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Hailu H, Skouteris H, Incollingo Rodriguez AC, Galvin E, Hill B. Drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women: A systematic review. Obes Rev 2024; 25:e13710. [PMID: 38343332 DOI: 10.1111/obr.13710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 04/18/2024]
Abstract
Women in the preconception, pregnant, or postpartum period are susceptible to weight stigma, particularly due to the risk of excess weight gain during the reproductive life period and the negative effects of stigma on the health of both the mother and the child. Identifying the drivers and facilitators of weight stigma will help guide focused weight stigma prevention interventions. This systematic review aimed to identify the drivers and facilitators of weight stigma among preconception, pregnant, and postpartum women. In May 2022, Medline, Embase, PsycINFO, and the Maternity and Infant Care Database were searched for peer-reviewed articles published since 2010 using search terms weight AND stigma AND preconception, OR pregnant, OR postpartum. Of the 1724 articles identified, 34 fulfilled the inclusion criteria and were included in a narrative synthesis. Women reported facing insensitive language, misconceptions about obesity across all settings, and inappropriate media representation. The unavailability of appropriate equipment at facilities was reported by both women and health professionals. Our findings indicate that a rigorous effort by all stakeholders is necessary to promote regulatory, legal, and educational initiatives designed to reduce weight stigma and discrimination against women in the reproductive period.
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Affiliation(s)
- Haimanot Hailu
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, The University of Warwick, Coventry, UK
| | - Angela C Incollingo Rodriguez
- Psychological and Cognitive Sciences, Department of Social Science and Policy Studies, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Emma Galvin
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Marín-García PJ, Rouco C, Llobat L, Larsen T, Hedemann MS. Targeted and untargeted metabolomic profiles in wild rabbit does (Oryctolagus cuniculus) of different breeding states ( pregnant and lactating). J Exp Zool A Ecol Integr Physiol 2024. [PMID: 38651595 DOI: 10.1002/jez.2818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/01/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Ecological nutrition aims to unravel the extensive web of nutritional links that drives animals in their interactions with their ecological environments. Nutrition plays a key role in the success of European wild rabbit (Oryctolagus cuniculus) and could be affected by the breeding status of the animals and reflected in the metabolome of this species. As nutritional needs are considerably increased during pregnancy and lactation, the main objective of this work was to determine how the breeding status (pregnant and lactating) of European wild rabbit does affects nutritional requirements and their metabolome (using targeted and untargeted metabolomics), aiming to find a useful biomarker of breeding status and for monitoring nutritional requirements. To address this gap, 60 wild European rabbits were studied. Animals were divided according to their breeding status and only pregnant (n = 18) and lactating (n = 11) rabbit does were used (n = 29 in total). The body weight and length of each animal were analyzed. The relative and absolute chemical composition of the gastric content and whole blood sample were taken, and targeted and untargeted metabolomics were analyzed. As a main result, there were no differences in biometric measurements, gastric content, and targeted metabolomics, except for live weight and nonesterified fatty acids (NEFA), as pregnant animals showed higher live weight (+12%; p = 0.0234) and lower NEFA acid levels (-46%; p = 0.0262) than lactating females. Regarding untargeted metabolomics, a good differentiation of the metabolome of the two breeding groups was confirmed, and it was proven that pregnant animals showed higher plasmatic levels of succinic anhydride (3.48 more times; p = 0.0236), succinic acid (succinate) (3.1 more times; p = 0.0068) and propionic acid (3.98 more times; p = 0.0121) than lactating animals. However, lactating animals showed higher levels of N-[(3a,5b,7b)-7-hydroxy-24-oxo-3-(sulfoxide) cholan-24-yl]-Glycine (cholestadien) (2.4 more times; p < 0.0420), 4-maleyl-acetoacetate (MAA) (3.2 more times; p < 0.0364) and irilone (2.2 more times; p = 0.0451) than pregnant animals, any of these metabolites could be used as a potential biomarker. From these results, it can be concluded that the most notable changes were observed in the metabolome of individuals, with most of the changes observed being due to energy and protein mobilisation.
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Affiliation(s)
- Pablo Jesús Marín-García
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology (PASAPTA), Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Carlos Rouco
- Department of Plant Biology and Ecology, University of Seville, Seville, Spain
| | - Lola Llobat
- Department of Animal Production and Health, Veterinary Public Health and Food Science and Technology (PASAPTA), Universidad Cardenal Herrera-CEU, Valencia, Spain
| | - Torben Larsen
- Department of Animal Science, Aarhus University, Tjele, Denmark
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Shara N, Mirabal-Beltran R, Talmadge B, Falah N, Ahmad M, Dempers R, Crovatt S, Eisenberg S, Anderson K. Use of Machine Learning for Early Detection of Maternal Cardiovascular Conditions: Retrospective Study Using Electronic Health Record Data. JMIR Cardio 2024; 8:e53091. [PMID: 38648629 DOI: 10.2196/53091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cardiovascular conditions (eg, cardiac and coronary conditions, hypertensive disorders of pregnancy, and cardiomyopathies) were the leading cause of maternal mortality between 2017 and 2019. The United States has the highest maternal mortality rate of any high-income nation, disproportionately impacting those who identify as non-Hispanic Black or Hispanic. Novel clinical approaches to the detection and diagnosis of cardiovascular conditions are therefore imperative. Emerging research is demonstrating that machine learning (ML) is a promising tool for detecting patients at increased risk for hypertensive disorders during pregnancy. However, additional studies are required to determine how integrating ML and big data, such as electronic health records (EHRs), can improve the identification of obstetric patients at higher risk of cardiovascular conditions. OBJECTIVE This study aimed to evaluate the capability and timing of a proprietary ML algorithm, Healthy Outcomes for all Pregnancy Experiences-Cardiovascular-Risk Assessment Technology (HOPE-CAT), to detect maternal-related cardiovascular conditions and outcomes. METHODS Retrospective data from the EHRs of a large health care system were investigated by HOPE-CAT in a virtual server environment. Deidentification of EHR data and standardization enabled HOPE-CAT to analyze data without pre-existing biases. The ML algorithm assessed risk factors selected by clinical experts in cardio-obstetrics, and the algorithm was iteratively trained using relevant literature and current standards of risk identification. After refinement of the algorithm's learned risk factors, risk profiles were generated for every patient including a designation of standard versus high risk. The profiles were individually paired with clinical outcomes pertaining to cardiovascular pregnancy conditions and complications, wherein a delta was calculated between the date of the risk profile and the actual diagnosis or intervention in the EHR. RESULTS In total, 604 pregnancies resulting in birth had records or diagnoses that could be compared against the risk profile; the majority of patients identified as Black (n=482, 79.8%) and aged between 21 and 34 years (n=509, 84.4%). Preeclampsia (n=547, 90.6%) was the most common condition, followed by thromboembolism (n=16, 2.7%) and acute kidney disease or failure (n=13, 2.2%). The average delta was 56.8 (SD 69.7) days between the identification of risk factors by HOPE-CAT and the first date of diagnosis or intervention of a related condition reported in the EHR. HOPE-CAT showed the strongest performance in early risk detection of myocardial infarction at a delta of 65.7 (SD 81.4) days. CONCLUSIONS This study provides additional evidence to support ML in obstetrical patients to enhance the early detection of cardiovascular conditions during pregnancy. ML can synthesize multiday patient presentations to enhance provider decision-making and potentially reduce maternal health disparities.
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Affiliation(s)
- Nawar Shara
- MedStar Health Research Institute, Hyattesville, MD, United States
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, DC, United States
| | | | | | - Noor Falah
- MedStar Health Research Institute, Hyattesville, MD, United States
| | - Maryam Ahmad
- MedStar Health Research Institute, Hyattesville, MD, United States
| | | | | | | | - Kelley Anderson
- School of Nursing, Georgetown University, Washington, DC, United States
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Almohanna AM, Noble K, Wray S. Extracellular acidification increases uterine contraction in pregnant mouse by increasing intracellular calcium. Acta Physiol (Oxf) 2024:e14147. [PMID: 38650469 DOI: 10.1111/apha.14147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/07/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
AIMS As uterine extracellular pH decreases during the ischemic conditions of labor, but its effects on myometrial contraction are largely unknown, there is a need to elucidate its physiological effects and mechanisms of action. Furthermore, it is not known if any of the effects of extracellular acidification are affected by pregnancy, thus we also determined how gestation affects the response to acidification. METHODS Nonpregnant, mid-, and term-pregnant myometrial strips were obtained from humanely killed mice. Contractions were recorded under spontaneous, depolarized, and oxytocin-stimulated conditions. The extracellular pH of the perfusate was changed from 7.4 to 6.9 or 7.9 in HEPES-buffered physiological saline. Intracellular pH was measured using SNARF, and intracellular calcium was measured using Indo-1. Statistical differences were tested using the appropriate t-test. RESULTS Extracellular acidification significantly increased the frequency and amplitude of spontaneous contractions in pregnant, but not nonpregnant, myometrium, whereas alkalinization decreased contractions. Intracellular acidification, via Na-butyrate, transiently increased force in pregnant tissue. Intracellular pH was gradually acidified when extracellular pH was acidified, but extracellular acidification increased contractility before any significant change in intracellular pH. If myometrial force was driven by oxytocin or high-K depolarization, then extracellular pH did not further increase force. Intracellular calcium changes mirrored those of force in the spontaneously contracting pregnant myometrium, and if calcium entry was prevented by nifedipine, extracellular acidification could not induce a rise in force. CONCLUSION Extracellular acidification increases excitability, calcium entry, and thus force in pregnant mouse myometrium, and this may contribute to increasing contractions during labor when ischemic conditions and acidemia occur.
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Affiliation(s)
- Asmaa M Almohanna
- Department of Basic Science, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Karen Noble
- Department of Veterinary Anatomy, Physiology and Pathology Institute of Infection, Veterinary and Ecological Sciences University of Liverpool, Liverpool, UK
| | - Susan Wray
- Department of Women and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Smith SM, Bais B, Ismaili M'hamdi H, Schermer MH, Steegers-Theunissen RP. Stimulating Preconception Care Uptake by Women With a Vulnerable Health Status Through a Mobile Health App ( Pregnant Faster): Pilot Feasibility Study. JMIR Hum Factors 2024; 11:e53614. [PMID: 38648092 DOI: 10.2196/53614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND A low socioeconomic status is associated with a vulnerable health status (VHS) through the accumulation of health-related risk factors, such as poor lifestyle behaviors (eg, inadequate nutrition, chronic stress, and impaired health literacy). For pregnant women, a VHS translates into a high incidence of adverse pregnancy outcomes and therefore pregnancy-related inequity. We hypothesize that stimulating adequate pregnancy preparation, targeting lifestyle behaviors and preconception care (PCC) uptake, can reduce these inequities and improve the pregnancy outcomes of women with a VHS. A nudge is a behavioral intervention aimed at making healthy choices easier and more attractive and may therefore be a feasible way to stimulate engagement in pregnancy preparation and PCC uptake, especially in women with a VHS. To support adequate pregnancy preparation, we designed a mobile health (mHealth) app, Pregnant Faster, that fits the preferences of women with a VHS and uses nudging to encourage PCC consultation visits and engagement in education on healthy lifestyle behaviors. OBJECTIVE This study aimed to test the feasibility of Pregnant Faster by determining usability and user satisfaction, the number of visited PCC consultations, and the course of practical study conduction. METHODS Women aged 18-45 years, with low-to-intermediate educational attainment, who were trying to become pregnant within 12 months were included in this open cohort. Recruitment took place through social media, health care professionals, and distribution of flyers and posters from September 2021 until June 2022. Participants used Pregnant Faster daily for 4 weeks, earning coins by reading blogs on pregnancy preparation, filling out a daily questionnaire on healthy lifestyle choices, and registering for a PCC consultation with a midwife. Earned coins could be spent on rewards, such as fruit, mascara, and baby products. Evaluation took place through the mHealth App Usability Questionnaire (MAUQ), an additional interview or questionnaire, and assessment of overall study conduction. RESULTS Due to limited inclusions, the inclusion criterion "living in a deprived neighborhood" was dropped. This resulted in the inclusion of 47 women, of whom 39 (83%) completed the intervention. In total, 16 (41%) of 39 participants visited a PCC consultation, with their main motivation being obtaining personalized information. The majority of participants agreed with 16 (88.9%) of 18 statements of the MAUQ, indicating high user satisfaction. The mean rating was 7.7 (SD 1.0) out of 10. Points of improvement included recruitment of the target group, simplification of the log-in system, and automation of manual tasks. CONCLUSIONS Nudging women through Pregnant Faster to stimulate pregnancy preparation and PCC uptake has proven feasible, but the inclusion criteria must be revised. A substantial number of PCC consultations were conducted, and this study will therefore be continued with an open cohort of 400 women, aiming to establish the (cost-)effectiveness of an updated version, named Pregnant Faster 2. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/45293.
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Affiliation(s)
- Sharissa M Smith
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Babette Bais
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Hafez Ismaili M'hamdi
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Maartje Hn Schermer
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
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Dema E, Peters H, Gilleece Y, Thorne C. Residential and healthcare mobility during pregnancy among women living with HIV in the UK, 2009-2019. HIV Med 2024. [PMID: 38599574 DOI: 10.1111/hiv.13648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION The extent to which individuals living with HIV experience residential and healthcare mobility during pregnancy in the UK is unknown. We aimed to determine a minimum estimate of residential and healthcare mobility during pregnancy in people living with HIV in the UK in 2009-2019 to explore patterns of and factors associated with mobility and to assess whether mobility was associated with specific HIV outcomes. METHODS We analyzed data from the Integrated Screening Outcomes Surveillance Service to assess pregnancies with HIV in the UK and included livebirths and stillbirths with estimated delivery in 2009-2019. Residential mobility was defined as changing residential postcode between notification and delivery, and healthcare mobility was defined as changing NHS Trust or Strategic Health Authority (SHA) in that same timeframe. We used logistic regression to determine factors associated with residential and healthcare mobility and with detectable delivery viral load. RESULTS Among 10 305 pregnancies, 19.6% experienced residential mobility, 8.1% changed NHS Trust, and 4.5% changed SHA during pregnancy. Mobility was more likely to be experienced by younger women, migrants, and those with new antenatal diagnosis; residential but not healthcare mobility declined over time. In a fully adjusted model, mobility was not associated with having a detectable viral load at delivery. Higher proportions of infants were lost to follow-up after mobile pregnancies than after non-mobile pregnancies. CONCLUSIONS This analysis provides new knowledge on mobility during pregnancy in the context of HIV, but further research is needed to understand its broader impacts and its utility as a marker to help identify families requiring additional follow-up and support.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Helen Peters
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Yvonne Gilleece
- Brighton & Sussex Medical School, Brighton, UK
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Claire Thorne
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Coutinho-Almeida J, Cardoso A, Cruz-Correia R, Pereira-Rodrigues P. Fast Healthcare Interoperability Resources-Based Support System for Predicting Delivery Type: Model Development and Evaluation Study. JMIR Form Res 2024; 8:e54109. [PMID: 38587885 PMCID: PMC11036185 DOI: 10.2196/54109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/04/2024] [Accepted: 02/06/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences. OBJECTIVE This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians' decisions. METHODS This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model's performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals. RESULTS The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries. CONCLUSIONS This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.
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Affiliation(s)
- João Coutinho-Almeida
- Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technologies and Services Research, University of Porto, Porto, Portugal
- Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Ricardo Cruz-Correia
- Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technologies and Services Research, University of Porto, Porto, Portugal
- Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Pereira-Rodrigues
- Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technologies and Services Research, University of Porto, Porto, Portugal
- Health Data Science, Faculty of Medicine, University of Porto, Porto, Portugal
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Onigahara M, Yanazume S, Torisu H, Kobayashi H. Invasive group A streptococcal infection can be fatal to pregnant women in restricted medical resources remote areas-Emergent alert after COVID-19 pandemic. J Obstet Gynaecol Res 2024. [PMID: 38561215 DOI: 10.1111/jog.15934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/15/2024] [Indexed: 04/04/2024]
Abstract
Invasive group A streptococcal (iGAS) infection is a leading cause of maternal death. The increase in the number of patients with iGAS in Japan is markedly greater than before the coronavirus pandemic. We encountered a case of iGAS infection, on a remote island with restricted medical resources, in a third-trimester pregnant woman, resulting in both maternal and fetal death. A 34-year-old woman was admitted via a local general hospital with a high fever. Intrauterine fetal death disseminated intravascular coagulation, and septic shock were confirmed. Broad-spectrum antibiotics were started, and the patient was returned to the local general hospital. Eight hours after arrival, the patient died of circulatory and respiratory dysfunction complications. iGAS infections in remote areas may directly lead to life-threatening conditions and should be treated as an emergency, comparable to the serious conditions of placental abruption or placenta previa.
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Affiliation(s)
| | - Shintaro Yanazume
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | | | - Hiroaki Kobayashi
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Hailu H, Skouteris H, Incollingo Rodriguez AC, Hill B. SWIPE: a conceptual, multi-perspective model for understanding and informing interventions for weight stigma in preconception, pregnancy, and postpartum. Health Psychol Rev 2024:1-17. [PMID: 38560922 DOI: 10.1080/17437199.2024.2333801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
Weight stigma is salient across the preconception, pregnancy, and postpartum (PPP) periods because of prevailing prescriptive norms and expectations about weight and weight gain during the reproductive period. Weight stigma is associated with negative physical and psychological health outcomes for mother and child. A clearly defined, multi-level conceptual model for interventions, research, and policy is critical to mitigating the adverse effects of weight stigma in PPP populations. Conceptual models of weight stigma towards PPP women have advanced our understanding of this issue and guided evidence accumulation but there remains a gap in informing the translation of evidence into action. Guided by evidence-based paradigms for conceptual model development, this paper has two primary objectives. First, we review and summarise theories, frameworks, and models from the PPP population and general literature to inform our understanding of the development and perpetuation of weight stigma for PPP women. Second, we propose a novel comprehensive intervention-guiding conceptual model that draws from and synthesises across multiple disciplines - the SWIPE (Stigma of Weight In the PPP Experience) model. This conceptual model will help to plan coordinated, multi-layered, and effective strategies to reduce and ultimately eliminate weight stigma for PPP women.
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Affiliation(s)
- Haimanot Hailu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Helen Skouteris
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Warwick Business School, The University of Warwick, Coventry, UK
| | - Angela C Incollingo Rodriguez
- Psychological & Cognitive Sciences, Department of Social Science & Policy Studies, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Briony Hill
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Koerner R, Rechenberg K, Rinaldi K, Duffy A. Are Providers Adequately Screening for Anxiety Symptoms During Pregnancy? Nurs Womens Health 2024; 28:109-116. [PMID: 38278513 DOI: 10.1016/j.nwh.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/19/2023] [Accepted: 12/06/2023] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To examine the difference in prevalence of self-reported anxiety symptoms throughout pregnancy compared to clinical diagnosis of an anxiety disorder by a provider. DESIGN Secondary data analysis of a prospective cohort study of 50 pregnant individuals. SETTING/LOCAL PROBLEM Pregnant individuals commonly experience heightened anxiety symptoms, which are associated with adverse perinatal outcomes. However, a diagnosis of an anxiety disorder by a health care provider is less common, which may result in insufficient mental health intervention. PARTICIPANTS Pregnant individuals were recruited at their first prenatal appointment and followed until birth. INTERVENTION/MEASUREMENTS We examined anxiety symptoms using the Edinburgh Postnatal Depression Scale Anxiety subscale. We conducted a medical record review to examine if pregnant individuals were clinically diagnosed with an anxiety disorder. RESULTS Based on an Edinburgh Postnatal Depression Scale Anxiety subscale cutoff score of ≥5, 40% (n = 20) of individuals experienced anxiety symptoms during pregnancy. However, only 16% (n = 8) of participants were diagnosed with an anxiety disorder by a health care provider. CONCLUSION Anxiety symptoms are prevalent throughout pregnancy and may be underdiagnosed by health care providers. An intervention to increase clinical diagnosis of an anxiety disorder and subsequent referral to a mental health specialist may be indicated.
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Patel A, Puglisi JL, Patel S, Tarn DM. COVID-19 Vaccine Acceptance in Pregnant Women in the United States: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2024; 33:453-466. [PMID: 38112561 DOI: 10.1089/jwh.2023.0498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.
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Affiliation(s)
- Amy Patel
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Jose L Puglisi
- Department of Basic Science, College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Seeta Patel
- College of Letters and Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Derjung M Tarn
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Taha AB. Bacteriological profile, antimicrobial susceptibility, and factors associated with urinary tract infection in pregnant women. J Infect Dev Ctries 2024; 18:391-398. [PMID: 38635608 DOI: 10.3855/jidc.18239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 09/14/2023] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Urinary tract infection (UTI) is a common bacterial complication in pregnancy. The study aimed to estimate the prevalence, risk factors, and bacterial etiology of UTI during pregnancy and determine the efficacy of antimicrobial drugs in treating UTIs. METHODOLOGY Urine specimens and clinical data were collected from pregnant women who attended primary health centers in Erbil, Iraq. All specimens were cultured on appropriate media and identified by standard microbiological methods. The pregnant women were grouped into symptomatic UTI group, asymptomatic bacteriuria group, and the control group. The agar dilution method was used to determine antimicrobial susceptibility. RESULTS Among the 5,042 pregnant women included in this study, significant bacteriuria was found in 625 (12.40%) of the cases, and 198 (31.68%) had symptomatic UTI, of which 43.59% were diagnosed during the third trimester. Out of the 643 bacteria isolated, 33.28% were symptomatic UTI, of which 43.59% developed during the third trimester. There was a significant difference in the bacterial etiology between symptomatic UTI and asymptomatic bacteriuria (p = 0.002), as well as between cystitis and pyelonephritis (p = 0.017). The most common bacterial species isolated was Escherichia coli, which was susceptible to fosfomycin (100%), meropenem (99.45%), and nitrofurantoin (97.8%). CONCLUSIONS Pregnant women are more likely to develop UTI in the third trimester. Escherichia coli is the predominant pathogen. The study suggests the use of fosfomycin, meropenem, and nitrofurantoin for the treatment of UTI. No Gram-positive isolates were resistant to daptomycin.
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Affiliation(s)
- Aza B Taha
- Medical Research Center, Hawler Medical University, Erbil, Kurdistan Region, Iraq
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13
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Epstein CM, Lustermans H, McCoy TP, Beijers R, Leerkes EM, de Weerth C. Implications of childhood adversity for women's perinatal sleep quality and depressive symptoms over time: A serial mediation model. J Sleep Res 2024:e14201. [PMID: 38531641 DOI: 10.1111/jsr.14201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
This study sought to examine the effects of childhood adversity on the longitudinal associations between perinatal sleep quality and depressive symptoms, and to determine the prospective associations between these constructs over time. A cross-lagged autoregressive model was used to examine the longitudinal association between sleep quality and depressive symptoms at four points during the perinatal period: 18 and 32 weeks of pregnancy, and 6 and 12 weeks postpartum. Longitudinal mediation models were used to examine whether sleep quality or depressive symptoms mediated the effects of childhood adversity on these symptoms. Most participants (86%) reported poor sleep quality during pregnancy. Significant cross-lagged effects of depressive symptoms on subsequent sleep quality were observed during pregnancy and postpartum. Depressive symptoms significantly mediated the effects of childhood trauma on sleep quality during pregnancy, but sleep quality did not significantly mediate the effects of childhood trauma on depressive symptoms. While sleep quality and depressive symptoms tend to co-occur, our analyses indicate that perinatal depressive symptoms work as the primary driver of sleep quality over time. Childhood adversity may have long-reaching effects in women as it was associated with more depressive symptoms in the perinatal period, which in turn appeared to undermine sleep quality.
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Affiliation(s)
- Crystal Modde Epstein
- School of Nursing, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Hellen Lustermans
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas P McCoy
- School of Nursing, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Roseriet Beijers
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Esther M Leerkes
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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14
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Peled T, Sela HY, Weiss A, Grisaru-Granovsky S, Agrawal S, Rottenstreich M. Evaluating the validity of ChatGPT responses on common obstetric issues: Potential clinical applications and implications. Int J Gynaecol Obstet 2024. [PMID: 38523565 DOI: 10.1002/ijgo.15501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To evaluate the quality of ChatGPT responses to common issues in obstetrics and assess its ability to provide reliable responses to pregnant individuals. The study aimed to examine the responses based on expert opinions using predetermined criteria, including "accuracy," "completeness," and "safety." METHODS We curated 15 common and potentially clinically significant questions that pregnant women are asking. Two native English-speaking women were asked to reframe the questions in their own words, and we employed the ChatGPT language model to generate responses to the questions. To evaluate the accuracy, completeness, and safety of the ChatGPT's generated responses, we developed a questionnaire with a scale of 1 to 5 that obstetrics and gynecology experts from different countries were invited to rate accordingly. The ratings were analyzed to evaluate the average level of agreement and percentage of positive ratings (≥4) for each criterion. RESULTS Of the 42 experts invited, 20 responded to the questionnaire. The combined score for all responses yielded a mean rating of 4, with 75% of responses receiving a positive rating (≥4). While examining specific criteria, the ChatGPT responses were better for the accuracy criterion, with a mean rating of 4.2 and 80% of the questions received a positive rating. The responses scored less for the completeness criterion, with a mean rating of 3.8 and 46.7% of questions received a positive rating. For safety, the mean rating was 3.9 and 53.3% of questions received a positive rating. There was no response with an average negative rating below three. CONCLUSION This study demonstrates promising results regarding potential use of ChatGPT's in providing accurate responses to obstetric clinical questions posed by pregnant women. However, it is crucial to exercise caution when addressing inquiries concerning the safety of the fetus or the mother.
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Affiliation(s)
- Tzuria Peled
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Hen Y Sela
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Ari Weiss
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Swati Agrawal
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel
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15
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Azab RY, Binyaseen JA, Almuwallad AS, Alomiri SS, Faden NM, Ramadan MM, Aldosary T. Treatment Perception and Utilization of Dental Care During Pregnancy Among Women Visiting Antenatal Clinics in King Abdulaziz Medical City & Primary Healthcare, National Guard, Jeddah, Saudi Arabia. Cureus 2024; 16:e56900. [PMID: 38659538 PMCID: PMC11042758 DOI: 10.7759/cureus.56900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Objectives To identify how readily accessible dental care is to a sample of pregnant women in King Abdulaziz Medical City (KAMC), Jeddah, and to determine any potential obstacles to receiving dental care while pregnant. Methodology Female patients visiting antenatal clinics in KAMC in Jeddah, Saudi Arabia were the target group for this cross-sectional study. The age range was limited to childbearing age (18-48 years old). Both pregnant and non-pregnant women were established in obstetrics and gynecology clinics. The pattern of dental service use and attitude toward dental treatment during pregnancy were assessed using a self-administered questionnaire. Other data were gathered, such as demographics, education, employment status, and the number of live births. Results This study included 361 participants in the survey with an 80% response rate. A large proportion of participants was in the age group of 19 to 35 years old (75.07%; p-value < 0.0001), holding undergraduate degrees (58.17%; p-value < 0.0001), housewives (77.56%; p-value < 0.0001), married (99.45%; p-value < 0.0001), non-pregnant women (75.07%; p-value < 0.0001), and have three or more children (42.94%; p-value < 0.0001). About two-thirds of the participants reported using private hospitals for their dental services (65.37%; p-value < 0.0001), while 22.03% (p-value < 0.0001) of the participants reported visiting a dentist in the last six months and 7.2% (p-value < 0.0001) visited a dentist during pregnancy. In terms of awareness questions, 72.02% (p-value < 0.0001) reported that if the mother did not eat well, the baby takes calcium from the mother's teeth, 43.77% (p-value < 0.0001) reported brushing teeth at least three times a day, and 42.94% (p-value < 0.0001) of women reported that they do not have an idea about what they need to do if a pregnant woman needs treatment that requires taking X-rays. Similar patterns were observed in other awareness answers. Conclusion Based on the study's findings, there is a significantly low rate of dental care utilization in the sample of pregnant women. We conclude that educated women are more likely to maintain good oral hygiene and are more satisfied with their oral health. However, a large proportion of participants reported dental problems during their pregnancy. In general, a lack of knowledge about the safety of dental care during pregnancy is the main obstacle to seeking dental care. Limitations The selected sample was from antenatal clinics in KAMC & Primary Healthcare, National Guard, Jeddah, Saudi Arabia. As a result, the findings of this study cannot be applied to the total female population of Jeddah, Saudi Arabia. Because the information was self-reported, which is a common issue with self-administered questionnaires, and because participation in the study was voluntary and participant confidentiality was maintained, there is a low chance that the data may be subject to recall or response bias.
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Affiliation(s)
| | | | | | | | - Neda M Faden
- Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | - Taghreed Aldosary
- Medical Sciences-Oral Biology, Ministry of National Guard - Health Affairs, King Abdulaziz Medical City, Jeddah, SAU
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16
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Hidayati E, Rauf S, Hatta M, Lisal ST, Wibisono JJ, Syamsuddin S, Chalid MT, Saleh A, Zainuddin AA, Hamidah H, Fatimah F, Hapsah H, Permatasari TAE, Lusida N. Interactive pregnancy education on stress, cortisol, and epinephrine level in primigravida of trimester III pregnant: a quasi-experimental. Ann Med Surg (Lond) 2024; 86:1386-1395. [PMID: 38463051 PMCID: PMC10923341 DOI: 10.1097/ms9.0000000000001666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/19/2023] [Indexed: 03/12/2024] Open
Abstract
Infant mortality is caused by various health problems, especially since the gestation period, even starting before the gestation period. Stress during pregnancy affects the motor, cognitive, and emotional development of the baby. This study aims to determine the effect of interactive pregnancy education (IPE) on decreasing levels of cortisol, epinephrine, and its relationship with stress levels in third-trimester primigravida pregnant women. This research is a quasi-experimental study using a nonequivalent control group design, which has two groups, namely the experimental group and the control group. The authors compared the experimental group that was given the intervention with the control group that was not given any treatment. This research was conducted in the three Community Health Centers in Indonesia from June 2022 until December 2022. The samples were 30 third-trimester primigravida pregnant women for the intervention and control groups. Data were analyzed using the Mann-Whitney and Wilcoxon tests with SPSS 22 software. The results of this study indicate that IPE has a good impact on pregnant women, where there is a significant relationship in the post-test cortisol and epinephrine levels in the intervention group. This indicates that IPE contributed to the difference in post-test scores in the intervention group. The IPE method is effective in reducing stress levels and cortisol levels in pregnant women, especially in pregnant women with high levels of stress.
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Affiliation(s)
- Elli Hidayati
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta
| | - Syahrul Rauf
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Mochammad Hatta
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | - Sonny T. Lisal
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | | | | | | | - Ariyanti Saleh
- Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
| | | | - Hamidah Hamidah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta
| | - Fatimah Fatimah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta
| | - Hapsah Hapsah
- Faculty of Nursing, Universitas Hasanuddin, Makassar
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17
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Inness BE, McCabe RE, Streiner DL, Barrett E, Green SM. The Worry Behaviors Inventory-Perinatal Revised: Adaptation and Initial Validation for Use in Perinatal Samples. Assessment 2024; 31:350-362. [PMID: 37005700 PMCID: PMC10822066 DOI: 10.1177/10731911231165071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Generalized anxiety disorder (GAD) is a leading mental health concern during pregnancy and the postpartum (perinatal) period. People with GAD engage in problematic behaviors to manage their distress. However, the extent of GAD behaviors during the perinatal period may not be adequately captured by the Worry Behaviors Inventory (WBI), the most comprehensive measure of GAD behaviors to date. We evaluated the structure of the initial WBI item-pool and then evaluated the internal consistency, construct validity, and predictive utility of the Perinatal Revised WBI (WBI-PR) in a sample of 214 perinatal women with and without GAD. A two-factor, 10-item scale was supported, and some of the retained items differed from the original WBI. Internal consistency of the WBI-PR was acceptable, and evidence of construct validity was demonstrated. The WBI-PR predicted GAD diagnostic status both alone and beyond existing generalized anxiety and depression symptoms. Implications of these findings are discussed.
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Affiliation(s)
| | - Randi E. McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | | | - Sheryl M. Green
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
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18
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Sutter C, Freundlich RE, Raymond BL, Osmundson S, Morton C, McIlroy DR, Shotwell M, Feng X, Bauchat JR. Effectiveness of Oral Iron Therapy in Anemic Inpatient Pregnant Women: A Single Center Retrospective Cohort Study. Cureus 2024; 16:e56879. [PMID: 38659546 PMCID: PMC11041524 DOI: 10.7759/cureus.56879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Background and aim Oral iron therapy is effective in treating iron deficiency anemia in outpatient pregnant women but has not been studied in inpatient pregnant women. We aimed to evaluate the effect of oral iron therapy versus no therapy during hospitalization on maternal and neonatal outcomes in women with anemia who are hospitalized for pregnancy-related morbidities (i.e., preterm premature rupture of membranes, preterm labor, pre-eclampsia, abnormal placentation, or fetal monitoring). Methods A retrospective, single-center study was conducted in hospitalized pregnant women (2018 to 2020) with inpatient stays of more than three days. The primary outcome was a change in hemoglobin level from admission to delivery in women treated with oral iron compared with those left untreated. Secondary outcomes included the total amount of iron administered before delivery, the time interval from admission to delivery, and neonatal effects. Results Two hundred sixty-three women were admitted, 79 women had anemia, and 29 (36.7%) received at least one dose of oral iron. Baseline patient characteristics were similar between groups. The median (interquartile range) dose of iron in the oral iron group was 1185.0 (477.0, 1874.0) mg. Neither absolute hemoglobin before delivery (control group: 10.0±1.2 g/dL; iron group: 10.1±1.1 g/dL; p=0.774) nor change in hemoglobin from admission to delivery (control group: -0.1±1.1 g/dL vs. iron group: 0.4±1.1 g/dL; p=0.232) differed between groups. Women in the control group had shorter length of stay (LOS) median (IQR) than women in the iron group (control group: 7.1 (5.0, 13.7) days; iron group: 11.4 (7.4, 25.9) days; p=0.03). There were no differences in maternal mode of delivery, though each group had high rates of cesarean delivery (control group: 53.7%; iron group: 72.4%; p=0.181). There were no differences in estimated blood loss at delivery (control group: 559±401; iron group: 662.1±337.4;p=0.264) in either group. Neonatal birthweight (control group: 1.9±0.7 kg; iron group: 1.9±0.7 kg; p=0.901), birth hemoglobin (control group: 16.3±2.2 g/dL; iron group: 16±2.2 g/dL; p=0.569), neonatal intensive care unit (NICU) admission (control group: 93.3%; iron group: 84.8%;p=0.272 ), or neonatal death (control group: 8.9%; iron group: 3%; p=0.394) were not different between groups. Conclusions Oral iron administered to anemic inpatient pregnant women was not associated with higher hemoglobin concentrations before delivery. Lack of standardized iron regimens and short hospital stays may contribute to the inefficacy of oral iron for this inpatient pregnant population. The small sample size and retrospective nature of this study are limiting factors in drawing conclusive evidence from this study.
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Affiliation(s)
- Claire Sutter
- Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
| | | | - Britany L Raymond
- Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
| | - Sarah Osmundson
- Maternal Fetal Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Colleen Morton
- Hematology, Vanderbilt University Medical Center, Nashville, USA
| | - David R McIlroy
- Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
| | - Matthew Shotwell
- Biostatistics, Vanderbilt University Medical Center, Nashville, USA
| | - Xiaoke Feng
- Biostatistics, Vanderbilt University Medical Center, Nashville, USA
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Benyian FF. Evaluation of pregnant women's knowledge and attitude toward physical exercise during pregnancy at maternity hospitals. J Educ Health Promot 2024; 13:79. [PMID: 38559481 PMCID: PMC10979779 DOI: 10.4103/jehp.jehp_982_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND There are major health benefits to physical exercise during pregnancy for mothers and newborns. However, physical inactivity during pregnancy varies worldwide, but it is more common during the third trimester of pregnancy. A positive attitude toward antenatal exercise can reduce physical inactivity. OBJECTIVES This study aimed to evaluate pregnant women's knowledge and attitude toward physical exercise during pregnancy and to find out the relationship between pregnant women's knowledge and attitude. METHODS This is a descriptive study utilizing a non-probability purposive sample of 200 women. The data were collected by distributing a structured, self-administered questionnaire. The questionnaire comprised 37 questions for knowledge and 15 questions for attitude. This study was conducted from October 2021 to November 2022. RESULTS The higher percentage of women's age was 20-24 years, and 30% graduated from primary school. Nearly two-thirds of them were in the second trimester. More than one-third of them have two to three living children. Nearly two-thirds of women have poor knowledge levels about physical exercise during pregnancy, but most of them have a positive attitude. There is a significant relationship between pregnant women's knowledge and attitude. CONCLUSION This study indicated that most of the study sample had poor knowledge regarding physical exercise during pregnancy. However, they have a positive attitude toward physical exercise during pregnancy.
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Affiliation(s)
- Fatima F. Benyian
- Maternal and Neonate Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq
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20
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Yalniz Dilcen H, Çakır Koçak Y, Ada G, Demir Bozkurt F, Dülger H. Determinants of Psychosocial Health Status in Pregnant and Postpartum Women Experiencing Earthquake in Turkey. Disaster Med Public Health Prep 2024; 18:e16. [PMID: 38304943 DOI: 10.1017/dmp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye. METHODS Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaraş region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder-Short Scale. RESULTS A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression. CONCLUSIONS It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.
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Affiliation(s)
- Hacer Yalniz Dilcen
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Yeliz Çakır Koçak
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Güleser Ada
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Feyza Demir Bozkurt
- Department of Nursing, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Hanifi Dülger
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
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21
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Kopačin V, Brkić H, Ivković A, Kasabašić M, Knežević Ž, Majer M, Nodilo M, Turk T, Faj D. Development and validation of the low-cost pregnant female physical phantom for fetal dosimetry in MV photon radiotherapy. J Appl Clin Med Phys 2024; 25:e14240. [PMID: 38150580 PMCID: PMC10860449 DOI: 10.1002/acm2.14240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Monte Carlo (MC) simulations or measurements in anthropomorphic phantoms are recommended for estimating fetal dose in pregnant patients in radiotherapy. Among the many existing phantoms, there is no commercially available physical phantom representing the entire pregnant woman. PURPOSE In this study, the development of a low-cost, physical pregnant female phantom was demonstrated using commercially available materials. This phantom is based on the previously published computational phantom. METHODS Three tissue substitution materials (soft tissue, lung and bone tissue substitution) were developed. To verify Tena's substitution tissue materials, their radiation properties were assessed and compared to ICRP and ICRU materials using MC simulations in MV radiotherapy beams. Validation of the physical phantom was performed by comparing fetal doses obtained by measurements in the phantom with fetal doses obtained by MC simulations in computational phantom, during an MV photon breast radiotherapy treatment. RESULTS Materials used for building Tena phantom are matched to ICRU materials using physical density, radiation absorption properties and effective atomic number. MC simulations showed that percentage depth doses of Tena and ICRU material comply within 5% for soft and lung tissue, up to 25 cm depth. In the bone tissue, the discrepancy is higher, but again within 5% up to the depth of 5 cm. When the phantom was used for fetal dose measurements in MV photon breast radiotherapy, measured fetal doses complied with fetal doses calculated using MC simulation within 15%. CONCLUSIONS Physical anthropomorphic phantom of pregnant patient can be manufactured using commercial materials and with low expenses. The files needed for 3D printing are now freely available. This enables further studies and comparison of numerical and physical experiments in diagnostic radiology or radiotherapy.
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Affiliation(s)
- Vjekoslav Kopačin
- Faculty of MedicineDepartment of RadiologyJ. J. Strossmayer University Osijek, University Hospital Center OsijekDepartment of Diagnostic and Interventional RadiologyOsijekCroatia
| | - Hrvoje Brkić
- Faculty of MedicineDepartment of Biophysics and Medical PhysicsJ. J. Strossmayer University OsijekOsijekCroatia
- Faculty of Dental Medicine and HealthDepartment of BiophysicsBiology and ChemistryJ. J. Strossmayer University OsijekOsijekCroatia
| | - Ana Ivković
- Faculty of MedicineDepartment of Biophysics and Medical PhysicsJ. J. Strossmayer University Osijek, University Hospital Center OsijekDepartment of Medical PhysicsOsijekCroatia
| | - Mladen Kasabašić
- Faculty of MedicineDepartment of Biophysics and Medical PhysicsJ. J. Strossmayer University Osijek, University Hospital Center OsijekDepartment of Medical PhysicsOsijekCroatia
| | - Željka Knežević
- Division of Materials ChemistryRuđer Bošković InstituteZagrebCroatia
| | - Marija Majer
- Division of Materials ChemistryRuđer Bošković InstituteZagrebCroatia
| | - Marijana Nodilo
- Division of Materials ChemistryRuđer Bošković InstituteZagrebCroatia
| | - Tajana Turk
- Faculty of MedicineDepartment of RadiologyJ. J. Strossmayer University Osijek, University Hospital Center OsijekDepartment of Diagnostic and Interventional RadiologyOsijekCroatia
| | - Dario Faj
- Faculty of MedicineDepartment of Biophysics and Medical PhysicsJ. J. Strossmayer University OsijekOsijekCroatia
- Faculty of Dental Medicine and HealthDepartment of BiophysicsBiology and ChemistryJ. J. Strossmayer University OsijekOsijekCroatia
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22
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Wang J, Deng Y, Wang W. COVID-19 vaccination during pregnancy and adverse perinatal outcomes: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2024:trad093. [PMID: 38291854 DOI: 10.1093/trstmh/trad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/05/2023] [Accepted: 12/17/2023] [Indexed: 02/01/2024] Open
Abstract
We aimed to estimate the associations between coronavirus disease 2019 (COVID-19) vaccination during pregnancy and the risks of adverse perinatal outcomes. We performed a literature search in PubMed, Web of Science and Embase to identify eligible studies published up to 24 September 2023, yielding 39 included studies. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random effects model. The pooled results showed that COVID-19 vaccination during pregnancy (any type or dose of COVID-19 vaccination during any trimester) was not associated with an increased risk of adverse perinatal outcomes. In particular, COVID-19 vaccination in the third trimester was associated with a decreased risk of preterm birth (<37 weeks) (RR 0.85 [95% CI 0.74 to 0.98]), 5-min Apgar <7 (RR 0.87 [95% CI 0.78 to 0.97]) and neonatal intensive care unit (NICU) admission (RR 0.90 [95% CI 0.86 to 0.95]). The inverse associations were also found in analysis of one-dose vaccination during pregnancy and the risk of miscarriage (RR 0.83 [95% CI 0.72 to 0.96]) and preterm birth (<37 weeks) (RR 0.90 [95% CI 0.80 to 1.00]) and two-dose vaccination during pregnancy and the risk of NICU admission (RR 0.86 [95% CI 0.76 to 0.96]). COVID-19 vaccination during pregnancy does not increase the risk of negative outcomes for the mother or baby.
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Affiliation(s)
- Jia Wang
- Public Health Department, Weihai Maternal and Child Health Hospital, Affiliated Weihai Second Municipal Hospital of Qingdao University, Weihai, Shandong, China
| | - Yuzhi Deng
- Public Health Department, Weihai Maternal and Child Health Hospital, Affiliated Weihai Second Municipal Hospital of Qingdao University, Weihai, Shandong, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, Qingdao, Shandong, China
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Barba M, Toquet M, García-Roselló E, Gomis J, Quereda JJ, González-Torres P, Carbonetto B, Gómez-Martín Á. Description of the vaginal microbiota in nulliparous ewes during natural mating and pregnancy: preliminary signs of the male preputial microbiota modulation. Front Microbiol 2024; 14:1224910. [PMID: 38274751 PMCID: PMC10808482 DOI: 10.3389/fmicb.2023.1224910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
The vaginal microbiota plays a key role in animals' health. Understanding its diversity and composition and associated changes occurring through the reproductive cycle represents valuable knowledge to disclose the mechanisms leading to dysbiosis and eventually to infection. Even if the human vaginal microbiota has been thoroughly studied, scarce research has been conducted on the vaginal microbiota of livestock. In this study, 16S rRNA gene-based sequencing was performed on vaginal samples of ten nulliparous ewes at three different sampling points: before the estrus synchronization protocol (T0), at the time of estrus before mating (Testrus), and the day of the pregnancy diagnosis (Tpreg). Preputial samples from the three males collected pre and post-mating were also analyzed. Firmicutes, Proteobacteria, Bacteroidetes, and Actinobacteria were the most abundant phyla in vaginal samples. The most abundant genera were Porphyromonas, Anaerococcus, and Peptinophilius. Vaginal microbiota biodiversity decreased during pregnancy. Tenericutes (Ureaplasma spp.) increased significantly at Tpreg in both pregnant and non-pregnant ewes. Differences were observed between pregnant and non-pregnant ewes at Tpreg where pregnant ewes had a significantly higher abundance of Actinobacillus spp. and Ureaplasma spp. Ewes that were diagnosed with pregnancy at Tpreg showed a decreased abundance of gram-negative bacteria such as Bacteroidales, Campylobacterales, and Enterobacteriales. In addition, a significant decrease in the relative abundances of genera within Firmicutes, such as Alloicoccus (Lactobacillales), Atopostipes (Lactobacillales), and an uncultured bacteria W5053 from Family XI (Firmicutes, Clostridiales) was observed in non-pregnant ewes at Tpreg. The four most abundant phyla in the rams' prepuce were the same as in the ewes' vagina. The most abundant genus was Corynebacterium. No major differences were observed in the ram's preputial microbiota between pre and post-mating samples. Nevertheless, the differences in the taxonomic composition of ewes' vaginal microbiota between Testrus and Tpreg could be explained by the exposure to the preputial microbiota. This study offers new insights into the effects of several key steps of the ewe's reproductive cycle such as estrus-synchronization protocol, mating, and pregnancy on ovine vaginal microbiota. The knowledge of the microbiota dynamics during the reproductive cycle can help improve the reproductive outcomes of dams by identifying biomarkers and putative probiotics.
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Affiliation(s)
- Marta Barba
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
- Agrifood Research and Technology Centre of Aragon (CITA), Teruel, Spain
| | - Marion Toquet
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
| | - Empar García-Roselló
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
| | - Jesús Gomis
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
| | - Juan J. Quereda
- Research Group Intracellular Pathogens: Biology and Infection, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Pedro González-Torres
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
- Microomics Systems S.L., Barcelona, Spain
| | - Belén Carbonetto
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
- Microomics Systems S.L., Barcelona, Spain
| | - Ángel Gómez-Martín
- Microbiological Agents Associated with Animal Reproduction (ProVaginBIO) Research Group, Departamento Producción y Sanidad Animal, Salud Pública Veterinaria y Ciencia y Tecnología de los Alimentos, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Carrer Tirant lo Blanc, Alfara del Patriarca, Valencia, Spain
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24
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Talebi AS, Bodaghi R, Bagherzadeh S. Lifetime attributable risks (LARs) of cancer in the fetus associated with maternal radiography examinations. Int J Radiat Biol 2024; 100:420-426. [PMID: 38193807 DOI: 10.1080/09553002.2023.2295294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE For various reasons, pregnant women are occasionally exposed to ionizing radiation during radiology examinations. In these situations, it is essential to determine the radiation dose to the fetus and any associated risks. The present study attempts to calculate the mean dose for the fetus to estimate the possible cancer induction and cancer mortality risks resulting from maternal radiography exams. MATERIAL AND METHODS The GATE Monte Carlo platform and a standard voxelized pregnant phantom were employed to calculate fetal radiation dose during maternal radiography exams. The data published in Biological Effects of Ionizing Radiation VII were used to convert fetal dose to lifetime attributable risks (LARs) of cancer incidence and cancer-related mortality. RESULTS The fetal doses and LARs of cancer incidence and cancer-related mortality for the radiographs of the chest and skull were negligible. The maximum LAR values for the lateral view of the abdomen in computed and digital radiography are 5598.29 and 2238.95 per 100,000 individuals, respectively. The computed radiography of the lateral view of the abdomen revealed the highest LAR of cancer-related mortality (2074.30 deaths for every 100,000 people). CONCLUSION The radiation dose incurred by the fetus due to chest and skull radiographs was minimal and unlikely to cause any abnormalities in the fetus. The discernible elevation in the lifetime attributable risk associated with cancer incidence and mortality arising from lateral computed radiography examinations of the abdomen warrants careful consideration within the realm of maternal radiography examinations.
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Affiliation(s)
- Asra Sadat Talebi
- Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
| | - Roghiyeh Bodaghi
- Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
| | - Saeed Bagherzadeh
- Department of Medical Physics, Tarbiat Modares University, Tehran, Iran
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25
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Tian ML, Ma GJ, Du LY, Xiao YG, Zhang YK, Tang ZJ. Prevalence and adverse perinatal outcomes of anaemia in the third trimester of pregnancy in Hebei Province, China. Int Health 2024; 16:91-96. [PMID: 37093789 PMCID: PMC10759283 DOI: 10.1093/inthealth/ihad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/10/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Anaemia in pregnancy is one of the most frequent complications related to pregnancy and is a public health concern. This article examines the prevalence of anaemia in the third trimester of pregnancy and the associations between anaemia and adverse perinatal outcomes in Hebei Province, China. METHODS We used SPSS software to describe the incidence of anaemia in the third trimester of pregnancy in Hebei Province and analysed the clinical characteristics in anaemic patients and the relationship between anaemia and adverse pregnancy outcomes. RESULTS The overall prevalence of anaemia in the third trimester of pregnancy was 35.0% in Hebei Province. The prevalence of anaemia in the population with a high education level was lower than that in the population with a low education level. The incidence rate in rural areas was higher than that in urban areas. After adjustment for confounding factors, anaemia in the third trimester of pregnancy is an independent risk factor in terms of placenta previa, placental abruption, uterine atony, pre-eclampsia, gestational diabetes mellitus, heart disease, postpartum haemorrhage, premature birth, laceration of birth canal, puerperal infection, caesarean section and large for gestational age. CONCLUSIONS The prevalence of anaemia in the third trimester of pregnancy is associated with an increased risk of adverse perinatal outcomes. A comprehensive approach to prevent anaemia is needed to improve maternal and child health outcomes.
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Affiliation(s)
- Mei-Ling Tian
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Guo-Juan Ma
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Li-Yan Du
- Department of Information Management, Hebei Center for Women and Children's Health, Shijiazhuang, China
| | - Yuan-Ge Xiao
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Ying-kui Zhang
- Department of Information Management, Hebei Center for Women and Children's Health, Shijiazhuang, China
| | - Zeng-Jun Tang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
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26
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Uludağ E, Serçekuş P, Yıldırım Gökşen DF, Alataş SE, Özkan S. Is decision-making based on the internet during pregnancy a predictive factor for vaccine hesitancy in pregnant women during the pandemic? Women Health 2024; 64:5-13. [PMID: 37933189 DOI: 10.1080/03630242.2023.2277879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
Pregnant women frequently use the Internet to get information, and the information they receive is effective in their decision-making. It is known that pregnant women get information about COVID-19 vaccines from the Internet. This study aims to determine whether decision-making based on Internet sources during pregnancy is a predictive factor for vaccine hesitancy in pregnant women during the pandemic. A descriptive, cross-sectional research design was used. The data were collected by using an online survey instrument. There was a positive, moderate, and significant relationship between the self-efficacy perception sub-dimension of the internet decision-making during pregnancy scale and the risk sub-dimension of the vaccine hesitancy in pandemics scale (r: .584, p < .05) and between the self-control sub-dimension of the internet decision-making during pregnancy scale and the risk sub-dimension of the vaccine hesitancy in pandemics scale (r: .546, p < .05). The perception of self-control (β: .291) affected the lack of confidence, and the perception of self-efficacy (β: .481) affected the risk perception more than other variables. There was a relationship between internet decision-making and COVID-19 vaccine hesitancy in pregnant women. Health professionals, information specialists, and librarians should orient people to reliable sources about vaccines.
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Affiliation(s)
- Elif Uludağ
- Faculty of Health Sciences, Pamukkale University, Denizli, Türkiye
| | - Pınar Serçekuş
- Faculty of Health Sciences, Pamukkale University, Denizli, Türkiye
| | | | | | - Sevgi Özkan
- Faculty of Health Sciences, Pamukkale University, Denizli, Türkiye
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27
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Nonaka M, Inomata S. Management of Labor and Anesthesia in a Patient With a History of Spontaneous Intracranial Hypotension: A Case Report With Literature Review. Cureus 2024; 16:e52254. [PMID: 38352098 PMCID: PMC10863527 DOI: 10.7759/cureus.52254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/16/2024] Open
Abstract
Spontaneous intracranial hypotension (SIH) is a rare disorder characterized by continuous or intermittent cerebrospinal fluid (CSF) leakage from the CSF cavity, which causes symptoms such as headache or neck pain upon standing. However, no well-established measures concerning the type of delivery and anesthesia for pregnant women with a history of SIH have been reported. A woman had developed SIH 9 years earlier from lifting luggage into an overhead bin with stretching movements, which required continuous saline epidural infusion for recovery. Upon the patient's pregnancy at the age of 35 years, although an elective cesarean section (CS) under general anesthesia was planned to avoid SIH recurrence, the patient had an emergency CS at 36 weeks. Since there is no prescribed method of delivery and anesthetic management for patients with a history of SIH, it is important to plan and adapt a treatment strategy based on the patient's wishes and the institution's protocols. As a sidenote, we reviewed the available literature regarding the type of delivery and anesthesia for pregnant women with a history of SIH.
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Affiliation(s)
- Mayuko Nonaka
- Department of Anesthesiology, University of Tsukuba Hospital, Tsukuba, JPN
| | - Shinichi Inomata
- Department of Anesthesiology, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, JPN
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Alzahrani SA, Bekhet GM, Ammar RB, Abdallah BM, Ali EM, Al-Ramadan SY, Althumairy D, Rajendran P. The Inhibitory Effect of Geraniol on CCL4-induced Hepatorenal Toxicity in Pregnant Mice through the PI3K/AKT Signaling Pathway. Saudi J Med Med Sci 2024; 12:17-26. [PMID: 38362098 PMCID: PMC10866391 DOI: 10.4103/sjmms.sjmms_225_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/21/2023] [Accepted: 10/08/2023] [Indexed: 02/17/2024]
Abstract
Background Hepatotoxicity caused by CCL4 is well known. Geraniol (GNL) has high antioxidant effect that can induces liver regeneration. However, the protective effect of GNL effect on CCL4-induced hepatorenal toxicity in pregnant mice has not yet been studied. Objective To investigate whether GNL could protect against oxidative stress induced by CCL4 via the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway, which is regulated by phosphatidylinositol 3 kinase/protein kinase B (PI3K/AKT), and has been found to have protective effects on renal and hepatic tissues. Materials and Methods Forty-eight female albino mice weighing 25-30 g were randomly allocated to 4 groups: Group I served as a control; Group II received a toxicity-inducing single dose of 15 μL of CCL4 on the 4th day after mating; Group III received 40 mg/kg GNL + CCL4 (with GNL from the 1st day of assimilation to delivery); and Group IV received GNL alone from the 1st day of assimilation to the end of the delivery period. GNL was evaluated for its protective effects on hepatotoxicity in CCL4-treated pregnant mice. Litter size, weight, survival rate, and resorption were recorded. In addition, H & E staining was done for liver and kidney pathology as well as biochemical markers and oxidative markers malondialdehyde, superoxide dismutase, and catalase were analyzed. Results CCL4 significantly reduced survival rate and increased resorption after exposure. Alanine transaminase and aspartate aminotransferase concentrations in the serum, tissue MDA, blood urea nitrogen, and creatinine were increased after CCL4 exposure. GNL improved enzyme and antioxidant levels and prevented CCL4-induced hepatic injury in mice. Caspase-3 cleavage was decreased by GNL, which increased PI3K, phosphorylated AKT, Nrf2, and B-cell lymphoma 2. Conclusion GNL demonstrates a protective effect against CCl4-induced hepatorenal toxicity, mediated through the activation of the PI3K/AKT signaling pathway and the upregulation of Nrf2. These findings highlight the potential therapeutic implications of GNL in mitigating oxidative stress and inflammation in liver and kidney tissues.
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Affiliation(s)
- Sabah Ali Alzahrani
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Gamal M. Bekhet
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Zoology, Faculty of Science, Alexandria University Egypt, Alexandria, Egypt
| | - Rebai Ben Ammar
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
- Laboratory of Aromatic and Medicinal Plants, Center of Biotechnology of Borj Cedria, Hammam-Lif, Tunisia
| | - Basem M. Abdallah
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Enas Mohamed Ali
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Botany and Microbiology, Faculty of Science, Cairo University, Cairo, Egypt
| | - Saeed Y. Al-Ramadan
- Department of Anatomy, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Duaa Althumairy
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Peramaiyan Rajendran
- Department of Biological Sciences, College of Science, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Biochemistry, Centre of Molecular Medicine and Diagnostics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Jordaan EM, Joubert G, Robb L, Ngounda J, Walsh CM. Associations between socio-demographic characteristics of pregnant women and birth outcome: The Nutritional status of Expectant Mothers and their newborn Infants study. Child Care Health Dev 2024; 50:e13181. [PMID: 37737654 DOI: 10.1111/cch.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/30/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Low socio-economic status is associated with poor birth outcomes, however, few studies on this topic have been conducted in South Africa. We determined associations between socio-demographic variables of pregnant women and birth outcome in their offspring. METHODS This study was nested in a prospective cohort study conducted at an antenatal clinic at a regional hospital in Bloemfontein, South Africa. Questionnaires on socio-demographic information were completed on 682 pregnant women in a structured interview. Post-delivery, 331 participants provided the Road to Health Booklets for 347 infants, in which birth data were recorded. Associations between socio-demographic variables and birth outcome (defined as premature delivery or low length-for-age or low weight-for-length at birth) were investigated. Logistic regression with backward selection (p < 0.05) was used to select independent factors that were significantly associated with birth outcome. Variables with a p-value of <0.15 on bivariate analysis were considered for inclusion in the model. RESULTS Poor birth outcome was observed in 36.3% (116/320) of women. The odds of experiencing poor birth outcome were lower for women who owned a stove versus those who did not (OR 0.11, 95% CI: 0.02-0.67), and higher for women with grade 8-10 (OR 5.84, 95% CI: 1.90-17.91) or grade 10-12 (OR 4.33, 95% CI: 1.50-12.49) as their highest level of education versus tertiary education. The odds of experiencing poor birth outcomes were also higher for those employed part-time (OR 2.55, 95% CI: 1.10-5.93) versus full-time and/or self-employed. CONCLUSION Our findings confirm that the presence of basic amenities such as a stove, better education and employment improve the chances of better birth outcomes. Early screening of pregnant women for the identification of socio-demographic risk factors that may impact on birth outcome is recommended.
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Affiliation(s)
- Elizabeth Margaretha Jordaan
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Gina Joubert
- Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Liska Robb
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
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30
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Verger EO, Eymard-Duvernay S, Bahya-Batinda D, Hanley-Cook GT, Argaw A, Becquey E, Diop L, Gelli A, Harris-Fry H, Kachwaha S, Kim SS, Nguyen PH, Saville NM, Tran LM, Zagré RR, Landais E, Savy M, Martin-Prevel Y, Lachat C. Defining a Dichotomous Indicator for Population-Level Assessment of Dietary Diversity Among Pregnant Adolescent Girls and Women: A Secondary Analysis of Quantitative 24-h Recalls from Rural Settings in Bangladesh, Burkina Faso, India, and Nepal. Curr Dev Nutr 2024; 8:102053. [PMID: 38187987 PMCID: PMC10767136 DOI: 10.1016/j.cdnut.2023.102053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 01/09/2024] Open
Abstract
Background The Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) indicator was validated as a proxy of micronutrient adequacy among nonpregnant women in low- and middle-income countries (LMICs). At that time, indeed, there was insufficient data to validate the indicator among pregnant women, who face higher micronutrient requirements. Objective This study aimed to validate a minimum food group consumption threshold, out of the 10 food groups used to construct MDD-W, to be used as a population-level indicator of higher micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Methods We used secondary quantitative 24-h recall data from 6 surveys in 4 LMICs (Bangladesh, Burkina Faso, India, and Nepal, total n = 4909). We computed the 10-food group Women's Dietary Diversity Score (WDDS-10) and calculated the mean probability of adequacy (MPA) of 11 micronutrients. Linear regression models were fitted to assess the associations between WDDS-10 and MPA. Sensitivity, specificity, and proportion of individuals correctly classified were used to assess the performance of MDD-W in predicting an MPA of >0.60. Results In the pooled sample, median values (interquartile range) of WDDS-10 and MPA were 3 (1) and 0.20 (0.34), respectively, whereas the proportion of pregnant women with an MPA of >0.60 was 9.6%. The WDDS-10 was significantly positively associated with MPA in each survey. Although the acceptable food group consumption threshold varied between 4 and 6 food groups across surveys, the threshold of 5 showed the highest performance in the pooled sample with good sensitivity (62%), very good specificity (81%), and percentage of correctly classified individuals (79%). Conclusions The WDDS-10 is a good predictor of dietary micronutrient adequacy among pregnant women aged 15-49 y in LMICs. Moreover, the threshold of 5 or more food groups for the MDD-W indicator may be extended to all women of reproductive age, regardless of their physiologic status.
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Affiliation(s)
- Eric O Verger
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | | | - Dang Bahya-Batinda
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Giles T. Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Alemayehu Argaw
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Elodie Becquey
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Loty Diop
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Aulo Gelli
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | - Helen Harris-Fry
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Sunny S Kim
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | - Phuong Hong Nguyen
- International Food Policy Research Institute (IFPRI), Washington, DC, United States
| | | | | | - Rock R Zagré
- International Food Policy Research Institute (IFPRI), Dakar, Senegal
| | - Edwige Landais
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Mathilde Savy
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Yves Martin-Prevel
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Ergani SY, Yücel KY, Şahin B, Ateş C, Reis YA, Köse C, Özden MP, Akpınar F, Çelen Ş, Üstün Y. The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters. Am J Reprod Immunol 2024; 91:e13806. [PMID: 38282603 DOI: 10.1111/aji.13806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024] Open
Abstract
PROBLEM This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM). METHOD OF STUDY Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group. RESULTS When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket. CONCLUSION SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.
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Affiliation(s)
- Seval Yılmaz Ergani
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut Yücel
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Büşra Şahin
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Cağlayan Ateş
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Caner Köse
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | | | - Funda Akpınar
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Şevki Çelen
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yaprak Üstün
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
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Miyauchi T, Hirata Y, Fukuda S. Postmortem diagnosis of gestational psittacosis: A case report. Acute Med Surg 2024; 11:e932. [PMID: 38370878 PMCID: PMC10873515 DOI: 10.1002/ams2.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024] Open
Abstract
Background Gestational psittacosis is one of the causes of unanticipated maternal death but has been difficult to diagnose early in clinical practice. Case Presentation A 28-year-old woman who was 7 months pregnant experienced flu-like symptoms, which deteriorated. She was brought to our hospital in shock, and the fetus was nonviable. The patient was diagnosed with pneumonia and septic shock and administered meropenem. Despite aggressive resuscitation, she died 7 h after symptom onset. After obtaining consent from the patient's family, the autopsy was done to identify the cause of death. Microscopically, there was intervillous neutrophil accumulation in the placenta. Genetic analysis detected the Chlamydia psittaci gene in several organs, including placenta. Conclusion Gestational psittacosis should be considered for a pregnant woman with flu-like symptoms. Moreover, unanticipated death of a pregnant woman might warrant a detailed autopsy to reveal the cause of death.
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Affiliation(s)
- Takashi Miyauchi
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
| | - Yutaro Hirata
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
| | - Shinya Fukuda
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
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Atak M, Sezerol MA, Koçak EN, Değer MS, Kurubal H. Prevalence of depression, anxiety, and associated factors in immigrant pregnant women in Türkiye: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36616. [PMID: 38206723 PMCID: PMC10754613 DOI: 10.1097/md.0000000000036616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
The prevalence of depression and anxiety in pregnant women is increasing and this is more important in migrants who are in the vulnerable group. The aim of this study was to evaluate the prevalence of depression and anxiety in Syrian immigrant pregnant women admitted to a Migrant Health Center and the associated factors. The study is a cross-sectional study. A questionnaire prepared using sociodemographic characteristics and the Beck depression and anxiety inventories in Arabic was applied to the participants. The study was conducted with immigrant pregnant women who applied to the Migrant Health Center between July 8, 2022, and December 31, 2022. The study was conducted through health workers who speak Arabic and had received training on the subject beforehand. The mean age of the research group was 26.67 ± 5.98 years. Of the participants, 73.0 percent (%) had primary education or less, 95.0% had low income, 87.2% had 3 or less children and 98.5% described their health status as good or very good. The mean Beck anxiety inventory score of the participants was found to be 4.65 ± 3.17. The mean Beck depression inventory score was found to be 4.48 ± 2.53. Smoking and first pregnancy status were found to be associated with anxiety, whereas smoking and history of delivery beyond 42 weeks were found to be associated with depression (P ˂ .05). Anxiety and depression levels of immigrant pregnant women were found to be very low. Minimal anxiety was found in 99.3% of the immigrant pregnant women and 97.1% had no symptoms of depression. It is thought that effective psychosocial support activities for immigrant pregnant women should be carried out in a way to cover the entire target group.
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Affiliation(s)
- Muhammed Atak
- Department of Public Health, Istanbul University – Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Akif Sezerol
- Department of Public Health, Istanbul Medipol University – School of Medicine, Istanbul, Turkey
| | - Elif Nur Koçak
- Department of Public Health, Sultangazi District Health Directorate, Turkish Ministry of Health – Istanbul Health Directorate, Istanbul, Turkey
| | - Mehmet Sait Değer
- Department of Public Health, Hitit University – Faculty of Medicine, Çorum, Turkey
| | - Hamza Kurubal
- Department of Orthopedics, Porta Westfalica Clinic, Bad Oeynhausen, Germany
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Balsam D, Bounds DT, Rahmani AM, Nyamathi A. Evaluating the Impact of an App-Delivered Mindfulness Meditation Program to Reduce Stress and Anxiety During Pregnancy: Pilot Longitudinal Study. JMIR Pediatr Parent 2023; 6:e53933. [PMID: 38145479 PMCID: PMC10775027 DOI: 10.2196/53933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Stress and anxiety during pregnancy are extremely prevalent and are associated with numerous poor outcomes, among the most serious of which are increased rates of preterm birth and low birth weight infants. Research supports that while in-person mindfulness training is effective in reducing pregnancy stress and anxiety, there are barriers limiting accessibility. OBJECTIVE The aim of this paper is to determine if mindfulness meditation training with the Headspace app is effective for stress and anxiety reduction during pregnancy. METHODS A longitudinal, single-arm trial was implemented with 20 pregnant women who were instructed to practice meditation via the Headspace app twice per day during the month-long trial. Validated scales were used to measure participant's levels of stress and anxiety pre- and postintervention. Physiological measures reflective of stress (heart rate variability and sleep) were collected via the Oura Ring. RESULTS Statistically significant reductions were found in self-reported levels of stress (P=.005), anxiety (P=.01), and pregnancy anxiety (P<.0001). Hierarchical linear modeling revealed a statistically significant reduction in the physiological data reflective of stress in 1 of 6 heart rate variability metrics, the low-frequency power band, which decreased by 13% (P=.006). A total of 65% of study participants (n=13) reported their sleep improved during the trial, and 95% (n=19) stated that learning mindfulness helped with other aspects of their lives. Participant retention was 100%, with 65% of participants (n=13) completing about two-thirds of the intervention, and 50% of participants (n=10) completing ≥95%. CONCLUSIONS This study found evidence to support the Headspace app as an effective intervention to aid in stress and anxiety reduction during pregnancy.
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Affiliation(s)
- Donna Balsam
- School of Nursing, San Diego State University, San Diego, CA, United States
| | - Dawn T Bounds
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Adeline Nyamathi
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
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Kobernik EK, Ford ND, Levecke M, Galang RR, Hoots B, Roehler DR, Ko JY. Marijuana Use among Pregnant and Nonpregnant Women of Reproductive Age, 2013-2019. Subst Use Misuse 2023; 59:690-698. [PMID: 38132561 PMCID: PMC11000143 DOI: 10.1080/10826084.2023.2294974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
BACKGROUND Marijuana is the most commonly used federally illicit substance among reproductive-age women in the United States. Updated information on marijuana use in this population can inform clinical and public health interventions. METHODS Data from the 2013-2019 National Survey on Drug Use and Health was used to report weighted prevalence estimates of marijuana use in the past month, past 2-12 months, and past year among women aged 18-44 years with self-reported pregnancy status. Bivariate analyses and general linear regression models with Poisson distribution using appropriate survey procedures identified factors associated with past-year marijuana use by pregnancy status. RESULTS Among pregnant women, 4.9% (95% confidence interval [CI]: 4.1-5.6) reported marijuana use in the past month, 10.4% (95% CI: 9.3-11.5) in the past 2-12 months, and 15.2% (95% CI: 13.9-16.6) in the past year. Among nonpregnant women, 11.8% (95% CI: 11.5-12.0) reported marijuana use in the past month, 7.8% (95% CI: 7.6-8.0) in the past 2-12 months, and 19.5% (95% CI: 19.2-19.9) in the past year. After adjusting for sociodemographic characteristics, past-year marijuana use was 2.3-5.1 times more likely among pregnant, and 2.1 to 4.6 times more likely among nonpregnant women who reported past-year tobacco smoking, alcohol use, or other illicit drug use compared to those reporting no substance use. CONCLUSIONS Pregnant and nonpregnant women reporting marijuana use, alone or with other substances, can benefit from substance use screening and treatment facilitation.
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Affiliation(s)
- Emily K Kobernik
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Nicole D Ford
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madison Levecke
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, ORISE Fellow, Oak Ridge, TN, USA
| | - Romeo R Galang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brooke Hoots
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA
| | - Douglas R Roehler
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jean Y Ko
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service Commissioned Corps, Atlanta, GA, USA
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Yadav P, Chen DB, Kumar S. Region-Specific and Pregnancy-Enhanced Vasodilator Effects of Hydrogen Sulfide. Obstet Gynecol Res 2023; 6:309-316. [PMID: 38288009 PMCID: PMC10824528 DOI: 10.26502/ogr0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Hydrogen sulfide (H2S) is a cardiovascular signaling molecule that causes vasodilation in vascular smooth muscle cells, but its mechanism is unclear. We examined how H2S affects mesenteric and uterine arteries without endothelium in nonpregnant and pregnant rats and the underlying mechanisms. H2S donors GYY4137 and NaHS relaxed uterine arteries more than mesenteric arteries in both pregnant and nonpregnant rats. GYY4137 and NaHS caused greater relaxation in the uterine artery of pregnant versus nonpregnant rats. High extracellular K+ abolished NaHS relaxation in pregnant uterine arteries, indicating potassium channel involvement. NaHS relaxation was unaffected by voltage-gated potassium channel blockers, reduced by ATP-sensitive potassium channel blockers, and abolished by calcium-activated potassium (BKCa) channel blockers. Thiol-reductant dithiothreitol also prevented NaHS relaxation. Thus, H2S has region-specific and pregnancy-enhanced vasodilator effects in the uterine arteries, mainly mediated by BKCa channels and sulfhydration.
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Affiliation(s)
- Pankaj Yadav
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Dong-Bao Chen
- Department of Obstetrics & Gynecology, University of California, Irvine, California, United States of America
| | - Sathish Kumar
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States of America
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Sánchez-García JC, Saraceno López-Palop I, Piqueras-Sola B, Cortés-Martín J, Mellado-García E, Muñóz Sánchez I, Rodríguez-Blanque R. Advancements in Nutritional Strategies for Gestational Diabetes Management: A Systematic Review of Recent Evidence. J Clin Med 2023; 13:37. [PMID: 38202044 PMCID: PMC10779518 DOI: 10.3390/jcm13010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is defined as hyperglycaemia first detected at any time during pregnancy with values lower than those determined by the WHO for diabetes diagnosis in adults. This pathology, with a worldwide prevalence of 13.4%, causes significant maternal and foetal risks. The first line of treatment consists of maintaining normo-glycaemia through an adequate diet and lifestyle changes. The aim is to synthesize the scientific evidence updating the nutritional recommendations for the effective management of GDM. A systematic review of the scientific literature was conducted following the PRISMA guidelines. Randomized clinical trials published within the last five years and providing information on nutritional recommendations to achieve an effective management of gestational diabetes were selected. The databases searched were PubMed, the WOS Core Collection, SCOPUS, and CINAHL, using the MeSH terms: "Diabetes, Gestational"; "Nutrition Assessment (nutrition*)"; "Diet"; "Eating"; and "Food"; with the Boolean operators "AND" and "OR". The PEDro scale (Physiotherapy Evidence Database) was used to assess the scientific quality of the studies, with a mean score of 8.9, indicating an average good scientific quality. Results: A total of 809 papers were collected, of which, after applying the inclusion and exclusion criteria, 14 randomized clinical trials were selected. Probiotic supplementation and co-supplementation with vitamin D have been found to be the most beneficial options for both mothers with GDM and neonates, but the most effective regimens are not known. Diets enriched with extra virgin olive oil (EVOO) and oat bran, as well as some recommendations focused on carbohydrates also seem effective, as well as diets designed for this group of women with GDM such as "CHOICE". Conclusions: Although there are numerous proposals that have been published in recent years focused on the diet of women with GDM in order to improve their results and those of their children, it is the supplementation with probiotics and the co-supplementation with vitamin D that is most agreed upon as beneficial; however, more research is needed into which protocols are most effective. Other proposals that could also be beneficial should be further studied.
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Affiliation(s)
- Juan Carlos Sánchez-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (E.M.-G.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | | | - Beatriz Piqueras-Sola
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (E.M.-G.); (R.R.-B.)
- Virgen de las Nieves University Hospital, 18014 Granada, Spain
| | - Jonathan Cortés-Martín
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (E.M.-G.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Elena Mellado-García
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (E.M.-G.); (R.R.-B.)
- Costa del Sol Health District, 29640 Fuengirola, Spain
| | | | - Raquel Rodríguez-Blanque
- Research Group CTS-1068, Andalusia Research Plan, Junta de Andalucía, 18014 Granada, Spain; (J.C.S.-G.); (B.P.-S.); (E.M.-G.); (R.R.-B.)
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
- San Cecilio University Hospital, 18071 Granada, Spain
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Nissen M, Perez CA, Jaeger KM, Bleher H, Flaucher M, Huebner H, Danzberger N, Titzmann A, Pontones CA, Fasching PA, Beckmann MW, Eskofier BM, Leutheuser H. Usability and Perception of a Wearable-Integrated Digital Maternity Record App in Germany: User Study. JMIR Pediatr Parent 2023; 6:e50765. [PMID: 38109377 PMCID: PMC10750977 DOI: 10.2196/50765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 12/20/2023] Open
Abstract
Background Although digital maternity records (DMRs) have been evaluated in the past, no previous work investigated usability or acceptance through an observational usability study. Objective The primary objective was to assess the usability and perception of a DMR smartphone app for pregnant women. The secondary objective was to assess personal preferences and habits related to online information searching, wearable data presentation and interpretation, at-home examination, and sharing data for research purposes during pregnancy. Methods A DMR smartphone app was developed. Key features such as wearable device integration, study functionalities (eg, questionnaires), and common pregnancy app functionalities (eg, mood tracker) were included. Women who had previously given birth were invited to participate. Participants completed 10 tasks while asked to think aloud. Sessions were conducted via Zoom. Video, audio, and the shared screen were recorded for analysis. Task completion times, task success, errors, and self-reported (free text) feedback were evaluated. Usability was measured through the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Semistructured interviews were conducted to explore the secondary objective. Results A total of 11 participants (mean age 34.6, SD 2.2 years) were included in the study. A mean SUS score of 79.09 (SD 18.38) was achieved. The app was rated "above average" in 4 of 6 UEQ categories. Sixteen unique features were requested. We found that 5 of 11 participants would only use wearables during pregnancy if requested to by their physician, while 10 of 11 stated they would share their data for research purposes. Conclusions Pregnant women rely on their medical caregivers for advice, including on the use of mobile and ubiquitous health technology. Clear benefits must be communicated if issuing wearable devices to pregnant women. Participants that experienced pregnancy complications in the past were overall more open toward the use of wearable devices in pregnancy. Pregnant women have different opinions regarding access to, interpretation of, and reactions to alerts based on wearable data. Future work should investigate personalized concepts covering these aspects.
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Affiliation(s)
- Michael Nissen
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carlos A Perez
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina M Jaeger
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hannah Bleher
- Department of Social Ethics, University of Bonn, Bonn, Germany
| | - Madeleine Flaucher
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nina Danzberger
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Adriana Titzmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Constanza A Pontones
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heike Leutheuser
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Yussuph ZH, Alwy Al-Beity FM, August F, Anaeli A. COVID-19 vaccine hesitancy among pregnant women attending public antenatal clinics in Dar es Salaam, Tanzania. Hum Vaccin Immunother 2023; 19:2269777. [PMID: 37942618 PMCID: PMC10653711 DOI: 10.1080/21645515.2023.2269777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
The COVID-19 pandemic has claimed over six million lives and caused significant morbidities globally. The development and use of COVID-19 vaccines is a key strategy in ending this. There is a general public hesitancy on vaccine uptake, including pregnant women who are at high risk of severe forms of the disease and death when infected with the virus. To determine the magnitude of hesitancy toward COVID-19 vaccines and the associated factors among pregnant women attending public antenatal clinics in Dar es Salaam. This was a cross-sectional analytical study conducted among 896 pregnant women attending antenatal clinics at public health facilities in Dar es Salaam. A structured interviewer-based questionnaire, in an electronic form, was used. The analysis was done by a multivariable linear regression model using STATA 16 to obtain factors associated with vaccine hesitancy, and P < .05 was considered significant. The proportion of pregnant women with vaccine hesitancy was 45%. Hesitancy was higher among unemployed pregnant women (AOR 2.16 (95% CI 1.36-3.42) and the self-employed group (AOR 1.62 (95% CI 1.07-2.44). It was also higher among pregnant women with poor attitudes to COVID-19 vaccines (AOR 2.44 (95% CI 1.75-3.39) and women who had low perceived benefits of the vaccines (AOR 2.57 (95% CI 1.83-3.60). COVID-19 vaccine-targeted interventions should aim at the provision of knowledge on COVID-19 and the COVID-19 vaccine and address poor attitudes and perceptions that pregnant women have on these vaccines.
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Affiliation(s)
- Zainab Hassan Yussuph
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Fadhlun M. Alwy Al-Beity
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Furaha August
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Amani Anaeli
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
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Chen X, Zhang Y, Chen H, Dou Y, Wang Y, He W, Ma X, Sheng W, Yan W, Huang G. Association Between Serum Glycated Hemoglobin Levels at Early Gestation and the Risk of Subsequent Pregnancy Loss in Pregnant Women Without Diabetes Mellitus: Prospective Cohort Study. JMIR Public Health Surveill 2023; 9:e46986. [PMID: 38085559 PMCID: PMC10751628 DOI: 10.2196/46986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/27/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND As a severe morbidity during pregnancy, the etiology of spontaneous pregnancy loss (SPL) remains largely unknown. Serum glycated hemoglobin (HbA1c) level is an established predictor of SPL risk among women with diabetes, but little is known about whether such an association exists among pregnant women without diabetes when glycemic levels are within the normal range. OBJECTIVE This study aimed to quantify the association between maternal HbA1c levels in early pregnancy and subsequent SPL risk in a cohort of pregnant women without diabetes. METHODS This prospective cohort study involved 10,773 pregnant women without diabetes enrolled at their first antenatal care visit at a hospital's early pregnancy clinic from March 2016 to December 2018 in Shanghai, China. HbA1c and fasting blood glucose (FBG) levels were examined at enrollment. Participants with diabetes before or pregnancy or those diagnosed with gestational diabetes were excluded. Diagnosis of SPL, defined as fetal death occurring before 28 gestational weeks, was derived from medical records and confirmed via telephone interviews. We used generalized linear models to quantify the associations of continuous and dichotomized maternal HbA1c levels with SPL risk and reported crude and adjusted risk ratios (RRs) and 95% CIs. A restricted cubic spline (RCS) regression model was used to assess the potential nonlinear dose-response relationship. Adjusted covariates included maternal age, education level, preconception BMI, gestational weeks, gravidity, history of adverse pregnancy outcomes, family history of diabetes, folic acid supplementation, and smoking and drinking during the periconception period. RESULTS In total, 273 (2.5%) SPL cases occurred. Every 0.5% increase in HbA1c levels was linearly associated with a 23% increase in SPL risk (adjusted RR [aRR] 1.23; 95% CI 1.01-1.50). The RCS model revealed that this association was linear (P=.77 for the nonlinearity test). Analyses based on dichotomized HbA1c levels showed a significantly increased risk of SPL when HbA1c levels were ≥5.9% (aRR 1.67; 95% CI 0.67-3.67), and the significance threshold was ≥5.6% (aRR 1.60; 95% CI 1.01-2.54). Sensitivity analyses showed similar results when including the participants with missing SPL records or HbA1c data. Linear associations of HbA1c levels remained significant even in the subgroups without overweight, alcohol consumption, and a family history of diabetes and adverse pregnancy outcomes. Every 1 mmol/L increment in maternal FBG levels was associated with a >2-fold higher risk of SPL (aRR 2.12; 95% CI 1.61-2.80; P<.001). CONCLUSIONS Higher HbA1c levels in early pregnant women without diabetes are associated with an increased SPL risk in a dose-response manner. Pregnant women with an HbA1c level above 5.6% at early gestation need attention for its potentially increased risk for SPL. Our findings support the need to monitor HbA1c levels to identify individuals at high risk of subsequent SPL in the general population of pregnant women. TRIAL REGISTRATION ClinicalTrials.gov NCT02737644; https://clinicaltrials.gov/study/NCT02737644.
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Affiliation(s)
- Xiaotian Chen
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yi Zhang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Hongyan Chen
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yalan Dou
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yin Wang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Wennan He
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Xiaojing Ma
- Pediatric Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, China
| | - Wei Sheng
- Shanghai Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
| | - Guoying Huang
- Pediatric Heart Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
- Shanghai Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, China
- Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Shanghai, China
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Chen WC, Hu SY, Shen CF, Cheng MH, Hong JJ, Shen CJ, Cheng CM. COVID-19 Vaccination in Pregnancy: Pilot Study for Maternal and Neonatal MicroRNA Profiles. Vaccines (Basel) 2023; 11:1814. [PMID: 38140218 PMCID: PMC10747030 DOI: 10.3390/vaccines11121814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
This pilot study explores alterations in miRNA profiles among pregnant women and their neonates upon receiving different doses of COVID-19 vaccines. Blood samples, including maternal blood (MB) and neonatal cord blood (CB), collected from five pregnant women were scrutinized using the miRNA PanelChip Analysis System, identifying nine distinct miRNAs, including miR-451a and miR-1972, which exhibited significant downregulation with two vaccine doses in both MB and CB. When compared with women vaccinated with four doses, miR-486-5p, miR-451a, and miR-1972 in the two-dose group also showed notable downregulation. Evaluating recipients of three and four doses, miR-423-5p and miR-1972 expression were significantly reduced in both MB and CB. Further comparative analysis highlighted a decline in miR-223-3p expression with increasing vaccine doses, while miR15a-5p, miR-16-5p, and miR-423-5p showed an upward trend. Notably, miR-451a, miR-1972, and miR-423-5p levels varied across doses and were associated with pathways such as "PI3K-Akt", "neurotrophin signaling", and "cortisol synthesis", suggesting the profound influence of vaccination on diverse molecular mechanisms. Our research has uncovered that escalating vaccine dosages impact miRNA profiles, which may be associated with the immunological response mechanisms in both the mother and fetus, thus indicating a substantial impact of vaccination on various molecular processes.
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Affiliation(s)
- Wei-Chun Chen
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan; (W.-C.C.); (S.-Y.H.)
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Obstetrics and Gynecology, New Taipei City Municipal Tucheng Hospital, New Taipei City 236, Taiwan
- International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu 300, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Shu-Yu Hu
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan; (W.-C.C.); (S.-Y.H.)
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
| | - Mei-Hsiu Cheng
- Taiwan Business Development Department, Inti Taiwan, Inc., Hsinchu 302, Taiwan; (M.-H.C.); (J.-J.H.)
| | - Jun-Jie Hong
- Taiwan Business Development Department, Inti Taiwan, Inc., Hsinchu 302, Taiwan; (M.-H.C.); (J.-J.H.)
| | - Ching-Ju Shen
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan; (W.-C.C.); (S.-Y.H.)
- International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu 300, Taiwan
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Craig AM, Campbell A, Snow SC, Spates TN, Goldstein SA, Denoble AE, Meng ML, Schroder JN, Flores KP, Agarwal R, Ward CC, Federspiel JJ. Maternal and Pregnancy Outcomes Following Heart Transplantation in the United States. JACC Heart Fail 2023; 11:1666-1674. [PMID: 37804312 PMCID: PMC10841668 DOI: 10.1016/j.jchf.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Improved survival following heart transplantation (HT) has led to more recipients contemplating pregnancy, but data on outcomes are limited. OBJECTIVES The authors used a national data set to investigate and describe outcomes of pregnancies and deliveries in the United States in HT recipients. METHODS Diagnosis and procedure codes from the 2010-2020 Nationwide Readmissions Database identified delivery hospitalizations, history of HT, comorbid conditions, and outcomes. The authors compared rates of severe maternal morbidity (SMM), nontransfusion SMM, cardiovascular SMM (cSMM), and preterm birth from delivery hospitalization between HT recipients and no-HT recipients. The authors evaluated readmission to 330 days postpartum. Logistic and proportional hazard regressions were performed, adjusting for age, socioeconomic and facility characteristics, and clinical comorbidities. RESULTS Among 19,399,521 deliveries, 105 were HT recipients. Compared with no-HT, HT recipients were at higher risk for all SMM (24.8% vs 1.7%), nontransfusion SMM (20.8% vs 0.7%), cSMM (7.3% vs 0.12%), and preterm birth (43.3% vs 8.2%), all P < 0.001. In adjusted analyses, HT recipients had 16-fold greater odds of SMM, 28-fold greater odds of nontransfusion SMM, 38-fold greater odds of cSMM, and 7-fold greater odds of preterm birth. HT recipients had higher morbidity rates during delivery hospitalization and higher readmission rates within 1 year following delivery (26.9% vs 3.8%; adjusted HR: 6.03 [95% CI: 3.73-9.75]). CONCLUSIONS Delivery with history of HT is associated with significantly increased rates of SMM, preterm birth, and hospital readmission. These results provide data regarding pregnancy outcomes for use when counseling patients with HT history who are considering pregnancy or who are pregnant.
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Affiliation(s)
- Amanda M Craig
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
| | - Alexa Campbell
- Duke University School of Medicine, Durham, North Carolina
| | - Sarah C Snow
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Toi N Spates
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Sarah A Goldstein
- Division of Cardiology, Department of Medicine, Yale University, New Haven, Connecticut
| | - Anna E Denoble
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Yale University, New Haven, Connecticut
| | - Marie-Louise Meng
- Division of Women's Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Jacob N Schroder
- Division of Cardiothoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Karen P Flores
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Richa Agarwal
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Cary C Ward
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Jerome J Federspiel
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
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Sterbling HM, Kelly CH, Stafford A, Willey S, Dort J. Pregnancy Curriculum: Advocating for a Healthier Pregnancy in General Surgery Residency. J Surg Educ 2023; 80:1799-1805. [PMID: 37661564 DOI: 10.1016/j.jsurg.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION With an increasing number of women entering surgical careers, pregnancy amongst surgical residents is anecdotally rising. There is no single resource to inform expectant surgical residents of potential occupational risks, or to help them optimize workplace safety during and after pregnancy. The aim of this initiative is to provide surgical residents with an overview of residency occupational risks applicable to maternal-fetal health, propose systemic and situational modifications, and to empower pregnant residents to better plan and advocate for a healthy pregnancy. METHODS Surgery department staff were invited to contribute to the pregnancy curriculum at the authors' institution. Feedback was received from attending physicians and surgical residents (N = 12), as well as all female residents having experienced in-training pregnancy or early child-rearing from 2017 to 2022 (N = 6). After identifying workplace hazard and compiling staff feedback, the authors developed a set of recommendations for the protection of pregnant and early-parenting female trainees. RESULTS Five areas of process improvements were identified for the protection of pregnant residents: culture, ergonomics, exposure, maternal & fetal care, and fourth trimester support. Specific recommendations ranged from widespread institutional support emphasizing psychological safety and zero-retaliation policies, to healthcare-related hazard exposure protections, as well as tangible postpartum and lactation support. Out of this initiative came the pregnancy curriculum. CONCLUSION Widespread and decisive institutional support is paramount to cultural shifts surrounding in-training pregnancy. The guidelines proposed in this project are intended to be enforced by surgical residency leadership with the precise goal of removing the cultural burden from the expectant resident. Only the resident herself can thereafter chose to adopt or decline the protective measures. Through our recommendations, we hope to offer a foundation upon which individual residents and program leaders can build tailored, pregnancy-specific interventions, with the ultimate goal of improving the antenatal outcomes of our trainees and their growing families without compromising surgical training.
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Affiliation(s)
| | - Colleen H Kelly
- Inova Health System, Department of Surgery, Falls Church, Virginia
| | - Arielle Stafford
- Inova Schar Cancer Institute, Department of Breast Surgery, Fairfax, Virginia
| | - Shawna Willey
- Inova Schar Cancer Institute, Department of Breast Surgery, Fairfax, Virginia
| | - Jonathan Dort
- Inova Health System, Department of Surgery, Falls Church, Virginia
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Badewy R, Cardoso E, Glogauer M, Sgro M, Connor KL, Lai JY, Bazinet RP, Tenenbaum HC, Azarpazhooh A. Oral health-related quality of life among women early postpartum: A cross-sectional study. J Periodontol 2023; 94:1475-1484. [PMID: 37326008 DOI: 10.1002/jper.23-0236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Periodontal diseases can negatively impact the oral health-related quality of life (OHRQoL) of pregnant women. This study investigates the association between maternal oral inflammatory load (OIL), sociodemographic characteristics, and the OHRQoL in postpartum women. METHODS In this cross-sectional study, breastfeeding mothers were recruited from St. Michael's Hospital, Toronto within 2-4 weeks postpartum. Mothers were categorized into "Normal/low" and "High" OIL groups based on the absolute counts of oral polymorphonuclear neutrophils (oPMNs). The Oral Health Impact Profile-14 questionnaire was used to assess the impact of the maternal OIL on the OHRQoL. Multiple linear regression analyses were performed to examine the association between maternal sociodemographic factors including age, marital status, education level, employment status, parity, and their OHRQoL. RESULTS Forty-seven mothers were included in this study. Mothers with high OIL reported higher impact on their OHRQoL (30%) than mothers with normal/low OIL (21%), but these differences were not statistically different. There was a negative relationship between the mother's education level and the extent of impact of OHRQoL on the "physical pain" dimension (p < 0.05), and between the mothers' age and employment status and the "physical disability" dimension (p < 0.05). A positive correlation was noted between multi-parity and the extent of impact of OHRQoL on the "physical disability" dimension (p = 0.009), and between the marital status and the "psychological disability" dimension (p < 0.05). CONCLUSION This study highlighted the significant impact of sociodemographic characteristics on the OHRQoL of mothers, showcasing the importance of considering these factors when implementing targeted preventive dental care programs for mothers.
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Affiliation(s)
- Rana Badewy
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Elaine Cardoso
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Dentistry, Center for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Dental Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Michael Sgro
- Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Kristin L Connor
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Jim Yuan Lai
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Howard C Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Dentistry, Center for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Department of Dentistry, Center for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada
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Wang N, Yu C, Wang W, Yang Q. Certolizumab treatment of localized pyoderma gangrenosum in a pregnant patient. J DERMATOL TREAT 2023; 34:2276044. [PMID: 37905433 DOI: 10.1080/09546634.2023.2276044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
THE PURPOSE OF THE ARTICLE Pyoderma gangrenosum (PG) is an ulcerating neutrophilic dermatosis with an incidence of 3-10 patients per million. PG equally affects patients of both sexes and of any age. Of these patients, 50-75% are associated with auto-immune disease. The lower extremities are the most commonly affected body parts. Minor trauma to the skin may result in the development of new lesions. Patients complain of chronic, nonhealing ulcers with associated pain. Treatment starts with systemic or intralesional corticosteroids, however, no official treatment protocol currently exists. Recent success has been found with biologic agents such as TNF-a inhibitor, although the treatment efficacy in these reports is limited. As for the pregnant patient, the drug selection is difficult. In this report, we want to assess the efficiency of certolizumab in the pregnant patient. RESULTS We report a case of a patient with PG, who responded well to certolizumab, 400 mg as a booster dose, followed by 200 mg biweekly for 8 weeks. The lesions gradually resolved and followed up for 5months without side effect. In addition, we reviewed the literature and compared the current treatment efficiency in the treatment of PG. CONCLUSION Certolizumab may be a promising therapeutic option for patients with severe PG.
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Affiliation(s)
- Na Wang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China
| | - Changping Yu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China
| | - Weiwei Wang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China
| | - Qing Yang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Medical Center for Dermatovenereology, Jinan, Shandong, China
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Wang M, Jiang XC, Lai SM, Gan ZJ, Wang JN, Zhan BD. Associations between maternal stressful life events experiences and risk of neural tube defects in offspring: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2023; 36:2279021. [PMID: 37946331 DOI: 10.1080/14767058.2023.2279021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Multiple factors associated with neural tube defects (NTDs) risk have been identified, yet there is little evidence on the possible effects of maternal stressful life events. In this study, we aimed to investigate the association between stressful life events during the periconceptional period and risk of NTDs in offspring. METHODS Relevant literature was searched in PubMed, Springer Link, ScienceDirect, and Cochrane Library up to July 2023. The pooled odds ratio (OR) and 95% confidence interval (CI) of NTDs risk with maternal stressful life events were estimated using a random effects model. Publication bias was assessed using Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. RESULTS Analysis results showed that mothers who experienced stressful life events during the periconceptional period were at greater risk of having NTDs offspring (OR: 1.37, 95% CI: 1.08-1.73) than those who did not. In subgroup analysis, the pooled OR was 1.37 (1.13-1.67) and 1.73 (0.36-8.32) for with and without adjusting for folic acid supplementation in each included study, while was 1.37 (1.13-1.67) and 1.64 (0.39-6.88) for exposure time of three months preconception until three months post conception and one year preconception until three months post conception, respectively. CONCLUSIONS This study suggests that maternal stressful life events during the periconceptional period are significantly associated with higher NTDs risk in offspring. Tailored approaches for evaluating the risk and policy of NTDs among women of childbearing age should emphasize individual stressful experiences before and during early pregnancy.
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Affiliation(s)
- Meng Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, China
| | - Xian Chen Jiang
- Department of NCDs Control and Prevention, Quzhou Center for Disease Control and Prevention, Quzhou City, China
| | - Shi Ming Lai
- Department of NCDs Control and Prevention, Quzhou Center for Disease Control and Prevention, Quzhou City, China
| | - Zhi Juan Gan
- Department of NCDs Control and Prevention, Quzhou Center for Disease Control and Prevention, Quzhou City, China
| | - Jin Na Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, China
| | - Bing Dong Zhan
- Department of NCDs Control and Prevention, Quzhou Center for Disease Control and Prevention, Quzhou City, China
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Bello OO, Bella-Awusah TT, Adebayo AM, John-Akinola YO, Ndikom CM, Ilori T, Cadmus EO, Omokhodion F. Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria. J OBSTET GYNAECOL 2023; 43:2205503. [PMID: 37140084 DOI: 10.1080/01443615.2023.2205503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statementWhat is already known on this subject? Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity.What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression.What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.
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Affiliation(s)
- Oluwasomidoyin Olukemi Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tolulope T Bella-Awusah
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodeji Matthew Adebayo
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Yetunde O John-Akinola
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Health Promotion and Education, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chizoma Milicent Ndikom
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temitope Ilori
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Eniola O Cadmus
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Folashade Omokhodion
- Women's Health Research Group, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Mrayan L, Abujilban S, Tanash M, Obeisat S. Knowledge, attitudes, and practices toward COVID-19 among pregnant women in Jordan during the COVID-19 outbreak. Birth 2023; 50:827-837. [PMID: 37347706 DOI: 10.1111/birt.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND COVID-19 is highly infectious and can cause harmful effects in pregnant women. As COVID-19 is a relatively new disease, there is a continuing need to assess the knowledge, attitudes, and practices (KAP) toward this virus among pregnant women globally in order to identify any gaps and suggest ways to address them. Little is known about how pregnant Jordanian women responded to the pandemic. OBJECTIVE The purpose of this study was to investigate the level of KAP toward COVID-19 among pregnant women in Jordan and to detect the variables associated with a satisfactory KAP level. METHODS A cross-sectional online survey based on a predesigned KAP survey was modified for use among pregnant women in Jordan. The data obtained from 574 participants were analyzed using the Statistical Package for the Social Sciences, version 23. RESULTS Overall, pregnant women in Jordan were found to be knowledgeable, to have a positive attitude, and to exhibit good practices in relation to COVID-19. Some demographic factors were significantly associated with high levels of knowledge, positive attitudes, and safer practices. CONCLUSIONS Results suggest that special attention should be given by the government to pregnant women with respect to any future emergent situations such as additional COVID-19 surges or other novel respiratory conditions in order to ensure that they are fully informed and prepared.
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Affiliation(s)
- Lina Mrayan
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Sanaa Abujilban
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Muath Tanash
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Salwa Obeisat
- Maternal-Child Health Nursing Department, Jordan University of Science and Technology, Irbid, Jordan
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Wang XY, Ying XH, Jiang HY. Antidepressant use during pregnancy and the risk for gestational diabetes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2023; 36:2162817. [PMID: 36599445 DOI: 10.1080/14767058.2022.2162817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Antidepressant medications are used by increasing numbers of pregnant women. The evidence on the relationship between antidepressant use during pregnancy and the risk for gestational diabetes mellitus (GDM) is inconsistent. We perform a systematic review and meta-analysis to assess the GDM risk associated with antidepressant exposure during pregnancy. METHODS We systematically searched the PubMed and EMBASE databases until December 2021. We sought observational studies assessing the association between gestational antidepressant use and GDM. RESULTS Five observational studies were included in the analysis. Mothers exposed to antidepressants during pregnancy were at a significantly increased risk for GDM (relative risk [RR] 1.20, 95% confidence interval [CI] 1.11-1.30; p < .001). However, after considering confounding by indication, we observed no significant effect of antidepressant use during pregnancy on the risk of GDM (RR 1.13, 95% CI 1-1.28; p = .054; I2 = 0%). Independent of clinical indication, subgroup analysis based on individual antidepressants suggested that the risk was increased by venlafaxine or amitriptyline use, but not by selective serotonin reuptake inhibitors. CONCLUSIONS The significant association between antidepressant exposure during pregnancy and GDM may be overestimated due to confounding by indication. However, the evidence remains insufficient, particularly for specific drug classes.
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Affiliation(s)
- Xiao-Yan Wang
- Department of Gynaecology and Obstetrics, Taizhou First People's Hospital, Taizhou, Zhejiang, China
| | - Xian-Hua Ying
- Department of Gynaecology and Obstetrics, Taizhou First People's Hospital, Taizhou, Zhejiang, China
| | - Hai-Yin Jiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Karihtala P. Pregnancy wishes after breast cancer-an unsettled conflict solved? Transl Cancer Res 2023; 12:2976-2978. [PMID: 38130301 PMCID: PMC10731361 DOI: 10.21037/tcr-23-1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/18/2023] [Indexed: 12/23/2023]
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