Evaluating the Impact of a Pragmatic Nutrition Awareness Program for Expectant Mothers upon Birth Weight of the Newborn

Poor maternal nutritional status and substandard antenatal care, which result in increased women's risk, low birth weight and stillbirth, afflict many countries with weak or emerging economies even today. Studies that address the effect of extending nutrition awareness among pregnant women to the net outcome of pregnancy remain scarce. We aimed to compare and contrast the effect of a pragmatic nutrition awareness program for expectant mothers (NAPEM) on birth weight of the newborn with a control group who received no such nutrition awareness activity. The effect of variables of mode of newborn delivery, associated complications at birth, and APGAR score of the newborn were also assessed. A pragmatic intervention trial of an antenatal care (ANC) program that consisted in nutrition awareness was conducted involving 53 pregnant women. Awareness was given through one-to-one interview and through informational literature provided to the participants in the local language. A hospital registry for deliveries undertaken during the study period was screened for identification of variables. A control group of matched pregnant women (n= 53) was obtained from the same hospital registry from preceding years, when the nutrition awareness program was not executed. A statistically significant improvement in birth weight of the newborn was observed in the intervention group, where expectant mothers were made aware about desired nutrition during pregnancy. A reduced incidence of complications associated with pregnancy was also observed in the intervention group. Providing awareness about nutritional requirements during pregnancy and suggesting the pragmatic ways to meet them was shown to be one possible effective measure to deal with pregnancy-related undernutrition. We show the efficacy of the intervention for underprivileged regions of India marked by inadequate health care delivery and lower socio-economical standards. We discuss our findings in the context of available evidence-based guidelines.

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The effect of a maternal mentoring program on the timing of first antenatal care visit among pregnant women in Bantul, Indonesia: Results of a cluster randomized trial

Health Promotion Perspectives ◽

10.34172/hpp.2021.39 ◽

2021 ◽

Vol 11 (3) ◽

pp. 307-315

Author(s):

Yhona Paratmanitya ◽

Siti Helmyati ◽

Detty Siti Nurdiati ◽

Emma C. Lewis ◽

Joel Gittelsohn ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Statistical Significance ◽

Intervention Group ◽

Future Research ◽

Control Group ◽

Mentoring Program ◽

Mixed Effect ◽

Cluster Randomized ◽

The Impact

Background: Antenatal care (ANC) is low in developing countries, with an estimated 20% of Indonesian women not initiating ANC during the first trimester. The present study sought to determine the impact of a mentoring program on the timing of the first ANC visit. Methods: This cluster randomized controlled trial was conducted in 3 subdistricts of the Bantul District, divided into 61 clusters per treatment arm, with a final sample size of 205 confirmed pregnant women. The mentoring program consisted of (1) health education, (2) monitoring, and (3) text-message reminders. The primary outcome was the timing of first ANC visit. A multilevel mixed-effect logistic regression model was used to measure the effect of the program on the likelihood of having an earlier first ANC visit, with statistical significance at α=0.05. Results: At the individual-level, the intervention group had a mean time of first ANC visit±2 days earlier than the control group (P<0.05). After adjusted for cluster and other covariates, the odds of starting the first ANC visit early (<39 days of gestation) was higher in the intervention group (adjusted odds ratio [AOR] 3.00; 95% confidence interval [CI] 1.17-7.72). Conclusion: Maternal mentoring can improve the timing of the first ANC visit. This program has the potential to be adopted by health care systems in settings where there is little education on the importance of ANC. Future research could extend the length of mentorship until delivery in order to better understand the relationship between mentorship and early ANC on pregnancy outcomes.

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Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04205-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Serge Henri Zango ◽

Moussa Lingani ◽

Innocent Valea ◽

Ouindpanga Sekou Samadoulougou ◽

Biebo Bihoun ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Antenatal Care ◽

Burkina Faso ◽

Pregnant Women ◽

Sexually Transmitted Infections ◽

Pregnancy Outcomes ◽

Rural Setting ◽

Sexually Transmitted ◽

The Impact

Abstract Background Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. Methods Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. Results During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 – 1.07)], STIs [Adjusted OR: 0.74 (0.51 – 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 – 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 – 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 – 1.59)], curable STI [Adjusted OR: 1.65 (1.06 – 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 – 3.52)]. Conclusion Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.

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Mhealth and Utilization of Health Care Services in Lagos Southwest Nigeria- A Pilot Study

10.21203/rs.3.rs-653798/v1 ◽

2021 ◽

Author(s):

Gbemisola E. Osanyin ◽

Esther O. Oluwole ◽

Adesumbo K. Odeseye ◽

Bosede B. Afolabi

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Health Care Services ◽

Intervention Group ◽

Control Group ◽

Willingness To Participate ◽

Birth Attendance ◽

Significant Difference ◽

Southwest Nigeria ◽

Antenatal Attendance

Abstract Background: A third of pregnant women in Nigeria do not attend Antenatal care, hence this quasi-experimental study was carried out within 500 consenting pregnant women within the 5 administrative zones of Lagos to determine the association between Mhealth services and utilization of antenatal and skilled delivery services amongst pregnant women in Lagos, Southwest Nigeria.Methods: Participants were divided into an intervention (who received voice messages) and a control arm (did not receive voice messages). Ownership of a mobile phone and willingness to participate were the selection criteria. Data was collected using a structured interviewer administered questionnaire. Analysis was by descriptive statistics with 95% CI to identify factors associated with antenatal attendance.Results: Total respondents were 488 (response rate 97.6%). One hundred and fifty-nine (63.8%) of the intervention group found the messages useful. Using the WHO 2016 ANC model, women in the intervention group had a significantly higher frequency of antenatal care attendance than the control group (p < 0.0001). There was a statistically significant difference in antenatal attendance between the intervention and the controls (p < 0.0001). There was also a significantly lower likelihood of poorly supervised (unskilled) home deliveries within the intervention arm (p=0.011). Conclusion: Mhealth was associated with an increased antenatal attendance and skilled birth attendance at delivery. This has a significant impact in reducing morbidity and mortality indices.

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Nutrition information system (SISFORNUTRIMIL) application With Online Food Record for Indonesia Pregnant Women: Protocol for Randomized Controlled Trial

10.21203/rs.3.rs-634069/v1 ◽

2021 ◽

Author(s):

Mira Trisyani Koeryaman ◽

Saseendran Pallikadavath ◽

Isobel Ryder ◽

Ngianga Kandala

Keyword(s):

Randomized Controlled Trial ◽

Pregnant Women ◽

Dietary Diversity ◽

Controlled Trial ◽

Intervention Group ◽

Eating Behaviour ◽

Control Group ◽

Food Record ◽

Randomized Controlled ◽

The Impact

Abstract Background: The pregnant women and family may not have the necessary knowledge and skills to estimate nutrient value in food in line with dietary targets and the guidelines, i.e. they do not know whether or not they are consuming the right amount of nutrition needed during pregnancy. The aims of this randomized controlled trial (RCT) is to examine the impact of SISFORNUTRIMIL application on maternal eating behaviour and associated maternal factors such as weight gain, blood pressure, biochemical measurement, and pregnancy outcome.Methods: The study recruits 112 participants with eligible criteria during December 2019 to January 2020. The allocation of participants is 1:1 to the SISFORNUTRIMIL application user and non-user application, with criteria: singleton pregnancy (22-26 weeks), mother age between 20-35 years), have monthly income and literate. Both groups will receive 12-week standard health services from health professionals and received information about dietary diversity and food record. Particularly, intervention group could be access the SISFORNUTRIMIL on their devices, which provide necessary information about nutrition in pregnancy, food record and food choice includes total serving size calculation. In contrast, the control group only receive food information and food intake record by paper-based, and they should record and calculate the nutrition intake by traditionally. Discussion: This is the first randomized controlled trial to examine the SISFORNUTIMIL application. This mandate reflects keen interest and motivation for the proposed research study. This is in addition to the researcher’s personal efforts to reduce morbidity and mortality rate as well as a general focus on pregnancy complication prevention than nutrition treatment. Thus, an investigation of eating behaviour and associated maternal needed to address this issue. Firstly, the results could extend the scope of knowledge about nutrition intervention to include the Indonesia pregnant women context as well as the Indonesia health ministry context. Secondly, this research could help to change individual health behaviour and activity undertaken by an individual who believes her-self to be healthy.Trial registration: ISRCTN Registry: ISRCTN42690828. Date of registration: 22 October 2019.

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Improving Knowledge of Antenatal Care (ANC) among Pregnant Women: A Field Trial in Central Java, Indonesia

Asia Pacific Journal of Public Health ◽

10.1177/101053950501700102 ◽

2005 ◽

Vol 17 (1) ◽

pp. 3-8 ◽

Cited By ~ 11

Author(s):

E. Nuraini ◽

E. Parker

Keyword(s):

Antenatal Care ◽

Maternal Mortality ◽

Pregnant Women ◽

Economic Status ◽

Intervention Group ◽

Control Group ◽

New Approach ◽

Advantages And Disadvantages ◽

Central Java ◽

Back Ground

The need for reducing maternal mortality has become a paramount concern in developing countries including Indonesia. One of the strategies for reducing maternal mortality in Indonesia is the provision of antenatal care (ANC). Previous studies have reported the advantages and disadvantages of ANC. The purpose of this study is to ascertain if a new approach to ANC can improve pregnant women's knowledge of its benefits. An experimental design with 60 pregnant women from 10 cluster villages is used in this study. The intervention group received the new approach to ANC, while the control group received routine ANC. The findings show that the improvement of knowledge in the intervention group is significant particularly in the knowledge about healthy pregnancy ( p=0.012), pregnancy complications ( p=0.01), safe birth ( p=0.01) and taking care of the newborn ( p=0.012). The improvement of knowledge was significantly influenced by the respondents' educational back ground ( p=0.002) and socio-economic status ( p=0.027). This study recommends that the new approach to ANC be considered to educate pregnant women regarding safe birth and it is considered as one of the strategies that may be adopted to reduce maternal mortality. Asia Pac J Public Health 2005: 17(1): 3-8.

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The Impact of Maryam Exercise Towards the Stress Level and Cortisol Serum Level among Primiparous Pregnant Women

International Journal of Nursing and Health Services (IJNHS) ◽

10.35654/ijnhs.v3i5.338 ◽

2020 ◽

Vol 3 (5) ◽

pp. 598-607

Author(s):

Maya Erisna ◽

Runjati Runjati ◽

Apoina Kartini ◽

Mahalul Azam ◽

Donny Kristanto Mulyantoro

Keyword(s):

Pregnant Women ◽

Positive Impact ◽

Intervention Group ◽

Serum Levels ◽

Control Group ◽

Significant Difference ◽

Stress Levels ◽

Before And After ◽

The Impact ◽

Experimental Group

Women are more at risk to stress in pregnancy than during the puerperium. One method of coping with stress is through physical exercise. Maryam Exercise can be used as an alternative to the development of pregnancy exercises in Indonesia because it covers the holistic aspects and easy to do. It is a combination of basic pregnancy exercises, Islamic prayer (Salat) movements and dhikr. The purpose of this study was to examine the impact of Maryam exercise on the stress levels and cortisol serum levels among primiparous pregnant women. This study used a quasi-experimental study design, pre-test and post-test with non-equivalent control group. In the third trimester of 40 primiparous women were randomly assigned into two groups such the experimental group (n=20) and the control group (n=20). The experimental group received the Maryam exercise while the control group received the standard antenatal exercise. There was a significant difference in stress levels between the intervention group and the control group before and after receiving the intervention (p <0.05). The cortisol levels also showed the significance difference between the intervention group and the control group before and after receiving the intervention (p <0.05). The findings of this study suggest that Maryam Exercise has a positive impact on stress levels and cortisol serum levels of primiparous pregnant women.

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Mobile-application Intervention on Physical Activity of Pregnant Women in Iran During the COVID-19 Epidemic in 2020

10.21203/rs.3.rs-144674/v1 ◽

2021 ◽

Author(s):

Neda Kiani ◽

Asiyeh Pirzadeh

Keyword(s):

Physical Activity ◽

Pregnant Women ◽

Intervention Group ◽

Mobile App ◽

T Test ◽

Control Group ◽

Perceived Benefits ◽

Significance Level ◽

Different Types ◽

The Impact

Abstract Background: Considering the low level of physical activity in pregnant women in the COVID-19 pandemic period and on the other hand the benefits of mobile app learning, we decided to conduct a study to determine the impact of educational intervention based on mobile app on physical activity in pregnant women.Methods: The present study was quasi-experimental and examined 93 pregnant women aged 16 to 20 weeks of gestation. Sampling was done on pregnant women participating in the childbirth preparation classes in Isfahan. We used the validated and reliable questionnaire including perceived benefits, perceived barriers, perceived enjoyment, perceived social support and Pregnancy Physical Activity Questionnaire (PPAQ). The intervention was based on mobile app and the content of the application contained 12 main domains such as : description of physical activity and benefits and barriers of exercise in the pregnancy, different types of proper pregnancy exercise , planning for exercise, different types of exercise. Finally, data were analyzed using SPSS20 and the Chi-square test, independent t-test Paired t-test were employed. The significance level was considered to be less than 0.05.Results: The results showed that after the intervention based on mobile app, the mean score of perceived benefits and enjoyment were significantly higher than before the intervention in the intervention group. Finally total mean score of physical activity significantly increased in the intervention group, while the change decreased in the control group.Conclusion: The results indicated that the use of mobile app can be used to promote physical activity in pregnant women. Therefore, it is recommended that mobile app education should apply with face-to-face classes in health centers for physical activity in pregnant women in pandemic situation.

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A smartphone coaching program (“Bouge Grossesse”) improves daily physical activity in pregnant women (Preprint)

10.2196/preprints.27495 ◽

2021 ◽

Author(s):

Matthieu MULLER ◽

Pandora JAMES ◽

Philippe MERVIEL ◽

Alain SARAUX ◽

Yannick GUILLODO ◽

...

Keyword(s):

Physical Activity ◽

Pregnant Women ◽

Primary Outcome ◽

Intervention Group ◽

Daily Physical Activity ◽

Controlled Study ◽

Control Group ◽

Sedentary Behaviors ◽

Significant Difference ◽

The Impact

BACKGROUND Physical activity has been shown to reduce obstetrical risks however pregnant women reduce their physical activity and sedentary behaviors increase. OBJECTIVE Our aim was to evaluate the impact of a smartphone application developed to increase daily physical activity in pregnant women. METHODS We enrolled 250 pregnant women in a prospective randomized controlled study. These women were instructed to download either an intervention application called «Bouge Grossesse» (coaching program and a pedometer; n=125) or a Placebo application (pedometer only; n=125). Primary outcome was defined as a daily increase of 2000 steps/day between day 1 and day 90 or 10 000 steps/week between week 1 and week 12. Data was analyzed with intention to treat. Secondary outcomes were the number of steps at week 12 and the evolution of quality of life measured by WHO score, EIFEL score and SPIEGEL scale, and on maternal and fetal outcomes. RESULTS Patients were enrolled between August 2017 and February 2019. They were retrospectively registered after September 2018. We found a significant difference in the primary outcome between the two groups in favor of the intervention group (22.4% success vs 3.2% in the control group, P<.001) but only 43 women in the intervention group (34.4%) and 16 women in the placebo group (12.8%) completed the 12-week coaching program. There were no significant differences in the SPIEGEL, EIFEL and WHO scores. The mean number of daily steps at week 12 was significantly higher in the intervention group (6900.0 vs 4371.9, P<.001). CONCLUSIONS The mobile health intervention « Bouge Grossesse » significantly increased physical activity in pregnant women but we observed a high percentage of withdrawals from the 12-week program. CLINICALTRIAL This clinical trial was registered under the number NCT03688087 ClinicalTrials.gov.

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Determinants of low birth weight in the context of maternal nutrition education in urban informal settlements, Kenya

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174418000715 ◽

2018 ◽

Vol 10 (02) ◽

pp. 237-245 ◽

Cited By ~ 6

Author(s):

C. K. Nyamasege ◽

E. W. Kimani-Murage ◽

M. Wanjohi ◽

D. W. M. Kaindi ◽

E. Ma ◽

...

Keyword(s):

Logistic Regression ◽

Birth Weight ◽

Low Birth Weight ◽

Antenatal Care ◽

Cesarean Delivery ◽

Maternal Nutrition ◽

Intervention Group ◽

Control Group ◽

Nutritional Counselling ◽

Urban Informal Settlements

AbstractInadequate knowledge in maternal nutrition is one of the determinants of low birth weight. However, little evidence is available on whether maternal nutrition counselling alone can influence birth weight among women from low socioeconomic households. This study assessed the effect of prenatal maternal nutritional counselling on birth weight and examined the related risk factors. A cluster randomized controlled trial was conducted to assess the effectiveness of home-based maternal nutritional counselling on nutritional outcomes, morbidity, breastfeeding, and infant feeding practices by the African Population and Health Research Center in two urban informal settlements of Nairobi. The intervention group received monthly antenatal and nutritional counselling from trained community health volunteers; meanwhile, the control group received routine antenatal care. A total of 1001 participants were included for analysis. Logistic regression was applied to determine associations between low birth weight and maternal characteristics. A higher prevalence of low birth weight was observed in the control group (6.7%) than in the intervention group (2.5%; P<0.001). Logistic regression identified significant associations between birth weight and intervention group (adjusted odds ratio (AOR)=0.26; 95% confidence interval (CI), 0.10–0.64); maternal height <154.5 cm (AOR=3.33; 95% CI, 1.01–10.96); last antenatal care visits at 1st or 2nd trimesters (AOR=9.48; 95% CI, 3.72–24.15); pre-term delivery (AOR=3.93; 95% CI, 1.93–7.98); maternal mid-upper arm circumference <23 cm (AOR=2.57; 95% CI, 1.15–5.78); and cesarean delivery (AOR=2.27; 95% CI, 1.04–4.94). Nutrition counselling during pregnancy reduced low birth weight and preterm births, which was determined by women of short stature, early stoppage of antenatal visit, and cesarean delivery.

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The effectiveness of interactive mobile health technologies in improving antenatal care service utilization in Dodoma region, Tanzania: A quasi experimental study

10.21203/rs.3.rs-34094/v1 ◽

2020 ◽

Author(s):

THERESIA JOHN MASOI ◽

Stephen M. Kibusi ◽

Alex Ernest ◽

Athanase G. Lilungulu

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Service Utilization ◽

Mobile Health ◽

Care Service ◽

Intervention Group ◽

Control Group ◽

Health Technologies ◽

Quasi Experimental ◽

The Mean

Abstract Background Antenatal care provides a platform for important health care functions during pregnancy, including health promotion, screening, and diagnosis and disease prevention. Timely and appropriate utilization of antenatal care can prevent complications and ensure better maternal and newborn health care. The aim of this study was to assess the effectiveness of interactive mobile health technologies in improving antenatal care service utilization in Dodoma region, Tanzania Methods A controlled quasi-experimental study was carried. Random selection of participants was employed to achieve a sample size of 450 pregnant women (Intervention=150 and Control=300). Interventions were matched to controls by gravidity and gestational age at a ratio of 1:2.The intervention group was enrolled in an interactive mobile messaging system and received health education messages. The control group continued with the standard antenatal care services being offered in local clinics. Pregnant women were followed from their initial visit to the point of delivery. Independent two-sample T-tests and logistic regression were used to test the effect of the intervention. Results The mean age of the participants was found to be 25.6 years with a range of 16 to 48 years. 77.3% of participants in the intervention group utilize ANC services as compared to 57.7% in the control group. The mean score was (M=2.77, SD 0.420) in the intervention group against (M=2.58, SD=0.495) in the control with (t=4.172, P<0.01) at 95% CI . Interactive SMS alert system,was observed to be effective on improving Antenatal care service utilization (AOR=2.164, P<0.05, 95% CI=1.351-3.466) as compared to conventional Antenatal care health education given in our health facilities. Conclusion The Interactive mobile health technologies used in this study has the potential of empowering pregnant women through greater access to information and in improving antenatal care service utilization in our setting.

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