Family structure and use of prenatal care

This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

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Adolescent childbearing in a Brazilian border municipality: the new mother’s profile

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.974 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F K Nampo ◽

C M Fernandes ◽

S Souza

Keyword(s):

Prenatal Care ◽

Predominantly White ◽

Adolescent Mothers ◽

Descriptive Analysis ◽

Public Health Problem ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Previous Pregnancy ◽

Adolescent Childbearing

Abstract Background Adolescent childbearing is considered a public health problem, due to the often associated social impacts. Understanding the phenomenon is necessary to support intervention proposals aimed at reducing its incidence. Methods In this cross-sectional study we investigated all adolescent mothers living in Foz do Iguassu that gave birth in the 2013-2017 period. Data from a governmental database were used and descriptive analysis was performed. Results Between 2013 and 2017, 3,207 adolescent mothers gave birth to a live child, of which 135 aged 10 to 14 years and 3,072 aged 15 to 19 years. 51.3% of the mothers were white, and 22.1% had previous pregnancy experience. 68.4% had a vaginal delivery, and 80.6% had full-term pregnancies. Among the women aged 10 to 14 years, 57.8% started prenatal care in the first trimester and 47.4% had 7 or more prenatal consultations. Among women aged between 15 and 19 years, 73.7% started prenatal care in the first trimester and 53.4% had 7 or more prenatal consultations. Additionally, at least 49% of the adolescents were delayed in school. Conclusions In Foz do Iguassu, adolescent mothers are predominantly white. At least half are delayed in school, and more than 1 in 5 already had previous pregnancy experience. Parturients between 15 and 19 years old start prenatal earlier and attend more prenatal consultations than parturients aged 10 to 14 years. Prematurity is more frequent among adolescents. Key messages Adolescents receive poor prenatal care, especially the younger ones. Adolescent pregnancy is not a synonym to unintended pregnancy, and its relationship should be further investigated.

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Qualidade da assistência pré-natal no sistema único de saúde

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i5a230531p1365-1371-2018 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1365

Author(s):

Diego Da Silva Dantas ◽

Rosemar Barbosa Mendes ◽

José Marcos De Jesus Santos ◽

Thiago Dos Santos Valença ◽

Claudiane Mahl ◽

...

Keyword(s):

Prenatal Care ◽

Health System ◽

First Trimester ◽

Cross Sectional Study ◽

Slight Reduction ◽

High Coverage ◽

Cross Sectional ◽

Unified Health System ◽

El Sistema ◽

Gestational Week

RESUMOObjetivo: Avaliar a qualidade da assistência pré-natal a partir do Programa de Humanização no Pré-Natal e Nascimento. Método: Estudo quantitativo, transversal, com 260 puérperas que realizaram o acompanhamento pré-natal no Sistema Único de Saúde em Lagarto, Estado de Sergipe, Brasil. As informações foram obtidas por meio de entrevistas e visualização do cartão de pré-natal. A análise estatística foi realizada no software SPSS 20.0. Resultados: Pouco mais da metade das puérperas haviam iniciado seu acompanhamento pré-natal antes da 16ª semana gestacional e também realizaram seis ou mais consultas (66,9%; n = 174, cada variável). Somente 41,5% (n = 108) das participantes receberam informações sobre a maternidade de referência para o parto e 42,7% (n = 111) sobre as atividades para facilitar o parto. Quanto aos exames, foi identificada elevada cobertura no primeiro trimestre, com discreta redução no terceiro. Conclusão: A assistência pré-natal oferecida às usuárias do SUS de Lagarto se mostrou inadequada às recomendações do Programa de Humanização no Pré-Natal e Nascimento, pois foi evidenciado o início tardio, número insuficiente de consultas, poucas orientações e cobertura insatisfatória dos exames preconizados pelo Ministério da Saúde. Descritores: Saúde Materna; Gravidez; Gestantes; Cuidado Pré-Natal; Saúde Materno-Infantil; Humanização da Assistência.ABSTRACTObjective: To evaluate the quality of prenatal care based on the Prenatal and Birth Humanization Program. Method: Quantitative and cross-sectional study conducted with 260 puerperal women who underwent prenatal care in the Unified Health System of Lagarto, State of Sergipe, Brazil. The data were obtained through interviews and prenatal records. The statistical analysis was performed using the SPSS 20.0 software. Results: A little more than half of the puerperal women had initiated prenatal care before the 16th gestational week and had also attended six or more consultations (66.9%, n = 174, each variable). Only 41.5% (n = 108) of the participants received information about reference maternities for childbirth, and 42.7% (n = 111) about activities to facilitate childbirth. Regarding the exams, there was high coverage in the first trimester, with a slight reduction in the third. Conclusion: Prenatal care provided to users of the Unified Health System of Lagarto was inadequate with respect to the recommendations of the Prenatal and Birth Humanization Program, since there was evidence of late initiation of prenatal care, insufficient number of consultations, few guidelines, and unsatisfactory performance of the exams recommended by the Ministry of Health. Descriptors: Maternal Health; Pregnancy; Pregnant Women; Prenatal Care; Maternal and Child Health; Humanization of Assistance.RESUMENObjetivo: Evaluar la calidad de la asistencia prenatal a partir del Programa de Humanización en Prenatal y Nacimiento. Método: Estudio cuantitativo y transversal conducido con 260 puérperas que realizaron cuidado prenatal en el Sistema Único de Salud en Lagarto, Estado de Sergipe, Brasil. La información fue obtenida por medio de entrevistas y expedientes de prenatal. El análisis estadístico se realizó en el software SPSS 20.0. Resultados: Poco más de la mitad de las puérperas habían iniciado cuidado prenatal antes de la 16ª semana gestacional y también realizaron seis o más consultas (66,9%, n = 174, cada variable). Sólo el 41,5% (n = 108) de las participantes recibieron información sobre la maternidad de referencia para el parto y el 42,7% (n = 111) sobre las actividades para facilitar el parto. En cuanto a los exámenes, se observó una elevada cobertura en el primer trimestre, con discreta reducción en el tercero. Conclusión: La asistencia prenatal ofrecida a las usuarias del Sistema Único de Salud de Lagarto fue inadecuada con respecto a las recomendaciones del Programa de Humanización en Prenatal y Nacimiento, pues se evidenció inicio tardío, número insuficiente de consultas, pocas orientaciones y cobertura insatisfactoria de los exámenes preconizados por el Ministerio de Salud. Descriptores: Salud Materna; Embarazo; Mujeres Embarazadas; Cuidado Prenatal; Salud Materno-Infantil; Humanización de la Asistencia.

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Evaluation of drug prescriptions for pregnant women in the Legal Amazon Region

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042018000400004 ◽

2018 ◽

Vol 18 (4) ◽

pp. 735-743

Author(s):

Vanessa Dela Justina ◽

Jéssica Silva Gonçalves ◽

Flávia Lúcia David ◽

Fernanda Regina Giachini ◽

Victor Vitorino Lima

Keyword(s):

Prenatal Care ◽

Drug Interactions ◽

Pregnant Women ◽

Prescription Drugs ◽

Medical Records ◽

First Trimester ◽

Cross Sectional Study ◽

Risk Classification ◽

Drug Prescriptions ◽

Cross Sectional

Abstract Objectives: to evaluate the drug prescriptions for pregnant women in the Legal Amazon during prenatal care. Methods: this is a pharmacoepidemiological, descriptive, retrospective and cross-sectional study. Medical records included sociodemographic variables, prenatal care, most frequent pharmacological classes prescribed, risk classification of drugs and possible drug-drug interactions among pregnant women. Results: a total of 159 records from pregnant women, enrolled in the Unified Health System were used. Most pregnant women began prenatal consultations in the first trimester of pregnancy (53.3%) whereas most of the drugs were prescribed in the second gestational trimester (55.5%). The most used pharmacological classes, classified according to the National List of Essential Drugs were: antianemic preparations (52.9%), vitamins (12.5%) and analgesic (10.6%). According to the risk classification, the highest prevalence of prescribed drugs belongs to category A (46.8%), followed by category C (28.9%), category B (20.0%) and category D (4.3%). Eight possible drug-drug interactions were found, being considered with mild severity, and six classified with moderate risk. Conclusions: the results demonstrate a lack of information regarding prescription drugs for pregnant women and this may endanger maternal and fetal health. It is essential that medical records be an effective therapeutic tool, which should be read, analyzed and reviewed in order to ensure effective and safe medical treatment.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001268 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001268

Author(s):

Angela Koipuram ◽

Sandra Carroll ◽

Zubin Punthakee ◽

Diana Sherifali

Keyword(s):

Quality Of Life ◽

Risk Perception ◽

South Asian ◽

Online Survey ◽

Educational Interventions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

Design And Methods

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.

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Knowledge and attitude of pregnant women towards preeclampsia and its associated factors in South Gondar Zone, Northwest Ethiopia: a multi‐center facility‐based cross‐sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03647-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maru Mekie ◽

Dagne Addisu ◽

Minale Bezie ◽

Abenezer Melkie ◽

Dejen Getaneh ◽

...

Keyword(s):

Associated Factors ◽

First Trimester ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sectional Study ◽

Cross Sectional ◽

Level Of Knowledge ◽

Knowledge And Attitude ◽

Study Participants ◽

South Gondar

Abstract Background Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide. It is one of the top five maternal mortality causes and responsible for 16 % of direct maternal death in Ethiopia. Little is known about the level of knowledge and attitude towards preeclampsia in Ethiopia. This study was designed to assess the knowledge and attitude towards preeclampsia and its associated factors in South Gondar, Northwest Ethiopia. Methods A multicenter facility-based cross-sectional study was implemented in four selected hospitals of South Gondar Zone among 423 pregnant women. Multistage random sampling and systematic random sampling techniques were used to select the study sites and the study participants respectively. Data were entered in EpiData version 3.1 while cleaned and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Descriptive and inferential statistics were performed. Adjusted odds ratio with 95 % confidence interval were used to identify the significance of the association between the level of knowledge on preeclampsia and its predictors. Results In this study, 118 (28.8 %), 120 (29.3 %) of the study participants had good knowledge and a positive attitude towards preeclampsia respectively. The likelihood of having good knowledge on preeclampsia was found to be low among women with no education (AOR = 0.22, 95 % CI (0.06, 0.85)), one antenatal care visit (ANC) (AOR = 0.13, 95 % CI (0.03, 0.59)). Whereas, those who booked for ANC in the first trimester (AOR = 6.59, 95 % CI (1.43, 30.33)), gave the last birth at a health facility (AOR = 2.61, 955 CI (1.03, 6.61)), and experienced a complication during previous births (AOR = 3.67, 95 % CI (1.78, 7.57)) were more likely to be knowledgeable on preeclampsia. Conclusions No formal education and not attending four ANC visits were associated with poor knowledge of preeclampsia. While participants who visited health facilities during the first trimester, who gave birth at health facilities, and those who experienced a complication in previous births were more likely to be knowledgeable on preeclampsia. Improving the numbers of ANC visits and encouraging facility delivery are important measures to improve women’s knowledge on preeclampsia. Health education regarding preeclampsia risk factors, symptoms, and complications shall be emphasized.

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Prevalence of suicidal ideation and associated factors among HIV positive perinatal women on follow-up at Gondar town health institutions, Northwest Ethiopia: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03529-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leul Belachew Zewdu ◽

Mebratu Mitiku Reta ◽

Niguse Yigzaw ◽

Koku Sisay Tamirat

Keyword(s):

Suicidal Ideation ◽

Unplanned Pregnancy ◽

Cross Sectional Study ◽

Hiv Positive ◽

Hiv Status ◽

Cross Sectional ◽

Factors Associated ◽

Gondar Town ◽

Perinatal Women ◽

Significant Factors

Abstract Background Suicidal behaviors cover a range or continuum of acts from suicidal ideations to a series of actions, commonly known as suicidal attempts or deliberate self-harms. Though different mental disorders related studies were conducted among HIV/AIDS patients, there is a scarcity of information about the magnitude and determinants of suicidal thoughts among perinatal women. Therefore, this study aimed to determine the prevalence of suicidal ideation and associated factors among HIV positive perinatal women in the study setting. Methods An institution-based cross-sectional study was conducted among perinatal women on treatment to the prevention of mother to child transmission of HIV/AIDS at Gondar town health facilities. A total of 422 HIV-positive perinatal women were selected systematically and the data collected through medical record review and interview using a Composite International Diagnostic Interview (CIDI) toolkit. A binary and multivariable logistic regression model was employed to identify factors associated with suicidal ideation. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. Characteristics having less than 0.05 p-value had been taken as significant factors associated with the outcome of interest. Result The prevalence of suicidal ideation was found to be 8.2% (95% CI; 5.7 to 11.3) and with a standard error of 0.013. Perinatal depression (AOR=4.40, 95%CI: 1.63 11.85), not disclosed HIV status (AOR=3.73, 95%CI: 1.44 9.65), and unplanned pregnancy (AOR=2.75, 95%CI: 1.21 6.21) were significant factors associated with suicidal ideation. Conclusion The magnitude of suicidal ideation among HIV positive perinatal women was found to be low. Perinatal depression, non-disclosed HIV status, and unplanned pregnancy were factors significantly associated with suicidal ideation. This finding suggests the integration of mental health services with maternal and HIV support programs.

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Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

BMC Geriatrics ◽

10.1186/s12877-021-02364-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lizhen Ye ◽

Liset E. M. Elstgeest ◽

Xuxi Zhang ◽

Tamara Alhambra-Borrás ◽

Siok Swan Tan ◽

...

Keyword(s):

Risk Factors ◽

Urban Health ◽

Cross Sectional Study ◽

Community Dwelling ◽

Household Composition ◽

European Countries ◽

Sectional Study ◽

Related Condition ◽

Cross Sectional ◽

Age Related

Abstract Background Frailty is an age-related condition resulting in a state of increased vulnerability regarding functioning across multiple systems. It is a multidimensional concept referring to physical, psychological and social domains. The purpose of this study is to identify factors (demographic characteristics, lifestyle factors and health indicators) associated with overall frailty and physical, psychological and social frailty in community-dwelling older people from five European countries. Methods This cross-sectional study used baseline data from 2289 participants of the Urban Health Center European project in five European countries. Multivariable logistic regression models were used to assess associations of the factors with overall frailty and the three frailty domains. Results The mean age was 79.7 (SD = 5.7). Participants who were older, were female, had secondary or equivalent education, lived alone, not at risk of alcohol use, were less physically active, had multi-morbidity, were malnourished or with a higher level of medication risk, had higher odds of overall frailty (all P < 0.05). Age was not associated with psychological and social frailty; sex was not associated with social frailty; smoking and migration background was not associated with overall frailty or any of its domains. There existed an interaction effect between sex and household composition regarding social frailty (P < 0.0003). Conclusions The present study contributed new insights into the risk factors for frailty and its three domains (physical, psychological and social frailty). Nurses, physicians, public health professionals and policymakers should be aware of the risk factors of each type of frailty. Furthermore, examine these risk factors more comprehensively and consider overall frailty as well as its three domains in order to further contribute to decision-making more precisely on the prevention and management of frailty. Trial registration The intervention of the UHCE project was registered in the ISRCTN registry as ISRCTN52788952. The date of registration is 13/03/2017.

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