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Bottemanne H, Joly L. [Mother brain: Bayesian theory of maternal interoception during pregnancy and postpartum]. L'ENCEPHALE 2023; 49:185-195. [PMID: 36243551 DOI: 10.1016/j.encep.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/05/2022]
Abstract
The perinatal period, including pregnancy and postpartum, causes major morphological, endocrinal, and thermal transitions in women. As the fetus grows, abdominal muscle fibers stretch, internal organs such as the bladder or colon move, and the uterine anatomy changes. Many of these changes involve interoception, the perception of internal body signals such as muscle and visceral sensations. Despite the importance of these interoceptive signals, few studies have explored perinatal interoception. We propose an innovative theory of maternal interoception based on recent findings in neuroscience. We show that interoceptive signals processing during pregnancy is crucial for understanding perinatal phenomenology and psychopathology, such as maternal perception of fetal movements, maternal-infant bonding, denial of pregnancy, phantom fetal movements after childbirth, pseudocyesis or even puerperal delusion. Knowing the importance of these interoceptive mechanisms, clinicians in obstetrics, gynecology and mental health should be particularly vigilant to maternal interoception during the perinatal period.
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Affiliation(s)
- Hugo Bottemanne
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neuroscience, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Brain Institute - Institut du Cerveau (ICM), Department of Neuroscience, UMR 7225/UMRS 1127, Sorbonne University/CNRS/INSERM, Paris, France; Sorbonne University, Department of Philosophy, SND Research Unit, UMR 8011, CNRS, Paris, France.
| | - Lucie Joly
- Department of Psychiatry, Sorbonne University, Pitié-Salpêtrière Hospital, DMU Neuroscience, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Paris Brain Institute - Institut du Cerveau (ICM), Department of Neuroscience, UMR 7225/UMRS 1127, Sorbonne University/CNRS/INSERM, Paris, France
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2
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Biogenic Phytochemicals Modulating Obesity: From Molecular Mechanism to Preventive and Therapeutic Approaches. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6852276. [PMID: 35388304 PMCID: PMC8977300 DOI: 10.1155/2022/6852276] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/05/2022] [Indexed: 02/06/2023]
Abstract
The incidence of obesity and over bodyweight is emerging as a major health concern. Obesity is a complex metabolic disease with multiple pathophysiological clinical conditions as comorbidities are associated with obesity such as diabetes, hypertension, cardiovascular disorders, sleep apnea, osteoarthritis, some cancers, and inflammation-based clinical conditions. In obese individuals, adipocyte cells increased the expression of leptin, angiotensin, adipocytokines, plasminogen activators, and C-reactive protein. Currently, options for treatment and lifestyle behaviors interventions are limited, and keeping a healthy lifestyle is challenging. Various types of phytochemicals have been investigated for antiobesity potential. Here, we discuss pathophysiology and signaling pathways in obesity, epigenetic regulations, regulatory mechanism, functional ingredients in natural antiobesity products, and therapeutic application of phytochemicals in obesity.
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Sinaci S, Ocal DF, Ozden Tokalioglu E, Halici Ozturk F, Aydin Senel S, Keskin LH, Moraloglu Tekin O, Sahin D. Cardiotocographic features in COVID-19 infected pregnant women. J Perinat Med 2022; 50:46-55. [PMID: 34411469 DOI: 10.1515/jpm-2021-0132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/22/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We aimed to evaluate the cardiotocograph (CTG) traces of 224 women infected with novel coronavirus 2019 (COVID-19) and analyze whether changes in the CTG traces are related to the severity of COVID-19. METHODS We designed a prospective cohort study. Two-hundred and twenty-four women who had a single pregnancy of 32 weeks or more, and tested positive for SARS-CoV-2 were included. Clinical diagnosis and classifications were made according to the Chinese management guideline for COVID-19 (version 6.0). Patients were classified into categories as mild, moderate, severe and the CTG traces were observed comparing the hospital admission with the third day of positivity. RESULTS There was no statistically significant relationship between COVID-19 severity and CTG category, variability, tachycardia, bradycardia, acceleration, deceleration, and uterine contractility, Apgar 1st and 5th min. CONCLUSIONS Maternal COVID-19 infection can cause changes that can be observed in CTG. Regardless of the severity of the disease, COVID-19 infection is associated with changes in CTG. The increase in the baseline is the most obvious change.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga Fatma Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Filiz Halici Ozturk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selvi Aydin Senel
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Levent Huseyin Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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4
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Annan RA, Gyimah LA, Apprey C, Asamoah-Boakye O, Aduku LNE, Azanu W, Luterodt HE, Edusei AK. Predictors of adverse birth outcomes among pregnant adolescents in Ashanti Region, Ghana. J Nutr Sci 2021; 10:e67. [PMID: 34527225 DOI: 10.1016/j.hnm.2021.200130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 05/27/2023] Open
Abstract
Adolescent pregnancy is associated with adverse birth outcomes. However, the determinants of these outcomes are understudied. The present study sought to identify the predictors of adverse birth outcomes among pregnant adolescents in Ghana. In this prospective health centre-based study, 416 pregnant adolescents, aged 13-19 years old, were followed, and 270 birth outcomes were evaluated. We collected data on socio-demographic variables, eating behaviour, household hunger scale (HHS), lived poverty index (LPI) and compliance to antenatal interventions. The prevalence of low birth weight (LBW) and preterm births (PTB) were 15⋅2 and 12⋅5 %, respectively. Pregnant adolescents with no formal education (AOR 9⋅0; P = 0⋅004; 95 % CI 2⋅1, 39⋅8), those who experienced illness (AOR 3⋅0; P = 0⋅011; 95 % CI 1⋅3, 7⋅0), those who experienced hunger (OR 2⋅9; P = 0⋅010; 95 % CI 1⋅3, 6⋅5) and those with high LPI (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅2, 5⋅3) presented increased odds of delivering preterm babies compared with those who have had secondary education, did not experience any illness, were not hungry or having low LPI, respectively. Pregnant adolescents who used insecticide-treated net (ITN) (AOR 0⋅4; P = 0⋅013; 95 % CI 0⋅2, 0⋅9) presented reduced odds LBW children; while those who experienced illness (AOR 2⋅7; P = 0⋅020; 95 % CI 1⋅2, 6⋅0), poorer pregnant adolescents (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅1, 4⋅8) and those who experienced hunger (AOR 3⋅0; P = 0⋅028; 95 % CI 1⋅1, 8⋅1) presented increased odds of LBW children compared with those who used ITN, were not ill, were not poor or did not experience hunger. Adverse birth outcomes were associated with ANC compliance and socioeconomic factors of the pregnant adolescents. Hence, strengthening antenatal uptake and compliance by pregnant adolescents, promoting their livelihood and socioeconomic status, and interventions to prevent teenage pregnancies are strongly recommended.
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Affiliation(s)
- Reginald Adjetey Annan
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Afriyie Gyimah
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Odeafo Asamoah-Boakye
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Nana Esi Aduku
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Azanu
- Department of Obstetrics and Gynecology, University of Allied Health Sciences, Ho, Ghana
| | - Herman E Luterodt
- Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony K Edusei
- Department of Community Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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5
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Annan RA, Gyimah LA, Apprey C, Asamoah-Boakye O, Aduku LNE, Azanu W, Luterodt HE, Edusei AK. Predictors of adverse birth outcomes among pregnant adolescents in Ashanti Region, Ghana. J Nutr Sci 2021; 10:e67. [PMID: 34527225 PMCID: PMC8411264 DOI: 10.1017/jns.2021.58] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 12/25/2022] Open
Abstract
Adolescent pregnancy is associated with adverse birth outcomes. However, the determinants of these outcomes are understudied. The present study sought to identify the predictors of adverse birth outcomes among pregnant adolescents in Ghana. In this prospective health centre-based study, 416 pregnant adolescents, aged 13-19 years old, were followed, and 270 birth outcomes were evaluated. We collected data on socio-demographic variables, eating behaviour, household hunger scale (HHS), lived poverty index (LPI) and compliance to antenatal interventions. The prevalence of low birth weight (LBW) and preterm births (PTB) were 15⋅2 and 12⋅5 %, respectively. Pregnant adolescents with no formal education (AOR 9⋅0; P = 0⋅004; 95 % CI 2⋅1, 39⋅8), those who experienced illness (AOR 3⋅0; P = 0⋅011; 95 % CI 1⋅3, 7⋅0), those who experienced hunger (OR 2⋅9; P = 0⋅010; 95 % CI 1⋅3, 6⋅5) and those with high LPI (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅2, 5⋅3) presented increased odds of delivering preterm babies compared with those who have had secondary education, did not experience any illness, were not hungry or having low LPI, respectively. Pregnant adolescents who used insecticide-treated net (ITN) (AOR 0⋅4; P = 0⋅013; 95 % CI 0⋅2, 0⋅9) presented reduced odds LBW children; while those who experienced illness (AOR 2⋅7; P = 0⋅020; 95 % CI 1⋅2, 6⋅0), poorer pregnant adolescents (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅1, 4⋅8) and those who experienced hunger (AOR 3⋅0; P = 0⋅028; 95 % CI 1⋅1, 8⋅1) presented increased odds of LBW children compared with those who used ITN, were not ill, were not poor or did not experience hunger. Adverse birth outcomes were associated with ANC compliance and socioeconomic factors of the pregnant adolescents. Hence, strengthening antenatal uptake and compliance by pregnant adolescents, promoting their livelihood and socioeconomic status, and interventions to prevent teenage pregnancies are strongly recommended.
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Affiliation(s)
- Reginald Adjetey Annan
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Afriyie Gyimah
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Odeafo Asamoah-Boakye
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Nana Esi Aduku
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Azanu
- Department of Obstetrics and Gynecology, University of Allied Health Sciences, Ho, Ghana
| | - Herman E. Luterodt
- Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony K. Edusei
- Department of Community Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Smith V, Muldoon K, Brady V, Delaney H. Assessing fetal movements in pregnancy: A qualitative evidence synthesis of women's views, perspectives and experiences. BMC Pregnancy Childbirth 2021; 21:197. [PMID: 33691666 PMCID: PMC7944914 DOI: 10.1186/s12884-021-03667-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Raising awareness of the importance of fetal movements (FMs) and advising women on the appropriate action to take if they experience reduced FMs, is important for minimising or avoiding adverse perinatal outcomes. To gain insight and understanding of women’s perspectives of assessing FMs in pregnancy, we conducted a qualitative evidence synthesis. Methods A qualitative evidence synthesis using thematic synthesis was conducted. Studies were eligible if they included pregnant women who were at least 20 weeks gestation and reported qualitative data from women on assessing FMs in pregnancy. MEDLINE, CINAHL, EMBASE, PsycINFO and Social Science Citation Index, from inception to July 2020, were searched. The methodological quality of included studies was assessed by at least two reviewers using an Evidence for Policy and Practice Information (EPPI)-Centre quality assessment tool. Data synthesis, using the Thomas and Harden framework, involved line by line coding of extracted data, establishing descriptive themes, and determining analytical themes. Confidence in the findings was assessed using GRADE CER-Qual. Results Nine studies, involving 2193 women, were included in the review. The methodological quality of the studies was overall generally high. The synthesis revealed three dominant themes, and seven sub-themes that reflected women’s perspectives of assessing FMs in pregnancy. These were; 1) How women engage with FMs, with subthemes of informal engagement, formal engagement, and strategies to stimulate FMs; 2) ‘ … like a feather inside my belly’ - articulating and describing FMs, with sub-themes of sensations associated with FMs and timing and frequency of FMs; and 3) FMs and help/health seeking, with sub-themes of information sources and interacting with healthcare professionals. Confidence in the findings was either high or moderate, although two findings were rated low confidence and one very low. Conclusion This qualitative evidence synthesis reveals that women informally engage with FMs during pregnancy. Women commonly adopt strategies to stimulate FMs when concerned. The use of the internet was a common source of obtaining information regarding FMs. Women require better support when contacting healthcare professionals about FMs. As only three of the nine included studies were exclusively qualitative in design, further qualitative studies exploring women’s perspective of assessing FMs in pregnancy are required. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03667-y.
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Affiliation(s)
- Valerie Smith
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.
| | - Kathryn Muldoon
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland
| | - Vivienne Brady
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland
| | - Hannah Delaney
- School of Nursing and Midwifery, University of Dublin Trinity College Dublin, Dublin, Ireland.,School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board-Trials Methodology Research Network (HRB-TMRN), National University of Ireland Galway, Galway, Ireland
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7
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Chrononutrition during Pregnancy: A Review on Maternal Night-Time Eating. Nutrients 2020; 12:nu12092783. [PMID: 32932985 PMCID: PMC7551833 DOI: 10.3390/nu12092783] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 01/20/2023] Open
Abstract
Evidence from women working night shifts during pregnancy indicates that circadian rhythm disruption has the potential to adversely influence pregnancy outcomes. In the general population, chronodisruption with the potential to affect pregnancy outcomes may also be seen in those with high energy intakes in the evening or at night. However, maternal night eating during pregnancy remains understudied. This narrative review provides an overview of the prevalence, contributing factors, nutritional aspects and health implications of night eating during pregnancy. We derived evidence based on cross-sectional studies and longitudinal cohorts. Overall, night eating is common during pregnancy, with the estimated prevalence in different populations ranging from 15% to 45%. The modern lifestyle and the presence of pregnancy symptoms contribute to night eating during pregnancy, which is likely to coexist and may interact with multiple undesirable lifestyle behaviors. Unfavorable nutritional characteristics associated with night eating have the potential to induce aberrant circadian rhythms in pregnant women, resulting in adverse metabolic and pregnancy outcomes. More research, particularly intervention studies, are needed to provide more definite information on the implications of night eating for mother-offspring health.
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8
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Bradford B, Cronin R, McKinlay C, Thompson J, McCowan L. Maternally perceived fetal movement patterns: The influence of body mass index. Early Hum Dev 2019; 140:104922. [PMID: 31739267 DOI: 10.1016/j.earlhumdev.2019.104922] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/06/2019] [Accepted: 10/26/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Maternal reports of decreased fetal movements are associated with adverse pregnancy outcome, but there are conflicting data about perception of fetal movements in women with obesity. AIM To compare perceived fetal movements in women with obesity (body mass index [BMI] ≥30 kg/m2) and women with normal BMI (<25 kg/m2). MATERIAL AND METHODS Data from two separate pregnancy studies were used for this analysis; the Healthy Mums and Babies (HUMBA) trial, which recruited women with obesity and the Multicentre Stillbirth Study (MCSS), which recruited women from a general obstetric population. Fetal movement data were collected using identical interviewer-administered questionnaire in each study. We compared fetal movement strength, frequency and pattern between HUMBA and MCSS women with obesity and MCSS women with normal BMI. RESULTS Participants were 233 women with obesity and 149 with normal BMI. Mean (SD) gestation at interview was similar between groups (36.9 [2.2] vs 36.6 [0.9], P = 0.06). Perceived fetal movement strength and frequency did not differ between groups. In both women with obesity and normal BMI, a diurnal fetal movement pattern was present, with the majority reporting strong or moderate movements in the evening (88.7% vs 99.3%) and at night-time (92.1% vs 93.1%). Women with obesity, were more likely to report strong fetal movements when hungry (29.1% vs 17.7%, P = 0.001) and quiet fetal movements after eating (47.4% vs 32.0%, P = 0.001). CONCLUSIONS In women with obesity compared to normal BMI, strength and frequency of fetal movements were similar, although patterns were altered in relation to maternal meals.
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Affiliation(s)
- Billie Bradford
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Robin Cronin
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher McKinlay
- Liggins Institute, University of Auckland, Auckland, New Zealand; Kids First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - John Thompson
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lesley McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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9
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Bradford BF, Cronin RS, McKinlay CJD, Thompson JMD, Mitchell EA, Stone PR, McCowan LME. A diurnal fetal movement pattern: Findings from a cross-sectional study of maternally perceived fetal movements in the third trimester of pregnancy. PLoS One 2019; 14:e0217583. [PMID: 31188847 PMCID: PMC6561638 DOI: 10.1371/journal.pone.0217583] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/14/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Encouraging awareness of fetal movements is a common strategy used to prevent stillbirths. Information provided to pregnant women about fetal movements is inconsistent perhaps due to limited knowledge about normal fetal movement patterns in healthy pregnancies. We aimed to describe maternally perceived fetal movement strength, frequency, and pattern in late pregnancy in women with subsequent normal outcomes. METHODS Participants were ≥28 weeks' gestation, with a non-anomalous, singleton pregnancy who had been randomly selected from hospital booking lists and had consented to participate. Fetal movement data was gathered during pregnancy via a questionnaire administered face-to-face by research midwives. Participants remained eligible for the study if they subsequently gave birth to a live, appropriate-for-gestational-age baby at ≥37 weeks. RESULTS Participants were 274 women, with normal pregnancy outcomes. The majority (59.3%, n = 162) of women reported during antenatal interview that the strength of fetal movements had increased in the preceding two weeks. Strong fetal movements were felt by most women in the evening (72.8%, n = 195) and at night-time including bedtime (74.5%, n = 199). The perception of fetal hiccups was also reported by most women (78.8%). Women were more likely to perceive moderate or strong fetal movements when sitting quietly compared with other activities such as having a cold drink or eating. CONCLUSIONS Our data support informing women in the third trimester that as pregnancy advances it is normal to perceive increasingly strong movement, episodes of movements that are more vigorous than usual, fetal hiccups, and a diurnal pattern involving strong fetal movement in the evening. This information may help pregnant women to better characterise normal fetal movement and appropriately seek review when concerned about fetal movements. Care providers should be responsive to concerns about decreased fetal movements in the evening, as this is unusual.
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Affiliation(s)
- Billie F. Bradford
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Robin S. Cronin
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher J. D. McKinlay
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand
| | - John M. D. Thompson
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Edwin A. Mitchell
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Peter R. Stone
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lesley M. E. McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Kroeger EN, Carson TL, Baskin ML, Langaigne A, Schneider CR, Bertrand B, Herbey II, Harper LM, Biggio JR, Chandler-Laney PC. Reasons for Late-Night Eating and Willingness to Change:A Qualitative Study in Pregnant Black Women. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:598-607. [PMID: 30579893 PMCID: PMC6511485 DOI: 10.1016/j.jneb.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Late-night eating during pregnancy is associated with greater risk for gestational diabetes. The purposes of this study were to describe reasons why women engage in late-night eating and to understand perceptions about changing this behavior. DESIGN Focus groups using a semi-structured interview script. SETTING Urban university-affiliated obstetric clinic. PARTICIPANTS Low-income black women (n = 18) with overweight/obesity at entry to prenatal care. PHENOMENON OF INTEREST Late-night eating. ANALYSIS Exhaustive approach coding responses to specific questions. RESULTS Individual and interpersonal contributors to late-night eating included hunger, altered sleep patterns, fetal movement, and the influence of others. Food choices were largely driven by taste and convenience. Some women reported that they could alter nightly eating patterns, whereas others would consider changing only if late-night eating were associated with a severe illness or disability for the child. CONCLUSIONS AND IMPLICATIONS There was considerable heterogeneity among the participants of this study regarding reasons for late-night eating during pregnancy and attitudes toward changing this behavior. Although the themes identified from this study cannot be generalized, they may be useful to inform future studies. Future research might develop strategies to overcome individual and social factors that contribute to late-night eating during pregnancy.
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Affiliation(s)
- Elizabeth N Kroeger
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL.
| | - Tiffany L Carson
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Monica L Baskin
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Alana Langaigne
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Camille R Schneider
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Brenda Bertrand
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Ivan I Herbey
- Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Lorie M Harper
- Division of Maternal Fetal Medicine, Department of Obstetrics, University of Alabama at Birmingham, Birmingham, AL
| | - Joseph R Biggio
- Women's Service Line, Ochsner Health System, New Orleans, LA
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11
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Bradford B, Maude R. Maternal perception of fetal movements in the third trimester: A qualitative description. Women Birth 2017; 31:e287-e293. [PMID: 29287635 DOI: 10.1016/j.wombi.2017.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
PROBLEM Decreased fetal movements is a common reason for unscheduled antenatal assessment and is associated with adverse pregnancy outcome. BACKGROUND Fetal movement counting has not been proven to reduce stillbirths in high-quality studies. AIMS The aim was to explore a qualitative account of fetal movements in the third trimester as perceived by pregnant women themselves. METHODS Using qualitative descriptive methodology, interviews were conducted with 19 women experiencing an uncomplicated first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis. FINDINGS Pregnant women described a sustained increase in strength, frequency and variation in types of fetal movements from quickening until 28-32 weeks. Patterns of fetal movement were consistently described as involving increased movement later in the day and as having an inverse relationship to the women's own activity and rest. At term, the most notable feature was increased strength. Kicking and jolting movements decreased whilst pushing and rolling movements increased. DISCUSSION Maternal descriptions of fetal activity in this study were consistent with other qualitative studies and with ultrasound studies of fetal development. CONCLUSION Pregnant women observe a complex range of fetal movement patterns, actions and responses that are likely to be consistent with normal development. Maternal perception of a qualitative change in fetal movements may be clinically important and should take precedence over any numeric definition of decreased fetal movement. Midwives may inform women that it is normal to perceive more fetal movement in the evening and increasingly strong movements as pregnancy advances.
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Affiliation(s)
- Billie Bradford
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, New Zealand.
| | - Robyn Maude
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, New Zealand
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Kim H, Sefcik JS, Bradway C. Characteristics of Qualitative Descriptive Studies: A Systematic Review. Res Nurs Health 2016; 40:23-42. [PMID: 27686751 DOI: 10.1002/nur.21768] [Citation(s) in RCA: 741] [Impact Index Per Article: 92.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 01/03/2023]
Abstract
Qualitative description (QD) is a term that is widely used to describe qualitative studies of health care and nursing-related phenomena. However, limited discussions regarding QD are found in the existing literature. In this systematic review, we identified characteristics of methods and findings reported in research articles published in 2014 whose authors identified the work as QD. After searching and screening, data were extracted from the sample of 55 QD articles and examined to characterize research objectives, design justification, theoretical/philosophical frameworks, sampling and sample size, data collection and sources, data analysis, and presentation of findings. In this review, three primary findings were identified. First, although there were some inconsistencies, most articles included characteristics consistent with the limited available QD definitions and descriptions. Next, flexibility or variability of methods was common and effective for obtaining rich data and achieving understanding of a phenomenon. Finally, justification for how a QD approach was chosen and why it would be an appropriate fit for a particular study was limited in the sample and, therefore, in need of increased attention. Based on these findings, recommendations include encouragement to researchers to provide as many details as possible regarding the methods of their QD studies so that readers can determine whether the methods used were reasonable and effective in producing useful findings. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hyejin Kim
- Doctoral Candidate, School of Nursing, University of Pennsylvania, 418 Curie Blvd., Philadelphia, PA, 19104
| | - Justine S Sefcik
- Doctoral Candidate, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Christine Bradway
- Associate Professor of Gerontological Nursing, School of Nursing, University of Pennsylvania, Philadelphia, PA
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Maude RM, Skinner JP, Foureur MJ. Putting intelligent structured intermittent auscultation (ISIA) into practice. Women Birth 2016; 29:285-92. [DOI: 10.1016/j.wombi.2015.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/30/2015] [Accepted: 12/04/2015] [Indexed: 11/25/2022]
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Sussman D, Lye SJ, Wells GD. Impact of maternal physical activity on fetal breathing and body movement--A review. Early Hum Dev 2016; 94:53-6. [PMID: 26811196 DOI: 10.1016/j.earlhumdev.2016.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 01/06/2023]
Abstract
Fetal movements, which include body and breathing movement, are important indicators of fetal well-being and nervous system development. These have been shown to be affected by intrauterine conditions. While maternal physical activity does induce a change in intrauterine conditions and physiology, its impact on fetal movements is still unclear. This paper will provide a brief review of the literature and outline the current knowledge with regards to the effects of maternal exercise on fetal body and breathing movements.
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Affiliation(s)
- Dafna Sussman
- Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
| | - Stephen J Lye
- Fraser Mustard Institute for Human Development, OISE, University of Toronto, Toronto, ON M5S 1V6, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada.
| | - Greg D Wells
- Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.
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