MEDICATIONS USED BY PREGNANT WOMEN: ANY SAFETY CONCERNS?

Objective: The use of medications during pregnancy may impose a potential risk to the fetus. Therefore, this study was conducted to determine the prevalence and safety of medications used by pregnant women.Methods: A cross-sectional study was conducted on pregnant women who attended the antenatal clinic of a major teaching hospital in Malaysia, from January to April 2013. Data was collected via face-to-face interviews using a structured questionnaire.Results: Of the 500 respondents in this study, 62% (95% confidence interval, CI: 57.7%, 66.3%) used at least one medication during their pregnancy and 30.8% (95% CI: 26.8%, 34.8%) took the medications during the first trimester. The classes of medications commonly used were analgesics (26.8%), followed by cough and cold medications (18.6%) and medications for gastrointestinal disorders (11.8%). Among the 697 medications used by the respondents during pregnancy, most of them were relatively safe, with approximately 50% being classified under the Food and Drug Administration of the United States (FDA, US)-assigned pregnancy category B. However, seven potentially teratogenic medications were identified, including four antiepileptic drugs and an antimigraine medication which contained ergotamine.Conclusion: This study found that a high proportion of pregnant woman consumed at least one medication during their pregnancy. The use of antimigraine medications containing ergotamine in pregnant women is of major concern as this medication could be obtained without a prescription in some countries, including in Malaysia. Therefore, it is essential for health care professionals to educate and counsel pregnant women on the safety of medications used.

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Pica Is Associated With Smoking and Self-Reported Stress Among Palestinian Pregnant Women: Cross-Sectional Study

Current Developments in Nutrition ◽

10.1093/cdn/nzab045_084 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 702-702

Author(s):

Souzan Zidan ◽

Manal Badrasawi ◽

May Hamdan

Keyword(s):

Pregnant Women ◽

Psychological Stress ◽

Health Care Professionals ◽

Dietary Habits ◽

First Trimester ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional

Abstract Objectives 1. To determine the prevalence of pica among Palestinian pregnant women. 2. To identify substance most commonly ingested by Palestinian pregnant women. 3. To explore whether dietary habits and lifestyle factors are associated with pica practice among Palestinian pregnant women. Methods A cross-sectional study was conducted among 170 pregnant women. Interview pre-tested structured questionnaire was administrated to pregnant women who were attending private gynecological clinics in Hebron district. Cronbach Alpha was used to determine the reliability of the questionnaire. The statistical analysis was done using descriptive statistics. Independent t-test and Chi-square test were also used to see whether pica practice is related to sociodemographic characteristics, dietary habits, and lifestyle factors. Results Eight (4.7%) participants reported experiencing pica during pregnancy. Pica prevalence categorized by substances ingested as follows: ice cube (62.5%); dirt (12.5%); cigarette ash residue (12.5%); toothpaste (12.5%). Minority of women who practiced pica reported experiencing pica in previous pregnancy, and health problems-related to pica. Most women who practiced pica reported ingestion of pica item during the first trimester. Pica practice was significantly associated with smoking and psychological stress during pregnancy. Moreover, pica practice was related to the dietary intake of milk and fat. Conclusions Pica practice is not common in the current sample. It was found that pica practice was associated with smoking and psychological stress. Health care professionals need to be conscious of the presence of this behavior. A nation-wide research of pica prevalence among pregnant women is highly needed. The phenomenon obviously needs further research. Funding Sources The authors declare that no external financial support was received for this study.

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Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03580-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saran Tenzin Tamang ◽

Thinley Dorji ◽

Sonam Yoezer ◽

Thinley Phuntsho ◽

Phurb Dorji

Keyword(s):

Pregnant Women ◽

Knowledge Score ◽

Antenatal Clinic ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Obstetric Danger Signs ◽

Danger Signs ◽

Obstetric Emergencies ◽

Level Of Knowledge

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

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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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Nutrient supplementation among pregnant women in China: an observational study

Public Health Nutrition ◽

10.1017/s1368980021001269 ◽

2021 ◽

pp. 1-19

Author(s):

Tao Han ◽

Jingwen Dong ◽

Jiangtao Zhang ◽

Chenxiao Zhang ◽

Yuxuan Wang ◽

...

Keyword(s):

Vitamin D ◽

Folic Acid ◽

Pregnant Women ◽

Family Members ◽

Primary Source ◽

Cross Sectional Study ◽

Cross Sectional ◽

Nutrient Supplementation ◽

Face To Face ◽

Source Of Information

Abstract Objective: To clarify nutrient supplementation usage and primary source of information among pregnant women in China. Design: This cross-sectional study used information on nutrient supplementation and primary source of information collected via face-to-face interviews. Data on the usage of folic acid, calcium/vitamin D, iron, vitamins, docosahexaenoic acid, and other dietary supplements were collected. Primary source of information were categorized as family/relatives, friends/co-workers, the Internet, books/magazines, television/radio, doctors, other people, and oneself. Setting: Maternal and Child Health Hospital in Chengdu, China. Participants: 1081 Chinese pregnant women aged ≥ 20 years with singleton pregnancies. Results: In all three trimesters of pregnancy, usage was highest and most stable for folic acid (81.7%), followed by vitamins (vitamin A, B-group vitamins, vitamin C, and multivitamins; 75.0%), whereas calcium/vitamin D (51.4%) and iron (18.1%) usage was low, potentially indicating a deficiency risk. All supplementation usage percentages increased with pregnancy duration (p < 0.05). Notably, approximately 10% of the pregnant women in our study did not use any nutrient supplementation, and this was especially common in early pregnancy. More than 50% of the women reported getting information on nutrient supplementation from family members, and about 30% reported getting this information from doctors. Conclusions: Among pregnant women in China, awareness about nutrient supplementation increases as the pregnancy progresses, but some types of nutrient supplementation (such as calcium/vitamin D and iron) remain at low levels. It is necessary to pay more attention to the health education of pregnant women in China, and the influence of family members should be emphasized.

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Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol

F1000Research ◽

10.12688/f1000research.28226.1 ◽

2021 ◽

Vol 10 ◽

pp. 223

Author(s):

Gayani Amarasinghe ◽

Vasana Mendis ◽

Thilini Agampodi

Keyword(s):

Sri Lanka ◽

Data Collection ◽

Pregnant Women ◽

Associated Factors ◽

First Trimester ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Anaemia In Pregnancy ◽

In Pregnancy

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.

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Awareness and perception of epidural labor analgesia among pregnant women visiting antenatal clinic in National Referral Hospital

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v16i1.37410 ◽

2021 ◽

Vol 16 (1) ◽

pp. 10-15

Author(s):

Tandin Tshomo ◽

Karma Tenzin ◽

Jamphel Tshering

Keyword(s):

Pain Relief ◽

Epidural Analgesia ◽

Pregnant Women ◽

Labour Pain ◽

Good Method ◽

Antenatal Clinic ◽

Cross Sectional Study ◽

Labour Analgesia ◽

Cross Sectional ◽

Labour Epidural Analgesia

Aims: To assess the awareness and perception of labour epidural analgesia among pregnant women visiting the antenatal clinic. Methods: This was an observational cross-sectional study. Study participants included pregnant women visiting the antenatal clinic during 2nd and 3 rd trimester conducted from 21 st September 2018 till 20 th September 2019. Data were collected by using an interviewer-administered questionnaire. Ethics approval was granted by the research Ethics Board of health, Bhutan. Results: Total 450 parturients participated in this study; 61.4% of the participants knew that labour epidural services were available and 37.5% got information through media. A total of 57.3% of respondents had severe fear about labour pain; 62.4% had severe fear about delivery complication; 85.2% thought that epidural labour analgesia was a good method of pain relief; and 67% were willing to accept it for their current pregnancy. However, 86.6% would recommend epidural labour analgesia as an option of pain relief to other pregnant women. Conclusion: Awareness about the availability of labour epidural analgesia services needs to be improved, as a majority of the parturient was keen to avail epidural analgesia after the information about its availability was provided.

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Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0041-1732463 ◽

2021 ◽

Vol 43 (06) ◽

pp. 442-451

Author(s):

Cesar Tello-Torres ◽

Akram Hernández-Vásquez ◽

Karla F. Dongo ◽

Rodrigo Vargas-Fernández ◽

Guido Bendezu-Quispe

Keyword(s):

Antenatal Care ◽

Health Care Professionals ◽

Age Groups ◽

Family Health ◽

Wealth Quintile ◽

First Trimester ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

First Trimester Of Pregnancy

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.

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Iron deficiency among pregnant women attending an antenatal clinic in Northern Uganda: a cross-sectional study

10.21203/rs.2.14386/v1 ◽

2019 ◽

Author(s):

Samson Udho ◽

Joyce Nankumbi ◽

Mariam Namutebi ◽

Grace Ndeezi ◽

Joshua Epuitai ◽

...

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Serum Ferritin ◽

Antenatal Clinic ◽

Cross Sectional Study ◽

Sectional Study ◽

Third Trimester ◽

Cross Sectional ◽

Iron Supplements ◽

The Third

Abstract Background Iron deficiency is a leading cause of anemia among pregnant women in Uganda. However, due to the high cost of biochemical tests required to determine iron deficiency, the prevalence and factors associated with iron deficiency remain largely unstudied in our setting. Therefore, this study aimed at determining the prevalence of iron deficiency and its associated factors among pregnant women attending an antenatal clinic, Lira District-Uganda.Methods A cross-sectional study was conducted among 320 pregnant women attending an antenatal clinic at Lira Regional Referral Hospital. Maternal serum ferritin was used as a measure of iron deficiency and was determined using a Cobas 6000 Automated Analyzer. Iron deficiency was based on serum ferritin of <30 μg/L. A semi-structured questionnaire was used to obtain the characteristics of the study participants. Binary and multivariate logistic regression were performed to identify the associated factors.Results The prevalence of iron deficiency was 45%. Non-adherence to iron supplements (AOR: 2.05 95% CI: 1.02-4.12) & third trimester pregnancy (AOR: 1.88 95% CI: 1.20-2.94) were significantly associated with iron deficiency during pregnancy.Conclusion Nearly 5 in 10 of the participants had iron deficiency. Iron deficiency during pregnancy was associated with non-adherence to iron supplements and being in the third trimester of pregnancy. Midwives should encourage pregnant women to adhere to iron supplements during pregnancy especially pregnant women who are in the third trimester.

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Prevalence of Domestic Violence Among the Pregnant Women Attending BPKIHS

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v12i1.18978 ◽

2018 ◽

Vol 12 (1) ◽

pp. 32-35 ◽

Cited By ~ 1

Author(s):

Mohan Chandra Regmi ◽

Laxmi Subedi ◽

Ramesh Shrestha ◽

Baburam Dixit ◽

Neha Shrestha

Keyword(s):

Domestic Violence ◽

Pregnant Women ◽

Emotional Abuse ◽

Cross Sectional Study ◽

Public Health Issue ◽

Cross Sectional ◽

Face To Face ◽

Tertiary Centre ◽

The Family ◽

Antenatal Clinics

Aims: To find out the prevalence of domestic violence in pregnant women attending Antenatal clinics (ANC) of B. P. Koirala Institute of Health Sciences, a tertiary centre in eastern Nepal.Methods: It was a hospital based cross-sectional study done at antenatal clinics of BPKIHS from 14th March 2015 to 30th August 2015. The total number of recruited antenatal patients was 470. Data were collected by face to face interview via pre-tested semi-structured questionnaire. Descriptive and inferential statistics were used for data analysis.Results: The prevalence of domestic violence among pregnant women was 53.2% of which prevalence of physical domestic violence was 9.6%. The most common person inflicting the domestic violence was husband (23.6%). Emotional abuse was the most common form of domestic violence experienced by the pregnant women (26.8%) and threatening for remarriage was most common emotional violence faced (43.2%). As the age of the pregnant women increases, they tend to have more domestic violence.Conclusions: The prevalence of Domestic Violence among pregnant women seemed alarmingly high in our society. Awareness to the family members and strengthening the women empowerment at community level might play a major role for reducing such violence. Pregnancy-related violence is a serious public health issue.

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Intimate partner violence against pregnant women: sociodemographic profile and characteristics of the aggressions

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2021.20200394 ◽

2021 ◽

Vol 42 ◽

Author(s):

Naiane Beatriz da Silva ◽

Rosely Erlach Goldman ◽

Hugo Fernandes

Keyword(s):

Black Women ◽

Pregnant Women ◽

Partner Violence ◽

Physical Violence ◽

First Trimester ◽

Cross Sectional Study ◽

Disease Notification ◽

Cross Sectional ◽

Notification System ◽

Sociodemographic Profile

ABSTRACT Objective: To identify the sociodemographic profile and the main characteristics of violence by intimate partners in pregnant women in São Paulo, Brazil. Method: Cross-sectional study based on notifications for suspected or confirmed cases of inter-police violence from the National Disease Notification System (SINAN) carried out in the 2016-2019 period. Collection was performed between March and June 2020. Chi-squared test or Fisher’s Exact test were used in statistical analysis. Results: A total of 4,269 notifications were obtained and the prevalent profile was women between 20 and 34 years old (62.5%), brown or black (51.3%), who have completed high school (22.5%) in the first trimester of pregnancy (44.2%). Physical violence was more frequent (48.3%), occurred at home (59.1%), motivated by sexism (22.29%). Sexual violence or rape was more frequent (85.4%) with abortion in cases provided for by law (39%). Conclusion: Adult brown or black women in the first gestational trimester experienced physical violence more frequently.

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