The Effect of Health Education of Anemia in Relation with Knowledge of First-Trimester Pregnant Women in PMB Putu Mastiningsih, Abiansemal

Anemia in pregnancy is the condition in which the level of mother’s hemoglobin is less than 12 gr/dL (Winkjosastro, 2002). According to WHO’s data, the maternal death in developing countries accounts for 40% related to anemia state in pregnancy. Most of the case is caused by iron deficiency and acute bleeding. Prevention of anemia can be done by giving the iron supplement tablets. However, by giving iron tablets alone, is not enough if pregnant women do not have any compliance about how to take it on. Maternal knowledge is known as the influence of that compliance. In order to increase their knowledge about anemia, providing the health education is a pivotal role. Health education in pregnancy care is an effort to influence other people, whether individuals, groups, or communities so that they do what is expected of education actors.

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Prevalence and aetiologies of anaemia among first trimester pregnant women in Sri Lanka; the need for revisiting the current control strategies

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04341-z ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Gayani Shashikala Amarasinghe ◽

Thilini Chanchala Agampodi ◽

Vasana Mendis ◽

Krishanthi Malawanage ◽

Chamila Kappagoda ◽

...

Keyword(s):

Public Health ◽

Iron Deficiency ◽

Pregnant Women ◽

Blood Count ◽

First Trimester ◽

Full Blood Count ◽

Red Cell ◽

Middle Income ◽

Anaemia In Pregnancy ◽

In Pregnancy

Abstract Background The Sustainable development goals, which focus strongly on equity, aim to end all forms of malnutrition by 2030. However, a significant cause of intergenerational transfer of malnutrition, anaemia in pregnancy, is still a challenge. It is especially so in the low- and middle-income settings where possible context-specific aetiologies leading to anaemia have been poorly explored. This study explores the prevalence of etiological factors significantly contributing to anaemia in pregnancy in Sri Lanka, a lower-middle-income country with a high prevalence of malnutrition albeit robust public health infrastructure. Methods All first-trimester pregnant women registered in the public maternal care programme in the Anuradhapura district from July to September 2019 were invited to participate in Rajarata Pregnancy Cohort (RaPCo). After a full blood count analysis, high-performance liquid chromatography, peripheral blood film examination, serum B12 and folate levels were performed in anaemic participants, guided by an algorithm based on the red cell indices in the full blood count. In addition, serum ferritin was tested in a random subsample of 213 participants. Anaemic women in this subsample underwent B12 and folate testing. Results Among 3127 participants, 14.4% (95%CI 13.2–15.7, n = 451) were anaemic. Haemoglobin ranged between 7.4 to 19.6 g/dl. 331(10.6%) had mild anaemia. Haemoglobin ≥13 g/dl was observed in 39(12.7%). Microcytic, normochromic-normocytic, hypochromic-normocytic and macrocytic anaemia was observed in 243(54%), 114(25.3%), 80(17.8%) and two (0.4%) of full blood counts in anaemic women, respectively. Microcytic anaemia with a red cell count ≥5 * 106 /μl demonstrated a 100% positive predictive value for minor haemoglobinopathies. Minor hemoglobinopathies were present in at least 23.3%(n = 105) of anaemic pregnant women. Prevalence of iron deficiency, B12 deficiency and Southeast Asian ovalocytosis among the anaemic was 41.9% (95%CI 26.4–59.2), 23.8% (95%CI 10.6–45.1) and 0.9% (95%CI 0.3–2.3%), respectively. Folate deficiency was not observed. Conclusion Even though iron deficiency remains the primary cause, minor hemoglobinopathies, B 12 deficiency and other aetiologies substantially contribute to anaemia in pregnancy in this study population. Public health interventions, including screening for minor hemoglobinopathies and multiple micronutrient supplementation in pregnancy, should be considered in the national programme for areas where these problems have been identified.

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DYNAMIC OF SERUM FERRITIN LEVEL IN FIRST TRIMESTER PREGNANCY

The Avicenna Medical Journal ◽

10.15408/avicenna.v1i1.15639 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1-4

Author(s):

Muniroh Muniroh ◽

Alyya Siddiqa ◽

Raden Partinah

Keyword(s):

Iron Deficiency ◽

Pregnant Women ◽

Serum Ferritin ◽

Serum Ferritin Level ◽

Ferritin Level ◽

Data Distribution ◽

First Trimester ◽

Normal Range ◽

Median Serum ◽

In Pregnancy

Background: Incidence of anemia in pregnant women was 37.1%, proportion was similar between urban vs rural areas (36.4% vs 37.8%). According to 2007 RISKESDAS, iron deficiency accounted for most common type of anemia in pregnancy. Iron deficiency anemia in pregnancy has a negative impact both on the mother and the fetus. Serum ferritin is a parameter for iron deficiency. Objective of this study was to overlook serum ferritin levels in trimester 1pregnancy.Methods: The design was retrospective cohort. Samples obtained from first trimester pregnant women who performed a pregnancy check up at Hasanah Graha Afiah Hospital Depok in the period of April 2016 - July 2017. Data were presented in percentages for categorical data. Numerical data presented in medians and ranges for abnormal data distribution; and mean and standard intersections for normal data distribution. This study involved 64 samples that met the inclusion and exclusion criteria.Results: Median serum ferritin levels in this study were still in the normal range of 40.82 (6.97 - 172.66) μg / L. Twenty one subjects (69.1%) had normal serum ferritin level (≥30 μg/L) and 47 (30.9%) had low ferritin level.Conclusions: Median serum ferritin in this study was within normal range. Low level of serum ferritin found in 21 subjects, three among them also suffered from anemia.

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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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Gestation at completion of prenatal questionnaires in ALSPAC

Wellcome Open Research ◽

10.12688/wellcomeopenres.15976.2 ◽

2020 ◽

Vol 5 ◽

pp. 100

Author(s):

Yasmin Iles-Caven ◽

Kate Northstone ◽

Jean Golding

Keyword(s):

Data Collection ◽

Pregnant Women ◽

First Trimester ◽

Environmental Data ◽

Parents And Children ◽

Using Data ◽

Time Critical ◽

Avon Longitudinal Study ◽

In Pregnancy ◽

Made In

Enrolling a cohort in pregnancy can be methodologically difficult in terms of structuring data collection. For example, some exposures of interest may be time-critical while other (often retrospective) data can be collected at any point during pregnancy. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prime example of a cohort where certain data were collected at specific time points and others at variable times depending on the gestation at contact. ALSPAC aimed to enrol as many pregnant women as possible in a geographically defined area with an expected date of delivery between April 1991 and December 1992. The ideal was to enrol women as early in pregnancy as possible, and to collect information, when possible, at two fixed gestational periods (18 and 32 weeks). A variety of methods were used to enrol participants. Approximately 80% of eligible women resident in the study area were enrolled. Gestation at enrolment ranged from 4-41 (median = 14) weeks of pregnancy. Given this variation in gestation we describe the various decisions that were made in regard to the timing of questionnaires to ensure that appropriate data were obtained from the pregnant women. 45% of women provided data during the first trimester, this is less than ideal but reflects the fact that many women do not acknowledge their pregnancy until the first trimester is safely completed. Data collection from women at specific gestations (18 and 32 weeks) was much more successful (80-85%). Unfortunately, it was difficult to obtain environmental data during the first trimester. Given the time critical nature of exposures during this trimester, researchers must take the gestational age at which environmental data was collected into account. This is particularly important for data collected using the questionnaire named ‘Your Environment’ (using data known as the A files).

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User Perception Towards mHealth Technologies for Health and Well-being Monitoring in Pregnancy Care: Qualitative Study (Preprint)

10.2196/preprints.28628 ◽

2021 ◽

Author(s):

Jane Li ◽

David Silvera-Tawil ◽

Marlien Varnfield ◽

M Sazzad Hussain ◽

Vanitha Math

Keyword(s):

Qualitative Study ◽

Pregnant Women ◽

Mobile Applications ◽

Data Privacy ◽

Perinatal Care ◽

Well Being ◽

Technical Solution ◽

Pregnancy Care ◽

Health And Well Being ◽

In Pregnancy

BACKGROUND Mobile Health (mHealth) technologies, such as wearable devices and mobile applications have become popular for lifestyle and healthcare support. They have the potential to be beneficial for pregnancy monitoring, in the form of health and well-being tools to facilitate the tracking of health status changes, risks and complications of pregnant women. However, research on understanding clinicians’ and pregnant women’s interests, preferences and requirements for mHealth solutions tailored to pregnancy care is limited. OBJECTIVE This qualitative study aimed to understand clinicians’ and pregnant women’s perceptions on the potential use of mHealth to support the monitoring of health and well-being during pregnancy. METHODS Semi-structured interviews were conducted with four pregnant women, four postnatal women, and thirteen clinicians working in perinatal care. RESULTS Clinicians perceived the potential benefit of mHealth in supporting different levels of health and wellbeing monitoring, risk assessment and care provision in pregnancy care. The majority of women participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians can monitor the data. While some pregnancy-related medical conditions can be suitable for an mHealth model of remote monitoring, there are clinical and technical challenges for introducing mHealth in pregnancy care. Incorporating appropriate health and well-being measures, intelligent detection of abnormalities and tailored information for pregnant women were considered critical. Usability and data privacy were among the concerns of participants. The challenges of getting pregnant women engaged in longitudinal mHealth monitoring, the extra work required for clinicians in monitoring data, and the need for an evidence-based technical solution were highlighted. CONCLUSIONS mHealth technologies, such as wearable sensors, smart health devices and mobile applications capable of supporting the pregnancy journey are emerging. Clinical, technical and practical factors associated with the use of mHealth technologies to monitor health and well-being, as well as strategies for motivating pregnant women and clinicians’ in the use of the technologies need to be carefully considered before the introduction of mHealth pregnancy care routine and practices.

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Hazards of vaccination in pregnancy

Drug and Therapeutics Bulletin ◽

10.1136/dtb.11.4.13 ◽

1973 ◽

Vol 11 (4) ◽

pp. 13-15

Keyword(s):

Pregnant Women ◽

Yellow Fever ◽

Early Pregnancy ◽

First Trimester ◽

Childbearing Age ◽

Department Of Health ◽

Chemical Agents ◽

Women And Girls ◽

Yellow Fever Vaccination ◽

In Pregnancy

With the effects of certain chemical agents and rubella in mind, most authorities advise caution in the use of all vaccines during pregnancy and especially during the first trimester. The booklet issued by the Department of Health and Social Security1 lists pregnancy as a contra-indication to rubella, smallpox and polio vaccinations, with certain provisions, and the manufacturers’ literature adds yellow fever vaccination. Pregnant women wishing to travel obviously pose a problem. Neither the doctor nor the patient may be aware of an early pregnancy and this is always a hazard when vaccinating women and girls of childbearing age. However, apart from rubella and smallpox vaccinations, the risks are hypothetical.

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Abstract P385: Pregnancy Care Must Do More to Meet Women's Social Needs: A Systematic Review of Interventions Addressing the Social Determinants of Health

Circulation ◽

10.1161/circ.141.suppl_1.p385 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Ana Reyes ◽

Rabih Dahdouh ◽

Precious Akanyirige ◽

Araceli Estrada ◽

Maria R Young ◽

...

Keyword(s):

Pregnant Women ◽

Social Determinants Of Health ◽

Social Determinants ◽

Social Needs ◽

Determinants Of Health ◽

Cochrane Library ◽

Risk Screening ◽

Pregnancy Care ◽

The Social ◽

In Pregnancy

Introduction: Consistent evidence has shown that the social determinants of health (SDoH) play an important role in shaping overall health. As health systems become more focused on improving the health of populations, there is an urgent need for interventions that address upstream factors such as the social determinants of health. Such interventions have not been widely studied and even less work exists in the realm of maternal health. But as maternal and infant mortality remain critical issues, there is great opportunity for the study and development of interventions to address social needs in pregnancy care. Hypothesis: We assessed the hypothesis that most existing interventions addressing the social needs of pregnant women would focus only on identifying social risks, while fewer would connect patients with resources in the community. We expected that most studies would not provide evaluations of effectiveness. Methods: We conducted a database search of MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and Web of Science to capture literature published between January 1970 and April 2019. A team of reviewers screened titles and abstracts for interventions that were issued in a clinical setting and addressed at least one SDoH as defined by the World Health Organization. Results: Preliminary results revealed 25 studies. All consisted of some form of risk screening and four included a referral process. Interventions addressing intimate partner violence were most numerous followed by psychosocial factors and cigarette smoking. Financial needs were assessed in one study. Eight studies included an evaluation process. Staff carrying out the interventions were primarily research staff, nurse practitioners or nurse midwives. Conclusions: In conclusion, more must be done to connect pregnant women with social resources. As unmet social needs put women at higher risk for poor outcomes in pregnancy, action should be taken to more seamlessly integrate social needs interventions into clinical workflows. Focus should expand beyond traditional social risk screening to capture a wider range of needs including financial stability, housing, and transportation. These are particularly important during pregnancy because adequate prenatal care requires women to be more engaged with the health care system than they would to maintain baseline health.

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Prevalence of thyroid disorders in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183401 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3493

Author(s):

Sangeeta Pahwa ◽

Sabia Mangat

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

First Trimester ◽

Antenatal Clinic ◽

Fetal Outcome ◽

Overt Hypothyroidism ◽

Thyroid Disorders ◽

Subclinical Hyperthyroidism ◽

Thyroid Screening ◽

In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

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Iron-Supplementation Programmes: Compliance of Target Groups and Frequency of Tablet Intake

Food and Nutrition Bulletin ◽

10.1177/156482659601700105 ◽

1996 ◽

Vol 17 (1) ◽

pp. 1-5 ◽

Cited By ~ 24

Author(s):

Werner Schultink

Keyword(s):

Developing Countries ◽

Iron Deficiency ◽

Pregnant Women ◽

Iron Deficiency Anaemia ◽

Large Scale ◽

Iron Supplementation ◽

Daily Basis ◽

Original Research ◽

Target Groups ◽

Deficiency Anaemia

The prevalence of iron-deficiency anaemia remains especially high in developing countries, despite large-scale iron-supplementation programmes. The reasons for the lack of success of these programmes are discussed based on the results of original research conducted in Indonesia. Studies among pregnant women in rural Sulawesi and urban Jakarta demonstrated that besides insufficient coverage of the target group, women's compliance with tablet intake was a serious problem. Compliance may be improved when it is not necessary to take tablets on a daily basis. Studies among pre-school children and non-pregnant women proved the effectiveness of once-weekly and twice-weekly supplementation. These supplementation schedules should also be investigated in pregnant women.

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Assessment of Thyroid Function in Early Pregnancy

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i2.35864 ◽

2018 ◽

Vol 19 (2) ◽

pp. 98

Author(s):

Mohammad Saifur Rahman ◽

Sadia Sultana ◽

Ayesha Nazneen

Keyword(s):

Pregnant Women ◽

Thyroid Function ◽

Early Pregnancy ◽

Correct Diagnosis ◽

First Trimester ◽

Military Hospital ◽

Thyroid Disorders ◽

Thyroid Disorder ◽

Cross Sectional ◽

In Pregnancy

Objectives: Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians. The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.Patients and Methods: A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT3, FT4, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT3, FT4, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.Results: Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.Conclusion: Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016

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