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Pawellek M, Köninger A, Melter M, Kabesch M, Apfelbacher C, Brandstetter S. Effect of mothers' health literacy on early childhood allergy prevention behaviours: results from the KUNO-Kids health study. BMC Public Health 2024; 24:2420. [PMID: 39237956 PMCID: PMC11375835 DOI: 10.1186/s12889-024-19906-8] [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: 05/16/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Parents can engage in several behaviours with regard to early childhood allergy prevention (ECAP). These can be related to diet of mother/child and the modification of the home environment; not all of them are justified by current evidence. Previous studies showed that parental health literacy (HL) is related to favourable health behaviours directed at the child. This study aimed to investigate the causal effect of mothers' HL on ECAP behaviours and to test different moderators of this effect. METHODS One thousand six hundred sixty-two mothers participating in the KUNO-Kids health study in the area of Regensburg, Germany were surveyed on HL (assessed via the health care scale of the Health Literacy Survey-EU questionnaire, HLS-EU-Q47) and ECAP behaviours implemented during pregnancy and the child's first year of life. Patterns in ECAP behaviours were identified by latent class analysis. Multinomial regression modelling was performed with HL as exposure, ECAP as outcome variable, allergy risk, parental competence and bonding, anxiety and depression as moderators as well as potentially confounding variables. RESULTS We identified three classes of ECAP behaviours (class 1: "breastfeeding " N = 871; class 2: "allergen-avoidance " N = 490; class 3: "mixed behaviours " N = 301). In univariable as well as fully adjusted regression models, compared to class 1, class 2 was negatively, and class 3 was not associated with HL. None of the tested moderating variables altered the association between HL and ECAP significantly. CONCLUSIONS We found an effect of mothers' HL on ECAP behaviours: lower HL of mothers increased allergen-avoiding behaviour directed at their child, while decreasing the chance of exclusive breastfeeding. Improving HL could contribute to the implementation of recommended ECAP behaviours in families, especially to the reduction of allergen-avoiding behaviours.
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Affiliation(s)
- Maja Pawellek
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany.
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany.
| | - Angela Köninger
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
- University Clinic of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Melter
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Michael Kabesch
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Christian Apfelbacher
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
- Institute of Social Medicine and Health Systems Research, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), Regensburg, Germany
- Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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Del Campo Giménez M, Fernández Bosch A, Martínez de la Torre C, Minuesa García M, López-Torres Hidalgo J, Córcoles García S, Párraga Martínez I. Impact of pregnancy on women's health-related lifestyle habits: Diet, physical activity, alcohol consumption, and smoking. Eur J Obstet Gynecol Reprod Biol 2024; 299:182-187. [PMID: 38878522 DOI: 10.1016/j.ejogrb.2024.06.021] [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: 07/25/2023] [Revised: 05/08/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES To explore health-related lifestyles in women before and during pregnancy, and to determine the potential differences between both and the relevant factors. MATERIALS AND METHODS A cross-sectional observational study including 348 women with a child <5 years of age was conducted in six health areas. The following variables were recorded: sociodemographic (age, educational level, marital status, social class, type of cohabitation, nationality), health-related habits (physical activity, diet, tobacco use, alcohol consumption), health conditions, and medication intake. RESULTS Four lifestyle habits were compared between the pre-conception and pregnancy periods: diet, physical activity, and alcohol and tobacco use. The proportion of women who consumed alcohol (42.8 % vs 3.4 %) or smoked (19.3 % vs 12.4 %) was significantly higher before conception (p < 0.01). Conversely, the proportion of inactive women was lower before pregnancy, with 23.3 % (CI95%: 18.7-27.9) formerly classified as active versus 35.3 % (CI95%: 30.2-40.5) (p < 0.01). Similarly, adherence to the Mediterranean diet increased during pregnancy (62.9 % vs 75.0 %; p < 0.01). Furthermore, 53.2 % (CI95%: 47.8-58.5) of women reported a change from non-healthy to healthy in at least one of the evaluated habits. Logistic regression analyses revealed the variables associated with a positive change, which were being national Spanish (OR: 6.9) and experiencing the first pregnancy (OR: 1.8). CONCLUSIONS The lifestyles of women undergo changes between the pre-gestation and pregnancy periods. However, such variations do not affect all health-related habits similarly. A positive change was observed in diet, alcohol consumption, and smoking habit, whereas pregnancy negatively impacted on physical activity and sedentary behaviours.
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Affiliation(s)
- María Del Campo Giménez
- Healthcare Centre Ledaña, Healthcare Centre Iniesta, Healthcare Management Atención Integrada de Albacete, Castilla-La Mancha Health Service, Spain.
| | - Alba Fernández Bosch
- Healthcare Centre Plaza Segovia, Primary Care Healthcare Management of Valencia, Hospital Doctor Peset (Valencia), Comunidad Valenciana Health Service, Spain
| | - Carlos Martínez de la Torre
- Healthcare Centre Zona VIII de Albacete, Multiprofessional Teaching Unit of Family and Community Medicine of Albacete, Castilla-La Mancha University, Castilla-La Mancha Health Service, Spain
| | - María Minuesa García
- Healthcare Centre Fonelas (Purullena), North-East Health Area of Granada, Andalucia Health Service, Spain
| | - Jesús López-Torres Hidalgo
- Healthcare Centre Zona VIII of Albacete, Healthcare Management Atención Integrada de Albacete, University of Medicine of Albacete, Castilla-La Mancha University, Castilla-La Mancha Health Service, Spain
| | - Sara Córcoles García
- Healthcare Centre Zona VIII de Albacete, Multiprofessional Teaching Unit of Family and Community Medicine of Albacete, Castilla-La Mancha University, Castilla-La Mancha Health Service, Spain
| | - Ignacio Párraga Martínez
- Healthcare Centre Zona VIII of Albacete, Healthcare Management Atención Integrada de Albacete, University of Medicine of Albacete, Castilla-La Mancha University, Castilla-La Mancha Health Service, Spain
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Awan AY, Channa NA, Solangi SP, Noorani L. Consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas. Biometals 2024; 37:839-847. [PMID: 38127179 DOI: 10.1007/s10534-023-00571-0] [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: 05/05/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Chewing tobacco may play a contributing role in complications during pregnancy as it contains various kinds of toxic metals such as lead (Pb), cadmium (Cd), cobalt (Co), manganese (Mn), chromium (Cr), and can cause alteration in serum metal concentration. Hence, the present study aimed to explore the effects of chewing tobacco consumption on serum metal contents in pregnant women. A total number of 200 chewing tobacco consumer pregnant women and 200 age-matched non-consumer pregnant women were selected for the study from the outpatient department of gynaecology at Rural Health Centre Tandojam, Pakistan. After obtaining the sociodemographic characteristics of all participants, 10 ml of venous blood was also drawn for serum metal analysis by atomic absorption spectroscopy. Different chewing tobacco samples consumed by consumer pregnant women were collected from local shops of Tandojam, Pakistan. Drinking water samples from the residential areas of consumer and non-consumer pregnant women were prepared and analysed for the same metal contents. In present study, serum Pb, Cd, K and Co were found significantly increased in CPW as compared to NCPW. Serum Pb was found significantly increased in gutkha consumers in comparison to mainpuri consumers. Serum Pb, Cd, and Co were present with significantly increased concentration in serum of CPW who were taking canal and well water for drinking purpose when compared with NCPW. Significant negative strong correlation of serum Pb with K and Cr of drinking water and Na of chewing tobacco samples were observed. Strong positive correlation of serum Cd and Cr with Co of drinking water had been observed. Whereas, serum maternal Co was strongly negatively correlated with Mn of chewing tobacco samples, and serum Cu of CPW had a strong positive correlation with K and Cr of drinking water and Na of chewing tobacco samples. In conclusion, consumption of chewing tobacco alters the serum metal contents in pregnant women at Tandojam and adjoining areas, Pakistan.
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Affiliation(s)
- Amna Yasin Awan
- Institue of Biochemistry, University of Sindh, Jamshoro, Pakistan
| | | | - Shazia Perveen Solangi
- Institue of Biochemistry, University of Sindh, Jamshoro, Pakistan
- Department of Biochemistry, Shah Abdul Latif University, Khairpur, Pakistan
| | - Lubna Noorani
- Department of Science and Technical Education, Faculty of Education, University of Sindh, Jamshoro, Pakistan
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Rasmussen JB, Rath SM, Wu C, Weile LKK, Schmal H, Olsen J, Bech BH, Nohr EA. Fractures in Childhood and Young Adulthood According to Maternal Smoking in Late Pregnancy. A Danish Cohort Study. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024; 162:410-418. [PMID: 37463590 DOI: 10.1055/a-2103-6915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Fractures account for the most frequent cause of hospitalization during childhood and numbers have increased over time. Of all fractures in childhood and young adulthood, 66% are recurrent fractures, suggesting that some people are predestined for fractures. The aim of this study was to investigate the association between maternal smoking during late pregnancy and the risk of fractures in the children.The study included 11,082 mothers and their children from the cohort "Healthy Habits for Two" born between 1984 and 1987. Information about maternal smoking during pregnancy came from questionnaires filled out in pregnancy, while information about fractures was derived from the Danish National Patient Registry. Over a follow-up of 24 years (1994-2018), Cox regression with multiple failures was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for fractures in childhood and young adulthood according to maternal smoking in late pregnancy. Information about body mass index (BMI) and smoking status in young adulthood was included as time variant covariates.During an age span of 8-32 years, 6,420 fractures were observed. Of the mothers, 39.1% smoked during late pregnancy. Compared to children of mothers who did not smoke, children of mothers who smoked 1-9 cigarettes per day and 10+ cigarettes per day had an increased risk of fractures (HR 1.14 [CI: 1.06; 1.21] and HR 1.14 [CI: 1.07; 1.22], respectively). After adjusting for BMI and smoking status in young adulthood, the findings were slightly strengthened, showing an increased risk of fractures of 23 and 25% in children of mothers smoking 1-9 cigarettes per day and 10+ cigarettes per day, respectively.Maternal smoking during late pregnancy was associated with a higher risk of fractures in the child. This result indicates that exposure to cigarette smoke in utero may play a role in lifelong bone health.
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Affiliation(s)
| | - Sabine Marie Rath
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | - Chunsen Wu
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | | | - Hagen Schmal
- Clinic of Orthopaedic Surgery, University of Southern Denmark, Odense, Denmark
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus Universitet, Aarhus, Denmark
| | | | - Ellen Aagaard Nohr
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
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Axelsson Fisk S, Cassel J, Rostila M, Liu C, Juárez SP. Intersectional socioeconomic disparities in continuous smoking through pregnancy among pre-pregnant smokers in Sweden between 2006 and 2016. BMC Pregnancy Childbirth 2024; 24:465. [PMID: 38971755 PMCID: PMC11227709 DOI: 10.1186/s12884-024-06647-0] [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: 03/02/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND While well-established associations exist between socioeconomic conditions and smoking during pregnancy (SDP), less is known about social disparities in the risk of continuous SDP. Intersectional analyses that consider multiple social factors simultaneously can offer valuable insight for planning smoking cessation interventions. METHODS We include all 146,222 pregnancies in Sweden between 2006 and 2016 where the mother smoked at three months before pregnancy. The outcome was continuous SDP defined as self-reported smoking in the third trimester. Exposures were age, education, migration status and civil status. We examined all exposures in a mutually adjusted unidimensional analysis and in an intersectional model including 36 possible combinations. We present ORs with 95% Confidence Intervals, and the Area Under the Curve (AUC) as a measure of discriminatory accuracy (DA). RESULTS In our study, education status was the factor most strongly associated to continuous SDP among women who smoked at three months before pregnancy. In the unidimensional analysis women with low and middle education had ORs for continuous SDP of 6.92 (95%CI 6.63-7.22) and 3.06 (95%CI 2.94-3.18) respectively compared to women with high education. In the intersectional analysis, odds of continuous SDP were 17.50 (95%CI 14.56-21.03) for married women born in Sweden aged ≥ 35 years with low education, compared to the reference group of married women born in Sweden aged 25-34 with high education. AUC-values were 0.658 and 0.660 for the unidimensional and intersectional models, respectively. CONCLUSION The unidimensional and intersectional analyses showed that low education status increases odds of continuous SDP but that in isolation education status is insufficient to identify the women at highest odds of continuous SDP. Interventions targeted to social groups should be preceded by intersectional analyses but further research is needed before recommending intensified smoking cessation to specific social groups.
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Affiliation(s)
- Sten Axelsson Fisk
- Department of Clinical Sciences Lund, Obstetrics and Gynaecology, Lund University, BMC C14. Lund, Lund, 22185, Sweden.
- Department of Obstetrics and Gynaecology, Ystad Hospital, Ystad, Sweden.
| | - Jannike Cassel
- Department of Obstetrics and Gynaecology, Ystad Hospital, Ystad, Sweden
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society (NVS), Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Stockholm, Sweden
| | - Can Liu
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Sol Pia Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Dupuis M, Weir KR, Vidonscky Lüthold R, Panchaud A, Baggio S. Social determinants of antidepressant continuation during pregnancy in the USA: findings from the ABCD cohort study. Arch Womens Ment Health 2024:10.1007/s00737-024-01470-0. [PMID: 38740587 DOI: 10.1007/s00737-024-01470-0] [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: 12/19/2023] [Revised: 03/08/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy. METHODS We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy. RESULTS In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015). CONCLUSIONS Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.
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Affiliation(s)
- Marc Dupuis
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
- Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland.
| | - Kristie Rebecca Weir
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Renata Vidonscky Lüthold
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland
- Graduate School for Health Sciences (GHS), University of Bern, Bern, Switzerland
| | - Alice Panchaud
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Stéphanie Baggio
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
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Wierenga H, Målqvist M. Differences in Antenatal Care Policies in England, Finland, and the Netherlands: A Framing analysis. Matern Child Health J 2024; 28:738-745. [PMID: 38334865 DOI: 10.1007/s10995-023-03882-3] [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] [Accepted: 12/20/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND PURPOSE The World Health Organization (WHO) states that good quality antenatal care should strive for both mother and child achieving their best possible health. On a policy level, in Europe these goals are reached with varying approaches. This research offers a fresh look on the underlying assumptions embedded in the ANC policies in three European countries. METHODS A framing analysis was conducted to publicly available ANC policies on uncomplicated pregnancies in Finland, England, and the Netherlands. Analysis was guided by van Hulst and Yanowa and included the following phases: a) Sense-making, b) Selecting, naming, and categorizing and c) Storytelling. MAIN FINDINGS Findings of this study demonstrate how ANC is organized with distinct frames. The Finnish ANC policies emphasized equity in care and instead of focusing on women, the ANC focused on the family. In England the pregnant woman was central, and it is seen as her responsibility to understand the ANC protocols. The ANC in the Netherlands focused on the pregnant woman's pregnancy experience and freedom. CONCLUSION The three studied countries had individual priorities and values guiding ANC provision. Despite each country being in line with the WHO ANC recommendations, areas requiring improvement should not be overlooked.
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Affiliation(s)
- Hanna Wierenga
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mats Målqvist
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Li Y, Liu J, Ran N, Zheng C, Wang P, Li J, Fang Y, Fang D, Ma Y. Potential pathological mechanisms and pharmacological interventions for cadmium-induced miscarriage. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 273:116118. [PMID: 38367606 DOI: 10.1016/j.ecoenv.2024.116118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
The prevalence of cadmium (Cd) contamination has emerged as a significant global concern. Exposure to Cd during pregnancy is associated with adverse pregnancy outcomes, including miscarriage. However, there is currently a lack of comprehensive summaries on Cd-induced miscarriage. Therefore, it is imperative to further strengthen research into in vivo studies, clinical status, pathological mechanisms, and pharmacological interventions for Cd-induced miscarriage. This study systematically presents the current knowledge on animal models and clinical trials investigating Cd exposure-induced miscarriage. The underlying mechanisms involving oxidative stress, inflammation, endocrine disruption, and placental dysfunction caused by Cd-induced miscarriage are also extensively discussed. Additionally, potential drug interventions such as melatonin, vitamin C, and vitamin E are highlighted for their pharmacological role in mitigating adverse pregnancy outcomes induced by Cd.
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Affiliation(s)
- Yufei Li
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Juan Liu
- Beijing Center for Disease Prevention and Control, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing 100013, China
| | - Na Ran
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Changwu Zheng
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - PingPing Wang
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Jiayi Li
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Yumeng Fang
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Danna Fang
- Medical College, Shaoxing University, Zhejiang 312000, China
| | - Yeling Ma
- Medical College, Shaoxing University, Zhejiang 312000, China.
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Williams N, Griffin G, Wall M, Watson S, Warland J, Bradfield Z. Patient evaluation of gynaecological information provision and preferences. J Adv Nurs 2024; 80:1188-1200. [PMID: 37731325 DOI: 10.1111/jan.15866] [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: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
AIM To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. DESIGN A descriptive cross-sectional survey design was used. METHODS A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. RESULTS Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. CONCLUSION Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. IMPACT This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. REPORTING METHOD The STROBE reporting method was used in the preparation of the manuscript. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart Watson
- Women's Health, Genetics & Mental Health, King Edward Memorial Hospital, Subiaco, Australia
| | - Jane Warland
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
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Nair NM, Makhanlall A, Roy S, Olola O, Altman E, Chaudhuri P, Wen X. Predictors of Quitting Dual Use of Electronic Cigarettes and Cigarettes During Pregnancy. J Womens Health (Larchmt) 2024; 33:239-253. [PMID: 38112533 PMCID: PMC10880298 DOI: 10.1089/jwh.2023.0179] [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] [Indexed: 12/21/2023] Open
Abstract
Background and Aims: There is limited research surrounding dual maternal use of cigarettes and electronic cigarettes (e-cigarettes). We aimed to assess predictors of maternal quitting of cigarettes, e-cigarettes, and both during late pregnancy. Materials and Methods: We analyzed dual use (n = 4,006) and exclusive e-cigarette use (n = 1,685) among mothers using data from the 2016 to 2019 phase of the Pregnancy Risk Assessment Monitoring Systems (PRAMS), a nationally representative sample of the United States. Dual use and exclusive e-cigarette use were defined based on use reported during the 3 months before pregnancy and quitting was assessed during the last 3 months of pregnancy. Multinomial and binomial logistic regression models estimated the odds ratios and 95% confidence intervals for predictors of quitting status among mothers who reported dual use and exclusive e-cigarette use, respectively. Separate predictor analyses were conducted in the dual and exclusive e-cigarette use groups to see predictors of quitting e-cigarettes, cigarettes, or both. Results: The highest proportion of mothers who used cigarettes and e-cigarettes before pregnancy quit both during late pregnancy (46.2%), followed by those who quit e-cigarette use only (26.5%) and those who quit cigarette use only (6.6%). Among mothers who reported dual use, those who were African American or Asian, of Hispanic ethnicity, consumed alcohol before pregnancy, had higher education, were married, had diabetes, had higher annual household income, had nongovernmental health insurance, had more prenatal care visits, had a higher frequency of e-cigarette use before pregnancy, had a lower frequency of cigarette use before pregnancy, and smoked hookah around pregnancy had a higher likelihood of quitting both cigarette and e-cigarette use during late pregnancy. Conclusions: Quitting use of cigarettes and/or e-cigarettes was fairly common among mothers who reported dual use or e-cigarette use only. Sociodemographics, pregnancy characteristics, and use of other tobacco products predicted quitting use of both cigarettes and e-cigarettes during late pregnancy.
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Affiliation(s)
- Nisha M. Nair
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Amelia Makhanlall
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Shannon Roy
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Olabowale Olola
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Elizabeth Altman
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Preyashi Chaudhuri
- Department of Psychology, College of Arts and Sciences, University at Buffalo, Buffalo, New York, USA
| | - Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
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11
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Treskina NA, Postoev VA, Usynina AA, Grjibovski AM, Odland JØ. Secular trends of socio-demographic and lifestyle characteristics among delivering women in Arctic Russia, 1973-2017. Int J Circumpolar Health 2023; 82:2161131. [PMID: 36547385 PMCID: PMC9793942 DOI: 10.1080/22423982.2022.2161131] [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] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to describe temporal trends in socio-demographic and lifestyle characteristics among delivering women in two Northern provinces of Russia from 1973 to 2017. Totally 161,730 births were registered in three birth registries. Changes in the distribution of maternal age, education, marital status, smoking during pregnancy were studied using Pearson's chi-squared tests and one-way ANOVA. The logistic regression models were used to assess factors, contributing to the variations in the prevalence of maternal smoking. The mean age of primiparous mothers increased from 22.1 years in 1973-1980 to 25.4 years in 2012-2017 (p < 0.001). The proportion of primiparous mothers with higher education increased from 26.2% in 2006 to 38.3% in 2017 (p < 0.001). The proportion of cohabiting primiparous women increased from 5.0% to 15.2% over the study period (p < 0.001). The proportion of mothers smoking during pregnancy decreased from 18.9% in 2006-2011 to 14.8% in 2012-2017 (p < 0.001). Downward in the prevalence of smoking was revealed in 2012-2017 compared to 2006-2011 (OR = 137.76; 95%CI:71.62-264.96, OR = 183.74; 95%CI:95.52-353.41, respectively). Over the past decades, women postpone childbearing until receiving higher education, continue living in cohabitation during pregnancy and smoke less.
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Affiliation(s)
- Natalia A. Treskina
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway,CONTACT Natalia A. Treskina Norwegian University of Science and Technology, 8900, NO-7491Trondheim, Norway
| | - Vitaly A. Postoev
- Department of Public Health, Health Care and Social Work, Northern State Medical University, Arkhangelsk, Russia
| | - Anna A. Usynina
- Department of Neonatology and Perinatology, Northern State Medical University, Arkhangelsk, Russia
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia,Department of Health Policy and Management, Al Farabi Kazakh National University, Almaty, The Republic of Kazakhstan,Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University, Moscow, Russia,Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway,Department of General Hygiene, I.M. Sechenov First Moscow State Medical University, Moscow, Russia,Institute of Ecology, National Research University Higher School of Economics, Moscow, Russia
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12
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Kääntä E, Parviainen R, Tikanmäki M, Alenius S, Sinikumpu JJ, Kajantie E. Maternal Smoking During Pregnancy and Offspring's Risk for Bone Fracture in Childhood and Adolescence. J Bone Miner Res 2023; 38:1791-1799. [PMID: 37823763 DOI: 10.1002/jbmr.4923] [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: 05/19/2023] [Revised: 09/06/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
Conditions during gestation, such as maternal smoking, may affect offspring's bone structure. This could increase the offspring's risk of bone fractures during childhood. In this study, we aimed to assess the association between prenatal exposure to maternal smoking and childhood bone fracture risk. We used a register-based birth cohort that included all children born in Finland between January 1987 and September 1990. After exclusions, the final study population consisted of 220,699 persons. Using a unique national identification number, we linked the cohort data to the fracture diagnosis in specialty care and covariate data using the Medical Birth Register (MBR), Statistics Finland and Care Register for Health Care (CRHC). The fractures were analyzed in three groups: all fractures, non-high-energy fractures, and high-energy fractures. The analyses were adjusted for sex, parity, child's year of birth, mother's age at childbirth, mother's and father's educational level, and mother's fracture status. We tested the association in three age groups: <1 year, 1-<5 years, and 5-<15 years using Cox and (recurrent fractures) Poisson regression. A total of 18,857 (8.5%) persons had at least one bone fracture diagnosis before the age of 15 years. In the age group 5-<15 years, maternal smoking during pregnancy was associated with higher fracture risk in all of the studied fracture groups: hazard ratio (HR) = 1.12 (95% confidence interval [CI] 1.06-1.17) in all fractures, 1.13 (95% CI 1.07-1.19) in non-high-energy, and 1.15 (95% CI 1.00-1.32) in high-energy fractures. There were no significant associations in other age groups in any of the fracture groups. No statistically significant association between maternal smoking during pregnancy and offspring's risk of recurrent fractures was found. In conclusion, 5- to 15-year-olds whose mothers have smoked during pregnancy have an increased risk of bone fractures treated in specialty care. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Emil Kääntä
- Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Roope Parviainen
- Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Marjaana Tikanmäki
- Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Suvi Alenius
- Finnish Institute of Health and Welfare, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha-Jaakko Sinikumpu
- Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Eero Kajantie
- Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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13
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Perinatal Psychoactive Substances Use: A Rising Perinatal Mental Health Concern. J Clin Med 2023; 12:jcm12062175. [PMID: 36983176 PMCID: PMC10056692 DOI: 10.3390/jcm12062175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction: A significant increase in psychoactive drugs use was observed in women of childbearing age and during the perinatal period worldwide. Yet, the use of illicit drugs, alcohol and tobacco during pregnancy is a serious health risk for the mother, developing fetus and newborn. Methods: This review of current trends and consequences of psychoactive substance use in the general population and in pregnant women was conducted using the English and French literature published during the years 2000 to 2022, supplemented by guidelines, meta-analyses and reviews. Results: According to current rates of prenatal substances use, it was calculated that 380,000 offspring were exposed to illicit substances, more than 500,000 to alcohol and over one million to tobacco during uterine life. Alarmingly, drug-related pregnancy-associated mortality has shown a staggering 190% rise between 2010 and 2019 in the USA. Different drugs of abuse, when used during pregnancy, increase the risk of stillbirth, neonatal abstinence syndrome and sudden infant death. Adverse effects on pregnancy include premature rupture of membranes, placental abruption, preterm birth, low birth space? weight and small-for-gestational-age infants. There is also an increased risk of morbidity and mortality for the pregnant women. Long-term negative adverse effects of perinatal exposure to substances also include a number of neurocognitive, behavioral and emotional dysfunctions in infants. Each type of substance has its own specificities, which will be briefly summarized. Conclusion: All childbearing age women must be informed about the potential harm of the prenatal use of psychoactive substances and should be encouraged to stop their use when pregnancy is planned and, at least, when pregnancy is known. Questioning women about their alcohol consumption should be systematic at the first prenatal visit and then at every prenatal visit until delivery. Multidisciplinary prevention approaches as well as intervention measures targeted to each type of psychoactive substance can save mothers’ lives and mitigate serious adversities to the offspring.
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14
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Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner. J Pediatr Health Care 2023; 37:333-346. [PMID: 36682969 DOI: 10.1016/j.pedhc.2022.12.007] [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: 09/18/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023]
Abstract
Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.
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15
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Identification of the Obstetric Factors Increasing Tendency to Smoking Cessation During Pregnancy. J Addict Nurs 2023; 34:E28-E38. [PMID: 34519688 DOI: 10.1097/jan.0000000000000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cigarette, one of the various forms of tobacco, is the most commonly used tobacco product in Turkey and in the world. Cigarette has several negative effects on general health and is a major problem in the pregnancy period. This study aims to identify pregnancy-related factors that affect the tendency to smoking cessation and their effect levels in pregnant women who continue to smoke during pregnancy. METHOD The sample of this descriptive and cross-sectional study was 430 pregnant women who smoked. Data were collected through an original interview form and face-to-face interviews. Data analysis was performed using chi-square, independent t test, and multiple logistic regression model in terms of demographic, obstetric, maternal, and fetal features. RESULTS The average number of cigarettes smoked before pregnancy was 13.28 ± 8.62, whereas the average number of cigarettes smoked during pregnancy was 6.60 ± 7.64. The tendency to decrease smoking increases 2.8 times ( OR = 2.825, 95% CI [1.631, 4.895]) with the number of pregnancies and approximately 2 times in case of a planned pregnancy ( OR = 1.946, 95% CI [1.076, 3.520]). The frequency of having prenatal visits showed a weak but significant relationship with the number of abortuses and the number of living children. CONCLUSIONS Developing a risk map in line with the findings of the study and considering the obstetric features of smoking women could enable to hypothesize about the types of behaviors in smoking in the following processes of pregnancy. With the precautions to be taken, the negative effects of smoking on maternal and fetal health could be prevented or minimized.
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16
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Agràs-Guàrdia M, Martínez-Torres S, Granado-Font E, Pallejà-Millán M, Villalobos F, Patricio D, Ruiz F, Marin-Gomez FX, Duch J, Rey-Reñones C, Martín-Luján F. Effectiveness of an App for tobacco cessation in pregnant smokers (TOBBGEST): study protocol. BMC Pregnancy Childbirth 2022; 22:933. [PMID: 36514020 PMCID: PMC9745963 DOI: 10.1186/s12884-022-05250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Tobacco consumption during pregnancy is one of the most modifiable causes of morbidity and mortality for both pregnant smokers and their foetus. Even though pregnant smokers are conscious about the negative effects of tobacco consumption, they also had barriers for smoking cessation and most of them continue smoking, being a major public health problem. The aim of this study is to determine the effectiveness of an application (App) for mobile devices, designed with a gamification strategy, in order to help pregnant smokers to quit smoking during pregnancy and in the long term. METHODS This study is a multicentre randomized community intervention trial. It will recruit pregnant smokers (200 participants/group), aged more than 18 years, with sporadically or daily smoking habit in the last 30 days and who follow-up their pregnancy in the Sexual and Reproductive Health Care Services of the Camp de Tarragona and Central Catalonia Primary Care Departments. All the participants will have the usual clinical practice intervention for smoking cessation, whereas the intervention group will also have access to the App. The outcome measure will be prolonged abstinence at 12 months after the intervention, as confirmed by expired-carbon monoxide and urinary cotinine tests. Results will be analysed based on intention to treat. Prolonged abstinence rates will be compared, and the determining factors will be evaluated using multivariate statistical analysis. DISCUSSION The results of this study will offer evidence about the effectiveness of an intervention using a mobile App in smoking cessation for pregnant smokers, to decrease comorbidity associated with long-term smoking. If this technology is proven effective, it could be readily incorporated into primary care intervention for all pregnant smokers. TRIAL REGISTRATION Clinicaltrials.gov ID NCT05222958 . Trial registered 3 February 2022.
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Affiliation(s)
- Maria Agràs-Guàrdia
- grid.22061.370000 0000 9127 6969Department of Primary Care Camp de Tarragona, Primary Care Center Llibertat (Reus – 3, Institut Català de La Salut, Reus, Spain ,grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain
| | - Sara Martínez-Torres
- grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.36083.3e0000 0001 2171 6620Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Ester Granado-Font
- grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain ,grid.22061.370000 0000 9127 6969Department of Primary Care Camp de Tarragona, Primary Care Center Horts de Miró (Reus – 4), Institut Català de La Salut, Reus, Spain
| | - Meritxell Pallejà-Millán
- grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.410367.70000 0001 2284 9230School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Spain
| | - Felipe Villalobos
- grid.36083.3e0000 0001 2171 6620Universitat Oberta de Catalunya (UOC), Barcelona, Spain ,grid.452479.9Fundació Institut Universitari Per a La Recerca a L’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), Barcelona, Spain
| | - Demetria Patricio
- grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain ,grid.22061.370000 0000 9127 6969Department of Primary Care Camp de Tarragona, Atenció a La Salut Sexual I Reproductive (ASSIR), Institut Català de La Salut, Reus, Spain
| | - Francisca Ruiz
- grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain ,grid.410367.70000 0001 2284 9230School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Spain ,grid.22061.370000 0000 9127 6969Department of Primary Care Camp de Tarragona, Atenció a La Salut Sexual I Reproductive (ASSIR), Institut Català de La Salut, Reus, Spain
| | - Francesc X. Marin-Gomez
- grid.452479.9Primary Healthcare Research Support Unit Catalunya Central, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Sant Fruitós de Bages, Spain ,grid.22061.370000 0000 9127 6969Health Promotion in Rural Areas Research Group, Gerència Territorial de La Catalunya Central, Institut Català de La Salut, Sant Fruitós de Bages, Spain
| | - Jordi Duch
- grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain ,grid.410367.70000 0001 2284 9230Department of Computer Engineering and Mathematics, Universitat Rovira I Virgili (URV), Tarragona, Spain
| | - Cristina Rey-Reñones
- grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.452479.9TICS-AP Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Barcelona, Spain ,grid.410367.70000 0001 2284 9230School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Spain
| | - Francisco Martín-Luján
- grid.452479.9Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), C/Cami de Riudoms, 53-55. Reus-43202, Tarragona, Spain ,grid.410367.70000 0001 2284 9230School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Spain
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Barnes LAJ, Longman J, Adams C, Paul C, Atkins L, Bonevski B, Cashmore A, Twyman L, Bailie R, Pearce A, Barker D, Milat AJ, Dorling J, Nicholl M, Passey M. The MOHMQuit (Midwives and Obstetricians Helping Mothers to Quit Smoking) Trial: protocol for a stepped-wedge implementation trial to improve best practice smoking cessation support in public antenatal care services. Implement Sci 2022; 17:79. [PMID: 36494723 PMCID: PMC9734467 DOI: 10.1186/s13012-022-01250-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/04/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Smoking during pregnancy is the most important preventable cause of adverse pregnancy outcomes, yet smoking cessation support (SCS) is inconsistently provided. The MOMHQUIT intervention was developed to address this evidence-practice gap, using the Behaviour Change Wheel method by mapping barriers to intervention strategies. MOHMQuit includes systems, leadership and clinician elements. This implementation trial will determine the effectiveness and cost-effectiveness of MOHMQuit in improving smoking cessation rates in pregnant women in public maternity care services in Australia; test the mechanisms of action of the intervention strategies; and examine implementation outcomes. METHODS A stepped-wedge cluster-randomised design will be used. Implementation of MOHMQuit will include reinforcing leadership investment in SCS as a clinical priority, strengthening maternity care clinicians' knowledge, skills, confidence and attitudes towards the provision of SCS, and clinicians' documentation of guideline-recommended SCS provided during antenatal care. Approximately, 4000 women who report smoking during pregnancy will be recruited across nine sites. The intervention and its implementation will be evaluated using a mixed methods approach. The primary outcome will be 7-day point prevalence abstinence at the end of pregnancy, among pregnant smokers, verified by salivary cotinine testing. Continuous data collection from electronic medical records and telephone interviews with postpartum women will occur throughout 32 months of the trial to assess changes in cessation rates reported by women, and SCS documented by clinicians and reported by women. Data collection to assess changes in clinicians' knowledge, skills, confidence and attitudes will occur prior to and immediately after the intervention at each site, and again 6 months later. Questionnaires at 3 months following the intervention, and semi-structured interviews at 6 months with maternity service leaders will explore leaders' perceptions of acceptability, adoption, appropriateness, feasibility, adaptations and fidelity of delivery of the MOHMQuit intervention. Structural equation modelling will examine causal linkages between the strategies, mediators and outcomes. Cost-effectiveness analyses will also be undertaken. DISCUSSION This study will provide evidence of the effectiveness of a multi-level implementation intervention to support policy decisions; and evidence regarding mechanisms of action of the intervention strategies (how the strategies effected outcomes) to support further theoretical developments in implementation science. TRIAL REGISTRATION ACTRN12622000167763, registered February 2nd 2022.
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Affiliation(s)
- Larisa Ariadne Justine Barnes
- grid.1013.30000 0004 1936 834XThe University of Sydney, The University Centre for Rural Health, 61 Uralba St., Lismore, NSW 2480 Australia
| | - Jo Longman
- grid.1013.30000 0004 1936 834XThe University of Sydney, The University Centre for Rural Health, 61 Uralba St., Lismore, NSW 2480 Australia
| | - Catherine Adams
- Northern New South Wales Local Health District, Byron Central Hospital, Ewingsdale Rd, Byron Bay, NSW 2480 Australia
| | - Christine Paul
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308 Australia
| | - Lou Atkins
- grid.83440.3b0000000121901201University College London, Centre for Behaviour Change, Gower Street, London, WC1E 6BT UK
| | - Billie Bonevski
- grid.1014.40000 0004 0367 2697Flinders University, College of Medicine & Public Health, Flinders Health and Medical Research Institute, Sturt Road, Bedford Park, SA 5042 Australia
| | - Aaron Cashmore
- grid.416088.30000 0001 0753 1056NSW Ministry of Health, Centre for Epidemiology and Evidence, 1 Reserve Road, St Leonards, NSW 2065 Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health, Camperdown, NSW 2006 Australia
| | - Laura Twyman
- grid.266842.c0000 0000 8831 109XTobacco Control Unit, Cancer Prevention and Advocacy Division, Cancer Council NSW, and Conjoint Fellow, School of Medicine and Public Health, University of Newcastle, 153 Dowling St., Woolloomooloo, NSW 2011 Australia
| | - Ross Bailie
- grid.1013.30000 0004 1936 834XThe University of Sydney, The University Centre for Rural Health, 61 Uralba St., Lismore, NSW 2480 Australia
| | - Alison Pearce
- grid.1013.30000 0004 1936 834XThe Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, and Sydney School of Public Health, The University of Sydney, Edward Ford Building, A27 Fisher Rd, Camperdown, NSW 2006 Australia
| | - Daniel Barker
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308 Australia
| | - Andrew J. Milat
- grid.416088.30000 0001 0753 1056NSW Ministry of Health, Centre for Epidemiology and Evidence, 1 Reserve Road, St Leonards, NSW 2065 Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health, Camperdown, NSW 2006 Australia
| | - Julie Dorling
- grid.492318.50000 0004 0619 0853Western NSW Local Health District, 7 Commercial Avenue, Dubbo, NSW 2830 Australia
| | - Michael Nicholl
- grid.1013.30000 0004 1936 834XClinical Excellence Commission-NSW Health and The University of Sydney Faculty of Medicine and Health, 1 Reserve Road, St. Leonards, NSW 2065 Australia
| | - Megan Passey
- grid.1013.30000 0004 1936 834XThe University of Sydney, The University Centre for Rural Health, 61 Uralba St., Lismore, NSW 2480 Australia
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Small SP, Maddigan J, Swab M, Jarvis K. Pregnant and postnatal women's experiences of interacting with health care providers about their tobacco smoking: a qualitative systematic review. JBI Evid Synth 2022:02174543-990000000-00111. [PMID: 36477572 DOI: 10.11124/jbies-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this review was twofold: (i) to comprehensively identify the best available evidence about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) concerning health care providers' interactions with them about their smoking, when such interactions occurred during contact for prenatal or postnatal health care in any health care setting; and (ii) to synthesize the research findings for recommendations to strengthen health care providers' interventions regarding smoking during pregnancy and smoking during the postnatal period. INTRODUCTION Maternal tobacco smoking during pregnancy and maternal tobacco smoking postnatally pose serious health risks for the woman, fetus, and offspring, whereas maternal smoking cessation has beneficial health effects. Given the importance of health care providers' interactions with pregnant and postnatal women for smoking cessation care, it is essential to understand women's experiences of such interactions. INCLUSION CRITERIA Studies considered for this review had qualitative research findings about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) in relation to health care providers' interactions with them about their smoking. METHODS The review was conducted using the JBI approach to qualitative systematic reviews. Published studies were sought through 6 academic databases (eg, CINAHL, MEDLINE). Unpublished studies were searched in 6 gray literature sources (eg, ProQuest Dissertations and Theses, Google Scholar). Reference lists of retrieved records were also searched. The searches occurred in October and November 2020; no country, language, or date limits were applied. Study selection involved title and abstract screening, full-text examination, and critical appraisal of all studies that met the inclusion criteria for the review. Study characteristics and research findings were extracted from the included studies. Study selection and extraction of findings were conducted by two reviewers independently; differences between reviewers were resolved through consensus. The research findings were categorized, and the categories were aggregated into a set of synthesized findings. The synthesized finding were assigned confidence scores. The categories and finalized synthesized findings were agreed upon by all reviewers. RESULTS The 57 included studies varied in qualitative research designs and in methodological quality (from mostly low to high). There were approximately 1092 eligible participants, and 250 credible and unequivocal research findings. The research findings yielded 14 categories and 6 synthesized findings with low to very low confidence scores. Some women who smoked tobacco during pregnancy and some women who smoked tobacco postnatally lacked supportive interactions by health care providers regarding their smoking; other women experienced supportive interactions by health care providers. Women were adversely impacted when health care providers' interactions lacked supportiveness, and were beneficially impacted when interactions were supportive. Women varied in openness to health care providers' interactions regarding their smoking, from not being receptive to being accepting, and some women wanted meaningful health care provider interactions. CONCLUSIONS Although confidence in the synthesized findings is low to very low, the evidence indicates that supportive health care provider interactions may facilitate positive smoking behavior change in pregnancy and postnatally. It is recommended that health care providers implement accepted clinical practice guidelines with women who smoke prenatally or postnatally, using an approach that is person-centered, emotionally supportive, engaging (eg, understanding), and non-authoritarian. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020178866.
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Affiliation(s)
- Sandra P Small
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
| | - Joy Maddigan
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
| | - Michelle Swab
- Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada.,Health Sciences Library, Memorial University, St. John's, NL, Canada
| | - Kimberly Jarvis
- Faculty of Nursing, Memorial University, St. John's, NL, Canada.,Memorial University Faculty of Nursing Collaboration for Evidence-Based Nursing and Primary Health Care: A JBI Affiliated Group, St. John's, NL, Canada
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Morris JK, Wellesley D, Limb E, Bergman JEH, Kinsner-Ovaskainen A, Addor MC, Broughan JM, Cavero-Carbonell C, Dias CM, Echevarría-González-de-Garibay LJ, Gatt M, Haeusler M, Barisic I, Klungsoyr K, Lelong N, Materna-Kiryluk A, Neville A, Nelen V, O'Mahony MT, Perthus I, Pierini A, Rankin J, Rissmann A, Rouget F, Sayers G, Stevens S, Tucker D, Garne E. Prevalence of vascular disruption anomalies and association with young maternal age: A EUROCAT study to compare the United Kingdom with other European countries. Birth Defects Res 2022; 114:1417-1426. [PMID: 36369770 PMCID: PMC10099853 DOI: 10.1002/bdr2.2122] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 10/17/2022] [Accepted: 10/24/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Younger mothers are at a greater risk of having a pregnancy with gastroschisis and the risk is higher in the United Kingdom than other European countries. Gastroschisis is thought to be a vascular disruption anomaly and the aim of this study was to analyze the prevalence of other possible vascular disruption anomalies to determine whether both the younger maternal age and the UK associations also occur with these anomalies. METHODS All pregnancies with anomalies considered potentially due to vascular disruption from January 1, 2005 to December 31, 2017 from 26 European population-based congenital anomaly registries who were members of EUROCAT were analyzed. Multilevel models were used to allow for differences between registries when analyzing associations with maternal age, year of birth and whether the registry was in the United Kingdom. RESULTS There were 5,220 cases with potential vascular disruption anomalies, excluding chromosomal and genetic conditions, with a prevalence of 8.85 per 10,000 births in the United Kingdom and 5.44 in the other European countries. The prevalence per 10,000 births of gastroschisis (4.45 vs. 1.56) and congenital constriction bands (0.83 vs. 0.42) was significantly higher in the United Kingdom, even after adjusting for maternal age. However, transverse limb reduction defects had a similar prevalence (2.16 vs. 2.14 per 10,000). The expected increased prevalence in younger mothers was observed for vascular disruption anomalies overall and for the individual anomalies: gastroschisis and congenital constriction bands. CONCLUSION Vascular disruption anomalies that had an increased risk for younger mothers (such as gastroschisis) had a higher maternal age standardized prevalence in the United Kingdom, while vascular disruption anomalies with weaker associations with younger mothers (such as transverse limb reduction defects) did not have an increased prevalence in the United Kingdom, which may indicate a different etiology for these anomalies.
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Affiliation(s)
- Joan K Morris
- St George's, University of London, London, United Kingdom
| | - Diana Wellesley
- Clinical Genetics, University of Southampton and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, United Kingdom
| | - Elizabeth Limb
- St George's, University of London, London, United Kingdom
| | - Jorieke E H Bergman
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
| | | | - Marie Claude Addor
- Department of Woman-Mother-Child, University Medical Center CHUV, Lausanne, Switzerland
| | | | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, Valencia, Spain
| | - Carlos M Dias
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge; Av padre Cruz, Lisbon, Portugal
| | | | - Miriam Gatt
- Directorate for Health Information and Research, Malta Congenital Anomalies Registry, G'Mangia, Malta
| | | | - Ingeborg Barisic
- Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia
| | - Kari Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Nathalie Lelong
- Université de Paris, INSERM U1153, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Paris, France
| | - Anna Materna-Kiryluk
- Polish Registry of Congenital Malformations, Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Amanda Neville
- Center for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Italy
| | - Vera Nelen
- Provincial Institute for Hygiene, Antwerp, Belgium
| | - Mary T O'Mahony
- Department of Public Health, Health Service Executive-South, Cork, Ireland
| | - Isabelle Perthus
- Auvergne Registry of Congenital Anomalies (CEMC-Auvergne), Department of Clinical Genetics, Centre de Référence des Maladies Rares, University Hospital of Clermont-Ferrand, CNRS-UMR 6602, Institut Pascal, Axe TGI, équipe PEPRADE, Clermont-Ferrand, France
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Florence Rouget
- Brittany Registry of Congenital Anomalies, CHU Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Geraldine Sayers
- Health Intelligence, Research and Development Health Service Executive, Dublin, Ireland
| | - Sarah Stevens
- National Disease Registration Service, NHS Digital, Leeds, United Kingdom
| | - David Tucker
- Public Health Knowledge and Research, Public Health Wales, Singleton Hospital, Swansea, United Kingdom
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
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20
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Chen S, Yue W, Han X, Luo J, Na L, Yang M. An integrative review on the maternal health literacy among maternal and child workers. J Nurs Manag 2022; 30:4533-4548. [PMID: 36190727 DOI: 10.1111/jonm.13830] [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: 05/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aim to capture the most comprehensive evidence-based dimensions of maternal health literacy, including summarizing the definitions, theoretical frameworks, measuring instruments, and the association between maternal health literacy and health behaviours. BACKGROUND Maternal health literacy has been recognized as an important approach to achieving high-quality maternal and child health; however, little is known about maternal health literacy comprehensively and scientifically. EVALUATION An integrative review retrieved articles from 11 databases, following the methodology of Whittemore and Knafl. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. KEY ISSUES A total of 5580 articles were retrieved and 23 articles were finally identified. Existing definitions and theoretical frameworks took less consideration of maternal applicability and failed to summarize maternal health literacy from a dynamic and systematic perspective. Measurement instruments were set up with many items that make it difficult to quickly screen for poor maternal health literacy. Most articles proved the association between maternal health literacy and health behaviours through correlation analysis or regression analysis but less explored the influence pathways between them. CONCLUSION The definition and theoretical framework need to focus on maternal applicability and explain the process of individual mothers acquiring and understanding health knowledge and skills from a dynamic and systematic perspective. A rapid instrument for maternal health literacy should be developed and high-quality empirical research was conducted to understand the associated mechanisms between maternal health literacy and health behaviours. IMPLICATIONS FOR NURSING MANAGEMENT It is necessary to strengthen maternal and child health education of primary health care nurses and enhance their ability to help perinatal women use maternal and child health information effectively.
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Affiliation(s)
- Shanxia Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Yue
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Xinrui Han
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianghe Luo
- Department of Gynecology and Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Liu Na
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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21
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Meldgaard M, Gamborg M, Terkildsen Maindal H. Health literacy in the prenatal phase: a systematic review. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 34:100796. [DOI: 10.1016/j.srhc.2022.100796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/15/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
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22
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Özpinar S, Demir Y, Yazicioğlu B, Bayçelebi S. Pregnant women's beliefs about third-hand smoke and exposure to tobacco smoke. Cent Eur J Public Health 2022; 30:154-159. [DOI: 10.21101/cejph.a7063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 08/02/2022] [Indexed: 11/15/2022]
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23
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Zhou W, Zhu X, Hu Z, Li S, Zheng B, Yu Y, Xie D. Association between secondhand smoke exposure in pregnant women and their socioeconomic status and its interaction with age: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:695. [PMID: 36085019 PMCID: PMC9461123 DOI: 10.1186/s12884-022-04968-6] [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: 04/13/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background Existing evidence highlights that exposure to secondhand smoke (SHS) is a risk factor for pregnant women’s health and is possibly affected by individual characteristics. This study aimed to explore the effect of individual socioeconomic status (SES) on SHS exposure among pregnant women in the third trimester and the interaction effect of age. Methods A total of 678 nonsmoking pregnant women with a median age of 29.0 years from 14 communities in a medium-sized city were recruited for this survey. Exposure to SHS was defined as the self-reported smoking habit of a spouse/partner. Individual SES characteristics consisted of marital status, educational attainment, employment and per capita monthly income. Results There were 238 (35.1%) participants who suffered from SHS exposure. Compared to the pregnant women who were employed, those who were unemployed were more likely to suffer from SHS exposure (OR = 1.572, 95% CI: 1.013–2.441). Participants who had a high school or technical secondary school education were more likely to be exposed to SHS than those with a college education or above (OR = 1.601, 95% CI: 1.029–2.449). Advanced age was a protective factor for participants with a college education or above (OR = 0.939, 95% CI: 0.884–0.997), but age increased the risk of SHS exposure among women who had unstable marriages (OR = 1.256, 95% CI: 1.019–1.549). Conclusion Exposure to SHS was very common among pregnant women in the third trimester. Pregnant women with a low SES and an older age should be considered a key population for the implementation of public health interventions.
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24
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Diabelková J, Rimárová K, Urdzík P, Dorko E, Houžvičková A, Andraščíková Š, Kaňuková L, Kluková D, Drabiščák E, Konrádyová N, Škrečková G. Influence of maternal smoking during pregnancy on birth outcomes. Cent Eur J Public Health 2022; 30:S32-S36. [PMID: 35841223 DOI: 10.21101/cejph.a6811] [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: 03/03/2021] [Accepted: 12/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. METHODS We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. RESULTS Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. CONCLUSION Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.
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Affiliation(s)
- Jana Diabelková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Peter Urdzík
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital in Kosice, Kosice, Slovak Republic
| | - Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Andrea Houžvičková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Štefánia Andraščíková
- Department of Midwifery, Faculty of Health Care, University of Presov, Presov, Slovak Republic
| | - Lívia Kaňuková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | | | - Erik Drabiščák
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Nika Konrádyová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Gabriela Škrečková
- Department of Physiotherapy, Faculty of Health Care, University of Presov, Presov, Slovak Republic
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25
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Šarac J, Havaš Auguštin D, Zajc Petranović M, Novokmet N, Bočkor L, Stanišić L, Petherick E, Karelović D, Šelović A, Mrdjen Hodžić R, Musić Milanović S, Demerath EW, Schell LM, Cameron N, Missoni S. Testing the Institute of Medicine (IOM) recommendations on maternal reproductive health and associated neonatal characteristics in a transitional, Mediterranean population. Ann Hum Biol 2022; 49:91-99. [PMID: 35604837 DOI: 10.1080/03014460.2022.2080863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND High pre-pregnancy body mass index (BMI) and excessive gestational weight gain (GWG) are significant risk factors for maternal and neonatal health. AIM To assess pre-pregnancy BMI and GWG during pregnancy and their association with different maternal and neonatal characteristics in the transitional Mediterranean population from the Eastern Adriatic islands. SUBJECTS AND METHODS 262 mother-child dyads from the CRoatian Islands' Birth Cohort Study (CRIBS) were included in the study. Chi-square test, ANOVA and regression analysis were used to test the association between selected characteristics. RESULTS 22% of women entered pregnancy with overweight/obesity and 46.6% had excessive GWG. Pre-pregnancy overweight and obesity were significantly associated with elevated triglycerides uric acid levels, and decreased HDL cholesterol in pregnancy. Excessive GWG was associated with elevated fibrinogen and lipoprotein A levels. Women with high pre-pregnancy BMI and GWG values were more likely to give birth to babies that were large for gestational age (LGA), additionally confirmed in the multiple logistic regression model. CONCLUSION High maternal pre-pregnancy BMI and excessive GWG were both significantly associated with deviated biochemical parameters and neonatal size. More careful monitoring of maternal nutritional status can lead to better pre- and perinatal maternal health care.
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Affiliation(s)
- Jelena Šarac
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | - Dubravka Havaš Auguštin
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | | | | | - Luka Bočkor
- Center for Applied Bioanthropology, Institute for Anthropological Research, Zagreb, Croatia.,Institute for Anthropological Research, Zagreb, Croatia
| | - Lada Stanišić
- Department of Medical Laboratory Diagnostics, Split University Hospital Centre, Split, Croatia
| | - Emily Petherick
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Deni Karelović
- Department of Obstetrics and Gynaecology, Split University Hospital Centre, Split, Croatia
| | - Alen Šelović
- Gynaecological practice Dr. Alen Šelović, Bjelovar, Croatia
| | | | - Sanja Musić Milanović
- Croatian National Institute of Public Health, Zagreb, Croatia.,University of Zagreb, School of Medicine, School of Public Health "Andrija Štampar", Zagreb, Croatia
| | - Ellen W Demerath
- School of Public Health, University of Minnesota, Minneapolis, USA
| | | | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Saša Missoni
- Institute for Anthropological Research, Zagreb, Croatia.,"J. J. Strossmayer" University, School of Medicine, Osijek, Croatia
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26
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Fuentes-Paez G, Escaramís G, Aguilar-Lacasaña S, Andrusaityte S, Brantsæter AL, Casas M, Charles MA, Chatzi L, Lepeule J, Grazuleviciene R, Gützkow KB, Heude B, Maitre L, Ruiz-Arenas C, Sunyer J, Urquiza J, Yang TC, Wright J, Vrijheid M, Vilor-Tejedor N, Bustamante M. Study of the Combined Effect of Maternal Tobacco Smoking and Polygenic Risk Scores on Birth Weight and Body Mass Index in Childhood. Front Genet 2022; 13:867611. [PMID: 35646076 PMCID: PMC9133473 DOI: 10.3389/fgene.2022.867611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Maternal smoking during pregnancy has adverse health effects on the offspring, including lower birth weight and increased risk for obesity. These outcomes are also influenced by common genetic polymorphisms. We aimed to investigate the combined effect of maternal smoking during pregnancy and genetic predisposition on birth weight and body mass index (BMI)-related traits in 1,086 children of the Human Early Life Exposome (HELIX) project. Methods: Maternal smoking during pregnancy was self-reported. Phenotypic traits were assessed at birth or at the age of 8 years. Ten polygenic risk scores (PRSs) per trait were calculated using the PRSice v2 program. For birth weight, we estimated two sets of PRSs based on two different base GWAS summary statistics: PRS-EGG, which includes HELIX children, and PRS-PanUK, which is completely independent. The best PRS per trait (highest R 2) was selected for downstream analyses, and it was treated in continuous or categorized into three groups. Multivariate linear regression models were applied to evaluate the association of the explanatory variables with the traits of interest. The combined effect was evaluated by including an interaction term in the regression models and then running models stratified by the PRS group. Results: BMI-related traits were correlated among them but not with birth weight. A similar pattern was observed for their PRSs. On average, the PRSs explained ∼4% of the phenotypic variation, with higher PRS values related to higher trait values (p-value <5.55E-08). Sustained maternal smoking was associated with lower birth weight and higher BMI and related traits (p-value <2.99E-02). We identified a gene by environment (GxE) interaction for birth weight between sustained maternal smoking and the PRS-EGG in three groups (p-value interaction = 0.01), which was not replicated with the PRS-PanUK (p-value interaction = 0.341). Finally, we did not find any statistically significant GxE interaction for BMI-related traits (p-value interaction >0.237). Conclusion: Sustained maternal smoking and the PRSs were independently associated with birth weight and childhood BMI-related traits. There was low evidence of GxE interactions.
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Affiliation(s)
- Georgina Fuentes-Paez
- Endocrine Regulatory Genomics, Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Geòrgia Escaramís
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Biomedicina, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
| | - Sofía Aguilar-Lacasaña
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Anne Lise Brantsæter
- Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maribel Casas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marie-Aline Charles
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Johanna Lepeule
- Inserm, CNRS, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, University Grenoble Alpes, Grenoble, France
| | | | - Kristine B. Gützkow
- Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Barbara Heude
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Léa Maitre
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carlos Ruiz-Arenas
- Genetics Unit, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Jordi Sunyer
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Fundació Institut Mar D'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Jose Urquiza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Tiffany C. Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Martine Vrijheid
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Natàlia Vilor-Tejedor
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, Netherlands
| | - Mariona Bustamante
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Childhood and Environment, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
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Nawabi F, Krebs F, Lorenz L, Shukri A, Alayli A, Stock S. Health Literacy among Pregnant Women in a Lifestyle Intervention Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5808. [PMID: 35627343 PMCID: PMC9141630 DOI: 10.3390/ijerph19105808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Health literacy plays a crucial role during pregnancy, influencing the mother's health behavior which in turn affects the unborn child's health. To date, there are only few studies that report on health literacy among pregnant women or even interventions to promote health literacy. GeMuKi (acronym for "Gemeinsam Gesund: Vorsorge plus für Mutter und Kind"-Strengthening health promotion: enhanced check-up visits for mother and child) is a cluster-randomized controlled trial, aimed at improving health literacy in pregnant women by means of a lifestyle intervention in the form of brief counseling. The women in the intervention group receive counseling on lifestyle topics, such as nutrition and physical activity, during their regular prenatal check-ups. The counseling is tailored to the needs of pregnant women. Demographic data is collected at baseline using a paper-based questionnaire. Data on health literacy is collected using the Health Literacy Survey Europe with 16 items (HLS-EU-16) at baseline and the Brief Health Literacy Screener (BHLS) questionnaire at two points during the pregnancy by means of an app, which was developed specifically for the purpose of the project. The results of the study indicate that around 61.9% of the women participating in the GeMuKi study have an adequate level of health literacy at baseline. The regression analyses (general estimating equations) showed no significant effect of the GeMuKi intervention on general health literacy as measured by the BHLS (ß = 0.086, 95% CI [-0.016-0.187]). However, the intervention was significantly positively associated with pregnancy specific knowledge on lifestyle (ß = 0.089, 95% CI [0.024-0.154]). The results of this study indicate that GeMuKi was effective in improving specific pregnancy related knowledge, but did not improve general health literacy.
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Affiliation(s)
- Farah Nawabi
- Institute for Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Cologne, Germany; (F.K.); (L.L.); (A.S.); (A.A.); (S.S.)
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The Health Literacy in Pregnancy (HeLP) Program Study Protocol: Development of an Antenatal Care Intervention Using the Ophelia Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084449. [PMID: 35457317 PMCID: PMC9030865 DOI: 10.3390/ijerph19084449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/27/2022] [Accepted: 04/01/2022] [Indexed: 01/21/2023]
Abstract
A pregnant woman needs adequate knowledge, motivation, and skills to access, understand, appraise, and apply health information to make decisions related to the health of herself and her unborn baby. These skills are defined as health literacy: an important factor in relation to the woman’s ability to engage and navigate antenatal care services. Evidence shows variation in levels of health literacy among pregnant women, but more knowledge is needed about how to respond to different health literacy profiles in antenatal care. This paper describes the development protocol for the HeLP program, which aims to investigate pregnant women’s health literacy and co-create health literacy interventions through a broad collaboration between pregnant women, partners, healthcare providers, professionals, and other stakeholders using the Ophelia (Optimising Health Literacy and Access) process. The HeLP program will be provided at two hospitals, which provide maternity care including antenatal care: a tertiary referral hospital (Aarhus University Hospital) and a secondary hospital (the Regional Hospital in Viborg). The Ophelia process includes three process phases with separate objectives, steps, and activities leading to the identification of local strengths, needs and issues, co-design of interventions, and implementation, evaluation, and ongoing improvement. No health literacy intervention using the Ophelia process has yet been developed for antenatal care.
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Loyal D, Sutter AL, Auriacombe M, Serre F, Rascle N. The Pregnant Smoker Stigma Scale – Public Stigma (P3S-PS): development and validation in general French population. Women Health 2022; 62:157-167. [DOI: 10.1080/03630242.2022.2030449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Deborah Loyal
- INSERM U1219, Bordeaux University, Bordeaux, France
- CRPMS EA 3522, Paris University, Paris, France
| | - Anne-Laure Sutter
- INSERM U1219, Bordeaux University, Bordeaux, France
- Perinatal Psychiatry Unit, Charles Perrens Hospital, Bordeaux, France
| | - Marc Auriacombe
- CNRS USR 3413, SANPSY, Bordeaux University, Bordeaux, France
- Addictology Unit, Charles Perrens Hospital, Bordeaux, France
| | - Fuschia Serre
- CNRS USR 3413, SANPSY, Bordeaux University, Bordeaux, France
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Sarala M, Mustonen A, Alakokkare AE, Salom C, Miettunen J, Niemelä S. Parental smoking and young adult offspring psychosis, depression and anxiety disorders and substance use disorder. Eur J Public Health 2022; 32:254-260. [PMID: 35092289 PMCID: PMC9090280 DOI: 10.1093/eurpub/ckac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background To study the associations between maternal smoking during pregnancy and paternal smoking before pregnancy and adult offspring psychiatric disorders. Methods Prospective general population cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986: 7259 subjects (77% of the original sample). Data on parental smoking were collected from parents during pregnancy using questionnaires. Outcomes were offspring’s register-based diagnoses: any psychiatric disorder, any non-organic psychosis, mood disorder, anxiety disorder and substance use disorder (SUD) until the age of 29–30 years. Maternal smoking during pregnancy and paternal smoking before pregnancy were pooled to three-class variables: (i) none; (ii) 1–9 and (iii) ≥10 cigarettes/day. Information regarding both parents’ alcohol use during pregnancy and at offspring age 15–16 years, maternal education level, family structure, parental psychiatric diagnoses and offspring gender, smoking, intoxication frequency and illicit substance use at the age of 15–16 years were investigated as covariates. Results In the multivariable analyses, maternal smoking during pregnancy did not associate with the studied outcomes after adjusting for offspring smoking and other substance use at offspring age 15–16 years and parental psychiatric disorders. However, paternal smoking ≥10 cigarettes/day before pregnancy [hazard ratio (HR) = 5.5, 95% confidence interval (CI) 2.7–11.2, P < 0.001] and paternal psychiatric disorders (HR = 1.7, 95% CI 1.1–2.8, P = 0.028) associated with offspring SUD after adjustments. Conclusions Information across the offspring life course is essential in exploring the association between parental smoking and offspring psychiatric disorders. Paternal smoking before pregnancy and paternal psychiatric disorders may act as modifiers in elevating the risk of substance-use-related problems among offspring.
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Affiliation(s)
- Marian Sarala
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Antti Mustonen
- Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Faculty of Medicine and Health Technology, University Consortium of Seinäjoki, Tampere University, Tampere, Finland
| | - Anni-Emilia Alakokkare
- Faculty of Medicine and Health Technology, University Consortium of Seinäjoki, Tampere University, Tampere, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Caroline Salom
- Institute for Social Science Research, University of Queensland, Queensland, Australia
| | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Solja Niemelä
- Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
- Department of Psychiatry, University of Turku, Turku, Finland
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31
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Been JV, Laverty AA, Tsampi A, Filippidis FT. European progress in working towards a tobacco-free generation. Eur J Pediatr 2021; 180:3423-3431. [PMID: 34032890 PMCID: PMC8589739 DOI: 10.1007/s00431-021-04116-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
Children have the right to grow up free from the hazards associated with tobacco smoking. Tobacco smoke exposure can have detrimental effects on children's health and development, from before birth and beyond. As a result of effective tobacco control policies, European smoking rates are steadily decreasing among adults, as is the proportion of adolescents taking up smoking. Substantial variation however exists between countries, both in terms of smoking rates and regarding implementation, comprehensiveness and enforcement of policies to address smoking and second-hand smoke exposure. This is important because comprehensive tobacco control policies such as smoke-free legislation and tobacco taxation have extensively been shown to carry clear health benefits for both adults and children. Additional policies such as increasing the legal age to buy tobacco, reducing the number of outlets selling tobacco, banning tobacco display and advertising at the point-of-sale, and introducing plain packaging for tobacco products can help reduce smoking initiation by youth. At societal level, health professionals can play an important role in advocating for stronger policy measures, whereas they also clearly have a duty to address smoking and tobacco smoke exposure at the patient level. This includes providing cessation advise and referring to effective cessation services.Conclusion: Framing of tobacco exposure as a child right's issue and of comprehensive tobacco control as a tool to work towards the ultimate goal of reaching a tobacco-free generation can help accelerate European progress to curb the tobacco epidemic. What is Known: • Tobacco exposure is associated with a range of adverse health effects among babies and children. • Comprehensive tobacco control policies helped bring down smoking rates in Europe and benefit child health. What is New: • Protecting the rights and health of children provides a strong starting point for tobacco control advocacy. • The tobacco-free generation concept helps policy-makers set clear goals for protecting future generations from tobacco-associated harms.
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Affiliation(s)
- Jasper V Been
- Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands.
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands.
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Aikaterini Tsampi
- Department of Transboundary Legal Studies, Faculty of Law, University of Groningen, Groningen, Netherlands
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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32
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Rodrigues VST, Moura EG, Peixoto TC, Soares PN, Lopes BP, Oliveira E, Manhães AC, Atella GC, Kluck GEG, Cabral SS, Trindade PL, Daleprane JB, Lisboa PC. Changes in gut-brain axis parameters in adult rats of both sexes with different feeding pattern that were early nicotine-exposed. Food Chem Toxicol 2021; 158:112656. [PMID: 34740714 DOI: 10.1016/j.fct.2021.112656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 01/09/2023]
Abstract
Nicotine is an endocrine disruptor and imprinting factor during breastfeeding that can cause food intake imbalance in the adulthood. As nicotine affects the intestinal microbiota, altering the composition of the bacterial communities and short-chain fatty acids (SCFAs) synthesis in a sex-dependent manner, we hypothesized that nicotine could program the gut-brain axis, consequently modifying the eating pattern of adult male and female rats in a model of maternal nicotine exposure (MNE) during breastfeeding. Lactating Wistar rat dams received minipumps that release 6 mg/kg/day of nicotine (MNE group) or saline for 14 days. The progeny received standard diet from weaning until euthanasia (26 weeks of age). We measured: in vivo electrical activity of the vagus nerve; c-Fos expression in the nucleus tractus solitarius, gastrointestinal peptides receptors, intestinal brain-derived neurotrophic factor (BDNF), SCFAs and microbiota. MNE females showed hyperphagia despite normal adiposity, while MNE males had unchanged food intake, despite obesity. Adult MNE offspring showed decreased Bacteroidetes and increased Firmicutes, Actinobacteria and Proteobacteria. MNE females had lower fecal acetate while MNE males showed higher vagus nerve activity. In summary nicotine exposure through the milk induces long-term intestinal dysbiosis, which may affect eating patterns of adult offspring in a sex-dependent manner.
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Affiliation(s)
- V S T Rodrigues
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - E G Moura
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - T C Peixoto
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - P N Soares
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - B P Lopes
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - E Oliveira
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - A C Manhães
- Neurophysiology Laboratory, Biology Institute, State University of Rio de Janeiro, RJ, Brazil
| | - G C Atella
- Laboratory of Lipids and Lipoprotein Biochemistry, Biochemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - G E G Kluck
- Laboratory of Lipids and Lipoprotein Biochemistry, Biochemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - S S Cabral
- Laboratory of Lipids and Lipoprotein Biochemistry, Biochemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - P L Trindade
- Laboratory for Studies of Interactions Between Nutrition and Genetics, Nutrition Institute, Rio de Janeiro State University, RJ, Brazil
| | - J B Daleprane
- Laboratory for Studies of Interactions Between Nutrition and Genetics, Nutrition Institute, Rio de Janeiro State University, RJ, Brazil
| | - P C Lisboa
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, RJ, Brazil.
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Olejniczak D, Klimiuk K, Religioni U, Staniszewska A, Panczyk M, Nowacka A, Mularczyk-Tomczewska P, Krzych-Fałta E, Korcala-Wichary A, Balwicki Ł. Willingness to Oppose Smoking among Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11636. [PMID: 34770159 PMCID: PMC8583594 DOI: 10.3390/ijerph182111636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/21/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022]
Abstract
Even though smoking causes numerous threats to the developing foetus, it is the most common addiction in Polish women of reproductive age. Most studies undertake to examine the subject of opposing second-hand smoking or creating tools to reprimand pregnant women more effectively using a qualitative methodology. The study aimed to determine the profile of a pregnant woman who is willing to oppose the smoking of another pregnant woman. The research was conducted using an original multiple-choice questionnaire. The survey was shared on websites for expecting parents. Completed questionnaires were collected from 11,448 pregnant women. The Wald test for logistic regression was used for statistical analysis. Predictors of whether someone would draw another pregnant women's attention to the fact that smoking is harmful were: intellectual work (OR 1.136; p-value 0.020) and currently being a student (OR 1.363; p-value 0.004), involvement of the child's father (OR 1.377; p-value < 0.001), contact with social campaigns (OR 1.150; p-value 0.005) and knowledge about the consequences of smoking, as well as talking to the midwife about the harmfulness of cigarettes during pregnancy (OR 1.655; p-value < 0.001). Interpersonal relationships leave scope for public health interventions. It is worth enhancing criticism against smoking by specialists through information and education campaigns.
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Affiliation(s)
- Dominik Olejniczak
- Department of Public Health, Faculty of Health Science, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.O.); (P.M.-T.)
| | - Krzysztof Klimiuk
- Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, 02-554 Warsaw, Poland;
| | - Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Mariusz Panczyk
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Zwirki Wigury 81, 01-580 Warsaw, Poland;
| | - Agnieszka Nowacka
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Paulina Mularczyk-Tomczewska
- Department of Public Health, Faculty of Health Science, Medical University of Warsaw, 02-091 Warsaw, Poland; (D.O.); (P.M.-T.)
| | - Edyta Krzych-Fałta
- Nursing Basics Facility, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Anna Korcala-Wichary
- Health Promotion Section, Students’ Scientific Public Health Association, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Łukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
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Pawellek M, Kopf FM, Egger N, Dresch C, Matterne U, Brandstetter S. Pathways linking parental health literacy with health behaviours directed at the child: a scoping review. Health Promot Int 2021; 37:6403923. [PMID: 34668013 DOI: 10.1093/heapro/daab154] [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] [Indexed: 01/15/2023] Open
Abstract
Health literacy (HL) is thought to be crucial for the management of the manifold demands relating to child health which parents are faced with. Albeit many studies have investigated parental HL and health behaviours (HBs) directed at the child, knowledge about the pathways which link parental HL with HB is scarce. The aim of this scoping review was to identify and comprehensively describe the variety of pathways linking parental HL with HBs directed at the child which were empirically analysed in previous studies. Following established scoping review methods database searches were conducted in MEDLINE, EMBASE, PsycINFO and WebofScience on 5 March 2020. Eligibility criteria included primary, empirical studies assessing parental HL and HB directed at the child in the general parent population. Titles and abstracts were screened independently by six reviewers for potentially relevant publications and data were extracted using standardized data extraction forms. The search identified 6916 articles for title and abstract screening. After full-text review, 50 studies were included in this review. Most studies (N = 24) assumed a direct association between HL and HBs and only few studies (N = 4) used more complex models investigating different pathways or mediation and/or moderation models. Overall, the evidence on the underlying pathways linking parental HL and HBs directed at the child is mixed and fairly limited. Therefore, hypothesis-driven research and integration of results into theoretical frameworks is needed for advancing both the research on HL and public health practice.
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Affiliation(s)
- Maja Pawellek
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany.,Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Felicitas Maria Kopf
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany
| | - Nina Egger
- Department of Public Health and Health Education, Freiburg University of Education, Kunzenweg 21, Freiburg 79117, Germany
| | - Carolin Dresch
- Department of Research Methods, Freiburg University of Education, Kunzenweg 21, Freiburg 79117, Germany
| | - Uwe Matterne
- Medical Faculty, Institute of Social Medicine and Health Systems Research, Otto von Guericke University, Leipziger Str. 44, Magdeburg 39120, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Klinik St. Hedwig, Steinmetzstr. 1-3, Regensburg 93049, Germany.,Member of the Research and Development Campus Regensburg (WECARE), Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
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35
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Loyal D, Sutter AL, Auriacombe M, Serre F, Calcagni N, Rascle N. Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population. Nicotine Tob Res 2021; 24:257-264. [PMID: 34546357 DOI: 10.1093/ntr/ntab190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be's access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy. METHOD Participants were French adults recruited from the general population through social networks (N=100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions and behaviours elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and inter-judge agreement was computed on 30% of the corpus analysed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood and smoking status was tested. RESULTS Themes (n=25) were defined regarding cognitions (n=9, e.g., irresponsible, thoughtless and unmindful, etc.), emotions (n=8, e.g., anger, disgust, etc.) and behaviours (n=8, e.g., inform and persuade, moralise and blame, etc.). Global inter-judge agreement was strong (κ=0.8). No difference was observed in themes according to gender, parental status or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ2 = 69.59, p = 0.02) (e.g., non-smokers more frequently stressed immorality). CONCLUSION The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population. IMPLICATIONS This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (e.g., irresponsible, thoughtless and unmindful, etc.), emotions (e.g., anger, disgust, etc.) and behaviours (e.g., inform and persuade, moralise and blame, etc.) were identified. These themes could guide further research regarding scale development and anti-stigma interventions to support smoking cessation.
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Affiliation(s)
- Deborah Loyal
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France.,CRPMS, EA 3522, Paris University, F-75000 Paris France
| | - Anne-Laure Sutter
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France.,Charles Perrens Hospital, F-33000 Bordeaux France
| | - Marc Auriacombe
- Charles Perrens Hospital, F-33000 Bordeaux France.,CNRS USR 3413, SANPSY, Bordeaux University, F-33000 Bordeaux France
| | - Fuschia Serre
- CNRS USR 3413, SANPSY, Bordeaux University, F-33000 Bordeaux France
| | | | - Nicole Rascle
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France
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36
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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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37
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Everson TM, Vives-Usano M, Seyve E, Cardenas A, Lacasaña M, Craig JM, Lesseur C, Baker ER, Fernandez-Jimenez N, Heude B, Perron P, Gónzalez-Alzaga B, Halliday J, Deyssenroth MA, Karagas MR, Íñiguez C, Bouchard L, Carmona-Sáez P, Loke YJ, Hao K, Belmonte T, Charles MA, Martorell-Marugán J, Muggli E, Chen J, Fernández MF, Tost J, Gómez-Martín A, London SJ, Sunyer J, Marsit CJ, Lepeule J, Hivert MF, Bustamante M. Placental DNA methylation signatures of maternal smoking during pregnancy and potential impacts on fetal growth. Nat Commun 2021; 12:5095. [PMID: 34429407 PMCID: PMC8384884 DOI: 10.1038/s41467-021-24558-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 06/22/2021] [Indexed: 02/07/2023] Open
Abstract
Maternal smoking during pregnancy (MSDP) contributes to poor birth outcomes, in part through disrupted placental functions, which may be reflected in the placental epigenome. Here we present a meta-analysis of the associations between MSDP and placental DNA methylation (DNAm) and between DNAm and birth outcomes within the Pregnancy And Childhood Epigenetics (PACE) consortium (N = 1700, 344 with MSDP). We identify 443 CpGs that are associated with MSDP, of which 142 associated with birth outcomes, 40 associated with gene expression, and 13 CpGs are associated with all three. Only two CpGs have consistent associations from a prior meta-analysis of cord blood DNAm, demonstrating substantial tissue-specific responses to MSDP. The placental MSDP-associated CpGs are enriched for environmental response genes, growth-factor signaling, and inflammation, which play important roles in placental function. We demonstrate links between placental DNAm, MSDP and poor birth outcomes, which may better inform the mechanisms through which MSDP impacts placental function and fetal growth.
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Affiliation(s)
- Todd M Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA.
| | - Marta Vives-Usano
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Emie Seyve
- University Grenoble Alpes, Inserm, CNRS, IAB, Grenoble, France
| | - Andres Cardenas
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Marina Lacasaña
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Andalusian School of Public Health, Granada, Spain
- Instituto de Investigación Biosantaria (ibs.GRANADA), Granada, Spain
| | - Jeffrey M Craig
- Epigenetics Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Corina Lesseur
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emily R Baker
- Department of Obstetrics & Gynecology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Nora Fernandez-Jimenez
- University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces-Bizkaia Health Research Institute, Barakaldo, Spain
- Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Barbara Heude
- Université de Paris, CRESS, INSERM, INRAE, Paris, France
| | - Patrice Perron
- Department of Medicine, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Beatriz Gónzalez-Alzaga
- Andalusian School of Public Health, Granada, Spain
- Instituto de Investigación Biosantaria (ibs.GRANADA), Granada, Spain
| | - Jane Halliday
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Reproductive Epidemiology, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Maya A Deyssenroth
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Carmen Íñiguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research, Universitat de València, València, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, València, Spain
| | - Luigi Bouchard
- Department of Biochemistry and Functional Genomics, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Pedro Carmona-Sáez
- Bioinformatics Unit, GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Granada, Spain
- Department of Statistics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Yuk J Loke
- Epigenetics Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Jordi Martorell-Marugán
- Bioinformatics Unit, GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Granada, Spain
- Atrys Health S.A., Barcelona, Spain
| | - Evelyne Muggli
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Reproductive Epidemiology, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Jia Chen
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mariana F Fernández
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosantaria (ibs.GRANADA), Granada, Spain
- Biomedical Research Centre (CIBM) and School of Medicine, University of Granada, Granada, Spain
| | - Jorg Tost
- Laboratory for Epigenetics and Environment, Centre National de Recherche en Génomique Humaine, CEA - Institut de Biologie François Jacob, Evry, France
| | - Antonio Gómez-Martín
- Genomics Unit, GENYO. Centre for Genomics and Oncological Research, Pfizer, University of Granada, Andalusian Regional Government, Granada, Spain
| | - Stephanie J London
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC, USA
| | - Jordi Sunyer
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public health at Emory University, Atlanta, GA, USA
| | - Johanna Lepeule
- University Grenoble Alpes, Inserm, CNRS, IAB, Grenoble, France
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Mariona Bustamante
- Center for Genomic Regulation (CRG), Barcelona Institute of Science and Technology, Barcelona, Spain.
- Universitat Pompeu Fabra, Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
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Abstract
Smoking during pregnancy has negative effects on both maternal and fetal health. One of these negative maternal effects is the potential for depression. A high rate of cigarette smoking in pregnancy is an important public health issue since it affects not only the pregnant woman but also the newborn and its healthy development. The aim of this study is to investigate the relationship between smoking, influencing factors, and depression prevalence in pregnant Syrian refugees and pregnant citizens of the Republic of Turkey (TR). Pregnant citizens in the TR and pregnant Syrian refugees who were registered at health centers between 15.04.2017 and 15.10.2017 in the border city of Ceylanpınar in the Province of Şanlıurfa in Syria were visited in their living areas in the district center and at a tent village, respectively. A total of 414 pregnant women agreed to participate in the study and were included in the survey. To collect data for the cross-sectional study, a sociodemographic and pregnancy characteristics questionnaire was used, in addition to the Fageström Test for Nicotine Dependence (FTND) and the Beck Depression Inventory (BDI). The rate of smoking in all pregnant women was determined to be 49.3% (n = 204) before pregnancy and 37.9% (n = 157) during pregnancy. A statistically significant difference was found between age groups and educational status in relation to smoking status (p = 0.005, p = 0.001). There was also a statistically significant difference between the smoking status of pregnant women and that of their partners and family members (p = 0.001, p = 0.002). The percentage of pregnant women who were passive smokers was 80.2% (n = 332), and a statistically significant difference was found between passive smoking and smoking status (Fisher; 0.000). The presence of risk for depression was detected in 49.8% (n = 206) of all pregnant women surveyed; the rate of depression risk was 50.5% (n = 104) in pregnant TR citizens and 49.5% (n = 102) in pregnant refugees, with no significant difference between the two groups. There was a statistically significant difference between smoking status in pregnancy and the presence of depression risk (p = 0.001). 32.5% of pregnant women were highly nicotine dependent. A moderate positive correlation was determined between the FTND and BDI scores of pregnant women (r = 0.346; p = 0.001). It was found that one-third of all pregnant women smoked and that one of every two showed a risk for depression. A statistically significant correlation was found between smoking status and risk for depression. No statistically significant difference was determined between the two groups, despite high levels of smoking, nicotine dependence, and depression in both. These data suggest the need to develop new preventive strategies in regard to smoking among pregnant women.
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Derksen ME, Jaspers MW, van Strijp S, Fransen MP. Mobile Health for Smoking Cessation Among Disadvantaged Young Women During and After Pregnancy: User-Centered Design and Usability Study. JMIR Form Res 2021; 5:e24112. [PMID: 34346895 PMCID: PMC8374659 DOI: 10.2196/24112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/26/2020] [Accepted: 05/31/2021] [Indexed: 01/29/2023] Open
Abstract
Background Smoking prevalence during and after pregnancy remains high among socioeconomically disadvantaged women. Mobile health (mHealth) apps with game and social support elements seem promising to support smoking cessation. Objective This study aims to describe the user-centered design and usability evaluation of Kindle, an mHealth app with game and social support elements, to support disadvantaged young women during and after pregnancy through the first stages of smoking cessation. Methods Disadvantaged women (n=9), members of their social networks (n=4), and nurses supporting these women (n=51) were informants throughout the iterative prototype development of Kindle according to the International Organization for Standardization 9241-11:2018. Specific phases included understanding the context of use through secondary analysis of qualitative interview data (phase 1), establishing the user and organizational requirements (phase 2), production of design solutions (phase 3), and usability inspection of the prototype through a heuristic evaluation (3 experts) along with user testing by a think aloud method (5 disadvantaged women and 5 nurses; phase 4). Usability problems were categorized according to the principles of the Healthcare Information and Management Systems Society. Results Phase 1 resulted in an understanding of the VoorZorg program and the needs of VoorZorg nurses and clients (eg, focus on early stages of change and building new supportive networks to aid clients in smoking cessation). In phase 2, we established requirements (n=22; eg, mHealth app, secure communication between nurses and clients, easy-to-use interfaces, inclusion of game elements, and tailoring at early stages of change in smoking cessation). Phase 3 resulted in a prototype of Kindle, combining the interface for nurses and clients, including the following functionalities: personal goal setting with earning points; secured chat function between nurses and other clients; and tips, diary, and profile creation. The heuristic evaluation and thinking aloud method in phase 4 revealed 78 usability problems in the interfaces. Most usability problems concerned simplicity (eg, unclear clickable button) and naturalness (eg, unclear icon). Conclusions The user-centered design and usability testing of the mHealth app Kindle yielded useful insights. The involvement of end users, specifically socioeconomically disadvantaged women during and after their pregnancy, resulted in a prototype that met their needs and requirements (eg, mHealth app, secure communication between nurses and clients, easy-to-use interfaces, inclusion of game elements, and tailoring to the early stages of change in smoking cessation) to achieve readiness for smoking cessation. Moreover, the usability evaluation by end users and experts revealed unique usability problems for this population. These insights allow for further optimization of Kindle and encourage future studies to engage disadvantaged populations in all phases of mHealth intervention design and usability testing.
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Affiliation(s)
- Marloes E Derksen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Monique Wm Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Sander van Strijp
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mirjam P Fransen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Flaathen EME, Lukasse M, Cvancarova Småstuen M, Garnweidner-Holme L, Henriksen L. Intimate partner violence and the association of pregnancy intendedness - A cross-sectional study in southeastern Norway. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100651. [PMID: 34364196 DOI: 10.1016/j.srhc.2021.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 07/06/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Unintended pregnancy in the context of intimate partner violence (IPV) is a public health issue. It is associated with increased health risks for women and their children. Our objective was to investigate the association between unintended pregnancy and emotional, physical and sexual IPV in a multi-cultural population attending routine antenatal care. STUDY DESIGN A prospective cross-sectional study of 1788 pregnant women who filled out a questionnaire during pregnancy as part of a randomized controlled trial conducted in southeastern Norway. MAIN OUTCOME MEASURES Pregnancy intendedness was measured by asking women if their pregnancy was planned or not. The Abuse Assessment Screen and the Composite Abuse Scale R-SF, consisting of descriptive questions, were used to measure IPV. Chi-square tests, a Mann-Whitney U test, and binary logistic regression analysis were used. RESULTS Almost one in five women (17.4%) reported that their current pregnancy was unintended. Women with unintended pregnancy were significantly younger, had lower educational backgrounds, more limited economic resources and were more likely to be non-native Norwegian speakers. A total of 15.3% of the women reported some experience of IPV in their lifetime. These women were significantly more likely to experience an unintended pregnancy than women who had not experienced IPV, after adjusting for confounding factors: AOR = 1.74 (95% CI [1.23-2.47]). CONCLUSIONS Women who had experienced IPV were significantly more likely to have an unintended pregnancy than women who had not experienced IPV. It is of major importance to identify those women and offer appropriate services during pregnancy.
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Affiliation(s)
- Eva Marie Engebakken Flaathen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, PO Box 235, 3603 Kongsberg, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
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Kheirallah KA, Shugaa Addin N, Alolimat MM. Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities. PLoS One 2021; 16:e0253655. [PMID: 34242237 PMCID: PMC8270187 DOI: 10.1371/journal.pone.0253655] [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: 01/27/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. Methods A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Results Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Conclusions Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette–waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.
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Affiliation(s)
- Khalid A. Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- * E-mail:
| | - Nuha Shugaa Addin
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Maan M. Alolimat
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Nawabi F, Alayli A, Krebs F, Lorenz L, Shukri A, Bau AM, Stock S. Health literacy among pregnant women in a lifestyle intervention trial: protocol for an explorative study on the role of health literacy in the perinatal health service setting. BMJ Open 2021; 11:e047377. [PMID: 34210730 PMCID: PMC8252873 DOI: 10.1136/bmjopen-2020-047377] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Pregnancy is a vulnerable period that affects long-term health of pregnant women and their unborn infants. Health literacy plays a crucial role in promoting healthy behaviour and thereby maintaining good health. This study explores the role of health literacy in the GeMuKi (acronym for 'Gemeinsam Gesund: Vorsorge plus für Mutter und Kind'-Strengthening health promotion: enhanced check-up visits for mother and child) Project. It will assess the ability of the GeMuKi lifestyle intervention to positively affect health literacy levels through active participation in preventive counselling. The study also explores associations between health literacy, health outcomes, health service use and effectiveness of the intervention. METHODS AND ANALYSIS The GeMuKi trial has a hybrid effectiveness-implementation design and is carried out in routine prenatal health service settings in Germany. Women (n=1860) are recruited by their gynaecologist during routine check-up visits before 12 weeks of gestation. Trained healthcare providers carry out counselling using motivational interviewing techniques to positively affect health literacy and lifestyle-related risk factors. Healthcare providers (gynaecologists and midwives) and women jointly agree on Specific, Measurable, Achievable Reasonable, Time-Bound goals. Women will be invited to fill in questionnaires at two time points (at recruitment and 37th-40th week of gestation) using an app. Health literacy is measured using the German version of the Health Literacy Survey-16 and the Brief Health Literacy Screener. Lifestyle is measured with questions on physical activity, nutrition, alcohol and drug use. Health outcomes of both mother and child, including gestational weight gain (GWG) will be documented at each routine visit. Health service use will be assessed using social health insurance claims data. Data analyses will be conducted using IBM SPSS Statistics, version 26.0. These include descriptive statistics, tests and regression models. A mediation model will be conducted to answer the question whether health behaviour mediates the association between health literacy and GWG. ETHICS AND DISSEMINATION The study was approved by the University Hospital of Cologne Research Ethics Committee (ID: 18-163) and the State Chamber of Physicians in Baden-Wuerttemberg (ID: B-F-2018-100). Study results will be disseminated through (poster) presentations at conferences, publications in peer-reviewed journals and press releases. TRAIL REGISTRATION German Clinical Trials Register (DRKS00013173). Registered pre-results, 3rd of January 2019, https://www.drks.de.
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Affiliation(s)
- Farah Nawabi
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Adrienne Alayli
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Federal Centre for Health Education, Cologne, Germany
| | - Franziska Krebs
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Arim Shukri
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - Stephanie Stock
- Institute of Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Nakamura A, Pryor L, Ballon M, Lioret S, Heude B, Charles MA, Melchior M, El-Khoury Lesueur F. Maternal education and offspring birth weight for gestational age: the mediating effect of smoking during pregnancy. Eur J Public Health 2021; 30:1001-1006. [PMID: 32529232 DOI: 10.1093/eurpub/ckaa076] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Small for gestational age (SGA) birth weight, a risk factor for infant mortality and delayed child development, is associated with maternal educational attainment. Maternal tobacco smoking during pregnancy could contribute to this association. We aimed to quantify the contribution of maternal smoking during pregnancy to social inequalities in child birth weight for gestational age (GA). METHODS Data come from the French nation-wide ELFE cohort study, which included 17 155 singletons. Birth weights for GA were calculated using z-scores. Associations between maternal educational attainment, tobacco smoking during pregnancy and child birth weight for GA were ascertained using mediation analysis. Mediation analyses were also stratified by maternal pre-pregnancy body mass index. RESULTS Low maternal educational attainment was associated with an increased odd of tobacco smoking during pregnancy [adjusted OR (ORa) = 2.58 (95% CI 2.34-2.84)] as well as a decrease in child birth weight for GA [RRa = 0.94 (95% CI 0.91-0.98)]. Tobacco smoking during pregnancy was associated with a decrease in offspring birth weight for GA [RRa = 0.73 (95% CI 0.70-0.76)]. Mediation analysis suggests that 39% of the effect of low maternal educational attainment on offspring birth weight for GA was mediated by smoking during pregnancy. A more important direct effect of maternal educational attainment on child birth weight for GA was observed among underweight women [RRa = 0.82 (95% CI 0.72-0.93)]. CONCLUSIONS The relationship between maternal educational attainment and child birth weight for GA is strongly mediated by smoking during pregnancy. Reducing maternal smoking could lessen the occurrence of infant SGA and decrease socioeconomic inequalities in birth weight for GA.
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Affiliation(s)
- Aurélie Nakamura
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France.,French School of Public Health (EHESP), Doctoral Network, Rennes, France
| | - Laura Pryor
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Morgane Ballon
- French School of Public Health (EHESP), Doctoral Network, Rennes, France.,INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Origin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, France
| | - Sandrine Lioret
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Origin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, France
| | - Barbara Heude
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Origin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, France
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Origin of the Child's Health and Development Team (ORCHAD), Paris Descartes University, Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France.,Institut Convergences Migrations, Paris, France
| | - Fabienne El-Khoury Lesueur
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
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Maricic M, Stojanovic G, Pazun V, Stepović M, Djordjevic O, Macuzic IZ, Milicic V, Vucic V, Radevic S, Radovanovic S. Relationship Between Socio-Demographic Characteristics, Reproductive Health Behaviors, and Health Literacy of Women in Serbia. Front Public Health 2021; 9:629051. [PMID: 33996713 PMCID: PMC8116654 DOI: 10.3389/fpubh.2021.629051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Health literacy of women can significantly affect different aspects of reproductive health. The aim of this study was the assessment of relationship of health literacy, socio-demographic characteristics and reproductive health behaviors of women in Serbia. Methodology: This was a cross-sectional study on a random sample of women aged 18 and over from the territories of three Serbian regions, stratified according to age groups, region and type of settlement. A standardized version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used in assessing health literacy of women. Results: Based on the calculated index of health literacy, 9.6% of respondents had inadequate health literacy. Inadequate levels of health literacy were more common in women living in rural areas (OR = 1.111) and the poorer classes (OR = 5.122). Employed women (OP = 1.249), with good health (OR = 1.512) with a degree (OR = 1.535) had bigger odds to have adequate health literacy. Multivariate regression analysis showed the following significant predictors: commitment to the chosen gynecologist (OR = 1.530), contraceptive use (OR = 1.020), knowledge of the damages that could be caused by the human papillomavirus (HPV) (OR = 1.578), awareness of vaccine availability against HPV infection (OR = 1.217) and following the health-related topics (OR = 2.350). Conclusion: Limited levels of health literacy were significantly higher among middle-aged women, among those living in rural areas, among women who rated their health as poor or very poor, and who exhibited more negative patterns of reproductive health behavior, indicating the need for implementation of prevention programs and strategies with the aim of increasing the level of health literacy.
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Affiliation(s)
- Milena Maricic
- Department School of Applied Health Science Studies, Academy of Applied Studies Belgrade, Belgrade, Serbia
| | - Goran Stojanovic
- Department School of Applied Health Science Studies, Academy of Applied Studies Belgrade, Belgrade, Serbia
| | - Vanja Pazun
- Department School of Applied Health Science Studies, Academy of Applied Studies Belgrade, Belgrade, Serbia
| | - Milos Stepović
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Ognjen Djordjevic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Ivana Zivanovic Macuzic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vesna Milicic
- Department of Dermatovenerology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | | | - Svetlana Radevic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Snezana Radovanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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McDaid L, Thomson R, Emery J, Coleman T, Cooper S, Phillips L, Naughton F. Agreement and Disparities between Women and Stop-Smoking Specialists about How to Promote Adherence to Nicotine Replacement Therapy in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094673. [PMID: 33924763 PMCID: PMC8125676 DOI: 10.3390/ijerph18094673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 11/16/2022]
Abstract
Evidence for the effectiveness of nicotine replacement therapy (NRT) for smoking-cessation in pregnancy is weak. This has been attributed to insufficient dosing and low adherence. This study investigated the acceptability of key messages and delivery modes for a behavioral intervention to increase NRT adherence in pregnancy. Semi-structured telephone interviews were carried out with pregnant or postpartum women aged ≥16 from across England, who had been offered NRT during pregnancy as part of a quit attempt and who struggled to quit (n = 10), and a focus group with stop-smoking specialists from across England (n = 6). The two data sources were coded separately using a thematic approach and then integrated to compare perspectives. Women and specialists agreed on message tone and delivery modes. However, views diverged on the most influential sources for certain messages and whether some information should be given proactively or reactively. There was also disagreement over which messages were novel and which were routinely delivered. This study demonstrates the value of capturing and integrating different perspectives and informational requirements when developing behavior-change interventions. The findings provide useful insights for designing a pregnancy-specific NRT adherence intervention that is acceptable to both those who will deliver and receive it.
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Affiliation(s)
- Lisa McDaid
- Behavioral and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK; (J.E.); (F.N.)
- Correspondence:
| | - Ross Thomson
- Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK; (R.T.); (T.C.); (S.C.); (L.P.)
| | - Joanne Emery
- Behavioral and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK; (J.E.); (F.N.)
| | - Tim Coleman
- Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK; (R.T.); (T.C.); (S.C.); (L.P.)
| | - Sue Cooper
- Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK; (R.T.); (T.C.); (S.C.); (L.P.)
| | - Lucy Phillips
- Division of Primary Care, University of Nottingham, Tower Building, University Park, Nottingham NG7 2RD, UK; (R.T.); (T.C.); (S.C.); (L.P.)
| | - Felix Naughton
- Behavioral and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK; (J.E.); (F.N.)
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Has contraceptive use at pregnancy an effect on the odds of spontaneous termination and induced abortion? Evidence from Demographic and Health Surveys. DEMOGRAPHIC RESEARCH 2021. [DOI: 10.4054/demres.2021.44.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Miller-Graff LE, Howell KH, Grein K, Keough K. Women's Cigarette and Marijuana Use in Pregnancy: Identifying the Role of Past Versus Recent Violence Exposure. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3982-NP3998. [PMID: 29936890 DOI: 10.1177/0886260518779068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Both cigarette smoking and marijuana use during pregnancy pose serious risks to healthy fetal development, yet little is known about the comparative contribution of recent versus past traumatic experiences to women's smoking behavior. The current study aimed to examine the relative contributions of childhood adversity and past year intimate partner violence (IPV) to women's cigarette and marijuana use during pregnancy in a high-risk, low-income sample. Participants (n = 101) were interviewed to evaluate past year IPV, childhood adversity, and cigarette and marijuana use. Results indicated that approximately one in four pregnant women in the sample reported that they were currently smoking cigarettes. Only a minority of those who reported prepregnancy smoking (22.5%) were able to quit smoking once pregnant. Regarding marijuana use, 6.9% of women reported use during pregnancy, with 68.1% of women using prior to pregnancy ceasing use once pregnant. Results of multinomial regressions controlling for income and education indicated that past year physical abuse by a partner was associated with light cigarette use during pregnancy whereas high rates of childhood adversity were associated with moderate cigarette use during pregnancy. Sexual IPV was associated with marijuana use during pregnancy. Comprehensive assessment of women's history of exposure to violence, including both past and recent exposure, provides insight into which women may have the most difficulty with unassisted cessation in the prenatal period. Providing better intervention and support around cigarette and marijuana cessation for women exposed to violence is a critical need, especially among groups that are at sociodemographic risk for substance use in pregnancy.
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Demiguel V, Blondel B, Bonnet C, Nguyen-Thanh V, Saurel-Cubizolles MJ, Regnault N. Trends in Tobacco Smoking in Pregnant Women: Data From French National Perinatal Surveys. Int J Public Health 2021; 66:602873. [PMID: 34744568 PMCID: PMC8565271 DOI: 10.3389/ijph.2021.602873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/11/2021] [Indexed: 01/04/2023] Open
Abstract
Objectives: To describe maternal smoking trends in France between 1972 and 2016, and identify whether maternal characteristics associated with smoking in the 3rd trimester of pregnancy evolved between 2010 and 2016. Methods: Using French National Perinatal Surveys, we estimated proportions of smokers and the number of cigarettes smoked both just before pregnancy and during the 3rd trimester from 1972 to 2016. We used a Poisson model with robust variance to estimate prevalence ratios for smoking during pregnancy. Results: Proportions of mothers quitting smoking were relatively stable (46.0% in 1972 and 45.8% in 2016). The number of cigarettes smoked just before pregnancy and in the 3rd trimester decreased from 1995 onward. However, proportions of smokers remained high before (30.1%) and during the 3rd trimester in 2016 (16.2%). Smoking in the 3rd trimester was associated with a lower education level and lower income in both 2010 and 2016, whereas the association with age, country of birth and parity varied according to the survey year. Conclusion: Early targeted interventions are needed for smokers who plan to have a child and must take smokers' characteristics during pregnancy into account.
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Affiliation(s)
- Virginie Demiguel
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Béatrice Blondel
- Université de Paris, CRESS, INSERM, INRA, Paris, France
- INSERM U1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Paris, France
| | - Camille Bonnet
- Université de Paris, CRESS, INSERM, INRA, Paris, France
- INSERM U1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Paris, France
| | - Viêt Nguyen-Thanh
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Marie-Josèphe Saurel-Cubizolles
- Université de Paris, CRESS, INSERM, INRA, Paris, France
- INSERM U1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (Epopé), Paris, France
| | - Nolwenn Regnault
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
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Phommachanh S, Essink DR, Wright PE, Broerse JEW, Mayxay M. Maternal health literacy on mother and child health care: A community cluster survey in two southern provinces in Laos. PLoS One 2021; 16:e0244181. [PMID: 33780460 PMCID: PMC8007003 DOI: 10.1371/journal.pone.0244181] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
RATIONAL Increased maternal health literacy (MHL) has contributed considerably to maternal and child health outcomes in many countries. Malnutrition, and low coverage of child vaccination and breastfeeding are major health concerns in Laos, but there is little insight into mothers' literacy on these issues. The aim of this study was to identify the level of MHL of Lao mothers and to explore factors influencing it, in order to provide evidence that can inform policies and planning of health services. METHODS A cross-sectional survey was conducted using a questionnaire on health literacy (ability to access, understand, appraise and apply health-related information) in relation to care during pregnancy, childbirth, and the postpartum period. We interviewed 384 mothers with children aged under five years; 197 from urban and 187 from rural areas. Descriptive and inferential statistics were applied to analyze the data. RESULTS Overall, MHL of Lao mothers was very low in both urban and rural areas; 80% of mothers had either inadequate or problematic MHL, while only 17.4% had sufficient and 3.5% excellent MHL. The MHL scores were significantly higher in urban than in rural areas. One third of mothers found it very difficult to access, understand, appraise and apply information on mother and child (MCH). Health personnel were the main source of MCH information for the mothers. Years of schooling, own income, health status, and number of ANC visits significantly predicted a higher level of MHL (R square = 0.250; adjusted R square = 0.240, P = <0.001). CONCLUSIONS MHL of Lao mothers was inadequate in both urban and rural areas. Socio-demographics and key practices of the mothers were significantly associated with a better level of MHL. Health education on MHL to mothers in both urban and rural areas needs attention, and could best be done by improving the quality of health providers' provision of information.
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Affiliation(s)
- Sysavanh Phommachanh
- Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
| | - Dirk R. Essink
- Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Pamela E. Wright
- Guelph International Health Consulting, Amsterdam, The Netherlands
| | - Jacqueline E. W. Broerse
- Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Mayfong Mayxay
- Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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Günther V, Alkatout I, Vollmer C, Maass N, Strauss A, Voigt M. Impact of nicotine and maternal BMI on fetal birth weight. BMC Pregnancy Childbirth 2021; 21:127. [PMID: 33579212 PMCID: PMC7881635 DOI: 10.1186/s12884-021-03593-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 01/27/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. As the individual factors (body mass index - BMI (kg/m2) - and cigarette consumption) have been extensively investigated in pregnancy, we aimed to establish how maternal BMI and nicotine interact with regard to perinatal outcomes and birth weight. METHODS Data from 110.047 singleton pregnancies, achieved from the German Perinatal Survey in Schleswig-Holstein and registered between 2010 and 2017 were analyzed in August 2018 concerning maternal BMI and smoking. The BMI was taken from the maternity log. Information concerning the smoking status were self-reported and further subdivided into the following four categories: a) non-smokers; b) 1-7 cigarettes/day; c) 8-14 cigarettes/ day; and d) ≥ 15 cigarettes/ day. Furthermore, we classified women by their BMI into underweight, normal weight, overweight and obese. Comparisons between non-smokers and the respective smoking group, and their relationship with maternal BMI were performed by the t-test (birth weight). A P-value ≤0.05 was considered to indicate statistical significance. RESULTS A number of 97.092 women (88.2%) were non-smokers and 12.955 (11.8%) were smokers. Furthermore 10.3% of women of normal weight smoked during pregnancy, but both high and low BMI were associated with a high prevalence of smoking. The proportion of smokers was highest (18.1%) among underweight women (BMI ≤ 18.5 kg/m2). A large number of smokers (15.5%) were registered in the obesity group (BMI ≥ 30 kg/m2). Mean birth weight (≥ 37 + 0 gestational age) increased with increasing maternal BMI, and was reduced by smoking for every BMI category. The differences between smokers and non-smokers were always highly significant (p < 0.001). Mean birth weight varied between 2995 g in underweight frequent smokers and 3607 g in obese non-smokers. CONCLUSION Both maternal BMI and smoking during pregnancy influences the birth weight and therefore pregnancy outcome. Smoking during pregnancy was significantly associated with low birth weight. Pregnant women should be advised to cease or at least reduce smoking in order to improve the birth weight of the newborn and to minimize child morbidities.
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Affiliation(s)
- Veronika Günther
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), 24105, Kiel, Germany.
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), 24105, Kiel, Germany
| | - Christoph Vollmer
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), 24105, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), 24105, Kiel, Germany
| | | | - Manfred Voigt
- Department of Gynecology, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
- Center for Medicine and Society, Albert-Ludwigs-University Freiburg, Friedrichstr. 39, 79098, Freiburg, Germany
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