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Andersen K, Rothausen KW, Håberg SE, Myrskylä M, Ramlau-Hansen CH, Gaml-Sørensen A. Sibling relatedness and pubertal development in girls and boys: A population-based cohort study. Ann Epidemiol 2024:S1047-2797(24)00215-1. [PMID: 39182628 DOI: 10.1016/j.annepidem.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/19/2024] [Accepted: 08/22/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE To investigate the association between sibling relatedness and pubertal development in girls and boys. METHODS This cohort study consisted of 10,657 children from the Puberty Cohort, Denmark. Information on sibling relatedness was obtained by self-report. Information on pubertal markers was obtained half yearly from age 11 and throughout puberty. Mean age difference at attaining pubertal markers was estimated using interval-censored regression models according to sibling relatedness (full, half and/or step siblings; half and/or step siblings; no siblings; relative to full siblings). RESULTS Girls with both full, half and/or step siblings (-1.2 (CI 95%: -2.5; 0.1) months), only half- and/or stepsiblings (-2.2 (CI 95%: -3.7; -0.7) months), and no siblings (-5.5 (CI 95%: -8.5; -2.5) months) entered puberty earlier than girls with full siblings. Boys with full, half and/or step siblings (-1.4 (CI 95%: -2.7; -0.1) months), only half and/or step siblings (-1.2 (CI 95%: -3.0; 0.6) months), and no siblings (-4.5 (CI 95%: -8.8; -0.3) months) entered puberty earlier than boys with full siblings. CONCLUSIONS Children with sibling relatedness other than full siblings entered puberty earlier than their peers with full siblings even after adjustment for parental cohabitation status, childhood body mass index and childhood internalizing and externalizing symptoms.
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Affiliation(s)
- Katrine Andersen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark
| | | | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany; Center for Social Data Science and Population Research Unit, University of Helsinki, Helsinki, Finland; Max Planck - University of Helsinki Center for Social Inequalities in Population Health, Rostock, Germany and Helsinki, Finland
| | | | - Anne Gaml-Sørensen
- Department of Public Health, Research Unit for Epidemiology, Aarhus University, Aarhus, Denmark.
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Özcan H, Oral S, Kuruay Ş, Yilmaz BM. The effect of music on pain, anxiety and satisfaction during nonstress testing. J Eval Clin Pract 2024. [PMID: 39038200 DOI: 10.1111/jep.14106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVE To determine the effect of instrumental music played during Nonstress Test (NST) on pain, anxiety and satisfaction. METHODS This research was planned as randomised controlled. The sample of the study consists of 64 pregnant women. In data collection, a survey form containing socio-demographic characteristics, State-Trait Anxiety Scale, Visual Analog Scale (VAS) and Evgeny Grinko-Valse piece were used as music. RESULTS Among the groups where music was applied, satisfaction with the procedure was significantly high (X2: 12.666, p: 0.049). No significant difference was detected between anxiety and pain conditions (p > 0.05). The scale scores of the groups before and after the procedure were evaluated; Before the procedure, significant differences were detected between the groups in terms of trait anxiety and fear of pain. As a result of the evaluation made after the procedure, there are significant differences between state anxiety and fear of pain (p < 0.05). It was determined that music played during the NST procedure reduced state and trait anxiety. Satisfaction levels are also higher among the group that is listened to music. CONCLUSION A successful pregnancy is important for the health of mother and baby. Reducing anxiety and stress, especially during the examinations, ensures that the process continues successfully. It is recommended that music played during pregnancy examinations and screening tests be used in clinics and during the procedure to increase satisfaction and reduce anxiety.
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Affiliation(s)
- Handan Özcan
- Department of Midwifery, University of Health Sciences Faculty of Health Sciences, Istanbul, Turkey
| | - Suna Oral
- Department of Midwifery, Midwifery, University of Health Sciences Faculty of Health Sciences, Istanbul, Turkey
| | - Şehma Kuruay
- Department of Midwifery, Midwifery, University of Health Sciences Faculty of Health Sciences, Istanbul, Turkey
| | - Banu Müşerref Yilmaz
- Department of Gynecology and Obstetrics, University of Health Sciences Zeynep Kamil Women's and Children's Research and Research Hospital, Istanbul, Turkey
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van Tintelen AMG, Jansen DEMC, Bolt SH, Warmelink JC, Verhoeven CJ, Henrichs J. The Association Between Unintended Pregnancy and Perinatal Outcomes in Low-Risk Pregnancies: A Retrospective Registry Study in the Netherlands. J Midwifery Womens Health 2024. [PMID: 38659281 DOI: 10.1111/jmwh.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/31/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION People with unintended pregnancies might be at increased risk of adverse perinatal outcomes due to structural factors, distress, or delayed prenatal care. Existing studies addressing this association yielded inconsistent findings. Using contemporary data from a large Dutch midwifery care registry, we investigated the association between unintended pregnancy ending in birth and neonatal outcomes, parental morbidity, and obstetric interventions. We extend previous research by exploring whether delayed initiation of prenatal care mediates these associations. METHOD This study used data (N = 9803) from a Dutch nationally representative registry of people with low-risk pregnancies receiving primary midwife-led care in the Netherlands between 2012 and 2020. Using logistic (mediation) regression analyses adjusted for potential confounders we investigated associations between unintended pregnancy and neonatal outcomes (low Apgar score, small for gestational age, and prematurity), parental morbidity (hypertension and gestational diabetes mellitus), and obstetric interventions (induction of labor, pain medication, assisted vaginal birth, and cesarean birth) and whether delayed initiation of prenatal care mediated these associations. RESULTS Unintended pregnancies were associated with increased odds of low Apgar scores (odds ratio [OR], 1.68; 95% CI, 1.09 -2.59), preterm birth (OR, 1.27; 95% CI, 1.02-1.58), small for gestational age (OR, 1.19; 95% CI, 1.00-1.41), and induction of labor (OR, 1.14; 95% CI, 1.01-1.28). Conversely, unintended pregnancy was associated with a decreased odds of cesarean birth (OR, 0.83; 95% CI, 0.71-0.97). The timing of prenatal care initiation did not mediate any of these associations. DISCUSSION Our findings suggest that people in primary midwifery-led care with unintended pregnancies ending in birth are at increased risk for adverse perinatal health outcomes and that structural factors might underlie this link. Health care professionals and policy makers should attend to their own biases and offer nonjudgmental, tailored preventive preconception care and antenatal care strategies for people with higher vulnerabilities.
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Affiliation(s)
- Amke M G van Tintelen
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
- Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Danielle E M C Jansen
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Sociology and Interuniversity Center for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands
- University Center for Child and Adolescent Psychiatry, Accare, Groningen, the Netherlands
| | - Sophie H Bolt
- Research Department, Fiom, 's-Hertogenbosch, the Netherlands
| | - J Catja Warmelink
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
- Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Corine J Verhoeven
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
- Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Division of Midwifery School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
| | - Jens Henrichs
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Groningen, the Netherlands
- Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Hollenberger JC, Madden EE. "At the End of the Day it's Their choice": An Exploratory Qualitative Study of Pregnancy Options Counseling. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:234-249. [PMID: 38421683 DOI: 10.1080/19371918.2024.2322594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
This study's purpose was to explore the current models and approaches of pregnancy options counseling across three types of agency settings in a Northeastern state. Additionally, this study aimed to determine if individuals who receive pregnancy options counseling obtained medically factual, non-directive, and non-biased information needed to make informed decisions related to their pregnancy decisions. Using qualitative research methodology, semi-structured interviews were conducted with 10 participants across three different agency settings in one state in the Northeastern United States. Results indicated agencies shared a definition of pregnancy options counseling. Outcomes also suggest agency type impacted how pregnancy options counseling was delivered, as variations were found in education provided to patients. Lastly, the interviews imply no standardized model or training for pregnancy options counselors is currently being used.
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Affiliation(s)
| | - Elissa E Madden
- Diana Garland School of Social Work, Baylor University, Waco, TX
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Reuterwall I, Hultstrand JN, Carlander A, Jonsson M, Tydén T, Kullinger M. Pregnancy planning and neonatal outcome - a retrospective cohort study. BMC Pregnancy Childbirth 2024; 24:205. [PMID: 38493168 PMCID: PMC10944595 DOI: 10.1186/s12884-024-06401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/08/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Unplanned pregnancy is common, and although some research indicates adverse outcomes for the neonate, such as death, low birth weight, and preterm birth, results are inconsistent. The purpose of the present study was to investigate associated neonatal outcomes of an unplanned pregnancy in a Swedish setting. METHODS We conducted a retrospective cohort study in which data from 2953 women were retrieved from the Swedish Pregnancy Planning Study, covering ten Swedish counties from September 2012 through July 2013. Pregnancy intention was measured using the London Measurement of Unplanned Pregnancy. Women with unplanned pregnancies and pregnancies of ambivalent intention were combined and referred to as unplanned. Data on neonatal outcomes: small for gestational age, low birth weight, preterm birth, Apgar score < 7 at 5 min, and severe adverse neonatal outcome defined as death or need for resuscitation at birth, were retrieved from the Swedish Medical Birth Register. RESULTS The prevalence of unplanned pregnancies was 30.4%. Compared with women who had planned pregnancies, those with unplanned pregnancies were more likely to give birth to neonates small for gestational age: 3.6% vs. 1.7% (aOR 2.1, 95% CI 1.2-3.7). There were no significant differences in preterm birth, Apgar score < 7 at 5 min, or severe adverse neonatal outcome. CONCLUSIONS In a Swedish setting, an unplanned pregnancy might increase the risk for birth of an infant small for gestational age.
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Affiliation(s)
- Isa Reuterwall
- Department of Obstetrics and Gynecology, Region Västmanland, Västerås, Sweden.
| | | | - Alisa Carlander
- Department of Obstetrics and Gynecology, Region Västmanland, Västerås, Sweden
| | - Maria Jonsson
- Department of Women´s and Children's Health, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women´s and Children's Health, Uppsala University, Uppsala, Sweden
| | - Merit Kullinger
- Centre for Clinical Research Västmanland Hospital, Västeras, Sweden
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Sikaluzwe M, Phiri M, Lemba M, Shasha L, Muhanga M. Trends in prevalence and factors associated with unintended pregnancies in Zambia (2001-2018). BMC Pregnancy Childbirth 2024; 24:148. [PMID: 38383354 PMCID: PMC10880343 DOI: 10.1186/s12884-024-06311-7] [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: 09/07/2022] [Accepted: 02/01/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Unintended pregnancies can pose significant public health concerns for both maternal and child health because of their associated risks and implications. Experience of unintended pregnancies may lead to delay in seeking antenatal care, thus leading to increased risk of complications during pregnancy and childbirth. Globally, the prevalence of unintended pregnancies has declined. However, the problem remains acute in sub-Saharan Africa. This study was conducted to examine the factors associated with an experience of unintended pregnancy among women of reproductive ages in Zambia. METHODS This study used secondary data from the Zambia Demographic and Health Surveys (ZDHSs) which were conducted between 2001 and 2018. A pooled weighted sample of 4,090 pregnant women of reproductive age 15-49 years at the time of the survey was included in the analysis. Multivariable binary logistic regression model was employed to examine the association between independent correlates and experience of unintended pregnancy. All statistical analyses were conducted using Stata software. RESULTS Findings show that the proportion of women of reproductive age who experienced unintended pregnancy in Zambia declined from 50.4% (95% CI: 47.1, 53.8) in 2001 to 45.2% (95% CI: 40.5, 49.9) in 2018. The decline in the prevalence of unintended pregnancy is more pronounced among women age groups 25-29 years and 30-34 years. Increasing age was associated with an increased risk of experiencing unintended pregnancies. On the other hand, women who were living in rural areas (aOR = 0.76; 95% CI: 0.58, 1.00) and those with tertiary education (aOR = 0.46; 95% CI: 0.26, 0.80) were less likely to experience an unintended pregnancy. Women who desired a large family (aOR = 0.45; 95% CI: 0.24, 0.85) and those who watched television (aOR = 0.75; 95% CI: 0.59, 0.94) had lower odds of experiencing unintended pregnancies. CONCLUSIONS The study has established that the prevalence of unintended pregnancy is still high in Zambia. Women's age, place of residence, level of education, desired family size and exposure to media were associated with the risk of experiencing an unintended pregnancy. Enhancing access to family planning services and commodities targeting women with low education levels will be key to further reduce unintended pregnancies.
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Affiliation(s)
- Milika Sikaluzwe
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
| | - Million Phiri
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Musonda Lemba
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Liness Shasha
- Department of Demography, Population Sciences, Monitoring and Evaluation, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia
| | - Mikidadi Muhanga
- Department of the Development and Strategic Studies, College of Social Sciences and Humanities, Sokoine University of Agriculture, Morogoro, Tanzania
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Alsahafi IK, Alblady EH, Magliah SF, Alahmadi LS, Alshareef RJ, Binmahfoodh DS, Alsalem MS. Unplanned pregnancy and risk of peripartum depression: a prospective cohort study in Saudi pregnant women attending antenatal care clinic. Ann Med Surg (Lond) 2024; 86:666-677. [PMID: 38333327 PMCID: PMC10849417 DOI: 10.1097/ms9.0000000000001573] [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: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 02/10/2024] Open
Abstract
Background Few studies have been conducted on unintended pregnancies and peripartum depression in Saudi Arabia. This study aimed to evaluate the relationship between unplanned pregnancies and peripartum depression among pregnant women in Jeddah, Saudi Arabia. Methods This prospective cohort study included pregnant women attending an antenatal care clinic in 2021. The London Measure of Unplanned Pregnancy was used to assess the prevalence of unplanned pregnancy, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal and postnatal depression. Results A total of 236 participants were included, of which 25.8% had unplanned pregnancies, 36.0% had ambivalent pregnancies, and 38.1% had planned pregnancies. EPDS results revealed that 77.5% and 73.35% of the females were negative for antenatal and postnatal depression, respectively. A history of stressful events (P=0.001), husband (P=0.020), and family support (P=0.007) was significantly associated with antenatal EPDS score, whereas age (P=0.005), type of delivery (P=0.019), and family support (P=0.031) were significantly associated with the postnatal score. Conclusion Unplanned pregnancies may affect the perinatal mental health of women. We demonstrated the importance of family or husbands' support for women with perinatal depression. In addition, our research showed that pregnancy at an early age is a risk factor for postnatal depression. Therefore, these women should be closely monitored not only during their pregnancy but also during the first postpartum year.
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Affiliation(s)
| | | | | | | | | | | | - Moayyad S. Alsalem
- Psychiatry Section, Department of Medicine, King Abdulaziz Medical City, Ministry of the National Guard – Health Affairs
- King Abdullah International Medical Research Center
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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8
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Schonewille NN, Jonkman NH, van Kempen AAMW, van Pampus MG, van den Heuvel OA, Broekman BFP. Pregnancy intention in relation to maternal and neonatal outcomes in women with versus without psychiatric diagnoses. Acta Psychiatr Scand 2024; 149:110-123. [PMID: 37933529 DOI: 10.1111/acps.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Studies have identified adverse maternal and neonatal outcomes for women with psychiatric disorders. Additionally, psychiatric disorders may pose an increased risk for unintended pregnancies (UPs) which in turn may also impact negatively on outcomes. The present study aims to compare the incidence of UPs in women with versus without current/past psychiatric diagnoses and investigates whether psychiatric history modifies the relation between delivery outcomes in women with and without UPs. METHODS A retrospective cohort was compiled of women who gave birth in a large hospital in Amsterdam, the Netherlands. Women ≥18 years old with singleton pregnancies and birth registrations in the electronic patient file during January 1, 2015 to March 1, 2020 were included. Patient characteristics (including pregnancy intention and psychiatric history), maternal (gestational diabetes, mode of delivery) and neonatal outcomes (e.g., gestational age [GA], birthweight and Apgar scores) were registered by health care providers in hospital charts. Incidence of UPs was compared between women with versus without current/past psychiatric diagnoses. Maternal and neonatal outcomes were compared between women with versus without UPs with linear or logistic regression models adjusted for relevant confounders with an interaction term for UP with current/past psychiatric diagnoses. RESULTS We included 1219 women with and 1093 women without current/past psychiatric diagnoses. Current/past psychiatric diagnoses were significantly associated with UPs after adjustment for confounders (39.0% vs. 29.6%, OR 1.56, CI 1.23-2.00, p < 0.001). In sub-analyses, women with depressive (OR 1.67, CI 1.24-2.26, p = 0.001), personality (OR 2.64, CI 1.38-5.11, p = 0.004) and substance-related and addictive disorders (OR 4.29, CI 1.90-10.03, p = 0.001) had higher odds of UPs compared to women without current/past psychiatric diagnoses. Amongst women with UPs, current/past psychiatric diagnoses did not modify maternal or neonatal outcomes, except for GA at delivery as women with both UPs and current/past psychiatric diagnosis had a 2.21-day higher mean GA at delivery than women in the reference group (p-value interaction = 0.001). CONCLUSIONS Current/past psychiatric diagnoses are associated with a higher odd of UPs. In our sample, maternal and neonatal outcomes were comparable for women with and without UPs and these results were similar for women with and without current/past psychiatric diagnoses, except for GA at delivery. Although our study is limited by several factors, we found that women with current/past psychiatric diagnoses, irrespective of pregnancy planning status, do not have more adverse maternal or pregnancy outcomes. Increased efforts are needed to ensure that psychoeducation and conversations about pregnancy planning and UPs are available for women with current/past psychiatric diagnoses.
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Affiliation(s)
- Noralie N Schonewille
- Department of Psychiatry and Medical Psychology, OLVG, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Nini H Jonkman
- Department of Research and Epidemiology, OLVG, Amsterdam, The Netherlands
| | | | - Maria G van Pampus
- Department of Gynaecology and Obstetrics, OLVG, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Anatomy & Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Compulsivity, Impulsivity & Attention Program, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Birit F P Broekman
- Department of Psychiatry and Medical Psychology, OLVG, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Mental Health Program, Amsterdam Public Health, Amsterdam, The Netherlands
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Ticona DM, Huanco D, Ticona-Rendón MB. Impact of unplanned pregnancy on neonatal outcomes: findings of new high-risk newborns in Peru. Int Health 2024; 16:52-60. [PMID: 36942842 PMCID: PMC10759294 DOI: 10.1093/inthealth/ihad018] [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: 11/10/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Unplanned pregnancy is a significant public health problem, especially in low- to middle-income countries. The objective of this study was to determine the neonatal outcomes associated with unplanned pregnancy in a public hospital in southern Peru. METHODS A cross-sectional analytical study was conducted from June to August 2021 among 306 mothers and their newborns selected by convenience sampling. After obtaining informed consent, mothers were surveyed during their postpartum hospitalization about their pregnancy intentions. Unintended pregnancy was considered when it was mistimed or unwanted. Neonatal outcomes were assessed by reviewing medical records prior to discharge, evaluating the presence of low birth weight, insufficient birth weight, prematurity, respiratory distress syndrome, sepsis and neonatal mortality. Association was measured in terms of prevalence ratio (PR) and beta coefficient and respective 95% CIs, crude and adjusted for variables that obtained a value of p<0.20 in the crude model (maternal age, education and parity). RESULTS The overall unplanned pregnancies rate was 65%, of which 40.5% were mistimed pregnancies and 24.5% unwanted pregnancies. Unplanned and mistimed pregnancies were significantly associated with insufficient birth weight [adjusted prevalence ratio (aPR)=2.14; 95% CI 1.01 to 4.56 and aPR=2.43; 95% CI 1.09 to 5.39, respectively] and unwanted pregnancies were significantly associated with preterm birth (aPR=3.49; 95% CI 1.01 to 12.11). Furthermore, adjusted analysis showed that birth weight and gestational age were lower in unplanned, mistimed and unwanted pregnancies. CONCLUSIONS Unplanned pregnancy was associated with lower birth weight and shorter gestational age of newborns. These data collected in a public hospital in a developing country may have significant implications today. If pregnancy intention is not included as a neonatal risk factor, insufficient birth weight and preterm birth could increase because a higher proportion of births will be unplanned.
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Affiliation(s)
| | - Diana Huanco
- Universidad Nacional Jorge Basadre Grohmann, Faculty of Health Sciences, 23003, Tacna, Peru
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Azad A, Su J, Nguyen M, Ly M, Wu I, Tracy D, Song A, Apollonio DE. Pharmacist furnishing of hormonal contraception in California's Central Valley. J Am Pharm Assoc (2003) 2024; 64:226-234.e2. [PMID: 37595885 DOI: 10.1016/j.japh.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/05/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND In the United States, more than 19 million people of reproductive age need access to publicly funded hormonal contraception or live in areas where it is not readily available. These include rural areas of the country, commonly known as contraception deserts. Pharmacist prescribing has been proposed to increase access, but little is known about its implementation in such areas. OBJECTIVE This study quantified the extent of pharmacists' furnishing (prescribing) of hormonal contraception in California's Central Valley community pharmacies and identified barriers and facilitators to implementation. METHODS The researchers conducted a cross-sectional, mixed methods, observational study by (1) contacting all community pharmacies in the 11 counties of the Central Valley to determine furnishing rates and (2) surveying and interviewing pharmacies that indicated they furnished hormonal contraception. RESULTS Overall, 13% of pharmacies within the Central Valley reported that they furnished hormonal contraception. Pharmacists reported that barriers to furnishing included costs to patients and the pharmacy, lack of time and staff, lack of training and certifications, limited patient awareness of pharmacists' ability to furnish, pharmacists' limited confidence in furnishing, and patient use of emergency contraception as an alternative to hormonal contraception. Pharmacists reported that patients often sought hormonal contraception from pharmacists owing to ease of accessibility to a pharmacist; some other facilitators included advertising, confidentiality, low cost to patients, and referrals from other providers. CONCLUSIONS Common barriers were identified across pharmacies that furnished hormonal contraception, indicating the need for strategies that reduce these barriers to help expand patient's access to these services and to increase pharmacists' ability and confidence to prescribe.
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Chen Q, Liu XL, Lin LZ, Wang X, Li MH, Dai MX, Cao MQ, Li XH, Jin J, Xu HQ, Cai L. Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements. Autism Res 2024; 17:172-181. [PMID: 38131613 DOI: 10.1002/aur.3070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/12/2023] [Indexed: 12/23/2023]
Abstract
There is limited evidence on the associations of unintended pregnancy with autism spectrum disorders (ASD). This study aimed to examine this relationship and the modification of pre-conceptional and prenatal folic acid supplements. Six thousand and five toddlers aged 16 to 30 months from seven cities of six provinces in China were eligible for participation. Information on unintended pregnancy and folic acid supplements was obtained via questionnaires from caregivers of toddlers. The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese version of the Childhood Autism Rating Scale (CARS). Of the 6005 toddlers in the study (3337 boys and 2668 girls), 71 (1.18%) received the diagnosis of ASD. Generalized linear models with a logit link function showed unintended pregnancy was positively associated with ASD (odds ratios [OR] = 1.69, 95% confidence interval [CI], 1.05-2.79). Stratified estimates indicated that the association remained stable among toddlers of mothers without pre-conceptional and prenatal folic acid supplements (OR = 2.75, 95% CI, 1.04-7.27; n = 1243, 20.70%). Unintended pregnancy was associated with higher odds of ASD in 16-30 months of toddlers, and the association was consistent among toddlers of mothers without prenatal folic acid supplements. Our findings emphasize the need to raise awareness of the risk of unintended pregnancy and the benefits of folic acid supplements among Chinese women.
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Affiliation(s)
- Qian Chen
- Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Xing-Lian Liu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Li-Zi Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xin Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Ming-Hui Li
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Mei-Xia Dai
- Department of Children's Healthcare and Mental Health Center, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Mu-Qing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiu-Hong Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jing Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Hai-Qing Xu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, People's Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
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12
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Nickels L, Yan W. Nonhormonal Male Contraceptive Development-Strategies for Progress. Pharmacol Rev 2023; 76:37-48. [PMID: 38101934 PMCID: PMC10759220 DOI: 10.1124/pharmrev.122.000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Despite the widely demonstrated public health benefits of contraception, limited contraceptive options are available for men, placing both the contraceptive burden and opportunity solely on women. This review outlines the need for an increased focus on male contraceptive development and highlights several related topics, including the perspectives of women and men on male contraceptives, historical challenges, and reasons behind the persistent delays in male contraceptive development. It also discusses the importance of serendipitous observations in drug discovery and the limitations of depleting sperm or spermatogenic cells as a contraceptive approach. It further provides an overview of ongoing research and development on novel methods, with a goal to offer insights into the multifaceted aspects of nonhormonal male contraceptive development, addressing its implications for the health of men and women. SIGNIFICANCE STATEMENT: Despite well over half a century of effort in developing male contraceptives, there are no approved male contraceptive drugs on the market. This review aims to present strategies for progress in nonhormonal male contraception based on lessons learned from history, with the hope of expediting development and bringing a male contraceptive drug closer to reality.
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Affiliation(s)
- Logan Nickels
- Male Contraceptive Initiative, Durham, North Carolina (L.N.); The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California (W.Y.); and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (W.Y.)
| | - Wei Yan
- Male Contraceptive Initiative, Durham, North Carolina (L.N.); The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California (W.Y.); and Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (W.Y.)
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13
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McGuire E, Curtis C, Duffy RM. Fertile ground: reproductive health consideration in mental health ward policy. Ir J Psychol Med 2023; 40:571-576. [PMID: 32718380 DOI: 10.1017/ipm.2020.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Women of childbearing age often experience mental health problems, receive psychotropic medication and are admitted to mental health units. Approximately 40% of pregnancies are unplanned and many women experience perinatal mental health problems. It is therefore vital that consideration is given to reproductive health in mental health policy. We aimed to evaluate the consideration of pregnancy and breastfeeding in the policies of an inpatient mental health service. METHODS The policies of a regional inpatient psychiatric unit were independently reviewed by two researchers. Policies that had implications for pregnancy and breastfeeding for patients were identified. Whether or not these policies considered pregnancy and breastfeeding and the detail of this consideration was evaluated. RESULTS One hundred and thirteen policies were evaluated. Forty had implications for pregnancy but only 10 of these mentioned pregnancy and only 3 in detail. Only 3 of the 28 policies that had relevance to breastfeeding mothers mentioned it and none discussed it in detail. Key areas of omission included prescribing, seclusion and restraint and cultural and religious considerations. CONCLUSION Pregnancy and breastfeeding were almost entirely absent in the ward policies of our inpatient unit. Their consideration in the acute setting is vital. An individual or group of individuals should be responsible for ensuring that reproductive health is considered in all policies as well as in a larger specific policy suitable for referencing. The rights of the reproductive woman should be comprehensively considered in inpatient mental health care policy.
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Affiliation(s)
- E McGuire
- Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
| | - C Curtis
- Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
| | - R M Duffy
- Specialist Perinatal Mental Health Service
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14
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Mondal S, Anand A, Awasthi N, Singh B, Pradhan MR. Factors affecting pregnancy registration in India: does the pregnancy intention matter? BMC Pregnancy Childbirth 2023; 23:674. [PMID: 37726663 PMCID: PMC10507949 DOI: 10.1186/s12884-023-06002-9] [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: 02/20/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Pregnancy registration is one of the most critical components of women's reproductive health because it is the gateway to entering the continuum of care services such as antenatal care, institutional delivery, and postnatal care. There is a lack of studies exploring the relationship between pregnancy intention and pregnancy registration, especially in the Indian context. METHOD This study used the National Family Health Survey-5 (2019-21) data to explore the relationship between birth intention and failure of pregnancy registration. The bivariate and multivariate (binary logistic regression) analysis was carried out. RESULTS Adjusting the effects of socio-demographic and economic characteristics, compared with women with an intended pregnancy, the odds of failure of pregnancy registration were significantly high among women with a mistimed pregnancy (OR = 1.60, 95% CI = 1.47-1.73) and unwanted pregnancy (OR = 1.38, 95% CI = 1.26-1.52). The study found pregnancy intention as a significant predictor of pregnancy registration. CONCLUSIONS Results suggest strengthening the interaction of grassroots-level health workers with women, especially those with possibly lower healthcare autonomy and unintended pregnancy. Higher and earlier pregnancy registration will enhance maternal healthcare utilization and reduce adverse health consequences to mothers and children, thus ensuring better maternal and child health.
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Affiliation(s)
- Sourav Mondal
- International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Abhishek Anand
- International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Niharika Awasthi
- International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Bharti Singh
- International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
| | - Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India.
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15
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Carlander A, Hultstrand JN, Reuterwall I, Jonsson M, Tydén T, Kullinger M. Unplanned pregnancy and the association with maternal health and pregnancy outcomes: A Swedish cohort study. PLoS One 2023; 18:e0286052. [PMID: 37216351 DOI: 10.1371/journal.pone.0286052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVES Unplanned pregnancies are common and associated with late initiation and inadequate antenatal care attendance, which may pose health risks to mother and child. How pregnancy planning relates to maternal health and delivery in Sweden, a country with free antenatal care and free abortion, has not been studied previously. Our aims were to study whether pregnancy planning was associated with antenatal care utilization and pregnancy outcomes in a Swedish setting. METHODS Data for 2953 women, who answered a questionnaire when recruited at antenatal clinics in Sweden and later gave birth, was linked to the Swedish Medical Birth Register. The degree of pregnancy planning was estimated using the London Measure of Unplanned Pregnancy. Unplanned (comprising unplanned and ambivalent intention to pregnancy) was compared to planned pregnancy. Differences between women with unplanned and planned pregnancy intention and associated pregnancy outcomes were analyzed using Fisher's exact test and logistic regression. RESULTS There were 31% unplanned (2% unplanned and 29% ambivalent) pregnancies, whereas most woman (69%) reported their pregnancy to be planned. Women with an unplanned pregnancy enrolled later to antenatal care, but there was no difference in number of visits compared with planned pregnancy. Women with an unplanned pregnancy had higher odds to have induced labor (17% versus 13%; aOR 1.33 95% CI 1.06-1.67) and a longer hospital stay (41% versus 37%; aOR 1.21 95% CI 1.02-1.44). No associations were found between pregnancy planning and pregnancy-induced hypertension, gestational diabetes mellitus, preeclampsia, epidural analgesia use, vacuum extraction delivery, Caesarean section or sphincter rupture. CONCLUSIONS Unplanned pregnancy was associated with delayed initiation of antenatal care, higher odds for induction of labor and longer hospital stay, but not with any severe pregnancy outcomes. These findings suggest that women with an unplanned pregnancy cope well in a setting with free abortion and free health care.
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Affiliation(s)
- Alisa Carlander
- Department of Obstetrics and Gynecology, Region Västmanland, Västerås, Sweden
| | | | - Isa Reuterwall
- Department of Obstetrics and Gynecology, Region Västmanland, Västerås, Sweden
| | - Maria Jonsson
- Department of Women´s and Children's Health, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women´s and Children's Health, Uppsala University, Uppsala, Sweden
| | - Merit Kullinger
- Department of Obstetrics and Gynecology, Region Västmanland, Västerås, Sweden
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16
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Nicolas CT, Carter SR, Martin CA. Impact of maternal factors, environmental factors, and race on necrotizing enterocolitis. Semin Perinatol 2023; 47:151688. [PMID: 36572622 DOI: 10.1016/j.semperi.2022.151688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Necrotizing enterocolitis (NEC) is a complex disease with a multifactorial etiology. As the leading cause of intestinal morbidity and mortality among premature infants, many resources are being dedicated to neonatal care and molecular targets in the newborn intestine. However, NEC is heavily influenced by maternal and perinatal factors as well. Given its nature, preventive approaches to NEC are more likely to improve outcomes than new treatment strategies. Therefore, this review focuses on maternal, environmental, and racial factors associated with the development of NEC, with an emphasis on those that may be modifiable to decrease the incidence of the disease.
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Affiliation(s)
- Clara T Nicolas
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Stewart R Carter
- Department of Surgery, Division of Pediatric Surgery, University of Louisville School of Medicine, Louisville, KY, United States
| | - Colin A Martin
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, United States; Department of General and Thoracic Surgery, Children's of Alabama, Birmingham, AL, United States.
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17
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Yu P, Zhou L, Meng F, Xu Y, Jiang Y, Zhou Y. Developmental trajectories of health-promoting behaviours among pregnant women: A longitudinal study. J Clin Nurs 2023; 32:234-242. [PMID: 35032069 DOI: 10.1111/jocn.16214] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study is to estimate differences in health-promoting behaviour levels throughout the pregnancy trimesters, to identify distinct patterns of health-promoting behaviour trajectories during pregnancy and to evaluate predictors of these trajectory group memberships. BACKGROUND Promoting healthy lifestyle behaviours during pregnancy could decrease devastating outcomes for the mother and foetus. However, there is currently limited insight into the dynamics of health-promoting behaviours during pregnancy. DESIGN An observational longitudinal study. METHODS 158 pregnant women were recruited from June 2020 to June 2021 in Qingdao, China. The Health-Promoting Lifestyle Profile was used to assess health-promoting behaviours. Latent growth model was performed to compare health-promoting behaviours at different time points. Group-based trajectory model was applied to identify health-promoting behaviour trajectories. Multinomial logistic regression was adopted to determine the predictors of trajectory group memberships. We used the STROBE checklist to report this study. RESULTS The entire sample of pregnant women experienced a significant increase in health-promoting behaviours during pregnancy. Three trajectories were identified including a 'low-increase behaviour trajectory (20.1% of sample)', a 'moderate-increase behaviour trajectory (58.0% of sample)' and a 'stable then increased behaviour trajectory (21.9% of sample)'. Low maternal sense of coherence, lack of pre-pregnancy exercise habit, artificial insemination and low monthly family income were significantly associated with the low-increase behaviour trajectory. High self-efficacy and pre-pregnancy exercise habit were significantly associated with the stable then increased behaviour trajectory. CONCLUSIONS Pregnant women exhibit different health-promoting behaviours throughout the pregnancy trimesters. Meanwhile, three trajectories were identified among pregnant women. Thus, more attentions should be paid on early identification and targeted intervention in a future study. RELEVANCE OF CLINICAL PRACTICE Healthcare providers should pay closer and earlier attention to identify women in the low-increase trajectory subgroup at the outset of pregnancy. Similarly, increased efforts should be made to improve maternal self-efficacy and develop good pre-pregnancy exercise habit in future study.
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Affiliation(s)
- Pengli Yu
- School of Nursing, Qingdao University, Qingdao, China
| | - Lixue Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Fei Meng
- School of Nursing, Qingdao University, Qingdao, China
| | - Yanhong Xu
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunxia Jiang
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
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18
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Murray AL, Taut D, Baban A, Hemady CL, Walker S, Osafo J, Sikander S, Tomlinson M, Toit SD, Marlow M, Ward CL, Fernando A, Madrid B, Van Thang V, Tuyen HD, Dunne M, Hughes C, Fearon P, Valdebenito S, Eisner M. Associations Between ADHD Symptoms and Maternal and Birth Outcomes: An Exploratory Analysis in a Multi-Country Cohort of Expectant Mothers. J Atten Disord 2022; 26:1882-1894. [PMID: 35815439 PMCID: PMC9597155 DOI: 10.1177/10870547221105064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. METHOD We used data (n = 1,204) from a longitudinal birth cohort study spanning eight countries to address this gap. RESULTS ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b = -0.16, p = .031), friends (b = -0.16, p = .024), and significant others (b = -0.09, p = .001); higher stress (b = 0.34, p < .001) and depressive symptoms (b = 0.31, p < .001), and increased likelihood of an unwanted pregnancy (b = 0.30, p = .009). Significant associations with tobacco use (b = 0.36, p = .023) and premature birth (b = 0.35, p = .007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. CONCLUSION Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.
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Affiliation(s)
- Aja Louise Murray
- University of Edinburgh, UK,Aja Louise Murray, Department of
Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9JZ, UK.
| | - Diana Taut
- Babes-Bolyai University, Cluj-Napoca,
Romania
| | | | | | - Susan Walker
- The University of the West Indies,
Kingston, Jamaica
| | | | | | - Mark Tomlinson
- Stellenbosch Uni`versity, Cape Town,
South Africa,Queens University, Belfast, UK
| | | | | | | | | | | | | | | | - Michael Dunne
- Queensland University of Technology,
Brisbane, Australia
| | | | | | | | - Manuel Eisner
- University of Cambridge, UK,University of Zurich,
Switzerland
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19
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Sökmen Y, Kaya Odabaş R, Bal Şaraldı H, Taşpınar A. The frequency of unplanned pregnancies during the COVID-19 pandemic and the factors affecting the situation. J OBSTET GYNAECOL 2022; 42:3621-3627. [PMID: 36394223 DOI: 10.1080/01443615.2022.2144172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study was conducted to determine the incidence of unplanned pregnancies and the factors affecting it during the COVID-19 pandemic. An analytical-cross-sectional study was carried out at a public hospital in Aydın, Turkey between January and October 2021. The sample of the study comprised 220 pregnant women. The data was collected with a Pregnant Information Form, and the Pearson Chi-square test and Binary Logistic Regression analysis were employed in the analysis. It was determined that the incidence of unplanned pregnancy during the COVID-19 pandemic was 33.6% and that number of living children [AOR:0.73, 95% CI:(0.23-0.99)], thought of having another child [AOR:1.21, 95% CI:(1.43-7.89)], the family planning method used [AOR:1.31, 95% CI:(1.05-5.22)], and having problems in reaching a family planning method [AOR:1.97, 95% CI:(0.04-0.50)] affected the occurrence of unplanned pregnancies (p < .05). IMPACT STATEMENTWhat is already known on this subject? Unplanned pregnancies adversely affect maternal and newborn health.What do the results of this study add? It was found that approximately one out of three pregnancies during the COVID-19 pandemic process was unplanned and that the number of living children, the thought of having another child, the family planning method used, and having problems in obtaining a family planning method affected the occurrence of unplanned pregnancies.What are the implications of these findings for clinical practice and/or further research? It can guide politicians in the arrangements regarding sexual and reproductive health services during the COVID-19 pandemic.
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Affiliation(s)
- Yasemin Sökmen
- Midwifery Department, Ondokuz Mayıs University, Samsun, Turkey
| | | | - Hilal Bal Şaraldı
- Midwifery Program PhD Student, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Ayten Taşpınar
- Midwifery Department, Aydın Adnan Menderes University, Aydın, Turkey
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20
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McNamee K, Edelman A, Li RHW, Kaur S, Bateson D. Best Practice Contraception Care for Women with Obesity: A Review of Current Evidence. Semin Reprod Med 2022; 40:246-257. [PMID: 36746158 DOI: 10.1055/s-0042-1760214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The prevalence of obesity among females of reproductive age is increasing globally. Access to the complete range of appropriate contraceptive options is essential for upholding the reproductive rights of this population group. People with obesity can experience stigma and discrimination when seeking healthcare, and despite limited evidence for provider bias in the context of contraception, awareness for its potential at an individual provider and health systems level is essential. While use of some hormonal contraceptives may be restricted due to increased health risks in people with obesity, some methods provide noncontraceptive benefits including a reduced risk of endometrial cancer and a reduction in heavy menstrual bleeding which are more prevalent among individuals with obesity. In addition to examining systems-based approaches which facilitate the provision of inclusive contraceptive care, including long-acting reversible contraceptives which require procedural considerations, this article reviews current evidence on method-specific advantages and disadvantages for people with obesity to guide practice and policy.
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Affiliation(s)
| | - Alison Edelman
- Department of Obstetrics and Gynecology, School of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Raymond Hang Wun Li
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong, Hong Kong
| | - Simranvir Kaur
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Palo Alto, California
| | - Deborah Bateson
- Faculty of Medicine and Health, Daffodil Centre, University of Sydney, Sydney, Australia
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21
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Khan MN, Akter S, Islam MM. Availability and readiness of healthcare facilities and their effects on long-acting modern contraceptive use in Bangladesh: analysis of linked data. BMC Health Serv Res 2022; 22:1180. [PMID: 36131314 PMCID: PMC9490900 DOI: 10.1186/s12913-022-08565-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Aim Increasing access to long-acting modern contraceptives (LMAC) is one of the key factors in preventing unintended pregnancy and protecting women’s health rights. However, the availability and accessibility of health facilities and their impacts on LAMC utilisation (implant, intrauterine devices, sterilisation) in low- and middle-income countries is an understudied topic. This study aimed to examine the association between the availability and readiness of health facilities and the use of LAMC in Bangladesh. Methods In this survey study, we linked the 2017/18 Bangladesh Demographic and Health Survey data with the 2017 Bangladesh Health Facility Survey data using the administrative-boundary linkage method. Mixed-effect multilevel logistic regressions were conducted. The sample comprised 10,938 married women of 15–49 years age range who were fertile but did not desire a child within 2 years of the date of survey. The outcome variable was the current use of LAMC (yes, no), and the explanatory variables were health facility-, individual-, household- and community-level factors. Results Nearly 34% of participants used LAMCs with significant variations across areas in Bangladesh. The average scores of the health facility management and health facility infrastructure were 0.79 and 0.83, respectively. Of the facilities where LAMCs were available, 69% of them were functional and ready to provide LAMCs to the respondents. The increase in scores for the management (adjusted odds ratio (aOR), 1.59; 95% CI, 1.21–2.42) and infrastructure (aOR, 1.44; 95% CI, 1.01–1.69) of health facilities was positively associated with the overall uptake of LAMC. For per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities, the aORs for women to report using LAMC were 2.16 (95% CI, 1.18–3.21) and 1.74 (95% CI, 1.15–3.20), respectively. A nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometre increase in the average regional-level distance between women’s homes and the nearest health facilities. Conclusion The proximity of health facilities and their improved management, infrastructure, and readiness to provide LAMCs to women significantly increase their uptake. Policies and programs should prioritise improving health facility readiness to increase LAMC uptake.
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Affiliation(s)
- Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, 2222, Bangladesh.
| | - Shahinoor Akter
- Gender and Women's Health, Centre for Health Equity School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, 3086, Australia
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22
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Maas VYF, Poels M, de Kievit MH, Hartog AP, Franx A, Koster MPH. Planning is not equivalent to preparing, how Dutch women perceive their pregnancy planning in relation to preconceptional lifestyle behaviour change - a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:577. [PMID: 35854217 PMCID: PMC9295368 DOI: 10.1186/s12884-022-04843-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Unhealthy prenatal lifestyle behaviours are associated with adverse pregnancy outcomes, but little is known about what motivates women to comply with preconceptional lifestyle recommendations or consciously plan their pregnancy. Therefore, the objective of this study is to explore the associations between preconceptional lifestyle behaviours, health beliefs and pregnancy planning among Dutch pregnant women. METHODS In this cross-sectional study based on the data of the APROPOS-II study, 1,077 low-risk pregnant women were eligible for inclusion. Preconception lifestyle behaviours and actively preparing for pregnancy were assessed in relation to planned pregnancies (based on the London Measure of Unplanned Pregnancies) and health beliefs (14 statements). The following preconceptional lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester of pregnancy: fruit intake, vegetable intake, caffeine intake, (second-hand)smoking, alcohol intake, folic acid supplement use and exercise. Data were analysed using multivariate logistic regression analyses. RESULTS A total of 921 (85.5%) women in our cohort had a planned pregnancy. However, of these women, 640 (69.5%) adequately used folic acid supplements and 465 (50.5%) women consumed alcohol at any point during pregnancy. Of the women considering themselves 'healthy enough and not needing preconception care', 48 (9.1%) women had an adequate vegetable intake, 294 (55.6%) women consumed alcohol at any point during pregnancy and 161 (30.4%) women were either over-or underweight. CONCLUSION Despite consciously planning their pregnancy, most women did not adhere to preconceptional lifestyle behaviour recommendations. Women's health beliefs and overestimation of their health status seem to interfere with actively planning and preparing for pregnancy. Findings from our study may encourage the development of prospective health-promoting interventions that focus on health beliefs and actively preparing for pregnancy, to improve preconceptional lifestyle behaviours, thereby optimizing the health of future generations.
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Affiliation(s)
- Veronique Y F Maas
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - Marjolein Poels
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
- Research Agency Care2Research, Niasstraat 7, 1095 TS, Amsterdam, the Netherlands
| | - Marleen H de Kievit
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Anniek P Hartog
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Maria P H Koster
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
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23
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Weiland S, Peters LL, Berger MY, Erwich JJHM, Jansen DEMC. Women who smoke during pregnancy are more likely to be referred to an obstetrician during pregnancy and birth: results from a cohort study. BMC Pregnancy Childbirth 2022; 22:479. [PMID: 35698051 PMCID: PMC9190098 DOI: 10.1186/s12884-022-04808-7] [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: 11/30/2021] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Women who smoke during pregnancy make less use of prenatal care; the relation of smoking behavior with the use of other forms of maternal healthcare is unknown. The objective of this study is to investigate the association between women’s smoking behavior and their use of healthcare during pregnancy, birth and six weeks postpartum. Methods We analyzed data from the Dutch Midwifery Case Registration System (VeCaS), period 2012–2019. We included women with a known smoking status, singleton pregnancies, and who had their first appointment before 24 weeks of gestation with the primary care midwife. We compared three groups: non-smokers, early stoppers (stopped smoking in the first trimester), and late- or non-stoppers (stopped smoking after the first trimester or continued smoking). Descriptive statistics were used to report maternal healthcare utilization (during pregnancy, birth and six weeks postpartum), statistical differences between the groups were calculated with Kruskal–Wallis tests. Multivariable logistic regression was conducted to assess the association between smoking behavior and referrals to primary, secondary or tertiary care. Results We included 41 088 pregnant women. The groups differed significantly on maternal healthcare utilization. The late- or non-stoppers initiated prenatal care later and had less face-to-face consultations with primary care midwives during pregnancy. Compared to the non-smokers, the early- and late- or non-stoppers were statistically signficiantly more likely to be referred to the obstetrician during pregnancy and birth. Postpartum, the early- and late- or non-stoppers were statistically signficantly less likely to be referred to the obstetrician compared to the non-smokers. Conclusions Although the early- and late- or non-stoppers initiated prenatal care later than the non-smokers, they did receive adequate prenatal care (according to the recommendations). The results suggest that not smoking during pregnancy may decrease the likelihood of referral to secondary or tertiary care. The large population of smokers being referred during pregnancy underlines the important role of the collaboration between healthcare professionals in primary and secondary or tertiary care. They need to be more aware of the importance of smoking as a medical and as a non-medical risk factor.
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Affiliation(s)
- S Weiland
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. .,Department of Midwifery Science AVAG, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - L L Peters
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Department of Midwifery Science AVAG, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Y Berger
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - J J H M Erwich
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - D E M C Jansen
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Olani AB, Bekelcho T, Woldemeskel A, Tefera K, Eyob D. Evaluation of the Amharic version of the London measure of unplanned pregnancy in Ethiopia. PLoS One 2022; 17:e0269781. [PMID: 35696385 PMCID: PMC9191743 DOI: 10.1371/journal.pone.0269781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 05/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background Unplanned pregnancy is an important public health problem in both the developing and developed world, as it may cause adverse social and health outcomes for mothers, children, and families as a whole. London Measure of Unplanned Pregnancy (LMUP) has been formally and informally validated in multiple and diverse settings. However, there is a dearth of literature on the validation of LMUP in Ethiopia either in the Amharic version or other languages. Objective The general objective of this study was to translate the LMUP into Amharic and evaluate its psychometric properties in a sample of Amharic-speaking women receiving antenatal care (ANC) service at public health facilities in Arbaminch and Birbir towns. Methods A cross-sectional study design was used for the study. Forward and backward translation of original English LMUP to Amharic was done. A cognitive interview using a pretested structured questionnaire was used to collect the data from respondents. The collected data was analyzed using SPSS version 25. Reliability was assessed using Cronbach’s alpha, inter-item correlations, and corrected item-total correlations while construct validity was assessed using principal components analysis and hypothesis testing. Results Data was collected from 320 women attending antennal care services at selected public health care facilities. LMUP range of 1to 11 was captured. The prevalence of unplanned pregnancies was 19(5.9%), while 136(42.5 were ambivalent and 165(51.6%) were planned pregnancies. The reliability testing demonstrated acceptable internal consistency (Cronbach’s alpha = 0.799) and the validity testing confirmed the unidimensional structure of the scale. In addition, all hypotheses were confirmed. Conclusions Amharic version of LMUP is a valid and reliable tool to measure pregnancy intention so that it can be used by Amharic speaking population in Ethiopia. It can also be used in research studies among Amharic-speaking women to measure unplanned pregnancy.
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Affiliation(s)
- Ararso Baru Olani
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
- Research and Collaboration Department, Slum and Rural Health Initiative Network, Addis Ababa, Ethiopia
- * E-mail:
| | - Tariku Bekelcho
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
- Research and Collaboration Department, Slum and Rural Health Initiative Network, Addis Ababa, Ethiopia
| | - Asfawosen Woldemeskel
- Department of Medicine, College of Health Sciences, Ethiopian Police University, Sendafa, Ethiopia
| | - Kibreyesus Tefera
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Degefe Eyob
- College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
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Bacteriuria in Pregnant Adolescents and Behavioral Risk Factors: A Cross-Sectional Study at a Brazilian Teaching Hospital. J Pediatr Adolesc Gynecol 2022; 35:314-322. [PMID: 34742938 DOI: 10.1016/j.jpag.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/08/2021] [Accepted: 10/25/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Bacteriuria during pregnancy is a frequent and important cause of morbidity and complications. Data on its occurrence in pregnant adolescents are still scarce. METHODS A cross-sectional study was conducted at a tertiary teaching hospital in São Paulo, Brazil. All adolescents (≤18 years) who came for prenatal care between January 2010 and January 2016 were included. Sociodemographic characteristics, medical history, obstetric history, and the results of laboratory tests were selected. A urine sample was aseptically collected from each patient to undergo microscopic and culture analysis. RESULTS A total of 388 pregnant adolescents averaging 15.30 ± 1.24 years of age were included. The frequency of bacteriuria in this group was 17.01% (66/388). The lack of sports practice (OR = 8.65; 95% CI, 1.09-68.39), the fact that pregnancy was desired (OR = 2.17; 95% CI, 1.08-4.34), and the use of hormonal methods of contraception (OR = 2.46; 95% CI, 1.04-5.84) turned out to be independent risk factors for bacteriuria. Protective factors were identified as late coitarche (OR = 0.75; 95% CI, 0.57-0.98) and a urine culture analysis at a later gestational age (OR = 0.94; 95% CI, 0.90-0.98). The most often isolated pathogens were Escherichia coli (49%) and Streptococcus agalactiae (18%). CONCLUSION Bacteriuria among pregnant adolescents is a relatively common condition. The infection risk of the urinary tract was increased by physical inactivity and seemingly by the influence of behavioral and sexual factors. Such results can help to identify patients at risk, favoring the early diagnosis of urinary tract infections and optimizing prenatal care.
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McNamara J, Risi A, Bird AL, Townsend ML, Herbert JS. The role of pregnancy acceptability in maternal mental health and bonding during pregnancy. BMC Pregnancy Childbirth 2022; 22:267. [PMID: 35351015 PMCID: PMC8966290 DOI: 10.1186/s12884-022-04558-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 03/08/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Pregnancy is an important time for women's mental health and marks the foundations of the emerging bond between mother and baby. This study aimed to investigate the role of pregnancy acceptability and intendedness in maternal mental health and bonding during pregnancy. METHODS Data were collected from a community sample of 116 Australian pregnant women (M = 29.54, SD = 5.31) through a series of self-report questionnaires pertaining to mental health and antenatal bonding. RESULTS Lower pregnancy acceptability was correlated with higher depression, anxiety and total distress, lower physical and environmental quality of life and lower antenatal bonding. Women who reported their pregnancy was intended reported higher physical quality of life than those who reported their pregnancy was unintended. The relationship between total distress and antenatal bonding was moderated by women's degree of pregnancy acceptability (low versus high). For women with low acceptability, higher distress was associated with lower bonding, but there was no such association for women with high pregnancy acceptability. The moderation model examining associations between distress and pregnancy acceptability explained 15% of the variance in antenatal bonding scores. CONCLUSION Consideration of women's appraisal of their pregnancy acceptability may provide a valuable framework for identifying individuals who may be at risk for mental health and bonding difficulties.
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Affiliation(s)
- Josephine McNamara
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Alixandra Risi
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Amy L Bird
- School of Psychology, University of Waikato, Hamilton, Waikato, 3240, New Zealand
| | - Michelle L Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Jane S Herbert
- School of Psychology, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Early Start, University of Wollongong, Wollongong, NSW, 2522, Australia.
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Kazemi A, Dadkhah A, Torabi F. Changes of health related quality of life during pregnancy based on pregnancy context: a prospective study. Arch Public Health 2022; 80:37. [PMID: 35063021 PMCID: PMC8781331 DOI: 10.1186/s13690-022-00802-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The significance of planned pregnancy is an accepted principle for improving the health of pregnant women; and quality of life, as one of the important indicators of women’s health, is reduced in high-risk pregnancies. The aim of this research was to investigate the changes in the health related quality of life (HRQL) in low risk pregnancies in different groups based on pregnancy context.
Methods
The present study was a prospective study conducted on 250 pregnant women divided into three groups of women with planned pregnancy, unplanned/wanted pregnancy and unwanted pregnancy. Then, using WHOQOL-26 questionnaire, the quality of life of these women was measured in physical, psychological, social and environmental dimensions at the beginning of pregnancy as well as at the end of the first, second and third trimesters.
Results
Based on the results, the mean score of environmental-HRQL in women with unwanted pregnancy was significantly lower than the other two groups. All dimensions on HRQL were influenced by time and group. However, changes in the physical, psychological and social dimensions of HRQL varied within the groups. Physical- HRQL changes were different within the groups. The intergroup effect on environmental dimension of quality of life changes was significant.
Conclusions
It was observed in this study that HRQL in the women with unwanted pregnancy was lower than the women with planned pregnancy and those with unplanned /wanted pregnancy. Moreover, increase in gestational age would lower quality of life, but this decline had a similar pattern in different groups.
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Toscano M, Wood J, Spielman S, Ferri R, Whaley N, Seligman NS. Prenatal care utilization in pregnant women who consider but do not have abortions. BMC Pregnancy Childbirth 2022; 22:53. [PMID: 35062913 PMCID: PMC8780296 DOI: 10.1186/s12884-021-04343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Over half of all pregnancies in the United States are unintended, and 18% result in termination of pregnancy (TOP). Some women seek TOP, but ultimately continue their pregnancy. Data are limited about their utilization of prenatal care and their perinatal outcomes. Our primary outcome was to investigate differences in guideline-based prenatal care utilization in women who consider but do not have an abortion.
Methods
Retrospective cohort study of patients having obstetrical dating ultrasound (US) from 2011–2018 at a single academic medical center that offers TOP. Contemplators completed US with intention of TOP but instead continued the pregnancy to live birth. A 2:1 group of non-contemplators completed US and continued to live birth. A prenatal care utilization scoring system was used to compare groups. Secondary outcomes investigated differences in adverse pregnancy outcomes and postpartum care.
Results
There were 94 contemplators and 183 non-contemplators. Inadequate prenatal care utilization initially was more common in contemplators than non-contemplators (62.8% vs 85.8%, p < 0.01) but was not significant after adjustment (aOR 1.0, 95% CI 0.40 – 2.56). There were no differences in adverse obstetric or neonatal outcomes. Contemplators were significantly more likely to have a postpartum contraceptive method (PPCM) upon hospital discharge (aOR 4.8, 95% CI 1.16 – 20.0) and significantly more likely to use a highly-effective PPCM (aOR 6.4, 95% CI 2.34 – 17.4).
Conclusions
Reversal of intention for TOP is not associated with differences in prenatal care utilization, but is associated with increased uptake of postpartum contraceptive method.
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Muskens L, Boekhorst MGBM, Kop WJ, van den Heuvel MI, Pop VJM, Beerthuizen A. The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study. Arch Womens Ment Health 2022; 25:611-620. [PMID: 35347473 PMCID: PMC9072423 DOI: 10.1007/s00737-022-01225-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/18/2022] [Indexed: 12/25/2022]
Abstract
Perinatal depression is common, affecting approximately 7-13% of women. Studies have shown an association between unplanned pregnancy and perinatal depressive symptoms, but many used a cross-sectional design and limited postnatal follow-up. The current study investigated the association of unplanned pregnancy with perinatal depressive symptoms using a longitudinal cohort study that followed women from the first trimester until 12 months postpartum. Pregnant women (N = 1928) provided demographic and clinical data and information about pregnancy intention at the first trimester. Depressive symptoms were assessed during each trimester of pregnancy and five times postpartum using the Edinburgh Postnatal Depression Scale (EPDS) until 12 months postpartum. Mixed model analyses were used to investigate the association between an unplanned pregnancy and the level of depressive symptoms. Women with an unplanned pregnancy (N = 111, 5.8%) reported persistently higher levels of depressive symptoms during the entire perinatal period compared to women with a planned pregnancy, after adjustment for confounders (p < 0.001). However, the course of depressive symptom scores over time in women with an unplanned pregnancy was similar to that of women with a planned pregnancy. Lower age (p = 0.006), unemployment (p = 0.004), and history of depression (p < 0.001) were significantly associated with higher levels of perinatal depressive symptoms. An unplanned pregnancy may have a long-lasting negative impact on a woman's perinatal mental health. Therefore, women with an unplanned pregnancy may benefit from systematic follow-up during the perinatal period with contingent mental health support.
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Affiliation(s)
- Lotte Muskens
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, Netherlands.
| | - Myrthe G. B. M. Boekhorst
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | - Willem J. Kop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | | | - Victor J. M. Pop
- Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, Netherlands
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Adelekun AA, Villa NM, Hsiao JL, Micheletti RG. Pregnancy in Hidradenitis Suppurativa-Patient Perspectives and Practice Gaps. JAMA Dermatol 2021; 157:227-230. [PMID: 33439230 DOI: 10.1001/jamadermatol.2020.5162] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Natalie M Villa
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Jennifer L Hsiao
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Robert G Micheletti
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Yu P, Jiang Y, Zhou L, Li K, Xu Y, Meng F, Zhou Y. Association between pregnancy intention and smoking or alcohol consumption in the preconception and pregnancy periods: A systematic review and meta-analysis. J Clin Nurs 2021; 31:1113-1124. [PMID: 34459054 DOI: 10.1111/jocn.16024] [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: 05/12/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
AIMS To investigate the association between pregnancy intention and smoking or alcohol consumption in preconception and pregnancy periods. BACKGROUND Suboptimal lifestyle such as smoking and alcohol consumption can lead to devastating outcomes on the maternal and foetus. Pregnancy intention exerts a significant effect on promoting healthy lifestyle behaviours. However, no reliable evidences confirmed pregnancy intention was associated with smoking and alcohol consumption before and during pregnancy. DESIGN Systematic review and meta-analysis. METHODS We performed a comprehensive search from databases including PubMed, Cochrane, Web of Science, IEEE Xplore, MEDLINE, ProQuest and Scopus from the inception of these databases up to November, 2020. All eligible studies exploring the association between pregnancy intention and smoking or alcohol consumption were included. The fixed- or random effect pooled measure was used to estimate the odds ratio (OR) or risk ratio (RR) and 95% CI. In addition, the PRISMA checklist was used in this meta-analysis. RESULTS A total of 23 studies were included in this systematic review and meta-analysis. During pregnancy, the findings suggested that women with unplanned pregnancy were 68% more likely to consume cigarettes (OR = 1.68, 95% CI = 1.44-1.95) and 44% more likely to consume alcohol (OR = 1.44, 95% CI = 1.15-1.81) than those women with planned pregnancy. Meanwhile, during preconception, women with unplanned pregnancy were 30% more likely to consume cigarettes (OR = 1.30, 95% CI = 1.10-1.53) and 20% more likely to consume alcohol (OR = 1.20, 95% CI = 1.01-1.42) than those women with planned pregnancy. CONCLUSION The findings suggested that women with unplanned pregnancy were more likely to follow unhealthy behaviours such as smoking and alcohol consumption before and during pregnancy. Health professionals should consider the women's desire for pregnancy to decrease preconception and pregnancy smoking or alcohol consumption in future studies. RELEVANCE OF CLINICAL PRACTICE Pregnancy intention is the key determinant of smoking and alcohol consumption during preconception and pregnancy periods. Offering effective contraception in primary healthcare setting could prevent unplanned pregnancy. Meanwhile, popularising minimal alcohol consumption and comprehensive smoke-free legislation would be beneficial to improve reproductive outcomes.
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Affiliation(s)
- Pengli Yu
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunxia Jiang
- School of Nursing, Qingdao University, Qingdao, China
| | - Lixue Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Kuinan Li
- School of Nursing, Qingdao University, Qingdao, China
| | - Yanhong Xu
- School of Nursing, Qingdao University, Qingdao, China
| | - Fei Meng
- School of Nursing, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
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Didn't Plan One but got One: Unintended and sooner-than-intended Parents in the East and the West of Europe. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2021; 37:727-767. [PMID: 34421451 PMCID: PMC8333183 DOI: 10.1007/s10680-021-09584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/12/2021] [Indexed: 10/26/2022]
Abstract
The realisation rates of short-term childbearing intentions are known to be consistently lower in post-socialist countries than in the rest of Europe. However, the East-West differences in the outcomes of intentions to postpone or forego (further) childbearing have not been previously examined. We employ two panel waves of the Generations and Gender Survey in six countries (three from Eastern and three from Western Europe), and, based on the short- and long-term fertility intentions expressed by respondents at the first survey wave, we classify the births occurring between two waves as intended, sooner-than-intended, or unintended. We find that in our study population of non-teenage respondents who had the same partner at both survey waves and a child between the two survey waves, between around 10% (Western European countries) and 30% (Eastern European countries) experienced an unintended or a sooner-than-intended birth. The East-West divide is largely driven by the share of unintended parents which is clearly higher in the post-socialist countries. However, the geographical pattern fades away once we control for the anticipated costs of having a child. Our study gives insight into East-West differences in attitudes to childbearing and into how they affect reproductive behaviour. It also offers methodological improvements of cross-national panel surveys designed to examine childbearing intentions that would allow for a more accurate assessment of childbearing intendedness.
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Du L, La X, Zhu L, Jiang H, Xu B, Chen A, Li M. Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China. BMC Pregnancy Childbirth 2021; 21:491. [PMID: 34233653 PMCID: PMC8262048 DOI: 10.1186/s12884-021-03940-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners. METHODS A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception. RESULTS Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45-4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48-5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03-4.39, P = 0.041] before conception. CONCLUSIONS Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.
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Affiliation(s)
- Li Du
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China
| | - Xuena La
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
- Shanghai Municipal Center for Disease Control and Prevention, No.1380 West Zhongshan Road, Shanghai, 200336, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, 339 Luding Road, Putuo District, Shanghai, 200062, China.
| | - Hong Jiang
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Biao Xu
- School of Public Health; Global Health Institute; Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA Institute), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, FI-02150, Espoo, Finland
| | - Mu Li
- School of Public Health, China Studies Centre, University of Sydney, Room 313, Edward Ford Building, Sydney, 2006, Australia
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Ueno Y, Kako M, Ohira M, Okamura H. Shared decision-making for women facing an unplanned pregnancy: A qualitative study. Nurs Health Sci 2021; 22:1186-1196. [PMID: 33159478 DOI: 10.1111/nhs.12791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
This study aimed to explore the competencies of health care practitioners who promote shared decision-making (SDM)-based care for women facing an unplanned pregnancy in Japan. We conducted semistructured interviews with 12 care providers who are pioneers in care for women facing an unplanned pregnancy and adopted a modified grounded theory approach for data analysis. A three-step model for shared decision making in practice (team talk, option talk, and decision talk) was used as a reference. The answers given by the care providers were analyzed to identify the competencies involved in shared decision making. We identified three stages: (i) building trust and promoting women's expression; (ii) discussing women's real needs; and (iii) exploring the intentions and goals expressed by women and finding the best choices while promoting women's autonomy in decision-making. The coordination between the support of partners, families, and professionals, and the care provided to strengthen women's identities facilitated shared decision making. Women facing an unplanned pregnancy can benefit from interventions designed to improve shared decision making. A key component of shared decision making-based care relates to practitioners' raised awareness toward their roles and responsibilities: developing good communication skills and fostering collaboration between all stakeholders.
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Affiliation(s)
- Yoko Ueno
- Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - Mayumi Kako
- Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuko Ohira
- Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
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Baser E, Aydogan Kirmizi D, Kasapoglu T, Fırtına Tuncer S, Ozturk Başarir Z, Salgur F, Bilge M, Altinbas SK, Tapisiz OL. Unplanned pregnancy and awareness of emergency contraception: a postpartum period survey. EUR J CONTRACEP REPR 2021; 26:507-512. [PMID: 33855927 DOI: 10.1080/13625187.2021.1906411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The study aimed to determine the awareness of emergency contraception (EC) and knowledge of its use as well as the unplanned pregnancy rate among women in the immediate postpartum period in Ankara, Turkey's second largest city. METHODS Interviews were carried out among 1955 women on their first or second day postpartum. The interview was based on a questionnaire containing 19 questions covering participants' awareness and experience of using EC as well as their future approach to its use. RESULTS The rate of unplanned pregnancy was 18.2% and the rate of EC awareness was 26.0%; 89.4% of those who were aware of EC knew how to use it correctly. In the multivariate regression analysis, employment, household income and level of education were independently associated with EC awareness; gravidity, household income, level of education and number of abortions were independently associated with unplanned pregnancy. Awareness of EC increased significantly (p < .05) with age, household income and educational level; knowledge about the correct use of EC increased with age and educational level (p < .05). CONCLUSION EC awareness among the study population was low and was related to household income and educational level. Household income, educational level and gravidity were the most important factors associated with unplanned pregnancy. Governments must therefore establish appropriate health policies and provide contraceptive education to women from adolescence onwards.
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Affiliation(s)
- Emre Baser
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Demet Aydogan Kirmizi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Taner Kasapoglu
- Department of Obstetrics and Gynaecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Serap Fırtına Tuncer
- Department of Obstetrics and Gynaecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Zehra Ozturk Başarir
- Department of Gynaecologic Oncology, Ankara Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey
| | - Funda Salgur
- Department of Family Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Melek Bilge
- Department of Obstetrics, Dr Ali Kemal Belviranli Hospital for Obstetrics and Paediatrics, Konya, Turkey
| | - Sadiman Kiykac Altinbas
- Department of Obstetrics and Gynaecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Omer Lutfi Tapisiz
- Department of Obstetrics and Gynaecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
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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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Salinas-Vilca A, Cuevas L, Bermejo-Sánchez E, Galán I. Smoking during pregnancy: changes and associated risk factors in Spain, 1980-2016. J Public Health (Oxf) 2021; 44:438-446. [PMID: 33522592 DOI: 10.1093/pubmed/fdaa277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 10/16/2020] [Accepted: 12/28/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Trends for maternal smoking rates have varied substantially across industrialized countries. The objective was to describe how the prevalence of maternal smoking evolved in Spain during 1980-2016. METHODS Data came from the Spanish Collaborative Study of Congenital Malformations. Our sample consisted of 40 934 mothers of newborns with no congenital defects from hospitals all across Spain. We estimated change points in trend and the mean annual change in smoking prevalence using 'joinpoint' regression. Relevant potential factors (age, country of birth, education, parity, planned pregnancy and alcohol consumption) were examined using multivariate logistic regression. RESULTS Maternal smoking prevalence in 1980 and 2016 were 14.3% (95% confidence interval [CI]: 11.9-17.0) and 20.4% (95% CI: 15.9-25.8). We identified four periods with distinct trends: a sharp increase during the 80s, a plateau during the 90s, a decrease starting in 2000 and a slowdown of such decrease from 2009 on. Smoking was significantly higher among young women, Spain-born, with low education, unplanned pregnancy, and alcohol consumption. CONCLUSIONS Currently in Spain maternal smoking remains very high. Tobacco consumption trend showed an increase during the 80s, a plateau during the 90s, and a reduction in the 2000s. Several sociodemographic and behavioural factors were associated to greater likelihood of smoking.
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Affiliation(s)
- Ana Salinas-Vilca
- Department of Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - Lourdes Cuevas
- ECEMC, Research Unit on Congenital Anomalies (UIAC), Institute of Health Carlos III, Madrid, Spain
| | | | - Eva Bermejo-Sánchez
- ECEMC, Research Unit on Congenital Anomalies (UIAC), Institute of Health Carlos III, Madrid, Spain.,Institute of Rare Diseases Research (IIER), Institute of Health Carlos III, Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
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Altiparmak S, Yilmaz AN, Aksoy Derya Y. The Turkish validity and reliability study of the London measure of unplanned pregnancy. J Obstet Gynaecol Res 2021; 47:1362-1370. [PMID: 33496061 DOI: 10.1111/jog.14678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/14/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Abstract
AIM This study aims to adapt the London Measure of Unplanned Pregnancy (LMUP) developed by Barrett et al. to Turkish by checking its validity and reliability. METHOD The sample of this methodological study consisted of 596 pregnant women who were referred to the antenatal outpatient clinics of a public hospital in eastern Turkey. Data were collected from those who agreed to participate in the study, by using a personal information form and the six-item LMUP. Data were analyzed using SPSS 25.0 and AMOS 24.0 statistical package programs, and statistically assessed using descriptive statistics such as number, percentage, mean and SD, language and content validity, explanatory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's α reliability coefficient, and test-retest analysis. RESULTS The EFA revealed that the Turkish version of the LMUP consisted of five items and one factor. The items' factor loadings were above 0.30, and explained 68.89% of the total variance. The CFA supported the one-factor structure of the scale, which was revealed by the EFA. As a result of the CFA, the fit indices were found to be very good. The Cronbach's α coefficient of the scale was determined as 0.90. CONCLUSION The Turkish version of the LMUP is a valid and reliable instrument to evaluate unplanned pregnancy.
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Affiliation(s)
- Sümeyye Altiparmak
- Research Assistant, Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Ayşe N Yilmaz
- Research Assistant, Department of Midwifery, Faculty of Health Sciences, Fırat University, Elazığ, Turkey
| | - Yeşim Aksoy Derya
- Associate Professor, Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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Wang X, Wu D, Li W, Yang L. Emerging biomaterials for reproductive medicine. ENGINEERED REGENERATION 2021; 2:230-245. [DOI: 10.1016/j.engreg.2021.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Sudhinaraset M, Vilda D, Gipson JD, Bornstein M, Wallace ME. Women's Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status. Am J Prev Med 2020; 59:787-795. [PMID: 33067070 PMCID: PMC7683369 DOI: 10.1016/j.amepre.2020.07.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Reproductive rights policies can potentially support or inhibit individuals' abilities to attain the highest standard of reproductive and sexual health; however, research is limited on how broader social policies may differentially impact women of color and immigrants in the U.S. This study examines the associations among state-level reproductive rights policies, race, and nativity status with preterm birth and low birth weight in the U.S. METHODS This was a retrospective, cross-sectional analysis of all births occurring within all the 50 states and the District of Columbia using vital statistics birth record data in 2016 (N=3,945,875). Modified log-Poisson regression models with generalized estimating equations were fitted to estimate the RR of preterm birth and low birth weight associated with tertiles of the reproductive rights policies index. Analyses were conducted between 2019 and 2020. RESULTS Compared with women in states with the most restrictive reproductive rights policies, women living in the least restrictive states had a 7% lower low birth weight risk (adjusted RR=0.93, 95% CI=0.88, 0.99). In particular, low birth weight risk was 8% lower among Black women living in the least restrictive states than among their counterparts living in the most restrictive states (adjusted RR=0.92, 95% CI=0.86, 0.99). In addition, low birth weight risk was 6% lower among U.S.-born Black women living in the least restrictive states than among those living in the most restrictive states, but this was marginally significant (adjusted RR=0.94, 95% CI=0.89, 1.00). No other significant associations were found for race-nativity-stratified models. CONCLUSIONS Women living in states with fewer restrictions related to reproductive rights have lower rates of low birth weight, especially for Black women.
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Affiliation(s)
- May Sudhinaraset
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
| | - Dovile Vilda
- Mary Amelia Douglas-Whited Community Women's Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Jessica D Gipson
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Marta Bornstein
- Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California; California Center for Population Research, University of California, Los Angeles, Los Angeles, California
| | - Maeve E Wallace
- Mary Amelia Douglas-Whited Community Women's Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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Ranatunga IDJC, Jayaratne K. Proportion of unplanned pregnancies, their determinants and health outcomes of women delivering at a teaching hospital in Sri Lanka. BMC Pregnancy Childbirth 2020; 20:667. [PMID: 33153469 PMCID: PMC7643445 DOI: 10.1186/s12884-020-03259-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unplanned pregnancy is a significant public health issue in both low- and high-income countries. The burden of unplanned pregnancy is reflected in women opting for pregnancy terminations and it can be detrimental to the women and her family as well as the health system and society. Solid data on the proportion of unplanned pregnancies are using more specific tools such as the London Measure of Unplanned Pregnancy (LMUP) needed to address the issue in Sri Lankan contexts. The objective was to describe the proportion of unplanned pregnancies, their determinants and the health outcomes of women delivering at Colombo North Teaching Hospital-Ragama (CNTH). METHODS A cross-sectional study was carried out among 494 consecutive pregnant women selected by non-probability consecutive sampling who were admitted for the confinement at CNTH. A pre-tested structured interviewer-administered questionnaire was used to collect data on antenatal women and intentionality measured by self-administered six-item LMUP. Maternal and newborn health outcomes were ascertained in each post-partum women before discharge. Data were analyzed with the Mann-Whitney U tests, Kruskal-Wallis tests and spearman rank correlation. We also evaluated the psychometric properties of the Sinhalese version of LMUP. RESULTS The response rate was 97.8 and 17.2% of pregnancies ending at birth were unplanned, 12.7% were ambivalent and 70.1% were planned. Associated factor profile of women with unplanned pregnancies includes; not married women (p = 0.001), educated up to the passing of GCE ordinary level by women (p < 0.001) and spouse (p < 0.001), primiparity (p = 0.002) and inadequate knowledge on emergency contraceptives (p = 0.037). Less planned pregnancies were also significantly associated with anemia (p = 0.004), low mood for last 2 weeks (p < 0.001), having a partner with problematic alcohol consumption (p < 0.001), presence of Gender-Based Violence (GBV) (p < 0.001), poor relationship satisfaction with partner (p < 0.001) and family (p < 0.001). Inadequate pre-pregnancy preparation and antenatal care were associated with an unplanned pregnancy. No differences were found in neonatal outcomes. Sinhalese version of the LMUP scale was found to be accepted, valid and reliable with the Cronbach's alpha of 0.936. CONCLUSIONS A sizeable proportion of pregnancies were unplanned. Teenage pregnancies, non-marital relationships and inadequate knowledge on emergency contraceptives, maternal anemia, low mood, and GBV were modifiable associated factors which could be prevented by evidence-based locally applicable approaches.
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Affiliation(s)
| | - Kapila Jayaratne
- Family Health Bureau, Ministry of Health, 231 De Saram Place, Colombo 10, Sri Lanka
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Motlagh ME, Nasrollahpour Shirvani SD, Hassanzadeh-Rostami Z, Torkestani F, Rabiee SM, Ashrafian Amiri H, Radpooyan L. Prevalence, Associated Factors and Consequences of Unwanted Pregnancy in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1530-1538. [PMID: 33083330 PMCID: PMC7554403 DOI: 10.18502/ijph.v49i8.3897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Unwanted pregnancy is a type of unplanned pregnancy that can endanger health of mother and child. This study aimed to determine the prevalence of unwanted pregnancy and its associated factors and consequences in Iran. Methods: This cross-sectional study was conducted in regions with low, moderate and high risk of maternal death. Two provinces were randomly selected in each region and 24 public health centers in each province during 2007–2012. Thereafter, 15–20 mothers, received at least one session of pregnancy care, were selected from each healthcare center. Data were gathered from both health records and interview with the mothers. Results: Of 2714 participants, 86.4% and 13.6% had respectively wanted and unwanted pregnancies. The underlying factors of unwanted pregnancy were determined as low distance with previous and next pregnancy, economic problems and have enough children. Moreover, there were significant relationships between unwanted pregnancy and place of residence, mother’s age and education, father’s education, pre-pregnancy care and number of previous pregnancies and children. There were also significant association between unwanted pregnancy and pregnancy care, anemia, exposure to risk factors and disease, intake of folic acid and iron, domestic violence, bitter memories and men’s participation. Conclusion: Although the prevalence of unwanted pregnancy has had a significant decrease in Iran, these mothers still require a higher level of educational, counseling and supportive services due to their low access to pregnancy care services and high exposure to associated risk factors.
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Affiliation(s)
- Mohammad Esmaeil Motlagh
- Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | | | - Zahra Hassanzadeh-Rostami
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farahnaz Torkestani
- Department of Obstetrics and Gynecology, School of Medicine, Shahed University, Tehran, Iran
| | - Seyed-Mozaffar Rabiee
- Department of Anesthesiology and Intensive Care, Babol University of Medical Sciences, Babol, Iran
| | | | - Laleh Radpooyan
- Department of Health, Ministry of Health and Medical Education, Tehran, Iran
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Child Wantedness and Low Weight at Birth: Differential Parental Investment among Roma. Behav Sci (Basel) 2020; 10:bs10060102. [PMID: 32570733 PMCID: PMC7349268 DOI: 10.3390/bs10060102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 12/29/2022] Open
Abstract
Studies investigating child wantedness, birthweight and parental care are limited. This study assessed relationships of child wantedness, low birthweight and differential parental investment in a poor population of Serbian Roma. Data from the Multiple Indicator Cluster Survey round 5 for Roma settlements were used to account for the association between child wantedness and birthweight, and three measures of parental investment: breastfeeding practices, immunization of children and quality of mother-child interaction. The sample included 584 children aged 0-24 months. The child variables were gender, birth order, birthweight (low birthweight at <2500 g and normal birthweight at >2500 g) and whether the child was wanted, while maternal independent variables included age, literacy and household wealth. The results show that unwanted children were at greater risk of having low birthweight. After controlling for birthweight, child wantedness emerged as a predictor of breastfeeding practices and immunization status: Roma mothers biased their investment toward children who were wanted. The quality of mother-child interaction varied with the mother's household wealth. Given the high rates of infant and child mortality among Roma, investments in children's health should be prioritized within the family, where maternal bias in parental investment may contribute to their children's health disparities.
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Khodr ZG, Hall C, Chang RN, Bukowinski AT, Gumbs GR, Conlin AMS. Japanese encephalitis vaccination in pregnancy among U.S. active duty military women. Vaccine 2020; 38:4529-4535. [PMID: 32423771 DOI: 10.1016/j.vaccine.2020.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Japanese encephalitis (JE) vaccine is an inactivated vaccine that has shown no risks in pregnancy in animal models, but epidemiologic studies are lacking. U.S. military service members located in JE endemic regions are required to be vaccinated; understanding the potential adverse events (AEs), including AEs that may occur in pregnancy, is needed. Here, we assessed pregnancy and infant health outcomes in association with JE vaccination in pregnancy. METHODS The study population consisted of 192,570 pregnancies to active duty women (2003-2014), captured in the Department of Defense Birth and Infant Health Research program. JE vaccine in pregnancy, vaccine count, formulation, trimester, and whether first career dose coincided with pregnancy were compared with unexposed pregnancies to assess risk of pregnancy and infant health outcomes. Adjusted risk estimates and 95% confidence intervals (CIs) were calculated by multivariable models. RESULTS Of the 192,570 identifed pregnancies, 513 were exposed to the JE vaccine; 474 exposures occurred in the first trimester. For all outcomes, elevated risk estimates ranging from 1.53 to 1.70, were observed with receipt of >1 JE vaccine in pregnancy, though 95% CIs were wide and encompassed the null. First dose of JE vaccination in pregnancy was associated with a 1.87 (95% CI: 1.12-3.13) times increased risk of low birthweight (LBW) when excluding pregnancies exposed to other non-routinely recommended vaccinations in pregnancy. All other associations were null in both main and subset analyses. CONCLUSIONS The overall results of these analyses provide reassuring findings for the safety of JE vaccination in pregnancy. Higher counts of JE vaccine received in pregnancy yielded large yet non-statistically significant risk estimates for all outcomes, though likely driven by lack of pregnancy awareness. An association was observed with LBW in subset analyses, but it was limited to women receiving their first JE vaccine and not observed in the larger main analyses.
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Affiliation(s)
- Zeina G Khodr
- Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Clinton Hall
- Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA.
| | - Richard N Chang
- Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Anna T Bukowinski
- Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Gia R Gumbs
- Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Ava Marie S Conlin
- Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
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Eick SM, Goin DE, Izano MA, Cushing L, DeMicco E, Padula AM, Woodruff TJ, Morello-Frosch R. Relationships between psychosocial stressors among pregnant women in San Francisco: A path analysis. PLoS One 2020; 15:e0234579. [PMID: 32530956 PMCID: PMC7292353 DOI: 10.1371/journal.pone.0234579] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/28/2020] [Indexed: 11/18/2022] Open
Abstract
Pregnant women who experience psychosocial stressors, such as stressful life events, poor neighborhood quality, and financial hardship, are at an increased risk for adverse pregnancy outcomes. Yet, few studies have examined associations between multiple stressors from different sources, which may be helpful to better inform causal pathways leading to adverse birth outcomes. Using path analysis, we examined associations between multiple self-reported stressor exposures during and before pregnancy in the Chemicals in Our Bodies-2 study (N = 510), a demographically diverse cohort of pregnant women in San Francisco. We examined associations between eight self-reported exposures to stressors and three responses to stress which were assessed via interview questionnaire at the 2nd trimester. Stressors included: neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, and unplanned pregnancy. Perceived stress, depression, and perceived community status were included as indicators of self-reported stress response. Our model indicated that women who experienced discrimination and food insecurity had a 3.76 (95% confidence interval [CI] = 1.60, 5.85) and 2.67 (95% CI = 1.31, 4.04) increase in depression scale scores compared to women who did not experience discrimination and food insecurity, respectively. We additionally identified job strain and caregiving for an ill family member as strong predictors of increased depressive symptoms (β = 1.63, 95% CI = 0.29, 3.07; β = 1.48, 95% CI = 0.19, 2.70, respectively). Discrimination, food insecurity, and job strain also influenced depression indirectly through the mediating pathway of increasing perceived stress, although indirect effects were less precise. In our study population, women who experienced discrimination, food insecurity, job strain and caregiving for an ill family member had an increased number of depressive symptoms compared to women who did not experience these stressors. Results from our study highlight the complex relationships between stressors and stress responses and may help to identify possible mediating pathways leading to adverse pregnancy outcomes.
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Affiliation(s)
- Stephanie M. Eick
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail: (SME); (RM)
| | - Dana E. Goin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Monika A. Izano
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Lara Cushing
- Department of Health Education, San Francisco State University, San Francisco, California, United States of America
| | - Erin DeMicco
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
| | - Rachel Morello-Frosch
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California, San Francisco, San Francisco, California, United States of America
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail: (SME); (RM)
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Gender Differences in Factors Influencing Self-Efficacy Toward Pregnancy Planning among College Students in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103735. [PMID: 32466212 PMCID: PMC7277331 DOI: 10.3390/ijerph17103735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to examine factors influencing college students' self-efficacy toward pregnancy planning by gender using the health belief model (HBM). Utilizing a comparative descriptive design, a total of 819 college students were recruited. A survey was administered to gather information on health beliefs related to pregnancy planning, self-efficacy toward pregnancy planning, fertility knowledge, and general characteristics. The main variables were compared by gender. The factors influencing self-efficacy toward pregnancy planning were identified using hierarchical regression analysis. Female students (476) had lower self-efficacy toward pregnancy planning than male students (343). The significant factors influencing self-efficacy toward pregnancy planning in female students were: depression (β = -0.09, p = 0.030), fertility knowledge (β = 0.08, p = 0.025), barriers (β = -0.57, p < 0.001), and cues to action (β = 0.16, p < 0.001), whereas the corresponding factors in male students were benefits (β = 0.12, p = 0.020), barriers (β = -0.44, p < 0.001), and cues to action (β = 0.16, p = 0.001). The present study confirmed the suitability of the HBM as a conceptual framework for identifying factors influencing self-efficacy toward pregnancy planning. Based on the findings of this study, gender-based similarities and differences in factors influencing self-efficacy should be considered when taking steps to promote self-efficacy toward pregnancy planning among college students.
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Wegner C, Kancherla V, Lux A, Köhn A, Bretschneider D, Freese K, Heiduk M, Redlich A, Schleef D, Jorch G, Rissmann A. Periconceptional folic acid supplement use among women of reproductive age and its determinants in central rural Germany: Results from a cross sectional study. Birth Defects Res 2020; 112:1057-1066. [PMID: 32445297 DOI: 10.1002/bdr2.1714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Prevalence of neural tube defects (NTD) has not decreased in Germany despite longstanding recommendations for folic acid supplementation. To examine the prevalence of periconceptional folic acid supplement use and associated factors among German women of reproductive age. METHODS Cross-sectional survey was conducted in hospital-based maternity units in rural Germany. A sample of 1,004 women of reproductive age, either pregnant or in their early postpartum period, took interviewer/self-administered paper-based survey questionnaire. Prevalence of periconceptional folic acid supplement use was assessed, where periconception was defined as 1 month prior to and 3 months post-conception. Prevalence odds ratios (POR) and 95% confidence intervals (CI) using crude and adjusted logistic regression analysis were estimated to examine determinants of folic acid supplement use. RESULTS Prevalence of folic acid supplement use was 41.5% (95% CI: 37.7%, 45.7%). Multivariable analysis showed lack of educational qualifications, unplanned pregnancy, later diagnosis of pregnancy, increased parity, and not having an awareness of importance of folic acid for optimal pregnancy outcomes were associated with not taking periconceptional folic acid supplements. Books, doctors, friends, media, were sources of information. CONCLUSION Periconceptional folic acid is sub-optimal in rural Germany and thus failing to prevent NTDs. Targeted promotion of folic acid supplement use should be conducted periodically by gynecologists and primary care physicians during annual medical screenings. Mandatory folic acid fortification of staple foods is a complementary approach to overcome limitations of individual behaviors of folic acid supplement intake, and should be considered as it has been proven effective in multiple countries.
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Affiliation(s)
- Clara Wegner
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Anke Lux
- Institute for Biometrics and Medical Informatics, University Magdeburg, Magdeburg, Germany
| | - Andrea Köhn
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Dirk Bretschneider
- Department of Pediatrics, Hospital Marienstift Magdeburg, Magdeburg, Germany
| | - Kristina Freese
- Department of Obstetrics and Gynecology, Hospital Marienstift Magdeburg, Magdeburg, Germany
| | - Mathias Heiduk
- Department of Pediatrics, Hospital Magdeburg gGmbH, Magdeburg, Germany
| | - Anke Redlich
- Department of Obstetrics and Gynaecology, University Hospital Magdeburg, Magdeburg, Germany
| | - Daniela Schleef
- Department of Obstetrics and Gynecology, Hospital Magdeburg GmbH, Magdeburg, Germany
| | - Gerhard Jorch
- Department of Paediatrics, University Hospital Magdeburg, Magdeburg, Germany
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Understanding Changes in Socioeconomic Inequality of Unintended Pregnancy Among Iranian Married Women: A Blinder-Oaxaca Decomposition Analysis. HEALTH SCOPE 2019. [DOI: 10.5812/jhealthscope.85011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rahman M, Nasrin SO, Rahman M, Rahman A, Mostofa G, Jesmin SS, Buchanan F. Maternal pregnancy intention and its association with low birthweight and pregnancy complications in Bangladesh: findings from a hospital-based study. Int Health 2019; 11:447-454. [DOI: 10.1093/inthealth/ihz010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/31/2018] [Accepted: 02/02/2019] [Indexed: 11/12/2022] Open
Abstract
ABSTRACT
Background
The investigation of the potential impact of unintended pregnancy on maternal and child health is important to design effective interventions. This study explored the associations between unintended pregnancy and low birthweight (LBW) and pregnancy complications.
Methods
A cross-sectional survey was conducted among 400 randomly selected women in the postnatal wards of Rajshahi Medical College Hospital, Bangladesh. Multivariate logistic regression analyses were used to identify associations.
Results
Results of this study indicate that 30.5% of all pregnancies were unintended and 29.3% of babies were born with LBW. Additionally, 79.3% of women experienced any pregnancy complication (AC), 69.5% experienced medical complications and 44.3% experienced obstetric complications (OCs) during their last pregnancy. Unintended pregnancy was significantly associated with LBW (adjusted odds ratio [AOR]: 3.18, 95% CI: 1.79 to 5.54), maternal experience of OCs (AOR: 1.83, 95% CI: 1.03 to 3.28) and AC (AOR: 2.93, 95%: 1.14 to 7.58). Women with unintended pregnancies were at higher risk of developing high blood pressure and anemia during pregnancy.
Conclusions
Women with unintended pregnancies are at increased risk of producing LBW babies and experiencing complications during pregnancy. Therefore, maternal pregnancy intention should be addressed in interventions aimed to reduce maternal and child morbidity and mortality.
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Affiliation(s)
- Mosfequr Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Sarkar Obaida Nasrin
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
- Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aminur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Golam Mostofa
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Syeda Sarah Jesmin
- Department of Sociology, University of North Texas at Dallas, Texas, USA
| | - Fiona Buchanan
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, Australia
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50
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Hill B, Kothe EJ, Currie S, Danby M, Lang AY, Bailey C, Moran LJ, Teede H, North M, Bruce LJ, Skouteris H. A systematic mapping review of the associations between pregnancy intentions and health-related lifestyle behaviours or psychological wellbeing. Prev Med Rep 2019; 14:100869. [PMID: 31011520 PMCID: PMC6465583 DOI: 10.1016/j.pmedr.2019.100869] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/11/2019] [Accepted: 04/03/2019] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to conduct a systematic mapping review of the literature that explored associations of pregnancy intentions with health-related lifestyle behaviours and psychological wellbeing before and during pregnancy. Six databases were searched (May 2017) for papers relating to pregnancy intentions, health-related lifestyle behaviours, and psychological wellbeing. The literature was mapped according to the preconception or pregnancy period; prospective or retrospective variable assessment; and reported lifestyle behaviours and psychological wellbeing outcomes. Of 19,430 retrieved records, 303 studies were eligible. Pregnancy intentions were considered during the preconception period in 103 studies (only 23 assessed prospectively), and during the pregnancy period in 208 studies (141 prospectively). Associations between pregnancy intention and preconception behaviours/psychological wellbeing were primarily reported for supplement use (n = 58) and were lacking for diet/exercise, and psychological factors. For behaviours/psychological wellbeing during pregnancy, associations with pregnancy intention were focused on prenatal care (n = 79), depression (n = 61), and smoking (n = 56) and were lacking for diet/exercise. Only 7 studies assessed pregnancy intentions with a validated tool. Despite a large body of literature, there were several methodological limitations identified, namely assessment of pregnancy intentions with non-validated measures and the reliance on retrospective assessment. Future primary studies are needed to fill gaps in our understanding regarding energy-balance-related behaviours. Future studies (including reviews/meta-analyses) should take care to address the noted limitations to provide a comprehensive and accurate understanding of the relationships between pregnancy intentions and health-related lifestyle behaviours and psychological wellbeing before and during pregnancy. Reliance on the assessment of pregnancy intentions with non-validated measures Reliance on retrospective assessment Studies on preconception pregnancy intentions and diet/exercise lacking
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Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia.,School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Emily J Kothe
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Sinéad Currie
- Psychology, Faculty of Natural Sciences, University of Stirling, FK9 4LA, United Kingdom
| | - Meaghan Danby
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Adina Y Lang
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Madelon North
- School of Psychology, Deakin University, Locked Bag 20000, Geelong 3220, Australia
| | - Lauren J Bruce
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Melbourne 3168, Australia
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