Evaluation of a blended care programme for caregivers and working pregnant women to prevent adverse pregnancy outcomes: an intervention study

ObjectiveWork-related activities can be a risk factor for pregnancy complications such as preterm birth. This study evaluates the effectiveness of a blended care programme, Pregnancy and Work, that provides pregnant workers and their obstetrical caregivers with advice on work adjustment.MethodsWomen less than 20 weeks of gestation, in paid employment or self-employed, in the care of four participating hospitals and their referring midwifery practices in the Netherlands received either the blended care programme (n=119), consisting of a training for professionals and a mobile health application, or care as usual (n=122) in a controlled intervention study with a follow-up in intervention and control populations. All participants completed three questionnaires concerning health and working conditions at 16, 24 and 32 weeks of pregnancy. Primary outcome was the percentage of women who received advice from their obstetrical caregiver about work adjustment. Secondary outcomes were work status, realised work adjustment and working conditions. Groups were compared using univariate and multivariate regression analyses.ResultsA total of 188 (78%) completed all three questionnaires. In the blended care group, women received more advice from obstetrical caregivers to adjust their work than in the control group, 41 (39%) vs 21 (18%) (adjusted relative risk (aRR) 2.2, 95% CI 1.4 to 3.4), but less from their employer 8 (8%) vs 31 (28%) (aRR 0.29, 95% CI 0.14 to 0.61). There were no significant differences in realised work adjustments. At 24 weeks, 30% of the pregnant women in both groups continued to work in hazardous workplaces.ConclusionAmong working pregnant women, the blended care intervention increases advice on work adjustment given by midwives and obstetricians, but does not lead to more work adjustments.

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COVID-19 Quarantine is a Risk Factor for Poor Pregnancy Outcomes in GDM Patients: A Retrospective Study

10.21203/rs.3.rs-836921/v1 ◽

2021 ◽

Author(s):

Qin-Yu Cai ◽

Yin Yang ◽

Ling-Ling Ruan ◽

Dang-Dang Wang ◽

Han-Lin Cui ◽

...

Keyword(s):

Pregnant Women ◽

Electronic Medical Records ◽

Pregnancy Outcomes ◽

Medical Records ◽

Control Group ◽

Second Trimester ◽

Public Health Emergencies ◽

Nuchal Cord ◽

Adverse Pregnancy ◽

Glucose Management

Abstract Aims: This study was to evaluate the effects of the home quarantine on pregnancy outcomes of gestational diabetes mellitus (GDM) patients during the COVID-19 outbreak.Methods: Thecomplete electronic medical records of GDM patients with home quarantine history were collected and classified into the home quarantine group from 24 February 2020 to 24 November 2020. The same period of GDM patients without home quarantine historywas included in the control group from 2018 and 2019.Results: A total of 1358 GDM patients were included in the analysis, including 484 in 2018, 468 in 2019, and 406 in 2020. GDM patients with home quarantine in 2020 had higher glycemic levels and worse pregnancy outcomes than 2018 and 2019, including higher cesarean section rate,lower Apgar scores, and higher incidence of macrosomia and nuchal cord. More importantly, the second trimester of home quarantine had brought a broader impactto pregnant women and fetuses.Conclusion: Home quarantine has aggravated the condition of GDM pregnant women and brought more adverse pregnancy outcomes during the COVID-19 outbreak. Therefore, we suggested that governments and hospitals should strengthen lifestyle guidance, glucose management, and antenatal care for GDM patients with home quarantine during public health emergencies.

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Home Care for Chronic Mental Illness in Bangalore: An Experiment in the Prevention of Repeated Hospitalisation

The British Journal of Psychiatry ◽

10.1192/bjp.147.2.175 ◽

1985 ◽

Vol 147 (2) ◽

pp. 175-179 ◽

Cited By ~ 11

Author(s):

Shaila Pai ◽

S. M. Channabasavanna ◽

Nagarajaiah ◽

R. Raghuram

Keyword(s):

Home Care ◽

Matched Control ◽

Psychiatric Patients ◽

Care Group ◽

Control Group ◽

Chronic Mental Illness ◽

Care Programme ◽

Duration Of Illness ◽

Chronic Psychiatric Patients ◽

Trained Nurse

SummaryThe article describes the outcome of a comparative study of home care, by a trained nurse, versus hospital out-patient supervision in the management of chronic psychiatric patients in Bangalore, India. Twenty-five patients, with a mean duration of illness of nine years, were started on the home care programme while a matched control group of 25 similar patients continued the regular out-patient contact offered by the hospital. Comparative assessments were carried out on the groups at the time of intake and again after two years. The results indicate that hospital admission was less often needed among the home care group.

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Maternal Pre-Pregnancy Obesity Combined With Abnormal Glucose Metabolism Further Increases Adverse Pregnancy Outcomes in Chinese Pregnant Women

Frontiers in Endocrinology ◽

10.3389/fendo.2021.754406 ◽

2022 ◽

Vol 12 ◽

Author(s):

Mei-Fang Li ◽

Jiang-Feng Ke ◽

Li Ma ◽

Jun-Wei Wang ◽

Zhi-Hui Zhang ◽

...

Keyword(s):

Glucose Metabolism ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Perinatal Outcomes ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Abnormal Glucose Metabolism ◽

Induced Hypertension ◽

Adverse Perinatal Outcomes ◽

Adverse Pregnancy

AimsOur aim was to evaluate the separate and combined effects of maternal pre-pregnancy obesity and gestational abnormal glucose metabolism (GAGM) on adverse perinatal outcomes.MethodsA total of 2,796 Chinese pregnant women with singleton delivery were studied, including 257 women with pre-pregnancy obesity alone, 604 with GAGM alone, 190 with both two conditions, and 1,745 with neither pre-pregnancy obesity nor GAGM as control group. The prevalence and risks of adverse pregnancy outcomes were compared among the four groups.ResultsCompared with the normal group, pregnant women with maternal pre-pregnancy obesity alone, GAGM alone, and both two conditions faced significantly increased risks of pregnancy-induced hypertension (PIH) (odds ratio (OR) 4.045, [95% confidence interval (CI) 2.286–7.156]; 1.993 [1.171–3.393]; 8.495 [4.982–14.485]), preeclampsia (2.649 [1.224–5.735]; 2.129 [1.128–4.017]; 4.643 [2.217–9.727]), cesarean delivery (1.589 [1.212–2.083]; 1.328 [1.095–1.611]; 2.627 [1.908–3.617]), preterm delivery (1.899 [1.205–2.993]; 1.358 [0.937–1.968]; 2.301 [1.423–3.720]), macrosomia (2.449 [1.517–3.954]; 1.966 [1.356–2.851]; 4.576 [2.895–7.233]), and total adverse maternal outcomes (1.762 [1.331–2.332]; 1.365 [1.122–1.659]; 3.228 [2.272–4.587]) and neonatal outcomes (1.951 [1.361–2.798]; 1.547 [1.170–2.046]; 3.557 [2.471–5.122]). Most importantly, there were no obvious risk differences in adverse pregnancy outcomes between maternal pre-pregnancy obesity and GAGM group except PIH, but pregnant women with both obesity and GAGM exhibited dramatically higher risks of adverse pregnancy outcomes than those with each condition alone.ConclusionsMaternal pre-pregnancy obesity and GAGM were independently associated with increased risks of adverse pregnancy outcomes. The combination of pre-pregnancy obesity and GAGM further worsens adverse pregnancy outcomes compared with each condition alone.

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Pregnancy outcome after exposure to oral contraceptives during the periconceptional period

Human & Experimental Toxicology ◽

10.1177/0960327108092290 ◽

2008 ◽

Vol 27 (4) ◽

pp. 307-313 ◽

Cited By ~ 11

Author(s):

HK Ahn ◽

JS Choi ◽

JY Han ◽

MH Kim ◽

JH Chung ◽

...

Keyword(s):

Pregnant Women ◽

Oral Contraceptives ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Exposed Group ◽

Large For Gestational Age ◽

Control Group ◽

Periconceptional Period ◽

Adverse Pregnancy

To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0–41.0) weeks in the exposed group and 39.3 (27.4–42.0) weeks in the control group ( P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group ( P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% ( n = 3/99) versus 3.6% ( n = 7/193) in the control group ( P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.

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First epidemiological data for venotonics in pregnancy from the EFEMERIS database

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515589679 ◽

2015 ◽

Vol 31 (5) ◽

pp. 344-348 ◽

Cited By ~ 6

Author(s):

Isabelle Lacroix ◽

Anna-Belle Beau ◽

Caroline Hurault-Delarue ◽

Claire Bouilhac ◽

Dominique Petiot ◽

...

Keyword(s):

Pregnant Women ◽

Adverse Pregnancy Outcome ◽

Pregnancy Termination ◽

Newborn Health ◽

Control Group ◽

Published Data ◽

Intrauterine Death ◽

Increased Risk ◽

Adverse Pregnancy ◽

In Pregnancy

Objective There are few published data about possible effects of veinotonics in pregnant women. The present study investigates potential adverse drug reactions of veinotonics in pregnancy. Method EFEMERIS is a database including prescribed and dispensed reimbursed drugs during pregnancy (data from Caisse Primaire d’Assurance Maladie) and outcomes (data from Maternal and Infant Protection Service and Antenatal diagnostic Centre). Women who delivered from 1 July 2004 to December 2007 in Haute-Garonne and were registered in the French Health Insurance Service have been included in the EFEMERIS database. We compared pregnancy outcomes and newborn health between women exposed to veinotonics during pregnancy and unexposed women. Results We found that 8998 women (24%) had received at least one prescription for venotonic agents during their pregnancy, corresponding to the period of organogenesis in 1200 cases. We compared data for these women with those for the 27,963 women for whom these drugs were not prescribed during pregnancy. The most widely used veinotonics were hesperidin, diosmin and troxerutin. Pregnancies led to 98.4% versus 93.6% of live births, 0.2% versus 0.2% of postnatal deaths and 1.6% versus 6.4% of pregnancy termination (miscarriage, ectopic pregnancy, medical termination, intrauterine death) in exposed and non-exposed groups, respectively. The risks of pregnancy termination (HR = 0.71 (0.60–0.84)) and prematurity (HR = 0.82 (0.73–0.93)) remained significantly lower in the women exposed to venotonics than in unexposed women. In the group of newborns whose mother had a prescription of veinotonics during organogenesis, 39 out of 1200 (3.4%) had a malformation versus 789 (3.0%) in the control group (ORa = 1.134 (0.873–1.472)). The risk of neonatal diseases was not increased by exposure to venotonic agents in the third trimester (4.9% versus 6.1% for the controls, ORa = 1.07 (0.95–1.20)). Conclusion We found no increased risk of adverse pregnancy outcome among women exposed to veinotonics compared with unexposed pregnant women.

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CLINICAL-ANAMNESTIC AND MOLECULAR-GENETIC FACTORS IN DIFFERENT FORMS OF HYPERTENSION AND ITS RELATIONSHIP TO COURSE AND PREGNANCY OUTCOMES

Annals of the Russian academy of medical sciences ◽

10.15690/vramn.v68i11.838 ◽

2013 ◽

Vol 68 (11) ◽

pp. 22-25 ◽

Cited By ~ 1

Author(s):

V. S. Chulkov ◽

N. K. Vereina ◽

S. P. Sinitsyn ◽

V. F. Dolgushina

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Genetic Factors ◽

Gestational Hypertension ◽

Molecular Genetic ◽

Renin Angiotensin System ◽

Overweight And Obesity ◽

Control Group ◽

Chronic Hypertension ◽

Adverse Pregnancy

Aim: to assess of the relationship of clinical and molecular genetic factors in the course and outcome of pregnancy in different forms of hypertension in pregnant women. Patients and methods: a total of 125 pregnant women who were divided into the following groups: with chronic hypertension (n =45), with gestational hypertension (n =20), with pre-eclampsia (n =10), superimposed preeclampsia upon chronic hypertension (n =15) and 35 women without hypertension in control group. Results: in pregnant women with chronic hypertension and superimposed preeclampsia upon chronic hypertension were observed higher incidence of overweight and obesity, smoking before pregnancy and family history of hypertension and thrombosis, the course and outcomes of pregnancy characterized by higher frequency of obstetric complications, higher frequency of polymorphisms of genes identified the renin-angiotensin system, folate cycle and endothelial function. Conclusions: Molecular-genetic factors, combined with the factors of cardiovascular risk may make some contribution to the phenotypic realization of pregnancy complications and adverse pregnancy outcomes in pregnant women with different forms of hypertension.

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Oral Anaerobic Microflora and Pregnancy Complication

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7601 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1681-1685

Author(s):

Irena Andonova ◽

Vasil Iliev

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Preterm Labor ◽

Bacterial Flora ◽

Anaerobic Bacteria ◽

Adverse Pregnancy Outcomes ◽

Obstetric Outcomes ◽

Control Group ◽

Adverse Pregnancy

Bacterial vaginosis and periodontal diseases share very similar pathogenesis. Each of these diseases occurs when healthy microbiome changes to predominately anaerobic bacterial flora. Bacterial vaginosis is proven factor for adverse pregnancy outcomes. In recent years it has been hypothesized that infection from distant sites of the fetoplacental unit may also elicit an inflammatory response in utero. Aim: The study is designed to determine whether the presence of specific oral anaerobic bacteria in subgingival sulcus of mother increase the risk of adverse obstetric outcomes. Material and Methods: Case-control study. Control group: 50 patients who gave birth to neonate whit normal birth weight at term. Group cases: I group - 40 pregnant women who were hospitalized with signs of preterm labor. II - 20 pregnant women, who have an ultrasound diagnosis of fetal growth retardation. Sub-gingival microbiological paper-point swab was taken in all patients. Results: The total number of isolated oral anaerobic bacteria was statistically significantly higher in the cases group compared to control group p <0.01. In our study, pregnant women who tested positive for Porphyrmonas gingivalis for 6.65 times were more likely to have preterm labor compare with pregnant women with negative oral swabs (95.0% CI: 1.38-32.11 / p <0.05), and for 2,79 times more likely to have fetus with intrauterine growth restriction (95.0% CI: 1.10-7.91 / p <0.05 Conclusions: The study confirmed the hypothesis of a statistically significant association between oral anaerobic infection and adverse pregnancy outcomes. In the future, more studies are needed to investigate the role of the microbial load, maternal immune response, pathophysiological pathway that leads to negative pregnancy outcome.

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Adverse pregnancy outcomes and inherited thrombophilia

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0059 ◽

2018 ◽

Vol 46 (4) ◽

pp. 411-417 ◽

Cited By ~ 5

Author(s):

Dominik Dłuski ◽

Radzisław Mierzyński ◽

Elżbieta Poniedziałek-Czajkowska ◽

Bożena Leszczyńska-Gorzelak

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Protein C ◽

Antithrombin Iii ◽

Activated Protein C ◽

Protein S ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Inherited Thrombophilia ◽

Adverse Pregnancy

Abstract Aim: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. Subjects and methods: The study comprised 162 pregnant women. The patients were divided into three test groups and one control group. In all 162 patients the following tests were completed: activated protein C resistance (APC-R), the level of free protein S, activity of protein C, antithrombin III and the level of homocysteine. The data were statistically analyzed via χ2 of independence or homogeneity test. Results: In 32 of 162 patients participating in clinical research thrombophilia was diagnosed (10 patients with APC-R, 21 patients with protein S deficiency, one patient with hyperhomocysteinemia): seven patients belonged to the control group and 25 patients had diagnosed adverse pregnancy outcomes (P=0.04). In 32 patients with diagnosed thrombophilia, level of protein S was decreased (P=0.04). Protein S deficiency was diagnosed, when level of protein S was lower than 30% in the second trimester and lower than 24% in the third trimester. The incidence of activated protein C resistance caused by the mutation of factor V Leiden was in six patients (5.9%) with adverse pregnancy outcomes, and in four patients (6.6%) from the control group. Results were not statistically significant. No protein C deficiency was diagnosed (diagnosis: level<60%), but in 50% of patients with thrombophilia level of protein C was over the norm (P=0.02). The level of antithrombin III was often decreased in patients with preeclampsia – (32.4%), then in the other patients – (17.2%) (P=0.04), but no patient was diagnosed with antithrombin III deficiency (diagnosis: level<60%). Conclusions: Tests for thrombophilia should be carried out in women with adverse pregnancy outcomes in their history, who are planning pregnancy, to start anticoagulant prophylaxis. Our study supports the thesis that tests for thrombophilia should be carried out in women with a history of adverse pregnancy outcomes and who are planning a pregnancy to start anticoagulant prophylaxis.

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Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol.

10.21203/rs.3.rs-24650/v2 ◽

2020 ◽

Author(s):

Jenna Hollis ◽

Emma Doherty ◽

Julia Dray ◽

Danika Tremain ◽

Mandy Hunter ◽

...

Keyword(s):

Systematic Review ◽

Antenatal Care ◽

Health Outcomes ◽

Pregnant Women ◽

Health Behaviours ◽

Control Group ◽

Behavioural Intervention ◽

Synthesis Methods ◽

Adverse Pregnancy ◽

In Pregnancy

Abstract Background: Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence, and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.Methods: Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ two behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped wedge RCTs, and non-randomised control trials will be eligible. Studies that include a no intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.Discussion: The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care, and will help researchers, policy makers, and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short and long term health outcomes for women and their children.Systematic review registration: PROSPERO 2018 CRD42018095315

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Psychological and support interventions to reduce levels of stress, anxiety or depression on women’s subsequent pregnancy with a history of miscarriage: an empty systematic review

BMJ Open ◽

10.1136/bmjopen-2017-017802 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017802 ◽

Cited By ~ 11

Author(s):

Indra San Lazaro Campillo ◽

Sarah Meaney ◽

Karen McNamara ◽

Keelin O'Donoghue

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Well Being ◽

Subsequent Pregnancy ◽

Small Sample ◽

Control Group ◽

Eligibility Criteria ◽

Medical Interventions ◽

History Of ◽

Adverse Pregnancy

ObjectiveThe aim of this systematic review was to assess the effect of interventions to reduce stress in pregnant women with a history of miscarriage.DesignA systematic review of randomised controlled trials (RCTs).Data sourceA total of 13 medical, psychological and social electronic databases were searched from January 1995 to April 2016 including PUBMED, CENTRAL, Web of Science and EMBASE.Eligibility criteriaThis review focused on women in their subsequent pregnancy following miscarriage. All published RCTs which assessed the effect of non-medical interventions such as counselling or support interventions on psychological and mental health outcomes such as stress, anxiety or depression when compared with a control group were included. Stress, anxiety or depression had to be measured at least preintervention and postintervention.ResultsThis systematic review found no RCT which met our initial inclusion criteria. Of the 4140 titles screened, 17 RCTs were identified. All of them were excluded. One RCT, which implemented a caring-based intervention, included pregnant women in their subsequent pregnancy; however, miscarriage was analysed as a composite variable among other pregnancy losses such as stillbirth and neonatal death. Levels of perceived stress were measured by four RCTs. Different types of non-medical interventions, time of follow-up and small sample sizes were found.ConclusionCohort studies and RCTs in non-pregnant women suggest that support and psychological interventions may improve pregnant women’s psychological well-being after miscarriage. This improvement may reduce adverse pregnancy-related outcomes in subsequent pregnancies. However, this review found no RCTs which met our criteria. There is a need for targeted RCTs that can provide reliable and conclusive results to determine effective interventions for this vulnerable group.

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