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Mohammed Seid A, Mehari EA, Bekalu AF, Dula Sema F, Limenh LW, Geremew DT, Tessema TA, Anagaw YK, Mitku ML, Worku MC, Bizuneh GK, Ayenew W, Simegn W. Prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia: Multicenter cross-sectional study. SAGE Open Med 2024; 12:20503121241257163. [PMID: 38846512 PMCID: PMC11155318 DOI: 10.1177/20503121241257163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Background Hyperemesis gravidarum is one of the problems encountered among pregnant women due to persistent and excessive vomiting starting before the end of the 22nd week of gestation. The current study aimed to assess the prevalence of hyperemesis gravidarum and associated factors among pregnant women at comprehensive specialized hospitals in northwest Ethiopia. Methods A multi-facility-based cross-sectional study was conducted at comprehensive specialized hospitals from 1st June 2022 to 30th July 2022. The data were entered using EPI Data Version 4.6 statistical software and analyzed using SPSS Version 26. Descriptive statistics such as frequency, mean, and percentage were calculated. Univariable and multivariable binary logistic regression analyses were carried out to identify the associated factors of hyperemesis gravidarum. Results In all, 404 study participants were enrolled. About 16.8% of pregnant women were found to have hyperemesis gravidarum. Age < 20 year (AOR = 3.170; 95% CI: 1.119, 8.980), study participants who cannot read and write (AOR = 5.662; 95% CI: 2.036, 15.7470), grade 1-8 (AOR = 4.679; 95% CI: 1.778, 12.316), and grade 9-10 (AOR = 8.594; 95% CI: 3.017, 24.481), being housewife (AOR = 6.275; 95% CI: 1.052, 37.442), living in urban area (AOR = 2.185; 95% CI: 1.035, 4.609), having previous hyperemesis gravidarum (AOR = 2.463; 95% CI: 1.210, 5.012), having family history of hyperemesis gravidarum (AOR = 2.014; 95% CI: 1.002, 4.047), unplanned pregnancy (AOR = 2.934; 95% CI: 1.030, 8.351), having recent abortion (AOR = 2.750; 95% CI: 1.010, 7.483), and gravidity (AOR = 1.956; 95%CI: 1.023, 3.737) were factors associated with hyperemesis gravidarum. Conclusion The prevalence of hyperemesis gravidarum is higher. Low maternal age, lower educational level, being a housewife, being an urban resident, having previous hyperemesis gravidarum, having a family history, having an unplanned pregnancy, and having a recent abortion were significantly associated with hyperemesis gravidarum.
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Affiliation(s)
- Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abaynesh Fentahun Bekalu
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Faisel Dula Sema
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Derso Teju Geremew
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Ayalew Tessema
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeniewa Kerie Anagaw
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melese Legesse Mitku
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Minichil Chanie Worku
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizachew Kassahun Bizuneh
- Department of Pharmacognocy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondim Ayenew
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tjernström K, Lindberg I, Wiklund M, Persson M. Overlooked by the obstetric gaze - how women with persistent health problems due to severe perineal trauma experience encounters with healthcare services: a qualitative study. BMC Health Serv Res 2024; 24:610. [PMID: 38724992 PMCID: PMC11084138 DOI: 10.1186/s12913-024-11037-5] [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: 09/11/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred. METHODS In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis. RESULTS Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women's difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a 'key person' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered. CONCLUSIONS Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.
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Affiliation(s)
| | - Inger Lindberg
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, 901 87, Umeå, Sweden
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Zhang X, Zhang Y, Lv D, Xie Y, Xu H, Li F, He M, Fan Y, Li X, Jallow F, Li W, Lin X, Ye F, Deng D. Association of the Verbal Rating Scale-Measured Dysmenorrhea with Nausea and Vomiting in Pregnancy: A Retrospective Cohort Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102406. [PMID: 38331093 DOI: 10.1016/j.jogc.2024.102406] [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: 07/30/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Nausea and vomiting in pregnancy (NVP) is a common condition that reduces the quality of life by negatively affecting work and family life, physical and mental health, and economic well-being. However, its risk factors remain unclear. This study aimed to explore the association between NVP and verbal rating scale (VRS)-measured dysmenorrhea and to explore potential protective factors. METHODS This retrospective cohort study was conducted from June 2018 to December 2020 at Tongji Hospital in Wuhan. Information on baseline characteristics, pregnancy-related history, periconceptional micronutrient supplementation, and obstetric outcomes were collected. The severity of dysmenorrhea was assessed using VRS. RESULTS A total of 443 pregnant women were recruited and divided into the NVP group (n = 76) and the control group (n = 367). A significant association was observed between NVP and VRS-measured dysmenorrhea (c2=10.038, P = 0.007). After adjusting for covariates, the association between moderate/severe dysmenorrhea and NVP remained significant (OR 2.384; 95% CI 1.104-5.148, P = 0.004). First-trimester docosahexaenoic acid supplement (OR 0.443; 95% CI 0.205-0.960, P = 0.039) may be beneficial in reducing the risk of NVP. CONCLUSIONS Women with moderate to severe dysmenorrhea have a higher risk of experiencing NVP during the first trimester. Periconceptional docosahexaenoic acid supplementation may play a protective role.
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Affiliation(s)
- Xiaolei Zhang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanling Zhang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Lv
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yin Xie
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heze Xu
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fanfan Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengzhou He
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yao Fan
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xufang Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fatoumata Jallow
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingguang Lin
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ye
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongrui Deng
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Lauridsen J, Momsen AH, Pedersen P, Hansen ML, Andersen DR, Maimburg RD. Workplace intervention among pregnant hospital employees - A protocol of a cluster randomized trial. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 39:100940. [PMID: 38065048 DOI: 10.1016/j.srhc.2023.100940] [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: 05/19/2023] [Revised: 11/03/2023] [Accepted: 12/01/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Sick leave during pregnancy is frequent and 36 % of Danish pregnant employees are on sick leave > 14 days. Health care professionals are considered a risk population. This intervention applies preventive sessions including the pregnant employee, her manager and a midwife in addition to usual practiceat Aarhus University Hospital, Denmark (AUH). It is hypothesised that pregnant employees who participate in preventive sessions will have less sick leave and report better wellbeing compared to the reference group. METHODS All departments at AUHare cluster randomized. A total of 25 and 24 departments are allocated to the intervention and reference group, respectively. The intervention is protocolled with preventive sessions in addition to usual practice. The reference group receives usual practice. The primary outcome is mean number of days on sick leave during pregnancy. Secondary outcomes are wellbeing measured as physical and mental health, general work ability, work-life balance, manager support, and completed work adjustments during pregnancy. Data on sick leave will be collected from the hospital payment system and survey data will be collected at inclusion and follow-up. DISCUSSION This study will contribute to limited experimental research aimed to reduce sickness leave during pregnancy. The overall strength is the study design with easy access to study participants within a large hospital. The main limitation of the study is the high complexity of the study. TRIAL REGISTRATION The trial is registered in ClinicalTrials.gov with ID number 29-2019-03.
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Affiliation(s)
- Jane Lauridsen
- Department of Occupational Medicine, Aarhus University Hospital, Denmark.
| | - Anne Hedeager Momsen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Denmark.
| | - Pernille Pedersen
- DEFACTUM, Social & Health Services and Labour Market, Central Denmark Region, Denmark; Department of Public Health, Aarhus University, Denmark.
| | | | - Dorte Raaby Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Denmark.
| | - Rikke Damkjær Maimburg
- Department of Occupational Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; University College of Northern Denmark, Denmark; School of Nursing and Midwifery, Western Sydney University, Australia.
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Alharbi NM, Al Zahrani SA, Basri TH, Tawfiq SA, Jokhdar NY, AlQahtani RY, Khair HS, Alghanem NA. The Awareness and Knowledge of Normal and Abnormal Signs and Symptoms of Pregnancy Among Women of Childbearing Age in Saudi Arabia. Cureus 2023; 15:e44470. [PMID: 37791216 PMCID: PMC10544270 DOI: 10.7759/cureus.44470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Pregnancy is a natural physiological process that leads to the outstanding outcome of giving birth. It involves normal and abnormal signs and symptoms that women need to be aware of during this period. OBJECTIVES This study aims to assess the awareness and knowledge about normal and abnormal signs and symptoms of pregnancy among women of childbearing age in Saudi Arabia. METHODS This is an online questionnaire-based cross-sectional study done in 2023 among women in Saudi Arabia, aged 18 to 45. The estimated sample size was 385 after applying inclusion and exclusion criteria. However, 981 responses were collected and included. RESULTS A total of 981 participants were included in our study. The study findings noted that the majority of women demonstrated a good level of knowledge about the normal signs and symptoms of pregnancy. About 82% of the women reported that they knew mood swings were normal symptoms during pregnancy, 80.1% were aware of nausea, 75.9% knew about fatigue, and 68.9% knew about fainting or dizziness. The findings noted that less than half of the participants were fully aware of the abnormal obstetric signs. For the abnormal signs and symptoms during the first trimester, only 45.2% were fully aware of the symptoms. In the second trimester, 39.0% were fully aware of the symptoms. Only 30.5% of the participants were fully aware of the abnormal signs and symptoms in the third trimester. The study established a statistically significant relationship between age and knowledge of abnormal symptoms during the first, second, and third trimesters (P=0.027, 0.041, and 0.006) (r=0.139, 0.105, and 0.146). Furthermore, a statistically significant relationship was found between the level of education of the participants and the level of awareness of abnormal symptoms during the first trimester (P=0.043). However, there was no significant relationship between education level and the level of knowledge regarding abnormal symptoms during the second and third trimesters (r=0.22, 0.061, P=0.578, 0.603). CONCLUSION The study found that the majority of women had a good level of awareness and knowledge about normal signs and symptoms of pregnancy, while less than half of the women were fully aware of the abnormal signs and symptoms at different stages of pregnancy. The older respondents and people with higher levels of education demonstrated more knowledge. The two variables, age and education level, had a statistically significant relationship with knowledge of abnormal signs and symptoms of pregnancy with education level being only significant during the first trimester period. Our study concluded that women had different symptoms during pregnancy, both normal and abnormal. Their knowledge about these signs and symptoms was considerably moderate, but further awareness about the normality of these signs is needed. The study recommends more research to measure women's awareness about normal and abnormal symptoms of pregnancy, and more awareness programs should be carried out in the region as a way of enhancing a better understanding of normal and abnormal pregnancy symptoms. This will go a long way in helping women through their pregnancy and make them more comfortable.
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Affiliation(s)
- Noof M Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Taghreed H Basri
- Department of Obstetrics and Gynecology, Madinah Health Cluster, Ohud Hospital, Madinah, SAU
| | | | - Nawal Y Jokhdar
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Haneen S Khair
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Noor A Alghanem
- Department of General Practice, Dar Al-Uloom University, Riyadh, SAU
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Saz-Leal P, Zamorano-Domínguez L, Frías J, Guerra P, Saura-Valls M, Roca-Juanes R, Nebot-Troyano J, García-Aguilar E, Vilchez T, Urso K. Bioavailability of Cariban ® Capsules: A Modified-Release Fixed-Dose Combination of Doxylamine and Pyridoxine to Relieve Nausea and Vomiting During Pregnancy. Drugs R D 2023:10.1007/s40268-023-00425-7. [PMID: 37318714 DOI: 10.1007/s40268-023-00425-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Nausea and vomiting is a very prevalent condition during pregnancy. Combination of doxylamine and pyridoxine is placed as first-line pharmacological option for its treatment in most clinical guidelines. Among different release forms available, Cariban® is a fixed-dose combination of doxylamine/pyridoxine 10/10 mg, formulated as modified-release capsules. OBJECTIVES In the present study, we aimed to characterize the bioavailability performance of Cariban® in vitro and in vivo. METHODS An in vitro dissolution test was performed to evaluate the release profile of Cariban®, together with immediate- and delayed-release formulations available on the market. A single-center, single-dose, open-label bioavailability study following Cariban® administration in 12 healthy adult female patients was carried out to explore the drug behavior in vivo (protocol NBR-002-13; EUDRA-CT 2013-005422-35). These data were additionally used to perform a computational pharmacokinetic simulation of the posology approved for this drug. RESULTS Cariban® capsules demonstrate a prolonged-release performance, with an early, gradual, and progressive release of both actives until reaching a complete dissolution after 4-5 h in solution. The pharmacokinetic features of these capsules show that doxylamine and pyridoxine metabolites are early absorbed, being all detectable in plasma within 1 h following oral administration. Computational pharmacokinetic simulation predicts that different posology provides distinct profiles of metabolites in plasma, with 1-1-2 (morning-midafternoon-night) being the one that concentrates higher plasma levels but lower dose dumping for 24 h. CONCLUSION Cariban® behaves as a prolonged-release formulation, which correlates with rapid absorption and arising of the actives in the plasma, but also long-lasting and sustained bioavailability, especially when administered following the complete posology. These results would underlie its demonstrated efficacy to relieve nausea and vomiting of pregnancy (NVP) under clinical settings.
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Affiliation(s)
- Paula Saz-Leal
- Medical Department, ITF Research Pharma S.L.U., Alcobendas, Spain
| | | | - Jesús Frías
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | - Pedro Guerra
- Clinical Pharmacology Department, La Paz University Hospital, School of Medicine, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | | | | | | | | | - Tatiana Vilchez
- Medical Department, ITF Research Pharma S.L.U., Alcobendas, Spain
| | - Katia Urso
- R&D Department, ITF Research Pharma S.L.U., Alcobendas, Spain.
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Ngo E, Truong MBT, Nordeng H. Impact of a primary care pharmacist consultations on pregnant women's medication use: the SafeStart intervention study linked to a national prescription database. Int J Clin Pharm 2023:10.1007/s11096-023-01577-x. [PMID: 37156960 PMCID: PMC10366231 DOI: 10.1007/s11096-023-01577-x] [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: 11/07/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Prior studies show that pharmacist consultations are highly appreciated by pregnant women and feasible in community pharmacies. However, it is unknown whether such counseling has an impact on medication use during pregnancy. AIM This study aimed to assess whether a pharmacist consultation in early pregnancy was associated with pregnant women's medication use, with a focus on antiemetic medications. METHOD The SafeStart study recruited Norwegian pregnant women in the first trimester between February 2018 and February 2019. Women in the intervention group received a pharmacist consultation in a community pharmacy or by phone. A follow-up questionnaire was completed 13 weeks after enrollment. Data from the SafeStart study were linked to the Norwegian Prescription Database. Logistic regression was used to assess the association between the pharmacist intervention and medication use in the second trimester. RESULTS The study included 103 women in the intervention group and 126 in the control group. Overall prescription fills in the first and second trimesters were 55% and 45% (intervention group) and 49% and 52% (control group), respectively. In total, 16-20% of women in the first trimester and 21-27% of women in the second trimester had a prescription for antiemetics. The pharmacist intervention was not associated with women's medication use in the second trimester. CONCLUSION This study did not detect an impact of a pharmacist consultation on pregnant women's use of medications. In the future, pharmacist consultations should focus on other outcome factors, such as risk perception, knowledge level, and the use of other health care services. Trial registration The SafeStart study is registered with ClinicalTrials.gov (identifier: NCT04182750, registration date: December 2, 2019).
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Affiliation(s)
- Elin Ngo
- PharmacoEpidemiology and Drug Safety, Department of Pharmacy, University of Oslo, Blindern, Postbox 1068, 0316, Oslo, Norway.
| | - Maria Bich-Thuy Truong
- PharmacoEpidemiology and Drug Safety, Department of Pharmacy, University of Oslo, Blindern, Postbox 1068, 0316, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety, Department of Pharmacy, University of Oslo, Blindern, Postbox 1068, 0316, Oslo, Norway
- Department of Child Health and Development, National Institute of Public Health, Oslo, Norway
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Gjellestad M, Haraldstad K, Enehaug H, Helmersen M. Women's Health and Working Life: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1080. [PMID: 36673834 PMCID: PMC9859470 DOI: 10.3390/ijerph20021080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.
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Affiliation(s)
- Marianne Gjellestad
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
| | - Heidi Enehaug
- Work Research Institute, Center for Welfare and Labour Research, Oslo Metropolitan University, 0176 Oslo, Norway
| | - Migle Helmersen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4604 Kristiansand, Norway
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AlDughaishi MYK, Seshan V, Matua GA. Antenatal Education Services in Oman: A Descriptive Qualitative Inquiry of Healthcare Provider's Perspective. SAGE Open Nurs 2023; 9:23779608231167820. [PMID: 37032959 PMCID: PMC10074616 DOI: 10.1177/23779608231167820] [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: 01/21/2023] [Revised: 02/22/2023] [Accepted: 03/19/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction To ensure positive pregnancy and birth outcomes, healthcare providers working in antenatal clinics are expected to provide regular antenatal education to enable early detection and timely treatment of pregnancy-related morbidities to prevent complications during labor, birth, and postnatal period. Although antenatal education and services are provided through standard programs in developed countries, presently there are no well-structured programs in many developing countries. The study compares the current service with the national and international guidelines. Objective To identify the current practices of healthcare providers in antenatal education service in Oman with the aim of identifying any major implementation gaps. Methods A qualitative inquiry was implemented through semi-structured in-depth interviews guided by open-ended questions. The study population were healthcare providers who routinely provide antenatal services at healthcare facilities. A purposive non-probability sampling technique was used to select the key informants. Data was analyzed manually using the thematic analysis framework. Results The antenatal education services provided fall under four themes: In relation to "Education for safe pregnancy," the findings revealed that healthcare providers did not adequately address the needs. In relation to "Education for Safe labor and Birth," the pregnant women are briefed with inadequate information about labor and birth during the antenatal period. In relation to "Education related to Postpartum," healthcare providers generally do not provide information regarding pregnant women's psychological wellbeing, breastfeeding, family planning, hygiene, and nutrition during antenatal visits. In relation to "Education related to Newborn Care," the study findings indicate that contrary to what was stipulated by the WHO (2016) to establish antenatal educational programs to help pregnant women gain the skills and knowledge regarding proper newborn care, our findings demonstrated a lack of education about newborn care by providers. Conclusion The findings have the capacity to contribute towards the development of remedial strategies to improve maternal and neonatal outcomes in Oman. This can be achieved by addressing the practice gaps identified when comparing the current practices with international standards.
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Affiliation(s)
| | - Vidya Seshan
- Maternal and Child Health Department, College
of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Gerald Amandu Matua
- Fundamentals and Administration Department,
College of Nursing, Sultan Qaboos University, Muscat, Oman
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AlDughaishi MYK, Matua GA, Seshan V. A Qualitative Inquiry of Women's Perspective of Antenatal Education Services in Oman. SAGE Open Nurs 2023; 9:23779608231159336. [PMID: 36895708 PMCID: PMC9989448 DOI: 10.1177/23779608231159336] [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: 08/28/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Antenatal care (ANC) provides an opportunity for systematic assessment and follow-up of pregnant women to ensure positive outcomes for mother and foetus. Pregnant women should be offered evidence-based information with support to enable them to make informed decisions. Objective To identify the gap between the current practices and the recommended guidelines for antenatal education services in Oman. Methods A qualitative inquiry was implemented through semistructured in-depth interviews guided by open-ended questions and probes. A purposive non-probability sampling technique was used to select 13 pregnant women who had completed 30 weeks of gestation. The women were selected from 9 antenatal healthcare facilities among them: 7 primary health centers, one polyclinic and one, tertiary hospital. Results Antenatal education focused on four thematic areas of safe pregnancy; safe labor and birth; postpartum care; and new-born care. Regarding antenatal education for safe pregnancy, the findings indicate that most healthcare workers provided pregnant women adequate information to promote healthy dietary habits; cope with pregnancy symptoms; recognize and manage medical conditions, and to adhere to dietary supplements and medication. In addition, the findings revealed that the healthcare team did not provide the required antenatal education to meet the pregnant women's needs to ensure they had safe labor and birth, postpartum care, and new-born care. Conclusion This study is the first of its kind in Oman to provide baseline data regarding the current antenatal education services from the perspective of pregnant women. These findings will help in developing strategies to improve maternal and neonatal outcomes in the country.
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Affiliation(s)
| | | | - Vidya Seshan
- College of Nursing, Sultan Qaboos University, Muscat, Oman
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11
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Furlan AD, Harbin S, Vieira FF, Irvin E, Severin CN, Nowrouzi-Kia B, Tiong M, Adisesh A. Primary Care Physicians' Learning Needs in Returning Ill or Injured Workers to Work. A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:591-619. [PMID: 35511378 DOI: 10.1007/s10926-022-10043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
Primary care physicians are uniquely positioned to assist ill and injured workers to stay-at-work or to return-to-work. Purpose The purpose of this scoping review is to identify primary care physicians' learning needs in returning ill or injured workers to work and to identify gaps to guide future research. Methods We used established methodologies developed by Arksey and O'Malley, Cochrane and adapted by the Systematic Review Program at the Institute for Work & Health. We used Distiller SR©, an online systematic review software to screen for relevance and perform data extraction. We followed the PRISMA for Scoping Reviews checklist for reporting. Results We screened 2106 titles and abstracts, 375 full-text papers for relevance and included 44 studies for qualitative synthesis. The first learning need was related to administrative tasks. These included (1) appropriate record-keeping, (2) time management to review occupational information, (3) communication skills to provide clear, sufficient and relevant factual information, (4) coordination of services between different stakeholders, and (5) collaboration within teams and between different professions. The second learning need was related to attitudes and beliefs and included intrinsic biases, self-confidence, role clarity and culture of blaming the patient. The third learning need was related to specific knowledge and included work capacity assessments and needs for sick leave, environmental exposures, disclosure of information, prognosis of certain conditions and care to certain groups such as adolescents and pregnant workers. The fourth learning need was related to awareness of services and tools. Conclusions There are many opportunities to improve medical education for physicians in training or in continuing medical education to improve care for workers with an illness or injury that affect their work.
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Affiliation(s)
- Andrea D Furlan
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada.
- KITE, University Health Network, Toronto, ON, Canada.
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Shireen Harbin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Fabricio F Vieira
- Faculty of Medicine, State University of Maringa, Avenida Colombo, 5790, CEP 87020-900, Maringa, PR, Brazil
| | - Emma Irvin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Colette N Severin
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Margaret Tiong
- Institute for Work & Health, 400 University Avenue, suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Anil Adisesh
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Occupational Medicine, St Michael's Hospital, Toronto, ON, Canada
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12
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Erdal H, Holst L, Heitmann K, Trovik J. Antiemetic treatment of hyperemesis gravidarum in 1,064 Norwegian women and the impact of European warning on metoclopramide: a retrospective cohort study 2002–2019. BMC Pregnancy Childbirth 2022; 22:464. [PMID: 35655181 PMCID: PMC9161510 DOI: 10.1186/s12884-022-04777-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Women suffering from severe nausea and vomiting during pregnancy, hyperemesis gravidarum, have poor quality of life and increased risk of potentially fatal maternal and fetal complications. There is increasing and reassuring knowledge about safety of antiemetics in pregnancy. In 2013, the European Medical Agency (EMA) issued a warning on metoclopramide limiting treatment to maximum five days. Metoclopramide was the most used antiemetic in pregnancy at the time the warning was implemented in the Norwegian hyperemesis guidelines (2014). We aimed at describing changes in the treatment of hyperemesis over time, including changes associated with the EMA warning. Methods Retrospective chart review of all women hospitalized for hyperemesis gravidarum with metabolic disturbances between 01/Jan/2002 and 31/Dec/2019 at a university hospital serving nearly 10% of the pregnant population in Norway. Time-series analysis described changes over time and interrupted time series analysis quantified changes in treatment and clinical outcomes related to the EMA warning. Results In total, 1,064 women (1.2% of the birthing population) were included. The use of meclizine, prochlorperazine, and ondansetron increased during 2002–2019. This led to a yearly increase in the percentage of women using any antiemetic of 1.5% (95%CI 0.6; 2.4) pre-hospital, 0.6% (95%CI 0.2; 1.1) during hospitalization, and 2.6% (95%CI 1.3; 3.8) at discharge. Overall, only 50% of the women received antiemetics pre-hospital. Following the EMA warning, prehospital use of metoclopramide dropped by 30% (95%CI 25; 36), while use of any antiemetic pre-hospital dropped by 20% (95%CI 5.7; 34). In timely association, we observed a decrease in gestational age (-3.8 days, 98.75%CI 0.6; 7.1) at first admission, as well as indication of increased rate of termination of pregnancy with an absolute increase of 4.8% (98.75%CI 0.9; 8.7) in 2014. Conclusion During 2002–2019, the overall use of antiemetics in treatment of hyperemesis increased. The EMA-warning on metoclopramide in 2013 temporarily limited pre-hospital antiemetic provision associated with hospitalization at lower gestational length and indication of an increase in termination of pregnancy.
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Şafak Öztürk C, Kaya Odabaş R, Sökmen Y, Taşpinar A. The Relationship between Nausea-Vomiting during Pregnancy and Attachment Styles, Marital Adjustment, and Ways of Coping. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:65-76. [PMID: 35531669 DOI: 10.1080/0092623x.2022.2073302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The objective of this study is to examine the relationship between nausea and vomiting during pregnancy (NVP) and attachment styles in close relationships, marital adjustment, and ways of coping with stress. This study was performed in 2019 as an analytic case-control design. The study group consists of 60 pregnant women hospitalized with a nausea-vomiting/hyperemesis gravidarum diagnosis. The control group is composed of 64 pregnant women who applied for gynecology polyclinic for routine control. The participants were applied Pregnancy-Information Form, Experiences in Close Relationships Scale-Revised (ECR-R), Marital Adjustment Test (MAT), and Coping Styles Inventory (CSI). It was observed that the scores of the pregnant women in the study group from the helpless approach subscale of CSI were significantly higher than the control group and no significant difference was found between the two groups in terms of other scale scores. A negative correlation was found between the perceived severity of nausea and the seeking social support subscale of CSI in the study group. The study revealed findings that support the biopsychosocial approach to the etiology of NVP and showed that the women with NVP use a helpless approach in coping with stress and apply seeking social support as the severity of nausea decreases.
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Affiliation(s)
- Cennet Şafak Öztürk
- Department of Psychology, Faculty of Arts and Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Resmiye Kaya Odabaş
- Department of Midwifery, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkey
| | - Yasemin Sökmen
- Department of Midwifery, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayten Taşpinar
- Department of Midwifery, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
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Jahani F, Khazaei Z, Moodi M, Zarban A, Salmani F, Tahergorabi Z. The relation of visfatin with nausea and vomiting in the pregnancy. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:80. [PMID: 33088317 PMCID: PMC7554417 DOI: 10.4103/jrms.jrms_39_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/19/2020] [Accepted: 04/25/2020] [Indexed: 11/04/2022]
Abstract
Background The etiology of nausea and vomiting during pregnancy (NVP) is unclear and appears multifactorial. It has been shown that the physiological changes associated with NVP include changes in the levels of adipocytokines. Therefore, we investigated the association of nausea and vomiting during pregnancy with visfatin, β-human chorionic gonadotropin (βHCG), and perceived stress. Materials and Methods In this cross-sectional study, 100 nulliparous pregnant women aged 18-45 years were evaluated. Participants completed two questionnaires including the Index of Nausea, Vomiting, and Retching (INVR) and Perceived Stress Scale (PSS) in the three trimesters of pregnancy. They also referred to the laboratory to conduct the biochemical examinations including serum visfatin and βHCG levels in three trimesters. The obtained data were analyzed by SPSS 16 using statistical repeated-measures analysis of variance, Friedman, Bonferroni, and Wilcoxon post hoc tests. Marginal model (method generalized estimating equation [GEE]) was performed to assess the predictors of the INVR in the participants. Results INVR, PSS, visfatin, and βHCG levels significantly decreased from the first trimester to the third trimester of pregnancy (P ≤ 0.001). As a result of simple marginal model (GEE method), visfatin was predicted log βHCG (P = 0.035). Furthermore, the multiple marginal model revealed that the two predictors of βHCG (P = 0.01) and PSS (P ≤ 0.001) were positively correlated with the INVR. Furthermore, visfatin had an indirect positive effect on INVR. Conclusion The present study showed that visfatin can be indirectly related with nausea and vomiting throughout pregnancy. Furthermore, it seems that fluctuations in visfatin levels are independent of weight gain during pregnancy.
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Affiliation(s)
- Farnaz Jahani
- Member of Student Research Committee, School of Medicine, Birjand University of Medical Science, Birjand, Iran
| | - Zohre Khazaei
- Department of Gynecology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Department of Health Education and Health Promotion, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Asghar Zarban
- Department of Clinical Biochemistry, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Fatemeh Salmani
- Social Determinants of Health Research Center, Department of Biostatic and Epidemiology, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Zoya Tahergorabi
- Medical Toxicology and Drug Abuse Research Center, Department of Physiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
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Regodón Wallin A, Tielsch JM, Khatry SK, Mullany LC, Englund JA, Chu H, LeClerq SC, Katz J. Nausea, vomiting and poor appetite during pregnancy and adverse birth outcomes in rural Nepal: an observational cohort study. BMC Pregnancy Childbirth 2020; 20:545. [PMID: 32943001 PMCID: PMC7499900 DOI: 10.1186/s12884-020-03141-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 07/28/2020] [Indexed: 01/17/2023] Open
Abstract
Background Nausea and vomiting are experienced by a majority of pregnant women worldwide. Previous studies have yielded conflicting results regarding their impact on birth outcomes and few studies have examined this relationship in settings with limited resources. We aimed to determine the effect of nausea, vomiting and poor appetite during pregnancy on birth outcomes in rural Nepal. Methods Observational cohort study using data collected in two randomized, community-based trials to assess the effect of influenza immunization during pregnancy on reproductive and respiratory outcomes among pregnant women and their offspring. Pregnant women in Sarlahi District, Nepal were recruited from 2011 to 2013. Exposure was defined as nausea, vomiting or poor appetite at any point during pregnancy and by trimester; symptoms were recorded monthly throughout pregnancy. Adverse outcomes were low birth weight (LBW), preterm birth and small for gestational age (SGA). Adjusted relative risks (aRR) with 95% CIs are reported from Poisson regressions with robust variance. Results Among 3,623 pregnant women, the cumulative incidence of nausea, vomiting or poor appetite was 49.5% (n = 1793) throughout pregnancy and 60.6% (n = 731) in the first trimester. Significantly higher aRRs of LBW and SGA were observed among women experiencing symptoms during pregnancy as compared to symptom free women (LBW: aRR 1.20; 95% CI 1.05 1.28; SGA: aRR 1.16; 95% CI 1.05 1.28). Symptoms in the first trimester were not significantly associated with any of the outcomes. In the second trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.17; 95% CI 1.01 1.36; SGA: aRR 1.16; 95% CI 1.05 1.29) and a significantly lower aRR for preterm birth (aRR 0.75; 95% CI 0.59 0.96). In the third trimester, we observed significantly higher aRRs for LBW and SGA (LBW: aRR 1.20; 95% CI 1.01 1.43; SGA: aRR 1.14; 95% CI 1.01 1.29). Conclusions Symptoms of nausea, vomiting or poor appetite during pregnancy are associated with LBW, SGA and preterm birth in a setting with limited resources, especially beyond the first trimester. Trial registration Prospectively registered at ClinicalTrials.gov on Dec 17, 2009 (NCT01034254).
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Affiliation(s)
- Amanda Regodón Wallin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W5009, 21203-2105, Baltimore, MD, USA.
| | - James M Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Luke C Mullany
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janet A Englund
- Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - Helen Chu
- Department of Medicine, University of Washington, WA, Seattle, USA
| | - Steven C LeClerq
- Nepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W5009, 21203-2105, Baltimore, MD, USA
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16
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Wu P, Jordan KP, Chew-Graham CA, Coutinho T, Lundberg GP, Park KE, Chappell LC, Myint PK, Maas AHEM, Mamas MA. Temporal Trends in Pregnancy-Associated Stroke and Its Outcomes Among Women With Hypertensive Disorders of Pregnancy. J Am Heart Assoc 2020; 9:e016182. [PMID: 32750300 PMCID: PMC7792242 DOI: 10.1161/jaha.120.016182] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Stroke is a serious complication of hypertensive disorders of pregnancy (HDP), with potentially severe and long‐term sequelae. However, the temporal trends, predictors, and outcomes of stroke in women with HDP at delivery remain unknown. Methods and Results All HDP delivery hospitalizations with or without stroke event (ischemic, hemorrhagic, or unspecified) between 2004 and 2014 in the United States National Inpatient Sample were analyzed to examine incidence, predictors, and prognostic impact of stroke. Of 4 240 284 HDP delivery hospitalizations, 3391 (0.08%) women had stroke. While the prevalence of HDP increased over time, incident stroke rates decreased from 10 to 6 per 10 000 HDP delivery hospitalizations between 2004 and 2014. Women with stroke were increasingly multimorbid, with some risk factors being more strongly associated with ischemic strokes, including congenital heart disease, peripheral vascular disease, dyslipidemia, and sickle cell disease. Delivery complications were also associated with stroke, including cesarean section (odds ratio [OR], 1.58; 95% CI, 1.33–1.86), postpartum hemorrhage (OR, 1.91; 95% CI, 1.33–1.86), and maternal mortality (OR, 99.78; 95% CI, 59.15–168.31), independently of potential confounders. Women with stroke had longer hospital stays (median, 6 versus 3 days), higher hospital charges (median, $14 655 versus $4762), and a higher proportion of nonroutine discharge locations (38% versus 4%). Conclusions The incidence of stroke in women with HDP has declined over time. While a relatively rare event, identification of women at highest risk of ischemic or hemorrhagic stroke on admission for delivery is important to reduce long‐term sequelae.
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Affiliation(s)
- Pensée Wu
- Keele Cardiovascular Research Group School of Primary, Community and Social Care Keele University Staffordshire United Kingdom.,Academic Unit of Obstetrics and Gynaecology University Hospital of North Midlands Stoke-on-Trent United Kingdom
| | - Kelvin P Jordan
- School of Primary, Community and Social Care Keele University Staffordshire United Kingdom
| | - Carolyn A Chew-Graham
- School of Primary, Community and Social Care Keele University Staffordshire United Kingdom.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West Midlands Keele University Staffordshire United Kingdom
| | - Thais Coutinho
- Division of Cardiac Prevention and Rehabilitation Division of Cardiology University of Ottawa Heart Institute Ottawa Canada
| | - Gina P Lundberg
- Division of Cardiology Emory University School of Medicine Atlanta GA.,Emory Women's Heart Center Atlanta GA
| | - Ki E Park
- Division of Cardiovascular Medicine University of Florida College of Medicine Gainesville FL
| | - Lucy C Chappell
- Women's Health Academic Centre King's College London London United Kingdom
| | - Phyo K Myint
- Institute of Applied Health Sciences University of Aberdeen United Kingdom
| | - Angela H E M Maas
- Department of Cardiology Women's Cardiac Health Radboud University Medical Center Nijmegen The Netherlands
| | - Mamas A Mamas
- Keele Cardiovascular Research Group School of Primary, Community and Social Care Keele University Staffordshire United Kingdom.,The Heart Centre University Hospital of North Midlands Stoke-on-Trent United Kingdom
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17
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Lutterodt MC, Kähler P, Kragstrup J, Nicolaisdottir DR, Siersma V, Ertmann RK. Examining to what extent pregnancy-related physical symptoms worry women in the first trimester of pregnancy: a cross-sectional study in general practice. BJGP Open 2019; 3:bjgpopen19X101674. [PMID: 31719117 PMCID: PMC6995862 DOI: 10.3399/bjgpopen19x101674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/08/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Women often wish to discuss their pregnancy symptoms with their GP. However, the two parties' understanding of symptoms may not be aligned. AIM To examine to what degree a specific pregnancy-related symptom worried women in the first trimester and analyse the characteristics of the most worried women. DESIGN & SETTING A cross-sectional study was performed in general practice in Denmark from 1 March 2015-15 August 2016. METHOD Women attending the first prenatal care visit completed a questionnaire about pregnancy-related physical symptoms and worries. Women were recruited from 125 GP practices and 294 GPs participated in the study. Further data were obtained from their pregnancy health record. Multivariable logistic regression analysis was used to assess the associations between the women's worries and the severity of the symptoms, which were adjusted for age and parity. RESULTS A total of 1508 women, aged 16-45 years, were included and 1455 completed the questionnaire. Nausea, vomiting, pelvic cavity pain, and back pain were the most common symptoms, and 88% reported having two or more symptoms simultaneously. Among the 1278 women reporting nausea, only 21% were worried, while 88% of the 252 women reporting vaginal bleeding were worried. Primigravidae (those pregnant for the first time) were significantly more worried about vomiting and nausea than multigravidae (those who have experienced pregnancy previously). Those aged >35 years were more worried about pelvic girdle pain and pelvic cavity pain than younger women. CONCLUSION Pregnancy-related physical symptoms are frequent in the first trimester. The severity of worries depends on the symptom. Vaginal bleeding and pain give rise to the majority of severe worries, especially among young women.
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Affiliation(s)
- Melissa C Lutterodt
- GP, The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Kähler
- The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- GP, The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Dagny R Nicolaisdottir
- The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ruth K Ertmann
- GP, The Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abstract
Nausea and vomiting of pregnancy (NVP) is a common condition that affects as many as 70% of pregnant women. Although no consensus definition is available for hyperemesis gravidarum (HG), it is typically viewed as the severe form of NVP and has been reported to occur in 0.3-10.8% of pregnant women. HG can be associated with poor maternal, fetal and child outcomes. The majority of women with NVP can be managed with dietary and lifestyle changes, but more than one-third of patients experience clinically relevant symptoms that may require fluid and vitamin supplementation and/or antiemetic therapy such as, for example, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in treating NVP. Ondansetron is commonly used to treat HG, but studies are urgently needed to determine whether it is safer and more effective than using first-line antiemetics. Thiamine (vitamin B1) should be introduced following protocols to prevent refeeding syndrome and Wernicke encephalopathy. Recent advances in the genetic study of NVP and HG suggest a placental component to the aetiology by implicating common variants in genes encoding placental proteins (namely GDF15 and IGFBP7) and hormone receptors (namely GFRAL and PGR). New studies on aetiology, diagnosis, management and treatment are under way. In the next decade, progress in these areas may improve maternal quality of life and limit the adverse outcomes associated with HG.
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Figueroa Gray M, Hsu C, Kiel L, Dublin S. Getting through the day: a pilot qualitative study of U.S. women's experiences making decisions about anti-nausea medication during pregnancy. BMC Pregnancy Childbirth 2018; 18:475. [PMID: 30514332 PMCID: PMC6280506 DOI: 10.1186/s12884-018-2093-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 11/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background Nausea during pregnancy affects 80% of pregnant women and can severely affect women’s functioning and quality of life. Women often have difficulty deciding whether to take anti-nausea medications due to concern about medication risks. This paper foregrounds U.S. women’s voices as they share their experiences making decisions about anti-nausea medication use. Methods As a pilot study, we conducted two focus groups including 20 women who had filled at least one prescription for an anti-nausea medication during pregnancy. Topics included deciding about and taking anti-nausea medications. Transcripts were analyzed by two medical anthropologists using an inductive or open coding approach. Results Women in our pilot study carefully considered whether to take anti-nausea medications. Most women preferred not to take medications, in general, but were willing to do so for severe symptoms. When considering medications, they expressed concerns about risks to fetal health. They considered information from internet research, their health care provider, and the experiences of friends and family. While some women in our study decided against taking medications, many did take a prescription medication, and they reported substantial improvement in their symptoms and sense of well-being. Conclusions Women weighed various sources of evidence to assess the risks and benefits of taking anti-nausea medication and ultimately made a range of choices. More research is needed about the effectiveness and risks of anti-nausea medication, to help support women in their decision-making process, and also about the best methods to communicate scientific evidence to women. Electronic supplementary material The online version of this article (10.1186/s12884-018-2093-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Linda Kiel
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Sascha Dublin
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.,University of Washington Epidemiology Department, Seattle, WA, USA
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Sridharan K, Sivaramakrishnan G. Interventions for treating nausea and vomiting in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials. Expert Rev Clin Pharmacol 2018; 11:1143-1150. [PMID: 30261764 DOI: 10.1080/17512433.2018.1530108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/26/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Several drugs were explored for their utility in treating nausea and vomiting in pregnancy (NVP). The present study is a network meta-analysis of such drugs. METHODS Electronic databases were searched for randomized clinical trials that have compared active interventions (with placebo or other active interventions) for treating NVP. Nausea scores were the primary outcome and changes in nausea scores, emetic episodes, adverse events, and vomiting control were the key secondary outcomes. Weighted mean difference was the effect estimate for continuous variable and odds ratio for the numerical variable. Random-effects model was used and the strength of the evidence was graded. RESULTS Fifty studies were included in the systematic review and 42 in the meta-analysis. Acupuncture, chamomile, dimenhydrinate, doxylamine/vitamin B6, ginger, quince, metoclopramide, and vitamin B6 were associated with reduced nausea scores compared to placebo. Of these interventions, ginger and vitamin B6 were also associated with better vomiting control and less incidence of adverse events. Adequate evidence supporting the use exists only for ginger and the quality of evidence for this comparison is moderate. Strength of evidence for all other comparisons is very low. CONCLUSION Present evidence is conclusive on the therapeutic benefits of ginger in treating NVP. Although favorable results were obtained for several other interventions, the strength of evidence is very low. The results of this network meta-analysis should be interpreted with extreme caution as it might change with the advent of data from future head-to-head clinical trials.
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Affiliation(s)
- Kannan Sridharan
- a Department of Pharmacology and Therapeutics, College of Medicine and Medical Sciences , Arabian Gulf University , Manama , Bahrain
| | - Gowri Sivaramakrishnan
- b School of Oral Health, College of Medicine, Nursing and Health Sciences , Fiji National University , Suva , Fiji
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Women with prolonged nausea in pregnancy have increased risk for depressive symptoms postpartum. Sci Rep 2018; 8:15796. [PMID: 30361517 PMCID: PMC6202412 DOI: 10.1038/s41598-018-33197-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023] Open
Abstract
The aim of this population-based, longitudinal study was to assess the association between nausea and vomiting in pregnancy (NVP) and perinatal depressive symptoms. Pregnant women (N = 4239) undergoing routine ultrasound at gestational week (GW) 17 self-reported on NVP and were divided into those without nausea (G0), early (≤17 GW) nausea without medication (G1), early nausea with medication (G2), and prolonged (>17 GW) nausea (G3). The Edinburgh Postnatal Depression Scale at GW 17 and 32 (cut-off ≥13) and at six weeks postpartum (cut-off ≥12) was used to assess depressive symptoms. Main outcome measures were depressive symptoms at GW 32 and at six weeks postpartum. NVP was experienced by 80.7%. The unadjusted logistic regression showed a positive association between all three nausea groups and depressive symptoms at all time-points. After adjustment, significant associations with postpartum depressive symptoms remained for G3, compared to G0 (aOR = 1.66; 95% CI 1.1–2.52). After excluding women with history of depression, only the G3 group was at higher odds for postpartum depressive symptoms (aOR = 2.26; 95% CI 1.04–4.92). In conclusion, women with prolonged nausea have increased risk of depressive symptoms at six weeks postpartum, regardless of history of depression.
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Kamali Z, Abedian Z, SaberMohammad A, Dehnavi ZM. The effect of small group teaching on quality of life in pregnant women with nausea and vomiting: A clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:112. [PMID: 30271797 PMCID: PMC6149123 DOI: 10.4103/jehp.jehp_162_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 06/02/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Nausea and vomiting in pregnancy is the most common medical complication in the first trimester of pregnancy. That associated with a wide range of physical and mental symptoms for the patient and his family and can affect the quality of life of women's life. In addition, the training to improve knowledge, in adjusting diet and lifestyle, and leading to decrease nausea and vomiting. Due to the positive characteristics of training using the small groups, this study was applied with the objective of "The effect of small group teaching on quality of life in pregnant women with nausea and vomiting." METHODS This study was applied based on intervention, on 59 nulliparous women with nausea and vomiting who referred to obstetrics ward of selected health and treatment centers in Neishaboor County. The training was presented by a researcher in group intervention in 8 sessions, each 45-30 min in small groups (3 groups 10 members). The control group received routine care. The study instruments (nausea and vomiting of pregnancy quality of life questionnaire) and (modified-PUGE) form. The results were analyzed using the Wilcoxon test, Mann-Whitney, and t-test. RESULTS Research units were no statistically significant difference of personal data, at the beginning of the study, and before intervention, was not differences between the mean change scores of postpartum stress disorder in two groups (P = 0/192). While the mean quality of life score in the intervention and control groups was statistically significant difference after intervention (P = 0.001). Quality of life score in the intervention group had statistically significant difference before and after the intervention (P = 0.001). CONCLUSION Training in the intervention group with small group strategies has more effective in comparison to conventional training of nausea and vomiting.
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Affiliation(s)
- Zahra Kamali
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Abedian
- Department of Midwifery, School of Nursing and Midwifery, Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala SaberMohammad
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mohebbi Dehnavi
- Department of Midwifery, School of Nursing and Midwifery, Esfahan University of Medical Sciences, Esfahan, Iran
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Tan A, Lowe S, Henry A. Nausea and vomiting of pregnancy: Effects on quality of life and day-to-day function. Aust N Z J Obstet Gynaecol 2017; 58:278-290. [PMID: 28949009 DOI: 10.1111/ajo.12714] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 08/11/2017] [Indexed: 12/26/2022]
Abstract
AIMS To investigate the effect of nausea and vomiting of pregnancy (NVP) on quality of life (QoL) and activities of daily living/socioeconomic function in a contemporary Australian setting. MATERIALS AND METHODS Observational, single centre prospective cohort study using validated survey instruments in pregnant women at 9-16 weeks gestation at a tertiary metropolitan women's hospital in Sydney, Australia. QoL measured by the Short-Form Health Survey (SF-12) was compared between those with and without NVP. NVP severity scores were correlated with QoL scores, work patterns and medication use. RESULTS Of 116 participants, 72% had NVP, with no baseline (including mental health) differences between women with or without NVP. As classified by modified Pregnancy-Unique-Quantified-Emesis (PUQE) survey, 42% had mild symptoms, 55% moderate and 1% severe. SF-12 Physical Component Summary (PCS) scores were significantly lower for those with NVP (P < 0.001), but not Mental Component Summary (MCS) scores (P = 0.11). Decreasing QoL was associated with increasing NVP severity (P < 0.001), most markedly in the physical domain (P < 0.001). Only 39% of women used any NVP treatment and 15% pharmacotherapy. Most used treatments were vitamin B6 , ginger, metoclopramide and natural remedies. Significantly more women with NVP required time off work (45% vs 16%, P = 0.003). CONCLUSIONS NVP is a physically morbid disease, affecting most pregnancies. NVP has a significant detrimental impact on QoL, especially physical QoL and work function. Despite this, we found low treatment utilisation, even in those with moderate/severe symptoms. Women should be encouraged to seek assistance for NVP and further education is required to improve practitioner awareness and management.
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Affiliation(s)
- Amelia Tan
- School of Women's and Children's Health, UNSW Medicine, Sydney, NSW, Australia
| | - Sandra Lowe
- School of Women's and Children's Health, UNSW Medicine, Sydney, NSW, Australia.,Department of Obstetrics, Royal Hospital for Women, Randwick, NSW, Australia
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, Sydney, NSW, Australia.,Department of Maternal-Fetal Medicine, Royal Hospital for Women, Randwick, NSW, Australia.,Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia
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Abstract
BACKGROUND AND OBJECTIVE A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use but also differences in sick leave policies. DESIGN AND SETTING Cross-sectional, web-based study in 12 European countries from October 2011 to February 2012. Data were collected via an electronic questionnaire. PARTICIPANTS Pregnant women and mothers of children under the age of 1 year. PRIMARY OUTCOME MEASURE Sick leave prevalence in pregnancy. RESULTS Of 6686 women included, 3385 (50.6%) had been on sick leave during pregnancy. The rates of sick leave varied across countries, ranging from 31.7%-34.8% in Sweden and the UK to 62.4%-71.3% in Norway, Serbia, Croatia and Poland. The most common reasons for being on sick leave were pregnancy complications (26.5%); pain in the neck, back or pelvic girdle (16.2%); and nausea and vomiting (NVP, 16.0%). Women using medications for acute illnesses were more likely to be on sick leave than their non-medicated counterparts, while an opposite trend was observed for women with chronic disorders, where non-medicated women were more likely to be on sick leave. Women from countries with 'low' sick leave policies were less likely to have extensions of sick leaves compared with women from countries with 'medium' policies (adjusted OR 0.63, 95% CI 0.49 to 0.82). CONCLUSION The rates of sick leave in pregnancy vary greatly across European countries. Women using medications were more likely to be on sick leave, especially for acute illnesses. The differences in sick leave patterns across countries only partially reflected differences in sick leave policies, which implies that sick leave in pregnancy is also affected by other national differences.
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Affiliation(s)
- Bich Thuy Truong
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Petter Kristensen
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Preventive Medicine and Epidemiology Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway
- Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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25
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Dochez V, Dimet J, David-Gruselle A, Le Thuaut A, Ducarme G. French family physician experience concerning the outpatient care for women suffering from nausea and vomiting in pregnancy. J Gynecol Obstet Hum Reprod 2017. [PMID: 28643666 DOI: 10.1016/j.jogoh.2017.02.010] [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: 10/20/2022]
Abstract
OBJECTIVE To explore thoughts and attitudes among French family physicians on the outpatient care for women suffering from nausea and vomiting in pregnancy (NVP). DESIGN AND SETTING A retrospective study was conducted among family physicians who had taken care of pregnant women who gave birth in our hospital in 1 year. PATIENTS AND METHODS Fifty-nine French family physicians responded to a questionnaire assessing their experience about outpatient care for women suffering from NVP. Analysis were done according to the physicians' age, as the annual demographics data analysis from the French Medical Council. RESULTS More than 89% of family physicians asked systematically the question concerning NVP (53/59), which were estimated as a frequent symptom (n=44, 74.6%). The intensity of NVP was assessed as mild in 28.8% (n=17), moderate in 62.7% (n=37), severe in 6.8% (n=4) and unbearable in 1.7% (n=1). Physicians younger than 40 years questionned less frequently about NVP compared to those older than 40 or older than 60 years (66.7% vs. 90.5% vs. 95.5%, respectively; P=0.04). Severe and unbearable NVP were significantly estimated more frequent among younger physicians (33.3% vs. 6.8%; P=0.03). Treatments (sick leave, diet, drugs, homeopathy, acupuncture or psychotherapy) did not differ between groups. DISCUSSION AND CONCLUSION Outpatient care for women suffering from NVP may vary according to the physician. French family physicians played a key role in NVP. Younger family physician considered NVP as a frequent symptom which needed active management in severe forms.
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Affiliation(s)
- V Dochez
- Department of obstetrics and gynecology, centre hospitalier departemental, Les Oudairies, 85000 La-Roche-sur-Yon, France; Department of obstetrics and gynecology, centre hospitalier universitaire, 44000 Nantes, France
| | - J Dimet
- Clinical research center, centre hospitalier departemental, Les Oudairies, La-Roche-sur-Yon, France
| | | | - A Le Thuaut
- Clinical research center, centre hospitalier departemental, Les Oudairies, La-Roche-sur-Yon, France
| | - G Ducarme
- Department of obstetrics and gynecology, centre hospitalier departemental, Les Oudairies, 85000 La-Roche-sur-Yon, France.
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Heitmann K, Nordeng H, Havnen GC, Solheimsnes A, Holst L. The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again - results from a cross-sectional study. BMC Pregnancy Childbirth 2017; 17:75. [PMID: 28241811 PMCID: PMC5329925 DOI: 10.1186/s12884-017-1249-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 02/08/2017] [Indexed: 11/15/2022] Open
Abstract
Background Though nausea and vomiting is very common during pregnancy, no studies have investigated the impact of this condition on the women’s daily lives in a Scandinavian population. The aim of this study was to describe the burden of nausea and vomiting during pregnancy (NVP) on global quality of life, daily life functioning and willingness to become pregnant again according to the severity of NVP symptoms. Methods This study is a cross-sectional population-based study conducted in Norway. Pregnant women and mothers with children <1 year of age with current or prior NVP were eligible to participate. Data were collected through an anonymous on-line questionnaire accessible from November 10th, 2014 to January 31st, 2015. Severity of NVP was measured using the 24-h Pregnancy Unique Quantification of Emesis Scale (PUQE). Associations between severity of NVP, daily life functioning and willingness to become pregnant again were tested using chi-square tests. Associations with global quality of life measured in terms of the Quality of Life Scale (QOLS) were estimated using generalized linear models and reported as unstandardized regression coefficients (β) with 95% confidence intervals (CI). Results 712 women with NVP were included in the study. NVP was significantly associated with several characteristics, including daily life functioning, quality of life and willingness to become pregnant again. The negative impact was greater the more severe the symptoms were, although considerable adverse effects were also seen among women with mild and moderate NVP symptoms. Over one fourth of the women with severe NVP considered terminating the pregnancy due to NVP, and three in four considered not to get pregnant again. Severity of NVP remained significantly associated with reduced global quality of life when adjusting for maternal characteristics and illnesses with β (95% CI) = −10.9 (−16.9, −4.9) for severe versus mild NVP. Conclusions NVP as measured by PUQE had a major impact on various aspects of the women’s lives, including global quality of life and willingness to become pregnant again. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1249-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristine Heitmann
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, P-Box 7804, N-5020, Bergen, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Gro C Havnen
- Regional Medicines Information and Pharmacovigilance Centre (RELIS), Oslo, Norway
| | - Anja Solheimsnes
- Department of Global Public Health and Primary Care, University of Bergen, P-Box 7804, N-5020, Bergen, Norway
| | - Lone Holst
- Department of Global Public Health and Primary Care, University of Bergen, P-Box 7804, N-5020, Bergen, Norway.
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Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study. PLoS One 2016; 11:e0166133. [PMID: 27814390 PMCID: PMC5096665 DOI: 10.1371/journal.pone.0166133] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 10/24/2016] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression). Health-related quality of life was assessed by the 12-item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.
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