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Sample records for positive pregnant women

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2013-04-01

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

  4. Positive life events predict salivary cortisol in pregnant women.

    PubMed

    Pluess, Michael; Wurmser, Harald; Buske-Kirschbaum, Angelika; Papousek, Mechthild; Pirke, Karl-Martin; Hellhammer, Dirk; Bolten, Margarete

    2012-08-01

    Maternal stress during pregnancy has been repeatedly associated with problematic child development. According to the fetal programming hypothesis adverse experiences during pregnancy increase maternal cortisol, which is then assumed to exert a negative effect on fetal development. Recent studies in non-pregnant women report significant associations between positive emotionality and low cortisol levels. We tested in a sample of 60 pregnant women whether both negative and positive life events independently predicted third-trimester baseline awakening cortisol levels. While the effect of negative life events proved unrelated positive life events significantly predicted lower cortisol levels. These findings suggest that positive experiences are of relevance regarding maternal morning cortisol levels in pregnancy reflecting a resource with potentially beneficial effects for the mother and the developing fetus. It might be promising for psychological intervention programs to focus on increasing positive experiences of the expecting mother rather than exclusively trying to reduce maternal stress during pregnancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2018-04-01

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

  6. Risk of anaemia in HIV positive pregnant women in Ibadan, south west Nigeria.

    PubMed

    Adesina, O; Oladokun, A; Akinyemi, O; Akingbola, T; Awolude, O; Adewole, I

    2011-03-01

    Anaemia in pregnancy is an important cause of maternal and neonatal mortality. It is a recognized co-morbidity of HIV infection. This study aimed to determine the risk of anaemia in HIV positive pregnant women. This is a cross sectional study of healthy pregnant women attending Adeoyo Hospital, a secondary health centre in South-western Nigeria over a 1-month period (January 2007). During the study period, 2737 eligible women presented for antenatal care. About 98% (2682) of these women consented to HIV testing. Over all, their mean (+ S.D) packed cell volume was 30.96% (+/- 4.13). The prevalence of HIV infection was 2.9% (95% CI 2.3% - 3.6%) and the overall prevalence of anaemia was 33.1%. Frequency of anaemia was significantly higher in HIV +ve women (57.3% vs. 42.7%, p = 0.00. OR = 2.81., CI = 1.72-4.58). HIV +ve women presented more frequently with moderate or severe anaemia. In the logistic regression analysis only HIV infection (OR = 2.4, 95% CI = 1.37-4.21) and primigravidity (OR = 1.25, 95% CI = 1.04-15.2) remained independently associated with anemia. Anaemia is common in HIV positive pregnant women in this environment. Care providers must endeavor to determine the HIV status of every pregnant woman especially if she presents with anaemia with a view to providing appropriate interventions.

  7. Plasma viraemia in HIV-positive pregnant women entering antenatal care in South Africa

    PubMed Central

    Myer, Landon; Phillips, Tamsin K; Hsiao, Nei-Yuan; Zerbe, Allison; Petro, Gregory; Bekker, Linda-Gail; McIntyre, James A; Abrams, Elaine J

    2015-01-01

    Introduction Plasma HIV viral load (VL) is the principle determinant of mother-to-child HIV transmission (MTCT), yet there are few data on VL in populations of pregnant women in sub-Saharan Africa. We examined the distribution and determinants of VL in HIV-positive women seeking antenatal care (ANC) in Cape Town, South Africa. Methods Consecutive HIV-positive pregnant women making their first antenatal clinic visit were recruited into a cross-sectional study of viraemia in pregnancy, including a brief questionnaire and specimens for VL testing and CD4 cell enumeration. Results & discussion Overall 5551 pregnant women sought ANC during the study period, of whom 1839 (33%) were HIV positive and 1521 (85%) were included. Approximately two-thirds of HIV-positive women in the sample (n=947) were not on antiretrovirals at the time of the first ANC visit, and the remainder (38%, n=574) had initiated antiretroviral therapy (ART) prior to conception. For women not on ART, the median VL was 3.98 log10 copies/mL; in this group, the sensitivity of CD4 cell counts ≤350 cells/µL in detecting VL>10,000 copies/mL was 64% and this increased to 78% with a CD4 threshold of ≤500 cells/µL. Among women on ART, 78% had VL<50 copies/mL and 13% had VL >1000 copies/mL at the time of their ANC visit. Conclusions VL >10,000 copies/mL was commonly observed in women not on ART with CD4 cell counts >350 cells/µL, suggesting that CD4 cell counts may not be adequately sensitive in identifying women at greatest risk of MTCT. A large proportion of women entering ANC initiated ART before conception, and in this group more than 10% had VL>1000 copies/mL despite ART use. VL monitoring during pregnancy may help to identify pregnancies that require additional clinical attention to minimize MTCT risk and improve maternal and child health outcomes. PMID:26154734

  8. A Ten-Year Review of Antenatal Complications and Pregnancy Outcomes Among HIV-Positive Pregnant Women.

    PubMed

    Yudin, Mark H; Caprara, Daniela; MacGillivray, S Jay; Urquia, Marcelo; Shah, Rajiv R

    2016-01-01

    To review the incidence of antenatal complications among a cohort of HIV-positive pregnant women over a 10-year period. A retrospective review was performed of all HIV-positive pregnant women receiving multidisciplinary prenatal care at an urban tertiary care centre from March 2000 to March 2010. Collected data included the presence of additional infectious or medical conditions, genetic screening information, and the presence or absence of antenatal complications. One hundred and forty-two singleton pregnancies during the study period were identified. Almost 95% of women were taking combination antiretroviral therapy during pregnancy, and greater than 90% had viral loads less than 1000 copies/ml at delivery. The presence of co-infections was low. Forty-one women (29%) had other medical comorbidities. Genetic screening occurred in 104 pregnancies (73%); 4% were abnormal screens. Rates of any hypertension, gestational diabetes, and fetal growth restriction were all low. Thirty-two percent of women were colonized with group B streptococcus. This study adds strength to the argument that good outcomes can be achieved for HIV-positive pregnant women with good access to both prenatal and HIV care, and appropriate management. Women with HIV should be optimally cared for in advance of and during pregnancy in order to maximize the likelihood of good pregnancy outcomes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  9. Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria.

    PubMed

    Abimiku, Alash'le; Villalba-Diebold, Pacha; Dadik, Jelpe; Okolo, Felicia; Mang, Edwina; Charurat, Man

    2009-09-01

    To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections.

  10. Management of group b streptococcus-positive pregnant women at maternity homes in JAPAN: a questionnaire survey of compliance among midwives.

    PubMed

    Yamaguchi, Kotomi; Ohashi, Kazutomo

    2018-01-01

    Per the 2014 Japanese Midwives Association (JMA) guidelines, midwives were allowed to manage the deliveries for group B streptococcus (GBS)-positive pregnant women in labour at maternity homes without the supervision of a medical doctor if they complied with the guidelines of the Japan Society of Obstetrics and Gynecology (JSOG), wherein midwives working for maternity homes are expected to cooperate with commissioned obstetricians and paediatricians in cooperative medical facilities. We examined the rate of compliance with these JMA and JSOG guidelines regarding the management of GBS-positive pregnant women among midwives at maternity homes in Japan. Between October and December 2015, an anonymous questionnaire was distributed to 337 maternity homes registered with the JMA by mail. The questionnaire obtained information regarding the timing of GBS screening, specimen collection, transfer of GBS-positive pregnant women from a maternity home to a hospital, administration of intrapartum antibiotic prophylaxis, and collaboration between midwives and commissioned obstetricians. Data were analysed using descriptive statistics. We used frequency distribution as the statistical test. Responses were received from 246 (73.0%) maternity homes, of which complete responses from 204 maternity homes (valid response rate, 60.5%) were analysed. Of these 204 maternity homes, only 97 (47.5%) conducted a GBS screening test during 33-37 weeks of gestation as recommended by the JSOG guidelines. Although midwives alone managed GBS-positive pregnant women in labour at 135 maternity homes (66.2%), intrapartum antibiotic prophylaxis, as recommended by the JSOG guidelines, was conducted in only 111 (54.4%). Moreover, only 37.0% (50/135) and 82.2% (111/135) of maternity homes ensured that GBS-positive pregnant women in labour with an elapse of ≥18 h after PROM and a body temperature of ≥38.0 °C, respectively, were transferred to a hospital by ambulance. Only at 58.3% (119/204) of

  11. Effect of clindamycin treatment on vaginal inflammatory markers in pregnant women with bacterial vaginosis and a positive fetal fibronectin test.

    PubMed

    Diaz-Cueto, Laura; Dominguez-Lopez, Pablo; Tena-Alavez, Gilberto; Cuica-Flores, Adrian; Rosales-Ortiz, Sergio; Arechavaleta-Velasco, Fabian

    2009-11-01

    To compare the levels of interleukin (IL)-1beta, IL-6, and matrix metalloproteinase (MMP)-8 in the vaginal secretions of pregnant women with a positive fetal fibronectin (fFN) test result with or without asymptomatic bacterial vaginosis (BV) before and after treatment with oral clindamycin. A prospective cohort study was conducted among 43 pregnant women with a positive fFN test result. All patients were treated with clindamycin, and the pre- and post-treatment levels of IL-1beta, IL-6, and MMP-8 were compared. Before treatment, levels of IL-1beta and MMP-8 were significantly higher in women with BV compared with women without BV (P<0.05). Vaginal levels of IL-1beta and IL-6, but not MMP-8, decreased after treatment in pregnant women with BV. The inability of clindamycin to decrease MMP-8 vaginal levels may explain why it is ineffective in reducing preterm birth in pregnant women with positive fFN and BV.

  12. A prospective study of Toxoplasma-positive pregnant women in southern Brazil: a health alert.

    PubMed

    Higa, Lourenço T; Araújo, Silvana M; Tsuneto, Luiza; Castilho-Pelloso, Marcela; Garcia, João L; Santana, Rosangela G; Falavigna-Guilherme, Ana L

    2010-06-01

    We evaluated anti-Toxoplasma gondii IgM-reactive pregnant women seen at a high-risk pregnancy outpatient clinic. From March 2005 to January 2008 in Paraná, Brazil, pregnant women seen by the Brazilian Public Health System, in any gestational period, who were anti-T. gondii IgM-positive, were followed. Clinical symptoms were noted, and tests performed including IgA, IgG avidity, ultrasonogram, and amniocentesis (PCR/inoculation in mice). Of 75 patients, 8 showed low, 3 intermediate and 31 high IgG avidity. Of those who underwent the avidity test, 31 (70.5%) were in the second trimester of pregnancy. Thirty-two (42.7%) pregnant women received specific treatment. Six received triple combination treatment; in three, tachyzoites were isolated, although only one was PCR-positive, showing changes in the cerebral sonogram, borderline IgA, and the Sabin tetrad. One fetus died, and one non-reactive IgM pregnant woman showed ocular recurrence. The municipality of residence, contact with cats during adulthood, and ingestion of unpasteurized milk were shown to be important risk factors. Congenital toxoplasmosis was observed in a pregnancy referred late for treatment. Follow-up of children born to mothers with diagnosed or suspected acute toxoplasmosis is crucial in the management of the changes that toxoplasmosis may cause. 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  13. Prevalence of Thyroid Peroxidase Antibody and Pregnancy Outcome in Euthyroid Autoimmune Positive Pregnant Women from a Tertiary Care Center in Haryana.

    PubMed

    Rajput, Rajesh; Yadav, Tekchand; Seth, Shashi; Nanda, Smiti

    2017-01-01

    To study the prevalence of thyroid peroxidase autoantibody in euthyroid pregnant women and to evaluate the association between thyroid peroxidase autoantibody and pregnancy outcomes. One thousand thirty consecutive pregnant women attending the antenatal clinic over a period of 1 year and were carrying a healthy singleton uncomplicated intrauterine pregnancy and consuming iodized salt were recruited for the study. Outcomes of the pregnancy was compared between TPO antibody positive euthyroid women (group 1) and TPO antibody negative euthyroid women (group 2). Out of 1030 women, 164 (18.9%) were detected TPO antibody positive with euthyroid status. The mean FT4 and TSH level were significantly different in those who were TPO Ab positive as compared TPO Ab negative euthyroid pregnant women. No correlation was observed between the maternal age, gestational age and gravidity with anti TPO antibody levels. Eighteen (12%) women in Group 1and 5 (3.3%) women in Group 2 had miscarriages and the difference was found to be statistically significant ( P value of 0.004). Twenty-one (14%) women in Group 1 and 5 (3.3%) women in Group 2 had preterm deliveries, which was also found to be statistically significantly (p value of 0.001). Other pregnancy related complications like Intrauterine death, IUGR, preeclampsia and PIH though are present in comparatively higher number in TPO Ab positive euthyroid pregnant women as compared to TPO Ab negative euthyroid pregnant women but this difference was not found to be statistically significant. To conclude with the present study shows that a good number of pregnant women with euthyroid status have TPO Ab positivity and this is associated with some adverse pregnancy outcomes like miscarriage and preterm birth of the baby.

  14. Multivitamin supplementation in HIV-positive pregnant women: impact on depression and quality of life in a resource-poor setting.

    PubMed

    Smith Fawzi, M C; Kaaya, S F; Mbwambo, J; Msamanga, G I; Antelman, G; Wei, R; Hunter, D J; Fawzi, W W

    2007-05-01

    The primary objective of this study was to examine the effect of vitamin supplementation on health-related quality of life and the risk of elevated depressive symptoms comparable to major depressive disorder (MDD) in HIV-positive pregnant women in Dar es Salaam, Tanzania. From April 1995 to July 1997, 1078 HIV-positive pregnant women were enrolled in a randomized controlled trial. We examined the effects of vitamin supplementation on quality of life and the risk of elevated depressive symptoms, assessed longitudinally every 6-12 months. A substantial prevalence of elevated depressive symptoms (42%) was observed in HIV-positive pregnant women. Multivitamin supplementation (B-complex, C and E) demonstrated a protective effect on depression [relative risk (RR)=0.78; P=0.005] and quality of life [RR=0.72 for social functioning (P=0.001) and vitality (P=0.0001); RR=0.70 for role-physical (P=0.002)]; however, vitamin A showed no effect on these outcomes. Multivitamin supplementation (B-complex, C and E) resulted in a reduction in risk of elevated depressive symptoms comparable to MDD and improvement in quality of life in HIV-positive pregnant women in Tanzania.

  15. The Prevalence and Risk Factors for Hepatitis B Surface Ag Positivity in Pregnant Women in Eastern Region of Ghana

    PubMed Central

    Cho, Younmo; Bonsu, George; Akoto-Ampaw, Arko; Nkrumah-Mills, Grace; Nimo, Julia J.A.; Park, Jin Kyung

    2012-01-01

    Background/Aims The aim of this study was to evaluate the prevalence and risk factors for hepatitis B surface antigen (HBsAg) positivity in pregnant Ghanaian women. Methods We surveyed 1,500 pregnant women in Eastern region of Ghana. Direct interviews were performed by trained nurses using standardized questionnaires. Pregnant women were screened for human immunodeficiency virus (HIV) and hepatitis B infections, hemoglobin levels and sickle cell anemia as part of the antenatal check-up. Results The overall HBsAg positive rate was 10.6%, which varied among districts (13.8% for Kwahu West, 12.4% for Upper Manya, and 2.2% for Yilo Krobo). HBsAg positivity was significantly higher in women with depression (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.13 to 6.57) and HIV (OR, 2.03; 95% CI, 1.06 to 3.89). Age, education, and gravidity were not related to HBsAg positivity. Anti-hepatitis B immunoglobulin for newborns of HBsAg-positive mothers is not provided at birth in public health facilities in Ghana. However, hepatitis B vaccination is provided as part of a routine vaccination schedule starting at 6 weeks of age. Conclusions To prevent mother-to-child transmission of hepatitis B, screening tests for HBsAg in pregnant women and hepatitis B vaccination of newborns immediately after birth need to be performed in this region. PMID:22570754

  16. Characteristics of pregnant women in motor vehicle crashes

    PubMed Central

    Weiss, H; Strotmeyer, S

    2002-01-01

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

  17. Racial Discrimination and Psychological Wellbeing of Pregnant Women.

    PubMed

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

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

  18. Predictors of HIV positivity among pregnant women presenting for obstetric care in South India - a case-control study.

    PubMed

    Solomon, Eileen; Visnegarwala, Fehmida; Philip, Philimol; Alexander, Glory

    2011-10-01

    Feminization of the HIV epidemic in India has increasingly burdened the public health infrastructure to provide prevention of mother-to-child transmission (PMTCT) services. A mere 20% of pregnant women in the country receive HIV counseling and testing. One of the strategies, for expansion of PMTCT services is to ascertain an accurate identification of HIV-positive pregnant women. Thus, we sought to characterize a demographic profile of pregnant women at high-risk for HIV infection. We performed a retrospective case-control study. We included as cases, all HIV-positive women identified in a PMTCT program implemented in 23 charitable faith-based hospitals in four states in South India over a period of 75 months, starting in January 2003. Thus a total of 320 HIV-positive cases were frequency matched using stratified random sampling to 365 HIV-negative pregnant women presenting for antenatal care during the same time period. Cases and controls were compared using Chi-square test for categorical variables and Student's t-test for continuous variables. Multivariate step-wise logistic regression analysis was performed. On multivariate analysis, following factors were independently predictive of HIV positivity: age ≤25 years (odds ratio [OR] 0.50; confidence interval [CI] 0.33-0.76; p = 0.001); illiteracy (OR 4.89; CI 2.79-8.57; p <0.0001); woman holding a service and/or professional job (OR 0.27; CI 0.14-0.53; p <0.0001); spouses holding a service or higher job (OR 3.13; CI 2.13-4.59; p <0.0001); being married ≤5 years (OR 2.89; CI 1.68-4.95; p <0.0001); late gestational age at presentation (OR 3.06; CI 2.04-4.59; p <0.0001); history of fetal and/or live born loss (OR 2.36; CI 1.51-3.67; p <0.0001). To our knowledge this is the first large study to evaluate factors predictive of HIV positivity among women presenting for antenatal care in the Indian setting. This type of profiling of HIV-positive pregnant women may help expand PMTCT services in a focused and cost

  19. Hematological parameters of human immunodeficiency virus positive pregnant women on antiretroviral therapy in Aminu Kano Teaching Hospital Kano, North Western Nigeria.

    PubMed

    Abdulqadir, Ibrahim; Ahmed, Sagir Gumel; Kuliya, Aisha Gwarzo; Tukur, Jamilu; Yusuf, Aminu Abba; Musa, Abubakar Umar

    2018-01-01

    Human immunodeficiency virus (HIV) scourge continues to affect young women within the reproductive age group and pregnancy is a recognized indication for the use antiretroviral (ARV) drugs among HIV-positive women. The aim is to determine the combined effect of pregnancy, HIV and ARV drugs on the hematological parameters of the pregnant women. This was a comparative cross-sectional study conducted among 70 each of HIV-positive and negative pregnant women. Bio-demographic and clinical data were extracted from the client folder and 4 ml of blood sample was obtained from each participant. Full blood count was generated using Swelab automatic hematology analyzer while reticulocyte count and erythrocyte sedimentation rate (ESR) were conducted manually. Data analysis was performed using SPSS version software 16 while P < 0.05 was considered statistically significant. Pregnant women with HIV had statistically significant lower hematocrit and white blood cell (WBC) and higher ESR than pregnant women without HIV ( P < 0.000). There was no statistically significant difference between the two groups in terms of platelet and reticulocyte ( P > 0.05). However, among HIV positive pregnant women, those with CD4 count <350/μL had statistically significant lower WBC and lymphocyte count than those with CD4 count ≥350/μL ( P < 0.05), whereas, those on zidovudine (AZT)-containing treatment had statistically significant lower hematocrit and higher mean cell volume than those on non-AZT-containing treatment ( P < 0.05), but there was no statistically significant difference in any of the hematological parameters ( P > 0.050) between women on first- and second-line ARV regimens. There is a significant difference in terms of hematological parameters between HIV-positive and HIV-negative pregnant women in this environment.

  20. Toxoplasmosis in pregnant Sudanese women.

    PubMed

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

    2003-08-01

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

  1. HIV-positive pregnant and postpartum women's perspectives about Option B+ in Malawi: a qualitative study.

    PubMed

    Katirayi, Leila; Namadingo, Hazel; Phiri, Mafayo; Bobrow, Emily A; Ahimbisibwe, Allan; Berhan, Aida Yemane; Buono, Nicole; Moland, Karen Marie; Tylleskär, Thorkild

    2016-01-01

    The implementation of lifelong antiretroviral treatment (ART) for all pregnant women (Option B+) in Malawi has resulted in a significant increase in the number of HIV-positive pregnant women initiating treatment. However, research has highlighted the challenge of retaining newly initiated women in care. This study explores barriers and facilitators that affect a woman's decision to initiate and to adhere to Option B+. A total of 39 in-depth interviews and 16 focus group discussions were conducted. Eligible women were ≥18 years old, living with HIV and either pregnant and receiving antenatal care from a study site or had delivered a child within the last 18 months, breastfed their child and received services at one of the study sites. Eligible women were identified by healthcare workers (HCWs) in the antenatal clinic and ART unit. Focus groups were also conducted with HCWs employed in these departments. Qualitative data were analyzed using Maxqda version 10 (VERBI Software, Berlin, Germany). The general perception towards the drug regimen used in Option B+ was positive; women reported fewer side effects and acknowledged the positive benefits of ART. Women felt hopeful about prolonging their life and having an HIV-uninfected baby, yet grappled with the fact that ART is a lifelong commitment. Women and HCWs discussed challenges with the counselling services for prevention of mother-to-child HIV transmission under the new Option B+ guidelines, and many women struggled with initiating ART on the same day as learning their HIV status. Women wanted to discuss their circumstances with their husbands first, receive a CD4 count and obtain an HIV test at another facility to confirm their HIV status. HCWs expressed concern that women might just agree to take the drugs to please them. HCWs also discussed concerns around loss to follow-up and drug resistance. Although Option B+ has significantly increased the number of women initiating ART, there are still challenges that need

  2. HIV-positive pregnant and postpartum women's perspectives about Option B+ in Malawi: a qualitative study

    PubMed Central

    Katirayi, Leila; Namadingo, Hazel; Phiri, Mafayo; Bobrow, Emily A; Ahimbisibwe, Allan; Berhan, Aida Yemane; Buono, Nicole; Moland, Karen Marie; Tylleskär, Thorkild

    2016-01-01

    Introduction The implementation of lifelong antiretroviral treatment (ART) for all pregnant women (Option B+) in Malawi has resulted in a significant increase in the number of HIV-positive pregnant women initiating treatment. However, research has highlighted the challenge of retaining newly initiated women in care. This study explores barriers and facilitators that affect a woman's decision to initiate and to adhere to Option B+. Methods A total of 39 in-depth interviews and 16 focus group discussions were conducted. Eligible women were ≥18 years old, living with HIV and either pregnant and receiving antenatal care from a study site or had delivered a child within the last 18 months, breastfed their child and received services at one of the study sites. Eligible women were identified by healthcare workers (HCWs) in the antenatal clinic and ART unit. Focus groups were also conducted with HCWs employed in these departments. Qualitative data were analyzed using Maxqda version 10 (VERBI Software, Berlin, Germany). Results The general perception towards the drug regimen used in Option B+ was positive; women reported fewer side effects and acknowledged the positive benefits of ART. Women felt hopeful about prolonging their life and having an HIV-uninfected baby, yet grappled with the fact that ART is a lifelong commitment. Women and HCWs discussed challenges with the counselling services for prevention of mother-to-child HIV transmission under the new Option B+ guidelines, and many women struggled with initiating ART on the same day as learning their HIV status. Women wanted to discuss their circumstances with their husbands first, receive a CD4 count and obtain an HIV test at another facility to confirm their HIV status. HCWs expressed concern that women might just agree to take the drugs to please them. HCWs also discussed concerns around loss to follow-up and drug resistance. Conclusions Although Option B+ has significantly increased the number of women initiating

  3. Seroprevalence of toxoplasmosis in Korean pregnant women.

    PubMed

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

    2005-06-01

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

  4. Clinical malaria in African pregnant women.

    PubMed

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

    2008-01-30

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

  5. Prevalence of human papilloma virus infection in pregnant Turkish women compared with non-pregnant women.

    PubMed

    Aydin, Y; Atis, A; Tutuman, T; Goker, N

    2010-01-01

    We aimed to find a prevalence of human papilloma virus (HPV) in order to define the 100 genotypes and subset of 14 oncogenic genotypes in pregnant Turkish women and to compare these with non-pregnant women. Cervical thin-prep specimens were obtained from 164 women in the first trimester pregnancy and 153 non pregnant women. 29.2% of pregnant versus 19.6% of non-pregnant Turkish women had at least one of the 100 types of HPV infection--a statistically significant difference. The rate of 14 high-risk HPV genotype infections was significantly higher in pregnant (14.6) compared to non-pregnant Turkish women (9.6%). Pregnant Turkish women are at higher risk for all HPV infections including high-risk cervical cancer genotypes.

  6. The impact of structured support groups for pregnant South African women recently diagnosed HIV positive.

    PubMed

    Mundell, Jonathan P; Visser, Maretha J; Makin, Jennifer D; Kershaw, Trace S; Forsyth, Brian W C; Jeffery, Bridget; Sikkema, Kathleen J

    2011-08-31

    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.

  7. HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising.

    PubMed

    Sagay, A S; Onakewhor, J; Galadanci, H; Emuveyan, E E

    2006-12-01

    This study was conducted to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The Site Coordinators of PMTCT programs in three Nigerian cities obtained data of the HIV status of the partners of HIV positive pregnant women. The selection of Benin City, Jos and Kano was made after consideration of their ethnic, religious and cultural representation of Nigeria. Benin City represents a traditional southern Nigeria city, Kano a traditional northern city and Jos, a middle-belt, ethnically diverse cosmopolitan setting. The data were analyzed using frequencies. A total of 500 partners of HIV infected pregnant women were tested for HIV using Determine Abbott test kits. Positive results were confirmed using Western blot or a second rapid test kit. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155). These results indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. Socio-cultural and religious settings play a significant role in HIV transmission among couples. These findings should guide prevention interventions in order to achieve maximal impact.

  8. Comparison of Sexual Functions in Pregnant and Non-Pregnant Women.

    PubMed

    Aydin, Mustafa; Cayonu, Neval; Kadihasanoglu, Mustafa; Irkilata, Lokman; Atilla, Mustafa Kemal; Kendirci, Muammer

    2015-11-14

    The physiology and anatomy of pregnant women change during pregnancy. Pregnancy is an anatomically and physiologically amended process experienced by women and as a result of these changes, sexual life of pregnant women alters during pregnancy. We aimed to compare sexual functions of pregnant and non-pregnant women. Sexually active 246 pregnant women were included into this cross-sectional controlled study. A total of 210 non-pregnant women were served as control. Both groups were compared in terms of age, gestational age, presence of urinary incontinence, body mass index, and obstetrical history. Sexual functions of the women were evaluated with Female Sexual Function Index (FSFI). Data were analyzed using chi-square, Mann-Whitney U, Fisher's Exact, Shapiro Wilk, Kruskal Wallis and Dunnett's tests where appropriate. The Pvalues < .05 were considered statistically significant. Mean age in both groups were comparable (P = .053). Median total FSFI scores in the pregnant women were significantly lower than those non-pregnant (18.9 vs. 22.7; P < .05). Additionally, the subgroup analyses of the FSFI scores were found that, total FSFI score is significantly lower in the pregnant group compared to non-pregnant group (P < .05). Furthermore, rate of sexual dysfunction in pregnant women was significantly higher than those non-pregnant women (91.08% vs. 67.61%, P = .0001). However, in pregnant women, no meaningful difference in rate of sexual dysfunction was found according to the trimesters (P = .632). Moreover, gravidity and parity exhibited negative impacts on the sexual functions. But number of abortions did not affect sexual function. These data demonstrate that pregnancy significantly diminishes sexual function in women. We believe that, couples need to be counseled regarding the impact of pregnancy on sexual functions.

  9. Anxiety and depression symptoms among sub-fertile women, women pregnant after infertility treatment, and naturally pregnant women.

    PubMed

    Salih Joelsson, L; Tydén, T; Wanggren, K; Georgakis, M K; Stern, J; Berglund, A; Skalkidou, A

    2017-09-01

    Infertility has been associated with psychological distress, but whether these symptoms persist after achieving pregnancy via assisted reproductive technology (ART) remains unclear. We compared the prevalence of anxiety and depressive symptoms between women seeking for infertility treatment and women who conceived after ART or naturally. Four hundred and sixty-eight sub-fertile non-pregnant women, 2972 naturally pregnant women and 143 women pregnant after ART completed a questionnaire in this cross-sectional study. The Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A≥8) and Edinburgh Postnatal Depression Scale (EPDS≥12) were used for assessing anxiety and depressive symptoms, respectively. Multivariate Poisson regression models with robust variance were applied to explore associations with anxiety and depressive symptoms. The prevalence of anxiety and depressive symptoms among sub-fertile, non-pregnant women (57.6% and 15.7%, respectively) were significantly higher compared to women pregnant after ART (21.1% and 8.5%, respectively) and naturally pregnant women (18.8% and 10.3%, respectively). History of psychiatric diagnosis was identified as an independent risk factor for both anxiety and depressive symptoms. The presence of at least one unhealthy lifestyle behavior (daily tobacco smoking, weekly alcohol consumption, BMI≥25, and regular physical exercise<2h/week) was also associated with anxiety (Prevalence Ratio, PR: 1.24; 95%CI: 1.09-1.40) and depressive symptoms (PR: 1.25; 95%CI: 1.04-1.49). Women pregnant after ART showed no difference in anxiety and depressive symptoms compared to naturally pregnant women. However, early psychological counseling and management of unhealthy lifestyle behaviors for sub-fertile women may be advisable, particularly for women with a previous history of psychiatric diagnosis. Copyright © 2017. Published by Elsevier Masson SAS.

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

    PubMed

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

    2007-01-01

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

  11. Rubella Immune Status in Pregnant Women in a Northern Mexican City

    PubMed Central

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

    2016-01-01

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

  12. Malaria and helminthic co-infection among HIV-positive pregnant women: prevalence and effects of antiretroviral therapy.

    PubMed

    Ivan, Emil; Crowther, Nigel J; Rucogoza, Aniceth T; Osuwat, Lawrence O; Munyazesa, Elizaphane; Mutimura, Eugene; Njunwa, Kato J; Zambezi, Kakoma J B; Grobusch, Martin P

    2012-12-01

    The impact of malaria on anemia and the interplay with helminths underline the importance of addressing the interactions between HIV/AIDS, malaria and intestinal helminth infections in pregnancy. The aim of this study was to determine the prevalence of malaria-helminth dual infections among HIV positive pregnant mothers after 12 months of ART. A cross sectional study was conducted on intestinal helminths and malaria dual infections among HIV-positive pregnant women attending antenatal health centers in Rwanda. Stool and malaria blood slide examinations were performed on 328 women residing in rural (n=166) and peri-urban locations (n=162). BMI, CD4 cell count, hemoglobin levels, type of ART and viral load of participants were assessed. Within the study group, 38% of individuals harbored helminths, 21% had malaria and 10% were infected with both. The most prevalent helminth species were Ascaris lumbricoides (20.7%), followed by Trichuris trichiura (9.2%), and Ancylostoma duodenale and Necator americanus (1.2%). Helminth infections were characterized by low hemoglobin and CD4 counts. Subjects treated with a d4T, 3TC, NVP regimen had a reduced risk of T. trichiura infection (OR, 0.27; 95% CIs, 0.10-0.76; p<0.05) and malaria-helminth dual infection (OR, 0.29; 95% CI, 0.11-0.75; p<0.05) compared to those receiving AZT, 3TC, NVP. This study shows a high prevalence of malaria and helminth infection among HIV-positive pregnant women in Rwanda. The differential effect of ARTs on the risk of helminth infection is of interest and should be examined prospectively in larger patient groups. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    PubMed

    Bödeker, Birte; Betsch, Cornelia; Wichmann, Ole

    2015-12-29

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

  14. Impact of positive thyroid autoimmunity on pregnant women with subclinical hypothyroidism.

    PubMed

    López-Tinoco, Cristina; Rodríguez-Mengual, Amparo; Lara-Barea, Almudena; Barcala, Julia; Larrán, Laura; Saez-Benito, Ana; Aguilar-Diosdado, Manuel

    2018-03-01

    The impact of subclinical hypothyroidism (SH) and thyroid autoimmunity on obstetric and perinatal complications continues to be a matter of interest and highly controversial. To assess the impact of SH and autoimmunity in early pregnancy on the obstetric and perinatal complications in our population. A retrospective cohort study in 435 women with SH (TSH ranging from 3.86 and 10 μIU/mL and normal FT4 values) in the first trimester of pregnancy. Epidemiological and clinical parameters were analyzed and were related to obstetric and perinatal complications based on the presence of autoimmunity (thyroid peroxidase antibodies [TPO] > 34 IU/mL). Mean age was 31.3 years (SD 5.2). Seventeen percent of patients had positive TPO antibodies. Presence of positive autoimmunity was associated to a family history of hypothyroidism (P=.04) and a higher chance of miscarriage (P=.009). In the multivariate analysis, positive TPO antibodies were associated to a 10.25-fold higher risk of miscarriage. No statistically significant associations were found with all other obstetric and perinatal complications. In our region, pregnant women with SH and thyroid autoimmunity had a higher risk of miscarriage but not of other obstetric and perinatal complications. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Circumstances of tobacco smoking by pregnant women.

    PubMed

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

    2004-01-01

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

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

    PubMed

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

    2017-08-01

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

  17. High-grade squamous intraepithelial lesions in pregnant and non-pregnant women.

    PubMed

    Xavier-Júnior, José Cândido C; Dufloth, Rozany M; do Vale, Diama B; Tavares, Thalita A; Zeferino, Luiz C

    2014-04-01

    To evaluate if the prevalence of cervical smear results varies between pregnant and non-pregnant women stratified by age group. Observational analytical study with a total sample of 1,336,180 pregnant and non-pregnant women, aged between 20 and 34 years, who underwent cervical cancer screening in the Primary Health Care of the national health system in the area of Campinas in Brazil during the period of 2005-2009. The source is the information system for cervical cancer screening. Data collected on abnormal cervical smears were analyzed using the Chi-square test and Fisher's exact test and the magnitude of the association between pregnancy and high-grade squamous epithelial lesions was analyzed by odds ratio (OR) and estimated values with confidence intervals (CI) of 95%. 15,190 pregnant women and 395,961 non-pregnant women were analyzed and fulfilled the inclusion criteria. Regardless of age, no statistical differences were observed for high-grade squamous intraepithelial lesion prevalence (OR 0.90; CI 0.66-1.23). Taking into account the five-year age groups, however, low-grade squamous intraepithelial lesion was less prevalent in pregnant women aged 20-24 (OR 0.71; 0.54-0.95) and 25-29 years (OR 0.56; 0.35-0.89); also, atypical squamous cells of undetermined significance was more prevalent in non-pregnant women aged 25-29 years (OR 0.72; 0.54-0.97). The study showed that the cytological prevalence of high-grade squamous intraepithelial lesion was similar in pregnant and non-pregnant women, regardless of age. The results indicate that there are no reasons for specific approaches to cervical cancer screening for pregnant women. The examination should be carried out only on pregnant women who have not been tested according to current recommendations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Factors influencing brain natriuretic peptide levels in healthy pregnant women.

    PubMed

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

    2017-02-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2017-02-22

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

  1. Intimate partner violence among pregnant women in Rwanda

    PubMed Central

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

    2008-01-01

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

  2. Becoming pregnant: exploring the perspectives of women living with diabetes

    PubMed Central

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

    2008-01-01

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

  3. Smoking as a decision among pregnant and non-pregnant women.

    PubMed

    Ortendahl, Monica

    2006-10-01

    The purpose was to examine values and beliefs related to smoking, and to test the validity of a decision model based on the product of the value of smoking-related events and states, and the belief that these will occur, (in decision research labeled Expected Utility, or EU). Over a two-week period eighty women, divided into subgroups consisting of pregnant vs. non-pregnant women, and those intending vs. those not intending to quit smoking, performed evaluations of values and beliefs for the two conditions of quitting and not quitting smoking. For both pregnant and non-pregnant women expected utility of smoking was negative. Of all the four groups pregnant women not intending to quit smoking estimated the expected utility of smoking as least negative. A decision analytic approach is applicable to describe the addictive behavior of smoking. Values as well as beliefs about smoking should be stressed in smoking cessation programs, especially among pregnant women.

  4. Seroprevalence of Cytomegalovirus among pregnant women and hospitalized children in Palestine.

    PubMed

    Neirukh, Tahani; Qaisi, Ayda; Saleh, Niveen; Rmaileh, Areej Abu; Zahriyeh, Eman Abu; Qurei, Lina; Dajani, Firas; Nusseibeh, Taghreed; Khamash, Hatem; Baraghithi, Sabri; Azzeh, Maysa

    2013-11-09

    Human Cytomegalovirus (HCMV) is the most common cause of congenital infections. The maternal immune status plays a major role in the likelihood of congenital infection. The aim of this study is to shed light on the seroprevalence of HCMV in pregnant women, hospitalized children and newborns including cases of congenital infections in Palestine. We analyzed HCMV IgG and IgM test results that had been ordered for pregnant women, hospitalized children and newborns in the years 2006-2012 at Al-Makassed Islamic Charitable Hospital (MICH) in East Jerusalem. Furthermore, we reviewed the medical charts of newborns and HCMV IgM-positive children. HCMV IgG was positive in 96.6% of pregnant women, in 88% of hospitalized children and in 98.4% of hospitalized newborns. HCMV IgM was positive in 11.5% of pregnant women, in 11.7% of hospitalized children and in 2% of hospitalized newborns respectively. The HCMV avidity assay revealed that 95% of IgM-positive pregnant women had high avidity (>60%) indicating that most Palestinian women were undergoing a recurrent HCMV infection. Real time PCR on limited number of cases indicated that 62.5% of infants, mostly born to IgM-positive mothers and 83.3% of HCMV IgM-positive children had detectable HCMV DNA in their urine. Out of the 249 newborns tested during this study period, four (1.6%) were subjected to Gancyclovir treatment because of symptomatic congenital HCMV infection. This is the first report to provide an insight into HCMV seroprevalence in Palestine. Despite the high rate of seropositivity, the importance of HCMV testing during pregnancy should not be underestimated. A comprehensive study with a long term follow-up examination of offspring born to HCMV IgM-positive mothers would be required to provide estimates of an accurate percentage of symptomatic congenital HCMV infection in Palestine.

  5. Pregnant Women Need a Flu Shot

    MedlinePlus

    Pregnant? You Need a Flu Shot! Information for pregnant women Because you are pregnant, CDC and your ob- ... more likely to get severely ill from flu. Pregnant women who get flu are at high risk of ...

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

    PubMed

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

    2017-02-01

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

  7. Toxoplasmosis among pregnant women in Qualyobia Governorate, Egypt.

    PubMed

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

    2009-08-01

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

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

    PubMed

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

    2008-01-01

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

  9. [Low back pain in pregnant women].

    PubMed

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

    2010-11-01

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

  10. [Relationship between the thyroid autoimmunity and the risk of preterm birth in pregnant women: a meta-analysis].

    PubMed

    Li, M; Wang, S W; Huang, S; Mao, Y

    2016-05-25

    To evaluate the relationship between thyroid autoimmunity and the risk of preterm birth. Literature search was done among PubMed, Embase, Wanfang Medical Database, China Academic Journal Network Publishing Database and China Biology Medicine disc from Jan. 1(st) 1980 to July 31(st), 2015. (1) Literature were extracted according to inclusion and exclusion standards, and the quality of the extracted literature were evaluated by Newcastle-Ottawa Scale (NOS). (2) Meta-analysis was performed by RevMan 5 software formulated by using the Cochrane library databases. Various heterogeneity of the research was inspected firstly. According to the results of the inspection a certain effect model was selected (including fixed effects model, the random effects model) to be utilized in merger analysis. In this study pregnant women with both thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin (TG-Ab) positive were defined as thyroid antibody positive pregnant women. Pregnant women with only TPO-Ab positive were defined as TPO-Ab positive pregnant women. Then the relationship of antibody positive and the risk of a preterm birth was analyzed respectively. (1) Ten cohort studies were enrolled, of which NOS scale score were 7 or higher. All the studies are of medium quality and above. A total of 1 322 cases of preterm birth occurred among 19 910 pregnant women. (2) Positive thyroid autoantibodies did not increase the risk of preterm birth in euthyroid pregnant women (OR=1.41, 95%CI: 0.83-2.40, P=0.200) or in pregnant women with hypothyroidism (OR=0.68, 95% CI: 0.32-1.44, P=0.310) . Positive TPO-Ab in euthyroid pregnant women increase the risk of preterm birth significantly (OR=2.08, 95%CI: 1.09-3.97, P=0.030), but positive TPO-Ab in pregnant women with hypothyroidism did not increase the risk of preterm birth significantly (OR=1.21, 95%CI: 0.65-2.24, P=0.550). Positive TPO-Ab is an independent risk factor of preterm birth in euthyroid pregnant women.

  11. [Violence towards pregnant women].

    PubMed

    Kramek, J; Grzymała-Krzyzostaniak, A; Celewicz, Z; Ronin-Walknowska, E

    2001-12-01

    The aim of this work was the evaluation of the scale of violence towards pregnant women in the westpomeranian province, the definition of the social-biological profile of women exposed to violence and social-biological profile of their partners. The evaluation of the influence of violence on pregnant women's ending term and the weight of the newborns. 481 women were enrolled and an anonymous study was used in the form of questionnaires. A questionnaire was a modified form of a query-sheet proposed by WHO. 25% of the enrolled women were exposed to physical and psychological (emotional) abuse, 7.1% to psychical violence, women and men exposed to violence in their childhood more often become violent in their adult life. Men that physically abuse pregnant women are often of primary school education, are unemployed, drink alcohol and smoke. Physical abuse by a partner during pregnancy usually experience women with primary school education, who drink and smoke. Violence during pregnancy is usually associated with premature delivery as well as low birth weight of the newborns.

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

    PubMed

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

    2015-03-01

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

  13. 42 CFR 435.116 - Pregnant women.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Pregnant women. 435.116 Section 435.116 Public..., AND AMERICAN SAMOA Mandatory Coverage Mandatory Coverage of Pregnant Women, Children Under 19, and Newborn Children § 435.116 Pregnant women. (a) Basis. This section implements sections 1902(a)(10)(A)(i...

  14. 42 CFR 435.116 - Pregnant women.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Pregnant women. 435.116 Section 435.116 Public..., AND AMERICAN SAMOA Mandatory Coverage Mandatory Coverage of Pregnant Women, Children Under 19, and Newborn Children § 435.116 Pregnant women. (a) Basis. This section implements sections 1902(a)(10)(A)(i...

  15. HIV shedding in cervico-vaginal secretions in pregnant women.

    PubMed

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

    2011-07-01

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

  16. Asymptomatic plasmodial infection in Colombian pregnant women.

    PubMed

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

    2017-08-01

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

  17. Dietary Predictors of Urinary Cadmium among Pregnant Women and Childrena

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-08-01

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

  19. Nutritional status among women with pre-eclampsia and healthy pregnant and non-pregnant women in a Latin American country.

    PubMed

    Reyes, Laura; Garcia, Ronald; Ruiz, Silvia; Dehghan, Mahshid; López-Jaramillo, Patricio

    2012-03-01

    Pre-eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It has been proposed that, among other risk factors, the nutritional status of women can lead to the endothelial dysfunction that characterizes this entity. The aim of the present study was to compare the nutritional status of women with PE with healthy pregnant and non-pregnant women. A multicenter case-control study was carried out. Between September 2006 and July 2009, 201 women with PE were compared with 201 pregnant, and 201 non-pregnant aged-matched women without cardiovascular or endocrine diseases. A clinical history and physical examination was performed. Fasting blood samples were drawn to measure serum glucose and lipid profile. The nutritional status of participants was assessed using a food frequency questionnaire. The average age of women was 26.6 ± 7.2 years. Compared to healthy pregnant controls, women with PE had a higher body mass index, higher fasting blood glucose levels, higher triglycerides, and lower high-density lipoprotein cholesterol levels. Women with PE had a higher intake of carbohydrates, energy intake and cereal compared to healthy pregnant and non-pregnant controls. A conditional logistic regression demonstrated that carbohydrate and sodium intake are associated with PE development. Diets of women with PE were characterized by higher energy and carbohydrate intake compared to normal pregnant and non-pregnant women. This suggests that higher carbohydrate and sodium intake increases the risk of PE among women in Colombia. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

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

    PubMed

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

    2018-01-29

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

  1. Variation in microbiologic profiles among pregnant women with bacterial vaginosis.

    PubMed

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

    2005-09-01

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

  2. [Prevalence of congenital and perinatal infection in HIV positive pregnant in Belo Horizonte metropolitan region].

    PubMed

    Maia, Marcelle Marie Martins; Lage, Eura Martins; Moreira, Bárbara Cecília Borges; Deus, Elayne Alayne Braga de; Faria, Joanna Gonçalves; Pinto, Jorge Andrade; Melo, Victor Hugo

    2015-09-01

    To evaluate the prevalence of toxoplasmosis, rubella, cytomegalovirus, hepatitis B&C and syphilis (Torchs) in a cohort pregnant women and to identify the sociodemographic, clinical and laboratory factors. A total of 1,573 HIV-infected pregnant women from a Brazilian metropolitan region were studied between 1998 and 2013. The results of serological tests were available for 704 (44.8%) pregnant women. Pregnant women were considered to be Torchs positive (Gtp) when they had positive results for at least one of these infections, and to be Torchs negative (Gtn) when they had negative results for all of them. Maternal covariables were: age, marital status, educational level, time and mode of infection, CD4 lymphocyte count, viral load at delivery, and use of antiretroviral therapy (ARV). Neonatal covariables were: HIV infection, prematurity, low birth weight, neonatal complications, abortion and neonatal death. Odds ratios with 95% confidence interval were used to quantify the association between maternal and neonatal variables and the presence of Torchs. Among 704 pregnant women, 70 (9.9%; 95%CI 7.8-12.4) had positive serological tests for any Torchs factor. The individual prevalence rates were: 1.5% (10/685) for toxoplasmosis; 1.3% (8/618) for rubella; 1.3% (8/597) for cytomegalovirus; 0.9% (6/653) for hepatitis B and 3.7% (20/545) for hepatitis C; and 3.8% (25/664) for syphilis. The HIV Vertical HIV transmission was 4.6% among Gtp pregnant women and 1.2% among Gtn women. Antiretroviral therapy (ARV), vertical transmission, low birth weight and neonatal complications were significantly associated with Torchs positivity in univariate analysis. The Torchs prevalence found in the study was high for some infections. These findings emphasize the need to promote serological Torchs screening for all pregnant women, especially HIV-infected women, so that an early diagnosis can be made and treatment interventions can be implemented to prevent vertical HIV transmission.

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

    PubMed

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

    2017-09-11

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

  4. Schistosomiasis among pregnant women in rural communities in Nigeria.

    PubMed

    Salawu, Oyetunde T; Odaibo, Alexander B

    2013-07-01

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

  5. Implementation and Operational Research: Integration of PMTCT and Antenatal Services Improves Combination Antiretroviral Therapy Uptake for HIV-Positive Pregnant Women in Southern Zambia: A Prototype for Option B+?

    PubMed

    Herlihy, Julie M; Hamomba, Leoda; Bonawitz, Rachael; Goggin, Caitlin E; Sambambi, Kennedy; Mwale, Jonas; Musonda, Victor; Musokatwane, Kebby; Hopkins, Kathryn L; Semrau, Katherine; Hammond, Emily E; Duncan, Julie; Knapp, Anna B; Thea, Donald M

    2015-12-01

    Early initiation of combination antiretroviral therapy (cART) for HIV-positive pregnant women can decrease vertical transmission to less than 5%. Programmatic barriers to early cART include decentralized care, disease-stage assessment delays, and loss to follow-up. Our intervention had 3 components: integrated HIV and antenatal services in 1 location with 1 provider, laboratory courier to expedite CD4 counts, and community-based follow-up of women-infant pairs to improve prevention of mother-to-child transmission attendance. Preintervention HIV-positive pregnant women were referred to HIV clinics for disease-stage assessment and cART initiation for advanced disease (CD4 count <350 cells/μL or WHO stage >2). We used a quasi-experimental design with preintervention/postintervention evaluations at 6 government antenatal clinics (ANCs) in Southern Province, Zambia. Retrospective clinical data were collected from clinic registers during a 7-month baseline period. Postintervention data were collected from all antiretroviral therapy-naive, HIV-positive pregnant women and their infants presenting to ANC from December 2011 to June 2013. Data from 510 baseline women-infant pairs were analyzed and 624 pregnant women were enrolled during the intervention period. The proportion of HIV-positive pregnant women receiving CD4 counts increased from 50.6% to 77.2% [relative risk (RR) = 1.81; 95% confidence interval (CI): 1.57 to 2.08; P < 0.01]. The proportion of cART-eligible pregnant women initiated on cART increased from 27.5% to 71.5% (RR = 2.25; 95% CI: 1.78 to 2.83; P < 0.01). The proportion of eligible HIV-exposed infants with documented 6-week HIV PCR test increased from 41.9% to 55.8% (RR = 1.33; 95% CI: 1.18 to 1.51; P < 0.01). Integration of HIV care into ANC and community-based support improved uptake of CD4 counts, proportion of cART-eligible women initiated on cART, and infants tested.

  6. A new threat to pregnant women's autonomy.

    PubMed

    Johnsen, D

    1987-01-01

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

  7. [Molecular tests in diagnosis of Cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV) using real-time PCR in HIV positive and HIV-negative pregnant women in Ouagadougou, Burkina Faso].

    PubMed

    Ouedraogo, Alice Rogomenoma; Kabre, Madeleine; Bisseye, Cyrille; Zohoncon, Théodora Mahoukèdè; Asshi, Maleki; Soubeiga, Serge Théophile; Diarra, Birama; Traore, Lassina; Djigma, Florencia Wendkuuni; Ouermi, Djénéba; Pietra, Virginio; Barro, Nicolas; Simpore, Jacques

    2016-01-01

    Herpesvirus EBV, CMV and HHV-6 are viruses that evolve based on pandemic modeling and are responsible for congenital infections causing severe sequelae in infants. This study aims to determine the prevalence of CMV, EBV and HHV-6 among HIV (+) and HIV (-) pregnant women in Ouagadougou. In this study 200 blood plasma samples taken from pregnant women, of whom 100 with HIV(+) and 100 with HIV(-), were analyzed using multiplex real-time PCR which detected three infections (EBV, CMV and HHV-6). Out of the 200 samples tested, 18(9.0%) were positive for at least one of the three viruses, 12(6.0%) were positive for EBV, 13(6.5%) were positive for CMV and 12(6.0%) were positive for HHV-6. Among the 18 cases with infections, 10 cases (55.6%) had co-infections of whom 90.0% (9/10) with multiple EBV/CMV/HHV6 infection and 10.0% with EBV/HHV6 co-infection. HHVs infection rate was higher among HIV (-) pregnant women than among HIV (+) pregnant women (12.0% versus 6.0%). Among HIV (+) pregnant women, PCR showed 7.1% (6/85) of HHVs infection in patients who were not treated with ARV against 0% in those treated with ARVs. Herpes virus infections are a common condition in pregnant women in Burkina Faso. They may represent a real threat to pregnant women because of complications and risks of infection in infants.

  8. Seroprevalence of hepatitis B virus serological markers among pregnant Nigerian women

    PubMed Central

    Aba, Henrietta Oneh; Aminu, Maryam

    2016-01-01

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

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

    PubMed

    Tophøj, A; Mortensen, J T

    1999-09-06

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

  10. Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age.

    PubMed

    Snijdewind, Ingrid J M; Smit, Colette; Godfried, Mieke H; Bakker, Rachel; Nellen, Jeannine F J B; Jaddoe, Vincent W V; van Leeuwen, Elisabeth; Reiss, Peter; Steegers, Eric A P; van der Ende, Marchina E

    2018-01-01

    The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight <10th percentile for gestational age), low birth weight and preterm delivery. A total of 1392 children born to 1022 mothers were included. Of these, 331 (23.8%) children were SGA. Women starting cART before conception had an increased risk of having a SGA infant compared to women starting cART after conception (OR 1.35, 95% CI 1.03-1.77, p = 0.03). The risk for SGA was highest in women who started a protease inhibitor-(PI) based regimen prior to pregnancy, compared with women who initiated PI-based cART during pregnancy. While the association of preterm delivery and preconception cART was significant in univariate analysis, on multivariate analysis only a non-significant trend was observed (OR 1.39, 95% CI 0.94-1.92, p = 0.06) in women who had started cART before compared to after conception. In multivariate analysis, the risk of low birth weight (OR 1.34, 95% CI 0.94-1.92, p = 0.11) was not significantly increased in women who had started cART prior to conception compared to after conception. In our cohort of pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction resulting in SGA. Data showed a non-significant trend in the risk

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

    PubMed

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

    2014-04-15

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

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

    PubMed

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

    2018-05-18

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

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

    PubMed Central

    2014-01-01

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

  14. Research with pregnant women: a call to action.

    PubMed

    Little, Margaret Olivia; Wickremsinhe, Marisha N

    2017-12-14

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

  15. Pregnant Enlisted Women in Navy Work Centers

    DTIC Science & Technology

    1991-03-01

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

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

    PubMed

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

    2013-05-01

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

  17. Vaccination knowledge and acceptability among pregnant women in Italy.

    PubMed

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

    2018-06-04

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

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

    PubMed

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

    2018-05-01

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

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

    PubMed

    Franklin, T L; Monif, G R

    2000-02-01

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

  20. Regional and ethnic aspects of viral hepatitis B among pregnant women.

    PubMed

    Kristian, Pavol; Veselská, Zuzana Dankulincová; Paralicová, Zuzana; Jarcuska, Peter; Virág, Ladislav; Valková, Ivana; Schréter, Ivan

    2013-03-01

    The aim of this study was to determine the prevalence of HBV infection among pregnant women in districts of Eastern Slovakia with a diverse prevalence of Roma population. Overall 59,279 serum samples from 9 regional departments of clinical microbiology from Eastern Slovakia were collected in the period from January 2008 till December 2009 and analysed. The number of HBsAg positive samples overall and during pregnancy was 1.74% and 2.12%, respectively. Comparing districts with higher (> 5%) and lower (< 5%) Roma population, there was no significant difference in the prevalence of HBsAg positive samples overall (1.95% vs.1.62%). However, in the subgroup of pregnant women the prevalence of HBsAg positive samples (2.72% vs. 0.95%) differs significantly (p < 0.01). The prevalence of HBV infection among pregnant women in Eastern Slovakia did not rapidly exceed the estimated nationwide prevalence. However, in districts with higher Roma population the expected higher prevalence of HBV infection was confirmed. This indicates the need to pay special attention to the prevention of hepatitis B in these districts.

  1. Increased risks of preterm birth and a low-birth-weight baby in Thai human immunodeficiency virus-positive pregnant women with periodontitis.

    PubMed

    Pattrapornnan, Pakkaporn; DeRouen, Timothy A; Songpaisan, Yupin

    2012-11-01

    Many studies have investigated the risks of adverse neonatal outcomes associated with the presence of periodontitis in non-human immunodeficiency virus (HIV)-infected pregnant women. To the best of our knowledge, there has been no study to investigate the risk of neonatal outcomes associated with periodontitis in HIV-infected pregnant women. The aim of this study is to measure the risk of having adverse neonatal outcomes: preterm delivery (<37 weeks of gestation), low birth weight (<2500 g at birth), and preterm and low-birth-weight baby (<37 weeks of gestation and <2500 g at birth) associated with the presence of periodontitis in HIV-infected women. A total of 292 HIV-infected pregnant women were interviewed for demographic information and medical history and were examined for their periodontal status during weeks 16 to 34 of gestation. Follow-up sessions were done after the delivery to record the baby's data. Periodontitis defined by various criteria were evaluated as exposures. Binomial regression (generalized linear model) was used to examine the risk ratios (RRs). Logistic regression, t tests, and χ2 test were used to examine the associations of periodontitis with adverse neonatal outcomes. Forty women had preterm delivery, 39 women delivered a low-birth-weight baby, and 22 women gave birth to a baby that was preterm and low birth weight. We found significant elevated risks of having preterm delivery as RR = 3.08, 95% confidence interval (CI) = 1.29 to 7.38, low birth weight RR = 2.55, 95% CI = 1.04 to 2.65, and preterm and low birth weight as RR = 4.08, 95% CI = 1.55 to 10.76 in women who had at ≥1 5-mm periodontal pocket. This study found a positive risk of adverse neonatal outcomes in HIV-infected pregnant women who had moderate periodontitis.

  2. Subtle differences in selective pressures applied on the envelope gene of HIV-1 in pregnant versus non-pregnant women.

    PubMed

    Ransy, Doris G; Lord, Etienne; Caty, Martine; Lapointe, Normand; Boucher, Marc; Diallo, Abdoulaye Baniré; Soudeyns, Hugo

    2018-04-17

    Pregnancy is associated with modulations of maternal immunity that contribute to foeto-maternal tolerance. To understand whether and how these alterations impact antiviral immunity, a detailed cross-sectional analysis of selective pressures exerted on HIV-1 envelope amino-acid sequences was performed in a group of pregnant (n = 32) and non-pregnant (n = 44) HIV-infected women in absence of treatment with antiretroviral therapy (ART). Independent of HIV-1 subtype, p-distance, dN and dS were all strongly correlated with one another but were not significantly different in pregnant as compared to non-pregnant patients. Differential levels of selective pressure applied on different Env subdomains displayed similar yet non-identical patterns between the two groups, with pressure applied on C1 being significantly lower in constant regions C1 and C2 than in V1, V2, V3 and C3. To draw a general picture of the selection applied on the envelope and compensate for inter-individual variations, we performed a binomial test on selection frequency data pooled from pregnant and non-pregnant women. This analysis uncovered 42 positions, present in both groups, exhibiting statistically-significant frequency of selection that invariably mapped to the surface of the Env protein, with the great majority located within epitopes recognized by Env-specific antibodies or sites associated with the development of cross-reactive neutralizing activity. The median frequency of occurrence of positive selection per site was significantly lower in pregnant versus non-pregnant women. Furthermore, examination of the distribution of positively selected sites using a hypergeometric test revealed that only 2 positions (D137 and S142) significantly differed between the 2 groups. Taken together, these result indicate that pregnancy is associated with subtle yet distinctive changes in selective pressures exerted on the HIV-1 Env protein that are compatible with transient modulations of maternal

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

    PubMed

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

    2015-07-01

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

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

    PubMed

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

    2013-12-01

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

  5. Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age

    PubMed Central

    Smit, Colette; Godfried, Mieke H.; Bakker, Rachel; Nellen, Jeannine F. J. B.; Jaddoe, Vincent W. V.; van Leeuwen, Elisabeth; Reiss, Peter; Steegers, Eric A. P.; van der Ende, Marchina E.

    2018-01-01

    Background The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. Materials and methods We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight <10th percentile for gestational age), low birth weight and preterm delivery. Results A total of 1392 children born to 1022 mothers were included. Of these, 331 (23.8%) children were SGA. Women starting cART before conception had an increased risk of having a SGA infant compared to women starting cART after conception (OR 1.35, 95% CI 1.03−1.77, p = 0.03). The risk for SGA was highest in women who started a protease inhibitor-(PI) based regimen prior to pregnancy, compared with women who initiated PI-based cART during pregnancy. While the association of preterm delivery and preconception cART was significant in univariate analysis, on multivariate analysis only a non-significant trend was observed (OR 1.39, 95% CI 0.94−1.92, p = 0.06) in women who had started cART before compared to after conception. In multivariate analysis, the risk of low birth weight (OR 1.34, 95% CI 0.94−1.92, p = 0.11) was not significantly increased in women who had started cART prior to conception compared to after conception. Conclusion In our cohort of pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction

  6. Primary Cytomegalovirus Infection in Pregnant Egyptian Women Confirmed by Cytomegalovirus IgG Avidity Testing

    PubMed Central

    Kamel, N.; Metwally, L.; Gomaa, N.; Sayed Ahmed, W.A.; Lotfi, M.; Younis, S.

    2013-01-01

    Objective To determine the frequency of primary cytomegalovirus (CMV) infection in pregnant Egyptian women using CMV IgG avidity testing. Subjects and Methods A cross-sectional study was conducted at Suez Canal University Hospital, Ismailia, Egypt. A total of 546 pregnant women, presenting for routine antenatal screening, were tested for CMV IgG and IgM using a commercially available enzyme-linked immunosorbent assay (ELISA). Sera from CMV IgM-positive women were tested by CMV IgG avidity assay. Results All the 546 pregnant women were seropositive for anti-CMV IgG. Of the 546 women, 40 (7.3%) were positive or equivocal for IgM antibodies. All sera from the 40 women (IgG+/IgM+) showed a high or intermediate CMV IgG avidity index. Of the 40 women, 23 (57.5%) were in the second or third trimesters of pregnancy and had their first-trimester blood retrieved, and the tested CMV IgG avidity assay showed a high avidity index. Conclusion Women who were IgM positive had no primary CMV infection in the index pregnancy as evidenced by the high CMV IgG avidity testing. PMID:24052007

  7. Primary cytomegalovirus infection in pregnant Egyptian women confirmed by cytomegalovirus IgG avidity testing.

    PubMed

    Kamel, N; Metwally, L; Gomaa, N; Sayed Ahmed, W A; Lotfi, M; Younis, S

    2014-01-01

    To determine the frequency of primary cytomegalovirus (CMV) infection in pregnant Egyptian women using CMV IgG avidity testing. A cross-sectional study was conducted at Suez Canal University Hospital, Ismailia, Egypt. A total of 546 pregnant women, presenting for routine antenatal screening, were tested for CMV IgG and IgM using a commercially available enzyme-linked immunosorbent assay (ELISA). Sera from CMV IgM-positive women were tested by CMV IgG avidity assay. All the 546 pregnant women were seropositive for anti-CMV IgG. Of the 546 women, 40 (7.3%) were positive or equivocal for IgM antibodies. All sera from the 40 women (IgG+/IgM+) showed a high or intermediate CMV IgG avidity index. Of the 40 women, 23 (57.5%) were in the second or third trimesters of pregnancy and had their first-trimester blood retrieved, and the tested CMV IgG avidity assay showed a high avidity index. Women who were IgM positive had no primary CMV infection in the index pregnancy as evidenced by the high CMV IgG avidity testing. © 2013 S. Karger AG, Basel.

  8. Rubella Seroprevalence and real-time PCR detection of RUBV among Congolese pregnant women.

    PubMed

    Zanga, Josue; Mbanzulu, Makola Kennedy; Kabasele, Arnold-Freddy; Ngatu, Nlandu Roger; Wumba, Dimosi Roger

    2017-04-05

    Rubella is an acute infectious disease caused by Rubella virus (RUBV). RUBV remains an important pathogen worldwide, causing approximately 100 000 cases of congenital rubella syndrome (CRS) every year; and the most severe consequence of rubella is teratogenicity. The aim of this study was to estimate the prevalence of RUBV IgG antibodies and determine RUBV genotypes in Congolese pregnant women in Kongo central province, Democratic Republic of Congo (DRC). This was a prospective cross-sectional study that consisted of a laboratory analysis of blood samples from 78 pregnant women to check for the presence of RUBV IgG antibodies, and also determine RUBV genotypes in seropositive samples (using primers targeting RUBV nucleoprotein), with the use of serological and molecular methods, respectively. Participants were pregnant women attending antenatal care clinics (ANC) at two health zones of Kisantu town in DRC. They were followed-up from the first to third trimester. Those who were negative for RUBV antibodies at the initial assay (first trimester) were tested in the second and, eventually, the third trimester. An overall rubella seroprevalence of 58.97% was observed, whereas RUBV nucleoprotein was detected in 60% of randomly selected 30 blood samples among the 46 RUBV seropositive pregnant women. Five (27.77%) of positive samples were positive for both RUBV genotypes (RV8633/9112 and RV8945/9577), whereas 11 (61.11%) of them were positive for RV8633/9112 and two (11.11%) were positive for RV8945/9577 only. Regarding rubella clinical signs and complications, two subjects (2.56%) presented with fever, whereas five pregnant women (6.41%) had experienced abortion. None (0%) of the participants has been vaccinated against RUBV. Findings from this study suggest that RUBV is prevalent in Congolese pregnant women. Further research is required to elucidate the molecular epidemiology of RUBV in order to design a rational rubella surveillance and control program in DRC.

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

    PubMed

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

    2010-02-01

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

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

    PubMed

    McCabe, Jennifer E; Arndt, Stephan

    2012-11-01

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

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

    PubMed

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

    2017-09-01

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

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

    PubMed

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

    2014-01-01

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

  13. Hepatitis B virus serosurvey and awareness of mother-to-child transmission among pregnant women in Shenyang, China: An observational study.

    PubMed

    Sheng, Qiu-Ju; Wang, Sui-Jing; Wu, Yu-Yu; Dou, Xiao-Guang; Ding, Yang

    2018-06-01

    Preventing hepatitis B virus (HBV) mother-to-child transmission (MTCT) is the key to controlling the prevalence of chronic HBV infection. Adequate awareness of hepatitis B in hepatitis B s antigen (HBsAg) positive pregnant women may be helpful to reduce HBV MTCT.The aim of this study was to explore HBV seroprevalence among pregnant women and investigate the level of hepatitis B awareness among HBsAg positive pregnant women.HBV serum biomarkers were tested among pregnant women visiting Shengjing Hospital of China Medical University. HBsAg-positive pregnant women received a HBV DNA test and completed a questionnaire. The different HBV DNA loads were interpreted as follows: 20 to  < 2 × 10 IU/mL was low viral load, 2 × 10 to  < 2 × 10 IU/mL was intermediate viral load and ≥2 × 10 IU/mL was high viral load. The pregnant women with high viral load were treated with telbivudine (LdT). HBV DNA at different times was tested. The rate of HBV MTCT was confirmed at 28 weeks postpartum.HBsAg prevalence among pregnant women was 3.1% (441/14314). There was significant difference in comparing HBsAg prevalence in different age groups (χ = 13.86, P < .01). Among 441 HBsAg-positive pregnant women, 151 (34.2%) were hepatitis B e antigen (HBeAg) positive and 112 (25.4%) had high viral load. After 4 weeks of treatment, the average HBV DNA load of 66 cases with high viral load was (5.0 ± 0.8) log10 IU/mL. The average HBV DNA load at 4 weeks postpartum rebounded to (7.9 ± 1.0) log10 IU/mL, which was not significantly different from that at baseline (t = 1.23, P = .22). At 28 weeks postpartum, the rate of HBV MTCT in the treatment group was significantly lower than that in the observation group (0% vs 12.2%; P = .02). Only 23.4% of pregnant women knew their HBV status before gestation and 17.7% of pregnant women knew the HBV status before delivery. However, only 21.3% of pregnant women realized to need antiviral

  14. Pharmacokinetics of Doxorubicin in Pregnant Women

    PubMed Central

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

    2014-01-01

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

  15. Association of spiritual/religious coping with depressive symptoms in high- and low-risk pregnant women.

    PubMed

    Vitorino, Luciano M; Chiaradia, Raíssa; Low, Gail; Cruz, Jonas Preposi; Pargament, Kenneth I; Lucchetti, Alessandra L G; Lucchetti, Giancarlo

    2018-02-01

    To investigate the role of spiritual/religious coping (SRC) on depressive symptoms in high- and low-risk pregnant women. Spiritual/religious coping is associated with physical and mental health outcomes. However, only few studies investigated the role of these strategies during pregnancy and whether low- and high-risk pregnant women have different coping mechanisms. This study is a cross-sectional comparative study. This study included a total of 160 pregnant women, 80 with low-risk pregnancy and 80 with high-risk pregnancy. The Beck Depression Inventory, the brief SRC scale and a structured questionnaire on sociodemographic and obstetric aspects were used. General linear model regression analysis was used to identify the factors associated with positive and negative SRC strategies in both groups of pregnant women. Positive SRC use was high, whereas negative SRC use was low in both groups. Although we found no difference in SRC strategies between the two groups, negative SRC was associated with depression in women with high-risk pregnancy, but not in those with low-risk pregnancy. Furthermore, positive SRC was not associated with depressive symptoms in both groups. Results showed that only the negative SRC strategies of Brazilian women with high-risk pregnancies were associated with worsened mental health outcomes. Healthcare professionals, obstetricians and nurse midwives should focus on the use of negative SRC strategies in their pregnant patients. © 2017 John Wiley & Sons Ltd.

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

    PubMed

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

    2014-12-12

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

  17. Seroprevalence of parvovirus B19 IgG and IgM antibodies among pregnant women in Oyo State, Nigeria.

    PubMed

    Abiodun, Iyanda; Opaleye, Oluyinka Oladele; Ojurongbe, Olusola; Fagbami, Ademola Hezekiah

    2013-12-15

    Human parvovirus B19 causes a wide range of complications in pregnant women including abortion, severe fetal anemia, non-immune hydrops fetalis, and even intrauterine fetal death. However, there is a dearth of information on the prevalence of the virus among pregnant women in southwestern Nigeria. Blood samples were collected from 231 pregnant women and screened for antibodies to human parvovirus B19 IgM and IgG using an enzyme immunosorbent assay kits. Of the 231 women, 31 were in their first trimester, 146 were in their second trimester, and 54 were in their third trimester. Forty-five (20%) were positive for parvovirus B19 IgG antibodies, 10 (4%) were positive for parvovirus B19 IgM antibodies, and 176 (76%) had no detectable parvovirus B19 antibodies. Twenty-eight (19%) of the 146 pregnant women in their second trimester were positive for parvovirus B19 IgG antibody while three (2%) of the 146 were positive for parvovirus B19 IgM antibody. It is evident that there is a high prevalence of human parvovirus B19 among pregnant women in south-western Nigeria. This suggests that there is an active transmission of the virus in the community; it is therefore necessary to conduct more studies on the virus in pregnant women in Nigeria to ascertain its effect on the fetus.

  18. Online Medicine for Pregnant Women

    PubMed Central

    Davidesko, Sharon; Segal, David

    2014-01-01

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

  19. Online medicine for pregnant women.

    PubMed

    Davidesko, Sharon; Segal, David; Peleg, Roni

    2014-01-01

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

  20. Urinary Tract Infections among HIV-Positive Pregnant Women in Mwanza City, Tanzania, Are High and Predicted by Low CD4+ Count

    PubMed Central

    Chaula, Tito; Ng'walida, Nhandi; Kajura, Alphaxaid; Mirambo, Mariam M.; DeVinney, Rebekah

    2017-01-01

    Introduction. Urinary tract infection (UTI) among pregnant women can lead to adverse maternal and foetal outcomes. UTI has been widely studied in the general obstetric population in Tanzania; the present study evaluated the magnitude, antimicrobial resistance, and predictors of UTI among HIV-positive pregnant women. Methods. Between March and May 2016 midstream urine samples from 234 women attending prevention of mother to child transmission of HIV (PMTCT) clinics were analyzed using standard methods. Data was analyzed by STATA version 11.0. Results. The prevalence of UTI was 21.4%, 50/234 [95% CI: 16.1–26.6]. The asymptomatically significant bacteriuria was higher than symptomatically significant bacteriuria (16.6% versus 4.7%, p < 0.001). On multivariable logistic regression analysis, single marital status (OR: 2.6, 95% CI: 1.1–6.1, and p = 0.026), low CD4+ counts of <200/μL (OR: 2.9, 95% CI: 1.1–7.7, and p = 0.031), and having UTI symptoms (OR: 2.5, 95% CI: 1.1–6.0, and p = 0.03) were independent predictors of UTI. Escherichia coli predominated (57.7%) and exhibited a low prevalence of resistance to nitrofurantoin (16.7%), gentamicin (10.0%), and ceftriaxone (13.3%). Four (13.3%) of these were extended-spectrum beta-lactamase producers. Conclusions. A considerable proportion of HIV-positive pregnant women in Mwanza have significant bacteriuria which calls for the need to introduce routine UTI screening at PMTCT clinics to guide specific treatment and prevent associated complications. PMID:28255302

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

    PubMed

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

    2018-07-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2012-07-01

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

  4. Plasminogen activator activity in tears of pregnant women.

    PubMed

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

    2017-01-01

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

  5. Breastfeeding knowledge among working pregnant women in Turkey.

    PubMed

    Karanci, Gülsah; Yenal, Kerziban

    2014-04-01

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

  6. Evaluation of thyroid dysfunction in pregnant women with gestational and pre-gestational diabetes.

    PubMed

    Shahbazian, Hajieh; Shahbazian, Nahid; Rahimi Baniani, Mahnaz; Yazdanpanah, Leila; Latifi, Seyed Mahmuod

    2013-04-01

    The aim of this study was to investigate thyroid function tests in Gestational Diabetes Mellitus (GDM) and pre-gestational DM and control group. Methodology : There were 61 pregnant diabetic women in study group and 35 pregnant women in control group. Serum T4, T3, T3RU, FTI, TSH and Anti TPO Ab were assessed in each person. Results : About 36% of patients had GDM and 64% pre-gestational DM. Thyroid dysfunction was detected in 18% of study group compared with 8.6% of control group (P = 0.2). There was Thyroid dysfunction in 4.5% of GDM and 25.6% of pregestational DM (P = 0.045). There was no statistically significant difference between thyroid dysfunction in GDM group and control group (P=0.99).27% of GDM and 36% of pregestational DM and 23% of control group had positive titer of Anti TPO Ab without statistically significant differences among the three groups. Conclusion : Thyroid dysfunction is prevalent in women with pre-gestational DM so, thyroid function should be evaluated in these patients during pregnancy. Rate of thyroid dysfunction in GDM patients is similar to normal pregnant control women. High prevalence of positive titer of TPO Ab was seen in diabetic and non-diabetic pregnant women.

  7. Evaluation of thyroid dysfunction in pregnant women with gestational and pre-gestational diabetes

    PubMed Central

    Shahbazian, Hajieh; Shahbazian, Nahid; Rahimi Baniani, Mahnaz; Yazdanpanah, Leila; Latifi, Seyed Mahmuod

    2013-01-01

    Objective: The aim of this study was to investigate thyroid function tests in Gestational Diabetes Mellitus (GDM) and pre-gestational DM and control group. Methodology : There were 61 pregnant diabetic women in study group and 35 pregnant women in control group. Serum T4, T3, T3RU, FTI, TSH and Anti TPO Ab were assessed in each person. Results : About 36% of patients had GDM and 64% pre-gestational DM. Thyroid dysfunction was detected in 18% of study group compared with 8.6% of control group (P = 0.2). There was Thyroid dysfunction in 4.5% of GDM and 25.6% of pregestational DM (P = 0.045). There was no statistically significant difference between thyroid dysfunction in GDM group and control group (P=0.99).27% of GDM and 36% of pregestational DM and 23% of control group had positive titer of Anti TPO Ab without statistically significant differences among the three groups. Conclusion : Thyroid dysfunction is prevalent in women with pre-gestational DM so, thyroid function should be evaluated in these patients during pregnancy. Rate of thyroid dysfunction in GDM patients is similar to normal pregnant control women. High prevalence of positive titer of TPO Ab was seen in diabetic and non-diabetic pregnant women. PMID:24353594

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

    PubMed

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

    2016-03-15

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

  9. 45 CFR 46.204 - Research involving pregnant women or fetuses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  10. 45 CFR 46.204 - Research involving pregnant women or fetuses.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  11. 45 CFR 46.204 - Research involving pregnant women or fetuses.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  12. 45 CFR 46.204 - Research involving pregnant women or fetuses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  13. 45 CFR 46.204 - Research involving pregnant women or fetuses.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

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

    PubMed

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

    2010-01-01

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

  15. The pharmacokinetics of abacavir 600 mg once daily in HIV-1-positive pregnant women.

    PubMed

    Schalkwijk, Stein; Colbers, Angela; Konopnicki, Deborah; Weizsäcker, Katharina; Moltó, José; Tenorio, Carmen Hidalgo; Hawkins, David; Taylor, Graham; Wood, Chris; van der Ende, Marchina; Burger, David

    2016-05-15

    To describe the pharmacokinetics of abacavir 600 mg once daily (q.d.) in HIV-1-positive women during pregnancy and postpartum. A nonrandomized, open-label, multicentre, phase-IV study. HIV-positive pregnant women receiving abacavir 600 mg q.d. as part of clinical care were included. Intensive 24-h pharmacokinetic sampling was performed during the third trimester and at least 2 weeks after delivery. Pharmacokinetic parameters were calculated by noncompartmental analysis. Paired cord blood and maternal blood samples were taken at delivery when feasible. A total of 14 women were included in the analysis. Geometric mean ratios (90% confidence intervals) of third trimester versus postpartum were 1.05 (0.92-1.19) for AUC0-24h and 1.00 (0.83-1.21) for Cmax. The median (range) ratio of abacavir cord plasma to maternal plasma was 1.0 (0.7-1.0, n = 3). Viral load at the third trimester visit was less than 50 copies/ml in 13 participants (93%; one unknown). In total, 13 (93%; one unknown) children were tested HIV-negative. The pharmacokinetics of abacavir 600 mg q.d. during pregnancy are equivalent to postpartum. No dose adjustments are required during pregnancy and similar antiviral activity is expected.

  16. Environmental odor intolerance in pregnant women.

    PubMed

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

    2005-02-15

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

  17. Kurdish pregnant women's feelings: a qualitative study.

    PubMed

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

    2011-04-01

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

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

    PubMed

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

    2015-05-01

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

  19. Asymptomatic group B streptococcal bacteriuria among pregnant women in Saudi Arabia.

    PubMed

    Ahmad, S

    2015-01-01

    This study aims to determine the asymptomatic bacteriuria in pregnancy due to GBS and its antimicrobial sensitivity pattern for planning strategy for the management of these cases and also to determine the relationship between asymptomatic bacteriuria and pyuria. A total of 3863 consecutive urine specimens were collected from 3863 pregnant women with asymptomatic bacteriuria attending the obstetrics and gynaecology department of our hospital over a period of two years. Specimens were processed using standard microbiological procedures. All the subjects were evaluated for bacteriuria. The prevalence of asymptomatic bacteriuria due to group B streptococci (GBS) was 82/3863 (2.1%) among pregnant women in Saudi Arabia. Among these, 69/82 patients (84.2%) had clinical and microbiological features consistent with cystitis, versus 13/82 (15.8%) for pyelonephritis. About 51.2% (42/82) of the patients who had urine analysis performed had positive results based on positive urinary leucocyte esterase and pyuria. Disc-diffusion analysis of all 82 GBS isolates showed that they were highly susceptible to Augmentin and linezolid. Screening for bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women. Further, ongoing surveillance and evaluation of outcomes in pregnancies complicated by GBS bacteriuria is required to optimise maternal and newborn care.

  20. [Integrated screening for HIV, syphilis, and toxoplasmosis among pregnant women in the Central African Republic].

    PubMed

    Gamba, E P; Nambei, W S; Kamandji, L

    2013-01-01

    The aim of this study was to determine the prevalence of syphilis and toxoplasmosis infection in pregnant women in the Central African Republic who were and were not HIV-infected, in the framework of HIV surveillance. This case-control study included 270 HIV(+) and 217 HIV(-) pregnant women among 4 750 women who attended prenatal-care clinics throughout the Central African Republic from November 2011 through January 2012. Blood specimens were collected and serological evidence of HIV1/2 was analyzed by ELISA1 and ELISA2. The Toxoplasma gondii antibody was detected with the Toxo-Hai Fumouze(®) diagnostic kit. A VDRL test was performed to screen for syphilis in all study participants. Of the 434 samples tested, 33 (7.60%) were positive for syphilis: 21 (9.7%) among HIV(+) and 12 (5.5%) among HIV(-) women (p = 0.1031); 221 (50.90%) were positive for toxoplasmosis: 117 (53.9%) among HIV(+) and 104 (47.9%) among HIV(-) women (p = 0, 2119). Coinfection with HIV, syphilis, and toxoplasmosis was found in 6.00%. No association was found between coinfection and age, parity, and residence area. The rate of syphilis infection was very high in pregnant women living in rural areas (ORcrude = 4.37; 95% CI = 2,11, 9.05). This study showed a high prevalence of toxoplasmosis and syphilis in pregnant women in the Central African Republic, regardless of their HIV infection status. Sexually transmitted infections (STIs) are common in pregnant women living in rural areas. It may be appropriate to include routine serological screening tests to determine of toxoplasmosis, syphilis and HIV in pregnant women in this country.

  1. Rubella seroprevalence among pregnant women in Beijing, China.

    PubMed

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

    2018-03-15

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

  2. Prevalence of HIV in pregnant women identified with a risk factor at a tertiary care hospital.

    PubMed

    Mahmud, Ghazala; Abbas, Shazra

    2009-01-01

    HIV is an epidemic quite unlike any other, combining the problems of a lifelong medical disease with immense social, psychological, economic and public health consequences. Since we are living in a global village where human interactions has become fast and frequent, diseases like HIV are no more alien to us. HIV/AIDS in Pakistan is slowly gaining recognition as a public health issue of great importance. Objectives of this study were to determine the prevalence of HIV in pregnant women identified with a high risk factor/behaviour at a tertiary care hospital. It is a Descriptive study. All pregnant women attending antenatal booking clinic were assessed via a pre-designed 'Risk assessment questionnaire'. Women identified with a risk factor were offered HIV Rapid screening test (Capillus HIV1/2). Positive (reactive) results on screening test were confirmed with ELISA. During the study period (March 2007-May 2008), out of 5263 antenatal bookings 785 (14%) women were identified with a risk factor. HIV screening test was done in 779 (99%), and 6 women refused testing. Three women (0.3%) were found positive (reactive) on screening. Two out of 3 women were confirmed positive (0.2%) on ELISA. Husbands of both women were tested and one found positive (migrant from Dubai). Second women had history of blood transfusion. Her husband was HIV negative. During the study period, in addition to 2 pregnant women diagnosed as HIV positive through ANC risk screening, 6 confirmed HIV positive women, found pregnant were referred from 'HIV Treatment Centre', Pakistan Institute of Medical Sciences (PIMS) to Prevention of Parent to Child Transmission (PPTCT) centre for obstetric care. Spouses of 5 out of 6 had history of working abroad and extramarital sexual relationships. All positive (8) women were referred to PPTCT centre for further management. A simple 'Risk Assessment Questionnaire' can help us in identifying women who need HIV screening. Sexual transmission still remains the

  3. Evaluation of rubella screening in pregnant women

    PubMed Central

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

    1998-01-01

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

  4. Seroepidemiology of Toxoplasma gondii in pregnant women in Aguascalientes City, Mexico: a cross-sectional study.

    PubMed

    Alvarado-Esquivel, Cosme; Terrones-Saldívar, María Del Carmen; Hernández-Tinoco, Jesús; Muñoz-Terrones, María Daniela Enriqueta; Gallegos-González, Roberto Oswaldo; Sánchez-Anguiano, Luis Francisco; Reyes-Robles, Martha Elena; Jaramillo-Juárez, Fernando; Liesenfeld, Oliver; Estrada-Martínez, Sergio

    2016-07-01

    We determined the seroprevalence and correlates of Toxoplasma gondii infection in pregnant women in Aguascalientes City, Mexico. A cross-sectional survey. Pregnant women were enrolled in the central Mexican city of Aguascalientes. We studied 338 pregnant women who attended prenatal care in 3 public health centres. Women were examined for IgG/IgM antibodies to T. gondii by using commercially available enzyme immunoassays, and an avidity test. Multiple analyses were used to determine the association of T. gondii seropositivity with the characteristics of the pregnant women. Of the 338 pregnant women studied, 21 (6.2%) had IgG antibodies to T. gondii, and 1 (4.8%) of them was also positive for IgM antibodies to T. gondii. Avidity of IgG antibodies to T. gondii was high in the IgM-positive sample. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that T. gondii seropositivity was associated with white ethnicity (OR=149.4; 95% CI 10.8 to 2054.1; p<0.01), not washing hands before eating (OR=6.41; 95% CI 1.73 to 23.6; p=0.005) and use of latrine (OR=37.6; 95% CI 4.63 to 306.31; p=0.001). Results demonstrate that pregnant women in Aguascalientes City have a low seroprevalence of T. gondii infection. However, this low prevalence indicates that most pregnant women are at risk for a primary infection. Factors associated with T. gondii exposure found in this study, including food hygiene, may be useful to determine preventive measures against T. gondii infection and its sequelae. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Happiness and related factors in pregnant women.

    PubMed

    Jayasvasti, Kanthika; Kanchanatawan, Buranee

    2005-09-01

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

  6. Evaluation of sexual functions of the pregnant women.

    PubMed

    Tosun Güleroğlu, Funda; Gördeles Beşer, Nalan

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2016-01-01

    poorer. The current strategy for the management of TB among the HIV-positive pregnant women needs urgent review. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  9. Correlates of HIV stigma in HIV-positive women.

    PubMed

    Wagner, Anne C; Hart, Trevor A; Mohammed, Saira; Ivanova, Elena; Wong, Joanna; Loutfy, Mona R

    2010-06-01

    We examined the variables associated with HIV stigma in HIV-positive women currently living in Ontario, Canada. Based on previous literature, we predicted that variables of social marginalization (e.g., ethnicity, income, education), medical variables (e.g., higher CD4 count, lower viral load), and increased psychological distress would be associated with higher perceived HIV stigma among HIV-positive women. One hundred fifty-nine HIV-positive women between the ages of 18 and 52 in Ontario completed self-report measures of the aforementioned variables. Women were recruited through 28 AIDS service organizations, eight HIV clinics, and two community health centers. In multiple regression analyses, for women born in Canada, lower educational level and higher anxiety were associated with higher HIV stigma. For women born outside of Canada, having been judged by a physician in Canada for trying to become pregnant was associated with higher HIV stigma. For HIV-positive women born outside of Canada, negative judgment by a physician regarding intentions to become pregnant should be addressed to reduce perceived HIV stigma and vice versa. Health care providers should be trained in the provision of sensitive and effective health care for women living with HIV, especially when providing reproductive health care.

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

    PubMed

    Arch, Joanna J

    2014-01-01

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

  11. Knowledge, attitudes and intended behaviours towards HIV testing and self-protection: a survey of Omani pregnant women.

    PubMed

    Al-Jabri, A A; Youssef, R M; Hasson, S S; Balkhair, A A; Al-Belushi, M; Al-Saadoon, M; Mathew, M; Al-Mahroqi, S; Said, E; Koh, C Y; Idris, M A

    2014-10-20

    Routine HIV testing of all pregnant women in Oman has been introduced without prior knowledge of women's attitudes towards testing or their behaviour in the event of a positive test. This study recruited 1000 Omani pregnant women from antenatal clinics to explore their knowledge of HIV/AIDS, attitudes towards HIV testing and intended behaviours in the event of a positive test. Mother-to-child transmission was recognized by 86.6% of the women but only 21.0% knew that it was preventable and a few acknowledged the important role of antiviral drugs. Half of the women (51.9%) reported having been tested for HIV and 75.8% agreed about routine HIV testing for all pregnant women. A higher level of knowledge was significantly associated with a favourable intended behaviour related to voluntary testing, disclosure and seeking professional assistance in the event of a positive HIV test. The results are discussed in relation to opt-in and opt-out approaches to voluntary testing during pregnancy.

  12. Domestic Violence Among Pregnant Women.

    PubMed

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

    2018-01-01

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

  13. Vulvovaginal Candidiasis in Pregnant Women and its Importance for Candida Colonization of Newborns.

    PubMed

    Zisova, Liliya G; Chokoeva, Anastasia A; Amaliev, Georgi I; Petleshkova, Penka V; Miteva-Katrandzhieva, Tsonka М; Krasteva, Maya B; Uchikova, Ekaterina H; Kouzmanov, Andrei H; Ivanova, Zoya V

    2016-01-01

    Vulvovaginal candidiasis is the second most common cause of vaginitis worldwide (after bacterial candidiasis). Maternal vulvovaginal candidiasis is a major risk factor for Candida colonization and infection of the infant where prognosis depends on different predisposing factors. The aim of this study was to determine the incidence and the etiological structure of vulvovaginal candidiasis in pregnant women and its impact on Candida colonization of newborns. Samples of vaginal secretions from 80 healthy pregnant women who were clinically suspicious for Candida vaginitis were collected within 48 hours before delivery. Samples for probable Candida colonization from the oral mucosa and feces were collected from their newborns within 47-72 hours after birth. Samples were plated on Sabouraud agar, followed by species identification by API Candida yeast assay. Twenty-three (28.75 ± 5.06%) of the evaluated pregnant women were positive for Candida spp. Positive samples for Candida colonization were found in 18 (22.22 ± 4.62%) of the examined 81 newborns (one pair of twins) from mothers who were clinically suspicious for vaginal candidiasis. Isolates of the newborns were 100% identical to those of the mothers' vaginal secretion. Candida albicans was the predominant species identified in the pregnant women (91.67 ± 0.06%) and in the neonates (83.33±8.78%).

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

    PubMed

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

    2017-06-01

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

  15. Plasma Selenium Levels in First Trimester Pregnant Women with Hyperthyroidism and the Relationship with Thyroid Hormone Status.

    PubMed

    Arikan, Tugba Atilan

    2015-10-01

    The thyroid gland has the highest selenium (Se) concentration per unit weight among all tissues. The aims of the present study were to evaluate the Se levels in the plasma of hyperthyroidic pregnant women and to investigate the association between maternal plasma Se concentrations and thyroid hormone levels. The study population consisted of 107 pregnant women, 70 healthy pregnant women (group 1) and 37 pregnant women with hyperthyroidism (group 2). The plasma free triiodothyronine (fT3) and free thyroxine (fT4) levels were significantly higher, and the plasma thyroid-stimulating hormone (TSH) and Se levels were significantly lower in group 2 than in group 1 (p < 0.05). A correlation analysis showed a positive correlation between Se and fT4 in group 1 and with TSH in group 2 (p < 0.05). Decreased maternal serum antioxidant trace element Se in hyperthyroidic pregnant women compared with normal pregnant women supported the hypothesis that hyperthyroidism was associated with decreased antioxidant response.

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

    PubMed

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

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

  17. Nutritional status and weight gain in pregnant women.

    PubMed

    Sato, Ana Paula Sayuri; Fujimori, Elizabeth

    2012-01-01

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

  18. Universal HIV screening of pregnant women in England: cost effectiveness analysis.

    PubMed

    Postma, M J; Beck, E J; Mandalia, S; Sherr, L; Walters, M D; Houweling, H; Jager, J C

    1999-06-19

    To estimate the cost effectiveness of universal, voluntary HIV screening of pregnant women in England. Cost effectiveness analysis. Cost estimates of caring for HIV positive children were based on the stage of HIV infection and calculated using data obtained from a London hospital between 1986 and 1996. These were combined with estimates of the health benefits and costs of antenatal screening so that the cost effectiveness of universal, voluntary antenatal screening for HIV infection in England could be estimated. Lifetime, direct costs of medical care of childhood HIV infection; life years gained as a result of the screening programme; net cost per life year gained for different pretest counselling costs; and different prevalence rates of pregnant women who were unaware that they were HIV positive. Estimated direct lifetime medical and social care costs of childhood HIV infection were pound178 300 using a 5% discount rate for time preference (1995-6 prices). In high prevalence areas screening pregnant women for HIV is estimated to be a cost effective intervention with a net cost of less than pound4000 for each life year gained. For areas with comparatively low prevalence rates, cost effectiveness could be less than pound20 000 per life year gained, depending on the number of pregnant women who are unaware that they are infected and local screening costs. Our results confirm recent recommendations that universal, voluntary antenatal HIV screening should be implemented in the London area. Serious consideration of the policy should be given for other areas in England depending on local prevalence and screening costs.

  19. Seroepidemiology of Toxoplasma gondii infection in pregnant women in rural Durango, Mexico.

    PubMed

    Alvarado-Esquivel, C; Torres-Castorena, A; Liesenfeld, O; García-López, C R; Estrada-Martínez, S; Sifuentes-Alvarez, A; Marsal-Hernández, J F; Esquivel-Cruz, R; Sandoval-Herrera, F; Castañeda, J A; Dubey, J P

    2009-04-01

    The epidemiology of Toxoplasma gondii infection in pregnant women in rural Mexico is largely unknown. The seroepidemiology of T. gondii infection in 439 pregnant women from 9 communities in rural Durango State, Mexico was investigated. Using commercial enzyme-linked immunoassays, sera were tested for T. gondii IgG, IgM, and avidity antibodies. Prevalences of T. gondii IgG antibodies in the communities varied from 0% to 20%. Overall, 36 (8.2%) of the 439 women had IgG T. gondii antibodies. Ten (2.3%) women had also T. gondii IgM antibodies; IgG avidity was high in all IgM-positive women, suggesting chronic infection. None of the women, however, had delivered a known T. gondii-infected child. The seroprevalence was significantly higher (P < 0.05) in women from low socio-economic conditions (14%) than in those with higher socio-economic status (6.6%). Multivariate analysis showed that T. gondii infection was associated with soil floors at home (adjusted OR = 2.89; 95% CI: 1.12-7.49). This is the first epidemiological study of T. gondii infection in pregnant women in rural Mexico.

  20. Prognosis of Pregnant Women with One Abnormal Value on 75g OGTT.

    PubMed

    Kozuma, Yutaka; Inoue, Shigeru; Horinouchi, Takashi; Shinagawa, Takaaki; Nakayama, Hitomi; Kawaguchi, Atsushi; Hori, Daizo; Kamura, Toshiharu; Yamada, Kentaro; Ushijima, Kimio

    2015-01-01

    The aim of this study was to identify risk factors to allow us to detect patients at high risk of requiring insulin therapy, among Japanese pregnant women with one abnormal value (OAV) on a 75-g oral glucose tolerance test (75-g OGTT). A total of 118 pregnant women with OAV on a previous 75-g OGTT between 1997 and 2010 were studied. We identified the factors which can predict patients at high risk of requiring insulin therapy among Japanese pregnant women with OAV, by comparing severe abnormal glucose tolerance (insulin treatment; n=17) with mild glucose tolerance patients (diet only; n=101). The following factors were examined; plasma level of glucose (PG) and immunoreactive insulin (IRI) at fasting, 0.5, 1 and 2 hours after loading glucose, insulinogenic index, homeostasis model assessment insulin resistance (HOMA-IR), insulin sensitivity index-composite (ISI composite), and HbA1c at the time of the 75-g OGTT. Univariate analysis showed a positive correlation between insulin therapy and 2-h PG value, 0.5-h and 1-h IRI values, AUC-IRI and insulinogenic index (p<0.05). Multivariate analysis showed that the PG 2-h value and insulinogenic index were independent predictive factors of insulin therapy. A 2-h PG ≥153 mg / dl and an insulinogenic index of <0.42 had a sensitivity of 81.8%, a specificity of 83.8%, a positive predictive value of 60.0% and a negative predictive value of 93.9% for the prediction of patients who required insulin therapy among pregnant women with OAV. These results suggest that a level of 2-h PG ≥153 mg/dl and an insulinogenic index of <0.42 on 75-g OGTT are predictive factors for insulin therapy in Japanese pregnant women with OAV.

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

    PubMed

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

    2014-01-01

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

  2. Dream-associated Behaviors Affecting Pregnant and Postpartum Women

    PubMed Central

    Nielsen, Tore; Paquette, Tyna

    2007-01-01

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

  3. [Health effects and psychological stress in pregnant women engaged in work outside the home].

    PubMed

    Anan, Ayumi; Shiiba, Michiyo; Sibata, Eiji; Kawamoto, Rieko

    2010-12-01

    Modern society demands working conditions in which pregnant women can successfully deliver children and maintain a professional position. The aim of this study is to investigate the effects of work on the health and psychological stress in working women and their newborns. We reviewed twenty-eight publications and found that health problems in working women occur at high rates. However, there is no report investigating the mechanism by which health problems occur, or describing the precise working conditions and symptoms in pregnant women who are engaged in work outside the home. In addition, the literature uses subjective evaluations, including psychological tests, to quantify stress and anxiety, but no biochemical analyses of stress-related substances were conducted. We suggest that a standard index to represent working conditions and job category, as well as an investigation of the workload of house-keeping, is needed to understand the total work effort by pregnant women in modern times. Finally, measurement of stress-related biological markers may be effective in the investigation from various perspectives of occupational stress in pregnant women.

  4. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008.

    PubMed

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother-to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Prevalence of HIV in pregnant women in Mumbai is decreasing.

  5. Seroprevalence of hepatitis B surface antigenemia and its effects on hematological parameters in pregnant women in Osogbo, Nigeria.

    PubMed

    Kolawole, Olatunji M; Wahab, Abideen A; Adekanle, Daniel A; Sibanda, Timothy; Okoh, Anthony I

    2012-12-27

    The transmission of the hepatitis B virus (HBV) is parenteral, sexual and perinatal. Prevention of vertical transmission of HBV is extremely important because HBV infection in early life usually results in a chronic carrier State. A descriptive seroepidemiological study of hepatitis B virus and its effects on hematological parameters was investigated in pregnant women attending antenatal clinic of LAUTECH Teaching Hospital, Osogbo, Nigeria. 200 venous samples were subjected to full blood count and its sera were subjected to enzyme-linked immunosorbent assay for the detection of surface antigen of hepatitis B virus. Prevalence rate of 16.5% was obtained for hepatitis B surface antigen in pregnant women. The highest HBsAg prevalence rate recorded was 23.3% for pregnant women between aged 30-34 years while the lowest recorded was zero percent for those aged greater than 40 years. RBC, WBC, neutrophil, hemoglobin lymphocyte and platelet counts have no significant effects on HBsAg positivity of pregnant women (p=0.801). There was no significant difference in HBsAg positivity in relation to maternal age, gravidity, gestational age, family type, level of education and occupation (p=0.073). Among the potential risk factors, there was significant difference in HBsAg positivity in the pregnant women in relation to their history of HBV vaccination (p=0.039). We advocate universal free screening of pregnant women as the endemicity of HBV infections is thus being propagated.

  6. Seroprevalence of hepatitis B surface antigenemia and its effects on hematological parameters in pregnant women in Osogbo, Nigeria

    PubMed Central

    2012-01-01

    Background The transmission of the hepatitis B virus (HBV) is parenteral, sexual and perinatal. Prevention of vertical transmission of HBV is extremely important because HBV infection in early life usually results in a chronic carrier State. Methods A descriptive seroepidemiological study of hepatitis B virus and its effects on hematological parameters was investigated in pregnant women attending antenatal clinic of LAUTECH Teaching Hospital, Osogbo, Nigeria. 200 venous samples were subjected to full blood count and its sera were subjected to enzyme–linked immunosorbent assay for the detection of surface antigen of hepatitis B virus. Results Prevalence rate of 16.5% was obtained for hepatitis B surface antigen in pregnant women. The highest HBsAg prevalence rate recorded was 23.3% for pregnant women between aged 30–34 years while the lowest recorded was zero percent for those aged greater than 40 years. RBC, WBC, neutrophil, hemoglobin lymphocyte and platelet counts have no significant effects on HBsAg positivity of pregnant women (p = 0.801). There was no significant difference in HBsAg positivity in relation to maternal age, gravidity, gestational age, family type, level of education and occupation (p = 0.073). Among the potential risk factors, there was significant difference in HBsAg positivity in the pregnant women in relation to their history of HBV vaccination (p = 0.039). Conclusions We advocate universal free screening of pregnant women as the endemicity of HBV infections is thus being propagated. PMID:23268985

  7. [An innovative policy for supporting pregnant women].

    PubMed

    Perz, Stéphanie

    2015-04-01

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

  8. Impact of Vaccination History on Serological Testing in Pregnant Women.

    PubMed

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

    2018-04-01

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

  9. [Oral hygiene in pregnant women versus cigarette smoking].

    PubMed

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

    2013-01-01

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

  10. Micronutrient intake inadequate for a sample of pregnant African American women

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-05-01

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

  12. Reagent strip testing is not sensitive for the screening of asymptomatic bacteriuria in pregnant women.

    PubMed

    Lumbiganon, Pisake; Chongsomchai, Chompilas; Chumworathayee, Bundit; Thinkhamrop, Jadsada

    2002-08-01

    The objective of the study was to assess the diagnostic performance of the reagent strip in screening for asymptomatic bacteriuria in pregnant women using urine culture as a gold standard. This study comprised 204 asymptomatic pregnant women who attended their first antenatal care at Srinagarind Hospital, Khon Kaen University from April 1, 1999 to June 30, 1999. Women with symptoms of urinary tract infection, antibiotic treatment within the previous 7 days, pregnancy-induced hypertension, bleeding per vagina and history of urinary tract diseases were excluded. Urine specimens were collected by clean catched midstream urine technique for urinalysis, reagent strip test and urine culture. Diagnostic performance of reagent strip in terms of sensitivity, specificity, positive and negative predictive value was analyzed. Urine reagent strip test had a sensitivity of 13.9 per cent, a specificity of 95.6 per cent, a positive predictive value of 46.1 per cent, a negative predictive value of 80.6 per cent in detecting asymptomatic bacteriuria in pregnant women.

  13. Pregnant Women's Perceptions of Harms and Benefits of Mental Health Screening.

    PubMed

    Kingston, Dawn; Austin, Marie-Paule; McDonald, Sheila W; Vermeyden, Lydia; Heaman, Maureen; Hegadoren, Kathleen; Lasiuk, Gerri; Kingston, Joshua; Sword, Wendy; Jarema, Karly; Veldhuyzen van Zanten, Sander; McDonald, Sarah D; Biringer, Anne

    2015-01-01

    A widely held concern of screening is that its psychological harms may outweigh the benefits of early detection and treatment. This study describes pregnant women's perceptions of possible harms and benefits of mental health screening and factors associated with identifying screening as harmful or beneficial. This study analyzed a subgroup of women who had undergone formal or informal mental health screening from our larger multi-site, cross-sectional study. Pregnant women >16 years of age who spoke/read English were recruited (May-December 2013) from prenatal classes and maternity clinics in Alberta, Canada. Descriptive statistics were generated to summarize harms and benefits of screening and multivariable logistic regression identified factors associated with reporting at least one harm or affirming screening as a positive experience (January-December 2014). Overall study participation rate was 92% (N = 460/500). Among women screened for mental health concerns (n = 238), 63% viewed screening as positive, 69% were glad to be asked, and 87% took it as evidence their provider cared about them. Only one woman identified screening as a negative experience. Of the 6 harms, none was endorsed by >7% of women, with embarrassment being most cited. Women who were very comfortable (vs somewhat/not comfortable) with screening were more likely to report it as a positive experience. Women were largely Caucasian, well-educated, partnered women; thus, findings may not be generalizable to women with socioeconomic risk. Most women perceived prenatal mental health screening as having high benefit and low harm. These findings dispel popular concerns that mental health screening is psychologically harmful.

  14. Nursing intervention to enhance acceptance of pregnancy in first-time mothers: focusing on the comfortable experiences of pregnant women.

    PubMed

    Nakamura, Yasuka

    2010-06-01

    The purpose of the present study was to describe effective nursing care through evaluation of a nursing intervention that enhanced acceptance of pregnancy and focused on a comfortable experience for pregnant women. Thirty-two subjects who were expected to have a normal pregnancy were assigned into either the intervention or the control group. The nursing intervention consisted of the use of a pregnancy diary and four interviews, two of which were held in the first trimester, one in the second and one in the third trimester. The nursing care given was recorded in tapes and field notes. The data were analyzed using a qualitative content analysis method. As a result of analyzing the nursing care of 13 women pregnant for the first time who were provided with nursing intervention, the following seven categories of nursing care were extracted for the intervention: encouragement of women to record their experiences using a pregnancy diary; recognizing and acknowledging negative feelings; reducing the negative aspects of pregnancy and reframing; expression and reinforcement of positive feelings; clarification and reinforcement of positive meanings; awareness of own comfortable experiences; promotion of diverse comfortable aspects and continuation of comfortable experiences. The seven nursing care interventions were effective in increasing the comfortable experiences of pregnant women and enhancing a positive attitude towards pregnancy. Nursing intervention can aid in enhancing positivity and comfort in pregnant women. Furthermore, this nursing intervention can be applied to adolescents, socially disadvantaged pregnant women, and hospitalized women.

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

    PubMed

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

    2017-11-02

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

  16. Sexually transmitted diseases in pregnant women in Lusaka.

    PubMed

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

    1980-01-01

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

  17. Sympathetic baroreflex gain in normotensive pregnant women

    PubMed Central

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

    2015-01-01

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

  18. Serodiagnosis of Toxoplasmosis: The effect of measurement of IgG avidity in pregnant women in Rabat in Morocco.

    PubMed

    Laboudi, Majda; Sadak, Abderrahim

    2017-08-01

    The diagnosis of Toxoplasmosis in pregnant women during the early first trimester of pregnancy is very important for preventing congenital infection of the fetus; it will not only prevent the risk of transmitting the infection to the fetus but it will also enable to give these women a preventive treatment. In this study, the avidity test was performed on pregnant women during their first prenatal visit at the National Institute of Hygiene in Rabat, Morocco. One hundred and twenty-eight sera samples were collected from 128 pregnant women between August 2015 and June 2016; these women were chosen retrospectively and were in their first four months of pregnancy. The samples were screened using the specific anti-Toxoplasma IgG and IgM antibodies and were subjected to an IgG avidity test. After the serological screening, only 54 women (42.4%) were tested positive for IgG antibodies and five women (3.9%) were tested positive for both anti-Toxoplasma IgG and IgM antibodies. Four IgM-negative women had low-avidity antibodies. However, none of the IgG-avidity test had detected low-avidity antibodies in the five IgM-positive women; three women (60%) had high-avidity antibodies, indicating that the infection was acquired in the distant past. The avidity test is a helpful tool to exclude a recently acquired toxoplasmosis infection within IgM-positive serum samples in pregnant women during their first trimester of pregnancy. Thus, allowing to perform an appropriate therapeutic intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    PubMed

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

    2014-09-05

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

  20. Breastfeeding attitude, health-related quality of life and maternal obesity among multi-ethnic pregnant women: A multi-group structural equation approach.

    PubMed

    Lau, Ying; Htun, Tha Pyai; Lim, Peng Im; Ho-Lim, Sarah Su Tin; Chi, Claudia; Tsai, Cammy; Ong, Kai Wen; Klainin-Yobas, Piyanee

    2017-02-01

    Identifying the factors influencing breastfeeding attitude is significant for the implementation of effective promotion policies and counselling activities. To our best knowledge, no previous studies have modelled the relationships among breastfeeding attitude, health-related quality of life and maternal obesity among multi-ethnic pregnant women; the current study attempts to fill this research gap. This study investigated the relationships among maternal characteristics, health-related quality of life and breastfeeding attitude amidst normal weight and overweight/obese pregnant women using a multi-group structural equation modelling approach. Exploratory cross-sectional design was used. Antenatal clinics of a university-affiliated hospital PARTICIPANTS: Pregnant women were invited to participate; 708 (78.8%) agreed to participate in the study. We examined a hypothetical model on the basis of integrating the concepts of a breastfeeding decision-making model, theory of planned behaviour-based model for breastfeeding and health-related quality of life model among 708 multi-ethnic pregnant women in Singapore. The Iowa Infant Feeding Attitude Scale and Medical Outcomes Study Short Form Health Survey were used to measure breastfeeding attitude and health-related quality of life, respectively. Two structural equation models demonstrated that better health-related quality of life, higher monthly household income, planned pregnancy and previous exclusive breastfeeding experience were significantly associated with positive breastfeeding attitude among normal and overweight/obese pregnant women. Among normal weight pregnant women, those who were older with higher educational level were more likely to have positive breastfeeding attitude. Among overweight/obese pregnant women, Chinese women with confinement nanny plan were less likely to have positive breastfeeding attitude. No significant difference existed between normal weight and overweight/obese pregnant women concerning

  1. Knowledge, attitude, and practices of pregnant women towards antenatal care in primary healthcare centers in Benghazi, Libya.

    PubMed

    Ibrahim, Hala K; El Borgy, Mohamed D; Mohammed, Huda O

    2014-12-01

    Many underlying factors influence the capacity of women to survive from complications emerging during pregnancy and childbirth, including women's health and nutritional status starting from childhood and during pregnancy. Also, women's access to and the use of appropriate health services according to their knowledge, attitude, and behavior during pregnancy. This study was designed to assess the knowledge, the attitude, and practices of pregnant women toward antenatal care in primary healthcare centers in Benghazi, Libya. A cross-sectional study was conducted on a sample of 300 pregnant women, who were chosen from three primary healthcare centers with the highest attendance rate of pregnant women in Benghazi, Libya, using a structured interview questionnaire. The highest percentage (85.3%) of pregnant women had a high knowledge score regarding antenatal care, and most of them (96.0%) showed a positive attitude; the highest percentage (76.4%) of pregnant women also had good practice scores.The level of overall knowledge had a significant direct correlation with the practices towards antenatal care (r=0.228, P≤0.001), whereas it had an insignificant correlation with the attitude (r=0.029, P=0.619). The majority of the participants of the study tended to have a high level of knowledge and practices. Also, most of them had a positive attitude towards antenatal care. These findings can be used to plan a customized health intervention program aiming to improve maternal health practices regarding antenatal care and eventually improve the health status of Libyan women.

  2. Knowledge and beliefs regarding oral health among pregnant women.

    PubMed

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

    2011-11-01

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

  3. The management of HCV-infected pregnant women.

    PubMed

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

    2010-01-01

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

  4. Preponderance of bacterial isolates in urine of HIV-positive malaria-infected pregnant women with urinary tract infection.

    PubMed

    Ako-Nai, Kwashie Ajibade; Ebhodaghe, Blessing Itohan; Osho, Patrick; Adejuyigbe, Ebun; Adeyemi, Folasade Mubiat; Kassim, Olakunle O

    2014-12-15

    This study examined HIV and malaria co-infection as a risk factor for urinary tract infections (UTIs) in pregnancy. The study group included 74 pregnant women, 20 to 42 years of age, who attended the antenatal clinic at the Specialist Hospital at Akure, Ondo State, Nigeria. Forty-four of the pregnant women were either HIV seropositive with malaria infection (HIV+Mal+) or HIV seropositive without malaria (HIV+Mal-). The remaining thirty pregnant women served as controls and included women HIV seronegative but with malaria (HIV-Mal+) and women HIV seronegative without malaria. UTI was indicated by a bacterial colony count of greater than 10⁵/mL of urine, using cysteine lactose electrolyte deficient medium (CLED) as the primary isolation medium. Bacterial isolates were characterized using convectional bacteriological methods, and antibiotics sensitivity tests were carried out using the disk diffusion method. A total of 246 bacterial isolates were recovered from the cultures, with a mean of 3.53 isolates per subject. Women who were HIV+Mal+ had the most diverse group of bacterial isolates and the highest frequency of UTIs. The bacterial isolates from the HIV+Mal+ women also showed the highest degree of antibiotic resistance. While pregnancy and HIV infection may each represent a risk factor for UTI, HIV and malaria co-infection may increase its frequency in pregnancy. The higher frequency of multiple antibiotic resistance observed among the isolates, particularly isolates from HIV+Mal+ subjects, poses a serious public health concern as these strains may aggravate the prognosis of both UTI and HIV infection.

  5. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    PubMed Central

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing. PMID:29302524

  6. Pregnant and breastfeeding women: A priority population for HIV viral load monitoring.

    PubMed

    Myer, Landon; Essajee, Shaffiq; Broyles, Laura N; Watts, D Heather; Lesosky, Maia; El-Sadr, Wafaa M; Abrams, Elaine J

    2017-08-01

    Landon Myer and colleagues discuss viral load monitoring for pregnant HIV-positive women and those breastfeeding; ART treatments can suppress viral load and are key to preventing transmission to the child.

  7. Tuberculosis care for pregnant women: a systematic review.

    PubMed

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

    2014-11-19

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

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

    PubMed

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

    2017-11-27

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

  9. Cognitive factors associated with the willingness for HIV testing among pregnant women in China.

    PubMed

    Li, Chunrong; Yang, Liu; Kong, Jinwang

    2014-01-01

    The spread of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in the worldwide trend is not contained effectively. The pregnant women infected HIV seriously in the high HIV epidemic areas in China. The transmission of HIV to child may be cut off if HIV positive mother was found early by HIV testing. Pregnant women mandatorily received the HIV counseling and testing services. Most of them did not know the knowledge about HIV prevention and were not willing to receive HIV testing actively. Willingness for HIV testing among pregnant women was investigated, which can help to promote them to take up HIV testing actively. This study assessed the prevalence of the willingness for HIV testing and cognitive factors associated with it. A cross-sectional survey was conducted to 500 pregnant women via face-to-face interviews with anonymous structured questionnaire guided by the Health Belief Model (HBM). The prevalence of the willingness for HIV testing was 58.60%. Perceived higher susceptibility to HIV (multivariate-adjusted odds ratio (ORm) = 2.02, 95% confidence interval (CI): 1.40-5.06), more knowledge for HIV (ORm = 1.92, 95% CI: 1.11-3.87) and perceived less social stigma (ORm = 0.80, 95% CI: 0.34-0.91) were associated with higher willingness for HIV testing among pregnant women. To prevent HIV mother to children transmission, it is necessary to enhance knowledge for HIV, change cognitive factors and increase willingness for HIV testing among pregnant women.

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

    PubMed

    Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia

    2014-03-24

    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. 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. 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. 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.

  11. Intestinal Parasitic Infections among Pregnant Women in Venezuela

    PubMed Central

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

    2006-01-01

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

  12. The burden of anaemia and associated factors in HIV positive Nigerian women.

    PubMed

    Ezechi, O C; Kalejaiye, O O; Gab-Okafor, C V; Oladele, D A; Oke, B; Ekama, S O; Odunukwe, N N; Ujah, I A O

    2013-02-01

    Anaemia is the most common complication of pregnancy and a predictor of poor maternal and foetal outcomes. HIV infection is now recognized as one of the major contributors to anaemia in pregnancy. It is therefore important to determine the burden and risk factors of anaemia in maternal HIV infection in others to plan effective prevention strategies as well as optimize management outcomes. To determine the prevalence and risk factors of anaemia in pregnant HIV positive Nigerians. The prevalence and possible risk factors of anaemia were investigated in HIV positive pregnant Nigerian women at a large HIV treatment clinic in southwestern Nigeria using a cross-sectional design between January 2006 and December 2011. Nine hundred and eighty-five (42.5 %) women of 2,318 HIV positive pregnant women seen during the period were anaemic by WHO standard defined by haemoglobin <11 g/dl. Majority were of mild to moderate severity (97.9 %). Short inter birth interval (p = 0.002), presence of opportunistic infections (OIs), (p = 0.001), use of zidovudine containing regimen (p = 0.0005) and CD4 cell count <200 cells/mm(3) (p = 0.001) were found to be independently associated with anaemia in HIV positive pregnant women after controlling for confounding variables. Anaemia was found to be high at 42.5 % among the HIV positive women studied and was found to be independently associated with short inter birth interval, presence of OIs, advanced HIV disease and use of zidovudine containing HAART regimen.

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

    PubMed

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

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

  14. Assessment of dietary intake and mineral status in pregnant women.

    PubMed

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

    2018-06-01

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

  15. Factors influencing intent to get pregnant in HIV-infected women living in the southern USA.

    PubMed

    Sowell, R L; Murdaugh, C L; Addy, C L; Moneyham, L; Tavokoli, A

    2002-04-01

    This descriptive study sought to identify factors that influence HIV-infected women's intent to get pregnant. Interviews were conducted with a convenience sample of n = 322 HIV-infected women at risk for pregnancy. Participants were predominantly African-American (84.4%), single (57.9%), and ranged in age from 17 to 48 years. Forty per cent (n = 128) of the women had been pregnant since becoming HIV-positive. Potential factors influencing intent to get pregnant that were examined included demographic characteristics, HIV-related factors and personal beliefs and attitudes. In simple logistic regression models, younger age, increased motivation for child bearing, decreased perceived threat of HIV, decreased HIV symptomatology, higher traditional gender role orientation, and greater avoidance coping were all associated with greater intent to get pregnant. Following a model selection procedure, motivation for child bearing (OR = 16.05, 95% CI 7.95, 30.41) and traditional sex roles (OR = 4.49, 95% CI 1.44, 13.55) were significantly associated with greater intent to get pregnant. Traditional gender role orientation and motivation for childbearing are significant factors in predicting intent to get pregnant among HIV-infected women. These factors, as well as other non HIV-related factors, need to be routinely assessed by health care providers in developing plans of care for HIV-infected women.

  16. Exploring fertility decisions among pregnant HIV-positive women on antiretroviral therapy at a health centre in Balaka, Malawi: A descriptive qualitative.

    PubMed

    Biseck, T; Kumwenda, S; Kalulu, K; Chidziwisano, K; Kalumbi, L

    2015-12-01

    The proportions of women of reproductive age living with the human immunodeficiency virus (HIV) vary between different regions of the world, with significantly higher proportions in sub-Saharan Africa. Family planning is one of the major issues that couples and families affected with HIV must confront. We aimed to assess the cultural and social factors associated with childbearing and family planning knowledge, decision-making, and practices among HIV-positive pregnant women attending antenatal clinic at a health centre in Balaka, Malawi. This was a qualitative descriptive study carried out at Kalembo Health Centre in Balaka. A purposive sampling technique was used to select pregnant women enroled in the antiretroviral therapy (ART) programme. A sample size of thirty-five women was decided upon after data saturation. Qualitative inquiry was used during data collection. Data were analysed using systematic text condensation, while numbers and percentages were generated using Microsoft Excel. Out of 35 participants, 20 were aged between 25 and 34 years, and 18 had been married at least three times. All 35 women wished to have their own biological child. Factors, reported by participants, that promote childbearing included: the desire to please their husbands, fear of losing their husbands to others if they did not bear children, the knowledge that ART would help prevent their children from acquiring the virus, the desire to prove to others that they can also bear children, and a lack of family planning leading to unplanned pregnancies. The factors that lead to pregnancies among women on ART in Balaka ranged from assured safety of the child from HIV, lack of contraception, to other factors related to their partners. The authors recognize and support the freedom for women to become pregnant and bear children, and, in the context of HIV infection, fertility and reproductive services should include a comprehensive approach towards addressing issues of HIV and AIDS and

  17. Evaluation of sexual function, quality of life, and mental and physical health in pregnant women.

    PubMed

    Nik-Azin, Amir; Nainian, Mohammad Reza; Zamani, Mahnaz; Bavojdan, Marjan Rabani; Bavojdan, Mozhgan Rabani; Motlagh, Marjan Jamali

    2013-12-01

    To evaluate sexual function and its relationship with quality of life, and mental and physical health in pregnant women. Obtained results showed that 59 (39/3%) pregnant women were "very dissatisfied", 25 (16/7%) women were "moderately dissatisfied", 64 (42/7%) women were "both satisfied and unsatisfied", only 2 (1/3%) women were relatively satisfied, and no one was "very satisfied". There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0.05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Obtained results showed that 59 (39/3%) pregnant women were "very dissatisfied", 25 (16/7%) women were "moderately dissatisfied", 64 (42/7%) women were "both satisfied and unsatisfied", only 2 (1/3%) women were relatively satisfied, and no one was "very satisfied". There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0.05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Depression as same as environment heath had an important effect on sexual

  18. Incidence and seroprevalence of hepatitis E virus infection in pregnant women infected with hepatitis B virus and antibody placental transfer in infants.

    PubMed

    Huang, Hongyu; Xu, Chenyu; Zhou, Xuan; Liu, Lanhua; Dai, Yimin; Xu, Biao; Yang, Jishi; Chen, Tingmei; Hu, Yali; Zhou, Yi-Hua

    2016-09-01

    Hepatitis E has poor outcomes in pregnant women. Superinfection of hepatitis E virus (HEV) in patients infected with hepatitis B virus (HBV) may worsen liver disease. To estimate the incidence and seroprevalence of HEV infection among HBV-infected pregnant women, to investigate the transplacental transfer of maternal anti-HEV IgG, and to compare the maternal and neonatal outcomes in anti-HEV positive and negative pregnant women. Totally 391 HBV-infected pregnant women were recruited from April 2012 to October 2014. Paired mothers and infants were followed up at an average 9.8 months postpartum. Anti-HEV IgG and IgM were tested by ELISA. Of the pregnant women, none was anti-HEV IgM positive and 42 (10.7%) were IgG positive. At the follow-up, 3 seronegative women converted to anti-HEV IgG positive, with an estimated incidence of 17 per 1000 person-years. No significant differences of gestational age, preterm birth rate, Apgar score and birthweight were observed between newborns of anti-HEV IgG positive and negative mothers. Of the 42 neonates born to anti-HEV IgG positive mothers, 38 (90.5%) had anti-HEV IgG in their cord blood. The neonatal and maternal anti-HEV IgG levels were positively correlated (r=0.827, p<0.05). All infants were negative for both anti-HEV IgM and IgG at the follow-up. HBV-infected pregnant women rarely have novel HEV infection during late pregnancy in Jiangsu, China. Maternal anti-HEV IgG efficiently transfers into the fetuses, and disappears in infants before 10 months old. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Pregnancy outcomes in HIV-positive women: a retrospective cohort study.

    PubMed

    Arab, Kholoud; Spence, Andrea R; Czuzoj-Shulman, Nicholas; Abenhaim, Haim A

    2017-03-01

    In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV. Multivariate logistic regression was used to estimate the adjusted effect of HIV status on obstetrical and neonatal outcomes. Among 7,772,999 births over the study period, 1997 were in HIV-positive women (an incidence of 25.7/100,000 births). HIV-infected patients had greater frequency of pre-existing diabetes and chronic hypertension, and use of cigarettes, drugs, and alcohol during pregnancy (p < 0.001). Upon adjustment for baseline characteristics, HIV-infected women had greater likelihood of antenatal complications: preterm premature rupture of membranes (OR 1.35, 95% CI 1.14-1.60) and urinary tract infections (OR 3.02, 95% CI 2.40-3.81). Delivery and postpartum complications were also increased among HIV-infected women: cesarean delivery (OR 3.06, 95% CI 2.79-3.36), postpartum sepsis (OR 8.05, 95% CI 5.44-11.90), venous thromboembolism (OR 2.21, 95% CI 1.46-3.33), blood transfusions (OR 3.67, 95% CI 3.01-4.49), postpartum infection (OR 3.00, 95% CI 2.37-3.80), and maternal mortality (OR 21.52, 95% CI 12.96-35.72). Neonates born to these mothers were at higher risk of prematurity and intrauterine growth restriction. Pregnancy in HIV-infected women is associated with adverse maternal and newborn complications. Pregnant HIV-positive women should be followed in high-risk healthcare centers.

  20. Vitamin D levels among pregnant and lactating women.

    PubMed

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

    2013-12-01

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

  1. Lack of association between Toxoplasma gondii exposure and depression in pregnant women: a case-control study.

    PubMed

    Alvarado-Esquivel, Cosme; Martínez-Martínez, Ana Liliana; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús; Castillo-Orona, Juan Manuel; Salas-Martínez, Carlos; Sifuentes-Álvarez, Antonio; Sandoval-Carrillo, Ada Agustina; Salas-Pacheco, José M; Liesenfeld, Oliver; Antuna-Salcido, Elizabeth Irasema

    2017-03-06

    Very little is known about the link of T. gondii infection and depression. Through an age-, gender-, and month of pregnancy-matched case-control study, we determined the association of T. gondii infection and depression in pregnant women. We studied 200 pregnant women with depression and 200 pregnant women without depression attended in a public hospital in Durango City, Mexico. Pregnant women were tested for the presence of anti-Toxoplasma IgG antibodies using an enzyme-linked immunoassay (EIA), and IgG seropositive women were further tested for the presence of IgM using an EIA. IgM positivity by EIA was further analyzed by enzyme-linked fluorescence assay (ELFA). Anti-T. gondii IgG antibodies were found in 9 (4.5%) of the 200 cases and in 12 (6.0%) of the 200 controls (OR = 0.73; 95% CI: 0.30-1.79; P = 0.50). The frequency of high (>150 IU/ml) anti-T. gondii IgG levels was similar in cases and in controls (OR = 1.20; 95% CI: 0.36-4.01; P = 0.75). Two women were positive for IgM by EIA but both were negative by ELFA. We did not find serological evidence of an association between T. gondii infection and depression in pregnant women attended in a public hospital in Durango City, Mexico. Since an association of T. gondii and depression in pregnancy has been reported in the U.S. previously, further research to elucidate the role of T. gondii in prenatal depression should be conducted.

  2. Bacteriuria in pregnant women with sickle cell trait.

    PubMed

    Thurman, Andrea Ries; Steed, Lisa L; Hulsey, Thomas; Soper, David E

    2006-05-01

    The purpose of this study was to compare the following outcome variables in pregnant patients with sickle cell trait and matched pregnant control patients: asymptomatic bacteriuria, acute cystitis, urinary pathogens that were present, and pyelonephritis. This was a retrospective cohort study that was conducted at a university clinic. Pregnant patients with sickle cell trait (n = 455) were matched with control patients (n = 448) for race, age, gestational age at entry into prenatal care, and number of prenatal visits. Women with sickle cell trait received urine testing significantly more often. There was no difference in the incidence of positive urine cultures, urinary pathogens, or asymptomatic bacteriuria among the comparison groups. Sickle cell trait carriers had significantly higher rates of pyelonephritis, but many affected patients had risk factors, such as previous pyelonephritis or noncompliance with therapy. Sickle cell trait carriers were no more susceptible to acute cystitis and asymptomatic bacteriuria than were the control patients. On the basis of these data, we outline recommendations for urinary screening and pyelonephritis prevention in pregnant patients with sickle cell trait.

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

    PubMed

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

    2018-07-01

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

  4. Activity Behaviours in Lean and Morbidly Obese Pregnant Women.

    PubMed

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

    2018-05-17

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

  5. Micronutrient Intake Is Inadequate for a Sample of Pregnant African-American Women.

    PubMed

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

    2017-04-01

    Micronutrient intake is critical for fetal development and positive pregnancy outcomes. Little is known about the adequacy of micronutrient intake in pregnant African-American women. To describe nutrient sufficiency and top food groups contributing to dietary intake of select micronutrients in low-income pregnant African-American women and determine whether micronutrient intake varies with early pregnancy body mass index (BMI) and/or gestational weight gain. Secondary analysis of data collected in a cohort study of pregnant African-American women. A total of 93 women aged 18 to 36 years, <20 weeks pregnant, with early pregnancy BMIs ≥18.5 and <40.0. The study was conducted during 2008 to 2012 with participants from university-affiliated obstetrics clinics in an urban setting in the northeastern United States. Proportion of women with dietary intakes below Estimated Average Requirement (EAR) or Adequate Intake (AI) for vitamin D, folate, iron, calcium, and choline throughout pregnancy. Top food groups from which women derived these micronutrients was also determined. Descriptive statistics included means, standard deviations, and percentages. Percent of women reaching EAR or AI was calculated. The χ 2 test was used to assess micronutrient intake differences based on early pregnancy BMI and gestational weight gain. A large percentage of pregnant women did not achieve the EAR or AI from dietary sources alone; EAR for folate (66%), vitamin D (100%), iron (89%), and AI for choline (100%). Mean micronutrient intake varied throughout pregnancy. Top food sources included reduced-fat milk, eggs, and mixed egg dishes, pasta dishes, and ready-to-eat cereal. The majority of study participants had dietary micronutrient intake levels below EAR/AI throughout pregnancy. Findings suggest that practitioners should evaluate dietary adequacy in women to avoid deficits in micronutrient intake during pregnancy. Top food sources of these micronutrients can be considered when assisting

  6. Evolution of childbirth expectations in Spanish pregnant women.

    PubMed

    Peñacoba-Puente, Cecilia; Carmona-Monge, Francisco Javier; Marín-Morales, Dolores; Écija Gallardo, Carmen

    2016-02-01

    To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant women's wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Effects of nutrition education on levels of nutritional awareness of pregnant women in Western iran.

    PubMed

    Fallah, Farnoush; Pourabbas, Ahmad; Delpisheh, Ali; Veisani, Yousef; Shadnoush, Mahdi

    2013-01-01

    Maternal nutritional health, before and during pregnancy, influences the health status of herself and her developing fetus. Pregnancy is an important condition for improving nutritional knowledge. The present study aimed at determining effects of nutrition education on levels of nutritional awareness of a representative group of pregnant women in Western Iran. A quasi-experimental intervention was undertaken on a random sample of pregnant women (n = 100) attending urban health centers in Ilam city (western Iran) during the year 2011 for prenatal care. A nutritional education program containing two to four lessons was undertaken for small groups of between six to ten women. Nutritional knowledge was assessed before intervention (pretest) and followed by two posttests within three weeks interval. The awareness level of pregnant women about healthy nutrition was significantly increased from 3% before intervention to 31% after the nutritional education intervention (P < 0.001). This significant difference was independent from maternal characteristics of age and levels of literacy and in obese mothers in particular. A nutritional education intervention will have a positive effect on nutritional awareness of pregnant women.

  8. [Partner violence against pregnant women in Mexico City].

    PubMed

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

    2007-08-01

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

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

    PubMed

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

    2006-09-01

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

  10. Nutritional behaviours of pregnant women in rural and urban environments.

    PubMed

    Suliga, Edyta

    2015-01-01

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

  11. Seroprevalence of rubella in school girls and pregnant women.

    PubMed

    Karakoc, Gulbin Bingol; Altintas, Derya Ufuk; Kilinc, Banu; Karabay, Aysun; Mungan, Neslihan Onenli; Yilmaz, Mustafa; Evliyaoglu, Nurdan

    2003-01-01

    Many studies have been assigned to investigate the surveillance of congenital rubella syndrome, acquired rubella and seroprevalence in different countries to determine the new vaccination program and national vaccination schedules. Seroprevalence of rubella in Turkey is still insufficient and national immunization schedules do not include routine rubella vaccination. In this study we aimed to investigate the seroprevalence of rubella at child bearing age in an unvaccinated population in Adana, southern Turkey, to help determine whether routine rubella vaccination is necessary, if so when it should be administered. Ninety-four school girls aged 12-18 years living in Adana were selected for the study and stratified according to the socioeconomic status of their parents and evaluated for rubella antibodies. One hundred pregnant women aged 18-25 years and 100 pregnant women aged 26-35 years were sampled rubella antibodies. Rubella specific IgG antibody was measured qualitatively and quantitatively by using microparticule enzyme immune assay technology. Rubella specific IgG antibody was positive in 87-94 school girls (92.5%). The geometric mean rubella specific IgG antibody value was found be 148.14 IU/ml. No correlation was found between socioeconomic status and rubella seropositivity (p = 0.6521). In all pregnant women rubella specific IgG antibody was found to be positive. In conclusion rubella vaccination should be considered carefully in developing countries. Because of the high seropositivity to rubella in our region we do not recommend rubella vaccination in early childhood. Yet this is a preliminary study and further studies with larger population size are needed to determine the national immunization policy for rubella.

  12. The magnitude and correlates of Parvovirus B19 infection among pregnant women attending antenatal clinics in Mwanza, Tanzania.

    PubMed

    Mirambo, Mariam M; Maliki, Fatma; Majigo, Mtebe; Mushi, Martha F; Moremi, Nyambura; Seni, Jeremiah; Matovelo, Dismas; Mshana, Stephen E

    2017-06-07

    Human parvovirus B19 (B19) infection has been associated with congenital infection which may result into a number of the adverse pregnancy outcomes. The epidemiology and the magnitude of B19 infections among pregnant women have been poorly studied in developing countries. This study was done to establish preliminary information about the magnitude of B19 among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania. A cross-sectional study was conducted between December 2014 and June 2015 among 258 pregnant women attending two antenatal clinics representing rural and urban areas in the city of Mwanza. Socio-demographic data were collected using structured data collection tool. Specific B19 IgM and IgG antibodies were determined using indirect enzyme linked immunosorbent assay kits (DRG Instruments GmbH, Germany). Data were analyzed using STATA version 11 software. The median age of study participants was 21 IQR (19-25) years. Of 253 pregnant women; 116(44.96%), 109(42.25%) and 33(12.79%) were in the first, second and third trimester respectively. The majority 168(66.4%) of women were from urban areas. Of 253 pregnant women, the overall prevalence of IgM was 83(32.8%) while that of IgG was 142(55.0%) among 258 women tested. A total of 50(19.4%) women were positive for both IgG and IgM indicating true IgM positive. History of baby with low birth weight (OR: 10, 95% CI: 1.82-58.05, P = 0.01) was independent predictor of B19 IgG seropositivity and being at the third trimester was protective (OR: 0.38, 95% CI: 0.16-0.92, P = 0.03). The IgG titers were found to decrease significantly as gestational age increases (Spearman's rho = -0.2939, p = 0.0004) CONCLUSION: More than a half of pregnant women in Mwanza city are B19 IgG sero-positive with about one third of these being B19 IgM seropositive. Further studies to determine the impact of B19 infections among pregnant women and their newborns are recommended in developing countries.

  13. Urinary concentrations of phthalates and phenols in a population of Spanish pregnant women and children.

    PubMed

    Casas, Lidia; Fernández, Mariana F; Llop, Sabrina; Guxens, Mònica; Ballester, Ferran; Olea, Nicolás; Irurzun, Mikel Basterrechea; Rodríguez, Loreto Santa Marina; Riaño, Isolina; Tardón, Adonina; Vrijheid, Martine; Calafat, Antonia M; Sunyer, Jordi

    2011-07-01

    Phthalate and phenol exposure is prevalent among the general population and of potential concern for pregnant women and children because of their suspected susceptibility to endocrine effects. To evaluate the extent of exposure to several phthalates and phenols in a sample of Spanish pregnant women - according to their individual characteristics (age, social class, education, and body mass index) - and children who participated in the INMA - Infancia y Medio Ambiente (Environment and Childhood) project. One spot urine sample was taken during the third trimester of pregnancy from 120 pregnant women and from 30 4-year old children belonging to 5 Spanish birth cohorts, and analyzed for 11 phthalate metabolites and 9 phenols. Three metabolites of di(2-ethylhexyl) phthalate, mono-2-ethyl-5-carboxypentyl phthalate, mono-2-ethyl-5-hydroxyhexyl phthalate, and mono-2-ethyl-5-oxohexyl phthalate; two metabolites of dibutyl phthalates, mono-isobutyl phthalate and mono-n-butyl phthalate; monoethyl phthalate (MEP), the main metabolite of diethyl phthalate; and two phenols, methyl paraben (M-PB) and 2,5-dichlorophenol were detected in the urine samples of all women. The highest urinary concentrations were for MEP and M-PB. Urinary concentrations of all phthalate metabolites and of 2,4-dichlorophenol, 2,5-dichlorophenol, and bisphenol A were lower in the pregnant women than in the children. Among women, a positive relationship with social class and education was shown for most of the phthalate metabolites and phenols. Almost all phthalate metabolites varied by region even after adjusting for social class and education. Phthalate and phenol exposures are prevalent in a group of pregnant women and young children, two susceptible populations, and these exposures might be positively related to social class. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    PubMed

    Wang, Yu; Gao, Jie; Du, Juan

    2016-06-01

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

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

    PubMed

    Rujumba, Joseph; Neema, Stella; Tumwine, James K; Tylleskär, Thorkild; Heggenhougen, Harald K

    2013-05-24

    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. 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. 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. 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

  16. Dental awareness and oral health of pregnant women in Poland.

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2016-12-01

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

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

    PubMed

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

    2012-01-01

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

  19. 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

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

    2014-01-01

    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

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

    PubMed

    Legault, Anik; Marquis, Marie

    2014-01-01

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

  1. Epidemiology and Risk Factors of Functional Constipation in Pregnant Women.

    PubMed

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

    2015-01-01

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

  2. Human immuno-deficiency virus antibody seroprevalence among pregnant women at booking at a university teaching hospital in South-Eastern Nigeria.

    PubMed

    Okeudo, C; Ezem, B U; Ojiyi, E C

    2012-01-01

    In Africa, human immuno-deficiency virus (HIV) infection continues to be progressively feminized. This has led to an increase in the number of paediatric HIV infections reported due to increased risk of mother-to-child transmission (MTCT) of HIV during pregnancy, labour and breastfeeding. The objective of the study was to determine the HIV positive sero-prevalence at booking among pregnant women at the Imo State University Teaching Hospital, Orlu. A retrospective analysis of the case records of women who booked and were screened for Human Immune-deficiency Virus at the Imo State University Teaching Hospital (IMSUTH), Orlu from 1st March 2008 to 28th February 2010 was done. Data on age, parity, educational status, gestational age at booking, and retroviral status were collected and analysed using spss version 13. Nine hundred and twenty one pregnant women were screened for the presence of HIV 1 & 2 antibodies in their serum. One hundred and six of them were positive, giving a sero-prevalence rate at booking of 11.5%. The highest sero prevalence rate of 45.2% occurred in the age group of 26-30 years. Petty traders contributed 97 (91.5%) of the HIV positive women, while multiparous (para 2-4) women contributed 50% of the positive pregnant women. Only 32 (30.2%) of the HIV positive women booked within the first trimester for antenatal care. Majority 53 (59.4%) of the HIV positive women had secondary education, while those that had no formal education contributed only 6 (5.7%) of the HIV positive women. There was a high HIV seroprevalence at booking among pregnant women at IMSUTH, Orlu. A lot more needs to be done in order to reduce vertical transmission of HIV in our environment.

  3. Pregnant Women and Influenza (Flu)

    MedlinePlus

    ... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Pregnant Women & Influenza (Flu) Language: English (US) Español Recommend on Facebook ...

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

    PubMed

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

    2015-08-01

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

  5. Morbidity in Pregnant Women Associated with Unverified Penicillin Allergies, Antibiotic Use, and Group B Streptococcus Infections.

    PubMed

    Desai, Shilpa H; Kaplan, Michael S; Chen, Qiaoling; Macy, Eric M

    2017-01-01

    The morbidity potentially associated with unverified penicillin allergy in pregnant women, with and without group B streptococcus (GBS) infections, is unknown. Penicillin allergy testing is safe during pregnancy but is done infrequently. To determine morbidity associated with antibiotic use in a large cohort of pregnant women, with and without an unverified history of penicillin allergy, and with and without GBS. Retrospective. All pregnant women who delivered live infants in Kaiser Permanente Southern California between January 1, 2009, and December 31, 2014, were identified. Penicillin allergy status at delivery, delivery method, maternal and infant hospital utilization, peripartum antibiotic exposures, new antibiotic-associated adverse drug reactions, and new Clostridium difficile infections. There were 170,379 unique women who had 201,316 pregnancies during the study period. There were 16,084 pregnancies in women with an active, but unverified, penicillin allergy at delivery. There were 42,524 pregnancies in GBS-positive women, and 3500 also had a penicillin allergy. Women with a penicillin allergy, with or without GBS, had significantly (about 10%) higher cesarean section rates and spent significantly more (about 0.1) days in the hospital after delivery. Among GBS-positive women, those with an unverified penicillin allergy were exposed to significantly more cefazolin, clindamycin, vancomycin, and gentamicin and had significantly higher rates of adverse drug reactions associated with all antibiotic use. Unverified penicillin allergy is associated with more hospital utilization and additional morbidity. Penicillin allergy testing of pregnant women with a history of penicillin allergy may help reduce these unwanted outcomes.

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

    PubMed

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

    2014-11-01

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

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

    PubMed

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

    2018-02-01

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

  8. Risk and other factors associated with toxoplasmosis and toxocariasis in pregnant women from southern Brazil.

    PubMed

    Santos, P C; Telmo, P L; Lehmann, L M; Mattos, G T; Klafke, G B; Lorenzi, C; Hirsch, C; Lemos, L; Berne, M E A; Gonçalves, C V; Scaini, C J

    2017-09-01

    Toxoplasmosis causes complications during pregnancy that have serious effects on fetal development. Thus far, toxocariasis has been reported to spread only via vertical transmission. Nonetheless, the population of pregnant women is also exposed to this infection. Co-infection with both Toxoplasma gondii and Toxocara spp. has been reported in children, but there are no reports of co-infection in the population of pregnant women. The aim of this study was to determine the prevalence of co-infection with T. gondii and Toxocara spp. in pregnant women at a university hospital in southern Brazil, and to identify the risk factors associated with infection by both parasites. Two hundred pregnant women were tested for the presence of anti-T. gondii and anti-Toxocara spp. antibodies and were asked to complete an epidemiological questionnaire. In this study, the co-infection rate observed in the total population of pregnant women was 8%. In addition, women with a positive result for a serology test for Toxocara spp. were at increased risk of infection by T. gondii (P = 0.019). Co-infection with both parasites in pregnant women was associated with low birth weights in neonates. The similar modes of transmission of both parasites could explain the co-infection. Only a few previous studies have investigated this phenomenon. The findings of the present study emphasize the importance of serological diagnosis during prenatal care and further research in this area to identify risk factors associated with this co-infection, and the possible implications of this co-infection during pregnancy and on the health of newborns.

  9. Fluorescence microscope (Cyscope) for malaria diagnosis in pregnant women in Medani Hospital, Sudan.

    PubMed

    Hassan, Saad El-Din H; Haggaz, Abd Elrahium D; Mohammed-Elhassan, Ehab B; Malik, Elfatih M; Adam, Ishag

    2011-09-24

    Accuracy of diagnosis is the core for malaria control. Although microscopy is the gold standard in malaria diagnosis, its reliability is largely dependent on user skill. We compared performance of Cyscope fluorescence microscope with the Giemsa stained light microscopy for the diagnosis of malaria among pregnant women at Medani Hospital in Central Sudan. The area is characterized by unstable malaria transmission. Socio-demographic characteristics and obstetrics history were gathered using pre-tested questionnaires. Blood samples were collected from febrile pregnant women who were referred as malaria case following initial diagnosis by general microscopist. During the study period 128 febrile pregnant women presented at the hospital. Among them, Plasmodium falciparum malaria was detected in 82 (64.1%) and 80 (62.5%) by the Giemsa-stained light microscopy and the Cyscope fluorescence microscope, respectively. The sensitivity of the Cyscope fluorescence microscope was 97.6% (95% CI: 92.2%-99.6%). Out of 46 which were negative by Giemsa-stained light microscopy, 5 were positive by the Cyscope fluorescence microscope. This is translated in specificity of 89.1% (95% CI: 77.5%-95.9%). The positive and negative predictive value of Cyscope fluorescence microscope was 94.1% (95% CI: 87.4% -97.8%) and 95.3% (95% CI: 85.4% - 99.2%), respectively. This study has shown that Cyscope fluorescence microscope is a reliable diagnostic, sensitive and specific in diagnosing P. falciparum malaria among pregnant women in this setting. Further studies are needed to determine effectiveness in diagnosing other Plasmodium species and to compare it with other diagnostic tools e.g. rapid diagnostic tests and PCR.

  10. Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.

    PubMed

    Oduyebo, Titilope; Igbinosa, Irogue; Petersen, Emily E; Polen, Kara N D; Pillai, Satish K; Ailes, Elizabeth C; Villanueva, Julie M; Newsome, Kim; Fischer, Marc; Gupta, Priya M; Powers, Ann M; Lampe, Margaret; Hills, Susan; Arnold, Kathryn E; Rose, Laura E; Shapiro-Mendoza, Carrie K; Beard, Charles B; Muñoz, Jorge L; Rao, Carol Y; Meaney-Delman, Dana; Jamieson, Denise J; Honein, Margaret A

    2016-07-25

    CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. To increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, CDC recommends expanding real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(†) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(§) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). Symptomatic pregnant women who are evaluated <2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic

  11. Correlation of Body Mass Index (BMI) with Thyroid Function in Euthyroid Pregnant Women in Manipur, India.

    PubMed

    Kumar, Sumit; Chiinngaihlun, T; Singh, M Rameswar; Punyabati, O

    2017-04-01

    Body Mass Index (BMI) is significantly increased during pregnancy due to gain of weight with normal progression of pregnancy. The exact influence of thyroid function on BMI are ill defined in euthyroid pregnant women. To correlate serum levels of Free Triiodothyronine (FT3), Free Thyroxine (FT4) and Thyroid Stimulating Hormone (TSH) level with BMI of participant normal pregnant women in all the three trimesters. In this cross-sectional comparative study, total of 210 healthy pregnant women comprising of 70 participants in each trimester, attending Obstetrics Outpatient Department (OPD) for antenatal check-up were consecutively selected. Estimation of serum FT3, FT4 and TSH level was done by ELISA based methods. The correlation of BMI with serum levels of FT3, FT4 and TSH was done using Pearson correlation test (r) by SPSS version 21.0 software. TSH level of participant normal pregnant women showed significant positive correlation with BMI during first (r=0.254 and p=0.034) and second trimester (r=0.263 and p=0.028) of pregnancy. FT4 level showed significant negative correlation in second (r= -0.454 and p<0.001) and third trimester (r= -0.351 and p=0.003) of pregnancy. Correlation between BMI and FT3 level showed no significant association in any of the trimesters. BMI correlates positively with TSH level in first and second trimesters while it correlates negatively with FT4 level in second and third trimesters, but, failed to demonstrate significant association with FT3 level in any of trimesters in euthyroid pregnant women. Serum TSH along with FT4 level appears more useful modality compared to serum TSH alone for targeted thyroid screening particularly in obese pregnant women.

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

    ERIC Educational Resources Information Center

    Deren, Sherry; And Others

    1993-01-01

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

  13. Dynamics of lipoprotein level in blood plasma of pregnant women as a function of gestational age according to FTIR spectroscopy

    NASA Astrophysics Data System (ADS)

    Korolik, E. V.; Korolenko, E. A.; Tretinnikov, O. N.; Kozlyakova, O. V.; Korolik, A. K.; Kirkovskiy, V. V.

    2013-01-01

    Results of an IR spectroscopic investigation of films of blood plasma taken from women of reproductive age, pregnant women with positive and negative Rh factors, and Rh-immunized women were presented as a function of gestational age. It was found that the lipoprotein content in blood plasma of all groups of pregnant women increased during the early stages of pregnancy (17-23 weeks) irrespective of the Rh factor and attained its peak value by weeks 30-35. It was shown that the lipoprotein level in blood plasma as a function of gestational age was quantitatively the same for pregnant women with positive and negative Rh factors. It was established for the first time that this dependence for Rh-immunized women featured a considerable increase of lipoprotein content at gestational age 30-32 weeks and declined acutely by week 36.

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

    PubMed

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

    2016-09-24

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

  15. The Physical Activity Patterns of Pregnant Taiwanese Women.

    PubMed

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

    2016-12-01

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

  16. Do pregnant women exercise their pelvic floor muscles?

    PubMed

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

    2007-07-01

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

  17. Knowledge and acceptability of Chlamydia trachomatis screening among pregnant women and their partners; a cross-sectional study

    PubMed Central

    2014-01-01

    Background Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals, women and partners and the acceptability for screening of the target population. We assessed the knowledge of chlamydia infection among pregnant women and their partners in the Netherlands, their attitudes towards testing, and their experiences of being offered a chlamydia test. In addition, we evaluated the association between participants’ background characteristics and knowledge of chlamydia. Methods Pregnant women aged ≤ 30 years and their partners (regardless of their age) attending one of the participating primary midwifery care practices in the Netherlands were invited to participate. All participants completed a questionnaire, pregnant women provided a vaginal swab and partners provided a urine sample to test for C. trachomatis. Results In total, 383 pregnant women and 282 partners participated in the study of whom 1.9% women and 2.6% partners tested chlamydia positive. Participants had high levels of awareness (92.8%) of chlamydial infection. They were knowledgeable about the risk of chlamydia infection; median knowledge score was 9.0 out of 12.0. Lower knowledge scores were found among partners (p-value <0.001), younger aged (p-value 0.02), non-western origin (p-value <0.001), low educational level (p-value <0.001), and no history of sexually transmitted infections (p-value <0.001). In total, 78% of respondents indicated that when pregnant women are tested for chlamydia, their partners should also be tested; 54% believed that all women should routinely be tested. Pregnant women more often indicated than partners that testing partners for chlamydial infection was not necessary (p-value <0.001). The majority of pregnant women (56.2%) and partners (59

  18. Knowledge and acceptability of Chlamydia trachomatis screening among pregnant women and their partners; a cross-sectional study.

    PubMed

    Pereboom, Monique T R; Spelten, Evelien R; Manniën, Judith; Rours, G Ingrid J G; Morré, Servaas A; Schellevis, François G; Hutton, Eileen K

    2014-07-09

    Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals, women and partners and the acceptability for screening of the target population. We assessed the knowledge of chlamydia infection among pregnant women and their partners in the Netherlands, their attitudes towards testing, and their experiences of being offered a chlamydia test. In addition, we evaluated the association between participants' background characteristics and knowledge of chlamydia. Pregnant women aged ≤ 30 years and their partners (regardless of their age) attending one of the participating primary midwifery care practices in the Netherlands were invited to participate. All participants completed a questionnaire, pregnant women provided a vaginal swab and partners provided a urine sample to test for C. trachomatis. In total, 383 pregnant women and 282 partners participated in the study of whom 1.9% women and 2.6% partners tested chlamydia positive. Participants had high levels of awareness (92.8%) of chlamydial infection. They were knowledgeable about the risk of chlamydia infection; median knowledge score was 9.0 out of 12.0. Lower knowledge scores were found among partners (p-value <0.001), younger aged (p-value 0.02), non-western origin (p-value <0.001), low educational level (p-value <0.001), and no history of sexually transmitted infections (p-value <0.001). In total, 78% of respondents indicated that when pregnant women are tested for chlamydia, their partners should also be tested; 54% believed that all women should routinely be tested. Pregnant women more often indicated than partners that testing partners for chlamydial infection was not necessary (p-value <0.001). The majority of pregnant women (56.2%) and partners (59.2%) felt satisfied by being offered

  19. Effects of an oral health education program for pregnant women.

    PubMed

    Cardenas, Lina M; Ross, Damon D

    2010-01-01

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

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

    PubMed

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

    2017-06-01

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

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

    PubMed

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

    2016-02-01

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

  2. Comparison of aerobic conjunctival bacterial flora in pregnant, reproductive-aged and postmenopausal women

    PubMed Central

    Balikoglu-Yilmaz, Melike; Sen, Emine; Sevket, Osman; Polat, Yusuf; Karabulut, Aysun; Uysal, Omer

    2012-01-01

    AIM To evaluate the effect of hormonal status on aerobic conjunctival flora in women. METHODS One hundred fifty-eight women [reproductive-aged (n=55), pregnant (n=51), and postmenopausal (n=52)] who admitted to outpatient clinic of Obstetrics and Gynecology Department of Denizli State Hospital were enrolled. Age, body-mass index (BMI), obstetric history, cigarette smoking, drug usage, presence of systemic disease, and intraocular pressure (IOP) were recorded for each patient. The samples were taken from the lower fornix with two culture swabs and directly incubated in culture containing 5% sheep blood, eosin-methylene blue and chocolate agar. The other swab specimen was Gram stained. All growths and microscopic results were analyzed. RESULTS The coagulase-negative Staphylococcus was the predominant organism isolated in the conjunctival samples in both three groups. The aerobic microorganism growth rate for all isolated aerobic organisms revealed no significant change in the three groups (P >0.05). The conjunctival culture positivity rates were similar in the three groups (49% in reproductive-aged, 57% in pregnant and 58% in postmenopausal women) (P >0.05). Age, IOP, BMI, gravidity, parity, cigarette smoking, drug usage, and presence of systemic diseases did not have an effect on culture positivity in three groups. CONCLUSION Results of this study showed that conjunctival aerobic flora and bacterial colonization did not differ between reproductive-aged, pregnant and postmenopausal women. PMID:23275909

  3. Midwifery Management of Pregnant Women Who Are Obese.

    PubMed

    Reither, Margi; Germano, Elaine; DeGrazia, Michele

    2018-05-19

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

  4. Effects of Online Self-Regulation Activities on Physical Activity Among Pregnant and Early Postpartum Women.

    PubMed

    Kim, Hye Kyung; Niederdeppe, Jeff; Graham, Meredith; Olson, Christine; Gay, Geri

    2015-01-01

    Physical and psychological changes that occur during pregnancy present a unique challenge for women's physical activity. Using a theory-based prospective design, this study examines the effects of pregnant women's (a) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (b) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. The authors used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. The authors also discuss practical implications for encouraging physical activity among pregnant and early postpartum women.

  5. Epidemiology and Risk Factors of Functional Constipation in Pregnant Women

    PubMed Central

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

    2015-01-01

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

  6. [Sexuality of pregnant women].

    PubMed

    Malarewicz, Andrzej; Szymkiewicz, Jadwiga; Rogala, Jerzy

    2006-09-01

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

  7. Effects of Nutrition Education on Levels of Nutritional Awareness of Pregnant Women in Western Iran

    PubMed Central

    Fallah, Farnoush; Pourabbas, Ahmad; Delpisheh, Ali; Veisani, Yousef; Shadnoush, Mahdi

    2013-01-01

    Background Maternal nutritional health, before and during pregnancy, influences the health status of herself and her developing fetus. Pregnancy is an important condition for improving nutritional knowledge. Objectives The present study aimed at determining effects of nutrition education on levels of nutritional awareness of a representative group of pregnant women in Western Iran. Patients and Methods A quasi-experimental intervention was undertaken on a random sample of pregnant women (n = 100) attending urban health centers in Ilam city (western Iran) during the year 2011 for prenatal care. A nutritional education program containing two to four lessons was undertaken for small groups of between six to ten women. Nutritional knowledge was assessed before intervention (pretest) and followed by two posttests within three weeks interval. Results The awareness level of pregnant women about healthy nutrition was significantly increased from 3% before intervention to 31% after the nutritional education intervention (P < 0.001). This significant difference was independent from maternal characteristics of age and levels of literacy and in obese mothers in particular. Conclusions A nutritional education intervention will have a positive effect on nutritional awareness of pregnant women. PMID:24348589

  8. In-Country Migration and Risk Factors for HIV Acquisition among Pregnant Women in Tijuana, Mexico

    PubMed Central

    Viani, Rolando M.; Araneta, Maria R.; Spector, Stephen A.

    2016-01-01

    Objective To compare HIV prevalence and HIV acquisition risk behaviors between pregnant women residents and migrants. Design A cross-sectional study of pregnant women of unknown HIV status seeking care at Tijuana General Hospital, Mexico. Methods Pregnant women attending the labor and delivery unit or the prenatal clinic had a rapid HIV test drawn, with positive results confirmed by Western blot. Migrants were defined as women who had resided in Tijuana for less than 5 years. Results Between 2007 and 2008, a total of 3331 pregnant women consented to participate. The HIV seroprevalence did not differ between Tijuana residents (18 of 2502, 0.72%) and migrants (3 of 829, 0.36%, P = .32). In multivariate regression analyses, HIV acquisition risk behaviors included methamphetamine use (adjusted odds ratio [OR]: 6.03, 95% confidence interval [CI]: 2.3–15.8, P < .001) and first presentation at labor (adjusted OR: 5.0, 95% CI: 1.6–15.3, P = .005), adjusted for migrant status, age, and history of sexually transmitted infections. Conclusion The overall HIV seroprevalence was 0.63% and did not differ between Tijuana residents and migrants. PMID:24935694

  9. In-Country Migration and Risk Factors for HIV Acquisition among Pregnant Women in Tijuana, Mexico.

    PubMed

    Viani, Rolando M; Araneta, Maria R; Spector, Stephen A

    2016-05-01

    To compare HIV prevalence and HIV acquisition risk behaviors between pregnant women residents and migrants. A cross-sectional study of pregnant women of unknown HIV status seeking care at Tijuana General Hospital, Mexico. Pregnant women attending the labor and delivery unit or the prenatal clinic had a rapid HIV test drawn, with positive results confirmed by Western blot. Migrants were defined as women who had resided in Tijuana for less than 5 years. Between 2007 and 2008, a total of 3331 pregnant women consented to participate. The HIV seroprevalence did not differ between Tijuana residents (18 of 2502, 0.72%) and migrants (3 of 829, 0.36%, P = .32). In multivariate regression analyses, HIV acquisition risk behaviors included methamphetamine use (adjusted odds ratio [OR]: 6.03, 95% confidence interval [CI]: 2.3-15.8, P < .001) and first presentation at labor (adjusted OR: 5.0, 95% CI: 1.6-15.3, P = .005), adjusted for migrant status, age, and history of sexually transmitted infections. The overall HIV seroprevalence was 0.63% and did not differ between Tijuana residents and migrants. © The Author(s) 2014.

  10. [Activity of alpha-amylase and concentration of protein in saliva of pregnant women].

    PubMed

    Ciejak, Magdalena; Olszewska, Maria; Jakubowska, Katarzyna; Zebiełowicz, Dariusz; Safranow, Krzysztof; Chlubek, Dariusz

    2007-01-01

    One of the hypothetical reasons of the increased incidence of caries in women during the pregnancy may be the increased activity of alpha-amylase, which can be found in their saliva. The enzyme takes part in the process of decomposition of simple sugars, which make basic substrate for caries-causing bacteria. The aim of the paper was the evaluation of the influence of pregnancy and gestational age on the activity of alpha-amylase and the concentration of protein in women's saliva. The examined group consisted of 64 pregnant women at age 17-39, between 21st and 40th week of pregnancy. The control group consisted of 44 healthy women at age 20-35, who were not pregnant. In saliva, which was taken before morning meal, without stimulation, protein concentration was determined by Bradford method and the activity of amylase was determined by kinetic method. The activity of amylase correlated strongly and positively with protein concentration in saliva of both the pregnant (RS = +0.65; p < 0.00001) and the control group (RS = +0.74; p < 0.00001) women. There were no significant differences between examined parameters in the examined and the control group. It has been observed in the examined group, that there is the significant negative correlation between protein concentration in saliva and the week of pregnancy (RS = -0.35; p <0.01). It has been observed, in conducted researches, that there is no relation between the activity of amylase and the pregnancy and gestational age, which proves against the essential role of this enzyme in the increased caries incidence of pregnant women. However, the observed changes of total protein concentration in saliva during pregnancy, suggest that the exact cognition of proteins in pregnant women's saliva may reveal new mechanisms, which lead to an increase of caries risk.

  11. Changes in the prevalence of HBV infection in pregnant women in Turkey between 1995 and 2015: a 20-year evaluation.

    PubMed

    Furuncuoglu, Yavuz; Bolukbas, F Fusun; Bolukbas, Cengiz; Torun, Perihan; Ozturk, Recep

    2016-09-01

    To determine changes in hepatitis B virus (HBV) prevalence across three different time periods in pregnant women. This was a retrospective study of pregnant women attending four healthcare centres between January 1995 and May 2015. Data for serum hepatitis B surface antigen (HBsAg) and anti-HBs levels were collected from routine antenatal screening records. The 20-year study was divided into three periods: 1995-2001, 2002-2008 and 2009-2015. The results are presented by the women's age and gravidity as possible determinants of HBV infection. 7605 pregnant women (56.0% primigravidae) (mean age 23.4±4.8 years) were tested for markers of HBV infection. 3010 pregnant women were screened between 1995 and 2001, 2995 between 2002 and 2008, and 1600 between 2009 and 2015. The overall prevalence of HBsAg and anti-HBs positivity in the 7605 pregnant women was 1.5% (n=114) and 11.5% (n=877), respectively. Regarding temporal change in the prevalence of HBV markers, HBsAg decreased significantly from 2.6% to 0.8% (p<0.01), while anti-HBs increased significantly from 9.5% to 17.5% (p<0.01), between the first and last study periods. Multigravidae and older women had higher HBsAg and anti-HBs positivity compared to primigravidae. The data suggest that the prevalence of HBsAg positivity is gradually decreasing among pregnant women, while the level of HBsAg antibody seropositivity is lower than expected. HBV carrier rate increases with increasing age and gravidity. In addition to the national HBV immunisation programme, the prevention of perinatal transmission should also be prioritised to decrease the HBV pool of infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

    PubMed

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

    2018-04-01

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

  13. Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia.

    PubMed

    Gebremedhin, Ketema Bizuwork; Tian, Bingjie; Tang, Chulei; Zhang, Xiaoxia; Yisma, Engida; Wang, Honghong

    2018-01-01

    The global human immunodeficiency virus (HIV) epidemic disproportionately affects sub-Saharan African countries, including Ethiopia. Provider-initiated HIV testing and counseling (PITC) is a tool to identify HIV-positive pregnant women and an effective treatment and prevention strategy. However, its success depends upon the willingness of pregnant women to accept HIV testing. To describe the level of acceptance of PITC and associated factors among pregnant women attending 8 antenatal care clinics in Adama, Ethiopia. Trained nursing students and employees from an HIV clinic conducted face-to-face structured interviews in private offices at the clinics from August to September, 2016. Among the 441 respondents, 309 (70.1%) accepted PITC. Women with more antenatal care visits (odds ratio [OR] =2.59, 95% CI: 1.01-6.63), reported better quality of the PITC service (OR =1.91, 95% CI: 1.19-3.08), and higher level of knowledge on mother-to-child transmission (OR =1.82, 95% CI: 1.03-3.20), were more likely to accept PITC, while women who were older in age (OR =0.37, 95% CI: 0.19-0.74) and perceived negative attitudes from their partners toward HIV-positive results (OR =0.31, 95% CI: 0.10-0.94) were less likely to accept the PITC service. About one-third of pregnant women are not willing to accept PITC. When designing intervention program to improve the acceptance of PITC, we should take into consideration the personal factors, HIV-related knowledge, and attitude of women as well as institutional factors.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

  16. Maternal predictors related to quality of life in pregnant women in the Northeast of Brazil.

    PubMed

    Calou, Cinthia Gondim Pereira; de Oliveira, Mirna Fontenele; Carvalho, Francisco Herlânio Costa; Soares, Paula Renata Amorim Lessa; Bezerra, Raylla Araújo; de Lima, Sâmua Kelen Mendes; Antezana, Franz Janco; de Souza Aquino, Priscila; Castro, Régia Christina Moura Barbosa; Pinheiro, Ana Karina Bezerra

    2018-05-31

    Gestation is a period that can positively or negatively influence the life of a woman in the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices, with the goal of making them more effective and practical or the promotion of humanized care. The present study aimed to evaluate the predictors that influence the health-related quality of life of low-risk pregnant women, as well as to describe the main areas affected in the quality of life of pregnant women. A correlational, quantitative and cross-sectional study was carried out in two public units that provide prenatal care services and a private unit in the city of Fortaleza, a municipality in the Northeast of Brazil. The sample consisted of 261 pregnant women who were interviewed from September to November 2014. The collection instruments were a questionnaire covering sociodemographic, obstetric and quality of life variables, in addition to the Brazilian version of the Mother-Generated Index (MGI). The data were compiled and analyzed through the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A descriptive analysis was performed through the application of Pearson's chi-square test, Fisher's exact test and one-way ANOVA. Maternal predictors for the quality of life of pregnant woman were identified through a multivariate analysis/multiple regression. The response rate was 100%, corresponding to 261 respondents. Occupation, parity, partner support, marital status and persons with whom the women live were the predictors that positively interfered in the quality of life of pregnant women. In contrast, gestational age, type of housing, occupation, use of illicit drugs, non-receipt of partner support and maternal age were the predictors that negatively influenced quality of life. Our results indicate that happiness to become a mother and body image were areas with the greatest positive and negative influence on

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

    PubMed

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

    2011-01-01

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

  18. The prevalence of parvovirus B19 infection among pregnant women of Ardabil in 2013

    PubMed Central

    Habibzadeh, Shahram; Peeri-Doghaheh, Hadi; Mohammad-Shahi, Jafar; Mobini, Elham; Shahbazzadegan, Samira

    2016-01-01

    Background and Objectives: Trans-placental transmission of parvovirus B19 during pregnancy can causes adverse outcomes. Regarding its importance in prenatal care, we decided to study prevalence of parvovirus B19 infection among pregnant woman in Ardabil, Iran. Materials and Methods: In a community based study with a cluster sampling, 350 pregnant women that attended in health care centers in Ardabil were selected. Serum samples were collected and Anti-B19 specific IgG was detected using commercial enzyme-linked immunosorbent assays (Euroimmune Elisa kit, Germany). Furthermore, a questionnaire filled for all participants during samples collection. Results: 64.6% (226/350) of participants were Ardabil citizen and the rest were from rural area (124/350). Anti-B19-specific IgG antibody was detected in 69.1% of pregnant women (242/350). Participants’ ages ranged from 15 to 34 years with average of 23 years. According to our study, seroprevalence of IgG antibodies had positive significant correlation with the participants’ age (r=0.268) but there were no significant relations between B19 seropositivity and living area, family member, number of commensals, number of living children, and the amount of hemoglobin (p>0.05). Conclusion: Approximately, one-third of the participants were at risk of primary B19 infection. Therefore, health education of pregnant women and screening of infected pregnant women is recommended to prevent fetal complications. PMID:27928490

  19. The prevalence of parvovirus B19 infection among pregnant women of Ardabil in 2013.

    PubMed

    Habibzadeh, Shahram; Peeri-Doghaheh, Hadi; Mohammad-Shahi, Jafar; Mobini, Elham; Shahbazzadegan, Samira

    2016-06-01

    Trans-placental transmission of parvovirus B19 during pregnancy can causes adverse outcomes. Regarding its importance in prenatal care, we decided to study prevalence of parvovirus B19 infection among pregnant woman in Ardabil, Iran. In a community based study with a cluster sampling, 350 pregnant women that attended in health care centers in Ardabil were selected. Serum samples were collected and Anti-B19 specific IgG was detected using commercial enzyme-linked immunosorbent assays (Euroimmune Elisa kit, Germany). Furthermore, a questionnaire filled for all participants during samples collection. 64.6% (226/350) of participants were Ardabil citizen and the rest were from rural area (124/350). Anti-B19-specific IgG antibody was detected in 69.1% of pregnant women (242/350). Participants' ages ranged from 15 to 34 years with average of 23 years. According to our study, seroprevalence of IgG antibodies had positive significant correlation with the participants' age (r=0.268) but there were no significant relations between B19 seropositivity and living area, family member, number of commensals, number of living children, and the amount of hemoglobin (p>0.05). Approximately, one-third of the participants were at risk of primary B19 infection. Therefore, health education of pregnant women and screening of infected pregnant women is recommended to prevent fetal complications.

  20. Hepatitis C Cascade of Care Among Pregnant Women on Opioid Agonist Pharmacotherapy Attending a Comprehensive Prenatal Program.

    PubMed

    Page, Kimberly; Leeman, Lawrence; Bishop, Steven; Cano, Sandra; Bakhireva, Ludmila N

    2017-09-01

    Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype. Information was abstracted from the medical records of women who were followed at a comprehensive prenatal care clinic for women with substance use disorders at the University of New Mexico. Results The sample included 190 pregnant women, of whom 188 were on pharmacotherapy (43.7% on buprenorphine and 55.3% on methadone); the remaining two had tested positive for heroin or prescription opioids. A total of 178 (93.7%) were tested for anti-HCV, 94 (98.9%) of whom were tested for RNA, and 41 (57.7%) were genotyped. Prevalence of exposure to HCV by anti-HCV results was 53.3%, and 37.3% were positive for HCV RNA indicating chronic infection. Conclusions The high prevalence of exposure and infection with HCV in pregnant women involved in pharmacotherapy for a substance use disorder indicate a need for ongoing surveillance and testing for HCV. Identifying HCV during pregnancy is crucial because this identification would serve to enhance medical care and potentially prevent vertical transmission. Identifying HCV would also facilitate referrals to newly available curative HCV treatments following delivery.

  1. Prevention and treatment strategy in pregnant women with group B streptococcal infection.

    PubMed

    Tevdorashvili, G; Tevdorashvili, D; Andghuladze, M; Tevdorashvili, M

    2015-04-01

    Group B streptococcus (GBS; Streptococcus agalactiae) are encapsulated gram-positive cocci belonging to Lancefield group B, that frequently colonizes the human genital and gastrointestinal tracts. It is an important cause of illness in three categories of population: infants, pregnant women, and adults with underlying medical conditions. In pregnant women and postpartum women, GBS is a frequent cause of asymptomatic bacteriuria, urinary tract infection, upper genital tract infection (i.e. intraamniotic infection or chorioamnionitis), postpartum endometritis (8%), pneumonia (2%), puerperal sepsis (2%), and bacteremia without a focal site (31%). It also can cause focal infections such as pneumonia, meningitis, and endocarditis, albeit rarely. Invasive maternal infection with GBS is associated with pregnancy loss and preterm delivery. Prior to the widespread use of maternal intrapartum chemoprophylaxis, maternal colonization with GBS conferred an increased risk of chorioamnionitis, and early postpartum infection. The serotype distribution of invasive GBS infection in pregnant women is similar to that of early-onset neonatal disease. The most common GBS serotypes causing invasive disease in adults and neonates are Ia, Ib, III, and V. Vaccination of adolescent women is considered an ideal solution. However, recent reports (April 2015) have shown that serotype IV GBS is emerging in pregnant carriers and causing infections in neonates and adults. This emergence is of concern because GBS conjugate vaccines that are being developed to prevent invasive disease may protect only against serotypes Ia, Ib, II, III, and V, or combinations thereof. Though research for the development of such a vaccine is underway, a good candidate vaccine has yet to surface.

  2. Knowledge of diabetes mellitus among pregnant women in three districts of Nepal.

    PubMed

    Shrestha, S; Thapa, P; Saleh, F; Thapa, N; Stray, B Pedersen; Khanom, K

    2013-09-01

    Diabetes mellitus is an emerging health problem in developing world with the consumption of energy dense diet and inactive lifestyle. The problem of diabetes is further expanded due to ignorance and lack of knowledge. The aim of the study was to assess the knowledge of diabetes among pregnant women in three districts of Nepal. A community based cross-sectional study was conducted in three districts in mountain, hilly and plain areas of Nepal. A total of 590 pregnant women were interviewed during the period of July 2009 to June 2010. A knowledge score system was applied. Poor score was <40%, average (40-60%) and good (>60%) of the total score. Statistical software SPSS 11.5 was used for data entry, data management and analysis. Out of 590 pregnant women, only 41% had heard about diabetes mellitus. Majority of the participants (75%) from age group >30 years had not heard about diabetes. Among the 241 with some knowledge, the knowledge score median percent(range) on the meaning, symptoms, risk factors, treatment, prevention, complications and overall knowledge were 50%(0-100), 25% (0-75), 20% (0-60), 20% (0-100), 25% (0-100), 20% (0-60) and 26% (0- 58) respectively. According to defined category, majority of those who ever heard about diabetes had poor knowledge (95%). Knowledge among literate women (p=.001), women residing in Kailali district (plain region) (p=.003) and those with positive family history of diabetes (p=.003) was found to be significant. As large proportions of Nepalese pregnant women do not have any knowledge or have poor knowledge regarding diabetes, extensive health education and health promotion programs are urgently recommended to prevent diabetes in Nepal.

  3. The diagnostic performance of ultrasound for acute appendicitis in pregnant and young nonpregnant women: A case-control study.

    PubMed

    Segev, Lior; Segev, Yakir; Rayman, Shlomi; Nissan, Aviram; Sadot, Eran

    2016-10-01

    Ultrasonography is frequently used to diagnose acute appendicitis in women of reproductive age, but its diagnostic value in pregnant patients remains unclear. This study sought to compare the diagnostic performance of ultrasound in pregnant and young nonpregnant women with suspected acute appendicitis. The database of a single tertiary medical center was reviewed for all women of reproductive age who underwent appendectomy either during pregnancy (2000-2014) or in the nonpregnant state (2004-2007) following ultrasound evaluation. The performance of ultrasound in terms of predicting the final pathologic diagnosis was compared between the pregnant and non pregnant groups using receiver operating characteristic curve analysis. Of 586 young women treated for appendicitis during the study periods (92 pregnant, 494 non-pregnant), 200 underwent preoperative ultrasound [67 pregnant, and 133 nonpregnant young women]. The pregnant and nonpregnant groups were comparable in age and presenting symptoms. There was no significant difference in the predictive performance of ultrasound between the two groups (AUC 0.76 and 0.73 respectively, p = 0.78) or within the pregnant group, by trimester [first (n = 23), AUC 0.73; second (n = 32), AUC 0.67; third (n = 12), AUC 0.86; p = 0.4]. Ultrasound had a positive predictive value of 0.94 in the pregnant group and 0.91 in the nonpregnant group; corresponding negative predictive values were 0.40 and 0.43. There appears to be no difference in the ability of ultrasound to predict the diagnosis of acute appendicitis between pregnant women and nonpregnant women of reproductive age. Therefore, similar preoperative imaging algorithms may be used in both patient populations. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2018-01-01

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

  5. [Serological Investigation of Toxoplasma gondii on Pregnant Women and Toxoplasmosis Suspected Patients Between 2012-2014 Years on a Tertiary Training Hospital].

    PubMed

    Selek, Mehmet Burak; Bektöre, Bayhan; Baylan, Orhan; Özyurt, Mustafa

    2015-09-01

    Toxoplasmosis is a zoonotic disease which is still an important health issue in both developing and developed countries. We aimed to evaluate Toxoplasma gondii (T. gondii) seropositivity on toxoplasmosis suspected patients and pregnant women, retrospectively. Blood samples taken from toxoplasmosis suspected patients (n=1296) and pregnant women (1737) on our tertiary training hospital between 2012-2014 years. Anti-T. gondii IgG and IgM seropositivity analyzed with chemiluminescent microparticle immunological assay (CMIA) method. Also IgG avidity index were evaluated on patients who had both antibodies. Of 1269 toxoplasmosis suspected patients, 37% (n=479) had only T. gondii IgG positive while 1.9% (n=25) had both IgG and IgM antibodies. Of 1737 pregnant women, 24.2% (n=421) had only T. gondii IgG positive while 0.7% (n=13) of women were found positive for both antibodies. None of the total 3033 patients were seropositive for sole IgG antibody. Avidity tests were applied to the double positive patients and low avidity were detected on only one person from each group. Nationwide, high throughput, systemic seroprevalance studies is needed in order to take precautions for the public health to protect sensitive groups and pregnant women especially because of congenital toxoplasmosis risk.

  6. Early ART initiation among HIV-positive pregnant women in central Mozambique: a stepped wedge randomized controlled trial of an optimized Option B+ approach.

    PubMed

    Cowan, James F; Micek, Mark; Cowan, Jessica F Greenberg; Napúa, Manuel; Hoek, Roxanne; Gimbel, Sarah; Gloyd, Stephen; Sherr, Kenneth; Pfeiffer, James T; Chapman, Rachel R

    2015-04-30

    Despite effective prevention strategies and increasing investments in global health, maternal to child transmission (MTCT) of HIV remains a significant problem globally, especially in sub-Saharan Africa. In 2012, there were 94,000 HIV-positive pregnant women in Mozambique. Approximately 15% of these women transmitted HIV to their newborn infants, resulting in nearly 14,000 new pediatric HIV infections that year. To address this issue, in 2013, the Mozambican Ministry of Health implemented the World Health Organization-recommended "Option B+" strategy in which all newly diagnosed HIV-positive pregnant women are counseled to initiate combination anti-retroviral therapy (ART) immediately upon diagnosis regardless of CD4 count and to continue treatment for life. Given the limited experience with Option B+ in sub-Saharan Africa, few rigorous pragmatic trials have studied this new treatment strategy. This study utilizes an initial formative research process involving patient and health care provider interviews and focus groups, workforce assessments, value stream mapping, and commodity utilization assessments to understand the strengths and weaknesses in the current Option B+ care cascade. The formative research is intended to guide identification and prioritization of key workflow modifications and the development of an enhanced adherence and retention package. These two components are bundled into a defined intervention implemented and evaluated across six health facilities utilizing a stepped wedge randomized controlled trial study design. The overall objective of this trial is to develop and test a pilot intervention in central Mozambique to implement the new Option B+ guidelines with high fidelity and increase the proportion of HIV-positive pregnant women in target antenatal clinics (ANC) who start ART prior to delivery and are retained in care. This pragmatic study utilizes research strategies that have the potential to meaningfully improve the Option B+ care

  7. [Analysis of Correlation between IgG Titer of Pregnant Women and Neonatal Hemolytic Complications of Different Blood Groups].

    PubMed

    Ye, Hai-Hui; Huang, Hong-Hai; Wang, Xiao-Lin; Pi, You-Jun

    2017-10-01

    To study the relationship between IgG titer of pregnant women and hemolytic disease of newborn(HDN) with different blood groups. Four hundred pregnant women, including pregnant women with type O blood, were selected from May 2014 to January 2015 in our hospital for inspection and a couple of different blood groups, the IgG titer of pregnant women were detected in the inspection process. According to neonatal HDN, newborns were divided into 2 groups: HDN group(85 cases) and non-HDN group(315 cases). The incidence of postpartum neonatal hemolytic disease was tracked and the correlation of IgG titers with HDN were systematically analyzed. In the production and inspection process, the IgG titer in pregnant women was divided into <1:64, 1:64, 1:128, 1:256 and greater than or equal to 1:512 five groups. the comparison of HDN incidence rate in 4 groups of IgG titer >64 and IgG titer <1:64 group showed that the prevalence of ABO hemolytic disease of newborn were 96.9%, 79.6%, 63, 7% and 28.8%, there was a certain correlation of pregnant women IgG titers with ABO hemolytic disease of the newborn, that is, with the increase of IgG titer, the incidence of hemolytic disease of newborns increased in certain degree (r=0.8832), the risk in 4 groups of neonatal HDN was higher than that in IgG titer <1:64 of IgG titer >64 HDN group. There is a certain corelation between prevalence of ABO-HDN and IgG titer of pregnant women. For these pregnant women, the control of the pregnant women IgG titer has a positive clinical significance to reduce the incidence of hemolytic disease of the newborn.

  8. Influence of a preventive program on the oral health-related quality of life (OHRQoL) of European pregnant women: a cohort study.

    PubMed

    Martínez-Beneyto, Yolanda; Montero-Martin, Javier; Garcia-Navas, Francisco; Vicente-Hernandez, Ascension; Ortiz-Ruiz, Antonio Jose; Camacho-Alonso, Fabio

    2018-04-06

    The aim of this study was to compare the impact of oral health on quality of life of a group of pregnant women enrolled in a program of oral health with respect to a control group of non-pregnant women. A cross-sectional study involving a sociodental indicator OHIP-14 and a dental examination was completed to assess pregnant women's knowledge of oral health, hygienic habits, periodontal and caries index. Data were collected from 113 pregnant women and 113 non-pregnant women. Sociodemographic data for both groups were homogeneous. Pregnant women have better values of general and oral health, even though they have not perceived need for dental treatment, compared with control group. A worse periodontal health was observed for the control group. Our results showed that quality of life in pregnant women has been influenced with a statistical significance (p < 0.05) by the variables age, unemployment, level of education, immigration, frequency of brushing, type of dental practice, self-reported general and oral health and perceived treatment needs. The oral quality of life of pregnant women seems to be positively influenced by the incorporation of preventive oral programs during pregnancy.

  9. Prevalence and typing of HPV DNA in atypical squamous cells in pregnant women.

    PubMed

    Lu, Danielle W; Pirog, Edyta C; Zhu, Xiaopei; Wang, Hanlin L; Pinto, Karen R

    2003-01-01

    To determine the prevalence and typing of HPV DNA in pregnant women with a diagnosis of atypical squamous cells (ASC) and to assess whether pregnancy-related changes contribute to the diagnosis of ASC. HPV testing was performed on residual specimens from the ThinPrep Pap test (Cytyc Corp., Boxborough, Massachusetts, U.S.A.) in pregnant women diagnosed as ASC (study group, n = 105), low and high grade squamous intraepithelial lesion (LSIL and HSIL) (positive control, n = 33) and negative for epithelial cell abnormality (negative control, n = 20). All cases were reviewed by 2 cytopathologists to obtain consensus diagnoses using the Bethesda System 2001 criteria. The study group cases were further subcategorized into ASC of undetermined significance (ASCUS, n = 99) and ASC cannot exclude HSIL (ASC-H, n = 6). HPV testing was also performed on an ASC control group consisting of 68 consecutive ASC cases in nonpregnant women, matched by age. Mean patient age was 23.7 years for the study group and 25.6 years for the ASC control group. HPV DNA was detected in 88.6% of cases in the study group, including 87.9% of ASC-US and 100% of ASC-H cases. Of the HPV positive cases, 79.6%, 4.3%, 5.4% and 10.8% had high-risk, mixed high- and low-risk, low-risk and unknown HPV types, respectively. The most frequent HPV types detected were: types 52 (31.2%), 16 (15.1%), 39 (11.8%), 53 (10.8%), and 18 and 58 (9.7% each). Multiple viral types were detected in 43.0% of cases. The prevalence of HPV DNA in the positive and negative controls in pregnant women was 100% and 55%, respectively. HPV DNA was detected in 83.8% of the ASC control group. Regardless of pregnancy-related changes, the prevalence of HPV DNA in pregnant women (88.6%) was similar to that found in ASC in nonpregnant women of the same reproductive-age group (83.8%), and the high-risk types accounted for the vast majority of cases (83.9%). These findings demonstrate that pregnancy-related changes do not contribute to the

  10. Factors Associated with Significant Anxiety and Depressive Symptoms in Pregnant Women with a History of Complications.

    PubMed

    Chen, Jing; Cai, Yiyun; Liu, Yue; Qian, Jieyan; Ling, Qing; Zhang, Wei; Luo, Jianfeng; Chen, Yan; Shi, Shenxun

    2016-10-25

    The occurrence of complications during the gestation period is higher among pregnant women with a history of complications than among pregnant women without previous complications. High-risk pregnancy can cause negative emotional symptoms such as anxiety and depression in pregnant women. Current research on anxiety and depression symptoms in pregnant women is sparse. To examine the incidence of anxiety and depression symptoms in pregnant women with a history of previous complications or high risk pregnancy and related risk factors. Women with a history of previous complications in pregnancy or current 'high risk' pregnancy (e.g. test tube fertilization, etc.) were classified as 'high risk'. 197 of these 'high risk' women who were in their second trimester (16 to 20 weeks) underwent a monthly comprehensive assessment using the Hospital Anxiety and Depression Scale (HAD) in the last 4 months of the gestation period. The Edinburgh Postnatal Depression Scale (EPDS) was used for assessment and risk factor investigation 3 to 7 days, 42 days, and 3 months after childbirth. The mean (sd) HAD anxiety score among 'high-risk'women at the time of enrollment was 3.69 (2.76) and depression score was 3.42 (2.53). Significant anxiety symptoms and depression symptoms were found in 14 cases (7.18 %) and 10 cases (5.13%), respectively. Multivariate analysis showed a correlation between anxiety symptoms and history of miscarriage (OR: 8.162, 95%CI: 1.213 to 54.914)and testing positive for hepatitis (OR: 8.912, 95%CI: 1.052 to 75.498). Depressive symptoms were correlated with glucose positive urine (OR: 30.529, 95%CI: 1.312 to 710.610) and history of hemorrhaging (OR: 7.122, 95%CI: 1.015 to 49.984). General factors associated with anxiety and depression symptoms include patients' health status in the recent 3 months, concerns about fetal health, quality of marital relationship, and relationship with in-laws. Anxiety and depression symptoms are commonly seen in pregnant women with a

  11. Factors associated with seasonal influenza vaccination in pregnant women.

    PubMed

    Henninger, Michelle L; Irving, Stephanie A; Thompson, Mark; Avalos, Lyndsay Ammon; Ball, Sarah W; Shifflett, Pat; Naleway, Allison L

    2015-05-01

    This observational study followed a cohort of pregnant women during the 2010-2011 influenza season to determine factors associated with vaccination. Participants were 1105 pregnant women who completed a survey assessing health beliefs related to vaccination upon enrollment and were then followed to determine vaccination status by the end of the 2010-2011 influenza season. We conducted univariate and multivariate analyses to explore factors associated with vaccination status and a factor analysis of survey items to identify health beliefs associated with vaccination. Sixty-three percent (n=701) of the participants were vaccinated. In the univariate analyses, multiple factors were associated with vaccination status, including maternal age, race, marital status, educational level, and gravidity. Factor analysis identified two health belief factors associated with vaccination: participant's positive views (factor 1) and negative views (factor 2) of influenza vaccination. In a multivariate logistic regression model, factor 1 was associated with increased likelihood of vaccination (adjusted odds ratio [aOR]=2.18; 95% confidence interval [CI]=1.72-2.78), whereas factor 2 was associated with decreased likelihood of vaccination (aOR=0.36; 95% CI=0.28-0.46). After controlling for the two health belief factors in multivariate analyses, demographic factors significant in univariate analyses were no longer significant. Women who received a provider recommendation were about three times more likely to be vaccinated (aOR=3.14; 95% CI=1.99-4.96). Pregnant women's health beliefs about vaccination appear to be more important than demographic and maternal factors previously associated with vaccination status. Provider recommendation remains one of the most critical factors influencing vaccination during pregnancy.

  12. Zika Virus Infection in Pregnant Women in Rio de Janeiro

    PubMed Central

    Brasil, P.; Pereira, J.P.; Moreira, M.E.; Nogueira, R.M. Ribeiro; Damasceno, L.; Wakimoto, M.; Rabello, R.S.; Valderramos, S.G.; Halai, U.-A.; Salles, T.S.; Zin, A.A.; Horovitz, D.; Daltro, P.; Boechat, M.; Gabaglia, C. Raja; de Sequeira, P. Carvalho; Pilotto, J.H.; Medialdea-Carrera, R.; da Cunha, D. Cotrim; de Carvalho, L.M. Abreu; Pone, M.; Siqueira, A. Machado; Calvet, G.A.; Baião, A.E. Rodrigues; Neves, E.S.; de Carvalho, P.R. Nassar; Hasue, R.H.; Marschik, P.B.; Einspieler, C.; Janzen, C.; Cherry, J.D.; de Filippis, A.M. Bispo; Nielsen-Saines, K.

    2017-01-01

    BACKGROUND Zika virus (ZIKV) has been linked to central nervous system malformations in fetuses. To characterize the spectrum of ZIKV disease in pregnant women and infants, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in infants. METHODS We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase–polymerase-chain-reaction assays. We followed women prospectively to obtain data on pregnancy and infant outcomes. RESULTS A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001). Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly. Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester

  13. Zika Virus Infection in Pregnant Women in Rio de Janeiro.

    PubMed

    Brasil, Patrícia; Pereira, José P; Moreira, M Elisabeth; Ribeiro Nogueira, Rita M; Damasceno, Luana; Wakimoto, Mayumi; Rabello, Renata S; Valderramos, Stephanie G; Halai, Umme-Aiman; Salles, Tania S; Zin, Andrea A; Horovitz, Dafne; Daltro, Pedro; Boechat, Marcia; Raja Gabaglia, Claudia; Carvalho de Sequeira, Patrícia; Pilotto, José H; Medialdea-Carrera, Raquel; Cotrim da Cunha, Denise; Abreu de Carvalho, Liege M; Pone, Marcos; Machado Siqueira, André; Calvet, Guilherme A; Rodrigues Baião, Ana E; Neves, Elizabeth S; Nassar de Carvalho, Paulo R; Hasue, Renata H; Marschik, Peter B; Einspieler, Christa; Janzen, Carla; Cherry, James D; Bispo de Filippis, Ana M; Nielsen-Saines, Karin

    2016-12-15

    Zika virus (ZIKV) has been linked to central nervous system malformations in fetuses. To characterize the spectrum of ZIKV disease in pregnant women and infants, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in infants. We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase-polymerase-chain-reaction assays. We followed women prospectively to obtain data on pregnancy and infant outcomes. A total of 345 women were enrolled from September 2015 through May 2016; of these, 182 women (53%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 6 to 39 weeks of gestation. Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). By July 2016, a total of 134 ZIKV-affected pregnancies and 73 ZIKV-unaffected pregnancies had reached completion, with outcomes known for 125 ZIKV-affected and 61 ZIKV-unaffected pregnancies. Infection with chikungunya virus was identified in 42% of women without ZIKV infection versus 3% of women with ZIKV infection (P<0.001). Rates of fetal death were 7% in both groups; overall adverse outcomes were 46% among offspring of ZIKV-positive women versus 11.5% among offspring of ZIKV-negative women (P<0.001). Among 117 live infants born to 116 ZIKV-positive women, 42% were found to have grossly abnormal clinical or brain imaging findings or both, including 4 infants with microcephaly. Adverse outcomes were noted regardless of the trimester during which the women were infected with ZIKV (55% of pregnancies had adverse outcomes after maternal infection in the first trimester, 52% after infection in the second trimester, and 29% after infection in the third trimester). Despite mild clinical symptoms in

  14. Monitoring Body Water Balance in Pregnant and Nursing Women: The Validity of Urine Color.

    PubMed

    McKenzie, Amy L; Armstrong, Lawrence E

    2017-01-01

    Urine osmolality (UOSM) reflects the renal regulation of excess fluid or deficit fluid, and therefore, serves as a marker of hydration status. Little is known about monitoring hydration in pregnant and lactating women despite significant physiological challenges to body water balance during that time. Therefore, we designed a study to assess if urine color (UCOL), an inexpensive and practical method, was a valid means of assessing urine concentration. Twenty-four hour UCOL was significantly correlated with 24 h UOSM in all women: pregnant, lactating, and control (r = 0.61-0.84, all p < 0.001). Utilizing a receiver operating characteristic statistical analysis, we found that 24 h and single sample UCOL had excellent diagnostic accuracy for identifying UOSM ≥500 mOsm·kg-1 in all women (area under the curve = 0.68-0.95, p < 0.001-0.46), and the UCOL that reflected this cut off was ≥4 on the UCOL chart. Therefore, UCOL is a valid marker of urine concentration and ultimately hydration status in pregnant, lactating, and non-pregnant, non-lactating women. For pregnant, lactating, and control women, the UCOL chart is a valid tool that can be used to monitor urine concentration in a single sample or over the course of the day via a 24 h sample. Key Message: Women who present with a UCOL of 4 or more likely have a UOSM ≥500 mOsm·kg-1. Given the positive health benefits associated with UOSM <500 mOsm·kg-1, women should aim for a 1, 2, or 3 on the UCOL chart. If a UCOL of ≥4 is observed, women should consider increasing fluid consumption to improve hydration status. © 2017 The Author(s) Published by S. Karger AG, Basel.

  15. Virtual traumatology of pregnant women: the PRegnant car Occupant Model for Impact Simulations (PROMIS).

    PubMed

    Auriault, F; Thollon, L; Peres, J; Delotte, J; Kayvantash, K; Brunet, C; Behr, M

    2014-01-03

    This study report documents the development of a finite element (FE) model for analyzing trauma in pregnant women involved in road accidents and help the design of a specific safety device. The model is representative of a 50th percentile pregnant woman at 26 weeks of pregnancy in sitting position. To achieve this, the HUMOS 2 model, which has been validated in a wide range of dynamic tests, was scaled to the morphology of a woman in the 50th percentile and coupled with a model of gravid uterus. During scaling, special attention was paid to the pelvic region which is known to differ considerably in morphological terms between men and women. The gravid uterus model includes a placenta, a fetus, uterosacral ligaments and the amniotic fluid by means of fluid structure interaction formulation. The uterus and the female model were coupled using an original method whereby the growth of an uterus was simulated to compress the abdominal organs in a realistic manner. The model was validated based on experimental tests described in the literature. Additional tests based on abdominal loadings with a seatbelt on Post Mortem Human Surrogates (PMHS) coupled to silicone uterus were also performed. Results highlighted the role of the possible interaction of the fetus in the pregnant woman abdominal response. Experimental corridors taking into account the presence of this fetus could therefore be proposed. © 2013 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2017-07-01

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

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

    PubMed

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

    2015-11-01

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

  18. Antimicrobial susceptibility patterns of Ureaplasma species and Mycoplasma hominis in pregnant women.

    PubMed

    Redelinghuys, Mathys J; Ehlers, Marthie M; Dreyer, Andries W; Lombaard, Hennie A; Kock, Marleen M

    2014-03-28

    Genital mycoplasmas colonise up to 80% of sexually mature women and may invade the amniotic cavity during pregnancy and cause complications. Tetracyclines and fluoroquinolones are contraindicated in pregnancy and erythromycin is often used to treat patients. However, increasing resistance to common antimicrobial agents is widely reported. The purpose of this study was to investigate antimicrobial susceptibility patterns of genital mycoplasmas in pregnant women. Self-collected vaginal swabs were obtained from 96 pregnant women attending an antenatal clinic in Gauteng, South Africa. Specimens were screened with the Mycofast Revolution assay for the presence of Ureaplasma species and Mycoplasma hominis. The antimicrobial susceptibility to levofloxacin, moxifloxacin, erythromycin, clindamycin and tetracycline were determined at various breakpoints. A multiplex polymerase chain reaction assay was used to speciate Ureaplasma positive specimens as either U. parvum or U. urealyticum. Seventy-six percent (73/96) of specimens contained Ureaplasma spp., while 39.7% (29/73) of Ureaplasma positive specimens were also positive for M. hominis. Susceptibilities of Ureaplasma spp. to levofloxacin and moxifloxacin were 59% (26/44) and 98% (43/44) respectively. Mixed isolates (Ureaplasma species and M. hominis) were highly resistant to erythromycin and tetracycline (both 97% resistance). Resistance of Ureaplasma spp. to erythromycin was 80% (35/44) and tetracycline resistance was detected in 73% (32/44) of Ureaplasma spp. Speciation indicated that U. parvum was the predominant Ureaplasma spp. conferring antimicrobial resistance. Treatment options for genital mycoplasma infections are becoming limited. More elaborative studies are needed to elucidate the diverse antimicrobial susceptibility patterns found in this study when compared to similar studies. To prevent complications in pregnant women, the foetus and the neonate, routine screening for the presence of genital mycoplasmas is

  19. Antimicrobial susceptibility patterns of Ureaplasma species and Mycoplasma hominis in pregnant women

    PubMed Central

    2014-01-01

    Background Genital mycoplasmas colonise up to 80% of sexually mature women and may invade the amniotic cavity during pregnancy and cause complications. Tetracyclines and fluoroquinolones are contraindicated in pregnancy and erythromycin is often used to treat patients. However, increasing resistance to common antimicrobial agents is widely reported. The purpose of this study was to investigate antimicrobial susceptibility patterns of genital mycoplasmas in pregnant women. Methods Self-collected vaginal swabs were obtained from 96 pregnant women attending an antenatal clinic in Gauteng, South Africa. Specimens were screened with the Mycofast Revolution assay for the presence of Ureaplasma species and Mycoplasma hominis. The antimicrobial susceptibility to levofloxacin, moxifloxacin, erythromycin, clindamycin and tetracycline were determined at various breakpoints. A multiplex polymerase chain reaction assay was used to speciate Ureaplasma positive specimens as either U. parvum or U. urealyticum. Results Seventy-six percent (73/96) of specimens contained Ureaplasma spp., while 39.7% (29/73) of Ureaplasma positive specimens were also positive for M. hominis. Susceptibilities of Ureaplasma spp. to levofloxacin and moxifloxacin were 59% (26/44) and 98% (43/44) respectively. Mixed isolates (Ureaplasma species and M. hominis) were highly resistant to erythromycin and tetracycline (both 97% resistance). Resistance of Ureaplasma spp. to erythromycin was 80% (35/44) and tetracycline resistance was detected in 73% (32/44) of Ureaplasma spp. Speciation indicated that U. parvum was the predominant Ureaplasma spp. conferring antimicrobial resistance. Conclusions Treatment options for genital mycoplasma infections are becoming limited. More elaborative studies are needed to elucidate the diverse antimicrobial susceptibility patterns found in this study when compared to similar studies. To prevent complications in pregnant women, the foetus and the neonate, routine screening for

  20. Drugs for preventing malaria in pregnant women.

    PubMed

    Garner, P; Gülmezoglu, A M

    2006-10-18

    Malaria contributes to maternal illness and anaemia in pregnancy, especially in first-time mothers, and can harm the mother and the baby. Drugs given routinely to prevent or mitigate the effects of malaria during pregnancy are often recommended. To assess drugs given to prevent malaria infection and its consequences in pregnant women living in malarial areas. This includes prophylaxis and intermittent preventive treatment (IPT). We searched the Cochrane Infectious Diseases Group Specialized Register (March 2006), CENTRAL (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to March 2006), EMBASE (1974 to March 2006), LILACS (1982 to March 2006), and reference lists. We also contacted researchers working in the field. Randomized and quasi-randomized controlled trials comparing antimalarial drugs given regularly with no antimalarial drugs for preventing malaria in pregnant women living in malaria-endemic areas. Both authors extracted data and assessed methodological quality. Dichotomous variables were combined using relative risks (RR) and weighted mean differences (WMD) for mean values, both with 95% confidence intervals (CI). Sixteen trials (12,638 participants) met the inclusion criteria; two used adequate methods to conceal allocation. Antimalarials reduced antenatal parasitaemia when given to all pregnant women (RR 0.53, 95% CI 0.33 to 0.86; 328 participants, 2 trials), placental malaria (RR 0.34, 95% CI 0.26 to 0.45; 1236 participants, 3 trials), but no effect was detected with perinatal deaths (2890 participants, 4 trials). In women in their first or second pregnancy, antimalarial drugs reduced severe antenatal anaemia (RR 0.62, 95% CI 0.50 to 0.78; 2809 participants, 1 prophylaxis and 2 IPT trials), antenatal parasitaemia (RR 0.27, 95% CI 0.17 to 0.44, random-effects model; 2906 participants, 6 trials), and perinatal deaths (RR 0.73, 95% CI 0.53 to 0.99; 1986 participants, 2 prophylaxis and 1 IPT trial; mean birthweight was higher (WMD 126.70 g, 95% CI 88

  1. Prevalence of Ethanol Use Among Pregnant Women in Southwestern Uganda.

    PubMed

    English, L L; Mugyenyi, G; Nightingale, I; Kiwanuka, G; Ngonzi, J; Grunau, B E; MacLeod, S; Koren, G; Delano, K; Kabakyenga, J; Wiens, M O

    2016-10-01

    Introduction The prevalence of ethanol use in many Sub-Saharan African countries is high, but little research exists on use during pregnancy. The objective of this study was to assess the prevalence and predictors of ethanol use among pregnant women in Southwestern Uganda. Methods This descriptive, cross-sectional study was conducted in the maternity ward at Mbarara Regional Referral Hospital (MRRH). All pregnant women giving birth at MRRH between September 23, 2013 and November 23, 2013 were eligible for enrollment. The primary outcome was the proportion of women with ethanol use during pregnancy as determined by self-report. Secondary outcomes included the proportion with positive fatty acid ethyl ester (FAEE) results (indicating ethanol use) and positive TWEAK questionnaire results (indicating possible problem drinking). Predictors of ethanol use were assessed and stratified by patterns of ethanol intake. Results Overall, 505 mother-child dyads enrolled in the study. The proportion of women who reported any ethanol use during pregnancy was 16 % (n = 81, 95 % CI 13-19 %) and the prevalence of heavy drinking 6.3 % (n = 32, 95 % CI 3.8-7.9 %). The strongest predictor of use during pregnancy was pre-pregnancy use, with maternal education as a protective factor. Few neonates (n = 11, 2 %) tested positive for FAEE > 2.00 nmol/g in meconium. The TWEAK questionnaire captured 75 % of women who reported moderate/heavy drinking and aligned more with self-reported ethanol use than meconium results. Conclusions The substantial prevalence and clear predictors of ethanol use suggest that legislative action and educational interventions to increase awareness of potential harms could assist in efforts to decrease use during pregnancy in Southwestern Uganda.

  2. Diagnosis of hepatitis C virus infection in pregnant women in the healthcare system in Poland: Is it worth the effort?

    PubMed

    Walewska-Zielecka, Bożena; Religioni, Urszula; Juszczyk, Grzegorz; Czerw, Aleksandra; Wawrzyniak, Zbigniew; Soszyński, Piotr

    2016-07-01

    The hepatitis C virus (HCV) is globally recognized as a serious public health concern. Current statistics indicate that approximately 2% of people worldwide and 1.9% of people in Poland suffer from HCV infection.This study was conducted to assess the anti-HCV seroprevalence in pregnant women in Poland and subsequently provide recommendations on the rationale for obligatory screening.A total of 42,274 women participated in our study, of which 16,130 were pregnant. We were granted access to their health data stored in the form of electronic medical records kept by the network of outpatient clinics throughout Poland.The lowest rate of positive anti-HCV test results was found in women ages 25 to 34 (0.73%); however, younger and older age groups had similar rates (15-24 = 0.86%; 35-44 = 0.84%). Additional analysis of data from the period between 2011 and 2014 revealed a downward trend in the proportion of positive anti-HCV tests among pregnant women (mean positive anti-HCV = -0.001 × year + 1.9451; R = 0.7274). Regardless of the gradual increase in the number of female patients undergoing screening between 2004 and 2015, there has been a constant decrease in the rate of positive cases. The rate of pregnant women potentially infected with HCV was twice as lower than that in a control group of women undergoing tests for other medical circumstances: 0.76% vs 1.67% (P < 0.0001).Analysis of real-world data of female patients in Poland provides evidence that screening based on an individual's medical history and behavioral risk factors in clinical circumstances would be more effective than obligatory testing of all pregnant women.

  3. Depression, Social Support, and Coping Styles among Pregnant Women after the Lushan Earthquake in Ya'an, China.

    PubMed

    Ren, Jianhua; Jiang, Xiaolian; Yao, Jianrong; Li, Xirong; Liu, Xinghui; Pang, Meiche; Chiang, Chung Lim Vico

    2015-01-01

    The aim of this study is to assess the depression of pregnant women in the aftermath of an earthquake, and to identify the social support that they obtained, their coping styles and socio-demographic factors associated with depression. A total of 128 pregnant women from three hospitals in the epicenter area were recruited immediately after the Ya'an earthquake. Their depression was investigated using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of 14; the social support that they obtained was measured using the Social Support Questionnaire; and their coping styles were assessed using the Coping Styles Questionnaire. Immediately after the earthquake, the incidence rate of depression in pregnant women was 35.2%, higher than that of the general pregnant population (7%-14%). The EPDS scores were significantly correlated with gestation age at the time of the earthquake, objective support, subjective support, use of support, negative coping style, and positive coping style. The regression analysis indicated that risk factors of prenatal depression include the number of children, relatives wounded, subjective support, and coping styles. A further analysis of the interaction between social support and two types of coping styles with depression showed that there was interaction effect between subjective social support and positive coping styles in relation to EPDS scores. There was an inverse relationship between low EPDS scores and positive coping styles and high social support, and vice versa. The timing of the occurrence of the earthquake may not necessarily affect the progress of the illness and recovery from depression, and psychological intervention could be conducted in the immediate aftermath after the earthquake. The impact of coping styles on prenatal depression appeared to be linked with social support. Helping pregnant women to adopt positive coping styles with good social support after a recent major earthquake, which is a stressor, may

  4. The effectiveness of breath carbon monoxide analyzer in screening for environmental tobacco smoke exposure in Saudi pregnant women.

    PubMed

    Alzeidan, Rasmieh Ayed; Mandil, Ahmed Amin; Fayed, Amel Ahmed; Wahabi, Hayfaa Abdulmajeed

    2013-10-01

    Exposure to environmental tobacco smoke (ETS) has harmful effects on the pregnancy outcomes similar to those observed in actively smoking pregnant women. The aim of this study was to estimate the sensitivity and specificity of the breath carbon monoxide (BCO) analysis in the assessment of smoking status among Saudi pregnant women, including ETS exposure compared to self-reported tobacco smoke exposure. A cross-sectional design was used during January 2012, 560 pregnant women, irrespective of their gestational age, agreed to undergo BCO testing and completed the data collection sheet for the study. Sensitivity, specificity, positive and negative predictive values were calculated to compare the BCO test with self-reported exposure to ETS. Of the study population 151 (27%) women self-reported ETS exposure during the index pregnancy, 409 (73%) self-reported non-exposure. Sensitivity of the test was 32.5% (95% CI; 25.2-40.3%), the Specificity was much higher at 69.2% (95% CI; 64.4-73.5%), the positive predictive value was 28% (95% CI, 21.9-35.1%), and the negative predictive value was 73.5% (95% CI; 68.9-77.7%). The BCO test is an ineffective tool to detect the level of ETS exposure among Saudi pregnant women.

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

    PubMed

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

    2006-11-01

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

  6. Clinically significant anemia in HIV-infected pregnant women in India is not a major barrier to zidovudine use for prevention of maternal-to-child transmission.

    PubMed

    Sinha, Gita; Choi, Tou J; Nayak, Uma; Gupta, Amita; Nair, Sandeep; Gupte, Nikhil; Bulakh, Pandurang M; Sastry, Jayagowri; Deshmukh, Sanjay D; Khandekar, Medha M; Kulkarni, Vandana; Bhosale, Ramesh A; Bharucha, Kapila E; Phadke, Mrudula A; Kshirsagar, Anandini S; Bollinger, Robert C

    2007-06-01

    To determine the prevalence of anemia (serum hemoglobin <10 g/dL) and assess zidovudine use and toxicity in HIV-positive pregnant women in India. From 2002 through 2006, 24,105 pregnant women in Pune were screened for HIV and anemia. As part of an infant prevention of mother-to-child transmission (PMTCT) trial, enrolled HIV-positive women (n = 467) were assessed for anemia and associated outcomes, comparing women receiving zidovudine for >or=2 weeks versus no zidovudine. The prevalence of anemia was 38.7% in HIV-positive women. Anemic women were as likely as nonanemic women to receive zidovudine. At delivery, regardless of anemia status at enrollment, women receiving >or=2 weeks of zidovudine were 70% less likely to be anemic compared with women receiving no zidovudine (odds ratio = 0.28, 95% confidence interval: 0.14 to 0.57; P < 0.01), received iron and folic acid supplements for longer periods, and had no increased adverse delivery or newborn birth outcomes. A significant proportion of HIV-positive pregnant women in India present for antenatal care with anemia. With concurrent iron and folic acid supplementation, however, zidovudine use is not associated with persistent or worsening anemia or associated adverse outcomes. In Indian community settings, all pregnant HIV-positive women should receive early anemia treatment. Mild anemia should not limit zidovudine use for PMTCT in India.

  7. Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening and treatment of pregnant women in Port-au-Prince, Haiti.

    PubMed

    Bristow, Claire C; Mathelier, Patricia; Ocheretina, Oksana; Benoit, Daphne; Pape, Jean W; Wynn, Adriane; Klausner, Jeffrey D

    2017-10-01

    In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi's sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated - 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.

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

    PubMed

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

    1992-02-01

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

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

    PubMed

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

    2014-08-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2018-05-01

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

  12. Examining the safety of dental treatment in pregnant women.

    PubMed

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

    2008-06-01

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

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

    PubMed

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

    2005-01-01

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

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

    PubMed

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

    2014-03-01

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

  15. External Pressure, Motivation, and Treatment Outcome among Pregnant Substance-Using Women

    PubMed Central

    Ondersma, Steven J.; Winhusen, Theresa; Lewis, Daniel F.

    2009-01-01

    The weight of evidence suggests that legal pressure to enter treatment facilitates retention. However, the extent to which such mandates (a) influence actual levels of substance use, or (b) also facilitate retention among pregnant women, is unclear. Associations between external pressure—defined as self-reported pressure to attend treatment under threat of incarceration, loss of child custody, and/or loss of subsidized housing—and the key outcomes of retention and substance use were therefore examined in a sample of 200 pregnant women receiving community-based substance abuse treatment. The role of external pressure was examined in a series of Cox and GEE regressions, which suggested that external pressure as measured at baseline was associated with decreased risk of dropout (Hazard Ratio = .47, p = .001) and fewer drug-positive urine tests throughout treatment and 12-week follow-up (OR = 0.48, p = .03). These differences did not appear to be the result of baseline differences between coerced and non-coerced participants in education, legal history, presence or absence of a substance use disorder, employment, or motivation. The present findings extend the larger literature on external pressure by demonstrating effects on drug use as well as on retention, and among pregnant women. PMID:19926408

  16. Associations between quality of life, physical activity, worry, depression and insomnia: A cross-sectional designed study in healthy pregnant women

    PubMed Central

    Mourady, Danielle; Richa, Sami; Karam, Rita; Papazian, Tatiana; Hajj Moussa, Fabienne; El Osta, Nada; Kesrouani, Assaad; Azouri, Joseph; Jabbour, Hicham; Hajj, Aline

    2017-01-01

    Health-related quality of life (QOL) is reported to be reduced during pregnancy. Associations between QOL, physical activity (PA), insomnia, depression and worry are insufficiently investigated among pregnant women. The aim of this study was to evaluate QOL and PA patterns among healthy pregnant women, and to examine how QOL might correlate to PA, sleep, worry and depression. This is an observational cross-sectional study, conducted among a convenient sample of 141 healthy pregnant women using five questionnaires: WHOQOL-brief (WHO quality of life questionnaire, brief version, ISI (Insomnia Severity Index), PSWQ (Penn State Worry Questionnaire), ZSRDS (Zung Self-Rating Depression Scale), and Pregnancy Physical Activity Questionnaire (PPAQ). Pre-gestational BMI was inversely correlated to overall health while education was positively correlated to psychological health, social relationships and environment domains. Smoking before and during pregnancy significantly impacted the general health and psychological health. Total and light PA were positively correlated to psychological health and social relationships. Sports/exercise showed positive correlations with several QOL domains. Insomnia and depression were significantly associated with a decrease in all domains of QOL, while worries were associated with a decrease in physical, psychological and environmental domains. There were significant negative correlations between ZSRDS scores and total activity. PA, worries, depression and insomnia affected QOL during pregnancy. Furthermore, pregnant women presenting depression had a reduced total PA. Sleep and mental health as well as encouraging PA during pregnancy are necessary to improve the quality of life of pregnant women. PMID:28542529

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

    PubMed

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

    2014-08-01

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

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

    PubMed

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

    2017-12-01

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

  19. The association between second-hand smoke exposure and depressive symptoms among pregnant women.

    PubMed

    Huang, Jingya; Wen, Guoming; Yang, Weikang; Yao, Zhenjiang; Wu, Chuan'an; Ye, Xiaohua

    2017-10-01

    Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. HIV Prevalence and Antenatal Care Attendance among Pregnant Women in a Large Home-Based HIV Counseling and Testing Program in Western Kenya.

    PubMed

    Ndege, Samson; Washington, Sierra; Kaaria, Alice; Prudhomme-O'Meara, Wendy; Were, Edwin; Nyambura, Monica; Keter, Alfred K; Wachira, Juddy; Braitstein, Paula

    2016-01-01

    To describe the uptake of and factors associated with HIV prevalence among pregnant women in a large-scale home-based HIV counseling and testing (HBCT) program in western Kenya. In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH) initiated HBCT to all individuals aged ≥13 years and high-risk children <13 years. Included in this analysis were females aged 13-50 years, from 6 catchment areas (11/08-01/12). We used descriptive statistics and logistic regression to describe factors associated with HIV prevalence. There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR: 18-34) years. Of these, 7,396 (6.2%) were pregnant at the time of HBCT; 4,599 (62%) had ever previously tested for HIV and 2,995 (40.5%) had not yet attended ANC for their current pregnancy. Testing uptake among pregnant women was high (97%). HBCT newly identified 241 (3.3%) pregnant HIV-positive women and overall HIV prevalence among all pregnant women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy was 5.4% compared to 9.0% among those who had not. Pregnant women were more likely to newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy (AOR: 6.85, 95% CI: 4.49-10.44). Pregnant women who had never attended ANC were about 6 times more likely to newly test HIV-positive compared to those who had attended ANC, suggesting that the cascade of services for prevention of mother-to-child HIV transmission should optimally begin at the home and village level if elimination of perinatal HIV transmission is to be achieved.

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

    PubMed

    Bbosa, Richard Serunkuma; Ehlers, Valerie Janet

    2017-04-01

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

  2. Development of a Diet Quality Index Adapted for Pregnant Women

    PubMed Central

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

    2018-01-01

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

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

    PubMed

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

    2018-01-06

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

  4. 18 Percent of Pregnant Women Drink Alcohol during Early Pregnancy

    MedlinePlus

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

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

    PubMed

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

    2012-05-01

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

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

    PubMed

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

    2017-02-01

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

  7. [Changes of iodine nutrition status and thyroid function among pregnant women in iodine sufficient rural area of Gansu province].

    PubMed

    Wang, Yanling; Sun, Wei; Zhu, Xiaonan; Cao, Yongqin; Ge, Pengfei

    2014-01-01

    To assess the iodine nutrition and thyroid function of pregnant women during different periods of pregnancy, to provide evidence for guiding iodine supplementation for them. A cross-sectional survey was performed in 215 pregnant women in Yongjing couty from May to June 2013. Samples of blood and random urine were collected, and serum thyrotrophin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), anti-thyroid peroxidase (anti-TPO), antithyroglobulin ( anti-TG)and urinary iodine were measured. The medians of urinary iodine from the three groups of pregnant women(first, second and third trimester) were 189.8 µg/L, 152.5 µg/L and 144.9 µg/L respectively. With the exception of pregnant women in the third trimester, the urinary iodine medians of pregnant women in the first and second trimesters were within the 150-249 µg/L range which was defined as optimal by WHO/UNICEF/ICCIDD. With the increase of gestational age, the level of FT3 decreased (P < 0.05), with the FT3 levels in the first trimester were higher than those in the second or third trimester (P < 0.05). The difference of TSH levels among the three groups of pregnant women was statistically significant (P < 0.01), with a U-shaped curve seen between the iodine TSH levels and the gestational age. The medians of anti-TG and anti-TPO appeared the lowest in the first trimester, and remained at a high level in women at second and third trimesters. Significant difference was seen in anti-TG, anti-TPO levels of the three groups of pregnant women (first, second and third trimester) (P < 0.01). The incidence of thyroid function disorder was 1.86%, including subclinical hypothyroidism accounted for 1.40%, and hypothyroidism accounted for 0.47%. The incidence of thyroid function disorder mainly appeared in the early pregnancy. Abnormal FT3, TSH, positive anti-TG and anti-TPO were mainly seen during early pregnancy. The changes of TSH, FT3, FT4, anti-TG and anti-TPO along with the changes of urine iodine levels

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

    PubMed

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

    2010-08-01

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

  9. Identifying Pregnant Women Experiencing Domestic Violence in an Urban Emergency Department

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  10. Improvement of perinatal outcome in diabetic pregnant women.

    PubMed

    Szilagyi, A; Szabo, I

    2001-01-01

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

  11. Cardiac index in term pregnant women in the sitting, lateral, and supine positions: an observational, crossover study.

    PubMed

    Armstrong, Sarah; Fernando, Roshan; Columb, Malachy; Jones, Tanya

    2011-08-01

    Aortocaval compression may affect maternal hemodynamic indices and fetal well-being in various maternal positions. There has been much debate regarding the optimal position for performing neuraxial blockade for labor analgesia and cesarean delivery. We hypothesized that in pregnant women at term, cardiac index (CI) may be improved in the lateral positions as compared with the flexed sitting position. Our primary outcome was to measure CI as assessed by suprasternal Doppler. A prospective, observational, crossover study was conducted in 25 ASA physical status I/II women with uncomplicated pregnancies presenting for elective cesarean delivery at term. Hemodynamic indices were measured in 4 positions in random order: supine with a 15-degree left tilt, sitting with neck and hips flexed, and flexed left lateral and flexed right lateral positions. Maternal CIs were measured using a noninvasive suprasternal Doppler device and upper arm noninvasive arterial blood pressure. Umbilical Dopplers were performed simultaneously to measure the fetal heart rate and umbilical artery pulsatility and resistivity indices. CI differed by position (P = 0.01); it was higher in the right lateral position compared with the sitting and supine positions (by 8.8% and 8.1%, respectively) and in the left lateral compared with sitting position (by 7.8%) (P < 0.05). Maternal stroke volume index, heart rate, and systolic blood pressure were higher in the lateral positions compared with the sitting and supine-tilt positions. We found no significant differences in fetal heart rate, pulsatility index, or resistivity index among positions. Positioning for neuraxial anesthesia may influence maternal hemodynamic variables. We found no difference in healthy fetal blood flow indices among positions, suggesting that these changes are not clinically significant. This study provides new physiological information on the changes that occur in a group in whom it has not been practical to study previously

  12. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia.

    PubMed

    Mengistie, Zemenu; Woldeamanuel, Yimtubezinash; Asrat, Daniel; Adera, Addis

    2014-11-20

    Bacterial vaginosis is one of the most common genital tract infections among reproductive age group. The prevalence of bacterial vaginosis varies from country to country even in the same country it varies among populations of interest. Different social and sexual factors can contribute to the development of bacterial vaginosis. The aim of this study was to determine the prevalence of bacterial vaginosis and to identify the possible risk factors associated among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Randomly selected 57 symptomatic and 195 asymptomatic pregnant women aged between 18 and 40 years visiting obstetric and gynecological clinic from November 2011 to April 2012 screenedusing Gram stain Nugent scoring system. Statistical analysis like univariate analysis to calculate frequencies and proportions, bivariate analysis to see association of selected exposure variables with the outcome variable, and multivariate analysis to check the association of possible factors with bacterial vaginosis by adjusting potential confounding factors was calculated using SPSS (Version 16.0). The prevalence of bacterial vaginosis is 19.4% using Gram stain Nugent scoring system. In addition, prevalence of bacterial vaginosis is 31.6% and 15.9% among symptomatic and asymptomatic pregnant women respectively. A high percentage of bacterial vaginosis positive pregnant women were asymptomatic (63.3%). 36.7% bacterial vaginosis positive pregnant women reported abnormal vaginal discharge with or without unpleasant smell. Multiple lifetime sexual partner (OR: 8.6; 95% CI: 2.5, 29) and previous history of spontaneous abortion (OR: 5.9; 95% CI: 1.5, 23) had remained significantly associated with prevalence of bacterial vaginosis. The prevalence of bacterial vaginosis is higher among asymptomatic pregnant women and associated with the factors previous history of multiple lifetime sexual partner and spontaneous abortion.

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

    PubMed

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

    2017-05-15

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

  14. Determinants of anaemia among pregnant women in rural Uganda.

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2018-03-01

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

  16. Current status of syphilis in pregnant women in Japan.

    PubMed

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

    2017-12-01

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

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

    PubMed

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

    2016-04-01

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

  18. Protection for pregnant women in employment.

    PubMed

    Potrykus, C

    1994-03-01

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

  19. Colpocytological abnormalities in HIV infected and uninfected pregnant women: prevalence, persistence and progression.

    PubMed

    Carriero, Carmine; Fascilla, Fabiana Divina; Cramarossa, Paola; Lepera, Achiropita; Bettocchi, Stefano; Vimercati, Antonella

    2018-02-01

    In this retrospective case-control study, we analyse data of 48 HIV-positive pregnant patients, versus a control group of 99 HIV-negative pregnant women, followed as outpatients by our department from 2009 to 2014. The aims of the study were to investigate the prevalence, persistence and progression of cervical squamous intraepithelial lesions (SIL) in each group and to correlate colpo-cytological lesions to the socio-demographic and clinical-laboratory findings in the HIV + pregnant women. In our study we observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions. Pap smear and colposcopy should be part of routine care for HIV-infected pregnant women because these lesions behave aggressively in these patients. Success of prevention depends on massive access of patients to screening. HAART reduces viral load and maintains CD4 count and can affect progression of SIL. Multidisciplinary services on the same site appear to be one promising strategy to improve compliance in patients. Impact Statement What is already known on this subject: Our study provided novel information on a highly vulnerable population of young HIV + pregnant women. What the results of this study add: We observed that immunosuppression, HPV infection and vaginal coinfections were predictive of cervical lesions remarkable with colposcopy. We could consider these important risk factors to evaluate to establish an appropriate strategy of management for these patients. What the implications are of these findings for clinical practice and/or further research: Association of the risk between SIL presence and HIV and HPV infection also deserves additional investigation. We believe that Pap smears and colposcopies should be part of the routine care for HIV-infected women because these lesions behave particularly aggressively in these patients.

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

    PubMed

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

    2015-08-01

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

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

    PubMed Central

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

    2017-01-01

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

  2. Leisure time physical activity among pregnant women and its associations with maternal characteristics and pregnancy outcomes.

    PubMed

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

    2016-10-01

    Physical activity during pregnancy is generally considered safe and beneficial for both the pregnant woman and her fetus. The overall aim was to investigate pregnant women's pre-pregnancy and early pregnancy physical activity and its associations with maternal characteristics and pregnancy outcomes. This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant women living in northern Sweden between 2011 and 2012. Almost half of the participants (47.1%) achieved the recommended level of physical activity. Compared to the women who did not achieve the recommended level of exercise, these women had lower BMI, very good or good self-rated health, and a higher educational level. No significant associations could be established between physical activity levels and GDM, birth weight, or mode of delivery. Positively, a considerably high proportion of Swedish pregnant women achieved the recommended level of physical activity. Factors associated with recommended physical activity level were BMI ≤30 kg/m(2), very good or good self-rated health, and higher educational level. Our findings emphasize the need for health care professionals to early detect and promote fertile and pregnant women towards health-enhancing physical activity, especially those with low levels of physical activity and overweight/obesity, to improve overall health in this population. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

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

    PubMed

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

    2018-01-01

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

  4. Seroprevalence of Herpes Simplex Virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti.

    PubMed

    Domercant, Jean Wysler; Jean Louis, Frantz; Hulland, Erin; Griswold, Mark; Andre-Alboth, Jocelyne; Ye, Tun; Marston, Barbara J

    2017-08-18

    Herpes simplex virus type 2 (HSV-2), one the most common causes of genital ulcers, appears to increase both the risk of HIV acquisition and HIV transmission. HSV-2/HIV co-infection among pregnant women may increase the risk of perinatal transmission of HIV. This study describes rates of HSV-2 among pregnant women in Haiti and HSV-2 test performance in this population. Unlinked residual serum specimens from the 2012 National HIV and Syphilis Sentinel Surveillance Survey among pregnant women in Haiti were tested using two commercial kits (Focus HerpeSelect, Kalon) for HSV-2 antibodies. We evaluated rates of HSV-2 seropositivity and HSV-2/HIV co-infection, associations between HSV-2 and demographic characteristics using multivariable Cox proportional hazards modeling, and HSV-2 test performance in this population. Serum samples from 1000 pregnant women (all 164 HIV positive and 836 random HIV negative) were selected. The overall weighted prevalence of HSV-2 was 31.4% (95% CI: 27.7-35.4) and the prevalence of HIV-positivity among HSV-2 positive pregnant women was five times higher than the prevalence among HSV-2 negative women (4.8% [95% CI: 3.9-6.0] vs. 0.9% [95% CI: 0.6-1.3], respectively). Factors significantly associated with HSV-2 positivity were HIV-positivity (PR: 2.27 [95% CI: 1.94-2.65]) and older age (PRs: 1.41 [95% CI: 1.05-1.91] for 20-24 years, 1.71 [95% CI:1.13-2.60] for 30-34 years, and 1.55 [95% CI: 1.10-2.19] for 35 years or greater]), while rural residence was negatively associated with HSV-2 positivity (PR 0.83 [95% CI: 0.69-1.00]), after controlling for other covariables. For this study a conservative Focus index cutoff of 3.5 was used, but among samples with a Focus index value ≥2.5, 98.4% had positive Kalon tests. The prevalence of HSV-2 is relatively high among pregnant women in Haiti. Public health interventions to increase access to HSV-2 screening in antenatal services are warranted.

  5. Pregnant Women in Louisiana Are Not Meeting Dietary Seafood Recommendations

    PubMed Central

    Lammi-Keefe, C. J.

    2016-01-01

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

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

    PubMed

    Kurnatowska, Anna; Stankiewicz, Anna

    2006-05-01

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

  7. [Evaluation of the toxoplasmosis seroprevalence in pregnant women and creating a diagnostic algorithm].

    PubMed

    Mumcuoglu, Ipek; Toyran, Alparslan; Cetin, Feyza; Coskun, Feride Alaca; Baran, Irmak; Aksu, Neriman; Aksoy, Altan

    2014-04-01

    Toxoplasma gondii, an obligatory intracellular protozoon is widely distributed around the world and can infect all mammals and birds. While acquired toxoplasmosis is usually asymptomatic in healthy subjects, acute infection during pregnancy may lead to abortion, stillbirth, fetal neurological and ocular damages. For the prevention of congenital toxoplasmosis it is recommended that a screening programme and a diagnostic algorithm in pregnant women should be implemented while considering the cost effectiveness. Thus, it is necessary to determine the seroprevalence of toxoplasmosis in pregnant women and the actual risk of T.gondii transmission during pregnancy in a certain area. The aims of this study were to detect the T.gondii seropositivity in the pregnant women admitted to our hospital and to create a diagnostic algorithm in order to solve the problems arising from interpretation of the serological test results. A total of 6140 women aged 15-49 years who were admitted to our hospital between April 1st, 2010 to July 31st, 2013, were evaluated retrospectively. In the serum samples, T.gondii IgM, IgG and IgG avidity tests were performed by VIDAS automated analyzer using TOXO IgM, TOXO IgG II and TOXO IgG avidity kits (bioMerieux, France). It was noted that, both T.gondii IgM and IgG tests were requested from 4758 (77.5%) of the pregnant women, while only IgM test from 1382 (22.5%) cases. Sole IgM positivity was found as 0.2% (11/6140), IgG as 26.4% (1278/4758) and both IgM + IgG as 0.9% (44/4758). T.gondii IgG avidity tests were requested from 12 of 44 women who were found both IgM and IgG positive and eight of them revealed high avidity and four low avidity. Avidity test was ordered for the 91 (7.1%) of 1278 sole IgG positive cases and four of them were found to have low avidity. IgG avidity test was ordered for 554 (16.2%) of IgM and/or IgG negative subjects, however, the test was not performed according to rejection criteria of the laboratory. It was noticed that

  8. Risk factors related to asymptomatic bacteriuria in pregnant women.

    PubMed

    Kovavisarach, Ekachai; Vichaipruck, Maytina; Kanjarahareutai, Suwattana

    2009-05-01

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

  9. Survey and analysis for impact factors of psychological distress in HIV-infected pregnant women who continue pregnancy.

    PubMed

    Qin, Shouxue; Tan, Yanping; Lu, Bingyan; Cheng, Yuqing; Nong, Yanli

    2018-05-15

    The objective of this study is to explore the psychological distress of HIV-infected pregnant women who continue pregnancy, and analyze the possible influencing factors. A total of 194 HIV-infected pregnant women who continue pregnancy were enrolled for this study by a convenient sampling method during June 2012-August 2016. Participants completed questionnaires including Hospital Anxiety and Depression Scale (HADS), Berger HIV Stigma Scale (BHSS), Distress Thermometer (DT) and Problem List (PL), and to determine the cut-off value of DT in the group. The positive detection rate of psychological distress in the HIV-infected pregnant women who continue pregnancy was 69.1%, and the highest frequency of PL was the emotional problems. The positive detection rate of anxiety was 60.8%, the positive detection rate of depression was 54.1%, and the discrimination score was 113.16 ± 19.21. Spearman relevant analysis showed that psychological distress score was positively correlated with anxiety, depression and discrimination score (p < .001). Multiple linear regression analysis showed that relationship between husband and wife, family misfortune, Medicaid, chronic disease or high-risk pregnancy, viral load, CD 4 + T cell count, infection and confidentiality could affect the psychological distress (p < .05). The ideal cut-off value of DT in the group was 5. HIV-infected pregnant women who continue pregnancy have higher incidence of psychological distress, and the psychological distress is not inferior to cancer patients. The influencing factors are mainly related to the infection and pregnancy characteristics, and have nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.

  10. Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities.

    PubMed

    Nogayeva, Maral G; Tuleutayeva, Svetlana A

    2015-01-01

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

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

    PubMed

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

    2016-09-01

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

  12. Seroprevalence of HIV, HBV, HCV, and HTLV among Pregnant Women in Southwestern Nigeria.

    PubMed

    Opaleye, Oluyinka Oladele; Igboama, Magdalene C; Ojo, Johnson Adeyemi; Odewale, Gbolabo

    2016-01-01

    Sexually transmitted infections (STIs) are major public health challenge especially in developing countries. This study was designed to determine the prevalence of Hepatitis B virus (HBV), Hepatitis C Virus (HCV), Human immunodeficiency virus (HIV), and Human T-cell lymphotropic Virus type I (HTLV-I) among pregnant women attending antenatal clinic, in Ladoke Akintola University Teaching Hospital, Osogbo, and South-Western Nigeria. One hundred and eighty two randomly selected pregnant women were screened for HBsAg, anti-HCV, anti-HIV and HTLV-1 IgM antibodies using commercially available ELISA kit. Of the 182 blood samples of pregnant women screened whose age ranged from 15-49 years, 13 (7.1%), 5 (2.7%), 9 (4.9%), and 44 (24.2%) were positive for HBsAg, anti-HCV, anti-HIV, and HTLV-1 IgM antibodies, respectively. The co-infection rate of 0.5% was obtained for HBV/HCV, HBV/HIV, HIV/HTLV-1, and HCV/HTLV-1 while 1.1% and 0% was recorded for HBV/HTLV-1 and HCV/HIV co-infections, respectively. Expected risk factors such as history of surgery, circumcision, tattooing and incision showed no significant association with any of the viral STIs (P > 0.05). This study shows that there is the need for a comprehensive screening of all pregnant women for HBsAg, anti-HCV, anti-HIV and HTLV-1 to prevent mother to child transmission of these viral infections and its attending consequences.

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

    PubMed Central

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

    2006-01-01

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

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

    PubMed

    Laskowska, Marzena; Laskowska, Katarzyna; Oleszczuk, Jan

    2010-11-01

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

  15. Eating for Two? Protocol of an Exploratory Survey and Experimental Study on Social Norms and Norm-Based Messages Influencing European Pregnant and Non-pregnant Women's Eating Behavior.

    PubMed

    Bevelander, Kirsten E; Herte, Katharina; Kakoulakis, Catherine; Sanguino, Inés; Tebbe, Anna-Lena; Tünte, Markus R

    2018-01-01

    The social context is an important factor underlying unhealthy eating behavior and the development of inappropriate weight gain. Evidence is accumulating that powerful social influences can also be used as a tool to impact people's eating behavior in a positive manner. Social norm-based messages have potential to steer people in making healthier food choices. The research field on nutritional social norms is still emerging and more research is needed to gain insights into why some people adhere to social norms whereas others do not. There are indications stemming from empirical studies on social eating behavior that this may be due to ingratiation purposes and uncertainty reduction. That is, people match their eating behavior to that of the norm set by their eating companion(s) in order to blend in and be part of the group. In this project, we explore nutritional social norms among pregnant women. This population is particularly interesting because they are often subject to unsolicited advice and experience social pressure from their environment. In addition, their pregnancy affects their body composition, eating pattern, and psychosocial status. Pregnancy provides an important window of opportunity to impact health of pregnant women and their child. Nevertheless, the field of nutritional social norms among pregnant women is understudied and more knowledge is needed on whether pregnant women use guidelines from their social environment for their own eating behavior. In this project we aim to fill this research gap by means of an exploratory survey (Study 1) assessing information about social expectations, (mis)perceived social norms and the role of different reference groups such as other pregnant women, family, and friends. In addition, we conduct an online experiment (Study 2) testing to what extent pregnant women are susceptible to social norm-based messages compared to non-pregnant women. Moreover, possible moderators are explored which might impact women

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

    PubMed

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

    2016-10-01

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

  17. Pilates workouts can reduce pain in pregnant women.

    PubMed

    Oktaviani, Ika

    2018-05-01

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

  18. Violence against pregnant women: prevalence and associated factors.

    PubMed

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

    2008-10-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2015-05-01

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

  1. Seroprevalence and risk factors for toxoplasma infection among pregnant women in Aydin province, Turkey.

    PubMed

    Ertug, Sema; Okyay, Pinar; Turkmen, Munevver; Yuksel, Hasan

    2005-06-15

    The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey. The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used. The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected. One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings.

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2012-12-01

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

  5. The use of the edinburgh postpartum depression scale in a population of teenager pregnant women in Mexico: a validation study.

    PubMed

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2014-01-01

    :Depression may occur in teenager pregnant women. The use of a validated tool for screening depression is highly recommended. The Edinburgh postnatal depression scale (EPDS) is a screening tool for depression used in women during the postnatal period and pregnancy. However, the EPDS has not been validated in teenager pregnant women. Therefore, we sought to validate a Spanish translated Mexican version of the EPDS in a population of teenager pregnant women. One hundred and twenty teenager pregnant women attending routine prenatal consultations in a public hospital in Durango City, Mexico participated in the study. All participants submitted a revised Spanish translated Mexican version of the EPDS and were examined by a psychiatrist to evaluate the presence of depression by using DSM-IV criteria. Of the 120 teenager pregnant women studied, 2 had major depression and 25 had minor depression according to the DSM-IV criteria. The optimal EPDS cut-off for screening combined major and minor depression in teenager pregnant women was 8/9. At this threshold, we found a sensitivity of 70.4%, a specificity of 84.9%, a positive predictive value of 47.6%, a negative predictive value of 91.0%, and an area under the curve of 0.81 (95% confidence interval: 0.56-1.07). The EPDS can be used for screening depression in Mexican teenager pregnant women whenever a cut-off score of 8/9 is used.

  6. The Use of the Edinburgh Postpartum Depression Scale in a Population of Teenager Pregnant Women in Mexico: A Validation Study

    PubMed Central

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2014-01-01

    Background :Depression may occur in teenager pregnant women. The use of a validated tool for screening depression is highly recommended. The Edinburgh postnatal depression scale (EPDS) is a screening tool for depression used in women during the postnatal period and pregnancy. However, the EPDS has not been validated in teenager pregnant women. Therefore, we sought to validate a Spanish translated Mexican version of the EPDS in a population of teenager pregnant women. Methods: One hundred and twenty teenager pregnant women attending routine prenatal consultations in a public hospital in Durango City, Mexico participated in the study. All participants submitted a revised Spanish translated Mexican version of the EPDS and were examined by a psychiatrist to evaluate the presence of depression by using DSM-IV criteria. Results: Of the 120 teenager pregnant women studied, 2 had major depression and 25 had minor depression according to the DSM-IV criteria. The optimal EPDS cut-off for screening combined major and minor depression in teenager pregnant women was 8/9. At this threshold, we found a sensitivity of 70.4%, a specificity of 84.9%, a positive predictive value of 47.6%, a negative predictive value of 91.0%, and an area under the curve of 0.81 (95% confidence interval: 0.56-1.07). Conclusion: The EPDS can be used for screening depression in Mexican teenager pregnant women whenever a cut-off score of 8/9 is used. PMID:25493092

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

    PubMed

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

    2010-09-01

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

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2015-03-01

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

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

    PubMed Central

    2014-01-01

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

  11. Asymptomatic Bacteriuria in Pregnant Women in Outpatient Facilities

    PubMed Central

    Nogayeva, Maral G.; Tuleutayeva, Svetlana A.

    2015-01-01

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

  12. T1 bright appendix sign to exclude acute appendicitis in pregnant women.

    PubMed

    Shin, Ilah; An, Chansik; Lim, Joon Seok; Kim, Myeong-Jin; Chung, Yong Eun

    2017-08-01

    To evaluate the diagnostic value of the T1 bright appendix sign for the diagnosis of acute appendicitis in pregnant women. This retrospective study included 125 pregnant women with suspected appendicitis who underwent magnetic resonance (MR) imaging. The T1 bright appendix sign was defined as a high intensity signal filling more than half length of the appendix on T1-weighted imaging. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the T1 bright appendix sign for normal appendix identification were calculated in all patients and in those with borderline-sized appendices (6-7 mm). The T1 bright appendix sign was seen in 51% of patients with normal appendices, but only in 4.5% of patients with acute appendicitis. The overall sensitivity, specificity, PPV, and NPV of the T1 bright appendix sign for normal appendix diagnosis were 44.9%, 95.5%, 97.6%, and 30.0%, respectively. All four patients with borderline sized appendix with appendicitis showed negative T1 bright appendix sign. The T1 bright appendix sign is a specific finding for the diagnosis of a normal appendix in pregnant women with suspected acute appendicitis. • Magnetic resonance imaging is increasingly used in emergency settings. • Acute appendicitis is the most common cause of acute abdomen. • Magnetic resonance imaging is widely used in pregnant population. • T1 bright appendix sign can be a specific sign representing normal appendix.

  13. Pilates program design and health benefits for pregnant women: A practitioners' survey.

    PubMed

    Mazzarino, Melissa; Kerr, Debra; Morris, Meg E

    2018-04-01

    Little is known about recommendations for safe and appropriate instruction of Pilates exercises to women during pregnancy. The aim of this study was to examine Pilates practitioners' perspectives regarding Pilates program design for pregnant women. We also sought to elucidate their views on the potential benefits, restrictions and contraindications on Pilates in pregnancy. A cross-sectional survey was performed. Pilates practitioners were invited to participate via email. Participants were surveyed about their experience and views on: screening processes in alignment with The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines; (ii) optimal exercise program features and (iii) physical and mental health benefits of Pilates for pregnant women. The survey was completed by 192 Pilates practitioners from a range of settings. Practitioners reported conducting formal screening (84%) for safety in pregnant women prior to commencing Pilates classes. Most did not routinely seek medical approval from the woman's general practitioner. Divergent views emerged regarding the safety and benefits of Pilates exercises in the supine position. Mixed opinions were also generated regarding the effects of spinal flexion exercises, single-leg stance exercises and breathing manoeuvres. There was little agreement on the optimal frequency or dosage of exercises. Views regarding absolute contraindications to exercise differed from The American College of Obstetricians and Gynecologists (ACOG) (2002) guidelines which cautioned about the dangers of persistent bleeding, premature labour, pre-eclampsia, placental praevia and incompetent cervix. The most frequent reported physical and psychological benefit of Pilates was improving pelvic floor strength (12%) and improved social wellbeing (23%). The study highlighted wide variations in practice for Pilates exercises with pregnant woman as well as low adherence to clinical practice guidelines. Further evidence is required to

  14. Serological survey of HIV and syphilis in pregnant women in Madagascar.

    PubMed

    Frickmann, Hagen; Schwarz, Norbert G; Girmann, Mirko; Hagen, Ralf M; Poppert, Sven; Crusius, Sabine; Podbielski, Andreas; Heriniaina, Jean N; Razafindrabe, Tsiriniaina; Rakotondrainiarivelo, Jean P; May, Jürgen; Rakotozandrindrainy, Raphaël

    2013-01-01

    Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow-up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow-up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission. © 2012 Blackwell Publishing Ltd.

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

    PubMed

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

    2017-05-13

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

  16. Immunization of pregnant women: Future of early infant protection

    PubMed Central

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

    2015-01-01

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

  17. The Relationship between Psychological Wellbeing and Body Image in Pregnant Women.

    PubMed

    Fahami, Fariba; Amini-Abchuyeh, Maryam; Aghaei, Asghar

    2018-01-01

    The aim of the present study was to determine the association between body image and psychological wellbeing during pregnancy. This descriptive correlational study was conducted on 320 pregnant women who were referred to health centers in Isfahan, Iran, during 2016 and had the inclusion criteria. They were selected by nonprobability convenient sampling. Data were gathered using standard psychological wellbeing and body image satisfaction questionnaires. The data were analyzed using Statistical Package for the Social Sciences software by descriptive and inferential statistical methods. The results showed that the mean (SD) score of psychological wellbeing among participants was 77.50 (10.10) and their mean (SD) score of satisfaction with body image was 89.30 (14.60). Moreover, the results revealed a positive and significant relationship between the scores of psychological wellbeing and body image satisfaction (r=0.354, p <0.001). The results of regression analysis showed that the two variables of self-acceptance ( t = 5.6, p <0.001) and personal growth ( t = 2.06, p = 0.04)) can predict body image in pregnant women. The findings revealed a significant positive relationship between body image satisfaction and psychological wellbeing. Therefore, the training of positive attitude with respect to body image or increasing the level of knowledge on psychological wellbeing can create a positive cycle for these variables, and thus, make the pregnancy more enjoyable and acceptable.

  18. Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women.

    PubMed

    Okun, Michele L; Buysse, Daniel J; Hall, Martica H

    2015-06-15

    Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identification of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specificity, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. The ISQ identified 12.6% of the sample as meeting a case definition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specificity (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. A commentary on this article appears in this issue on page 593. © 2015 American Academy of Sleep Medicine.

  19. Toxoplasmosis seroprevalence in relation to knowledge and practice among pregnant women in Dhahran, Saudi Arabia.

    PubMed

    Elsafi, Salah H; Al-Mutairi, Wasaef F; Al-Jubran, Khalid M; Abu Hassan, Mohamed M; Al Zahrani, Eidan M

    2015-01-01

    The epidemiological importance of the different routes of Toxoplasma gondii transmission is not known and depends largely on population behaviour and knowledge. This study was conducted to assess toxoplasmosis seropositivity and the related knowledge and preventive practices that are necessary for the prevention of the disease among pregnant women. All pregnant women attending antenatal clinic were tested for T. gondii immunoglobulins followed by a survey questionnaire that tested their knowledge and preventive practice. Statistical comparisons were made between the seropositive and negative ones. We determined a low to moderate seroprevalence of toxoplasmosis among pregnant women in Dhahran, Saudi Arabia as compared to many other parts of the world. The overall positivity rates of IgG and IgM against T. gondii among 400 pregnant women were 28.5 and 3%, respectively. 75.5% of the participants had never heard about toxoplasmosis and the associated risk factors. Lack of knowledge was associated with the higher risk of infection (OR = 4.04, p < 0.001). Keeping pet cats was not common and poorly associated with infections (OR = 1.15, p ≥ 0.64). Consumption of undercooked meat was reported frequently and only slight risk was associated with sheep/goat meat (OR = 1.39, p = 0.15). Eating outside the home at restaurants was reported for the first time to be related to a higher risk of infection (OR = 2.69, p < 0.001). Several possible risk factors were suggested through odds ratios calculation and overall knowledge of toxoplasmosis by pregnant women was poor. It is therefore vital to provide a formal education about toxoplasmosis risk factors to women of childbearing age.

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

    PubMed

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

    2018-01-18

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

  1. Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana.

    PubMed

    Obiri-Yeboah, Dorcas; Asante Awuku, Yaw; Adu, Joseph; Pappoe, Faustina; Obboh, Evans; Nsiah, Paul; Amoako-Sakyi, Daniel; Simpore, Jacques

    2018-01-01

    Hepatitis E virus is an emerging infection in Africa with poor maternal and foetal outcomes. There is scanty data on the sero-prevalence of HEV infection among pregnant women in Ghana. This study highlighted the prevalence and risk factors associated with HEV infection among pregnant women in Cape Coast Metropolis, Central Region of Ghana. A multicenter (3 selected sites) analytical cross sectional study involving 398 pregnant women in the Cape Coast metropolis was conducted. HEV (Anti-HEV IgG and Anti-HEV IgM) ELISA was performed. Sero-positive women had liver chemistries done and data collected on maternal and neonatal outcomes. Data analyses were performed using Stata version 13 software (STATA Corp, Texas USA). Mean age was 28.01 (± 5.93) years. HEV sero-prevalence was 12.2% (n = 48) for IgG and 0.2% (n = 1) for IgM with overall of 12.3%. The odds of being HEV sero-positive for women aged 26-35 years was 3.1 (95% CI: 1.1-8.1), p = 0.02 and ≥36 years it was 10.7 (95% CI; 3.4-33.5), p = 0.0001. Living in urban settlement was associated with lowest odds of HEV infection {OR 0.4 (95% CI; 0.2-0.8), p = 0.01}. Factors with no statistical evidence of association include main source of drinking water and history of blood transfusion. The sero-prevalence of HEV IgG increased progressively across trimesters with the highest among women in their third trimester (55.3%). None of the 49 HEV sero-positive women had elevated ALT level. Ten (N = 41) of the neonates born to sero-positive women developed jaundice in the neonatal period. The mean birth weight was 3.1kg (SD 0.4). HEV sero-prevalence among pregnant women in the Cape Coast Metropolis is high enough to deserve more attention than it has received so far. It is therefore important to conduct further research on the potential impact on maternal and neonatal mortality and morbidity in Ghana.

  2. First-trimester markers of aneuploidy in women positive for HIV.

    PubMed

    Savvidou, M D; Samuel, I; Syngelaki, A; Poulton, M; Nicolaides, K H

    2011-06-01

    To investigate whether the sonographic and maternal serum biochemical markers used in first-trimester screening for chromosomal abnormalities are altered in pregnancies affected by maternal HIV infection. Nested case-control study. Routine antenatal visit in a teaching hospital. Ninety HIV-positive and 450 HIV-negative pregnant women. Findings from first-trimester antenatal visit for calculation of the risk for chromosomal abnormalities were compared between HIV-positive (treated and untreated) and HIV-negative women. First-trimester maternal serum free β human chorionic gonadotrophin (free β-hCG) pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal translucency thickness (NT), were compared. There were no statistically significant differences between the HIV-positive and HIV-negative women in the median maternal levels of free β-hCG, PAPP-A and fetal NT. However, within the HIV-positive group those receiving antiretroviral treatment (n = 41) had a significantly lower median multiple of the median (MoM) for free β-hCG (0.74, interquartile range [IQR] 0.45-1.32 MoM) than HIV-positive women on no treatment (1.03, IQR 0.76-1.85 MoM; P = 0.006) and HIV-negative women (1.0, IQR 0.68-1.47 MoM; P = 0.003). There was no correlation between the level of free β-hCG or PAPP-A and maternal viral load or CD4(+) count. Maternal levels of free β-hCG in treated HIV-positive pregnant women were lower compared with those in non-treated HIV-positive and HIV-negative women, whereas the PAPP-A levels and fetal NT remained unaltered. © 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.

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

    PubMed

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

    2005-01-01

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

  4. Iron status and its determinants in a nationally representative sample of pregnant women.

    PubMed

    Vandevijvere, Stefanie; Amsalkhir, Sihame; Van Oyen, Herman; Egli, Ines; Ines, Egli; Moreno-Reyes, Rodrigo

    2013-05-01

    Iron-deficiency anemia is associated with adverse neonatal health outcomes. Iron status and its determinants were assessed in a representative sample of Belgian pregnant women. Blood samples were collected and a questionnaire was completed face-to-face. Hemoglobin (Hb) and mean cell volume were measured using a Beckman Coulter Hematology Analyzer and serum ferritin (SF) and transferrin receptor (sTfr) concentrations by immunoassay. In total, 55 obstetric clinics and 1,311 pregnant women were included. Approximately 40% of third-trimester and 6% of first-trimester women had SF levels less than 15 μg/L. Approximately 21% of third-trimester and 4% of first-trimester women had anemia (Hb <110 g/L). Of the third-trimester women, 23% were iron-deficient nonanemic (SF <15 μg/L and Hb ≥110 g/L), 16% had iron-deficiency anemia (SF <15 μg/L and Hb <110 g/L), and approximately 7% had tissue iron deficiency (sTfr >8.5 mg/L). The median body iron stores were 8.1 mg/kg among first-trimester women, but only 3.6 mg/kg among third-trimester women. SF levels were significantly positively associated with age and education level, and were higher among nulliparous women and lower among North-African women. sTfr concentrations were significantly negatively associated with age and were lower among smokers, nulliparous women, and women who planned their pregnancy. Despite the fact that two thirds of Belgian pregnant women took iron-containing supplements, iron deficiency and iron-deficiency anemia were frequent in third-trimester women. The World Health Organization regards this as a moderate public health problem. National iron supplementation guidelines are needed in Belgium to optimize iron status during pregnancy. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  5. Melissa Rowland and the rights of pregnant women.

    PubMed

    Minkoff, Howard; Paltrow, Lynn M

    2004-12-01

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

  6. Psychiatric disorders and treatment in low-income pregnant women.

    PubMed

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

    2010-07-01

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

  7. Administration of praziquantel to pregnant and lactating women.

    PubMed

    Olds, G Richard

    2003-05-01

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

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

    PubMed

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

    2017-08-01

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

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

    PubMed Central

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

    2016-01-01

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

  10. Depression, Social Support, and Coping Styles among Pregnant Women after the Lushan Earthquake in Ya’an, China

    PubMed Central

    Yao, Jianrong; Li, Xirong; Liu, Xinghui; Pang, Meiche

    2015-01-01

    Aim The aim of this study is to assess the depression of pregnant women in the aftermath of an earthquake, and to identify the social support that they obtained, their coping styles and socio-demographic factors associated with depression. Methods A total of 128 pregnant women from three hospitals in the epicenter area were recruited immediately after the Ya’an earthquake. Their depression was investigated using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of 14; the social support that they obtained was measured using the Social Support Questionnaire; and their coping styles were assessed using the Coping Styles Questionnaire. Results Immediately after the earthquake, the incidence rate of depression in pregnant women was 35.2%, higher than that of the general pregnant population (7%-14%). The EPDS scores were significantly correlated with gestation age at the time of the earthquake, objective support, subjective support, use of support, negative coping style, and positive coping style. The regression analysis indicated that risk factors of prenatal depression include the number of children, relatives wounded, subjective support, and coping styles. A further analysis of the interaction between social support and two types of coping styles with depression showed that there was interaction effect between subjective social support and positive coping styles in relation to EPDS scores. There was an inverse relationship between low EPDS scores and positive coping styles and high social support, and vice versa. Conclusion The timing of the occurrence of the earthquake may not necessarily affect the progress of the illness and recovery from depression, and psychological intervention could be conducted in the immediate aftermath after the earthquake. The impact of coping styles on prenatal depression appeared to be linked with social support. Helping pregnant women to adopt positive coping styles with good social support after a recent major

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2011-07-01

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

  13. A Comparison of Masculinity Facial Preference Among Naturally Cycling, Pregnant, Lactating, and Post-Menopausal Women.

    PubMed

    Marcinkowska, Urszula M; Jasienska, Grazyna; Prokop, Pavol

    2018-07-01

    Women show cyclical shifts in preferences for physical male traits. Here we investigated how fertility status influences women's facial masculinity preference in men by analyzing a large sample of heterosexual women (N = 3720). Women were regularly either cycling (in both low- and high-conception probability groups), lactating or were currently in a non-fertile state (pregnant or post-menopausal). Analyses simultaneously controlled for women's age and sexual openness. Participants via two alternative forced choice questions judged attractiveness of masculinized and feminized men's faces. After controlling for the effect of age and sociosexuality, regularly cycling and pregnant women showed a stronger preference for masculinity than lactating and post-menopausal women. However, there was no significant difference in masculinity preference between women in the low- and high-conception probability groups. Women's sociosexuality showed a positive, but very weak association with men's facial masculinity preference. We suggest that women's overall, long-term hormonal state (cycling, post-menopausal) is a stronger predictor of preference for sexual dimorphism than changes in hormonal levels through the cycle.

  14. Need of tetraiodothyronine supplemental therapy in pregnant women

    NASA Astrophysics Data System (ADS)

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

    2013-10-01

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

  15. PERIPHERAL PARASITAEMIA AND ITS ASSOCIATION WITH PLASMA CYTOKINES LEVELS IN MALARIA-INFECTED PREGNANT WOMEN IN ABA, ABIA STATE, NIGERIA

    PubMed Central

    Ifeanyichukwu, M.O.; Okamgba, O.C.; Amilo, G.I.; Nwokorie, E.A.

    2017-01-01

    Background: Cytokines in pregnant female may not be a normal phenomenon as malarial infection is often associated with strong CD4+ cell activation and up-regulation of pro-inflammatory cytokines. We investigated the relationship between peripheral parasitaemia and plasma levels of cytokines among malaria infected pregnant women in Aba, Abia State, Nigeria. Materials and Methods: A total of 206 non-HIV positive asymptomatic malaria parasitaemic (n=144) and non-parasitaemic (n=62) pregnant women were recruited for this study alongside 80 non-pregnant women who served as positive (n=40) and negative (n=40) controls. Blood samples were aseptically collected from each subject and tested for HIV and malaria parasites using standard methods. Also, plasma levels of cytokines were measured using Th1/Th2 human cytokine ELISA kits (Abcam, UK). Analysis of Variance and Student’s t-test were used for Comparison of groups while Pearson’s Correlation Coefficient was used for tests of association. Results: The results revealed a mean parasite density of 685.56±484.55 parasites/µl of blood. Malaria infected pregnant subjects showed significantly higher levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-10 when compared with their non-infected counterparts (P< 0.05). The cytokines evaluated were higher in moderate parasitaemia than mild parasitaemia. Positive correlation existed between peripheral parasite density (PPD) and IL-4 (r= 0.24, P=0.004), PPD and IL-6 (r = 0.35, P = 0.001) as well as PPD and IL-10 (r = 0.29, P = 0.001). Conclusion: This study showed that increase in peripheral parasitaemia increased levels of some plasma cytokines (IL-4, IL-6 and IL-10) but not IFN-γ and TNF-α in the malaria infected pregnant women studied. PMID:28670640

  16. PERIPHERAL PARASITAEMIA AND ITS ASSOCIATION WITH PLASMA CYTOKINES LEVELS IN MALARIA-INFECTED PREGNANT WOMEN IN ABA, ABIA STATE, NIGERIA.

    PubMed

    Ifeanyichukwu, M O; Okamgba, O C; Amilo, G I; Nwokorie, E A

    2017-01-01

    Cytokines in pregnant female may not be a normal phenomenon as malarial infection is often associated with strong CD4+ cell activation and up-regulation of pro-inflammatory cytokines. We investigated the relationship between peripheral parasitaemia and plasma levels of cytokines among malaria infected pregnant women in Aba, Abia State, Nigeria. A total of 206 non-HIV positive asymptomatic malaria parasitaemic (n=144) and non-parasitaemic (n=62) pregnant women were recruited for this study alongside 80 non-pregnant women who served as positive (n=40) and negative (n=40) controls. Blood samples were aseptically collected from each subject and tested for HIV and malaria parasites using standard methods. Also, plasma levels of cytokines were measured using Th1/Th2 human cytokine ELISA kits (Abcam, UK). Analysis of Variance and Student's t-test were used for Comparison of groups while Pearson's Correlation Coefficient was used for tests of association. The results revealed a mean parasite density of 685.56±484.55 parasites/µl of blood. Malaria infected pregnant subjects showed significantly higher levels of IFN-γ, TNF-α, IL-4, IL-6 and IL-10 when compared with their non-infected counterparts (P< 0.05). The cytokines evaluated were higher in moderate parasitaemia than mild parasitaemia. Positive correlation existed between peripheral parasite density (PPD) and IL-4 (r= 0.24, P=0.004), PPD and IL-6 (r = 0.35, P = 0.001) as well as PPD and IL-10 (r = 0.29, P = 0.001). This study showed that increase in peripheral parasitaemia increased levels of some plasma cytokines (IL-4, IL-6 and IL-10) but not IFN-γ and TNF-α in the malaria infected pregnant women studied.

  17. Screening pregnant women for suicidal behavior in electronic medical records: diagnostic codes vs. clinical notes processed by natural language processing.

    PubMed

    Zhong, Qiu-Yue; Karlson, Elizabeth W; Gelaye, Bizu; Finan, Sean; Avillach, Paul; Smoller, Jordan W; Cai, Tianxi; Williams, Michelle A

    2018-05-29

    We examined the comparative performance of structured, diagnostic codes vs. natural language processing (NLP) of unstructured text for screening suicidal behavior among pregnant women in electronic medical records (EMRs). Women aged 10-64 years with at least one diagnostic code related to pregnancy or delivery (N = 275,843) from Partners HealthCare were included as our "datamart." Diagnostic codes related to suicidal behavior were applied to the datamart to screen women for suicidal behavior. Among women without any diagnostic codes related to suicidal behavior (n = 273,410), 5880 women were randomly sampled, of whom 1120 had at least one mention of terms related to suicidal behavior in clinical notes. NLP was then used to process clinical notes for the 1120 women. Chart reviews were performed for subsamples of women. Using diagnostic codes, 196 pregnant women were screened positive for suicidal behavior, among whom 149 (76%) had confirmed suicidal behavior by chart review. Using NLP among those without diagnostic codes, 486 pregnant women were screened positive for suicidal behavior, among whom 146 (30%) had confirmed suicidal behavior by chart review. The use of NLP substantially improves the sensitivity of screening suicidal behavior in EMRs. However, the prevalence of confirmed suicidal behavior was lower among women who did not have diagnostic codes for suicidal behavior but screened positive by NLP. NLP should be used together with diagnostic codes for future EMR-based phenotyping studies for suicidal behavior.

  18. Predictors of asymptomatic bacteriuria among pregnant women in a low-resource setting.

    PubMed

    Awoleke, J O; Adanikin, A I; Ajayi, D D; Ayosanmi, O S

    2015-01-01

    This study aims at identifying predictors of asymptomatic bacteriuria (AB) among pregnant women in a low-resource setting, with the intent of recommending a guideline for screening during antenatal care. A total of 266 healthy pregnant women were antenatally recruited after informed consent. They had routine antenatal investigations, a 1 h 50-g oral glucose tolerance test and quantitative urine culture and sensitivity. The data collected were analysed using statistical software package SPSS v. 17. Prevalence of AB was 23 (8.6%). Escherichia coli was the commonest isolate (6, 26.1%), closely followed by Staphylococcus aureus (5, 21.7%). AB was commoner among patients aged 25-34 years, of low parity and higher education. Blood group B- rhesus-positive significantly predicts the likelihood of developing AB in pregnancy (adjusted OR: 0.36; 95% CI: 0.14-0.96). We conclude that blood group B-rhesus-positive in association with other patients' characteristics, such as age 25-34 years, low parity and higher education could form guidelines for a screening algorithm in our environment.

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

    PubMed

    Hayman, Melanie; Short, Camille; Reaburn, Peter

    2016-08-01

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

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

    PubMed

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

    2017-08-03

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

  1. False-positive IgM for CMV in pregnant women with autoimmune disease: a novel prognostic factor for poor pregnancy outcome.

    PubMed

    De Carolis, S; Santucci, S; Botta, A; Garofalo, S; Martino, C; Perrelli, A; Salvi, S; Degennaro, Va; de Belvis, Ag; Ferrazzani, S; Scambia, G

    2010-06-01

    Our aims were to assess the frequency of false-positive IgM antibodies for cytomegalovirus in pregnant women with autoimmune diseases and in healthy women (controls) and to determine their relationship with pregnancy outcome. Data from 133 pregnancies in 118 patients with autoimmune diseases and from 222 pregnancies in 198 controls were assessed. When positive IgM for cytomegalovirus was detected, IgG avidity, cytomegalovirus isolation and polymerase chain reaction for CMV-DNA in maternal urine and amniotic fluid samples were performed in order to identify primary infection or false positivity. A statistically significantly higher rate of false-positive IgM was found in pregnancies with autoimmune diseases (16.5%) in comparison with controls (0.9%). A worse pregnancy outcome was observed among patients with autoimmune disease and false cytomegalovirus IgM in comparison with those without false positivity: earlier week of delivery (p = 0.017), lower neonatal birth weight (p = 0.0004) and neonatal birth weight percentile (p = 0.002), higher rate of intrauterine growth restriction (p = 0.02) and babies weighing less than 2000 g (p = 0.025) were encountered. The presence of false cytomegalovirus IgM in patients with autoimmune diseases could be used as a novel prognostic index of poor pregnancy outcome: it may reflect a non-specific activation of the immune system that could negatively affect pregnancy outcome. Lupus (2010) 19, 844-849.

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

    PubMed

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

    2004-04-01

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

  3. Effects of Online Self-Regulation Activitieson Physical Activity among Pregnant and Early Postpartum Women

    PubMed Central

    Niederdeppe, Jeff; Graham, Meredith; Olson, Christine; Gay, Geri

    2015-01-01

    Physical and psychological changes that occur during pregnancy present a unique challenge for women’s physical activity. Using a theory-based prospective design, this study examines effects of pregnant women’s (1) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (2) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. We used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. We also discuss practical implications for encouraging physical activity among pregnant and early postpartum women. PMID:26132887

  4. Is Passive Smoking Associated With Sleep Disturbance Among Pregnant Women?

    PubMed Central

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

    2007-01-01

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

  5. Community attitudes towards childbearing and abortion among HIV-positive women in Nigeria and Zambia.

    PubMed

    Kavanaugh, Megan L; Moore, Ann M; Akinyemi, Odunayo; Adewole, Isaac; Dzekedzeke, Kumbutso; Awolude, Olutosin; Arulogun, Oyedunni

    2013-01-01

    Although stigma towards HIV-positive women for both continuing and terminating a pregnancy has been documented, to date few studies have examined relative stigma towards one outcome versus the other. This study seeks to describe community attitudes towards each of two possible elective outcomes of an HIV-positive woman's pregnancy - induced abortion or birth - to determine which garners more stigma and document characteristics of community members associated with stigmatising attitudes towards each outcome. Data come from community-based interviews with reproductive-aged men and women, 2401 in Zambia and 2452 in Nigeria. Bivariate and multivariate analyses revealed that respondents from both countries overwhelmingly favoured continued childbearing for HIV-positive pregnant women, but support for induced abortion was slightly higher in scenarios in which anti-retroviral therapy (ART) was unavailable. Zambian respondents held more stigmatising attitudes towards abortion for HIV-positive women than did Nigerian respondents. Women held more stigmatising attitudes towards abortion for HIV-positive women than men, particularly in Zambia. From a sexual and reproductive health and rights perspective, efforts to assist HIV-positive women in preventing unintended pregnancy and to support them in their pregnancy decisions when they do become pregnant should be encouraged in order to combat the social stigma documented in this paper.

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

    PubMed

    Popovski, N; Popovski, K; Nedelkovski, V

    2016-01-01

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

  7. Seroprevalence and risk factors for toxoplasma infection among pregnant women in Aydin province, Turkey

    PubMed Central

    Ertug, Sema; Okyay, Pinar; Turkmen, Munevver; Yuksel, Hasan

    2005-01-01

    Background The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey. Method The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used. Results The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected. Conclusion One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings. PMID:15958156

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

    PubMed

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

    2017-12-14

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

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

    PubMed

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

    2005-06-01

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

  10. Human Papillomavirus (HPV) infection in pregnant women and mother-to-child transmission of genital HPV genotypes: a prospective study in Spain

    PubMed Central

    2009-01-01

    Background Studies on HPV infection in pregnant women and HPV transmission to the child have yielded inconsistent results. Methods To estimate mother-to-child HPV transmission we carried out a prospective cohort study that included 66 HPV-positive and 77 HPV-negative pregnant women and their offspring attending a maternity hospital in Barcelona. To estimate HPV prevalence and genotype distribution in pregnancy we also carried out a related screening survey of cervical HPV-DNA detection among 828 pregnant women. Cervical cells from the mother were collected at pregnancy (mean of 31 weeks) and at the 6-week post-partum visit. Exfoliated cells from the mouth and external genitalia of the infants were collected around birth, at the 6-week post-partum visit, and around 3, 6, 12, and 24 months of age. All samples were tested for HPV using PCR. Associations between potential determinants of HPV infection in pregnant women and of HPV positivity in infants were also explored by logistic regression modelling. Results Overall cervical HPV-DNA detection in pregnant women recruited in the HPV screening survey was 6.5% (54/828). Sexual behavior-related variables, previous histories of genital warts or sexually transmitted infections, and presence of cytological abnormalities were statistically significantly and positively associated with HPV DNA detection in pregnant women recruited in the cohort. At 418 infant visits and a mean follow-up time of 14 months, 19.7% of infants born to HPV-positive mothers and 16.9% of those born to HPV-negative mothers tested HPV positive at some point during infants' follow-up. The most frequently detected genotype both in infants and mothers was HPV-16, after excluding untyped HPV infections. We found a strong and statistically significant association between mother's and child's HPV status at the 6-week post-partum visit. Thus, children of mothers' who were HPV-positive at the post-partum visit were about 5 times more likely to test HPV-positive

  11. The Pregnant Women with HIV Attitude Scale: development and initial psychometric evaluation.

    PubMed

    Tyer-Viola, Lynda A; Duffy, Mary E

    2010-08-01

    This paper is a report of the development and initial psychometric evaluation of the Pregnant Women with HIV Attitude Scale. Previous research has identified that attitudes toward persons with HIV/AIDS have been judgmental and could affect clinical care and outcomes. Stigma towards persons with HIV has persisted as a barrier to nursing care globally. Women are more vulnerable during pregnancy. An instrument to specifically measure obstetric care provider's attitudes toward this population is needed to target identified gaps in providing respectful care. Existing literature and instruments were analysed and two existing measures, the Attitudes about People with HIV Scale and the Attitudes toward Women with HIV Scale, were combined to create an initial item pool to address attitudes toward HIV-positive pregnant women. The data were collected in 2003 with obstetric nurses attending a national conference in the United States of America (N = 210). Content validity was used for item pool development and principal component analysis and analysis of variance were used to determine construct validity. Reliability was analysed using Cronbach's Alpha. The new measure demonstrated high internal consistency (alpha estimates = 0.89). Principal component analysis yielded a two-component structure that accounted for 45% of the total variance: Mothering-Choice (alpha estimates = 0.89) and Sympathy-Rights (alpha estimates = 0.72). These data provided initial evidence of the psychometric properties of the Pregnant Women with HIV Attitude Scale. Further analysis is required of the validity of the constructs of this scale and its reliability with various obstetric care providers.

  12. Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo

    PubMed Central

    Niama, Roch Fabien; Loukabou Bongolo, Nadia Claricelle; Bayonne Kombo, Edith Sophie; Yengo, Ruth; Mayengue, Pembe Issamou; Mandingha Kosso, Etoka-Beka; Louzolo, Igor; Macosso, Lucette; Dzeret, Ghislain; Dzabatou Babeaux, Angélie Serge Patrick; Puruehnce, Marie-Francke; Parra, Henri Joseph

    2017-01-01

    Introduction HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attending antenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. The objective was to estimate the syphilis and HIV infection rate in this population. Methods A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan, Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software. Results A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p < 0.01). Also, women living in the urban area are more at risk to be infected (5.04 VS 2.38, p < 0.01). The RPR test was positive in 117 pregnant women (3.92%). The risk for syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p < 0.01). It was also estimated that the HIV and syphilis coinfection occurred in 22 cases (0.73%). Conclusion The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated with HIV and syphilis

  13. Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo.

    PubMed

    Niama, Roch Fabien; Loukabou Bongolo, Nadia Claricelle; Bayonne Kombo, Edith Sophie; Yengo, Ruth; Mayengue, Pembe Issamou; Mandingha Kosso, Etoka-Beka; Louzolo, Igor; Macosso, Lucette; Dzeret, Ghislain; Dzabatou Babeaux, Angélie Serge Patrick; Puruehnce, Marie-Francke; Parra, Henri Joseph

    2017-01-01

    HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women attending antenatal clinics sites for the first time between September and December 2011 and who accepted to participate in the study were enrolled. The objective was to estimate the syphilis and HIV infection rate in this population. A study was conducted in 44 selected ANCs from 12 departments (5 urban and 7 rural). Pregnant women who accepted to participate in the study, attending selected sentinel ANCs sites for the first time between September and December 2011 were enrolled. To detect HIV antibodies, two consecutive ELISA assays were used (Genscreen Ultra HIV Ag/Ac, (BioRad, France) and Enzygnostic Intergral II (Siemens, GMBH, Marbug-Germany). In case of discordant results, the Western blot test II, HIV1 and 2 (Bio-Rad, Marne la Coquette, France) was used as the reference method. The RPR (Bio-Scan, Karnataka, India) test was performed to detect syphilis infection. The RPR positive results were confirmed using the TPHA test (Biotech, Cambridge, UK). Data were analyzed using SPSS 17.0 software. A total of 2979 pregnant women attending ANCs were enrolled. The global HIV infection rate was estimated to be 3.6% (CI: 95%; 3.0-4.4). As expected, HIV prevalence was significantly higher in women aged above 25 years (4.4% (3.4-5.6), p = 0.026) and those attending urban ANCs (5.04%, p < 0.01). Also, women living in the urban area are more at risk to be infected (5.04 VS 2.38, p < 0.01). The RPR test was positive in 117 pregnant women (3.92%). The risk for syphilis occurrence was significantly higher among the single women compared to the married ones (4.4% VS 2.7%; p < 0.01). It was also estimated that the HIV and syphilis coinfection occurred in 22 cases (0.73%). The prevalence's of syphilis and HIV were relatively low. Marital status and sentinel site location were a risk factor associated with HIV and syphilis infections respectively. Therefore

  14. Comparison of pregnant and non-pregnant occupant crash and injury characteristics based on national crash data.

    PubMed

    Manoogian, Sarah

    2015-01-01

    The objective of this study was to provide specific characteristics of injuries and crash characteristics for pregnant occupants from the National Automotive Sampling System/Crashworthiness Data System (NASS/CDS) database for pregnant women as a group, broken down by trimester, and compared to non-pregnant women. Using all NASS/CDS cases collected between the years 2000 and 2012 with at least one pregnant occupant, the entire pregnant data set included 321,820 vehicles, 324,535 occupants, and 640,804 injuries. The pregnant occupant data were compared to the characteristics of NASS/CDS cases for 14,719,533 non-pregnant females 13-44 years old in vehicle crashes from 2000 to 2012. Sixty five percent of pregnant women were located in the front left seat position and roughly the same percentage of pregnant women was wearing a lap and shoulder belt. The average change in velocity was 11.6 mph for pregnant women and over 50% of crashes for pregnant women were frontal collisions. From these collisions, less than seven percent of pregnant women sustained MAIS 2+ injuries. Minor differences between the pregnant and non-pregnant occupants were identified in the body region and source of injuries sustained. However, the data indicated no large differences in injury or crash characteristics based on trimester of pregnancy. Moreover, the risk of an MAIS 2+ level injury for pregnant occupants is similar to the risk of injury for non-pregnant occupants based on the total vehicle change in velocity. Overall this study provides useful data for researchers to focus future efforts in pregnant occupant research. Additionally, this study reinforces that more detailed and complete data on pregnant crashes needs to be collected to understand the risk for pregnant occupants. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Discrimination, acculturation and other predictors of depression among pregnant Hispanic women.

    PubMed

    Walker, Janiece L; Ruiz, R Jeanne; Chinn, Juanita J; Marti, Nathan; Ricks, Tiffany N

    2012-01-01

    The purpose of our study was to examine the effects of socioeconomic status, acculturative stress, discrimination, and marginalization as predictors of depression in pregnant Hispanic women. A prospective observational design was used. Central and Gulf coast areas of Texas in obstetrical offices. A convenience sample of 515 pregnant, low income, low medical risk, and self-identified Hispanic women who were between 22-24 weeks gestation was used to collect data. The predictor variables were socioeconomic status, discrimination, acculturative stress, and marginalization. The outcome variable was depression. Education, frequency of discrimination, age, and Anglo marginality were significant predictors of depressive symptoms in a linear regression model, F (6, 458) = 8.36, P<.0001. Greater frequency of discrimination was the strongest positive predictor of increased depressive symptoms. It is important that health care providers further understand the impact that age and experiences of discrimination throughout the life course have on depressive symptoms during pregnancy.

  16. Discrimination, Acculturation and Other Predictors of Depression among Pregnant Hispanic Women

    PubMed Central

    Walker, Janiece L.; Ruiz, R. Jeanne; Chinn, Juanita J.; Marti, Nathan; Ricks, Tiffany N.

    2012-01-01

    Objective The purpose of our study was to examine the effects of socioeconomic status, acculturative stress, discrimination, and marginalization as predictors of depression in pregnant Hispanic women. Design A prospective observational design was used. Setting Central and Gulf coast areas of Texas in obstetrical offices. Participants A convenience sample of 515 pregnant, low income, low medical risk, and self-identified Hispanic women who were between 22–24 weeks gestation was used to collect data. Measures The predictor variables were socioeconomic status, discrimination, acculturative stress, and marginalization. The outcome variable was depression. Results Education, frequency of discrimination, age, and Anglo marginality were significant predictors of depressive symptoms in a linear regression model, F (6, 458) = 8.36, P<.0001. Greater frequency of discrimination was the strongest positive predictor of increased depressive symptoms. Conclusions It is important that health care providers further understand the impact that age and experiences of discrimination throughout the life course have on depressive symptoms during pregnancy. PMID:23140083

  17. Determinants of vct uptake among pregnant women attending two ANC clinics in Addis Ababa City: unmatched case control study.

    PubMed

    Maedot, Paulos; Haile, Amaha; Lulseged, Sileshi; Belachew, Ayele

    2007-10-01

    With HAART PMTCT interventions can reduce the risk of MTCT below 2%. However, low uptake of VCT is challenging effectiveness of PMTCT programs in sub-Saharan Africa. The aim of this study is to identify factors that determine VCT uptake among pregnant women attending ANC services. A case-control study was conducted from August 30, 2005 - November 30, 2005 among pregnant women attending ANC PMTCT services at Teklehaimanot Health Center and Gandhi memorial Hospital in Addis Ababa City. Cases were pregnant mothers who accepted VCT (n=202) and controls were pregnant mothers who refused VCT (n=200). Data was collected by counselor nurses working at the respective services Factors that determine VCT acceptance were women's perceived ability to cope with a positive result (OR = 5.5, 95% CI 3.5-8.5, MHOR = 6.3, 95% CI 3.9-10.2); perceived favorable reaction of husband's after sharing positive test result (OR = 2.7 95% CI 1.4-5.1, MHOR = 2.9, 95% CI 1.4-5.7); perceived positive community response (OR = 2.2 95% CI 1.1-4.2, MHOR = 2.6 95% CI 1.3-5.2); perceived ability to get continuous medical care if found out to be positive (OR = 2.0, 95% CI 1.2-3.5, MHOR = 2.4, 95% CI 1.3-4.5). Women's perceived ability to cope with a positive result, accesses to medical care, fear of husband's negative reaction and the stigma and discrimination following a positive test result were key determinants of uptake of VCT. Therefore, increasing uptake of VCT/PMTCT services needs policy makers and service providers' effort to promote couple counseling, intensifying the fight against stigma and discrimination and ensuring continuous HIV/AIDS related medical care.

  18. Offering fragile X syndrome carrier screening: a prospective mixed-methods observational study comparing carrier screening of pregnant and non-pregnant women in the general population

    PubMed Central

    Martyn, M; Anderson, V; Archibald, A; Carter, R; Cohen, J; Delatycki, M; Donath, S; Emery, J; Halliday, J; Hill, M; Sheffield, L; Slater, H; Tassone, F; Younie, S; Metcalfe, S

    2013-01-01

    Introduction Fragile X syndrome (FXS) is the leading cause of inherited intellectual and developmental disability. Policy development relating to carrier screening programmes for FXS requires input from large studies examining not only test uptake but also psychosocial aspects. This study will compare carrier screening in pregnant and non-pregnant populations, examining informed decision-making, psychosocial issues and health economics. Methods and Analysis Pregnant and non-pregnant women are being recruited from general practices and obstetric services. Women receive study information either in person or through clinic mail outs. Women are provided pretest counselling by a genetic counsellor and make a decision about testing in their own time. Data are being collected from two questionnaires: one completed at the time of making the decision about testing and the second 1 month later. Additional data are gathered through qualitative interviews conducted at several time points with a subset of participating women, including all women with a positive test result, and with staff from recruiting clinics. A minimum sample size of 500 women/group has been calculated to give us 88% power to detect a 10% difference in test uptake and 87% power to detect a 10% difference in informed choice between the pregnant and non-pregnant groups. Questionnaire data will be analysed using descriptive statistics and multivariate logistic regression models. Interview data will be thematically analysed. Willingness-to-pay and cost effectiveness analyses will also be performed. Recruitment started in July 2009 and data collection will be completed by December 2013. Ethics and Dissemination Ethics approval has been granted by the Universities of Melbourne and Western Australia and by recruiting clinics, where required. Results will be reported in peer-reviewed publications, conference presentations and through a website http://www.fragilexscreening.net.au. The results of this study will

  19. Obstetric outcome in pregnant women subjected to domestic violence.

    PubMed

    Ameh, N; Shittu, S O; Abdul, M A

    2009-06-01

    To determine the prevalence of domestic violence and its relationship to adverse obstetric outcomes amongst pregnant women who deliver at a tertiary level hospital in Zaria, Nigeria. A cross-sectional study involving 310 women who delivered at the labour ward. Questionnaires were administered to parturient women. Details of their socio-demographic characteristics and obstetric outcome were compiled and the relationship to experiences of domestic violence studied. The prevalence of domestic violence was 28.4%. There was positive relationship between domestic violence during pregnancy, non-supervision of pregnancy and poor attendances to antenatal clinic (p<0.05). There was however, no statistically significant relationship between domestic violence, and complications of labour and neonatal outcome (p>0.05). The prevalence of domestic violence in pregnancy is high in this environment. Poor attendances to the antenatal clinic is a significant association.

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

    PubMed

    Jensen, Puk; Brodersen, John

    2010-06-07

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

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

    PubMed

    Flavin, Jeanne; Paltrow, Lynn M

    2010-04-01

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

  2. Psychological violence against pregnant women in a prenatal care cohort: rates and associated factors in São Luís, Brazil.

    PubMed

    Ribeiro, Marizélia Rodrigues Costa; da Silva, Antônio Augusto Moura; E Alves, Maria Teresa Seabra Soares de Britto; Batista, Rosângela Fernandes Lucena; de Rocha, Lourdes Maria Leitão Nunes; Schraiber, Lilia Blima; Medeiros, Nilzângela Lima; Costa, Danielle Cristina Silva; Bettiol, Heloisa; Barbieri, Marco Antônio

    2014-02-12

    Violence against pregnant women has been associated with gestational and perinatal disorders. Psychological violence is the type least investigated and its associated factors have been little studied. The present study was conducted in order to estimate prevalence rates and analyze the factors associated with exclusive and recurrent psychological violence in the municipality of São Luís, Brazil. Data regarding 982 pregnant women, aged from 14 to 45 years, interviewed in 2010 and 2011 in a prenatal cohort were used. A self-applied questionnaire was used to screen for violence. Pregnant women submitted to physical and sexual violence were excluded from the analysis of factors associated with exclusive psychological violence. Prevalence ratios and 95% confidence intervals were estimated by a Poisson regression model with a hierarchical approach at three levels. At level 1 of the theoretical-conceptual model, we analyzed demographic and socioeconomic characteristics and variables that express gender inequalities; at level 2, we analyzed social support received by the women, and at level 3, the life experiences of the pregnant women. Prevalence rate of exclusive psychological violence was 41.6% and of recurrent violence was 32.6%. Exclusive psychological violence was associated with pregnant women's age of 14 to 18 years (PR: 1.32 95% CI: 1.04 - 1.70), pregnant women's schooling superior to that of her intimate partner (PR: 1.54 95% CI: 1.09 - 2.16), inadequate social affective support/positive social interaction (PR: 1.34 95% CI: 1.11 - 1.62), use of illicit drugs by the pregnant women (PR: 1.80 95% CI: 1.16 - 2.81) and having had six or more intimate partners in life (PR: 1.52 95% CI: 1.18 - 1.96). Recurrent exclusive psychological violence was associated with inadequate social affective support/positive social interaction (PR: 1.47 95% CI: 1.15 - 1.87), use of illicit drugs by the pregnant women (PR: 2,28 95% CI: 1,40 - 3,71) and having had six or more intimate

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

    PubMed

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

    2017-10-01

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

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

    PubMed Central

    Harm, Sarah K.; Yazer, Mark H.

    2012-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2012-11-01

    The objective of this study was to explore pregnant and recently pregna