Pregnant Aboriginal women self-assess health risks from smoking and efficacy to quit over time using an adapted Risk Behaviour Diagnosis (RBD) Scale

AbstractIntroductionDuring pregnancy, the imperative to stop smoking becomes urgent due to health risks for mother and baby.AimExplore responses to a smoking-related, pregnancy-focused Risk Behaviour Diagnosis (RBD) Scale over time with Aboriginal1 pregnant women.MethodsSix Aboriginal Medical Services in three states recruited 22 eligible women: ⩽28 weeks' gestation, ⩾16 years old, smoked tobacco, pregnant with an Aboriginal baby. Surveys were completed at baseline (n = 22), 4-weeks (n = 16) and 12-weeks (n = 17). RBD Scale outcome measures included: perceived threat (susceptibility and severity), perceived efficacy (response and self-efficacy), fear control (avoidance), danger control (intentions to quit) and protection responses (protecting babies).ResultsAt baseline, the total mean threat scores at 4.2 (95% CI: 3.9–4.4) were higher than total mean efficacy scores at 3.9 (95% CI: 3.6–4.1). Over time there was a non-significant reduction in total mean threat and efficacy; fear control increased; danger control and protection responses remained stable. Reduction of threat and efficacy perceptions, with raised fear control responses, may indicate a blunting effect (a coping style which involves avoidance of risks).ConclusionIn 22 Aboriginal pregnant women, risk perception changed over time. A larger study is warranted to understand how Aboriginal women perceive smoking risks as the pregnancy progresses so that health messages are delivered accordingly.

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An Estimation of Endogenous Formaldehyde Exposure due to Consumption of Indonesian Opah Fish (Lampris guttatus) in Three Major Export Destination Countries

SQUALEN Bulletin of Marine and Fisheries Postharvest and Biotechnology ◽

10.15578/squalen.v14i1.369 ◽

2019 ◽

Vol 14 (1) ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

Umi Anissah ◽

Ajeng Kurniasari Putri ◽

Giri Rohmad Barokah

Keyword(s):

Risk Assessment ◽

Health Risks ◽

Health Problem ◽

International Market ◽

Formaldehyde Content ◽

Export Volume ◽

Formaldehyde Exposure ◽

Export Destination ◽

Export Product ◽

Over Time

The demand for Indonesian opah fish as an export product is increasing in the international market. Three countries (Malaysia, Mauritius, and Taiwan) recorded as the leading export destination of Indonesian opah fish. However, as the fish kept in a frozen state during export transportation, the endogenous formaldehyde may increase over time. This research presented the health risk assessment of population in the leading export destination countries that consumed opah fish from Indonesia. The study aimed to reveal the most potential export destination country that may accept an increasing volume of opah fish supply from Indonesia. The potency was determined from current export volume, the amount of endogenous formaldehyde content, and fish consumption at each country. The data were calculated with @Risk®7.0 software. The results showed opah fish consumed by Malaysian can be categorized as safe. Increasing the number of opah fish imported by Malaysian as much as six times, 12 times, 18 times, 27 and 36 times relatively does not cause health risks related to the presence of its endogenous formaldehyde. Moreover, opah fish consumed by Taiwanese is also safe, but with increasing the number of consumptions by more than 26 times is suspected to be potentially causing a health problem. However, opah fish consumed in Mauritius was categorized as unsafe and potentially caused health risks. Based on these results, Indonesia may consider to increase the opah fish export to Malaysia and Taiwan in the future.

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What are the effects of providing pregnant women with incentives to stop smoking?

Cochrane Clinical Answers ◽

10.1002/cca.1534 ◽

2017 ◽

Author(s):

Harish Kavirajan

Keyword(s):

Pregnant Women ◽

Stop Smoking

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Arguments used by proponents and opponents in Brazil’s regulatory discussions of e-cigarettes and heated tobacco products

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056628 ◽

2021 ◽

pp. tobaccocontrol-2021-056628

Author(s):

Mônica Nunes-Rubinstein ◽

Teresa Leão

Keyword(s):

Public Health ◽

Content Analysis ◽

Cigarette Smoking ◽

Health Risks ◽

Regulatory Agency ◽

Economic Consequences ◽

The Other ◽

Tobacco Products ◽

The Right ◽

Over Time

ObjectivesTo identify proponents and opponents of the commercialisation and marketing of e-cigarettes and heated tobacco products (HTPs), identify the arguments used on both sides and compare how the arguments have changed over time, we analysed three policy discussions occurring in 2009, 2018 and 2019.MethodsWe conducted a content analysis of one document and six videos from these discussions, provided on the Brazilian Health Regulatory Agency website, or upon request.ResultsThe arguments most used by tobacco companies were related to claims that the use of e-cigarettes and HTPs is less harmful than conventional tobacco. Unions that support its commercialisation also argued that lifting the ban would prevent smuggling and guarantee their quality. On the other side, universities, medical and anti-tobacco institutions argued that such devices may have health risks, including the risk of inducing cigarette smoking. In 2009, most arguments belonged to the ‘health’ theme, while in 2018 and 2019 economic arguments and those related to morals and ethics were frequently used.ConclusionsThose that supported the commercialisation and marketing of e-cigarettes and HTPs first focused on arguments of harm reduction, while 10 years later the right to access and potential economic consequences also became common. Public health agents and academics must gather evidence to effectively respond to these arguments and discuss these policies, and must prepare themselves to use and respond to arguments related to moral and economic themes.

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Exercise to Support Indigenous Pregnant Women to Stop Smoking: Acceptability to Māori

Maternal and Child Health Journal ◽

10.1007/s10995-017-2303-2 ◽

2017 ◽

Vol 21 (11) ◽

pp. 2040-2051

Author(s):

Vaughan Roberts ◽

Marewa Glover ◽

Lesley McCowan ◽

Natalie Walker ◽

Michael Ussher ◽

...

Keyword(s):

Pregnant Women ◽

Stop Smoking

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Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

Lipids in Health and Disease ◽

10.1186/s12944-021-01549-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Yandi Zhu ◽

Haiyan Zhu ◽

Qinyu Dang ◽

Qian Yang ◽

Dongxu Huang ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Blood Lipid ◽

Roc Curves ◽

Population Based ◽

Linear Mixed Effect Model ◽

Mixed Effect ◽

Adverse Pregnancy ◽

Stratified Analysis ◽

Over Time

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

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What’s the Rush?

10.18574/nyu/9781479812257.003.0005 ◽

2021 ◽

pp. 94-113

Author(s):

Louise Marie Roth

Keyword(s):

Pregnant Women ◽

Healthcare Providers ◽

Labor Induction ◽

Low Risk ◽

Early Term ◽

Elective Induction ◽

Liability Risk ◽

Term Births ◽

Changes Over Time ◽

Over Time

This chapter analyzes changes over time in early-term births. Labor induction rates have risen over time and many experts speculate that at least half of inductions are elective. Popular accounts suggest that pregnant women are driving this by requesting inductions. Healthcare providers are also part of the story because they can refuse women’s requests, but hospitals and OB/GYN practices benefit enormously from scheduling births even though they pose medical risks. Analyses of early-term births in low-risk pregnancies reveal that providers are more likely to take unnecessary risks in states with tort reforms that limit their liability risk. This effect was strongest during the period before 2009, when the strength of professional recommendations against early elective induction had eroded.

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Antiretroviral Therapy in Pregnant Women

Fundamentals of HIV Medicine 2019 ◽

10.1093/med/9780190942496.003.0027 ◽

2019 ◽

pp. 281-286

Author(s):

William R. Short ◽

Jason J. Schafer

Keyword(s):

Clinical Trials ◽

Pregnant Women ◽

Hiv Transmission ◽

Pediatric Aids ◽

Women Living With Hiv ◽

Pivotal Study ◽

Aids Clinical Trials ◽

Living With Hiv ◽

Mother To Child ◽

Over Time

Upon completion of this chapter, the reader should be able to describe the appropriate management of antiretrovirals for pregnant women living with HIV. Over time, research has demonstrated that proper prevention strategies and interventions during pregnancy, labor, and delivery can significantly reduce the rate of mother-to-child transmission (MTCT) of HIV. In 1994, a pivotal study in the field of HIV medicine, the Pediatric AIDS Clinical Trials Group 076, demonstrated that the use of zidovudine (ZDV) monotherapy during pregnancy substantially reduced the risk of HIV transmission to infants by 67% (...

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“Got to build that trust”: the perspectives and experiences of Aboriginal health staff on maternal oral health

International Journal for Equity in Health ◽

10.1186/s12939-020-01301-5 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Ariana C. Kong ◽

Mariana S. Sousa ◽

Lucie Ramjan ◽

Michelle Dickson ◽

Joanne Goulding ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Pregnant Women ◽

Dental Care ◽

Health Workers ◽

Aboriginal Health ◽

Health Staff ◽

Care Providers ◽

Aboriginal Women ◽

Family Partnership

Abstract Background In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. Methods A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. Results A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. Conclusions The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.

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Trends in resource use and effectiveness of ultrasound detection of fetal structural anomalies in France: a multiple registry-based study

BMJ Open ◽

10.1136/bmjopen-2018-025482 ◽

2019 ◽

Vol 9 (2) ◽

pp. e025482 ◽

Cited By ~ 3

Author(s):

Clément Ferrier ◽

Ferdinand Dhombres ◽

Babak Khoshnood ◽

Hanitra Randrianaivo ◽

Isabelle Perthus ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Pregnant Women ◽

Outcome Measures ◽

Resource Use ◽

Congenital Anomalies ◽

Ultrasound Screening ◽

Healthcare Database ◽

Prenatal Detection ◽

Two Samples ◽

Over Time

ObjectiveTo analyse trends in the number of ultrasound examinations in relation to the effectiveness of prenatal detection of birth defects using population-based data in France.DesignA multiple registry-based study of time trends in resource use (number of ultrasounds) and effectiveness (proportion of cases prenatally diagnosed).SettingThree registries of congenital anomalies and claims data on ultrasounds for all pregnant women in France.ParticipantsThere were two samples of pregnant women. Effectiveness was assessed using data from three French birth defect registries. Resource use for ultrasound screening was based on the French national healthcare database.Main outcome measuresThe main outcome measures were prenatal diagnosis (effectiveness) and the average number of ultrasounds (resource use). Statistical analyses included linear and logistic regression models to assess trends in resource use and effectiveness of prenatal testing, respectively.ResultsThe average number of ultrasound examinations per pregnancy significantly increased over the study period, from 2.47 in 2006 to 2.98 in 2014 (p=0.005). However, there was no significant increase in the odds of prenatal diagnosis. The probability of prenatal diagnosis was substantially higher for cases associated with a chromosomal anomaly (91.2%) than those without (51.8%). However, there was no evidence of an increase in prenatal detection of either over time.ConclusionsThe average number of ultrasound examinations per pregnancy increased over time, whereas the probability of prenatal diagnosis of congenital anomalies did not. Hence, there is a need to implement policies such as high-quality training programmes which can improve the efficiency of ultrasound examinations for prenatal detection of congenital anomalies.

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