Effects of prenatal education on complaints during pregnancy and on quality of life

The effect of educational intervention on the quality of life of women suffering from pregnancy-related nausea and vomiting: a systematic review

OBJECTIVE

The present study aimed to determine the influence of educational interventions on improving the quality of life (QOL) of women suffering from pregnancy-related nausea and vomiting (NVP) as a systematic review.

METHODS

The current systematic review followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guideline. The English electronic databases were used to identify relevant studies published 2000 until 14 August 2023. The search strategies employed were based on Mesh browser keywords and free-text words. The study risk of bias was evaluated using the Cochrane Collaboration's tool for assessing the risk of bias tools and publication bias was evaluated using a funnel plot and Begg and Egger tests. The heterogeneity of the studies was evaluated using I2 and tau-squared tests. Data were analyzed using the RevMan 5 software. Results of the random-effects meta-analysis were presented using the standard mean difference, along with a 95% confidence interval (CI).

RESULTS

Out of the seven randomized clinical/control trial (RCT) studies with a total of 946 subjects included in the review, five studies reported a significant result, indicating that the interventions had a statistically significant effect on the QOL of women suffering NVP and in two studies did not have a significant result. A subgroup analysis was done based on the type of quality-of-life measurements. The pooled standardized mean difference (SMD) of four articles (Nausea and Vomiting Pregnancy Quality of Life, NVPQOL) with a total of 335 subjects was -2.91, and CI of -4.72 to -1.11, p value = .002, I2 = 97.2%. The pooled SMD of three articles (SF36) with a total of 611 subjects was -0.05, and CI of -0.23 to -0.12, p value = .550, I2 = 10%.

CONCLUSIONS

The overall results of the analysis indicated that educational intervention had a small positive impact on the QOL of women experiencing NVP. However, to draw a better conclusion, it is recommended to conduct further studies with larger sample sizes and longer follow-up periods.

Impact of no publicly accessible prenatal education programming on patients and their care providers: a descriptive qualitative study in Nova Scotia, Canada

OBJECTIVE

Patients in Nova Scotia do not have access to public prenatal education programming. This study aimed to explore whether care providers find patients are uninformed or misinformed, and the impact of that on patients and their care providers with a focus on clinical outcomes, time, resources and informed decision-making.

METHODS

Semistructured interviews were conducted with 13 care providers around Halifax and Cape Breton. An interview guide (supplemental) of open-ended questions was used for consistency. A descriptive qualitative approach was employed to describe the contents of the interviews. Each interview was audio-taped and transcribed verbatim by an interdependent transcriber. Transcripts were analysed using established techniques in qualitative descriptive research including coding, grouping, detailing and comparing the data using NVivo V.12 software. A co-coder (SS) independently coded two interviews for inter-rater reliability.

RESULTS

The study revealed six themes: (1) concern for a significant population of Nova Scotians experiencing pregnancy, birth and postpartum uninformed and misinformed, (2) consequences for patients who are uninformed and misinformed, (3) more time and resources spent on care for patients who are uninformed or misinformed, (4) patients and their care providers need a publicly available education programme, particularly vulnerable populations, (5) emphasis on programme quality and disappointment with the programme previously been in place and (6) recommendations for an effective prenatal education programme for Nova Scotians.

CONCLUSIONS

This study shows care providers believe a public prenatal education programme could improve health literacy in Nova Scotia. Patients are seeking health education, but it is not accessible to all and being uninformed or misinformed negatively impacts patients' experiences and outcomes. This study revealed excess time and resources are being spent on individualised prenatal education by care providers with high individual and system-wide cost and explored the complicated process of providing patient-centred care for people who are uninformed or misinformed.

Haemorrhoids and Anal Fissures in Pregnancy: Predictive Factors and Effective Treatments

Introduction Haemorrhoids and anal fissures (HAF) are common in pregnancy and can severely affect the quality of life of those suffering from them. Despite the condition being common, there is limited evidence, formal guidelines or recommendations on treatment, and little is known about the natural course during pregnancy. Methods This was a prospective, observational cohort study conducted at a tertiary-referral university maternity hospital (The National Maternity Hospital, Dublin), conducted over a nine-month period. The first part of the study was a case-control study of antenatal patients over 34 weeks' gestation. The second part of the study involved a cohort of postnatal patients. Anonymous patient surveys were performed and analysed. Results Two hundred and fifty-eight patients were recruited into the study from the outpatient clinics and wards of one maternity hospital from April to December 2021. Of the antenatal patients, 82/184 (45%) of these patients had symptoms of HAF and 102/184 (55%) antenatal patients were unaffected, acting as controls. In addition, 74 affected postnatal patients were also included. In the affected antenatal group, 36/82 (44%) of patients had self-reported HAF (symptoms or signs of HAF); 50/82 (61%) of patients diagnosed with HAF on their own. 12/82 (15%) noticed symptoms in the first trimester, 25/82 (30%) in the second and 45/82 (55%) in the third. 142/184 (77%) of antenatal patients used conservative methods to manage their symptoms, including an increase in dietary fibre. 144/184 (78%) used medical treatments including suppositories. Only one patient had surgery. 70/156 (45%) of postnatal patients' symptoms resolved within days, 42/156 (27%) in weeks and 44/156 (28%) within months. Conclusion HAF affect almost half of the pregnancies. Age over 35 was significantly associated with antenatal haemorrhoids or anal fissures. Concerningly, the majority of patients (64%) self-diagnose and manage the condition without either seeking or receiving guidance from medical professionals. In terms of the natural course of the disease, it was encouraging that 45% of patients' symptoms resolved within a few days. This will help when counselling patients with distressing symptoms. Conservative measures such as increased dietary fibre, increased fluid intake and bath salts were effective in relieving symptoms for the majority of patients.

Exploring women's self-reported health problems in pregnancy in the UK and Norway

Women usually conceptualize pregnancy as a normal physiological state. In contrast, formal maternity care provision tends to be focused on pathology and risk. The authors aim to explore the extent to which childbearing women apply a sickness lens to pregnancy. We have therefore examined antenatal problems spontaneously reported by 4,000 UK and Norwegian women who responded to the international social media-based Babies Born Better survey. We coded and classified the free-text comments of the respondents as either complaint or disease. We found striking differences in the rates and types of problems reported by the women. We discuss our findings by applying different perspectives of medicalization and of lay and biomedical knowledge.

COVID-19 Impact on Group Prenatal Education: A Comparison of Virtual and In-Person Formats

This retrospective study compared knowledge, intention, and satisfaction outcomes between pregnant women who attended prenatal education in person (n = 202; 55%) prior to the COVID-19 pandemic or virtually (n = 166; 45%) during the pandemic. Results identified increases in knowledge and intention for a healthy pregnancy and safe infant care for both groups. Virtual participants were less likely to endorse developing a birth plan (p = 0.035), knowledge of breastfeeding resources (p = 0.006), confidence in the ability to breastfeed (p = 0.033), and plans to use only a safe infant sleep location (p = 0.045). Important education was provided by continuing Baby Talk during the pandemic. However, topics with activities/demonstrations during in-person learning that were discontinued for virtual learning had significantly lower increases for virtual participants. Virtual education should incorporate more demonstrations/activities.

Quality of Life During Pregnancy from 2011 to 2021: Systematic Review

Purpose

Health-related quality of life (HRQoL) has emerged as a key concern in patient care. It has become one of the major objectives of clinical trials. Our study aims to describe the quality of life (QoL) during uncomplicated pregnancy and to assess its associated factors.

Patients and Methods

The search of articles was carried out using the online database of PUBMED and Web of Science with a limit of time between 2011 and 2021. Data were retrieved by two independent reviewers.

Results

721 publications responding to keywords were identified, of which 73 articles on the topic were selected. The main countries that have published on this subject are Australia (n = 10) and China (n = 7). Twenty-three articles deal with QoL for pathological pregnancies. All the pathologies studied have a negative impact on the HRQoL of pregnant women, and its improvement depends on the type of treatment. Obesity, low back, and pelvic girdle pain, and hyperemesis gravidarum were the frequent pathologies during pregnancy. Socio-demographic characteristics related to improved well-being (favorable economic status, social support). Similarly, better sleep quality and moderate physical exercise were linked to an increased QoL. Physical and psychological factors were associated with a lower QoL.

Conclusion

The HRQoL refers to patients’ subjective evaluation of physical, mental, and social components of well-being. Optimizing the QoL during pregnancy necessitates a deeper understanding of their issues as well as counseling which provides support wherever needed.

[Fatigue relief by aromatherapy use in prenatal and postnatal women: a systematic review and meta-analysis]

Purpose

The purpose of this systematic review was to examine aromatherapy interventions for prenatal and postnatal women, and to determine the effectiveness of these interventions on fatigue.

Methods

Six national and international databases were reviewed to retrieve and collect studies published up to September 7, 2021, describing randomized controlled trials and controlled clinical trials of aromatherapy interventions for prenatal and postnatal women's fatigue. Of the 323 articles initially identified, 64 duplicates were excluded and 259 were screened. After further excluding 216 articles not related to PICO framework, 10 were selected for review. Two reviewers independently selected studies and conducted data extraction and quality appraisal using Cochran's Risk of Bias and Risk of Bias Assessment Tool for Non-randomized Studies.

Results

The quality of the 10 selected studies was overall satisfactory. A meta-analysis of three studies showed that aromatherapy with lavender oil? produced a 0.75-point reduction in postnatal mothers' fatigue when compared to control groups. Sleep quality was also analyzed as a secondary outcome of fatigue. A meta-analysis of four studies using lavender and/or orange peel oil found that aromatherapy produced a 0.98-point improvement in postnatal mothers' quality of sleep. Although a meta-analysis could not be conducted to synthesize the findings for fatigue in pregnant women, inhalation and massage therapy using lavender oil showed positive effects on prenatal fatigue and sleep quality.

Conclusion

Aromatherapy using lavender oil and orange peel oil is effective in improving prenatal and postnatal fatigue and sleep quality.

Relationship of spiritual wellbeing with life expectancy and quality of life for patients living with heart failure

Aim: Spirituality is a crucial dimension in human health. However, it is often overlooked in patients with heart failure (HF) in Iran. Thus, the purpose of this study was to determine the relationship between spiritual wellbeing, life expectancy and quality-of-life (QOL) in patients with HF. Methods: This cross-sectional study was performed with 150 HF patients, who were enrolled through convenience sampling. Data were collected using a questionnaire comprising four parts: the Minnesota Living with Heart Failure Questionnaire, Schneider's life expectancy instrument, Ellison's and Paulotzin's (1982) Spiritual Well-Being Scale, and a demographic checklist. SPSS software was used for data analysis. Results: In this study, mean and standard deviation of QOL, life expectancy and spiritual wellbeing were 41.82±19.17, 30.20±4.58 and 87.80±5.28 respectively. There was a significant relationship between spiritual wellbeing and quality of life (r=-0.633, P<0.001) and also life expectancy (r=0.544, P<0.001). Quality of life and life expectancy were significantly higher in men than in women. Linear regression tests showed that the existential and religious dimensions of spirituality could influence 44.9% of the QOL variance (F=54.54, P<0.001) and increased values of existential spirituality would improve QOL by an average of 3.45 units. Improving life expectancy also raised QOL by 14.0% (F=21.26, P<0.001). This study also demonstrated that life expectancy is impacted by spiritual health, with a variance of 34.2%, in which the role of existential-spiritual health is of particular significance (t=7.10, P<0.001). Conclusion: The results revealed that spiritual wellbeing, especially the existential type, enhances life expectancy and quality-of-life among HF patients. Therefore, it is recommended that healthcare professionals design a comprehensive and supportive care model for the promotion of spiritual wellbeing in HF patients.

Effectiveness of aromatherapy versus standard care on physiological and psychological symptoms in pregnant women: a systematic review protocol

OBJECTIVE

This review aims to evaluate the effectiveness of aromatherapy versus standard care on common physiological and psychological symptoms in low-risk pregnant women.

INTRODUCTION

Women report common symptoms that result from anatomical and physiological changes significant for fetal development and maternal-fetal protection during pregnancy. Aromatherapy is an integrative and complementary practice of ancient origin that works through the administration of essential oils. The practice is used to promote physical and psychological well-being.

INCLUSION CRITERIA

This systematic review will include studies on healthy pregnant women before labor who received aromatherapy as antenatal care for common physiological and psychological symptoms. Randomized clinical trials, quasi-experimental studies, cohort, and case-control studies will be included. This review will exclude studies that focus on women in labor unless data relating to pregnant women can be separated.

METHODS

The searches will be carried out on the following databases: MEDLINE, Scopus, CINAHL, Web of Science, CENTRAL, PsycINFO, LILACS, BDENF, CUIDEN, and MOSAICO in Portuguese, English, and Spanish, with no time limit. The searches for unpublished studies will be carried out on the following repositories: ProQuest Dissertations and Theses, Brazilian Digital Library of Theses and Dissertations, British Library EThOS, and the Canadian Theses and Dissertation Portal. The JBI approach will be used for study selection, critical evaluation, data extraction, and synthesis.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020218730.

Self-perceived evaluation of prenatal care: a hierarchical analysis by the users of Primary Health Care services in Brazil

Abstract Objective: to analyze the factors associated with positive self-perceived evaluation of prenatal care among users of Primary Health Care (PHC). Methods: the analytical cross-sectional study was carried out with secondary data from the 3rd Module of the 2nd cycle (2013 / 2014) of the External Evaluation of the Improvement of Access and Quality of Primary Care Program (PMAQ-AB – Portuguese acronym), collected from users in the Basic Health Units (BHU) that joined the PMAQ-AB in Brazil. The hierarchical analysis was performed using a theoretical model and logistic regression was performed between the self-perceived evaluation (positive - very good/good or negative - regular/poor/very bad) and the sociodemographic characteristics, prenatal care and health service evaluation (p<0.05). Results: the sample consisted of 9,922 women and 81.7% rated care as very good/good. In the final model, positive evaluation was associated to women with incomplete higher education or over (OR=1.05; CI95%=1.01-1.09; p=0.010), who underwent the VDRL exam (OR=1.07; CI95%=1.01-1.14; p=0.020), consultation with the same professional (OR=1.07; CI95%=1.02-1.12; p=0.010), received guidance on the gynecological preventive exam (OR=1.05; CI95%=1.01-1.08; p=0.007), believed that guidance helped with pregnancy and child care (OR=1.24; CI95%=1.05-1.46; p=0.012), evaluated the BHU structure as very good/good (OR=1.19; CI95%=:1.14-1.24; p<0.001) and would not change BHU or team (OR=1.62; CI95%=1.48-1.68; p<0.001). Conclusion: the positive evaluation of prenatal care was associated with sociodemographic factors, prenatal care and health service evaluation.

Prenatal Depression in Women in the Third Trimester: Prevalence, Predictive Factors, and Relationship With Maternal-Fetal Attachment

Objective: The prevalence of prenatal depression in pregnant women has found to be high, which may adversely affect the intimacy of a mother to her fetus. Few studies have investigated the relationship between prenatal depression and maternal-fetal attachment in pregnant Chinese women. This study is thus designed to evaluate the prevalence rate, predictive factors of prenatal depression in Chinese pregnant women in the third trimester of pregnancy, and the effect of prenatal depression on maternal-fetal attachment.

Methods: A total of 340 pregnant women in the third trimester of pregnancy were recruited from a hospital in Anhui Province. The Edinburgh Postpartum Depression Scale (EPDS) was rated to assess the prenatal depression; the Pittsburgh Sleep Quality Index (PSQI) and Zung Self-Rating Anxiety Scale (SAS) were used to assess sleep quality and anxiety level for all participants. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal-fetal attachment.

Results: The prevalence of prenatal depression in the participants was high (19.1%) in our study. The scores of prenatal anxiety and sleep disorders were higher with prenatal depression than in those without prenatal depression (47.6 ± 9.5 vs. 38.9 ± 6.9; 8.3 ± 3.3 vs. 6.1 ± 2.7, all p < 0.01). MAAS quality was lower in prenatal depression women than those in non-prenatal depression women (43.8 ± 5.6 vs. 46.4 ± 4.5, p < 0.01). Correlation analysis showed that prenatal depression was associated with parity, prenatal education, education level, marital satisfaction, anxiety and sleep disorders (all p < 0.05). Furthermore, binary logistic regression results showed that anxiety and sleep disorders were risk factors for prenatal depression. Prenatal education, higher marriage satisfaction were protective factors for prenatal depression. In addition, correlation analysis also showed that prenatal depression was positively correlated with MAAS intensity, but negatively correlated with MAAS quality.

Conclusions: Our results indicated a high prevalence of prenatal depression in women in the third trimester. Prenatal education and higher marital satisfaction were protective factors for prenatal depression; antenatal anxiety and sleep disorders during pregnancy were risk factors for prenatal depression. Prenatal depression was negatively correlated with MAAS quality, but positively correlated with MAAS intensity.

Socioeconomic Status in Pregnant Women and Sleep Quality During Pregnancy

This review focuses on factors contributing to sleep quality among pregnant women with low socioeconomic statuses during the third trimester of their pregnancy. Electronic searches were conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched for published, peer reviewed, English language primary research articles using electronic databases including PubMed, EMBASE, Ovid, MEDLINE and Google Scholar ending June 2019. All references were reviewed manually and independently by authors. After applying the inclusion criteria, 56 articles were selected; 38 of which are full-text and included in this review. All articles related to the analysis of poor sleep quality among uncomplicated pregnant women were included. Pregnant women with a specific pathology were excluded.

We found poor sleep quality among pregnant women is correlated with low socioeconomic levels. Pregnant women with lower incomes tend to have inadequate diets, which further complicates the health of the mother and the baby. External factors including low income, poor quality of life and poor diet tend to increase the possibility of future health complications in both mother and child, and can result in complications such as preterm labor, low birth weight, preeclampsia, perinatal death, and spontaneous abortion.

Mothers' and fathers' cognitive and affective responses to epigenetics concepts

Advances in our understanding of epigenetics present new opportunities to improve children's health through the counseling of parents about epigenetics concepts. However, it is important to first evaluate how parents respond to this type of information and determine the consequences of educating parents about epigenetics. We have taken an initial step toward this goal by assessing parental responses to an epigenetics learning module. Parents (n = 190, 126 mothers) responded to pre- and post-module survey questions. Prior to the module, parents reported that mothers' lifestyles prior to conception were more important for children's health than fathers' lifestyles prior to conception (t = 4.49, df = 316.5, P < 0.0001). However, after the module, there was no difference between ratings of the importance of mothers' and fathers' preconception lifestyles (t = 1.18, df = 319.8, P = NS). Furthermore, after viewing the module, parents increased their ratings of the importance of both mothers' (t = -5.65, df = 294.8, P < 0.0001) and father's (t = -9.01, df = 287.2, P < 0.0001) preconception lifestyles for child health. After viewing the module, most parents reported feelings of guilt and negativity regarding epigenetics (78 and 55%, respectively). When compared with lean parents, parents with overweight more often reported feelings of guilt (χ ² =10.27, P = 0.001). This work represents an important first step in evaluating parental responses to epigenetics concepts.