Venlafaxine prescription claims among insured women of reproductive age and pregnant women, 2011–2016

2021 ◽  
Author(s):  
April D. Summers ◽  
Kayla N. Anderson ◽  
Elizabeth C. Ailes ◽  
Scott D. Grosse ◽  
William V. Bobo ◽  
...  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.


2020 ◽  
Vol 8 (2) ◽  
pp. 1-11
Author(s):  
Mane Hélène Faye ◽  
Nicole Idohou-Dossou ◽  
Abdou Badiane ◽  
Anta Agne-Djigo ◽  
Papa Mamadou DD Sylla ◽  
...  

Background: Like many developing countries, Senegal does not have data on the extent of vitamin A deficiency (VAD) that is representative of its population. The present survey was conducted to fill this gap and to identify factors associated with VAD, prior to the introduction of a large-scale vitamin A oil fortification program. Procedures: A nationwide representative cross-sectional survey involving 1887 children 12 to 59 months old and 1316 women of reproductive age (WRA) was conducted. Blood samples were collected and plasma concentrations of retinol (PR), C-reactive protein (CRP), and alpha-1-acidglycoprotein were measured. PR was adjusted for subclinical inflammation using the BRINDA regression methodology. Multivariate logistic regression was used to identify factors associated with VAD. Findings: The adjusted prevalence of VAD (PR ≤ 0.7 μmol/L) in children was 15.3% and differed by age group, area of residence, and socioeconomic status and half of them had subclinical inflammation. Among WRA, VAD was low (2.3%) and 18.1% had vitamin A insufficiency (VAI). Pregnant women were more affected by VAI (28.4%) and Dakar had lower figures compared with other cities and rural strata. Prevalence of VAI decreased with increasing wealth quintile. In logistic regression, abnormal CRP, poverty, scarce consumption of poultry, oysters, melon, red palm oil, palm kernel oil, Saba senegalensis fruit pulp (Maad) and cowpea, frequent consumption of leeks and consumption of Leptadenia hastata leaves (Mbuum tiakhat), were associated with VAD in children. For women, lower socioeconomic status, fair or poor health status and anemia were negatively associated with VAI. Conclusions: In Senegal, VAD is a moderate public health problem in children and slight among women. Particular attention should be paid to children older than 23 months, pregnant women, rural populations, and poorest households. Nutritional interventions should be implemented alongside morbidity prevention and control. Keywords: vitamin A deficiency, children 12-59 months, women of reproductive age, Senegal.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Erica Sedlander ◽  
Chandni Ladwa ◽  
Sameera Talegawkar ◽  
Rohini Ganjoo ◽  
Rajiv Rimal

Abstract Objectives Half of women of reproductive age in India have iron deficiency anemia compared to only 23% of men. Most research focuses on biological reasons for this discrepancy and access to iron-folic acid and iron-rich foods. However, recent research in India shows that inequitable gender norms may affect a woman's ability or desire to take iron supplements and to eat iron-rich food. The objective of this study is to examine how and why gender norms may be affecting high and persistent rates of anemia in India. Methods We conducted 25 key informant interviews and 16 focus group discussions with women of reproductive age, adolescents, husbands and mothers-in-law (n = 148) in Odisha, India. We purposively sampled key informants and randomly sampled focus group participants. We analyzed the data using applied thematic analysis in Nvivo software. Results Our data shows that unequal gender norms impact behaviors that are directly related to high rates of anemia. Women are often serving their husband, children, and in-laws first and “adjusting” to whatever is leftover which may be poor in nutritional qualities and less iron rich. Men are also the main breadwinners but often spend their money on alcohol, money that could be spent on iron-rich food for the household. Women reported that extreme fatigue is a normal part of being a woman and that a woman's plight is to take care of her family at any cost. Given that fatigue, the primary symptom of anemia is normalized; women may be less likely to seek treatment. Women tend to prioritize the health of their family over her own which could affect her ability or desire to go to the health center to get tested for anemia or to obtain iron supplements. Pregnant women are more likely to take iron supplements for the health of the baby, not her own health. While non-pregnant women of reproductive age who were not diagnosed with anemia were not focused on preventive health, only major illnesses and thus, were not taking supplements at all. Conclusions More upstream barriers, like gender norms, may be impinging on a woman's ability to take iron folic acid and to eat iron rich foods. Understanding how gender norms contribute to anemia could change the narrative from a biomedical issue to a social justice issue. Funding Sources The Bill and Melinda Gates Foundation. Supporting Tables, Images and/or Graphs


2014 ◽  
Vol 95 (2) ◽  
pp. 287-291
Author(s):  
A Yu Marianian

Alcohol consumption during pregnancy can cause serious birth defects and developmental disorders. The article reviews scientific literature describing modern conceptions of alcohol-associated teratogenicity. Problems of public awareness of alcohol negative impact on pregnancy and the fetus (particularly by informing women of reproductive age and pregnant women) are raised. Literature review revealed that there is a lack of information on fetal disorders associated with alcohol consumption by the mother. Nowadays, alcohol consumption in Russia is one of the highest in the world (15.8 liters per capita per year, including newborns, 2011), which is significantly higher than the absolute level of alcohol consumption associated with serious health risk for an individual and for the population as a whole. Awareness among women of reproductive age and pregnant women is very low. Therefore, it is necessary to inform and teach physicians screening methods of medical problems associated with alcohol intake and brief intervention strategies that will help to identify and inform women at risk for having children with fetal alcohol syndrome and fetal alcohol spectrum disorders and prevent the birth of mentally retarded children. The problem of fetal alcohol syndrome and the whole spectrum of fetal alcohol disorders is of great theoretical and practical significance in Russia.


2019 ◽  
Author(s):  
Humphrey Deogratias Mazigo ◽  
Antonio Montresor

Abstract Background Women of reproductive age carry a large burden of disease from soil-transmitted helminths infections. Preventive chemotherapy with anthelminthic is an effective treatment to control soil-transmitted helminths morbidity. However, as a precautionary measure, the treatment of pregnant women is recommended only after the first trimester. This has resulted in many women of reproductive age be denied treatment because of doubt on their pregnancy status. The standard assessments of the pregnancy status (i.e. urine pregnancy rapid test or blood test) are too expensive to be used in mass drug administration campaigns. Thus, use of a simple alternative approach is recommended. The present study was conducted to evaluate the performances of a questionnaire in assessing the pregnancy status of women of reproductive age during preventive chemotherapy interventions. Methodology A questionnaire (20 questions) followed by rapid pregnancy test (RPT) were administered to a group of women of reproductive age in two districts in North-western Tanzania. Results A total of 1,217 women of reproductive age participated in the study. Overall, 10.8% of the women reported to be pregnant at the specific question in the questionnaire. The rapid pregnancy test identified 15.1% (184/1217) of the women to be pregnant. In total, 86.4% (114/1,217) of the women who reported to be pregnant during the interview were confirmed to be pregnant using the RPT. The question on pregnancy demonstrated an overall sensitivity of 62% and specificity 98.3%. Conclusion The questionnaire can be used to identify pregnant women in first trimester during preventive chemotherapy campaigns. The question on last date of start of menstrual period yield the highest sensitivity and appeared to be the key one to be used in combination with other questions. However, validation of these results in other countries with different cultures are needed to fully evaluate performance of this method.


2020 ◽  
Author(s):  
Erica Sedlander ◽  
Michael Long ◽  
Satyanarayan Mohanty ◽  
Ashita Munjral ◽  
Jeffrey B. Bingenheimer ◽  
...  

Abstract Background: To reduce the prevalence of anemia, the Indian government recommends daily iron and folic acid supplements (iron supplements) for pregnant women and weekly iron supplements for adolescents and all women of reproductive age. The government has distributed free iron supplements to adolescents and pregnant women for over four decades. However, initial uptake and adherence remain inadequate and non-pregnant women of reproductive age are largely ignored. The aim of this study is to examine the multilevel barriers to iron supplement use and to subsequently identify promising areas to intervene. Methods: We conducted a qualitative study in the state of Odisha, India. Data collection included key informant interviews, focus group discussions with women, husbands, and mothers-in-law, and direct observations in health centers, pharmacies and village health and nutrition days. Results: We found that at the individual level, participants knew that iron supplements prevent anemia but underestimated anemia prevalence and risk in their community. Participants also believed that taking too many iron supplements during pregnancy would “make your baby big” causing a painful birth and a costly cesarean section. At the interpersonal level, mothers-in-law were not supportive of their daughters-in-law taking regular iron supplements during pregnancy but husbands were more supportive. At the community level, participants reported that only pregnant women and adolescents are taking iron supplements, ignoring non-pregnant women altogether. Unequal gender norms are also an upstream barrier for non-pregnant women to prioritize their health to obtain iron supplements. At the policy level, frontline health workers distribute iron supplements to pregnant women only and do not follow up on adherence. Conclusions: Interventions should address multiple barriers to iron supplements use along the socio-ecological model. They should also be tailored to a woman’s reproductive life course stage: adolescents, pregnancy, and non-pregnant women of reproductive age because social norms and available services differ between the subpopulations.


Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3729
Author(s):  
Isabelle Herter-Aeberli ◽  
Nina Wehrli ◽  
Kurt Bärlocher ◽  
Maria Andersson ◽  
Janice Sych

Background: Folate plays an essential role in the prevention of neural tube defects, yet little is known about the folate status of women of reproductive age or to what degree the general population is aware of the importance of folate in early-life development. We aimed to determine folate status in women of reproductive age and pregnant women in Switzerland, and to assess folate awareness in the Swiss population. Methods: In a convenience sample of 171 women of reproductive age and 177 pregnant women throughout Switzerland, we measured red blood cell (RBC) folate concentration. In a second convenience sample (n = 784, men and women) we assessed folate knowledge with an online survey. Results: RBC folate concentration (median interquartile range) was 442 (366, 564) nmol/L in women of reproductive age and 873 (677, 1177) nmol/L in pregnant women. Folate deficiency (RBC folate <340 nmol/L) was found in 19.9% of women of reproductive age and 2.8% of pregnant women, while 91.8% of women of reproductive age and 52.0% of pregnant women showed folate concentrations indicating an elevated risk of neural tube defects (RBC folate <906 nmol/L). The online survey showed that a high proportion (≥88%) of participants were aware of folate’s role in neural tube defect (NTD) prevention and fetal development, yet knowledge about dietary sources and national recommendations of folate supplementation when planning pregnancy were limited. Conclusion: The high prevalence of folate inadequacy in Swiss women suggests an elevated risk of neural tube defects and calls for urgent measures to increase folate intakes.


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