban Women Attending a Community College  

Microsoft Academic Search

The study examines both the attitudes towards the role of women in society and the psychological masculinity\\/femininity manifested by a small group of Cuban-American college women. In Miami, 31 such women completed the Attitudes Towards Women Scale and the Personal Attributes Questionnaire. Overall, the means for this group corresponded with the established American norms. The authors thought that age, number

Oliva M. Espin; Beth Warner

1982-01-01

104

Trends in the uptake of antenatal voluntary counselling and testing for HIV and HIV prevalence among childbearing women in Barbados, 1993-2004: evidence to gauge the effectiveness of HIV prevention measures  

Microsoft Academic Search

Objectives: To describe the long term trends on the uptake of antenatal voluntary counselling and testing (VCT) for Human Immunodeficiency Virus (HIV) and on the HIV prevalence among pregnant women. These data were used to gauge the impact of the National Acquired Immunodeficiency Syndrome (AIDS) Intervention Programme on preventing mother-to-child transmission (PMTCT) in Barbados. Methods: This was a population based

A Kumar; H St White; AO Carter

2007-01-01

105

Association between maternal occupational status and utilization of antenatal care  

Microsoft Academic Search

Objectives: Adequate utilization of antenatal care reduces the morbidity of mother and child. How frequent a pregnant woman attends\\u000a antenatal care is dependent on many factors. The aim of this study was to assess the current influence of educational level\\u000a and occupational status on maternal utilization of antenatal care under the conditions of an industrialized country and provision\\u000a of universal

Elisabeth Simoes; Siegfried Kunz; Ralf Münnich; Friedrich Wilhelm Schmahl

2006-01-01

106

Nutritional Factors Associated with Anaemia in Pregnant Women in Northern Nigeria  

Microsoft Academic Search

This study was conducted to assess the relative contribution of iron, folate, and B12 deficiency to anaemia in pregnant women in sub-Saharan Africa. In total, 146 pregnant women, who attended two antenatal clinics in Gombe, Nigeria, were recruited into the study. The majority (54%) of the women were in the third trimester. Blood samples were obtained for determination of haematocrit

Dorothy J. VanderJagt; Hugh S. Brock; George S. Melah; Aliyu U. El-Nafaty; Michael J. Crossey; Robert H. Glew

2007-01-01

107

Predictors of change in mental health and distress among women attending a women's shelter  

PubMed Central

Background Intimate partner violence (IPV) is detrimental to mental health. The Domestic Violence Survivor Assessment (DVSA), which includes a mental health assessment, is often used to evaluate abuse survivors in a counseling situation. The DVSA seeks to outline the cognitive state of women as per the stages of change as they attempt to move toward a life with no IPV. Objective The objective of this study was to explore predictors of change in mental health and distress among women who entered a women's shelter more than once. Methods Women entering a women's shelter more than once over a 3-year period were assessed by a trained social worker using the DVSA. A logistic regression analysis examined relationships between the chosen characteristics and the participants’ mental health through the DVSA stages of change. Results We analyzed complete data for 94 women who entered the shelter a mean of 3.3 times (range 2–8) over a mean period of 16.1 days (range: 1–391). Thirty-six women (36/94; 38.3%) progressed through the stages. The average number of visits among women who progressed through the stages was 4. Our multivariable logistic regression showed women who had more visits to the shelter were almost twice as likely to progress through the stages compared to women who entered the shelter fewer times (OR=1.928; 95% CI=1.292–2.877; p=0.001). In the univariate analysis, only increased number of visits was significantly associated with progressing through the stages of change (OR=1.694; 95% CI=1.237–2.322; p=0.001). The other factors were not significantly associated with a change in mental health and distress (p>0.05). Conclusion Women who enter women's shelters more frequently may be more likely to progress through the DVSA mental health stages compared to other women. Women's shelters may be helpful in assisting progression through the stages of change, thereby improving their mental health after abuse. PMID:25279102

Hoyeck, Patricia; Madden, Kim; Freeman, Clare; Scott, Taryn; Bhandari, Mohit

2014-01-01

108

Osteopenia and osteoporosis among 16-65 year old women attending outpatient clinics.  

PubMed

Women living in developing countries are more prone to osteoporotic fractures than women in developed countries. The objectives of this study were to estimate the burden of osteopenia and osteoporosis and examine their correlates among Bangladeshi women. This cross-sectional study consisted of 500 women aged 16-65 years attending gynecology and family planning clinics of a tertiary hospital which cares urban/suburban low income population in Dhaka, Bangladesh. Bone mineral density (BMD) was measured at the lumbar spine and femoral neck using dual X-ray absorptiometry. We calculated T scores based on sex-matched reference data from Caucasian women provided by the manufacturer. Osteoporosis was defined as a BMD at either site more than 2.5 standard deviations (SD) below the young healthy adult woman mean while the osteopenia was defined as a BMD between 1 and 2.5 SD below the mean as suggested by the World Health Organization. Separate multivariable logistic regression analysis was used to examine the correlates of osteopenia/osteoporosis among 16-45 and 46-65 year old women. Overall, 43.6 and 5.5 % of 16-45 year old women, and 40.7 and 41.8 % of 46-65 year old women had osteopenia and osteoporosis based on T scores either of the two sites (lumbar spine or femoral neck), respectively. Body mass index was negatively associated with osteopenia/osteoporosis at both lumbar spine and femoral neck, while age was positively associated. The burden of osteopenia/osteoporosis is very high in Bangladeshi women which warrants appropriate interventional strategies to minimize future fractures and reduce related social and economic burden of the society. PMID:24599664

Begum, Rowshan Ara; Ali, Liaquat; Akter, Jesmin; Takahashi, Osamu; Fukui, Tsuguya; Rahman, Mahbubur

2014-12-01

109

Universal antenatal screening for hepatitis C.  

PubMed

The aims of this study were to pilot universal antenatal HCV screening and to determine the true seroprevalence of HCV infection in an unselected antenatal population. A risk assessment questionnaire for HCV infection was applied to all women booking for antenatal care over a 1-year period. In addition the prevalence of anti-HCV antibody positive serology in this population was determined. Over the course of the year, 9121 women booked for antenatal care at the Rotunda and 8976 women agreed to take part in the study, representing an uptake of 98.4%. 78 (0.9%) women were diagnosed as anti-HCV positive, the majority of whom were Irish (60.3%) or from Eastern Europe (24.4%). 73% of anti-HCV positive women reported one or more known risk factor with tattooing and a history of drug abuse the most commonly reported. 27% (n = 21) of anti-HCV positive women had no identifiable risk factors. Due to selective screening, seroprevalence of HCV is impossible to accurately calculate. However the universal screening applied here and the high uptake of testing has allowed the prevalence of anti-HCV among our antenatal population to be calculated at 0.9%. A significant proportion (27%) of anti-HCV positive women in this study reported no epidemiological risk factors at the time PMID:23914572

Lambert, J; Jackson, V; Coulter-Smith, S; Brennan, M; Geary, M; Kelleher, T B; O'Reilly, M; Grundy, K; Sammon, N; Cafferkey, M

2013-05-01

110

Age and religion selection biases in HIV-1 prevalence data from antenatal clinics in Manicaland, Zimbabwe.  

PubMed

Sera from 487 women attending antenatal clinics in two areas of Manicaland were tested for the presence of HIV-1 infection. In the Honde Valley and Rusitu Valley areas, 24,3 pc and 14 pc respectively, were found to be infected. HIV-1 infection was found to be associated with age, marital status and location. Younger women, non-married women and women living in the Honde Valley were all more likely to be infected. There was also a weak association with level of education, with women with secondary education being at greater risk of being infected. The unadjusted overall figures for HIV-1 prevalence from the antenatal clinics were shown to provide a poor indication of the relative levels of prevalence of infection in the two study areas because of differences in the age structure and religious affiliations of the antenatal clinic and study populations. Similar problems may exist in sentinel surveillance data and would distort comparisons between locations and over time, especially during periods of rapid fertility change. In particular, the age bias is liable to exaggerate differences between urban and rural populations in developing societies. Where comparable information is available for the general population and sample sizes permit, this problem may be overcome by collecting basic socio-demographic data on the individuals tested and then applying standardization techniques. In the Honde Valley and Rusitu Valley example, the levels of HIV-1 prevalence after adjusting for age differences are 18,4 pc and 13,2 pc respectively. PMID:8932576

Gregson, S; Zhuwau, T; Anderson, R M; Chimbadzwa, T; Chiwandiwa, S K

1995-11-01

111

Attitudes of Singapore women toward cesarean and vaginal deliveries  

Microsoft Academic Search

Objectives: To assess the attitude, knowledge, and expectations of Asian pregnant women toward cesarean and vaginal deliveries. Methods: Written questionnaires were given to pregnant women attending the National University Hospital antenatal clinics, and 160 responses were tabulated and analyzed using SPSS software. Results: The participation rate was 65% and 50% of the respondents were Chinese, 20% Indian, 21% Malay, 2%

E. S. Y. Chong; M. Mongelli

2003-01-01

112

High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention  

Microsoft Academic Search

BACKGROUND: In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors

Moke Magoma; Jennifer Requejo; Simon Cousens; Veronique Filippi

2010-01-01

113

Motivations and reasons for women attending a Breast Self-Examination training program: A qualitative study  

PubMed Central

Background Breast cancer is a major threat to Taiwanese women's health. Despite the controversy surrounding the effectiveness of breast self-examination (BSE) in reducing mortality, BSE is still advocated by some health departments. The aim of the study is to provide information about how women decide to practice BSE and their experiences through the training process. Sixty-six women aged 27-50 were recruited. Methods A descriptive study was conducted using small group and individual in-depth interviews to collect data, and using thematic analysis and constant comparison techniques for data analysis. Results It was found that a sense of self-security became an important motivator for entering BSE training. The satisfaction in obtaining a sense of self-security emerged as the central theme. Furthermore, a ladder motivation model was developed to explain the participants' motivations for entering BSE training. The patterns of motivation include opportunity taking, clarifying confusion, maintaining health, and illness monitoring, which were connected with the risk perception for breast cancer. Conclusions We recognize that the way women decide to attend BSE training is influenced by personal and social factors. Understanding the different risk assessments women rely on in making their health decisions is essential. This study will assist researchers and health professionals to gain a better understanding of alternative ways to deal with breast health, and not to be limited by the recommendations of the health authorities. PMID:20618986

2010-01-01

114

Prevalence of Chlamydia trachomatis in women attending a family planning clinic in Papua New Guinea.  

PubMed Central

OBJECTIVE--To determine the prevalence of Chlamydia trachomatis infection in women attending a family planning clinic in Papua New Guinea, in the period between April and June 1991. SETTING--The outpatient department of Obstetrics and Gynaecology of Port Moresby General Hospital, Port Moresby, Papua New Guinea, the departments of Dermato-Venereology and Clinical Microbiology of the Erasmus University, Rotterdam, The Netherlands and the National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands. PATIENTS--A total of 254 consecutive women who attended the family planning clinic at Port Moresby General Hospital, Papua New Guinea were enrolled into this study. METHODS--Cervical infections with C trachomatis were diagnosed using the direct immunofluorescent assay (DFA) and the polymerase chain reaction (PCR). Serum IgM and IgG antibodies directed against C trachomatis were detected using the enzyme-linked fluorescent assay (ELFA). RESULTS--The prevalence of C trachomatis was 14.6% using the PCR, 9.1% using the DFA and 17.3% when the results of the PCR and the DFA were combined. An elevated IgM titre was observed in 14.2% of the women, whereas 44.1% had an elevated IgG titre. The titres of IgM or IgG were significantly higher in women who were positive using the PCR or the DFA than in those who were negative in both the PCR and the DFA (p = 0.032 and p = 0.0046, respectively). CONCLUSION--Cervical infection by C trachomatis can be considered a major health problem in at least the studied population in Papua New Guinea. The prevalence of C trachomatis infection is at least comparable with that in groups with a high prevalence in industrialized countries. Effective screening and treatment programmes are imperative to combat this problem. PMID:7490045

Theunissen, J J; Kariwiga, G; Ossewaarde, J M; van Rijsoort-Vos, J H; Stolz, E; van der Meijden, W I

1995-01-01

115

Relations of body esteem factors with exercise session attendance in women initiating a physical activity program.  

PubMed

Based on tenets of cognitive behavioral and social cognitive theory, the association of change in body-esteem factors and attendance in a newly initiated, 12-wk. cardiovascular exercise program was estimated in women (age range=21 to 60 years, M=41.4, SD= 12.2). For the group given the exercise program (n=48), there were significant positive changes on the Weight Control and Physical Condition scores of the Body Esteem Scale at 12 weeks, but not on Sexual Attractiveness scores. For the no-exercise control group (n=30), no significant changes were found on any of the Body Esteem Scale subscales. For the exercise group, regression analyses indicated between 8% and 9% of the variance in exercise session attendance was accounted for by the changes in scores on each of the three subscales. Entering age into multiple regression equations did not increase the explained variances in attendance. The fit of the findings within behavioral theory, implications for change in exercise behavior, and the need for replication and extension were discussed. PMID:16158686

Annesi, James J

2005-06-01

116

Immigrant status, antenatal depressive symptoms, and frequency and source of violence: what's the relationship?  

PubMed

This study describes the prevalence of violence during pregnancy and examines the association between the experience of violence since the beginning of pregnancy and the prevalence of antenatal depressive symptoms while taking into account immigrant status. Cross-sectional study including 5,162 pregnant women attending Montreal hospitals for antenatal care was conducted, with 1,400 being born outside of Canada. CES-D scale was used to evaluate depression at 24-26 weeks of pregnancy. The Abuse Assessment Screen scale was used to determine the frequency and severity of violence since the beginning of pregnancy. Relationship with abuser was also considered. All modeling was done using logistic regressions. Threats were the most frequent type of violence, with 63 % happening more than once. Long-term immigrant women reported the highest prevalence of all types of violence (7.7 %). Intimate partner violence (IPV) (15 %) was most frequently reported among the poorest pregnant women. Strong associations exist between more than one episode of abuse and depression (POR?=?5.21 [3.73; 7.23], and IPV and depression [POR?=?5.81 [4.19; 8.08]. Immigrant status did not change the associations between violence and depression. Violence against pregnant women is not rare in Canada, and it is associated with antenatal depressive symptoms. These findings support future development of perinatal screening for violence, follow-up, and a culturally sensitive referral system. PMID:22847826

Miszkurka, Malgorzata; Zunzunegui, Maria Victoria; Goulet, Lise

2012-10-01

117

Antenatal and delivery care in rural western Kenya: the effect of training health care workers to provide "focused antenatal care"  

PubMed Central

Background Maternal mortality remains high in developing countries and data to monitor indicators of progress in maternal care is needed. We examined the status of maternal care before and after health care worker (HCW) training in WHO recommended Focused Antenatal Care. Methods An initial cross-sectional survey was conducted in 2002 in Asembo and Gem in western Kenya among a representative sample of women with a recent birth. HCW training was performed in 2003 in Asembo, and a repeat survey was conducted in 2005 in both areas. Results Antenatal clinic (ANC) attendance was similar in both areas (86%) in 2005 and not significantly different from 2002 (90%). There was no difference in place of delivery between the areas or over time. However, in 2005, more women in Asembo were delivered by a skilled assistant compared to Gem (30% vs.23%, P = 0.04), and this proportion increased compared to 2002 (17.6% and 16.1%, respectively). Provision of iron (82.4%), folic acid (72.0%), sulfadoxine-pyrimethamine (61.7%), and anthelminths (12.7%) had increased in Asembo compared to 2002 (2002: 53.3%, 52.8%, 20.3%, and 4.6%, respectively), and was significantly higher than in Gem in 2005 (Gem 2005: 69.7%, 47.8%, 19.8%, and 4.1%, respectively) (P < 0.05 for all). Offering of tests for sexually transmitted diseases and providing information related to maternal health was overall low (<20%) and did not differ by area. In 2005, more women rated the quality of the antenatal service in Asembo as very satisfactory compared to Gem (17% vs. 6.5%, P < 0.05). Conclusions We observed improvements in some ANC services in the area where HCWs were trained. However, since our evaluation was carried out 2 years after three-day training, we consider any significant, sustained improvement to be remarkable. PMID:20429906

2010-01-01

118

Healthcare-seeking behaviours for sexually transmitted infections among women attending the National Institute of Dermatology and Venereology in Vietnam  

Microsoft Academic Search

Objectives: To investigate the determinants of delay in seeking healthcare for sexually transmitted infections (STIs) among Vietnamese women attending the National Institute of Dermatology and Venereology (NIDV), through assessing to what extent women’s sociodemographic backgrounds and their knowledge, attitudes and practices (KAP) relating to STIs\\/STI prevention influence their delay in seeking healthcare for STIs.Methods: A face-to-face semistructured interview of 60

Hien Thi Thu; Anna Ziersch; Gavin Hart

2007-01-01

119

DETECTION OF HEPATITIS B SURFACE ANTIGEN IN PREGNANT WOMEN ATTENDING A PUBLIC HOSPITAL FOR DELIVERY: IMPLICATION FOR VACCINATION STRATEGY IN BANGLADESH  

Microsoft Academic Search

Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babies is very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800 parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg

M. A. KARIM RUMI; KOHINOOR BEGUM; M. SAWKAT HASSAN; S. M. MUNIR; M. GOLAM AZAM

120

Assessing Readiness to Lose Weight among Obese Women Attending the Nutrition Clinic  

PubMed Central

Background: Assessing individual’s readiness to change and targeting the inter­vention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05). Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change ori­entates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes. PMID:25097834

Ghannadiasl, Fatemeh; Mahdavi, Reza; AsghariJafarabadi, Mohammad

2014-01-01

121

[Positive impact of a video and TV documentary on attendance of women to catch-up collective vaccinations and reasons for non-attendance].  

PubMed

The impact of medical documentaries on attendance to immunization sessions is not documented in developing countries. The impact of a video and TV medical documentary on women's vaccination during a catch-up tetanus collective immunization was studied in Cambodia (2002-2004). A medical video documentary produced locally was publicly shown in 10 villages chosen at random among 63 villages to be covered by collective tetanus immunization. In each village where the video was shown, 33 women, older than age 11, were selected at random and questioned about their tetanus vaccination records, to assess if they attended the video and to evaluate their knowledge about tetanus. A second interview was conducted after the first collective vaccination to check their attendance and to record reasons for non-attendance. The same interview was conducted 10 months later, after the documentary was shown on a local TV channel and a second collective tetanus vaccination conducted. Data were collected from 323 (98%) women. Seventy-eight (24%) women saw the video documentary and only eight (2.4%) saw it on TV. Compared to farmers, shopkeepers saw significantly less the documentary (?² of Yates: 5.77,P = 0.016; 95% CI: 0.10 < RR = 0.29 < 0.88) and no home keeper or civil servant attended it. Women of childbearing age with no school education were significantly more attracted by the video documentary (?² of Yates: 5.99,P = 0.01; 95% CI: 1.10 < RR = 1.57 < 2.22) than other childbearing-aged women, although their final immunization coverage was not better. The documentary did not increase the knowledge that contamination for tetanus may come from earth and tools, but not from air and water, and that all ages are at-risk for tetanus, but it increased significantly the knowledge that vaccination can prevent the disease (?² of Yates: 13.98;P = 0.0001; 95% CI: 1.28 < RR = 1.57 < 1.93). Women who saw the video documentary attended the first collective session more often than those who did not (?² of Yates: 11.00; P = 0.0006; 95% CI: 1.23 < RR = 1.51 < 1.84)in spite of their better vaccination status before the immunization, and this was mostly significant for farmers and women more than 45 years of age. Women who saw the documentary either on video or on TV also attended more the second collective session, but not significantly (?² of Yates: 1.23;P = 0.266; 95% CI: 0.91 < RR = 1.23 < 1.66). Forty-nine percent of women had not attended school and the video documentary was re-run twice after the first performance. Women older than 45 years (55%) completely escaped immunization significantly more often than women of childbearing age (35%) (?² of Yates: 17.26;P = 0.00003, 95% CI: 1.53 < RR = 2.13 < 2.97), who did it more often than schoolgirls (2%) (?² of Yates: 9.69;P = 0.002; 95% CI: 0.01 < RR = 0.09 < 0.65). The main reasons for not being vaccinated during catch-up collective tetanus vaccinations were a too short interval between doses according to the WHO schedule (25%), agricultural task (18%), leisure travel (8%), fear of injections (7%), and being completely vaccinated according to the WHO schedule (7%). Only 2% of women were not informed, showing that vaccination was well-publicized. This educational technique should be re-used in all villages during coming catch-up tetanus collective immunizations in Cambodia, mostly in urban contexts where coverage during these sessions is lower. Video is still the best method in rural context if some education is also provided to the audience. According to the WHO schedule, the interval between two catch-up tetanus sessions should be extended to over a year to be able to give booster shots to women who already received three or more tetanus doses. Vaccination of schoolgirls is significantly easier to achieve with the help of the teachers. Vaccinating women aged over 45 should be encouraged as they are at risk of tetanus even in developed Asian countries. PMID:21279494

Painvin, C; Schlumberger, M; Chhem, Dy Bun; Savannarom, Dim; Phong, Phing; Gilberg, S

2011-02-01

122

Pregnant Women after Physical and Sexual Abuse in Germany  

Microsoft Academic Search

Background\\/Aims: The aim of our study was to evaluate the prevalence of abuse among pregnant women in Germany attending our antenatal outpatient clinic and to observe whether a history of abuse had consequences for women’s feelings about their pregnancy. Methods: 455 women between the 35th and 42nd weeks of gestational age were included and were asked to fill out an

Katharina Jundt; Kristin Haertl; Angelika Knobbe; Ralph Kaestner; Klaus Friese; Ursula M. Peschers

2009-01-01

123

Awareness and practices of contraception among Pakistani women attending a tertiary care hospital.  

PubMed

Pakistan is one of the most populous nations in the world, with an annual growth rate of 2.8 and high total fertility rate, even among developing nations. The Pakistan Reproductive Health and Family Planning Survey highlighted the wide gap between knowledge (97%) and use of contraceptives (28%) among currently married women. Our actual need is to enhance contraceptive practice in our country. This study was designed to investigate contraceptive knowledge and practice in Pakistani women attending a tertiary care hospital. This questionnaire-based study was conducted at the Gynaecology Unit II of Sir Ganga Ram Hospital, Fatima Jinnah Medical College, Lahore, Pakistan. A total of 204 married women of reproductive age were interviewed by a registrar to record their age, occupation, educational status, number of children, knowledge about contraceptive methods, source of the knowledge, attitudes and practices of contraception. About 57% of women were between 26 and 35 years of age, while 52% of men were between 31 and 40 years. Educational status of the majority of females was below matriculation (33%), while 34% males were above matriculation; 88% of females were housewives and less than 1% of men were out of work. Regarding the social status of couples, 64% were living on income less than 5000 rupees /month (about 60 pound sterling). Of the women, 67% were para 2-5; 68% had some sort of awareness regarding contraception. The main source of information was television (26%) and relatives (24%). The majority knew about the pill (68%) and IUCD (55%). Only 47% were using some sort of contraception. The most common method chosen was the barrier method (15%), followed by IUCD (10%) and the pill (10%). The least common methods were sterilisation (2%) and the rhythm method (2%); 85% of the women and 74% of the men in the study group had a positive attitude toward contraception. In order to improve contraceptive use in Pakistan we need to use multiple media sources to educate couples and their parents regarding contraceptive services, strengthen the perceptions that religion not only allows but also recommends family planning and to create awareness among women to have their rights and opinions about the size of family. The concept of differentiation between sons and daughters should be discouraged. In addition government and non-governmental organisations (NGOs) should organise groups to provide counselling and promotion of contraceptive services at the doorstep. We must act as a team to control our growth rate for economic stabilisation of the country and to raise the living standards of our people. PMID:15369942

Khawaja, N P; Tayyeb, R; Malik, N

2004-08-01

124

Determinants of the number of antenatal visits in a metropolitan region  

PubMed Central

Background Antenatal care has a positive effect on pregnancy, both clinically and psychologically, but consensus about the optimal number of antenatal visits is lacking. This study aims to provide insight into the dynamics of the number of antenatal visits a woman receives. Independent effects of predisposing, enabling and pregnancy-related determinants are examined. Methods Women were recruited in nine clinical centres in the Brussels Metropolitan region. Antenatal care use was measured prospectively. A Poisson regression model was applied to measure the independent effect of individual determinants on the number of antenatal visits. Results Data on antenatal care trajectories in 333 women were collected. The multivariate analyses showed that women with a Maghreb or Turkish origin had 14% fewer visits compared with European (EU15) women. More highly educated women had 22% more visits compared with those with a low education. Women with a high income had 14% more antenatal visits compared with those with a low income. Fewer antenatal visits were observed in multiparae (15%), women initiating care after 14 weeks of gestation (31%), women without medical risks during the pregnancy (12%) and in women with a continuity of care index of 50% or more (12%). More visits were observed in delivering after week 37 (22% increase). Conclusions Predisposing and enabling factors have to be considered when antenatal care programmes are evaluated in a metropolitan area. Variations in the number of antenatal visits show that socially vulnerable women are more at risk of having fewer visits. PMID:20809951

2010-01-01

125

A Randomized Placebo-Controlled Trial of Intermittent Preventive Treatment in Pregnant Women in the Context of Insecticide Treated Nets Delivered through the Antenatal Clinic  

PubMed Central

Background Current recommendations to prevent malaria in African pregnant women rely on insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp). However, there is no information on the safety and efficacy of their combined use. Methods 1030 pregnant Mozambican women of all gravidities received a long-lasting ITN during antenatal clinic (ANC) visits and, irrespective of HIV status, were enrolled in a randomised, double blind, placebo-controlled trial, to assess the safety and efficacy of 2-dose sulphadoxine-pyrimethamine (SP). The main outcome was the reduction in low birth weight. Findings Two-dose SP was safe and well tolerated, but was not associated with reductions in anaemia prevalence at delivery (RR, 0.92 [95% CI, 0.79–1.08]), low birth weight (RR, 0.99 [95% CI, 0.70–1.39]), or overall placental infection (p?=?0.964). However, the SP group showed a 40% reduction (95% CI, 7.40–61.20]; p?=?0.020) in the incidence of clinical malaria during pregnancy, and reductions in the prevalence of peripheral parasitaemia (7.10% vs 15.15%) (p<0.001), and of actively infected placentas (7.04% vs 13.60%) (p?=?0.002). There was a reduction in severe anaemia at delivery of borderline statistical significance (p?=?0.055). These effects were not modified by gravidity or HIV status. Reported ITN's use was more than 90% in both groups. Conclusions Two-dose SP was associated with a reduction in some indicators, but these were not translated to significant improvement in other maternal or birth outcomes. The use of ITNs during pregnancy may reduce the need to administer IPTp. ITNs should be part of the ANC package in sub-Saharan Africa. Trial Registration ClinicalTrials.gov NCT00209781 PMID:18398460

Menendez, Clara; Bardaji, Azucena; Sigauque, Betuel; Romagosa, Cleofe; Sanz, Sergi; Serra-Casas, Elisa; Macete, Eusebio; Berenguera, Anna; David, Catarina; Dobano, Carlota; Naniche, Denise; Mayor, Alfredo; Ordi, Jaume; Mandomando, Inacio; Aponte, John J.; Mabunda, Samuel; Alonso, Pedro L.

2008-01-01

126

Use of maternity services by pregnant women in a small Nigerian community  

Microsoft Academic Search

Pregnancy is a time when women's health is placed at risk by a host of factors; however, professionals providing antenatal care can reduce that risk by monitoring women's health regularly and offering preventive services. Hygienic delivery services by a qualified attendant also help to reduce risks associated with childbearing. We explored these considerations in a rural Nigerian town by following

William R. Brieger; Kathryn J. Luchok; Eugenia Eng; Jo Anne Earp

1994-01-01

127

Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection  

Microsoft Academic Search

Sex workers have long been considered a high-risk group for HIV infection, but to date little quantitative research has explored the association between HIV risk and exchange of sex for material gain by women in the general population. The objective of this study was to estimate the prevalence of such transactional sex among women attending antenatal clinics in Soweto, South

Kristin L. Dunkle; Rachel K. Jewkes; Heather C. Brown; Glenda E. Gray; James A. McIntryre

2004-01-01

128

Factors affecting women's preference for type of prenatal screening test for chromosomal anomalies  

Microsoft Academic Search

Objective To ascertain, by means of a questionnaire, women's preferences for four different approaches to prenatal screening for Down syndrome. Methods Women attending antenatal clinics at six UK maternity units were asked to put in order of prefer- ence four different approaches to screening for Down syndrome all of which had the same false positive rate of 5%. The options

K. Spencer; D. Aitken

2004-01-01

129

Women's need for information before attending genetic counselling for familial breast or ovarian cancer: a questionnaire, interview, and observational study.  

PubMed Central

OBJECTIVES: To describe women's information needs prior to genetic counselling for familial breast or ovarian cancer. DESIGN: Prospective study including semistructured telephone interviews before genetic counselling, observations of consultations, completion of postal questionnaires, and face-to face interviews within two months of counselling. SUBJECTS: 46 women attending genetic counselling for familial breast or ovarian cancer. MAIN OUTCOME MEASURES: Subjects' understanding of process and content of genetic counselling before attending and attitudes about their preparation for the counselling session. RESULTS: Although all women interviewed before the clinic expected to discuss their risk of developing cancer and risk management options, there was evidence of a lack of knowledge about the process and content of genetic counselling, 17 (37%) women said they did not know what else would happen. Most women interviewed after counselling viewed it positively, but 26 (65%) felt they had been inadequately prepared and 11 (28%) felt that their lack of preparation meant that they could not be given an accurate estimation of their risk of cancer. CONCLUSIONS: Some women felt that they did not obtain optimum benefit from genetic counselling because they were inadequately prepared for it. We suggest that cancer family history clinics should provide women with written information about the process and content of genetic counselling before their clinic attendance. PMID:9022494

Hallowell, N.; Murton, F.; Statham, H.; Green, J. M.; Richards, M. P.

1997-01-01

130

Vulval disease in HIV-positive women attending a tertiary vulval dermatology clinic over a five-year period.  

PubMed

There is a paucity of data on vulval disease in HIV-infected women. We describe the spectrum of vulval disease in HIV-infected women attending a tertiary vulval dermatology referral centre over a five-year period. Seven vulval conditions were identified in 14 women. Most were attending for HIV care (n = 12, 86%), and on combined antiretroviral therapy (CART) with a CD4 cell count above 200 cells/µL (n = 9, 64%) at diagnosis. Imiquimod therapy was effective in treating undifferentiated vulval intraepithelial neoplasia (uVIN) - the most common diagnosis. There were no cases of invasive vulval carcinoma. Hypertrophic herpes simplex virus occurred in one woman stable on CART with good immune reconstitution. Clinicians should be vigilant about the spectrum of vulval disease in HIV-infected women and consider genital examination as part of routine care. PMID:23970605

Dosekun, Olamide; Farrugia, Pippa; Lewis, Fiona; Sethi, Gulshan

2013-10-01

131

A survey describing the use of complementary therapies and medicines by women attending a family planning clinic  

PubMed Central

Background Complementary medicines (CMs) are widely used by women. Although, women in Australia are frequent users of CM, few studies have examined their utilisation by women attending a family planning service. The aim of this study was to examine (i) the extent of and type of CM, (ii) women’s views about safety and efficacy, and (iii) the factors influencing women’s decision-making. Methods A cross-sectional survey using a convenience sample of 221women aged greater than 18 years attending a family planning (FP) service was undertaken over a two week period in Sydney, Australia. An anonymous self-administered questionnaire was designed to examine women’s current and previous use of CMs, their attitudes towards safety and effectiveness, the factors influencing their decision-making, and their disclosure of CM use to a FP health professional. Demographic questions were designed to describe the diversity of the participants. Logistic regression was used to examine the association between CM use and demographics. Results Sixty-seven percent of women surveyed were currently using CMs, and 83% reported use during the previous 12 months. Most respondents utilised CMs to maintain their general health or for prevention of ill health. Over 30% of women lacked information to make an informed response to questions examining their views about the safety of CMs. Forty-four percent of participants stated they discussed their use of CMs with their FP providers. The main reason why women did not mention CMs was they did not see the relevance to their consultation (43%). Lower rates of CM use were found for younger women (OR 0.24, 95% CI 0.09-0.61), and those not completing high school (OR 0.44, 95% 0.20-1.00). Conclusion The use of CM is very common among women attending an Australian FP clinic, however our findings may not be generalisable to all women. We identified a notable gap in women’s awareness of the potential for interactions between CM and prescribed medication. Our findings also emphasise the need for healthcare providers to initiate discussions with clients about their utilisation of CM. PMID:24025479

2013-01-01

132

Correlation between clinical presentation and urodynamic findings in women attending urogynecology clinic  

PubMed Central

Introduction: Urodynamic studies objectively observe lower urinary tract function and dysfunction so that an appropriate treatment can be planned. In the present study, we tried to evaluate the role of urodynamic studies in the final diagnosis and management plan in patients attending an urogynecology clinic. Materials and Methods: This observational study was conducted in an urogynecology clinic. 202 women were included. After detailed history, pelvic examination and introital sonography these women were subjected to urodynamic study. During the filling cystometry detrusor activity, first desire to void and bladder capacity was recorded. This was followed by urethral pressure measurements, when functional urethral length, maximum urethral closure pressure and stress urethral pressure profile was recorded. Results: Most prevalent complaint was mixed urinary incontinence (33.17%), followed by stress incontinence (31.68%) and urge incontinence (13.37%). According to the standard urodynamic definition 66.33% were normal in the population studied. None of the urodynamic parameters individually or in combination were found to be very useful for establishing a diagnosis. Conclusion: Establishment of the final diagnosis of urinary incontinence and planning of management should be based on detailed history, physical examination, bladder diaries, and careful interpretation of urodynamic data. Urodynamic study; however, doesn’t seem to be imperative to establish a diagnosis in uncomplicated cases where symptoms and signs are reliable and correlating. PMID:24672187

Pandey, Deeksha; Anna, Gasser; Hana, Ottenschlaeger; Christian, Fuenfgeld

2013-01-01

133

The Experiences of Cuban American Women Attending a Hispanic Serving Institution and the Influences on Identity Development  

Microsoft Academic Search

The purpose of this study was to gain an understanding and gather insight into the experiences of Cuban American women attending a 4-year, public, Hispanic Serving Institution and how those experiences influenced their identity development. This was accomplished by conducting in-depth interviews and focus groups with 12 self-identified Cuban American women who were classified as sophomores, juniors, seniors, or graduate

Veronica Lynn Owles

2009-01-01

134

The experiences of Cuban American women attending a Hispanic serving institution and the influences on identity development  

Microsoft Academic Search

The purpose of this study was to gain an understanding and gather insight into the experiences of Cuban American women attending a 4-year, public, Hispanic Serving Institution and how those experiences influenced their identity development. This was accomplished by conducting in-depth interviews and focus groups with 12 self-identified Cuban American women who were classified as sophomores, juniors, seniors, or graduate

Veronica Owles

2009-01-01

135

Prevalence of Gestational Diabetes Mellitus (GDM) in Pregnant Women Aged 30 to 34 Years Old at Phramongkutklao Hospital  

Microsoft Academic Search

Objective: To assess the prevalence of GDM in pregnant women aged 30 to 34 years old who were screened by glucose challenge test (GCT) at Phramongkutklao Hospital Material and Method: The cross-sectional data were collected from 1332 pregnant women aged between 30- 34 years who attended the antenatal care clinic and delivered at Phramongkutklao Hospital from March, 2003 to January,

136

Antenatal Bartter syndrome.  

PubMed

Antenatal Bartter syndrome is characterized by severe polyhydramnios in mother leading to premature delivery. Antenatal treatment has proven effective to prevent these problems. Postnatally newborns suffer from recurrent episodes of severe dehydration and electrolyte imbalance which can lead to fatal outcome. These manifestations are likely to be overlooked and missed under the umbrella of diagnosis of prematurity. This premature newborn with antenatal polyhydramnios had severe manifestations of polyuria, recurrent dehydration, electrolyte derangements and metabolic alkalosis. She was managed accordingly but unfortunately could not survive beyond 4 weeks. PMID:24906263

Afzal, Muhammad; Khan, Ejaz A; Khan, Wisal A; Anwar, Viqas; Yaqoob, Asma; Rafiq, Shahid; Azam, Shaheena

2014-05-01

137

Knowledge and attitude of women on the available PMTCT services at the antenatal clinic of the Coast Province General Hospital  

PubMed Central

Introduction Several high profile events of the last decade have served as catalysts for the now widely available prevention of mother-to-child transmission of HIV services. However, Kenya continues to face challenges in assuring that all women in need of PMTCT services receive the full package. Methods A cross sectional survey was undertaken. Systematic sampling method was used for sample selection. Data was collected using pretested structured questionnaires. Data was analyzed in SPSS and Epi Info using bivariate and multivariate logistic regression. Results Approximately 75% of participants were seeking PMTCT services in CPGH for the first time, 71% knew of their HIV status. About 95% of participants were satisfied with privacy during testing. Clients who had never delivered in CPGH had a significantly (p<0.001) higher odds compared to those who had previously delivered in CPGH and had their first PMTCT visit. participants who had never lost a pregnancy in CPGH and were in the hospital for the first time were 3 times likely to seek PMTCT services compared to those who had lost a pregnancy in CPGH. There was a significant association between family planning use before pregnancy and first PMTCT. Conclusion Participants seeking PMTCT services had poor HIV knowledge; but reported positive experiences and good provider – client relationship. However for a successful PMTCT program in CPGH attention needs to be paid in the patient experiences as they seek other reproductive services.

Kevin, Adam; Mutugi, Marion; Wanzala, Peter

2014-01-01

138

Physical and social predictors of partner abuse in women attending general practice: a cross-sectional study  

PubMed Central

Background Intimate partner abuse causes significant morbidity and mortality in women attending general practice. Currently there is insufficient evidence for screening all women but case finding of women at risk of intimate partner abuse is recommended. Aim To develop physical symptoms and sociodemographic indicators for partner abuse for women attending general practice. Design of study Descriptive, cross-sectional survey. Setting Thirty general practices in Victoria, Australia. Method A total of 1257 consecutive women attending general practice (response rate 77%) were screened for a history of partner abuse using a self-report questionnaire. The presence of partner abuse in the last 12 months was measured by the Composite Abuse Scale. Results Women who reported more than two physical symptoms in the last month were more likely to report experiencing partner abuse in the last 12 months (3–5 symptoms, odds ratio [OR] = 2.32, 95% confidence interval [CI] = 1.55 to 3.48; 6–15 symptoms OR = 3.47, 95% CI = 2.21 to 5.47). Many individual physical symptoms were associated with partner abuse in the bivariable analysis. Multivariable analysis showed clinical indicators of partner abuse (excluding the strong association with depression) which included sociodemographic features (age, separated/divorced, low education, low income, no private insurance) and physical symptoms (diarrhoea, tiredness, chest pain). Conclusion Clinicians should be alert for current and past partner abuse in women who are separated/divorced, on low incomes, have poor education, or have multiple physical symptoms in the past month. Future research questions include what interventions would work for women who have been or are being abused once identified. PMID:18611314

Hegarty, Kelsey; Gunn, Jane; Chondros, Patty; Taft, Angela

2008-01-01

139

Popular Contraceptive Methods in Women Aged 35 Years and Older Attending Health Centers of 4 Cities in Khuzestan Province, Iran  

PubMed Central

Background The prevalence of unintended pregnancy and associated risks are higher in late reproductive years. Limited studies have focused on contraceptive choices in these women. The aim of the study was to identify contraceptive choices and their related factors in women 35 years or older attending health centers of Khuzestan province. Objectives Additionally, several line of evidence indicated relationship between increasing maternal age and poor pregnancy outcomes (1, 2). Pregnancies above the age of 35 are accompanied with more risks for complication related to pregnancy as compared to younger women (3-5). Risk of spontaneous abortion is 74.4% in mothers aged 45 years or more. Patients and Methods In a cross-sectional study 1584 women aged 35 years and older attending public health centers of four cities of Khuzestan were studied. We used an interviewer-administered questionnaire for data collection. Women investigators were recruited for interview and filling the questionnaire. Participants were assured of the confidentiality of their responses. Results The mean age of women was 39.8 ± 4.2 years. The most popular contraceptive methods used in this age group were oral contraceptive pills (31.4%), condom (28.1%), and tubal ligation (14.8%). Less effective contraceptive methods were used in 41.5% of women. Significant associations were found between the use of effective methods and literacy of husband (OR = 0.80, 95% CI: 0.75, 0.91), city of residence (OR = 0, 92, 95%CI: 0.87-0.97), women age (OR = 0.97, 95% CI; 0.94-0.99), and women education (OR = 0.87, 95%CI: 0.76-0.99) (P < 0.01). Conclusions In spite of risk of pregnancy and unintended pregnancy in this age group, about a half of them used less effective contraceptive methods, hence family planning education, and counseling to older women should be a priority in health centers. PMID:24693364

Nouhjah, Sedighe; Amiri, Elham; Khodai, Azim; Yazdanpanah, Azar; Nadi Baghu, Maryam

2013-01-01

140

Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil  

PubMed Central

Background Socio-economic inequalities in maternal and child health are ubiquitous, but limited information is available on how much the quality of care varies according to wealth or ethnicity in low- and middle-income countries. Also, little information exists on quality differences between public and private providers. Methods Quality of care for women giving birth in 2004 in Pelotas, Brazil, was assessed by measuring how many of 11 procedures recommended by the Ministry of Health were performed. Information on family income, self-assessed skin colour, parity and type of provider were collected. Results Antenatal care was used by 98% of the 4244 women studied (mean number of visits 8.3), but the number of consultations was higher among better-off and white women, who were also more likely to start antenatal care in the first trimester. The quality of antenatal care score ranged from 0 to 11, with an overall mean of 8.3 (SD 1.7). Mean scores were 8.9 (SD 1.5) in the wealthiest and 7.9 (SD 1.8) in the poorest quintiles (P < 0.001), 8.4 (SD 1.6) in white and 8.1 (SD 1.9) in black women (P < 0.001). Adjusted analyses showed that these differences seemed to be due to attendance patterns rather than discrimination. Mean quality scores were higher in the private 9.3 (SD 1.3) than in the public sector 8.1 (SD 1.6) (P < 0.001); these differences were not explained by maternal characteristics or by attendance patterns. Conclusions Special efforts must be made to improve quality of care in the public sector. Poor and black women should be actively encouraged to start antenatal care early in pregnancy so that they can fully benefit from it. There is a need for regular monitoring of antenatal attendances and quality of care with an equity lens, in order to assess how different social groups are benefiting from progress in health care. PMID:20123940

Victora, CG; Matijasevich, A; Silveira, MF; Santos, IS; Barros, AJD; Barros, FC

2010-01-01

141

Infant Feeding among Women Attending an Immunisation Clinic at a Tertiary Health Institution in Ibadan, Nigeria  

ERIC Educational Resources Information Center

Maternal characteristics can affect a mother's decision to breastfeed. This study used a cross-sectional design to assess maternal variables and infant feeding patterns among nursing mothers attending an immunisation clinic in Ibadan, Nigeria. A total of 264 mothers who consecutively attended the immunisation clinic and met certain inclusion…

Fatiregun, A. A.; Abegunde, V. O.

2009-01-01

142

Quality of antenatal care in rural Tanzania: counselling on pregnancy danger signs  

Microsoft Academic Search

BACKGROUND: The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania. METHODS: A cross-sectional study was conducted in 18 primary health facilities. Thirty two

Andrea B Pembe; Anders Carlstedt; David P Urassa; Gunilla Lindmark; Lennarth Nyström; Elisabeth Darj

2010-01-01

143

Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia  

Microsoft Academic Search

BACKGROUND: Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care

Christiana R Titaley; Cynthia L Hunter; Michael J Dibley; Peter Heywood

2010-01-01

144

SEXUAL BEHAVIOR AND HIV INFECTION AMONG PREGNANT HILLTRIBE WOMEN IN NORTHERN THAILAND  

Microsoft Academic Search

A case-control study was carried out to determine factors associated with HIV infec- tion among pregnant hilltribe women who attended the antenatal clinics of six hospitals in northern Thailand (Mae Suai, Wieng Pa Pao, Mae Sai, Mae Chan, Wieng Kaen, Mae Fa Luang, and Chiang Rai hospitals) between 1 January 2005- 31 May 2007. Data were collected using questionnaires and

Tawatchai Keereekamsuk; Sukhum Jiamton; Sutthi Jareinpituk; Jaranit Kaewkungwal

145

Breast and Cervical Cancer Screening and Health Beliefs Among African American Women Attending Educational Programs  

Microsoft Academic Search

This article assessed the relationship between breast and cervical cancer screening rates and health beliefs in African American women participating in Witness Project of Harlem (WPH) education sessions. WPH is a culturally sensitive, faith-based breast and cervical cancer screening education program targeting African American women in medically underserved New York City communities. A questionnaire administered to women participating for the

Lisa Ochoa-Frongia; Hayley S. Thompson; Yulinda Lewis-Kelly; Terri Deans-McFarlane; Lina Jandorf

2012-01-01

146

Level of awareness of mammography among women attending outpatient clinics in a teaching hospital in Ibadan, South-West Nigeria  

PubMed Central

Background Mammography has been used in developed countries with considerable success but very little is known about this imaging modality in low resource settings. This study examined the level of awareness of mammography and determined factors influencing the level of awareness. Methods We conducted a hospital based cross sectional study to investigate the level of awareness of mammography among 818 randomly selected women attending the General Outpatient clinics (GOP) of the University College Hospital (UCH), Ibadan, Nigeria. Independent predictors of level of awareness of mammography were identified using multiple logistic regression analysis. Results The proportion of women who ever heard of mammography was 5%, and they demonstrated poor knowledge of the procedure. Those with primary or secondary levels of education were about three times less likely to be aware of mammography when compared with those with tertiary level of education (OR?=?0.3, 95% CI, 0.12 – 0.73). Also, participation in community breast cancer prevention activities (OR?=?3.4, 95% CI, 1.39 – 8.36), and previous clinical breast examination (OR?=?2.34, 95% CI, 1.10 – 4.96) independently predicted mammography awareness. Newspapers and magazines appeared to be the most important sources of information about mammography screening. Conclusion The level of awareness of mammography is poor among women attending outpatient clinics in the studied population. Interventions promoting awareness of this screening procedure should give particular attention to the illiterate and older women while clinicians performing breast examinations should utilize the opportunity to inform women about the mammography procedure. Promotion of educational articles on breast cancer and its screening methods via media remains vital for the literate. PMID:23324312

2013-01-01

147

Motivations and reasons for women attending a Breast Self-Examination training program: A qualitative study  

Microsoft Academic Search

BACKGROUND: Breast cancer is a major threat to Taiwanese women's health. Despite the controversy surrounding the effectiveness of breast self-examination (BSE) in reducing mortality, BSE is still advocated by some health departments. The aim of the study is to provide information about how women decide to practice BSE and their experiences through the training process. Sixty-six women aged 27-50 were

Rea-Jeng Yang; Lian-Hua Huang; Yeu-Sheng Hsieh; Ue-Lin Chung; Chiun-Sheng Huang; Herng-Dar Bih

2010-01-01

148

Proposed Framework for Making Focused Antenatal Care Services Accessible: A Review of the Nigerian Setting  

PubMed Central

The aim of this paper is to propose a framework for making antenatal care an effective strategy in reducing the high maternal mortality ratio in Nigeria. On-site visits to five teaching hospitals were carried out between 2006 and 2008 to assess the practice of antenatal care. Group discussions with 200 parturients on their awareness of birth preparedness/complication readiness were conducted, in October, 2008. The findings of this study are discussed in line with the proposed practice of focused antenatal care. The practice of antenatal care in all the hospitals visited was the traditional approach based on earlier European models. Awareness of birth preparedness/complication readiness, by parturients, as a goal-directed intervention during antenatal care was low (21.5%). To reduce maternal deaths through antenatal care, it is critical to link care with detecting and treating causes of maternal mortality by a skilled attendant. PMID:22263112

Ekabua, John; Ekabua, Kufre; Njoku, Charles

2011-01-01

149

Prevalence and risk factors for Hepatitis C and HIV1 infections among pregnant women in Central Brazil  

Microsoft Academic Search

BACKGROUND: Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in

Zelma B Costa; Gustavo C Machado; Mariza M Avelino; Clidenor Gomes Filho; Jose V Macedo Filho; Ana L Minuzzi; Marilia D Turchi; Mariane MA Stefani; Wayner Vieira de Souza; Celina MT Martelli

2009-01-01

150

Antenatal and obstetric care in Afghanistan - a qualitative study among health care receivers and health care providers  

PubMed Central

Background Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled “the worst country in which to be a mom” in Save the Children’s World’s Mothers’ Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Methods Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi’s phenomenological analysis. Results Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. Conclusion This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care, especially by poorly educated rural women. Patients frequently complained of being treated disrespectfully, and health care providers correspondingly complained about poor working conditions leading to exhaustion and a lack of compassion. Widespread corruption, including the necessity of personal contacts inside hospitals, was also emphasized as an obstacle to equitable antenatal and obstetric health care. PMID:23642217

2013-01-01

151

Hepatitis B virus, human immunodeficiency virus type-1, and syphilis among women attending prenatal clinics in Belize, Central America.  

PubMed

Women and their infants may benefit from therapeutic interventions when hepatitis B, human immunodeficiency virus (HIV), or syphilis are detected during the prenatal period. We initiated hepatitis B and HIV screening of women attending prenatal clinics in Belize. Risk factor assessment information for hepatitis B infection and demographic data were determined by interview. Of 543 evaluable women, 81 (14.9%) were seropositive for hepatitis B core antibody (anti-HBc); one woman had asymptomatic hepatitis B surface antigenemia. Antibodies to HIV-1 were detected in one woman. Reactive syphilis serologies were detected in 15 (2.8%) women. Anti-HBc seroprevalence varied by district (range 3.1-43.5%) and by ethnicity (range 0.0-40.9%). Significant identified risks for anti-HBc seropositivity from univariate analyses included being of the Garifuna ethnic group, residence or birth in the Stann Creek or Toledo districts, a reactive syphilis serology, a household size of eight or greater, and five or more lifetime sexual partners. Multivariate analyses identified ethnicity and a reactive rapid plasma reagin as the best predictors of anti-HBc seropositivity. Highly variable differences in anti-HBc prevalence by district may permit the targeting of limited public health resources for education, screening, and prevention programs. PMID:9129530

Scott-Wright, A; Hakre, S; Bryan, J P; Jaramillo, R; Reyes, L G; Cruess, D; Macarthy, P O; Gaydos, J C

1997-03-01

152

Knowledge, Awareness and Prevention of Cervical Cancer among Women Attending a Tertiary Care Hospital in Puducherry, India  

PubMed Central

Background: Cervical cancer is one of the most common cancers among women worldwide, with highest mortality in India. The incidence and mortality of cervical cancer can be reduced by screening women for precancerous lesion and by administration of human papilloma virus vaccine to adolescent girls. Knowledge of the women about cervical cancer and awareness about its prevention are the key factors that determine their utilization of screening services. Methods: A cross sectional survey of women attending Gynaecology Out-Patient Department (OPD) in a tertiary care hospital in Puducherry was conducted. Information about their knowledge of cervical cancer, awareness of its prevention and their socio demographic characters were collected. Results: Mean age of the study population was 40.45 ± 12 years. Less than half of the study population (178, 44.5%) knew about cervical cancer. Less than one-fourth of the population knew about screening services for prevention of cervical cancer, and majority (389, 97.2%) were not aware of vaccination as prevention for cervical cancer. Conclusion: Our study population shows poor knowledge about cervical cancer and is unaware of the concept of prevention. Hence extensive health education to the public is needed regarding cervical cancer and its prevention. PMID:25121031

Siddharthar, Jansirani; Deivasigamani, Kuberan

2014-01-01

153

Rh isoimmunization during pregnancy: antenatal prophylaxis.  

PubMed Central

Of 3533 Rh-negative women who began a pregnancy without detectable Rh antibodies, 62 (1.8%) demonstrated evidence of Rh isoimmunization during pregnancy or within 3 days after delivery. All denied transfusions as well as abortions or previous pregnancies not followed by the administration of Rh immune globulin. Rh isoimmunization during pregnancy or within 3 days after delivery, which will not be prevented by the administration of Rh immune globulin after delivery, is the most important cause of residual Rh isoimmunization. A clinical trial of antenatal administration of Rh immune globulin, initially at 34 weeks's and subsequently at 28 and 34 weeks' gestation, in 1357 Rh-negative pregnant women who were delivered of Rh-positive babies, was effective in preventing the development of Rh isoimmunization during pregnancy or within 3 days after delivery. Antenatal prophylaxis with Rh immune globulin will be necessary if the incidence of Rh isoimmunization is to be reduced to its lowest possible level. Antenatal prophylaxis at 28 weeks' gestation is now an insured service in Manitoba. PMID:77714

Bowman, J. M.; Chown, B.; Lewis, M.; Pollock, J. M.

1978-01-01

154

Antenatal Depression: A Rationale for Studying Exercise  

PubMed Central

Background Major Depressive Disorder (MDD) in pregnancy, or antenatal depression poses unique treatment challenges and has serious consequences for mothers, unborn babies, and families when untreated. This review presents current knowledge on exercise during pregnancy, antidepressant effects of exercise, and the rationale for the specific study of exercise for antenatal depression. Method A systematic literature review was performed using English language articles published in Medline, PsycINFO, CINAHL, and the Cochrane Library from 1985 to January 2010. Results There is a broad literature supporting the antidepressant effects of exercise, but a paucity of studies specifically for antenatal depression. A small number of observational studies have reported that regular physical activities improve self-esteem and reduce symptoms of anxiety and depression during pregnancy. To date, there have not been randomized controlled studies of exercise for the treatment of MDD in pregnant women. Conclusions Systematic studies are needed to assess exercise as a treatment alternative for MDD during pregnancy. In consideration of the benefits of exercise for the mother and baby, and the burden of depression, studies are needed to determine the role of exercise for pregnant women with depression. PMID:21394856

Shivakumar, Geetha; Brandon, Anna R.; Snell, Peter G.; Santiago-Munoz, Patricia; Johnson, Neysa L.; Trivedi, Madhukar H.; Freeman, Marlene P.

2010-01-01

155

[Accidents and violence among women attended in Sentinel Emergency Services--Brazil, 2009].  

PubMed

Accidents from external causes affect the human population in different ways. This article seeks to analyze emergency care for women who are victims of accidents and violence. Data from the Surveillance System for Violence and Accidents were analyzed. This study was carried out in 74 emergency units of 23 state capitals and the Federal District in 2009 and included 6,965 women aged from 20-59 years. The age groups of 20-39 and 40-59 years were compared for the occurrence of accidents and violence. Accidents were more frequent among young black women (20-39 years) with more than nine years of schooling. The occurrence of violence was also prevalent in young black women but with less schooling. Falls were the most frequent accidents (38.6%), followed by traffic accidents. The occurrence of violence was more frequent in the home (p <0.000) and the mention of alcohol abuse among victims of violence was predominant. The most frequent type of violence was aggression (84.6%), in which the aggressor was male (79.1%) and identified as an intimate partner (44.1%). It is increasingly important that services are able to provide comprehensive and humanized care to the victims of this important public health problem. PMID:22996883

Rodrigues, Celeste de Souza; Malta, Deborah Carvalho; Godinho, Tatau; Mascarenhas, Márcio Dênis Medeiros; da Silva, Marta Maria Alves; Silva, Rurany Ester

2012-09-01

156

Intimate Partner Violence and Mental Health Consequences in Women Attending Family Practice in Spain  

Microsoft Academic Search

Objective: Despite the abundant literature on the consequences of intimate partner violence (IPV) on mental health, psychological abuse has rarely been considered, and the separate effects of the different types of IPV have been understudied. The aim of this study was to analyze the association between physical, psychological, and sexual IPV and women's mental health. Methods: The sample included 1402

I. Ruiz-Perez; JUNCAL PLAZAOLA-CASTAÑO

2005-01-01

157

Self-Efficacy, Motivation, and Academic Adjustment among African American Women Attending Institutions of Higher Education  

ERIC Educational Resources Information Center

This study examined the relationships among self-efficacy beliefs, intrinsic and extrinsic motivation, and academic adjustment among 111 African American women in college. Results revealed that self-efficacy beliefs predicted Motivation to Know, Externally Regulated motivation, Identified motivation, and academic adjustment. Furthermore,…

Thomas, Deneia M.; Love, Keisha M.; Roan-Belle, Clarissa; Tyler, Keneth M.; Brown, Carrie Lynn; Garriott, Patton O.

2009-01-01

158

The impact of newspaper advertising on a regional antenatal health campaign  

Microsoft Academic Search

IN 1981 the West Midlands Health services undertook a publicity campaign aimed at helping women to under stand more about keeping healthy during pregnancy and encouraging them to seek early ante-natal care. A series of full page advertisements on ante-natal care were placed in local newspapers in the Region. Set out here are the findings of two studies of the

Judith M. Berry

1984-01-01

159

High-Grade Cervical Lesions Among Women Attending A Reference Clinic In Brazil: Associated Factors And Comparison Among Screening Methods  

PubMed Central

Background Although screening for cervical cancer is recommended for women in most countries, the incidence of cervical cancer is greater in developing countries. Our goal was to determine the prevalence and factors associated with high-grade lesions/cervical cancer among women attending a reference clinic in Brazil and evaluate the correlation of histology with cytology, colposcopy and the high-risk HPV (HR-HPV) tests. Methods A cross-sectional study of women attending a colposcopy clinic was carried out. The patients were interviewed to collect demographic, epidemiological and clinical data. Specimens were collected for cervical cytology, Chlamydia trachomatis and HPV testing using the Hybrid Capture (HC) and PCR tests. Colposcopy was performed for all patients and biopsy for histology when cell abnormalities or cervical intraepithelial neoplasia (CIN) were present. Results A total of 291 women participated in the study. The median age was 38 years (DIQ: 30–48 years). The prevalence of histologically confirmed high-grade lesions/cervical cancer was 18.2% (95%, CI: 13.8%–22.6%), with 48 (16.5%) cases of CIN-2/CIN-3 and 5 (1.7%) cases of invasive carcinoma. In the final logistic regression model, for ages between 30 and 49 years old [OR?=?4.4 (95%: 1.01–19.04), history of smoking [OR?=?2.4 (95%, CI: 1.14–5.18)], practice of anal intercourse [OR?=?2.4 (95%, CI: 1.10–5.03)] and having positive HC test for HR-HPV [OR?=?11.23 (95%, CI: 4 0.79–26, 36)] remained independently associated with high-grade lesions/cervical cancer. A total of 64.7% of the cases CIN-3\\Ca in situ were related to HPV-16. Non-oncogenic HPV were only found in CIN-1 biopsy results. Compared to histology, the sensitivity of cytology was 31.8%, the specificity 95.5%; the sensitivity of colposcopy for high-grade lesions/cervical cancer was 51.0%, specificity was 91.4% and the concordance with HPV testing was high. Conclusions The results confirm an association of HR-HPV with precursor lesions for cervical cancer. These data emphasize that cytological screening to detect precursor lesions is still important in some regions and that HR-HPV should be included for screening. PMID:25019210

Boldrini, Neide T.; Freitas, Luciana B.; Coutinho, Amanda R.; Loureiro, Flavia Z.; Spano, Liliana C.; Miranda, Angelica E.

2014-01-01

160

Breast and cervical cancer screening and health beliefs among African American women attending educational programs.  

PubMed

This article assessed the relationship between breast and cervical cancer screening rates and health beliefs in African American women participating in Witness Project of Harlem (WPH) education sessions. WPH is a culturally sensitive, faith-based breast and cervical cancer screening education program targeting African American women in medically underserved New York City communities. A questionnaire administered to women participating for the first time in a Witness Project education session collected demographics, adherence to breast and cervical cancer screening, and information about health beliefs related to cancer worry, medical mistrust, and religious faith. Screening adherence guidelines applied were as per the American Cancer Society recommendations. No statistically significant relationship was found between worry about getting breast or cervical cancer and screening adherence, or between screening adherence and agreement with statements about medical mistrust and religious beliefs. The low screening mammography and monthly breast self-exam rates emphasize the utility of programs like WPH that teach the importance of screening mammography and breast self-exam and point to the need for increased access to quality health care and cancer screening in underserved populations. PMID:21451008

Ochoa-Frongia, Lisa; Thompson, Hayley S; Lewis-Kelly, Yulinda; Deans-McFarlane, Terri; Jandorf, Lina

2012-07-01

161

Syphilis--an appraisal of the Groote Schuur Hospital antenatal screening programme.  

PubMed

Syphilis is a major public health problem in pregnant women. Since congenital syphilis is preventable, an adequate screening programme is an essential facet of antenatal care. At Groote Schuur Hospital, Cape Town, the Venereal Disease Research Laboratory and Treponema, pallidum haemagglutination tests are employed for antenatal screening. A survey of the current literature on serological testing for syphilis does not reveal clear guidelines for an optimal antenatal screening programme. The high prevalence of syphilis in pregnant women is confirmed by this study, which shows the current programme to be very effective in excluding women without disease. PMID:4002085

Gonin, J M

1985-06-15

162

Factors influencing attendance in a structured physical activity program for Aboriginal and Torres Strait Islander women in an urban setting: a mixed methods process evaluation  

PubMed Central

Background Aboriginal and Torres Strait Islander women experience higher rates of obesity, chronic disease, and are less active than non-Indigenous Australian women. Lifestyle programs designed to increase physical activity and encourage healthy eating are needed to ameliorate this disparity. The aim of this study was to identify participants’ perceived barriers and enablers to attend group exercise classes as part of a 12-week fitness program. Methods To understand the factors that influence attendance, a mixed method process evaluation was undertaken in which a quantitative measure of attendance in the group exercise classes was used to identify cases for further qualitative investigation. Aboriginal and/or Torres Strait Islander women aged 18 to 64 years were recruited to a research trial of a fitness program. The 12-week program included two 60-minute group exercise classes per week, and four nutrition education workshops. Semi-structured interviews were conducted at program completion. Participants were stratified by attendance, and interviews from the highest and lowest 25 percentiles analysed. Rigour was strengthened through use of multiple data analysts, member checking and prolonged engagement in the field. Results Analyses of the post-program interviews revealed that participants enrolled in the program primarily for the perceived health benefits and all (with one exception) found the program met their needs and expectations. The atmosphere of classes was positive and comfortable and they reported developing good relationships with their fellow participants and program staff. Low attendees described more barriers to attendance, such as illness and competing work and family obligations, and were more likely to report logistical issues, such as inconvenient venue or class times. Conclusions Attendance to the ‘Aboriginal and Torres Strait Islander Women’s Fitness Program’ was primarily influenced by the participant’s personal health, logistics and competing obligations. Low attendees reported more barriers during the 12-week period and identified fewer enabling factors than high attendees. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12610000224022 PMID:23347750

2013-01-01

163

The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study  

Microsoft Academic Search

BACKGROUND: Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing

Bibha Simkhada; Maureen A Porter; Edwin R van Teijlingen

2010-01-01

164

Trends of HIV-1, HIV-2 and dual infection in women attending outpatient clinics in Senegal, 1990-2009  

PubMed Central

Summary We assessed trends in the relative prevalences of HIV-1, HIV-2 and dual HIV-1/HIV-2 infection in 10,321 women attending outpatient clinics in Senegal between 1990 and 2009. The relative prevalence of HIV-1 (defined as the proportion of seropositive subjects having HIV-1) rose sharply from 38% in 1990 until 1993 (P < 0.001), whereupon it continued to rise, but at a slower rate, reaching 72% of HIV infections in 2009. As compared with HIV-1, the relative prevalence of HIV-2 decreased sharply from 54% in 1990 until 1993 (P < 0.001) and continued to decrease at a slower rate through 2009. The relative prevalence of dual infection, as compared with HIV-1, was stable from 1990 to 1993, but decreased slightly thereafter (P < 0.001). These study findings indicate that during the early 1990s, the relative prevalence of HIV-1 increased markedly, while the relative prevalence of HIV-2 decreased and the relative prevalence of dual infection remained stable in Senegal. From 1993 to 2009, the relative prevalence of HIV-1 increased at a slower rate, while the relative prevalences of HIV-2 and dual infection decreased. These results confirm trends in HIV prevalence observed in other West African populations and provide a critical update on HIV transmission risk among women in Senegal. PMID:23104745

Heitzinger, K; Sow, P S; Badiane, N M Dia; Gottlieb, G S; N'Doye, I; Toure, M; Kiviat, N B; Hawes, S E

2013-01-01

165

A community effectiveness trial of strategies promoting intermittent preventive treatment with sulphadoxine-pyrimethamine in pregnant women in rural Burkina Faso  

Microsoft Academic Search

BACKGROUND: Intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP) is currently being scaled up in many countries in sub-Saharan Africa. Despite high antenatal clinic (ANC) attendance, coverage with the required two doses of SP remains low. The study investigated whether a targeted community-based promotion campaign to increase ANC attendance and SP uptake could effectively improve pregnancy outcomes in the

Sabine Gies; Sheick Oumar Coulibaly; Florence Tiemegna Ouattara; Clotilde Ky; Bernard John Brabin; Umberto D'Alessandro

2008-01-01

166

Racial Identity Attitudes, Womanist Identity Attitudes, and Self-Esteem in African American College Women Attending Historically Black Single-Sex and Coeducational Institutions  

ERIC Educational Resources Information Center

This study examines racial identity attitudes, womanist identity attitudes, and self-esteem of 111 African American college women attending two historically Black higher educational institutions, one coeducational and one single-sex. The major findings indicate that pre-encounter and encounter attitudes of racial and womanist identity are…

Watt, Sherry Kay

2006-01-01

167

Understanding exercise adherence and dropout: an interpretative phenomenological analysis of men and women's accounts of gym attendance and non-attendance  

Microsoft Academic Search

This study was designed to investigate experiences of maintaining and dropping out of a gym-based exercise programme. Interviews were carried out with 14 people, aged 19–32?years, comprising seven men and two women who had maintained their gym membership and three women and two men who had not. Member validation interviews were conducted 20?months later with one man who was previously

Lisa Pridgeon; Sarah Grogan

2012-01-01

168

Intralobar bronchopulmonary sequestration: antenatal diagnosis.  

PubMed Central

A child with the antenatal diagnosis of pulmonary cystic adenomatoid malformation underwent thoracotomy and an intralobar bronchopulmonary sequestration was found. Histological examination of the resected specimen showed cystic adenomatoid malformation within the sequestered segment. Images PMID:8202912

Ng, K. J.; Hasan, N.; Gray, E. S.; Jeffrey, R. R.; Youngson, G. G.

1994-01-01

169

Towards the participation of traditional birth attendants in primary health care in Kenya.  

PubMed

This study of 80 traditional birth attendants from Homa Bay District sought their knowledge, functions, and participation in maternal-child health care and family planning. The TBAs were all women with a median age of 50 years. They formed a significant feature of the Luo medical landscape offering a wide range of antenatal, perinatal and postnatal services. The TBAs could become part of the official health care providers offering services, making early diagnoses of difficult pregnancy cases and providing appropriate referrals to health facilities. However, their vocation requires to be enhanced and certain practices such as the use of herbal medicines rationalized through training and research. PMID:7498031

Sindiga, I

1995-07-01

170

Antenatal psychosocial assessment for reducing perinatal mental health morbidity  

PubMed Central

Background Mental health conditions arising in the perinatal period, including depression, have the potential to impact negatively on not only the woman but also her partner, infant, and family. The capacity for routine, universal antenatal psychosocial assessment, and thus the potential for reduction of morbidity, is very significant. Objectives To evaluate the impact of antenatal psychosocial assessment on perinatal mental health morbidity. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register, the Cochrane Depression, Anxiety and Neurosis Group’s Trials Register (CCDAN TR-Studies), HSRProj in the National Library of Medicine (USA), and the Current Controlled Trials website: http://www.controlled trials.com/ and the UK National Research Register (last searched March 2008). Selection criteria Randomised and quasi-randomised controlled trials. Data collection and analysis At least two review authors independently assessed trials for eligibility; they also extracted data from included trials and assessed the trials for potential bias. Main results Two trials met criteria for an RCT of antenatal psychosocial assessment. One trial examined the impact of an antenatal tool (ALPHA) on clinician awareness of psychosocial risk, and the capacity of the antenatal ALPHA to predict women with elevated postnatal Edinburgh Depression Scale (EDS) scores, finding a trend towards increased clinician awareness of ‘high level’ psychosocial risk where the ALPHA intervention had been used (relative risk (RR) 4.61 95% confidence interval (CI) 0.99 to 21.39). No differences between groups were seen for numbers of women with antenatal EDS scores, a score of greater than 9 being identified by ALPHA as of concern for depression (RR 0.69 95% CI 0.35 to 1.38); 139 providers. The other trial reported no differences in EPS scores greater than 12 at 16 weeks postpartum between the intervention (communication about the EDS scores with the woman and her healthcare providers plus a patient information booklet) and the standard care groups (RR 0.86 95% CI 0.61 to 1.21; 371 women). Authors’ conclusions While the use of an antenatal psychosocial assessment may increase the clinician’s awareness of psychosocial risk, neither of these small studies provides sufficient evidence that routine antenatal psychosocial assessment by itself leads to improved perinatal mental health outcomes. Further studies with better sample size and statistical power are required to further explore this important public health issue. It will also be important to examine outcomes up to one year postpartum not only for mother, but also infant and family. PMID:18843682

Austin, Marie-Paule; Priest, Susan R; Sullivan, Elizabeth A

2014-01-01

171

Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China  

PubMed Central

Background Antenatal ultrasound scan is a widely accepted component of antenatal care. Studies have looked at the relationship between ultrasound scanning and caesarean section (CS) in certain groups of women in China. However, there are limited data on the utilization of antenatal ultrasound scanning in the general population, including its association with CS. The purpose of this study is to describe the utilization of antenatal ultrasound screening in rural Eastern China and to explore the association between antenatal ultrasound scan and uptake of CS. Methods Based on a cluster randomized sample, a total of 2326 women with childbirth participated in the study. A household survey was conducted to collect socio-economic information, obstetric history and utilization of maternal health services. Results Coverage of antenatal care was 96.8% (2251/2326). During antenatal care, 96.1% (2164/2251) women received ultrasound screening and the reported average number was 2.55. 46.8% women received at least 3 ultrasound scans and the maximum number reached 11. The CS rate was found to be 54.8% (1275/2326). After adjusting for socio-demographic and clinical variables, it showed a statistically significant association between antenatal ultrasound scans and uptake of CS by multivariate logistic regression model. High husband education level, high maternal age, having previous adverse pregnant outcome and pregnancy complications during the index pregnancy were also found to be risk factors of choosing a CS. Conclusions A high use of antenatal ultrasound scan in rural Eastern China is found and is influenced by socio-demographic and clinical factors. Evidence-based guidelines for antenatal ultrasound scans need to be developed and disseminated to clinicians including physicians, nurses and sonographers. Guidance about the appropriate use of ultrasound scans should also be shared with women in order to discourage unreasonable expectations and demands. It is important to monitor the use of antenatal ultrasound scan as well as the indications for caesarean section in rural China. PMID:22494358

2012-01-01

172

Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia  

PubMed Central

Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized. PMID:20701762

2010-01-01

173

Relations of Changes in SelfEfficacy, Exercise Attendance, Mood, and Perceived and Actual Physical Changes in Obese Women: Assessing Treatment Effects Using Tenets of Self Efficacy Theory  

Microsoft Academic Search

Obese and sedentary women ( N = 76) initiated an exercise and nutrition program based on self-efficacy theory. Significant within-group improvements in body fat, waist size, and body mass index were found over 6 months. Changes in Physical Self-Concept (task self-efficacy) and Exercise Self-Efficacy (self-regulatory efficacy) scores, together, accounted for a significant portion of the variance in exercise session attendance,

James J. Annesi; Jennifer L. Unruh; Ann C. Whitaker

2007-01-01

174

HPV testing on self collected cervicovaginal lavage specimens as screening method for women who do not attend cervical screening: cohort study  

Microsoft Academic Search

Objective To determine whether offering self sampling of cervicovaginal material for high risk human papillomavirus (HPV) testing is an effective screening method for women who do not attend regular cervical screening programmes.Design Cohort study (the PROHTECT trial).Settings Noord-Holland and Flevoland regions of the Netherlands, December 2006 to December 2007, including 13 laboratories, gynaecologists, and more than 800 general practitioners.Participants 28

Murat Gök; Daniëlle A M Heideman; Folkert J van Kemenade; Johannes Berkhof; Lawrence Rozendaal; Johan W M Spruyt; Feja Voorhorst; Jeroen A M Beliën; Milena Babovi?; Peter J F Snijders; Chris J L M Meijer

2010-01-01

175

Depression among Women with Primary Infertility attending an Infertility Clinic in Riyadh, Kingdom of Saudi Arabia: Rate, Severity, and Contributing Factors  

PubMed Central

Background Infertility is a severely distressing experience for many couples. Depression is considered as one of the main psychological disorders associated with infertility and it may significantly affect the life of infertile individuals, their treatment, and follow-up. Objective The objective of the study was to determining the prevalence and predisposing factors of depressive disorders among the infertile compared to fertile women. Methodology Rate of depression was explored by this cross-sectional study carried out among women attending In-Vitro Fertilization Clinic (91 infertile women) and Well Baby Clinic (94 fertile women) at King Abdulaziz Medical City (KAMC) in Riyadh, KSA. Self administrated questionnaire including Beck Depression Inventory (BDI) was used. Mean BDI score was measured and its relation with different variables was explored, such as age, educational level, duration of infertility, pressure from family members, miscarriages and support from husband. Results This study showed that 49 (53.8%) of the infertile women and 35 (37.2%) of the fertile women had depression. Mean BDI score between infertile and fertile women was significantly different (p <0.001). Infertile women were found to be more severely depressed (p =0.014). Among the infertile women, those who had pressure from family members for not getting pregnant were more depressed than those with no such pressure (P=0.001). Conclusion Depression is more common and severe in infertile women than fertile women. Pressure from family to get pregnant is a significant contributor to depression. Caregivers should routinely screen infertile women for depression during and after treatment for infertility and manage concomitantly. PMID:23267288

Al-Homaidan, Homaidan Turki

2011-01-01

176

Use of antenatal corticosteroids prior to preterm birth in four South East Asian countries within the SEA-ORCHID project  

Microsoft Academic Search

BACKGROUND: There is strong evidence supporting the use of antenatal corticosteroids in women at risk of preterm birth to promote fetal lung maturation and reduce neonatal mortality and morbidity. This audit aimed to assess the use of antenatal corticosteroids prior to preterm birth in the nine hospitals in four South East Asian countries participating in the South East Asia Optimising

Porjai Pattanittum; Melissa R Ewens; Malinee Laopaiboon; Pisake Lumbiganon; Steven J McDonald; Caroline A Crowther

2008-01-01

177

Do antenatal care interventions improve neonatal survival in India?  

PubMed

Although antenatal care (ANC) interventions have been in place for a long time, there is hardly any systematic evidence on the association between ANC interventions and neonatal mortality in India. The present study attempts to investigate the association between ANC interventions and neonatal mortality in India using data from the District Level Household Survey conducted in India during 2007-8. The ANC interventions included in the analysis are at least four antenatal visits, consumption of 90 or more iron-folic acid (IFA) tablets, and uptake of two or more tetanus toxoid (TT) injections. We have used discrete-time logistic regression models to investigate the association between ANC interventions and neonatal mortality. Risk of neonatal mortality was significantly lower for infants of mothers who availed four or more antenatal visits [odds ratio (OR): 0.69; 95% confidence interval (CI): 0.60-0.81], consumed 90 or more IFA tablets (OR: 0.85; 95% CI: 0.73-0.99), received two or more TT injections (OR: 0.73; 95% CI: 0.63-0.83). When we analysed different combinations of antenatal visits, IFA supplementation and TT injections, TT injections provided the main protective effect-the risk of neonatal mortality was significantly lower in newborns of women who received two or more TT injections but did not consume 90 or more IFA tablets (OR: 0.69; 95% CI: 0.60-0.78), or who received two or more TT injections but did not avail four or more antenatal visits (OR: 0.75; 95% CI: 0.66-0.86). In the statistical model, 6% (95% CI: 4-8%) of the neonatal deaths in India could be attributed to a lack of at least two TT injections during pregnancy. Indian public health programmes must ensure that every pregnant woman receives two or more TT injections during antenatal visits. PMID:24038077

Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Alagarajan, Manoj

2014-10-01

178

A Comparison of Excessive Postpartum Blood Loss Estimates Among Three Subgroups of Women Attending Births in Matlab, Bangladesh  

PubMed Central

Objective Postpartum hemorrhage (PPH) is the leading cause of maternal death and disability worldwide. Recognition depends on subjective visual quantification. This study sought to assess and compare the thresholds for excessive postpartum blood loss reported by skilled birth attendants (SBA), traditional birth attendants (TBA), and laywomen in Matlab, Bangladesh. Method Data from six questions asking about excessive blood loss in the postpartum period were analyzed using analysis of variance (ANOVA), Hochberg test, Kruskal-Wallis and standard descriptive statistics. Results Thresholds for excessive blood loss estimated by laywomen and TBAs exceed biomedical standards for PPH. Skilled birth attendant reports are consistent with the definition of severe acute PPH. Conclusion Further research on locally validated blood collection devices, in birth kits, for diagnostic aid or referral indication is needed. Areas where coverage and uptake of skilled birth attendance are low should be targeted due to the number of home births attended by TBAs and laywomen in such settings. Precis A comparison of excessive postpartum blood loss estimates among skilled birth attendants, traditional birth attendants and laywomen in Matlab, Bangladesh. PMID:20625452

Edmonds, Joyce K.; Hruschka, Daniel; Sibley, Lynn M.

2009-01-01

179

Sexually transmitted pathogens in pregnant women in a rural South African community  

Microsoft Academic Search

One hundred and ninety three consecutive pregnant women attending peripheral antenatal clinics attached to Ngwelezana Hospital, Empangeni, Kwa-Zulu, were examined for evidence of sexually transmitted pathogens. The following incidences were found: Trichomonas vaginalis 49.2% (95), Candida spp 38.3% (74), Chlamydia trachomatis 11.4% (22), Gardnerella vaginalis 6.2% (12), Neisseria gonorrhoeae 5.7% (11), positive syphilis serology results 11.9% (23), hepatitis B surface

N OFarrell; A A Hoosen; A B Kharsany; J van den Ende

1989-01-01

180

Seroprevalence of Toxoplasma gondii infection among immigrant and native pregnant women in Eastern Spain  

Microsoft Academic Search

In European countries, toxoplasma antenatal screening is recommended to prevent toxoplasmosis. The seroprevalence of these\\u000a infections in immigrants can be different than in native population. From February 2006 to June 2010, a cross-sectional study\\u000a was carried out in all pregnant women attended at a reference unit in Elche, Spain. An enzyme immunoassay was used for detection\\u000a of IgG antibodies against

José M. Ramos; Afredo Milla; Juan C. Rodríguez; Sergio Padilla; Mar Masiá; Félix Gutiérrez

181

TOXOPLASMOSIS-RELATED KNOWLEDGE AMONG PREGNANT AND POSTPARTUM WOMEN ATTENDED IN PUBLIC HEALTH UNITS IN NITER?I, RIO DE JANEIRO, BRAZIL  

PubMed Central

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented. PMID:25229225

Millar, Patricia Riddell; de Moura, Fernanda Loureiro; Bastos, Otilio Machado Pereira; de Mattos, Danuza Pinheiro Bastos Garcia; Fonseca, Ana Beatriz Monteiro; Sudre, Adriana Pittella; Leles, Daniela; Amendoeira, Maria Regina Reis

2014-01-01

182

Intermittent preventive treatment of malaria during pregnancy: a qualitative study of knowledge, attitudes and practices of district health managers, antenatal care staff and pregnant women in Korogwe District, North-Eastern Tanzania  

Microsoft Academic Search

BACKGROUND: Intermittent preventive treatment of malaria during pregnancy (IPTp) is a key intervention in the national strategy for malaria control in Tanzania. SP, the current drug of choice, is recommended to be administered in the second and third trimesters of pregnancy during antenatal care (ANC) visits. To allow for a proper design of planned scaling up of IPT services in

Godfrey Mubyazi; Paul Bloch; Mathias Kamugisha; Andrew Kitua; Jasper Ijumba

2005-01-01

183

The burden of antenatal heart disease in South Africa: a systematic review  

PubMed Central

Background Maternal mortality in South Africa is rising, and heart conditions currently account for 41 per cent of indirect causes of deaths. Little is known about the burden of heart disease in pregnant South Africans. Methods We systematically reviewed the contemporary epidemiology and peripartum outcomes of heart disease in South African women attending antenatal care. Searches were performed in PubMed, ISI Web of Science, the EBSCO Africa-Wide database, the South African Union Catalogue, and the Current and Completed Research database (South Africa). References of included articles were also hand-searched. Studies reporting epidemiologic data on antenatal heart disease in South Africa were included. Data on morbidity and mortality were also collected. Results Seven studies were included in the systematic review. The prevalence of heart disease ranged from 123 to 943 per 100,000 deliveries, with a median prevalence of 616 per 100,000. Rheumatic valvular lesions were the commonest abnormalities, although cardiomyopathies were disproportionately high in comparison with other developing countries. Peripartum case-fatality rates were as high as 9.5 per cent in areas with limited access to care. The most frequent complications were pulmonary oedema, thromboembolism, and major bleeding with warfarin use. Perinatal mortality ranged from 8.9 to 23.8 per cent, whilst mitral lesions were associated with low birth weight. Meta-analysis could not be performed due to clinical and statistical heterogeneity of the included studies. Conclusion Approximately 0.6 per cent of pregnant South Africans have pre-existing cardiac abnormalities, with rheumatic lesions being the commonest. Maternal and perinatal morbidity and mortality continue to be very high. We conclude this review by summarising limitations of the current literature and recommending standard reporting criteria for future reports. PMID:22463484

2012-01-01

184

Stigma and Attitudes towards Antenatal Depression and Antidepressant Use during Pregnancy in Healthcare Students  

ERIC Educational Resources Information Center

Depression in pregnancy or antenatal depression (AD) occurs in approximately one in five women, with potentially deleterious effects to the mother and fetus. People are encouraged to get treatment for depression; however, pregnant women can experience stigma when they reach out for help with depression. Research indicates that healthcare…

Gawley, Laura; Einarson, Adrienne; Bowen, Angela

2011-01-01

185

Factors perceived to contribute to mathematics avoidance or mathematics confidence in non-traditional age women attending a community college  

Microsoft Academic Search

Over the past decade, the number of students entering postsecondary institutions immediately after high school has been decreasing, while the number of non-traditional aged students, defined as adults over 25, has substantially increased, with women making up the majority of this adult student group. Mathematics education is an area where non-traditional age women tend to have difficulty. Fifteen individual interviews

Jo Ann K Rawley

2007-01-01

186

Postpartum Dietary Intakes and Food Taboos Among Chinese Women Attending Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur  

Microsoft Academic Search

Traditionally, Chinese women adhere to special dietary practices during the month following childbirth. This paper discusses the dietary practices and food taboos practised by Chinese women in Kuala Lumpur. A total of 134 Chinese mothers of children below one year were recruited from three Maternal and Child Health Clinics and Maternity Hospital, Kuala Lumpur. Questionnaires and in-depth interviews were used

Poh Bee Koon; Wong Yuen Peng; Norimah A. Karim

2005-01-01

187

Uptake of provider-initiated HIV testing and counseling among women attending an urban sexually transmitted disease clinic in South Africa – missed opportunities for early diagnosis of HIV infection  

Microsoft Academic Search

This study assessed the uptake of provider-initiated HIV testing and counseling (PITC) among women attending an urban sexually transmitted diseases (STD) clinic in South Africa. From July 2005 to June 2006, women were offered HIV testing following group information and education on HIV and STDs in the clinic waiting area. Of those who were provided with education, information, and offered

Ayesha B. M. Kharsany; Quarraisha Abdool Karim; Salim S. Abdool Karim

2010-01-01

188

Factors influencing the use of antenatal care in rural West Sumatra, Indonesia  

PubMed Central

Background Every year, nearly half a million women and girls needlessly die as a result of complications during pregnancy, childbirth or the 6 weeks following delivery. Almost all (99%) of these deaths occur in developing countries. The study aim was to describe the factors related to low visits for antenatal care (ANC) services among pregnant women in Indonesia. Method A total of 145 of 200 married women of reproductive age who were pregnant or had experienced birth responded to the questionnaire about their ANC visits. We developed a questionnaire containing 35 items and four sections. Section one and two included the women's socio demographics, section three about basic knowledge of pregnancy and section four contained two subsections about preferences about midwives and preferences about Traditional Birth Attendant (TBA) and the second subsections were traditional beliefs. Data were collected using a convenience sampling strategy during July and August 2010, from 10 villages in the Tanjung Emas. Multiple regression analysis was used for preference for types of providers. Results Three-quarter of respondents (77.9%) received ANC more than four times. The other 22.1% received ANC less than four times. 59.4% received ANC visits during pregnancy, which was statistically significant compared to multiparous (p = 0.001). Women who were encouraged by their family to receive ANC had statistically significant higher traditional belief scores compared to those who encouraged themselves (p = 0.003). Preference for TBAs was most strongly affected by traditional beliefs (p < 0.001). On the contrary, preference for midwives was negatively correlated with traditional beliefs (p < 0.001). Conclusions Parity was the factor influencing women's receiving less than the recommended four ANC visits during pregnancy. Women who were encouraged by their family to get ANC services had higher traditional beliefs score than women who encouraged themselves. Moreover, traditional beliefs followed by lower income families had the greater influence over preferring TBAs, with the opposite trend for preferring midwives. Increased attention needs to be given to the women; it also very important for exploring women's perceptions about health services that they received. PMID:22353252

2012-01-01

189

The Prevalence of Domestic Violence Among Pregnant Women Who Were Attended in Iran University of Medical Science Hospitals  

Microsoft Academic Search

The prevalence of domestic violence (DV) during pregnancy could be high and is associated with significant psychological and\\u000a physical impairment for mother and the fetus. The major objective of this study was to determine the prevalence of DV in expectant\\u000a mothers who have attended the Iran University of Medical Sciences’ Hospitals (IUMS). In this cross-sectional study, 1,800\\u000a subjects were interviewed

Shayesteh Jahanfar; Zahra Malekzadegan

2007-01-01

190

Validation of the multi-dimensional scale of perceived social support (MSPSS) and the relationship between social support, intimate partner violence and antenatal depression in Malawi  

PubMed Central

Background Lack of social support is an important risk factor for antenatal depression and anxiety in low- and middle-income countries. We translated, adapted and validated the Multi-dimensional Scale of Perceived Social Support (MSPSS) in order to study the relationship between perceived social support, intimate partner violence and antenatal depression in Malawi. Methods The MSPSS was translated and adapted into Chichewa and Chiyao. Five hundred and eighty-three women attending an antenatal clinic were administered the MSPSS, depression screening measures, and a risk factor questionnaire including questions about intimate partner violence. A sub-sample of participants (n?=?196) were interviewed using the Structured Clinical Interview for DSM-IV to diagnose major depressive episode. Validity of the MSPSS was evaluated by assessment of internal consistency, factor structure, and correlation with Self Reporting Questionnaire (SRQ) score and major depressive episode. We investigated associations between perception of support from different sources (significant other, family, and friends) and major depressive episode, and whether intimate partner violence was a moderator of these associations. Results In both Chichewa and Chiyao, the MSPSS had high internal consistency for the full scale and significant other, family, and friends subscales. MSPSS full scale and subscale scores were inversely associated with SRQ score and major depression diagnosis. Using principal components analysis, the MSPSS had the expected 3-factor structure in analysis of the whole sample. On confirmatory factor analysis, goodness–of-fit indices were better for a 3-factor model than for a 2-factor model, and met standard criteria when correlation between items was allowed. Lack of support from a significant other was the only MSPSS subscale that showed a significant association with depression on multivariate analysis, and this association was moderated by experience of intimate partner violence. Conclusions The MSPSS is a valid measure of perceived social support in Malawi. Lack of support by a significant other is associated with depression in pregnant women who have experienced intimate partner violence in this setting. PMID:24938124

2014-01-01

191

Poor glycemic control in younger women attending Malaysian public primary care clinics: findings from adults diabetes control and management registry  

PubMed Central

Background Women of reproductive age are a group of particular concern as diabetes may affect their pregnancy outcome as well as long-term morbidity and mortality. This study aimed to compare the clinical profiles and glycemic control of reproductive and non-reproductive age women with type 2 diabetes (T2D) in primary care settings, and to determine the associated factors of poor glycemic control in the reproductive age group women. Methods This was a cross-sectional study using cases reported by public primary care clinics to the Adult Diabetes Control and Management registry from 1st January to 31st December 2009. All Malaysian women aged 18 years old and above and diagnosed with T2D for at least 1 year were included in the analysis. The target for glycemic control (HbA1c < 6.5%) is in accordance to the recommended national guidelines. Both univariate and multivariate approaches of logistic regression were applied to determine whether reproductive age women have an association with poor glycemic control. Results Data from a total of 30,427 women were analyzed and 21.8% (6,622) were of reproductive age. There were 12.5% of reproductive age women and 18.0% of non-reproductive age women that achieved glycemic control. Reproductive age group women were associated with poorer glycemic control (OR = 1.5, 95% CI = 1.2-1.8). The risk factors associated with poor glycemic control in the reproductive age women were being of Malay and Indian race, longer duration of diabetes, patients on anti-diabetic agents, and those who had not achieved the target total cholesterol and triglycerides. Conclusion Women with T2D have poor glycemic control, but being of reproductive age was associated with even poorer control. Health care providers need to pay more attention to this group of patients especially for those with risk factors. More aggressive therapeutic strategies to improve their cardiometabolic control and pregnancy outcome are warranted. PMID:24325794

2013-01-01

192

How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania  

Microsoft Academic Search

BACKGROUND: Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO). In this study we assess the time health workers

Claudia von Both; Steffen Fle?a; Ahmad Makuwani; Rose Mpembeni; Albrecht Jahn

2006-01-01

193

Pregnant women's experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study  

PubMed Central

Background Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women’s experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. Methods This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. Results Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. Conclusions In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for primary and post exposure HIV prevention. Partnerships and linkages with people living with HIV, especially those in existing support groups such as those at The AIDS Support Organization (TASO), may help to strengthen counselling and support for pregnant women. For effective HIV prevention, women who test HIV negative should be supported to remain negative. PMID:23705793

2013-01-01

194

The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial  

Microsoft Academic Search

Observational studies suggest that including men in reproductive health interventions can enhance positive health outcomes. A random- ized controlled trial was designed to test the impact of involving male partners in antenatal health education on maternal health care utili- zation and birth preparedness in urban Nepal. In total, 442 women seeking antenatal services during second trimester of pregnancy were randomized

Britta C. Mullany; S. Becker; M. J. Hindin

2007-01-01

195

Histologic chorioamnionitis, antenatal steroids, and perinatal outcomes  

Microsoft Academic Search

Objective: To determine the perinatal effects of histologic chorioamnionitis on preterm neonates and the effectiveness of antenatal steroids in the presence of histologic chorioamnionitis.Methods: We studied neonates at our institution who weighed 1750 g or less at birth from January 1990 through December 1997. The population was stratified primarily by presence of histologic chorioamnionitis and secondarily by exposure to antenatal

Andrew Elimian; Uma Verma; Debra Beneck; Rebecca Cipriano; Paul Visintainer; Nergesh Tejani

2000-01-01

196

Childhood Sexual Abuse and Sexual Risk Behavior among Men and Women Attending a Sexually Transmitted Disease Clinic  

ERIC Educational Resources Information Center

Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior,…

Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.

2006-01-01

197

Correlates of abortions and condom use among high risk women attending an std clinic in st Petersburg, Russia  

PubMed Central

Background Many women in Russia rely on abortion as a primary birth control method. Although refusal to use contraceptives, including condoms, may undermine public health efforts to decrease HIV sexual risk behaviors, few studies have investigated the risk factors associated with abortion among women at high risk for HIV. This study sought to identify the correlates of abortions and of lack of condom use among high risk STD clinic patients in St Petersburg Russia. Methods Cross-sectional analysis of data collected between 2009 and 2010 from women who had casual or multiple sexual partners in the previous three months was analyzed. Multivariate logistic regression assessed the independent correlates of abortion(s) and no condom use in the prior three months. Independent variables included socio-demographics, at risk drinking per alcohol use disorder identification test (AUDIT-C) criteria, having sex after drinking alcohol, having a sexual partner who injects illicit drugs, and parity. Results Of 87 participants, 45% had an abortion in their lifetime and 26% did not use condoms in the prior three months. Abortion was independently associated with low income (OR, 3.33, 95%CI, 1.13-9.78) and at risk drinking (OR, 3.52, 95%CI, 1.24-10.05). Lack of condom use was independently associated with being more likely to have sex after drinking (OR, 3.37, 95%CI, 1.10-10.28) and parity (OR, 3.69, 95%CI, 1.25-10.89). Conclusions Programs to increase contraceptive use including condom use among women at high risk for STD/HIV in Russia are needed. Programs to reduce sexual HIV risk and abortion rates must address alcohol misuse and target women with limited income. PMID:21992690

2011-01-01

198

Family Planning Practices Prior to the Acceptance of Tubectomy: A Study Among Women Attending a Maternity Home in Bangalore,India  

PubMed Central

Introduction: The extent of acceptance of contraceptive methods still varies within societies. Reliance on sterilisation is appearing earlier in marriage and among ever-younger ages and lower parities. Aim and Objective: To study the family planning practices adopted by women who undergo tubectomy before the acceptance of tubectomy. Material and Methods: Cross–sectional study of tubectomy acceptors who attended a corporation referral maternity home in Bangalore, India by interview method using a pre–designed a pre–tested structured questionnaire. Results: Majority 295(73.9%) of the study subjects had not practised any method of contraception before they underwent sterilisation. Increase in the education levels of the study subjects was associated with an increase in the contraceptive use (temporary methods) before they accepted tubectomy; this association was found to be statistically significant (p<0.0001). PMID:24086862

V, Srividya; Kumar, Jayanth

2013-01-01

199

Differences in timely antenatal care between first and second-generation migrants in the Netherlands.  

PubMed

To assess whether there are differences in the timing of first antenatal care visit between 1st and 2nd-generation migrants, and if so, how such differences could be explained. The study has been conducted in the framework of Generation R Study, a multi-ethnic population-based study conducted in Rotterdam, the Netherlands. The study population consists of 845 women of the six largest ethnic groups. Data were derived from the electronic antenatal charts of the participating midwives and from written questionnaires. Logistic regression analyses have been carried out to investigate whether difference could be explained by need, predisposing and enabling factors. More first than second generation women enter antenatal care after 14 weeks of pregnancy (28.1 vs. 18.7 %). Women who were not likely to adopt healthy behaviour regarding pregnancy--such as timely taking folic acid--equally were not inclined to enter antenatal care early in pregnancy. The role of Dutch language mastery was limited. Given our results, first generation women are less likely to receive timely health educational advice or to benefit from screening opportunities than second generation women. Future studies should pay more attention to adequate assessment of proficiency of the host language. PMID:23702785

Choté, Anushka A; Koopmans, Gerrit T; de Groot, Christianne J M; Hoefman, Renske J; Jaddoe, Vincent W V; Hofman, Albert; Steegers, Eric A P; Mackenbach, Johan P; Trappenburg, Margo; Foets, Marleen

2014-08-01

200

Prevalence of Candida albicans and bacterial vaginosis in asymptomatic pregnant women in South Yorkshire, United Kingdom  

Microsoft Academic Search

Objective  The aim of the study was to determine the prevalence and age distribution of Candida albicans and bacterial vaginosis in asymptomatic pregnant women.\\u000a \\u000a \\u000a \\u000a Method  One thousand and seventy-three (1,073) consecutive women who attended the antenatal clinic at Barnsley District General Hospital,\\u000a Barnsley, UK, over a 15-month period were studied. Endo-cervical and high vaginal swabs for Candida albicans were obtained.\\u000a \\u000a \\u000a \\u000a Results  Sixty-five percent

A. A. Akinbiyi; Robert Watson; Paul Feyi-Waboso

2008-01-01

201

Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study  

PubMed Central

Background Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men’s perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Methods Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Results Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even ‘forced’, their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men’s participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Conclusion Although men reported to facilitate their wives’ utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting men, exploring promotion of joint HIV testing and counselling, staff training, and design of couple friendly antenatal and delivery units. PMID:23800139

2013-01-01

202

Health insurance for the poor decreases access to HIV testing in antenatal care: evidence of an unintended effect of health insurance reform in Colombia.  

PubMed

Prevention of mother-to-child transmission of HIV was added to standard antenatal care (ANC) in 2000 for Colombians enrolled in the two national health insurance schemes, the 'subsidized regime' (covering poor citizens) and the 'contributory regime' (covering salaried citizens with incomes above the poverty threshold), which jointly covered 80% of the total Colombian population as of 2007. This article examines integration of HIV testing in ANC through the relationship between ordering an HIV test with the type of health insurance, including lack of health insurance, using data from the nationally representative 2005 Colombia Demographic and Health Survey. Overall, health-care providers ordered an HIV test for only 35% of the women attending ANC. We regressed the order of an HIV test during ANC on health systems characteristics (type of insurance and type of ANC provider), women's characteristics (age, wealth, educational attainment, month of pregnancy at first antenatal visit, HIV knowledge, urban vs. rural residence and sub-region of residence) and children's characteristics (birth order and birth year). Women enrolled in the subsidized regime were significantly less likely to be offered and receive an HIV test in ANC than women without any health insurance (adjusted odds ratio = 0.820, P < 0.001), when controlling for the other independent variables. Wealth, urban residence, birth year of the child and the type of health-care provider seen during the ANC visit were significantly associated with providers ordering an HIV test for a woman (all P < 0.05). Our findings suggest that enrolment in the subsidized regime reduced access to HIV testing in ANC. Additional research is needed to elucidate the mechanisms through which the potential effect of health insurance coverage on HIV testing in ANC occurs and to examine whether enrolment in the subsidized regime has affected access to other essential health services. PMID:23598426

Ettenger, Allison; Bärnighausen, Till; Castro, Arachu

2014-05-01

203

Effect of Health Education on Willingness to Undergo HIV Screening among Antenatal Attendees in a Teaching Hospital in North Central Nigeria  

PubMed Central

Background. Testing for HIV during pregnancy provides a useful opportunity to institute treatment for HIV as required as well as protect the unborn baby. The aim of this study was to evaluate the effect of health education on the willingness of antenatal attendees to be screened for HIV. Methods. This was a quasiexperimental study involving the sequential enrolment of 122 pregnant women attending antenatal care who were at a gestational age of between 13 and 28 weeks for the study group and subsequent enrolment of the same one month after for the control. Two-stage analysis was done with the use of descriptive statistics and bivariate analysis. Level of significance was set at 5%. Results. Mean age of the study respondents was 27.6 ± 4.6 years while that of the control was 27.5 ± 4.8 years. Majority of the respondents were married in both study, 88 (72.7%), and control groups 84 (72.4%), 76.1% of the study group and 79.3% of the control group had at least secondary education, and 39.7% of the study group and 37.9% of the control group were primigravidae. Before intervention, 88.4% of the study group and 88.8% of the control group were willing to undergo voluntary HIV screening. There was an increase in this number after intervention (P < 0.05). Age, education, occupation, marital status, and parity were not significantly associated with a willingness to be screened for HIV before and after intervention among the study or control groups. Conclusion. Health education as a strategy to enhance voluntary counseling and testing uptake in antenatal settings is advocated. PMID:25101281

Sekoni, O. O.; Aderibigbe, S. A.; Akande, T. M.

2014-01-01

204

In-vitro fertilization, gamete donation and surrogacy: perceptions of women attending an infertility clinic in Ibadan, Nigeria.  

PubMed

Infertility affects 20% of couples in Nigeria. Assisted reproductive techniques (ART) offered in Nigeria include in-vitro fertilization (IVF), gamete donation and surrogacy. This cross-sectional questionnaire study aimed at assessing the acceptability of ART to women seeking infertility treatment at the University College Hospital, Ibadan, Nigeria. Of the 307 respondents, 58.3% were aware of IVF and 59.3% would accept it as treatment; 35.2% would accept donor eggs and 24.7% would accept donor sperms-a smaller proportion anticipated acceptability by their husbands. Thirty five percent were aware of surrogacy, 37.8% would accept it as treatment; most preferring a stranger as a surrogate. Most felt surrogates should not be paid. Acceptance of ART was associated with older age, longer duration of infertility, previous failed treatment and women without other children. As chances of successful pregnancy are improved in younger individuals, counselling towards overcome barriers to accepting gamete donation and surrogacy should be instituted early. PMID:25022149

Bello, Folasade A; Akinajo, Opeyemi R; Olayemi, Oladapo

2014-06-01

205

Effects of Antenatal Betamethasone on Human Fetal Branch Pulmonary Artery Flow Velocity Waveforms  

Microsoft Academic Search

Objective: To evaluate the effect of antenatal betamethasone on fetal branch pulmonary artery flow velocity waveforms. Methods: Betamethasone 12 mg i.m. in 2 injections 24 h apart was given to 25 pregnant women at risk of preterm delivery. Pulsatility (PI) and resistance (RI) indexes were measured at the proximal, middle and distal segments of the fetal pulmonary artery before and

José L. Bartha; Marta Largo-Heinrich; María J. Machado; Fernando González-Bugatto; Blas Hervías-Vivancos

2008-01-01

206

Antenatal maternal serum screening for Down's syndrome: results of a demonstration project  

Microsoft Academic Search

OBJECTIVES--To assess the implementation of antenatal screening for Down's syndrome in practice, using individual risk estimates based on maternal age and the three serum markers: alpha fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin. DESIGN--Demonstration project of Down's syndrome screening; women with a risk estimate at term of 1 in 250 or greater were classified as \\

N. J. Wald; A. Kennard; J. W. Densem; H. S. Cuckle; T. Chard; L. Butler

1992-01-01

207

Using the ALPHA form in practice to assess antenatal psychosocial health  

Microsoft Academic Search

Background: The assessment of the psychosocial health of pregnant women and their families, although recommended, is not carried out by most practitioners. One reason is the lack of a practical and evidence-based tool. In response, a multidisciplinary group created the Antenatal Psychosocial Health Assessment (ALPHA) form. This article describes the development of this tool and experi- ence with it in

Anthony J. Reid; Anne Biringer; June D. Carroll; Deana Midmer; Lynn M. Wilson; Beverley Chalmers; Donna E. Stewart

1998-01-01

208

Evaluation of the quality of antenatal care using electronic health record information in family medicine clinics of Mexico City  

PubMed Central

Background Evaluation of the quality of antenatal care (ANC) using indicators should be part of the efforts to improve primary care services in developing countries. The growing use of the electronic health record (EHR) has the potential of making the evaluation more efficient. The objectives of this study were: (a) to develop quality indicators for ANC and (b) to evaluate the quality of ANC using EHR information in family medicine clinics (FMCs) of Mexico City. Methods We used a mixed methods approach including: (a) in-depth interviews with health professionals; (b) development of indicators following the RAND-UCLA method; (c) a retrospective cohort study of quality of care provided to 5342 women aged 12–49 years who had completed their pregnancy in 2009 and attended to at least one ANC visit with their family doctor. The study took place in four FMCs located in Mexico City. The source of information was the EHR. SAS statistical package served for programing and performing the descriptive statistical analysis. Results 14 ANC quality indicators were developed. The evaluation showed that 40.6% of women began ANC in the first trimester; 63.5% with low-risk pregnancy attended four or more ANC visits; 4.4% were referred for routine obstetric ultrasound, and 41.1% with vaginal infection were prescribed metronidazole. On average, the percentage of recommended care that women received was 32.7%. Conclusions It is feasible to develop quality indicators suitable for evaluating the quality of ANC using routine EHR data. The study identified the ANC areas that require improvement; which can guide future strategies aimed at improving ANC quality. PMID:24885103

2014-01-01

209

Maternal identity change as a consequence of antenatal hospitalization.  

PubMed

Despite low fertility rates in Western countries, maternity remains one of the major goals of women from various socioeconomic backgrounds. While most women will have low-risk pregnancies, common serious disorders of pregnancy, such as preeclampsia, premature rupture of the membranes, placenta previa, or fetal growth restriction, may compromise maternal and infant outcomes. The experiences of urban and rural women in Australia who have had difficulties in maintaining their pregnancies are analyzed in this article. We study the impact of individual and social factors that facilitate or impede women's adjustment to the risks associated with these disorders. The analysis of in-depth interviews with 27 women hospitalized antenatally indicates that most women were unfamiliar with the diagnoses and acted as passive "decision takers," complying with medical advice to remain in the hospital. Admission to a tertiary hospital ward that provided care to women with pregnancy disorders promoted the formation of a new identity, that of a woman whose pregnancy did not follow the expected path. Further, hospitalization offered women the opportunity to interact with others in similar difficult situations and, hence, feel less isolated. PMID:17060177

Markovic, Milica; Manderson, Lenore; Schaper, Heather; Brennecke, Shaun

2006-10-01

210

Case-control study of antenatal cocaine use and platelet levels  

Microsoft Academic Search

Objective: Our aim was to determine the prevalence of thrombocytopenia in pregnant patients who did and did not use cocaine. Study Design: A 1:1 case-control study of 326 patients attending an inner-city, neighborhood-based antenatal program between January 1992 and December 1998 is presented. Data concerning cocaine use (history and urine toxicology study) and platelet count, along with gestational age, were

Joseph M. Miller; Thomas E. Nolan

2001-01-01

211

Evaluation of Anaemia in Booked Antenatal Mothers During the Last Trimester  

PubMed Central

Background and Aim: Anaemia occurring during pregnancy is an important public health problem in developing countries. In India, anaemia is one of the most common causes of maternal death, accounting for 20% of total maternal deaths. This study was conducted with the aim of evaluating anaemia among booked antenatal mothers during the last trimester, its possible impact on pregnancy and its outcome in antenatal mothers, visiting antenatal clinic in a teaching tertiary care hospital at Pondicherry, India. Material and Methods: This hospital based, descriptive, cross sectional study was conducted in the Department of Clinical Pathology and Pharmacology at Sri Manakula Vinayagar Medical College Hospital in Pondicherry, India. Socio–economic and gestational status data was collected with the help of structured questionnaire from booked antenatal mothers in third trimester. Venous blood was collected for the estimation of Haemoglobin by using Sahli’s Haemoglobinometer and morphological typing of anaemia was estimated by using Leishmann Stain peripheral blood smears. The women were followed-up till delivery and their antenatal, neonatal and other birth outcomes were recorded. Results: Seventy five booked antenatal women, aged 19 - 40 years, with gestational ages of 27– 40 weeks, were recruited for the study. We observed that among 75 antenatal mothers, the Haemoglobin level was less than 10grams% in 83% cases and that it was more than 10 grams% in 17% cases. Iron deficiency anaemia and dimorphic anaemia were recorded in 37% and 19% of the women respectively. High percentage of anaemia was noted in women of higher age group (23–27 years), in those with multi–parity (55%) and low educational levels (100%) and in mothers of low socio–economic status (100%). In the pregnancy outcomes, 85% and 60% anaemic mothers reported maternal and foetal complications respectively. Conclusion: In spite of regular antenatal visits in third trimester, maternal anaemia is still high and it is often associated with low education status, socio-economic status and multi-parity, based on our study. There is a need of health education programmes with respect to haematinics compliance and adequate intake of iron rich diet during pregnancy, to be strengthened for safe maternal and foetal outcomes. PMID:24392379

Amel Ivan, Erli; A., Mangaiarkkarasi

2013-01-01

212

Knowledge and utilization of intermittent preventive treatment for malaria among pregnant women attending antenatal clinics in primary health care centers in rural southwest, Nigeria: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: Intermittent preventive treatment for prevention of malaria in pregnancy (IPTp) is a key component of malaria control strategy in Nigeria and sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy the uptake and coverage in Nigeria is low. This study set

Stella O Akinleye; Catherine O Falade; Ikeoluwapo O Ajayi

2009-01-01

213

Effect of antenatal peer support on breastfeeding initiation: a systematic review  

PubMed Central

Background Our objective was to examine the effect of antenatal peer support on rates of breastfeeding initiation. Methods We performed a systematic review of randomized controlled trials, quasi-randomized trials and cohort studies with concurrent controls. We searched the Cochrane Library, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Research Register and the British Nursing Index from inception or from 1980 to 2009. We carried out study selection, data abstraction and quality assessment independently and in duplicate. We defined high-quality studies as those that minimized the risk of at least three of the following types of bias: selection, performance, measurement and attrition bias. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for individual studies and undertook separate meta-analyses for high-quality trials of universal peer support and targeted peer support. We did not include low-quality studies. Results We selected 11 studies, which involved 5445 women in total. Seven of these studies (involving 4416 women in total) evaluated universal peer support, and four studies (involving 1029 women in total) targeted antenatal peer support. In the three high-quality studies of universal peer support, all involving low-income women, the relative risk for not initiating breastfeeding was 0.96 (95% CI 0.76–1.22). In the three high-quality studies of antenatal peer support that targeted women considering breastfeeding, the relative risk for not initiating breastfeeding was 0.64 (95% CI 0.41 – 0.99). Interpretation Universal antenatal peer support does not appear to improve rates of breastfeeding initiation, but targeted antenatal peer support may be beneficial. This effect may be related to context, however, so any new peer-support program should undergo concurrent high-quality evaluation. PMID:20940234

Ingram, Lucy; MacArthur, Christine; Khan, Khalid; Deeks, Jonathan J.; Jolly, Kate

2010-01-01

214

Antenatal counseling on breastfeeding - is it adequate? A descriptive study from Pondicherry, India  

PubMed Central

Background Antenatal counseling on breastfeeding and postnatal lactation support are likely to improve rates of exclusive breastfeeding. This descriptive study was undertaken to assess whether antenatal visits were utilized for promotion of exclusive breastfeeding in addition to the routine obstetric services. Methods This descriptive study was conducted at a tertiary hospital in Pondicherry, India. Every third primigravida mother admitted in the maternity ward from June to December 2005 was recruited. Among these 144 primigravida mothers, 108 who had a minimum of three antenatal visits ("booked") were included in the study. These 108 mothers were administered a pre-tested semi-structured questionnaire on breastfeeding in the local language, Tamil, within 24 hours of giving birth. Appropriate flash cards with pictures were also used while administering the questionnaire. The awareness among mothers (both "counseled" and "not counseled") regarding health information pertaining to breastfeeding was assessed. Results Of the booked mothers, 21% (n = 23) had received some antenatal counseling about breastfeeding while 79% (n = 85) had not received any such counseling. Four percent had undergone breast examination during antenatal visits. Awareness related to breastfeeding among mothers in the "counseled" group was better than those in the "not counseled" group. Even in the "counseled" group, awareness among mothers with regard to correct breastfeeding technique and concept of continuing breastfeeding during illness in the baby was no different from those in the "not counseled" group. Conclusion Existing antenatal counseling on breastfeeding is inadequate in the population studied and needs to be strengthened. Informing all pregnant women about the benefits and management of breastfeeding should be a priority during antenatal visits. PMID:18318899

Dhandapany, Gunasekaran; Bethou, Adhisivam; Arunagirinathan, Arulkumaran; Ananthakrishnan, Shanthi

2008-01-01

215

Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity.  

PubMed

Antenatal depression is associated with small-for-gestational age, but few studies have examined associations with weight during childhood. Similarly, few studies address whether antenatal and postpartum depression differentially affect child weight. Among 838 mother-child dyads in Project Viva, a prospective cohort study, we examined relationships of antenatal and postpartum depression with child weight and adiposity. We assessed maternal depression at mid-pregnancy and 6 months postpartum with the Edinburgh Postnatal Depression Scale (score > or =13 indicating probable depression). We assessed child outcomes at age 3 years: body mass index (BMI) z-score, weight-for-height z-score, sum of subscapular (SS) and triceps (TR) skinfold thickness (SS + TR) for overall adiposity, and SS : TR ratio for central adiposity. Sixty-nine (8.2%) women experienced antenatal depression and 59 (7.0%) postpartum depression. Mean (SD) outcomes at age 3 were: BMI z-score, 0.45 (1.01); SS + TR, 16.72 (4.03) mm; SS : TR, 0.64 (0.15). In multivariable models, antenatal depression was associated with lower child BMI z-score (-0.24 [95% confidence interval: -0.49, 0.00]), but higher SS : TR (0.05 [0.01, 0.09]). There was no evidence of a dose-response relationship between antenatal depression and these outcomes. Postpartum depression was associated with higher SS + TR (1.14 [0.11, 2.18]). In conclusion, whereas antenatal depression was associated with smaller size and central adiposity at age 3 years, postpartum depression was associated with higher overall adiposity. PMID:20415775

Ertel, Karen A; Koenen, Karestan C; Rich-Edwards, Janet W; Gillman, Matthew W

2010-03-01

216

Antenatal hormone therapy for improving the outcome of the preterm infant.  

PubMed

The value of antenatal therapy with glucocorticoids in improving the pulmonary outcome of preterm human infants was first demonstrated in 1972. Accelerated lung maturation occurs with physiologic stress levels of corticosteroid by receptor-mediated induction of specific developmentally regulated proteins. Since the first report by Liggins, multiple controlled trials have demonstrated a decreased number of cases of respiratory distress syndrome and mortality in treated infants. In addition, prenatal therapy leads to decreased intraventricular hemorrhage and hospital costs, and there is strong evidence for decreased incidence of both patent ductus arteriosus requiring therapy and necrotizing enterocolitis. The recommendations of the 1994 National Institutes of Health Consensus Conference include use of antenatal corticosteroids in virtually all women who are in labor when the fetus is between 24 to 34 weeks' gestation. The combination of antenatal corticosteroids with thyrotropin releasing hormone holds promise for further reducing the incidence and severity of respiratory distress syndrome and decreasing chronic lung disease in the preterm infant. PMID:8915940

Ballard, R A; Ballard, P L

1996-01-01

217

Individual and local level factors and antenatal care use in Colombia: a multilevel analysis.  

PubMed

This paper examined the association between individual and local level factors and the number of antenatal care visits completed by women in Colombia using data from the 2010 Colombian Demographic and Health Survey and multilevel logistic regression models. Our findings suggest that, in addition to maternal socioeconomic status, contextual factors influence whether pregnant women complete the minimum recommended number of antenatal care visits. These factors include: level of women's autonomy in the community, regional inequalities and access barriers caused by distance (OR = 0.057), costs of services (OR = 0.035), and/or a lack of confidence in doctors (OR = 0.036). Our results highlight the existence of inequalities in access to antenatal care and the importance of considering the local context in the design of effective maternal care policies in Colombia. Furthermore, our findings regarding individual factors corroborate the evidence from other countries and offer new insights into the association between local level factors and number of antenatal care visits. PMID:24936823

Osorio, Ana María; Tovar, Luis Miguel; Rathmann, Katharina

2014-05-01

218

Stigma and attitudes towards antenatal depression and antidepressant use during pregnancy in healthcare students  

Microsoft Academic Search

Depression in pregnancy or antenatal depression (AD) occurs in approximately one in five women, with potentially deleterious\\u000a effects to the mother and fetus. People are encouraged to get treatment for depression; however, pregnant women can experience\\u000a stigma when they reach out for help with depression. Research indicates that healthcare professionals hold stigma against\\u000a patients who experience mental health conditions, including

Laura Gawley; Adrienne Einarson; Angela Bowen

219

Barriers to antenatal syphilis screening in Burkina Faso  

PubMed Central

Introduction Despite advances in treatment and management, syphilis remains a major public health problem in Burkina Faso. Syphilis in pregnancy poses major health risks for the mother and the fetus and also increases the risk for HIV transmission. Despite its potential benefits, antenatal syphilis screening is often poorly implemented in many sub-Saharan African countries. The purpose of the study is to identify and understand barriers affecting health system performance for syphilis screening among pregnant women in Burkina Faso. Methods We conducted in-depth interviews and observations in the Kaya health district, Burkina Faso. Participants were purposively selected to capture a range of perspectives across different actors with different roles and responsibilities. Seventy-five interviews were conducted with health providers, district managers, facility managers, traditional healers, pregnant women, community health workers, and Non-Governmental Organizations (NGO) managers. Interviews were transcribed and organized into codes and categories using NVivo software. Results Participants identified multiple barriers at health providers and community levels. Key barriers at provider level included fragmentation of services, poor communication, low motivation for prescription, and low awareness of syphilis burden. Cost of testing, distance to laboratory and lack of knowledge about syphilis were identified as barriers at community level. Conclusion The study highlights barriers such as distance, cost of testing, and knowledge about syphilis. The introduction of point of care testing for syphilis could be an entry point for improving coverage of antenatal syphilis screening. PMID:24624245

Bocoum, Fadima Yaya; Kouanda, Seni; Zarowsky, Christina

2014-01-01

220

Patient awareness and acceptability of antenatal perineal massage.  

PubMed

Antenatal perineal massage is recommended to reduce perineal trauma at the time of delivery. The practice has been shown to be acceptable to pregnant women taking part in research studies. The aim of this study was to establish its acceptability to pregnant women in day-to-day clinical practice, as well as their awareness of its technique. An anonymous self-construct questionnaire was given to mothers after their first delivery. A total of 113 questionnaires were returned over a 4-month period. With regard to acceptability, 61.4% of respondents indicated that the practice was acceptable, only 25.7% felt the practice was embarrassing and 56.7% were happy for their husband/partner to perform it for them. With respect to awareness, 37.2% of the respondents had heard about the practice, 9.7% knew it should be practised from 34 weeks onwards, 11.5% knew it should be maintained for 5-10 min and 30.1% knew it ought to be performed daily. This showed first time mothers' awareness of antenatal perineal massage to be low, despite the idea being acceptable to them, which calls for action to improve awareness and provide more instruction and encouragement to take up the practice. PMID:24219726

Ismail, S I M F; Emery, S J

2013-11-01

221

Comparison of human papillomavirus detections in urine, vulvar, and cervical samples from women attending a colposcopy clinic.  

PubMed

While urine-based sampling for human papillomavirus (HPV) is being explored as a simple and noninvasive approach for cervical cancer screening, data comparing HPV genotyping in urine and those in cellular sampling of the cervix and vulva, and their correlation with rigorously confirmed cervical disease status, are sparse. We performed HPV genotyping on voided-urine and clinician-collected vulvar and cervical samples from 72 women undergoing colposcopy. Although urine-based HPV carcinogenic HPV detection was lower (58.3%) than cervical (73.6%) and vulvar (72.1%) detection (P = 0.05 and 0.07, respectively), the agreement of urine HPV with cervical and vulvar HPV was moderate (kappa = 0.55) and substantial (kappa = 0.62), respectively. Urine-based carcinogenic HPV detection had a clinical sensitivity of 80.8% (95% confidence interval [CI] = 60.7 to 93.5) and a specificity of 53.3% (95% CI = 37.9 to 68.3) for diagnosing cervical intraepithelial neoplasia grades 2/3 (CIN2/3) on histology; 90.0% of CIN3 was positive for urine HPV. The corresponding sensitivity and specificity values for vulvar sampling were 92% (95% CI = 74 to 99) and 40.5% (95% CI = 25.6 to 56.7), and those for cervical sampling were 96.2% (95% CI = 80.4 to 99.9) and 40% (95% CI = 25.7 to 55.7), respectively. HPV16 was the most common carcinogenic genotype detectable in 25% of urine, 33.8% of vulvar, and 31.9% of cervical samples overall, with prevalence increasing with cervical disease grade, regardless of the sampling method. Stronger cervical HPV PCR signal strengths were associated with increased frequency of urine HPV detection. In summary, the relatively lower detection rates but comparable clinical performance of urine-based HPV sampling underscore the need for larger studies to evaluate urine-based sampling for cervical cancer screening, epidemiologic studies, and postvaccination HPV disease surveillance. PMID:24197879

Sahasrabuddhe, Vikrant V; Gravitt, Patti E; Dunn, S Terence; Brown, David; Allen, Richard A; Eby, Yolanda J; Smith, Katie; Zuna, Rosemary E; Zhang, Roy R; Gold, Michael A; Schiffman, Mark; Walker, Joan L; Castle, Philip E; Wentzensen, Nicolas

2014-01-01

222

Using the community-based health planning and services program to promote skilled delivery in rural Ghana: socio-demographic factors that influence women utilization of skilled attendants at birth in Northern Ghana  

PubMed Central

Background The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women. Methods We conducted a cross-sectional household survey with women who had ever given birth in the three years prior to the survey. We employed a two stage sampling techniques: In the first stage we proportionally selected enumeration areas, and the second stage involved random selection of households. In each household, where there is more than one woman with a child within the age limit, we interviewed the woman with the youngest child. We collected data on awareness of the program, use of the services and factors that are associated with skilled attendants at birth. Results A total of 407 households/women were interviewed. Eighty three percent of respondents knew that CHO-midwives provided delivery services in CHPS zones. Seventy nine percent of the deliveries were with skilled attendants; and over half of these skilled births (42% of total) were by CHO-midwives. Multivariate analyses showed that women of the Nankana ethnic group and those with uneducated husbands were less likely to access skilled attendants at birth in rural settings. Conclusions The implementation of the CHO-midwife program in UER appeared to have contributed to expanded skilled delivery care access and utilization for rural women. However, women of the Nankana ethnic group and uneducated men must be targeted with health education to improve women utilizing skilled delivery services in rural communities of the region. PMID:24721385

2014-01-01

223

Knowledge of periconceptional folic acid use among pregnant women at Ain Shams University Hospital, Cairo, Egypt.  

PubMed

Egypt has a high incidence of neural tube defects. Folic acid supplementation in the periconceptional period is known to lower the risk of such defects. This cross-sectional study aimed to measure the level of knowledge about periconceptional folic acid use among pregnant women attending for antenatal care at Ain Shams University Hospital, Cairo, Egypt in 2012. Questionnaires were filled through personal interviews with 660 pregnant women. Of the respondents, 62.4% had heard of folic acid and 39.2% knew about the role of folic acid supplementation in prevention of congenital anomalies. Knowledge about using folic acid before and in the first trimester of pregnancy was highest among university-educated women and those working in professional occupations. Only 18.8% of women reported taking folic acid, and 8.8% had used it before conception. Awareness campaigns are suggested to improve knowledge about folic acid among women in the childbearing period in Egypt. PMID:25343469

Al-Darzi, W; Al-Mudares, F; Farah, A; Ali, A; Marzouk, D

2014-09-01

224

HIV infection among pregnant women in Lindi, Tanzania, 1989-1993.  

PubMed

One obstacle to contain the HIV-1 epidemic in the general population in Africa is a lack of knowledge about how it is spread in rural areas. We examined 683 pregnant women in 1989 and 484 in 1993 who attended antenatal clinics in Lindi district, Tanzania to determine changes in the prevalence of HIV-1 in a remote area in East Africa. The prevalence rose from 0.44% in 1989 to 8.7% in 1993. Women with more than 1 partner (17.25% vs 2.78%), STD patients (42.4% vs 6.2%), women from urban areas (10.2% vs 3.57%) and patients younger than 21 years were more likely to have HIV antibodies. By logistic regression analysis, 1993 as year of testing was associated with the greatest risk for HIV seropositivity (P < 0.00002) followed by clinical signs of STD (P < 0.00005) and urban residence (P = 0.0275). Teaching of all women attending antenatal care how to minimize their future risk of acquiring HIV is urgently needed as one tool to prevent a fast spread of HIV throughout the continent. PMID:8876357

Petry, K U; Kingu, H

1996-07-01

225

Pregnancy Intention and Antenatal Care Use in Two Rural North Indian States  

PubMed Central

Objectives Many studies have shown strong effects of pregnancy intention on antenatal care behavior in developed countries, but studies from developing settings have shown mixed results. Few investigators have utilized a prospective measure of pregnancy intention. This paper will analyze the association of pregnancy intention and the utilization of antenatal services in two states in northern India using a prospective measure of whether a future pregnancy would be wanted or unwanted. Methods A prospective cohort study was conducted between 1998–2003 in Jharkhand and Bihar, India of 2028 women with one or two pregnancies resulting in the live births of singleton infants during the study time period. Results Antenatal care utilization was not found to be significantly associated with prospective pregnancy intention (OR=1.18, [95% CI 0.91, 1.52]). Among women who received ANC (N=701), initiation of care was not delayed in unwanted pregnancies. Significant differences existed between the numbers of women who reported their pregnancy unwanted retrospectively, as compared with prospectively. These differences were not associated with the utilization of antenatal care services or timing of care initiation. The exception to these findings were women who consistently reported their pregnancies unwanted both before and after conception, who were twice as likely to delay ANC initiation as women with consistently wanted pregnancies. Conclusions Demographic characteristics of reproductive aged women, such as age and parity, seem to predict more closely the use of ANC services than pregnancy intention in Bihar and Jharkhand. Delayed ANC initiation may be significantly associated with unwanted pregnancy, but only when pregnancies were most decisively identified as unwanted. PMID:19550160

Barrick, Lindsey; Koenig, Michael A

2014-01-01

226

Do assisted-reproduction twin pregnancies require additional antenatal care?  

PubMed

Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women <45 years of age are not associated with a notable increase in antenatal complication rates and thus do not require additional antenatal care compared with spontaneous twins. The risks of maternal and fetal morbidity and mortality associated with assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are obviously at higher risk of perinatal complications than singletons due to a natural increase in the incidence of fetal anomalies, antenatal disorders and obstetric and neonatal complications associated with the development of two fetuses instead of one. Overall, our review indicates that some antenatal complications are more frequent in assisted-conception twin pregnancies than in spontaneous twin pregnancies but their prevalence is low and thus their impact on the morbidity and mortality of an individual assisted-conception twin pregnancy is limited. Assisted reproduction treatment has become available to older women with pre-existing maternal medical conditions such as chronic hypertension and diabetes. The increased obstetrical risks in this population must be considered prior to attempts at assisted conception, and the transfer of more than one embryo should be avoided in women with a pre-existing maternal medical condition. PMID:23273753

Jauniaux, E; Ben-Ami, I; Maymon, R

2013-02-01

227

Determinants of Institutional Delivery Among Women in Bangladesh.  

PubMed

This study examines the factors that influence institutional delivery among women in Bangladesh extracting data from 2007 Bangladesh Demographic and Health Survey. We employed both bivariate and multivariate statistical analyses in this study. Findings revealed that, only 14.7% of the women went for institutional delivery and 28.8% births were delivered by trained birth attendance. The multivariate logistic regression analysis yielded quantitatively important and reliable estimates of facility delivery. The likelihood of institutional delivery was significantly higher for first-order pregnancy, couples' higher education, the richest, higher autonomy, TV ownership, non-Muslims, who received antenatal care services, pregnancy complications, and urban residents. Government should ensure quality of care, easy accessibility, and availability of all facilities free of cost in the public medical institutions. Women should be informed regarding the long-term benefit of institutional delivery through information, education, and communication program. PMID:23666835

Kamal, S M Mostafa; Hassan, Che Hashim; Alam, Gazi Mahabubul

2013-05-10

228

Effectiveness of Antenatal Clinics to Deliver Intermittent Preventive Treatment and Insecticide Treated Nets for the Control of Malaria in Pregnancy in Mali: A Household Survey  

PubMed Central

Background WHO recommends intermittent-preventive-treatment (IPTp) with sulphadoxine-pyrimethamine (SP) and insecticide-treated-nets (ITNs) to prevent malaria in pregnancy in sub-Saharan Africa, however uptake remains unacceptably low. We evaluated the effectiveness of antenatal clinics (ANC) to deliver two doses of IPTp and ITNs to pregnant women in Segou district, Mali. Methods We used household data to assess the systems effectiveness of ANC to deliver IPTp and ITNs to pregnant women and used logistic regression to identify predictors of ANC attendance, receipt of IPTp and ITN use during pregnancy, and the impact on community effectiveness. Results Of 81% of recently pregnant women who made at least one ANC visit, 59% of these attended during the eligible gestational age for IPTp. Of these, 82% reported receiving one dose of SP and 91% attended ANC again, of whom 66% received a second dose, resulting in a cumulative effectiveness for 2-dose IPTp of 29%, most of whom used an ITN (90%). Cumulative effectiveness of 2-dose SP by directly observed therapy (DOT) was very low (6%). ITN use was 92%, and ANC was the main source (81%). Reported and ANC-card data showed some doses of SP are given to women in their first trimester. Women were less likely to receive two doses by DOT if they were married (OR 0.10; CI 0.03, 0.40), or lived <5 km from the health facility (OR 0.34; CI 0.14, 0.83). A high household person-LLIN ratio predicted low ITN use in pregnant women (OR 0.16; CI 0.04, 0.55). Conclusion Our findings suggest poor adherence by health workers to provision of IPTp by eligible gestational age and DOT, contributing to low effectiveness of this strategy in this setting. ITN delivery and use among women was substantially higher. Efforts to improve health worker adherence to IPTp guidelines are needed to improve service delivery of IPTp. PMID:24651078

Hill, Jenny; Kayentao, Kassoum; Toure, Mahamoudou; Diarwara, Sory; Bruce, Jane; Smedley, James; Doumbo, Ogobara K.; Kuile, Feiko O. ter.; Webster, Jayne

2014-01-01

229

Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol  

PubMed Central

Background Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. Methods We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1) diffusing recommendations for antenatal corticosteroids use to health providers, (2) training health providers on identification of women at high risk of preterm birth, (3) providing reminders to health providers on the use of the kits, and (4) using a color-coded tape to measure uterine height to estimate gestational age in women with unknown gestational age. In both intervention and control clusters, health providers will be trained in essential newborn care for low birth weight babies. The primary outcome is neonatal mortality at 28 days of life in preterm infants. Trial registration ClinicalTrials.gov. Identifier: NCT01084096 PMID:22992312

2012-01-01

230

Why do women prefer home births in Ethiopia?  

PubMed Central

Background Skilled attendants during labor, delivery, and in the early postpartum period, can prevent up to 75% or more of maternal death. However, in many developing countries, very few mothers make at least one antenatal visit and even less receive delivery care from skilled professionals. The present study reports findings from a region where key challenges related to transportation and availability of obstetric services were addressed by an ongoing project, giving a unique opportunity to understand why women might continue to prefer home delivery even when facility based delivery is available at minimal cost. Methods The study took place in Ethiopia using a mixed study design employing a cross sectional household survey among 15–49 year old women combined with in-depth interviews and focus group discussions. Results Seventy one percent of mothers received antenatal care from a health professional (doctor, health officer, nurse, or midwife) for their most recent birth in the one year preceding the survey. Overall only 16% of deliveries were assisted by health professionals, while a significant majority (78%) was attended by traditional birth attendants. The most important reasons for not seeking institutional delivery were the belief that it is not necessary (42%) and not customary (36%), followed by high cost (22%) and distance or lack of transportation (8%). The group discussions and interviews identified several reasons for the preference of traditional birth attendants over health facilities. Traditional birth attendants were seen as culturally acceptable and competent health workers. Women reported poor quality of care and previous negative experiences with health facilities. In addition, women’s low awareness on the advantages of skilled attendance at delivery, little role in making decisions (even when they want), and economic constraints during referral contribute to the low level of service utilization. Conclusions The study indicated the crucial role of proper health care provider-client communication and providing a more client centered and culturally sensitive care if utilization of existing health facilities is to be maximized. Implications of findings for maternal health programs and further research are discussed. PMID:23324550

2013-01-01

231

Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data  

PubMed Central

Background Good quality antenatal care (ANC) reduces maternal and neonatal mortality and improves health outcomes, particularly in low-income countries. Quality of ANC is measured by three dimensions: number of visits, timing of initiation of care and inclusion of all recommended components of care. Although some studies report on predictors of the first two indicators, no studies on the third indicator, which measures quality of ANC received, have been conducted in Nepal. Nepal follows the World Health Organization’s recommendations of initiation of ANC within the first four months of pregnancy and at least four ANC visits during the course of an uncomplicated pregnancy. This study aimed to identify factors associated with 1) attendance at four or more ANC visits and 2) receipt of good quality ANC. Methods Data from Nepal Demographic and Health Survey 2011 were analysed for 4,079 mothers. Good quality ANC was defined as that which included all seven recommended components: blood pressure measurement; urine tests for detecting bacteriuria and proteinuria; blood tests for syphilis and anaemia; and provision of iron supplementation, intestinal parasite drugs, tetanus toxoid injections and health education. Results Half the women had four or more ANC visits and 85% had at least one visit. Health education, iron supplementation, blood pressure measurement and tetanus toxoid were the more commonly received components of ANC. Older age, higher parity, and higher levels of education and household economic status of the women were predictors of both attendance at four or more visits and receipt of good quality ANC. Women who did not smoke, had a say in decision-making, whose husbands had higher levels of education and were involved in occupations other than agriculture were more likely to attend four or more visits. Other predictors of women’s receipt of good quality ANC were receiving their ANC from a skilled provider, in a hospital, living in an urban area and being exposed to general media. Conclusions Continued efforts at improving access to quality ANC in Nepal are required. In the short term, less educated women from socioeconomically disadvantaged households require targeting. Long-term improvements require a focus on improving female education. PMID:24589139

2014-01-01

232

Use of antenatal corticosteroids for preterm birth in Latin America: providers knowledge, attitudes and practices  

PubMed Central

Background Antenatal corticosteroids administered to women at risk of preterm birth is an intervention which has been proved to reduce the risk of respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality. There is a significant gap in the literature regarding the prevalence of the use of antenatal corticosteroids in Latin American countries and the attitudes and opinions of providers regarding this practice. The aim of this study was to assess the knowledge, attitudes and practices of health care providers regarding the use of antenatal corticosteroids in women at risk of preterm birth in Latin America. Methods This was a multicenter, prospective, descriptive study conducted in maternity hospitals in Ecuador, El Salvador, Mexico and Uruguay. Physicians and midwives who provide prenatal care or intrapartum care for women delivering in the selected hospitals were approached using a self-administered questionnaire. Descriptive statistics was used. Results The percentage of use of ACT in threatened preterm labour (TPL) reported by providers varies from 70% in Mexico to 97% in Ecuador. However, 60% to 20% of the providers mentioned that they would not use this medication in women at risk and would limit its use when there was a threatened preterm labour. In only one country recommended regimens of antenatal corticosteroids are followed by around 90% of providers whereas in the other three countries recommended regimens are followed by only 21%, 61%, 69% of providers. Around 40% of providers mentioned that they would administer a new dose of corticosteroids again, regardless the patient already receiving an entire regimen. Between 11% and 35% of providers, according to the countries, mentioned that they do not have adequate information on the correct use of this medication. Conclusions This study shows that the use of this intervention could be improved by increasing the knowledge of Latin American providers on its indications, benefits, and regimens. PMID:23360713

2013-01-01

233

Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda  

Microsoft Academic Search

IntroductionAssistance by skilled birth attendants (SBAs) during childbirth is one of the strategies aimed at reducing maternal morbidity and mortality in low-income countries. However, the relationship between birth preparedness and decision-making on location of birth and assistance by skilled birth attendants in this context is not well studied. The aim of this study was to assess the influence of birth

Jerome K. Kabakyenga; Per-Olof Östergren; Eleanor Turyakira; Karen Odberg Pettersson

2012-01-01

234

Relations of Self-Motivation, Perceived Physical Condition, and Exercise-Induced Changes in Revitalization and Exhaustion with Attendance in Women Initiating a Moderate Cardiovascular Exercise Regimen  

Microsoft Academic Search

This field investigation tested relationships between personal characteristics, feeling state changes occurring after exercise, and attendance in females (N = 50, Mage = 39 years) initiating a 12-week, 3 days\\/week cardiovascular, community wellness center-based exercise program. Self-motivation and changes in exercise-induced revitalization demonstrated significant positive correlations with attendance (r = .28 and .31, respectively), while a significant negative correlation of

James J. Annesi

2006-01-01

235

Intimate partner violence among pregnant women in Rwanda  

PubMed Central

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:18847476

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

2008-01-01

236

Antenatally diagnosed hydronephrosis: current postnatal management.  

PubMed

The issue of antenatal hydronephrosis has become a routine component for the care of a pregnant woman despite limited evidence of a clinical benefit. The genitourinary tract represents the most commonly detected organ system with identified abnormalities, with antenatal hydronephrosis (ANH), being the most notable and common finding. ANH represents a spectrum, with most cases being a trivial and inconsequential finding on maternal fetal ultrasound. However, there is a correlation with increased grades of ANH being associated with increased severity of urinary tract pathology. Most patients can be managed expectantly with appropriate evaluation commenced postnatally based on severity of ANH and proper parental counseling and education. The purpose of this review was to assess current literature and guidelines pertaining to ANH and incorporate our practical interpretations of their significance. PMID:23325322

Davenport, Michael T; Merguerian, Paul A; Koyle, Martin

2013-03-01

237

The role of traditional birth attendants in Atakumosa, Nigeria.  

PubMed

All 26 traditional birth attendants (TBAs) and their 109 clients in 15 settlements in Atakumosa West Local Government Area (LGA) in Nigeria were interviewed to assess TBA training, practices and utilisation. The study showed that more than 80% of TBAs were older women with more than four children, practiced single-handedly and held other occupations. About 54% of those studied had no designated room for deliveries; twenty-one (80.8%) did not consider any pregnant woman to be at high risk; three (11.5%) perform intravaginal examinations during labour and only a few recognise complications; twelve (46.2%) never refer patients. Despite these deficiencies, TBAs continue to practise in appreciable numbers and their services continue to be on demand in the communities under study. Nearly all of the clients interviewed had started to use TBAs by the age of 25 and 50% had used TBAs for all of their deliveries. Most TBAs provide antenatal care and 77% had a case load of less than five clients per month. Ninety-six per cent of the clients had not been referred by the TBA before. Although 61% of clients felt TBAs in a future pregnancy and 49% would recommend TBA care to other women. Low socio-economic status, illiteracy, poor awareness of modern maternal health (MCH) facilities, personalized care, strong family influence and easy access to TBA services were strong factors promoting traditional midwifery in the LGA. If adequately trained, equipped, supported and supervised, TBAs can contribute towards safe motherhood in Nigeria and in other developing countries. PMID:11467204

Abioye-Kuteyi, E A; Elias, S O; Familusi, A F; Fakunle, A; Akinfolayan, K

2001-06-01

238

Prevalence of syphilis among antenatal clinic attendees in Karachi: Imperative to begin universal screening in Pakistan  

PubMed Central

Objectives Sexually transmitted infections are thought by some to be rare in socially conservative Muslim countries. Little is known about prevalence of syphilis in Pakistani women from the general population. We determined syphilis prevalence in a multi-center cross-sectional study of low risk pregnant women in Karachi, Pakistan. Methods We administered a structured questionnaire and obtained a blood sample for syphilis serology (rapid plasma reagin test with Treponema pallidum hemagglutination assay confirmation) from all women giving informed consent over six weeks in 2007. Results The prevalence of confirmed syphilis was less than one percent (0.9%; 95%CI: 0.4, 1.8) in a sample size of 800 women recruited from three urban sites (?1% refusal rate). Women who lived in an area where male drug use is prevalent (Ibrahim Hyderi Hospital) had 1% (1.5%) higher prevalence rates than women from the other two sites 0.5%. Conclusions We documented higher-than-expected syphilis seroprevalence rates in a low risk population of antenatal clinic attendees in Pakistan. Bridge populations for syphilis may include drug users, who are usually married, and Hijras or their clients. Hijras are transgender and/or transvestite men who may provide sex for money to men. In accordance with our results, the national policy for syphilis control in Pakistan should be modified to include universal syphilis screening in antenatal clinics with subsequent partner notification. PMID:22356034

Shah, SA; Kristensen, S; Memon, MA; Usman, G; Ghazi, A; John, R; Sathiakumar, N; Vermund, SH

2013-01-01

239

Antenatal Glucocorticoid Treatment Affects Hippocampal Development in Mice  

PubMed Central

Synthetic glucocorticoids are administered to pregnant women at risk for preterm delivery, to enhance fetal lung maturation. The benefit of this treatment is well established, however caution is necessary because of possible unwanted side effects on development of different organ systems, including the brain. Actions of glucocorticoids are mediated by corticosteroid receptors, which are highly expressed in the hippocampus, a brain structure involved in cognitive functions. Therefore, we analyzed the effects of a single antenatal dexamethasone treatment on the development of the mouse hippocampus. A clinically relevant dose of dexamethasone (0.4 mg/kg) was administered to pregnant mice at embryonic day 15.5 and the hippocampus was analyzed from embryonic day 16 until adulthood. We investigated the effects of dexamethasone treatment on anatomical changes, apoptosis and proliferation in the hippocampus, hippocampal volume and on total body weight. Our results show that dexamethasone treatment reduced body weight and hippocampal volume transiently during development, but these effects were no longer detected at adulthood. Dexamethasone treatment increased the number of apoptotic cells in the hippocampus until birth, but postnatally no effects of dexamethasone treatment on apoptosis were found. During the phase with increased apoptosis, dexamethasone treatment reduced the number of proliferating cells in the subgranular zone of the dentate gyrus. The number of proliferative cells was increased at postnatal day 5 and 10, but was decreased again at the adult stage. This latter long-term and negative effect of antenatal dexamethasone treatment on the number of proliferative cells in the hippocampus may have important implications for hippocampal network function. PMID:24465645

Noorlander, Cornelle W.; Tijsseling, Deodata; Hessel, Ellen V. S.; de Vries, Willem B.; Derks, Jan B.

2014-01-01

240

Antenatal fetal assessment using biophysical profile score.  

PubMed

This prospective cross sectional study was conducted in a tertiary hospital in Northern India. The objective of the study was to investigate the utility of recording certain fetal biophysical variables at or near term in high risk pregnancy for predicting the fetal outcome. A fetal biophysical profile score was used for predicting the outcome. The scoring system utilized following variables: non stress test, fetal breathing movement, fetal movement, fetal tone and amniotic fluid volume. One hundred and fifty four pregnant women attending a high risk pregnancy clinic were consecutively included in the study. At a cut off score < or = 4, sensitivity of the scoring system was 12.5% and specificity 99.23%. At score < or = 8, corresponding figures were 70.83% and 91.53%. As compared to each individual variable, the positive predictive value for abnormal perinatal outcome improved considerably after combining all the variables. The negative predictive value for normal perinatal outcome did not improve. Though biophysical profile scoring is used as a valuable adjunct in caring high risk fetuses, a simple and more practical screening test should be sought for. The cost-benefit analysis of such tests should also be performed. PMID:9103656

Begum, F; Buckshee, K; Pande, J N

1996-08-01

241

Early teenage pregnancy outcome: a comparison between a standard and a dedicated teenage antenatal clinic.  

PubMed

Britain has the highest rate of teenage pregnancy in the European Union. In the younger teenager inadequate sex education, poor knowledge of and use of contraception, resulting from poor home circumstances and a high school drop-out rate appear to be important aetiological factors. A dedicated teenage clinic can enhance pregnancy outcome in this group of women, and results better than those from a standard antenatal clinic are achievable. For this group of women, other sources of sex education apart from the home and schools need to be explored. PMID:12521497

Ukil, Dipti; Esen, U I

2002-05-01

242

Human papillomavirus (HPV) testing on self-collected specimens: perceptions among HIV positive women attending rural and urban clinics in South Africa  

PubMed Central

Introduction Cervical cancer is the most common cancer among women in Sub-Saharan Africa. Cervical cancer is treatable if detected timeously, yet only 20% of South African women have ever been for a Pap smear in their lifetime due to limited access to screening, transport or child care responsibilities. Objective To evaluate the acceptability of self-collection for cervical cancer screening. We aimed to identify which self-collection device women prefer and if they would consider using them for routine cervical cancer screening. Methods HIV-positive women (>18 years) from urban and rural HIV clinics were interviewed following an education session on HIV, human papillomavirus (HPV) and cervical cancer. Participants were shown three self-collection devices; (i) an Evalyn cervical brush, (ii) a Delphilavager and (iii) a tampon-like plastic wand before completing a short questionnaire. Results A total of 106 women from the urban (n = 52) and rural (n = 54) clinic were interviewed. Overall 51% of women preferred the cervical brush, while fewer women preferred the tampon-like plastic wand (31%) or lavage sampler (18%). More than 75% of women from the rural site preferred the cervical brush, compared to 22% from the urban site (p < 0.001). Women from the urban clinic preferred the tampon-like plastic wand (45%) and then the lavage sampler (33%), as compared to women from the rural clinic (19% and 4%, respectively). Conclusion Women from urban or rural settings had different preferences for the various self-collection devices. Patient self-collection with HPV testing may be an acceptable way to improve coverage to cervical cancer screening in high risk HIV-seropositive women.

Mahomed, Kay; Evans, Denise; Sauls, Celeste; Richter, Karin; Smith, Jennifer; Firnhaber, Cindy

2014-01-01

243

Malarial Infection among Antenatal and Maternity Clinics Attendees at the Federal Medical Centre, Makurdi, Benue State, Nigeria  

PubMed Central

This study assessed the level of malarial infection in relation to some epidemiological factors, gravidity and pregnancy period of antenatal clinic attendees of the Federal Medical Centre, Makurdi, Benue State, Nigeria. We also assessed malarial infection in placental blood in relation to gravidity of pregnant women at delivery in the maternity clinic of the same hospital. Thin and thick blood films were prepared for microscopic examination. A questionnaire was administered to each pregnant woman at the antenatal clinic to collect data on educational level, occupation, gravidity, pregnancy period, malaria preventive measures and malaria symptoms. Of the 163 pregnant women examined at the antenatal clinic, 68.3% (111/163) were infected with malaria. Pregnant women that are illiterates (?2=15.44, P=0.100) and those that are farmers (?2=9.20, P=0.270) had the highest infection rate with no significant difference respectively. Malarial infection was significantly higher in the multigravidae, 57.6% (34/59) (?2=5.16, P=0.007) and non-significant in the pregnant women at their third trimester of pregnancy, 60.9% (53/89) (?2=4.45, P=0.108). Placental malaria was significantly higher in the primigravidae among pregnant women at delivery (?2=9.33, P=0.000). A significant difference (?2=33.52, P=0.000) was observed between pregnant women that did not use any malaria preventive methods, 91.2% (31/34) and those that used single, 64.3% (65/101) and combined, 46.4% (13/28) methods of prevention. Malaria remains highly prevalent among antenatal clinics attendees in Makurdi, Nigeria. Combined method of prevention (insecticides treated nets and insecticide spray) yielded good results and its use is advocated in preventing malaria among the pregnant women. PMID:24757507

Amuta, Elizabeth; Houmsou, Robert; Wama, Emmanuel; Ameh, Mary

2014-01-01

244

Influential Factors on Choice of Home Economics as a Major for Black and White Women Attending Land-Grant Colleges in the Southern Region  

Microsoft Academic Search

The relative importance of selected significant other, social origin, and curricular-related educational and work experience variables on choice of major was determined. A stepwise form of discriminant analysis was used to distinguish black women (N = 1198) majoring in home economics at predominantly black land-grant colleges from white women (N = 1005) majoring in home economics at predominantly white institutions

Betty L. Stout; Anne L. Huber; Treva M. Babcock; Thomas A. Lyson; Victoria R. LeNoir; Leola Adams

1981-01-01

245

Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania  

Microsoft Academic Search

Background  The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged.\\u000a Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants\\u000a of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health\\u000a workers' antenatal care practices with

Karin Gross; Joanna Armstrong Schellenberg; Flora Kessy; Constanze Pfeiffer; Brigit Obrist

2011-01-01

246

The Effect of Health-Facility Admission and Skilled Birth Attendant Coverage on Maternal Survival in India: A Case-Control Analysis  

PubMed Central

Background Research in areas of low skilled attendant coverage found that maternal mortality is paradoxically higher in women who seek obstetric care. We estimated the effect of health-facility admission on maternal survival, and how this effect varies with skilled attendant coverage across India. Methods/Findings Using unmatched population-based case-control analysis of national datasets, we compared the effect of health-facility admission at any time (antenatal, intrapartum, postpartum) on maternal deaths (cases) to women reporting pregnancies (controls). Probability of maternal death decreased with increasing skilled attendant coverage, among both women who were and were not admitted to a health-facility, however, the risk of death among women who were admitted was higher (at 50% coverage, OR?=?2.32, 95% confidence interval 1.85–2.92) than among those women who were not; while at higher levels of coverage, the effect of health-facility admission was attenuated. In a secondary analysis, the probability of maternal death decreased with increasing coverage among both women admitted for delivery or delivered at home but there was no effect of admission for delivery on mortality risk (50% coverage, OR?=?1.0, 0.80–1.25), suggesting that poor quality of obstetric care may have attenuated the benefits of facility-based care. Subpopulation analysis of obstetric hemorrhage cases and report of ‘excessive bleeding’ in controls showed that the probability of maternal death decreased with increasing skilled attendant coverage; but the effect of health-facility admission was attenuated (at 50% coverage, OR?=?1.47, 0.95–1.79), suggesting that some of the effect in the main model can be explained by women arriving at facility with complications underway. Finally, highest risk associated with health-facility admission was clustered in women with education 8 years. Conclusions The effect of health-facility admission did vary by skilled attendant coverage, and this effect appears to be driven partially by reverse causality; however, inequitable access to and possibly poor quality of healthcare for primary and emergency services appears to play a role in maternal survival as well. PMID:24887586

Montgomery, Ann L.; Fadel, Shaza; Kumar, Rajesh; Bondy, Sue; Moineddin, Rahim; Jha, Prabhat

2014-01-01

247

Antenatal Syphilis Screening Using Point-of-Care Testing in Sub-Saharan African Countries: A Cost-Effectiveness Analysis  

PubMed Central

Background Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA), where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs) averted. Methods and Findings The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86%) and specificity (99%) reported for the immunochromatographic strip (ICS) test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2–US$48). Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%–14.0%) to 0.038% (range: 0.002%–0.113%). Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million DALYs at an estimated annual direct medical cost of US$20.8 million. Conclusions Use of ICS tests for antenatal syphilis screening is highly cost-effective in SSA. Substantial reduction in DALYs can be achieved at a relatively modest budget impact. In SSA, antenatal programs should expand access to syphilis screening using the ICS test. Please see later in the article for the Editors' Summary PMID:24223524

Kuznik, Andreas; Lamorde, Mohammed; Nyabigambo, Agnes; Manabe, Yukari C.

2013-01-01

248

Iron, folate and vitamin B12 status of apparently healthy Irish adult women attending general practitioners in inner-city Dublin  

Microsoft Academic Search

There is substantial related morbidity and mortality among men and women in developed countries. Certain events during the course of a woman’s life such as menstruation, pregnancy, lactation and the menopause may compromise haematinic nutrient status. The purpose of this study was to investigate iron, folate and vitamin B12 status among a sample of apparently healthy, non-pregnant Irish adult women

Helen R. Casey

2002-01-01

249

Antenatal Ultrasound and Risk of Autism Spectrum Disorders  

ERIC Educational Resources Information Center

We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations;…

Grether, Judith K.; Li, Sherian Xu; Yoshida, Cathleen K.; Croen, Lisa A.

2010-01-01

250

Utilization of antenatal care in Madhya Pradesh, India  

Microsoft Academic Search

INTRODUCTION: Improving the utilization of antenatal care services is a global challenge for the health system in low and middle income countries. Antenatal care is one of preventive health care to diagnose early the morbidity during the pregnancy and plan to avert any complication to mother and new born during delivery. During the pregnancy it is very essential and important

C. K. Dolla

2008-01-01

251

Prospective study of outcome in antenatally diagnosed renal pelvis dilatation  

Microsoft Academic Search

AIMSTo ascertain the outcome associated with antenatal renal pelvis dilatation; to recommend guidelines for postnatal investigation and determine an upper limit of normal for the anterioposterior dimensions of the fetal renal pelvis.METHODSInfants whose antenatal ultrasound scan showed a fetal renal pelvis of 5 mm or greater were investigated using postnatal renal tract ultrasound and a micturating cystogram. Isotope studies were

Mervyn S Jaswon; Laraine Dibble; Sheila Puri; Jacky Davis; Jane Young; Raj Dave; Heulwen Morgan

1999-01-01

252

Revised guidelines on management of antenatal hydronephrosis.  

PubMed

Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. The present guidelines update the recommendations published in 2000. Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. All patients with ANH should undergo postnatal ultrasonography; the intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux (VUR). Infants with VUR should receive antibiotic prophylaxis through the first year of life, and their parents counseled regarding the risk of urinary tract infections. The management of patients with pelviureteric junction or vesicoureteric junction obstruction depends on clinical features and results of sequential ultrasonography and radionuclide renography. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. Further studies are necessary to clarify the role of prenatal intervention, frequency of follow-up investigations and indications for surgery in these patients. PMID:23716913

Sinha, A; Bagga, A; Krishna, A; Bajpai, M; Srinivas, M; Uppal, R; Agarwal, I

2013-03-01

253

Revised guidelines on management of antenatal hydronephrosis.  

PubMed

Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. The present guidelines update the recommendations published in 2000. Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. All patients with ANH should undergo postnatal ultrasonography; the intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux. Infants with vesicoureteric reflux should receive antibiotic prophylaxis through the first year of life, and their parents counseled regarding the risk of urinary tract infections. The management of patients with pelviureteric junction or vesicoureteric junction obstruction depends on clinical features and results of sequential ultrasonography and radionuclide renography. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. Further studies are necessary to clarify the role of prenatal intervention, frequency of follow up investigations and indications for surgery in these patients. PMID:23474928

Sinha, Aditi; Bagga, Arvind; Krishna, Anurag; Bajpai, Minu; Srinivas, M; Uppal, Rajesh; Agarwal, Indira

2013-02-01

254

Effect of shifting policies on traditional birth attendant training  

Microsoft Academic Search

Traditional birth attendant (TBA) training commenced in many places in the non-Western world in the 1970s, supported by the World Health Organization and other funding bodies. By 1997, senior policy makers decided to refocus priorities on the provision of “skilled attendants” to assist birthing women. The definition of skilled attendants excluded TBAs and resulted in the subsequent withdrawal of funding

Sue Kruske; Lesley Barclay

2004-01-01

255

Screening for Chlamydia trachomatis infection among infertile women in Saudi Arabia  

PubMed Central

Background Chlamydia trachomatis infection is a worldwide-distributed sexually transmitted infection that may lead to infertility. Objectives This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. Patients and methods A community-based study carried out at the obstetrics and gynecology clinic at Jazan General Hospital, Saudi Arabia. The study group included 640 Saudi infertile women who were aged between 18 and 40 years and who attended the gynecology clinic for infertility examination throughout 1 year of study (from July 1, 2011 to June 30, 2012). The randomized control group included 100 Saudi fertile women who attended the obstetrics clinic for routine antenatal care. All recruited women were screened for chlamydia infection by enzyme-linked immunosorbent assay (ELISA) for detection of serum-specific antibodies and then retested by the McCoy cell culture technique. Results The prevalence of Chlamydia trachomatis infection among infertile women was high, at 15.0%. The rate of chlamydia infection detected by ELISA was 9.84%, and it was 12.03% by the culture method (P = 0.2443). Conclusion The high prevalence of Chlamydia trachomatis infection among Saudi infertile women demands a national screening program for early detection among infertile couples. ELISA is available as a simple screening test alternative to the culture method. PMID:23785247

Kamel, Remah M

2013-01-01

256

Caste and maternal health care service use among rural Hindu women in Maitha, Uttar Pradesh, India.  

PubMed

The objective of this study was to examine the association between caste and maternal health care service use among rural Hindu women in India. We analyzed data from the Morbidity and Performance Assessment, a population-based cross-sectional study, for 482 Hindu women who were pregnant during January 1998 to January 1999 in Maitha, Uttar Pradesh, India. Maternal health care service use among both upper and lower caste women was very low. Upper caste women were almost three times more likely to use antenatal care (odds ratio [OR] = 2.72; 95% confidence interval [CI], 1.40-5.30), tetanus toxoid (OR = 2.50; 95% CI, 1.48-4.21), and contraceptives (OR = 2.66; 95% CI, 1.28-5.54) and almost five times (OR = 4.77; 95% CI, 1.81-12.54) more likely to have a trained birth attendant compared to the lower caste women. Caste was a significant determinant of tetanus toxoid use and trained birth attendant even after adjusting for sociodemographic factors. Besides caste, maternal literacy was the one sociodemographic factor that was significantly associated with the use of all maternal health care services. Information dissemination and awareness generation can improve the use of subsidized maternal health care services among women of all caste groups. PMID:18761290

Saroha, Ekta; Altarac, Maja; Sibley, Lynn M

2008-01-01

257

Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia.  

PubMed

The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community. Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive analysis was used to develop final themes. Worry about forthcoming delivery and fears for the woman's survival were prominent concerns of all participants, but only rarely perceived to be pathological in intensity. Sociocultural practices such as continuing physical labour, dietary restriction, prayer and rituals to protect against supernatural attack were geared towards safe delivery and managing vulnerability. Despite strong cultural norms to celebrate pregnancy, participants emphasised that many pregnancies were unwanted and an additional burden on top of pre-existing economic and marital difficulties. Short birth interval and pregnancy out of wedlock were both seen as shameful and potent sources of mental distress. The notion that pregnancy in traditional societies is uniformly a time of joy and happiness is misplaced. Although antenatal mental distress may be self-limiting for many women, in those with enduring life difficulties, including poverty and abusive relationships, poor maternal mental health may persist. PMID:20148274

Hanlon, Charlotte; Whitley, Rob; Wondimagegn, Dawit; Alem, Atalay; Prince, Martin

2010-10-01

258

Antenatal psychosomatic programming to reduce postpartum depression risk and improve childbirth outcomes: a randomized controlled trial in Spain and France  

PubMed Central

Background Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women. Methods A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis. Results A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ? 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01). Conclusions The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and the rate of preterm childbirth was lower in the EG, our results suggest that the psychosomatic approach may be more helpful to the target population than the standard antenatal programs. PMID:24422605

2014-01-01

259

CENTERING PREGANCY- AFRICA: A PILOT OF GROUP ANTENATAL CARE TO ADDRESS MILLENIUM DEVELOPMENT GOALS  

PubMed Central

Background Severe health worker shortages and resource limitations negatively affect quality of antenatal care (ANC) throughout sub-Saharan Africa. Group ANC, specifically CenteringPregnancy (CP), may offer an innovative approach to enable midwives to offer higher quality ANC. Objective Our overarching goal was to prepare to conduct a clinical trial of CenteringPregnancy – Africa (CP-Africa) in Malawi and Tanzania. In Phase 1, our goal was to determine the acceptability of CP as model for ANC in both countries. In Phase 2, our objective was to develop CP-Africa session content consistent with the Essential Elements of CP model and with national standards in both Malawi and Tanzania. In Phase 3, our objective was to pilot CP-Africa in Malawi to determine whether sessions could be conducted with fidelity to the Centering process. Setting Phase 1 and 2 took place in Malawi and Tanzania. Phase 3, the piloting of two sessions of CP-Africa, occurred at two sites in Malawi: a district hospital and a small clinic. Design We used an Action Research approach to promote partnerships among university researchers, the Centering Healthcare Institute, healthcare administrators, health professionals and women attending ANC to develop CP-Africa session content and pilot this model of group ANC. Participants For Phases 1 and 2, members of the Ministries of Health, health professionals and pregnant women in Malawi and Tanzania were introduced to and interviewed about CP. In Phase 2, we finalized CP-Africa content and trained thirteen health professionals in the Centering Healthcare model. In Phase 3, we conducted a small pilot with 24 pregnant women (12 at each site). Measurements and Findings Participants enthusiastically embraced CP-Africa as an acceptable model of ANC healthcare delivery. The CP-Africa content met both CP and national standards. The pilot established that the CP model could be implemented with process fidelity to the 13 Essential Elements. Several implementation challenges and strategies to address these challenges were identified. Key Conclusions Preliminary data suggest that CP-Africa is feasible in resource-constrained, low-literacy, high-HIV settings in sub-Saharan Africa. By improving the quality of ANC delivery, midwives have an opportunity to make a contribution towards Millennium Development Goals (MDG) targeting improvements in child, maternal and HIV-related health outcomes (MDGs 4, 5 and 6). A clinical trial is needed to establish efficacy. Implications for Practice CP-Africa also has the potential to reduce job-related stress and enhance job satisfaction for midwives in low income countries. If CP can be transferred with fidelity to process in sub-Saharan Africa and retain similar results to those reported in clinical trials, it has the potential to benefit pregnant women and their infants and could make a positive contribution to MGDs 4, 5 and .6. PMID:23871278

Patil, Crystal L.; Abrams, Elizabeth T.; Klima, Carrie; Kaponda, Chrissie P.N.; Leshabari, Sebalda C.; Vonderheid, Susan C.; Kamaga, Martha; Norr, Kathleen F.

2013-01-01

260

Self-Defining as Sexually Abused and Adult Sexual Risk Behavior: Results from a Cross-Sectional Survey of Women Attending an STD Clinic  

ERIC Educational Resources Information Center

Objective: Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as…

Senn, Theresa E.; Carey, Michael P.; Coury-Doniger, Patricia

2011-01-01

261

Seroprevalence and risk factors for hepatitis C virus (HCV) infection in pregnant women attending public sector tertiary care hospital in Hyderabad Sindh  

PubMed Central

Background and Objectives: Pakistan is among the countries having high prevalence of HCV infection in the population but there is dearth of proper epidemiological data regarding acquisition of HCV infection in the pregnant population. Our objective was to determine the seroprevalence of HCV antibodies in healthy pregnant women and to assess the potential risk factors for HCV infection in HCV positive subjects and in the control group. Methodology: This cross sectional and comparative study was conducted from 1st January to 31st December 2010 in the Department of Obstetrics/Gynaecology Unit–I, Liaquat University Hospital Hyderabad. Sera were collected from all admitted pregnant women and tested for HCV anti bodies using Elisa kits (Abbott, USA). Data were analyzed using SPSS version 16.0 statistical package. Results: The seroprevalence of HCV among pregnant population was found to be 4.7%. HCV positive women were more likely to have a history of blood transfusion (OR 1.99, 95% CI 1.26- 3.12), History of therapeutic injection use (OR 2.46, 95% CI 1.43-4.26), history of surgery (OR 1.72, 95% CI 1.12-2.66) and history of sharing household products (OR 1.81, 95% CI 1.14-2.87). Conclusion: HCV seropositive pregnant women were more likely to have a history of blood transfusion, therapeutic injection use, surgery and sharing household items. PMID:24353565

Bibi, Seema; Dars, Saira; Ashfaq, Sanober; Ara Qazi, Roshan; Akhund, Sadaf

2013-01-01

262

Race/Ethnic Differences in Desired Body Mass Index and Dieting Practices Among Young Women Attending College in Hawai'i  

PubMed Central

In accordance with the sociocultural model, race/ethnicity is considered a major influence on factors associated with body image and body dissatisfaction, and eating disorders are often characterized as problems that are primarily limited to young White women from Western cultures. The purpose of this study was to determine whether there are differences that exist by race in desired body weight; the importance placed on those ideals; and dieting strategies among White, Asian American, Native Hawaiian/Pacific Islanders, and other mixed-race young women in Hawai‘i. A total of 144 female college students 18–20 years of age were surveyed about body weight as well as eating and exercise habits. Results demonstrated that all the young women wanted to lose weight. However, there were no differences in desired body weight or desired weight change by race after controlling for body mass index suggesting that current weight rather than race/ethnicity is the predominant influence on weight-related concerns. Young White women placed the greatest level of importance on achieving a lower body weight, which corresponded with a greater likelihood to be attempting weight loss (dieting) and greater endorsement of behaviors consistent with weight loss compared to their counterparts. Findings imply that, for young women, race/ethnicity may not have as significant an impact on factors associated with body weight ideals as previously believed. Rather, differences in the value placed on achieving a desired body weight, as it relates to disordered eating, should be further explored among race/ethnic groups. PMID:21886291

Nigg, Claudio R; Albright, Cheryl L

2011-01-01

263

Race/ethnic differences in desired body mass index and dieting practices among young women attending college in Hawai'i.  

PubMed

In accordance with the sociocultural model, race/ethnicity is considered a major influence on factors associated with body image and body dissatisfaction, and eating disorders are often characterized as problems that are primarily limited to young White women from Western cultures. The purpose of this study was to determine whether there are differences that exist by race in desired body weight; the importance placed on those ideals; and dieting strategies among White, Asian American, Native Hawaiian/Pacific Islanders, and other mixed-race young women in Hawai'i. A total of 144 female college students 18-20 years of age were surveyed about body weight as well as eating and exercise habits. Results demonstrated that all the young women wanted to lose weight. However, there were no differences in desired body weight or desired weight change by race after controlling for body mass index suggesting that current weight rather than race/ethnicity is the predominant influence on weight-related concerns. Young White women placed the greatest level of importance on achieving a lower body weight, which corresponded with a greater likelihood to be attempting weight loss (dieting) and greater endorsement of behaviors consistent with weight loss compared to their counterparts. Findings imply that, for young women, race/ethnicity may not have as significant an impact on factors associated with body weight ideals as previously believed. Rather, differences in the value placed on achieving a desired body weight, as it relates to disordered eating, should be further explored among race/ethnic groups. PMID:21886291

Schembre, Susan M; Nigg, Claudio R; Albright, Cheryl L

2011-07-01

264

Antenatal Atazanavir: A Retrospective Analysis of Pregnancies Exposed to Atazanavir  

PubMed Central

Introduction. There are few data regarding the tolerability, safety, or efficacy of antenatal atazanavir. We report our clinical experience of atazanavir use in pregnancy. Methods. A retrospective medical records review of atazanavir-exposed pregnancies in 12 London centres between 2004 and 2010. Results. There were 145 pregnancies in 135 women: 89 conceived whilst taking atazanavir-based combination antiretroviral therapy (cART), “preconception” atazanavir exposure; 27 started atazanavir-based cART as “first-line” during the pregnancy; and 29 “switched” to an atazanavir-based regimen from another cART regimen during pregnancy. Gastrointestinal intolerance requiring atazanavir cessation occurred in five pregnancies. Self-limiting, new-onset transaminitis was most common in first-line use, occurring in 11.0%. Atazanavir was commenced in five switch pregnancies in the presence of transaminitis, two of which discontinued atazanavir with persistent transaminitis. HIV-VL < 50 copies/mL was achieved in 89.3% preconception, 56.5% first-line, and 72.0% switch exposures. Singleton preterm delivery (<37 weeks) occurred in 11.7% preconception, 9.1% first-line, and 7.7% switch exposures. Four infants required phototherapy. There was one mother-to-child transmission in a poorly adherent woman. Conclusions. These data suggest that atazanavir is well tolerated and can be safely prescribed as a component of combination antiretroviral therapy in pregnancy. PMID:25328370

Samuel, Miriam; Bradshaw, Daniel; Perry, Melissa; Chan, Sum Yee; Dhairyawan, Rageshri; Byrne, Laura; Smith, Katherine; Zhou, Judith; Short, Charlotte Eve; Naftalin, Claire; Offodile, Ngozi; Mandalia, Sundhiya; Roedling, Sherie; Shah, Rimi; Brook, Gary; Poulton, Mary; Rodgers, Mette; Sarner, Liat; Noble, Heather; Hay, Philip; Anderson, Jane; Natha, Macky; Hawkins, David; Taylor, Graham; de Ruiter, Annemiek

2014-01-01

265

Delivery Practices of Traditional Birth Attendants in Dhaka Slums, Bangladesh  

Microsoft Academic Search

This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993- May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related com- plications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home- based birth attendants, and audits in 20

N. Fronczak; S. E. Arifeen; A. C. Moran; L. E. Caulfield; A. H. Baqui

2007-01-01

266

Women's attitudes to being asked about exposure to violence  

Microsoft Academic Search

Objective: to examine women's attitudes to being questioned by their midwife, during and after pregnancy, about exposure to violence.Design: an explorative study using content analysis of one open-ended question.Setting: all antenatal clinics in Uppsala, a medium-sized Swedish university town.Participants: all women registered for antenatal care before 32 weeks of pregnancy, during a period of 6 months.Measurements: all women were assessed

Kristina Stenson; Hilkka Saarinen; Gun Heimer; Birgitta Sidenvall

2001-01-01

267

Protein supplementation and dietary behaviours of resistance trained men and women attending commercial gyms: a comparative study between the city centre and the suburbs of Palermo, Italy  

PubMed Central

Background It is anecdotally recognized that commercial gym users assume supplements in order to improve performance or health. However, dietary behaviours of people and athletes attending commercial gyms have been poorly studied. The exact amount and frequency of dietary supplements consumption are still needed to be investigated. The main purpose of this study is to understand the quantity and quality of food intake, as well as dietary supplementation in people attending commercial gyms. Secondly to compare the city centre and the suburbs of Palermo, Italy. Methods A face-to-face questionnaire was administered to 561 subjects, 207 from the city centre (CC) and 354 from the suburbs (SB) of Palermo, Italy. Frequency of protein supplements use and association with dietary behaviours were investigated. Subsequently, the frequency distribution was used for demographic assessment. Results Frequency of protein consumption was similar in both groups (30% for CC and 28.8% for SB). Males show greater consumption percentages than females (30.5% in males and 6.9% in females). Milk and chicken are the most frequently consumed foods. Data show that non-supplement users (NSU) consume significantly more snacks and bakery products than supplement users (SU) (P?

2014-01-01

268

Rural Gambian women's reliance on health workers to deliver sulphadoxine - pyrimethamine as recommended intermittent preventive treatment for malaria in pregnancy  

PubMed Central

Background The use of most anti-malarial medications is restricted during pregnancy, but two doses of sulphadoxine-pyrimethamine are recommended after the first trimester as intermittent preventive treatment in pregnancy (IPTp). In The Gambia, only 32% of women receive two doses and very little research has been conducted on women's awareness of drug safety during pregnancy. The objective of this paper was to assess whether rural Gambian women were aware of the importance of the timing of the two-dose IPT dose schedule and its relevance to drug safety. Methods This was a qualitative study in which 41 interviews and 16 focus group discussions with women, adolescents, men and traditional birth attendants were conducted. A generic qualitative approach was used to generate a theory as to why women might not participate in IPTp as recommended. Results Although most women used calendar months to count their stage of pregnancy, these months did not correlate with their concept of foetal development. Foetal growth was described following Islamic tradition as water, clot, piece of meat and human being, although there was little consensus about the order or timing in which these stages occurred. Common signs and conditions of malaria were known. Women were anxious about miscarriage and recognized that some medicines should not be taken in the first trimester, but were urged by men and traditional birth attendants to attend for antenatal care in the first trimester to "start treatment." General knowledge about the purpose of pregnancy medications and when they should be taken was poor among both men and women. One important result was that women relied entirely on health workers to provide safe drugs, at the correct time. Conclusion Women did not have relevant information to judge the safety and appropriate timing of pregnancy drugs, which made them over-reliant on health workers. They should be encouraged to date their own pregnancies in culturally relevant terms and to anticipate when and which medications they should receive. PMID:19216759

Brabin, Loretta; Stokes, Elizabeth; Dumbaya, Isatou; Owens, Stephen

2009-01-01

269

Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol-Serving Venues in a South African Township  

PubMed Central

Objective: South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship. Method: A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0–7) and drinking behavior. Results: The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0–34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT ? 8). The mean PTSD score was 36.32 (range: 17–85, SD = 16.3), with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ? 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the “other” category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior. Conclusions: Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas. PMID:22630793

Watt, Melissa H.; Ranby, Krista W.; Meade, Christina S.; Sikkema, Kathleen J.; MacFarlane, Jessica C.; Skinner, Donald; Pieterse, Desiree; Kalichman, Seth C.

2012-01-01

270

Motivations for Movie Attendance.  

ERIC Educational Resources Information Center

A study investigated audience motives for movie attendance. Subjects were 493 college students, who indicated on an eight-point scale the extent to which a series of 70 reasons for movie going matched their own reasons for movie attendance. Three frequency of attendance groups were identified: infrequent--once in two to six months;…

Austin, Bruce A.

271

Preterm Labour and Birth: A Survey of Clinical Practice Regarding Use of Tocolytics, Antenatal Corticosteroids, and Progesterone  

Microsoft Academic Search

Objectives: We wished to determine prescribing practices of obstetricians in Canada regarding tocolytics, antenatal corticosteroids, and progesterone for women at increased risk of preterm labour and birth, and to determine whether these practices changed between 1997-98 and 2004. Methods: Two cross-sectional surveys of Canadian obstetricians were conducted. The initial survey was in 1997-98 (N = 1313); the follow-up survey was

Dini Hui; Grace Liu; Edna Kavuma; Sheila A. Hewson; Darren McKay BCS; Mary E. Hannah

2007-01-01

272

Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal1-3  

Microsoft Academic Search

Background: Previously we showed that women in rural Nepal experience multiple micronutrient deficiencies in early pregnancy. Objective: This study examined the effects of daily antenatal mi- cronutrientsupplementationonchangesinthebiochemicalstatusof several micronutrients during pregnancy. Design: In Nepal, we conducted a randomized controlled trial in which4combinationsofmicronutrients(folicacid,folicacidiron, folic acid iron zinc, and a multiple micronutrient supplement containingfolicacid,iron,zinc,and11othernutrients)plusvitamin A, or vitamin A alone as a control,

Parul Christian; Tianan Jiang; Subarna K Khatry; Steven C LeClerq; Sharada R Shrestha; Keith P West Jr

273

The Impact of Including Husbands in Antenatal Health Education Services on Maternal Health Practices in Urban Nepal: Results from a Randomized Controlled Trial  

ERIC Educational Resources Information Center

Observational studies suggest that including men in reproductive health interventions can enhance positive health outcomes. A randomized controlled trial was designed to test the impact of involving male partners in antenatal health education on maternal health care utilization and birth preparedness in urban Nepal. In total, 442 women seeking…

Mullany, Britta C.; Becker, S.; Hindin, M. J.

2007-01-01

274

The quality-coverage gap in antenatal care: toward better measurement of effective coverage  

PubMed Central

Background: The proportion of pregnant women receiving 4 or more antenatal care visits (ANC 4+) is used prominently as a global benchmark indicator to track maternal health program performance. This has contributed to an inappropriate focus on the number of contacts rather than on the content and process of care. This paper presents analysis of specific elements of care received among women reporting 4 or more ANC visits. Methods: We conducted secondary analysis using Demographic and Health Survey data from 41 countries to determine coverage for specific elements of antenatal care. The analysis was conducted for: (1) women who delivered during the 2 years preceding the survey and who reported receiving 4 or more ANC visits, and (2) all women who delivered during the preceding 2 years. The specific ANC services that we assessed were: blood pressure measurement, tetanus toxoid vaccination, first ANC visit at less than 4 months gestation, urine testing, counseling about danger signs, HIV counseling and testing, iron–folate supplementation (? 90 days), and at least 2 doses of sulfadoxine/pyramethamine for malaria prevention. The difference between expected (100%) and actual coverage (the quality–coverage gap) was calculated for each service across the 41 surveys. Results: Coverage for specific elements of care among women reporting 4 or more ANC visits was generally low for most of the specific elements assessed. Blood pressure and tetanus toxoid performed best, with median quality–coverage gaps of 5% and 18%, respectively. The greatest gaps were for iron–folate supplementation (72%) and malaria prevention (86%). Coverage for specific interventions was generally much lower among all pregnant women (reflecting population effective coverage) than among only those who had received ANC 4+ visits. Although ANC 4+ and average coverage across the elements of care correlated relatively well (Pearson r2 ?=? 0.56), most countries had lower average coverage for the content of care than for ANC 4+ (among all pregnant women). Conclusion: We argue for the adoption of a summary indicator that better reflects the content of antenatal care than does the current ANC 4+ indicator. We propose, as an alternative, the simple average of a set of ANC content indicators available through surveys and routine health information systems.

Hodgins, Stephen; D'Agostino, Alexis

2014-01-01

275

Prevalence and risk factors for Hepatitis C and HIV-1 infections among pregnant women in Central Brazil  

PubMed Central

Background Hepatitis C (HCV) and human immunodeficiency virus (HIV) infections are a major burden to public health worldwide. Routine antenatal HIV-1 screening to prevent maternal-infant transmission is universally recommended. Our objectives were to evaluate the prevalence of and potential risk factors for HCV and HIV infection among pregnant women who attended prenatal care under the coverage of public health in Central Brazil. Methods Screening and counselling for HIV and HCV infections was offered free of charge to all pregnant women attending antenatal clinic (ANC) in the public health system, in Goiania city (~1.1 million inhabitants) during 2004–2005. Initial screening was performed on a dried blood spot collected onto standard filter paper; positive or indeterminate results were confirmed by a second blood sample. HCV infection was defined as a positive or indeterminate sample (EIA test) and confirmed HCV-RNA technique. HIV infection was defined according to standard criteria. Factors associated with HIV and HCV infections were identified with logistic regression. The number needed to screen (NNS) to prevent one case of infant HIV infection was calculated using the Monte Carlo simulation method. Results A total of 28,561 pregnant women were screened for HCV and HIV-1 in ANC. Mean maternal age was 23.9 years (SD = 5.6), with 45% of the women experiencing their first pregnancy. Prevalence of HCV infection was 0.15% (95% CI 0.11%–0.20%), and the risk increased with age (p < 0.01). The prevalence of anti-HIV infection was 0.09% (95% CI 0.06%–0.14%). Black women had a 4.9-fold (95% CI 1.42–16.95) greater risk of HIV-1 infection compared to non-black women. NNS to prevent one case of infant HIV infection ranged from 4,141 to 13,928. Conclusion The prevalence of HIV and HCV infections were low among pregnant women, with high acceptability rates in the opt-in strategy in primary care. Older maternal age was a risk factor for HCV and antenatal HCV testing does not fulfill the requirements for screening recommendation. The finding of higher risk of HIV-1 infection among black women despite being in consonance with the HIV-1 ethnic pattern in some American regions cannot be ruled out to be a surrogate marker of socio-economic condition. PMID:19635135

2009-01-01

276

Reasons for disclosure of gender to pregnant women during prenatal ultrasonography  

PubMed Central

Background The objective of this study was to determine the proportion of women who want to know fetal gender on antenatal ultrasonography and the reasons behind this. Methods A descriptive, cross-sectional study was carried out between March 10, 2012 and September 10, 2012 at two tertiary care hospitals (Dow University Hospital, Ojha Campus, and Lady Dufferin Hospital) in Karachi. In total, 223 pregnant women who attended the antenatal clinic and gave their consent were included in the study. Information was collected on a predesigned questionnaire. Results Of the 223 pregnant women, 109 (49.1%) were younger than 25 years. The majority (216, 96.9%) were Muslim, 164 (73.4%) were educated to different levels, 121 (54.3%) spoke Urdu, and 66 (29.6%) were primigravidas. Thirty-four (15.2%) women had a preference for a male child, 24 (10.8%) had a female preference, and 165 (74%) had no preference. Seventy (31.4%) women were interested to know the fetal gender. The association between education and gender preference was found to be statistically significant (P = 0.004) and also that between age and gender preference (P = 0.05), but no relationship was found between gender preference and gender of previous babies (P = 0.317 for males and P = 0.451 for females). Association of ethnicity was also not statistically significant (P = 0.102). Conclusion This study revealed that 31.4% of women were interested in disclosure of gender on prenatal ultrasonography and only15.2% women had a preference for a male child. PMID:24363561

Shukar-ud-din, Shazia; Ubaid, Fareeha; Shahani, Erum; Saleh, Farah

2013-01-01

277

Factors Associated with Pregnant Women's Anticipations and Experiences of HIV-related Stigma in Rural Kenya  

PubMed Central

Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1,777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4–8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women’s empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination. PMID:22799618

Cuca, Yvette P.; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M.

2012-01-01

278

Comparative performance of novel self-sampling methods in detecting high-risk human papillomavirus in 30,130 women not attending cervical screening.  

PubMed

We determined whether the participation rate for a brush-based cervicovaginal self-sampling device is noninferior to the participation rate for a lavage-based one for testing for hrHPV (high-risk human papillomavirus). Additionally, positivity rates for hrHPV, the detection rates for cervical intraepithelial neoplasia grades 2 and 3 or worse (CIN2+/3+), and user comfort were compared. A total of 35,477 non-responders of the regular cervical screening program aged 33-63 years were invited to participate. Eligible women (n?=?30,130) were randomly assigned to receive either a brush-based or a lavage-based device, and a questionnaire for reporting user convenience. Self-sampling responders testing hrHPV-positive were invited for a physician-taken sample for cytology; triage-positive women were referred for colposcopy. A total of 5,218 women participated in the brush-based sampling group (34.6%) and 4809 women in the lavage-based group (31.9%), i.e. an absolute difference of 2.7% (95%CI 1.8-4.2). The hrHPV-positivity rates in the two groups were identical (8.3%, relative risk (RR) 0.99, 95%CI 0.87-1.13). The detection of CIN2+ and CIN3+ in the brush group (2.0% for CIN2+; 1.3% for CIN3+) was similar to that in the lavage group (1.9% for CIN2+; 1.0% for CIN3+) with a cumulative RR of 1.01, 95%CI 0.83-1.24 for CIN2+ and 1.25, 95%CI 0.92-1.70 for CIN3+. The two self-sampling devices performed similarly in user comfort. In conclusion, offering a brush-based device to non-responders is noninferior to offering a lavage-based device in terms of participation. The two self-sampling methods are equally effective in detecting hrHPV, CIN2+/CIN3+ and are both well accepted. PMID:24923998

Bosgraaf, Remko P; Verhoef, Viola M J; Massuger, Leon F A G; Siebers, Albert G; Bulten, Johan; de Kuyper-de Ridder, Gabriëlle M; Meijer, Chris J M; Snijders, Peter J F; Heideman, Daniëlle A M; IntHout, Joanna; van Kemenade, Folkert J; Melchers, Willem J G; Bekkers, Ruud L M

2015-02-15

279

Attitudes to routine HIV counselling and testing, and knowledge about prevention of mother to child transmission of HIV in eastern Uganda: a cross-sectional survey among antenatal attendees  

Microsoft Academic Search

BACKGROUND: HIV testing rates have exceeded 90% among the pregnant women at Mbale Regional Referral Hospital in Mbale District, eastern Uganda, since the introduction of routine antenatal counselling and testing for HIV in June 2006. However, no documented information was available about opinions of pregnant women in eastern Uganda about this HIV testing approach. We therefore conducted a study to

Robert Byamugisha; James K Tumwine; Grace Ndeezi; Charles AS Karamagi; Thorkild Tylleskär

2010-01-01

280

Environments For Healthy Living (EFHL) Griffith birth cohort study: characteristics of sample and profile of antenatal exposures  

PubMed Central

Background The Environments for Healthy Living (EFHL) study is a repeated sample, longitudinal birth cohort in South East Queensland, Australia. We describe the sample characteristics and profile of maternal, household, and antenatal exposures. Variation and data stability over recruitment years were examined. Methods Four months each year from 2006, pregnant women were recruited to EFHL at routine antenatal visits on or after 24 weeks gestation, from three public maternity hospitals. Participating mothers completed a baseline questionnaire on individual, familial, social and community exposure factors. Perinatal data were extracted from hospital birth records. Descriptive statistics and measures of association were calculated comparing the EFHL birth sample with regional and national reference populations. Data stability of antenatal exposure factors was assessed across five recruitment years (2006–2010 inclusive) using the Gamma statistic for ordinal data and chi-squared for nominal data. Results Across five recruitment years 2,879 pregnant women were recruited which resulted in 2904 live births with 29 sets of twins. EFHL has a lower representation of early gestational babies, fewer still births and a lower percentage of low birth weight babies, when compared to regional data. The majority of women (65%) took a multivitamin supplement during pregnancy, 47% consumed alcohol, and 26% reported having smoked cigarettes. There were no differences in rates of a range of antenatal exposures across five years of recruitment, with the exception of increasing maternal pre-pregnancy weight (p=0.0349), decreasing rates of high maternal distress (p=0.0191) and decreasing alcohol consumption (p<0.0001). Conclusions The study sample is broadly representative of births in the region and almost all factors showed data stability over time. This study, with repeated sampling of birth cohorts over multiple years, has the potential to make important contributions to population health through evaluating longitudinal follow-up and within cohort temporal effects. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12610000931077 PMID:23241307

2012-01-01

281

Inadequate Knowledge of Neonatal Danger Signs among Recently Delivered Women in Southwestern Rural Uganda: A Community Survey  

PubMed Central

Background Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda. Methods Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed. Results Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2–2.3). Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8–1.4), or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9–1.7). Conclusions Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care. PMID:24824364

Sandberg, Jacob; Odberg Pettersson, Karen; Asp, Gustav; Kabakyenga, Jerome; Agardh, Anette

2014-01-01

282

A cross-sectional analytical study of geophagia practices and blood metal concentrations in pregnant women in Johannesburg, South Africa.  

PubMed

Background. Geophagia, a form of pica, has been shown to be widely practised in sub-Saharan Africa, especially among pregnant women.Objective. To assess the prevalence of geophagia and examine exposure to selected metals and associated risk factors in women attending an antenatal clinic at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa, during June and July 2010.Methods. We conducted a cross-sectional study on a convenience sample of 307 pregnant women, ranging in age from 18 to 46 years. Structured interviews were conducted to understand geophagia practices. Blood samples were collected to determine haemoglobin values and concentrations of arsenic, cadmium, mercury and lead. Statistical analyses using the ?2 test, Wilcoxon's rank-sum test and logistic regression analyses were performed as appropriate.Results. Mean parity was 1.4 and the mean (standard deviation) gestational age 30.3 (6.0) weeks. Geophagia was reported by 60 women (19.5%), and the majority purchased soil from street vendors (83.3%). The prevalence of anaemia in the study sample was 16.9% (95% confidence interval 13.1 - 21.6%). Geophagic women had significantly higher blood lead levels than non-geophagic women (2.1 v. 1.4 µg/dl; p<0.001). Anaemia, the use of African traditional medicines and craving of non-nutritive substances in a previous pregnancy were associated with geophagia.Conclusions. Geophagia is practised by a considerable proportion of pregnant women in Johannesburg, especially migrant women. Greater vigilance in respect of pica, especially geophagia, may be needed as part of antenatal care programmes to avoid potentially detrimental health effects of the practice. PMID:25213850

Mathee, Angela; Naicker, Nisha; Kootbodien, Tahira; Mahuma, Tshepo; Nkomo, Palesa; Naik, Inakshi; De Wet, Thea

2014-08-01

283

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

PubMed Central

Objectives: 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. Design: Serial population-based household surveys in 13 SSA countries. Methods: 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. Results: 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. Conclusion: 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. PMID:25406753

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

2014-01-01

284

Mistrust in marriage-Reasons why men do not accept couple HIV testing during antenatal care- a qualitative study in eastern Uganda  

Microsoft Academic Search

BACKGROUND: A policy for couple HIV counseling and testing was introduced in 2006 in Uganda, urging pregnant women and their spouses to be HIV tested together during antenatal care (ANC). The policy aims to identify HIV-infected pregnant women to prevent mother-to-child transmission of HIV through prophylactic antiretroviral treatment, to provide counseling, and to link HIV-infected persons to care. However, the

Elin C Larsson; Anna Thorson; Xavier Nsabagasani; Sarah Namusoko; Rebecca Popenoe; Anna Mia Ekström

2010-01-01

285

A cross-sectional study of antenatal depression and associated factors in Malawi.  

PubMed

Depression, and disabling levels of mixed depressive, anxious and somatic symptoms, termed common mental disorder, occurring in the perinatal period are an important health problem in low- and middle-income countries. In this cross-sectional study, pregnant women were recruited from a district hospital antenatal clinic in Malawi. Symptoms of depression and anxiety, and non-specific somatic symptoms commonly associated with distress, were measured using validated local versions of the Self Reporting Questionnaire (SRQ). In a sub-sample, Diagnostic Statistical Manual (DSM)-IV diagnoses of major and minor depressive disorders were made using the Structured Clinical Interview for DSM-IV. Maternal socio-demographic and health variables were measured, and associations with SRQ score and depression diagnosis were determined. Of 599 eligible women, 583 were included in the analysis. The adjusted weighted prevalence of current major depressive episode and current major or minor depressive episode were 10.7 % (95 % CI 6.9-14.5 %) and 21.1 % (95 % CI 15.5-26.6 %), respectively. On multivariate analysis, SRQ score was significantly associated with lower perceived social support, experience of intimate partner violence, having had a complication in a previous delivery, higher maternal mid-upper arm circumference and more years of schooling. Major depressive episode was associated with lower perceived social support and experience of intimate partner violence. This study demonstrates that antenatal depression/CMD is common in Malawi and is associated with factors that may be amenable to psychosocial interventions. PMID:24240635

Stewart, Robert C; Umar, Eric; Tomenson, Barbara; Creed, Francis

2014-04-01

286

women  

Microsoft Academic Search

background: More than 15 million women, many of reproductive age, were infected with human immunodeficiency virus (HIV) at the end of 2007. As the HIV epidemic evolves, heterosexual intercourse is increasingly risky: the risk of infection in exposed young women is 4- to 7-fold higher than in young men and nearly half a million newborns annually have HIV. This review

Oskari Heikinheimo; Pekka Lahteenmaki

2002-01-01

287

Variations in NHL Attendance  

Microsoft Academic Search

In recent years the National Hockey League (NHL) has put policies in place to boost attendance. Specifically, these changes have been to curb violence, increase scoring, and move to an unbalanced schedule featuring more games against regional rivals. This research looks at variations in game-to-game attendance in the NHL, focusing on these policy changes. It is found that violence, specifically

Rodney J. Paul

2003-01-01

288

Motivations for movie attendance  

Microsoft Academic Search

This study investigated college students' motives for attendance at theatrically exhibited motion pictures and the relationship between the motivations and frequency of attendance, pattern of movie?going, and the students' gender and age. Respondents (n = 493) completed a survey instrument consisting of 70 motivation items and other items. Factor analysis of the motivation items resulted in seven motives for movie

Bruce A. Austin

1986-01-01

289

A comparison between antenatal care quality in public and private sector in rural Hebei, China  

PubMed Central

Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftic, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

2013-01-01

290

Maternal adverse effects of different antenatal magnesium sulphate regimens for improving maternal and infant outcomes: a systematic review  

PubMed Central

Background Antenatal magnesium sulphate, widely used in obstetrics to improve maternal and infant outcomes, may be associated with adverse effects for the mother sufficient for treatment cessation. This systematic review aimed to quantify maternal adverse effects attributed to treatment, assess how adverse effects vary according to different regimens, and explore women’s experiences with this treatment. Methods Bibliographic databases were searched from their inceptions to July 2012 for studies of any design that reported on maternal adverse effects associated with antenatal magnesium sulphate given to improve maternal or infant outcomes. Primary outcomes were life-threatening adverse effects of treatment (death, cardiac arrest, respiratory arrest). For randomised controlled trials, data were meta-analysed, and risk ratios (RR) pooled using fixed-effects or random-effects models. For non-randomised studies, data were tabulated by design, and presented as RR, odds ratios or percentages, and summarised narratively. Results A total of 143 publications were included (21 randomised trials, 15 non-randomised comparative studies, 32 case series and 75 reports of individual cases), of mixed methodological quality. Compared with placebo or no treatment, magnesium sulphate was not associated with an increased risk of maternal death, cardiac arrest or respiratory arrest. Magnesium sulphate significantly increased the risk of 'any adverse effects’ overall (RR 4.62, 95% CI 2.42-8.83; 4 trials, 13,322 women), and treatment cessation due to adverse effects (RR 2.77; 95% CI 2.32-3.30; 5 trials, 13,666 women). Few subgroup differences were observed (between indications for use and treatment regimens). In one trial, a lower dose regimen (2 g/3 hours) compared with a higher dose regimen (5 g/4 hours) significantly reduced treatment cessation (RR 0.05; 95% CI 0.01-0.39, 126 women). Adverse effect estimates from studies of other designs largely supported data from randomised trials. Case reports supported an association between iatrogenic overdose of magnesium sulphate and life-threatening consequences. Conclusions Appropriate administration of antenatal magnesium sulphate was not shown to be associated with serious maternal adverse effects, though an increase in 'minor’ adverse effects and treatment cessation was shown. Larger trials are needed to determine optimal regimens, achieving maximal effectiveness with minimal adverse effects, for each antenatal indication for use. Vigilance in the use of magnesium sulphate is essential for women’s safety. PMID:24139447

2013-01-01

291

Impact of a maternal health voucher scheme on institutional delivery among low income women in Pakistan  

PubMed Central

Background Only 39% of deliveries in Pakistan are attended by skilled birth attendants, while Pakistan's target for skilled birth attendance by 2015 is > 90%. Methods A 12-month maternal health voucher intervention was implemented in Dera Ghazi Khan City, located in Southern Punjab, Pakistan in 2009. A pre-test/post-test non-experimental study was conducted to assess the impact of the intervention. Household interviews were conducted with randomly selected women who delivered in 2008 (the year prior to the voucher intervention), and with randomly selected women who delivered in 2009. A strong outreach model was used and voucher booklets valued at $50, containing redeemable coupons for three antenatal care (ANC) visits, a postnatal care (PNC) visit and institutional delivery, were sold for $1.25 to low-income women targeted by project workers. Regression analysis was conducted to determine the impact of the voucher scheme on ANC, PNC, and institutional delivery. Marginal effects estimated from logistic regression analyses were used to assess the magnitude of the impact of the intervention. Results The women targeted by voucher outreach workers were poorer, less educated, and at higher parity. After adjusting for these differences, women who delivered in 2009 and were sold voucher booklets were significantly more likely than women who delivered in 2008 to make at least three ANC visits, deliver in a health facility, and make a postnatal visit. Purchase of a voucher booklet was associated with a 22 percentage point increase in ANC use, a 22 percentage point increase in institutional delivery, and a 35 percentage point increase in PNC use. Conclusions A voucher intervention implemented for 12 months was associated with a substantial increase in institutional delivery. A substantial scale-up of maternal health vouchers that focus on institutional delivery is likely to bring Pakistan closer to achieving its 2015 target for institutional delivery. PMID:21539744

2011-01-01

292

Comparison of interval duration between single course antenatal corticosteroid administration and delivery on neonatal outcomes  

PubMed Central

Objective This study was performed to determine the effect of antenatal corticosteroid the interval between administration and delivery affect on neonatal outcomes. Material and Methods An observational study was performed on all deliveries between 28–34 weeks gestation where delivery occurred vaginally after completing a single course of antenatal corticosteroid (dexamethasone). Women were divided into 3 groups on the basis of the interval from first corticosteroid dose to delivery (<2 days, 2–7 and >7 days). The primary outcome was the need for neonatal resuscitation and the secondary outcome was respiratory distress syndrome (RDS), which was described as “need for ventilation with positive pressure O2 during the first 24 hrs of life”. P value <0.05 was significant. Results Of 104 neonates whose mothers received a full course of antenatal corticosteroid, 29 delivered <2 days, 41 delivered 2–7 days, and 34 delivered more than 7 days after the initial dose. Overall, those delivering within 2 days after the first injection of corticosteroid had more need for resuscitation and ventilation than those infants delivering between 2–7 days and after 7 days. Infants delivering between 2–7 days had a lower incidence of need for resuscitation and receiving respiratory support for more than 24 hours. Conclusion We found that the interval between corticosteroid administration and delivery influences the incidence of need for resuscitation and ventilation. Infants delivering less than 2 days of corticosteroid exposure have a higher frequency of need for resuscitation and ventilation than delivering between 2–7 days and after 7 days. PMID:24591968

Sekhavat, Leila; Firouzabadi, Raziah Dehghani; Karbasi, Sedighah Akhavan

2011-01-01

293

Consequences of Missed Opportunities for HIV Testing during Pregnancy and Delayed Diagnosis for Mexican Women, Children and Male Partners  

PubMed Central

Introduction HIV testing during pregnancy permits prevention of vertical (mother-to-child) transmission and provides an opportunity for women living with HIV to access treatment for their own health. In 2001, Mexico’s National HIV Action Plan committed to universal offer of HIV testing to pregnant women, but in 2011, only 45.6% of women who attended antenatal care (ANC) were tested for HIV. The study objective was to document the consequences of missed opportunities for HIV testing and counseling during pregnancy and late HIV diagnosis for Mexican women living with HIV and their families. Methods Semi-structured-interviews with 55 women living with HIV who had had a pregnancy since 2001 were completed between 2009 and 2011. Interviews were analyzed thematically using a priori and inductive codes. Results Consistent with national statistics, less than half of the women living with HIV (42%) were offered HIV testing and counseling during ANC. When not diagnosed during ANC, women had multiple contacts with the health-care system due to their own and other family members’ AIDS-related complications before being diagnosed. Missed opportunities for HIV testing and counseling during antenatal care and health-care providers failure to recognize AIDS-related complications resulted in pediatric HIV infections, AIDS-related deaths of children and male partners, and HIV disease progression among women and other family members. In contrast, HIV diagnosis permitted timely access to interventions to prevent vertical HIV transmission and long-term care and treatment for women living with HIV. Conclusions Omissions of the offer of HIV testing and counseling in ANC and health-care providers’ failure to recognize AIDS-related complications had negative health, economic and emotional consequences. Scaling-up provider-initiated HIV testing and counseling within and beyond antenatal care and pre-service and in-service trainings on HIV and AIDS for health-care providers can hasten timely HIV diagnosis and contribute to improved individual and public health in Mexico. PMID:25372464

Kendall, Tamil

2014-01-01

294

Development and pretesting of an information, education and communication (IEC) focused antenatal care handbook in Pakistan  

PubMed Central

Background Improvement of maternal morbidity and mortality indicators remains a major challenge for developing countries. Antenatal care is one of the key strategies in maintaining safe motherhood. The objective of this study was to develop and pretest a culturally relevant Antenatal Care Handbook (ANC handbook) utilizing the principles of information, education, and communication (IEC). We developed the ANC handbook after an extensive review of existing literature, available instruments (for keeping track of pregnancy and informing pregnant women), and seeking expert opinion. To pretest the ANC handbook, a cross-sectional approach was adopted, and information was collected from 300 expectant women, 150 women each from the community and from the health facility arm. Trained field workers conducted the pretesting from May 2004 to June 2004. Feedback on messages for pregnant mothers contained in the handbook was also assessed. At the same time, the ANC handbook was reviewed by 25 health care providers (including community health workers, physicians, nurses, and other health staff working at various kinds of health care facilities). Data were analyzed using both quantitative and qualitative methods. Findings Twenty-three percent of the interviewed women were primigravida, 50% were multigravida and 27% were grandmultipara. The mean age of the women in the community sample was 25.8 SD: 4.9 years and in the hospital sample it was 25.7 SD: 5.2 years. No significant differences were observed between women interviewed at community or health facilities related to their understanding of ANC messages, and the majority of messages were well understood. Similarly, health care providers found all of the instruments useful and workable in the health system. Finally, feedback from pregnant women and health care staff regarding different components of the handbook were incorporated and later verified by them. Conclusions Findings of pretesting reveal that a majority of pregnant women have an understanding of the culturally relevant ANC handbook. The handbook was found to be practical by healthcare paraprofessionals and community workers for use in different tiers of the health care system in Pakistan. The ANC handbook can be applied in the health service sector of Pakistan and can be adopted with relevant cultural modifications by countries with a similar context. PMID:21450064

2011-01-01

295

Biology of Women  

NSDL National Science Digital Library

The importance of a course that teaches about the biology of women is discussed. This type of course was developed while the authors attended the Women's Curricular Reform Institute in Oshkosh, Wisconsin. The interaction of biological and sociological iss

Lea-Fox, Deborah; Kennedy, Frances G.

2002-12-01

296

Mammography screening attendance  

Microsoft Academic Search

BackgroundPersonal or telephone contact methods are often used to increase attendance for mammography screening. A meta-analysis of the literature was performed to assess the overall effect of direct-contact recruitment on mammography participation.

Kris Denhaerynck; Emmanuel Lesaffre; Jo Baele; Kaat Cortebeeck; Eef Van Overstraete; Frank Buntinx

2003-01-01

297

Quality and quantity of antenatal HIV counselling in a PMTCT programme in Mombasa, Kenya.  

PubMed

A recent report from a PMTCT implementation study in Mombasa, Kenya, points at an important gap between the efficacy in clinical trial circumstances and the effectiveness of PMTCT programmes when implemented in real life. Hence, the quality and quantity of antenatal HIV counselling in a routine setting were appraised. The counsellors' social and communicative skills, duration and topics covered during pre- and post-test counselling sessions were assessed by means of the VCT assessment tools published by UNAIDS. A total of 14 group educational sessions, 66 pre-test counselling sessions and 50 post-test counselling sessions were observed and assessed. In general, the frequency and duration of the counselling was low. Crucial topics such as window period and partner involvement and follow-up support were covered haphazardly. The counsellor's social and communicative skills were given high marks, yet information was rarely repeated or summarized. The limited time dedicated to women receiving antenatal VCT contrasts with the heavy and comprehensive load of health information and advice they are supposed to receive. Ample pre- and post-test counselling including follow-up should be pursued for optimal effectiveness of PMTCT. We propose a number of health system interventions preceded and guided by ongoing audit. PMID:16546777

Delva, Wim; Mutunga, Lillian; Quaghebeur, Ann; Temmerman, Marleen

2006-04-01

298

Relationship between professional antenatal care and facility delivery: an assessment of Colombia.  

PubMed

The determinants of maternal and child health have been the recurrent topics of study in developing countries. Using the Demographic and Health Survey (2010) of Colombia, this study aimed to identify the determinants for professional antenatal care and institutional delivery, taking into account the interdependence of these two decisions, which we consider using a bivariate probit model. This study found that when certain factors affecting both the decision to seek prenatal care and giving birth in a hospital are neglected, the results of the estimates are inefficient. Estimates show that the effects of education, parity, regional location and economic status on institutional delivery tend to be underestimated in a univariate probit model. The results indicate that economic status, level of education, parity and medical-insurance affiliation influenced the joint likelihood of accessing professional antenatal care and delivering in a health facility. An important finding is that mothers with a higher level of education are 9 percentage points more likely to access these two health services compared with mothers who are illiterate. Another observed finding is the regional disparities. The evidence indicates that mothers in the Pacific Region, the poorest region of Colombia, are 6 percentage points less likely to access such services. Thus, the results indicate that the Colombian health policy should emphasize increasing the level of schooling of mothers and establish health facilities in the poorest regions of the country to ensure that women in need are provided with social health insurance. PMID:23735737

Trujillo, Juan C; Carrillo, Bladimir; Iglesias, Wilman J

2014-07-01

299

Strategies to Improve Child Immunization via Antenatal Care Visits in India: A Propensity Score Matching Analysis  

PubMed Central

Numerous studies have examined the empirical evidence concerning the influence of demographic and socio-economic factors influencing child immunization, but no documentation is available which shows the actual impact of antenatal care (ANC) visits on subsequent child immunization. Therefore, this paper aims to examine the net impact of ANC visits on subsequent utilization of child immunization after removing the presence of selection bias. Nationwide data from India’s latest National Family Health Survey conducted during 2005–06 is used for the present study. The analysis has been carried out in the two separate models, in the first model 1–2 ANC visit and in the second model three or more ANC visits has been compared with no visit. We have used propensity score matching method with a counterfactual model that assesses the actual ANC visits effect on treated (ANC visits) and untreated groups (no ANC visit), and have employed Mantel-Haenszel bounds to examine whether result would be free from hidden bias or not. Using matched sample analysis result shows that child immunization among the groups of women who have completed 1–2 ANC visits and those who had more than two visits was about 13 percent and 19 percent respectively, higher than the group of women who have not made any ANC visit. Findings of nearest neighbor matching with replacement method, which completely eliminated the bias, indicate that selection bias present in data set leads to overestimates the positive effects of ANC visits on child immunization. Result based on Mantel-Haenszel bounds method suggest that if around 19 percent bias would be involved in the result then also we could observe the true positive effect of 1–2 ANC visits on child immunization. This also indicates that antenatal clinics are the conventional platforms for educating pregnant women on the benefits of child immunization. PMID:23824555

Dixit, Priyanka; Dwivedi, Laxmi Kant; Ram, Faujdar

2013-01-01

300

Where There Are (Few) Skilled Birth Attendants  

PubMed Central

Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol, family planning, measurement of blood loss, and postpartum care) will increase the chance that women in the lowest economic quintiles will also benefit from global safe motherhood efforts. PMID:21608417

Prata, Ndola; Rowen, Tami; Bell, Suzanne; Walsh, Julia; Potts, Malcolm

2011-01-01

301

Maternal health care amid political unrest: the effect of armed conflict on antenatal care utilization in Nepal.  

PubMed

Armed conflicts, which primarily occur in low- and middle-income countries, have profound consequences for the health of affected populations, among them a decrease in the utilization of maternal health care services. The quantitative relationship between armed conflict and maternal health care utilization has received limited attention in the public health literature. We evaluate this relationship for a particular type of health care service, antenatal care, in Nepal. Using count regression techniques, household survey data and sub-national conflict data, we find a negative correlation between the number of antenatal care visits and incidents of conflict-related violence within a respondent's village development committee. Specifically, we find that under high-intensity conflict conditions women receive between 0.3 and 1.5 fewer antenatal care check-ups. These findings imply that maternal health care utilization is partially determined by characteristics of the social environment (e.g. political instability) and suggest health care providers need to revise maternal health strategies in conflict-affected areas. Strategies may include decentralization of services, maintaining neutrality among factions, strengthening community-based health services and developing mobile clinics. PMID:22773608

Price, James I; Bohara, Alok K

2013-05-01

302

Staff-related access deficit and antenatal care coverage across the NUTS level 1 regions of Turkey.  

PubMed

At the heart of each health system, the workforce is central to advancing health. The World Health Organization has identified a threshold in workforce density below which high coverage of essential interventions, including those necessary to meet the health-related Millennium Development Goals (MDGs), is very unlikely. The International Labor Organization (ILO) has launched a similar indicator -staff related access deficit- using Thailand's health care professional density as a benchmark. The aim of this study is to assess the staff-related access deficit of the population across the 12 NUTS 1 level regions of Turkey. The main hypothesis is that staff-related access deficit has a correlation with and predicts the gap in antenatal care coverage (percentage of women unable to access to antenatal care) across different regions. Staff-related access deficit, as a threshold indicator, seems to have a linear relationship with the antenatal care coverage gap. The known inequalities in the distribution of the health care workforce among different regions of Turkey were put forward once more in this study using the SRA indicator. The staff-related access deficit indicator can be easily used to monitor the status of distributional inequalities of the health care workforce at different sub-national levels in the future. PMID:21375148

Yardim, Mahmut S

2010-01-01

303

Antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus.  

PubMed

Hydrometrocolpos is cystic dilatation of the vagina and uterus due to congenital vaginal obstruction. It may be secretory or urinary in character and manifests in the neonatal period with abdominal distension. Urinary hydrometrocolpos occurs in patients with urogenital sinus or cloacal anomaly. A rare case of antenatal MR diagnosis of urinary hydrometrocolpos due to urogenital sinus is presented. PMID:16810498

Subramanian, Subramanian; Sharma, Raju; Gamanagatti, Shivanand; Agarwala, Sandeep; Gupta, Prerna; Kumar, Sunesh

2006-10-01

304

Mothers' Antenatal Depression and Their Children's Antisocial Outcomes  

ERIC Educational Resources Information Center

Interviews of 120 British adolescents and their parents (80% of a random sample of antenatal patients drawn from a representative urban population and followed longitudinally) revealed that 40 (33%) had been arrested and/or had a diagnosis of "DSM-IV" conduct disorder by 16 years of age; of those, 18 (45%) had committed violent acts. Depression in…

Hay, Dale F.; Pawlby, Susan; Waters, Cerith S.; Perra, Oliver; Sharp, Deborah

2010-01-01

305

HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women's human rights?  

PubMed Central

Background In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Methods Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India’s National AIDS Control Organization. Results While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. Conclusions There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV. PMID:24656059

2014-01-01

306

Women's views on consent, counseling and confidentiality in PMTCT: a mixed-methods study in four African countries  

PubMed Central

Background Ambitious UN goals to reduce the mother-to-child transmission of HIV have not been met in much of Sub-Saharan Africa. This paper focuses on the quality of information provision and counseling and disclosure patterns in Burkina Faso, Kenya, Malawi and Uganda to identify how services can be improved to enable better PMTCT outcomes. Methods Our mixed-methods study draws on data obtained through: (1) the MATCH (Multi-country African Testing and Counseling for HIV) study's main survey, conducted in 2008-09 among clients (N = 408) and providers at health facilities offering HIV Testing and Counseling (HTC) services; 2) semi-structured interviews with a sub-set of 63 HIV-positive women on their experiences of stigma, disclosure, post-test counseling and access to follow-up psycho-social support; (3) in-depth interviews with key informants and PMTCT healthcare workers; and (4) document study of national PMTCT policies and guidelines. We quantitatively examined differences in the quality of counseling by country and by HIV status using Fisher's exact tests. Results The majority of pregnant women attending antenatal care (80-90%) report that they were explained the meaning of the tests, explained how HIV can be transmitted, given advice on prevention, encouraged to refer their partners for testing, and given time to ask questions. Our qualitative findings reveal that some women found testing regimes to be coercive, while disclosure remains highly problematic. 79% of HIV-positive pregnant women reported that they generally keep their status secret; only 37% had disclosed to their husband. Conclusion To achieve better PMTCT outcomes, the strategy of testing women in antenatal care (perceived as an exclusively female domain) when they are already pregnant needs to be rethought. When scaling up HIV testing programs, it is particularly important that issues of partner disclosure are taken seriously. PMID:22236097

2012-01-01

307

Antenatal HIV testing in rural eastern Uganda in 2003: incomplete rollout of the prevention of mother-to-child transmission of HIV programme?  

Microsoft Academic Search

Background  Uganda began to implement the prevention of mother-to-child transmission (PMTCT) of HIV programme in 2000, and by the end\\u000a of 2003 it had expanded to cover 38 of the 56 districts including Mbale District. However, reports from Mbale Hospital showed\\u000a that less than 10% of pregnant women accepted antenatal HIV testing. We therefore conducted a study to determine the proportion

Charles AS Karamagi; James K Tumwine; Thorkild Tylleskar; Kristian Heggenhougen

2006-01-01

308

The effect of tenofovir on renal function in HIV-positive pregnant women  

PubMed Central

Introduction Tenofovir is a commonly used component of antiretroviral therapy (ART) to reduce vertical transmission of HIV. Although systematic review of tenofovir use in pregnancy concluded it to be low risk for foetal abnormalities [1], data is limited on its impact on renal function in pregnant women. A recent South African study [2] concluded that renal dysfunction in HIV-infected pregnant women is significantly less common than in other HIV-infected adults, however there is currently no UK data. We aimed to investigate the effect of tenofovir on renal function in HIV-1 positive pregnant women in a UK clinic. Methods We retrospectively analyzed data on renal function in pregnancy from a cohort of women attending a busy inner city London antenatal clinic. All women were screened for renal function throughout pregnancy via serum creatinine and estimated glomerular filtration rate (eGFR) calculated using modification of diet in renal disease (MDRD) and corrected for ethnicity. Results Ninety-seven HIV-1 positive women were registered at Homerton Hospital antenatal service of a total of 105 pregnancies between January 2010 and September 2013. Tenofovir was prescribed in 71/105 pregnancies (67.6%). Of the 71 pregnancies, 41 were prescribed tenofovir pre-conception (57.7%). Of the pregnant women who started tenofovir in pregnancy, 21/31 (67.7%) were initiated before week 24 of pregnancy, in line with British HIV association (BHIVA) guidelines [3]. There was no deterioration in median serum creatinine or decline in eGFR in women prescribed tenofovir during pregnancy. At six weeks after delivery, in the 42 women who continued tenofovir therapy and had eGFR measured, one woman had eGFR=60, all others eGFR >90 (Table 1). Conclusions Consistent with current guidelines and experience, this study shows tenofovir did not cause decline in renal function in pregnancy in our cohort of HIV-1 positive women, whether started during pre-conception or during pregnancy. More evidence should be prospectively collected looking at effects of tenofovir on other measures of tubular renal function in pregnancy such as proteinuria and protein-creatinine ratio.

Flanagan, Stuart; Barnes, Lynne; Anderson, Jane; Barber, Tristan

2014-01-01

309

Church Attendance or Religiousness  

Microsoft Academic Search

The purpose of the study was to determine if religiousness, instead of church attendance, was related to alcohol consumption, other drug use, and delinquency after considering socio-demographic, familial and peer factors. Many researchers argue that religion only inhibits relative minor, or ascetic, offenses, such as underage consumption of alcohol. They also argue that religion ceases to be related to offenses

Brent B. Benda; Sandra K. Pope; Kelly J. Kelleher

2006-01-01

310

DEVELOP students attend conference  

NASA Technical Reports Server (NTRS)

Last month, Madeline Brozen and Jason Jones of the DEVELOP Program at John C. Stennis Space Center joined members from the program's national office at Langley Research Center to attend the Southern Growth Policies Board annual conference in Biloxi. Pictured are (l to r): Karen Allsbrook, Jonathan Gleason, Gov. Haley Barbour, Madeline Brozen, Lindsay Rogers and Tracey Silcox.

2009-01-01

311

Pathways of decision making among Yucatan Mayan traditional birth attendants  

Microsoft Academic Search

In rural, developing world communities, women are often isolated from biomedical services. Frequently, traditional birth attendants (TBAs) are the only caregivers during childbirth, both normal and complicated. Women trust their TBAs to manage their births. Globally, government and non-governmental organizations (NGOs) have sought to upgrade TBAs’ skills and to encourage them to refer complications. However, most training programs have failed

Barbara A. Anderson; E. N. Anderson; Tracy Franklin; Aurora Dzib-Xihum de Cen

2004-01-01

312

Antenatal depression: an artefact of sleep disturbance?  

PubMed

Research indicates that poor sleep quality is linked to and may precede depressive symptomatology in pregnancy, complicating screening for either condition. Pregnancy onset may also contribute to the development of sleep-disordered breathing (SDB). For the first time, the link between SDB and depression was examined in pregnancy. A total of 189 pregnant women completed the Edinburgh Postnatal Depression Scale (EPDS), Pittsburgh Sleep Quality Index (PSQI) for sleep quality and the Berlin Questionnaire for SDB. Women were also asked what they felt was the cause of their symptoms. PSQI-assessed poor sleep quality and self-perceived depression were strongly associated with EPDS scores of probable depression (X (2) 13.39; p?

Mellor, R; Chua, S C; Boyce, P

2014-08-01

313

Perceived risks and benefits of HIV testing, and predictors of acceptance of HIV counselling and testing among pregnant women in Zimbabwe.  

PubMed

This project evaluated perceived risks and benefits and determined predictors of acceptance of voluntary HIV counselling and testing (VCT) among pregnant women in Zimbabwe. One hundred and seventy pregnant women attending an urban antenatal clinic were surveyed. Implications of a negative or positive HIV test result and of telling a partner or community members that one is HIV positive were queried. Forty women (23.5%) consented to VCT, and 16 (40%) were HIV positive. Women who saw VCT as lower risk (odds ratio [OR] = 2.3, 95% confidence interval [CI] [1.1-5.0]) and women who had had a stillbirth or child die (OR = 0.4, 95% CI [0.16-0.97]) were more likely to consent. Prenatal HIV VCT offers the best opportunity for prevention of mother-to-child transmission of HIV; however, less than 25% of women consented. If such interventions are to be successful, attention must be directed towards developing culturally appropriate strategies to address women's concerns and improve future acceptance of VCT in Zimbabwe. PMID:17212862

Martin-Herz, Susanne P; Shetty, Avinash K; Bassett, Mary T; Ley, Catherine; Mhazo, Miriam; Moyo, Sostain; Herz, Arnd M; Katzenstein, David

2006-12-01

314

Utilisation of postnatal care among rural women in Nepal  

PubMed Central

Background Postnatal care is uncommon in Nepal, and where it is available the quality is often poor. Adequate utilisation of postnatal care can help reduce mortality and morbidity among mothers and their babies. Therefore, our study assessed the utilisation of postnatal care at a rural community level. Methods A descriptive, cross-sectional study was carried out in two neighbouring villages in early 2006. A total of 150 women who had delivered in the previous 24 months were asked to participate in the study using a semi-structured questionnaire. Results The proportion of women who had received postnatal care after delivery was low (34%). Less than one in five women (19%) received care within 48 hours of giving birth. Women in one village had less access to postnatal care than women in the neighbouring one. Lack of awareness was the main barrier to the utilisation of postnatal care. The woman's own occupation and ethnicity, the number of pregnancies and children and the husband's socio-economic status, occupation and education were significantly associated with the utilisation of postnatal care. Multivariate analysis showed that wealth as reflected in occupation and having attended antenatal are important factors associated with the uptake of postnatal care. In addition, women experiencing health problems appear strongly motivated to seek postnatal care. Conclusion The postnatal care has a low uptake and is often regarded as inadequate in Nepal. This is an important message to both service providers and health-policy makers. Therefore, there is an urgent need to assess the actual quality of postnatal care provided. Also there appears to be a need for awareness-raising programmes highlighting the availability of current postnatal care where this is of sufficient quality. PMID:17767710

Dhakal, Sulochana; Chapman, Glyn N; Simkhada, Padam P; van Teijlingen, Edwin R; Stephens, Jane; Raja, Amalraj E

2007-01-01

315

Prevalence and pattern of domestic violence against pregnant Nigerian women.  

PubMed

Five hundred and twenty-two pregnant Nigerians attending the antenatal clinic in two private hospitals in Lagos between January and June 2003 were interviewed using a structured questionnaire about their experiences of domestic violence. One hundred and four women declined to participate; a response rate of 80.1% was obtained. Analysis of the completed questionnaire by 418 respondents showed that 197 (47.1%) women reported a history of abuse. Of the 197 women who reported abuse, 23 (11.7%) experienced abuse for the first time during the current pregnancy, 97 (49.2%) experienced abuse prior to and during the current pregnancy and in the remaining 77 (39.1%) abuse predate the current pregnancy. A total of 120 (28.7%) women experienced some form of abuse during current pregnancy. Although all social and ethnic groups were involved, no association could be established between prevalence and pattern of abuse and sociodemographic characteristics. Verbal abuse was the most common type of abuse reported (52.3%), followed by economic deprivation (30%), physical abuse (25%), threat of violence (10.8%) and forced sex in 14.2%. The perpetrators of the abuse were husband and boyfriend (78.7%), in-laws (31.5%) and other relations (6.1%). The majority of abused women (99.0%) were not ready to report the abuse to the police. In conclusion, domestic violence is common in our environment and health-care providers should be alert to the clues in order to protect the women from further abuse. PMID:16147605

Ezechi, O C; Kalu, B K; Ezechi, L O; Nwokoro, C A; Ndububa, V I; Okeke, G C E

2004-09-01

316

Traditional practices and medicinal plants use during pregnancy by Anyi-Ndenye women (Eastern Côte d'Ivoire).  

PubMed

The use of plants during pregnancy is a common practice in Africa. In Côte d'Ivoire, despite modern antenatal medical prescriptions, most pregnant women resort to traditional medicine to ensure foetus development and facilitate childbirth. Yet, there is not enough research on the African traditional medicine concerning this aspect of health. Therefore, the plants used by pregnant women need to be better known in order to offer integrated antenatal care. This study analyzes the salience of plants used, the associated practices and reasons of such practices by pregnant women in Yakassé-Féyassé, an Anyi-Ndenye town of the Eastern Côte d'Ivoire. Methods include an ethnobotany survey (freelist method, interview with pregnant women during their antenatal consultation and with specialists). The survey led to a list of 75 plants distributed in 3 class of salience. In addition, 90.3 % of pregnant women use these practices which are nevertheless ignored by Midwives during antenatal visits. PMID:21987942

Malan, Djah F; Neuba, Danho F R

2011-03-01

317

Moderate antenatal anxiety symptoms and birth outcomes of boys and girls.  

PubMed

Abstract Women's antenatal anxiety, especially if paired with significant life stressors or comorbid physical or mental health disorders, can predict adverse birth outcomes, defined in terms of birth weight, gestational age at birth and obstetric complications. Here, we tested for an impact of moderate anxiety symptoms on these outcomes because many women experience these kinds of symptoms during pregnancy, and even subtle differences in birth outcomes can have significant effects on children's development. We also tested for moderation of anxiety effects by infant gender. The sample comprised 219 women with anxiety symptoms ranging from none to moderate levels on the Beck Anxiety Inventory. Multivariate models estimated main effects of Group (no/minimal versus moderate symptoms) and interactions between Group and infant Gender. Results indicate that moderate anxiety predicted more obstetric complications, particularly among mothers of daughters. Results also demonstrate a Group?×?Gender interaction on BW, indicating that sons of anxious mothers weighed more than sons of controls; whereas, daughters of anxious mothers weighed less than daughters of controls. These findings show that moderate anxiety symptoms may affect some birth outcomes, and differently for males and females. PMID:25204367

Kaitz, Marsha; Mankuta, David; Rokem, Ann Marie; Faraone, Stephen V

2014-12-01

318

Review of the antenatal and postnatal use of steroids.  

PubMed

Antenatal and postnatal corticosteroids play an extremely important role in the management of premature infants. The antenatal administration of steroids has been universally implemented. They have not only been shown to reduce the incidence and severity of respiratory distress syndrome (RDS), but also have an impact on the incidence of intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and possibly retinopathy of prematurity (ROP) by reducing the need for supplemental oxygen due to improved lung function. The postnatal use of dexamethasone in ventilated infants has been adopted with caution, as there have been several reports of long-term neurodevelopmental complications with this therapy. Hence, changes in dosage and indications and the search for alternative therapies has emerged. Hydrocortisone appears to be a good alternative, with reassuring long-term evaluations thus far. PMID:24682835

Bartholomew, Julie; Kovacs, Lajos; Papageorgiou, Apostolos

2014-05-01

319

Recommendations for repeat courses of antenatal corticosteroids: A decision analysis  

Microsoft Academic Search

Objective: The objective was to review the evidence regarding multiple versus single courses of antenatal corticosteroids (ACS), devise dosing regimens based on this evidence, and then, by using decision analysis, compare 5 ACS regimens: (1) single course, (2) weekly courses, (3) every-other-week dosing, (4) every-other-week dosing with no more than 2 courses, and (5) an every-other-week dosing regimen with no

Aaron B. Caughey; Julian T. Parer

2002-01-01

320

Maternal demand for cesarean section: perception and willingness to request by Nigerian antenatal clients  

PubMed Central

Background Contrary to the widely reported aversion to cesarean section in the West African subregion, maternal demand for cesarean section (MDCS) seems to be on the increase, and there is little evidence to explain this trend. The purpose of this study was to determine the perception and attitudes of Nigerian antenatal clients towards MDCS, their willingness to request MDCS, and the relationship between willingness to request MDCS and sociodemographic characteristics. Methods A cross-sectional survey was undertaken among 843 antenatal clients at Agbongbon/Orayan primary health care centers (PHCs), Adeoyo Maternity Hospital (SHC), and UCH Ibadan (THC), representing the three different levels of health care in Nigeria, ie, primary, secondary, and tertiary. Results The proportion of women aware of MDCS was 39.6%. Predictors of awareness were education and type of health facility. Women from THC and those with tertiary education and above were more likely to be aware of MDCS than others (P = 0.001). Doctors were major sources of information on MDCS (30.8%) as well as friends (24.3%). Common reasons reported for MDCS were fear of labor pains (68.9%), and fear of poor labor outcome (60.1%), and fear of fecal (20.2%) and urinary incontinence (16.8%). More women from the THC than other facilities believed that requests for MDCS should be granted (P < 0.001). However, willingness to request MDCS was low (6.6%). More than 50% of those willing to request MDCS would likely be criticized, mainly by their husbands. On multiple logistic regression, respondents at the THC were significantly more likely than those at the SHC or the PHCs to request cesarean section and to favor a woman’s right of autonomy to choose her mode of delivery. Conclusion The decision for MDCS is a difficult one, because willingness is low and criticism by partners of those who choose MDCS is high. Provision of epidural anesthesia and improved safety of vaginal delivery is recommended. This may prevent Nigerian women from making a difficult choice for MDCS based on fear of pain and poor labor outcome. The role of the male partner should be taken into consideration in order to make sustainable policies or guidelines for MDCS in developing countries. PMID:22505833

Okonkwo, Ngozi S; Ojengbede, Oladosu A; Morhason-Bello, Imran O; Adedokun, Babatunde O

2012-01-01

321

Antenatal and postnatal management of congenital cystic adenomatoid malformation.  

PubMed

Congenital thoracic malformations (CTMs) are a heterogeneous group of rare disorders that may involve the airways or lung parenchyma. The authors have focused on the condition that causes the most controversy, namely, congenital cystic adenomatoid malformation (CCAM). The reported incidence is 3.5 and 0.94 per 10,000 live births for CTMs and CCAMs respectively. Ultrasound is the antenatal imaging modality of choice for screening for CCAMs whilst magnetic resonance imaging is complimentary for morphological and volumetric evaluation of the foetal lung. Most CCAMs are detected antenatally with only a small proportion presenting postnatally. Only a few CCAMs cause foetal problems, with foetal hydrops being the best predictor of death. Although many CCAMs regress during pregnancy, most remain detectable postnatally by CT scans. Surgical excision of symptomatic lesions is relatively straightforward, but management of asymptomatic lesions is controversial. Some surgeons adopt a "wait and see" approach operating only on those patients who develop symptoms, but others operate on asymptomatic patients usually within the first year of life. Due to the potential of malignant transformation, children should have long term follow up. There is an urgent need to delineate the natural history of antenatally detected CCAMs to guide future management. PMID:22726873

Kotecha, S; Barbato, A; Bush, A; Claus, F; Davenport, M; Delacourt, C; Deprest, J; Eber, E; Frenckner, B; Greenough, A; Nicholson, A G; Antón-Pacheco, J L; Midulla, F

2012-09-01

322

Socio-Demographic Determinants of Maternal Health-Care Service Utilization Among Rural Women in Anambra State, South East Nigeria  

PubMed Central

Background: Although, antenatal care (ANC) attendance in sub Saharan Africa is high, however this does not always translate into quality ANC care service utilization. Aim: This study therefore is aimed at exploring pattern of maternal health (MH) services utilization and the socio-demographic factors influencing it in Anambra State, South East Nigeria. Subjects and Methods: A total of 310 women of reproductive age with a previous history of gestation attending ANC services between September, 2007 and August, 2008 in selected Primary Health Centers in Anambra State were studied. Responses were elicited from the study participants using a pre-tested, semi-structured interviewer-administered questionnaire. Data collected were analyzed using Statistical Package for Social Sciences (SPSS) version 17 (SPSS Inc, Chicago Illinois, USA). Association between socio-demographic characteristics and pattern of utilization of ANC and delivery services was measured using ?2-test, Regression analysis was done to identify factors associated with utilization of MH services. P < 0.05 was assumed to be significant. Results: Use of health facility was 293 (97.0%) and 277 (92,7%) out 302 women for ANC and delivery services respectively. Most women attended their first ANC consultation during the preceding pregnancy was after the first trimester and about 31% (94/298) of them had <4 ANC visits prior to delivery. Socio-demographic factors were found to be significantly associated with places where MH care services are accessed. Parity was found to be associated with timing of ANC booking and number of ANC attendance (?2 = 9.49, P = 0.05). Odds of utilizing formal health facility for MH services were found to be significantly associated with increasing age (P < 0.01) and educational status of mothers (P < 0.001). Conclusions: The study revealed high maternal service utilization and 10% fetal loss, hence the need to address the gaps of late ANC booking and low ANC visits. PMID:24971212

Emelumadu, OF; Ukegbu, AU; Ezeama, NN; Kanu, OO; Ifeadike, CO; Onyeonoro, UU

2014-01-01

323

Antenatal magnesium individual participant data international collaboration: assessing the benefits for babies using the best level of evidence (AMICABLE)  

PubMed Central

Background The primary aim of this study is to assess, using individual participant data (IPD) meta-analysis, the effects of administration of antenatal magnesium sulphate given to women at risk of preterm birth on important clinical outcomes for their child such as death and neurosensory disability. The secondary aim is to determine whether treatment effects differ depending on important pre-specified participant and treatment characteristics, such as reasons at risk of preterm birth, gestational age, or type, dose and mode of administration of magnesium sulphate. Methods Design The Antenatal Magnesium Individual Participant Data (IPD) International Collaboration: assessing the benefits for babies using the best level of evidence (AMICABLE) Group will perform an IPD meta-analysis to answer these important clinical questions. Setting/Timeline The AMICABLE Group was formed in 2009 with data collection commencing late 2010. Inclusion Criteria Five trials involving a total 6,145 babies are eligible for inclusion in the IPD meta-analysis. Primary study outcomes For the infants/children: Death or cerebral palsy. For the women: Any severe maternal outcome potentially related to treatment (death, respiratory arrest or cardiac arrest). Discussion Results are expected to be publicly available in 2012. PMID:22587882

2012-01-01

324

Nasal, axillary, and perineal carriage of Staphylococcus aureus among women: identification of strains producing epidermolytic toxin.  

PubMed Central

Following two outbreaks of staphylococcal scalded skin syndrome in a maternity unit, 500 pregnant women attending an antenatal clinic were screened for carriage of epidermolytic toxin producing Staphylococcus aureus. Nasal, axillary, and perineal swabs were collected from women whose gestational ages ranged from 12-40 weeks. Isolates of S aureus were purified, phage typed, and tested for methicillin sensitivity and production of epidermolytic toxin. The results showed that 164 (33%) women carried S aureus; of these, 100 (61%) were from the nose and three (2%) from axillae, but 41 (25%) strains were isolated from the perineum alone. Screening for nasal carriage alone will therefore miss 25% of carriers. More than one strain of S aureus was identified in seven of 20 women with multiple site carriage. Three (2%) methicillin resistant strains were isolated during the survey, and five (3%) isolates produced epidermolytic toxin. Phage typing identified 63 (34%) strains as non-typable, but 50% of isolates typed either groups I, II or III, and a further 10% represented varying combinations of these and other phage groups. These results provide baseline information on S aureus in the community, and identification of methicillin resistant and toxin producing strains shows a reservoir of outbreak potential which could become relevant on hospital admission of such a carrier. PMID:1890203

Dancer, S J; Noble, W C

1991-01-01

325

Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands.  

PubMed

Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed that half of all the women adhered to Ramadan fasting. With strict adherence to Ramadan fasting in pregnancy, the birth weight of newborns tended to be lower than that of newborns of non-fasting mothers, although this was not statistically significant ( - 198 g, 95 % CI - 447, 51, P= 0·12). Children of mothers who fasted in the first trimester of pregnancy were lighter at birth than those whose mothers had not fasted ( - 272 g, 95 % CI - 547, 3, P= 0·05). There were no differences in birth weight between children whose mothers had or had not fasted if Ramadan fasting had taken place later in pregnancy. Ramadan fasting during early pregnancy may lead to lower birth weight of newborns. These findings call for further confirmation in larger studies that should also investigate potential implications for perinatal and long-term morbidity and mortality. PMID:25231606

Savitri, Ary I; Yadegari, Nasim; Bakker, Julia; van Ewijk, Reyn J G; Grobbee, Diederick E; Painter, Rebecca C; Uiterwaal, Cuno S P M; Roseboom, Tessa J

2014-11-01

326

75 FR 61860 - Advisory Committee on Women Veterans; Notice of Meeting  

Federal Register 2010, 2011, 2012, 2013

...readjustment counseling, women Veterans' legislative issues, special health initiatives, women Veterans' research, rural health, and homeless initiatives for women Veterans. Interested persons may attend, appear before, or file...

2010-10-06

327

Quality of antenatal care in rural southern Tanzania: a reality check  

PubMed Central

Background Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. Findings The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions. Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Conclusion Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions. PMID:20663202

2010-01-01

328

Randomised trial of alternative malaria chemoprophylaxis strategies among pregnant women in Kigoma, Tanzania: I. Rationale and design.  

PubMed

This randomized antimalarial prophylactic trial assessed the effectiveness of alternative malaria chemoprophylaxis strategies on the reduction of malaria episodes and prevalence of parasitemia among pregnant women in urban Kigoma, Tanzania. All pregnant women attending antenatal care services at an urban maternal and child health clinic were randomly exposed to either intermittent or continuous malaria chemoprophylaxis using chloroquine and proguanil. The main outcome measures of the study were reduction of malaria episodes and parasitemia and hemoglobin levels among pregnant women. Baseline findings suggest that the overall mean hemoglobin concentrations among primigravida and multigravida women were similar within the intervention and comparison groups (P = 0.27). Similarly, no significant difference was observed in the prevalence of malaria parasitemia within the primigravida intervention and comparison groups (P = 0.4). Hence, the process of randomization produced comparable intervention and comparison groups with balanced characteristics. As malaria is a common cause of morbidity and mortality among pregnant women in Tanzania, this study provided useful data for improving reproductive health in the Kigoma region. PMID:10774083

Mnyika, K S; Kabalimu, T K; Rukinisha, K; Mpanju-Shumbusho, W

2000-02-01

329

Antenatal depression and children's developmental outcomes: potential mechanisms and treatment options.  

PubMed

During the last decade there has been increased recognition of the prevalence of antenatal depression as well as an expansion in research examining the impact of maternal mood during pregnancy on offspring development. The aim of this review was to summarise the theoretical underpinnings and empirical evidence regarding the impact of antenatal depression on children's developmental outcomes. Biological mechanisms hypothesised to account for an association between antenatal depression and adverse offspring outcomes are first identified including the functioning of the prenatal Hypothalamic Pituitary Adrenal (HPA) axis and epigenetic processes. A systematic literature search is then conducted of studies examining the impact of antenatal depression on child development. In general, studies examining associations between antenatal depression and offspring temperament, cognitive and emotional outcomes reveal either no effect of the prenatal environment or small effects that often attenuate following adjustment for other antenatal and postnatal risk factors. In contrast, an independent effect of antenatal depression on children's conduct problems and antisocial behaviour is a well-replicated finding. There is emerging evidence that exposure to depression during pregnancy impacts negatively on offspring biology, although the findings are complex and require replication. Psychological and pharmacological treatments of antenatal depression are then reviewed, considering whether antidepressant medication exerts harmful effects on the foetus. We close by proposing that antenatal depression is an early marker of a developmental cascade to future mental health problems for both mothers and offspring. PMID:25037152

Waters, Cerith S; Hay, Dale F; Simmonds, Jessica R; van Goozen, Stephanie H M

2014-10-01

330

Prevention and management of excessive gestational weight gain: a survey of overweight and obese pregnant women  

PubMed Central

Background Excessive gestational weight gain is associated with adverse infant, childhood and maternal outcomes and research to develop interventions to address this issue is ongoing. The views of women on gestational weight gain and the resources they would consider helpful in addressing this are however largely unknown. This survey aimed to determine the views of newly pregnant women, living in areas of social disadvantage, on 1) their current body weight and potential gestational weight gain and 2) the resources or interventions they would consider helpful in preventing excessive gestational weight gain. Methods A convenience sample of overweight and obese pregnant women living in Fife, UK, were invited to complete a short anonymised questionnaire at their 12?week booking visit. Results 428 women, BMI>25?kg/m2, completed the questionnaire. Fifty-four per cent of respondents were obese (231) and 62% were living in areas of mild to moderate deprivation. Over three-quarters of participants felt dissatisfied with their current weight (81%). The majority of women (60%) expressed some concern about potential weight gain. Thirty-nine percent were unconcerned about weight gain during their pregnancy, including 34 women (19%) who reported having retained weight gained in earlier pregnancies. Amongst those concerned about weight gain advice on physical activity (41%) and access to sports/leisure facilities were favoured resources (36%). Fewer women (12%) felt that group sessions on healthy eating or attending a clinic for individualised advice (14%) would be helpful. “Getting time off work” was the most frequently cited barrier (48%) to uptake of resources other than leaflets. Conclusions These data suggest a lack of awareness amongst overweight and obese women regarding excessive gestational weight gain. Monitoring of gestational weight gain, and approaches for its management, should be formally integrated into routine antenatal care. Barriers to the uptake of resources to address weight gain are numerous and must be considered in the design of future interventions and services. PMID:23324195

2013-01-01

331

Determinants of skilled birth attendants for delivery in Nepal.  

PubMed

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women's role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women's involvement in decision making; and women's autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women's role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services. PMID:22610739

Baral, Y R; Lyons, K; Skinner, J; van Teijlingen, E R

2010-01-01

332

Postnatal depression: A comparison of African and Scottish women  

Microsoft Academic Search

A total of 183 Ugandan women were interviewed at their first visit to a rural antenatal clinic and again 6–15 weeks after childbirth. The Luganda modification of Goldberg's Standardised Psychiatric Interview was administered on each occasion. Eighteen women had a depressive illness following childbirth, which in all but four had not been present during pregnancy. No association was found between

John L. Cox

1983-01-01

333

School Exclusion and Educational Inclusion of Pregnant Young Women  

ERIC Educational Resources Information Center

This article analyses the school exclusion and subsequent educational inclusion of pregnant young women participating in a course of antenatal and key skills education at an alternative educational setting. It examines the young women's transitions from "failure" in school to "success" in motherhood and re-engagement with…

Rudoe, Naomi

2014-01-01

334

An interview study of pregnant women's attitudes to ultrasound scanning  

Microsoft Academic Search

404 pregnant women were interviewed, in the ante-natal clinics of two hospitals, concerning their attitudes to ultrasound scanning, which is routine at one of these hospitals, selective at the other. It was found at the hospital where scanning is selective, that women who had not been examined by ultrasound were less likely to regard a scan as an additional source

Beverley Hyde

1986-01-01

335

Late-Term Abortion for Fetal Anomaly: Vietnamese Women's Experiences  

Microsoft Academic Search

Screening for fetal anomalies in the second trimester of pregnancy is increasingly becoming a part of antenatal care. As a consequence, more pregnant women are learning that the child they are expecting has an anomaly. This article derives from anthropological research in a hospital in Hanoi, Viet Nam, from 2003–2006 that investigated 30 women's experiences after a fetal anomaly was

Tine Gammeltoft

2008-01-01

336

An audit of NICE guidelines on antenatal pelvic floor exercises  

Microsoft Academic Search

Introduction and hypothesis  The National Institute for Health and Clinical Excellence (NICE) recommends antenatal pelvic floor exercises during first\\u000a pregnancy to reduce postpartum stress incontinence. The aim of this audit was to assess patient awareness and compliance with\\u000a this guideline.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  An anonymous self-constructed questionnaire was given to patients after their first delivery.\\u000a \\u000a \\u000a \\u000a Results  A total of 223 questionnaires were returned over a

Sharif I. M. F. Ismail

2009-01-01

337

Antenatal irradiation and childhood cancer: causation or coincidence?  

PubMed

A re-analysis of published data from the Oxford Childhood Cancer Survey shows that the frequency of leukaemia and of solid cancers in childhood is greater following antenatal x-radiography, not only in singleton births but also in monozygotic and dizygotic twins. The radiography rate was 10% in singletons and 55% in twins. A similar excess of leukaemia and of solid cancers in the x-rayed with such different rates of radiography is strong evidence for irradiation as the cause. The low observed frequency of malignant disease in Japanese bomb survivors exposed in utero may not be in serious conflict with this conclusion, as has been supposed. PMID:4476218

Mole, R H

1974-09-01

338

Preparing for parenthood: the role of antenatal education.  

PubMed

The transition to parenthood is a time of great change for mothers and fathers, and also lays the foundation for the long-term health and wellbeing of the child. This emphasises the importance of preparation for parenthood. A Department of Health-commissioned review found provision and uptake of antenatal education to be variable, and so brought a group of experts together to consider Preparation for Pregnancy, Birth and Beyond. This paper provides an overview of the learning from the expert group's work, offering a new framework that professionals may use to plan effective local programmes and services. PMID:21667713

Billingham, Kate

2011-05-01

339

Attending, questioning, and quality.  

PubMed

Health care is just now feeling the effects of many years of neglect of serious attention to quality outcomes. We have many tools available now to change our thinking and to provide techniques to attain excellence in quality, such as Six Sigma and principals from Toyota. However, these techniques will only get us to a minimal level of quality. We need to change our questions, think the impossible, and break out of our old modes of thinking about quality. Zero defects are possible. We only have to take that quantum leap and think in new ways. We are posed on the edge of a quantum leap into new ways of thinking about quality. We will hear much more about nurse-sensitive indicators in the near future. Nurse leaders should change their questions now to attend to new models that will get us closer to the ultimate "impossible thinking" goal of zero defects in nurse-sensitive indicators of quality. PMID:15586486

Kerfoot, Karlene

2004-01-01

340

Awareness and views of the law on termination of pregnancy and reasons for resorting to an abortion among a group of women attending a clinic in Colombo, Sri Lanka  

Microsoft Academic Search

In Sri Lanka, induced abortion is a criminal offence except to save the life of the mother. This study determined the awareness and views of the law on abortion among women seeking an abortion. Three hundred and thirteen women were interviewed. The characteristics of the study group are discussed. 65.8% of the respondents stated they knew the current law, 25.6%

N. L. Abeyasinghe; B. J. Weerasundera; P. A. Jayawardene; S. D. Somarathna

2009-01-01

341

Birth Preparedness and Complication Readiness among Pregnant Women in Southern Ethiopia  

PubMed Central

Background Birth preparedness and complication preparedness (BPACR) is a key component of globally accepted safe motherhood programs, which helps ensure women to reach professional delivery care when labor begins and to reduce delays that occur when mothers in labor experience obstetric complications. Objective This study was conducted to assess practice and factors associated with BPACR among pregnant women in Aleta Wondo district in Sidama Zone, South Ethiopia. Methods A community based cross sectional study was conducted in 2007, on a sample of 812 pregnant women. Data were collected using pre-tested and structured questionnaire. The collected data were analyzed by SPSS for windows version 12.0.1. The women were asked whether they followed the desired five steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transport, identified blood donor and saved money for emergency. Taking at least two steps was considered being well-prepared. Results Among 743 pregnant women only a quarter (20.5%) of pregnant women identified skilled provider. Only 8.1% identified health facility for delivery and/or for obstetric emergencies. Preparedness for transportation was found to be very low (7.7%). Considerable (34.5%) number of families saved money for incurred costs of delivery and emergency if needed. Only few (2.3%) identified potential blood donor in case of emergency. Majority (87.9%) of the respondents reported that they intended to deliver at home, and only 60(8%) planned to deliver at health facilities. Overall only 17% of pregnant women were well prepared. The adjusted multivariate model showed that significant predictors for being well-prepared were maternal availing of antenatal services (OR?=?1.91 95% CI; 1.21–3.01) and being pregnant for the first time (OR?=?6.82, 95% CI; 1.27–36.55). Conclusion BPACR practice in the study area was found to be low. Effort to increase BPACR should focus on availing antenatal care services. PMID:21731747

Hailu, Mesay; Gebremariam, Abebe; Alemseged, Fissehaye; Deribe, Kebede

2011-01-01

342

Predictors of HIV serostatus disclosure to partners among HIV-positive pregnant women in Morogoro, Tanzania  

PubMed Central

Background Prevention of mother to child transmission of HIV (PMTCT) has been scaled, to more than 90% of health facilities in Tanzania. Disclosure of HIV results to partners and their participation is encouraged in the program. This study aimed to determine the prevalence, patterns and predictors of HIV sero-status disclosure to partners among HIV positive pregnant women in Morogoro municipality, Tanzania. Methods A cross sectional study was conducted in March to May 2010 among HIV-positive pregnant women who were attending for routine antenatal care in primary health care facilities of the municipality and had been tested for HIV at least one month prior to the study. Questionnaires were used to collect information on possible predictors of HIV disclosure to partners. Results A total of 250 HIV-positive pregnant women were enrolled. Forty one percent (102) had disclosed their HIV sero-status to their partners. HIV-disclosure to partners was more likely among pregnant women who were?women reported to have been counseled on importance of disclosure and partner participation. Conclusions Six in ten HIV positive pregnant women in this setting had not disclosed their results of the HIV test to their partners. Empowering pregnant women to have an individualized HIV-disclosure plan, strengthening of the HIV provider initiated counseling and testing and addressing economic development, may be some of the strategies in improving HIV disclosure and partner involvement in this setting. PMID:23641927

2013-01-01

343

Screening Networks: Shared agendas in feminist and disability movement challenges to antenatal screening and abortion  

Microsoft Academic Search

This paper identifies common ground in feminist and disability movement concerns with the social and ethical implications of antenatal screening and abortion. By examining the frameworks used by particular authors within each area, I argue that they both can and do have a shared agenda, which is focused on the social values that are embedded in antenatal screening and promote

JANICE MCLAUGHLIN

2003-01-01

344

National Health Insurance and the antenatal care use: a case in Taiwan  

Microsoft Academic Search

Many studies have found evidence for the importance of antenatal care on pregnancy outcomes. This paper focuses on the determinants of antenatal care use in Taiwan and provides a comparison of access to care before and after National Health Insurance (NHI) was implemented in 1995. A negative binomial model is applied to data from the 1989 and 1996 Taiwan Maternal

Chin-Shyan Chen; Tsai-Ching Liu; Li-Mei Chen

2003-01-01

345

Interest of pregnant women in the use of SMS (short message service) text messages for the improvement of perinatal and postnatal care  

PubMed Central

Background Mobile health (mHealth) is emerging as a useful tool to improve healthcare access especially in the developing world, where limited access to health services is linked to poor antenatal care, and maternal and perinatal mortality. The objective of this study is to 1) understand pregnant women’s access and usage of cell phones and 2) survey the health information needs and interests in a population attending public hospitals and health centers of two cities in Argentina. This information is not available and it is the basis to develop a strategy for improving maternal care via cell phones. Methods Questionnaires were verbally administered to pregnant women who were attending an antenatal care visit in community health centers and public hospitals in Rosario, Santa Fe and Mercedes, Corrientes. Participants were 18?years of age or older and had previously given birth. The data obtained was qualitative and analyzed using SPSS version 18. Results A total of 147 pregnant women meeting inclusion criteria (Rosario: 63; Mercedes: 84) were approached and verbally consented to participate. The average age was 29.5?years, most lived in urban areas (89%) with a mean travel time of 43.4 minutes required to get to the health center and 57.3 minutes to get the hospital. Ninety-six percent of women (n?=?140) responded that they would like to receive text messages and cell phone calls with information regarding prenatal care, although the topics and period of time to receive information varied greatly. Conclusions Considering the vast majority of the interviewed women had access to and were interested in receiving text messages and calls with educational information regarding pregnancy and infant health, pregnant women in Argentina could benefit from such an mHealth program. The low access to Internet suggests it is not an option for this population; however, this cannot be assumed as representative of the country’s situation. To retain active participation, other forms of health communication, such as a 2-way text message systems or toll-free numbers, could be considered in the future. Cost of use and implementing these options should be studied. PMID:22866753

2012-01-01

346

Iron and Folic Acid Consumption by the Ante-natal Mothers in a Rural Area of India in 2010  

PubMed Central

Background: The average rural Indian women enter her reproductive life, particularly in pregnancy, suffer from nutritional anemia due to iron deficiency. National program of India had implemented a strategy for supplementation of iron folic acid by means of iron folic acid (IFA) tablets at least 3 months during antenatal period. The study had been conducted to assess the proportion of pregnant mothers consumes the IFA tablets and the factors determine compliance. Methods: A cross-sectional, community-based study was conducted in rural area of India on 50 antenatal mothers by multistage sampling technique. The data were analyzed by using SPSS 16 (Statistical Package for the Social Sciences, ver. 16), Chicago, considering the level of significance at 95%. Results: The IFA tablet was adequately consumed by 62% mother among the study population. The consumption is more among the mother who were explained properly than those who were not explained by the health worker (?2= 4.529, P < 0.05). Conclusions: The compliance of iron folic acid tablets was still far behind to reach the National Goal though the service component are quite strong by the front line workers and health providers. An effort should be given at the level of front line health workers by training and re-training them to improve the compliance of IFA consumption. PMID:24319564

Pal, Partha Pratim; Sharma, Shilpi; Sarkar, Tarun Kumar; Mitra, Pevel

2013-01-01

347

The impact of structured support groups for pregnant South African women recently diagnosed HIV positive.  

PubMed

The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p<0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t=2.68, p<0.05) and lower levels of avoidant coping (t=-2.02, p<0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t=2.11, p<0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time. PMID:21973110

Mundell, Jonathan P; Visser, Maretha J; Makin, Jennifer D; Kershaw, Trace S; Forsyth, Brian W C; Jeffery, Bridget; Sikkema, Kathleen J

2011-08-31

348

Field performance of a rapid point-of-care diagnostic test for antenatal syphilis screening in the Amazon region, Brazil.  

PubMed

We evaluated an immunochromatographic point-of-care (POC) syphilis test in 712 pregnant women under field conditions in remote communities of the Amazon region (Brazil), and identified risk factors for syphilis. Women were screened by POC test using whole blood obtained by fingerprick, the fluorescent treponemal antibody absorption (FTA-Abs) test as the gold standard and the Venereal Diseases Research Laboratory (VDRL) test to determine test performance in active syphilis. Multivariate analysis was conducted to identify factors associated with syphilis infection. Among women, 2.2% had syphilis (positive FTA-Abs) and 0.8% active syphilis (FTA-Abs and VDRL positive). In all, 2.2% of samples were positive by the POC test. The sensitivity, specificity, positive and negative predictive values were 62.5% (95% confidence interval [CI]: 38.6-81.5), 99.1% (95% CI: 98.1-99.6), 62.5% (95% CI: 38.6-81.5) and 99.1% (95% CI: 98.1-99.6), respectively. The POC test identified 62.5% (10/16) of syphilis cases, 66.7% (4/6) of active syphilis cases and all high-titre syphilis cases (VDRL > 1:8). Older age was associated with syphilis infection. The rapid test performed moderately well as a screening tool for low-risk populations. This combined with on-site testing and same day treatment could expand antenatal syphilis screening programmes in distant communities characterized by difficult access to antenatal services and infrequent clinical follow-up visits. PMID:21364061

Benzaken, A S; Sabidó, M; Galban, E; Pedroza, V; Araújo, A J G; Peeling, R W; Mabey, D

2011-01-01

349

The ethics of antenatal screening: lessons from Canute.  

PubMed

Modern medicine has given us the power to identify many diseases before they occur and apply preventative measures so that morbidity and mortality may be avoided. When these screening measures are offered to someone who is capable of making an informed decision to proceed, they may be uncontroversial but may actually cause more harm than good. In antenatal screening, it is difficult to define who the patient is, because there are several possibilities: the pregnant woman, the foetus, or the family. Consequently, it can be difficult to identify whether the treatment offered is in the best interest of all concerned. Our growing knowledge about the human genome will in future give us more power to be able to identify undesirable traits, but there is no strict definition where the line of acceptability lies. The eugenic excesses of the mid-20(th) century are often cited as a reason why antenatal screening is bad. The story of King Canute informs us that defining a 'line in the sand' cannot prevent the rising tide of medical capability overwhelming any arbitrary level of acceptability. This paper discusses the history of eugenics from Sparta to the modern day and attempts to give some perspective on this crucial policy area. No one paper can provide the answer: it is necessary that society as a whole debates where it wishes to go... PMID:20011211

Reynolds, Timothy M

2009-11-01

350

The effect of health and nutrition education intervention on women's postpartum beliefs and practices: a randomized controlled trial  

PubMed Central

Background 'Sitting month' is the Chinese tradition for postpartum customs. Available studies indicate that some of the traditional postpartum practices are potentially harmful for women's health. However, no intervention study aiming at postpartum practices has been performed. In this paper we evaluated the effect of a health and nutrition education intervention, which focused on improving postpartum dietary quality and optimal health behaviors. Methods The study design was a randomized controlled trial conducted in both urban and rural area of Hubei between August 2003 and June 2004. A total of 302 women who attended the antenatal clinic during the third trimester with an uncomplicated pregnancy were recruited. Women randomized to the education intervention group in both urban and rural area received two two-hour prenatal education sessions and four postpartum counseling visits. Control group women received usual health care during pregnancy and postpartum period. Women were followed up until 42 days postpartum. Outcome measures were nutrition and health knowledge, dietary behavior, health behavior and health problems during the postpartum period. Results Women in the intervention groups exhibited significantly greater improvement in overall dietary behaviors such as consumption of fruits, vegetables, soybean and soybean products as well as nutrition and health knowledge than those in the control groups. Significantly more women in the intervention groups give up the traditional behavior taboos. The incidence of constipation, leg cramp or joint pain and prolonged lochia rubra was significantly lower in the intervention groups as compared with the control groups. Conclusion The study shows that health and nutrition education intervention enable the women take away some of the unhealthy traditional postpartum practices and decrease the prevalence of postpartum health problems. The intervention has potential for adaptation and development to large-scale implementation. Trial registration number klACTRN12607000549426 PMID:19183504

Liu, Nian; Mao, Limei; Sun, Xiufa; Liu, Liegang; Yao, Ping; Chen, Banghua

2009-01-01

351

Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment  

PubMed Central

Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

Villadsen, Sarah Fredsted; Tersb?l, Britt Pinkowski; Negussie, Dereje; GebreMariam, Abebe; Tilahun, Abebech; Friis, Henrik; Rasch, Vibeke

2014-01-01

352

Noninvasive prenatal testing creates an opportunity for antenatal treatment of Down syndrome.  

PubMed

Trisomy 21 (T21) is the most common autosomal aneuploidy that is associated with intellectual disability. It is the focus of many prenatal screening programs across the globe. Pregnant women who receive a prenatal diagnosis of T21 in their fetus currently have the option of continuing or terminating their pregnancy, but no fetal treatment is available. In this paper, we review compelling morphogenetic, cellular, and molecular studies that, taken together, suggest that there is an important window of opportunity during fetal life to positively impact brain development to improve postnatal neurocognition and behavior. Although substantial progress has been made in understanding the basic neurobiology of Down syndrome (DS), the majority of pre-clinical trials is currently focused on adults. There are a number of challenges in the identification and development of novel antenatal therapies for DS, including the lack of toxicity and teratogenicity for the pregnant woman and the fetus, evidence that the compounds can cross the placenta and achieve therapeutic levels, and the demonstration of clinical improvement. Preliminary experiments in mouse models suggest that prenatal treatment of DS is an achievable goal. PMID:23595836

Guedj, Faycal; Bianchi, Diana W

2013-06-01

353

BETAMETHASONE PHARMACOKINETICS AFTER TWO PRODRUG FORMULATIONS IN SHEEP: IMPLICATIONS FOR ANTENATAL CORTICOSTEROID USE  

PubMed Central

Maternal administration of betamethasone to enhance fetal lung maturation for women who threaten preterm labor is common clinical practice. However, recommendations regarding the choice of betamethasone formulations for perinatal use are vague. The disposition of betamethasone from two commonly used antenatal formulations is poorly understood. We therefore designed a study to capture the true pharmacokinetic profiles of betamethasone from these fast acting and dual-release formulations. Betamethasone in sheep plasma was measured by a newly designed, highly sensitive liquid chromatography/tandem mass spectrometry assay after intramuscular injection (n = 4) of 0.25 mg/kg betamethasone phosphate and 0.5 mg/kg betamethasone phosphate/acetate formulations. Compartmental modeling was performed using the ADAPT II program. Betamethasone pharmacokinetics could be captured for 24 h for the phosphate and for 5 days for the phosphate/acetate formulations. The phosphate formulation profile had the appearance of a traditional Bateman function with a terminal half-life of 4 h, whereas the phosphate/acetate formulation produced a biexponential decline with a terminal half-life of 14 h. The latter is much longer than is commonly reported and has been missed in the literature due to assay limitations. Extrapolations to humans indicate that although both formulations might have similar therapeutic indices, the dual formulation might be associated with a lower safety profile. In light of this newly identified long terminal half-life for the betamethasone dual formulation, dosing practices for betamethasone in pregnancy need to be reassessed. PMID:15860658

Samtani, Mahesh N.; Lohle, Matthias; Grant, Angela; Nathanielsz, Peter W.; Jusko, William J.

2014-01-01

354

Antenatal care strengthening in jimma, ethiopia: a mixed-method needs assessment.  

PubMed

Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health. PMID:25258631

Villadsen, Sarah Fredsted; Tersbøl, Britt Pinkowski; Negussie, Dereje; GebreMariam, Abebe; Tilahun, Abebech; Friis, Henrik; Rasch, Vibeke

2014-01-01

355

Antenatal environmental stress and maturation of the breathing control, experimental data.  

PubMed

The nervous respiratory system undergoes postnatal maturation and yet still must be functional at birth. Any antenatal suboptimal environment could upset either its building prenatally and/or its maturation after birth. Here, we would like to briefly summarize some of the major stresses leading to clinical postnatal respiratory dysfunction that can occur during pregnancy, we then relate them to experimental models that have been developed in order to better understand the underlying mechanisms implicated in the respiratory dysfunctions observed in neonatal care units. Four sections are aimed to review our current knowledge based on experimental data. The first will deal with the metabolic factors such as oxygen and glucose, the second with consumption of psychotropic substances (nicotine, cocaine, alcohol, morphine, cannabis and caffeine), the third with psychoactive molecules commonly consumed by pregnant women within a therapeutic context and/or delivered to premature neonates in critical care units (benzodiazepine, caffeine). In the fourth section, we take into account care protocols involving extended maternal-infant separation due to isolation in incubators. The effects of this stress potentially adds to those previously described. PMID:19427414

Cayetanot, F; Larnicol, N; Peyronnet, J

2009-08-31

356

A cross-sectional study of maternal perception of fetal movements and antenatal advice in a general pregnant population, using a qualitative framework  

PubMed Central

Background Maternal perception of fetal movements has been used as a measure of fetal well-being. Yet a Cochrane review does not recommend formal fetal movement counting compared to discretional fetal movement counting. There is some evidence that suggests that the quality of fetal movements can precede quantitative changes however there has been almost no assessment of how women describe movements and whether these descriptions may be useful in a clinical setting. Therefore we aimed to examine maternal perception of fetal movements using a qualitative framework. Methods Using a cross-sectional design we identified women during routine antenatal care at a tertiary referral hospital, in Sydney, Australia. Eligible women were pregnant ??28 weeks, carrying a single child, >?18 years old, and with sufficient English literacy to self-complete a questionnaire. Post-natally the medical records were reviewed and demographic, pregnancy and fetal outcome data were extracted. Text responses to questions regarding maternal descriptions of fetal movements throughout pregnancy, were analysed using thematic analysis in an explicit process. Results 156 women participated. There was a general pattern to fetal movement descriptions with increasing gestation, beginning with words such as “gentle”, to descriptions of “strong” and “limb” movements, and finally to “whole body” movements. Women perceived and described qualitative changes to fetal movements that changed throughout gestation. The majority (83%) reported that they were asked to assess fetal movements in an implicit qualitative method during their antenatal care. In contrast, only 16% regularly counted fetal movements and many described counting as confusing and reported that the advice they had received on counting differed. Conclusions This is the first study to use qualitative analysis to identify that pregnant women perceive fetal movements and can describe them in a relatively homogenous way throughout pregnancy that follow a general pattern of fetal growth and development. These findings suggest that women’s perception of fetal wellbeing based on their own assessment of fetal movement is used in an ad hoc method in antenatal care by clinicians. PMID:23383737

2013-01-01

357

Identifying Two Potential Mechanisms for Changes in Alcohol Use Among College-Attending and Non-College-Attending Emerging Adults  

Microsoft Academic Search

This study tested whether pro-alcohol peer influences and prosocial involvement account for increases in drinking during the transition into emerging adulthood and whether these mechanisms differ depending on college attendance and\\/or moving away from home. The authors used structural equation modeling of prospective data from 825 young men and women. For 4 groups defined by college and residential status, more

Helene R. White; Charles B. Fleming; Min Jung Kim; Richard F. Catalano; Barbara J. McMorris

2008-01-01

358

Autosomal Recessive Polycystic Kidney Disease: Antenatal Diagnosis and Histopathological Correlation  

PubMed Central

Autosomal recessive polycystic kidney disease (ARPKD) is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease. PMID:23814685

Rajanna, Dayananda Kumar; Reddy, Anjani; Srinivas, Naren Satya; Aneja, Ankur

2013-01-01

359

Is advice to stop smoking from a midwife stressful for pregnant women who smoke? Data from a randomized controlled trial  

Microsoft Academic Search

Background. There are no randomized trials examining whether intensive advice to pregnant smokers is more stressful than standard care. Method. Nine hundred eighteen U.K. women currently smoking on commencing antenatal care were randomized into three arms. Women in Arm A received one episode of brief advice to stop smoking. Women in Arm B were assessed for stage of change and

Paul Aveyard; Terry Lawrence; Emma Croghan; Olga Evans; K. K. Cheng

2005-01-01

360

HTLV-1 in pregnant women from the Southern Bahia, Brazil: a neglected condition despite the high prevalence  

PubMed Central

Background As the most frequent pathway of vertical transmission of HTLV-1 is breast-feeding, and considering the higher prevalence in women, it is very important to perform screening examinations for anti-HTLV-1 antibodies as part of routine prenatal care. So far, no studies of HTLV-1 seroprevalence in pregnant women in the Southern region of Bahia, Brazil, have been described. Methods Pregnant women were selected at the two regional reference centers for health care from Southern Bahia. A total of 2766 pregnant women attending the antenatal unit between November 2008 and May 2010 have been analyzed. An extra blood sample was drawn during their routine antenatal testing. A standardized questionnaire was applied and all positive plasma samples were tested by ELISA and were confirmed by Western Blot and PCR. Besides that, positive women were contacted and visited. The family members that were present during the visit were asked to be serologically screened to the virus. A prospective study was also carried out and newborns were followed up to two years for evaluation of vertical transmission. Results HTLV prevalence was 1.05% (CI 95%: 0.70-1.50). There was no association of HTLV-1 infection with age, education, income and ethnic differences. The association with marital status was borderline (OR?=?7.99; 95% CI 1.07-59.3; p?=?0.042). In addition, 43 family members of the HTLV-1 seropositive women have been analyzed and specific reactivity was observed in 32.56%, including two children from previous pregnancy. Conclusion: It is very important to emphasize that the lack of HTLV-1 screening in pregnant women can promote HTLV transmission especially in endemic areas. HTLV screening in this vulnerable population and the promotion of bottle-feeding for children of seropositive mothers could be important cost-effective methods to limit the vertical transmission. Besides that, our data reinforce the need to establish strategies of active surveillance in household and family contacts as important epidemiological surveillance actions for the early detection of virus infection and the prevention of transmission by sexual or and parenteral contact. PMID:24524416

2014-01-01

361

Religious Attendance as Reproductive Support  

PubMed Central

We argue that a central function of religious attendance in the contemporary U.S. is to support a high-fertility, monogamous mating strategy. Although religious attendance is correlated with many demographic, personality, moral, and behavioral variables, we propose that sexual and family variables are at the core of many of these relationships. Numerous researchers have assumed that religious socialization causes people to feel moral reactions and engage in behaviors promoted by religious groups. On our view, mating preferences are centrally involved in individual differences in attraction to religious groups. In a sample of 21,131 individuals who participated in the U.S. General Social Survey, sexual behaviors were the relatively strongest predictors of religious attendance, even after controlling for age and gender. Effects of age and gender on religious attendance were weaker, and substantially reduced when controlling for sexual and family patterns. A sample of 902 college students provided more detailed information on religious, moral, and sexual variables. Results suggest that 1) moral views about sexual behavior are more strongly linked to religious attendance than other moral issues, and 2) mating strategy is more powerful than standard personality variables in predicting religious attendance. These findings suggest that reproductive strategies are at the heart of variations in religious attendance. PMID:21874105

Weeden, Jason; Cohen, Adam B.; Kenrick, Douglas T.

2009-01-01

362

Religion and healthy lifestyle behaviors among postmenopausal women: the women’s health initiative  

Microsoft Academic Search

Worship attendance has been associated with longer survival in prospective cohort studies. A possible explanation is that\\u000a religious involvement may promote healthier lifestyle choices. Therefore, we examined whether attendance is associated with\\u000a healthy behaviors, i.e. use of preventive medicine services, non-smoking, moderate drinking, exercising regularly, and with\\u000a healthy dietary habits. The population included 71,689 post-menopausal women enrolled in the Women’s

Elena Salmoirago-Blotcher; George Fitchett; Judy K. Ockene; Eliezer Schnall; Sybil Crawford; Iris Granek; JoAnn Manson; Ira Ockene; Mary Jo O’Sullivan; Lynda Powell; Stephen Rapp

363

Cardiac rehabilitation programmes: predictors of non-attendance and drop-out  

Microsoft Academic Search

Background Despite evidence of its benefits, attendance at cardiac rehabilitation (CR) programmes is poor. Past studies to identify predictors of non-attendance have been limited by their small sample size, particularly for female patients. The present study was designed to identify socio-demographic and clinical predictors of non-attendance and drop-out separately for men and women automatically referred to CR programmes.Method and subjects

Marian U. C. Worcester; Barbara M. Murphy; Virginia K. Mee; Susan B. Roberts; Alan J. Goble

2004-01-01

364

The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand.  

PubMed

The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13.8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997). Other behaviours which increased risks associated with child birth included non-antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well-planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the programme using a pre-test-post-test method among selected pregnant women who participated in the newly designed health education programme. PMID:11136413

Thassri, J; Kala, N; Chusintong, L; Phongthanasarn, J; Boonsrirat, S; Jirojwong, S

2000-12-01

365

The Role of Traditional Birth Attendants in the Reduction of Maternal Mortality  

Microsoft Academic Search

Summary Throughout history traditional birth attendants (TBAs) have been the main human resource for women during childbirth. Their role varies across cultures and at different times, but even today, they attend the majority of deliveries in rural areas of develop- ing countries. There is little doubt that they have a significant role when it comes to cultural competence, consolation, empathy

Staffan Bergström; Elizabeth Goodburn

366

Dynamic attending and responses to time  

Microsoft Academic Search

A temporally based theory of attending is proposed that assumes that the structure of world events affords different attending modes. Future-oriented attending supports anticipatory behaviors and occurs with highly coherent temporal events. Time judgments, given this attending mode, axe influ- enced by the way an event's ending confirms or violates temporal expectancies. Analytic attending supports other activities (e.g., grouping, counting),

Mari Riess Jones; Marilyn Boltz

1989-01-01

367

Intimate Partner Violence and Sexual Coercion among Pregnant Women in India: Relationship with Depression and Post-Traumatic Stress Disorder  

PubMed Central

Background Intimate partner violence (IPV) is prevalent in most parts of the world. It is also prevalent during pregnancy. Methods This study assessed the prevalence of IPV during pregnancy and evaluated its relationship with mental health outcomes, including depression and post-traumatic stress disorder (PTSD). Pregnant women (n = 203) attending an antenatal clinic in a public hospital in Bangalore were assessed for presence of IPV as well as depressive, somatic and PTSD symptoms as well as life satisfaction. Results Self-reported physical violence in the last year was reported by 14% of women, psychological abuse by 15%, and sexual coercion by 9%. One-half of these women reported ongoing abuse during pregnancy. Depression, somatic, and PTSD symptoms were higher in those with a history of abuse or sexual coercion, and life satisfaction was poorer in those with any form of violence. Among those reporting a history of sexual coercion, severity of violence was related to increased psychiatric morbidity. Alcohol abuse in the spouse was a predictor of the presence and severity of abuse. Limitations The study was conducted in a single clinic in southern India which is a large country with very diversified populations. Conclusion The experience of intimate partner violence and its mental health consequences are quite prevalent in India which is a culture where gender disparities are normative and pregnancy is a particularly vulnerable period. PMID:17109969

Varma, Deepthi; Chandra, Prabha S.; Thomas, Tinku; Carey, Michael P.

2007-01-01

368

The Effect of Mass Media Campaign on the Use of Insecticide-Treated Bed Nets among Pregnant Women in Nigeria  

PubMed Central

Background. Malaria during pregnancy is a major public health problem in Nigeria especially in malaria-endemic areas. It increases the risk of low birth weight and child/maternal morbidity/mortality. This paper addresses the impact of radio campaigns on the use of insecticide-treated bed nets among pregnant women in Nigeria. Methods. A total of 2,348 pregnant women were interviewed during the survey across 21 of Nigeria's 36 states. Respondents were selected through a multistage sampling technique. Analysis was based on multivariate logistic regression. Results. Respondents who knew that sleeping under ITN prevents malaria were 3.2 times more likely to sleep under net (OR: 3.15; 95% CI: 2.28 to 4.33; P < 0.0001). Those who listened to radio are also about 1.6 times more likely to use ITN (OR: 1.56; 95% CI: 1.07 to 2.28; P = 0.020), while respondents who had heard of a specific sponsored radio campaign on ITN are 1.53 times more likely to use a bed net (P = 0.019). Conclusion. Pregnant women who listened to mass media campaigns were more likely to adopt strategies to protect themselves from malaria. Therefore, behavior change communication messages that are aimed at promoting net use and antenatal attendance are necessary in combating malaria. PMID:24778895

Ankomah, A.; Adebayo, S. B.; Arogundade, E. D.; Anyanti, J.; Nwokolo, E.; Inyang, U.; Ipadeola, Oladipupo B.; Meremiku, M.

2014-01-01

369

Factors associated with dental visit and barriers to utilisation of oral health care services in a sample of antenatal mothers in Hospital Universiti Sains Malaysia  

PubMed Central

Background The aims of this study were to determine factors associated with dental visit and to describe barriers to utilisation of oral health care services among antenatal mothers attending the Obstetric and Gynaecology Specialist clinic in Hospital Universiti Sains Malaysia. Methods A structured, self-administered questionnaire was used obtain information on the variables of interest pertaining to the current pregnancy from 124 antenatal mothers. Results The majority of the mothers claimed that their oral health status was good (67.0%) or very good (2.4%). On the contrary, most of them admitted of having had at least one oral health problem (59.7%) including cavitated (43.5%) and painful teeth (15.3%), bleeding gum (21.0%), and bad breath (10.5%). However, only 29% of the mothers visited dentist during the current pregnancy. Factors associated with the mothers' dental visit were exposure to oral health education before the pregnancy and awareness of relationship between poor maternal oral health and adverse pregnancy outcomes with odds ratio of 4.06 (95% CI: 1.67-9.78) and 3.57 (95% CI: 1.30-9.77) respectively. Common excuses given by most mothers include perceptions of not having any oral health problems (65.9%), long waiting time at the clinic (71.6%), and no immediate treatment given by the dentist (64.8%). Conclusions Utilisation of oral health care services among antenatal mothers was low. Mothers who reported dental visit were more likely to be those who had received oral health education before the current pregnancy and knew of the association between poor maternal oral health and adverse pregnancy outcomes. Dissatisfaction with the services rendered and perceptions of not having any oral health problems were the main barriers. PMID:20163741

2010-01-01

370

Taking Attendance: Learn About Data  

NSDL National Science Digital Library

In this activity, learners will track attendance over time, and look for trends in the data. Combine data collection and analysis with daily attendance. Each day, engage learners in counting and recording how many of the group are present. Review data weekly to explore median, mode, and range, and to look for other patterns in how many show up on which days. This activity requires at least a week's worth of data. Available as a web page and downloadable pdf.

Terc

2010-01-01

371

Leaf Concentrate Fortification of Antenatal Protein-Calorie Snacks Improves Pregnancy Outcomes  

PubMed Central

ABSTRACT Ready-to-eat (RTE) snacks are routinely distributed to pregnant women in India. These provide protein and calories but are low in micronutrients. We investigated whether RTE snacks fortified with leaf concentrate (LC) could improve pregnancy outcomes, including maternal haemoglobin (Hb) concentrations and infants’ birthweight. This randomized controlled two-arm trial was conducted over 18 months: control (sRTE) group received standard 120 g RTE snack (102 g wheat flour, 18 g soya flour); intervention (lcRTE) group received the same snack fortified with 7 g LC. The study was conducted in Jaipur, Rajasthan, India. One hundred and five pregnant women aged 18-35 years were studied. Among the 105 women randomized to the two arms of the trial, 2 (1.9%) were severely anaemic (Hb ?6.0 g/dL); 55 (53.4%) were moderately anaemic (Hb 6.0-8.0 g/dL); 34 (33.0%) were mildly anaemic (Hb 8.6-10.9 g/dL); and 12 (11.7%) were not anaemic (Hb ?11.0 g/dL). In the final month of pregnancy, 83.0% (39/47) of women in the sRTE group had Hb ?8.5 g/dL compared to 37.8% (17/45) in the lcRTE group (p<0.001). After adjustment for age and baseline Hb concentration, the difference in Hb concentrations due to LC fortification was 0.94 g/dL (95% CI 6.8-12.0; p<0.001). Mean live birthweight in the lcRTE group was 2,695 g (SD 325 g) compared to 2,545 g (297 g) in the sRTE group (p=0.02). The lcRTE snacks increased infants’ birthweight by 133.7 g (95% CI 7.3-260.2; p=0.04) compared to sRTE snacks. Leaf concentrate fortification of antenatal protein-calorie snacks in a low-income setting in India protected against declining maternal haemoglobin concentrations and increased infants’ birthweight when compared with unfortified snacks. These findings require replication in a larger trial.

Magon, Anjna; Joshi, Pallavi; Davys (Late), Glyn; Attlee, Amita; Mathur, Beena

2014-01-01

372

Leaf concentrate fortification of antenatal protein-calorie snacks improves pregnancy outcomes.  

PubMed

Ready-to-eat (RTE) snacks are routinely distributed to pregnant women in India. These provide protein and calories but are low in micronutrients. We investigated whether RTE snacks fortified with leaf concentrate (LC) could improve pregnancy outcomes, including maternal haemoglobin (Hb) concentrations and infants' birthweight. This randomized controlled two-arm trial was conducted over 18 months: control (sRTE) group received standard 120 g RTE snack (102 g wheat flour, 18 g soya flour); intervention (lcRTE) group received the same snack fortified with 7 g LC. The study was conducted in Jaipur, Rajasthan, India. One hundred and five pregnant women aged 18-35 years were studied. Among the 105 women randomized to the two arms of the trial, 2 (1.9%) were severely anaemic (Hb ? 6.0 g/dL); 55 (53.4%) were moderately anaemic (Hb 6.0-8.0 g/dL); 34 (33.0%) were mildly anaemic (Hb 8.6-10.9 g/dL); and 12 (11.7%) were not anaemic (Hb ? 11.0 g/dL). In the final month of pregnancy, 83.0% (39/47) of women in the sRTE group had Hb ? 8.5 g/dL compared to 37.8% (17/45) in the lcRTE group (p<0.001). After adjustment for age and baseline Hb concentration, the difference in Hb concentrations due to LC fortification was 0.94 g/dL (95% CI 6.8-12.0; p<0.001). Mean live birthweight in the lcRTE group was 2,695 g (SD 325 g) compared to 2,545 g (297 g) in the sRTE group (p=0.02). The lcRTE snacks increased infants' birthweight by 133.7 g (95% CI 7.3-260.2; p=0.04) compared to sRTE snacks. Leaf concentrate fortification of antenatal protein-calorie snacks in a low-income setting in India protected against declining maternal haemoglobin concentrations and increased infants' birthweight when compared with unfortified snacks. These findings require replication in a larger trial. PMID:25395906

Magon, Anjna; Collin, Simon M; Joshi, Pallavi; Davys Late, Glyn; Attlee, Amita; Mathur, Beena

2014-09-01

373

Sister Act: Understanding Sorority Women's Communication About Condom Use  

E-print Network

Young women‘s sexual health is declining. Sorority women face an intersectionality of risk for the negative consequences of sexual activity because of college attendance, sex, and age. The influence of peer communication about condom use can provide...

Hernandez, Rachael A.

2011-10-21

374

Seroprevalence of Rubella IgG Antibody in Pregnant Women in Osogbo, Nigeria  

PubMed Central

Background: Infection of mothers with Rubella virus during pregnancy can be serious; if the mother is infected within the first 20 weeks of pregnancy she is likely to have miscarriage, stillbirth, or baby with congenital rubella syndrome. This study was carried out to define Rubella virus seroprevalence in pregnancy in Osogbo, Nigeria. Methods: This study is a cross-sectional sero-survey of rubella IgG antibody among pregnant women attending antenatal clinic of Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria. Socio-demographic information on participants was collected by interviewer-administered questionnaire while venous samples were collected, stored at ?20°C and serum samples were screened for detection of rubella IgG antibodies using the enzyme linked immunosorbent assay. Results: Of the 200 sample evaluated for rubella Immunoglobulin G antibody, 175 (87.5%) were positive and 25 (12.5%) were negative. The result indicated prevalence of 85.7% in 15-19 year age group, 86.8% in 20-24 year age group, 89.6% in 25-29 year group, and 100% in greater than 40 year age group. Rubella IgG seroprevalence was not associated with age, gestational age, gravidity, vaccination, occupation and education. Conclusions: As the immunity gap in the studied population was high, rubella vaccination should be provided for all women of child-bearing age and children. PMID:24829712

Kolawole, Olatunji Mathew; Anjorin, Ekuntoye O.; Adekanle, Daniel A.; Kolawole, Caroline Folashade; Durowade, Kabir Adekunle

2014-01-01

375

Reducing the risk of HIV infection during pregnancy among South African women: a randomized controlled trial.  

PubMed

Mpumalanga Province, South Africa has one of the highest HIV/AIDS diagnosis rates among pregnant women (~29.4%). This study sought to enhance male involvement in pregnancy to increase HIV disclosure, sexual communication, HIV knowledge and reduce unprotected sex. Participants attending Antenatal Clinics (ANC) completed HIV counseling and testing and were enrolled with male partners (n=239 couples, 478 individuals). Twelve ANCs were randomly assigned to provide a prevention of mother-to-child transmission (PMTCT) intervention or the standard of care, health education sessions plus PMTCT. Participants were assessed at baseline and post-intervention (approximately 6-8 weeks post-baseline) on demographics, sexual behavior, HIV-related knowledge, and conflict resolution strategies. Experimental participants increased HIV knowledge, use of negotiation, and decreased intimate partner violence. Additionally, they were more likely to have increased condom use from baseline to post-intervention (OR=5.1, 95% CI=[2.0, 13.3]). Seroconversions in the control condition exceeded experimental (6 vs. 0). HIV serostatus disclosure to partner did not increase over time for men or women within the experimental or control condition. Male involvement in pregnancy may be an important strategy to reduce sexual risk behavior and HIV transmission. Results support the utility of group interventions to enhance communication and HIV knowledge among pregnant couples. PMID:23438041

Jones, D L; Peltzer, K; Villar-Loubet, O; Shikwane, E; Cook, R; Vamos, S; Weiss, S M

2013-01-01

376

Privatisation of health services and the reproductive health of rural Chinese women.  

PubMed

China's rural health care system has undergone major changes since the early 1980s, when the country began privatising rural health services. Following fiscal devolution, the rural primary health service was transformed into a fee-for-service system, dependent on the availability of local resources. This article reports some of the results of a study undertaken in 1994-96 to examine the impact of privatization on financing, provision and use of reproductive health services by women in two rural counties in Yunnan Province, China. The most common self-reported symptoms of reproductive morbidity were abnormal vaginal discharge and vaginal tears during home delivery, which went mostly untreated. Hospital-based delivery and use of antenatal care was very low, adversely affected by costs and perceived low quality. Service quality was affected by low investment in training, maintenance and supervision of workers. Most of the burden for maternal and child health care fell on local health workers, yet resources for these services had declined from 1985 to 1995. Only support for family planning services, which were funded and provided separately, had increased. Rural women's reproductive health needs were inadequately attended to by rural health services following reforms. Our data has helped to increase attention to those needs within planned reform efforts. PMID:12557647

Kaufman, Joan; Jing, Fang

2002-11-01

377

Between life and death: exploring the sociocultural context of antenatal mental distress in rural Ethiopia  

Microsoft Academic Search

The high prevalence of antenatal common mental disorders in sub-Saharan Africa compared to high-income countries is poorly\\u000a understood. This qualitative study explored the sociocultural context of antenatal mental distress in a rural Ethiopian community.\\u000a Five focus group discussions and 25 in-depth interviews were conducted with purposively sampled community stakeholders. Inductive\\u000a analysis was used to develop final themes. Worry about forthcoming

Charlotte Hanlon; Rob Whitley; Dawit Wondimagegn; Atalay Alem; Martin Prince

2010-01-01