scholarly journals Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour

2017 ◽  
Vol 20 (8) ◽  
pp. 1405-1413 ◽  
Author(s):  
Nuria Aranda ◽  
Carmen Hernández-Martínez ◽  
Victoria Arija ◽  
Blanca Ribot ◽  
Josefa Canals
Keyword(s):  
Pregnant Women ◽  
Self Regulation ◽  
Clinical History ◽  
Normal Weight ◽  
State Regulation ◽  
University Hospital ◽  
Third Trimester ◽  
Prospective Longitudinal Study ◽  
The Third ◽  
Prospective Longitudinal

AbstractObjectiveTo determine the associations between haemoconcentration at the end of pregnancy (third trimester and delivery) and neonatal behaviour in healthy pregnant women supplemented with moderate doses of Fe.DesignA prospective longitudinal study in which obstetric and clinical history, maternal toxic habits, maternal anxiety and Hb levels were recorded at the third trimester and delivery. Neonatal behaviour was assessed at 48–72 h of age using the Neonatal Behavioral Assessment Scale.SettingUnit of Obstetrics and Gynaecology of the Sant Joan University Hospital in Reus, Tarragona (Spain).SubjectsA total of 210 healthy and well-nourished pregnant women and their full-term, normal-weight newborns.ResultsThe results showed that, after adjusting for confounders, in the third trimester the risk of haemoconcentration (6·2 % of pregnant women) was related to decreased neonatal state regulation (B=−1·273, P=0·006) and alertness (B=−1·848, P=0·006) scores. In addition, the risk of haemoconcentration at delivery (12·0 % of pregnant women) was also related to decreased neonatal state regulation (B=−0·796, P=0·021) and poor robustness and endurance (B=−0·921, P=0·005) scores.ConclusionsOur results show that the risk of haemoconcentration at the end of pregnancy is related to the neonate’s neurodevelopment (and self-regulation capabilities), suggesting that Fe supplementation patterns and maternal Fe status during pregnancy are important factors for neurodevelopment which may be carefully controlled.

scholarly journals The Maternal Cytokine and Chemokine Profile of Naturally Conceived Gestations Is Mainly Preserved duringIn VitroFertilization and Egg Donation Pregnancies

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Alicia Martínez-Varea ◽  
Begoña Pellicer ◽  
Vicente Serra ◽  
David Hervás-Marín ◽  
Alicia Martínez-Romero ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Transforming Growth Factor Beta ◽  
Plasma Levels ◽  
Transforming Growth Factor ◽  
Egg Donation ◽  
Third Trimester ◽  
Necrosis Factor Alpha ◽  
Prospective Longitudinal Study ◽  
The Third ◽  
Prospective Longitudinal

This prospective longitudinal study aimed at comparing maternal immune response among naturally conceived (NC;n=25),in vitrofertilization (IVF;n=25), and egg donation (ED;n=25) pregnancies. The main outcome measures were, firstly, to follow up plasma levels of interleukin (IL) 1beta, IL2, IL4, IL5, IL6, IL8, IL10, IL17, interferon gamma, tumor necrosis factor-alpha (TNFα), transforming growth factor-beta (TGFβ), regulated upon activation normal T-cell expressed and secreted (RANTES), stromal cell-derived factor 1 alpha (SDF1α), and decidual granulocyte-macrophage colony-stimulating factor (GM-CSF) during the three trimesters of pregnancy during the three trimesters of pregnancy; secondly, to evaluate if the cytokine and chemokine pattern of ED pregnant women differs from that of those with autologous oocytes and, thirdly, to assess if women with preeclampsia show different cytokine and chemokine profile throughout pregnancy versus women with uneventful pregnancies. Pregnant women in the three study groups displayed similar cytokine and chemokine pattern throughout pregnancy. The levels of all quantified cytokines and chemokines, except RANTES, TNFα, IL8, TGFβ, and SDF1α, rose in the second trimester compared with the first, and these higher values remained in the third trimester. ED pregnancies showed lower SDF1αlevels in the third trimester compared with NC and IVF pregnancies. Patients who developed preeclampsia displayed higher SDF1αplasma levels in the third trimester.

Mechanisms of Gait Adaptation in Overweight Pregnant Women

2020 ◽  
Vol 110 (4) ◽  
Author(s):  
Jolanta Pauk ◽  
Dagna Swinarska ◽  
Kristina Daunoraviciene
Keyword(s):  
Pregnant Women ◽  
Plantar Pressure ◽  
Normal Weight ◽  
Ground Reaction Forces ◽  
Third Trimester ◽  
Gait Adaptation ◽  
The Third ◽  
Plantar Pressure Distribution ◽  
Gait Parameters ◽  
Reaction Forces

Background Pregnancy is a period when a woman's body undergoes changes. The purpose of this study was to analyze the mechanisms of gait adaptation in overweight pregnant women regarding spatiotemporal gait parameters, ground reaction forces, and plantar pressure distribution. Methods The tests were performed in 29 normal-weight pregnant women and 26 pregnant women who were overweight before pregnancy. The measurements included spatiotemporal gait parameters, in-shoe plantar pressure distribution, and ground reaction forces during gestation. Results The results indicate that both normal-weight and overweight pregnant women make use of the same spatiotemporal gait parameters to increase body stability and safety of movement during pregnancy. The double-step duration in the third trimester of pregnancy was higher in normal-weight and overweight pregnant women compared with in the first trimester (P < .05). A significant change in pressure amplitude was found under all anatomical parts of the foot in the third trimester (P < .05). The results also suggest a higher increase in the maximum amplitude of force in overweight pregnant women in the third trimester compared with the normal-weight group. Conclusions This study suggests that both normal-weight and overweight pregnant women use different mechanisms of gait adaptation during pregnancy. In practice, understanding the biomechanical changes in women's gait can protect the musculoskeletal system during gestation.

scholarly journals Circadian misalignment measured by social jetlag from early to late pregnancy and its association with nutritional status: a longitudinal study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Cristina Tibiletti Balieiro ◽  
Cristiana Araújo Gontijo ◽  
Luisa Pereira Marot ◽  
Gabriela Pereira Teixeira ◽  
Walid Makin Fahmy ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Absolute Difference ◽  
Third Trimester ◽  
Circadian Misalignment ◽  
The Third ◽  
Social Jetlag ◽  
Increased Risk

AbstractA mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m2) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

Features of the course and treatment of glaucoma during pregnancy

2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Pregnant Women ◽  
Laser Treatment ◽  
Progressive Disease ◽  
Clinical Course ◽  
The Other ◽  
Third Trimester ◽  
The Third ◽  
Chronic Progressive Disease ◽  
Hypotensive Therapy ◽  
Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

scholarly journals A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Behnam Khaledi-Paveh ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Third Trimester ◽  
Cross Sectional ◽  
The Third ◽  
Physical Problems ◽  
Meta Regression Analysis

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Disease Activity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Third Trimester ◽  
Low Disease Activity ◽  
The Third ◽  
Observational Prospective Cohort Study ◽  
Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio &gt; 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

scholarly journals Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Najmieh Saadati ◽  
Poorandokht Afshari ◽  
Hatam Boostani ◽  
Maryam Beheshtinasab ◽  
Parvin Abedi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Care Providers ◽  
Health Anxiety ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Third Trimester ◽  
Related Factors ◽  
Cross Sectional ◽  
The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

Effect of routine iron–folic acid supplementation among rural pregnant women living in low- and high-groundwater-iron areas in Bangladesh

2019 ◽  
Vol 22 (15) ◽  
pp. 2844-2855 ◽  
Author(s):  
Faruk Ahmed ◽  
Moududur Rahman Khan ◽  
Ireen Akhtar Chowdhury ◽  
Rubhana Raqib ◽  
Anjan Kumar Roy ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Significant Proportion ◽  
Significant Risk ◽  
Folic Acid Supplementation ◽  
Fe Deficiency ◽  
Prospective Longitudinal Study ◽  
Iron Folic Acid ◽  
Hb Concentration ◽  
Prospective Longitudinal

AbstractObjective:The present study investigated the risks and benefits of routine Fe–folic acid (IFA) supplementation in pregnant women living in low- and high-groundwater-Fe areas in Bangladesh.Design:A case-controlled prospective longitudinal study design was used to compare the effect of daily Fe (60 mg) and folic acid (400 μg) supplementation for 3·5 months.Setting:A rural community in Bangladesh.Participants:Pregnant women living in low-groundwater-Fe areas (n 260) and high-groundwater-Fe areas (n 262).Results:Mean Hb and serum ferritin concentrations at baseline were significantly higher in pregnant women in the high-groundwater-Fe areas. After supplementation, the mean change in Hb concentration in the women in the low-groundwater-Fe areas (0·10 mg/dl) was higher than that in the pregnant women in the high-groundwater-Fe areas (–0·08 mg/dl; P = 0·052). No significant changes in the prevalence of anaemia or Fe deficiency (ID) in either group were observed after IFA supplementation; however, the prevalence of Fe-deficiency anaemia (IDA) decreased significantly in the women in the low-groundwater-Fe areas. The risk of anaemia, ID and IDA after supplementation did not differ significantly between the groups. None of the participants had Fe overload. However, a significant proportion of the women in the high- and low-groundwater-Fe areas remained anaemic and Fe-deficient after supplementation.Conclusion:IFA supplementation significantly increased the Hb concentration in pregnant women living in the low-groundwater-Fe areas. Routine supplementation with 60 mg Fe and 400 μg folic acid does not pose any significant risk of haemoconcentration or Fe overload. Further research to identify other nutritional and non-nutritional contributors to anaemia is warranted to prevent and treat anaemia.

EFFECT OF ZINK TABLETS INTERVENTION IN ZINC DEFICIENCY OF TRIMESTER III PREGNANT WOMEN TOWARD WEIGHT AND BODY LENGTH OF NEWBORN

2021 ◽  
Vol 10 (2) ◽  
pp. 304-312
Author(s):  
Nurfadillah S ◽  
Wardihan Sinrang ◽  
Suryani As'ad ◽  
Muh. Nasrum Massi ◽  
Mardiana Ahmad ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Zinc Deficiency ◽  
Birth Length ◽  
World Health ◽  
Third Trimester ◽  
Average Value ◽  
The Third ◽  
A Value ◽  
Zinc Levels

Background: According to 2018 World Health Organization (WHO) data globally, an estimated 17.3% of the population has inadequate zinc intake, with estimates ranging from 5.7% in Oceania to 7.6% in Europe, 9.6% in America and the Caribbean, highest in Africa (23.9%) and Asia (19.6%). Zinc is important for the function of a number of enzymes and growth hormones during pregnancy. In pregnant women, the relative zinc concentration decreases up to 35% due to the influence of hormonal changes and the transport of nutrients from mother to baby. Objectives: The purpose of this study was to identify the effect of giving zinc tablets to pregnant women with zinc deficiency in the third trimester on body weight and length of babies born at the Makassar City Health Center. Methods: This type of research is True Experimental with a pretest-posttest design with a control group. The sample in this study was 62 samples of third trimester pregnant women, and the sampling technique used was purposive sampling. Measurement of zinc levels in third trimester pregnant women using the Elisa reader kit at the Research Laboratory of the Hasanuddin University Teaching Hospital. The research instruments were in the form of a research explanation sheet, respondent's consent sheet, respondent's checklist sheet, and the mother's zinc tablet consumption control sheet for 14 days. Results: Judging from the average value of newborns in pregnant women who did not have zinc deficiency, the average value of birth weight in pregnant women with zinc deficiency was 15.70 g/dL and 18.95 g/dL. zinc deficiency with a value (p < 0.05), while pregnant women with zinc deficiency have an average birth length of 10.00 g/dL and mothers who do not have a deficiency of 19.87 g/dL with a value (p < 0.05). So, it can be concluded that giving zinc tablets to pregnant women in the third trimester has an effect on Birth Weight (BBL) and Birth Length (PBL). Conclusion: Giving zinc tablets has an effect on increasing zinc levels in third trimester zinc deficiency pregnant women and increasing birth weight and length of the baby.  

MENGURANGI KECEMASAN PADA MASA KEHAMILAN TM III DENGAN METODE ACCUPRESSURE DEPRESSION POINTS

2021 ◽  
Vol 13 (02) ◽  
pp. 172
Author(s):  
Dyah Ayu Wulandari ◽  
Meika Jaya Rockhmana ◽  
Adelina Cahyaningrum
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Psychological Adaptation ◽  
The Body ◽  
Wilcoxon Test ◽  
P Value ◽  
Third Trimester ◽  
Purposive Sampling ◽  
The Third

ABSTRAKAdaptasi fisik dan psikis kehamilan trimester III secara fisiologis dapat menimbulkan kecemasan ibu hamil. Adanya kecemasan pada ibu hamil trimester III dapat menyebabkan komplikasi ibu dan janin saat kehamilan, persalinan bahkan nifas. Terapi acupressure merupakan natural terapi dengan cara menekan acupoint  untuk merelaksasi tubuh, melancarkan sirkulasi darah serta memberikan rasa tenang dan nyaman. Acupoint KID 27 dan CV 17 adalah titik yang berhubungan dengan kecemasan, agitasi, penyimpangan kelenjar tiroid, keseimbangan tubuh dan pusat jantung. Penekanan pada titik ini menyeimbangkan kadar hormon tiroid dan mengatasi gangguan kecemasan. Tujuan penelitian mengetahui pengaruh acupressure depression points terhadap kecemasan ibu hamil trimester III. Metode: Jenis penelitian kuantitatif dengan metode penelitian pre-experimental One Group Pretest-Posttest Design. Penelitian dilakukan Bulan Februari-Agustus 2021. Populasi penelitian ibu hamil trimester III yang melakukan ANC bulan Juni 2021 dengan keluhan kecemasan. Sampel penelitian 22 ibu hamil trimester III dengan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner PRAQ-R2. Analisa data univariat dan bivariat (Uji Wilcoxon) Hasil: Hasil analisa statistik dengan uji Wilcoxon diperoleh nilai P-value 0,000 pada tingkat kecemasan. Kesimpulan: Acupressure depression points berpengaruh terhadap tingkat kecemasan ibu hamil trimester III di Semarang.Kata kunci: kecemasan, ibu hamil trimester IIIREDUCE ANXIETY IN PREGNANT MOTHER TRIMESTER III WITH ACCUPRESSURE DEPRESSION POINTS METHODABSTRACTPhysical and psychological adaptation of the third trimester of pregnancy can physiologically cause anxiety for pregnant women. The existence of anxiety in third trimester pregnant women can affect the quality of sleep which causes maternal and fetal complications during pregnancy, delivery and even postpartum. Acupressure therapy is a natural therapy by pressing the acupoints to relax the body, improve blood circulation and provide a sense of calm and comfort. Acupoints KID 27 and CV 17 are points associated with anxiety, agitation, thyroid disorders, body balance and heart centers. Emphasis on this point balances thyroid hormone levels and treats anxiety disorders thereby improving sleep quality. Objective: to determine the effect of acupressure depression points on the level of anxiety and sleep quality of pregnant women in the third trimester. Methods: This type of research is quantitative with pre-experimental research method One Group Pretest-Posttest Design. The study was conducted in February-August 2021. The study population was pregnant women in the third trimester who performed ANC in June 2021 with complaints of anxiety. The study sample was 22 pregnant women in the third trimester with purposive sampling technique. The research instrument used the PRAQ-R2. Analysis of univariate and bivariate data (Wilcoxon test) Results: The results of statistical analysis using the Wilcoxon test obtained a P-value of 0.000 on anxiety levels. Conclusion: Acupressure depression points have an effect on the level of anxiety of pregnant women in the third trimester at Semarang.Keyword: Anxiety, Pregnant Women In The Third Trimester

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