scholarly journals Biological and Psychosocial Factors, Risk Behaviors, and Perinatal Asphyxia in a University Hospital: Matched Case–Control Study, Cali, Colombia (2012–2014)

2021 ◽  
Vol 9 ◽  
Author(s):  
Javier Torres-Muñoz ◽  
Javier Enrique Fonseca-Perez ◽  
Katherine Laurent
Keyword(s):  
Social Support ◽  
Risk Factor ◽  
Pregnant Women ◽  
Psychosocial Factors ◽  
Risk Behaviors ◽  
Gestational Age ◽  
Low Income ◽  
Perinatal Asphyxia ◽  
University Hospital ◽  
Biological Variables

Introduction: Perinatal asphyxia is one of the main causes of morbidity and mortality in newborns. It generates high costs, both social and economic, and presents modifiable risk factors.Objective: To determine the biological and psychosocial factors and risk behaviors associated with the development of perinatal asphyxia (Sarnat II-III) in newborns from low socioeconomic status in a tier III university hospital in the city of Cali, Colombia.Materials and Methods: With a case and control design, 216 patients were studied (54 cases/162 controls) (1 case/3 matched controls). The cases were defined as newborns with modified or severe perinatal asphyxia (Sarnat II-III) between 2012 and 2014, with gestational age ≥ 36 weeks, with neurological signs not attributable to other causes, multiorgan compromise, advanced reanimation, and presence of a sentinel event. For the analysis, conditional logistic regression models were developed to evaluate association (OR), considering that the cases and controls had been paired by the birth and gestational age variables.Results: The final model showed that, from the group of biological variables, meconium amniotic fluid was identified as a risk factor (OR 15.28, 95%CI 2.78–83.94). Induction of labor lowered the risk of perinatal asphyxia by 97% (OR 0.03, 95%CI 0.01–0.21), and monitoring of fetal heart rate was associated with lower odds by 99% (OR 0.01, 95%CI 0.00–0.31) of developing perinatal asphyxia in the newborn. Regarding social variables, the lack of social support was identified as a risk factor for the development of perinatal asphyxia (OR 6.44, 95%CI 1.16–35.66); in contrast, secondary education lowered the odds of developing perinatal asphyxia by 85% when compared with pregnant women who only had primary school education (OR 0.15, 95%CI 0.03–0.77).Conclusion: Assessment of biological and psychosocial factors and social support is important in pregnant women to determine the risk of developing perinatal asphyxia in a low-income population.

scholarly journals Food insecurity as a risk factor for preterm birth: a prospective facility-based cohort study in rural Haiti

2020 ◽  
Vol 5 (7) ◽  
pp. e002341
Author(s):  
Aaron Richterman ◽  
Maxi Raymonville ◽  
Azfar Hossain ◽  
Christophe Millien ◽  
Jean Paul Joseph ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Preterm Birth ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Low Income ◽  
Tertiary Care ◽  
Western Hemisphere

IntroductionHaiti has an estimated neonatal mortality rate of 32/1000 live births, the highest in the Western Hemisphere. Preterm birth and being born small for gestational age (SGA) are major causes of adverse neonatal outcomes worldwide. To reduce preterm birth and infants born SGA, it is important to understand which women are most at risk and how risk varies within countries. There are few studies estimating the prevalence and risk factors for these conditions in Haiti, particularly in rural regions.MethodsWe conducted a prospective cohort study of pregnant women at a rural tertiary care centre in Haiti from May to December 2017. We collected data during interviews and from the medical record. We built multivariable models to identify risk factors for preterm birth and being born SGA among women who had a facility-based delivery.Results1089 pregnant women delivered at the hospital and were included in this analysis. Median gestational age at delivery was 38 weeks (IQR 36–40). In multivariable analyses, risk factors for preterm birth included maternal age <20 years (adjusted OR (AOR) 1.76, 95% CI 1.14 to 2.72) and >34 years (AOR 1.46, 95% CI 1.01 to 2.11) and severe hunger in the household (AOR 1.57, 95% CI 1.09 to 2.26). Risk factors for SGA were age >34 years (AOR 1.76, 95% CI 1.18 to 2.59), twin pregnancy (AOR 3.28, 95% CI 1.20 to 8.95) and first pregnancy (AOR 1.57, 95% CI 1.12 to 2.23). Number of prior abortions was associated with reduced risk for SGA (AOR 0.41, 95% CI 0.17 to 0.97).ConclusionsFood insecurity as a risk factor for preterm birth stands out as an important addition to the understanding of the risk of neonatal morbidity and mortality. This association highlights a potentially important intervention target to improve birth outcomes and suggests that food support has an important role to play for pregnant women who are food insecure in low-income settings.

scholarly journals Serum Concentrations of Selected Organochlorines in Pregnant Women and Associations with Pregnancy Outcomes. A Cross-Sectional Study from Two Rural Settings in Cambodia

2020 ◽  
Vol 17 (20) ◽  
pp. 7652
Author(s):  
Margit Steinholt ◽  
Shanshan Xu ◽  
Sam Ol Ha ◽  
Duong Trong Phi ◽  
Maria Lisa Odland ◽  
...  
Keyword(s):  
Polychlorinated Biphenyls ◽  
Pregnant Women ◽  
Gestational Age ◽  
Low Income ◽  
Cross Sectional Study ◽  
Maternal Serum ◽  
Sectional Study ◽  
Serum Samples ◽  
Cross Sectional ◽  
Rural Settings

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.

scholarly journals Follow-up of Toxoplasmosis during Pregnancy: Ten-Year Experience in a University Hospital in Southern Brazil

2019 ◽  
Vol 41 (09) ◽  
pp. 539-547 ◽  
Author(s):  
Amanda Andrade Diesel ◽  
Suzana de Azevedo Zachia ◽  
Ana Lúcia Letti Müller ◽  
Amanda Vilaverde Perez ◽  
Flavio Antonio de Freitas Uberti ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Triple Therapy ◽  
Gestational Age ◽  
Congenital Toxoplasmosis ◽  
Immunoglobulin M ◽  
University Hospital ◽  
Pcr Analysis ◽  
Ultrasound Findings

Abstract Objective To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. Methods Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between - January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. Results A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented positive IgG (but none presented positive immunoglobulin M [IgM]), and 1 (2,9%) presented alterations compatible with congenital disease and started treatment with the triple therapy soon after birth. Out of the total sample of 60 patients, among the 25 who did not perform amniotic fluid PCR, 5 were treated with triple therapy (ultrasound findings/prior treatment) and 20 patients were submitted to monotherapy; only two newborns underwent treatment for congenital toxoplasmosis. Among the 65 cases of gestational toxoplasmosis, 6 (9,2%) children had a diagnosis of congenital toxoplasmosis, and 2 patients with triple therapy felt severe adverse effects of the medications. Conclusions The present study suggests that research on PCR screening of the amniotic fluid may be useful to identify patients with a higher potential for fetal complications, who may benefit from the poly-antimicrobial treatment. Patients with negative PCR results must continue to prevent fetal infection with monotherapy, without risk of fetal or maternal impairment.

Telephone Social Support for Low-Income Pregnant Women

2002 ◽  
Vol 31 (6) ◽  
pp. 658-664 ◽  
Author(s):  
L.F.C. Bullock ◽  
C. Browning ◽  
E. Geden
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Low Income

Relationship between perceived family functioning and recovery from surgery

2011 ◽  
Vol 26 (S2) ◽  
pp. 1333-1333
Author(s):  
F.J. Vaz-Leal ◽  
M.J. Cardoso-Moreno ◽  
M.I. Ramos-Fuentes ◽  
L. Rodriguez-Santos ◽  
N. Fernandez-Sanchez
Keyword(s):  
Social Support ◽  
Salivary Cortisol ◽  
Family Cohesion ◽  
Surgical Intervention ◽  
Recovery Phase ◽  
Daily Basis ◽  
University Hospital ◽  
Biological Variables ◽  
Cortisol Levels ◽  
The Impact

ObjectiveThe aim of the study was to assess the impact of several psychological and/or biological variables in the recovery from surgery.MethodsThe selected sample was composed of 42 patients (age range: 25–70) admited for surgical treatment to a University Hospital. The patients who presented impaired cognitive functioning were excluded from the study. Prior to surgical intervention (48 to 72 hours), patients were administered the Family Adaptability and Cohesion Evaluation Scale (FACES-II). Salivary cortisol was measured 24 hours before surgery. Following surgical intervention, recovery was coded as “good” or “poor” accordingly to Moix et al.’s criteria (1995). Dietary intake, resting and sleeping time, fever, perceived pain and surgery-related complications were assessed on a daily basis.ResultsSignificant relationships between better recovery, family cohesion and salivary cortisol level were found. The patients with lower scores in the cohesion dimension of the FACES-II and higher cortisol levels had more complications during the recovery phase (F = 10.96, p = 0.006).ConclusionsOur results suggest that social support (family cohesion) and the activity of the hypothalamus-pituitary-adrenal axis (cortisol levels) can have a significant influence on postoperatory recovery. Taking these data into account, it would be suitable to assess psychopathology and social support in patients waiting for surgically interventions.

scholarly journals Relationship between Sonographic Umbilical cord Diameter and Gestational Age in Third Trimester of Pregnancy

2021 ◽  
pp. 20-27
Author(s):  
Sara Essam ALdabouly ◽  
Mohamed Mohsen El Namori ◽  
Mona Khaled Omar ◽  
Essmat Hamdy AboZeid
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Gestational Age ◽  
Umbilical Vein ◽  
Well Being ◽  
Fetal Weight ◽  
University Hospital ◽  
Third Trimester ◽  
Estimated Fetal Weight

Background: Throughout the fourth week of embryonic development the umbilical cord (UC) is formed, which corresponds to the fifth to the twelfth weeks of gestation. Fetuses with intrauterine growth restriction (IUGR) have leaner UCs than fetuses of appropriate gestational age do, and the caliber of the umbilical vein decreases significantly, resulting in a worsening of the Doppler parameters of the umbilical artery in the mother. The goal of this study was to evaluate the significance of sonographic UC diameter in determining gestational age in third trimester in pregnant women. Methods: We conducted a comparative cross-sectional research on 300 pregnant women aged range between (20-35) years, singleton gestation, gestational age (3rd) trimester estimated from antenatal mothers last menstrual period (LMP), viable fetus, presenting to obstetrics and gynecology department at Tanta university hospital. Results: Highly statistically significant positive correlation between UC diameter and gestational age, BPD, FL, AC, AFI, and estimated fetal weight was found. The increase in UC diameter was positively and significantly correlated with the increase in gestational age and estimated fetal weight, indicating that those who have prolonged gestational age and estimated fetal weight are more likely to have wider UC diameter. Conclusions: The UC diameter (UCD) has the potential to be a valuable indicator of fetal growth, well-being, and perinatal outcome. Sonographic measurement of UC diameter could be an efficient method of measuring fetal growth and predicting gestational age (GA), particularly between 28-40 weeks GA. It is possible that abnormal UC diameter can be a strong indicator to identify antenatal mothers at risk for IUFD and poor fetal outcomes.

scholarly journals Prenatal distress level and its predictors according to the gestational age in pregnant women in the semi-urban region in Northwestern Turkey: A cross-sectional study

2020 ◽  
Author(s):  
Yeliz Mercan ◽  
Kevser TARI SELCUK ◽  
Figen DIGIN ◽  
Hasan SAYGIN
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Education Level ◽  
Urban Region ◽  
Sectional Study ◽  
Cross Sectional ◽  
Northwestern Turkey ◽  
Prenatal Distress

Abstract Background: The aim of the present study was to determine the level and predictors of prenatal distress in pregnant women according to gestational age.Methods: This a cross-sectional study was conducted in eight Family Health Centers (FHCs) in Kirklareli, in Turkey. The study included 179 pregnant women who presented to the FHCs, who were at ≥12th week of gestation. Results:The frequency of prenatal distress in the participants was 21.2% (between 12th-27th weeks:16.5%, between 28th-41st weeks: 26.8%). It was found that level of education, age of the spouse, current pregnancy being unplanned, and social support levels were associated with the level of prenatal distress in ≥12th week or between 12th-27th weeks or between 28th-41st weeks (p<0.05). And also, perceived income level, abortion, and the number of pregnancies were associated with the level of prenatal distress in ≥12th weeks; the age of women, perceived income levels, previous abortion experience, and the number of pregnancies were associated with the level of prenatal distress in between 12th-27th weeks; the age of women, education level of spouse', and previous birth experience prenatal distress levels were associated in between 28th-41st weeks (p<0.05).Conclusion: The level of prenatal distress according to the gestational age, the education level of the woman, the age of her spouse’, the unplanned pregnancy, and social support levels were predictors. In both periods, the age of women were determinants in prenatal stress levels in pregnant women. Pregnant women should be screened and evaluated for prenatal distress in their application to FHCs.

Telephone Social Support for Low-Income Pregnant Women

2002 ◽  
Vol 31 (6) ◽  
pp. 658-664 ◽  
Author(s):  
Linda F.C. Bullock ◽  
Catherine Browning ◽  
Elizabeth Geden
Keyword(s):  
Social Support ◽  
Pregnant Women ◽  
Low Income

scholarly journals Evaluating Health Literacy among Adolescent and Young Adult Pregnant Women from a Low-Income Area of Northeast Brazil

2020 ◽  
Vol 17 (23) ◽  
pp. 8806
Author(s):  
Allen Suzane França ◽  
Catherine M. Pirkle ◽  
Tetine Sentell ◽  
Maria P. Velez ◽  
Marlos R. Domingues ◽  
...  
Keyword(s):  
Social Support ◽  
Health Literacy ◽  
Prenatal Care ◽  
Pregnant Women ◽  
School Performance ◽  
Low Income ◽  
Adverse Outcomes ◽  
Northeast Brazil ◽  
Pregnant Adolescents ◽  
Inadequate Health Literacy

Adequate health literacy is important for strong health outcomes during pregnancy, particularly among mothers with high risk of adverse outcomes related to pregnancy and childbirth. Understanding the health literacy of young pregnant women in low-income settings could support strategies to reduce adverse outcomes in this population. This exploratory study assessed the health literacy of young pregnant adolescents and young adults from a rural area in Northeast Brazil and associated factors such as socioeconomic conditions, adequacy of prenatal care, and social support from family and friends. In this cross-sectional study, 41 pregnant adolescents (13–18 years) and 45 pregnant adults (23–28 years) from the Rio Grande do Norte state, Brazil, were assessed regarding health literacy through the Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA, score from 0–18, inadequate if <15). Income sufficiency, self-perceived school performance, compliance with recommendations for adequate prenatal care, and social support were also assessed. A linear regression analysis was conducted to evaluate the variables associated with the SAHLPA score. Ninety-five percent of the adolescents and 53.3% of the adults (p < 0.001) presented inadequate health literacy. Adolescent age (β − 3.5, p < 0.001), poorer self-perceived school performance (β − 2.8, p < 0.001), and insufficient income for basic needs (β − 2.8, p = 0.014) were associated with worse SAHLPA scores. Adolescent mothers have higher rates of inadequate health literacy in this population. Policies are needed to improve access to health information for young populations from rural low-income areas.

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