The Effects of Relaxing Music on Life Distress and Maternal-fetal Attachment in Pregnant Women

Background: Although pregnancy and motherhood are enjoyable experiences, they are associated with numerous biopsychological changes requiring adaptation. The present study aimed to assess the effects of relaxing music on life distress and Maternal-Fetal Attachment (MFA) in pregnant women. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The research population included all Iranian pregnant women referring to Laleh Hospital in Tehran City, Iran, in 2020. In total, 30 women were selected using the convenience sampling method and randomly assigned into the intervention and control groups (n=15/group). The required data were collected using the Life Distress Inventory (LDI) and the Maternal-Fetal Attachment Scale (MFAS). The intervention group listened to relaxing music for twelve 45-50-minute sessions in the morning and during routine midwifery visits; however, the controls received no intervention. The collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS V. 22. Results: The obtained results indicated that the intervention group reported a lower level of life distress in the post-test, compared to the controls (P=0.0001, F=15.860). The intervention group also achieved a higher mean score on MFA, than the control group (P=0.0001, F=35.872). Conclusion: According to the present research findings, reproductive health, nursing professionals, and psychologists could recommend music as a complementary therapy to reduce stress and distress experienced by expecting mothers and to improve MFA.

The Effect of Steamed Tempeh on Hemoglobin Levels and Body Weight in Pregnant Women at the Kalar - Kalar Health Center, Aru Islands District

Background: Nutrition of pregnant women is very influential on fetal growth, one of which is iron deficiency anemia. Iron deficiency increases in pregnant women with increasing age in pregnancy. Significantly low intake of nutrients will make pregnant women experience Chronic Energy Deficiency. The nutritional content of tempeh can be used to meet the nutritional needs of pregnant women. Objective: The aim of this study was to analyze the effect of giving steamed tempeh to the increase in hemoglobin and Body Weight levels in pregnant women at the Kalar-kalar Health Center, Aru Islands Regency. Method: This type of research is a quasi-experimental with a pre-posttest control group design. The intervention was given to the respondents as many as 24 people with 12 people in the control group and 12 people in the treatment group. Sampling purposive sampling. Subjects were taken from two villages in the working area of ​​the Kalar-Kalar Public Health Center which have relatively the same geography and socioeconomic status and only pregnant women with Hb <11 G/dL were selected. The form of treatment was giving 100 G of steamed tempeh 2 times a week for 30 days while the control group was given biscuits for pregnant women 2 times per week 100 G. Data analysis used univariate and bivariate analysis with paired T test and Mann Whitney. Results: Mann Whitney test results of the effect of steamed tempeh on weight gain in the treatment group obtained a p-value of 0.050 (p=0.05). Differences in hemoglobin levels in anemic pregnant women with a p-value of 0.018 (<0.05) with a mean difference of 0.42 G/dL in the pre-posttest treatment group and the control group with a p-value of 0.217 (<0.05) with a mean difference of 0.21 G/d dL. Conclusion: There is an effect of giving steamed tempeh to increase hemoglobin and body weight in pregnant women. Keywords: Anemia, Pregnant women, Hemoglobin, Body Weight, Tempeh.

Calcemia, Vitamin D and seasonal influences in preeclampsia in Goma

Background: The etiology of preeclampsia remains less well known. It is noted that low vitamin D levels are associated with a high risk of preeclampsia (PE). Calcium (Ca2+) levels during pregnancy appear to be involved in pregnancy-induced hypertension. Recent studies indicate that serum calcium levels may have a role in preeclampsia. Vitamin D promotes absorption of proper concentration of calcium in the blood which helps to lower blood pressure. The complications associated with calcium deficiency during a normal pregnancy are numerous and have not been extensively studied in Goma. Objective: To assess blood calcium levels (ionic and total) in preeclamptic women and to analyse the seasonal influence on preeclampsia in Goma. Method: A prospective case-control study (without matching) of 190 pregnant women without cardiovascular or endocrine diseases for a case-control ratio of 1∶1 was conducted in six hospitals in Goma. Blood ionogram was performed by an automated system directly after blood sampling and vitamin D was measured using enzyme-linked immunosorbent method. Results: The mean ionised calcium level in preeclamptic woman was 1.24±0.16 mmol/L (0.48-1.59) compared to 1.27±0.17 mmol/L (0.88-2.30) in normal pregnant woman (p=0.214). A slight negative correlation between blood calcium and blood pressure was observed in pregnant women. Low vitamin D levels were associated with preeclampsia. Hypovitaminosis D in the preeclamptic group was more observed during the rainy season than during the dry season. Pregnancies complicated by PE were from fertilisations occurring during the rainy season while the dry season was characterised by a high admission of preeclamptics. Conclusion: The study found that preeclamptic women in Goma had hypocalcemia. There was also a weak negative correlation between blood pressure and serum calcium levels. The majority of preeclamptics were diagnosed during the dry season, while conception with a PE complication occurred during the rainy season. As this is a first study in this area for the Great Lakes region of Africa, a more in-depth study with a larger sample size is desired.

Profile and Predictors of Maternal Quality of Life During Physiological Pregnancy: A Cross-Sectional Analysis

BackgroundQuality of Life (QoL) and its determinants are significant in all stages of life, including pregnancy. The physical and emotional changes during pregnancy affect the QoL of pregnant women, affecting both maternal and infant health. Hence, assessing the QoL of pregnant women is gaining interest in literature. We, therefore, aimed to describe the QoL of pregnant women during physiological pregnancy and to identify its associated predictors in women attending a public healthcare institute of Quetta city, Pakistan.MethodsA cross-sectional study was conducted at the Obstetrics and Gynecology Department of Sandeman Provincial Hospital Quetta city, Pakistan. The respondents were asked to answer the Urdu (lingua franca of Pakistan) version of the Quality of Life Questionnaire for Physiological Pregnancy. Data were coded and analyzed by SPPS v 21. The Kolmogorov–Smirnov test was used to establish normality of the data and non-parametric tests were used accordingly. Quality of Life was assessed as proposed by the developers. The Chi-square test was used to identify significant associations and linear regression was used to identify the predictors of QoL. For all analyses, p &lt; 0.05 was taken significantly.ResultsFour hundred and three pregnant women participated in the study with a response rate of 98%. The mean QoL score was 19.85 ± 4.89 indicating very good QoL in the current cohort. The Chi-Square analysis reported a significant association between age, education, occupation, income, marital status, and trimester. Education was reported as a positive predictor for QoL (p = 0.006, β = 2.157). On the other hand, trimester was reported as a negative predictor of QoL (p = 0.013, β = −1.123).ConclusionImproving the QoL among pregnant women requires better identification of their difficulties and guidance. The current study highlighted educational status and trimester as the predictors of QoL in pregnant women. Health care professionals and policymakers should consider the identified factors while designing therapeutic plans and interventions for pregnant women.

Safety and Efficacy of Tenofovir Alafenamide Fumarate in Early-Middle Pregnancy for Mothers With Chronic Hepatitis B

BackgroundTenofovir alafenamide fumarate has been used in late pregnancy; however, no data exist regarding its safety and effectiveness in early and middle pregnancy for mothers with hepatitis B virus infection.AimsTo design a prospective study to investigate the efficacy and safety of TAF in pregnant women with chronic HBV infection during early-middle pregnancy.MethodsPregnant women with active chronic hepatitis B who received tenofovir alafenamide fumarate during early and middle pregnancy were enrolled and followed up until 6 months postpartum. Infants received immunoprophylaxis. The primary endpoint was the safety of mothers and infants. The secondary endpoints were maternal hepatitis B virus DNA reduction at delivery and mother-to-child transmission rate.ResultsAmong 98 mothers enrolled, 31 initiated tenofovir alafenamide fumarate in early pregnancy, and 57 in middle pregnancy. The mean (± standard deviation) age was 29.00 (±3.81) years. At delivery, 100% (98/98) of the mothers achieved hepatitis B virus DNA levels &lt;200,000 IU/L. Ninety-eight infants were born, and none had congenital defects or malformations. All infants received hepatitis B virus immunoprophylaxis. The mother-to-child transmission rate was 0%. Growth parameters including body weight, height, and head circumference were comparable to the national standards for physical development. No severe adverse effects were reported in either mothers or infants. No severe liver function damage occurred in any of the mothers.ConclusionsInitiating tenofovir alafenamide fumarate in early and middle pregnancy appears safe for both mothers and infants, and it is effective for controlling maternal disease as well as interrupting mother-to-child transmission.

Anemia among Pregnant Women at Nepalgunj Medical College

Introduction: Anemia in pregnancy is major health issue of developing countries responsible for adverse maternal and fetal outcome. According to World health organization pregnant women with hemoglobin level less than 11 gm/dl in first trimester and less than 10.5gm/dl in second and third trimester are considered to be anemic. Iron deficiency anemia is common during pregnancy followed by megaloblastic anemia. Aims: To find out the prevalence of anemia during pregnancy. To correlate the maternal and fetal complications associated with anemia during pregnancy. Methods: This is a prospective hospital based study done at department of obstetrics and gynecology Nepalgunj Medical College from July 2020 to January 2021. All pregnant women with hemoglobin level <11 gm/dl were enrolled in the study. Data were collected from antenatal clinic and biochemistry laboratory. Results: In this study maximum participants were of age group 20-25 consisting of 38.5%. Anemia was more common in multiparous i.e. 60% as compared to primipara i.e. 40%. In this study maximum participant had vaginal delivery (57%) followed by LSCS (29%) then instrumental delivery (14%). These ladies had complications like postpartum hemorrhage (27.7%), preterm labor (16.9%), pregnancy induced hypertension (9.2%). similarly 10.8% had sepsis and 20% had no complications. About 23.1% babies delivered by anemic ladies required neonatal intensive care. Intrauterine growth restriction was seen in 12.3%, preterm birth in 10.3% and 53.8% babies had no complications. Conclusion: The prevalence of anemia during pregnancy is high leading to adverse maternal and fetal outcome.

Effects of Maternal Anemia on Neonatal Outcome

Introduction: Anemia is one of the most prevalent nutritional deficiency problem affecting pregnant women. It is defined by World Health Organization as hemoglobin (Hb) level of less than 11 g/dl. Hemoglobin level of 9.0- 10.9 g/dl is mild, 7.0-8.9 g/dl is moderate and less than 7 g/dl is severe anemia respectively. Maternal anemia in pregnancy is commonly considered as a risk factor for poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus. Aims: To find out neonatal outcome delivered to anemic mothers. Methods: A prospective case control study was carried out among 75 newborns delivered to pregnant women with hemoglobin below 10.9g/dL. Another 75 newborns were taken delivered at the same time, matched age and sex wise as a control group to mothers whose hemoglobin was more than 11g/dl. Results: Out of total 75 cases 35(46.7%) mothers had mild, 32(42.6%) had moderate and 8(10.7%) had severe anemia respectively. Similarly, the risk of having preterm baby among anemia group was 4.42 times higher than that in control group (p 0.033). The risk of having low birth weight in anemia group was 3.9 times higher than that in control group (p 0.04). The mean of head circumference (HC) among the anemia group was 33.9cm +1.40 (Mean+SD) and among the control group was 34.4cm+1.24(Mean+SD) with a mean difference of 0.5cm (p 0.032). The mean of length among anemia group was 45.3cm+1.97 (Mean+ SD) and among the control group was 46.2cm+1.69 (Mean+ SD) with a mean difference of 0.9 cm (p 0.003). Conclusion: Maternal anemia in pregnancy is associated with increased risk of adverse neonatal outcome. Efforts must be made to reduce the prevalence of anemia especially during pregnancy to reduce neonatal morbidity and mortality.