scholarly journals An evidence-based definition of anemia for singleton, uncomplicated pregnancies

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262436
Author(s):  
Amanda C. Zofkie ◽  
W. Holt Garner ◽  
Rachel C. Schell ◽  
Alexandra S. Ragsdale ◽  
Donald D. McIntire ◽  
...  
Keyword(s):  
United States ◽  
Private Hospital ◽  
Short Interval ◽  
First Trimester ◽  
Public Hospitals ◽  
Multiple Gestation ◽  
The Public ◽  
Anemia In Pregnancy ◽  
Definition Of ◽  
In Pregnancy

Background The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student’s t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix.

Prevalence and factors associated with anemia in pregnancy among women receiving antenatal care at the West Gonja District Hospital of Northern Ghana.

2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hemoglobin Concentration ◽  
World Health ◽  
Multiple Gestation ◽  
The West ◽  
Factors Associated ◽  
Folate Supplement ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

scholarly journals The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns

2022 ◽  
Vol 10 (1) ◽  
pp. 176
Author(s):  
Irina Anatolyevna Andrievskaya ◽  
Irina Valentinovna Zhukovets ◽  
Inna Victorovna Dovzhikova ◽  
Nataliya Alexandrovna Ishutina ◽  
Ksenia Konstantinovna Petrova
Keyword(s):  
Neonatal Period ◽  
Recurrent Infection ◽  
First Trimester ◽  
Placental Insufficiency ◽  
Igg Antibodies ◽  
Pregnancy And Childbirth ◽  
Serological Status ◽  
Anemia In Pregnancy ◽  
In Pregnancy ◽  
Hsv 1

The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.

scholarly journals How I treat anemia in pregnancy: iron, cobalamin, and folate

Blood ◽  
2017 ◽  
Vol 129 (8) ◽  
pp. 940-949 ◽  
Author(s):  
Maureen M. Achebe ◽  
Anat Gafter-Gvili
Keyword(s):  
Iron Deficiency ◽  
First Trimester ◽  
Cobalamin Deficiency ◽  
Iron Treatment ◽  
Iron Deficient ◽  
Iv Iron ◽  
Anemia In Pregnancy ◽  
Surgery Rates ◽  
Global Health Problem ◽  
In Pregnancy

AbstractAnemia of pregnancy, an important risk factor for fetal and maternal morbidity, is considered a global health problem, affecting almost 50% of pregnant women. In this article, diagnosis and management of iron, cobalamin, and folate deficiencies, the most frequent causes of anemia in pregnancy, are discussed. Three clinical cases are considered. Iron deficiency is the most common cause. Laboratory tests defining iron deficiency, the recognition of developmental delays and cognitive abnormalities in iron-deficient neonates, and literature addressing the efficacy and safety of IV iron in pregnancy are reviewed. An algorithm is proposed to help clinicians diagnose and treat iron deficiency, recommending oral iron in the first trimester and IV iron later. Association of folate deficiency with neural tube defects and impact of fortification programs are discussed. With increased obesity and bariatric surgery rates, prevalence of cobalamin deficiency in pregnancy is rising. Low maternal cobalamin may be associated with fetal growth retardation, fetal insulin resistance, and excess adiposity. The importance of treating cobalamin deficiency in pregnancy is considered. A case of malarial anemia emphasizes the complex relationship between iron deficiency, iron treatment, and malaria infection in endemic areas; the heightened impact of combined etiologies on anemia severity is highlighted.

scholarly journals Elonis v. United States: The Doctrine of True Threats: Protecting Our Ever-Shrinking First Amendment Rights in the New Era of Communication

2015 ◽  
Vol 15 (2) ◽  
pp. 197-223
Author(s):  
Mary Margaret Roark
Keyword(s):  
United States ◽  
Supreme Court ◽  
First Amendment ◽  
Free Speech ◽  
Freedom Of Speech ◽  
The United States ◽  
New Era ◽  
The Public ◽  
Definition Of ◽  
The U.S

The First Amendment protects one of our most precious rights as citizens of the United States—the freedom of speech. Such protection has withstood the test of time, even safeguarding speech that much of the population would find distasteful. There is one form of speech which cannot be protected: the true threat. However, the definition of what constitutes a "true threat" has expanded since its inception. In the new era of communication—where most users post first and edit later—the First Amendment protection we once possessed has been eroded as more and more speech is considered proscribable as a "true threat." In order to adequately protect both the public at large and our individual right to free speech, courts should analyze a speaker’s subjective intent before labeling speech a "true threat." Though many courts have adopted an objective, reasonable listener test, the U.S. Supreme Court now has the opportunity, in deciding Elonis v. United States, to take a monumental step in protecting the First Amendment right to free speech. By holding that the speaker’s subjective intent to threaten is necessary for a true threat conviction, the Court will restore the broad protection afforded by the First Amendment and repair years of erosion caused by an objective approach.

scholarly journals Patterns of Opioid Utilization in Pregnancy in a Large Cohort of Commercial Insurance Beneficiaries in the United States

2014 ◽  
Vol 120 (5) ◽  
pp. 1216-1224 ◽  
Author(s):  
Brian T. Bateman ◽  
Sonia Hernandez-Diaz ◽  
James P. Rathmell ◽  
John D. Seeger ◽  
Michael Doherty ◽  
...  
Keyword(s):  
United States ◽  
First Trimester ◽  
The United States ◽  
Large Cohort ◽  
Research Database ◽  
Opioid Use ◽  
Commercial Insurance ◽  
Few Data ◽  
Exposures During Pregnancy ◽  
In Pregnancy

Abstract Background: There are few data regarding the utilization of opioids during pregnancy. The objective of this study was to define the prevalence and patterns of opioid use in a large cohort of pregnant women who were commercial insurance beneficiaries. Methods: Data for the study were derived from a deidentified research database of women from across the United States who had both medical and prescription benefits. By using diagnostic codes, the authors defined a cohort of 534,500 women with completed pregnancies who were enrolled in a commercial insurance plan from 6 months before pregnancy through delivery. Results: Overall, 76,742 women (14.4%) were dispensed an opioid at some point during pregnancy. There were 30,566 women (5.7%) dispensed an opioid during the first trimester, 30,434 women (5.7%) during the second trimester, and 34,906 women (6.5%) during the third trimester. Of these, 11,747 women (2.2%) were dispensed opioids three or more times during pregnancy. The most commonly dispensed opioids during pregnancy were hydrocodone (6.8%), codeine (6.1%), and oxycodone (2.0%). The prevalence of exposure at anytime during pregnancy decreased slightly during the study period from 14.9% for pregnancies that delivered in 2005 to 12.9% in 2011. The prevalence of exposure varied significantly by region and was lowest in the Northeast and highest in the South. Conclusions: This study demonstrates that opioids are very common exposures during pregnancy. Given the small and inconsistent body of literature on their safety in pregnancy, these findings suggest a need for research in this area.

scholarly journals The cost analysis of breast cancer: A comparison between private and public hospitals 

2020 ◽  
Author(s):  
Abolhasan Afkar ◽  
Habib Jalilian ◽  
Abolghasem Pourreza ◽  
Habibeh Mir ◽  
Abdolhosein Emami Sigaroudi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Public Hospital ◽  
Private Hospital ◽  
Public Hospitals ◽  
The Public ◽  
Illness Study ◽  
Collection Data ◽  
Private And Public ◽  
Spss Software ◽  
The Cost

Abstract Backgrounds Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017). Methods This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22. Results The estimated total mean (SD) direct cost of patients who referred to the private hospital and the public hospital was $10050 (19480) and $3960 (6780), respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870 (%15 of total costs) and $22350 (%85 of total costs), respectively. These differences were statistically significant (P<0.05). Conclusion Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.

scholarly journals The cost of breast cancer: A comparison between private and public hospitals

2020 ◽  
Author(s):  
Abolhasan Afkar ◽  
Habib Jalilian ◽  
Abolghasem Pourreza ◽  
Habibeh Mir ◽  
Abdolhosein Emami Sigaroudi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Public Hospital ◽  
Private Hospital ◽  
Public Hospitals ◽  
The Public ◽  
Illness Study ◽  
Collection Data ◽  
Private And Public ◽  
Spss Software ◽  
The Cost

Abstract Backgrounds Breast cancer is the most prevalent cancer among women. Breast cancer imposes a considerable economic burden on the health system. This study aimed to compare the cost of breast cancer among patients who referred to private and public hospitals in Iran (2017).Methods This was a prevalence-based cost of illness study. A total of 179 patients were selected from private and public hospitals using the census method. The researcher-constructed checklist was used for data collection. Data were analyzed using SPSS software version 22.Results The estimated total mean ± SD direct cost of patients who referred to the private hospital and the public hospital was $10051.78 ± 19484.61 and $3956.33 ± 6783.02, respectively. Further, the total mean indirect cost of patients who referred to the private hospital was lower than those referring to the public hospital at $1870.89 (%15.69 of total costs) and $22348.5 (%84.95 of total costs), respectively. These differences were statistically significant (P < 0.05).Conclusion Breast cancer imposes a substantial cost on patients, health insurance organizations and the whole society in Iran. Therefore, the adoption of effective measures for the prevention and early diagnosis of breast cancer is urgently needed.

The evolution of human trafficking messaging in the United States and its effect on public opinion

2018 ◽  
Vol 39 (2) ◽  
pp. 201-234 ◽  
Author(s):  
Tabitha Bonilla ◽  
Cecilia Hyunjung Mo
Keyword(s):  
United States ◽  
Public Opinion ◽  
Human Trafficking ◽  
Sexual Exploitation ◽  
The United States ◽  
Survey Experiment ◽  
Public Response ◽  
The Public ◽  
Security Problem ◽  
Definition Of

AbstractDespite a near unanimous agreement that human trafficking is a morally reprehensible practice, there is confusion around what qualifies as human trafficking in the United States. Adopting a mixed-method strategy, we examine how human trafficking is defined by the public; how contemporary (mis)understanding of human trafficking developed; and the public opinion consequence of this (mis)understanding. The definition of human trafficking has evolved over time to become nearly synonymous with slavery; however, we demonstrate that media and anti-trafficking organisations have been focussing their attention on the sexual exploitation of foreign women. We show that general public opinion reflects this skewed attention; the average citizen equates human trafficking with the smuggling of women for sexual slavery. Using a survey experiment, we find that shining light on other facets of human trafficking – the fact that human trafficking is a security problem and a domestic issue – can increase public response to the issue.

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