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2021 ◽  
Author(s):  
Marie‐Julie Trahan ◽  
Annabelle Cumyn ◽  
Matthew P. Cheng ◽  
Emily G. Mcdonald ◽  
Stephen E. Lapinsky ◽  
...  

2021 ◽  
Author(s):  
Delelegn Emwodew Yehualashet ◽  
Binyam Tariku Seboka ◽  
Getanew Aschalew Tesfa ◽  
Tizalegn Tesfaye Mamo ◽  
Elias Seid

Abstract Background: Optimal antenatal care (ANC4 +) needs to be used throughout pregnancy to reduce pregnancy complications and maternal mortality. The World Health Organization (WHO) recommends eight ANC contacts, while Ethiopia has the lowest coverage of at least four ANC visits. Therefore, this study aimed to identify factors associated with optimal ANC visits among pregnant women in Ethiopia. Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A multilevel logistic regression model is set up to identify factors associated with optimal ANC visits. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to estimate the strength of the association between the outcome and the predictor variables. Results: Overall, 43% of women had optimal ANC visits during their last pregnancy. Higher educated women are 3.99 times more likely (AOR = 3.99; 95% CI: 2.62-6.02) to have optimal ANC visits than women with no formal education. The wealthiest women are 2.09 times more likely (AOR = 2.09; 95% CI: 1.56-2.82) to have optimal ANC visits than women in the poorest quintile. The odds of optimal ANC visit is 42 percent lower in rural women (AOR = 0.58, 95% CI: 0.41-0.83) compared to women living in urban areas. Conclusion: Women's educational status, wealth status, mass media exposure, place of residence and region are factors that are significantly associated with optimal ANC visit. These findings help health care programmers and policymakers to introduce appropriate policies and programs to ensure optimal ANC coverage. Priority should be given to addressing economic and educational interventions.


Author(s):  
Alexander Strauss ◽  
Niels Rochow ◽  
Mirjam Kunze ◽  
Volker Hesse ◽  
Joachim W. Dudenhausen ◽  
...  

Abstract Background/objective To investigate the longitudinal development of maternal body weight and analyze the influence of obesity on obstetrics during more than two decades in Germany. Subjects/methods Data collected from the Federal state of Schleswig-Holstein (German Perinatal Survey) were analyzed with regard to the dynamics of maternal anthropometric variables (body weight, BMI) between 1995–7 and 2004–17. In total 335,511 mothers substantiated the presented study-collective. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY. Results Maternal BMI advanced significantly over the study period. Among a rise in mean periconceptional body weight (67.6–72.0 kg), the segment of obese women increased disproportionately (in average 9.4–19.2%). Despite the observed trend to late giving birth (mean maternal age 1995: 29.3 vs. 30.7 years in 2017), it was not advanced maternal age but parity that influenced the continuous increase in maternal weight (mean maternal body weight 1995–7: primi- bi-, multiparae 67.4, 68.3 and 69.0 kg vs. 2004–17: primi- bi-, multiparae 70.0, 71.5 and 73.2 kg respectively). Conclusion Obesity is a major problem on health issues in obstetrics. Advancing maternal BMI, increasing mother’s age and derived prenatal risks considerably complicate pregnancy and delivery. It has to be emphasized that its consequences do not end with delivery or childbed, but represent a livelong burden to the mother and their offspring. Hence, multimodal strategies to reduce/control periconceptional body weight are mandatory.


2021 ◽  
Author(s):  
MEKDES Gurara ◽  
Veerle Draulans ◽  
Jean-Pierre Van Geertruyden ◽  
Yves Jacquemyn

Abstract Background: In low- and middle-income countries, considerable proportions of women and newborns are dying from easily preventable pregnancy and childbirth-related causes. The utilisation of maternal health care (MHC) is a proven intervention that significantly reduces maternal and newborn morbidity and mortality. Despite efforts to make MHC available in rural Ethiopia, utilisation of these services remains low. Therefore, this study aimed to assess MHC services’ status and determinants in rural Ethiopia.Methods: The study used a community-based, cross-sectional design. A pretested, semi-structured, interviewer-administered questionnaire was used to collect data. A multilevel, mixed-effects, logistic regression model was used to identify individual and communal factors level factors associated with utilisation of antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC). Adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) were estimated at a p-value < 0.05, indicating statistical significance.Results: A total of 727 pregnant women from rural areas took part, with a response rate of 99.3%. About 63.4% of the women visited ANC clinics at least once during their last pregnancy while only 46.5% had given birth with SBA, and 32.8% had received PNC. The study revealed that women’s employment, awareness of danger signs and pregnancy planning were associated with increased MHC service utilisation from individual-level factors. The odds of using SBA (AOR=3.3; 95% CI: 1.8–5.9) and PNC (AOR=2.8; 95% CI: 1.2–6.7) were associated with ANC use. Similarly, PNC utilisation was associated with SBA (AOR=3.3; 95% CI: 1.8–6.1). At the cluster level, being a lowlands resident was found to be associated with ANC (AOR = 4.1; 95% CI: 1.1–14). Similarly, a proximity of less than two hours of travel time from the nearest health facility was found to be associated with SBA use (AOR=2.9; 95% CI: 1.4–5.8) and ANC use (AOR=1.9; 95% CI: 1.1–3.7).Conclusions: Individual and community-level factors play a key role in determining utilization of MHC services. Women’s empowerment, promotion of contraceptive methods to avoid unintended pregnancy and improved access to health care services, particularly in highlands areas, are recommended.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jia-Yi Zhao ◽  
Qing Yu ◽  
Xiao-Ming Yang ◽  
Xiang-Xin Li

Abstract Objectives The present study aimed to survey the prevalence of gestational diabetes mellitus (GDM) in Southern China and further to analyze the correlation between the prevalence of GDM and maternal age. Methods A retrospective cross-sectional study was carried out at the Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, Foshan, China between January and April 2020. Oral glucose tolerance tests (OGTT) was performed, using a 75 g glucose load and venous samples were drawn at 0 h, 1 h and 2 h at 24–28 weeks of gestation. GDM was diagnosed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results The prevalence of GDM was 14.87% by IADPSG criteria. The incidence of GDM outcome increased and plasma glucose levels remained high among the age subgroups (<20, 20–24, 25–29, 30–34, 35–39, ≥40 years old) in pregnant women. Moreover, the levels of plasma glucose levels after OGTT kept rising among the pregnant women with non-gestational diabetes mellitus (non-GDM). Furthermore, pregnant women were inclined to have abnormal plasma glucose values at 1 h and 2 h than initial fasting plasma glucose (FPG) after OGTT as the age increased. Conclusions Our findings demonstrate that the incidence of GDM outcome and plasma glucose levels increase as the maternal age increase.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yossy Machluf ◽  
Sherman Rosenfeld ◽  
Izhar Ben Shlomo ◽  
Yoram Chaiter ◽  
Yaron Dekel

Abundant evidence strongly suggests that the condition of pregnancy makes women and their fetuses highly vulnerable to severe Corona-virus 2019 (COVID-19) complications. Here, two novel hypoxia-related conditions are proposed to play a pivotal role in better understanding the relationship between COVID-19, pregnancy and poor health outcomes. The first condition, “misattributed dyspnea (shortness of breath)” refers to respiratory symptoms common to both advanced pregnancy and COVID-19, which are mistakenly perceived as related to the former rather than to the latter; as a result, pregnant women with this condition receive no medical attention until the disease is in an advanced stage. The second condition, “silent hypoxia”, refers to abnormally low blood oxygen saturation levels in COVID-19 patients, which occur in the absence of typical respiratory distress symptoms, such as dyspnea, thereby also leading to delayed diagnosis and treatment. The delay in diagnosis and referral to treatment, due to either “misattributed dypsnea” or “silent hypoxia”, may lead to rapid deterioration and poor health outcome to both the mothers and their fetuses. This is particularly valid among women during advanced stages of pregnancy as the altered respiratory features make the consequences of the disease more challenging to cope with. Studies have demonstrated the importance of monitoring blood oxygen saturation by pulse oximetry as a reliable predictor of disease severity and outcome among COVID-19 patients. We propose the use of home pulse oximetry during pregnancy as a diagnostic measure that, together with proper medical guidance, may allow early diagnosis of hypoxia and better health outcomes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miguel Rodriguez ◽  
Antoinette A. Danvers ◽  
Carolina Sanabia ◽  
Siobhan M. Dolan

Abstract Background The objective of the study was to understand how pregnant women learned about Zika infection and to identify what sources of information were likely to influence them during their pregnancy. Methods We conducted 13 semi-structed interviews in English and Spanish with women receiving prenatal care who were tested for Zika virus infection. We analyzed the qualitative data using descriptive approach. Results Pregnant women in the Bronx learned about Zika from family, television, the internet and their doctor. Informational sources played different roles. Television, specifically Spanish language networks, was often the initial source of information. Women searched the internet for additional information about Zika. Later, they engaged in further discussions with their healthcare providers. Conclusions Television played an important role in providing awareness about Zika to pregnant women in the Bronx, but that information was incomplete. The internet and healthcare providers were sources of more complete information and are likely the most influential. Efforts to educate pregnant women about emerging infectious diseases will benefit from using a variety of approaches including television messages that promote public awareness followed up by reliable information via the internet and healthcare providers.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiamei Guo ◽  
Anhai Zheng ◽  
Jinglan He ◽  
Ming Ai ◽  
Yao Gan ◽  
...  

Abstract Background Antenatal depression has become a common and serious problem, significantly affecting maternal and fetal health. However, evaluation and intervention methods for pregnant women in obstetric clinics are inadequate. This study aimed to determine the prevalence of and risk factors for depression among all pregnant women at their first attending antenatal care in the obstetrics clinic, a comprehensive teaching hospital, southwest of China. Methods From June to December 2019, 5780 pregnant women completed online psychological assessments, and data from 5728 of the women were analyzed. The women were categorized into two groups according to the presence or absence of depression. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a cutoff point of 10 for depression. Anxiety and somatic symptoms were measured by the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-15 (PHQ-15), respectively. Univariate analysis and binary logistic regression analysis were used to determine the association among antenatal depression, anxiety, somatic symptoms and participants’ characteristics. Results The prevalence of antenatal depression among all the pregnant women at their first attending antenatal care was 16.3%, higher in the first trimester (18.1%). Anxiety symptoms (Mild anxiety AOR = 2.937; 95% CI: 2.448–3.524) and somatic symptoms (Mild somatic symptoms AOR = 3.938; 95% CI: 2.888–3.368) were major risk factors for antenatal depression among women and the risk increased more with the anxiety level or somatic symptoms level. Gestational weeks (second trimester AOR = 0.611; 95% CI: 0.483–0.773; third trimester AOR = 0.337; 95% CI: 0.228–0.498) and urban residence (AOR = 0.786; 95% CI: 0.652–0.947) were protective factors for antenatal depression among women. Conclusions About one in six pregnant women would experience depression, and special attention should be paid to some risk factors (i.e., early pregnancy, anxiety symptoms, somatic symptoms, rural residence). Online psychological assessments might be a time-saving and convenient screening method for pregnant women in obstetric clinics.


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