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Laudańska-Krzemińska I, Krzysztoszek J. Physical activity promotion among pregnancy - the role of physician from the women's perspective. Front Public Health 2024; 12:1335983. [PMID: 38487188 PMCID: PMC10937457 DOI: 10.3389/fpubh.2024.1335983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The clear benefits of planned and supervised physical activity (PA) during pregnancy make it imperative that women are encouraged and educated about this activity. This study aimed to investigate how effectively physician promote physical activity and exercise among pregnant women. It also examines pro-health changes in selected health behaviours during pregnancy. Methods This cross-sectional study recruited a total of 353 pregnant women in Wielkopolskie Voivodship in Poland. An anonymous survey (on-line or in-paper) was used to assess physical activity before and during pregnancy (with Pregnancy Physical Activity Questionnaire), physical activity self-efficacy, well-being (WHO-5 Well-Being Index), and guidance received from physicians on physical activity during pregnancy. Results Only 41% of women surveyed followed WHO recommendations for PA before pregnancy, and they were much more likely to discuss safety and the need to change the intensity or type of PA with their doctor or gynaecologist. Only 23% of women were asked about their PA before pregnancy and less than 40% were encouraged to be active during pregnancy. We observed a higher probability of poor well-being among pregnant women who were inactive before pregnancy (OR = 1.873, 95%CI 1.026 to 3.421, p = 0.041). Conclusion Health professionals infrequently educate and motivate women to be physically active during pregnancy. Physician advice, as it is currently perceived by women, seems to be insufficient to help pregnant women meet the recommendations for PA during pregnancy.
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Affiliation(s)
- Ida Laudańska-Krzemińska
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Poznan, Poland
| | - Jana Krzysztoszek
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Poznan, Poland
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A review of current knowledge about the importance of iodine among women of child-bearing age and healthcare professionals. J Nutr Sci 2022; 11:e56. [PMID: 35836700 PMCID: PMC9274385 DOI: 10.1017/jns.2022.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
Iodine is required for thyroid hormone synthesis and fetal neurogenesis. Recent population studies in the United Kingdom (UK) have found iodine deficiency among schoolgirls, women of child-bearing age and pregnant women. This review explores knowledge and awareness of iodine among women of child-bearing age and healthcare professionals (HCPs) in the UK, set within a global context. We aimed to identify gaps in iodine knowledge in the current UK setting of iodine deficiency without iodine fortification and where iodine is not included in antenatal guidelines. The search terms ‘iodine knowledge’ and ‘iodine awareness’ were used to identify relevant papers. Iodine knowledge is poor among women of child-bearing age in the UK according to four studies using questionnaires and qualitative methods. They were unsure of dietary sources of iodine and were not consistently provided with relevant information from HCPs during clinical care. Midwives have been recognised as the main providers of dietary information during pregnancy and, although they recognised the importance of their role in providing nutrition advice, they did not feel equipped to do so and lacked confidence in addressing nutritional concerns. Globally, there was a similar lack of knowledge, however, this was somewhat improved by the inclusion of iodine in antenatal care guidelines. Midwives’ knowledge of iodine was poor, as was knowledge among women of child-bearing age. Improved HCP knowledge and effective communication of information to pregnant women and women planning to conceive may help to improve iodine status which is of particular concern in pregnancy.
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Koivuniemi E, Hart K, Mazanowska N, Ruggeri S, Egan B, Censi L, Roccaldo R, Mattila L, Buonocore P, Löyttyniemi E, Raats MM, Wielgos M, Laitinen K. Food Supplement Use Differs from the Recommendations in Pregnant Women: A Multinational Survey. Nutrients 2022; 14:2909. [PMID: 35889867 PMCID: PMC9322729 DOI: 10.3390/nu14142909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/01/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use.
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Affiliation(s)
- Ella Koivuniemi
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Kathryn Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK;
| | - Natalia Mazanowska
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Stefania Ruggeri
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Bernadette Egan
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Laura Censi
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Romana Roccaldo
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Lilja Mattila
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
| | - Pasquale Buonocore
- Council for Agricultural Research and Economics (CREA), Research Centre for Food and Nutrition, 00178 Rome, Italy; (S.R.); (L.C.); (R.R.); (P.B.)
| | - Eliisa Löyttyniemi
- Biostatistics, Department of Clinical Medicine, University of Turku, 20014 Turku, Finland;
| | - Monique M. Raats
- Food, Consumer Behaviour and Health (FCBH) Research Centre, University of Surrey, Guildford GU2 7XH, UK; (B.E.); (M.M.R.)
| | - Miroslaw Wielgos
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland; (N.M.); (M.W.)
| | - Kirsi Laitinen
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, University of Turku, 20014 Turku, Finland; (L.M.); (K.L.)
- Functional Foods Forum, University of Turku, 20014 Turku, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, 20521 Turku, Finland
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Avram C, Bucur OM, Zazgyva A, Avram L, Ruta F. Vitamin Supplementation in Pre-Pregnancy and Pregnancy among Women-Effects and Influencing Factors in Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8503. [PMID: 35886354 PMCID: PMC9318761 DOI: 10.3390/ijerph19148503] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
Introduction: The aim of the study was to identify the consumption of vitamin and folic acid supplements before and during pregnancy in a group of post-partum women (Romanian, Hungarian, and Roma) from Mureș County, Romania, and the influence of socio-economic and behavioral factors on the consumption of vitamins. Materials and Methods: This cross-sectional questionnaire-based study included 1278 post-partum women (during the three days of hospitalization for birth), average age 29.5, registered for giving birth in the three hospitals in Mureș County, 2015−2016. Results: In our sample, 69.58% of the interviewed women did not use any vitamin and folic acid supplements before pregnancy, while 30.70% did not use vitamin supplements during pregnancy. The lack of vitamin supplementation during pregnancy was associated with the low birth weight (<2500 g) of newborns (OR = 2.4, 95% CI [1.6−3.8]) and birth at under 36 weeks of gestation (OR = 0.5, 95% CI [0.2−0.8]). Conclusion: The use of vitamin supplements, including folic acid, continues to be deficient among Romanian women before getting pregnant, as well as during their pregnancy. We observed a lack of vitamin supplementation for pregnant women even if they were influenced by risk factors. This highlights the importance of promoting the benefits of vitamin supplementation equally among all subjects.
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Affiliation(s)
- Calin Avram
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gh. Marinescu St., 540139 Targu Mureș, Romania; (A.Z.); (F.R.)
| | - Oana Maria Bucur
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gh. Marinescu St., 540139 Targu Mureș, Romania; (A.Z.); (F.R.)
| | - Ancuța Zazgyva
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gh. Marinescu St., 540139 Targu Mureș, Romania; (A.Z.); (F.R.)
| | - Laura Avram
- Dimitrie Cantemir University, 3-5 Bodoni Sandor St., 540545 Targu Mureș, Romania;
| | - Florina Ruta
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gh. Marinescu St., 540139 Targu Mureș, Romania; (A.Z.); (F.R.)
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Kim HW, Kang SY, Kim J. Factors influencing adolescents' healthy pregnancy preparation behavior: a cross-sectional gender comparison applying the health belief model. Reprod Health 2022; 19:90. [PMID: 35382837 PMCID: PMC8985308 DOI: 10.1186/s12978-022-01392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interventions to prepare for a healthy pregnancy from an early age can ensure the health of both mother and child. This study aims to compare the factors associated with healthy pregnancy preparation behavior (HPPB) among male and female adolescents. METHODS A total of 690 Korean adolescents participated in this cross-sectional study from July 11 to August 24, 2018. Determinants of the likelihood of engaging in HPPB were described using hierarchical regression about the importance of and confidence in HPPB, the gender equality related to pregnancy and birth, and the health belief model (HBM) constructs about HPPB. RESULTS Smoking experience (β = - 0.18, p < 0.001 for boys, β = - 0.25, p < 0.001 for girls), and HBM constructs were identified as factors correlated with HPPB in both genders. The significant factors in boys were perceived susceptibility (β = - 0.13, p = 0.005), perceived severity (β = 0.12, p = 0.015), perceived benefits (β = 0.23, p < 0.001), and perceived barriers (β = - 0.18, p < 0.001), whereas the corresponding factors in girls were perceived severity (β = 0.20, p = 0.001), and perceived barriers (β = - 0.23, p < 0.001). The importance of HPPB was identified as a factor only among girls (β = 0.19, p = 0.005), while confidence in HPPB (β = 0.12, p = 0.401), gender equality related to pregnancy and childbirth (β = - 0.20, p = 0.001 for women's responsibility variable, β = 0.14, p = 0.018 for men's responsibility variable), and alcohol (β = - 0.10, p = 0.022) were factors identified only among boys. CONCLUSIONS The gender differences in opinions on HPPB identified in this study can help nurses and community health care professionals recognize issues for which they can develop and implement preventive interventions. For healthy pregnancy preparation, interventions based on HBM constructs and smoking should be presented for both male and female adolescents. Imparting education to females on the importance of HPPB and to males on confidence in HPPB, gender equality related to pregnancy and childbirth, and alcohol consumption, should be emphasized. In addition, as perceived susceptibility may be low in a disease prevention model using the health belief model, it is necessary to prioritize increasing the perceived susceptibility of school-age children as an intervention.
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Affiliation(s)
- Hae Won Kim
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, 03080, Republic of Korea
| | - Saem Yi Kang
- College of Nursing, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Jieun Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Corrales-Gutierrez I, Baena-Antequera F, Gomez-Baya D, Leon-Larios F, Mendoza R. Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities. Nutrients 2022; 14:nu14030557. [PMID: 35276912 PMCID: PMC8839613 DOI: 10.3390/nu14030557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child's. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies.
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Affiliation(s)
- Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, University of Seville, 41009 Seville, Spain
| | - Francisca Baena-Antequera
- Obstetric Unit, University Hospital Virgen de Valme, 41014 Seville, Spain
- Nursing Department, Osuna’s University School, 41640 Osuna, Spain
- Correspondence: ; Tel.: +34-615-51-95-65
| | - Diego Gomez-Baya
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Ramon Mendoza
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
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Been JV, Laverty AA, Tsampi A, Filippidis FT. European progress in working towards a tobacco-free generation. Eur J Pediatr 2021; 180:3423-3431. [PMID: 34032890 PMCID: PMC8589739 DOI: 10.1007/s00431-021-04116-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
Children have the right to grow up free from the hazards associated with tobacco smoking. Tobacco smoke exposure can have detrimental effects on children's health and development, from before birth and beyond. As a result of effective tobacco control policies, European smoking rates are steadily decreasing among adults, as is the proportion of adolescents taking up smoking. Substantial variation however exists between countries, both in terms of smoking rates and regarding implementation, comprehensiveness and enforcement of policies to address smoking and second-hand smoke exposure. This is important because comprehensive tobacco control policies such as smoke-free legislation and tobacco taxation have extensively been shown to carry clear health benefits for both adults and children. Additional policies such as increasing the legal age to buy tobacco, reducing the number of outlets selling tobacco, banning tobacco display and advertising at the point-of-sale, and introducing plain packaging for tobacco products can help reduce smoking initiation by youth. At societal level, health professionals can play an important role in advocating for stronger policy measures, whereas they also clearly have a duty to address smoking and tobacco smoke exposure at the patient level. This includes providing cessation advise and referring to effective cessation services.Conclusion: Framing of tobacco exposure as a child right's issue and of comprehensive tobacco control as a tool to work towards the ultimate goal of reaching a tobacco-free generation can help accelerate European progress to curb the tobacco epidemic. What is Known: • Tobacco exposure is associated with a range of adverse health effects among babies and children. • Comprehensive tobacco control policies helped bring down smoking rates in Europe and benefit child health. What is New: • Protecting the rights and health of children provides a strong starting point for tobacco control advocacy. • The tobacco-free generation concept helps policy-makers set clear goals for protecting future generations from tobacco-associated harms.
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Affiliation(s)
- Jasper V Been
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands.
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands.
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Aikaterini Tsampi
- Department of Transboundary Legal Studies, Faculty of Law, University of Groningen, Groningen, Netherlands
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Weiler HA, Vanstone CA, Razaghi M, Gharibeh N, Patel S, Wei SQ, McNally D. Disparities in Vitamin D Status of Newborn Infants from a Diverse Sociodemographic Population in Montreal, Canada. J Nutr 2021; 152:255-268. [PMID: 34612495 PMCID: PMC8754562 DOI: 10.1093/jn/nxab344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation. OBJECTIVES We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status. METHODS In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy. RESULTS Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07). CONCLUSIONS In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
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Affiliation(s)
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Sharina Patel
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada
| | - Shu Q Wei
- Québec National Institute of Public Health, Montréal, Québec, Canada
| | - Dayre McNally
- Division of Critical Care, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
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Rajendran A, Eudy AM, Balevic SJ, Clowse MEB. The importance of pregnancy planning in lupus pregnancies. Lupus 2021; 30:741-751. [PMID: 33509066 DOI: 10.1177/0961203321989803] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE In seeking new approaches to improve lupus pregnancy outcomes, we study the association between pregnancy planning, behaviors recommended by American College of Rheumatology's Reproductive Health Guideline 2020, and pregnancy and infant outcomes. METHODS Lupus pregnancies in a prospective registry (1/1/2018 to 4/1/2020) were classified as planned or not-planned using the patient-reported London Measure of Unplanned Pregnancy. These groups were compared for demographics, pre-pregnancy disease activity, pregnancy planning behaviors, and delivery outcomes. RESULTS Among 43 women with 43 singleton pregnancies the average age was 29.4 years and 42% were Black. Overall, 60% were planned pregnancies and 40% were not-planned (16 ambivalent, 1 unplanned). Women with not-planned pregnancies had lower age, income, and education, and more required Medicaid. Women with not-planned pregnancies were more likely to conceive when lupus activity was higher (p = 0.001), less likely to receive pre-pregnancy counseling with a rheumatologist (p = 0.02), and less likely to continue pregnancy-compatible medications (p = 0.03). Severe PROMISSE adverse pregnancy outcomes (APOs) and severe neonatal outcomes were higher among women with not-planned than planned pregnancies (43% vs 0% p = 0.003; 70% vs 30% p = 0.06). CONCLUSION This study identifies pregnancy intention as a potentially modifiable risk factor for poor outcomes in women with lupus. It highlights a unique population of women with lupus at high risk for pregnancy and infant complications: those ambivalent about pregnancy. These women may not be effectively engaging in health behaviors that prevent pregnancy nor those that will prepare for a safe pregnancy. With effective pregnancy planning and contraception guidance, we may decrease their risk for maternal-fetal morbidity and mortality.
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Jafari A, Rajabi A, Gholian-Aval M, Peyman N, Mahdizadeh M, Tehrani H. National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis. Environ Health Prev Med 2021; 26:5. [PMID: 33419408 PMCID: PMC7796590 DOI: 10.1186/s12199-020-00924-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/20/2020] [Indexed: 02/07/2023] Open
Abstract
Background This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. Results The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. Conclusions The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00924-y.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Biostatistics and Epidemiology Department, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ayyala MS, Coughlin JW, Martin L, Henderson J, Ezekwe N, Clark JM, Appel LJ, Bennett WL. Perspectives of pregnant and postpartum women and obstetric providers to promote healthy lifestyle in pregnancy and after delivery: a qualitative in-depth interview study. BMC Womens Health 2020; 20:44. [PMID: 32131832 PMCID: PMC7057562 DOI: 10.1186/s12905-020-0896-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/03/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pregnancy provides an opportunity to promote healthy lifestyle behaviors. This study's aim was to explore the perspectives of pregnant and postpartum women and obstetric providers around behavioral lifestyle changes in pregnancy and postpartum. METHODS We conducted a qualitative study with pregnant and postpartum patients recruited from 2 prenatal care clinics at an urban, academic hospital in the United States. In-depth interviews with 23 pregnant or postpartum women and 11 obstetric providers were completed between October 2015-April 2016. Interviews were audio-recorded and transcribed verbatim. We coded transcripts for thematic content and applied the PRECEDE-PROCEED framework for results to directly inform program development. RESULTS Six themes highlighted the predisposing, enabling and reinforcing factors that enable and sustain health behavior changes in pregnancy and postpartum: 1) "Motivation to have a healthy baby" during pregnancy and to "have my body back" after delivery, 2) Pre-pregnancy knowledge and experiences about pregnancy and the postpartum period, 3) Prioritizing wellness during pregnancy and postpartum, 4) The power of social support, 5) Accountability, 6) Integration with technology to reinforce behavior change. CONCLUSIONS In this qualitative study, pregnant and postpartum women and obstetric providers described themes that are aimed at encouraging lifestyle changes to promote healthy weight gain in pregnancy and can directly inform the development of a behavioral weight management intervention for pregnant and postpartum women that is patient-centered and tailored to their needs.
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Affiliation(s)
- Manasa S. Ayyala
- Rutgers New Jersey Medical School, Department of Medicine, Division of General Internal Medicine, 185 South Orange Avenue, MSB B624, Newark, NJ 07103 USA
| | - Janelle W. Coughlin
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 1100, Baltimore, MD 21224 USA
| | - Lindsay Martin
- Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Suite 2-616, Baltimore, MD 21205 USA
| | - Janice Henderson
- Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, 600 N. Wolfe St, Nelson Building, Baltimore, MD 21287 USA
| | - Nneamaka Ezekwe
- School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216 USA
| | - Jeanne M. Clark
- Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Suite 2-616, Baltimore, MD 21205 USA
| | - Lawrence J. Appel
- Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Suite 2-616, Baltimore, MD 21205 USA
| | - Wendy L. Bennett
- Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Suite 2-616, Baltimore, MD 21205 USA
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