scholarly journals Adequacy of prenatal care considering nutritional assistance in Southern Brazil: Maternar Cohort Study

2021 ◽  
Vol 37 (6) ◽  
Author(s):  
Bruna Luiza Holand ◽  
Simone Guerra Fonseca ◽  
Michele Drehmer ◽  
Vera Lúcia Bosa
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Prenatal Care ◽  
Unplanned Pregnancy ◽  
Southern Brazil ◽  
Porto Alegre ◽  
Cross Sectional ◽  
Risk Pregnancy ◽  
Adequacy Of Prenatal Care

Abstract: We verified the prevalence of adequacy in prenatal care considering nutritional assistance and associated factors. It is a cross-sectional study, part of Maternar Cohort Study, conducted between 2018-2019 in Southern Brazil. Women were interviewed during hospitalization in the immediate postpartum period and data were collected from the prenatal chart. Prenatal adequacy and nutritional care were assessed according to criteria from the Brazilian Ministry of Health. Two outcome models were constructed. Outcome 1 consisted of minimal coverage (early prenatal start and minimum number of visits) and exams, and Outcome 2 comprised minimal coverage, exams, and nutritional assistance. Poisson regression was used to estimate prevalence ratios. A total of 802 women were analyzed, and we identified 57% of adequacy of Outcome 1. Unplanned pregnancy (PR = 0.76; 95%CI: 0.68-0.86), parity (PR = 0.88; 95%CI: 0.83-0.94) and prenatal care outside Porto Alegre, Rio Grande do Sul State (PR = 0.80; 95%CI: 0.69-0.92), were associated with lower prenatal adequacy frequencies. Outcome 2 was considered adequate for 10.2% of women. Follow-up by different professionals during prenatal care was associated with lower adequacy (PR = 0.49; 95%CI: 0.28-0.86). Women with high-risk pregnancies had a higher frequency of adequacy in Outcome 1 (PR = 1.21; 95%CI: 1.07-1.37) and in Outcome 2 (PR = 1.75; 95%CI: 1.16-2.64). General adequacy was considered low in both outcomes. There was a lack of nutritional assistance during prenatal care. Characteristics such as pregnancy planning, lower parity, prenatal care in Porto Alegre, follow-up by the same professional and high-risk pregnancy were predictors for the adequacy of prenatal care.

scholarly journals Factors Associated to the Search for Dental Care in High Risk Pregnancy

2020 ◽  
pp. 66-70
Author(s):  
Jessica Galvan ◽  
Danielle Bordin ◽  
Cristina Berger Fadel
Keyword(s):  
High Risk ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Service ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Factors Associated ◽  
Risk Pregnancy

Introduction: Conducting dental consultations during pregnancy is considered an important challenge in the context of Maternal and Child Health Policies, as it is surrounded by myths rooted among users and health professionals. In this sense, it is important to identify barriers and facilitators to the search for dental assistance in this period, in order to support strategies that make this practice feasible. Objective: To analyze the search for dental care during high-risk pregnancies, according to sociodemographic, gestational and health characteristics. Methods: Observational study with a cross-sectional design, carried out with high-risk pregnant women referred to a teaching hospital in southern Brazil, from January to May 2018. Data collection was performed using an unprecedented structured form and considered as a dependent variable the search for dental care during pregnancy and as independent variables sociodemographic, gestational and dental characteristics. Pearson's chi-square association test and Fisher's exact test were used. Results: To reach the sample of 190 pregnant women at high gestational risk, a total of 230 women considered valid were approached, counting on the following losses: refusal to participate (n=23), no answer to any question (n=10), duplicity in participant approach (n=7). Advanced maternal age (p=0.000) and history of premature birth in previous pregnancies (p=0.047) were factors associated with a lower frequency of seeking dental care in the current pregnancy. On the other hand, the habit of dental consultation prior to the gestational period (p=0.001), the knowledge about the importance of this monitoring (p=0.050), as well as the safety (p=0.000) in performing dental prenatal care, were related positively to the search during pregnancy. Conclusion: Specific incentive strategies and access to dental prenatal care are necessary to neutralize barriers that may compromise the search for oral health services during pregnancy. For this reason, identifying the facilitators and hinders to the dental service is essential for planning effective actions related to prenatal care.

scholarly journals Factors Associated to the Search for Dental Care in High Risk Pregnancy

2020 ◽  
pp. 66-70
Author(s):  
Jessica Galvan ◽  
Danielle Bordin ◽  
Cristina Berger Fadel ◽  
Alessandra Martins ◽  
Fabiana Bucholdz Teixeira Alves
Keyword(s):  
High Risk ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Service ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Factors Associated ◽  
Risk Pregnancy

Introduction: Conducting dental consultations during pregnancy is considered an important challenge in the context of Maternal and Child Health Policies, as it is surrounded by myths rooted among users and health professionals. In this sense, it is important to identify barriers and facilitators to the search for dental assistance in this period, in order to support strategies that make this practice feasible. Objective: To analyze the search for dental care during high-risk pregnancies, according to sociodemographic, gestational and health characteristics. Methods: Observational study with a cross-sectional design, carried out with high-risk pregnant women referred to a teaching hospital in southern Brazil, from January to May 2018. Data collection was performed using an unprecedented structured form and considered as a dependent variable the search for dental care during pregnancy and as independent variables sociodemographic, gestational and dental characteristics. Pearson's chi-square association test and Fisher's exact test were used. Results: To reach the sample of 190 pregnant women at high gestational risk, a total of 230 women considered valid were approached, counting on the following losses: refusal to participate (n=23), no answer to any question (n=10), duplicity in participant approach (n=7). Advanced maternal age (p=0.000) and history of premature birth in previous pregnancies (p=0.047) were factors associated with a lower frequency of seeking dental care in the current pregnancy. On the other hand, the habit of dental consultation prior to the gestational period (p=0.001), the knowledge about the importance of this monitoring (p=0.050), as well as the safety (p=0.000) in performing dental prenatal care, were related positively to the search during pregnancy. Conclusion: Specific incentive strategies and access to dental prenatal care are necessary to neutralize barriers that may compromise the search for oral health services during pregnancy. For this reason, identifying the facilitators and hinders to the dental service is essential for planning effective actions related to prenatal care.

scholarly journals Prenatal follow-up of high-risk pregnancy in the public service

2019 ◽  
Vol 72 (suppl 3) ◽  
pp. 204-211
Author(s):  
Fabiana Fontana Medeiros ◽  
Izabel Dayana de Lemos Santos ◽  
Rosângela Aparecida Pimenta Ferrari ◽  
Deise Serafim ◽  
Sandra Mara Maciel ◽  
...  
Keyword(s):  
High Risk ◽  
Prenatal Care ◽  
Public Service ◽  
Statistical Significance ◽  
High Risk Pregnancy ◽  
High Coverage ◽  
The Public ◽  
Risk Pregnancy ◽  
Specific Protocol

ABSTRACT Objective: to analyze the prenatal follow-up of high-risk pregnancy in the public service. Method: an analytical cross-sectional study carried out in a public maternity hospital in the South of Brazil, during the hospitalization of 319 postpartum women using a semi-structured tool for transcription of the prenatal card records and interview. The data were analyzed using the Chi-Square test (p≤0.05). Results: the adequacy of prenatal care was high (74%); 22.6% intermediate; 3.4% inefficient. Prenatal care had high coverage (100%), early onset (81.5%) and six or more visits (92.4%), but (77.4%) did not receive information about gestational disease and examinations (69.3%). There was statistical significance between the quality of prenatal care and the place of prenatal care (p=0.005). Conclusion: the need to implement a specific protocol for high-risk gestation and continuous education to the teams was evidenced.

scholarly journals Web and mobile-based technologies for monitoring high-risk pregnancies

2019 ◽  
Vol 26 (1) ◽  
pp. e000025 ◽  
Author(s):  
Haleh Ayatollahi ◽  
Malihe Ghalandar Abadi ◽  
Morteza Hemmat
Keyword(s):  
High Risk ◽  
Prenatal Care ◽  
Fetal Loss ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
High Risk Pregnancy ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Web Based ◽  
Risk Pregnancy

IntroductionHigh-risk pregnancy is an illness in which there are severe complications and problems that may cause fetal loss and requires continuous care. It seems that using telemedicine technology is helpful to provide wider access to prenatal care. The aim of this study was to compare the feasibility of using web-based and mobile-based technologies in caring for high-risk pregnancy.Materials and methodsThis was a cross-sectional study and the participants included midwives and gynaecologists who worked at teaching hospitals. The data were collected by using two five-point Likert scale questionnaires which were designed based on the literature review. The questionnaires included two main sections: demographic questions and questions related to five aspects of a feasibility study. Face and content validity of the questionnaires were confirmed by the experts and the reliability was checked by using the test-retest method. The data were analysed using descriptive and inferential statistics.ResultsIn this study, 79 questionnaires were completed by 50 midwives (63.29%) and 29 gynaecologists (36.71%). Overall, midwives (p=0.001) and gynaecologists (p=0.003) believed that using mobile-based technologies was more feasible than using web-based technologies in caring for high-risk pregnancies.ConclusionIt seems that planning for the future technological direction and providing mobile-based applications should be taken into account and prioritised to improve the quality of prenatal care and to increase access to healthcare services for high-risk pregnancies.

scholarly journals Factors Associated With Cannabis Use During the Reproductive Cycle: A Retrospective Cross-Sectional Study of Women in States With Recreational and Medical Cannabis Legalization

2021 ◽  
Author(s):  
Danica Loralyn Taylor ◽  
Janice F. Bell ◽  
Susan L. Adams ◽  
Christiana Drake
Keyword(s):  
Substance Use ◽  
Prenatal Care ◽  
Post Partum ◽  
Cannabis Use ◽  
Provider Education ◽  
Substance Use Prevention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Adequacy Of Prenatal Care ◽  
The Impact

Abstract Introduction Passage of cannabis laws may impact cannabis use and the use of other substances. The suggested association is of particular concern in pregnant women where exposure to substances can cause harm to both the pregnant woman and fetus. The present study contributes to the minimal literature on factors associated with cannabis use during the preconception, prenatal, and postpartum periods including state legalization status, concurrent use of tobacco and e-cigarettes and adequacy of prenatal care. Methods We conducted a cross-sectional analysis using combined survey data from the 2016–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) collected from 36,391 women. Logistic regression was used to estimate the impact of state-legalization, adequacy of prenatal care, and other substance use on cannabis use during the preconception, prenatal, and post-partum periods. Results In the preconception model, residence in a recreationally legal state (OR: 2.37; 95% CI, 2.04–2.75) or medically legal state (OR:3.32; 95% CI, 2.90–3.80) compared to a non-legal state was associated with higher odds of cannabis use. In the prenatal model, residence in a recreationally legal state was associated with higher odds of cannabis use (OR: 1.51; 95% CI, 1.29–1.79) whereas there was no association with residence in a medically legal state. Tobacco use including e-cigarettes and moderate prenatal alcohol use were also significantly associated with cannabis use. Conclusion Recreational cannabis legalization is associated with the use of cannabis prior to, during, and after pregnancy. Renewed clinical and policy efforts may be warranted to update prenatal substance use prevention programs, educational campaigns, and provider education as cannabis legalization evolves.

scholarly journals Long‐term follow‐up of the DeKAF cross‐sectional cohort study

2019 ◽  
Vol 19 (5) ◽  
pp. 1432-1443 ◽  
Author(s):  
Arthur J. Matas ◽  
Ann Fieberg ◽  
Roslyn B. Mannon ◽  
Robert Leduc ◽  
Joe Grande ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cross Sectional ◽  
Long Term Follow Up

scholarly journals Uptake and detection rate of a stepwise cardiometabolic disease detection program in primary care—a cohort study

2019 ◽  
Vol 30 (3) ◽  
pp. 402-407
Author(s):  
Daphne M Stol ◽  
Monika Hollander ◽  
Ilse F Badenbroek ◽  
Mark M J Nielen ◽  
François G Schellevis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Cohort Study ◽  
High Risk ◽  
Newly Diagnosed ◽  
Additional Risk ◽  
High Risk Patients ◽  
Detection Program ◽  
Risk Patients

Abstract Background Early detection and treatment of cardiometabolic diseases (CMD) in high-risk patients is a promising preventive strategy to anticipate the increasing burden of CMD. The Dutch guideline ‘the prevention consultation’ provides a framework for stepwise CMD risk assessment and detection in primary care. The aim of this study was to assess the outcome of this program in terms of newly diagnosed CMD. Methods A cohort study among 30 934 patients, aged 45–70 years without known CMD or CMD risk factors, who were invited for the CMD detection program within 37 general practices. Patients filled out a CMD risk score (step 1), were referred for additional risk profiling in case of high risk (step 2) and received lifestyle advice and (pharmacological) treatment if indicated (step 3). During 1-year follow-up newly diagnosed CMD, prescriptions and abnormal diagnostic tests were assessed. Results Twelve thousand seven hundred and thirty-eight patients filled out the risk score of which 865, 6665 and 5208 had a low, intermediate and high CMD risk, respectively. One thousand seven hundred and fifty-five high-risk patients consulted the general practitioner, in 346 of whom a new CMD was diagnosed. In an additional 422 patients a new prescription and/or abnormal diagnostic test were found. Conclusions Implementation of the CMD detection program resulted in a new CMD diagnosis in one-fifth of high-risk patients who attended the practice for completion of their risk profile. However, the potential yield of the program could be higher given the considerable number of additional risk factors—such as elevated glucose, blood pressure and cholesterol levels—found, requiring active follow-up and presumably treatment in the future.

scholarly journals ANALYSIS OF DETERMINANT FACTORS OF AFFECTING FAMILY ABILITY IN HIGH-RISK PREGNANCY

2021 ◽  
Vol 10 (1) ◽  
pp. 141-148
Author(s):  
Ika Mardiyanti ◽  
Yasi Anggasari
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Simple Random Sampling ◽  
Early Response ◽  
Significance Test ◽  
Questionnaire Data ◽  
Personal Factors ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Risk Pregnancy

Background: The ability of pregnant women to deal with early response to high risks is still below the average, which is one of the causes of complications that can indicate the welfare of the mother and her fetus. Objectives: The aim of this study was to look at the determinants that influence early detection of high-risk pregnancies. Methods: This study used an analytic design with a cross sectional design. The sample size of 112 from a population of 155 was obtained by simple random sampling. The independent variables are individual factors, interpersonal influence, filial value and commitment, while the dependent variable is the family's ability to detect high risk of pregnancy for 3 months, namely August-October 2020 at PMB Ika Mardiyanti. This study uses a questionnaire. Data collection in the form of a questionnaire. Data analysis using SEM-PLS. Results: The results of the significance test concluded that all the path coefficients and the T statistical value of personal factors on interpersonal (0.453; 6.612), interpersonal on filial values ​​(0.753; 7.267), filial value for commitment (0.851; 17.048), filial value for ability (0.667 ; 4,679), commitment to ability (0.358; 2.356) is significant. Because all have a T-statistic value that is more than the T-table 1.96. Conclusion: The determinant factors that contribute to the ability of families to detect high risk of pregnancy need to be considered so that families are independent and have efforts to maintain the health of pregnant women in their families. In further research, it is necessary to involve other factors to improve family capacity, especially in the ability of families to detect high-risk pregnancies early.   Keywords: Ability, family, high-risk.

scholarly journals Critical Predictors for the Early Detection of Conversion From Unipolar Major Depressive Disorder to Bipolar Disorder: Nationwide Population-Based Retrospective Cohort Study (Preprint)

2019 ◽  
Author(s):  
Ya-Han Hu ◽  
Kuanchin Chen ◽  
I-Chiu Chang ◽  
Cheng-Che Shen
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Cohort Study ◽  
High Risk ◽  
Retrospective Cohort ◽  
Risk Group ◽  
Population Based ◽  
Major Depressive ◽  
Risk Stratification Model

BACKGROUND Unipolar major depressive disorder (MDD) and bipolar disorder are two major mood disorders. The two disorders have different treatment strategies and prognoses. However, bipolar disorder may begin with depression and could be diagnosed as MDD in the initial stage, which may later contribute to treatment failure. Previous studies indicated that a high proportion of patients diagnosed with MDD will develop bipolar disorder over time. This kind of hidden bipolar disorder may contribute to the treatment resistance observed in patients with MDD. OBJECTIVE In this population-based study, our aim was to investigate the rate and risk factors of a diagnostic change from unipolar MDD to bipolar disorder during a 10-year follow-up. Furthermore, a risk stratification model was developed for MDD-to-bipolar disorder conversion. METHODS We conducted a retrospective cohort study involving patients who were newly diagnosed with MDD between January 1, 2000, and December 31, 2004, by using the Taiwan National Health Insurance Research Database. All patients with depression were observed until (1) diagnosis of bipolar disorder by a psychiatrist, (2) death, or (3) December 31, 2013. All patients with depression were divided into the following two groups, according to whether bipolar disorder was diagnosed during the follow-up period: converted group and nonconverted group. Six groups of variables within the first 6 months of enrollment, including personal characteristics, physical comorbidities, psychiatric comorbidities, health care usage behaviors, disorder severity, and psychotropic use, were extracted and were included in a classification and regression tree (CART) analysis to generate a risk stratification model for MDD-to-bipolar disorder conversion. RESULTS Our study enrolled 2820 patients with MDD. During the follow-up period, 536 patients were diagnosed with bipolar disorder (conversion rate=19.0%). The CART method identified five variables (kinds of antipsychotics used within the first 6 months of enrollment, kinds of antidepressants used within the first 6 months of enrollment, total psychiatric outpatient visits, kinds of benzodiazepines used within one visit, and use of mood stabilizers) as significant predictors of the risk of bipolar disorder conversion. This risk CART was able to stratify patients into high-, medium-, and low-risk groups with regard to bipolar disorder conversion. In the high-risk group, 61.5%-100% of patients with depression eventually developed bipolar disorder. On the other hand, in the low-risk group, only 6.4%-14.3% of patients with depression developed bipolar disorder. CONCLUSIONS The CART method identified five variables as significant predictors of bipolar disorder conversion. In a simple two- to four-step process, these variables permit the identification of patients with low, intermediate, or high risk of bipolar disorder conversion. The developed model can be applied to routine clinical practice for the early diagnosis of bipolar disorder.

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