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2021 ◽  
Vol 82 (4) ◽  
Author(s):  
Vivien K. Burt ◽  
Sonya Rasminsky
Keyword(s):  

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 700
Author(s):  
Sajaan Praveena Gunarathne ◽  
Nuwan Darshana Wickramasinghe ◽  
Thilini Chanchala Agampodi ◽  
Indika Ruwan Prasanna ◽  
Suneth Buddhika Agampodi

Background: Investigating the out-of-pocket expenditure (OOPE) associated with maternal health is important since OOPE directly affects the affordability of health services. Global evidence suggests the importance of capturing the productivity cost during pregnancy in terms of absenteeism and presenteeism. Furthermore, the impact of the ongoing COVID-19 pandemic on the household economy needs to be further evaluated as pregnant women are one of the most vulnerable groups. This study aims at determining the economic burden of OOPE, productivity cost, and COVID-19 impact on pregnant women's household economy in a cohort of pregnant women in Anuradhapura District, Sri Lanka. Methods: The study setting is all 22 Medical Officer of Health (MOH) areas in Anuradhapura district, Sri Lanka. The study has three components; a follow-up study of a cohort of pregnant women to assess the magnitude and associated factors of OOPE and to assess the productivity cost (Component 1), a qualitative case study to explore the impact and causes of the OOPE under free health services (Component 2) and a cross-sectional study to describe the effects of COVID-19 outbreak on household economy (Component 3). The study samples consist of 1,393 and 1,460 participants for components one and three, respectively, and 25 pregnant women will be recruited for component two. The data will be analyzed using descriptive, parametric, and non-parametric statistics for the first and third components and thematic analysis for the second component. Discussion: With the lack of evidence on OOPE, productivity loss/cost in terms of maternal health, and COVID-19 impact on household economy in Sri Lanka, the evidence generated from this study would be valuable for policymakers, health care administrators, and health care practitioners globally, regionally, and locally to plan for future measures for reducing the OOPE, productivity loss/cost, and minimizing the economic hardship of the COVID-19 outbreak during pregnancy.


2021 ◽  
Author(s):  
ISHIAQ OMOTOSHO ◽  
Olufunke Akinade

Abstract Background: Incidence of Autism Spectrum Disorders (ASD) in children as a neurodevelopmental abnormality is growing. Compounded by equivocal deductions from several genetic and environmental studies aimed at establishing its aetiology, it is becoming a global medical challenge. This work investigated placental transfer of some micronutrients (Cu, Zn, Ca, Mg, Se) and toxic (Cd, Pb) metals in occupationally vulnerable pregnant mothers as possible basis of neurodevelopmental abnormalities in children with ASD. Method: 105 third trimester pregnant women comprising 50 occupationally exposed (cases) (27.68±5.57 years) and 55 non-occupationally exposed age-matched pregnant women (28.84±5.37 years) (controls) were recruited by convenient sampling method for this study. Blood (including cord blood) was collected from all participants. Trace and toxic elements levels were determined in the blood samples using Induction-Coupled Plasma-Mass Spectroscopy; anthropometric and sociodemographic data of the women along with the developmental milestone indices of the baby at infancy were also recorded.Results: Levels of trace elements were 328.02±109.99mg/L, 370.82±192.97umol/L, 8.61±0.89mg/dl, 1.52±0.26mg/dl and 10.17±1.22mg/L; 348.27±150.61mg/L, 416.80±276.73umol/L, 8.61±0.86mg/dl, 1.46±0.35mg/dl and 8.96±1.15 mg/L for Cu, Zn, Ca, Mg and Se in cases and controls respectively. The differences were not significant. Less than 10% of participants samples (maternal and cord blood) had detectable toxic metal levels. However, cord blood trace elements concentrations were 125.07±24.66mg/l, 525.38±45.86umol/L, 8.44±0.15mg/dl, 1.51±0.31mg/dl and 7.02±0.72mg/dl in cases and 91.05±13.27mg/l, 591.22±44.62umol/l, 1.63±0.15mg/dl and 8.19±0.78mg/L in control for Cu, Zn, Ca, Mg and Se respectively. Only cord blood Mg level was significantly different (p=0.013). Baby weight and head circumferences also correlated significantly with cord Zn and Cu levels (r=0.293, p=0.039), (r=0.478, p=0.010) respectively. Discussion: The observed downregulation of Mg and Se may have initiated a prooxidant reaction of the upregulated Cu in the foetus overwhelming the protective effects of Zn in scavenging the ROS produced by the combined effects of Cu and the toxic metals to which the cases were occupationally exposed. Our hypothesis is that given the role of Se, Cu and Mg in neurodevelopment, this may be the basis of the abnormal developmental milestones characteristic of ASD. Conclusion: The need to monitor environmental exposure in pregnancy may be an imperative step in stemming the growing incidence of neurodevelopmental disorders in this environment.


2021 ◽  
pp. e20210050
Author(s):  
Ângela Tamye Lopes Fujita1 ◽  
Antonio Luiz Rodrigues-Junior2 ◽  
Nayna Cândida Gomes3 ◽  
Bruno Spinosa de Martinis4 ◽  
José Antonio Baddini-Martinez5,6

Objective: To investigate how social and psychological characteristics differ between pregnant women who smoke and do not smoke. To explore associations between social and psychological features with changes of smoking habits by the end of pregnancy. Methods: A case-control study was set up. Smokers cases were never-smokers and ex-smokers controls. Pregnant women (n=328) from public prenatal services were interviewed. Socio-demographic data and psychological variables - personality traits, anxiety, depression, perceived stress, maternal fetal-attachment - were measured. Saliva samples were collected to measure cotinine and to check self-informed smoking status. In addition, 66 smokers were also assessed regarding smoking habits by late pregnancy. Smoking status was defined as a dependent variable. Exposure factors were analyzed through odds ratios. Logistic models and contingency tables were employed according to the nature of variables. "Qualitative change in smoking" was defined as a dependent variable for the last evaluation, and a logistic regression model was built. Results: Lower schooling, higher age, use of alcohol and drugs, living without a partner, and passive smoking showed associations with smoking. Anxiety, depression and perceived stress also exhibited positive association with smoking. Among personality traits, only Neuroticism was associated with smoking. None of the variables were associated with qualitative change in smoking by the end of pregnancy. Conclusion: Smoking during pregnancy is associated with more unfavorable social conditions. Pregnant women who smoke exhibit more negative psychological states than nonsmokers, including a profile of accentuated Neuroticism. None of the investigated variables could predict changes in smoking during pregnancy.


Author(s):  
Nouf Humayun ◽  
Shahid Bashir ◽  
Sidra Khalid

Background: Anemia, interpreted as a low blood hemoglobin values, was considered as a major health complication in the world.  However, anemia in pregnancy is a global public health problem in the developing countries, posing high risk of adverse results for expecting mothers as well as their fetus. The aim of study was to compare nutrients' intake among pregnant anemic & non-anemic women. Methods: A comparative cross-sectional study was conducted at Sir Ganga Ram Hospital, Lahore over a period of 4 months. The data were collected from 150 pregnant women, including 75 anemic and 75 non-anemic women, through pre-tested questionnaire using non-probability convenient sampling method. Data were tabulated and analyzed with help of SPSS version 21.0. Results: Analysis revealed that 34% of women had carbohydrate intake between 0-150 g/day, 44% had protein intake less than 50 g daily, and 36% had daily fat intake between 0-100 g/day. Moreover, 46.7% of the pregnant women were vitamins deficient, 51% were minerals deficient, 52% were iron deficient, 54.7% consumed tea with their meals, 44% had vitamin B3 intake less than 10 mg, 48% had vitamin C intake less than 50 mg, 48% had vitamin A intake between 0-500 RAE, 42% had calcium intake between 0-500 mg, and 31% had iron intake between 0-10 mg. Conclusion: The findings showed that nutrient intake of anemic pregnant women was not sufficient in the protein rich diet; they had high consumption of tea with their meals. Their overall energy intake and micronutrients were less than the required as per recommended dietary allowance in pregnancy.


2021 ◽  
Author(s):  
Anna Wong Shee ◽  
Natasha Frawley ◽  
Carolyn Robertson ◽  
Anne Marie McKenzie ◽  
Julie Lodge ◽  
...  

Abstract BackgroundPregnant teenagers in rural and regional areas experience distinct disadvantages, that are not simply a function of their age, and these have a substantial impact on their health and that of their baby. Studies demonstrate that antenatal care improves pregnancy outcomes amongst pregnant women, especially adolescents. Understanding teenager’s views and experiences of pregnancy and motherhood is important to ensure antenatal care meets young women’s needs. This study explored teenage women’s experiences and perceptions of barriers and facilitators to engaging in pregnancy care in rural and regional Victoria, Australia.MethodsBetween February - October 2017, semi structured interviews were conducted with pregnant women aged ≤ 19 years from rural and regional areas. Interviews were audio-taped, professionally transcribed and thematic analysis undertaken.ResultsFour key themes emerged from the analysis of the transcripts of 16 interviews: Valuing pregnancy care, Interactions with Maternity Service, Woman-centred care, and Support systems. Teenage women primary motivation to attend care was to ensure their baby’s wellbeing and lack of engagement occurred when the relevance of antenatal care was not understood. Appointment flexibility and an accessible location was important; most participants were reliant on others for transport. Continuity of carer and respectful, non-judgement communication by staff was highly valued. Many young women had fractured families with pregnancy diminishing their social world, yet having a baby gave them purpose in their lives.ConclusionMaternity services and health professionals that provide flexible, adaptable women-centred care and support through pregnancy and early motherhood will assist young women’s engagement in antenatal care.


Author(s):  
Tunji Oloyede Oladoyinbo ◽  
Adedapo Olufemi Adeogun ◽  
Ayodele Samuel Babalola ◽  
Muideen Babatunde ◽  
Olatunji Taiwo Ladipo ◽  
...  

Abstract This study assessed the perception of pregnant women on indoor residual spraying (IRS), documented acceptability, and factors that significantly dictate willingness to use IRS among the pregnant women attending antenatal clinic in Ibadan Nigeria. A structured questionnaire was used to obtain relevant information from 500 pregnant women. Descriptive and principal component analysis (PCA) were done at 5% level of significance. Majority of the pregnant women had between good and fair knowledge of IRS. Less than 70% of the respondents were willing to allow IRS in their homes. Our PCA revealed that major factors responsible for acceptance and willingness to use IRS were associated with perceived benefits, advantages, and disadvantages of IRS rather than overall knowledge of IRS among the respondents. The analysis revealed that these factors were responsible for at least 80% of the reasons for a pregnant woman to willingly accept IRS or not. The factors that positively influenced willingness to use IRS include its benefit in controlling mosquitoes and other insects, reducing malaria incidence, and prolonged effects of IRS which is an added advantage over continuous purchase of aerosols. One major factor that may negatively affect the acceptance of IRS is the fact that you may have to pack out of the house and wait for more than 3 d before entering. This current study has identified some specific factors that seem to promote and/or reduce willingness to accept IRS as a malaria control intervention among pregnant women in South Western Nigeria.


2021 ◽  
Vol 15 (7) ◽  
pp. e0009612
Author(s):  
Nivison Nery ◽  
Juan P. Aguilar Ticona ◽  
Claudia Gambrah ◽  
Simon Doss-Gollin ◽  
Adeolu Aromolaran ◽  
...  

This study aims to describe the sociodemographic determinants associated with exposure to Zika Virus (ZIKV) in pregnant women during the 2015–2016 epidemic in Salvador, Brazil. Methods We recruited women who gave birth between October 2015 and January 2016 to a cross-sectional study at a referral maternity hospital in Salvador, Brazil. We collected information on their demographic, socioeconomic, and clinical characteristics, and evaluated their ZIKV exposure using a plaque reduction neutralization test. Logistic regression was then used to assess the relationship between these social determinants and ZIKV exposure status. Results We included 469 pregnant women, of whom 61% had a positive ZIKV result. Multivariate analysis found that lower education (adjusted Prevalence Rate [aPR] 1.21; 95%CI 1.04–1.35) and food insecurity (aPR 1.17; 95%CI 1.01–1.30) were positively associated with ZIKV exposure. Additionally, age was negatively associated with the infection risk (aPR 0.99; 95%CI 0.97–0.998). Conclusion Eve after controlling for age, differences in key social determinants, as education and food security, were associated with the risk of ZIKV infection among pregnant women in Brazil. Our findings elucidate risk factors that can be targeted by future interventions to reduce the impact of ZIKV infection in this vulnerable population.


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