Epidemiology of Substance use in Pregnancy

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M.T. Kumar
Keyword(s):  
Substance Use ◽  
Pregnant Women ◽  
Young Women ◽  
Postpartum Period ◽  
Substance Misuse ◽  
Measurement Techniques ◽  
Alcohol Exposure ◽  
High Rate ◽  
Pregnancy And Postpartum ◽  
The Impact

An understanding of the epidemiology of alcohol and drug use in young women is important to appreciate the considerable morbidity and mortality associated with it and to understand the impact of such use on offspring. Although abstention rates are consistently higher among women than men in general substance misuse is increasing in young women. Differences in definitions, measurement techniques, availability, social acceptability and affordability partly explain the great variability in reported prevalence rates. Alcohol exposure among pregnant women varies from 0.2% to 14.8%. An Australian national survey revealed that nearly half of pregnant and or breast-feeding women up to 6 months postpartum were using alcohol. A Swedish study reported risky use of alcohol during the first 6 weeks of pregnancy, at 15%. Cannabis use among pregnant women varies from 1.8% to 15%. The reported prevalence of opiate use during pregnancy ranges from 1.65 to 8.5%. Cocaine use among pregnant women is reported to be between 0.3% and 9.5. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment. Substance use tends to increase sharply in the postpartum period with adverse consequences on mother and baby. Perinatal substance misuse interventions can reduce adverse neonatal outcomes. On the basis of relatively high rate of substance use disorders during pregnancy and postpartum period, effective screening and intervention strategies should be implemented.

Epidemiology of Substance Use in Pregnancy

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M.T. Kumar
Keyword(s):  
Substance Use ◽  
Pregnant Women ◽  
Young Women ◽  
Postpartum Period ◽  
Substance Misuse ◽  
Measurement Techniques ◽  
Alcohol Exposure ◽  
High Rate ◽  
Pregnancy And Postpartum ◽  
The Impact

An understanding of the epidemiology of alcohol and drug use in young women is important to appreciate the considerable morbidity and mortality associated with it and to understand the impact of such use on offspring. Although abstention rates are consistently higher among women than men in general substance misuse is increasing in young women. Differences in definitions, measurement techniques, availability, social acceptability and affordability partly explain the great variability in reported prevalence rates. Alcohol exposure among pregnant women varies from 0.2% to 14.8%. An Australian national survey revealed that nearly half of pregnant and or breast-feeding women up to 6 months postpartum were using alcohol. A Swedish study reported risky use of alcohol during the first 6 weeks of pregnancy, at 15%. Cannabis use among pregnant women varies from 1.8% to 15%. The reported prevalence of opiate use during pregnancy ranges from 1.65 to 8.5%. Cocaine use among pregnant women is reported to be between 0.3% and 9.5. Most pregnant women stop or reduce their substance use during pregnancy and this might be an opportune moment for detection and treatment. Substance use tends to increase sharply in the postpartum period with adverse consequences on mother and baby. Perinatal substance misuse interventions can reduce adverse neonatal outcomes. On the basis of relatively high rate of substance use disorders during pregnancy and postpartum period, effective screening and intervention strategies should be implemented.

Clinical Pharmacokinetic Studies in Pregnant Women and the Relevance of Pharmacometric Tools

2019 ◽  
Vol 25 (5) ◽  
pp. 483-495 ◽  
Author(s):  
André Dallmann ◽  
Paola Mian ◽  
Johannes Van den Anker ◽  
Karel Allegaert
Keyword(s):  
Pregnant Women ◽  
Clinical Pharmacokinetic ◽  
Individual Variability ◽  
Current Status ◽  
Pharmacokinetic Studies ◽  
Full Potential ◽  
Pbpk Models ◽  
Pregnancy And Postpartum ◽  
Population Pk ◽  
The Impact

Background: In clinical pharmacokinetic (PK) studies, pregnant women are significantly underrepresented because of ethical and legal reasons which lead to a paucity of information on potential PK changes in this population. As a consequence, pharmacometric tools became instrumental to explore and quantify the impact of PK changes during pregnancy. Methods: We explore and discuss the typical characteristics of population PK and physiologically based pharmacokinetic (PBPK) models with a specific focus on pregnancy and postpartum. Results: Population PK models enable the analysis of dense, sparse or unbalanced data to explore covariates in order to (partly) explain inter-individual variability (including pregnancy) and to individualize dosing. For population PK models, we subsequently used an illustrative approach with ketorolac data to highlight the relevance of enantiomer specific modeling for racemic drugs during pregnancy, while data on antibiotic prophylaxis (cefazolin) during surgery illustrate the specific characteristics of the fetal compartments in the presence of timeconcentration profiles. For PBPK models, an overview on the current status of reports and papers during pregnancy is followed by a PBPK cefuroxime model to illustrate the added benefit of PBPK in evaluating dosing regimens in pregnant women. Conclusions: Pharmacometric tools became very instrumental to improve perinatal pharmacology. However, to reach their full potential, multidisciplinary collaboration and structured efforts are needed to generate more information from already available datasets, to share data and models, and to stimulate cross talk between clinicians and pharmacometricians to generate specific observations (pathophysiology during pregnancy, breastfeeding) needed to further develop the field.

Improving the Timely Delivery of Antihypertensive Medication for Severe Perinatal Hypertension in Pregnancy and Postpartum

2021 ◽  
Author(s):  
Patrick Schneider ◽  
Patricia Ann Lee King ◽  
Lauren Keenan-Devlin ◽  
Ann E.B. Borders
Keyword(s):  
Quality Improvement ◽  
Postpartum Period ◽  
Care Team ◽  
Quality Improvement Initiative ◽  
Elevated Blood ◽  
Statistical Process ◽  
Pregnancy And Postpartum ◽  
Blood Pressures ◽  
The Impact ◽  
Timely Delivery

Objective Sustained blood pressures ≥160/110 during pregnancy and the postpartum period require timely antihypertensive therapy. Hospital-level experiences outlining the efforts to improve timely delivery of care within 60 minutes have not been described. The objective of this analysis was to assess changes in care practices of an inpatient obstetrical health care team following the implementation of a quality improvement initiative for severe perinatal hypertension during pregnancy and the postpartum period. Study Design In January 2016, NorthShore University HealthSystem Evanston Hospital launched a quality improvement initiative focusing on perinatal hypertension, as part of a larger, statewide quality initiative via the Illinois Perinatal Quality Collaborative. We performed a retrospective cohort study of all pregnant and postpartum patients with sustained severely elevated blood pressure (two severely elevated blood pressures ≤15 minutes apart) with baseline data from 2015 and data collected during the project from 2016 through 2017. Changes in clinical practice and outcomes were compared before and after the start of the project. Statistical process control charts were used to demonstrate process-behavior changes over time. Results Comparing the baseline to the last quarter of 2017, there was a significant increase in the administration of medication within 60 minutes for severe perinatal hypertension (p <0.001). Implementation of a protocol for event-specific debriefing for each severe perinatal hypertension episode was associated with increased odds of the care team administering medication within 60 minutes of the diagnosis of severe perinatal hypertension (adjusted odds ratio 3.20, 95% confidence interval 1.73–5.91, p < 0.01). Conclusion Implementation of a quality improvement initiative for perinatal hypertension associated with pregnancy and postpartum improved the delivery of appropriate and timely therapy for severely elevated blood pressures and demonstrated the impact of interdisciplinary communication in the process. Key Points

scholarly journals Special footwear designed for pregnant women and its effect on kinematic gait parameters during pregnancy and postpartum period

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0232901 ◽  
Author(s):  
Marta Gimunová ◽  
Martin Zvonař ◽  
Martin Sebera ◽  
Pavel Turčínek ◽  
Kateřina Kolářová
Keyword(s):  
Pregnant Women ◽  
Postpartum Period ◽  
Gait Parameters ◽  
Pregnancy And Postpartum

The relationship between interpersonal trauma and substance misuse in pregnancy

2019 ◽  
Vol 27 (9) ◽  
pp. 578-588 ◽  
Author(s):  
Naomi Waddell ◽  
Thanos Karatzias
Keyword(s):  
Substance Use ◽  
Pregnant Women ◽  
Substance Misuse ◽  
Interpersonal Trauma ◽  
Obstetric Outcomes ◽  
Quantitative Methodology ◽  
Problematic Substance Use ◽  
Problematic Substance ◽  
Strong Body ◽  
The Relationship

BackgroundThere is a strong body of evidence supporting associations between interpersonal trauma (IPT) and substance use; however, this tends to focus on associations between childhood trauma and substance use in non-pregnant populations. Neonatal and obstetric outcomes are poorer among pregnant women with problematic substance use, yet few studies have explored IPT as a possible mechanism underlying their use of substances.AimTo explore the literature regarding the relationship between IPT and substance misuse among pregnant women.MethodA systematic search of relevant databases was conducted and a narrative review of the literature was undertaken. Titles, abstracts and full articles were screened against inclusion criteria. Data were extracted and quality assessed.FindingsA total of 15 studies were identified that suggested associations between negative life events and substance misuse in pregnant women/new mothers.ConclusionsAlthough a link between IPT and substance misuse is suggested, this review has highlighted a number of important gaps in the literature that warrant further investigation. These include a paucity of UK-based studies, and a lack of research that fully explores possible associations between IPT and substance use in pregnant women. Moreover, research to date has employed quantitative methodology.

Concentration of fibrin monomer in pregnancy and during the postpartum period

2019 ◽  
Vol 56 (6) ◽  
pp. 692-700
Author(s):  
Ann Helen Kristoffersen ◽  
Per Hyltoft Petersen ◽  
Line Bjørge ◽  
Thomas Røraas ◽  
Sverre Sandberg
Keyword(s):  
Venous Thromboembolism ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Monomer Concentration ◽  
Blood Samples ◽  
Fibrin Monomer ◽  
Three Samples ◽  
Pregnancy And Postpartum ◽  
D Dimer ◽  
In Pregnancy

Background D-dimer increases during pregnancy and is problematic to use in the diagnosis of venous thromboembolism. Fibrin monomer represents an alternative biomarker for venous thromboembolism. However, to be useful in pregnancy, the fibrin monomer concentration should be stable throughout pregnancy and during postpartum. Methods To describe the course of fibrin monomer concentration during pregnancy and the postpartum period in healthy pregnant women and to compare their within-subject biological variation (CVI) with non-pregnant women. Blood samples were obtained every fourth week during pregnancy and three samples after delivery in 20 healthy women and every fourth week during a 40-week period in 19 healthy non-pregnant women. Fibrin monomer (STA Liatest FM, Stago) was analysed in duplicates for all samples. Concentrations of fibrin monomer in pregnant and non-pregnant women were compared and the CVI for fibrin monomer was calculated. Results The median fibrin monomer concentration in pregnant women was 6.2 mg/L (2.5 and 97.5 percentiles 3.7–10.8 mg/L) and in non-pregnant women 4.8 mg/L (3.6–8.2) ( P < 0.01). The fibrin monomer concentration was relatively stable during pregnancy, although a few unexplained high fibrin monomer concentrations were found during pregnancy/postpartum. Fibrin monomer CVI in pregnancy and postpartum was 20.6% (95% CI 18.3, 23.5) and in non-pregnant 16.1% (13.7, 18.9). Conclusions For clinical purposes, fibrin monomer concentration can be considered stable during pregnancy, although it is slightly higher than in non-pregnant women. Pregnant and non-pregnant women have the same CVI. The suitability of fibrin monomer in venous thromboembolism diagnosis in pregnant women should be validated in further studies.

scholarly journals Perspectives on mHealth Interventions During and After Gestational Diabetes

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 768-768
Author(s):  
Niamh Kelly-Whyte ◽  
Ciara McNulty ◽  
Sharleen O'Reilly
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Intervention Development ◽  
Intervention Design ◽  
Cochrane Central Register ◽  
Lifestyle Interventions ◽  
Pregnancy And Postpartum ◽  
Meta Analyses ◽  
The Impact ◽  
In Pregnancy

Abstract Objectives To systematically review the perspectives of women with gestational diabetes (GDM) or a recent history of GDM on mHealth lifestyle interventions during pregnancy and postpartum to inform future intervention development. Methods This systematic review was published according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The research was conducted in PubMed, MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Central Register of Controlled Trials for qualitative studies up until 28 April 2020. Study quality was evaluated using Joanna Briggs Institute critical appraisal checklist for qualitative research and a reflexive thematic synthesis was performed. The COM-B model was used to apply findings to improve future intervention development. Results 14 studies met the inclusion criteria representing the views of 327 women. Differences emerged within the themes identified in pregnancy and postpartum. In pregnancy 3 overarching themes emerged relating to mHealth interventions- support, connectedness and trust. Pregnant women valued the support of healthcare professionals (HCPs) when participating in mHealth interventions, along with information from sources they can trust. The use of self-monitoring was useful in pregnancy as they could see their progress and feel connected to their pregnancy. Using mHealth alongside usual care in pregnancy was seen as beneficial. Postpartum 2 overarching themes emerged- support and connectedness. Postpartum women did not value the input of HCPs as much as pregnant women. They valued connections made with their peers. They indicated more limitations with mHealth interventions than women during pregnancy. They discussed the use of rewards to remain motivated, while in pregnancy the health of the baby appeared to be the main motivator. 7 key recommendations have been made for future intervention design using the COM-B model, most with high or moderate confidence. Conclusions Women's views on mHealth lifestyle interventions differ between pregnancy and the postpartum period, and these needs should be reflected in intervention design. The results also reflect the impact a GDM diagnosis has on women highlighting the need for ongoing support continuing into postpartum. Funding Sources No funding was received for this research.

scholarly journals A Correlation between Complication in Pregnancy and Postpartum Depression: Literature Review

2021 ◽  
Vol 3 (1) ◽  
pp. 31-39
Author(s):  
Desy Meldawati
Keyword(s):  
Literature Review ◽  
Postpartum Depression ◽  
Pregnant Women ◽  
General Hospital ◽  
Maternal Anemia ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
The Impact ◽  
History Of Depression ◽  
In Pregnancy

Postpartum depression is a depression syndrome that occurs in mothers after childbirth and can be prevented and cured. According to Fazraningtyas, in South Kalimantan, to be precise in the city of Banjarmasin, namely Ulin General Hospital of Banjarmasin and Dr. H.M. Ansari Saleh General Hospital of Banjarmasin showed 56.8% mild postpartum depression, 26.1% moderate postpartum depression, 17.0% severe postpartum depression. The impact of mothers experiencing postpartum depression is that mothers have difficulty interacting and can endanger their children. Postpartum depression is caused by several factors, the factors that contributed are complications in pregnancy. This study used a literature review approach. The articles obtained from Google Scholar, Biomed Central, and Pubmed. The criterias applied be restricted. As many as 10 journals are found. Based on the previous study, complications in pregnancy are the cause of postpartum depression. Complications that are often experienced by pregnant women are maternal anemia that can appear during the pregnancy process until the birth process occurs and 30-70% of pregnant women with maternal anemia have a risk of postpartum depression. Second, gestational diabetes is one of the complications of pregnancy that occurs in women who are pregnant. Pregnant women can increase hormones including the progesterone hormone, human placental lactogen estrogen, and cortisol. The last, a history of depression is a cause of postpartum depression because if pregnant women have a history of depression before pregnancy, they will have a higher risk of experiencing postpartum depression.

scholarly journals Malaria Prevalence Investigation among Pregnant Women in Relation to Their Social Well Being: A Case Study of Lugbe and Gosa, Abuja, Nigeria

2020 ◽  
pp. 7-15
Author(s):  
Onyemaechi Ngozi Edith ◽  
Malann Yoila David
Keyword(s):  
Pregnant Women ◽  
Well Being ◽  
Malaria Prevalence ◽  
Living Conditions ◽  
High Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Smear Preparation ◽  
Study Results ◽  
The Impact

Aim: This research aim was to investigate the impact of living conditions (Socio demographic characteristics) of pregnant women on their malarial status. Study Design: In order to achieve the objectives of the study, Cross sectional survey was used. This is because only a subsect of the population was used. Descriptive designs was utilised in the Questionnaire aspect of the study. Place and Duration of Study: The Presidential Malarial initiative PMI/USAID - funded Insectary Laboratory at Nasarawa State University, Keffi/six (6) Months. Methodology: Blood samples were collected from the participating pregnant women by pricking their thumb and the blood droplet was examined using a direct thin and thick blood smear preparation stained with giemsa for the presence of the ring form stages of the parasites in the blood of the individuals in the laboratory. Qualitative data were sourced through Questionnaire administration to 589 pregnant women in Antenatal care clinics (ANC) in the area and their malaria status was also determined. Results: Study results showed a high prevalence rate of malaria in pregnancy (70.5%), the greater number of occurrences being in Lugbe (42.3%) than in Gosa (28.2%). Those living in houses built with wood recorded more positive cases of malaria and are at greater risk of infection (odds = 1.866%). Conclusion: This study has shown an increased rate of malaria infection amongst pregnant women living in wood and mud houses. The result also shows high rate of malaria occurrences due to low living conditions amongst pregnant women domiciled in this area of study. Hence, pregnant women should as a routine be placed on malaria prophylaxis and periodically checked as they can be asymptomatic, only exhibiting symptoms when its already late.

A Family Guide to Coping with Substance Use Disorders

2019 ◽  
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Misuse ◽  
Family Members ◽  
Drug Problem ◽  
Family Issues ◽  
The Family ◽  
Affected Person ◽  
Key Issues ◽  
The Impact

This guide was written for family members, significant others, and people concerned about their relatives or friends who have an alcohol or drug problem, which in this book is referred to as substance misuse or substance use disorder (SUD). Substance problems can take many shapes and forms and differ in their severity and impact. This family guide will discuss these problems and how to help the affected person and other family members (including children) who may have been harmed by a loved one’s substance problem. This guide can also help individuals with a substance use problem understand the impact of their SUDs on the family as well as what their family members can do to help themselves. Addressing family issues and making amends are key issues for people in recovery from SUDs.

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