Prenatal folic acid supplementation and folate status in early pregnancy: ECLIPSES study

This research evaluates the prevalence of inadequate folate status in early pregnancy, the pattern of prenatal folic acid (FA) supplementation and associated factors in Spanish pregnant women from the ECLIPSES study, which included 791 participants prior gestational week 12. A cross-sectional evaluation of red blood cell (RBC) folate levels was performed at recruitment and used to calculate the prevalence of folate deficiency (RBC folate<340 nmol/L) and insufficiency (RBC folate<906 nmol/L). Sociodemographic and lifestyle data, as well as information on prenatal FA supplementation were recorded. Descriptive and multivariate statistical analyses were performed. The prevalence of folate deficiency and insufficiency were 9.6% and 86.5%, respectively. Most of women used prenatal FA supplements but only 6.3% did so as recommended. Supplementation with FA during the periconceptional period abolished folate deficiency and reduced folate insufficiency. Prenatal folic acid supplementation with ≥1000 µg/d in periconceptional time and pregnancy planning increased RBC folate levels. The main risk factor for folate insufficiency in early pregnancy were getting prenatal FA supplementation out of the periconceptional time (OR 3.32, 95%CI 1.02–15.36), while for folate deficiency they were young age (OR 2.02, 95%CI 1.05–3.99), and smoking (OR 2.39, 95%CI 1.30–4.37). In addition, social and ethnic differences according to folate status were also identified. As conclusion, periconceptional FA use is crucial for achieving optimal folate levels in early pregnancy. Pregnancy planning should focus on young women, smokers, those with low consumption of folate-rich foods, low socioeconomic status or from ethnic minorities.

What Does Family Building Mean? A Qualitative Exploration and a New Definition: a Uk-based Study.

Introduction The importance of improving men’s and women’s knowledge of sexual and reproductive health has been emphasised in numerous global health policies. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, the recent concerted effort to improve fertility awareness warrants a closer investigation of basic terminologies in the field. For example, although the term family planning encompasses attaining the desired number of children and spacing pregnancies, it is typically attributed to the practice of limiting the number of children.MethodsWe conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. We asked participants about terms such as ‘family planning’ and ‘family building’ to elicit views and explored the appropriateness of the term “family building.” Data were transcribed and analysed via Framework analysis. Results When asked what ‘family planning’ meant to them, study participants stated that the term meant the avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods,” that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. Reasons cited for this perspective include the focus of school education and usage in clinical settings. Conclusions In the absence of an explicit definition in literature, we generated a new definition for family building as follows: “Family building refers to the construction or formation of a family, which can include steps or actions taken by an individual towards having children. In contrast to family planning, the intent focuses on pregnancy planning and childbearing rather than pregnancy prevention. However, it can also include actions taken to space the number of children one has.” Some balance in the global public health messages, including bridging the gap in reproductive health literature, may contribute to the effort to improve fertility knowledge. Additionally, this has implications for promotion of preconception and optimising reproductive health in order to enable men and women achieve their desired fertility intentions, whatever they may be.

THE DIFFERENCES OF BEHAVIOUR TOWARDS PREGNANCY READINESS AMONG PREGNANT WOMEN BASED ON PARITY

Background : Low pregnancy planning can cause unwanted pregnancy, abortion, loss of reproductive health, domestic violence until death. 40% of 85 million pregnancies in the world are unplanned and 38% end with abortions, miscarriage and unplanned childbirth. Unplanned pregnancy are associated with an increased risk of birth outcomes, including preterm birth, low birth weight (LBW), high risk of congenital anomalies, and developmental delay. Most woman who have plan to get pregnant don’t prepare their pregnancy as well. Women who have children (Multiparous) having unreadiness of pregnancy as same as women who do not have children (Nulliparous). Therefore, pregnancy planning is required to avoid risks so that women become more prepared on facing the pregnancy. This study aimed to analyze the differences behaviour toward readiness of pregnancy among pregnancy women based on parity. Method : This study used observational analytical research with cross sectional approach. The sampling technique used was total sampling which was conducted for 2 months and the sample obtained 92 pregnant women (include nulliparous, primiparous and multiparous) who met the inclusion criteria. The collected data was analyzed by Fisher Exact levels with a degree of α = 0.05. Result : The study showed there were 12 respondents who ready to face pregnancy. Meanwhile, there were 80 respondents who were not ready enough to face pregnancy, it was based on the result of Fisher Exact test with the value obtained was P value = 0.223 (P > 0.223). Conclusion : This showed that there was no difference of attitudes about pregnancy readiness of nulliparous, primiparous and multiparous woman

Pregnancy planning in women with diabetes mellitus type 2

BACKGROUND: The increase in the incidence of type 2 diabetes mellitus worldwide and the improvement in the quality of diabetic and obstetric care lead to an increase in the number of pregnant women with type 2 diabetes mellitus. The incidence of obstetric and perinatal adverse outcomes in women with type 2 diabetes mellitus is often higher than in women with type 1 diabetes. In the world literature, there are few works on the effect of pregnancy planning on the course and outcome of pregnancy in women with type 2 diabetes mellitus. AIM: The aim of this study was to evaluate the role of pregnancy planning in patients with type 2 diabetes mellitus in improvement of pregnancy and birth outcomes. MATERIALS AND METHODS: We retro- and prospectively analyzed the course and outcome of pregnancy in 124 women with type 2 diabetes mellitus, who were observed in the Diabetes Mellitus and Pregnancy Center of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott for the period from 2010 to 2019. The study included 34 women with type 2 diabetes mellitus at the stage of pregnancy planning and 90 women during pregnancy. All patients underwent a general clinical examination, carbohydrate metabolism correction, training at the School of Diabetes Mellitus in the principles of rational nutrition, self-control of glycemia and insulin therapy. Diabetes compensation was assessed by the level of glycated hemoglobin, determined using a method certified in accordance with the National Glycogemoglobin Standartization Program and standardized in accordance with the reference values adopted in the Diabetes Control and Complications Trial, as well as by the level of glycemia (self-control at least four times a day). We also assessed the severity of vascular complications of type 2 diabetes mellitus before and during pregnancy, and identified and treated comorbidities. To assess the degree of obesity, the criteria of the World Health Organization and the pregravid body mass index calculated by the Quetelet formula were used. The severity of preeclampsia was assessed in accordance with federal clinical guidelines. Ultrasound examination of the fetus with Doppler blood flow in the vessels of the fetoplacental complex was performed using a Voluson E6 ultrasound system (GE Healthcare, USA). For the timely diagnosis of diabetic fetopathy and fetal cardiomyopathy, dynamic fetometry and echocardiography were conducted. In addition, cardiotocography was performed for antenatal assessment of the fetus from the 30th week of pregnancy. After delivery, a neonatologist assessed the condition of the newborn using the Apgar scale at the first and fifth minutes of life, and then the assessment was carried out in the early neonatal period. RESULTS: In the group of women who received pregravid training, the course and outcomes of pregnancy were significantly better: the frequency of preeclampsia was lower (14.7%) compared to the group of women with an unplanned pregnancy (40.0%); there was no severe preeclampsia compared to the same women (13.3%). The number of preterm births was significantly lower (14.7%) in the group of women with planned pregnancy compared to the group of women without pregravid preparation (37.8%). In addition, in the group of women planning pregnancy, there were no fetal congenital malformations, neonatal hypoglycemic conditions, hypertrophic cardiomyopathy; in the group of women with an unplanned pregnancy, these parameters being found to amount to 6.7%, 24.4% and 6.7%, respectively. There was no perinatal mortality in the group of women with a planned pregnancy; however, this parameter was shown to be 3.3% in the group of women with an unplanned pregnancy. CONCLUSIONS: Pregnancy planning in patients with type 2 diabetes mellitus can significantly improve the course of pregnancy and childbirth outcomes.

Epilepsy: take care of the women’s beauty from childhood

The report considers an important issues of the course and treatment of epilepsy in women. Specific aspects of the problem are noted, the basic principles and features of the treatment of female epilepsy are shown, the problems of pregnancy planning are discussed.

KETIDAKSIAPAN BIDAN DALAM PERENCANAAN KEHAMILAN PADA WANITA DENGAN HIV/AIDS DI PUSKESMAS KOTA SURABAYA

Abstrak Latar Belakang: HIV merupakan sejenis virus yang dapat menyebabkan turunnya kekebalan tubuh manusia. Pada wanita hamil dengan HIV mempunyai kemungkinan melahirkan anak dengan HIV. Dalam tugasnya, bidan mempunyai peran untuk melakukan pencegahan penularan HIV/AIDS dari ibu ke anak, termasuk melakukan perencanaan kehamilan terhadap wanita dengan HIV/AIDS. Penelitian bertujua untuk mengetahui kesiapan bidan dalam perencanaan kehamilan pada wanita dengan HIV/AIDS. Metode: Penelitian deskriptif observasional dengan pendekatan cross sectional. Besar sampel sebanyak 88 bidan yang bekerja di 12 puskesmas wilayah Surabaya. Teknik sampling dilakukan sesuai dengan daftar puskesmas yang telah diberikan oleh Dinas Kesehatan Kota Surabaya. Variabel dalam penelitian yaitu pengetahuan, sikap, dan kesiapan bidan dalam perencanaan kehamilan pada wanita dengan HIV/AIDS. Hasil: Didapatkan mayoritas bidan berusia 23-32 tahun (62,5%) dan lama bekerja 1-10 tahun (71,6%). Puskesmas yang memiliki layanan PMTCT sebanyak 11 puskesmas (91,7%) dan 100% puskesmas mempunyai lembar balik HIV/AIDS. Sebagian besar bidan mempunyai pengetahuan baik (87,5%). Sebanyak (48,9%) bidan memiliki sikap negative dan (53,4%) bidan tidak siap dalam perencanaan kehamilan terhadap wanita dengan HIV/AIDS. Kesimpulan: Sebagian besar bidan tidak siap dan masih memiliki stigma negatif terhadap ODHA. Mayoritas bidan belum mengetahui keuntungan dan kerugian dari jenis persalinan pada ibu dengan HIV/AIDS serta belum mengetahui pemberian nutrisi pada bayi bagi ibu dengan HIV/AIDS.Abstract Background: HIV is a type of virus that can cause a decrease in human immunity. In pregnant women with HIV it is possible to give birth to children with HIV. In their duties, midwives have a role to prevent HIV / AIDS transmission from mother to child, including pregnancy planning for women with HIV / AIDS. The study aimed to determine the readiness of midwives in pregnancy planning in women with HIV / AIDS. Method: An observational descriptive study with cross sectional approach. The sample size was 88 midwives who worked in 12 Puskesmas in Surabaya. The sampling technique was carried out according to the list of health centers that had been given by the Surabaya City Health Office. The variables in the study were the knowledge, attitudes, and readiness of midwives in pregnancy planning in women with HIV / AIDS. Results: The majority of midwives aged 23-32 years (62.5%) and working duration 1-10 years (71.6%) were obtained. Puskesmas that have PMTCT services are 11 health centers (91.7%) and 100% puskesmas have a back sheet of HIV / AIDS. Most midwives have good knowledge (87.5%). As many as (48.9%) midwives have a negative attitude and (53.4%) midwives are not ready for pregnancy planning for women with HIV / AIDS. Conclusion: Most midwives are not ready and still have a negative stigma towards PLWHA. The majority of midwives do not yet know the advantages and disadvantages of the type of childbirth to mothers with HIV / AIDS and do not yet know the provision of nutrition to infants for mothers with HIV / AIDS.

Relationship between marriage readiness and pregnancy planning among prospective brides

Background: The growing marriage rates need to be followed with marriage readiness and pregnancy planning to become parents. The readiness of marriage includes age readiness, physical, financial, mental, emotional, social, moral, interpersonal, intellectual, and life skills. Unprepared marriage can have an impact on domestic violence and divorce. The readiness of marriage should be balanced with the existence of important pregnancy planning carried out to realize reproductive rights responsibly and the government program movement 1000 The First Day of Life as a golden period of child development, and avoid unplanned pregnancy in 4T conditions. Marriage readiness of prospective bride affects the readiness to maintain health of children in the future.Design and Methods: This research aimed to determine the relationship between marriage readiness and pregnancy planning among prospective brides. A correlative descriptive design with a cross-sectional method is used with a convenience sampling technique in determining the respondents, and obtained a total of 258 respondents.Results: The results showed a meaningful relationship between marital readiness and pregnancy planning (p=0.000, α=0.05).Conclusions: This study recommends education of pregnancy planning and readiness before marriage, both physical and psychological, with interactive media and nurse cooperation with community cadres in socialization on wedding preparation and preconceptions that are not only attended by prospective brides, but also women of childbearing age and adolescence in minimizing misinformation in unmarried women.

Preconception prevention of lactation disorders in women with fibrocystic breast disease

Study objective: to establish the clinical efficacy of 1.0% micronized progesterone gel Progestogel® at the preconception stage in order to prevent lactation disorders in women with fibrocystic breast disease (FBD).Materials and methods. The main group consisted of 30 women with diffuse forms of FBD who applied on each mammary gland 2.5 g 1.0% micronized progesterone gel Progestogel® for 6 months daily at the stage of pregnancy planning. The comparison group included 30 women with diffuse forms of FBD who did not use Progestogel® at the stage of pregnancy planning. The control group consisted of 30 healthy pregnant women without pathological changes in mammary glands. Stages of observation included preconception period, pregnancy, postpartum period, lactation period and long-term period (6 month after the end of lactation).Results. Preconception preparation with transdermal 1.0% micronized progesterone gel Progestogel® in patients with diffuse forms of FBD promoted long-term breastfeeding and a regressive course of the breast pathological process. Examination of this group of patients in the long-term period (6 month after the end of lactation) showed no clinical manifestations of the breast disease (pain syndrome and edema) in 24 (80.0%) women and regression of ultrasound signs of FBD in 21 (70.0%) patients. Manifestation of both clinical and echographic signs of the breast disease was diagnosed in 26 (86.7%) women in the comparison group. Transdermal 1.0% micronized progesterone gel in the preconception preparation associated with no complications of the early lactation period in 83.3% of patients and provided a long (12 months) lactation process in 66.7% of patients.Conclusion. Progestogel® is an effective pathogenically substantiated means of safe therapy for diffuse forms of FBD. The protective effect of 1.0% micronized progesterone gel Progestogel® associated with regression of clinical and echographic manifestations of FBD in 80.0% of women.

Fertility Desires and Intentions of HIV-Positive Women of Reproductive Age in Ontario, Canada: A Cross-Sectional Study

Background: Improvements in life expectancy and quality of life for HIV-positive women coupled with reduced vertical transmission will likely lead numerous HIV-positive women to consider becoming pregnant. In order to clarify the demand, and aid with appropriate health services planning for this population, our study aims to assess the fertility desires and intentions of HIV-positive women of reproductive age living in Ontario, Canada. Methodology/Principal Findings: A cross-sectional study with recruitment stratified to match the geographic distribution of HIV-positive women of reproductive age (18–52) living in Ontario was carried out. Women were recruited from 38 sites between October 2007 and April 2009 and invited to complete a 189-item self-administered survey entitled ‘‘The HIV Pregnancy Planning Questionnaire’’ designed to assess fertility desires, intentions and actions. Logistic regression models were fit to calculate unadjusted and adjusted odds ratios of significant predictors of fertility intentions. The median age of the 490 participating HIV-positive women was 38 (IQR, 32–43) and 61%, 52%, 47% and 74% were born outside of Canada, living in Toronto, of African ethnicity and currently on antiretroviral therapy, respectively. Of total respondents, 69% (95% CI, 64%–73%) desired to give birth and 57% (95% CI, 53%–62%) intended to give birth in the future. In the multivariable model, the significant predictors of fertility intentions were: younger age (age,40) (p,0.0001), African ethnicity (p,0.0001), living in Toronto (p = 0.002), and a lower number of lifetime births (p = 0.02). Conclusions/Significance: The proportions of HIV-positive women of reproductive age living in Ontario desiring and intending pregnancy were higher than reported in earlier North American studies. Proportions were more similar to those reported from African populations. Healthcare providers and policy makers need to consider increasing services and support for pregnancy planning for HIV-positive women. This may be particularly significant in jurisdictions with high levels of African immigration.