Dietary Practices Among Pregnant Women in Rural Amhara, Ethiopia

Abstract Objectives Malnutrition affects 25% of women in Ethiopia. We are conducting a study to determine the impact of a prenatal nutrition intervention on maternal and infant health in Ethiopia. The objective of this formative study was to better describe dietary practices among pregnant women and community members in rural Ethiopia prior to initiation the parent study. Methods This formative study was conducted from October-November 2018 among pregnant women and community members in the rural Amhara region of Ethiopia, prior to the “Enhancing Nutrition and Antenatal Infection Treatment (ENAT)” study [ISRCTN15116516]. 28 in-depth interviews (IDIs) were conducted among 16 pregnant women and 12 community members. IDIs were recorded, transcribed, and translated. We used a grounded theory approach and inductive reasoning for content analysis of interview transcripts. Results Fasting norms in the Ethiopian Orthodox religion had a significant impact on dietary behaviors which occurs for more than 200 days annually. Community members indicated that fasting during pregnancy is common and is also supported and encouraged by religious leaders and community members. Accordingly, women adhered to fasting restrictions during pregnancy, and many women maintained a vegan diet under direction of local religious leaders. Furthermore, many women reported restricting dietary intake in pregnancy to prevent growth of the fetus because of the concern for obstructed labor. A women's diet depended on her husbands’/family earnings and household food preferences. Sharing of meals is a cultural norm; the husband is served first, with the remaining portions to the pregnant women/children. Pregnant women in the area also reported regular consumption of a locally brewed alcohol (“tella”), as it is believed to have lower alcohol levels. These findings demonstrate the impact of traditional and cultural beliefs on dietary decisions amongst pregnant women in this population. Conclusions Reduced food intake in pregnancy is common in this population, due to fasting, reduced appetite, and food restriction to avoid pregnancy complications. Context-specific interventions are needed, and this formative work will inform the future delivery and education regarding nutrition interventions in rural Ethiopia. Funding Sources Bill & Melinda Gates Foundation (OPP1184363).

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A review of guidance on fish consumption in pregnancy: is it fit for purpose?

Public Health Nutrition ◽

10.1017/s1368980018000599 ◽

2018 ◽

Vol 21 (11) ◽

pp. 2149-2159 ◽

Cited By ~ 11

Author(s):

Caroline M Taylor ◽

Pauline M Emmett ◽

Alan M Emond ◽

Jean Golding

Keyword(s):

Pregnant Women ◽

Fish Consumption ◽

Evidence Base ◽

Positive Contribution ◽

National Guidelines ◽

International Guidelines ◽

Beneficial Effects ◽

Use Of Technology ◽

The Impact ◽

In Pregnancy

AbstractObjectivePublic health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption.DesignWe searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed.ResultsWe identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all.ConclusionsGuidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

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RELATIONSHIP OF MATERNAL VITAMIN B12 STATUS IN PREGNANCY WITH PRETERM BIRTH AND MATERNAL HEALTH RISKS

International Medical Journal ◽

10.37436/2308-5274-2020-2-7 ◽

2020 ◽

pp. 32-38

Author(s):

VICTORIA LAZAROVA SPASOVA ◽

LILIA IVANOVA KOLEVA ◽

MARIETA ANTONOVA POPOVA ◽

VALENTINA BOYANOVA PETKOVA ◽

MILEN VENTZISLAVOV DIMITROV

Keyword(s):

Preterm Birth ◽

Vitamin B12 ◽

Pregnant Women ◽

Serum Vitamin ◽

Vitamin B12 Deficiency ◽

Inverse Association ◽

Maternal Vitamin ◽

B12 Deficiency ◽

The Impact ◽

In Pregnancy

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.

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Mindfulness and insomnia at pregnancy

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.706 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s269-s269

Author(s):

M. Marques ◽

A.T. Pereira ◽

E. Bento ◽

S. Xavier ◽

J. Azevedo ◽

...

Keyword(s):

Anxiety Disorders ◽

Pregnant Women ◽

Mean Value ◽

Inner Experience ◽

The Mean ◽

Competing Interest ◽

Acting With Awareness ◽

The Impact ◽

Insomnia Symptoms ◽

In Pregnancy

IntroductionThe impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep.ObjectiveTo explore differences in the Facets Mindfulness Questionnaire-10 (FMQ-10; Azevedo et at. 2015), between sleep groups, in Portuguese pregnant women.MethodsFour hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) answered the Facets Mindfulness Questionnaire-10 and the Insomnia Assessment Scale (IAS, Marques et al., 2015). Three sleep groups were created considering all the IAS items: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment; exclusion of other conditions/disorders explaining the symptoms); insomniacs (one/more insomnia symptoms; one/more daily associated impairment; exclusion of other conditions/disorders explaining the symptoms).ResultsThere were significant differences in the total FMQ-10 score, the F1/Nonjudging of inner experience and the F2/acting with awareness, between sleep groups [respectively, F (2.402) = 6,933; P = 0.001; F (2.406) = 10.243; P = 0.001; F (2.406) = 37.431; P = 0.002]. Tukey tests indicated that the mean total FMQ-10 and F1/Nonjudging of inner experience scores of good sleepers and insomnia symptoms group were significantly higher than of the insomniacs. The mean value of F2/acting with awareness in the good sleepers was significantly higher than of the insomniacs.ConclusionsIt seems important to develop mindfulness to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Self-compassion and insomnia at pregnancy

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.703 ◽

2016 ◽

Vol 33 (S1) ◽

pp. s268-s268 ◽

Cited By ~ 1

Author(s):

M. Marques ◽

A.T. Pereira ◽

V. Freitas ◽

E. Bento ◽

J. Azevedo ◽

...

Keyword(s):

Psychological Distress ◽

Pregnant Women ◽

The Self ◽

Common Humanity ◽

Self Compassion ◽

Competing Interest ◽

The Impact ◽

Compassion Scale ◽

Insomnia Symptoms ◽

In Pregnancy

IntroductionMindfulness based programs during pregnancy (some including self-compassion components) increase self-compassion, mindfulness and maternal self-efficacy, and reduce anxiety, stress and psychological distress in pregnant women. According to our knowledge, there are no studies about the association between self-compassion and sleep outcomes in pregnancy.ObjectiveTo explore differences in self-compassion, between three sleep groups, in a sample of Portuguese pregnant women.MethodsFour hundred and nineteen pregnant women (mean age: 32.51 ± 4.759; weeks of gestation: 17.32 ± 4.803) completed the Self-Compassion Scale (SCS, Bento et al., 2015), presenting six dimensions (self-kindness, self-judgment, common humanity, isolation, mindfulness and over-identification) and the Insomnia Assessment Scale (Marques et al., 2015). Three sleep groups were formed: good sleepers (no insomnia symptoms; no associated daily impairment); insomnia symptoms groups (one/more insomnia symptoms; no associated daily impairment); insomniacs (one/more insomnia symptoms; daily associated impairment).ResultsThere were significant differences in the total SCS, self-judgment, isolation and over-identification scores, between sleep groups [respectively, F (2,396) = 7,926, P ≤ 0,001; F (2,409) = 19,155, P ≤ 0,001; F (2,410) = 13,016, P ≤ 0,001; F (2,412) = 11,258, P ≤ 0,001]. Self-judgement, isolation and over-identification scores of good sleepers and insomnia symptoms group were higher than of insomniacs. Total SCS score of good sleepers was higher than of insomniacs and the same score of symptoms of insomnia group was also higher than of insomniacs.ConclusionsResults seem to show the importance of developing self-compassion to improve sleep in pregnancy or reduce the impact of insomnia symptoms (common at pregnancy).Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Iodine and Pregnancy

Journal of Thyroid Research ◽

10.4061/2011/934104 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 25

Author(s):

Christina Yarrington ◽

Elizabeth N. Pearce

Keyword(s):

Thyroid Hormone ◽

Pregnant Women ◽

Thyroid Function ◽

Environmental Contaminants ◽

Iodine Status ◽

Nutritional Recommendations ◽

Iodine Metabolism ◽

The Impact ◽

In Pregnancy

Iodine is a necessary element for the production of thyroid hormone. We will review the impact of dietary iodine status on thyroid function in pregnancy. We will discuss iodine metabolism, homeostasis, and nutritional recommendations for pregnancy. We will also discuss the possible effects of environmental contaminants on iodine utilization in pregnant women.

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Perspectives on mHealth Interventions During and After Gestational Diabetes

Current Developments in Nutrition ◽

10.1093/cdn/nzab046_065 ◽

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.

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

International Journal of Clinical Inventions and Medical Science ◽

10.36079/lamintang.ijcims-0301.181 ◽

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.

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Planning for a cohort study to investigate the impact and management of influenza in pregnancy in a future pandemic

Health Services and Delivery Research ◽

10.3310/hsdr03060 ◽

2015 ◽

Vol 3 (6) ◽

pp. 1-48 ◽

Cited By ~ 2

Author(s):

Marian Knight ◽

Peter Brocklehurst ◽

Pat O’Brien ◽

Maria A Quigley ◽

Jennifer J Kurinczuk

Keyword(s):

Cohort Study ◽

Pregnant Women ◽

Influenza Pandemic ◽

Influenza Infection ◽

H1n1 Influenza ◽

Steering Committee ◽

Pandemic Strain ◽

Increased Risk ◽

The Impact ◽

In Pregnancy

BackgroundEvidence from the 2009 A/H1N1 influenza pandemic demonstrated that pregnant women are particularly vulnerable to infection and at an increased risk of death. Active data collection through the UK Obstetric Surveillance System (UKOSS) about women admitted to hospital during the 2009 A/H1N1 pandemic was used to inform ongoing clinical guidance regarding the use of antiviral treatment for pregnant women and demonstrated that, in addition to an increased risk of maternal morbidity, influenza infection in pregnancy is associated with poor perinatal outcomes, including an increased risk of stillbirth and preterm birth. This evidence influenced the decision to offer routine influenza immunisation to pregnant women. Even in a non-epidemic period, pregnant women continue to die from influenza.ObjectiveTo establish, and then to put into hibernation, the study mechanisms needed to mount a rapid investigation of the impact of pandemic influenza in pregnancy in the event of a newly emerging pandemic strain.DesignA new UKOSS cohort study was designed, based on the 2009–10 study, and following consultation with the Pandemic Flu Planning Group at the Royal College of Obstetricians and Gynaecologists and the UKOSS Steering Committee, to identify potential previously unanswered questions.SettingUK maternity units.ParticipantsAll pregnant women admitted to hospital with influenza in a future pandemic.Main outcome measuresManagement of pregnant women with influenza infection, intervention rates, treatment and pregnancy outcome for both the mother and fetus.ResultsThe study was designed and approved by the UKOSS Steering Committee and then placed into hibernation for activation in the event of an influenza pandemic.ConclusionsPregnant women, as a result of their changed immunological status, appear to be particularly susceptible to infection, including from influenza. The existence of the UKOSS enabled us to rapidly mount a study of pregnant women who were hospitalised with 2009 A/H1N1 influenza. Minor modifications to incorporate previously unanswered questions and our previous study enabled us to design, and then put into hibernation, a new study ready to investigate the impact and management of influenza in pregnancy, which is poised for activation in the event of a newly emerging pandemic strain. This will enable real-time data to be available on which to base rapid changes in clinical management as the as-yet-unforeseen pandemic unfolds. In the event of an influenza pandemic the study will be available to be immediately activated following expedited regulatory approvals.Trial registrationCurrent Controlled Trials ISRCTN44137563.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: Findings from the All Our Families Cohort

10.21203/rs.3.rs-33576/v2 ◽

2020 ◽

Author(s):

Cheryl L. Currie ◽

Suzanne C Tough

Keyword(s):

Drug Use ◽

Pregnant Women ◽

Adverse Childhood Experiences ◽

Illicit Drug ◽

Illicit Drug Use ◽

Fold Increase ◽

Childhood Experiences ◽

Adverse Childhood ◽

The Impact ◽

In Pregnancy

Abstract Background: Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES. Methods: This study is a secondary analysis of a prospective cohort study that collected data from 1,660 women during and after pregnancy in Calgary, Canada between 2008-2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34-36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results: Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2-3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0-1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions: Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.

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Adverse Childhood Experiences are Associated with illicit drug use among pregnant women with middle to high socioeconomic status: Findings from the All Our Families Cohort

10.21203/rs.3.rs-33576/v1 ◽

2020 ◽

Author(s):

Cheryl L. Currie ◽

Suzanne C Tough

Keyword(s):

Drug Use ◽

Pregnant Women ◽

Adverse Childhood Experiences ◽

Illicit Drug ◽

Illicit Drug Use ◽

Fold Increase ◽

Childhood Experiences ◽

Adverse Childhood ◽

The Impact ◽

In Pregnancy

Abstract Background: Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use is reduced among pregnant women who are well educated and have higher socioeconomic status, this assumption has not been well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use among pregnant women who are well-educated women, have middle to high household incomes, and seeking regular prenatal care. Findings can inform clinicians about potential associations between ACEs and drug use in pregnancy within a population that they are frequently in contact with. Methods: This study is a secondary analysis of a prospective cohort study that collected data from 1,680 women during and after pregnancy in Calgary, Canada between 2008-2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34-36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results: Overall, 3.3% of women in this predominantly married, well-educated, middle and upper middle income sample (mean age 31 years) reported illicit drug use in pregnancy. Women with 2-3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0-1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions: Findings combine with others to speak to the public health significance of maternal ACEs on substance use among expectant mothers across the socioeconomic spectrum; particularly child abuse. This information, can be used by women and the clinicians serving them, to better understand the role that ACEs could play in their decision to use illicit drugs in pregnancy.

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