Screening the risk factors for methamphetamine use in pregnant women not receiving prenatal care

Author(s):  
Piyanuch Saysukanun ◽  
Kullathorn Thephamongkhol ◽  
Pathamaporn Tiengladdawong ◽  
Julaporn Pooliam ◽  
Porndara Sae Chua ◽  
...  
2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S167-S167
Author(s):  
Tripti Adhikari ◽  
Rachel Scott ◽  
Utsav Timalsina ◽  
Ariunzaya Amgalan ◽  
Shari L Sawney ◽  
...  

Abstract Background Prevalence of HCV in pregnancy is 0.1–3.6%. AASLD and IDSA now recommend HCV screening in pregnancy although CDC, USPSTF, or ACOG still do not—though HCV can be perinatally transmitted and carries associated complications for the mother and fetus. Our study objectives were to analyze prenatal HCV screening practices at a large regional healthcare system and the prevalence of HCV-associated maternal and fetal/neonatal outcomes. Methods We performed a nested propensity score (PS) case–control study of pregnant women who tested HCV Ab+ in a cross-sectional study of women presenting for prenatal care at a large regional healthcare system from January 17 to December 18. We collected retrospective EHR data, including state of residency, HCV Ab, RNA, care engagement, HCV risk factors, comorbidities, maternal and fetal/neonatal morbidity, and neonatal HCV testing (when available). Mixed and generalized linear models were used to examine differences in continuous and categorical variables, respectively, between cases and controls Results 14,363 women were seen for prenatal care; 4,891 (34%) were HCV tested, 75 (1.5%) tested HCV Ab+. Demographic and comorbidity data are shown in Table 1. HCV Ab+ cases had more co-morbidities, including obesity, heart disease, opioid use, and behavioral health issues compared with the controls. HCV risk factors included IVDU (64%) and tattoos (24%) (Figure 1). Neither past/current pregnancy-related complications nor fetal or neonatal adverse events (Figure 2) were statistically significantly different except for cholestasis in HCV Ab+ cases (5.3 vs. 0%, P = 0.04). Conclusion Our study showed only one-third of pregnant women are currently HCV screened in our health system. Universal screening would likely increase the number of HCV-infected women identified. Early HCV detection, repeated testing, and behavioral health intervention of those at high-risk may decrease further horizontal and vertical transmission of HCV in pregnancy. Disclosures All authors: No reported disclosures.


Author(s):  
Margarita E. Ahumada-Barrios ◽  
German F. Alvarado

Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth.


2019 ◽  
Author(s):  
Imelda K Moise

Abstract Background Alcohol consumption during pregnancy is associated with adverse pregnancy outcomes such as preventable alcohol-related developmental disability fetal alcohol syndrome. In Zambia, alcohol use and associated risk factors have not been investigated, and screening in prenatal care is nonexistent. This study determined individual correlates and the prevalence of alcohol use in pregnant women attending prenatal care at two health clinics in Lusaka, Zambia. Methods A study adopted a cross-sectional design and recruited 188 pregnant women after seeking their informed consent from July 19 to 31, 2017. Participants aged 18 or over completed the T-ACE (Tolerance, Annoyance, Cut Down and Eye Opener) screening tool and validated alcohol-screening questionnaires on self-reported alcohol use periconceptional and during conception period while at their regular prenatal visit. The T-ACE screening tool assessed the risk of alcohol dependence in four short questions. The questionnaires included demographic questions. Bivariate analyses were performed using the χ2 test for dichotomous variables and the t-test for continuous variables. Mixed-effects linear models were used to evaluate the effect of outcome variables with patient-level variables. Results About 40 (21.2%) pregnant women were identified by the T-ACE as at-risk for problem drinking during pregnancy. Except for regular prenatal care and distance, there was no difference in the demographic factors between pregnant women who scored <2 on the T-ACE and those that scored > 2 points (all p’s > 0.05). A small proportional of women at both clinics reported binge drinking during the periconceptional period (12.7% vs. 3.2%, p=0.003) and beyond periconception period. Excluding employed women, no significant relationships were observed between alcohol use and demographic factors. Conclusion These findings underscore the need for targeted screening and intervention for alcohol use in all pregnant women in Zambia.


2014 ◽  
Vol 56 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Maria F.M. Barral ◽  
Gisele R. de Oliveira ◽  
Rubens C. Lobato ◽  
Raul A. Mendoza-Sassi ◽  
Ana M.b. Martínez ◽  
...  

In the absence of intervention, the rate of vertical transmission of HIV can range from 15-45%. With the inclusion of antiretroviral drugs during pregnancy and the choice of delivery route this amounts to less than 2%. However ARV use during pregnancy has generated several questions regarding the adverse effects of the gestational and neonatal outcome. This study aims to analyze the risk factors for vertical transmission of HIV-1 seropositive pregnant women living in Rio Grande and the influence of the use of ARVs in pregnancy outcome. Among the 262 pregnant women studied the rate of vertical transmission of HIV was found to be 3.8%. Regarding the VT, there was a lower risk of transmission when antiretroviral drugs were used and prenatal care was conducted at the referral service. However, the use of ART did not influence the outcome of pregnancy. However, initiation of prenatal care after the first trimester had an influence on low birth weight, as well as performance of less than six visits increased the risk of prematurity. Therefore, the risk factors analyzed in this study appear to be related to the realization of inadequate pre-natal and maternal behavior.


1998 ◽  
Vol 116 (6) ◽  
pp. 1852-1857 ◽  
Author(s):  
Márcia Maria Auxiliadora de Aquino ◽  
José Guilherme Cecatti ◽  
Coríntio Mariani Neto

OBJECTIVE: The purpose of this study was to investigate risk factors associated to fetal death in a Brazilian population. DESIGN: A case control study. SETTING: The Hospital Maternidade Leonor Mendes de Barros in São Paulo. PARTICIPANTS:122 pregnant women with diagnosis of fetal death and gestation age of 20 or more weeks and 244 controls of pregnant women who delivered liveborns. VARIABLES STUDIED: The fetal death (dependent variable), independent variable (the social demographic factors, clinical and obstetrical history, prenatal care indicators and pathological conditions). RESULTS: The risk factors associated to fetal death were abruptio placentae, syphilis, few prenatal care visits, one or more previous stillbirths, hospitalization during pregnancy, diabetes, age above or equal to 25 years, hypertension during pregnancy, anemia and age below 20 years. CONCLUSIONS: Results of the current study might be useful to orientate a primary prevention health program, specially those concerning antenatal care.


2019 ◽  
Author(s):  
Imelda K Moise

Abstract Background Alcohol consumption during pregnancy is associated with adverse pregnancy outcomes such as preventable alcohol-related developmental disability fetal alcohol syndrome. In Zambia, alcohol use and associated risk factors have not been investigated, and screening in prenatal care is nonexistent. This study determined individual correlates and the prevalence of alcohol use in pregnant women attending prenatal care at two health clinics in Lusaka, Zambia. Methods A study adopted a cross-sectional design and recruited 188 pregnant women after seeking their informed consent from July 19 to 31, 2017. Participants aged 18 or over completed validated alcohol screening questionnaires on self-reported alcohol use periconceptional and during conception period while at their regular prenatal visit. The questionnaires included demographic questions. Bivariate analyses were performed using the χ2 test for dichotomous variables and the t-test for continuous variables. Mixed-effects linear models were used to evaluate the effect of outcome variables with patient-level variables. Results About 40 (21.2%) pregnant women were identified by the T-ACE as at-risk for problem drinking during pregnancy. Except for regular prenatal care and distance, there was no difference in the demographic factors between pregnant women who scored <2 on the T-ACE and those that scored > 2 points (all p’s > 0.05). A small proportional of women at both clinics reported binge drinking during the periconceptional period (12.7% vs. 3.2%, p=0.003) and beyond periconception period. Excluding employed women, no significant relationships were observed between alcohol use and demographic factors. Conclusion These findings underscore the need for targeted screening and intervention for alcohol use in all pregnant women in Zambia.


2016 ◽  
Vol 9 (3) ◽  
pp. 138
Author(s):  
Fereshteh Farzianpour ◽  
Khatere Ramezani ◽  
Najmeh Bahmanziari ◽  
Omolbanin Atashbahar

<p><strong>BACKGROUND &amp; OBJECTIVES:</strong> Ending mortality in pregnant women is not just a health challenge, but a development challenge. The purpose of this study was to access the frequency and risk factors associated with maternal mortality in Tehran from 2008 to 2011.</p><p><strong>METHODS: </strong>The present study was a case-control study with a population group which consists of all the women who have died since the beginning of pregnancy up to 42 days after delivery from the year 2008 to 2011 and a control group which consists of all delivered pregnant women with a perfect record in the hospitals (n=16) in Tehran from 2008 to 2011. In the case group, sampling was done through census (n = 113) and random sampling was used in the control group and 327 people were selected. Data collection tool was a record sheet consisting of two parts: demographic and risk factors associated with pregnancy which was completed using the data in the case and control groups. Finally, SPSS 22, descriptive statistics and statistical tests such as Chi-square, t-test and Fisher were used to analyze the data.</p><p><strong>RESULTS:</strong> Maternal deaths were reported in Tehran from 2008 to 2011 and the ratio was 15.8 in 100 thousand of live births during the period. Among the mothers who died, 73.5% of them were 18 to 34 years old, 1.22% were 35 years old or above and only 4.4% were less than 18 years of age. Of these mothers that died, 83.2% lived in the city and 16.8% lived in rural areas, but there were significant relationship between age, place of residence and maternal deaths. In combination with other risk factors, such as pregnancy age, pregnancy number, number of abortions, underlying medical condition, access to appropriate prenatal care, methods of delivery, factors of delivery, and the time may be between two last pregnancy, a significant difference was observed between the case and control groups, except for the distance between the two last pregnancy.</p><p><strong>CONCLUSION: </strong>Maternal mortality has been declining over the years; due to the identified factors associated with maternal death, proposed strategies, such as improving the quality of hospital services in the field of obstetric emergencies, improving the quality and coverage of prenatal care, avoidance of selective cesarean sections, identifying high risk pregnancies and referrals to specialized centers.</p>


2019 ◽  
Vol 4 (3) ◽  

Sexually transmitted infections are among the most common public health problems worldwide. Female and male infertility, mother to child transmission, causing miscarriages or congenital disease, and increased risk for Human Immunodeficiency Virus infection (HIV) are some of their consequences. In Sub-Saharan Africa countries, such as Mozambique, the prevalence of these infections is high, women being those who carry the higher burden. Thus we developed this cross-sectional study with objective of characterizing some sexually transmitted infections, HIV infection, syphilis and trichomoniasis in pregnant women, verifying if their management was in accordance with guidelines and recommendations in the country and identifying practice, Knowledge and associated risk factors. Samples were collected from 253 pregnant women attending Centro de Saúde de Maxixe. Vaginal samples were obtained and observed microscopically by wet mount and direct microscopic examination (Trichomonas vaginalis). HIV antibody testing was performed with the tests Determine HIV-1/2 and Uni-GoldTM and against, T. pallidum by RPR, SD BIOLINE Syphilis 3.0 and Determine TP tests in plasma samples. In this study, 11.1% of the pregnant women were infected with HIV, 2.8% with active syphilis, 5.1% with Trichomonas vaginalis and 9.1% with yeast. Antibodies against T. pallidum were identified in 8,3% of these women. In relation to HIV, 7, 5% of them were new cases. Samples were taken from 253 pregnant women attending ante-natal outpatient consultation at the health centre, which were informed about the nature of the study and submitted to a semi-structured interview after signing the free informed consent. In this study, the inconsistency on condoms use and the existence of multiple partners by the participants contributing for these infections transmission. Participants have shown that they had information about these infections modes of transmission, as also which measures to use to prevent them. A significant number of women present with any symptom related to infections that were diagnosed to them, proving that the use of syndrome approach in vaginal discharge must be given some thought in relation to its value in this situation. The data obtained in this study shows that some gaps also exist in the prenatal care clinics of this Centre, from routine procedures that are not performed in accordance with MISAU recommendations. The high prevalence of some STI found in this population, their risk behavior, together with the non-observance of some guidelines in the management of those infections by the health personal very worrying. The implementation of a teaching program on quality control, prevention and management of these infections by the health professional seems to us to be of utmost importance, so these can act in accordance with the present guidelines and transmit correct information to the pregnant women who attend prenatal care.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Imelda K. Moise

Abstract Background Alcohol consumption during pregnancy is associated with adverse pregnancy outcomes such as preventable alcohol-related developmental disability fetal alcohol syndrome. In Zambia, alcohol use and associated risk factors have not been investigated, and screening in prenatal care is nonexistent. This study determined individual correlates and the prevalence of alcohol use in pregnant women attending prenatal care at two health clinics in Lusaka, Zambia. Methods A study adopted a cross-sectional design and recruited 188 pregnant women after seeking their informed consent from July 19 to 31, 2017. Participants aged 18 or over completed the T-ACE (Tolerance, Annoyance, Cut Down and Eye Opener) screening tool and validated alcohol-screening questionnaires on self-reported alcohol use periconceptional and during conception period while at their regular prenatal visit. The T-ACE screening tool assessed the risk of alcohol dependence in four short questions. The questionnaires included demographic questions. Bivariate analyses were performed using the χ2 test for dichotomous variables and the t-test for continuous variables. Mixed-effects linear models were used to evaluate the effect of outcome variables with patient-level variables. Results About 40 (21.2%) pregnant women were identified by the T-ACE as at-risk for problem drinking during pregnancy. Except for regular prenatal care and distance, there was no difference in the demographic factors between pregnant women who scored < 2 on the T-ACE and those that scored > 2 points (all p’s > 0.05). A small proportional of women at both clinics reported binge drinking during the periconceptional period (12.7% vs. 3.2%, p = 0.003) and beyond periconception period. Excluding employed women, no significant relationships were observed between alcohol use and demographic factors. Conclusion Alcohol consumption is prevalent in the periconceptional period and during pregnancy in pregnant women attending prenatal care in Zambia. Findings underscore the need for targeted alcohol use screening and intervention for pregnant women.


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