Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a medi...Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.展开更多
Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors...Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors,and the impact of UI on daily life in pregnant and postpartum women in Nanjing,China.Methods:The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life.The associated factors were estimated by using logistic regression analysis.Results:UI affected 37.80%of pregnant women and 16.41%of postpartum women of the study population.Among the pregnant participants,the prevalence rates of stress UI,urge UI,and mixed UI were 25.77%,4.47%,and 7.10%,respectively.Among the postpartum women,the prevalence rates of stress UI,urge UI,and mixed UI were 11.15%,1.92%,and 2.69%,respectively.In both pregnant women and postpartum women,vaginal delivery had significantly increased the odds of reporting UI(p=0.007,p=0.003,respectively).The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment(p=0.000).Conclusion:The prevalence rates of UI were high in pregnant women in Nanjing,China.Vaginal delivery significantly increased odds of reporting UI.UI has a great impact on pregnant and postpartum women’s life,especially in social embarrassment.展开更多
Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii...Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords “COVID-19”, “Pregnant Women” and “Depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% - 33.5% using EPDS ≥ 9 in three articles and 12.0% - 43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% - 48.7%, and seven articles reported 5.3% - 59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.展开更多
Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature sear...Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.展开更多
Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of ...Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.展开更多
Background: Zambia has a population of 17.4 million people of which 48% are unable to meet their minimum calorie requirement and 35% of the children in Zambia are stunted (ZDHS, 2018). In the 2018 ZDHS report, 31% of ...Background: Zambia has a population of 17.4 million people of which 48% are unable to meet their minimum calorie requirement and 35% of the children in Zambia are stunted (ZDHS, 2018). In the 2018 ZDHS report, 31% of women aged 15 - 49 had anaemia. Most cases of anaemia in pregnancy are due to micronutrient deficiency and maternal malnutrition. The 2020 Zambia Global Nutrition Report shows an increase in the prevalence of anaemia among women of reproductive age (45%) and low birth weight infants (13.0%) which suggested a need to explore determinants of pregnant women’s nutrition uptake in order to improve the nutritional status of pregnant women particularly those in Solwezi district of the north-western province of Zambia. Methods: An analytical cross-sectional study was conducted on antenatal mothers aged 15 - 49 accessing routine antenatal care from four selected health facilities in Solwezi district from July 2021 to February 2021. Cluster sampling method was used to select the 4 health facilities and the 98 antenatal mothers were selected using systematic sampling method. Data was collected using a pretested researcher-assisted semi-structured questionnaire and analyzed using the SPSS version 26. Chi-square test was used to determine associations between the independent and independent variables. The level of significance was set at 0.05 and the confidence interval was set at 95%. Multiple logistic regression analysis was done to predict associations among variables. Results: The findings revealed that a large proportion of respondents (71.4 %) had high knowledge regarding nutrition during pregnancy compared to (19.4%) and (9.2%) who expressed medium and low knowledge levels respectively. Attitude towards nutrition in pregnancy was positive in the majority, 82 (83.7%) of the respondents, and over half, (55%) of the respondents reported good nutrition uptake during pregnancy. Conclusions: In this study, nutrition uptake in pregnancy was significantly associated with women’s attitudes towards nutrition. It was also observed that more respondents who had a positive attitude towards nutrition had good nutrition uptake during pregnancy. We can therefore, conclude that the research study has revealed that majority of the respondents had high knowledge level and positive attitudes towards nutrition during pregnancy and only half of the respondents had good nutrition uptake during pregnancy which should be able to prompt all the stakeholders of health to focus their attention on behavioural change messages, policies and intervention in order to enhance good nutrition uptake among pregnant women.展开更多
Human toxoplasmosis is caused by the intracellular protozoan parasite Toxoplasma gondii. Although T. gondii infection is generally asymptomatic for most of the immunocompetent adults, severe complications may occur pa...Human toxoplasmosis is caused by the intracellular protozoan parasite Toxoplasma gondii. Although T. gondii infection is generally asymptomatic for most of the immunocompetent adults, severe complications may occur particularly in pregnant women and immunocompromised individual. Host cell immunity plays a critical role in parasite differentiation and persistence in the host. Therefore, genetic polymorphism in the host immune genes, for instance interferon-γ gene could be linked with possibility of T. gondii infection. The objective of the study was to verify the link between the single nucleotide polymorphisms (SNPs) in the IFN-γ gene of pregnant women and T. gondii infection through correlating with anthropometric and sociodemographic parameters. In this study, ninety-two (N = 92) pregnant women (16 - 40 years) and healthy controls (N = 95) with similar age ranges were included. Among them, 25% (n = 23) pregnant women were seropositive for T. gondii IgG antibodies by Rapid Test Assay. Allelic and genotypic frequencies of IFN-γ +874T/A (rs2430561) SNPs were evaluated by using ARMS-PCR. The distribution of the A and T alleles in the specific position of the IFN-γ gene in the T. gondii-infected pregnant women and the control groups did not differ significantly, according to the data. However, we found a higher frequency (13.04%) of A/A genotype in T. gondii infected pregnant women as compared to non-infected individuals (8.70%), demonstrating that T. gondii infection susceptibility may be increased by homozygosity for the A allele. Further studies are to be needed to find out the link between host gene polymorphism and T. gondii infection in Bangladesh.展开更多
BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpar...BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.展开更多
Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnanc...Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnancy. Objective: The aim of the study was to assess whether the trans-cerebellar diameter, placental thickness or combining both of them is more accurate for assessment of gestational age in the 3<sup>rd</sup> trimester of pregnancy. Patients and Methods: This is a cross sectional study conducted at outpatient Clinic and Obstetric ward, Ain Shams University Maternity Hospital, over a period of six months from March 2019 to September 2019. One hundred pregnant women were recruited according to inclusion criteria either from outpatient clinic or were admitted in obstetric ward Ain Shams Maternity Hospital to find out the most accurate fetal biometric measurement in the third trimester either trans-cerebellar diameter placental thickness or both compared to reliable LMP (last menstrual period) dates confirmed by crown rump length (CRL) in the first trimester. Results: Trans-cerebellar diameter mean ± SD was 46.0 ± 3.5 with range 38.2 - 51.7. The mean of placental thickness was 39.6 ± 7.1 with range 22.8 - 54.3. Placental thickness had highest determination (0.813) for last menstrual period followed by trans-cerebellar diameter (0.802). Combining trans-cerebellar diameter and placental thickness increased determination (0.902) for last menstrual period. Conclusion: Combined use of trans-cerebellar diameter and placental thickness in the third trimester of pregnancy is a reliable indicator for gestational age in women whose last menstrual period is unreliable or unknown, but placental thickness had higher accuracy than trans-cerebellar diameter.展开更多
Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation o...Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.展开更多
Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of thi...Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).展开更多
Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successiv...Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successive visits separated by at least 4 hours in a woman who has been at rest for 10 to 15 minutes in the seated position and then in the left lateral decubitus position. The aim of this study was to determine the prevalence and types of arterial hypertension among pregnant women in the maternity ward of the CMC les Flamboyants. Methods: This was a prospective descriptive study lasting six (6) months, from 1 October 2021 to 31 March 2022, of all pregnant women and/or parturients admitted to the maternity ward of the CMC les Flamboyants with a resting blood pressure (BP) greater than or equal to 140/90 mm Hg during the study period. Results: During the study period, we recorded 707 cases of pregnant and/or parturient women, 50 (7.07%) of whom were hypertensive. The average age of the patients was 29 years, with extremes of 18 and 41 years. The 20 - 29 age group was the most affected, with 26 cases (52%). Headache, dizziness and oedema of the lower limbs were constant in all cases. The risk factors for arterial hypertension were dominated by familial hypertension in 19 cases (38%), multiple gestures in 17 cases (34%) and a history of gestational hypertension in 16 cases (32%). Gestational age between 28 and 36 weeks’ amenorrhoea was the most common, with 20 cases (40%). Type I hypertension was most common on admission, with 34 cases (68%), followed by type II hypertension, with 8 cases (16%). Pre-eclampsia was the most frequent maternal complication with 27 cases (54%) followed by eclampsia with 15 cases (30%). Fetal distress was the most frequent fetal complication, 19 cases (38%), followed by death in utero 9 cases (18%). Conclusion: Compliance with consultation programmes and correct patient follow-up could help reduce maternal-foetal complications.展开更多
HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclo...HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.展开更多
Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has sig...Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has significant implications to the physical and mental wellbeing of both the mother and her baby. Only non-depressed pregnant women (score of ≤ 6 on Edinburgh Postnatal Depression Scale) were recruited into this study. Data collection was done at 2 different stages;at recruitment stage (during the third trimester of pregnancy) and at the follow up stage (4<sup>th</sup> - 6<sup>th</sup> week postpartum). During the recruitment stage, intimate partner violence (IPV) and level of social support perception, among the women, were assessed using Hurt Insult Threaten Scream (HITS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires respectively. While at the follow up stage, the Obstetric questionnaire and Mini International Neuropsychiatric Interview (MINI-7) were used respectively to obtain obstetric-related data and to diagnose for occurrence of depression. The incidence of PPD was found to be 16.34%. Several factors such as level of education, husband’s socioeconomic status, stressful life events, low perception of social support, obstetric instrumentation and not having a baby of preferred gender were significantly associated with PPD. Positive predictors of PPD included not practicing breast feeding (OR = 186.72, 95% CI = 8.32 - 4188.35), family history of mental illness (OR = 4.95, 95% CI = 1.04 - 23.81) and pregnancy lasting beyond 40 weeks (OR = 7.26, 95% CI = 1.51 - 34.88). High incidence of PPD with numerous associated but largely modifiable risk factors call for more proactive measures, such as PPD screening among pregnant women.展开更多
Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patien...Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patients during pregnancy may have a variety of complications, which can have a serious adverse impact on their own and fetal health. This article elaborates on home protection and diet and exercise guidance for pregnant women with diabetes in order to provide guidance for pregnant women with diabetes in a special period, and further prevent and control the pneumonia epidemic caused by novel COVID-19 infection in pregnant women.展开更多
Introduction: Pregnancy can be a risk factor for dental diseases as oral tissues are liable to changes due to hormonal variations. High levels of secretion of progesterone predispose gums tissues to inflammation leadi...Introduction: Pregnancy can be a risk factor for dental diseases as oral tissues are liable to changes due to hormonal variations. High levels of secretion of progesterone predispose gums tissues to inflammation leading to gingivitis. Also, oral pathologies in pregnant women can adversely affect pregnancy outcomes. This may be because pro-inflammatory cytokines are released into the system of the pregnant woman, which can reach the womb, causing harm to the baby. Pathogenic bacteria can also get into circulation leading to septicemia. This can cause abortion, preterm delivery, low birth weight, pre-eclampsia and many others. There is a high prevalence of oral diseases in pregnant women in developing countries, but just a few of them actually access dental care services. This is more rampant in countries with no oral health programs and where oral health is not included in the antenatal care package. Lack of knowledge about the importance of oral health to pregnancy outcome, cost of dental treatment, as well as fear of the effect of dental treatment on pregnancy, are among the barriers to pregnant women not accessing dental care services during pregnancy. Objective: The main objective of the study was to assess the oral health status among pregnant women attending antenatal clinics in Bamenda. Methods: A cross-sectional community-based study was carried out on 295 pregnant women attending ANC in Nkwen, Mankon, and Bamendankwen, which have specialized dental units and so all these pregnan</sp.展开更多
BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant i...BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant impact on both maternal and child health.AIM To review summarizes HIV seroprevalence among pregnant women in Africa.It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.METHODS The study included pregnant women from any African country or region,irrespective of their symptoms,and any study design conducted in any setting.Using electronic literature searches,articles published until February 2023 were reviewed.The quality of the included studies was evaluated.The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa.Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity.Heterogeneity was assessed with Cochran's Q test and I2 statistics,and publication bias was assessed with Egger's test.RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis(meta-analysis).Out of the total studies,146(58.9%)had a low risk of bias and 102(41.1%)had a moderate risk of bias.No HIV-positive pregnant women died in the included studies.The overall HIV seroprevalence in pregnant women was estimated to be 9.3%[95%confidence interval(CI):8.3-10.3].The subgroup analysis showed statistically significant heterogeneity across subgroups(P<0.001),with the highest seroprevalence observed in Southern Africa(29.4%,95%CI:26.5-32.4)and the lowest seroprevalence observed in Northern Africa(0.7%,95%CI:0.3-1.3).CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant,particularly in Southern African countries.This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.展开更多
Background:Bacterial vaginosis(BV),a lower genital tract syndrome,has been linked to adverse pregnancy outcomes and is regarded as the prevalent type of vaginal infection in females of childbearing age.Objectives:To d...Background:Bacterial vaginosis(BV),a lower genital tract syndrome,has been linked to adverse pregnancy outcomes and is regarded as the prevalent type of vaginal infection in females of childbearing age.Objectives:To determine the accuracy of Nugent scoring and Gardnerella vaginalis culture in the diagnosis of bacterial vaginosis(BV)among pregnant women attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital,Nnewi,Nigeria.Method:This cross-sectional study evaluated biospecimen from 333 pregnant women enrolled through systematic random sampling technique.Biospecimens of vaginal discharge were tested for BV infection using Amsel’s criteria,Nugent’s score and culture of G.Vaginalis.Using Amsel’s criteria as a“gold standard”,the Nugent’s score and culture of G.vaginalis were estimated.Results:Prevalence of 26.12%,25.82% and 28.20% of BV was found using Amsel criteria,Nugent’s method and culture of G.vaginalis,respectively.No statistical relationship exists between socio-demographic characteristics and BV(P>0.05).Sexual exposure,and vaginal hygienic practices influences BV(P<0.05)infection and also with fishy odor during or after sexual intercourse,Gardnerella morphotypes,Bacteroides morphotypes and BV(P<0.05).An inverse relationship existed between lactobacilli morphotypes and BV.The prevalence of HIV was 5.41% and 16 out of 18 had BV diagnosed using Amsel criteria.Nugent method correlated strongly with Amsel criteria(P<0.05).In comparison with Amsel criteria,it had 78.16% sensitivity,92.68% specificity,79.07% positive predictive value,92.31% negative predictive value and 88.89% accuracy rate.This was in contrast distinction to the culture of G.vaginalis,which had 56.32%sensitivity,81.70% specificity,52.13% positive predictive value,84.10% negative predictive value and 75.08% accuracy rate.Conclusion:Nugent method correlated strongly with Amsel criteria(P<0.05)and had 78.16% sensitivity,92.68% specificity,79.07% positive predictive value,92.31% negative predictive value and 88.89% accuracy rate.Contrariwise,the culture of G.vaginalis had 56.32% sensitivity,81.70% specificity,52.13% positive predictive value,84.10% negative predictive value and 75.08% accuracy rate for BV diagnosis.展开更多
Objective:To understand the vitamin levels in pregnant women and its influencing factors and provide a basis for formulating scientific and reasonable vitamin supplement plans for pregnant women.Methods:Pregnant women...Objective:To understand the vitamin levels in pregnant women and its influencing factors and provide a basis for formulating scientific and reasonable vitamin supplement plans for pregnant women.Methods:Pregnant women with a pregnancy period of 12 weeks to 36 weeks in Baoding area were selected as the research subjects using the random sampling method.The sample size is estimated to be 5,000 people,and the diversity of the research subjects,such as age,education level,pregnancy,etc.,were recorded through a survey.The content of the survey included the personal information of the research subjects,pregnancy conditions,eating habits,vitamin supplements taken,etc.At the same time,blood tests were carried out on the research subjects to detect indicators such as vitamin levels.Results:The results of serum measurement showed that the vitamin A level of pregnant women was 0.38±0.12 mg/L,the vitamin E level was 13.51±3.17 mg/L,and the vitamin D level was 17.82±4.18 ng/L;the level of vitamin A of pregnant women in the first trimester was significantly lower than those in the second and third trimesters,and the level of vitamin E of pregnant women in second trimester was significantly higher than those in the first and third trimesters,with statistically significant differences(P<0.05).The rate of vitamin A deficiency in the early stage was significantly higher than that in the middle and late stages of pregnancy,(P<0.05);vitamin D deficiency existed in all pregnant women.Conclusion:Pregnant women should maintain a reasonable diet and eat more vitamin-rich foods,such as vegetables,fruits,etc.;besides,pregnant women should take vitamin supplements under the guidance of doctors or professionals according to their own conditions;moreover,the publicity and education for pregnant women should be improved with more emphasis on vitamin supplementation.展开更多
Background: Suicide rates in the United States have increased by 30% since 1999 and suicide is currently the 10th leading cause of death. Suicide has also become one of the leading causes of death in pregnant and post...Background: Suicide rates in the United States have increased by 30% since 1999 and suicide is currently the 10th leading cause of death. Suicide has also become one of the leading causes of death in pregnant and postpartum women. The aim of this study is to examine whether rurality affects the risk of suicide in pregnant and postpartum women. Methods: This study used data from the National Violent Death Reporting System, Restricted Access Dataset (2003-2012). Bivariate and multivariate analyses were used to first describe the pregnant and postpartum population versus non-pregnant females (ages 15 - 54), who all died by suicide, and then to examine urban-rural differences. Results: Rural suicide decedents were much older, married, less likely to have had a mental health diagnosis, and more likely to use a firearm. Recent intimate partner crisis and intimate partner problems were both associated with increased odds that the suicide decedent was pregnant or postpartum in both urban and rural counties, whereas presence of job problems and report of history of suicide attempt decreased the odds that the suicide decedent was pregnant or postpartum in both urban and rural counties. Multivariable polytomous logistic regression analyses revealed differences in suicide risk factors among pregnant, postpartum and non-pregnant decedents when stratified by rural and urban status. Conclusion: Our findings suggest that pregnant and postpartum women should be screened for risk of suicide, in the clinical setting, especially if there are intimate partner problems or a crisis. With proper identification and response, suicide in pregnant and postpartum women might be decreased.展开更多
基金sponsored by the Fujian Provincial Health Technology Project[2020CXA020]Fujian Provincial Natural Science Funding[2020J01093]Construction of Fujian Provincial Scientific and Technological Innovation Platform[2019Y2001]
文摘Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.
文摘Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors,and the impact of UI on daily life in pregnant and postpartum women in Nanjing,China.Methods:The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life.The associated factors were estimated by using logistic regression analysis.Results:UI affected 37.80%of pregnant women and 16.41%of postpartum women of the study population.Among the pregnant participants,the prevalence rates of stress UI,urge UI,and mixed UI were 25.77%,4.47%,and 7.10%,respectively.Among the postpartum women,the prevalence rates of stress UI,urge UI,and mixed UI were 11.15%,1.92%,and 2.69%,respectively.In both pregnant women and postpartum women,vaginal delivery had significantly increased the odds of reporting UI(p=0.007,p=0.003,respectively).The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment(p=0.000).Conclusion:The prevalence rates of UI were high in pregnant women in Nanjing,China.Vaginal delivery significantly increased odds of reporting UI.UI has a great impact on pregnant and postpartum women’s life,especially in social embarrassment.
文摘Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords “COVID-19”, “Pregnant Women” and “Depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% - 33.5% using EPDS ≥ 9 in three articles and 12.0% - 43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% - 48.7%, and seven articles reported 5.3% - 59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.
文摘Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.
文摘Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2<sup>nd</sup> trimester and 17 in 3<sup>rd</sup> trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1<sup>st</sup>-trimester visit, 23 in the 2<sup>nd</sup> trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2<sup>nd</sup> trimester and 2 in the 3<sup>rd</sup> trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1<sup>st</sup> ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.
文摘Background: Zambia has a population of 17.4 million people of which 48% are unable to meet their minimum calorie requirement and 35% of the children in Zambia are stunted (ZDHS, 2018). In the 2018 ZDHS report, 31% of women aged 15 - 49 had anaemia. Most cases of anaemia in pregnancy are due to micronutrient deficiency and maternal malnutrition. The 2020 Zambia Global Nutrition Report shows an increase in the prevalence of anaemia among women of reproductive age (45%) and low birth weight infants (13.0%) which suggested a need to explore determinants of pregnant women’s nutrition uptake in order to improve the nutritional status of pregnant women particularly those in Solwezi district of the north-western province of Zambia. Methods: An analytical cross-sectional study was conducted on antenatal mothers aged 15 - 49 accessing routine antenatal care from four selected health facilities in Solwezi district from July 2021 to February 2021. Cluster sampling method was used to select the 4 health facilities and the 98 antenatal mothers were selected using systematic sampling method. Data was collected using a pretested researcher-assisted semi-structured questionnaire and analyzed using the SPSS version 26. Chi-square test was used to determine associations between the independent and independent variables. The level of significance was set at 0.05 and the confidence interval was set at 95%. Multiple logistic regression analysis was done to predict associations among variables. Results: The findings revealed that a large proportion of respondents (71.4 %) had high knowledge regarding nutrition during pregnancy compared to (19.4%) and (9.2%) who expressed medium and low knowledge levels respectively. Attitude towards nutrition in pregnancy was positive in the majority, 82 (83.7%) of the respondents, and over half, (55%) of the respondents reported good nutrition uptake during pregnancy. Conclusions: In this study, nutrition uptake in pregnancy was significantly associated with women’s attitudes towards nutrition. It was also observed that more respondents who had a positive attitude towards nutrition had good nutrition uptake during pregnancy. We can therefore, conclude that the research study has revealed that majority of the respondents had high knowledge level and positive attitudes towards nutrition during pregnancy and only half of the respondents had good nutrition uptake during pregnancy which should be able to prompt all the stakeholders of health to focus their attention on behavioural change messages, policies and intervention in order to enhance good nutrition uptake among pregnant women.
文摘Human toxoplasmosis is caused by the intracellular protozoan parasite Toxoplasma gondii. Although T. gondii infection is generally asymptomatic for most of the immunocompetent adults, severe complications may occur particularly in pregnant women and immunocompromised individual. Host cell immunity plays a critical role in parasite differentiation and persistence in the host. Therefore, genetic polymorphism in the host immune genes, for instance interferon-γ gene could be linked with possibility of T. gondii infection. The objective of the study was to verify the link between the single nucleotide polymorphisms (SNPs) in the IFN-γ gene of pregnant women and T. gondii infection through correlating with anthropometric and sociodemographic parameters. In this study, ninety-two (N = 92) pregnant women (16 - 40 years) and healthy controls (N = 95) with similar age ranges were included. Among them, 25% (n = 23) pregnant women were seropositive for T. gondii IgG antibodies by Rapid Test Assay. Allelic and genotypic frequencies of IFN-γ +874T/A (rs2430561) SNPs were evaluated by using ARMS-PCR. The distribution of the A and T alleles in the specific position of the IFN-γ gene in the T. gondii-infected pregnant women and the control groups did not differ significantly, according to the data. However, we found a higher frequency (13.04%) of A/A genotype in T. gondii infected pregnant women as compared to non-infected individuals (8.70%), demonstrating that T. gondii infection susceptibility may be increased by homozygosity for the A allele. Further studies are to be needed to find out the link between host gene polymorphism and T. gondii infection in Bangladesh.
基金This study was reviewed and approved by the Ethics Committee of Suzhou Ninth People's Hospital.
文摘BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.
文摘Background: Accurate determination of gestational age has become important for deciding the appropriate time for termination of the pregnancy as well as to monitor the fetal growth during the entire period of pregnancy. Objective: The aim of the study was to assess whether the trans-cerebellar diameter, placental thickness or combining both of them is more accurate for assessment of gestational age in the 3<sup>rd</sup> trimester of pregnancy. Patients and Methods: This is a cross sectional study conducted at outpatient Clinic and Obstetric ward, Ain Shams University Maternity Hospital, over a period of six months from March 2019 to September 2019. One hundred pregnant women were recruited according to inclusion criteria either from outpatient clinic or were admitted in obstetric ward Ain Shams Maternity Hospital to find out the most accurate fetal biometric measurement in the third trimester either trans-cerebellar diameter placental thickness or both compared to reliable LMP (last menstrual period) dates confirmed by crown rump length (CRL) in the first trimester. Results: Trans-cerebellar diameter mean ± SD was 46.0 ± 3.5 with range 38.2 - 51.7. The mean of placental thickness was 39.6 ± 7.1 with range 22.8 - 54.3. Placental thickness had highest determination (0.813) for last menstrual period followed by trans-cerebellar diameter (0.802). Combining trans-cerebellar diameter and placental thickness increased determination (0.902) for last menstrual period. Conclusion: Combined use of trans-cerebellar diameter and placental thickness in the third trimester of pregnancy is a reliable indicator for gestational age in women whose last menstrual period is unreliable or unknown, but placental thickness had higher accuracy than trans-cerebellar diameter.
文摘Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.
文摘Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).
文摘Introduction: Arterial hypertension (AH) during pregnancy is defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg on two (2) successive visits separated by at least 4 hours in a woman who has been at rest for 10 to 15 minutes in the seated position and then in the left lateral decubitus position. The aim of this study was to determine the prevalence and types of arterial hypertension among pregnant women in the maternity ward of the CMC les Flamboyants. Methods: This was a prospective descriptive study lasting six (6) months, from 1 October 2021 to 31 March 2022, of all pregnant women and/or parturients admitted to the maternity ward of the CMC les Flamboyants with a resting blood pressure (BP) greater than or equal to 140/90 mm Hg during the study period. Results: During the study period, we recorded 707 cases of pregnant and/or parturient women, 50 (7.07%) of whom were hypertensive. The average age of the patients was 29 years, with extremes of 18 and 41 years. The 20 - 29 age group was the most affected, with 26 cases (52%). Headache, dizziness and oedema of the lower limbs were constant in all cases. The risk factors for arterial hypertension were dominated by familial hypertension in 19 cases (38%), multiple gestures in 17 cases (34%) and a history of gestational hypertension in 16 cases (32%). Gestational age between 28 and 36 weeks’ amenorrhoea was the most common, with 20 cases (40%). Type I hypertension was most common on admission, with 34 cases (68%), followed by type II hypertension, with 8 cases (16%). Pre-eclampsia was the most frequent maternal complication with 27 cases (54%) followed by eclampsia with 15 cases (30%). Fetal distress was the most frequent fetal complication, 19 cases (38%), followed by death in utero 9 cases (18%). Conclusion: Compliance with consultation programmes and correct patient follow-up could help reduce maternal-foetal complications.
文摘HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.
文摘Depressive disorder is a major contributor to years lived with disability (YLD) globally. It is estimated that 13% of all women experience the disorder in the first year postpartum. Postpartum depression (PPD) has significant implications to the physical and mental wellbeing of both the mother and her baby. Only non-depressed pregnant women (score of ≤ 6 on Edinburgh Postnatal Depression Scale) were recruited into this study. Data collection was done at 2 different stages;at recruitment stage (during the third trimester of pregnancy) and at the follow up stage (4<sup>th</sup> - 6<sup>th</sup> week postpartum). During the recruitment stage, intimate partner violence (IPV) and level of social support perception, among the women, were assessed using Hurt Insult Threaten Scream (HITS) and Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires respectively. While at the follow up stage, the Obstetric questionnaire and Mini International Neuropsychiatric Interview (MINI-7) were used respectively to obtain obstetric-related data and to diagnose for occurrence of depression. The incidence of PPD was found to be 16.34%. Several factors such as level of education, husband’s socioeconomic status, stressful life events, low perception of social support, obstetric instrumentation and not having a baby of preferred gender were significantly associated with PPD. Positive predictors of PPD included not practicing breast feeding (OR = 186.72, 95% CI = 8.32 - 4188.35), family history of mental illness (OR = 4.95, 95% CI = 1.04 - 23.81) and pregnancy lasting beyond 40 weeks (OR = 7.26, 95% CI = 1.51 - 34.88). High incidence of PPD with numerous associated but largely modifiable risk factors call for more proactive measures, such as PPD screening among pregnant women.
文摘Under the epidemic situation of novel COVID-19 pneumonia, pregnant women belong to the susceptible population, and their physiological and psychological conditions are particularly worthy of attention. Diabetes patients during pregnancy may have a variety of complications, which can have a serious adverse impact on their own and fetal health. This article elaborates on home protection and diet and exercise guidance for pregnant women with diabetes in order to provide guidance for pregnant women with diabetes in a special period, and further prevent and control the pneumonia epidemic caused by novel COVID-19 infection in pregnant women.
文摘Introduction: Pregnancy can be a risk factor for dental diseases as oral tissues are liable to changes due to hormonal variations. High levels of secretion of progesterone predispose gums tissues to inflammation leading to gingivitis. Also, oral pathologies in pregnant women can adversely affect pregnancy outcomes. This may be because pro-inflammatory cytokines are released into the system of the pregnant woman, which can reach the womb, causing harm to the baby. Pathogenic bacteria can also get into circulation leading to septicemia. This can cause abortion, preterm delivery, low birth weight, pre-eclampsia and many others. There is a high prevalence of oral diseases in pregnant women in developing countries, but just a few of them actually access dental care services. This is more rampant in countries with no oral health programs and where oral health is not included in the antenatal care package. Lack of knowledge about the importance of oral health to pregnancy outcome, cost of dental treatment, as well as fear of the effect of dental treatment on pregnancy, are among the barriers to pregnant women not accessing dental care services during pregnancy. Objective: The main objective of the study was to assess the oral health status among pregnant women attending antenatal clinics in Bamenda. Methods: A cross-sectional community-based study was carried out on 295 pregnant women attending ANC in Nkwen, Mankon, and Bamendankwen, which have specialized dental units and so all these pregnan</sp.
文摘BACKGROUND Human immunodeficiency virus(HIV)is a major public health concern,particularly in Africa where HIV rates remain substantial.Pregnant women are at an increased risk of acquiring HIV,which has a significant impact on both maternal and child health.AIM To review summarizes HIV seroprevalence among pregnant women in Africa.It also identifies regional and clinical characteristics that contribute to study-specific estimates variation.METHODS The study included pregnant women from any African country or region,irrespective of their symptoms,and any study design conducted in any setting.Using electronic literature searches,articles published until February 2023 were reviewed.The quality of the included studies was evaluated.The DerSimonian and Laird random-effects model was applied to determine HIV pooled seroprevalence among pregnant women in Africa.Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity.Heterogeneity was assessed with Cochran's Q test and I2 statistics,and publication bias was assessed with Egger's test.RESULTS A total of 248 studies conducted between 1984 and 2020 were included in the quantitative synthesis(meta-analysis).Out of the total studies,146(58.9%)had a low risk of bias and 102(41.1%)had a moderate risk of bias.No HIV-positive pregnant women died in the included studies.The overall HIV seroprevalence in pregnant women was estimated to be 9.3%[95%confidence interval(CI):8.3-10.3].The subgroup analysis showed statistically significant heterogeneity across subgroups(P<0.001),with the highest seroprevalence observed in Southern Africa(29.4%,95%CI:26.5-32.4)and the lowest seroprevalence observed in Northern Africa(0.7%,95%CI:0.3-1.3).CONCLUSION The review found that HIV seroprevalence among pregnant women in African countries remains significant,particularly in Southern African countries.This review can inform the development of targeted public health interventions to address high HIV seroprevalence in pregnant women in African countries.
文摘Background:Bacterial vaginosis(BV),a lower genital tract syndrome,has been linked to adverse pregnancy outcomes and is regarded as the prevalent type of vaginal infection in females of childbearing age.Objectives:To determine the accuracy of Nugent scoring and Gardnerella vaginalis culture in the diagnosis of bacterial vaginosis(BV)among pregnant women attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital,Nnewi,Nigeria.Method:This cross-sectional study evaluated biospecimen from 333 pregnant women enrolled through systematic random sampling technique.Biospecimens of vaginal discharge were tested for BV infection using Amsel’s criteria,Nugent’s score and culture of G.Vaginalis.Using Amsel’s criteria as a“gold standard”,the Nugent’s score and culture of G.vaginalis were estimated.Results:Prevalence of 26.12%,25.82% and 28.20% of BV was found using Amsel criteria,Nugent’s method and culture of G.vaginalis,respectively.No statistical relationship exists between socio-demographic characteristics and BV(P>0.05).Sexual exposure,and vaginal hygienic practices influences BV(P<0.05)infection and also with fishy odor during or after sexual intercourse,Gardnerella morphotypes,Bacteroides morphotypes and BV(P<0.05).An inverse relationship existed between lactobacilli morphotypes and BV.The prevalence of HIV was 5.41% and 16 out of 18 had BV diagnosed using Amsel criteria.Nugent method correlated strongly with Amsel criteria(P<0.05).In comparison with Amsel criteria,it had 78.16% sensitivity,92.68% specificity,79.07% positive predictive value,92.31% negative predictive value and 88.89% accuracy rate.This was in contrast distinction to the culture of G.vaginalis,which had 56.32%sensitivity,81.70% specificity,52.13% positive predictive value,84.10% negative predictive value and 75.08% accuracy rate.Conclusion:Nugent method correlated strongly with Amsel criteria(P<0.05)and had 78.16% sensitivity,92.68% specificity,79.07% positive predictive value,92.31% negative predictive value and 88.89% accuracy rate.Contrariwise,the culture of G.vaginalis had 56.32% sensitivity,81.70% specificity,52.13% positive predictive value,84.10% negative predictive value and 75.08% accuracy rate for BV diagnosis.
基金Medical Science Research Project of Hebei Provincial Health and Health Commission,Epidemiological Investigation of Vitamin A,D,and E Levels of Pregnant Women in Baoding Area(Fund number:20190947)。
文摘Objective:To understand the vitamin levels in pregnant women and its influencing factors and provide a basis for formulating scientific and reasonable vitamin supplement plans for pregnant women.Methods:Pregnant women with a pregnancy period of 12 weeks to 36 weeks in Baoding area were selected as the research subjects using the random sampling method.The sample size is estimated to be 5,000 people,and the diversity of the research subjects,such as age,education level,pregnancy,etc.,were recorded through a survey.The content of the survey included the personal information of the research subjects,pregnancy conditions,eating habits,vitamin supplements taken,etc.At the same time,blood tests were carried out on the research subjects to detect indicators such as vitamin levels.Results:The results of serum measurement showed that the vitamin A level of pregnant women was 0.38±0.12 mg/L,the vitamin E level was 13.51±3.17 mg/L,and the vitamin D level was 17.82±4.18 ng/L;the level of vitamin A of pregnant women in the first trimester was significantly lower than those in the second and third trimesters,and the level of vitamin E of pregnant women in second trimester was significantly higher than those in the first and third trimesters,with statistically significant differences(P<0.05).The rate of vitamin A deficiency in the early stage was significantly higher than that in the middle and late stages of pregnancy,(P<0.05);vitamin D deficiency existed in all pregnant women.Conclusion:Pregnant women should maintain a reasonable diet and eat more vitamin-rich foods,such as vegetables,fruits,etc.;besides,pregnant women should take vitamin supplements under the guidance of doctors or professionals according to their own conditions;moreover,the publicity and education for pregnant women should be improved with more emphasis on vitamin supplementation.
文摘Background: Suicide rates in the United States have increased by 30% since 1999 and suicide is currently the 10th leading cause of death. Suicide has also become one of the leading causes of death in pregnant and postpartum women. The aim of this study is to examine whether rurality affects the risk of suicide in pregnant and postpartum women. Methods: This study used data from the National Violent Death Reporting System, Restricted Access Dataset (2003-2012). Bivariate and multivariate analyses were used to first describe the pregnant and postpartum population versus non-pregnant females (ages 15 - 54), who all died by suicide, and then to examine urban-rural differences. Results: Rural suicide decedents were much older, married, less likely to have had a mental health diagnosis, and more likely to use a firearm. Recent intimate partner crisis and intimate partner problems were both associated with increased odds that the suicide decedent was pregnant or postpartum in both urban and rural counties, whereas presence of job problems and report of history of suicide attempt decreased the odds that the suicide decedent was pregnant or postpartum in both urban and rural counties. Multivariable polytomous logistic regression analyses revealed differences in suicide risk factors among pregnant, postpartum and non-pregnant decedents when stratified by rural and urban status. Conclusion: Our findings suggest that pregnant and postpartum women should be screened for risk of suicide, in the clinical setting, especially if there are intimate partner problems or a crisis. With proper identification and response, suicide in pregnant and postpartum women might be decreased.
