Passive Fetal Movement Recognition Approaches Using Hyperparameter Tuned LightGBM Model and Bayesian Optimization

Fetal movement is an important clinical indicator to assess fetus growth and development status in the uterus. In recent years, a noninvasive intelligent sensing fetal movement detection system that can monitor high-risk pregnancies at home has received a lot of attention in the field of wearable health monitoring. However, recovering fetal movement signals from a continuous low-amplitude background that is heavily contaminated with noise and recognizing real fetal movements is a challenging task. In this paper, fetal movement can be efficiently recognized by combining the strength of Kalman filtering, time and frequency domain and wavelet domain feature extraction, and hyperparameter tuned Light Gradient Boosting Machine (LightGBM) model. Firstly, the Kalman filtering (KF) algorithm is used to recover the fetal movement signal in a continuous low-amplitude background contaminated by noise. Secondly, the time domain, frequency domain, and wavelet domain (TFWD) features of the preprocessed fetal movement signal are extracted. Finally, the Bayesian Optimization algorithm (BOA) is used to optimize the LightGBM model to obtain the optimal hyperparameters. Through this, the accurate prediction and recognition of fetal movement are successfully achieved. In the performance analysis of the Zenodo fetal movement dataset, the proposed KF + TFWD + BOA-LGBM approach’s recognition accuracy and F1-Score reached 94.06% and 96.85%, respectively. Compared with 8 existing advanced methods for fetal movement signal recognition, the proposed method has better accuracy and robustness, indicating its potential medical application in wearable smart sensing systems for fetal prenatal health monitoring.

“When I think of mental healthcare, I think of no care.” Mental Health Services as a Vital Component of Prenatal Care for Black Women

Purpose Black people give birth joyously despite disproportionate rates of adverse perinatal outcomes. Given that group prenatal care shows promise in mitigating these inequities, we sought to solicit the opinions of Black peripartum women on how group prenatal care could be tailored to fit their specific needs. In this study, we describe attitudes about a proposed Black group prenatal care in a single focus group of 11 Black women who receive maternal health services from Black Infant Health (BIH, a state and federal funded state-wide program for Black pregnant people with the goal to improve infant and maternal health). These data were used to design a race-conscious group prenatal care curriculum specifically for Black women at UCSF. Description This study was an analysis of focus group data generated as part of a larger project focused on community involvement in Black maternal health. English speaking pregnant or recently postpartum women age 18 or older who receive services from BIH were recruited to participated in the focus group analyzed in this study. All facilitators of the focus group were Black women in order to facilitate candid conversation about racism in prenatal care. Assessment The need for mental health care was common thread underlying all conversations about prenatal health improvements desired by our focus groups. Participants expressed the centrality of mental health access during our discussion of other themes (e.g.: ease of access, inclusion of partners, special classes for teen moms) by discussing them in terms of their relationship to mental health. Our participants’ clear expression of the centrality of mental health care to their prenatal health guided our decision to focus on mental health as a necessary pillar of any group prenatal care intervention designed to mitigate perinatal healthcare disparities in this paper. Three themes related to mental health integration into group prenatal care emerged from thematic analysis of the transcripts. Participants expressed insufficient access and advocacy, and provider distrust. Conclusion Evidence exists supporting group prenatal care as a tool for mitigation of perinatal health disparities among Black women. There is also a large body of data describing the disproportionate burden of mental health needs among Black women. The rich data we present here from Black women on their desire for the integration of these two needs fits well into the parallel conversation occurring in the literature. To our knowledge, this is the first study investigating desires of Black women regarding group prenatal care designed specifically for them. They expressed a strong desire for more access to mental health care providers who are racially conscious and aware of white supremacy, and nuanced opinions on the role of racial concordance in health equity.

Quality of provider-client interaction in a reproductive health clinic in Isabela, Philippines

The quality of provider-interaction determines client satisfaction and decision to seek health care. This research aimed to determine the women clients’ perception of their quality of interaction with the health care providers in a government reproductive health clinic in one of the municipalities in northern Philippines. Respondents consisted of 30 pregnant women who had visited the clinic for prenatal health care check-up were interviewed. A structured questionnaire and a semi-structured guided for probing served as the study’s research instruments. Women perceived the health care providers to possess good communication skills, and had displayed behavior that showed a regard for them. However, the providerinteraction was considered to be unilinear, with the provider perceived to have dominated the interface, The women also perceived only a somewhat evident show of sympathy/empathy. Hostile words were heard frequently. Creation of a two-way interaction with respect for their clients must be considered by the health care providers. Policies must also be formulated to improve the quality of provider-client interaction inside reproductive health clinics.

Prenatal care of Venezuelans in Colombia: migrants navigating the healthcare system

OBJECTIVES To explore the experiences of irregular (undocumented) Venezuelan migrants in accessing prenatal health services in Colombia and to examine the economic, social, and cultural resources mobilized by them to gain access to care. METHODS Data was retrieved from the qualitative component of a multi-method research conducted with pregnant immigrants in Barranquilla, Colombia, between 2018 and 2019, and triangulated with a review of regulations established by the Ministry of Health and Social Protection. RESULTS Having limited economic capital, participants use social capital from personal networks and migrant organizations. They obtain cultural health capital in the form of information on the health system and use their cultural competencies to interact with this system. CONCLUSIONS Migrants exert their agency through the use of capitals, although with certain constraints. Policies aimed at this social group should consider the strengths of migrants.

Air pollutants-particular matter (PM)2.5 with antenatal exposure leading to Adverse Obstetrical Outcomes of Birth Weight and Preterm Birth: A Systematic Review and Meta-Analysis.

Introduction: PM 2.5 exposure impacts on prenatal health and birth outcomes including low birth weight and preterm delivery. Objective: To identify and explore PM 2.5 exposure on adverse obstetrical outcomes including preterm birth and low birth weight. Method: A total of 409 studies was identified by searching from PUBMED, EMBASE, SCOPUS, WEB OF SCIENCE, and SCIENCE DIRECT. Of the 409 articles from 1982 to 2020, 24 articles were identified qualitatively considered, and 7 articles were quantitively eligible included in this meta-analysis. The pooled effect of PM 2.5 exposure and LBW, PTD were calculated using a random effect model with significant heterogeneity.Totally, 7 studies conducted in meta-analysis, and the pooled effect of PM 2.5 exposure in LBW and entire pregnant were 1.033 (95%CI: 1.025, 1.041) with significant high heterogeneity (I 2 = 96.110, P=0.000). The pooled effect of PM 2.5 exposure PTD and entire pregnant were 1.024 (95%CI: 1.015, 1.033) with significant different low heterogeneity (I 2 = 60.036, P=0.082). Discussion: Although prenatal exposure of PM 2.5 during pregnancy is significantly associated with the risk of LBW, the risk of PTD is a significant differrent, but consistently associated with PM 2.5 . Conclusion: Globally, PM 2.5 exposure is significantly associated with serious outcomes of pregnancy and birth outcomes across the world. It appears in the prenatal health emerging risks that government is needed to influence the health policies to pursue on maternal and child health. Key words: “maternal”, “prenatal”, “air pollution”, “PM 2.5 ”, “Preterm Birth”, and ”Low Birth Weight.”

Application of Blended Learning on the Antenatal Education Center Course: A Review of Flipped Classroom with Team-based Learning

Background: The goal is to evaluate the effects of a flipped class strategy on knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes in primiparas undergoing antenatal education. Methods: A convenience sampling method was adopted. A total of 621 primiparas who were diagnosed with early pregnancy in a first-class hospital in southeast China and received continuous prenatal health education from May to July 2020 were selected as the research subjects. The primiparas were divided into two groups in the antenatal education centre. One was the experimental group, who used the prenatal health education model based on blended learning (a flipped classroom with team-based learning); the other was the control group, who used the traditional mode of prenatal health education. The two groups were compared on the following outcomes: knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes. Results: The blended learning approach enhanced the primiparas’ knowledge, self-directed learning ability, and learning satisfaction, effectively controlled the gestational weight gain (GWG), alleviated the degree of anxiety and depression in the pregnant women during pregnancy, improved the self-efficacy and the natural delivery rate of the primipara, shortened the delivery process and reduced the risk of gestational diabetes mellitus (GDM), all P<0.05. Conclusions: Blended learning may be an effective strategy because of its validity and practicality in antenatal education.

Monitoring of Influenza Vaccination Coverage among Pregnant Women in Germany Based on Nationwide Outpatient Claims Data: Findings for Seasons 2014/15 to 2019/20

Pregnant women and their infants are at increased risk for severe influenza-related complications. A decade has passed since influenza vaccination was first recommended for pregnant women in Germany in 2010; however, monitoring of vaccination coverage (VC) has not yet been implemented for this target group. Using nationwide outpatient claims data, we here provide results on influenza VC among pregnant women in Germany for seasons 2014/15 to 2019/20. For any given season, pregnant women were defined as women who had undergone prenatal health care in at least two consecutive quarters within a season. VC increased from 9.0% in season 2014/15 to 16.6% in 2019/20 (+84%), while most of the increase occurred from season 2016/17 (VC: 9.9%) onwards (+68%). Consistently across seasons, women in east Germany were 40 to 60% more likely to be vaccinated compared to women residing in west Germany. According to age, the highest VC was observed among women aged 35 to <40 years (2019/20: 18.2%). Despite noticeable increases in influenza VC during recent years, overall coverage remains low among pregnant women. Starting with this analysis, VC among pregnant women in Germany will be monitored on a yearly basis in order to detect trends and identify immunization gaps.

The Effects of Caring for Young Children with Developmental Disabilities on Mothers’ Health and Healthcare Use: Analysis of Primary Care Data in the Born in Bradford Cohort

We explored the association between caregiving for preschool children with developmental disabilities and maternal health and healthcare use using linked primary care and Born in Bradford birth cohort data. Adjusting for prenatal health, healthcare use and socioeconomic status, mothers who were caregivers were more likely than other mothers to have symptoms of psychological distress (odds ratio 1.24; 95% CI 1.01, 1.53), exhaustion (1.42; 1.12, 1.80) and possibly head and musculoskeletal pain (1.18; 0.97, 1.43). Despite the higher prevalence of symptoms, they did not access healthcare services more and may seek healthcare for psychological distress less often (0.64; 0.40, 1.02). In general, socioeconomic disadvantage was associated with worse health. Pakistani ethnicity (versus white British) and prenatal consultation were strongly associated with higher postnatal consultation rates. Prenatal ill health, healthcare use and socioeconomic status are important factors in the detection of postnatal ill health via primary care services. If caregiver burden and the risk of under-detecting (and thus under treating) caregiver ill health is not addressed during the preschool period health inequalities between caregivers and other mothers and their families may persist and grow. The health of mothers of young disabled children, in particular their unmet health needs, warrants attention in research and clinical practice.

Mobile Remote Monitoring of Intimate Partner Violence Among Pregnant Patients During the COVID-19 Shelter-In-Place Order: Quality Improvement Pilot Study

Background Intimate partner violence (IPV) is one of the leading causes of pregnancy-related death. Prenatal health care providers can offer critical screening and support to pregnant people who experience IPV. During the COVID-19 shelter-in-place order, mobile apps may offer such people the opportunity to continue receiving screening and support services. Objective We aimed to examine cases of IPV that were reported on a prenatal care app before and during the implementation of COVID-19 shelter-in-place mandates. Methods The number of patients who underwent voluntary IPV screening and the incidence rate of IPV were determined by using a prenatal care app that was disseminated to patients from a single, large health care system. We compared the IPV screening frequencies and IPV incidence rates of patients who started using the app before the COVID-19 shelter-in-place order, to those of patients who started using the app during the shelter-in-place order. Results We found 552 patients who started using the app within 60 days prior to the enforcement of the shelter-in-place order, and 407 patients who used the app at the start of shelter-in-place enforcement until the order was lifted. The incidence rates of voluntary IPV screening for new app users during the two time periods were similar (before sheltering in place: 252/552, 46%; during sheltering in place: 163/407, 40%). The overall use of the IPV screening tool increased during the shelter-in-place order. A slight, nonsignificant increase in the incidence of physical, sexual, and psychological violence during the shelter-in-place order was found across all app users (P=.56). Notably, none of the patients who screened positively for IPV had mentions of IPV in their medical charts. Conclusions App-based screening for IPV is feasible during times when in-person access to health care providers is limited. Our results suggest that the incidence of IPV slightly increased during the shelter-in-place order. App-based screening may also address the needs of those who are unwilling or unable to share their IPV experiences with their health care provider.