Missed opportunities for congenital syphilis and HIV perinatal transmission prevention

OBJECTIVE: To estimate the prevalence of missed opportunities for congenital syphilis and HIV prevention in pregnant women who had access to prenatal care and to assess factors associated to non-testing of these infections. METHODS: Cross-sectional study comprising a randomly selected sample of 2,145 puerperal women who were admitted in maternity hospitals for delivery or curettage and had attended at least one prenatal care visit, in Brazil between 1999 and 2000. No syphilis and/or anti-HIV testing during pregnancy was a marker for missed prevention opportunity. Women who were not tested for either or both were compared to those who had at least one syphilis and one anti-HIV testing performed during pregnancy (reference category). The prevalence of missed prevention opportunity was estimated for each category with 95% confidence intervals. Factors independently associated with missed prevention opportunity were assessed through multinomial logistic regression. RESULTS: The prevalence of missed prevention opportunity for syphilis or anti-HIV was 41.2% and 56.0%, respectively. The multivariate analysis showed that race/skin color (non-white), schooling (<8 years), marital status (single), income (<3 monthly minimum wages), having sex during pregnancy, history of syphilis prior to the current pregnancy, number of prenatal care visits (<6), and last prenatal visit before the third trimester of gestation were associated with an increased risk of missed prevention opportunity. A negative association with missed prevention opportunity was found between marital status (single), prenatal care site (hospital) and first prenatal visit in the third trimester of gestation. CONCLUSIONS: High rates of non-tested women indicate failures in preventive and control actions for HIV infection and congenital syphilis. Pregnant women have been discontinuing prenatal care at an early stage and are failing to undergo prenatal screening for HIV and syphilis.

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Pengaruh Prenatal Care Yoga terhadap Pengurangan Keluhan Ketidaknyamanan Ibu Hamil Trimester III di Puskesmas Putri AyuKota Jambi

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v9i2.229 ◽

2020 ◽

Vol 9 (2) ◽

pp. 240

Author(s):

Gustina Gustina ◽

Nurbaiti Nurbaiti

Keyword(s):

Prenatal Care ◽

Pregnant Women ◽

Health Center ◽

Design Method ◽

P Value ◽

Entire Body ◽

Third Trimester ◽

The Third ◽

Post Test ◽

Quasi Experimental

AbstractDuring pregnancy changes will occur in the entire body system of the mother both physically and psychologically, although physiological but if not understood by the mother and not treated will be able to make discomfort very disturbing during the process of pregnancy, childbirth and the puerperium, Prenatal Care Yoga is expected to help in dealing with discomfort during pregnancy, especially the third trimester of pregnancy Putri Ayu Health Center has provided pregnancy exercise services but has never given prenatal care yoga, due to the absence of trained staff at the Puskesmas, the researchers chose Puskesmas Putri Ayu as a research site. Intervene prenatal care yoga with quasi experimental one group pre-post-test design method. affordable population of 301 people visits K4 pregnant women to the Putri Ayu health center. he sample of purposive sampling was 32 people. The subject was carried out pre test and post test in the form discomfort questionnaire using a comparative scale of pain. Prenatal care yoga 4 times for 4 consecutive weeks Most of the third stage discomfort was pre-test, 21 (65.6%), post-test to 15 (46.9) there was an effect of prenatal care yoga on reducing complaints of discomfort of third trimester pregnant women with a p-value <0,000 (95% CI).

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The Prevalence of Vitamin A Deficiency and Associated Factors in Pregnant Women Receiving Prenatal Care at a Reference Maternity Hospital in Northeastern Brazil

Nutrients ◽

10.3390/nu10091271 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1271 ◽

Cited By ~ 6

Author(s):

Sabina Bastos Maia ◽

Maria Costa Caminha ◽

Suzana Lins da Silva ◽

Alex Rolland Souza ◽

Camila Carvalho dos Santos ◽

...

Keyword(s):

Public Health ◽

Prenatal Care ◽

Vitamin A ◽

Pregnant Women ◽

Vitamin A Deficiency ◽

Northeastern Brazil ◽

World Health ◽

Serum Retinol ◽

Third Trimester ◽

The Third

Vitamin A is essential for mother and child; however, vitamin A deficiency (VAD) remains a public health issue in various countries, affecting around 19 million pregnant women. In Brazil, the scarcity and inconsistency of data have prevented the prevalence and epidemiological status of VAD from being established. This study aimed to analyze vitamin A nutritional status in women receiving prenatal care at a reference center in northeastern Brazil. A cross-sectional study was conducted with a sample of 676 women. Serum retinol was measured by high-performance liquid chromatography. Subclinical infection was detected by measuring C-reactive protein (CRP). The World Health Organization criteria were used in the prevalence analysis, VAD classification level, and CRP effect evaluation. The prevalence of VAD (serum retinol <0.70 μmol/L) was 6.2% (95% confidence interval 4.5–8.3). In the univariate analysis, the variables significantly associated with VAD (p < 0.05) were having <12 years of schooling, being in the third trimester of pregnancy, and anemia. In the final multivariate model, the variables that remained significantly associated (p < 0.05) were being in the third trimester of pregnancy and anemia. VAD constituted a mild public health problem in this sample of pregnant women and was associated with the third trimester of pregnancy and maternal anemia.

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Earlier the Patients Entering Into Prenatal Care, Higher the Cesarean Rates: Analysis of 17.035 Cases

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.985 ◽

2019 ◽

pp. 1

Author(s):

Pinar Calis ◽

Burak Gultekin ◽

Fatma Doga Ocal ◽

Gurcan Akgul ◽

Afra Alkan

Keyword(s):

Prenatal Care ◽

Antenatal Care ◽

Pregnant Women ◽

Third Trimester ◽

Fetal Outcomes ◽

Prenatal Visit ◽

Cesarean Deliveries ◽

Route Of Delivery ◽

In Pregnancy

Objective: To analyze whether the time the patients entering into prenatal care affects the route of delivery, maternal, and fetal outcomes.Study Design: The electronic medical files of 17,035 women who delivered at the same hospital between January 2008 and December 2014, were retrospectively reviewed. Pregnant women were distributed into one of 5 groups (No-prenatal-visit group, Only-pregestational-visit group, First-visit-prior-to-24-weeks-follow-up group, Early-third-trimester-follow-up group, Late-third-trimester-follow-up group) according to the time of their first pregnancy follow-up visit. The route of delivery, maternal anemia, and fetal outcomes were compared among the groups.Results: Pregnant women in the no-prenatal-visit group were younger and showed higher rates of vaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to-24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%), and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p<0.001).Conclusion: The rates of cesarean deliveries were found to be increased prominently in pregnant women who began antenatal care early in pregnancy with frequent follow-ups.

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Features of the course and treatment of glaucoma during pregnancy

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-3-178-184 ◽

2020 ◽

Vol 98 (3) ◽

pp. 178-184

Author(s):

T. V. Chernyakova ◽

A. Yu. Brezhnev ◽

I. R. Gazizova ◽

A. V. Kuroyedov ◽

A. V. Seleznev

Keyword(s):

Pregnant Women ◽

Laser Treatment ◽

Progressive Disease ◽

Clinical Course ◽

The Other ◽

Third Trimester ◽

The Third ◽

Chronic Progressive Disease ◽

Hypotensive Therapy ◽

Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

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A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03755-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nader Salari ◽

Niloofar Darvishi ◽

Behnam Khaledi-Paveh ◽

Aliakbar Vaisi-Raygani ◽

Rostam Jalali ◽

...

Keyword(s):

Pregnant Women ◽

Sleep Disorders ◽

Sleep Disturbances ◽

Meta Analysis ◽

Physical And Mental Health ◽

Third Trimester ◽

Cross Sectional ◽

The Third ◽

Physical Problems ◽

Meta Regression Analysis

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

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The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽

10.1093/rheumatology/keab372 ◽

2021 ◽

Author(s):

Rugina I Neuman ◽

Hieronymus T W Smeele ◽

A H Jan Danser ◽

Radboud J E M Dolhain ◽

Willy Visser

Keyword(s):

Rheumatoid Arthritis ◽

Cohort Study ◽

Disease Activity ◽

Pregnant Women ◽

Gestational Age ◽

Third Trimester ◽

Low Disease Activity ◽

The Third ◽

Observational Prospective Cohort Study ◽

Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio > 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

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Health anxiety and related factors among pregnant women during the COVID-19 pandemic: a cross-sectional study from Iran

BMC Psychiatry ◽

10.1186/s12888-021-03092-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Najmieh Saadati ◽

Poorandokht Afshari ◽

Hatam Boostani ◽

Maryam Beheshtinasab ◽

Parvin Abedi ◽

...

Keyword(s):

Pregnant Women ◽

Health Care Providers ◽

Health Anxiety ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Third Trimester ◽

Related Factors ◽

Cross Sectional ◽

The Third

Abstract Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of < 27, 27–34 and more than 35 were defined as low, moderate and high health anxiety, respectively. Due to nationwide restrictions, data were collected through social media groups. Chi-square tests, ANOVA and multiple linear regression were used to analyze the data. Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

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EFFECT OF ZINK TABLETS INTERVENTION IN ZINC DEFICIENCY OF TRIMESTER III PREGNANT WOMEN TOWARD WEIGHT AND BODY LENGTH OF NEWBORN

Nurse and Health: Jurnal Keperawatan ◽

10.36720/nhjk.v10i2.295 ◽

2021 ◽

Vol 10 (2) ◽

pp. 304-312

Author(s):

Nurfadillah S ◽

Wardihan Sinrang ◽

Suryani As'ad ◽

Muh. Nasrum Massi ◽

Mardiana Ahmad ◽

...

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Zinc Deficiency ◽

Birth Length ◽

World Health ◽

Third Trimester ◽

Average Value ◽

The Third ◽

A Value ◽

Zinc Levels

Background: According to 2018 World Health Organization (WHO) data globally, an estimated 17.3% of the population has inadequate zinc intake, with estimates ranging from 5.7% in Oceania to 7.6% in Europe, 9.6% in America and the Caribbean, highest in Africa (23.9%) and Asia (19.6%). Zinc is important for the function of a number of enzymes and growth hormones during pregnancy. In pregnant women, the relative zinc concentration decreases up to 35% due to the influence of hormonal changes and the transport of nutrients from mother to baby. Objectives: The purpose of this study was to identify the effect of giving zinc tablets to pregnant women with zinc deficiency in the third trimester on body weight and length of babies born at the Makassar City Health Center. Methods: This type of research is True Experimental with a pretest-posttest design with a control group. The sample in this study was 62 samples of third trimester pregnant women, and the sampling technique used was purposive sampling. Measurement of zinc levels in third trimester pregnant women using the Elisa reader kit at the Research Laboratory of the Hasanuddin University Teaching Hospital. The research instruments were in the form of a research explanation sheet, respondent's consent sheet, respondent's checklist sheet, and the mother's zinc tablet consumption control sheet for 14 days. Results: Judging from the average value of newborns in pregnant women who did not have zinc deficiency, the average value of birth weight in pregnant women with zinc deficiency was 15.70 g/dL and 18.95 g/dL. zinc deficiency with a value (p < 0.05), while pregnant women with zinc deficiency have an average birth length of 10.00 g/dL and mothers who do not have a deficiency of 19.87 g/dL with a value (p < 0.05). So, it can be concluded that giving zinc tablets to pregnant women in the third trimester has an effect on Birth Weight (BBL) and Birth Length (PBL). Conclusion: Giving zinc tablets has an effect on increasing zinc levels in third trimester zinc deficiency pregnant women and increasing birth weight and length of the baby.

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MENGURANGI KECEMASAN PADA MASA KEHAMILAN TM III DENGAN METODE ACCUPRESSURE DEPRESSION POINTS

Jurnal Kebidanan ◽

10.35872/jurkeb.v13i02.465 ◽

2021 ◽

Vol 13 (02) ◽

pp. 172

Author(s):

Dyah Ayu Wulandari ◽

Meika Jaya Rockhmana ◽

Adelina Cahyaningrum

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Psychological Adaptation ◽

The Body ◽

Wilcoxon Test ◽

P Value ◽

Third Trimester ◽

Purposive Sampling ◽

The Third

ABSTRAKAdaptasi fisik dan psikis kehamilan trimester III secara fisiologis dapat menimbulkan kecemasan ibu hamil. Adanya kecemasan pada ibu hamil trimester III dapat menyebabkan komplikasi ibu dan janin saat kehamilan, persalinan bahkan nifas. Terapi acupressure merupakan natural terapi dengan cara menekan acupoint untuk merelaksasi tubuh, melancarkan sirkulasi darah serta memberikan rasa tenang dan nyaman. Acupoint KID 27 dan CV 17 adalah titik yang berhubungan dengan kecemasan, agitasi, penyimpangan kelenjar tiroid, keseimbangan tubuh dan pusat jantung. Penekanan pada titik ini menyeimbangkan kadar hormon tiroid dan mengatasi gangguan kecemasan. Tujuan penelitian mengetahui pengaruh acupressure depression points terhadap kecemasan ibu hamil trimester III. Metode: Jenis penelitian kuantitatif dengan metode penelitian pre-experimental One Group Pretest-Posttest Design. Penelitian dilakukan Bulan Februari-Agustus 2021. Populasi penelitian ibu hamil trimester III yang melakukan ANC bulan Juni 2021 dengan keluhan kecemasan. Sampel penelitian 22 ibu hamil trimester III dengan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner PRAQ-R2. Analisa data univariat dan bivariat (Uji Wilcoxon) Hasil: Hasil analisa statistik dengan uji Wilcoxon diperoleh nilai P-value 0,000 pada tingkat kecemasan. Kesimpulan: Acupressure depression points berpengaruh terhadap tingkat kecemasan ibu hamil trimester III di Semarang.Kata kunci: kecemasan, ibu hamil trimester IIIREDUCE ANXIETY IN PREGNANT MOTHER TRIMESTER III WITH ACCUPRESSURE DEPRESSION POINTS METHODABSTRACTPhysical and psychological adaptation of the third trimester of pregnancy can physiologically cause anxiety for pregnant women. The existence of anxiety in third trimester pregnant women can affect the quality of sleep which causes maternal and fetal complications during pregnancy, delivery and even postpartum. Acupressure therapy is a natural therapy by pressing the acupoints to relax the body, improve blood circulation and provide a sense of calm and comfort. Acupoints KID 27 and CV 17 are points associated with anxiety, agitation, thyroid disorders, body balance and heart centers. Emphasis on this point balances thyroid hormone levels and treats anxiety disorders thereby improving sleep quality. Objective: to determine the effect of acupressure depression points on the level of anxiety and sleep quality of pregnant women in the third trimester. Methods: This type of research is quantitative with pre-experimental research method One Group Pretest-Posttest Design. The study was conducted in February-August 2021. The study population was pregnant women in the third trimester who performed ANC in June 2021 with complaints of anxiety. The study sample was 22 pregnant women in the third trimester with purposive sampling technique. The research instrument used the PRAQ-R2. Analysis of univariate and bivariate data (Wilcoxon test) Results: The results of statistical analysis using the Wilcoxon test obtained a P-value of 0.000 on anxiety levels. Conclusion: Acupressure depression points have an effect on the level of anxiety of pregnant women in the third trimester at Semarang.Keyword: Anxiety, Pregnant Women In The Third Trimester

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Trends in Heart Rate and Heart Rate Variability during Pregnancy and Three Months Postpartum: Continuous Monitoring in a Free-Living Context (Preprint)

10.2196/preprints.33458 ◽

2021 ◽

Author(s):

Fatemeh Sarhaddi ◽

Iman Azimi ◽

Anna Axelin ◽

Hannakaisa Niela-Vilen ◽

Pasi Liljeberg ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Pregnant Women ◽

Time Domain ◽

Second Trimester ◽

Third Trimester ◽

Non Invasive ◽

The Third ◽

Invasive Method ◽

Frequency Power

BACKGROUND Heart rate variability (HRV) is a non-invasive method reflecting autonomic nervous system (ANS) regulations. Altered HRV is associated with adverse mental or physical health complications. ANS also has a central role in physiological adaption during pregnancy causing normal changes in HRV. OBJECTIVE Assessing trends in heart rate (HR) and HRV parameters as a non-invasive method for remote maternal health monitoring during pregnancy and three months postpartum. METHODS Fifty-eight pregnant women were monitored using an Internet-of-Things (IoT)-based remote monitoring system during pregnancy and 3-months postpartum. Pregnant women were asked to continuously wear Gear sport smartwatch to monitor their HR and HRV. In addition, a cross-platform mobile application was utilized for collecting pregnancy-related information. The trends of HR and HRV parameters were extracted using reliable data. We also analyzed the trends of normalized HRV parameters based on HR to remove the effect of HR changes on HRV trends. Finally, we exploited hierarchical linear mixed models to analyze the trends of HR, HRV, and normalized HRV parameters. RESULTS HR increased significantly during the second trimester (P<.001) and decreased significantly during the third trimester (P<.01). Time-domain HRV parameters, average normal interbeat intervals (AVNN), standard deviation of normal interbeat intervals (SDNN), root mean square of the successive difference of normal interbeat intervals (RMSSD), normalized SDNN (nSDNN), and normalized RMSSD (nRMSSD) decreased significantly during the second trimester (P<.001) then increased significantly during the third trimester (P<.01). Some of the frequency domain parameters, low-frequency power (LF), high-frequency power (HF), and normalized HF (nHF) decreased significantly during the second trimester (P<.01), and HF increased significantly during the third trimester (P<.01). In the postpartum period, nRMSSD decreased (P<.05), and the LF to HF ratio (LF/HF) increased significantly (P<.01). CONCLUSIONS Our study showed that HR increased and HRV parameters decreased as the pregnancy proceeded, and the values returned to normal after the delivery. Moreover, our results show that HR started to decrease while time-domain HRV parameters and HF started to increase during the third trimester. Our results also demonstrate the possibility of continuous HRV monitoring in everyday life settings.

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