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Liu Y, Che CC, Hamdan M, Chong MC. Cross-cultural adaptation of the empowerment scale of pregnant women in China context: An integrative method of translation and linguistic validation. Nurs Open 2024; 11:e70017. [PMID: 39279598 PMCID: PMC11403275 DOI: 10.1002/nop2.70017] [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: 01/10/2024] [Revised: 07/09/2024] [Accepted: 08/08/2024] [Indexed: 09/18/2024] Open
Abstract
AIM To translate the Empowerment Scale for Pregnant Women (ESPW) into Chinese and to assess its linguistic validity. METHODS The integrative method of the translation process, the Delphi technique, and cognitive interviews were used to implement cross-cultural adaptation and enhance comprehensibility and linguistic validation. This study recruited 14 experts in the expert review and cognitively reviewed 15 pregnant women. RESULTS The two-round Delphi method created agreement on cultural applicability. The results of content validity achieved good levels: The item-level content validity index (CVI) ranged from 0.78 to 1.00, and the scale-level content validity index, calculated using two different formulas, were 0.97 and 0.81, respectively. Kappa values ranged from 0.74 to 1.00. Pregnant women could understand most of the items and response options in the cognitive interview. The revisions to the wording were made based on suggestions from experts and pregnant women. CONCLUSION The prefinal simplified Chinese ESPW was semantically and conceptually equivalent to the English version, which was well prepared for further psychometric tests in the next stage of cross-cultural adaptation. PATIENT OR PUBLIC CONTRIBUTION This comprehensive method successfully developed a Chinese tool to measure the empowerment of pregnant women, indicating the international applicability of this tool and the methodological scientific nature. The simplified Chinese ESPW has the potential to support the identification of empowerment levels of pregnant women and the evaluation of the effectiveness of health education and promotion programmes.
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Affiliation(s)
- Yanjia Liu
- Department of Nursing Science, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Mukhri Hamdan
- Department of Obstetrics and Gynecology, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
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Liu Y, Che CC, Hamdan M, Chong MC. Psychometric validation of the Chinese version of the empowerment scale for pregnant women. Res Nurs Health 2024. [PMID: 39177122 DOI: 10.1002/nur.22419] [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: 12/05/2023] [Revised: 07/11/2024] [Accepted: 08/11/2024] [Indexed: 08/24/2024]
Abstract
Empowering pregnant women is a crucial process that healthcare providers should evaluate, as empowerment is a meaningful indicator that can reflect the impact of health promotion and education in antenatal care. The Empowerment Scale for Pregnant Women (ESPW) is a reliable and valid instrument for measuring empowerment. The cross-sectional study was conducted to translate and validate the psychometric properties of the ESPW among 526 pregnant women in China. The forward-backward method was used to translate the English version of the ESPW into the Chinese version. Reliability was examined with the internal consistency and test-retest coefficients. Validity was analyzed with structural, dimensionality, convergent, discriminant, and concurrent validity. The Cronbach's α value of 0.97 and the intraclass correlation coefficient of 0.98 (95% confidence interval [CI], [0.96, 0.99]) demonstrated excellent internal consistency and test-retest reliability. Exploratory factor analysis revealed that five factors with eigenvalues > 1 explained 68.41% of the total variance. Confirmatory factor analysis verified an acceptable model that fit the data exceptionally. The Chinese-translated version of the ESPW (CV-ESPW) had acceptable convergent and discriminant validity. Concurrent validity was supported by the correlation between the total scores of the CV-ESPW and the Chinese version of the Patient Perceptions of the Empowerment Scale (r = 0.64, p < 0.001). The CV-ESPW is a valid and reliable assessment tool for measuring pregnant women's empowerment in China and can potentially contribute to evaluating the effectiveness of programs that empower pregnant women.
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Affiliation(s)
- Yanjia Liu
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mukhri Hamdan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Ningrum EW, Lusmilasari L, Huriyati E, Marthias T, Hasanbasri M. Improving maternal health literacy among low-income pregnant women: A systematic review. NARRA J 2024; 4:e886. [PMID: 39280277 PMCID: PMC11391996 DOI: 10.52225/narra.v4i2.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 08/06/2024] [Indexed: 09/18/2024]
Abstract
Previous studies on maternal health have highlighted the need to improve health literacy, particularly among women from lower socioeconomic backgrounds. Some crucial factors for improving maternal health literacy are midwife capacity and systems support that can help ensure women's ability and motivation to access timely health services. However, the extent of roles midwives need and the system that must be developed require further elaboration. The aim of this systematic review was to investigate approaches for enhancing maternal health literacy in low-income pregnant women. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic search was conducted on two databases: PubMed and ScienceDirect. All English articles published from 2011 to 2023 were searched using the keywords pregnant, antenatal, prenatal, perinatal, midwife, health literacy, midwife-led care, helpline, and photo novel. Of the 1,539 articles, 15 were included in the final assessment. The results suggested that improving maternal health literacy among low-income pregnant women was related to: (a) empowering low-income women; (b) empowering midwives as frontline care providers engaging with low-income pregnant women; and (c) empowering the health care system as a health literacy organization. In conclusion, improving the healthcare system and strengthening midwives' leadership as proximal caregivers is crucial for improving maternal health literacy among low-income pregnant mothers. These efforts could be realized with support from government roles, educational institutions, and professional associations.
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Affiliation(s)
- Ema W Ningrum
- Doctoral Program in Medical and Health Science, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Nursing Study Program, Faculty of Health, Universitas Harapan Bangsa, Purwokerto, Indonesia
| | - Lely Lusmilasari
- Department of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Emy Huriyati
- Department of Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tiara Marthias
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
| | - Mubasysyir Hasanbasri
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Liu Y, Che CC, Hamdan M, Chong MC. Measuring empowerment in pregnant women: A scoping review of progress in instruments. Midwifery 2024; 134:104002. [PMID: 38669756 DOI: 10.1016/j.midw.2024.104002] [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: 06/22/2023] [Revised: 02/25/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The empowerment of pregnant women is a meaningful strategy that profoundly impacts the health of women and their children. Despite a significant increase in the empowerment of pregnant women and its measurement, little attention was given to a consensus on the selection and application of assessment instruments used for pregnant women. OBJECTIVE To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties. METHODS We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties. RESULTS A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity. CONCLUSION There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.
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Affiliation(s)
- Yanjia Liu
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Mukhri Hamdan
- Department of Obstetric and Gynaecology, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia.
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López-Gimeno E, Falguera-Puig G, García-Sierra R, Vicente-Hernández MM, Cubero LB, Seguranyes G. Impact of shared decision-making on women's childbirth preferences: A cluster randomised controlled trial. Midwifery 2024; 133:103999. [PMID: 38643600 DOI: 10.1016/j.midw.2024.103999] [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: 05/14/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Midwives provide counselling for birth plans (BPs) to women during prenatal care; however, the impact of individualised BP counselling interventions based on shared decision-making (SDM) regarding women's preferences is unknown. METHODS This randomised cluster trial included four primary healthcare units. Midwives provided BP counselling based on SDM to women in the intervention group (IG) during prenatal care along with a handout about evidence-based recommendations. Women in the control group (CG) received standard BP counselling from midwives. The main outcome was preference changes concerning BPs. RESULTS A total of 461 (95.5 %) pregnant women received BP counselling (IG, n = 247; CG, n = 214). Women in the IG changed their BP preferences for 13 items compared with those in the CG. These items were: using an unique space during birth (81.1 % vs 51.6 %; p < 0.001), option for light graduation (63 % vs 44.7 %; p < 0.001), listening to music (57.3 % vs 43.6 %; p = 0.006), drinking fluids during labour (84.6 % vs 93.6 %; p = 0.005), continuous monitoring (59 % vs 37.8 %; p < 0.001); desire for natural childbirth (36.6 % vs 25 %; p = 0.014), epidural analgesia (55.1 % vs 43.6 %; p = 0.023); breathing techniques (65.2 % vs 50.5 %; p = 0.003), massage (74.9 % vs 55.3 %; p < 0.001); birthing ball use (81.9 % vs 56.9 %; p < 0.001), spontaneous pushing (49.3 % vs 28.7 %; p < 0.001), choosing birth position (69.6 % vs 41.5 %) and delayed umbilical cord clamping (67.8 % vs 44.1 %; p = 0.001). CONCLUSION SDM counselling, together with a handout about evidence-based recommendations on childbirth and newborn care, produced more changes in women's preferences expressed in the BP than standard counselling.
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Affiliation(s)
- Encarnación López-Gimeno
- Sexual and Reproductive Healthcare Services (ASSIR), Barcelona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain.
| | - Gemma Falguera-Puig
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Rosa García-Sierra
- Research Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Spain; Nursing Department, Faculty of Medicine, Campus Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; Primary Care Group, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Multidisciplinary Research Group in Health and Society (GREMSAS) (2021-SGR-01484), Barcelona, Spain
| | - Mª Mercedes Vicente-Hernández
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Badalona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Lucia Burgos Cubero
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Mollet del Vallés, Spain
| | - Gloria Seguranyes
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
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de Araujo G, Rauber ED, Segatto MC, Pacheco SC, Knorst JK, Emmanuelli B. Oral health literacy and its association with oral health-related quality of life amongst pregnant women: a cross-sectional study. Qual Life Res 2024; 33:219-227. [PMID: 37582819 DOI: 10.1007/s11136-023-03502-1] [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] [Accepted: 07/31/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE This study aimed to evaluate the association of oral health literacy (OHL) and oral health-related quality of life (OHRQoL) of pregnant women. METHODS This cross-sectional study evaluated a representative sample of pregnant women assisted in public health services in southern Brazil. Demographic, socioeconomic, psychosocial and behavioural data were collected through structured questionnaires. The Oral Health Impact Profile (OHIP-14) questionnaire was used to evaluate the OHRQoL. The Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) was used to measure OHL. Dental caries and gingival bleeding were evaluated by clinical examinations. Adjusted multilevel Poisson regression models with a hierarchical approach were used to assess the associations. The results are presented as rate ratio (RR) and 95% confidence interval (95% CI). RESULTS A total of 520 pregnant women were evaluated. Pregnant women with lower levels of OHL presented overall OHIP-14 scores 14% higher (RR 1.14; 95% CI 1.07-1.22) than their counterparts. High household income and high education level were related to low overall OHIP-14 scores. Furthermore, less dental attendance, low social support, untreated dental caries and gingival bleeding were also associated with high overall OHIP-14 scores. CONCLUSION Our findings reinforce that health literacy levels influence patient-reported outcomes. Pregnant women with lower OHL were more likely to present poorer OHRQoL.
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Affiliation(s)
- Gabriela de Araujo
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil
| | - Everton D Rauber
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil
| | - Maiara C Segatto
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil
| | - Sabrina C Pacheco
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil
| | - Jessica K Knorst
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Bruno Emmanuelli
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Campus Federal University of Santa Maria, 47 - Camobi, Santa Maria, Rio Grande do Sul, 97000-001, Brazil.
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Chen X, Xiao X, Huang X, Wang R, Yang J, Yang L, Wang Y, Zhou C. Empowerment and quality of life: the mediating role of self-efficacy and health literacy among spousal caregivers in China. Health Promot Int 2023; 38:daad133. [PMID: 37874985 DOI: 10.1093/heapro/daad133] [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] [Indexed: 10/26/2023] Open
Abstract
The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.
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Affiliation(s)
- Xuan Chen
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Xiuying Xiao
- Department of Nursing, Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, 519090, PR China
| | - Xiu'e Huang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Run Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Jing Yang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Lingli Yang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Yiling Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
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Lailler G, Grave C, Gabet A, Regnault N, Deneux-Tharaux C, Kretz S, Tsatsaris V, Plu-Bureau G, Blacher J, Olie V. Aspirin for the Prevention of Early and Severe Pre-Eclampsia Recurrence: A Real-World Population-Based Study. Drugs 2023; 83:429-437. [PMID: 36867398 PMCID: PMC10042896 DOI: 10.1007/s40265-023-01842-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Many clinical trials have reported that low-dose aspirin decreases the risk of pre-eclampsia in women with prior pre-eclampsia. However, its impact in a real-world population has not been fully assessed. OBJECTIVES To assess the rates of low-dose aspirin initiation during pregnancy in women with a history of pre-eclampsia, and to evaluate the impact of low-dose aspirin in prevention of pre-eclampsia recurrence in a real-world population. STUDY DESIGN CONCEPTION is a French nationwide cohort study which uses data from the country's National Health Data System database. We included all women in France who gave birth at least twice between 2010-2018, and who had pre-eclampsia during their first pregnancy. Every dispensing of low-dose aspirin (75-300 mg) between the beginning of their second pregnancy and 36 weeks of gestation (WG) was identified. We used Poisson regression models to estimate the adjusted incidence rate ratios (aIRRs) of receiving aspirin at least once during their second pregnancy. In women who had early and/or severe pre-eclampsia during their first pregnancy, we estimated the IRRs of pre-eclampsia recurrence during their second pregnancy according to the aspirin therapy. RESULTS In 28,467 women who were included in the study, the aspirin initiation rate during the second pregnancy ranged from 27.8% for women in whose first pregnancy the pre-eclampsia was mild and late, to 79.9% for those women whose pre-eclampsia was severe and early. Just over half (54.3%) of those treated with aspirin-initiated treatment before 16 WG and adhered to treatment. Compared with women with mild and late pre-eclampsia, the aIRRs (95% CI) for receiving aspirin at least once during the second pregnancy were 1.94 (1.86-2.03) for women with severe and late pre-eclampsia, 2.34 (2.17-2.52) for those with early and mild pre-eclampsia, and 2.87 [2.74-3.01] for those with early and severe pre-eclampsia E. Social deprivation was associated with a lower initiation of aspirin (IRR = 0.74 [0.70-0.78]). Aspirin was not associated with a lower risk of mild and late pre-eclampsia, severe and late pre-eclampsia, or mild and early pre-eclampsia during the second pregnancy. The aIRRs for severe and early pre-eclampsia during the second pregnancy were 0.77 (0.62-0.95) for women who received prescribed aspirin at least once, 0.71 (0.5-0.89) for those who initiated aspirin therapy before 16 WG, and 0.60 (0.47-0.77) for those who adhered to aspirin treatment throughout their second pregnancy. The risk of severe and early pre-eclampsia was lower only when the prescribed mean daily dose was ≥ 100 mg/day. CONCLUSION In women with a history of pre-eclampsia, aspirin initiation during a second pregnancy and adherence to the prescribed dosage were largely insufficient, especially for women experiencing social deprivation. Aspirin initiated before 16 WG at a dose ≥ 100 mg/day was associated with a lower risk of severe and early pre-eclampsia.
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Affiliation(s)
- Grégory Lailler
- Santé publique France, Saint-Maurice, France.
- Université Paris Est, Créteil, France.
| | | | | | | | - Catherine Deneux-Tharaux
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France
- Université Paris Cité, Paris, France
| | - Sandrine Kretz
- Centre de diagnostic et de thérapeutique, Hôtel Dieu, AP-HP, Paris, France
| | - Vassilis Tsatsaris
- Université Paris Cité, Paris, France
- Maternité Port-Royal, FHU PREMA, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Geneviève Plu-Bureau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France
- Université Paris Cité, Paris, France
- Unité de gynécologie médicale, APHP, Hôpital Port-Royal Cochin, Paris, France
| | - Jacques Blacher
- Université Paris Cité, Paris, France
- Centre de diagnostic et de thérapeutique, Hôtel Dieu, AP-HP, Paris, France
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Lailler G, Grave C, Gabet A, Regnault N, Deneux-Tharaux C, Kretz S, Tsatsaris V, Plu-Bureau G, Blacher J, Olié V. Recurrence of hypertensive disorders of pregnancy: results from a nationwide prospective cohort study (CONCEPTION). BJOG 2023. [PMID: 36802131 DOI: 10.1111/1471-0528.17424] [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: 07/22/2022] [Revised: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/20/2023]
Abstract
OBJECTIVE To assess the risk of gestational hypertension (GH) and pre-eclampsia (PE) during a second pregnancy after occurrence during a first pregnancy. DESIGN Prospective cohort study. SETTING CONCEPTION is a French nationwide cohort study that used data from the National Health Data System (SNDS) database. METHODS We included all women who gave birth for the first time in France in 2010-2018 and who subsequently gave birth. We identified GH and PE through hospital diagnoses and the dispensing of anti-hypertensive drugs. The incidence rate ratios (IRR) of all hypertensive disorder of pregnancy (HDP) during the second pregnancy were estimated using Poisson models adjusted for confounding. MAIN OUTCOME MEASURES Incidence rate ratios of HDP during the second pregnancy. RESULTS Of the 2 829 274 women included, 238 506 (8.4%) were diagnosed with HDP during their first pregnancy. In women with GH during their first pregnancy, 11.3% (IRR 4.5, 95% confidence interval [CI] 4.4-4.7) and 3.4% (IRR 5.0, 95% CI 4.8-5.3) developed GH and PE during their second pregnancy, respectively. In women with PE during their first pregnancy, 7.4% (IRR 2.6, 95% CI 2.5-2.7) and 14.7% (IRR 14.3, 95% CI 13.6-15.0) developed GH and PE during their second pregnancy, respectively. The more severe and earlier the PE during the first pregnancy, the stronger the likelihood of having PE during the second pregnancy. Maternal age, social deprivation, obesity, diabetes and chronic hypertension were all associated with PE recurrence. CONCLUSION These results can guide policymaking that focuses on improving counselling for women who wish to become pregnant more than once, by identifying those who would benefit more from tailored management of modifiable risk factors, and heightened surveillance during post-first pregnancies.
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Affiliation(s)
- G Lailler
- Santé Publique France, Saint-Maurice, France.,Université Paris Est, Créteil, France
| | - C Grave
- Santé Publique France, Saint-Maurice, France
| | - A Gabet
- Santé Publique France, Saint-Maurice, France
| | - N Regnault
- Santé Publique France, Saint-Maurice, France
| | - C Deneux-Tharaux
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France.,Université Paris Cité, Paris, France
| | - S Kretz
- Centre de Diagnostic et de Thérapeutique, Paris, France
| | - V Tsatsaris
- Université Paris Cité, Paris, France.,Maternité Port-Royal, FHU PREMA, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - G Plu-Bureau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France.,Université Paris Cité, Paris, France.,Unité de Gynécologie Médicale, APHP, Hôpital Port-Royal Cochin, Paris, France
| | - J Blacher
- Université Paris Cité, Paris, France.,Centre de Diagnostic et de Thérapeutique, Paris, France
| | - V Olié
- Santé Publique France, Saint-Maurice, France
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Sakurai S, Mwilike B, Horiuchi S. Women's experiences with hypertensive disorders of pregnancy from a national referral hospital in Tanzania: A qualitative study. Jpn J Nurs Sci 2023; 20:e12513. [PMID: 36116438 DOI: 10.1111/jjns.12513] [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: 04/25/2022] [Revised: 07/22/2022] [Accepted: 08/22/2022] [Indexed: 01/05/2023]
Abstract
AIM This study aimed to explore the experiences among postpartum women with hypertensive disorders of pregnancy, from pregnancy to admission at a referral hospital in Tanzania. METHODS This was a descriptive cross-sectional design with purposive sampling. Data were collected from semi-structured in-depth interviews with postpartum women diagnosed with hypertensive disorders and who were admitted to the maternity ward of Muhimbili National Hospital. Data were analyzed using NVivo software for qualitative content analysis. RESULTS Fourteen women participated in interviews. Half were primipara and two-thirds had over four antenatal visits. Data analysis yielded four categories and 27 sub-categories. The four categories were: "I'm shocked; I thought I was normal," "The treatment journey," "What health care providers did and did not teach me," "I have a risky future; I hope health care providers can help me." CONCLUSION Women regarded themselves going from being normal to having a risk through the process of experiencing their treatments. They did not expect to be admitted or referred to a major hospital and while they demanded more information and education, they also expressed appreciation for their health care providers. Education during pregnancy addressing their needs and level of understanding is recommended for improvement of early detection and access to the health service.
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Affiliation(s)
| | - Beatrice Mwilike
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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