OBJECTIVE: Pregnancy is associated with increased influenza hospitalizations and physician visits (events) in healthy women and those with co-morbidities. Annual influenza immunization is recommended for all pregnant women. Although vaccination is expected to reduce influenza-related events, the economic implications are unclear. We developed an economic model to estimate the cost-effectiveness (CE) of different vaccination strategies in Nova Scotia. METHODS: A decision tree characterized the one-year costs and consequences of targeted (pregnant women with co-morbidities only) and universal (all pregnant women) vaccination strategies relative to a no-vaccination strategy. Baseline event probabilities, vaccine effectiveness, costs and quality-of-life weights were derived from individual-level Nova Scotia administrative databases, health system sources and published reports. Sensitivity analyses tested the impact of varying key parameters, including vaccine effectiveness and mode of delivery. RESULTS: Targeted vaccination was cost-saving relative to no vaccination when delivered by public health clinics (PHC) or routine family practitioner (FP) visit. Cost per quality-adjusted life year gained by universal vaccination relative to targeted strategy was < $40,000 when delivered by PHC or routine FP visit. Net cost of universal vaccination by PHC or a routine FP visit was < $10 per pregnant woman. CONCLUSION: Universal vaccination of pregnant women appears cost-effective when delivered by PHC or as part of a routine FP prenatal visit. Targeted vaccination of pregnant women with co-morbidities can be cost-saving, but the possibility of higher vaccine uptake with a universal compared to a targeted strategy must be considered in addition to costs in program planning.
Skedgel C; Langley JM; MacDonald NE; Scott J; McNeil S
A universal vs a targeted hepatitis C virus (HCV) screening policy for identifying pregnant women with the virus were compared. Universal screening did not yield significantly more identification of patients with HCV than targeted screening. However, 14 of 67 (21%) women with confirmed HCV would not have been detected by targeted risk-based HCV screening.
Diab-Elschahawi M; Dosch V; Honsig C; Jatzko B; Segagni L; Assadian O; Presterl E
Regardless of the fact, that pancreatitis during pregnancy is rare; this disease is characterized by high indices of maternal and perinatal mortality. Among variety of etiological and pathogenetic aspects of pregnant women's acute pancreatitis, leading role in its development belongs to bile-excreting system diseases, conditioned by physiological processes in women's organism during gestational period. Also there is a genetic theory of acute pancreatitis genesis in pregnant women, based on dislipoproteinemia development caused by lipoprotein lipase insufficiency, when severity of pancreatitis course is correlated with morphotype of this enzyme gene mutation. Chronic pancreatitis is conditioned by the same causes and can develop and recur during pregnancy and right after parturition. Diagnostics of pregnant women's pancreatitis is complicated because of limitation of the use of some methods (radiation and endoscopic). Pancreatitis clinical course does not differ from the one in nonpregnant women and is manifested by pain abdominal and dyspeptic syndromes, and also by syndromes of exocrine and endocrine pancreatic insufficiency. The main clinical feature of pregnant women's pancreatitis is high occurrence of painless forms. Approaches to treatment include pain relief disintoxication, use of pancreatic secretion blockers, multienzyme complexes, glycemia correction.
Maev IV; Burkov SG; Kucheriavy? IuA; Ovlashenko EI
The current literature concerning violence against pregnant women is reviewed. The prevalence of battering during pregnancy is estimated to be between one and ten percent, and the problem is most often hidden from the medical staff. In one fourth of the cases, violence increases during pregnancy, and usually the violent episodes are a continuation of the couple's habitual way of life. An episode of battering per se is only in extreme situations dangerous for the pregnancy, but serves as a marker of negative social events, e.g. unemployment, smoking, emotional instability etc., which increases the risk of an adverse pregnancy outcome. Furthermore, the violent husband may extend the battering to the child after delivery. It is concluded, that all medical personnel dealing with pregnant women should be aware of the high prevalence of battering during pregnancy. If battering is detected, the pregnancy may be at risk, but the main problem is the social issue and the later consequences for the child. The general practitioner is central in the long-term approach to these cases.
Rasmussen KL; Knudsen HJ
Among patients with stenosis of the aorta, pregnant women are a special problem because during pregnancy the extra demands on the heart can change an asymptomatic stenosis of the aorta to a serious disease. Here we report two examples.
Saekmose S; Svendsen JJ
Respiratory disorders during pregnancy are connected with its physiology. About half of pregnant women suffer from dyspnea on exertion and some 20 % also from dyspnea at rest. Symptoms may intensify in obese patients. Smoking and respiratory disorders influence the well-being of the fetus. This study evaluates respiratory function in pregnant women as assessed by spirometry. The tests were carried out in 54 pregnant women in the 2nd and 3rd trimester. We found reduced values of vital capacity and expiratory reserve volume in all women, which suggests the existence a restrictive respiratory disorder in physiological pregnancy. Smoking seems to cause obstructive disorders; in smoking patients there was a reduction of the Tiffenau ratio. Participation in birth classes had a positive influence on inspiratory capacity. High BMI before pregnancy, excessive weight gain during pregnancy, or age of becoming pregnant did not appreciably influence spirometry results.
Hirnle L; Lysenko L; Gerber H; Lesnik P; Baranowska A; Rachwalik M; Leszczyszyn J; Strozecki L
Coagulability increases during pregnancy, and thromboembolism can easily occur. Venous thromboembolism is a cause of death in pregnant women, but arterial thrombosis such as ischemic stroke in pregnancy is also not uncommon. In pharmacotherapy for thromboembolism in pregnant women, fetal toxicity and teratogenicity must be carefully considered. As anticoagulants in pregnant women, unfractionated heparin and low-molecular-weight heparin are recommended, but warfarin is not recommended since it has a low molecular weight and crosses the placenta. Various types of new oral anticoagulant drugs have been available in Japan since 2011. However, the Japanese package inserts for these anticoagulants advise quite cautious administration in pregnant women. The guidelines on pregnant women include less information about antiplatelet drugs than anticoagulant drugs. Aspirin may cause teratogenicity and fetal toxicity, and perinatal mortality is increased. However, when low doses of aspirin are administered as antiplatelet therapy, the US Food and Drug Administration has assigned pregnancy category C, and treatment is relatively safe. Neurosurgeons and neurologists commonly encounter pregnant women with thromboembolism, such as ischemic stroke. Up-to-date information and correct selection of drugs are necessary in consultation with specialists in perinatal care.
Coagulability increases during pregnancy, and thromboembolism can easily occur. Venous thromboembolism is a cause of death in pregnant women, but arterial thrombosis such as ischemic stroke in pregnancy is also not uncommon. In pharmacotherapy for thromboembolism in pregnant women, fetal toxicity and teratogenicity must be carefully considered. As anticoagulants in pregnant women, unfractionated heparin and low-molecular-weight heparin are recommended, but warfarin is not recommended since it has a low molecular weight and crosses the placenta. Various types of new oral anticoagulant drugs have been available in Japan since 2011. However, the Japanese package inserts for these anticoagulants advise quite cautious administration in pregnant women. The guidelines on pregnant women include less information about antiplatelet drugs than anticoagulant drugs. Aspirin may cause teratogenicity and fetal toxicity, and perinatal mortality is increased. However, when low doses of aspirin are administered as antiplatelet therapy, the US Food and Drug Administration has assigned pregnancy category C, and treatment is relatively safe. Neurosurgeons and neurologists commonly encounter pregnant women with thromboembolism, such as ischemic stroke. Up-to-date information and correct selection of drugs are necessary in consultation with specialists in perinatal care. PMID:23979047
BACKGROUND: We wanted to determine the usefulness of chemical dipstick tests and office culture in diagnosing asymptomatic bacteriuria in pregnant women in general practice. MATERIAL AND METHODS: Dipstick and office urine culture were compared with standard culture results from a microbiology laboratory. The comparison was based on 294 urine samples obtained from pregnant women in a standard general practice setting. RESULTS: Asymptomatic bacteriuria was found in 16 out of 294 urine samples. The sensitivity of dipstick tests was less than 30%. The positive predictive value was 100% for the nitrite test and 40% for office culture. INTERPRETATION: Standard urine culture is the only way to diagnose asymptomatic bacteriuria.
Kolstrup N; Vold C; Melbye H
Heartburn is a common symptom in pregnancy, affecting about two-thirds of pregnant women. The aetiology of gastro-oesophageal reflux in pregnancy is multifactorial. Reduced lower basal gastro-oesophageal sphincter pressure, increased intragastric pressure, delayed intestinal transit time and duodenogastric reflux have been found in pregnant women with heartburn, all factors which dispose to increased gastro-oesophageal reflux. Gastric emptying is apparently normal during pregnancy, but delayed during delivery. Therapy involves lifestyle modification and nonsystemic medication as the initial choices. H-2-antagonists should only be used in severe and refractory cases.
Okholm M; Jensen SM
... Guías Sumaria de los Consumidores Aug. 25, 2010 Gestational Diabetes Related Products Future Research Needs: Prioritizing Research Needs ... Pregnant Women" /> Consumer Summary – Aug. 5, 2009 Gestational Diabetes: A Guide for Pregnant Women Formats Consumer Guide ( ...
A review of the literature of the 1980s reveals that women living in rural American are at risk for receiving inadequate prenatal and maternal care. Documented risk factors include poverty and concomitant lack of medical insurance, residence in the most restrictive Medicaid states, and loss of local services including the closure of obstetric units of rural hospitals and the decision by local physicians to discontinue obstetrics. A prominent factor in a physician's decision to stop providing maternity care is the escalating cost of medical liability insurance; however, other forces are also at work, including interference with personal and family activities, disruption of other aspects of professional life (e.g., office schedule), inadequate reimbursement, and an inability to keep up with advancing technology. A research agenda for the 1990s should be consistent with previous recommendations and must stimulate the development of new programs that will induce the maximum number of providers to again offer high quality perinatal care to rural women. Other items on the 1990s research agenda include: (1) the clarification of the impact of lost perinatal services in rural areas, (2) the effects of travel time and distance on perinatal outcomes and cost of care, (3) the effect of loss of obstetric services on other health care services for women and children, and (4) comparisons of regionalized versus centralized systems for the provision of perinatal services.
Lawhorne L; Zweig S; Tinker H
INTRODUCTION: Errors in nourishment and unstable nutritional status of pregnant women can have a negative impact on the development of the foetus and the course of pregnancy. The aim of the study: The aim of the study was the estimation of nutritional behaviour of pregnant women, nutritional status before pregnancy and their body weight gain during pregnancy. It is also examined whether the educational level is a factor that differentiates the manner of nourishment, and the nutritional status of the investigated women. MATERIAL AND METHODS: The investigation included 200 women, 30 of them were in I, 70 - in II, and 100 - in III trimester of pregnancy; 19% had elementary general or vocational education; 35% - secondary education; and 46% - higher education. Information about eating habits as well as body height and mass was collected by means of an anonymous questionnaire. BMI of the investigated women before pregnancy and average weekly increases of body mass during pregnancy were calculated. RESULTS: The investigation has shown insufficient consumption of vegetables and fruits, milk and dairy products, wholemeal cereal products, fish or supplements containing polyunsaturated fatty acids n-3, and high consumption of sweets. The folic acid before or during pregnancy was taken by 88% of the investigated women. An insufficient body mass before pregnancy (BMI <18.5) was found in 7%, and a small body weight gain during pregnancy was found in 28.8% of women. 5% of the investigated women had both risk factors simultaneously. CONCLUSIONS: A number of irregular nutritional behaviours were found among the investigated women. Most errors in nourishment were found in the group of women with elementary general or vocational education.
In the study period of two years 145 pregnant and 79 non-pregnant women with malarial infection were recorded. Plasmodium falciparum was the most prevalent species accounting for 72% of the total malaria infection in pregnant women while, in non-pregnant women it accounted for 58%. Results were analysed according to the species to which the parasite belonged, period of gestation and parity. While cerebral malaria, abortions, intrauterine foetal death, maternal anaemia were common in pregnant patients, only one neonatal death was recorded. Malaria parasites were not found in infants born to mothers with very heavy parasitaemia at the time of delivery. Even though pregnant women of all age groups and parity remain highly susceptible to malaria throughout pregnancy and puerperium from this area, some striking differences like malaria infection more prevalent in primigravidas than multigravidas and in second trimester than in third trimester were noticed in comparison to northern India. Results emphasize the need to target malaria control for this group of women. Failure to clear parasitaemia after chloroquine administration in P. falciparum was common in both pregnant and non-pregnant women. This is an area, where there is a great need to introduce effective malaria interventions. As chloroquine resistant parasites spread a better understanding of the problem is needed leading to a few chemotherapeutic options for pregnant women.
Singh N; Shukla MM; Srivastava R; Sharma VP
Full Text Available All the elective surgeries are to be avoided during pregnancy and pregnant women should undergo only emergency surgical interventions. Pregnancy is associated with different physiological changes in the organism, which should be taken into account in preparative preparation of the pregnant women. Expanded body fluid volume leads to dilutional anemia, however other hematological disorders may be present as well. Extreme obesity is a frequent comorbidity, while hypertension is associated with the highest risks since it may lead to a life-threatening complication - eclampsia. As for other coexisting diseases, urinary tract infections and gestational diabetes are the most common as well as hyperthyroidism and other diseases that may also develop. The type and severity of the acute surgical disease, extensiveness of the planned surgery as well as the type of planned anesthesia to be applied, occasionally necessitate, depending on the gestational age, termination of pregnancy to be considered. Gynecological-obstetric consultations are mandatory in all surgical interventions planned in pregnant women.
Liki?-La?evi? Ivana; Argirovi? Rajka; Kadija Saša; Maksimovi? Milica; Živaljevi? Biljana; Terzi? Milan
BACKGROUND: Iodine is essential for biosynthesis of thyroid hormones and daily iodine intake needs are increased during pregnancy. Thyroid dysfunctions (hypothyroidism, hyperthyroidism) are due to autoimmune diseases (Hashimoto's disease, Graves' disease) in most women of childbearing age. During pregnancy they are associated with maternal and fetal complications: maternal hypothyroxinemia during the first trimester of gestation can be associated with abnormal cognitive development and intellectual outcomes in the newborn and the children. In patients with Graves' disease, TSH-receptor antibodies cross the placenta and can induce fetal and neonatal dysfunctions. OBJECTIVES: In order to prevent maternal and fetal complications and ameliorate the pronostic of thyroid disorders in pregnant women, the prevention should be: a systematic prophylaxis of iodine deficiency in pregnant women; an adjustment of the preconception levothyroxine treatment in women with hypothyroidism diagnosed before the pregnancy; a targeted screening for maternal hypothyroidism in high-risk women; a rational measurement for TSH-receptor and anti-thyroperoxydase antibodies in some women with autoimmune thyroid diseases.
Note is taken of the fact that air travel is increasingly frequent on the part of persons of nearly all categories. The effect of hypoxia due to altitude on the body, especially during pregnancy, is considered. Particular attention is given to vasomotor activity, uterine contractility and anxiety. Flight in air-conditioned, pressurised cabins with reduced noise and vibration is recommended for pregnant women, following obstetric examination to see whether the history contraindicates travel by air. Elementary recommendations are made with respect to what should be done during the journey.
It is relatively uncommon for pregnant women to suffer multiple injuries. In such a situation, however, two lives are at stake. The survival of the foetus depends on the mother's condition with regard to respiratory passage, oxygenation, and hypovolemia. This last condition implies that the blood is shunted away from the uteroplacental circulation, thus endangering the foetus. The principles of treatment are the ones described in this series of articles, and furthermore, in addition to concern for the foetus. Blows against the abdomen can cause abruption of the placenta, which is a frequent cause of death of the foetus after closed trauma, and can occur up to 48 hours after the accident. This necessitates monitoring of the foetus during this period.
Solheim K; Jerve F
The prevalence of HIV infection among pregnant women is low in Norway (4.5/100,000). HIV screening has been offered on a routine basis in antenatal care since 1987. 96% of all pregnant women are screened for HIV. After the introduction of the screening programme, effective treatment (zidovudin) has become available to pregnant women. This treatment reduces mother-to-child transmission of HIV by two thirds. By screening all pregnant women during a period of two years (95% confidence interval 1-6 years), transmission can be reduced to one child if the HIV positive women are offered and accept treatment. According to a review presented here, doctors and midwives involved in antenatal care do not seem to have good enough routines for giving women information about the screening test and for offering informed choices.
Reinar LM; Haegeland A; Tollefsen MF; Bjørkeng W
Pregnant women experience extensive physiologic and structural changes during pregnancy that affect their daily functioning. The addition of osteopathic manipulative treatment (OMT) to the standard care of pregnant women has been hypothesized to enhance homeostasis and improve quality of life as the body adapts to these changes. Specifically, it has been postulated that OMT can ease pain in pregnant women by eliminating somatic dysfunction and maintaining proper structure. Also, through the viscerosomatic connection, the hemodynamic changes of the maternal body can be controlled, the duration of labor reduced, and the complications of labor avoided. The author reviews the available literature on the use and effectiveness of OMT during pregnancy. PMID:22707643
Lavelle, John M
Pregnant women experience extensive physiologic and structural changes during pregnancy that affect their daily functioning. The addition of osteopathic manipulative treatment (OMT) to the standard care of pregnant women has been hypothesized to enhance homeostasis and improve quality of life as the body adapts to these changes. Specifically, it has been postulated that OMT can ease pain in pregnant women by eliminating somatic dysfunction and maintaining proper structure. Also, through the viscerosomatic connection, the hemodynamic changes of the maternal body can be controlled, the duration of labor reduced, and the complications of labor avoided. The author reviews the available literature on the use and effectiveness of OMT during pregnancy.
The incidence and predisposing factors of urinary calculi are generally the same in both pregnant and non pregnant women, but anatomic changes during pregnancy make diagnosis and treatment a more challenging issue. We reviewed 16 patients (22 stones) of urinary stone during pregnancy between 1986 an...
Lee, S. J.; Rho, S. K.; Lee, C. H.; Chang, S. G.; Kim, J. I.
Background & Objective: However, pregnancy is a common event among reproductive-age women, it is often stressful. Physical and emotional changes can alter the ability of women to carry out their usual roles. The aim of this study was to assess quality of life in pregnant women and its related fa...
F Abbaszadeh; A Baghery; N Mehran
Maternal iodine requirements increase during pregnancy. Studies performed before the introduction of mandatory iodine fortification of salt in Denmark in 2000 showed that pregnant women with no intake of iodine-containing supplements were moderately iodine-deficient and showed signs of thyroidal stress. We investigated the intake of iodine-containing supplements and urinary iodine excretion in Danish pregnant women after the introduction of iodine fortification of salt.
Andersen, Stine Linding; SØrensen, Louise Kolding
OBJECTIVE: To know extent of iodine deficiency (ID), role of thyroid enlargement (goiter) as marker of ID and current status of iodized salt intake in pregnant women of Lahore. METHODS: A cross sectional study was carried out at Institute of Chemistry, University of the Punjab, during March 2002 to September 2005. Pregnant women (n = 254) during first trimester attending antenatal clinic participated voluntarily. Iodine intake status was determined by urinary iodine (UI) excretion. RESULTS: UI excretion ranged from 34 to 142 microg/L and median value was 67 microg/L. According to international criteria, 202 (79.5%) pregnant women were iodine deficient (UI < 100 microg/L) mostly (68.8%) of mild (UI: 50-99 microg/L) degree. Moderate iodine deficiency (MID; UI < 50 microg/L) was found in 63 (24.8%) pregnant women. Among all pregnant women 80 (31.5%) had slightly visible goiter and only 87 (34.2%) were currently taking iodized salt. The difference in UI excretion between goitrous and non-goitrous pregnant women was not significant. Among iodized salt users percentage of women with MID was less, though not significant, as compared to non-users (20.7% Vs 26.9%). CONCLUSION: About one-fourth of pregnant women screened in this study are moderately iodine deficient in Lahore. These women and their neonates are at increased risk of iodine deficiency disorders. Goiter is not a good indicator of low iodine intake while iodized salt consumption is beneficial in this regard.
Elahi S; Rizvi NB; Nagra SA
BACKGROUND: Despite the fact that many pregnant women are affected by a range of serious health conditions and take medications for these conditions, there is widespread reticence to include them in clinical intervention research. Hence, their clinical care is typically not informed by evidence derived from pregnant populations. METHOD: In October 2010, the National Institutes of Health Office of Research on Women's Health convened a workshop to address ethical, regulatory, and scientific issues raised by the enrollment of pregnant women in clinical research. This report summarizes three areas that emerged from that meeting as important next steps to be taken to promote ethically responsible and scientifically sound research during pregnancy. FINDINGS: The three areas are: 1) Reclassify pregnant women from their current status in regulations as a "vulnerable" population to a scientifically "complex" population and change the presumption of exclusion to one of inclusion; 2) examine the institutional review boards' (IRB) gatekeeper role in interpreting regulations governing pregnancy research and identify steps to facilitate IRB approval of ethically informed pregnancy research; and 3) develop a pregnancy-focused research agenda that addresses pressing clinical needs, identifies opportunities to gather information from existing resources and studies, and encourages important new research areas. CONCLUSION: Research is needed to address the therapeutic needs of pregnant women and to study pregnancy as it may shed light on a pregnant woman's later health and the health of her child.
Blehar MC; Spong C; Grady C; Goldkind SF; Sahin L; Clayton JA
Full Text Available Background/aim: Ureaplasma urealyticum, a common commensal of the female lower genital tract, has been observed as an important opportunistic pathogen during pregnancy. The aims of this study were to determine the degree of cervical colonization with U. urealyticum in pregnant women with risk pregnancy and in pregnant women with normal term delivery and to evaluate the correlation between high-density cervical U. urealyticum colonization and premature rupture of membranes (PROM) as well. Methods. This research was conducted on the samples comprising 130 hospitalized pregnant women with threatening preterm delivery and premature rupture of membranes. The control group consisted of 39 pregnant women with term delivery without PROM. In addition to standard bacteriological examination and performing direct immunofluorescence test to detect Chlamydia trachomatis, cervical swabs were also examined for the presence of U. urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France). Results. The number of findings with isolated high-density U. urealyticum in the target group was 69 (53.08%), while in the control group was 14 (35.90%). Premature rupture of membranes (PROM) occurred in 43 (33.08%) examinees: 29 were pPROM, and 14 were PROM. The finding of U.urealyticum ?104 was determined in 25 (58.14%) pregnant women with rupture, 17 were pPROM, and 8 were PROM. There was statistically significant difference in the finding of high-density U. urealyticum between the pregnant women with PROM and the control group (?² = 4.06, p < 0.05). U. urealyticum was predominant bacterial species found in 62.79% of isolates in the PROM cases, while in 32.56% it was isolated alone. Among the 49 pregnant women with preterm delivery, pPROM occurred in 29 (59.18%) examinees, and in 70.83% of pregnant women with findings of high-density U. urealyticum pPROM was observed. Conclusion. Cervical colonization with U. urealyticum ? 104 is more frequent in pregnant women with risk pregnancy than in pregnant women with normal term delivery. High-density cervical U. urealyticum colonization should be observed as a possible etiological factor for PROM.
Ran?elovi? Gordana; Koci? Branislava; Miljkovi?-Selimovi? Biljana; Mladenovi?-Anti? Snežana; Stojanovi? Predrag; Stefanovi? Milan
October 19 is the deadline for employers to implement improvements in maternity rights laid down by the Trade Union Reform and Employment Rights Act (TURERA) and the European directive to protect pregnant women's health and safety at work. Christina Potrykus outlines what the government and, separately, the general Whitley council have in store for women employees.
Full Text Available Background & Objective: However, pregnancy is a common event among reproductive-age women, it is often stressful. Physical and emotional changes can alter the ability of women to carry out their usual roles. The aim of this study was to assess quality of life in pregnant women and its related factors. Methods & Materials: In this cross-sectional study, 600 pregnant women referred to the prenatal clinics of Kashan University of Medical Sciences were selected randomly. Then they were asked to complete the Short Form 36 Health Survey (SF-36) to assess the quality of life. The results were analyzed using t-test, c2, and ANOVA in SPSS. Results: Results showed that the mean of quality of life in pregnant women was 61.18 13.21 (27.96-92.62). A higher score represented a better health status. Statistically significant differences were found in all of the quality of life dimensions in pregnant women except for social functioning (P<0.005). Quality of life was correlated with age (P=0.002), gestational age (P=0.017), gravidity (P<0.001), number of deliveries (P<0.001), income (P<0.001), husband's support (P=0.017) and life satisfaction (P=0.011). Conclusion: Results of this study showed that the quality of life in pregnant women was low. Thus, it is important for primary care providers to be aware of the changes in health status of pregnant woman to help them to promote their quality of lives. Key words: quality of life, pregnancy, correlation factors
F Abbaszadeh; A Baghery; N Mehran
Full Text Available Abstract Background There is uncertainty as to whether there is a safe threshold for drinking alcohol during pregnancy. We explored pregnant women's attitudes towards drinking alcohol in pregnancy and their attitudes towards sources of information about drinking in pregnancy following recent changes in UK government guidance. Methods A qualitative study involving individual, semi-structured interviews with 20 pregnant women recruited from community organisations in the UK. Interview transcripts were analysed qualitatively using thematic analysis. Results Most women found information and advice about safe levels of drinking in pregnancy confusing and lacking in evidence and detail. Although most women considered that there were risks involved with drinking in pregnancy and these perceptions influenced their behaviour, only six women reported abstinence. Women reported being influenced by advice from family and friends and their experiences of previous pregnancies. Many had received no individual advice from general practitioners or midwives relating to drinking during pregnancy. Conclusion Pregnant women wished to take responsibility for their own health and make choices based on informed advice. In order to do so, they require clear and consistent advice about safe levels of drinking from policy makers and health professionals. This is an important issue as women might drink socially during their pregnancy.
Raymond Neil; Beer Charlotte; Glazebrook Cristine; Sayal Kapil
PURPOSE: Eating behaviours were assessed among pregnant women in a mid-sized Canadian city. METHODS: As part of the Prenatal Health Project, we interviewed 2313 pregnant women in London, Ontario. Subjects also completed a food frequency questionnaire. Recruitment took place in ultrasound clinics at 10 to 22 weeks of gestation. The main outcome measures were number of daily servings for each food group, measured against the minimum number recommended by the 2007 Eating Well with Canada's Food Guide (CFG), the proportion of women consuming the recommended number of servings for each and all of the four food groups, and factors associated with adequate consumption. We also determined the number of servings of "other foods." Analysis included descriptive statistics and logistic regression, all at p<0.05. RESULTS: A total of 3.5% of women consumed the recommended number of servings for all four food groups; 15.3% did not consume the minimum number of servings of foods for any of the four food groups. Women for whom this was their first pregnancy were less likely to consume the recommended number of servings from all four food groups (odds ratio=0.41; confidence interval=0.23, 0.74). CONCLUSIONS: Very few pregnant women consumed food group servings consistent with the 2007 recommendations. Strategies to improve dietary behaviours must focus on the establishment of healthy eating behaviours among women of reproductive age.
Fowler JK; Evers SE; Campbell MK
Pregnancy increases the requirement for nutrients and changes the metabolism of lipids and other compounds. We investigated the dietary composition and followed the changes in serum lipids during pregnancy among 20 women age 25-36 years. The women's diet was stable during pregnancy, but the intake of vitamin D, iron and fibre was lower than the national recommendations. Fat provided about 31% of the energy, saturated fat 12%. The total cholesterol concentration rose from 4.4 (95% confidence interval 4.2-4.6) to 7.0 mmol/l (6.5-7.5) (p < 0.0001) without changes in dietary composition. Even in this group of health-conscious, pregnant women the diet did not meet the national dietary recommendations. In addition, the composition of the fat in the diet was unfavourable. Optimal follow-up of pregnant women should include dietary counselling.
Gørbitz C; Bergei CS; Sivertsen M; Ose L; Abyholm T
Several questions arise concerning the election and use of the various antiretroviral medicines in pregnant women, questions arising from the specific medical problems of many women at this stage of their lives. The authors use published data and their own experience to pose the following questions and draw conclusions: 1. During pregnancy women undergo a series of physiological changes that could affect the pharmacokinetics of the various antiretroviral medicines. Are adjustments to drug doses needed? 2. What are the real risks of antiretroviral drugs for the foetus or neonate? 3. Can pregnancy make women more sensitive to pharmacological toxicity? 4. Are there any other reasons, apart from the above, for changing a previously efficacious antiretroviral treatment because a woman becomes pregnant?
Peña Sánchez De Ribera JM; Ramos Amador JT; Domingo Pedrol P; Miralles Martín P
Zinc is one of the elements necessary for growth and health in human. Some evidences indicate that the zinc deficiency is one of real difficulties for the public health in developed and developing countries. Since the pregnant women are more at risk by the zinc deficiency, and this can cause many pr...
S Salimi; M Yaghmaei; HR Joshaghani; AR Mansourian
Folic acid (FA) deficiency is associated with neural tube defects (NTD). In a non-risk pregnancy, The Danish National Board of Health recommends FA supplementation from planned pregnancy until three months after conception. We explored pregnant women's knowledge about and actual supplementation with FA and related this to education, number of pregnancies and age.
Rasmussen, Mikkel Mylius; Clemmensen, Dorte
Full Text Available Zinc is one of the elements necessary for growth and health in human. Some evidences indicate that the zinc deficiency is one of real difficulties for the public health in developed and developing countries. Since the pregnant women are more at risk by the zinc deficiency, and this can cause many problems, in this study we tried to find out the rate of zinc deficiency in pregnant women within the region. This research project was analytical-descriptive study which was done on the 400 pregnant women whom referred to Zahedan Ghods hospital. A questionnaire was set up for each case which contained the following items, mother age, pregnancy age, numbers of deliveries, education, and consumption of iron tablet during pregnancy. The serum zinc level in each mother in this project was determined by atomic absorption technique. Prevalence of zinc deficiency among the pregnant women was 49%. Statistical analysis indicated that zinc deficiency had correlation with mother age, term of pregnancy and iron consumption. But zinc deficiency showed no correlation with numbers of deliveries and education.
S Salimi; M Yaghmaei; HR Joshaghani; AR Mansourian
The present invention relates to nutritional supplements to be administered to, or to be taken by, women desiring to become pregnant, and pregnant and nursing women. The nutritional supplements of this invention have a unique blend of vitamins, minerals, lycopene, co-enzyme Q10, DHA, docusate (such as docusate sodium), folic acid, and a nutritionally acceptable carrier therefor. The invention includes specific nutritional supplements for the uses set forth above.
MORRISON JOHN C; GREATHOUSE KENNETH R
Full Text Available T. gondii is a worldwide zoonosis. Children of women who acquire the infection during gestational period can develop congenital infection. In this study our aim was to determine the prevalence of Toxoplasma gondii in 455 pregnant women with an age range of 17-45 years. In this retrospective study, pregnant women applied to Obstetrics and Gynaecology Department of Ad?yaman 82’nd Year State Hospital between January 2007 and December 2008 were evaluated in order to find the prevalence of anti-Toxoplasma gondii IgG and IgM antibodies. Seropositivity rates of anti-Toxoplasma gondii IgG and IgM antibodies were found to be 48.4% and 0.65%, respectively. In conclusion, due to the high seroprevalence rate of anti-T gondii antibodies we believe that taking measures related to the hygiene of the foods consumed and determining T. gondii serological markers of pregnant women in our region is essential.
Servet Kölgelier; Hayati Demiraslan; Bekir Kata?; Dilek Güler
Full Text Available BACKGROUND: The high prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in pregnant women is considered the most important factor contributing to the higher carrier rate of HBsAg in some populations, including Saudi Arabia. Universal hepatitis B vaccination in infancy was implemented in Saudi Arabia in 1990 to avoid early acquisition of infection. At the same time, another program was launched to vaccinate all school children at school entry as a second target group. The aim of this study was to evaluate the HBsAg prevalence rate in Saudi pregnant women 12 years after launching the program and to assess regional variation, if any. METHODS: In a cross-sectional study, 2664 pregnant Saudi women were recruited from the five main regions in Saudi Arabia. Blood samples were tested for HBsAg. Positive samples were tested also for HBeAg. RESULTS: Of 2664 pregnant Saudi women, 65 were positive for HBsAg (2.46%, 95% CI=2.11%-2.69%). Four were positive for HBeAg (0.15%). The HBsAg prevalence rate was higher in Gizan (4.2%) and lower in Tabuk (1.4%) (P=-0.035). Only one case was positive for HBsAg in women under the age of 20 years (1/186), a 0.5% positivity rate in this age group compared with 2.6% in the older age group (P=-0.049 for the one-sided test). A history of surgical procedures was associated with a higher (3%), but not significantly higher rate of HBsAg positivity. No significant association was found between HBsAg positivity and a history of dental procedures or blood transfusion. CONCLUSION: Although the HBsAg prevalence rate among Saudi pregnant women was lower than previously published data, the full impact of the hepatitis B vaccination program in infancy and childhood will take more years to decrease the prevalence rate in pregnant women. The MOH should continue to give the first dose of hepatitis B vaccine at birth to prevent early acquisition, but in the meantime a regional policy can be adopted to deal with the high prevalence rate of HBsAg among pregnant Saudi women.
Al-Mazrou Yagob; Al-Jeffri M; Khalil Mohamed; Al-Ghamdi Yasser; Mishkhas A; Bakhsh M; Eisa M; Nageeb M; Tumsah S
Full Text Available Scorpion envenomation is common in many countries; however, its effects on pregnancy are still unclear. In the present paper, we described the effects of scorpion envenomation on pregnant patients. A retrospective study was carried out considering the clinical and laboratory exams of patients admitted to the emergency room of Habib Bourguiba Hospital, Sfax, Tunisia, from 1990 to 2004. Variability of these clinical and laboratory profiles according to maternal age, gestational age and number of previous parities was also discussed. Among 167 scorpion-envenomed women, age ranged from 17 to 42 years, 7.18% were pregnant. These presented symptoms similar to those of non-pregnant women envenomed by scorpions. Two pregnant patients developed intense pelvic pain and one manifested vaginal bleeding. Although the studied parameters showed non-significant differences, we could conclude that scorpion envenomation may lead to abnormal uterine contraction probably causing preterm delivery. Maternal disturbances induced by scorpion envenomation may influence the fetus development. The effects were more severe in the second trimester of pregnancy.
H. Ben Nasr; T. S. Hammami; Z. Sahnoun; T. Rebai; M. Bouaziz; M. Kassis; K. M. Zeghal
Full Text Available Abstract in english Scorpion envenomation is common in many countries; however, its effects on pregnancy are still unclear. In the present paper, we described the effects of scorpion envenomation on pregnant patients. A retrospective study was carried out considering the clinical and laboratory exams of patients admitted to the emergency room of Habib Bourguiba Hospital, Sfax, Tunisia, from 1990 to 2004. Variability of these clinical and laboratory profiles according to maternal age, gestati (more) onal age and number of previous parities was also discussed. Among 167 scorpion-envenomed women, age ranged from 17 to 42 years, 7.18% were pregnant. These presented symptoms similar to those of non-pregnant women envenomed by scorpions. Two pregnant patients developed intense pelvic pain and one manifested vaginal bleeding. Although the studied parameters showed non-significant differences, we could conclude that scorpion envenomation may lead to abnormal uterine contraction probably causing preterm delivery. Maternal disturbances induced by scorpion envenomation may influence the fetus development. The effects were more severe in the second trimester of pregnancy.
Ben Nasr, H.; Hammami, T. S.; Sahnoun, Z.; Rebai, T.; Bouaziz, M.; Kassis, M.; Zeghal, K. M.
Full Text Available QUESTION: One of my patients is planning pregnancy and has started taking multivitamin supplements. She is experiencing gastric discomfort. What are the alternatives? ANSWER: Gastric discomfort is usually related to iron intake; pregnant women could use supplements with less iron. Pregnant women need 0.4 to 1.0 mg of folic acid daily. If they have a family history of neural tube defects (NTDs), insulin-dependent diabetes mellitus, or epilepsy, or are currently taking valproic acid, carbamazepine, or antifolates (eg, sulfonamides), they are at intermediate-to-high risk of having babies with NTDs and need 4.0 to 5.0 mg of folic acid daily.
Ahn E; Nava-Ocampo AA; Koren G
Pregnant women and parents of young children travelling to non-western countries should consider the risks to which they expose themselves and their children. Travelling during these periods of life needs to be particularly well planned. Travel insurance should cover the whole family, and for pregnant women also the risk of premature birth. Travelling long distances during pregnancy involves a certain amount of risk in itself. This risk could be increased if complications were to occur in areas with a lower standard of health service. As a rule, infants and young children easily adapt to new environments but children abroad should be expected to need a doctor at least as often as at home. Some vaccines and antimalarials must not be used for children below a certain age. Only a few vaccines and antimalarials have been systematically studied in pregnant women in order to exclude teratogenicity. We present some aspects of vaccination and malaria prevention, transport, climate and environment, nutrition, food and drinking water hygiene.
Sandbu S; Nøkleby H
One hundred and six pregnant women with uterine myomas were admitted to a clinical protocol for operative or conservative management of myomas. The criteria for decision to submit to surgery were: (i) recurrent pain; (ii) large or rapidly growing myomas; (iii) large or medium myomas located in the lower uterine segment or deforming the placental site. According to these criteria 18 patients underwent myomectomy (operative group) and 88 were conservatively treated (conservative group). Complications and fetoneonatal outcome were monitored. The data were also compared to a control group of 2463 normal pregnant women. No spontaneous abortion occurred in the operated group, while the conservative group had a 13.6% spontaneous abortion rate (control group: 9.3%). The operated group had the highest cesarean section rate (93.7%), but no post-cesarean hysterectomy. The conservative group had a higher cesarean section rate compared with the pregnant women without myomas (34% vs 16.3%, respectively); they also had a 4.5% post-cesarean hysterectomy rate compared with 0.12% in the control group. Fetoneonatal outcome was good both in the conservative and operated group. The only perinatal death regarded a patient with a large myoma who refused surgery and went into premature labour at 32 weeks of gestation. Therefore, our study demonstrates that myomectomy during pregnancy is of advantage when performed early on selected patients.
Mollica G; Pittini L; Minganti E; Perri G; Pansini F
Pain of lumbosacral segment of the vertebral column and the pelvis concerns about 45% of all pregnant women. The change of the body posture during pregnancy is the result of gravity centre relocation, which affects the musculosceletal system. Development of the joint, ligament and myofascial dysfunctions, as well as the pain in the lumbosacral segment and the pelvis, are the most common reasons of spine pain. The aim of this review is to present the current state of knowledge about lumbar spine pain in pregnant women with special focus on the pain connected with muscular, joint and ligament disorders. Pregnancy is a serious burden for the female osteo-skeletal system. Lumbar pain with different location and intensification is the negative consequence of the position changes during pregnancy. Pharmacotherapy could be useful only in cases of intensive low back pain, with possible application of small spectrum of drugs that are safe during pregnancy. Physical therapy including manual therapy exercises, massage and techniques of local anesthesia are alternative methods in case of low back pain in pregnant women. PMID:21365902
Majchrzycki, Marian; Mrozikiewicz, Przemys?aw M; Kocur, Piotr; Bartkowiak-Wieczorek, Joanna; Hoffmann, Marcin; Stry?a, Wanda; Seremak-Mrozikiewicz, Agnieszka; Grze?kowiak, Edmund
Pain of lumbosacral segment of the vertebral column and the pelvis concerns about 45% of all pregnant women. The change of the body posture during pregnancy is the result of gravity centre relocation, which affects the musculosceletal system. Development of the joint, ligament and myofascial dysfunctions, as well as the pain in the lumbosacral segment and the pelvis, are the most common reasons of spine pain. The aim of this review is to present the current state of knowledge about lumbar spine pain in pregnant women with special focus on the pain connected with muscular, joint and ligament disorders. Pregnancy is a serious burden for the female osteo-skeletal system. Lumbar pain with different location and intensification is the negative consequence of the position changes during pregnancy. Pharmacotherapy could be useful only in cases of intensive low back pain, with possible application of small spectrum of drugs that are safe during pregnancy. Physical therapy including manual therapy exercises, massage and techniques of local anesthesia are alternative methods in case of low back pain in pregnant women.
Majchrzycki M; Mrozikiewicz PM; Kocur P; Bartkowiak-Wieczorek J; Hoffmann M; Stry?a W; Seremak-Mrozikiewicz A; Grze?kowiak E
Full Text Available Pregnancy is a crucial period of woman’s life where socio-demographic factors affect her health as well asdetermine the health of future generation. A cross-sectional community based study was conducted in pregnant women inthe field practice area of RCHTC, Hebbal. Variables considered for the study were: Age, religion, Socio-economics status,type of family & house, parity, spacing methods, utilization of health services, height, weight and Body Mass Index (BMI).Majority of pregnant woman had inadequate protien & calorie consumption during pregnancy; 23.93%, woman werehaving BMI<18.5; 66.67%, were anemic (Hb<11 gm%). The overall prevalence of anemia was found to be high amongilliterate (98.2%), Hindu (92.31%) and moderately working woman (83.34% ). Anemia was found to be more common whoseage at first pregnancy was <20 years (57.28%), age at marriage <20 years (87.17%), in IInd trimester of pregnancy(62.83% ) and in age group of 20-24 years (39.14%). Government hospital services were utilized by 78.63% but only 58.97%received iron & folic acid tablets and 70.94% had taken injection Tetanus Toxoid (TT).Hence, effective intervention should be directed towards young pregnant women <20 years of age to improvematernal nutritional status, literacy level, and health education for utilization of health services.
L.H. Madhavi,; H.K.G. Singh
OBJECTIVE: Systematic full-mouth dental examination during pregnancy is an official preventive measure recently advocated by the French Health policy. The aim of this study was firstly to evaluate the oral health related to some sociodemographic factors among pregnant women, and secondly to propose this dental examination together with the routine antenatal interview. MATERIAL AND METHOD: This cross-sectional study combined several medical questionnaires with an oral examination. It concerned all pregnant women attending their routine antenatal interview in the maternity unit of the Montpellier hospital. Socioeconomic status was assessed by Epices index. So that two groups were determined : the deprived group (D), and the non-deprived group (ND). RESULTS: Oral examination revealed that 93% of the women were suffering from at least one oral disease, 74% had a periodontal disease (9% had a periodontitis), and 74% had at least one carious tooth. The mean Epices score was 30.5 and the mean number of carious teeth was significantly higher in the group D (3.4) than in the group ND (2.35), (p=0.02). The prevalence of periodontal disease or periodontitis were not significantly different between the two groups (p=0.81 and p=0.99 respectively). After stratification on the degree of dental hygiene knowledge, it was found that knowing about an adequate dental hygiene and specific preventive measures regarding pregnancy could reduce the gap between the oral health status of the two socioeconomic groups. CONCLUSION: This study showed that performing an oral examination, at the same time than the antenatal interview, could highly improve the knowledge about dental hygiene among pregnant women and the screening of oral diseases, especially for deprived population.
Delemotte M; Valcarcel J; Tramini P
51% of 710 women in paid employment and resident in the municipality of Baerum were certified as sick during their gestationel period. In 1/3 of the cases the medical certificate referred to musculoskeletal/connective tissue diseases, a problem which increased with duration of pregnancy. 208 women (29%) were incapacitated from work for more than two weeks and in 36% of these women, the sickness certificate was obtained on grounds of threatened well-being of the foetus. According to the current Norwegian legislation, morbidity of the mother is the only indication for granting certification of illness to a pregnant woman. The paper indicates that the law should be updated to include morbidity of the foetus as a justifiable reason for certifying the mother as sick. In addition, the perinatal audit should be expanded to include cases of foetal morbidity as well as cases of foetal mortality.
Lundby IH; Stray-Pedersen B; Tellnes G
BACKGROUND: A growing body of evidence suggests that physical activity during pregnancy can reduce risk of pregnancy complications. However, factors influencing activity in pregnant Hispanic women, who have high rates of sedentary activity as compared to non-Hispanic whites, are not well characterized. PURPOSE: To assess patterns and correlates of physical activity among 1355 participants in Proyecto Buena Salud, a prospective cohort of pregnant Hispanic women in Massachusetts from 2006 to 2011. METHODS: Analyses were conducted in 2012. Pre-, early-, mid-, and late-pregnancy physical activity were assessed using the Pregnancy Physical Activity Questionnaire. Women reported the frequency and duration of household/caregiving, occupational, sports/exercise, and transportation activities and were classified according to compliance with American College of Obstetricians and Gynecologists guidelines for physical activity. RESULTS: Household/caregiving activity was the primary mode of pregnancy activity ranging from 56% to 60% of total activity while sports/exercise contributed the least (<10%). Compared to nulliparous women, women with two or more children were 85% less likely to become inactive at any time during pregnancy (OR=0.15, 95% CI=0.04, 0.56, p-trend <0.01). Women with one or more children increased their total physical activity on average 9.73±2.04 MET-hours/week and 12.04±2.39 MET-hours/week, respectively, with the onset of pregnancy (p<0.01). Those with the highest levels of total physical activity prior to pregnancy were 87% less likely to become inactive with the onset of pregnancy than those who were inactive prior to pregnancy (OR=0.13, 95% CI= 0.05, 0.29). CONCLUSIONS: Findings can inform culturally appropriate interventions designed to reduce pregnancy complications through the promotion of physical activity during pregnancy.
Lynch KE; Landsbaugh JR; Whitcomb BW; Pekow P; Markenson G; Chasan-Taber L
The weight gain chart for pregnant women, developed by Rosso and Mardones (RM chart, 1997), is analysed and compared with other charts in terms of its usefulness for targeting nutritional interventions aimed at preventing low or high birth weights. The RM chart defines categories of maternal nutritional status in early gestation based on weight/height, expressed either as percentage of standard weight (PSW) or body mass index (BMI), and desirable gestational weight gains for each of these categories. Weight gain recommendations of the RM chart are proportional to maternal height. For underweight women the weight recommendation was derived from actual data, while for overweight and obese women it is based on data extrapolations. Since 1987 the Chilean National Health Service has used the RM chart as a standard in prenatal care in all its clinics, covering approximately 70% of the country's population, mostly middle and low income women. During the 1987-2001 period the proportion of underweight pregnant women and infants with birth weight or = 4000 g increased during this period. Multifactorial social changes including a decade of substantial economic growth in the country with improved family income, precludes the possibility of determining the efficacy of the RM chart in this group. However, the widespread use of the RM chart indicates that it is a helpful and easy-to-use instrument in the field. Further, by its clear graphical presentation of maternal nutritional status it helps draw the attention of health personnel to women who need special nutritional advice and support. PMID:16881883
Mardones, Francisco; Rosso, Pedro
The aim was to identify factors that could influence recruitment in a prospective longitudinal study involving pregnant women. A total of 269 nulliparous women were enrolled for a prospective longitudinal study, to establish the prevalence of levator ani muscle defects during childbirth. The project was explained verbally and potential participants were given an information leaflet. When eligible and interested, they provided their contact details to enquire if they were willing to participate. Out of the 1,473 women approached, 269 (18.3%) agreed to participate and 1,043 (70.8%) declined; 420 women (40.3%) did not provide a reason for non-participation (see text for further details). Most often mentioned reasons were 'being too busy', 'other pregnancy problems', 'no additional (internal) examination', 'moving (abroad)' and 'husband'. Women from different ethnicities and age groups gave a wide variety of reasons for non-participation. This information can now be used by researchers recruiting women for comparable studies, to enhance recruitment and participation of eligible patients.
van Delft K; Schwertner-Tiepelmann N; Thakar R; Sultan AH
The aim of this case report is to present a rare case which has been reported with the history of small nodule like growth on mandibular buccal and lingual area. Thirty year old pregnant women reported a nodule on left mandibular buccal and lingual region. The lesion was surgically excised and sent for biopsy to differentiate from kimura's disease, pyogenic granuloma, epithelioid angiosarcoma (EH). Histologically lesion shows proliferation of endothelial cells along blood vessels suggesting epithelioid hemangioma. The purpose of this report is to discuss and differentiate EH and other vascular rare entities occurring in the oral cavity.
Kumar M; Goyal N; Dahiya P; Gupta R
Pregnant women and children have special needs and vulnerabilities that should be addressed when preparing for travel abroad. The most stable time for travel during pregnancy is the second trimester. Live vaccines should be avoided during pregnancy. Children should be up to date on both routine and travel-related vaccines. Elective travel to malarious areas, especially where chloroquine-resistant malaria is endemic, should be avoided, as some vaccines and antimalarial drugs may not be used during pregnancy and for children below a certain age. Guidelines on preventive measures are given.
Høgh B; Rønn AM
FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely obstetrics, and can be used for treating anaemia in pregnant women. For this purpose, iron preparations are added with Poetam 900 mg/day. The length of the therapeutic course is 3 weeks in moderate severity of anaemia, 6 weeks - in severe anaemia, and 8 weeks - in very severe anaemia. ^ EFFECT: method provides intensified therapeutic effect ensured by stimulating production of endogenous renal erythropoietin and higher concentration of sulphhydryl groups and lipoproteins in red blood cell membranes with no side effects. ^ 6 tbl, 1 ex
DYGAJ ALEKSANDR MIKHAJLOVICH; UDUT ELENA VLADIMIROVNA; SOTNIKOVA LARISA STEPANOVNA; BURMINA JANA VADIMOVNA; UDUT VLADIMIR VASIL EVICH; ZHDANOV VADIM VADIMOVICH; MINAKOVA MARIJA JUR EVNA
The aim of this case report is to present a rare case which has been reported with the history of small nodule like growth on mandibular buccal and lingual area. Thirty year old pregnant women reported a nodule on left mandibular buccal and lingual region. The lesion was surgically excised and sent for biopsy to differentiate from kimura's disease, pyogenic granuloma, epithelioid angiosarcoma (EH). Histologically lesion shows proliferation of endothelial cells along blood vessels suggesting epithelioid hemangioma. The purpose of this report is to discuss and differentiate EH and other vascular rare entities occurring in the oral cavity. PMID:23723608
Kumar, Mukesh; Goyal, Niti; Dahiya, Parveen; Gupta, Rajan
The aim of this case report is to present a rare case which has been reported with the history of small nodule like growth on mandibular buccal and lingual area. Thirty year old pregnant women reported a nodule on left mandibular buccal and lingual region. The lesion was surgically excised and sent for biopsy to differentiate from kimura's disease, pyogenic granuloma, epithelioid angiosarcoma (EH). Histologically lesion shows proliferation of endothelial cells along blood vessels suggesting epithelioid hemangioma. The purpose of this report is to discuss and differentiate EH and other vascular rare entities occurring in the oral cavity.
Kumar, Mukesh; Goyal, Niti; Dahiya, Parveen; Gupta, Rajan
[en] Data from two pregnant women contaminated with 137Cs, body burdens of 0.2 and 300 MBq, respectively at the time of the Goiania accident, were compared. The first one, with lower body burden was exposed during the fourth month of pregnancy, while the second became pregnant three years and eight months after 137Cs intake. For the first woman 137Cs concentrations were equal for the mother, infant and placenta, indicating an easy and homogeneous transport of 137Cs from mother to foetus. The whole body monitoring data from the second woman, who became pregnant four years after intake, did not show a reduction in biological half-life during the pregnancy. Cs concentration in the mother was found to be 13 times higher than in the infant. One possible reason for this result is that four years after intake, Cs is supposed to be concentrated mainly in skeletal muscle tissue. During the pregnancy the blood flux becomes higher in most of the organs and tissues except brain, liver and skeletal muscle tissue. (author)
INTRODUCTION: Pregnant women frequently show significant changes in their eating habits. The aim of the study was to evaluate the pleasure derived from the consumption of selected food groups in women during the first and second trimester of pregnancy. MATERIAL AND METHODS: The studied group included 64 healthy women, aged 23-38. 32 women were in the first trimester of pregnancy and 32 women in the second trimester. The food preference interviews were conducted by the presentation of colourful photographs showing selected food groups. Then each participant answered the following question: "How much pleasure do you take from this food?". The results were recorded on a linear analogue scale. The women evaluated the pleasure they derived from food before pregnancy and in the first or second trimester of pregnancy. RESULTS: The women in the first trimester of pregnancy, showed a lower preference for eggs, sweets, pasta, red meat, fast food, salty snacks, spicy food, and seafood as compared to their preferences before the pregnancy. The women in the second trimester declared a significantly higher preference for chicken soup, fruit and sour food, and rated the taste of beef and pork, spicy food and salty snacks as less pleasurable than before the pregnancy. CONCLUSIONS: The first trimester of pregnancy is a period of decreased pleasure derived from food, whereas the perception of food in the second trimester is characterized by a general hedonic dimension similar to that from before the pregnancy. Both in the first and the second trimester of pregnancy women show a lower preference for beef and pork, spicy food and salty snacks.
Klimacka-Nawrot E; Suchecka W; Hartman M; Ga?azka A; Musialik J; Petelenz M; B?onska-Fajfrowska B
44 pregnant women were treated at the Department of Clinical Toxicology in years 1986-1996 as a result of acute poisonings with different xenobiotics. Acute pesticide poisoning that involved 4 cases were always severe and had dramatic clinical course. Carbofuran intoxication stated in a 17-year-old woman (18 weeks of pregnancy) resulted in fetus death. Toxicological findings revealed that the level of the poison in the mothers blood was comparable to that in the fetus. Carbofuran evidently passed the placental barrier in concentration which was sufficient to cause the fetus death. In the second woman (20-year-old, 12 weeks pregnant) who was classified as severely poisoned on admission to the clinic a spontaneous abortion was stated on 27th day after poisoning. The highest level of carbofuran in the blood of the mother was 9.71 micrograms/g. A 30-year-old woman, 10 weeks pregnant took formothion (50 ml) per vaginam in order to provoke abortion. She was classified as moderately poisoned. Gynecological examination and ultrasonography confirmed the pregnancy. The fetus heart tones were audible. The patient was discharged from hospital after 3 days at her own request in a good general condition. The concentration of formothion in washings from vagina was similar to the levels observed in blood serum on the patient admission to the Clinic, and 24 hour later. A 21-year-old woman, 5 month pregnant ingested an unknown amount of endosulfan to provoke abortion. Gynecological examination and abdominal ultrasonography revealed longitudinal pelvic presentation of fetus. Neither fetal movement nor heart tones were audible as early as four hours after the clinical symptoms occurred. Such low concentration of endosulfan in the blood of the mother as 0.47 microgram/g of the poison caused relatively quick fetus death. The highest levels of endosulfan were found in the liver and in the fetus kidneys. PMID:9478098
Sancewicz-Pach, K; Groszek, B; Pach, D; K?ys, M
44 pregnant women were treated at the Department of Clinical Toxicology in years 1986-1996 as a result of acute poisonings with different xenobiotics. Acute pesticide poisoning that involved 4 cases were always severe and had dramatic clinical course. Carbofuran intoxication stated in a 17-year-old woman (18 weeks of pregnancy) resulted in fetus death. Toxicological findings revealed that the level of the poison in the mothers blood was comparable to that in the fetus. Carbofuran evidently passed the placental barrier in concentration which was sufficient to cause the fetus death. In the second woman (20-year-old, 12 weeks pregnant) who was classified as severely poisoned on admission to the clinic a spontaneous abortion was stated on 27th day after poisoning. The highest level of carbofuran in the blood of the mother was 9.71 micrograms/g. A 30-year-old woman, 10 weeks pregnant took formothion (50 ml) per vaginam in order to provoke abortion. She was classified as moderately poisoned. Gynecological examination and ultrasonography confirmed the pregnancy. The fetus heart tones were audible. The patient was discharged from hospital after 3 days at her own request in a good general condition. The concentration of formothion in washings from vagina was similar to the levels observed in blood serum on the patient admission to the Clinic, and 24 hour later. A 21-year-old woman, 5 month pregnant ingested an unknown amount of endosulfan to provoke abortion. Gynecological examination and abdominal ultrasonography revealed longitudinal pelvic presentation of fetus. Neither fetal movement nor heart tones were audible as early as four hours after the clinical symptoms occurred. Such low concentration of endosulfan in the blood of the mother as 0.47 microgram/g of the poison caused relatively quick fetus death. The highest levels of endosulfan were found in the liver and in the fetus kidneys.
Sancewicz-Pach K; Groszek B; Pach D; K?ys M
Full Text Available Objectives: Insufficient data are available comparing medical costs, hospitalization or admission rate, and drugs used for the treatment of pregnant and non-pregnant women admited to the emergency department (ED) due to suicide attempts following drug intoxication. We sought to evaluate these differences in our ED. Methods: This is a prospective, cross-sectional study; hence we attempted to follow all pregnant and non-pregnant women who were admitted in our ED at Ataturk University, Erzurum-Turkey, due to suicide attempt with drug intoxication. We have obtained records of management plans, estimated costs and hospital admission rate in the ED from 2008 to 2011 and compared in both groups. Results: A total of 309 women were registered as suicide attempts with drug intoxication. Out of these, 23 (7.4%) were pregnant and 286 (92.6%) were non-pregnant. The pregnant women had lower rate of past history of psychiatric illness as compared to non-pregnant women (4.3% vs. 26.2%; p=0.019). Comparison of drug intoxication revealed a higher rate of intake of organophosphate (39.1%; vs. 34.8% p<0.001) and paracetamol (39.1% vs. 19.9%; p=0.031), but a lower rate of multidrug ingestion (39.1% vs. 67.8%; p=0.005) in pregnant women. Furthermore, pregnant women have a lower rate of hospitalization in ED (56.5% vs. 77.6%), but higher rates of hospitalization in internal services (13% vs. 6.3%), and intensive care units (13% vs. 3.1%; p=0.039) compared to non-pregnant women. Consequently, the cost of therapy was also higher in pregnant (2553.5±6206.7 TL vs. 581.3±490.3 TL; p<0.001). Conclusions: Though pregnant women were admitted less frequently compared to non-pregnant women, suicide attempts with drug intoxication among pregnant women have increased consequences in terms of hospitalization rate and cost. Thus there is an urgent need to incorporate a special screening program to measure suicide risk followed by counseling for pregnant women during post-conceptual care.
Mustafa UZKESER; Murat SARITEMUR; Ayhan AKÖZ; At?f BAYRAMO?LU; Mücahit EMET
BACKGROUND: Human immunodeficiency virus (HIV) prevalence is high among rural dwellers and pregnant women. AIMS: This study aims to determine the prevalence of HIV and anemia among pregnant women attending antenatal clinic in rural community of Okada, Edo State, Nigeria. PATIENTS AND METHODS: Anticoagulated blood and sera samples were obtained from 480 women consisting of 292 pregnant and 188 non-pregnant women. Antibodies to HIV were detected in the sera samples and hemoglobin concentration of the anticoagulated blood specimens were determined using standard techniques. Anemia was defined as hemoglobin concentration <11g/dl for pregnant women and <12g/dl for non-pregnant women. RESULTS: Pregnancy was not a risk factor for acquiring HIV infection (pregnant vs. non-pregnant: 10.2% vs. 13.8%; OR=0.713, 95% CI=0.407, 1.259, P = 0.247). The prevalence of HIV was significantly (P = 0.005 and P = 0.025) higher in the age group 10-20 years and 21 - 30 years among pregnant and non-pregnant women respectively. Pregnancy was a risk factor for acquiring anemia (OR=1.717, 95% CI=1.179, 2.500, P = 0.006). Only the age of pregnant women significantly (P = 0.004) affected the prevalence of anemia inversely. CONCLUSION: The prevalence of HIV and anemia among pregnant women were 10.2% and 49.3% respectively. Pregnancy was associated with anemia. Interventions by appropriate agencies are advocated to reduce associated sequelae.
Oladeinde BH; Phil RO; Olley M; Anunibe JA
Background: Human immunodeficiency virus (HIV) prevalence is high among rural dwellers and pregnant women. Aims: This study aims to determine the prevalence of HIV and anemia among pregnant women attending antenatal clinic in rural community of Okada, Edo State, Nigeria. Patients and Methods: Anticoagulated blood and sera samples were obtained from 480 women consisting of 292 pregnant and 188 non-pregnant women. Antibodies to HIV were detected in the sera samples and hemoglobin concentration of the anticoagulated blood specimens were determined using standard techniques. Anemia was defined as hemoglobin concentration <11g/dl for pregnant women and <12g/dl for non-pregnant women. Results: Pregnancy was not a risk factor for acquiring HIV infection (pregnant vs. non-pregnant: 10.2% vs. 13.8%; OR=0.713, 95% CI=0.407, 1.259, P = 0.247). The prevalence of HIV was significantly (P = 0.005 and P = 0.025) higher in the age group 10-20 years and 21 – 30 years among pregnant and non-pregnant women respectively. Pregnancy was a risk factor for acquiring anemia (OR=1.717, 95% CI=1.179, 2.500, P = 0.006). Only the age of pregnant women significantly (P = 0.004) affected the prevalence of anemia inversely. Conclusion: The prevalence of HIV and anemia among pregnant women were 10.2% and 49.3% respectively. Pregnancy was associated with anemia. Interventions by appropriate agencies are advocated to reduce associated sequelae.
Oladeinde, Bankole Henry; Phil, Richard Omoregie M.; Olley, Mitsan; Anunibe, Joshua A.
Consecutive serum samples from 5402 women were analyzed for specific IgG and IgM Toxoplasma gondii antibodies by enzyme immunosorbent assay. The prevalence of IgG antibodies was 27.4%. The seroconversion rate was estimated to be 1.16% per year (SE = 0.0017) in all age groups, consistent with an incidence of acute toxoplasmosis in pregnant women of 0.65%. Based on theses figures, the estimated number of congenitally infected cases are discussed. There was no difference in the prevalence of antibodies in women from rural or urban areas, or from different parts of Denmark.
Lebech M; Larsen SO; Petersen E
Urinary Incontinence in Women Who Have Never Been Pregnant Summaries for Patients are a service provided by ... of modern medicine. The full report is titled “Urinary Incontinence in Young Nulligravid Women. A Crosssectional Analysis.” ...
White blood count (WBC) with differential counts and packed cell volume (PCV) were studied in 100 pregnant and 30 non-pregnant control women aged 18-45 years. Eighty of the pregnant women were homozygous HbAA and 20 heterozygous HbAS. The non-pregnant women's PCV, lymphocyte and eosinophils counts were significantly higher (p < 0.005) while their leucocytes neutrophil counts were significantly lower (p < 0.005) compared with HbAA and HbAS pregnant women. However, HbAS pregnant women had higher leucocyte, lymphocyte and eosinophil counts compared with HbAA, but these were not significant. There were no variations in basophil and monocyte counts. HbAA pregnant women had no change in PCV but significant changes occurred in leucocyte and neurophil counts with increase in the second trimester with decreasing lymphocyte and eosinophil counts in the second and third trimesters. However, HbAS pregnant women had significant increase in PCV in their first trimester, leucocyte and neutrophil counts in their third trimester but no variation in lymphocyte, eosinophil and basophil and monocyte counts. The increased leucocyte and neutrophil counts in the second trimester in HbAA and third trimester in HbAS may be due to genetic factor and/or oestrogen secretion reaching production peak at different periods of pregnancy. The relative increase in these haematological indices in HbAS women may be a protective mechanism against infection during pregnancy.
Awodu OA; Enosolease ME; Ubaru AG; Famodu AA
Full Text Available Background and Objective: Based on the latest researches it is concluded that periodontal disease is an important risk factor, leading to preterm delivery low birth weight babies and the effects of socioeconomic status on periodontal condition. The aim of this study, evaluation of periodontal condition of pregnant and non-pregnant women based on CPITN index and relation between the demographic and clinical variables. Subjects and Methods: A cross–sectional descriptive study was carried out among 540 pregnant and non-pregnant women. Data collection was carried out with a questionnaire with demographic and clinical variables. Examinations were performed with WHO probes and dental mirrors. Data were analyzed by the means on Chi-square T-test and Anova. SPSS Software was used.Results: The results of study showed that 66.7% pregnant women had periodontal disease and 92% pregnant women in third trimester had periodontal disease. There was a significant relation between CPITN and gestational age, education level, economic level and frequency of tooth brushing. Conclusion: The results of this study showed that pregnant women had higher CPITN than non pregnant women, then it might be suggested that simple preventive oral hygiene program help to maintain healthy periodontium during pregnancy. Sci Med J 2011; 10(3):309-316
Golpasand Hagh Leila; Zakavi Faramarz; Teimouri Hossein
Full Text Available Abstract Background The function of the hypothalamic-pituitary-adrenal (HPA) axis is known to be altered during pregnancy, but it has not been tested with a natural stressor. Methods A group of pregnant women (n = 10) were tested towards the end of pregnancy (mean 36.8 ± 2.5 weeks gestation) and about 8 weeks postpartum (mean 7.8 ± 1.5 weeks), together with a matched control group, with a one minute cold hand stressor test. Saliva samples were collected before and 10 and 20 minutes after the test, and stored for later radioimmunoassay of cortisol. Results The control group showed a highly significant response to the test. The pregnant group showed no response, and the postpartum group a variable but non significant one Conclusions This shows that the HPA axis becomes hypofunctional to a natural stressor at the end of pregnancy. It is suggested that one possible evolutionary function for this is to protect the fetus from the stress responses of the mother.
Kammerer Martin; Adams Diana; Castelberg Brida von; Glover Vivette
Influenza is a major cause of morbidity and mortality worldwide. During seasonal influenza epidemics and pandemics, pregnancy places otherwise healthy women at an increased risk of complications from influenza. The factors believed to increase the susceptibility of complicated influenza infection during pregnancy are linked to the physiologic changes, including immunologic changes (attenuation of the cell-mediated immune responses, selective suppression of T-helper 1 cell mediated immunity while the adaptive humoral immunity remains unimpaired), increased cardiac output and oxygen consumption and tidal volume. Pregnant women have similar incidence of seasonal influenza as the general population, however because of the physiological changes, they are at an increased risk of complications (including secondary pneumonia, acute respiratory insufficiency increased risk of stillbirth, premature deliveries) and death. Immunization of pregnant women against influenza is currently recommended in many countries. Vaccination against influenza with trivalent inactivated vaccine (TIV) has been proven to be safe and effective. Lack of harmful effect of TIV on pregnant women and newborns has been demonstrated in several studies: no increased risk of spontaneous abortions, preterm birth, low birth weight, congenital malformations, cesarean section have been reported. Vaccination against influenza has been proven to be effective in reducing rates and severity of the disease in vaccinated mothers and their children. Several studies revealed a decreased risk of influenza-like illnesses among mothers who were vaccinated during pregnancy but also a decreased risk of laboratory confirmed cases of influenza and hospitalizations due to influenza and its complications among newborns and infants born to vaccinated mothers. Currently available inactivated influenza vaccines are not licensed for use in infants younger than 6 months. Protection of young infants against the infection in early life thus requires a cocooning strategy to reduce the number of vulnerable individuals among care givers and contacts. Neonates and infants may be also protected against influenza directly by antibodies of maternal origin that cross the placenta or are transferred via breast milk. The duration of passively acquired antibodies depends on the initial blood concentration and is probably less than 6 months. Vaccine coverage among pregnant women rdmains low Possible explanations include lack of education by health care workers, the feeling among the general public that influenza is not a serious problem, and the failure of prenatal care providers to offer the vaccine. Overall, the most important factor for a woman to decide to be immunized during pregnancy was to have a clear recommendation from the health care provider Reasons evoked by obstetricians for not providing influenza vaccines included lack sufficient data on safety and efficacy concerns about the medical legal risks of vaccination during pregnancy and the perdeption that pregnant women would not want to be vaccinated. Educational intervention targeting health care workers in charge of pregnant women should be primary implemented to provide higher influenza vaccine coverage and to protect pregnant women and young infants from influenza related morbidity PMID:23488311
Nitsch-Osuch, Aneta; Wo?niak Kosek, Agnieszka; Brydak, Lidia Bernadeta
Full Text Available Introduction: A strong relationship between maternal weight and birth weight has been demonstrated consistently and low maternal weight is considered as a preventable risk factor for low birth weight.Objectives: To determine the frequency of preterm labour and fetal outcome in terms of low birth weight in pregnant women with low body mass index 37 weeks gestation. Mean gestational age observed 38.5±4.1. Out of 15 preterm deliveries, 10 (66.7%) had uterine contractions >4/10 min 5 and (33.3%) patients had Cervical dilatation >2cm. Out of 114 patients, 12 (10.5%) cases had fetal weight <2.5 kg and while remaining 102 cases (89.5%)had fetal weight 2.5-4 Kg. Conclusions: In conclusion, this study demonstrates that low BMI is associated with preterm delivery and low birth weight babies.
UZMA UROOJ; ASMA ANSARI; SHEHLA BAQAI
Full Text Available This study was carried out on a cross-sectional prospective basis on 590 pregnant women attending ante natal OPD in government medical college and hospital over a period of 1 year during their routine ante natal check up for screening cervical malignancies. The data obtained were analysed. 99% of the cases were less than 30 years of age. No single case of cervical dysplasia or malignancy was reported. Considering that we have limited resources, screening these young patients in whom we expect low incidence of pre cancer or cancerous lesions doesn?t appear to be a very good approach. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 359-362
Pooja Singh; Vibha Baghel
BACKGROUND: Occurrence of birth defects (BD) remains an important public health issue. Inadequate knowledge about the defects among prospective mothers could result in delayed interventions. The study determined the knowledge of BD among pregnant women in relation to their socio-demographic profile. METHOD: Four hundred and forty-three (443) pregnant women gave their consent to participate in this study. A researcher-administered questionnaire was used to obtain information on socio-demographic characteristics from the participants and their knowledge about BD. The questionnaire was assessed for test re-test reliability before been administered. The possible scores on the knowledge domain of the questionnaire were categorized into three levels: low knowledge (0-4), moderate knowledge (5-8) and high knowledge (9-12) levels. Data were analyzed using percentages while Spearman's rank correlation was used to determine the relationship between the knowledge of BD among the participants and their socio-demographic profile. Alpha level was set at p < 0.05. RESULTS: A greater proportion of the participants, 235(53.0%) were found in the age range 21 to 30 years, and 234(52.8%) attained secondary level of education. Majority of the participants, 205(46.3%) had high knowledge on the risk factors while 213(48.1%) and 224(50.6%) had moderate overall knowledge and specific knowledge about BD respectively. Most of the participants (48.1%) believed that BD were of supernatural origin. The age, level of education, number of antenatal visits and parity of the participants were not significantly correlated (p > 0.05) with their specific and overall knowledge. CONCLUSIONS: Particpants generally had moderate knowledge about BD. However, this had no bearing on their socio-demographic profile. The knowledge base about BD seems to be influenced by traditional belief of the participants. This finding should therefore serve as a guide for health care providers while planning awareness campaign about BD.
Bello AI; Acquah AA; Quartey JN; Hughton A
Protein turnover was studied in nine non-pregnant (NP) women, eight pregnant (P) and two gestational diabetic (GDM) women. Whole body protein turnover, synthesis and catabolism rates were measured using a single oral dose of /sup 15/N-glycine followed by measurement of enrichment of urinary ammonia. Urinary 3-methylhistidine (3MH) excretion was measured for three consecutive days, including the day of the protein turnover study. Whole body protein turnover and synthesis rates did not differ between the P and NP women, although the synthesis rates tended to be higher in the P group. Gestational diabetic women appeared to have considerably higher rates of both turnover and synthesis. Pregnant women excreted significantly more urinary 3MH than did non-pregnant women. GDM women appeared to have lower 3MH excretion than the P women. Correlation between 3MH excretion and protein turnover rates was nearly significant (p = .06) in the NP women, but was poorly correlated (p = .43) in the P women, suggesting that muscles may be a less important site of whole body protein turnover in pregnancy than in the non-pregnant state.
Fitch, W.L.; King, J.C.
Protein turnover was studied in nine non-pregnant (NP) women, eight pregnant (P) and two gestational diabetic (GDM) women. Whole body protein turnover, synthesis and catabolism rates were measured using a single oral dose of 15N-glycine followed by measurement of enrichment of urinary ammonia. Urinary 3-methylhistidine (3MH) excretion was measured for three consecutive days, including the day of the protein turnover study. Whole body protein turnover and synthesis rates did not differ between the P and NP women, although the synthesis rates tended to be higher in the P group. Gestational diabetic women appeared to have considerably higher rates of both turnover and synthesis. Pregnant women excreted significantly more urinary 3MH than did non-pregnant women. GDM women appeared to have lower 3MH excretion than the P women. Correlation between 3MH excretion and protein turnover rates was nearly significant (p = .06) in the NP women, but was poorly correlated (p = .43) in the P women, suggesting that muscles may be a less important site of whole body protein turnover in pregnancy than in the non-pregnant state.
The objective was to elicit the mental representations about the sex of the future child of 89 nulliparous pregnant women who declared having no sex preference, using the Kelly's Repertory Grid. Analyses showed that 67% of these women had no explicit and clear representation about the sex of their first child. These data suggest that these pregnant women seemed really to have no sex preference.
Marleau JD; Saucier JF; Bernazzani O; Borgeat F; David H
The objective of the study was to evaluate the level of knowledge about the influence of diet during pregnancy on the development and health of a child, among pregnant women in relation to their eating habits. The diet of a woman before and during pregnancy has immense influence on the course of pregnancy and health of a child--both after its delivery and in the future. Lack of dietary knowledge and the knowledge about consequences of malnutrition among future mothers may result in a lot of dietary indiscretion, which in turn can cause deficiency or excess of energy and particular nutrients, as well as abnormal course of pregnancy. Hence, for keeping a proper diet during pregnancy a woman must not only know the healthy eating guidelines, but also realise how a diet influences the course of pregnancy and child's health. The study was conducted with the use of 3 specially prepared questionnaires, among 77 women in the III trimester of pregnancy, participating in the Parturition School course. The first questionnaire referred to general data (age, education, antropometric data) and the way of supplementing diet with medicinal compounds supplying vitamins and minerals. The second questionnaire showed the dietary habits before pregnancy, while the third questioned the influence of diet on the course of pregnancy and health of the infant. In the second stage the eating habits of the subjects were studied also with the use of a 24-hour interview and an album of food products issued by the Institute of Food and Nutrition. Summing it up, the analysis of the results of the study showed that though pregnancy is a difficult period for a woman, it did not make the subjects pay particular attention to their diet. The study showed also that the majority of women does have knowledge on the influence of diet and the influence of her nourishment before pregnancy on the development of foetus, however, it hardly results in the change of their eating habits.
Koz?owska-Wojciechowska M; Wujec MM
OBJECTIVE: In pregnant women, the pituitary is enlarged and the prolactin (PRL) secreting cells increase in size and number. This PRL cell hyperplasia is associated with hyperprolactinemia. The aim of the present work was to investigate adenohypophysial vascularization and immunoexpression of vascular endothelial growth factor (VEGF) in pituitaries of pregnant and post-partum women and compare the results with age-matched adenohypophyses of nonpregnant women who had no endocrine diseases. DESIGN: Pituitaries (n=18) obtained by autopsy from female patients of reproductive age who had died during pregnancy, after abortion or during post-partum were immunostained for CD-34 and VEGF using the streptavidinbiotin- peroxidase complex method. RESULTS: The results showed that microvessel densities and VEGF immunoexpression in the adenohypophyses of pregnant and post-partum women were similar to those found in the control pituitaries. CONCLUSION: It can be concluded that pituitary enlargement and PRL cell hyperplasia in pregnant women may occur without neovascularization and increased VEGF immunoexpression.
Rotondo F; Rotondo A; Jentoft M; Scheithauer BW; Syro LV; Donado JH; Tarara JE; Kovacs K
BACKGROUND: Iodine requirements increase during pregnancy and previous studies have reported the inadequate iodine status of pregnant women in areas that have achieved iodine sufficiency in the general population. We examined the urinary iodine (UI) concentrations of pregnant women in Ukraine, where the iodine status is showing improvement among the general population. METHODS: We enrolled 148 pregnant women<16 weeks pregnant and 80 healthy women as a control group living in Zhitomir, Ukraine. UI concentration, thyroid-stimulating hormone (TSH), antithyroglobulin antibodies (TGAb), and antithyroid peroxidase antibodies (TPOAb) were measured. RESULTS: The median UI concentrations were significantly lower in pregnant women than in control women [13.0 (ND–51.0) ?g/L vs. 62.0 (35.3–108.5) ?g/L, p<0.001]. TSH concentrations were significantly lower in pregnant women than in control women [1.7 (1.2–2.7) IU/L vs. 2.2 (1.4–3.1) IU/L, p=0.011], but this difference disappeared when adjusted for age (2.1±0.1 IU/L vs. 2.4±0.2 IU/L, p=0.097). The frequency of TSH over 6.2 IU/L and the frequency of positive TGAb and/or TPOAb were not statistically different between groups (p=0.70 and p=0.48, respectively). The UI concentrations of 142 pregnant women (95.9%) were <150 ?g/L indicating insufficient iodine intake. CONCLUSIONS: The UI concentration of pregnant women in Ukraine revealed severe iodine deficiency. Regular monitoring and appropriate nutrition education are essential because iodine deficiency can be easily prevented by adequate iodine intake. The risk of iodine deprivation during pregnancy needs to be assessed locally over time because it may occur in areas that are not globally recognized as being iodine-deficient.
Sekitani Y; Hayashida N; Takahashi J; Kozlovsky AA; Rudnitskiy S; Petrova A; Gutevych OK; Chorniy SA; Yamashita S; Takamura N
Chlamydia trachomatis infection is currently among the most prevalent sexually transmitted diseases in the United States. A review of three textbooks of obstetrics reveals that none of them recommend routine chlamydia screening in prenatal patients, although two recommend routine screening for gonorrhea. A study was done at the Barberton Citizens Hospital Family Practice Residency Program to determine the incidence of asymptomatic chlamydia infection in pregnant women and to compare this to the incidence of asymptomatic Neisseria gonorrhoeae infection in the same population. A total of 69 patients were screened for Neisseria gonorrhoeae and Chlamydia trachomatis as part of their routine prenatal evaluations at the first prenatal visit and the visit of 36 weeks gestation. Neisseria gonorrhoeae was detected by growth on standard Martin-Lewis culture plates. Chlamydia trachomatis was detected by positive immunofluorescence using a standardized specimen kit (Syva Company, Palo Alto, California). The data were collected over a 12-month period from July of 1987 through July of 1988. There were no positive cultures for Neisseria gonorrhoeae (0%) in this group of patients. On the other hand, five patients tested positive for Chlamydia trachomatis (7.2%). The results of this study indicate that routine screening for Chlamydia trachomatis should be considered as part of the routine prenatal care. A larger, multi-centered study could be done in the future to confirm these results, as well as to determine if any regional differences exist.
Hagley MT; Costa AJ
Chlamydia trachomatis infection is currently among the most prevalent sexually transmitted diseases in the United States. A review of three textbooks of obstetrics reveals that none of them recommend routine chlamydia screening in prenatal patients, although two recommend routine screening for gonorrhea. A study was done at the Barberton Citizens Hospital Family Practice Residency Program to determine the incidence of asymptomatic chlamydia infection in pregnant women and to compare this to the incidence of asymptomatic Neisseria gonorrhoeae infection in the same population. A total of 69 patients were screened for Neisseria gonorrhoeae and Chlamydia trachomatis as part of their routine prenatal evaluations at the first prenatal visit and the visit of 36 weeks gestation. Neisseria gonorrhoeae was detected by growth on standard Martin-Lewis culture plates. Chlamydia trachomatis was detected by positive immunofluorescence using a standardized specimen kit (Syva Company, Palo Alto, California). The data were collected over a 12-month period from July of 1987 through July of 1988. There were no positive cultures for Neisseria gonorrhoeae (0%) in this group of patients. On the other hand, five patients tested positive for Chlamydia trachomatis (7.2%). The results of this study indicate that routine screening for Chlamydia trachomatis should be considered as part of the routine prenatal care. A larger, multi-centered study could be done in the future to confirm these results, as well as to determine if any regional differences exist. PMID:2601940
Hagley, M T; Costa, A J
Full Text Available Aim. To assess the efficacy of specialized management of pregnant women with cardiovascular diseases (CVD) in the Udmurt Republic (UR) of Russia.Material and methods. In prospective and retrospective study we investigated pregnancy outcomes in all 17948 women in management system created for pregnant patients with CVD in the UR from 2000 to 2007. The system comprises specialized outpatient and inpatient departments and an obstetric hospital within the regional cardiological centre.Pregnant women had different CVD including hypertension, congenital and rheumatic heart disease, cardiac arrhythmias, noncoronary myocardial disease, disorders and autoimmune diseases of connective tissue, etc.Results. Perinatal mortality decreased by 41,1% from 11,2‰in 2000 to 6,6‰in 2007. During 8 years, no one woman died.Conclusion. The management system for pregnant women with CVD within the regional cardiological clinic makes it possible to reduce of maternal and perinatal mortality rates significantly.
I.R. Gaisin; R.M. Valeeva; L.V. Shilina; N.Yu. Chernisheva; N.I. Maksimov
The article presents the peculiarities of gestasion in pregnant women with metabolic syndrome. The obtained findings testify that metabolic syndrome is a factor of high risk in the development of gestosis, fetoplacental insufficiency and another obstetrical complication.
R.R. Berihanova; G.I. Khripunova
Full Text Available Background & Aim: Pregnancy can conflict with sexual function that can be affected by physical and psychological changes during pregnancy. The aim of this study was to compare sexual functions between nulliparous and multiparous pregnant women referred to health centers in Eastern district of Guilan. Methods & Materials: This cross-sectional study was carried out in Guilan during 2009-2010. We used convenient sampling method to select 554 pregnant women. Data were gathered using a questionnaire including demographic characteristics, sexual function and fear of harm to fetus. The SPSS-16 was used to analyze the data by the Mann-Whitney U and Generalized linear models. The level of significance was set at 5%. Results: There was no significant difference between nulliparous and multiparous pregnant women regarding sexual function in the first and second trimesters of pregnancy (P=0.353, P=0.251). There were significant differences between nulliparous and multiparous pregnant women regarding sexual desire (P=0.002), arousal (P=0.01), orgasm (P=0.01), pain (P=0.02) and sexual function total score (P=0.016). There was significant difference between nulliparous and multiparous pregnant women regarding sexual function (P=0.008). Conclusion: Sexual counseling and rehabilitation programs should be compiled as part of the comprehensive care of prenatal care especially for multiparous pregnant women.
Kobra Abouzari Gazafroodi; Fatemeh Najafi; Ehsan Kazemnejad; Fatemeh Rahimikian; Mamak Shariat; Parvin Rahnama
The aim of this study was to investigate the urine iodine concentration in women with severe preeclampsia and in healthy women in Erzurum, Turkey. Urine specimens were obtained from 40 severe preeclampsia and 18 healthy pregnant women. Urinary iodine levels were determined by the Foss method based on the Sandell-Kolthoff reaction. The urinary iodine level for women with severe preeclampsia was 4.25 +/- 2.7 microg/dL, lower than 20.89 +/- 6.4 microg/dL of urinary iodine for healthy pregnant women (p < 0.001). Blood magnesium concentration was found to be 1.63 +/- 0.05 mg/dL for women with severe preeclampsia, which is lower than that of healthy pregnant women (1.87 +/- 0.05 mg/dL; p < 0.001). There was a positive correlation between urinary iodine level and blood magnesium level in pregnant women with preeclampsia (Pearson correlation coefficient = 0.43; p < 0.01). However, there was no correlation between urinary iodine level and blood magnesium level in healthy pregnant women. There was no difference in thyroid hormone levels (T4, TSH, FT4) between women with severe preeclampsia and healthy pregnant women. However, there was a difference in T3 thyroid hormone levels between women with severe preeclampsia (1.86 +/- 0.4 microg/dL) and healthy pregnant women (1.45 +/- 0.3 microg/dL; p < 0.001). There was also a difference in FT3 between women with severe preeclampsia (2.77 +/- 0.4 pg/mL) and healthy pregnant women (2.41 +/- 0.5 microg/dL; p < 0.01). Urinary iodine excretion is currently the most convenient laboratory marker of iodine deficiency. The method is useful for the rapid and low-cost assessment of iodine deficiency. Our results suggested that urinary iodine concentration might be a useful marker for prediagnosing preeclamptic women. In addition, iodine supplementation may also be considered for preeclamptic therapy.
Gulaboglu M; Borekci B; Delibas I
Hypothyroxinaemia early in pregnancy may impair fetal brain development. Increased body weight has been associated with low thyroxine concentrations in non-pregnant women. In pregnant women, morbid maternal obesity is a risk factor for thyroid dysfunction. But whether lesser degrees of overweight that are much more common could be a risk factor for hypothyroxinaemia in pregnancy is unclear. The objective of this study was to investigate if overweight increases risk for thyroid dysfunction, and specifically hypothyroxinaemia, in iodine-deficient pregnant women. We performed a cross-sectional study at first hospital visit among healthy Thai pregnant women. We measured weight and height, urinary iodine concentration (UIC), serum thyroid hormones and thyroglobulin. Pre-pregnancy weight and relevant dietary factors were determined by questionnaire, and body mass index (BMI) was used to classify weight status. Among 514 women (mean gestational age, 11 weeks) with a median UIC of 111??g?dL(-1) , indicating mild iodine deficiency, 12% had low free thyroxine (fT4) concentrations: 3% had overt hypothyroidism; 7% had subclinical hypothyroidism; and 8% had isolated hypothyroxinaemia. Based on pre-pregnancy BMI, 26% of women were overweight or obese. In a multiple regression model, BMI was a negative predictor of fT4 (??=?-0.20, P?0.001). Compared to normal weight women, the prevalence ratio (95% CI) of a low fT4 in overweight women was 3.64 (2.08-6.37) (P?0.01). Iodine-deficient pregnant Thai women who are overweight have a 3.6-fold higher risk of hypothyroxinaemia in the first trimester compared to normal weight women. Targeted screening should consider overweight a potential risk factor for thyroid dysfunction in pregnant women in iodine-deficient areas.
Gowachirapant S; Melse-Boonstra A; Winichagoon P; Zimmermann MB
OBJECTIVE: To evaluate the placental activity of steroid sulfatase (STS), 3?-hydroxysteroid dehydrogenase type 1 (3?-HSD-1) and P450 aromatase (P450arom) in polycystic ovarian syndrome (PCOS) compared to normal pregnant women. DESIGN: Twenty pregnant women with PCOS and 30 control pregnant women who delivered at term were studied. Samples of placental tissue and cord blood were obtained after delivery. A maternal blood sample was obtained during the 34th week of gestation. In placental tissue, the activities of STS, 3?-HSD-1 and P450arom were evaluated. In the blood samples, progesterone, DHEAS, DHEA, androstenedione, testosterone, estrone, estradiol and total estriol were determined. RESULT: In placental tissue from women with PCOS, higher 3?-HSD-1 and lower P450 aromatase activities were observed compared to control women. Moreover, women with PCOS showed higher androstenedione and testosterone concentrations compared to normal pregnant women (p=0.016 and p=0.025, respectively). In cord blood, female newborns of women with PCOS exhibited lower androstenedione and higher estriol concentrations compared to daughters of control women (p=0.038; p=0.031, respectively). CONCLUSION: These data suggest that placental tissue from women with PCOS shows changes in the activities of two important enzymes for steroid synthesis, higher 3?-HSD-1 and lower P450, which could increase androgen production during pregnancy.
Maliqueo M; Lara HE; Sánchez F; Echiburú B; Crisosto N; Sir-Petermann T
BACKGROUND AND OBJECTIVE: Different epidemiological studies have shown that maternal excess of weight during pregnancy is associated with adverse outcomes of pregnancy, childbirth and morbidity of the neonate. Prevalence of obesity in a pregnant population of Canary Islands is reported here. SUBJECTS AND METHODS: The group studied was an integrated cohort of all the pregnant women being followed-up at the Materno-Infant University Hospital of the Canarias [Hospital Universitario Materno-Infantil de Canarias; HUMIC] and who concluded their gestation during the year 2008 (n=6693). BMI was measured at the beginning of the pregnancy. RESULTS: 25.0% of the sample of pregnant women were overweight and 17.1% were obese, increasing both with age and not influenced with the educational level. CONCLUSIONS: The prevalence of obesity and overweight among pregnant women from the Canary Islands is high. Among the values available from other European countries, only the UK reported values greater than our study sample.
Bautista-Castaño I; Alemán-Perez N; García-Salvador JJ; González-Quesada A; García-Hernández JA; Serra-Majem L
OBJECTIVE: To investigate highly active antiretroviral therapy (HAART) initiation among pregnant women and the optimum model of service delivery for integrating HAART services into antenatal care. METHODS: We analysed clinic records to reconstruct a cohort of all HIV-infected pregnant women eligible for HAART at four antenatal clinics representing three service delivery models in Cape Town, South Africa. To assess HAART coverage, records of women determined to be eligible for HAART in pregnancy were reviewed at corresponding HIV treatment services. RESULTS: Of 13,208 pregnant women tested for HIV, 26% were HIV-infected and 15% were HAART-eligible based on a CD4 cell count of
Stinson K; Boulle A; Coetzee D; Abrams EJ; Myer L
Full Text Available This study aimed to identify the forms of violence against pregnant women represented in (physical violence, psychological, and social), as well as identifying the consequences of violence against pregnant women, also identifying the impact of some qualitative variables such as (level of education, housing, income level, family members). The forms of violence against a pregnant woman, and to identify the relationship between some qualitative variables and consequences of violence against pregnant women, a study in which consisted of 250 women from pregnant women attending antenatal clinics in the city of Salt in Jordan, was used package Statistical Social Sciences (SPSS).The study was applied at statistical methods and simple statistics advanced test, to analysis of variance T-test and F-test, to show the differences and implications of statistical variables, the results revealed that the actions stressful work, being forced to have sex, and beating, is one of the most prevalent forms of physical violence. A Study also demonstrated that questioning the sex of the baby, neglecting, and the carelessness of the husband to towards the health status, was one of the most common forms of psychological violence known. The exposure of pregnant women to smoke, and the neglect of her husband because of being pregnant with a female and not allowing seeing the doctor was one of the forms of social violence. Also showed that stress, the anxiety and depression is the psychological effects of violence, also the slackness to perform house duties, and isolation forms other social impacts. The results also showed the presence of statistically significant relationships between forms of violence against a pregnant woman due to the variable places of residence, and monthly income. And there are no statistically significant differences to forms of violence attributed to the educational level.
Lubna Makhled Al-adayleh; Hana Husni Al Nabulsi
INTRODUCTION: Female immigration from less developed countries into Spain has grown in number over the years, and could contribute to changing the prevalence of routine serological markers in pregnant women. MATERIAL AND METHODS: From April 2007 until May 2008 we studied the prevalence of serum antibodies against Treponema pallidum, Toxoplasma gondii, rubella virus, human immunodeficiency virus (HIV 1/2), and hepatitis B virus (HBV) in samples from 4,171 immigrant and Spanish pregnant women in Granada. RESULTS: The seroprevalence of toxoplasmosis in pregnant immigrants was higher than in non-immigrants (44% vs. 14.4%). The overall prevalence against rubella was 97.3%. Sub-Saharan and North African women showed the lowest prevalence (88% and 89%). The prevalence of HBsAg was higher in immigrants than in Spanish women (2.6% vs. 0.4%), and especially high among the Eastern European (6.9%) and Asian (8.1%) pregnant women. The seroprevalences of HIV (0.9% vs. 0.1%) and syphilis (TPHA) (3.5% vs. 0.07%), were higher in immigrants. Seroprevalence against T. pallidum was higher among Eastern European (11.5%) and Latin-American (3.5%) women, whereas sub-Saharan (11.8%) and North African (1%) women showed the highest anti-HIV prevalence. CONCLUSION: Hepatitis B, anti-HIV, syphilis, and antibodies against T. gondii are found more frequently in immigrants than in Spanish pregnant women, whereas rubella protection in Spanish women is higher than immigrant pregnant women.
Sampedro A; Mazuelas P; Rodríguez-Granger J; Torres E; Puertas A; Navarro JM
BACKGROUND: Sleep disturbances and symptoms of depression are common during pregnancy. Both are independent and interrelated risk factors for adverse outcomes. It is unclear the degree to which sleep differs between depressed and nondepressed pregnant women. We sought to (1) describe and compare sleep disturbances in depressed pregnant and nondepressed pregnant women, (2) determine the impact of selective serotonin reuptake inhibitors (SSRI) treatment on sleep, and (3) evaluate whether sleep at 20 weeks is associated with increased depressive symptoms and major depressive disorder (MDD) in later pregnancy. METHODS: Pregnant women (N = 240) were recruited in the second trimester (20 weeks gestation) and assigned to depressed (N = 59) and nondepressed (N = 181) groups based on a Structured Clinical Interview for DSM-IV diagnosis of major depressive disorder. The Structured Interview Guide for the Hamilton Rating Scale with Atypical Depression Supplement was administered at 20, 30, and 36 weeks gestation from which the sleep variables were obtained. RESULTS: Depressed women had more fragmented sleep at each assessment (P values?.05). However, the frequency of insomnia symptoms was greater for depressed women only at 20 weeks gestation. SSRI use, regardless of MDD status, did significantly affect several sleep variables. Among the nondepressed women, those with short or longer sleep duration, symptoms of insomnia and long periods of nocturnal waketime had higher Structured Interview Guide for the Hamilton Rating Scale with Atypical Depression Supplement scores later in pregnancy (P values?.05). CONCLUSIONS: At 20 and 30 weeks gestation sleep was more disturbed in depressed pregnant women compared to nondepressed pregnant women. At 36 weeks, sleep was disturbed regardless of depression status or SSRI use. Among the nondepressed women, disturbed sleep in conjunction with SSRI use was associated with higher depressive symptoms.
Okun ML; Kiewra K; Luther JF; Wisniewski SR; Wisner KL
Selecting an infant feeding method is one of the most important decisions a mother-to-be makes. Little information is available to characterize women who plan to use both formula and breast milk. In this study, 89 pregnant women indicated their anticipated feeding method and the sources and initiato...
Chezem, JoCarol; Friesen, Carol; Clark, Heidi
OBJECTIVE: To assess the epidemiology of urogenital schistosomiasis among pregnant women in rural communities of southwestern Nigeria. METHODS: The present cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted during 2010-2011 among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically screened for infection with Schistosoma haematobium. RESULTS: Of 313 volunteer participants, 20.8% tested positive for S. haematobium infection. The prevalence of infection was highest (31.5%) among women aged 20-24years. The infection intensity did not differ significantly between age groups (t=1.848, P=0.71). Primigravidae and women in the first trimester of pregnancy had the highest intensity of infection with 33.1 and 27.7 eggs/10mL of urine, respectively. There was an association between disease prevalence and parasite intensity across the age groups (?(2)=68.82, P=0.02). The prevalence of S. haematobium was not associated with age or pregnancy trimester (P=0.06), but associations existed between intensity of infection and gravidity (P=0.001). CONCLUSION: The prevalence of urogenital schistosomiasis among pregnant women in Nigeria was high, with younger women and primigravidae at the greatest risk. These data can be used to develop a schistosomiasis control program among pregnant women in the study area.
Salawu OT; Odaibo AB
Introduction: Obesity is a growing global public health problem and is as prevalent among pregnant women as in the general population. It is well known that obese women have an increased risk for several complications during pregnancy and delivery and this is also true for the neonate. Excessive ges...
To determine the frequency pattern of presentation and causative agents of lower urinary tract symptoms in pregnant females. One thousand consecutive pregnant women, attending the antenatal clinics of Fatima Memorial Hospital, were included in the study. Women with renal pathology, postrenal transplant and those on immunosuppressive agents were excluded. All women underwent complete examination of urine. Those who had one or more urinary complaints had culture and sensitivity test of urine. Other variables studied were the symptomatology. Out of one thousand pregnant women, 426 (42.6%) complained of one or more urinary symptoms. Diurnal and nocturnal frequency was the most commonly encountered symptom (87.32%), followed by irritative symptoms and voiding difficulties. Complete urine examination of symptomatic patients revealed
BACKGROUND: The overall seroprevalence of HTLV infection among pregnant women in Spain is below 0.02% and accordingly universal antenatal screening is not recommended. However, as the number of immigrants has significantly increased during the last decade, this population might warrant specific considerations. OBJECTIVE: To evaluate the seroprevalence of HTLV infection among immigrant pregnant women living in Spain. METHODS: From January 2009 to December 2010 a cross-sectional study was carried out in all foreign pregnant women attended at 14 Spanish clinics. All were tested for HTLV antibodies using a commercial enzyme-immunoassay, being reactive samples confirmed by Western blot or PCR. RESULTS: A total of 3337 foreign pregnant women were examined. Their origin was as follows: Latin America 1579 (47%), North Africa 507 (16%), East Europe 606 (18%), Sub-Saharan Africa 316 (9%), North America and West Europe 116 (3.5%) and Asia and Australia 163 (5%). A total of 7 samples were confirmed as HTLV positive, of which 6 were HTLV-1 and 1 HTLV-2. HTLV-1 infection was found in 5 women coming from Latin America and 1 from Morocco. The only woman with HTLV-2 came from Ghana. The overall HTLV seroprevalence was 0.2%, being 0.3% among Latin Americans and 0.2% among Africans. It was absent among women coming from other regions. CONCLUSIONS: The seroprevalence of HTLV infection among foreign pregnant women in Spain is 0.2%, being all cases found in immigrants from Latin America and Africa. Given the benefit of preventing vertical transmission, antenatal screening should be recommended in pregnant women coming from these regions.
Treviño A; Benito R; Caballero E; Ramos JM; Parra P; Roc L; Eiros JM; Aguilera A; García J; Cifuentes C; Marcaida G; Rodríguez C; Trigo M; Arroyo LA; de Mendoza C; de Lejarazu RO; Soriano V
Human parvovirus B19 (B19) has been shown to be associated with erythema infectiosum. Recently, it was reported that when a pregnant woman is infected with B19, the fetus in her uterus sometimes becomes hydropic and results in a stillbirth. But no epidemiologic study of pregnant women in Japan has been performed yet. We have established an in vitro propagation system of B19 virions and an assay system for detecting anti-B19 antibody by indirect immunofluorescence (IF) staining. We examined the positive rate of anti-B19 antibody among 337 normal blood donors, 329 normal pregnant women, 23 early aborted women and 24 non-immune hydrops fetalis cases by IF staining. The positive rate for anti-B19 IgG among normal blood donors increased with age. It was 22% aged 21 to 30, 44% aged 31 to 40, 65% aged 41 to 50, and 76% aged 51 to 60, respectively. Anti-B19 IgG was detected in 33% of 329 of normal pregnant women. The anti-B19 IgG positive rate was 26% in pregnant women in their twenties and 44% in those in their thirties. There was a significant difference between the two generations. The results show that more than half the women in their twenties and thirties risk B19-infection during pregnancy. Nine of twenty-three early aborted women were positive for anti-B19 antibody. Among six pregnant women who were positive for anti-B19 IgM, four delivered normal babies and the others aborted artificially or spontaneously. Anti-B19 IgG and IgM of twenty four non-immune hydrops fetalis (NIHF) were examined and four cases were found to be anti-B19 IgG positive.(ABSTRACT TRUNCATED AT 250 WORDS)
Yaegashi N; Okamura K; Hamazaki Y; Yajima A; Shiraishi H; Sugamura K
Full Text Available Introduction. Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. Methods. Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. Results. During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 ( P<.01 ). Discussion. Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered.
Alfonso J. Rodríguez-Morales; Rosa A. Barbella; Cynthia Case; Melissa Arria; Marisela Ravelo; Henry Perez; Oscar Urdaneta; Gloria Gervasio; Nestor Rubio; Andrea Maldonado; Ymora Aguilera; Anna Viloria; Juan J. Blanco; Magdary Colina; Elizabeth Hernández; Elianet Araujo; Gilberto Cabaniel; Jesús Benitez; Pedro Rifakis
The aim was to investigate the prevalence of anaemia in pregnant women emigrated from regions with a high prevalence of anaemia. Of a total of 1741 pregnant immigrant women referred to haemoglobinopathy screening, 406 immigrant women were included when matched by gestational age with a cohort of 205 pregnant ethnic Danish women. The prevalence of anaemia was 20.0% in the immigrant group compared to 4.9% among the Caucasian women, and iron parameters indicated iron-deficiency. Attention and nutritional counselling is thus needed on anaemia in this population group.
Nybo M; Friis-Hansen L; Felding P; Milman N
Abstract The current study examined the correlates of knowledge about human immunodeficiency virus (HIV) transmission through breast milk among drug-dependent pregnant women. There is a tremendous need to examine the knowledge about HIV transmission through breastfeeding among this largely understudied, but high-risk subset of pregnant women in order to minimize the extent to which they pass HIV to their children after giving birth. Participants included 97 pregnant women from Baltimore, MD, USA. Prevalence of drug use over the last 6 months included 37.1% reporting smoking marijuana, 36.1% injecting heroin, and 67.0% smoking crack. When asked whether HIV could be transmitted through breast milk, 72 women (74.2%) answered correctly. Our results indicate that the overall knowledge about transmission through breast milk is relatively low. Furthermore, participants who smoked crack during the past 6 months and participants who were white were significantly less likely to have correct knowledge about this topic. Our findings have important implications with regard to preventive interventions for this population. Future research is needed to determine how to best modify these interventions to address the specific needs of drug-dependent pregnant women, and how to specifically target white women and women who smoke crack.
Zur J; Dunne E; Rose J; Latimer W
Iron homeostasis in pregnancy compensates for increased iron requirements and in women of child-bearing age for iron loss in menses. Oral administration of ferrous sulfate, prescribed to cure iron deficiency (ID) and ID anemia (IDA), often fails to increase hematological parameters and causes adverse effects. Recently, we demonstrated safety and efficacy of bovine lactoferrin (bLf) in pregnant women suffering from ID/IDA. Two clinical trials were conducted on pregnant and non-pregnant women of child-bearing age suffering from ID/IDA. In both trials, women received oral administration of bLf 100 mg/twice/day (Arm A), or ferrous sulfate 520 mg/day (Arm B). Hematological parameters, serum IL-6 and prohepcidin were assayed before and after therapy. Unlike ferrous sulfate, bLf increased hematological parameters (P less than 0.0001). In pregnant women, bLf decreased serum IL-6 (P less than 0.0001), and increased prohepcidin (P=0.0007). In non-pregnant women bLf did not change the low IL-6 levels while it increased prohepcidin (P less than 0.0001). Ferrous sulfate increased IL-6 (P less than 0.0001) and decreased prohepcidin (P=0.093). bLf established iron homeostasis by modulating serum IL-6 and prohepcidin synthesis, whereas ferrous sulfate increased IL-6 and failed to increase hematological parameters and prohepcidin. bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA.
Paesano R; Berlutti F; Pietropaoli M; Goolsbee W; Pacifici E; Valenti P
Full Text Available From a feminist perspective, research on childbirth and women’s health is a means to a positive change that is conducted in partnership with women for their benefit. A patient-led National Health System (NHS) (Hillan, 1999) also calls for consultation with patients and the wider public for shaping the current and future health services. This study was aimed at exploring and describing the expectations that pregnant women have regarding antenatal care service by the midwife practitioner. In-depth interviews were conducted in an antenatal unit of an Academic Hospital in Gauteng Povince. Data saturation was reached with a sample of eighteen pregnant women who were conveniently selected. Data analysis ran concurrently with data collection. A manual content analysis as described by Tesch was used. Lincoln and Guba’s method of ensuring trustworthiness was adopted (Lincoln & Guba, 1985:328)
OBJECTIVE: Cervix cancer is one of the most common gynecological cancer types that cause cancer deaths among women. This study was planned based on a descriptive method in order to evaluate the results of PAP smear screening during pregnancy for prevention of cancer. MATERIALS AND METHODS: The research involved 110 pregnant women registered at the Obstetrics and Gynecology Polyclinic of Bagcilar Training and Research Hospital and 86 non-pregnant women of the same ages as a control group. As criteria for acceptance were conditions such as not being in coitus within the last 48 hours, not using vaginal ovule, and not performing vaginal lavage. A survey consisting of 33 questions was conducted and the results were processed using Bethesda. RESULTS: The average ages were 27.1±4.70 for the pregnant women and 28.8±4.24 for the control group. 60.7% of cases had previously heard of a PAP smear test, 49% were aware of why PAP smear tests were conducted, 26.4% of pregnant participants and 27.3% of non-pregnant participants had previously undergone a smear test. In this study, smear results of all cases were 95.4% sufficient. 18.2% of pregnant cases had an infection, 54.5% had reactive cellular change, and 0.9% had atypical squamous cells of undetermined significance (ASC-US). 16.3% of non-pregnant cases had an infection, 58.1% had reactive cellular change, 3.5% had atypical squamous cells of undetermined significance (ASC-US), and 1.2% had low-grade squamous intraepithelial lesions (LGSIL). CONCLUSION: PAP smear test is a good opportunity to identify pre-invasive lesions in early phases of pregnancy.
Full Text Available Objectives: To study time estimates by women smokers for when smoking-related consequences will occur given continuing or quitting smoking. The relationship of these estimates to pregnancy and intent to quit smoking was also investigated. Methods: Over a two-week period, eighty women, selected to constitute four subgroups formed by pregnant vs. non-pregnant and trying vs. not trying to quit smoking, rated times at which they would expect smoking-related consequences to occur given continuing or quitting smoking. Results: Somatic health consequences were estimated to occur later than consequences related to mood and social relations. All consequences were estimated to occur later given quitting smoking. Pregnancy had an effect on the estimated time that consequences would occur, with pregnant women estimating earlier occurrence of consequences related to mood and social relations than non-pregnant women did. Conclusion: Health messages should stress consequences for somatic health in quitting smoking, since outcomes later in time might have too low a value to exert a positive effect on decisions to quit smoking.
Monica Ortendahl; Alf Uttermalm; Bo Simonsson; Per Näsman; Tuula Wallsten
Full Text Available Research Goal was to study features of psychoemotional status of pregnant women with chronic fetoplacental insuffciency. Materials. 112 pregnant women with chronic fetoplacental insuffciency; 73 women with physiological course of pregnancy and delivery. Research of personal psychological characteristics was carried out by Minnesota multidimensional personal index (MMPI), adapted by F. B. Berezina and V. P Miroshnikova (1989). Personal and reactive anxiety was defned by method of self-appraisal according to D. Spilberger and Yu. L. Khalin. Results. Psychoveg-etative changes lead to unequal mobilization of various visceral systems, which can promote development of different complications of pregnancy course along with other factors, including fetoplacental insuffciency. Pregnant women with increased level of reactive anxiety more often have isolated decrease of uteroplacental blood fow; at hyperdepression combined disturbance of uteroplacental and fetoplacental blood fow was revealed; at hypochondria disturbance of uteroplacental and fetoplacental blood fow was also marked. Conclusion. Pregnant women with fetoplacental insuf-fciency demonstrated increase of anxiety and psychasthenia. As gestation period extended, patients with fetoplacental insuffciency marked high level of lability and reactivity of vegetative nervous system in combination with increased anxiety and presence of depression. Taking into consideration psychovegetative basis of occurrence of functional disturbances in the system mother-placenta-fetus, determination of personal psychoemotional features and state of vegetative nervous system, with future correction of reveled disturbances, should be obligatory.
Chekhonatskaya M.L.; Chernyshkova E.V.; Chekhonatsky A.A.; Kipchatova T.Yu.
AIM OF THE STUDY: To analyse the influence of antithyroid antibodies (ATA) on the frequency of spontaneous abortions (SA) by pregnant women with a normal thyroid gland function. DESIGN OF THE STUDY: Prospective clinical study on 42 selected pregnant women with a normal thyroid gland function divided into two groups: I-st group--ATA positive pregnant [n = 28] and II-end group ATA negative pregnant [n = 14]. RESULTS: Increased ATA have been found by 30 (71.4%) out of the studied 42 pregnant women. There has been no significant difference found among the values of FT3, FT4 and TSH for women with positive and negative ATA. SA have been observed at 63.3% (19/30 women) from the ATA positive ones and at 25% (4/12 women) from the ATA negative ones (P = 0.001). By the ATA positive women with SA the average values of antithyroglobulin autoantibody (Tg-Ab) (Tg-Ab positive.-189.6 +/- 49.8 IU/ml vs. Tg-Ab -negative 118.2 +/- 58.3 IU/ml, P = 0.02) and antithyroid peroxidase autoantibody (TPO-Ab) (TPO-Ab positive-176.9 +/- 57.4 IU/ml vs. TPO - negative 118.2 +/- 81.3 IU/ml, P = 0.004) are both found to be significantly higher. CONCLUSION: There is a correlation found between ATA and the increased risk of SA, where the increased concentration of ATA is combined with an increased frequency of SA.
Todorova K; Genova M; Konova E
The aim of the study was to estimate the levels of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) in maternal serum from normal pregnant women and women with pre-eclampsia. Serum concentrations of VEGF and ET-1 were measured in maternal blood in control group (n = 40) and in pregnancies complicated by pre-eclampsia (n = 40). Results showed that maternal VEGF levels were significantly raised in women with pre-eclampsia (p < 0.001). ET-1 concentration was not significantly different among women with pre-eclampsia compared with that in the control group. It was concluded that an increase in serum VEGF level was demonstrated in pre-eclampsia, suggesting that VEGF is involved in pathogenesis of pre-eclampsia. Further studies are needed to determine the serum concentrations of VEGF in pregnant women before the development of pre-eclampsia.
Celik H; Avci B; I?ik Y
Blood concentration profiles for follicle-stimulating hormone, luteinizing hormone, chorionic gonadotropin, testosterone, estradiol, estriol, progesterone, cortisol and sex hormonebinding globulin throughout a menstrual cycle were derived from measurements by radioimmunoassay and related procedures on serial blood samples from 16 normal women as controls. Similar studies were then performed on 9 normal women receiving a low-dose oral contraceptive combination of D-norgestrel and ethynlestradiol. Further studies were performed on 9 out of 16 normal women in whom progestational contraception was carried out with orally administered lynestrenol or intramuscularly administered norethindrone enathate and on 12 normal pregnant women from the 28th to the 38th week of pregnancy. Additional studies embracing chorionic gonadotropin progesterone and 17-hydroxyprogesterone were performed on 10 normal pregnant women from the 6th to the 12th week of pregnancy. Detailed results are presented and their significance discussed
OBJECTIVE: To determine the baseline intraabdominal pressure (IAP) in pregnant women at term. STUDY DESIGN: Pregnant women at term undergoing scheduled cesarean delivery in the absence of labor had IAP measured via an intravesical catheter. Abdominal pressures were obtained in the dorsal supine position with a leftward tilt after the placement of spinal anesthesia. Measurements were taken immediately before and after cesarean delivery. RESULTS: One hundred subjects were included in this Institutional Research Board-approved study. The median preoperative IAP measurement was 22 mm Hg, and the median postoperative IAP measurement was 16 mm Hg. The decrease in the IAP from the preoperative to the postoperative measurement was statistically significant (p < 0.0001). CONCLUSION: The median IAP measurement for pregnant patients at term is 22 mm Hg and is followed by a statistically significant decline after delivery.
Al-Khan A; Shah M; Altabban M; Kaul S; Dyer KY; Alvarez M; Saber S
The present literature review was conducted to determine what information has been published on the topic of undocumented pregnant migrants. Scientific databases and gray literature sources were searched for articles published between January 1967 and September 2010. Eighty-seven articles met the inclusion criteria and were reviewed. A final sample of 23 articles was included in the review. Existing evidence suggests that pregnant undocumented migrants living in Western societies tend to be younger, unmarried, and more likely to be employed in the domestic sector than documented migrants and permanent residents. They have less access to prenatal care and consult later in pregnancy than controls. Findings concerning delivery and birth outcomes are conflicting and subject to several biases. Little has been published on programs to address the needs of undocumented pregnant women living in Western countries. More research on the particular health and social issues faced by these women is needed.
Munro K; Jarvis C; Munoz M; D'Souza V; Graves L
Earlier studies in animals have suggested an essential role for Si in connective tissues, but such works have not been replicated per se. Nonetheless, a study conducted in 2000 has reported that Si may be essential during pregnancy for the growing fetus, since serum Si concentrations in infants were approximately 300 % higher than those in older children and adults and serum Si concentrations in pregnant women were approximately 300 % lower than those in age-matched non-pregnant controls. To reproduce these potentially important findings, in the present study, serum Si concentrations were measured in fourteen pregnant women (15-24 weeks of gestation) and compared with those of seventeen non-pregnant, non-lactating female controls. Serum Si concentrations were also measured in fourteen full-term mothers at the time of delivery and in the umbilical cord (UC) vein and artery where possible. Fasting serum Si concentrations in pregnant women were not significantly different from those of the female controls and showed little change with advancing gestation (r 0·2). Mean serum Si concentrations in the UC vein samples were 52 % higher, while those in the UC artery samples were 235 % higher than those in the maternal forearm vein samples, although data were widely spread and differences were not significant. Mean maternal forearm vein Si concentrations at delivery were 50 % lower than those of pregnant women and female controls, but, again, these were not significant. Overall, we note that there are significant analytical challenges in comparing baseline Si levels between different groups; notwithstanding, our findings cannot confirm a reduction in fasting serum Si levels during pregnancy, but, equally, we cannot rule out higher serum Si levels in newborns than in their mothers, and further work is required.
Jugdaohsingh R; Anderson SH; Lakasing L; Sripanyakorn S; Ratcliffe S; Powell JJ
OBJECTIVE: Determine factors associated with syphilis among pregnant women. DESIGN: Cross-sectional study. SETTING: Antenatal clinics of Juba Teaching Hospital, Malakia National Health Insurance Centre and Munuki Primary Health Care Centre in Juba, Southern Sudan. SUBJECTS: Consenting pregnant women not on syphilis treatment. MAIN OUTCOME MEASURES: Socio-demographic and clinical data, knowledge and behavioural characteristics. RESULTS: Of the 231 pregnant women participants, 51 (22.1%) were positive for syphilis with the rapid plasma reagin test and 79 (34.2%) were positive with the treponema pallidum Haemagglutination assay. Risk factors for syphilis were: housewife (OR 2.808; P= 0.0116), abortion (OR 2.654; P= 0.0116) and partner travel (OR 2.149; P= 0.028). Attending antenatal clinic for previous pregnancy was protective (OR 0.281; P= 0.0004) for syphilis. CONCLUSIONS: This is the first study to determine the prevalence and associated factors in the three clinics in Juba, South Sudan. There is a high prevalence of syphilis in pregnant women attending the selected health facilities. Treponema Pallindum Haemagglulination Assay can be used as a field test for syphilis due to its high sensitivity and specificity. Health education, screening and treating positive expectant mothers can reduce the prevalence of syphilis.
Emmanuel SK; Lado M; Amwayi S; Abade AM; Oundo JO; Ongus JR
Full Text Available OBJECTIVE: To determine the seroprevalence of hepatitis B in pregnant women from several regions of Mexico, as well as the risk factors associated with its occurrence. MATERIAL AND METHODS: A cross-sectional study was conducted between May and August 2000. It included 9 992 pregnant women attending the health services of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS) in five cities: Tijuana, Ciudad Juarez, Acapulco, Cancun, and Mexico City (northeast and southeast regions). RESULTS: The overall prevalence for confirmed cases was 1.65% (165/9 992). The prevalences for individual cities were as follows: Tijuana, 1.27%; Ciudad Juarez, 1.46%; Acapulco, 2.47%; Cancun, 0.93%; northeastern Mexico City, 1.20%, and southeastern Mexico City, 2.52%. The risk factors found to be associated with HBsAg were: age, age at first sexual intercourse, city (Acapulco and southeastern Mexico City), and marital status (single or divorced). CONCLUSIONS: The prevalence of HBsAg in pregnant women (1.65%) was greater than that reported in previous studies and showed geographical differences. This high prevalence suggests that a considerable amount of cases of hepatitis B occurs perinatally and through contact with carriers in the general population. Vaccination of newborns of high-risk pregnant women should be considered.
Vázquez-Martínez José Luis; Coreño-Juárez María Ofelia; Montaño-Estrada Luis Felipe; Attlan Michaël; Gómez-Dantés Héctor
The vitamin A status of 101 pregnant women attending clinic at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria was assessed based on 24 h dietary recall, serum retinol concentration, history of night blindness, physical appearance and clinical eye signs. The study revealed t...
Ima O. Williams; Okon U. Eka; Essien U. Essien
OBJECTIVE: To assess alcohol use by pregnant women in three underprivileged areas of the Western Cape. DESIGN: Data were collected from subjects, selected in a randomised manner, during a single, structured interview. SUBJECTS AND SETTING: Interviews were conducted among pregnant women voluntarily attending selected antenatal clinics in the George/Oudtshoorn, Vredenburg/Saldanha, and Cape Metropole areas of the Western Cape. OUTCOME MEASURES: On completion of the interview, women at risk were counselled with regard to the dangers of prenatal alcohol exposure to the fetus. RESULTS: 42.8% of the women in the sample admitted to varying degrees of alcohol ingestion during the current pregnancy. The reported alcohol intake of over 55% of these women, i.e. 23.7% of the sample, was sufficient to place their unborn children at high risk for the fetal alcohol syndrome (FAS). These heavy drinkers followed a pattern of binge drinking over weekends and showed a marked preference for beer. Combined alcohol and tobacco use occurred in 29.6% of the sample. Only one subject admitted to using marijuana. CONCLUSION: The data in this study confirm that a high rate of alcohol and tobacco use prevails among pregnant women in poorer communities of the Western Cape. Extrapolating from experience, as many as 9.5% of the sample may produce children with FAS.
Croxford J; Viljoen D
Full Text Available Cytomegaloviurs (CMV) is the most frequent cause of congenital infection in humans. In various parts of the world the prevalence of antibodies to CMV ranges from 40-100%. The prevalence of primary infection with CMV in pregnant Iranian women and risk of congenital CMV infection in their neonates are unknown. To Determine the prevalence of CMV infection in primiparous pregnant (youner) women and incidence rate of cangenital CMV infection among preterm and full-term infants borned from these women, in serum of 164 primigravid women before delivery, CMV IgG and IgM antibodies were measured by ELISA method and CMV-DNA detection by PCR in ~10% of their infants. 100% of women were immune to CMV infection (CMV-IgG positive) were detected in mothers and newborns. Therefore, we can not compare gestational age and weight of infants in seropositive and serongegative mothers. Probably, in Iranian pregnant women, CMV screening test is not recommended.
"Siadati A; Noorbakhsh S; Ghazi F; Rimaz Sh; Monavari SHR
Publications of the last years evidence that lower extremity varicosity during pregnancy is a socially important problem. The works describe the etiology and pathogenesis of varicosity, clinical cases, and peculiarities of gestation course in women with varicosity. PMID:17882818
Omarova, Kh M
Publications of the last years evidence that lower extremity varicosity during pregnancy is a socially important problem. The works describe the etiology and pathogenesis of varicosity, clinical cases, and peculiarities of gestation course in women with varicosity.
Recent decisions of the Committee on the Elimination of Discrimination against Women (CEDAW), the Inter-American Court of Human Rights, and the High Court of Delhi have shown how the pregnancy-related deaths of individual women have been bases on which these authoritative tribunals have held Brazil, Paraguay, and India respectively accountable for avoidable maternal mortality not only in these cases, but also among their populations more generally. The right to life is the most fundamental of women's human rights, recognized in international human rights treaties and national laws. Failure of governments to apply their resources adequately to address, respect, and protect this right violates the law of human rights. These cases show, however, that governments may fail to allocate adequate resources to women's survival of pregnancy. Tribunals can build on the failures in individual cases to set standards of performance to which governments will legally be held to achieve safe motherhood.
Cook RJ; Dickens BM
OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including subgroups informed in different ways about prenatal examinations. METHODS: Data stem from a population-based cross-sectional questionnaire study including 15 multiple-choice questions assessing knowledge of different screening aspects. Included were 6,427 first trimester pregnant women from three Danish obstetric departments offering prenatal screening free of charge. Both participants and non-participants in the screening programme were included. The results are based on 4,095 responders (64%). Differences between sub-groups were examined by chi-squared tests and logistic regression analysis. Estimates are stated with 95% CI. RESULTS: The majority of the participants (87.6% (86.6-88.6) to 92.6% (91.7-93.3)) correctly identified the test concept and the main condition being screened for. Fewer participants (16.4% (15.3-17.6) to 43.3% (41.8-44.8)) correctly recognised test accuracy and the potential risk of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session was weakly associated with more knowledge. CONCLUSION: The majority of the pregnant women correctly identified the test concept and the main condition being screened for. The pregnant women were found less knowledgeable on test accuracy and drawbacks. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.
Dahl, Katja; Hvidman, Lone
Full Text Available Background: Nutritional anaemia in pregnant women is one of the India’s major public health problems, despite the fact that this problem is largely preventable & easily treatable. Objectives: 1.To determine the prevalence of anaemia in pregnant women. 2. To assess the epidemiological determinants of anaemia in pregnancy. Methodology: A descriptive case series study was conducted among the pregnant women from second trimester onwards from urban field practice area from 1st March 2010 to 31st July 2010 by using pre-designed, pre-tested, structured schedule. Haemoglobin estimation was done by Sahli’s method & anaemia was graded according to WHO criteria. Statistical analyses were done by percentages and proportions, Mean and Standard Deviation (S.D), Chi-square test. Results: A high prevalence (82.9%) of anaemia (Haemoglobin - < 11.0gm/dl) was observed among 228 pregnant women. Majority (50.4%) had moderate degree of anaemia (Haemoglobin - 7.0 to 10.0 gm/dl) and 7.0% had severe anaemia (Haemoglobin - < 7.0 gm/dl). Severity of anaemia was more in 26 years of age, from nuclear families, educated upto secondary level, having vegetarian diet, parity two or more & those in third trimester with two or more abortions, although statistically not significant. However, anaemia prevalence was significantly higher among those subjects from below Class IV socio-economic status, those with less than two years of spacing between previous and index pregnancies & with less than two months IFA tablet consumption. Conclusion: A very high prevalence of anaemia in pregnancy needs mandatory regular supply of IFA tablets to adolescent and pregnant women from 4th month onwards till 3-6 months post-partum along with correction of other nutritional deficiencies and timely intervention for reducing the burden of related diseases.
R.G.Viveki; A.B. Halappanavar; P.R.Viveki; S.B.Halki; V.S.Maled; P.S.Deshpande
OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first-trimester combined Down syndrome screening in a setting of required informed consent. As the secondary aim, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including those informed in different ways about prenatal examinations. METHODS: Data stem from a population-based cross-sectional questionnaire study including 15 multiple-choice questions assessing knowledge of different aspects of screening. Included were 6427 first-trimester pregnant women from three Danish obstetric departments offering prenatal screening free of charge. Both participants and non-participants in the screening program were included. The results are based on 4095 responders (64%). Differences between subgroups were examined using chi-squared tests and logistic regression analysis. Estimates are stated with 95% CI. RESULTS: The majority of the participants (87.6 (86.6-88.6)% to 92.6 (91.7-93.3)%) correctly identified the test concept and the main condition being screened for. Fewer participants (16.4 (15.3-17.6)% to 43.3 (41.8-44.8)%) correctly recognized test accuracy and the potential risk of adverse findings other than Down syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening program (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session was weakly associated with more knowledge. CONCLUSION: The majority of the pregnant women correctly identified the test concept and the main condition being screened for. The pregnant women were found less knowledgeable on test accuracy and drawbacks.
Dahl K; Hvidman L; Jørgensen FS; Henriques C; Olesen F; Kjaergaard H; Kesmodel US
INTRODUCTION: In spite of intervention efforts, in Uganda, as in other developing countries, high levels of anaemia among pregnant women continue. Anaemia among women of reproductive age (15-49 years) is a matter of national concern. This study was carried out to assess determinants of anaemia in Kiboga district. METHODS: This was a single cross-sectional, descriptive survey. The anaemia status of the pregnant women was determined by measuring their haemoglobin levels. Possible determinant factors including socio-economic characteristics, knowledge, attitudes, practices and food intake were assessed using a structured questionnaire. RESULTS: Results showed that the prevalence of anaemia among pregnant women in Kiboga district was high enough (63.1%) to be described as a severe public health problem. The uptake and utilisation of the public-health intervention package to combat anaemia in pregnancy was low, with iron/folic acid supplementation at 13.2%, use of intermittent preventive treatment of malaria 45.4%, and use of de-worming medicines 14.5%. Women from households without a functional radio were 2.07 times more likely be anaemic (95%CI, 1.08-3.00) compared with women from households where there was a functional radio. There was little awareness and functional knowledge about anaemia among pregnant women. CONCLUSION: The high prevalence of anaemia observed in Kiboga district can be attributed to poverty and limited access to nutrition and health education information which lead to low uptake and utilization of the public-health intervention package to combat anaemia in pregnancy.
Mbule MA; Byaruhanga YB; Kabahenda M; Lubowa A
Smoking during pregnancy is harmful to the health of the fetus and the newborn. Smoking increases the risk of low birthweight, preterm delivery and perinatal death. In developed countries smoking during pregnancy is regarded as the single most important risk factor for which it is possible to intervene. We reviewed the Scandinavian and English randomized controlled intervention studies directed towards smoking cessation during pregnancy. The intervention studies were classified according to the method of intervention namely antismoking advice, self-help manuals, measurements of smoking dependent chemical factors and multifactorial methods. We conclude that it is possible to reduce smoking during pregnancy only by an efficient and personal effort performed by a committed person towards each pregnant woman.
Wisborg K; Obel C; Henriksen TB; Hedegaard M; Secher NJ
Full Text Available Abstract Background Early and frequent antenatal care attendance during pregnancy is important to identify and mitigate risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. However, many pregnant women in sub-Saharan Africa start antenatal care attendance late, particularly adolescent pregnant women. Therefore they do not fully benefit from its preventive and curative services. This study assesses the timing of adult and adolescent pregnant women's first antenatal care visit and identifies factors influencing early and late attendance. Methods The study was conducted in the Ulanga and Kilombero rural Demographic Surveillance area in south-eastern Tanzania in 2008. Qualitative exploratory studies informed the design of a structured questionnaire. A total of 440 women who attended antenatal care participated in exit interviews. Socio-demographic, social, perception- and service related factors were analysed for associations with timing of antenatal care initiation using regression analysis. Results The majority of pregnant women initiated antenatal care attendance with an average of 5 gestational months. Belonging to the Sukuma ethnic group compared to other ethnic groups such as the Pogoro, Mhehe, Mgindo and others, perceived poor quality of care, late recognition of pregnancy and not being supported by the husband or partner were identified as factors associated with a later antenatal care enrolment (p Conclusions Factors including poor quality of care, lack of awareness about the health benefit of antenatal care, late recognition of pregnancy, and social and economic factors may influence timing of antenatal care. Community-based interventions are needed that involve men, and need to be combined with interventions that target improving the quality, content and outreach of antenatal care services to enhance early antenatal care enrolment among pregnant women.
Gross Karin; Alba Sandra; Glass Tracy R; Schellenberg Joanna; Obrist Brigit
Full Text Available UTI is one of the most common medical complications of pregnancy together with anemia and hypertension and it occurs approximately in 5-10% of all pregnancies. The aim of this study was to determine the distribution of uropathogens isolated from pregnant women. During the study period, 255 pregnant women urine samples were analysed. Urinary tract infection was diagnosed by growth of at least 105 colony-forming units of a urinary tract pathogen per milliliter in a culture of a midstream urine sample. After 24-48 h incubation organisms verified by biochemical tests. The results show that the 10.58% of pregnant women have UTI and most agent of UTI in these group was E. coli. UTIs may be more serious during pregnancy because they are more likely to travel to the kidneys. If a UTI is not treated promptly in a pregnant woman, she may be more likely to have problems like high blood pressure or premature delivery of her baby.
Habib Zeighami; Ali Mota; Mohammad Rahmati
Full Text Available Background: Toxoplasma gondii is an obligate intracellular protozoan parasite which can infect human and animals. Acquired toxoplasmosis during pregnancy can lead to fetal infection, which may ultimately result in loss of fetus or lesion in brain and eyes. This study was performed to evaluate the seroepidemiological status of toxoplasmosis in pregnant women in Ilam City, western Iran. Methods: In this cross-sectional study, 553 blood samples were collected from pregnant women. Sera were separated by blood centrifugation at 3000 rpm for 5 min and frozen at -20 °C until use. The samples were tested for IgG antibody by Indirect Immunoflourecence antibody test (IFA). Results: Out of the 553 pregnant women, 247 were positive for T. gondii IgG antibodies and 306 were negative. The mean age of women was 21 and the seropositive rate of latent T. gondii infection was 44.8%. Conclusion: About half of the married women in the present study were at risk of infection with T.gondii, so preventive method should be considered. Keywords: Seroepidemiology, Toxoplasmosis, IFA, Iran.
J Abdi; S Shojaee; A Mirzaee; H Keshavarz
OBJECTIVES: To describe the immunization coverage of the influenza vaccine for pregnant women, and factors associated to vaccination compliance. METHODS: This is a prospective, descriptive study including 300 women who had just given birth at Hospital and Maternity Santa Joana in Sao Paulo, Brazil. Data were collected through a pre-tested questionnaire applied by a trained evaluator during October 2010. RESULTS: The mean age of mothers was 30.5 years; 231 (77%) were married; 164 (54.7%) were primigravidas; 192 (64%) had higher education; and 240 (80%) were employed. During the prenatal period, 234 (78%) received information about the influenza vaccine and 287 (95.7%) were immunized; 210 (73.2%) women knew about neonatal protection achieved through maternal vaccination. The factors associated with maternal acceptance of the vaccine were government campaign (133; 44.3%), and medical recommendation during prenatal visits (163; 54.3%). A total of 13 pregnant women refused vaccination for the following reasons: neglect (4), lack of time (4), lack of recommendation from their physician (3) or contraindication by physician (2), but 69.2% of them would have accepted immunization had they been informed about neonatal protection. CONCLUSIONS: The fear of a pandemic and the public vaccination campaign had an important impact on the high immunization coverage for influenza on pregnant women. Medical recommendation and the government campaign were the main reasons for vaccine compliance.
Kfouri RD; Richtmann R
The aim of this study was to assess the prevalence and risk factors of anal incontinence in an unselected pregnant population at second trimester. A survey of pregnant women attending a routine ultrasound examination was conducted in a university hospital in Oslo, Norway. A questionnaire consisting of 105 items concerning anal incontinence (including St. Mark's score), urinary incontinence, medication use, and comorbidity was posted to women when invited to the ultrasound examination. Results. Prevalence of self-reported anal incontinence (St. Mark's score ? 3) was the lowest in the group of women with a previous cesarean section only (6.4%) and the highest among women with a previous delivery complicated by obstetric anal sphincter injury (24.4%). Among nulliparous women the prevalence of anal incontinence was 7.7% and was associated to low educational level and comorbidity. Prevalence of anal incontinence increased with increasing parity. Urinary incontinence was associated with anal incontinence in all parity groups. Conclusions. Anal incontinence was most frequent among women with a history of obstetric anal sphincter injury. Other obstetrical events had a minor effect on prevalence of anal incontinence among parous women. Prevention of obstetrical sphincter injury is likely the most important factor for reducing bothersome anal incontinence among fertile women. PMID:23819058
Laine, Katariina; Skjeldestad, Finn Egil; Sandvik, Leiv; Staff, Anne Cathrine
Full Text Available Abstract Background Intimate partner violence (IPV), defined as actual or threatened physical, sexual, psychological, and emotional abuse by current or former partners is a global public health concern. The prevalence and determinants of intimate partner violence (IPV) against pregnant women has not been described in Rwanda. A study was conducted to identify variables associated with IPV among Rwandan pregnant women. Methods A convenient sample of 600 pregnant women attending antenatal clinics were administered a questionnaire which included items on demographics, HIV status, IPV, and alcohol use by the male partner. Mean age and proportions of IPV in different groups were assessed. Odds of IPV were estimated using logistic regression analysis. Results Of the 600 respondents, 35.1% reported IPV in the last 12 months. HIV+ pregnant women had higher rates of all forms of IVP violence than HIV- pregnant women: pulling hair (44.3% vs. 20.3%), slapping (32.0% vs. 15.3%), kicking with fists (36.3% vs. 19.7%), throwing to the ground and kicking with feet (23.3% vs. 12.7%), and burning with hot liquid (4.1% vs. 3.5%). HIV positive participants were more than twice likely to report physical IPV than those who were HIV negative (OR = 2.38; 95% CI [1.59, 3.57]). Other factors positively associated with physical IPV included sexual abuse before the age of 14 years (OR = 2.69; 95% CI [1.69, 4.29]), having an alcohol drinking male partner (OR = 4.10; 95% CI [2.48, 6.77] for occasional drinkers and OR = 3.37; 95% CI [2.05, 5.54] for heavy drinkers), and having a male partner with other sexual partners (OR = 1.53; 95% CI [1.15, 2.20]. Education was negatively associated with lifetime IPV. Conclusion We have reported on prevalence of IPV violence among pregnant women attending antenatal care in Rwanda, Central Africa. We advocate that screening for IPV be an integral part of HIV and AIDS care, as well as routine antenatal care. Services for battered women should also be made available.
Ntaganira Joseph; Muula Adamson S; Masaisa Florence; Dusabeyezu Fidens; Siziya Seter; Rudatsikira Emmanuel
Full Text Available INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.
Nucci Luciana Bertoldi; Schmidt Maria Inês; Duncan Bruce Bartholow; Fuchs Sandra Costa; Fleck Eni Teresinha; Britto Maria Margarida Santos
BACKGROUND: HIV-related outcomes may be affected by biological sex and by pregnancy. Including women in general and pregnant women in particular in HIV-related research is important for generalizability of findings. OBJECTIVE: To characterize representation of pregnant and non-pregnant women in HIV-related research conducted in general populations. DATA SOURCES: All HIV-related articles published in fifteen journals from January to March of 2011. We selected the top five journals by 2010 impact factor, in internal medicine, infectious diseases, and HIV/AIDS. STUDY ELIGIBILITY CRITERIA: HIV-related studies reporting original research on questions applicable to both men and women of reproductive age were considered; studies were excluded if they did not include individual-level patient data. STUDY APPRAISAL AND SYNTHESIS METHODS: Articles were doubly reviewed and abstracted; discrepancies were resolved through consensus. We recorded proportion of female study participants, whether pregnant women were included or excluded, and other key factors. RESULTS: In total, 2014 articles were published during this period. After screening, 259 articles were included as original HIV-related research reporting individual-level data; of these, 226 were determined to be articles relevant to both men and women of reproductive age. In these articles, women were adequately represented within geographic region. The vast majority of published articles, 183/226 (81%), did not mention pregnancy (or related issues); still fewer included pregnant women (n=33), reported numbers of pregnant women (n=19), or analyzed using pregnancy status (n=9). LIMITATIONS: Data were missing for some key variables, including pregnancy. The time period over which published works were evaluated was relatively short. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: The under-reporting and inattention to pregnancy in the HIV literature may reduce policy-makers' ability to set evidence-based policy around HIV/AIDS care for pregnant women and women of child-bearing age.
Westreich D; Rosenberg M; Schwartz S; Swamy G
The authors' and literature results concerning the peculiarities of a clinical course, diagnosis and therapy of the upper digestive tract in women during pregnancy were summed up. Exacerbation or first symptoms of diseases like cardiospasm, reflux esophagitis can often occur during pregnancy. Peptic ulcer in most pregnant women has a favorable course, exacerbations are rare. A conclusion has been made that measures aimed at the prevention of exacerbations and complications of these diseases, are recommended to women with chronic diseases of the digestive tract during pregnancy.
Shekhtman MM; Burkov SG; Polozhenkova LA
OBJECTIVE: To determine whether a provider-focused reminder improved vaccination rates as compared with no reminder. STUDY DESIGN: This was a retrospective cohort study comparing vaccination rates among pregnant patients seen in October and November 2003 (no reminder) and October and November 2005 (provider-focused reminder). Charts of all patients presenting for prenatal care during those months were reviewed for vaccination order. Vaccination rates were calculated and compared by year, provider, age, race, education, primary language, insurance type, and presence or absence of medical risk factors. RESULTS: A total of 1,367 records were reviewed: 504 from 2003 and 863 from 2005. Overall vaccination rate increased from 15-52% with a provider-focused reminder in place. In our study population medical risk factors were identified in 396 patients (29%). Vaccination rates for patients with medical risk factors increased from 18-47%. All provider groups demonstrated significant increases in the rates of vaccination with a reminder, however, there were no differences in age, race, education, primary language, or insurance. CONCLUSION: Although a low-cost, provider-focused reminder improved vaccination rates to 52%, additional measures including patient and provider education, dedicated vaccination clinics, and standing orders will be needed to achieve the ACOG goal of 100% vaccination.
Sherman MJ; Raker CA; Phipps MG
Full Text Available Research Question: What is the coverage level of immunization and other maternal services by a modified technique developed by IRMS (ICMR) Delhi in comparison to standard WHO technique. Objectives: To study the â€"Coverage level for immunization, antenatal care and IFA tablets â€"Relationship of caste and education with the coverage levels. â€"Place and persons conducting deliveries. Study design: Cross-sectional. Setting: Both in rural and urban areas of Bihar. Participants: 375 mothers having children up to one year of age selected by a stratified random sampling technique developed by IRMS Delhi. Study variables: Immunisation status, antenatal care, Use of IFA tabs, Education of the female, Education of husband, place and person conducting the delivery. Statistical analysis: Proportions. Results: Overall immunization coverage was 42% for pregnant females. Coverage was high (60%) in urban areas compared to rural areas (40%). Coverage was low among females from SC/ST category, also when females and their husbands were illiterates. Similar trend was observed for antenatal care and IFA tabs. 90% deliveries took place at home and were mainly attended by village dais. Majority of mothers received immunization from some. Govt. agency lack of, awareness and lack of motivation were more commonly found as reasons for non-immunisation among SC/ST as compared to others. Lack of awareness was also found as a common reason for non-immunisation among illiterate females.
Yadav R. J; Singh Padam
INTRODUCTION: Throughout the Eastern Mediterranean region, tobacco is used primarily in 2 forms: cigarette smoking and waterpipe smoking. Despite the fact that tobacco use is considered as a global public health threat, waterpipe smoking is reported to be growing in popularity, particularly among women. The objectives of this study are to determine the prevalence and patterns of cigarette, waterpipe, and passive smoking among pregnant women in Jordan, and to assess their perception of harmful effects of cigarette and waterpipe smoking. METHODS: A total of 500 pregnant women were randomly recruited from maternity clinics in North and Middle of Jordan and surveyed regarding exposure to waterpipe tobacco and cigarette smoking. RESULTS: The results showed that 7.9% of women were current cigarette smokers and 8.7% were current waterpipe smokers. About 82.4% of all women reported that they are exposed to cigarette smoke and 32.8% reported that they are exposed to waterpipe smoke. The most common place where women are exposed to cigarette and waterpipe smoke was their house (50.4% and 48.7%, respectively) followed by public places (31.4% and 21.4%, respectively). In addition, the husband was the main source for exposure to cigarette and waterpipe smoke (48.5% and 42.7%, respectively). Approximately, 74% of women believed that cigarette smoking is addictive, whereas only 55.1% reported that waterpipe smoking leads to addiction. CONCLUSIONS: Exposure of pregnant women to tobacco smoke is a public health problem in Jordan that requires immediate action.
Azab M; Khabour OF; Alzoubi KH; Anabtawi MM; Quttina M; Khader Y; Eissenberg T
The incidence of genital herpes infection is increasing. About 50% of infections in women are asymptomatic. Neonatal infection is the most serious complication of genital HSV-infection, the mortality being 70% if untreated. The incidence of asymptomatic HSV-infection in pregnant women at the time of giving birth is 0.2%. These women cannot be identified on the basis of clinical symptoms and medical history, and the diagnostic methods currently in use are not sufficiently sensitive for the screening of low risk groups. Pregnant women with primary HSV-infection shed larger quantities of virus than women with recurrent infection, furthermore the foetus has not received passive immunisation by maternal antibody transfer. There is an increased risk of miscarriage, intrauterine infection and premature birth in connection with primary HSV-infection in pregnancy. Almost 50% of children born to mothers with primary HSV-infection at the time of birth become infected neonatally, compared with only 2-5% of children born to mothers with active recurrent HSV-infection. Recommendations are given for monitoring primary HSV-infection in the third trimester with viral cultures, monitoring recurrent HSV-infections clinically and indications for when delivery should be by caesarean section. Children born to women with active primary HSV-infection should be treated with antiviral agents. Children born to women with recurrent infection should have their secretions cultured for HSV.
BACKGROUND: Cytomegalovirus (CMV) is the most frequent cause of congenital virus infection. Approximately 1% of newborns are infected by CMV at birth with severe consequences among 10% of them. Efficacy of hygienic counselling is nowadays established and should be spread. OBJECTIVE: To evaluate pregnant women's awareness of cytomegalovirus infection in France. STUDY DESIGN: Pregnant women receiving prenatal care, at any moment of their pregnancy, in two different obstetrics clinics with different information policies, were asked to complete a written questionnaire about CMV infection. RESULTS: More than half (217/362, 60%) of the pregnant women had heard of congenital CMV infection, and most of them (72%) knew the hygiene measures to use to prevent infection. Nevertheless, most could not correctly identify the symptoms associated with congenital CMV disease. Awareness was associated with hospital's policy concerning CMV infection information, the mother's educational level, parity, and employment in health care. Indeed, when information is supposed to be given (hospital A), 74% (vs 34%) know congenital CMV infection and among them the knowledge is more precise. CONCLUSIONS: This study tends to confirm that there is a large gap between knowledge of CMV and the burden of this disease. To bridge this gap, women should receive education about congenital CMV. Hospital-based prenatal education increases awareness and knowledge about CMV and CMV prevention.
Cordier AG; Guitton S; Vauloup-Fellous C; Grangeot-Keros L; Ayoubi JM; Benachi A; Picone O
Full Text Available Abstract Background Thyroid function changes during pregnancy and maternal thyroid dysfunction have been associated with adverse outcomes. Our aim was to evaluate thyroid hormones levels in pregnant women resident in Aragon, Spain. Findings Samples for 1198 pregnant women with no apparent thyroid disorders were analyzed, using paramagnetic microparticle and chemiluminescent detection technologies, in order to determine levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab). Of the women in our sample, 85.22% had normal values for TPO-Ab and Tg-Ab and 14.77% had results revealing the presence of autoimmune diseases of the thyroid. The thyroid hormone reference values obtained according to gestational age (in brackets) were as follows: for free T3, values were 3.38 ± 0.52 pg/mL (36 weeks); for free T4, values were 1.10 ± 0.14 ng/dL (36 weeks); and for TSH, values were (?IU/mL): 1.12 ± 0.69 (36 weeks). Conclusion Pregnant women with normal antibody values according to gestational age had values for FT4 and TSH, but not for FT3, that differed to a statistically significant degree. The values we describe can be used as reference values for the Aragon region of Spain.
Bocos-Terraz Julia; Izquierdo-Álvarez Silvia; Bancalero-Flores Jose; Álvarez-Lahuerta Rosa; Aznar-Sauca Ana; Real-López Elisabet; Ibáñez-Marco Raquel; Bocanegra-García Virgilio; Rivera-Sánchez Gildardo
Pregnant women and infants are exceptionally vulnerable to iodine deficiency. The aims of the present study were to estimate iodine intake, to investigate sources of iodine, to identify predictors of low or suboptimal iodine intake (defined as intakes below 100 ?g/day and 150 ?g/day) in a large population of pregnant Norwegian women and to evaluate iodine status in a sub-population. Iodine intake was calculated based on a validated Food Frequency Questionnaire in the Norwegian Mother and Child Cohort. The median iodine intake was 141 ?g/day from food and 166 ?g/day from food and supplements. Use of iodine-containing supplements was reported by 31.6%. The main source of iodine from food was dairy products, contributing 67% and 43% in non-supplement and iodine-supplement users, respectively. Of 61,904 women, 16.1% had iodine intake below 100 ?g/day, 42.0% had iodine intake below 150 ?g/day and only 21.7% reached the WHO/UNICEF/ICCIDD recommendation of 250 ?g/day. Dietary behaviors associated with increased risk of low and suboptimal iodine intake were: no use of iodine-containing supplements and low intake of milk/yogurt, seafood and eggs. The median urinary iodine concentration measured in 119 participants (69 ?g/L) confirmed insufficient iodine intake. Public health strategies are needed to improve and secure the iodine status of pregnant women in Norway.
Brantsæter AL; Abel MH; Haugen M; Meltzer HM
Full Text Available Pregnant women and infants are exceptionally vulnerable to iodine deficiency. The aims of the present study were to estimate iodine intake, to investigate sources of iodine, to identify predictors of low or suboptimal iodine intake (defined as intakes below 100 ?g/day and 150 ?g/day) in a large population of pregnant Norwegian women and to evaluate iodine status in a sub-population. Iodine intake was calculated based on a validated Food Frequency Questionnaire in the Norwegian Mother and Child Cohort. The median iodine intake was 141 ?g/day from food and 166 ?g/day from food and supplements. Use of iodine-containing supplements was reported by 31.6%. The main source of iodine from food was dairy products, contributing 67% and 43% in non-supplement and iodine-supplement users, respectively. Of 61,904 women, 16.1% had iodine intake below 100 ?g/day, 42.0% had iodine intake below 150 ?g/day and only 21.7% reached the WHO/UNICEF/ICCIDD recommendation of 250 ?g/day. Dietary behaviors associated with increased risk of low and suboptimal iodine intake were: no use of iodine-containing supplements and low intake of milk/yogurt, seafood and eggs. The median urinary iodine concentration measured in 119 participants (69 ?g/L) confirmed insufficient iodine intake. Public health strategies are needed to improve and secure the iodine status of pregnant women in Norway.
Anne Lise Brantsæter; Marianne Hope Abel; Margaretha Haugen; Helle Margrete Meltzer
The objective of this work was to evaluate results of control epidemiological studies of iodine-deficiency condition in pregnant and breast-feeding women; the secondary objective was to develop standard prophylactic iodine dose schedule for these patients. The study included two groups of pregnant women treated either with a daily dose of 200 mcg potassium iodide (group 1, n=52) or with 300 mcg Kl/day (group 2, n=69). In all of them, blood TSH, free thyroxin and antithyroid peroxidase antibody levels were measured along with iodine excretion in urine. Thyroid volume was determined by ultrasound. Initially, median urinary iodine excretion in all the patients was 62.7 mcg/l. Three months after onset of the treatment with potassium iodide it significantly increased to 83.5 mcg/l and 1120.8 mcg/l in groups 1 and 2 respectively (p = 0.006 and 0.001). However, the desired level of >150 mcg/l was not achieved. Treatment with KI in the period of lactation within 2 months after delivery resulted in median urinary iodine excretion of = >100 mcg/l in 10.5% of the women in group 1. None of the patients in group 2 showed the required iodine concentration in the urine. It means that the minimal daily prophylactic dose of iodine for pregnant and lactating women should be 300 mg.
Troshina EA; Abdulkhabirova FM; Sekinaeva AV; Il'in AV; Arbuzova MI; Petrova VN; Petrova SV
Full Text Available Background: The prevalence of gestational diabetes mellitus (GDM) in Sudan is less compared with international reports. Whether there is concomitant difference in the risk factors for GDM among Sudanese women is uncertain. Aim: This study investigated the common risk factors for GDM among Sudanese pregnant women. Materials and Method: The study involved a control group of 60 apparently healthy pregnant women matched with a test group of 60 pregnant women with GDM. Data were obtained through a questionnaire, proper examination, including anthropometric measurements, and laboratory evaluation for glycaemic control. Results: The age (mean (M) ± standard deviation (SD) = 32.8±7.4 years) and body mass index (BMI) (M±SD = 27.9±4.9 Kg/m2) were significantly higher in pregnant ladies with GDM compared with the control group (M±SD = 29.7±6.0 years, 25.1±3.1 Kg/m2 respectively) (P < 0.02 for both). There were significant associations between presence of GDM and age ? 30 years (relative risk (RR) = 1.28, P = 0.016), BMI ? 25 Kg/m2 (RR = 1.48, P = 0.001), family history of diabetes mellitus (DM) (RR = 1.8, P = 0.002), glucosuria (RR = 2.39, P = 0.000), proteinuria (RR = 1.98, P = 0.008). In contrast, parity and urinary tract infections failed to demonstrate significant associations with GDM. Conclusion: The strongest predictor of GDM in Sudanese women is glucosuria, followed by proteinuria, family history of DM, BMI ? 25 Kg/m2 and age ? 30 years in a descending pattern.
Mardi T.G; Lutfi M.F
Full Text Available BACKGROUND: The use of traditional historic risk factors to identify gestational diabetes mellitus (GDM) will miss half of women with gestational diabetes mellitus. Our aim was to evaluate whether impaired glucose tolerance is a risk factor for vaginal candidiasis in pregnant women. PATIENTS AND METHODS: In a cross-sectional study, we compared the prevalence of impaired glucose tolerance in 64 pregnant women with vaginal candidiasis (positive microscopy) and 59 Candida-negative control subjects. Subjects underwent standardized 75-gram oral glucose tolerance testing between the 24th and 28th weeks of their pregnancies. Patients were included only if they had no known diabetes mellitus or historic risk factors for gestational diabetes mellitus, and had not been receiving antibiotic or steroid therapy. We compared glucose levels at fasting, 30 minutes, 60 minutes and 120 minutes, and perinatal and neonatal outcomes in the two groups. RESULTS: There were no statistical differences between cases and controls in demographic characteristics. Glucose concentrations were higher in pregnant women with vaginal candidiasis than in control subjects at fasting (89 vs. 84 mg/dL, P=0.021), 30 minutes (139 vs. 126 mg/dL, P=0.050), and 60 minutes (124 vs. 106 mg/dL, P= 0.018) after intake of 75 gram of glucose. The two groups did not differ in glucose level at 120 minutes after glucose administration. Gestational diabetes prevalence was 3.1% and 3.4% in the study and control group, respectively (P=0.274). CONCLUSION: The tolerance to glucose in pregnant women with vaginal candidiasis seems discretely impaired.
Kelekci S; Kelekci H; Cetin M; Inan I; Tokucoglu S
Black women are at a greater risk to develop hypertension during pregnancy, with a 4.5 times higher rate of fatal preeclampsia than white women. Therefore, it is important to identify factors that may affect this risk. Our group previously proposed that high activity of the central regulatory enzyme of energy metabolism, creatine kinase (CK), may increase ATP-buffering capacity and lead to enhanced vascular contractility and reduced nitric oxide bioavailability. Therefore, we assessed microvascular contractility characteristics in isolated resistance arteries from self-defined black and white normotensive pregnant women using a Mulvany-Halpern myograph. Additionally, morphology was assessed with electron microscopy. Resistance-sized arteries obtained from omentum donated during cesarean sections (11 black women and 20 white women, mean age: 34 yr) studied in series showed similar morphology but significantly greater maximum contractions to norepinephrine (10(-5) M) in blacks [14.0 mN (1.8 SE)] compared with whites [8.9 mN (1.4 SE), P = 0.02]. Furthermore, we found greater residual contractility after the specific CK inhibitor dinitrofluorobenzene (10(-6) M) in black women [55% (6 SE)] compared with white women [28% (4 SE), P = 0.001] and attenuated vasodilation after bradykinin (10(-7) M) in black women [103% (6 SE)] compared with white women [84% (5 SE), P = 0.023], whereas responses to sodium nitroprusside (10(-4) M) and amlodipine (10(-6) M) were similar. We conclude that compared with white women, normotensive pregnant black women display greater resistance artery contractility and evidence of higher vascular CK activity with attenuated nitric oxide synthesis. These findings in normotensives may imply that the black population is at risk for a further incline in pregnancy-related hypertensive disorders.
Brewster LM; Taherzadeh Z; Volger S; Clark JF; Rolf T; Wolf H; Vanbavel E; van Montfrans GA
Depression during the perinatal period is common, debilitating, and consequential for women and their children, particularly among low income African American women. Viable approaches to prevention of depression have emerged. Yet little is known about women's preferences for approaches to preventing depression. A sample of 60 pregnant, low-income African American women seeking routine prenatal care was presented with standardized descriptions of three approaches to depression prevention (pharmacotherapy and two psychosocial approaches) and measures of preferences, perceived credibility, and personal reactions to each approach. Women also completed measures of perceived barriers and facilitators and current depression. Consistent with expectations, both of the psychosocial approaches were rated as more strongly preferred, more credible, and associated with more positive personal reactions relative to the pharmacotherapy approach. Depression did not alter women's preferences among the approaches. Contrary to prediction, women with clinically significant levels of depression did not find the pharmacotherapy approach to be more credible or to have more favorable personal reactions to it than women with low depression symptom levels. Exploration of women's perceptions of barriers revealed the importance of logistics, beliefs, and stigma barriers whereas women reported that concern about depression being impairing and ease of pragmatics would both facilitate engagement with preventive interventions. The findings suggest the need to examine the role of preferences in tests of the effectiveness of approaches to the prevention of perinatal depression in order to enhance service delivery among low income African American women. PMID:23356356
Goodman, Sherryl H; Dimidjian, Sona; Williams, Kristen G
Depression during the perinatal period is common, debilitating, and consequential for women and their children, particularly among low income African American women. Viable approaches to prevention of depression have emerged. Yet little is known about women's preferences for approaches to preventing depression. A sample of 60 pregnant, low-income African American women seeking routine prenatal care was presented with standardized descriptions of three approaches to depression prevention (pharmacotherapy and two psychosocial approaches) and measures of preferences, perceived credibility, and personal reactions to each approach. Women also completed measures of perceived barriers and facilitators and current depression. Consistent with expectations, both of the psychosocial approaches were rated as more strongly preferred, more credible, and associated with more positive personal reactions relative to the pharmacotherapy approach. Depression did not alter women's preferences among the approaches. Contrary to prediction, women with clinically significant levels of depression did not find the pharmacotherapy approach to be more credible or to have more favorable personal reactions to it than women with low depression symptom levels. Exploration of women's perceptions of barriers revealed the importance of logistics, beliefs, and stigma barriers whereas women reported that concern about depression being impairing and ease of pragmatics would both facilitate engagement with preventive interventions. The findings suggest the need to examine the role of preferences in tests of the effectiveness of approaches to the prevention of perinatal depression in order to enhance service delivery among low income African American women.
Goodman SH; Dimidjian S; Williams KG
Abstract Objective To describe the characteristics of a national cohort of pregnant women on methadone maintenance treatment (MMT) and to provide treatment outcome data for integrated care programs. Design Retrospective chart review. Setting Three different integrated care programs in geographically distinct cities: the Toronto Centre for Substance Use in Pregnancy in Toronto, Ont; the Herzl Family Practice Centre in Montreal, Que; and the Sheway clinic in Vancouver, BC. Participants Pregnant women meeting criteria for opioid dependence and attending an integrated care program between 1997 and 2009. Women were excluded if they were on MMT only for chronic pain. Main outcome measures Patient demographic characteristics, concurrent medical and psychiatric disorders, and substance use outcome data. Results A total of 102 opioid-dependent pregnancies were included. The mean age was 29.7 years and 64% of women were white. Women in Montreal were more likely to have partners and had fewer children. Differences in living and housing situations among the sites tended to resolve by the time of delivery. Almost half of this cohort tested positive for hepatitis C. Women had a high prevalence of depression and anxiety across all sites. Half of this cohort was on MMT before conception and for the other half, MMT was initiated at a mean gestational age of 20.7 weeks, resulting in a mean dose of 82.4 mg at delivery. At the first visit, polysubstance use was common. Prescription opioid use was more frequent in Toronto and heroin use was more prevalent in Vancouver and Montreal. For the entire population, significant reductions were found by the time of delivery for illicit (P < .001) and prescription opioids (P = .001), cocaine (P < .001), marijuana (P = .009), and alcohol use (P < .001). Conclusion Despite geographic differences, all 3 integrated care programs have been associated with significant decreases in substance use in pregnant opioid-dependent women.
Ordean, Alice; Kahan, Meldon; Graves, Lisa; Abrahams, Ronald; Boyajian, Talar
Full Text Available The experiment was aimed at investigating the medicinal value of vegetable consumption among Berom pregnant women at four local government areas namely (Barkin-ladi, Jos south, Jos north and Riyom LGAS) of plateau state, Nigeria in the Southern guinea savanna ecological zone in 2011 was considered. Data were collected using structured questionnaire. Multi stage random sampling of four autonomous communities in the areas was employed in selecting 120 Berom pregnant women who consume vegetable as a staple food. Simple descriptive statistics (frequencies, percentages) and correlation analysis were used in data analysis. The result of the finding revealed that women in the areas had experienced very little health complications due to pregnancy related problems (9%). It revealed that vegetables are cheap sources of proteins; vitamins and minerals that help the women to meet their daily protein requirement and as well improve the living standard of the women but as well supplement their starchy diets, hence making the women healthy. Considering these benefits vegetable consumption should be encouraged.
S.H. Badi; N. Dabels; G.G. Jibung
OBJECTIVE: The objective of this study was to document oral health practices of pregnant women in two tertiary institutions in North-eastern Nigeria. MATERIALS AND METHODS: This was a cross-sectional study of pregnant women seen at the antenatal clinics of the University of Maiduguri Teaching Hospital and Federal Medical Centre Yola from May 1, 2009 to July 1, 2009. RESULTS: A total of 294 women were interviewed. They were aged 15-46 with a mean of 27.42 ± 5.97 years. The parity ranged from 1 to 9 with a mean of 2.23 ± 1.65. Twelve (4.1%) women gave a history of symptomatic oral lesion in index pregnancy. Forty-four (15%) had had previous encounter with a dentist, while the highest frequency of oral care was twice a day in 164 (55.8%) of respondents. The majority, 264 (89.9%), used toothbrush/toothpaste as a form of oral care while 2 (0.7%) used charcoal. Women of low parity tended to have better oral care than those of high parity (P = 0.002). Women who are employed had better oral care than housewives (x2 = 27.749, P = 0.001). There was no significant relationship between oral complaints and trimester of pregnancy (x2 = 4.271, P = 0.118). CONCLUSION: Oral healthcare among the respondents was encouraging but involvement of the dental surgeon in preventive oral care in pregnancy is rather dismal.
Bukar M; Audu BM; Adesina OA; Marupa JY
Full Text Available Background: There are few studies focusing on women's experiences of early pregnancy. Medical and psychological approaches have dominated the research. Taking women's experiences seriously during early pregnancy may prevent future suffering during childbirth. Aim: To describe and understand women's first time experiences of early pregnancy. Method: Qualitative study using a phenomenological hermeneutic approach. Data were collected via tape-recorded interviews in two antenatal care units in Sweden. Twelve first time pregnant women in week 10–14, aged between 17 and 37 years participated. Results: To be in early pregnancy means for the women a life opening both in terms of life affirming and suffering. The central themes are: living in the present and thinking ahead, being in a change of new perspectives and values and being in change to becoming a mother. Conclusions: The results have implications for the midwife's encounter with the women during pregnancy. Questions of more existential nature, instead of only focusing the physical aspects of the pregnancy, may lead to an improvement in health condition and a positive experience for the pregnant woman.
Modh Carin; Ingela Lundgren; Ingegerd Bergbom
Urinary excretion of free and total (free plus conjugated) forms of methyl, ethyl, n-propyl and n-butyl parabens (MP, EP, PP and BP, respectively) and their metabolite p-hydroxybenzoic acid were measured for 111 pregnant Japanese women. Frequent detection of parabens and their metabolite indicated that exposure takes place daily for pregnant Japanese women. The estrogenic potency of PP was 20 times higher than those of the other 3 parabens for the present subjects when both abundance in the urine and the relative estrogenic activity of each compound was considered. Detection of free parabens suggested dermal exposure, probably from their inclusion in personal care products. No statistical association was found between the anogenital index (birth weight-adjusted AGD) of male offspring and the concentrations of any parabens in the urine of the mothers suggesting that the parabens were not apparently estrogenically active at the exposure level of the present subjects.
Shirai S; Suzuki Y; Yoshinaga J; Shiraishi H; Mizumoto Y
Urinary excretion of free and total (free plus conjugated) forms of methyl, ethyl, n-propyl and n-butyl parabens (MP, EP, PP and BP, respectively) and their metabolite p-hydroxybenzoic acid were measured for 111 pregnant Japanese women. Frequent detection of parabens and their metabolite indicated that exposure takes place daily for pregnant Japanese women. The estrogenic potency of PP was 20 times higher than those of the other 3 parabens for the present subjects when both abundance in the urine and the relative estrogenic activity of each compound was considered. Detection of free parabens suggested dermal exposure, probably from their inclusion in personal care products. No statistical association was found between the anogenital index (birth weight-adjusted AGD) of male offspring and the concentrations of any parabens in the urine of the mothers suggesting that the parabens were not apparently estrogenically active at the exposure level of the present subjects. PMID:22789395
Shirai, Sayaka; Suzuki, Yayoi; Yoshinaga, Jun; Shiraishi, Hiroaki; Mizumoto, Yoshifumi
Infections during pregnancy have been suggested to be involved in childhood leukemias. We used high-throughput sequencing to describe the viruses most readily detectable in serum samples of pregnant women. Serum DNA of 112 mothers to leukemic children was amplified using whole genome amplification. Sequencing identified one TT virus (TTV) isolate belonging to a known type and two putatively new TTVs. For 22 mothers, we also performed TTV amplification by general primer PCR before sequencing. This detected 39 TTVs, two of which were identical to the TTVs found after whole genome amplification. Altogether, we found 40 TTV isolates, 29 of which were putatively new types (similarities ranging from 89% to 69%). In conclusion, high throughput sequencing is useful to describe the known or unknown viruses that are present in serum samples of pregnant women.
Bzhalava D; Ekström J; Lysholm F; Hultin E; Faust H; Persson B; Lehtinen M; de Villiers EM; Dillner J
Infections during pregnancy have been suggested to be involved in childhood leukemias. We used high-throughput sequencing to describe the viruses most readily detectable in serum samples of pregnant women. Serum DNA of 112 mothers to leukemic children was amplified using whole genome amplification. Sequencing identified one TT virus (TTV) isolate belonging to a known type and two putatively new TTVs. For 22 mothers, we also performed TTV amplification by general primer PCR before sequencing. This detected 39 TTVs, two of which were identical to the TTVs found after whole genome amplification. Altogether, we found 40 TTV isolates, 29 of which were putatively new types (similarities ranging from 89% to 69%). In conclusion, high throughput sequencing is useful to describe the known or unknown viruses that are present in serum samples of pregnant women. PMID:22819835
Bzhalava, Davit; Ekström, Johanna; Lysholm, Fredrik; Hultin, Emilie; Faust, Helena; Persson, Bengt; Lehtinen, Matti; de Villiers, Ethel-Michele; Dillner, Joakim
Twenty-four hour noninvasive, automatic and ambulatory control of blood pressure (BP) was carried out on 11 normotensive pregnant women in the third trimester of pregnancy with a Del Mar Avionics Model 1978 Pressurometer III System at 7.5 min intervals during 24 h. The patients kept a detailed record of their activities during those 24 h. BP increased from 9 AM to a peak between 7 and 10 PM. Mean (+/- SD) waking and sleeping values were 110.56 +/- 6.68 mm Hg and 96.5 +/- 10.01 mm Hg, respectively, for systolic BP, and 71.41 +/- 5.35 mm Hg and 62.82 +/- 5.47 mm Hg, respectively, for diastolic BP. There was a significant difference in systolic and diastolic BP between sleeping hours and waking hours. We believe that 24-h control of BP behavior in normotensive pregnant women allows us to adequately diagnose hypertensive disease in pregnancy.
Margulies M; Zin C; Margulies ND; Voto LS
The aim of this study was to assess the association between the occurrence of hypertension (HTN) in pregnancy and antiphospholipid antibodies. We conducted a cross-sectional study of 100 pregnant women with their first pregnancy induced HTN and no history of thrombosis, renal disease or systemic autoimmune diseases. HTN was defined as blood pressure (BP) of 140/90 mmHg or higher on two measurements with 6 hours apart. Control group comprised of pregnant women without hypertension or proteinuria and without history of thrombosis or systemic autoimmune disease. Antiphospholipid Antibodies (Antiphospholipid IgG and IgM and anticardiolipin IgG and IgM) levels were measured in both groups. There were significantly higher titer of Antiphospholipid IgG and anticardiolipin IgG and IgM in case group (p
Smoking during pregnancy is associated with neonatal complications and health problems later in life. However, about 10% of the pregnant women in the Netherlands smoke and those with a psychiatric illness smoke even more frequently. Although giving up smoking may be more difficult for these women, it does not lead to an increase of psychiatric symptoms. We present two patients who smoked during pregnancy. A 28-year-old female started smoking again during her first pregnancy when her depression relapsed. We advised a higher dose of medication and with her midwife's support she gave up smoking. A 35-year-old female, suffering from posttraumatic stress disorder, had an increase of symptoms during her second pregnancy. She resumed smoking to feel more relaxed. Treatment with bupropion and an online support program helped her to give up smoking. We advise that every smoking pregnant woman with psychiatric problems be treated concurrently for the psychiatric illness and for smoking.
Smit M; Jongedijk EJ; Heres MH; Dolman KM; Honig A
Euthyroid or even hypothyroid pregnant women without antithyroid medication but with a history of treatment for thyrotoxicosis, almost always a subtotal strumectomy, may still produce thyroid-stimulating immunoglobulins. This can induce fetal and neonatal thyrotoxicosis. Without treatment this results in a high fetal and neonatal mortality and morbidity. Fetal treatment by administering antithyroid drugs during pregnancy improves this prognosis remarkably. A case is described, the literature is reviewed and guidelines for diagnosis and treatment are presented.
Bruinse HW; Vermeulen-Meiners C; Wit JM
Full Text Available Managing medical complications in pregnancy is a challenge to clinicians. Objectives: This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs) in Nigeria. A risk classification of the medicines was also determined. Methods: Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The prescription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results: A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38%) was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13%) and gastrointestinal disturbances (GIT, 12%). The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43%) of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42%) were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8%) of the total medicines. Of all medicines prescribed, 984 (17%) were included in the foetal risk category C and 286 (5%) in category D. Conclusion: The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent anti-malarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.
Eze UI; Eferakeya AE; Oparah AC; Enato EF
Full Text Available ABSTRACTSmoking during pregnancy is an important, preventable risk factor for late fetal death and even SIDS.There is a strong dose-response relationship between cigarette smoking and spontaneous abortion,reduction in birth weight, abruptio placentae, placenta previa and bleeding during pregnancy. Ten yearsago, the prevalence of smoking among Norwegian pregnant women was between 35 and 40%. Duringthe last 8 years there has been a dramatic change and in 1995 the prevalence seems to be around 20%.
Full Text Available "nAlthough pregnancy was once thought to protect against psychiatric disorders, gravid and non gravid women have similar risks for major depression, at 10% to 15%. Both depression and antidepressant treatment during pregnancy have been associated with risks. Few medications have been proved unequivocally safe during pregnancy. Although certain antidepressants have not been linked with an increased risk of birth defects or impaired development including bupropion, citalopram, escitalopram and venlafaxine, the latest studies aren't necessarily reassuring. As researchers continue to learn more about antidepressants, the risks and benefits of taking the drugs during pregnancy must be weighed carefully on a case-by-case basis. This review discusses about the use of new generation of antidepressants in pregnancy
Ladan Kashani; Shahin Akhondzadeh
Full Text Available An estimated 200,000 children born in Thailand each year are at risk of prenatal exposure to pesticides and associated neurodevelopmental outcomes because of their mothers’ agricultural occupations. Children born to non-agricultural workers may also be at risk of exposure from other pathways of maternal pesticide exposure, including exposure through home use, diet, and other environmental media. Pesticide exposure in Thailand has been linked to unsafe practices and beliefs about pesticides. However, limited information exists on pesticide knowledge, attitudes, and practices among pregnant women in Thailand or elsewhere. Obtaining this information is essential to understand the factors associated with prenatal pesticide exposure, identify populations potentially at risk, and ultimately protect pregnant women and their children. We administered surveys to 76 pregnant women in northern Thailand and used multivariable logistic regression to evaluate associations among pesticide-related knowledge, pregnancy trimester, and pesticide use behavior. In this pilot study, lower knowledge score and earliest trimester of pregnancy were marginally (p < 0.1) associated with unsafe practices in the home, but not at work. Women who worked in agriculture or applied pesticides before becoming pregnant, or who had a previous child were significantly (p < 0.05) more likely to engage in unsafe behaviors in the home during their current pregnancy. We preliminarily conclude that increasing pesticide-related knowledge among pregnant women may help promote safe practices and reduce prenatal exposure. Knowledge-based interventions may be most effective when implemented early in pregnancy and targeted to agricultural workers and other sub-populations at risk of pesticide exposure.
Alyson N. Lorenz; Tippawan Prapamontol; Warangkana Narksen; Niphan Srinual; Dana B. Barr; Anne M. Riederer
Full Text Available Abstract Background In areas where malaria is endemic, pregnancy is associated with increased susceptibility to malaria. It is generally agreed that this risk ends with delivery and decreases with the number of pregnancies. Our study aimed to demonstrate relationships between malarial parasitaemia and age, gravidity and anaemia in pregnant women in Libreville, the capital city of Gabon. Methods Peripheral blood was collected from 311 primigravidae and women in their second pregnancy. Thick blood smears were checked, as were the results of haemoglobin electrophoresis. We also looked for the presence of anaemia, fever, and checked whether the volunteers had had chemoprophylaxis. The study was performed in Gabon where malaria transmission is intense and perennial. Results A total of 177 women (57%) had microscopic parasitaemia; 139 (64%)of them were primigravidae, 38 (40%) in their second pregnancy and 180 (64%) were teenagers. The parasites densities were also higher in primigravidae and teenagers. The prevalence of anaemia was 71% and was associated with microscopic Plasmodium falciparum parasitaemia: women with moderate or severe anaemia had higher parasite prevalences and densities. However, the sickle cell trait, fever and the use of chemoprophylaxis did not have a significant association with the presence of P. falciparum. Conclusions These results suggest that the prevalence of malaria and the prevalence of anaemia, whether associated with malaria or not, are higher in pregnant women in Gabon. Primigravidae and young pregnant women are the most susceptible to infection. It is, therefore, urgent to design an effective regimen of malaria prophylaxis for this high risk population.
Bouyou-Akotet Marielle K; Ionete-Collard Denisa E; Mabika-Manfoumbi Modeste; Kendjo Eric; Matsiegui Pierre-Blaise; Mavoungou Elie; Kombila Maryvonne
OBJECTIVES: Infections of the vagina and the uterine cervix are some of the most frequently diagnosed and treated complications during pregnancy. AIMS: The aim of the study was to carry out biocenosis of the uterine cervix among pregnant women and the assessment of the resistance of the previously isolated types of bacteria to antibiotics. MATERIAL AND METHODS: The study was done in a group of 244 pregnant women, aged from 17 to 43, hospitalized and treated for various reasons in the Department of Pathology of Pregnancy at Medical University in Lód?. The biocenosis of the uterine cervix and the results of microbiological bacterial culture have been analyzed and the sensitivity of bacterial flora on the applied antibiotics has been assessed. RESULTS: Enterococcus faecalis, Escherichia coli and Staphylococcus epidermidis were the most frequent bacteria found in the smear from the uterine cervix. Negative culture was obtained in 2% of the pregnant women. The most frequently observed resistance to antibiotics manifested itself in case of amoxicillin, ampicillin, penicillin, erythromycin, clarithromycin and azithromycin. The bacteria showed least resistance to cephalosporins and fluoroquinolones. Staphylococcus epidermidis showed the highest resistance to antibiotics in general. CONCLUSIONS: In cases of bacterial vaginal infections, with unknown sensitivity to bacteria, treatment the use of cephalosporins is highly recommended.
Kazimierak W; Swierczewski A; Kowalska-Koprek U; Karowicz-Bili?ska A; Berner-Trabska M; Nowak Z; Ku? E
Full Text Available Objective: In this study, we evaluated the management of cervical intraepithelial neoplasia (CIN) in pregnant women and evaluated the postpartum prognosis. Methods: Twenty-four pregnant women, who were diagnosed with CIN at Ehime University Hospital between January 2008 and October 2012, were recruited. The mode of delivery and pathophysiological examination results in the postpartum period were evaluated. Results: Four patients were antenatally diagnosed with either CIN1 or CIN2. Of these patients, CIN regressed or remained stable during pregnancy, and there was no disease progression in the postpartum period. Nine patients were diagnosed with severe dysplasia (CIN3) and eleven patients had carcinoma in situ (CIS). Of these patients, 5/9 (55%) and 4/11 (36%), respectively, had disease regression postnatally. No CIN lesion progressed to invasive carcinoma after delivery. Conclusions: We determined that many cases diagnosed antenatally with CIN regressed during the postpartum period, regardless of the grade of CIN. We recommend a conservative management strategy with careful ante- and postpartum examinations for pregnant women with CIN.
Yuko Matsubara; Toru Fujioka; Hisashi Hashimoto; Katsuyuki Hamada; Keiichi Matsubara; Akihiro Nawa
BACKGROUND: Daily oral hygiene and regular dental visits are important components of oral health care. The authors' objective in this study was to examine women's oral hygiene practices and use of dental services during pregnancy. METHODS: The authors developed a written oral health questionnaire and administered it to 599 pregnant women. They collected demographic information, as well as data on oral hygiene practices and use of dental services during pregnancy. They used chi2 and multivariable logistic regression models to assess associations between oral hygiene practice and dental service use during pregnancy and to identify maternal predictor variables. RESULTS: Of the 599 participants, 83 percent (n=497) reported brushing once or twice per day. Twenty-four percent (n=141) reported flossing at least once daily; Hispanic women were more likely to floss than were white or African American women (28 percent [52 of 183] versus 22 percent [54 of 248] versus 19 percent [23 of 121], respectively, P<.001). Seventy-four percent (n=442) of the participants reported having received no routine dental care during pregnancy. Hispanic women were significantly less likely than were black or white women to receive routine dental care during pregnancy (13 percent versus 21 percent versus 36 percent, respectively, P<.001). The authors found that being older than 36 years, being of Hispanic race or ethnicity, having an annual income of less than $30,000, flossing infrequently and receiving no dental care when not pregnant were significantly associated with lack of routine dental care during pregnancy (adjusted odds ratios, 95 percent confidence intervals: 2.56 [1.33-4.92]; 2.19 [1.11-4.29]; 2.02 [1.12-3.65]; 1.86 [1.13-3.07]; and 4.35 [2.5-7.69], respectively). A woman's lack of receiving routine dental care when not pregnant was the most significant predictor of lack of receiving dental care during pregnancy. CONCLUSION: Racial, ethnic and economic disparities related to oral hygiene practices and dental service utilization during pregnancy exist. CLINICAL IMPLICATIONS: Medical and dental care providers who treat women of reproductive age and pregnant women need to develop policy strategies to address this population's access barriers to, and use of, dental care services.
Boggess KA; Urlaub DM; Massey KE; Moos MK; Matheson MB; Lorenz C
OBJECTIVE: To differentiate the effect of gestation on the mode of delivery by analysing the difference in the mode of induction, length of labour and the difference in parity or Bishop score and their effect on the mode of delivery of postdates women. STUDY DESIGN: A cross-sectional observational study. PLACE AND DURATION OF STUDY: PAEC General Hospital, Islamabad, from July 2006 to July 2008. METHODOLOGY: Patients were induced at 41 weeks (Group B) and > 40 weeks (Group A) of gestation. Tab misoprostol and PGE2 tablets were administered according to amniotic fluid index (AFI) and parity. Study variables included duration of gestation, mode of induction, length of labour, difference in parity and Bishop score assessed before induction in each group. The outcome was assessed by applying Chi-square test by comparing mode of delivery with the study variables in both groups. RESULTS: A total of 78 patients were inducted in the study. They were divided in group B (n = 39) induced 41 weeks and group A (n = 39) induced at 40 weeks. Eighty four percent (n = 35) patients in group B delivered vaginally as compared to 71% (n = 28) in the 40 weeks group (p < 0.0001). The higher number of vaginal deliveries in 41 weeks group was independent of association between the induction agent, parity and mode of delivery. CONCLUSION: The mean length of gestation was the single most important factor among the studied variables in predicting a vaginal delivery.
Haq AN; Ahsan S; Sher Z
Fundal height measurements in centimeters (FH) have always been an objective method of evaluating fetal growth in pregnancy. The popular Mcdonald's rule refers mainly to caucasions unfortunately. Since FH may actually vary in an anthropological sense it was considered necessary to apply Mcdonald's rule to African subjects. Pregnant Nigerian women were studied to observe how their fundal height values compared with those obtained for caucasian women in western communities. A gravidogram was derived for the 10th, 50th and 90th centiles. Values outside the range of 10-90th centiles are to be used for the prediction of small-for-dates and large-for-dates babies accordingly. Prediction formulae for the various centiles derived from regression analysis were obtained and their usefulness in clinical anthropological practice using fundal height measurement highlighted. A simple universal formula for African subjects is presented. Normal values of pregnant women for somatotype, height, and abdominal girth are also presented. The result of this survey demonstrates a significant difference in fundal height values of African women from those of the hitherto utilized standards derived from the study of caucasian women, especially in early pregnancy. This report suggests an early intra-uterine growth retardation in the African pregnancies which is corrected in the third trimester.
Full Text Available Background : Provision of antenatal care (ANC) is included in the pillars of maternal health care promoted as effective answers to maternal mortality. Early antenatal registration has been linked with optimal utilization and appreciable reduction of perinatal morbidity and mortality. This study aimed to determine the profile and possible predictors of pregnant women who presented early for antenatal registration. Methods : A cross-sectional study was conducted among 796 women presented for antenatal registration at a tertiary hospital. Information was obtained by a self-administered open- and closed-ended questionnaire and analyzed with Statistical Package of Social Science (SPSS) 12.0 software. Results : The mean gestational age at booking was 20 weeks. Univariate analysis showed that first trimester booking was significantly with more educated women, professionals, women of lower parity and those who have had previous stillbirths (P Conclusion : Long-term advocacy and investment in female education will contribute significantly to primary prevention of late or non-attendance of ANC. Pre-conception clinics and community awareness campaigns would be necessary tools to reach these women and encourage them to register early when pregnant.
Oladokun Adesina; Oladokun Regina; Morhason-Bello Imran; Bello Adenike; Adedokun Babatunde
Full Text Available Introduction: Down syndrome is one of the most prevalent genetic diseases. Screening methods for this syndrome are easy and safe and are recommended to all pregnant wom-en particularly mothers over 35 years of age. This study aimed to review the status of Down syndrome screening and related factors in Iranian pregnant women. Methods: This descriptive analytical study was carried out in 2011. It included 400 women who were randomly selected from those referring to Alzahra Hospital (Tabriz, Iran) during their third trimester of pregnancy. Data was collected through a question-naire whose reliability and validity have been approved. The data was analyzed by chi-square test in SPSS13. Results: The results showed that while 28 and 26 women imple-mented screening tests during the first and second trimesters, respectively, only 5 sub-jects benefited from both (integrated test). Chi-square test showed significant correla-tions between the implementation of screening methods and age, education level, in-come, and the location of prenatal care (p < 0.05). Conclusion: The findings of the present study showed women to poorly implement Down syndrome screening methods. Therefore, the necessity of providing appropriate educational programs for health staff and mothers seems undeniable. Moreover, paying attention to the related factors such as income, educational level, and adequate training of mothers during pregnancy is essential.
Azizeh Farshbaf Khalili; Mahnaz Shahnazi; Khadijeh Hajizadeh; Mahmoud Shekari Khaniani
OBJECTIVE: To determine the incidence of clinically significant anti-erythrocyte alloantibodies in pregnant women, which can cause severe hemolytic disease in the fetus and newborn. DESIGN: Retrospective-prospecitive clinical study. SETTING: Transfusion Department, University Hospital Olomouc, Department of Obstetrics and Gynecology, University Hospital Olomouc. SUBJECT AND METHOD: Between the years 2000-2011, a total of 45 435 pregnant women were examined at the Department of Transfusion Medicine at the University Hospital Olomouc. Screening for irregular anti-erythrocyte antibodies followed by identification of the alloantibody was performed in all women at the beginning of the pregnancy. RESULTS: Clinically significant anti-erythrocyte antibodies were diagnosed in 1.5% pregnant women (683/45435). The most common cause of maternal alloimmunization was antigen E with an incidence of 5.7 (258/45435), followed by antigen D 4.0 (181/45435), M 1.5 (70/45435), C 1.2 (54/45435), K 1.2 (55/45435), c 0.6 (26/45435), S 0.4 (20/45435), Jka 0.2 (9/45435), PP1pk (Tja) 0.1 (3/45435) and antigen Fya 0.0 (2/45435). CONCLUSION: Despite performing prophylaxis for RhD alloimmunization by administering anti-D immunoglobulin to RhD negative women during pregnancy and after the birth of an RhD positive child, antigen RhD still represents the 2nd most frequent cause of maternal erythrocyte alloimmunization. The remaining clinically significant alloimmunizations are caused by non-D antigens of the Rh system, antigens of the Kell system, and rarely observed antigens of the MNS and Kidd blood systems.
Holusková I; Lubušký M; Studni?ková M; Procházka M
Full Text Available Abstract Background Pregnant women are at an increased risk for HIV infection due to unknown biological causes. Given the strong effect of sex-hormones on the expression of immunomuodulatory factors, the central role of mucosal immunity in HIV pathogenesis and the lack of previous studies, we here tested for differences in immunomuodulatory factors in cervico-vaginal secretions between pregnant and non-pregnant women. Methods We compared concentrations of 39 immunomodulatory factors in cervicovaginal lavages (CVL) from 21 pregnant women to those of 24 non-pregnant healthy women from the US. We used Bonferroni correction to correct for multiple testing and linear regression modeling to adjust for possible confounding by plasma cytokine concentration, cervical ectopy, total protein concentration, and other possible confounders. Cervical ectopy was determined by planimetry. Concentration of immunomodulatory factors were measured by a multiplex assay, protein concentration by the Bradford Method. Results Twenty six (66%) of the 39 measured immunomodulatory factors were detectable in at least half of the CVL samples included in the study. Pregnant women had threefold lower CVL concentration of CCL22 (geometric mean: 29.6 pg/ml versus 89.7 pg/ml, p = 0.0011) than non-pregnant women. CVL CCL22 concentration additionally correlated negatively with gestational age (Spearman correlation coefficient [RS]: -0.49, p = 0.0006). These associations remained significant when corrected for multiple testing. CCL22 concentration in CVL was positively correlated with age and negatively correlated with time since last coitus and the size of cervical ectopy. However, none of these associations could explain the difference of CCL22 concentration between pregnant and non-pregnant women in this study, which remained significant in adjusted analysis. Conclusions In this study population, pregnancy is associated with reduced concentrations of CCL22 in cervicovaginal secretions. The role of CCL22 on HIV transmission should now be investigated in prospective studies.
Walter Jan; Fraga Linda; Orin Melanie J; Decker William D; Gipps Theresa; Stek Alice; Aldrovandi Grace M
Seventy-five pregnant women underwent MR imaging at 0.35 T. The subjects fell into two broad categories: women with suspected medical or surgical disease (n = 37), and women with abnormal gestations, as determined by prior US studies (n = 38). In the first group, MR imaging depicted a wide variety of maternal ailments, including abnormalities in the brain, chest, liver, adrenals, kidneys, and pelvis. There were no false-positive MR imaging studies. There were two true-negative studies in this group. The only false-negative examination occurred in a patient with a tubal ectopic pregnancy. In the second group, MR imaging depicted fetal anomalies in all 24 cases identified on US. However, in every instance, US provided equivalent or more morphologic information and also physiologic information not available from MR imaging. MR imaging may be useful for evaluating pregnant women with medical or surgical diseases, but currently it provides only limited morphologic data on the fetus, in comparison to US
OBJECTIVES: The Norwegian Mother and Child Cohort Study (MoBa) started in 1999 to identify environmental factors that could be involved in mechanisms leading to disease. Questions have been raised about potential risks to the fetus from prenatal exposure to mercury from amalgam fillings in pregnant women. The aim of the present study was to identify factors potentially associated with amalgam fillings in pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa). An additional aim was to obtain information about dental treatment in the cohort. METHODS: Total of 67,355 pregnancies from the MoBa study were included in the present study. Information regarding age, education, smoking habits, alcohol consumption, weight, and height for the women was obtained from a questionnaire that was filled in at the 17th week of pregnancy. In another questionnaire, which was sent to all participants in the 30th week of pregnancy, the women reported types of dental treatment during pregnancy, total number of teeth, and number of teeth with amalgam fillings. The self-assessed number of teeth and number of teeth with amalgam fillings were validated in an external sample of 97 women of childbearing age. RESULTS: Odds ratio for having more than 12 teeth with amalgam fillings increased considerably with age. Other significant risk factors for having high exposure to amalgam were low education, high body mass index (BMI), and smoking during pregnancy. Women with the lowest levels of education had a twofold increased odds ratio of having more than 12 teeth filled with amalgam compared with women who had more than 4 years of university studies. According to the results from the validation of self-assessed number of teeth with amalgam fillings, the information obtained was reliable. CONCLUSION: Age, education, smoking habits, and BMI were associated with amalgam exposure.
Lygre GB; Björkman L; Haug K; Skjaerven R; Helland V
Full Text Available The prevalence of primary infection with T. gondii in pregnant women and risk of congenital infection in their neonates in various parts of Tehran are unknown. The prevalence rate of antibodies to T. gondii ranges from 24% in Tehran to 62.7% in Babol. This study describes the epidemiology of toxoplasma infection in pregnant women in Tehran and risk factors of congenital toxoplasmosis in newborn among preterm infants and full- term infants born from these mothers. A cross sectional study was carried out in 140 primiparus women living in various part of Tehran. Initially from each case a questionnaire was completed by the authorized physician, followed by clinical exams in newborns. The birth certificate was the data source used for such as gestational age, birthweigt, etc. The centrifuged blood specimens from all pregnant women are screened using an assay for Toxoplasma- specific IgM and IgG based on preliminary evidence in Iran. Specific toxo- IgM was positive in 7.1% (90% of them were also IgG positive) , toxo – IgG was positive in 34.3% of mothers. Mean age of IgG positive mothers (22.49±4.22), mean age of IgM positive mothers (19.90± 3.48). There were significantly differences between living place of mothers and IgG positive (p=0.007) . There were significantly differences between living place of mothers (East and central) and IgM positive (Fisher test = 0.023). Elaborating an epidemiological profile and risk correlates might help focus prenatal education and newborn screening strategies. Prenatal screening could be more easily justified in central part of Tehran because low incidence populations detected and probably treatment of mothers infected during pregnancy led to lower rates of transmission to the newborn. In contrast, in eastern part of Tehran due to high seroprevalence rate detected, newborn screening is relatively inexpensive and efficient.
S Noorbakhsh; S Mamishi; S Rimaz; SHR Monavari
BACKGROUND: Although it is recommended that pregnant women at risk for influenza complications receive influenza vaccine, it is not clear if healthy pregnant women are at increased risk for adverse outcomes. We aimed to estimate the rate of hospitalization attributable to influenza for healthy pregnant women and for those with known co-morbidities. METHODS: Hospital admission records of women admitted from 1994 to 2000 with a respiratory condition during pregnancy were extracted from the hospitalization database (Canadian Institute of Health Information). Admissions for childbirth were excluded. Weekly admissions, stratified by the presence of co-morbid conditions, were modelled as a function of viral activity, seasonality, trend, and holiday effects using Poisson regression with proxies for influenza and other viral activity developed previously for similar age-specific models of influenza-attributed hospital admissions. RESULTS: Approximately 300 hospitalizations of pregnant women per year were attributed to influenza, of which 140 were in women with co-morbidities. This hospitalization rate corresponds to 150 (95% CI 140-170) hospitalizations per 100,000 pregnant women per year. An estimated 1 in 1000 healthy pregnant women were hospitalized due to influenza per year. Asthma was the most important risk factor, accounting for an estimated 450 (95% CI 300-600) admissions per 100,000 pregnant women. Admission rates in pregnant women were relatively constant across multiple influenza seasons of varying severity among older adults. During the four weeks of peak influenza activity, 60% of respiratory-related admissions of otherwise healthy pregnant women could be attributed to influenza. CONCLUSION: Healthy pregnant Canadian women have consistently higher rates of hospital admission attributable to influenza infection than their non-pregnant peers. The admission rate for healthy pregnant women corresponds to the rate for men and women aged 65 to 69 years, which suggests that this population may benefit from annual influenza immunization.
Schanzer DL; Langley JM; Tam TW
OBJECTIVE: To study how living conditions influence pregnancy planning and acceptance among Danish women. METHOD: A cross-sectional questionnaire study performed among 3516 pregnant women attending Odense University Hospital, Denmark. The study population consisted of women with spontaneous abortion, women with ectopic pregnancies, women attending antenatal care and women with induced abortion. They were divided into four groups: women with planned and accepted pregnancies (accepting planners, n=2137), women who accepted an initially unplanned pregnancy (accepting non-planners, n=1006), women who rejected an initially planned pregnancy (rejecting planners, n=31), and women with unplanned and rejected pregnancies (rejecting non-planners, n=342). The association between socio-economic characteristics and pregnancy planning and acceptance was evaluated by comparing accepting non-planners with accepting planners and by comparing rejecting planners with rejecting non-planners. The variables studied comprise age, number of children, partner relationship, education, occupation, economic situation and contraceptives. RESULTS: The characteristics of accepting non-planners and accepting planners were in accordance and in contrast to those of rejecting planners and in particular of rejecting non-planners. The contraceptive prevalence rate among accepting non-planners was 15%. Among rejecting non-planners the same figure was 51%. CONCLUSION: Accepting non-planners seemed to be in a situation which could be considered appropriate for childbirth. The contraceptive prevalence rate among accepting non-planners was low and might reflect that these women were not entirely against the thought of having a child, although they did not actively plan to have one.
Rasch, V; Knudsen, L B
BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are compounds that are formed as a result of incomplete combustion of organic matter. The most common sources of PAHs are cigarette smoke, coal-fired utilities, steel plants, coke-oven plants, graphite electrode manufacturing plant, Söderberg aluminum electrolysis plant, vehicle exhaust, wood-burning ovens and fireplaces, and charcoal-grilled and smoked food. The aim of the study was to assess the exposure of smoking pregnant women to PAHs. MATERIAL AND METHODS: The study population consisted of 189 pregnant women from the Lód? voivodeship (province). Smoking status was assessed based on saliva cotinine level analyzed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The cutoff point 10 ng/ml was adopted for saliva cotinine level. 1-hydroxypyrene (1-HP) concentration in urine sample was chosen as the biomarker of exposure to PAHs. RESULTS AND CONCLUSIONS: The mean concentration of 1-HP in urine of nonsmoking woman was 0.60 microg/g creatinine, whereas in smoking one 1.35 microg/g creatinine. Among the women with saliva cotinine level higher than 10 ng/ml, the mean concentration of 1-HP in urine was over twofold higher than that in women with cotinine level lower than 10 ng/ml after adjustment for the day of urine ample collection (ratio of geometric mean 2.3; 95% CI 1.7-3.0). The study confirmed a higher risk of exposure to PAHs in the group of women who smoke cigarettes during pregnancy as compared to nonsmoking women. It should be stressed that cigarette smoking is not the only source of exposure to PAHs.
Pola?ska K; Hanke W; Sobala W; Brze?nicki S; Ligocka D
Full Text Available Abstract in portuguese OBJETIVO: analisar a evolução clínica de três pacientes grávidas com malária grave internadas em unidade de terapia intensiva de um hospital localizado em Porto Velho (RO). MÉTODOS: foi realizado estudo descritivo em três gestantes, portadoras de malária por Plasmodium falciparum, internadas em unidade de terapia intensiva em Porto Velho, no período de 2005 a 2006. As variáveis categóricas utilizadas foram os critérios de classificação da Organização Mund (more) ial de Saúde para classificação de malária grave e os índices Acute Physiology and Chronic Health disease Classification System II (APACHE II) e Sepsis Related Organ Failure Assessment (SOFA) preditores de morbidade e gravidade das doenças em unidade de terapia intensiva. RESULTADOS: a malária adquirida pelas gestantes, caracterizada pela infecção por Plasmodium falciparum na forma grave da doença, resultou em óbito para as três pacientes e seus conceptos. CONCLUSÕES: embora a casuística seja pequena, a importância deste estudo reflete a repercussão da malária grave em gestantes, bem como a necessidade de um acompanhamento pré-natal mais criterioso e atento à identificação precoce do início das complicações da malária em gestantes. Abstract in english PURPOSE: to analyze the clinical course of three pregnant patients with severe malaria admitted to the intensive care unit of a hospital in Porto Velho (RO), Brazil. METHODS: a descriptive study was conducted on three pregnant women infected with Plasmodium falciparum malaria, admitted to the intensive care unit of a hospital in Porto Velho from 2005 to 2006. Categorical variables used were the classification criteria of the World Health Organization which ranks severe ma (more) laria and the Acute Physiology and Chronic Health Disease Classification System II (APACHE II) and Sepsis Related Organ Failure Assessment (SOFA) predictors of morbidity and severity of intensive care unit diseases. RESULTS: the malaria acquired by the pregnant subjects characterized by infection with Plasmodium falciparum in its most serious form resulted in death for all three patients and their fetuses. CONCLUSIONS: although the sample of this study was small it reflects the important impact of severe malaria on pregnant women as well as the need for a more judicious and attentive prenatal care to identify the disease in its early stages and its first complications in pregnant women.
Fernandes, Flavia Barbosa; Lopes, Reginaldo Guedes Coelho; Mendes Filho, Sérgio Paulo de Mello
Full Text Available OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth > 4 mm and an attachment loss > 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.
Maria Dilma Bezerra de Vasconcellos Piscoya; Ricardo Arraes de Alencar Ximenes; Genivaldo Moura da Silva; Sílvia Regina Jamelli; Sonia Bechara Coutinho
Full Text Available Abstract in english OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and (more) 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth > 4 mm and an attachment loss > 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.
Piscoya, Maria Dilma Bezerra de Vasconcellos; Ximenes, Ricardo Arraes de Alencar; Silva, Genivaldo Moura da; Jamelli, Sílvia Regina; Coutinho, Sonia Bechara
AIMS: This study describes women with induced abortion and thereby elucidates how living conditions and contraceptive failure are associated with the choice of induced abortion in a population of Danish pregnant women. METHODS: The study population consisted of pregnant women attending Odense Univer...
Rasch, Vibeke; Wielandt, Hanne; Knudsen, Lisbeth B.
Sixty healthy pregnant women (aged 21-35 years), including 30 pregnant women at the beginning of second trimester and 30 women at the beginning of third trimester underwent a psychosocial stress test. Physiological (salivary free cortisol levels, salivary alpha-amylase levels) and psychological (per...
Nierop, A; Wirtz, P H; Bratsikas, A; Zimmermann, R; Ehlert, U
Clinicians who provide care for incarcerated women should be aware of the special health care needs of pregnant incarcerated women and the specific issues related to the use of restraints during pregnancy and the postpartum period. The use of restraints on pregnant incarcerated women and adolescents may not only compromise health care but is demeaning and rarely necessary.
Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04µg/L; Pb soil <3.0µg/g; Pb dust 16.5µg/g; Pb blood 3.67µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0µg/g; Hg dust <1.0µg/g; Hg blood 0.46µg/L; Hg urine <0.40µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02µg/L; Cdsoil <0.30ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55µg/L, creatinine corrected 0.70µg/g (range <0.2-7.06µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects.
Hinwood AL; Callan AC; Ramalingam M; Boyce M; Heyworth J; McCafferty P; Odland JØ
Full Text Available Abstract Background Over 20% of women smoke throughout pregnancy despite the known risks to mother and child. Engagement in face-to-face support is a good measure of service reach. The Scottish Government has set a target that by 2010 8% of smokers will have quit via NHS cessation services. At present less than 4% stop during pregnancy. We aimed to establish a denominator for pregnant smokers in Scotland and describe the proportion who are referred to specialist services, engage in one-to-one counselling, set a quit date and quit 4 weeks later. Methods This was a descriptive epidemiological study using routinely collected data supplemented by questionnaire information from specialist pregnancy cessation services. Results 13266 of 52370 (25%) pregnant women reported being current smokers at maternity booking and 3133/13266 (24%) were referred to specialist cessation services in 2005/6. Two main types of specialist smoking cessation support for pregnant women were in place in Scotland. The first involved identification using self-report and carbon monoxide breath test for all pregnant women with routine referral (1936/3352, 58% referred) to clinic based support (386, 11.5% engaged). 370 (11%) women set a quit date and 116 (3.5%) had quit 4 weeks later. The second involved identification by self report and referral of women who wanted help (1195/2776, 43% referred) for home based support (377/1954, 19% engaged). 409(15%) smokers set a quit date and 119 (4.3%) had quit 4 weeks later. Cost of home-based support was greater. In Scotland only 265/8062 (3.2%) pregnant smokers identified at maternity booking, living in areas with recognised specialist or good generic services, quit smoking during 2006. Conclusions In Scotland, a small proportion of pregnant smokers are supported to stop. Poor outcomes are a product of current limitations to each step of service provision - identification, referral, engagement and treatment. Many smokers are not asked about smoking at maternity booking or provide false information. Carbon monoxide breath testing can bypass this difficulty. Identified smokers may not be referred but an opt-out referral policy can remove this barrier. Engagement at home allowed a greater proportion to set a quit date and quit, but costs were higher.
Tappin David M; MacAskill Susan; Bauld Linda; Eadie Douglas; Shipton Debbie; Galbraith Linsey
The article deals with the issues of dispensarization of pregnant women and puerperants as exemplified by Moscow oblast and certain maternity clinics in municipal districts of oblast. The article presents the results of sociological survey of obstetricians-gynecologists and pregnant women about issues of dispensarization. The organizational functional model is presented to develop the means of dispensarization of pregnant women and to increase its role in population health promotion.
This study focuses on the incidence and risk profile among young women with a diagnosis of pulmonary embolism over the 10-year period 1988-97. A total of 66 non-pregnant women aged 15-44, treated for the first event of pulmonary embolism, were identified by discharge diagnosis at two main Norwegian hospitals (The Regional Hospital of Trondheim and Ullevål Hospital, Oslo). The estimated overall incidence of pulmonary embolism was 6.8 per 100,000 women-years. The crude incidence decreased from 7.5 per 100,000 women-years in 1988-90 to 4.1 per 100,000 women-years in 1996-97 (p < 0.1). 25 (38%) of the 66 patients were identified with at least one medical risk factor, four patients (6%) with a family history of thrombophilia and 30 patients (45%) used oral contraceptives (OC) at the time of diagnosis. 25 (68%) of the 37 patients without registered risk factors used OC. The incidence of pulmonary embolism decreased during the 10-year period, with unchanged risk profile. Two women (3%) died from pulmonary emboli shorter than three weeks after onset of symptoms.
Amundsen T; Høibraaten E; Skjeldestad FE
This is the first prospective study carried out in Argentina and Latin America to provide the impact of epilepsy throughout the childbearing years life of women, and pregnancy outcome in a population of pregnant women with diagnosis of epilepsy and antiepileptics drugs (AEDs). Ninety-four women were studied prospectively at the Epilepsy Center, the largest in Argentina. Of the 94 women examined in this study only 10% planned their pregnancy and received folic acid before conception.More than half of women in our study were on monotherapy, with the most frequently prescribed drugs being carbamazepine and valproic acid. In all, 90.4% of the women had a normal pregnancy and delivery. There were 8.5% spontaneous abortions. Major congenital malformations (MCM) was detected in 10.6% of newborns at birth; in the general population it varies between 1.6-3.2%. The results from this study are helpful in the highlighting correct gaps in knowledge in this population group.
Kochen S; Salera C; Seni J
DeQuervain tenosynovitis, which involves the abductor pollicis longus and extensor pollicis brevis tendons, is much more common in women than men and is due to repetitive movements of the hand such as grasping and twisting. Housewives and persons involved in manual occupations using the hands and wrists account for most cases in previous series. In this series, six of 24 female patients (25%) were pregnant or postpartum at the time of onset. In five of the six, activities of infant care aggravated symptoms. Both pregnancy, per se, and mechanical factors appear to play a role in causing this condition. PMID:3488531
Schned, E S
DeQuervain tenosynovitis, which involves the abductor pollicis longus and extensor pollicis brevis tendons, is much more common in women than men and is due to repetitive movements of the hand such as grasping and twisting. Housewives and persons involved in manual occupations using the hands and wrists account for most cases in previous series. In this series, six of 24 female patients (25%) were pregnant or postpartum at the time of onset. In five of the six, activities of infant care aggravated symptoms. Both pregnancy, per se, and mechanical factors appear to play a role in causing this condition.
OBJECTIVE: The aim of this review is to give comprehensive summary of erythrocyte alloimunization of pregnant women, laboratory dignostics and clinical importance. DESIGN: Review. SETTING: University Hospital Olomouc, Transfusion Department, Department of Obstetrics and Gynecology. SUBJECT AND METHOD: Based on literature analysis using database search engines PubMed, Google Scholar, Ovid in field of erythrocyte antibodies, laboratory diagnostics and clinical importance up-to-date knowledge. CONCLUSION: Erythrocyte alloimunization anti-D antibodies decreases in connection with the introduction of immunoprofylaxis. Immunization of non RhD antibodies with impossibility using of immunoprofylaxis remains still clinical problem.
Holusková I; Lubušký M; Studni?ková M; Procházka M
PURPOSE: To describe the maternal and perinatal outcomes of pregnant women diagnosed with leukemia who were followed up for prenatal care and delivery at a university hospital. METHODS: A retrospective study of the period from 2001 to 2011, which included 16 pregnant women with a diagnosis of leukemia followed by antenatal care specialists in hematological diseases and pregnancy. For acute leukemia diagnosed after the first trimester, the recommendation was to perform chemotherapy despite the current pregnancy. For chronic leukemia, patients who were controlled in hematological terms were maintained without medication during pregnancy, or chemotherapy was introduced after the first trimester. We analyzed the maternal and perinatal outcome. RESULTS: Acute lymphoblastic leukemia (ALL) was diagnosed in five cases (31.3%), acute myeloid leukemia (AML) in two cases (12.5%) and chronic myeloid leukemia (CML) in nine cases (56.3%). Of the cases of acute leukemia, two (28.6%) were diagnosed in the first trimester, two (28.6%) in the second and three (42.9%) in the third. Two patients with ALL diagnosed in the first trimester opted for therapeutic abortion. Four patients with acute leukemia received chemotherapy during pregnancy, with a diagnosis established after the 20th week. In one case of ALL with a late diagnosis (30 weeks), chemotherapy was started after delivery. All pregnant women with acute leukemia developed anemia and thrombocytopenia, and four (57.1%) developed febrile neutropenia. Of nine pregnant women with CML, four were treated with imatinib mesylate when they became pregnant, with treatment being interrupted in the first trimester in three of them and in the second trimester in one. During pregnancy, three patients (33.3%) required no chemotherapy after discontinuation of imatinib, and six (66.7%) were treated with the following drugs: interferon (n=5) and/or hydroxyurea (n=3 ). In the group of pregnant women with CML, anemia occurred in four (44.4%) cases and thrombocytopenia in one (11.1%). The perinatal outcomes of pregnancies complicated by acute leukemia were as follows: mean gestational age at delivery was 32 weeks (standard deviation - SD=4.4) and the mean birth weight was 1476 g (SD=657 g), there were 2 (40.0%) perinatal deaths (a fetal one and a neonatal one). In pregnancies complicated by CML, the mean gestational age at delivery was 37.6 weeks (SD=1.1) and the mean birth weight was 2870 g (SD=516 g). There was no perinatal death and no fetal abnormality was detected. CONCLUSIONS: Maternal and fetal morbidity is high in pregnancies complicated by acute leukemia. Whereas, in pregnancies complicated by CML, the maternal and fetal prognosis appears to be more favorable, with greater ease in management of complications.
Nomura RM; Igai AM; Faciroli NC; Aguiar IN; Zugaib M
Pregnant women traditionally have been assigned priority in the allocation of prevention and treatment resources during outbreaks of influenza because of their increased risk of morbidity and mortality. The Committee on Ethics of the American College of Obstetricians and Gynecologists explores ethical justifications for assigning priority for prevention and treatment resources to pregnant women during an influenza pandemic, makes recommendations to incorporate ethical issues in pandemic influenza planning concerning pregnant women, and calls for pandemic preparedness efforts to include clinical research specifically designed to address safety and efficacy of treatment interventions or prevention strategies used by pregnant women.
CONTEXT: Gingival changes in pregnancy have been attributed to changes in the subgingival biofilm related to hormonal variations. AIMS: To evaluate the subgingival plaque microflora in pregnant and nonpregnant women to determine if pregnancy induces any alterations in the subgingival plaque and to associate these changes with changes in periodontal status. SETTINGS AND DESIGN: Thirty pregnant and 10 nonpregnant women within the age group of 20-35 years having a probing pocket depth (PPD) of 3-4 mm were included in the study. The pregnant women were equally divided into 3 groups of 10, each belonging to I, II, and III trimester. MATERIALS AND METHODS: Plaque index, gingival index, PPD, and microbiologic evaluation for specific bacterial counts for Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, and Fusobacterium nucleatum were carried out for all subjects. STATISTICAL ANALYSIS: Mann-Whitney U test. RESULTS: Increase in gingival inflammation was observed in II and III trimester as compared with I trimester and control. Plaque scores did not show any significant difference between pregnant and nonpregnant women. Specific bacterial examination revealed an increase in proportion of P. intermedia in pregnant women of both II and III trimester as compared with I trimester and nonpregnant women. CONCLUSIONS: A definite increase in proportions of P. intermedia occurs in subgingival plaque microflora in pregnancy that may be responsible for the exaggerated gingival response.
Emmatty R; Mathew JJ; Kuruvilla J
OBJECTIVE: To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy. RESEARCH DESIGN AND METHODS: At 8, 14, 21, 27, and 33 gestational weeks, insulin requirements and HbA(1c) were compared between 15 twin pregnant women from 2000 to 2011 and 108 singleton pregnant women from 2004 to 2006. RESULTS: In twin pregnancies, the weekly increase in daily insulin dose between 14 and 27 weeks was higher than in singleton pregnancies (median 3.0 international units [IU] [range 0.9-4.9] versus 1.5 IU [-1.5 to 5.9]; P = 0.008) and remained stable from 27 to 33 weeks. The increment in total insulin requirement from before pregnancy until 33 weeks tended to be higher in twin pregnancies (103% [36-257%] versus 71% [-20 to 276%]; P = 0.07). Throughout pregnancy, HbA(1c) was similar in twin and singleton pregnancies. CONCLUSIONS: In twin pregnancies, the weekly increase in insulin dose between 14 and 27 weeks was doubled compared with singleton pregnancies.
Callesen NF; Ringholm L; Stage E; Damm P; Mathiesen ER
Background: Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life. Methods: This was a prospective cohort study based on data from a national Danish registry on smoking cessation interventions. The study population included 10,682 women of a fertile age. The pregnancy status of the study population was identified using the National Patient Registry. Results: The response rate to follow up was 76%. The continuous abstinence rate for both pregnant and non-pregnant smokers was 24–32%. The following prognostic factors for continuous abstinence were identified: programme format (individual/group), older age, heavy smoking, compliance with the programme, health professional recommendation, and being a disadvantaged smoker. Conclusions: The GSP seems to be as effective among pregnant smokers as among non-pregnant smoking women. Due to the relatively high effect and clinical significance, the GSP would be an attractive element in smoking cessation intervention among pregnant women.
Rasmussen, Mette; Heitmann, Berit Lilienthal; T?nnesen, Hanne
Full Text Available Background: Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life. Methods: This was a prospective cohort study based on data from a national Danish registry on smoking cessation interventions. The study population included 10,682 women of a fertile age. The pregnancy status of the study population was identified using the National Patient Registry. Results: The response rate to follow up was 76%. The continuous abstinence rate for both pregnant and non-pregnant smokers was 24–32%. The following prognostic factors for continuous abstinence were identified: programme format (individual/group), older age, heavy smoking, compliance with the programme, health professional recommendation, and being a disadvantaged smoker. Conclusions: The GSP seems to be as effective among pregnant smokers as among non-pregnant smoking women. Due to the relatively high effect and clinical significance, the GSP would be an attractive element in smoking cessation intervention among pregnant women.
Mette Rasmussen; Berit Lilienthal Heitmann; Hanne Tønnesen
BACKGROUND: Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life. METHODS: This was a prospective cohort study based on data from a national Danish registry on smoking cessation interventions. The study population included 10,682 women of a fertile age. The pregnancy status of the study population was identified using the National Patient Registry. RESULTS: The response rate to follow up was 76%. The continuous abstinence rate for both pregnant and non-pregnant smokers was 24-32%. The following prognostic factors for continuous abstinence were identified: programme format (individual/group), older age, heavy smoking, compliance with the programme, health professional recommendation, and being a disadvantaged smoker. CONCLUSIONS: The GSP seems to be as effective among pregnant smokers as among non-pregnant smoking women. Due to the relatively high effect and clinical significance, the GSP would be an attractive element in smoking cessation intervention among pregnant women.
Rasmussen M; Heitmann BL; Tønnesen H
Full Text Available Objectives: To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy.The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes.
Per-Anders Mårdh; Natalia Novikova; Ola Niklasson; Zoltan Bekassy; Lennart Skude
Data on respiratory burst activity of granulocytes from healthy and preeclamptic pregnant women are contradictory. To further investigate a possible role of reactive oxygen species in the etiology of preeclampsia, the induced superoxide-anion generation by granulocytes from non-pregnant, healthy pregnant and preeclamptic pregnant women were measured. The reciprocal effects of heat-inactivated and non-inactivated plasma on superoxide production by neutrophils from non-pregnant, healthy pregnant and preeclamptic pregnant subjects were also examined. Superoxide generation was measured by ferricytochrome c reduction. Both phorbol-12.13-dibutirate- and N-formyl-methionyl-leucyl-phenylalanine-induced superoxide production was significantly decreased in normal pregnancy compared to results obtained in non-pregnant and preeclamptic pregnant women. Phorbol-12.13-dibutirate-induced superoxide generation by non-pregnant and preeclamptic neutrophils was significantly inhibited by heat-inactivated and non-inactivated healthy pregnant plasma. N-formyl-methionyl-leucyl-phenylalanine-stimulated superoxide production by non-pregnant and preeclamptic granulocytes was suppressed only by non-inactivated healthy pregnant plasma. Phorbol-12.13-dibutirate-induced superoxide generation of healthy pregnant neutrophils was significantly increased by inactivated and non-inactivated non-pregnant and preeclamptic plasma. N-formyl-methionyl-leucyl-phenylalanine-stimulated superoxide production by healthy pregnant granulocytes was significantly enhanced following treatment of the cells with non-inactivated non-pregnant and preeclamptic pregnant plasma. Deficient superoxide generation in normal pregnancy may be caused by maternal immunosuppressive factors. The failure of reduction in superoxide production in preeclampsia may be partly responsible for endothelial dysfunction. Apart from oxidative stress, a possible role of inefficient maternal immunosuppression should also be considered in the pathogenesis of preeclampsia.
Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 ?g/ml at 18-24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 ?g/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women.
Ekaidem IS; Bolarin DM; Udoh AE; Etuk SJ; Udiong CE
Proper folate supplementation is required in order to ensure proper folate concentration in the organism, and consequently to prevent the development of numerous complications in general population and pregnant women. Metafolin (stable calcium salt of L-5-methyltetrahydrofolate acid, L-5-MTHF) is the most active form of reduced folate circulating in plasma, which directly enters the metabolic process of folate. After administration metafolin shows optimum absorption, comparable or higher bioavailability as well as physiological activity when compared to folic acid. Metafolin supplementation is effective in decreasing plasma homocysteine, as well as increasing folate in plasma and erythrocytes, in pregnant and breastfeeding women or those who wish to conceive. In addition, metafolin administration omits the multistage process of reduction before entering the folate cell cycle, as well as a possible deficiency of activity of enzymes participating in the reduction of folate process in the intestine epithelium (DHFR and MTHFR enzymes). So far no potential adverse and toxic effects of metafolin management have been reported. The published findings require confirmation in larger groups of patients and an additional analysis of the presence of particular genotypes of 677C > T polymorphism of the MTHFR gene. Analysis of the recent literature reposts suggests that metafolin could be an effective and safe alternative to folic acid supplementation and could effectively prevent complications in pregnancy and series birth defects in fetuses and newborns. PMID:24032278
Full Text Available "nBackground: The purpose of this study was to describe the knowledge and attitude of pregnant women in Qazvin Province, central Iran, Relating to oral Hygiene."nMethods: The study group comprised of 760 pregnant women living in Qazvin, center of Iran in 2004. The questions were formulated to evaluate information without the need for dental examination. The age groups between 17-41 years old were randomly selected and a question was given to woman in three family planning center. Statistical analysis was done by SPSS."nResults: 94.4% responded the questionnaire and participated in statistical procedure. 73.1% of the patients used to brush their teeth at least twice a day and also 70.3% used to brush their teeth after meal."nConclusion: Health authorities should strengthen the implementation of community- based oral disease prevention and health promotion programmes. More importance must be given to oral health care center in family planning centers.
J Hamissi; P Bakianian Vaziri; A Davalloo
Proper folate supplementation is required in order to ensure proper folate concentration in the organism, and consequently to prevent the development of numerous complications in general population and pregnant women. Metafolin (stable calcium salt of L-5-methyltetrahydrofolate acid, L-5-MTHF) is the most active form of reduced folate circulating in plasma, which directly enters the metabolic process of folate. After administration metafolin shows optimum absorption, comparable or higher bioavailability as well as physiological activity when compared to folic acid. Metafolin supplementation is effective in decreasing plasma homocysteine, as well as increasing folate in plasma and erythrocytes, in pregnant and breastfeeding women or those who wish to conceive. In addition, metafolin administration omits the multistage process of reduction before entering the folate cell cycle, as well as a possible deficiency of activity of enzymes participating in the reduction of folate process in the intestine epithelium (DHFR and MTHFR enzymes). So far no potential adverse and toxic effects of metafolin management have been reported. The published findings require confirmation in larger groups of patients and an additional analysis of the presence of particular genotypes of 677C > T polymorphism of the MTHFR gene. Analysis of the recent literature reposts suggests that metafolin could be an effective and safe alternative to folic acid supplementation and could effectively prevent complications in pregnancy and series birth defects in fetuses and newborns.
In the present study, the hair of pregnant women was sampled between November 2007 and January 2008 in Ahvaz and Noushahr cities and the countryside of Noushahr, Iran. They were analyzed for organochlorine pesticides (OCPs), such as dichlorodiphenyltrichloroethane (DDT) and its metabolites, hexachlorobenzene (HCB), ?-, ?-, and ?-hexachlorocyclohexane (HCH) isomers and seven polychlorinated (PCBs) congeners (IUPAC Nos. 28, 52, 101, 118, 138, 153 and 180). Significant differences between the concentrations of investigated pollutants were found between the locations (p<0.05). For HCHs, the ?-HCH isomer was measured at higher mean concentrations (6 ng g(-1) hair) compared to the ?-HCH isomer (0.03 ng g(-1)), which generally is the most prevalent HCH in biological matrices. Very high mean concentrations of p,p'-DDT in countryside of Noushahr (24 ng g(-1)) combined with lower values (0.6) of ratio p,p'-DDE/p,p'-DDT in the hair samples suggest recent exposure to "fresh" DDT in this region. Significant differences in OCPs and PCBs were found between primiparous and multiparous mothers (p<0.05). There was no correlation between levels of OCPs and PCBs in the hair of Iranian pregnant women and their age. There was a significant difference (p<0.05) in the organochlorine levels, including HCHs, between mothers who have eaten fish once a week and those who consumed fish more than once per week in Noushahr.
Dahmardeh Behrooz R; Barghi M; Bahramifar N; Esmaili-Sari A
Full Text Available Introduction: “Geographic tongue” or benign migratory glossitis is a tongue disorder which causes pain and dysfunction and its persistence leads to cancer phobia. Based on some reports, hormones (especially female sex hormones) are associated with geographic tongue development or exacerbation. Geographic tongue might be confused with lichen planus and candidiasis. The aim of this study was to evaluate the association of the lesion with pregnancy and its changes during each trimester. Materials and Methods: In this descriptive, analytical and cross-sectional study, 451 eligible cases were selected. After clinical examination and completion of questionnaires, if geographic tongue was diagnosed, photographs were taken and compared between the three trimesters. Data was analyzed with chi-squared test and Pearson’s correlation coefficient at a confidence interval of 95%. Results: The prevalence of geographic tongue in pregnant women was 36.8%. There were no significant relationships between the number of pregnancies, age and the frequency of the lesions. However, there was a significant relationship between the ectopic lesions and the fissured tongue (p value = 0.001) and also between the gestational age and geographic tongue lesions (p value = 0.043). The lesions were most prevalent in the second trimester, but in third trimester, prevalence of severs lesions decreased. Conclusions: Under the limitations of the present study, prevalence of geographic tongue in pregnant women was higher than previous reports in other communities. Severe lesions were more prevalent in the second trimester. Key words: Benign migratory glossitis, Hormones, Pregnancy.
Parichehr Ghalyani; Samira Hajisadeghi; Hojatollah Mokhtari
OBJECTIVE: To investigate the effect of gestation on the pharmacokinetics of orally administered beta-lactams, choosing cefatrizine as the model antibiotic. SETTING: A tertiary teaching hospital. DESIGN: Prospective study. METHODS: In 20 women with affected fetuses, 17 by beta-thalassemia major and 3 with congenital malformations, termination of gestation between 19 and 24 weeks was induced by intra-amniotic administration of prostaglandin F(2)(alpha). Pharmacokinetics of cefatrizine in maternal and fetal blood were studied after the administration of three 1 g doses of oral cefatrizine, every 12 h. Twenty female non-pregnant volunteers consisted the control group. RESULTS: Gestation was found to decrease substantially both cefatrizine oral bioavailability and maximum serum plasma concentration (42.8 and 44.5%, respectively) but increased elimination half-life. This effect can be attributed to a substantial increase of the apparent volume of distribution of cefatrizine in relation to a moderate increase of clearance that occurs during pregnancy. Fetal serum cefatrizine levels were lower for the first few hours after administration and then exceeded the corresponding maternal ones. CONCLUSIONS: Our results indicate that gestation decreases the oral bioavailability of cefatrizine. A delay in the maternal drug elimination compared to non-pregnant controls was more pronounced in the fetus.
Papantoniou N; Ismailos G; Daskalakis G; Karabinas C; Mesogitis S; Papapanagiotou A; Antsaklis A
Full Text Available Background: Cognitive behavioral interventions consisting of brief counseling and the provision of self-help material designed for pregnancy have been documented as effective smoking cessation interventions for pregnant women. However, there is a need to understand how such interventions are perceived by the targeted group. Aim: To understand the cognitive, emotional, and behavioral responses of pregnant women to a clinic-based smoking cessation intervention. Methods: In-depth interviews with women attending four antenatal clinics in Cape Town, South Africa, who were exposed to a smoking intervention delivered by midwives and peer counselors. Women were purposively selected to represent a variation in smoking behavior. Thirteen women were interviewed at their first antenatal visit and 10 were followed up and reinterviewed later in their pregnancies. A content analysis approach was used, which resulted in categories and themes describing women's experiences, thoughts, and feelings about the intervention. Results: Five women quit, five had cut down, and three could not be traced for follow-up. All informants perceived the intervention positively. Four main themes captured the intervention's role in influencing women's smoking behavior. The process started with ‘understanding their reality,’ which led to ‘embracing change’ and ‘deciding to hold nothing back,’ which created a basis for ‘turning hopelessness into a feeling of competence.’Conclusion: The intervention succeeded in shifting women from feeling pessimistic about ever quitting to feeling encouraged to try and quit. Informants rated the social support they received very highly and expressed the need for the intervention to become a routine component of clinic services.
Zaino Petersen; Krisela Steyn; Katherine Everett-Murphy; Maria Emmelin
This paper examines the net effect of women's autonomy on their pregnancy intention status among currently pregnant Bangladeshi women. This study is based on data from the Bangladesh Demographic Health Survey, 2007 (BDHS). A subset of interviews from currently pregnant women (718) were extracted from 10,146 married women of reproductive age. The BDHS 2007 used a pre-tested, structured questionnaire to collect sociodemographic, women's empowerment, and pregnancy information. Associations between unintended pregnancy and explanatory variables were assessed using bivariate analysis. Logistic regression was used to assess the net effect of women's autonomy on current pregnancy intention status after controlling for other variables. Results indicate that women's autonomy is a significant predictor of unintended pregnancy after adjusting for other factors. A unit increase in the autonomy scale decreases the odds of unintended pregnancy by 16%. Besides autonomy, our results also indicate that current age, number of children ever born, age at marriage, religion, media access, and contraceptive use exert strong influences over unintended pregnancy. Women who have ever used contraceptives are 82% more likely to classify their current pregnancies as unintended compared with women who are non-users of contraceptives. Improvement in women's autonomy and effective and efficient use of contraceptives may reduce unintended pregnancies as well as improve reproductive health outcomes.
Physical activity significantly impacts public health as it reduces the risk of chronic diseases and provides numerous protective factors during pregnancy. Although Canadian guidelines recommend regular physical activity for healthy pregnant women, little is known about their leisure-time physical activity patterns. This study compared the physical activity levels of pregnant and non-pregnant women and examined socio-demographic and health correlates of physical activity during pregnancy. Canadian Community Health Survey data (2005-2008) from 623 pregnant women and 20,392 non-pregnant women aged 15-49 years in Ontario, Canada were examined. The prevalence of regular physical activity (15 or more minutes on at least 3 days of the week) was 58.3 % [95 % CI 52.9, 63.4], among pregnant women and 66.9 % [95 % CI 65.8, 68.0] among non-pregnant women. However, the prevalence of meeting Canadian guidelines for physical activity during pregnancy (30 or more minutes on at least 4 days of the week) was only 23.3 %, [95 % CI 19.4, 27.7] among pregnant women and 33.6 % [95 % CI 32.7, 34.6] among non-pregnant women. Pregnant women were less likely to be meeting guidelines if they were single, divorced, separated or widowed, a visible minority, had a household income between $20,000 and $79,999, and reported being in good or fair/poor health; when it came to education, women who had completed high school were more likely to be meeting guidelines. Few pregnant women in Ontario are meeting guidelines for physical activity during pregnancy. Results indicate that promoting physical activity during pregnancy should remain a public health priority.
Gaston A; Vamos CA
Full Text Available Background: There is paucity of epidemiological data on infectious diseases among antenatal mothers in Bayelsa State of the Niger Delta, Nigeria. Aims: The aim of this study was to determine the seroprevalence of the serological markers Human immunodeficiency virus-antibody (HIV-Ab), Hepatitis B surface antigen(HBsAg), Hepatitis C virus antibody(HCV-A)and antibodies to T.pallidum among pregnant women in Yenagoa, Bayelsa State, South-South Nigeria. Settings and Design: This is a cross-sectional study which was carried out in Yenagoa city, the heart of the Niger Delta, Nigeria. Materials and Methods: Human immunodeficiency virus (HIV) antibodies were detected by using "Determine" HIV-1/2 test strip (Abbott Laboratories, Japan); hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV) and antibodies to T. pallidum were carried out using ACON rapid test strips (ACON Laboratories, USA). All positive samples for HIV, HBV and HCV were confirmed using the Clinotech diagnostic enzyme-linked immunosorbent assay (ELISA) test kits (Clinotech Laboratories, USA), while all reactive samples to Treponema pallidum antibodies were confirmed by the Treponema pallidum hemagglutination (TPHA) test (Lorne Laboratories Ltd., UK). All test procedures were carried out according to the manufacturers? instructions. Statistical Analysis Used: The data generated were coded, entered, validated and analyzed using Statistical Package for Social Science (SPSS), version 12.0, and Epi info. The seroprevalence of syphilis, HBsAg, HCV and HIV was expressed for the entire study group by age, sex and other demographic features using Pearson chi-square analysis. Values below 0.05 were considered statistically significant. Results: A total of 1,000 apparently healthy pregnant women aged between 15 and 44 years with a mean of 27.34?5.43 years were screened. In terms of percentage, 89.4% of the subjects were married, and 10.6% were without formal husbands. The overall seroprevalence of HIV, HBsAg, HCV and syphilis was found to be 4.1%, 5.3%, 0.5% and 5.0%, respectively. Conclusions: High prevalence of some infectious diseases was observed in the present study, which may pose serious health risk to women of reproductive age in this region. It is important to point out that there is need to improve antenatal care of pregnant women by mandatory screening for these infectious diseases.
Buseri F; Seiyaboh E; Jeremiah Z
AimThe aims of this study were to investigate the relationship between pregnant women's personal exposures to NOx, NO2, PM2.5 concentration and absorbance as a marker for black carbon and their indoor and outdoor concentration levels at their residence, and also to identify predictors of personal exposure and indoor levels using questionnaire and time activity data. MethodWe recruited 54 pregnant women in Barcelona who carried a personal PM2.5 sampler for two days and NOx/NO2 passive badges for one week, while indoor and outdoor PM2.5 and NOx/NO2 levels at their residence were simultaneously measured. Time activity and house characteristics were recorded. Gravimetry determinations for PM2.5 concentration and absorbance measurements were carried out on the PM2.5 filter samples. ResultsLevels of personal exposure to NOx, PM2.5 and absorbance were slightly higher than indoor and outdoor levels (geometric mean of personal NOx = 61.9 vs indoor NOx = 60.6 ?g m-3), while for NO2 the indoor levels were slightly higher than the personal ones. Generally, there was a high statistically significant correlation between personal exposure and indoor levels (Spearman's r between 0.78 and 0.84). Women spent more than 60% of their time indoors at home. Ventilation of the house by opening the windows, the time spent cooking and indicators for traffic intensity were re-occurring statistically significant determinants of the personal and indoor pollutants levels with models for NOx explaining the 55% and 60% of the variability respectively, and models for NO2 explaining the 39% and 16% of the variability respectively. Models for PM2.5 and absorbance explained the least of the variability. ConclusionOur findings improve the current understanding of the characterization and inter-associations between personal, indoor and outdoor pollution levels among pregnant women. Variability in personal and indoor NOx and to a lesser extent NO2 levels could be explained well, but not the variability in PM2.5 could be explained.
Schembari, Anna; Triguero-Mas, Margarita; de Nazelle, Audrey; Dadvand, Payam; Vrijheid, Martine; Cirach, Marta; Martinez, David; Figueras, Francesc; Querol, Xavier; Basagaña, Xavier; Eeftens, Marloes; Meliefste, Kees; Nieuwenhuijsen, Mark J.
AIM: Prescription of psychotropic medicines carries risks to pregnancy. It is therefore appropriate to measure the prescription rate of these compounds in pregnant women. METHOD: We studied the prescription rate for psychotropic agents to pregnant women from the Cnamts medicines reimbursement data and we compared this to prescriptions in non-pregnant women in the same age group. RESULTS: There is a fall in the use of psychotropic agents in women during pregnancy compared to a non-pregnant population of the same age. Pregnant women receive 2.17 times less psychotropic agents. Nevertheless, approximately one out of every twenty women is prescribed a proprietary product with known risk to the neonate and four out of a thousand are prescribed a proprietary product which carries a risk of malformation during the first trimester. CONCLUSION: Medical practice takes account of embryo-fetal risk in prescribing psychotropic agents in general although more communication is needed about the risk of some compounds during pregnancy.
Danel T; Plancke L; Amariei A; Benoit E; Gautier S; Capele C; Vaiva G
The present study aimed to assess the changes in the pattern of rising from a chair and walking forward as pregnancy progressed. Twelve pregnant women and 10 nulliparous women were included in this study. Participants were videotaped with a digital video camera in the sagittal plane, and the coordinates of the markers attached to the subjects were identified using image analysis software. The peak trunk-flexion angle in pregnant women during rising was smaller, but the hip-extension angle during the stance phase was larger than in controls. Also, the peak horizontal and vertical velocities of the center of mass were lower, and appeared earlier, in pregnant women than in controls. During rising, pregnant women dampened the propulsion attributable to increased uterus volume, and they enhanced the forward propulsion at gait initiation. To ensure safe motion, pregnant women should not initiate gait until reaching a stable standing position after rising.
Sunaga Y; Anan M; Shinkoda K
Full Text Available Objective. The purpose of this study was to describe the epidemiology of coinfection with hepatitis C virus (HCV) and HIV among a cohort of pregnant Thai women. Methods. Samples from 1771 pregnant women enrolled in three vertical transmission of HIV studies in Bangkok, Thailand, were tested for HCV. Results. Among HIV-infected pregnant women, HCV seroprevelance was 3.8% and the active HCV infection rate was 3.0%. Among HIV-uninfected pregnant women, 0.3% were HCV-infected. Intravenous drug use by the woman was the factor most strongly associated with HCV seropositivity. Among 48 infants tested for HCV who were born to HIV/HCV coinfected women, two infants were HCV infected for an HCV transmission rate of 4.2% (95% 0.51Ã¢Â€Â“14.25%). Conclusions. HCV seroprevalence and perinatal transmission rates were low among this Thai cohort of HIV-infected pregnant women.
Denise J. Jamieson; Natapakwa Skunodom; Thanyanan Chaowanachan; Anuvat Roongpisuthipong; William A. Bower; Tawee Chotpitayasunondh; Wendy Bhanich Supapol; Wendi L. Kuhnert; Wimol Siriwasin; Jeffrey Wiener; Sanay Chearskul; Michelle S. McConnell; Nathan Shaffer
Full Text Available Domestic violence is an important risk factor for pregnancy complications. The aim of this study is to determine the prevalence of domestic violence and its related factors in a population of pregnant women. A cross sectional study was done on 426 women who were attended to an obstetrics ward of a hospital in Iran. A 35 item questionnaire was completed by the respondents. The life time prevalence of domestic violence was 42% and it was 19.3% during pregnancy. There was no relation between socioeconomic status, women`s education and employment and age of marriage with domestic violence. Unemployment, addiction and alcohol use among husbands were related to domestic violence. Slapping and punching were the most common kinds of violent behavior. The prevalence of domestic violence even during pregnancy is high in Iran, so there is a need to increase the awareness of the community and empower the health workers and professionals in order to prevent and control this problem.
S. Taghavi; M. Alizadeh; D. Khalilzadeh
AIM: The aim of this study was to investigate the benefit of antioxidant supplementation in a cohort of women with low antioxidant status and determine the changes in cell-free mRNA. MATERIAL AND METHODS: This study was a randomized, placebo-controlled trial of 8-12 weeks' pregnant women who had low antioxidant status treated with either antioxidants or control diets daily until 2 weeks' postpartum. The primary end-point was the risk of pre-eclampsia and the secondary end-point was the changes of angiogenic and anti-oxidant mRNA markers related to the outcome (ClinicalTrial.gov, number NCT01232205). RESULTS: There were 110 women enrolled in the study, randomly assigned to the supplementation (n = 52) and control group (n = 58). The overall rate of pre-eclampsia was 8.7% (nine subjects). There were significant differences (P = 0.034) between the supplementation and control group in the incidence of pre-eclampsia (2.0% [one case] and 14.5% [eight cases], respectively) and mRNA level of superoxide-dismutase, heme oxygenase-1, vascular endothelial growth factor receptor-1, endoglin and placental growth factor after supplementation. CONCLUSION: Supplementation of women with low antioxidant status with micronutrients containing antioxidants during early gestation might reduce the risk of pre-eclampsia.
Wibowo N; Purwosunu Y; Sekizawa A; Farina A; Idriansyah L; Fitriana I
Proper metabolism of folates has a crucial role for body homeostasis. Folate metabolism regulates changing of amino acids (homocysteine and methionine), purine and pyrimidine synthesis and DNA methylation. These whole biochemical processes have significant influence on hematopoietic, cardiovascular and nervous system functions. The disturbances of folate cycle could result in chronic hypertension, coronary artery disease, higher risk of heart infarction, could promote cancers development, and psychic and neurodegenerative diseases. No less important is the connection with complications appearing in pregnant woman (recurrent miscarriages, preeclampsia, fetus hypotrophy intrauterine death, preterm placenta ablation, preterm delivery) and fetus defects (Down syndrome, spina bifida, encephalomeningocele, myelomeningocele). The complex process of folate metabolism requires adequate activity of many enzymes and presence of co-enzymes. A key enzyme in folate metabolism is methylenetetrahydrofolate reductase (MTHFR - methylenetetrahydrofolate reductase), and 677C>T polymorphism of MTHFR gene is connected with lower enzymatic activity In several researches it was indicated that 677C>T MTHFR polymorphism is an independent factor influencing homocysteine concentration in serum, and also folate concentration in serum and red blood cells. Nevertheless, it was also observed the correlation of 677C>T MTHFR polymorphism with Down syndrome, and neural tube defects appearance in fetus. In European populations frequency of mutated 677TT genotype ranges from a few to several percent. Women carriers of 677TT or 677CT MTHFR genotypes are exposed on folate metabolism disturbances and on the consequences of incorrect folate process during pregnancy Nowadays in this group of women folic acid supplementation is widely recommended. In the light of modern knowledge the attention was also focused on the importance of metafolin administration that omitted pathways of folic acid transformation after administration, and in pregnant women certainly is valuable complement of supplementation in this respect. PMID:23819405
Proper metabolism of folates has a crucial role for body homeostasis. Folate metabolism regulates changing of amino acids (homocysteine and methionine), purine and pyrimidine synthesis and DNA methylation. These whole biochemical processes have significant influence on hematopoietic, cardiovascular and nervous system functions. The disturbances of folate cycle could result in chronic hypertension, coronary artery disease, higher risk of heart infarction, could promote cancers development, and psychic and neurodegenerative diseases. No less important is the connection with complications appearing in pregnant woman (recurrent miscarriages, preeclampsia, fetus hypotrophy intrauterine death, preterm placenta ablation, preterm delivery) and fetus defects (Down syndrome, spina bifida, encephalomeningocele, myelomeningocele). The complex process of folate metabolism requires adequate activity of many enzymes and presence of co-enzymes. A key enzyme in folate metabolism is methylenetetrahydrofolate reductase (MTHFR - methylenetetrahydrofolate reductase), and 677C>T polymorphism of MTHFR gene is connected with lower enzymatic activity In several researches it was indicated that 677C>T MTHFR polymorphism is an independent factor influencing homocysteine concentration in serum, and also folate concentration in serum and red blood cells. Nevertheless, it was also observed the correlation of 677C>T MTHFR polymorphism with Down syndrome, and neural tube defects appearance in fetus. In European populations frequency of mutated 677TT genotype ranges from a few to several percent. Women carriers of 677TT or 677CT MTHFR genotypes are exposed on folate metabolism disturbances and on the consequences of incorrect folate process during pregnancy Nowadays in this group of women folic acid supplementation is widely recommended. In the light of modern knowledge the attention was also focused on the importance of metafolin administration that omitted pathways of folic acid transformation after administration, and in pregnant women certainly is valuable complement of supplementation in this respect.
Muscular cramp is a painful, local and unusual contraction of one or a group of muscles; more than half of pregnant women suffer from leg muscular cramps. The present study investigates the effect of vitamin E treatment, milk of magnesium suspension and calcium carbonate treatment on pregnant women ...
Azar Danesh Shahraki
OBJECTIVE: To investigate the relationship between the hepatitis B virus (HBV) infection in pregnant women and intrauterine infection in local region. METHODS: The markers of hepatitis B (HBVM) were determined by time-resolved fluoroimmunoassay and HBV-DNA were determined by FQ-PCR. RESULTS: A total of 1262 pregnant women were examined the HBVM, 2.6%, 38.2%, 0.9%, 22.6%, 23.1% subjects were identified HBsAg, HBsAb, HBeAg, HBeAb, HBcAb positive respectively. In 33 cases of serum HBsAg-positive pregnant women, HBV-DNA were observed in most of 11 cases of pregnant women with HBeAg-positive and intrauterine infection rates were 6/11. In contrast, 22 cases of pregnant women with HBeAg negative, HBV-DNA were detected lowly-loaded and intrauterine infection rates were 2/22 (P < 0.01). Intrauterine infection rates of HBV in pregnant women with HBsAg-positive were 24.2% (8/33). CONCLUSION: HBV infective rates in pregnant women in the local region were low. Pregnant women with serum HBeAg positive and HBV-DNA high-loaded were prone to intrauterine infection.
Lu HF; Jin WJ; Huang XH; Zhao QY; Mao HY
Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P 330 ?g/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women. PMID:22468048
Ekaidem, Itemobong S; Bolarin, Debayo M; Udoh, Alphonsus E; Etuk, Saturday J; Udiong, Christopher E J
Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty n...
Ekaidem, Itemobong S.; Bolarin, Debayo M.; Udoh, Alphonsus E.; Etuk, Saturday J.; Udiong, Christopher E. J.
AIM: The aim of this study was to observe insulin resistance and ?-cell function changes among women diagnosed with gestational impaired glucose tolerance or gestational diabetes mellitus (GDM) in mid-pregnancy. MATERIAL AND METHODS: Sixty-four pregnant women receiving prenatal care underwent an oral glucose tolerance test at 20-24 weeks of gestation and an insulin release test. The GDM group included 34 pregnant women diagnosed with gestational impaired glucose tolerance or GDM, and the subjects with normal blood glucose were the control group. Insulin resistance and islet ?-cell function changes were observed with the oral glucose tolerance test and insulin release test. RESULTS: The homeostatic model assessment-? levels in late pregnancy were higher than those in mid-pregnancy for both groups, and the primary time effect was statistically significant. The early insulin secretion index (?I(30)/?G(30)) values in mid- and late pregnancy were lower in the GDM group. The values of the area under the curve of blood glucose in mid- and late pregnancy were higher in the GDM group than those in the control group. Insulin resistance was higher in GDM patients than in normal pregnant women. CONCLUSIONS: Insulin resistance was aggravated, and ?-cell's ability to compensate for the increased insulin resistance by modulating insulin secretion was aggravated, as gestational week increased in women with gestational diabetes and normal pregnant women. Insulin resistance in women with GDM is higher than in pregnant women with normal metabolism of glucose.
Wang YH; Wu HH; Ding H; Li Y; Wang ZH; Li F; Zhang JP
Full Text Available The aim of this study was to use the fluorescence in situ hybridization (FISH) technique to test the hypothesis of qualitative and quantitative differences of 8 periodontopathogens between pregnant and non-pregnant women. This cross-sectional study included 20 pregnant women in their second trimester of pregnancy and 20 non-pregnant women. Probing depth, bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected and the FISH technique identified the presence and numbers of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia and Prevotella nigrescens. The Mann-Whitney U-test was applied to compare the data between the two groups. The mean age, ethnicity, marital status, education, and economic level in both groups were similar. The clinical parameters showed no significant differences between pregnant and non-pregnant women. The numbers of subgingival periodontopathogens were not found to be significantly different between groups, despite the higher mean counts of P. intermedia in pregnant women. Colonization patterns of the different bacteria most commonly associated with periodontal disease were not different in the subgingival plaque of pregnant and non-pregnant women.
Fernanda Campos Machado; Dionéia Evangelista Cesar; Amanda Vervloet Dutra Agostinho Assis; Cláudio Galuppo Diniz; Rosangela Almeida Ribeiro
Full Text Available Abstract in english The aim of this study was to use the fluorescence in situ hybridization (FISH) technique to test the hypothesis of qualitative and quantitative differences of 8 periodontopathogens between pregnant and non-pregnant women. This cross-sectional study included 20 pregnant women in their second trimester of pregnancy and 20 non-pregnant women. Probing depth, bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were (more) collected and the FISH technique identified the presence and numbers of Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Campylobacter rectus, Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia and Prevotella nigrescens. The Mann-Whitney U-test was applied to compare the data between the two groups. The mean age, ethnicity, marital status, education, and economic level in both groups were similar. The clinical parameters showed no significant differences between pregnant and non-pregnant women. The numbers of subgingival periodontopathogens were not found to be significantly different between groups, despite the higher mean counts of P. intermedia in pregnant women. Colonization patterns of the different bacteria most commonly associated with periodontal disease were not different in the subgingival plaque of pregnant and non-pregnant women.
Machado, Fernanda Campos; Cesar, Dionéia Evangelista; Assis, Amanda Vervloet Dutra Agostinho; Diniz, Cláudio Galuppo; Ribeiro, Rosangela Almeida
BACKGROUND: Among Alaska Native women residing in the Yukon-Kuskokwim (Y-K) Delta region of Western Alaska, about 79% smoke cigarettes or use smokeless tobacco during pregnancy. Treatment methods developed and evaluated among Alaska Native pregnant tobacco users do not exist. This pilot study used a randomized two-group design to assess the feasibility and acceptability of a targeted cessation intervention for Alaska Native pregnant women. METHODS: Recruitment occurred over an 8-month period. Enrolled participants were randomly assigned to the control group (n = 18; brief face-to-face counseling at the first visit and written materials) or to the intervention group (n = 17) consisting of face-to-face counseling at the first visit, four telephone calls, a video highlighting personal stories, and a cessation guide. Interview-based assessments were conducted at baseline and follow-up during pregnancy (>or=60 days postrandomization). Feasibility was determined by the recruitment and retention rates. RESULTS: The participation rate was very low with only 12% of eligible women (35/293) enrolled. Among enrolled participants, the study retention rates were high in both the intervention (71%) and control (94%) groups. The biochemically confirmed abstinence rates at follow-up were 0% and 6% for the intervention and control groups, respectively. DISCUSSION: The low enrollment rate suggests that the program was not feasible or acceptable. Alternative approaches are needed to improve the reach and efficacy of cessation interventions for Alaska Native women.
Patten CA; Windsor RA; Renner CC; Enoch C; Hochreiter A; Nevak C; Smith CA; Decker PA; Bonnema S; Hughes CA; Brockman T
Full Text Available Abstract Background Pregnancy is associated with an increased risk of developing a malaria infection and a higher risk of developing severe malaria. The pharmacokinetic properties of many anti-malarials are also altered during pregnancy, often resulting in a decreased drug exposure. Piperaquine is a promising anti-malarial partner drug used in a fixed-dose combination with dihydroartemisinin. The aim of this study was to investigate the population pharmacokinetics of piperaquine in pregnant and non-pregnant Sudanese women with uncomplicated Plasmodium falciparum malaria. Method Symptomatic patients received a standard dose regimen of the fixed dose oral piperaquine-dihydroartemisinin combination treatment. Densely sampled plasma aliquots were collected and analysed using a previously described LC-MS/MS method. Data from 12 pregnant and 12 non-pregnant women were analysed using nonlinear mixed-effects modelling. A Monte Carlo Mapped Power (MCMP) analysis was conducted based on a previously published study to evaluate the power of detecting covariates in this relatively small study. Results A three-compartment disposition model with a transit-absorption model described the observed data well. Body weight was added as an allometric function on all clearance and volume parameters. A statistically significant decrease in estimated terminal piperaquine half-life in pregnant compared with non-pregnant women was found, but there were no differences in post-hoc estimates of total piperaquine exposure. The MCMP analysis indicated a minimum of 13 pregnant and 13 non-pregnant women were required to identify pregnancy as a covariate on relevant pharmacokinetic parameters (80% power and p=0.05). Pregnancy was, therefore, evaluated as a categorical and continuous covariate (i.e. estimate gestational age) in a full covariate approach. Using this approach pregnancy was not associated with any major change in piperaquine elimination clearance. However, a trend of increasing elimination clearance with increasing gestational age could be seen. Conclusions The population pharmacokinetic properties of piperaquine were well described by a three-compartment disposition model in pregnant and non-pregnant women with uncomplicated malaria. The modelling approach showed no major difference in piperaquine exposure between the two groups and data presented here do not warrant a dose adjustment in pregnancy in this vulnerable population.
Hoglund Richard M; Adam Ishag; Hanpithakpong Warunee; Ashton Michael; Lindegardh Niklas; Day Nicholas PJ; White Nicholas J; Nosten Francois; Tarning Joel
It is assumed that 25% of patients with epilepsy are women of fertile age and 0.3% to 0.6% of all children are born of mothers with epilepsy. The aim of this study was to evaluate the quality of life on pregnant with epilepsy and compare with non-pregnant women with epilepsy. We evaluated two groups (Experimental Group--29 pregnant women with epilepsy and Control Group--30 women with epilepsy); they were attended at the HC/UNICAMP. The patients had three meetings to carry out and implement the anamnesis and the application of QQV-65. There were no significant differences in the measurement of quality of life when comparing both groups. However, when we analyzed individually in the pre- and post-partum periods, we observed significant differences in health aspects (p=0.0495), physical (p=0.02868) and emotional (p=0.0253) dimensions in QQV-65. This study shows that pregnancy could be interpreted as a stressor. In late pregnancy when this stressor was removed, women with epilepsy had improvement in their quality of life.
Lunardi LL; Costa AL; Guerreiro CA; Souza EA
A total of 315 pregnant women were under observation: 290 (92.1%) of women with myopia made up the main group, and 25 (7.9%), which had no extragenital pathologies or any pregnancy complications, were in the control group. It was for the first time that an algorithm of pregnancy and delivery monitoring for myopic patients was worked out: the algorithm comprises ophthalmologic examinations including rheoophthalmography carried out during the delivery. The specific features of the ocular hemodynamics and intraocular pressure as well as their dependence on the parameters of central hemodynamics and volumetric cerebral blood velocity at all stages of spontaneous delivery were studied. The role of prolonged epidural anesthesia, as a method normalizing the hemodynamics of the ciliary tract, was defined to optimize the delivery by women with average and high myopia. The above stated makes it possible to prevent possible complications (in the organ of vision) in patients with average and high myopia and to decrease the frequency of operative delivery from 21.8% to 1.3%.
Travkin AG; Akh vlediani KN; Petrova TKh
Between 2005 and 2007 we examined 2356 pregnant women. We interviewed the patients concerning their dietary behaviour and lifestyles during pregnancy in correlation with the possibility of contracting toxoplasmosis. Our purpose was to ascertain the importance of different risk factors in a group of Italian patients and assess the level of knowledge on this matter. The survey questions were related to: 1) eating rare/raw meat; 2) eating commercial or homemade ham or other pork derivatives such as dry sausage and salami; 3) owning a garden or a plot for fruit and vegetables; 4) owning pets, especially cats; 5) living in town or in the country; 6) eating fresh uncooked vegetables. On the basis of serological tests (Toxo IgG, IgM, IgA, avidity test) we identified three groups of women: those with primary infection, seronegative women (control), and those with inactive infections. Comparison of the first two groups showed that each risk factor significantly increases the likelihood of acquiring toxoplasmosis. Higher odds ratios were observed for those living in the country and for those consuming homemade cured meat.
Thaller R; Tammaro F; Pentimalli H
We have observed 74 HIV-seropositive and 48 HIV-seronegative drug-addicted women and 22 HIV-seropositive nondrug-addicted pregnant women during pregnancy and we report their perinatal outcome. 8 out of 96 HIV-seropositive patients had hematological signs of immunodeficiency and 2 of these patients were symptomatic belonging to CDC class III. We recorded 2 early and 3 late spontaneous abortions, no intrauterine fetal death and 3 neonatal deaths. Seropositive patients had 3 malformed babies, seronegative patients had 1. All these women had a high incidence of premature delivery and intrauterine fetal growth retardation: seropositive patients had a higher incidence of fetuses small for gestational age and a lower incidence of preterm delivery compared to seronegative patients, but the difference was not statistically significant. The incidence of malformation was comparable to the general population: 3 malformed babies were born to HIV-positive drug-addicted mothers, and 1 to a seronegative drug-addicted mother. These findings do not support the hypothesis of a direct detrimental effect of HIV on perinatal outcome. Consequences of fetal exposure to maternal HIV infection involve mostly postnatal life and development of acquired immunodeficiency.
Semprini AE; Ravizza M; Bucceri A; Vucetich A; Pardi G
OBJECTIVE: To determine whether supplementation with vitamin B(6) improves nausea and/or vomiting in pregnancy. METHODS: This experimental study was conducted with 60 pregnant women experiencing nausea and/or vomiting prior to the 12th gestational week. Of these women, 30 were treated daily with 10mg and the remaining 30 with 1.28 mg of pyridoxine hydrochloride for 2 weeks. The primary outcome was the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) score in each group at the end of treatment. RESULTS: The women experiencing nausea and/or vomiting in pregnancy had significantly lower levels of circulating vitamin B(6) (P=0.007) compared with those without this symptom. Vitamin B(6) supplementation significantly increased plasma vitamin B(6) concentration (P<0.05 in both groups). There were no significant differences in PUQE score or in plasma concentration levels of protein, dopamine, serotonin, unconjugated estriol, and ghrelin after supplementation between the 2 groups at baseline, but there was a significantly lesser decrease in PUQE score and a greater increase in vitamin B(6) level and vitamin B(6) concentration to plasma protein concentration ratios in group 1 than in group 2 after supplementation (P<0.05 for all). CONCLUSION: Although the high-supplementation group had a greater decrease in PUQE score in comparison to the low-supplementation group, the difference is unlikely to affect the severity of symptoms.
Wibowo N; Purwosunu Y; Sekizawa A; Farina A; Tambunan V; Bardosono S
FIELD: medicine. ^ SUBSTANCE: invention refers to medicine and covers treatment of urinogenital infections in pregnant women. Complex pharmacotherapy is combined with daily SCENAR-therapy with using pulse bipolar current without constant pulse component at frequency 90.7, including swept frequency mode within 30-120 Hz to pack pulses 2 to 8 and repetition frequency 540 Hz to 4.5 kHz. Said treatment is started in 16-18 weeks of pregnancy with applying the general exposure techniques. The exposure covers vertebral and perivertebral lines - three paths, then six points of trifacial exit, cervicocollar region and hepatic projection during 10-15 minutes. If any small asymmetry is observed, hepatic region is processed till elimination said signs. Therapeutic course involves 10 procedures, each 35-40 minutes. ^ EFFECT: offered method allows for considerable reduction of development and suppression level of cell and humoral immunity, as well as development and severity of inflammatory processes in afterbirth. ^ 1 ex
BOROVKOVA LJUDMILA VASIL EVNA; KOLOBOVA SVETLANA OLEGOVNA
Although drugs are prescribed during pregnancy with some reluctance, they fulfill a real need in some circumstances. Adequate drug evaluation is thus essential, either based on efficacy and safety or mainly safety, using available data from non-pregnant women. Evaluation methodology is not fundamentally different during pregnancy. Recommendations for drug development are formulated on the basis of the most common situations as well as specific suggestions, thus raising the awareness of the different partners participating in healthcare (institutions, the pharmaceutical industry and prescribers). In particular, regulatory and economic incentives superimposed upon those recommendations adopted in Europe and the US for orphan diseases should be put into place to assist in the evaluation of drugs used in obstetrics. Medical needs in obstetrics should be better identified, and labelling of drugs for use during pregnancy should be better directed towards prescribers; a national registry of pregnancies should be established in France. PMID:14655319
Chauvenet, Marina; Rimailho, Alain; Hoog-Labouret, Natalie
Although drugs are prescribed during pregnancy with some reluctance, they fulfill a real need in some circumstances. Adequate drug evaluation is thus essential, either based on efficacy and safety or mainly safety, using available data from non-pregnant women. Evaluation methodology is not fundamentally different during pregnancy. Recommendations for drug development are formulated on the basis of the most common situations as well as specific suggestions, thus raising the awareness of the different partners participating in healthcare (institutions, the pharmaceutical industry and prescribers). In particular, regulatory and economic incentives superimposed upon those recommendations adopted in Europe and the US for orphan diseases should be put into place to assist in the evaluation of drugs used in obstetrics. Medical needs in obstetrics should be better identified, and labelling of drugs for use during pregnancy should be better directed towards prescribers; a national registry of pregnancies should be established in France.
Chauvenet M; Rimailho A; Hoog-Labouret N
The emotional states of pregnant women affect the course of their pregnancies, their deliveries and the behaviour and development of their infants. The aim of this study is to analyse the influence of positive and negative maternal emotional states on neonatal behaviour at 2-3 days after birth. A sample of 163 healthy full-term newborns was evaluated using the Neonatal Behavioral Assessment Scale. Maternal anxiety, perceived stress, and emotional stability during pregnancy were evaluated in the immediate postpartum period with the State Trait Anxiety Inventory and the Perceived Stress Scale. Moderate levels of anxiety during pregnancy alter infant orientation and self-regulation. These aspects of infant behaviour could lead to later attachment, behavioural and developmental problems. Maternal emotional stability during pregnancy improves infant self-regulation and several aspects of infant behaviour that may predispose them to better interactions with their parents.
Hernández-Martínez C; Arija V; Balaguer A; Cavallé P; Canals J
The emotional states of pregnant women affect the course of their pregnancies, their deliveries and the behaviour and development of their infants. The aim of this study is to analyse the influence of positive and negative maternal emotional states on neonatal behaviour at 2-3 days after birth. A sample of 163 healthy full-term newborns was evaluated using the Neonatal Behavioral Assessment Scale. Maternal anxiety, perceived stress, and emotional stability during pregnancy were evaluated in the immediate postpartum period with the State Trait Anxiety Inventory and the Perceived Stress Scale. Moderate levels of anxiety during pregnancy alter infant orientation and self-regulation. These aspects of infant behaviour could lead to later attachment, behavioural and developmental problems. Maternal emotional stability during pregnancy improves infant self-regulation and several aspects of infant behaviour that may predispose them to better interactions with their parents. PMID:18571345
Hernández-Martínez, Carmen; Arija, Victoria; Balaguer, Albert; Cavallé, Pere; Canals, Josefa
Full Text Available Abstract in spanish Manejar las complicaciones médicas en el embarazo es un reto para los clínicos. Objetivos: Este estudio delineó algunos patrones de enfermedades y prescripciones en embarazadas que visitan una clínica prenatal en Nigeria. Se determinó una clasificación de riesgo de los medicamentos. Métodos: Se investigaron los historiales médicos de 1200 mujeres embarazadas que visitaron las clínicas de preparto de tres centros en la ciudad de Benin , Nigeria. Los patrones de en (more) fermedades se determinaron desde sus diagnósticos. Los patrones de prescripción se evaluaron utilizando los indicadores del a OMS y la clasificación de medicamentos de la Food and Drug Adminsitration de Estados Unidos según el riesgo para el feto. Resultados: Durante el periodo de revisión, se evaluaron 1897 prescripciones de las 1200 mujeres embarazadas que visitaron. Los resultados indicaron que la malaria con 554 (38%) fue la enfermedad más prevalente, seguida de las infeccione respiratorias altas (IRA) con 13% y enfermedades gastrointestinales (GI) con 12%. La media de medicamentos prescritos por visita fue de 3,0 y 2434 (43%) fueron prescritas en genéricos. Minerales/vitaminas, con 2396 (42%) fueron los medicamentos mas prescritos, y los antibióticos aparecieron en 502 (8,8%). De todos los medicamentos prescritos, 984 (17%) se incluían en la categoría de riesgo fetal C y 286 (5%) en la categoría D. Conclusión: Este estudio concluyó que entre las mujeres embarazadas, la malaria era la enfermedad más frecuente, seguida de las IRA y las GI. Los minerales y vitaminas seguidos el os antibióticos encabezaron l alista de medicamentos prescritos. La media de medicamentos por visita fue mucho mayor que los estándares recomendados por la OMS. La aparición de medicamentos contraindicados era baja. Abstract in english Managing medical complications in pregnancy is a challenge to clinicians. Objectives: This study profiled some disease and prescription patterns for pregnant women attending antenatal clinics (ANCs) in Nigeria. A risk classification of the medicines was also determined. Methods: Medical case files of 1,200 pregnant women attending antenatal clinics of 3 health facilities in Benin City, Nigeria were investigated. Disease pattern was determined from their diagnoses. The pre (more) scription pattern was assessed using WHO indicators, and the United States Food and Drug Administration classification of medicines according to risk to the foetus. Results: A total of 1,897 prescriptions of the 1,200 pregnant women attendees during the period under review were evaluated. Results indicated that malaria 554 (38%) was the most prevalent disease, followed by upper respiratory tract infections (URTIs, 13%) and gastrointestinal disturbances (GIT, 12%). The average number of drugs prescribed per encounter was found to be 3.0, and 2,434 (43%) of medicines were prescribed by generic name. Minerals/ Vitamins 2,396 (42%) were the most frequently prescribed medicines, and antibiotics occurred in 502 (8.8%) of the total medicines. Of all medicines prescribed, 984 (17%) were included in the foetal risk category C and 286 (5%) in category D. Conclusion: The study concluded that malaria fever occurred most frequently followed by URTIs and GIT disturbances among the pregnant women. Minerals, vitamins and to a less extent anti-malarials topped the list of the prescribed medicines. The average number of medicines per encounter was much higher than WHO standards. The occurrence of contraindicated medicines was low.
Eze, Uchenna I.; Eferakeya, Adego E.; Oparah, Azuka C.; Enato, Ehijie F.
AIM: The purpose of this study was to clarify the risk of rubella infection for pregnant women in the outbreak area. MATERIAL & METHODS: We performed a retrospective, population-based study on all 232 pregnant women during the rubella outbreak period in Tokunoshima Island. All women had a rubella hemagglutination inhibition (HI) titer drawn during their current pregnancy. In 61 women, HI titers were compared between the current and past pregnancies. Rubella IgG antibody titers were measured and IgG avidity index (AI) was calculated for 92 non-infected pregnant women. RESULTS: Of the 232 candidates, 22 pregnant women contracted rubella infection (congenitally infected infants: 2). Seventeen of 61 pregnant women showed a four-fold or greater elevation in HI titer when compared with previous titers. Their previous HI titers were all ?64. Low IgG AIs (<30%) were only observed in women with a HI titer of ?64 (92 non-infected women). CONCLUSIONS: The risk of maternal rubella infection in the outbreak was as follows: non-immunized pregnant woman and pregnant woman with a rubella HI antibody titer ?64 and low IgG AI.
Kusumoto K; Kaneko M; Sameshima H; Minematsu T; Furuta K; Ikenoue T
In 2004, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) reissued joint advice recommending that pregnant women, nursing mothers, young children, and women who may become pregnant not consume fish high in mercury such as shark, swordfish, king mackerel, and tilefish, and not consume more than 12 ounces (340.2g) of other lower mercury fish per week. These groups were encouraged to eat up to 12 ounces (340.2g) of low mercury fish per week to get the health benefits of fish. Using a survey of 1286 pregnant women, 522 postpartum women, and a control group of 1349 non-pregnant/non-postpartum women of childbearing age, this study evaluated awareness of mercury as a problem in food and examined fish consumption levels across groups using regression analysis. We also compared awareness of mercury as a problem in food to awareness of Listeria, dioxins and PCBs. We found that the majority of all 3 groups of women were aware of mercury and that nearly all women in all 3 groups limited consumption consistent with the advice; they ate less than 340.2g (12 oz) of fish per week and no high mercury fish. Compared with the control group, pregnant and postpartum women were more likely to be aware of mercury as a problem in food, and pregnant women ate less total fish and were less likely to eat fish, to eat more than 340.2g (12 oz) of fish, and to eat high mercury fish. However, all groups ate much less than the recommended 340.2g (12 oz) of low mercury fish per week for optimum health benefits. Among women who ate fish, the median intake of total fish was 51.6 g/wk (1.8 oz/wk), 71.4 g/wk (2.5 oz/wk), and 85.3 g/wk (3.0 oz/wk) for the pregnant, postpartum, and control groups, respectively. Thus, it appears that the targeted groups of women were more aware of mercury and were eating fish within the FDA/EPA guidelines, but these women may be missing the health benefits to themselves and their children of eating a sufficient amount of fish.
Lando AM; Fein SB; Choinière CJ
Full Text Available OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos) da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS) e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5). Seis mulheres (46,2%) estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014). CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores) of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with abdominal trauma and surgical treatment, from 1990 to 2002. Thirteen pregnant women with abdominal injury were identified. All cases were registered in the Epi-Info 6.04 protocol and data were analyzed statistically by the Fisher exact test, with confidence interval of 95%. RESULTS: ages ranged from 13 to 34 years (mean of 22.5). Six women (46.2%) were in the third trimester of pregnancy. Penetrating trauma accounted for 53.8% of injuries and in six of these patients the mechanism of trauma was gunshot wounds. Three patients had uterine injuries associated with fetal death. There were no maternal deaths and fetal mortality was 30.7%. The use of trauma scores was not associated with maternal and fetal mortality. Uterine injury was the only predictive risk factor for fetal loss (p=0.014). CONCLUSIONS: this is a retrospective study analyzing a small number of pregnant women victims of severe trauma. However, the results show that there are no predictive accuracy scores to evaluate maternal and fetal outcomes.
Gustavo Pereira Fraga; Mario Mantovani; Ana Carla Mesquita; Andrea Boldrin Soares; Renato Passini Júnior
: The survival advantage of women over men with cutaneous melanoma and the reports of accelerated progression of melanoma during pregnancy have led to studies of the effect of hormones and hormone receptors on the development and progression of melanoma. However, the results are inconclusive. We therefore evaluated the expression of estrogen receptor ?, estrogen receptor ?, and androgen receptor in melanomas of stage- and age-matched pregnant women, nonpregnant women, and men by immunohistochemical analysis of formalin-fixed, paraffin-embedded archival tissues. In addition, we also assessed the mitotic rate using the antiphosphohistone H3 antibody by immunohistochemistry. Our data showed a trend of more frequent expression of estrogen receptor ? in the melanomas of pregnant patients than in the melanomas of male patients, without a significant difference observed between pregnant and nonpregnant women. However, no association between the expression of estrogen receptor ? and survival was observed. The small cohort may have limited the statistical power of the study, and large-scale studies are needed to elucidate the potential role of estrogen receptor ? as a prognostic marker of melanoma.
Zhou JH; Kim KB; Myers JN; Fox PS; Ning J; Bassett RL; Hasanein H; Prieto VG
Full Text Available Low compliance has been linked to the ineffectiveness of supplementation programme among pregnant women. This cross-sectional study was carried out to determine the compliance of vitamin and mineral supplementation among pregnant women attending public antenatal clinics in urban and rural areas. A total of 118 pregnant women aged 28±4 years (urban areas = 62; rural areas = 56) were recruited. Socio demographic data and compliance to supplementation were obtained through self-reported questionnaire. Haemoglobin concentration (Hb) was obtained from the antenatal records. More than two-thirds of the subjects (79.7%) were in third trimester and less than a third (20.3%) was in second trimester. Overall, 49.2% of subjects complied with vitamin and mineral supplementation. The mean of weight and haemoglobin concentration were 63.7±15.1 kg and 11.3±1.1 g d/L, respectively. The overall percentage of subjects who complied with vitamin and mineral supplementation was 49.2%. There was no significant difference in percentage of subjects who complied with the supplements in urban (46.8%) and rural areas (51.8%) (p = 0.587). The prevalence of anaemia among the subjects (Hb <11 g d/L) was 42.3% (n = 50). Prevalence of anaemia was lower in the compliant group compared with the non-compliant group (34.5% vs 50%, p = 0.01). Pregnant mothers who did not comply to the supplementation had significantly lower haemoglobin concentration (11.0±1.0 g d/L) compared with those who complied (11.5±1.2 g d/L) (p = 0.01). Percentage of compliance in anaemic and non-anaemic subjects were 34.5 and 65.5%, respectively (p = 0.088). The main reasons for non-compliance reported by subjects in both areas were forgetfulness (33.9%), side effects (nausea and vomiting) (11.9%) and worry regarding big size of babies (5.1%). In summary, the incidence of anemia is still high while compliance to supplementation is still low. Comprehensive nutrition education and health promotion programme should be carried out targeting pregnant women in urban and rural to educate the importance of compliance with the vitamin and mineral supplementation during pregnancy.
S. Thirukkanesh; A.M. Zahara
OBJECTIVE: to investigate the factors that affect the use of emergency obstetric care services among pregnant women in Turkey with antenatal bleeding. DESIGN: descriptive, cross-sectional study. SETTING: Mersin Maternity and Child Hospital, Mersin, Turkey. PARTICIPANTS: 125 pregnant women who had been admitted to the emergency department for antenatal bleeding. FINDINGS: advanced age, high level of education, lack of health insurance, receiving antenatal care, nuclear family structure and knowledge of the danger signs during pregnancy were found to affect the use of emergency obstetric care services among pregnant women with antenatal bleeding. KEY CONCLUSIONS: delays in seeking emergency obstetric care among pregnant women with antenatal bleeding are due to the difficulties faced by women when deciding whether or not to seek health care. Access to health services and health institutions themselves do not cause any delay in terms of provision of emergency obstetric care to pregnant women with antenatal bleeding. IMPLICATIONS FOR PRACTICE: pregnant women should be informed about the causes of antenatal bleeding, what to do in the case of bleeding, and the need to seek health care as soon as possible. In addition, midwives should inform families and pregnant women about the use of emergency medical services and the relevant procedures.
Ko?um Z; Yurdakul M
Full Text Available Background: Improving adherence to care standards is one way to im¬prove quality of delivered care. This study aimed to determine the degree of provid¬ers' adherence to maternity care standards from the perspective of pregnant women.Methods: This cross-sectional study was conducted on 185 pregnant women in their ninth month of pregnancy who received maternity care from health centres in Tabriz, Iran. Participants were selected randomly from 40 health centres. Data collection used a researcher-developed ques¬tionnaire based on Iranian Ministry of Health (MOH) standards for mater¬nity care. Question¬naire validity was reviewed and confirmed by 10 experts.Results: About 69% of pregnant mothers during their 9-month pregnancy received at least six items of standard maternity care. Almost two-thirds of participants received recommended maternity care at or above minimal standards for some aspect, such as the number of care during pregnancy, referral to health centre physician, and weight and blood pressure measure¬ment. Some other services such as measuring uterus height, review for oedema and varicosities, referral to a dentist, listening for fetal heart sound and vaginal examination, were reported at very low adherence to the Ministry of Health guidelinesConclusion: A notable proportion of pregnant mothers reported receiving subop-timal care indicating significant room for improving the quality of maternity care based on Iranian MOH standards and guidelines. The results indicate potential benefits from interventions to improve health care provid¬ers training and the awareness of pregnant women about the standards for good maternity care.
Andrew Wilson; Jafar Sadegh Tabrizi; Kamal Gholipour; Mostafa Farahbakhsh
PURPOSE: To explore risk perception and medicines information needs in pregnant women with epilepsy (WWE). METHOD: In-depth interviews with pregnant WWE treated with antiepileptic drugs (AEDs). RESULTS: Ten women aged 22-39 years in 20-34 weeks' gestation were interviewed. Avoiding seizures by taking AEDs in pregnancy outweighed perceived risks, but dose adjustments during and after pregnancy increased perceived risks of teratogenicity or seizures. The women had restrictive attitudes towards taking medicines for other indications than epilepsy. They appreciated their neurologist as a source for medicines information, though their needs for medicines information were reduced by long-term use of AEDs. CONCLUSIONS: Pregnant WWE were confident in using AEDs through communication with their neurologist, but dose adjustments caused concern. Medicines information to pregnant WWE should focus on empowering the women to control the disease, supporting realistic risk perceptions of AEDs and other necessary medicines. In this article, we outline some medicines information strategies to pregnant WWE.
Widnes SF; Schjøtt J; Granas AG
BACKGROUND/OBJECTIVES: Folic acid deficiency during pregnancy can lead to neural tube defects (NTD) in the fetus. Folate status was determined in a representative sample of Belgian pregnant women and determinants of folate status were assessed. SUBJECTS/METHODS: The women were selected using a multi-stage proportionate-to-size sampling design. Blood samples were collected and a questionnaire was completed face-to-face with a study nurse. Erythrocyte (red blood cell (RBC)) folate concentration was measured by chemoluminescence. RESULTS: In total, 1311 pregnant women participated and women with a lower socio-economic status were well represented. Median RBC folate concentration was 436?ng/ml (95% confidence interval=425-452?ng/ml) among first trimester and 496?ng/ml (95% confidence interval=474-515?ng/ml) among third trimester women. Few women had a RBC folate concentration below 140?ng/ml, indicating depletion of folate stores. In the first trimester, 39% of women had a RBC concentration below 400?ng/ml, whereas 15% of the first trimester women had a RBC concentration below 300?ng/ml. Among women in the first trimester, 69.1% reported taking folic acid-containing supplements of which 41.2% started taking them before pregnancy. For third trimester women, these percentages were 76.2% and 21.9%, respectively. In both trimesters, folate status increased significantly with education level and was significantly higher among women who planned the pregnancy and who did not smoke. CONCLUSIONS: It was found that 39% of the first trimester pregnant women had a folate status that might not be optimal to prevent NTD. Some groups of women need to be targeted as they are at higher risk of inadequate folate status.
Vandevijvere S; Amsalkhir S; Van Oyen H; Moreno-Reyes R
Background: Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life. Met...
Mette Rasmussen; Berit Lilienthal Heitmann; Hanne Tønnesen
Urinary and anal incontinence are prevalent in pregnant and parturient women. Pelvic floor muscle training is frequently employed for prevention and treatment. A recent Cochrane review is discussed. Fifteen studies with a total of 6,181 women were included. Pregnant women without urinary incontinence experienced a reduction of the risk of developing urinary incontinence in later pregnancy or post partum. Peripartum patients with urinary and anal incontinence experienced a reduction of their symptoms following training.
Brostrøm S; Due U; Lose G
BACKGROUND: Human Herpes Virus (HHV-8) is related to Kaposi Saracoma, an opportunistic infection occurring with HIV infection. Little is known about the seroepidemiology of Human Herpesvirus 8 (HHV-8) infection among Ethiopian women, even though women are a major HIV risk group in Ethiopia. OBJECTIVES: This study aimed at determining the seroprevalence of HHV-8 infection in HIV-1-infected and uninfected pregnant women in five selected regions of Ethiopia. METHODS: A cross-sectional study was conducted from December 2006 to June 2007 where pregnant women were recruited after age-matching in groups. A total of 400 pregnant women were enrolled, with 200 being HIV-infected and 200 being HIV-uninfected Sera were screened for IgG lytic antibody to HHV-8 using an Indirect Fluorescence Assay (IFA) in Virology Unit of Ethiopian Health and Nutrition Research Institute (EHNR1). RESULTS: Of 400 pregnant women attending antenatal clinic (ANC) testing sites of five regions in Ethiopia, 212 (53.0%) were positive for HHV-8 IgG lytic antibody. There was a high prevalence of HHV-8 infection among HIV-1-infected pregnant women (138, 69.0%) as compared with HIV-1-uninfected pregnant women (74, 37.0%). CONCLUSION: The study shows a high prevalence of HHV-8 infection among HIV-1-infected pregnant women as compared with HIV-1-uninfected pregnant women. Therefore, creating awareness and educating women on safe sexual practice and avoiding deep kissing may be a fundamental ways to limit the roots of transmission. Moreover, initiating strong antiretroviral therapy (ART) for HIV infected women would be best treatment prior to the development of Kaposi's sarcoma (KS).
Lemma E; Constantine NT; Kassa D; Messele T; Mindaye T; Taye G; Abebe A; Tamene W; Tebje M; Gebremeskel W; Adane A; Gezahegn N
Objective: To investigate the variations of serum leptin levels in pregnant women of various trimesters and their neonates as well as the correlativity in-between. Methods: Serum leptin levels in 300 women at pregestation during the three trimesters and the umbilical blood leptin levels in their neonates were measured with RIA. Results: Serum leptin levels in pregnant women rose significantly only from midgestation with a peak at partum (p
Full Text Available Background:Syphilis is an infectious disease caused by Treponema pallidum and transmitted via sexual contact, infected discharge and blood as well as vertical transmission. It causes various impacts on women during pregnancy and their newborns which results in various complications. Thus, screening of syphilis is routinely performed during pregnancy. Choosing to perform a specific screening test is based on the prevalence of the disease in the target population which needs adequate information in this regard. The aim of the present study was to determine the prevalence of syphilis among pregnant women in Shiraz, South-west of Iran. Materials and Methods: in this 15 month prospective study, 1100 pregnant women aged between 15 – 42 years, referred to University affiliated hospital in shiraz, Iran were included Blood samples were obtained from all of our study population for performing RPR test. FTA-ABS serologic test was carried out on positive cases of RPR test. Results:15 suspicious cases with weakly positive RPR test were detected but in all of them FTA-ABS tests were negative.Conclusions: The prevalence and incidence of syphilis was low in our area which may be due to variable reasons, such as reduction in the rate of unsafe and unprotected sex, improving knowledge, and adequate health care services. More studies are still needed to decide whether syphilis screening is beneficial in our area and should be considered as a routine test in pregnancy
Mohammad Motamedifar; Parvin Hassanzadeh; Mohammad Amin Taghinia; Yashgin Hassazadeh
BACKGROUND: Obesity is increasingly common in the obstetric population. Maternal obesity and excess gestational weight gain (GWG) are associated with increased perinatal risk. There is limited published data demonstrating the level of pregnant women's knowledge regarding these problems, their consequences and management strategies.We aimed to assess the level of knowledge of pregnant women regarding: (i) their own weight and body mass index (BMI) category, (ii) awareness of guidelines for GWG, (iii) concordance of women's own expectations with guidelines, (iv) knowledge of complications associated with excess GWG, and (v) knowledge of safe weight management strategies in pregnancy. METHODS: 364 pregnant women from a single center university hospital antenatal clinic were interviewed by an obstetric registrar. The women in this convenience sample were asked to identify their weight category, their understanding of the complications of obesity and excessive GWG in pregnancy and safe and/or effective weight management strategies in pregnancy. RESULTS: Nearly half (47.8%) of the study population were overweight or obese. 74% of obese women underestimated their BMI category. 64% of obese women and 40% of overweight women overestimated their recommended GWG. Women's knowledge of the specific risks associated with excess GWG or maternal obesity was poor. Women also reported many incorrect beliefs about safe weight management in pregnancy. CONCLUSIONS: Many pregnant women have poor knowledge about obesity, GWG, their consequences and management strategies. Bridging this knowledge gap is an important step towards improving perinatal outcomes for all pregnant women, especially those who enter pregnancy overweight or obese.
Shub A; Huning EY; Campbell KJ; McCarthy EA
INTRODUCTION: Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. OBJECTIVE: To describe pregnant women's experiences of PGP as related to daily life. METHODS: In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010-2011. Qualitative content analysis was used. RESULTS: Five main categories emerged: PGP affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached the breaking point; Questioning one's identity as defined by profession and work, and Lessons learned from living with PGP. The categories illustrate how women's everyday lives were interrupted. Their inability to meet their own and others' expectations put a strain on their lives causing disappointment, sadness and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies, and acknowledge their limitations. CONCLUSION: PGP severely affects pregnant women's everyday lives. There appears to be a lack of knowledge and awareness in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman's life is highly warranted.
Elden H; Lundgren I; Robertson E
Falls are the leading cause of nonfatal injury across all age groups and a common incident for pregnant women. Thus, there is a critical demand for research to evaluate if walking strategies in pregnant women change throughout pregnancy in order to effectively intervene and minimize the incidence rate. The aim of the present study was to analyze modifications in temporal-spatial parameters as well as muscle activity during hill walking transitions in pregnant women between gestational week 20 and 32. Based upon previous literature, we hypothesized that in comparison to level walking, the transition strides of pregnant women would be distinct between trimesters in order to accommodate the physical changes within twelve weeks. Thirteen pregnant women completed a series of randomly assigned walking conditions on level and hill surfaces during gestational week 20 and 32. Our results demonstrated that pregnant women modulated their gait patterns throughout pregnancy with additional joint flexion as well as muscle activity at the ankle, knee and hip. In summary, pregnant women exaggerate cautious gait patterns by walking slower and wider with greater joint flexion and muscle activity in order to safely transition between level and hill surfaces.
Gottschall JS; Sheehan RC; Downs DS
Falls are the leading cause of nonfatal injury across all age groups and a common incident for pregnant women. Thus, there is a critical demand for research to evaluate if walking strategies in pregnant women change throughout pregnancy in order to effectively intervene and minimize the incidence rate. The aim of the present study was to analyze modifications in temporal-spatial parameters as well as muscle activity during hill walking transitions in pregnant women between gestational week 20 and 32. Based upon previous literature, we hypothesized that in comparison to level walking, the transition strides of pregnant women would be distinct between trimesters in order to accommodate the physical changes within twelve weeks. Thirteen pregnant women completed a series of randomly assigned walking conditions on level and hill surfaces during gestational week 20 and 32. Our results demonstrated that pregnant women modulated their gait patterns throughout pregnancy with additional joint flexion as well as muscle activity at the ankle, knee and hip. In summary, pregnant women exaggerate cautious gait patterns by walking slower and wider with greater joint flexion and muscle activity in order to safely transition between level and hill surfaces. PMID:23770002
Gottschall, Jinger S; Sheehan, Riley C; Downs, Danielle S
OBJECTIVE: To understand the situation of Toxoplasma gondii infection among pregnant women in Jiangsu Province. METHODS: The pregnant women from 7 cities in Jiangsu Province were involved in this survey and the information was recorded according to the request of unified admission information of the case questionnaire of toxoplasmosis in Jiangsu Province. The specific antibodies IgM and IgG to Toxoplasma gondii in sera of these pregnant women were tested by ELISA. RESULTS: The specific antibody IgM to Toxoplasma gondii of all the respondents was negative. The positive rate of IgG was 3.98% (43/1 081), which was little different from the control group's 2.27% (4/176), and every city shared a similar positive rate. The positive rate of IgG of early pregnant women was 3.78%, which was also not obviously different from the 4.17% appearing in mid and late pregnant women. The respondents who previously had pathological abortions did not show positive IgG. Only 1.84% (8/435) of pregnant women had had the examinations related to Toxoplasma gondii before this survey. CONCLUSIONS: The rate of Toxoplasma gondii infection is low among pregnant women in Jiangsu Province. The situations in different areas are not far from each other. We should enhance the peri-conception tests of Toxoplasma gondii and take prevention and treatment countermeasures based on corresponding objects, and also further strengthen the healthy education.
Hua HY; Tang F; Liu YX; You L; Dong MH; Chen YE; Chen H; Hu YH; Ding GS; Sun BC; Guo JH; Gao Q
Pregnant women and their newborns are at elevated risk for influenza-associated hospitalization and death. The Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) have recommended influenza vaccination for all women who are or will be pregnant during the influenza season, regardless of trimester. To estimate influenza vaccination coverage among pregnant women for the 2011-12 influenza season, CDC analyzed data from an Internet panel survey conducted April 3-17, 2012, among women pregnant at any time during the 4-month period October 2011-January 2012. Among 1,660 survey respondents, 47.0% reported they had received influenza vaccination; 9.9% were vaccinated before pregnancy, 36.5% during pregnancy, and <1.0% after pregnancy. Overall, 43.7% of women reported receipt of both a health-care provider recommendation and offer of influenza vaccination; these women had higher vaccination coverage (73.6%) than women who received only a recommendation but no offer of vaccination (47.9%) and women who received neither a recommendation nor an offer (11.1%). Continued efforts are needed to encourage providers of medical care to routinely recommend and offer influenza vaccination to women who are pregnant or who might become pregnant.
In order to describe smoking habits among pregnant women and predictors of smoking cessation all pregnant women attending routine antenatal care from 1989 to 1991 at the Department of Obstetrics, Aarhus University Hospital, were asked to fill in questionnaires. Information about smoking habits from 8806 women revealed that 44% smoked prior to pregnancy. One fifth of the smokers stopped smoking early in pregnancy, leaving 33% women smoking during pregnancy. The strongest predictor of smoking cessation was the number of cigarettes smoked prior to pregnancy, where those that smoked the least were most likely to give up smoking. Caffeine intake, parity, years of education, and partner's smoking habits were also associated with smoking cessation whereas social status, alcohol intake, marital status, and age of the women had no influence on smoking cessation. Thus, a strategy for a smoking cessation campaign among pregnant women could be directed towards women who smoke heavily prior to pregnancy and women with a high daily intake of caffeine.
Wisborg K; Henriksen TB; Hedegaard M; Secher NJ
AIMS: To estimate the frequency of double incontinence, and to identify associated risk factors during pregnancy and postpartum in previously continent nulliparous women. METHODS: A cohort study in healthy, nulliparous, continent pregnant women, attending the public healthcare system of Catalonia (Spain) was designed. The field work was conducted during the control visits of pregnancy, at the time of delivery, and in the postpartum. Double incontinence was defined as a situation in which participants reported simultaneously urinary incontinence (UI) and anal incontinence with the help of a self-administered questionnaire. Prevalence rates, and their corresponding confidence intervals (95% CI), were calculated, as well as the impact on daily life. Multivariable logistic regressions in pregnancy and postpartum were estimated to assess the association of potential risk factors. RESULTS: The prevalence rate of double incontinence during pregnancy was 8.6% (95% CI: 7.0-10.3). Age over 35 years, and family history of UI were associated to a higher risk of double incontinence. After delivery, the prevalence rate decreased to 3.5% (95% CI: 2.4-4.6); only 6.7% of women with double incontinence in pregnancy had a persistency of their symptoms in early postpartum. Instrumental vaginal deliveries carried 2.2 times more risk of double incontinence than spontaneous ones. Episiotomy implied a higher risk for double incontinence. CONCLUSIONS: Symptoms of double incontinence are prevalent during first pregnancy; age and other intrinsic factors may favor the occurrence of double incontinence throughout gestation, while instrumental delivery and episiotomy increase the risk of double incontinence in the postpartum period.
Espuña-Pons M; Solans-Domènech M; Sánchez E
BACKGROUND: It is not clear how widely it is appreciated in Australia that certain antiepileptic drugs, particularly valproate, are teratogenic. AIM: The aim of the study is to assess trends in the pattern of antiepileptic drug prescribing for pregnant women in Australia to determine whether drug use is optimal, particularly from the fetal viewpoint. METHODS: Analysis of data contained in the Australian Register of Antiepileptic Drugs, assessing trends in antiepileptic drug use correlated with pregnancy outcomes. RESULTS: Valproate was the only significant teratogen among the antiepileptic drugs in common use. There was a fetal malformation rate of 14.5% associated with its use in monotherapy, as compared with a rate of 3.15% in antiepileptic drug-unexposed pregnancies in women with epilepsy (OR = 5.23, 95% CI = 1.81, 15.09). The highest malformation rate associated with any other antiepileptic drug used in monotherapy was 5.0%, for carbamazepine. Neurologists had progressively prescribed valproate less frequently and in lower dosage than other classes of practitioner over the 10-year study period, with a parallel decrease in occurrence of fetal malformations in pregnancies referred to the Register. Other prescribers of valproate did not seem to have adopted these practices to the same extent and had not obtained similar degrees of reduction in the occurrence of fetal malformations. CONCLUSIONS: Contemporary Australian obstetricians, even though they may not be valproate prescribers, when managing pregnancies in women taking valproate, need to be alert to the possibility that it may not be being used optimally from the fetal point of view, especially when not prescribed by neurologists.
Vajda FJ; Horgan D; Hollingworth S; Graham J; Hitchcock AA; Roten A; O'Brien TJ; Lander CM; Eadie MJ
BACKGROUND: We evaluated the effectiveness of a transtheoretical model (TTM)-based passive smoking prevention programme developed to enhance passive smoking avoidance among pregnant women and women with young children in Taiwan. Methods: Subjects were pregnant women recruited from the obstetrics/gynaecology department and women with children younger than age 3 recruited from the paediatrics department of four hospitals in Taiwan. Participants were randomly assigned to a group receiving a TTM-based intervention programme or a comparison group receiving routine care. The intervention programme consisted of educational materials and phone counselling. Baseline assessment and post-test data were collected from both groups using a self-reported questionnaire developed based on stages of change related to readiness for passive smoking avoidance. RESULTS: Determinants of change, post-test scores of knowledge, experiential and behavioural processes and self-efficacy were significantly different between the intervention group and comparison group among both pregnant women and mothers. Among pregnant women, the intervention group had significantly higher post-test scores than the comparison group. The distribution of percentages in three stages of change (Precontemplation, Contemplation/Preparation and Action/Maintenance) was significantly different between the two groups among both pregnant women and mothers. However, a higher percentage of mothers made progress in stages of change compared with pregnant women. Conclusion: A TTM-based intervention programme was potentially effective in passive smoking prevention by improving knowledge, experiential and behavioural processes and self-efficacy among pregnant women and women with young children. A higher percentage of mothers with young children had progressed in stages of change post-intervention compared with pregnant women.
Huang CM; Wu HL; Huang SH; Chien LY; Guo JL
Full Text Available Background: Eclampsia, defined as the occurrence during pregnancy of hypertension, oedema, proteinuria and/or other neurologic abnormalities, causes substantial morbidity and mortality for both mother and foetus. However, its aetiology is largely unknown. Genetic and immune factors may play a role including a reduced maternal response to paternal antigen and an altered adaptation of the maternal immune system to the foetus. Methods: Participants consisted of pregnant women with and without a diagnosis of eclampsia (N = 20, each group), and normal healthy nonpregnant controls (N = 18). Women with smear positive malaria or clinical infections were excluded. Serum levels of TNF? and IL-10 were assayed by ELISA. T lymphocyte subsets of pregnant patients with and without eclampsia were also studied by direct immunofluorescence using monoclonal antibodies and compared with the control group of 18 normal healthy nonpregnant women (NHC). Results: Eclampsia was associated with significantly lower mean serum IL-10 levels compared to normal pregnant and nonpregnant controls. Levels of the pro-inflammatory cytokine TNF? were higher in pregnant women with and without eclampsia, compared to control nonpregnant women. Further differences on serum cytokine levels were observed in the significantly increasing ratio of IL-10 to TNF? from nonpregnant controls to normal pregnant women and to pregnant women with eclampsia. The mean values of CD3+ and CD4+ positive lymphocytes was significantly decreased in patients with eclampsia (p < 0.05) in this study compared to pregnant controls. Similarly, CD3+ and CD4+ T cells were further decreased in eclampsia and pregnant controls compared to nonpregnant controls (p < 0.05). A decreasing CD4/CD8 ratio was observed from non-pregnant to pregnant controls and to patients with eclampsia buttressing an increase in CD8+ cells in eclampsia and pregnancy compared to controls. Conclusions: While a pro-inflammatory immune milieu during pregnancy complicated with eclampsia was demonstrated, the presence of eclampsia was not associated with further cytokine differences.
Bolanle O. P. Musa; Geoffrey C. Onyemelukwe; Olubunmi A. Olatunji; Kingsley O. Odogwu; Joseph O. Hambolu; Terfa S. Kene
Full Text Available The purpose of this present study was to know the pharmacoepidemiological profile of pregnant women carrying HIV, the prevention actions against vertical transmission, and evaluate the service respecting the patients' level of satisfaction. It was developed a quali-quantitative longitudinal study, with the sample being composed by pregnant women carrying HIV attended at the Pharmaceutical Care Service of a public hospital of Fortaleza - state of Ceará, during the period between January and September, 2007. The data were collected by means of follow-up cards, patients' medical history and, finally, interviews to verify the users' level of satisfaction related to the service. Twenty seven pregnant and parturient women have participated in the study. The mean profile found was of a single woman, aged in the range between 18 and 28 years, of Caucasian race or dark colored, with familial revenue below the minimum wage, having elementary or high school, and being unemployed. It was observed that 77.8% (n=21) of patients followed all prevention strategies against maternal-infant transmission. Twenty nine drug related problems have been detected, out of which 51.7% (n=15) were resolved. The general level of satisfaction respecting the Pharmaceutical Care Service was quite satisfactory. By means of the Pharmaceutical Care Service, the pharmacist professional effectively collaborates for the correct utilization of medications, and this action results directly in a decrease of HIV vertical transmission.Objetivou-se com o presente estudo conhecer o perfil farmacoepidemiológico das gestantes portadoras do vírus HIV, as ações de prevenção da transmissão vertical e avaliar o serviço quanto ao nível de satisfação das pacientes. Realizou-se estudo quali-quantitativo, longitudinal, sendo a amostra composta pelas gestantes portadoras do vírus HIV atendidas no Serviço de Atenção Farmacêutica de um hospital público de Fortaleza-CE, no período de janeiro a setembro de 2007. Coletaram-se os dados por meio de fichas de seguimento, prontuários das pacientes e, finalmente, entrevistas para verificar o nível de satisfação das usuárias em relação ao serviço. Participaram do estudo 27 gestantes e parturientes infectadas pelo HIV. O perfil encontrado foi de mulheres solteiras, na faixa etária de 18 a 28 anos, de cor branca ou parda, com renda familiar inferior a um salário mínimo, com ensino fundamental ou médio e desempregadas. Observou-se que 77,8% (n=21) pacientes seguiram todas as estratégias de prevenção da transmissão materno-infantil. Detectaram-se 29 problemas relacionados ao uso de medicamentos, dos quais 51,7% (n=15) foram resolvidos. O nível de satisfação geral em relação ao serviço de atenção farmacêutica foi bastante satisfatório. Por meio do serviço de atenção farmacêutica, o profissional farmacêutico colabora com a utilização correta dos medicamentos, podendo repercutir diretamente na redução da transmissão vertical do HIV.
Geysa Aguiar Romeu; Larissa Varela de Paiva; Mariana Mota Moura Fé
Pregnant women constitute a risk group for any infection due to their low immunity condition. This is a descriptive study with a qualitative approach, grounded in the Theory of Social Representations that sought to understand the reasons why pregnant women did not vaccinate against influenza A (H1N1). The study included 10 women who were pregnant during the vaccination campaign of 2010. Data were collected in May 2011 through interviews and interpreted by content analysis. From the speeches it was possible to identify the various representations that the vaccine against H1N1 had for these women during their pregnancy as an element which would cause miscarriage and birth defects. The reasons why pregnant women did not vaccinate against H1N1 are associated with fear, lack of information and the myths and beliefs that people bring in their representations and their cultural values.
Pereira BF; Martins MA; Barbosa TL; e Silva CS; Gomes LM
Objective: To study the relationships between plasma adrenomedullin (ADM) and normal pregnancy and pathogenesis of pregnancy-induced hypertension (PIH). Methods: ADM concentrations in the plasma from 10 normal non-pregnant women, 36 normal pregnant women (12 first, 12 second, 12 third trimester, respectively) and 30 cases of PIH (10 mild, 10 moderate, 10 severe, respectively) were determined by radioimmunoassay, and data were analyzed statistically. Results: ADM concentrations in the first, second and third trimester of normal pregnancy increased significantly than that of normal non-pregnant women (P
Full Text Available Background: The aim of this study was to evaluate copper status in women with preeclampsia.Materials and Methods: Sixty preeclamptic, sixty normotensive pregnant and sixty healthy nonpregnantwomen were enrolled in a cross sectional study. The 24-hour urine copper was comparedamong the women.Results: There was significant difference in the copper concentration of 24-hour urine amongthe three groups due to the difference between preeclamptic and normotensive pregnant women(12.19±3.71 vs. 5.69±2.05, p<0.001).Conclusion: The results of this study revealed that the level of urine copper increases preeclampticpregnancy. Prospective studies are needed to determine whether observed alternation in copperprecede preeclampsia or the difference may be attributed to preeclampsia-related alternations inmaternal trace metal metabolism.
Saeideh Ziaei; Fatemeh Ranjkesh; Soghrat Faghihzadeh
INTRODUCTION: Recruiting participants for research studies can be challenging. Many studies fall short of their target or must prolong recruitment to reach it. We examined recruitment and retention strategies and report lessons learned in a behavioral intervention developmental trial to encourage healthy pregnancy weight gain and stress reduction in low-income overweight pregnant women. METHODS: In the San Francisco Bay area from February 2010 through March 2011, we used direct and indirect strategies to recruit English-speaking overweight and obese pregnant women who were aged 18 to 45, were in the early stages of pregnancy, and who had an annual household income less than 500% of the federal poverty guidelines. Eligible women who consented participated in focus groups or an 8-week behavioral intervention. We identified successful recruiting strategies and sites and calculated the percentage of women who were enrolled and retained. RESULTS: Of 127 women screened for focus group participation, 69 were eligible and enrolled. A total of 57 women participated in 9 focus groups and 3 women completed individual interviews for a completion rate of 87%. During recruitment for the intervention, we made contact with 204 women; 135 were screened, 33% were eligible, and 69.1% of eligible women enrolled. At 1 month postpartum, 82.6% of eligible women completed an assessment. Recruiting at hospital-based prenatal clinics was the highest-yielding strategy. CONCLUSION: The narrow window of eligibility for enrolling early stage pregnant women in a group intervention presents obstacles. In-person recruitment was the most successful strategy; establishing close relationships with providers, clinic staff, social service providers, and study participants was essential to successful recruitment and retention.
Coleman-Phox K; Laraia BA; Adler N; Vieten C; Thomas M; Epel E
We sought to examine motivators and barriers related to monovalent 2009 influenza A (H1N1) vaccination among pregnant women. We conducted a national poll of pregnant women using a random online sample (237) and opt-in supplement (277). In all, 42% of pregnant women reported getting the vaccine. Vaccination was positively associated with attitudinal factors including believing the vaccine is very safe or benefits the baby, and with provider recommendations. Women in racial/ethnic minority groups, women with less education, and women <35 years were less likely to get the vaccine and had differing views and experiences. Despite H1N1 vaccination rates that are higher than past seasonal influenza rates, barriers like safety concerns may persist in a pandemic. Messaging from providers that encourages women to believe the vaccine is very safe and benefits their baby may be compelling. Messaging and outreach during future pandemics may require customization to increase vaccination among high-risk groups.
Steelfisher GK; Blendon RJ; Bekheit MM; Mitchell EW; Williams J; Lubell K; Peugh J; DiSogra CA
There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals). Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines). The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.
Saleh Gargari S; Fallahian M; Haghighi L; Hosseinnezhad-Yazdi M; Dashti E; Dolan K
Full Text Available Abstract Background Physical activity may reduce the risk of adverse maternal outcomes, yet there are very few studies that have examined the correlates of exercise amongst obese women during pregnancy. We examined which relevant sociodemographic, obstetric, and health behaviour variables and pregnancy symptoms were associated with exercise in a small sample of obese pregnant women. Methods This was a secondary analysis using data from an exercise intervention for the prevention of gestational diabetes in obese pregnant women. Using the Pregnancy Physical Activity Questionnaire (PPAQ), 50 obese pregnant women were classified as "Exercisers" if they achieved ?900 kcal/wk of exercise and "Non-Exercisers" if they did not meet this criterion. Analyses examined which relevant variables were associated with exercise status at 12, 20, 28 and 36 weeks gestation. Results Obese pregnant women with a history of miscarriage; who had children living at home; who had a lower pre-pregnancy weight; reported no nausea and vomiting; and who had no lower back pain, were those women who were most likely to have exercised in early pregnancy. Exercise in late pregnancy was most common among tertiary educated women. Conclusions Offering greater support to women from disadvantaged backgrounds and closely monitoring women who report persistent nausea and vomiting or lower back pain in early pregnancy may be important. The findings may be particularly useful for other interventions aimed at reducing or controlling weight gain in obese pregnant women.
Foxcroft¹ Katie F; Rowlands Ingrid J; Byrne Nuala M; McIntyre H; Callaway Leonie K
Full Text Available There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals). Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines). The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.
Soraya Saleh Gargari; Masoumeh Fallahian; Ladan Haghighi; Maryam Hosseinnezhad-Yazdi; Elahe Dashti; Kate Dolan
Full Text Available Introduction: the Consensus Conference of the American College ofChestSurgeons and the American Society of Critical Care Medicine in 1992, definesthe systemic inflammatory response syndrome (SIRS). In pregnantwomen, a seriesof physiological and anatomical changes. These changes SIRS denote by definition,being only physiological parameters in a pregnant woman with variation accordingto gestational age. The aim of this study is to perform a diagnostic evaluation of thedefinition of SIRS in critically ill obstetric patient, taking into account the parametersfound in two cohorts of patients.Methodology: we performed a multicenter comparative diagnostic study of twocohorts: a retrospective cohort of patients admitted to two intensive care units inthe city of Cartagena, Colombia, with a diagnosis ofsepsis of any origin, which werecompared with healthy pregnantpatients without septic focus in prenatal care in order toestimateappropriate cutoff for the definition of SIRS in pregnant women.Results: in developing this study we found that the cut-off points at 12400 cell/mm3 for leukocyte count, heart rate greater than 105 per minute and respiratory rate of20 per minute showed the best statistical behavior. With regard to the definition ofSIRS ConsensusConference of the American College of Chest Surgeons and the AmericanSociety of Critical Care Medicine in 1992, the only variation was found within thecutoff for heart rate, where 105 beats per minute, was show the best sensitivity andspecificity.Conclusión: the current criteria to define SIRS in pregnant women do not seem to beadequate according to the results of this study.RESUMEN:Introducción: en la Conferencia de Consenso del Colegio Americano de Cirujanos delTórax y de la Sociedad Americana de Medicina Crítica en 1992, se define el Síndromede Respuesta Inflamatoria Sistémica (SRIS). En la mujer gestante ocurren una seriede cambios fisiológicos y anatómicos. Estos cambios denotarían por su definición SRIS,siendo solamente parámetros fisiológicos en una mujer gestante con variación según suedad gestacional. El objetivo del presente trabajo es realizar una evaluación diagnósticade la definición de SRIS en la paciente obstétrica críticamente enferma, teniendo encuenta, los parámetros encontrados en dos cohortes de pacientes.Metodología: se realiza un estudio diagnóstico comparativo multicéntrico, de doscohortes; una cohorte retrospectiva de pacientes, ingresadas a dos unidades decuidados intensivos, en la ciudad de Cartagena, Colombia, con el diagnóstico de sepsisde cualquier origen, que se compararon con pacientes embarazadas sanas sin focoséptico en control prenatal, con el fin de estimar puntos de corte adecuados para ladefinición de SRIS en la embarazada.Resultados: al desarrollar este estudio encontramos que los puntos de corteestablecidos en 12400 cell/mm3 para el conteo leucocitario, frecuencia cardiaca mayorde 105 por minuto y frecuencia respiratoria mayor de 20 por minuto mostraron el mejorcomportamiento estadístico. Con respecto a la definición de SRIS de la conferencia deConsenso del Colegio Americano de Cirujanos del Tórax y de la Sociedad Americanade Medicina Crítica en 1992, la única variación encontrada corresponde al punto decorte para frecuencia cardiaca, donde 105 latidos por minuto, resultó mostrar la mejorsensibilidad y especificidad.Conclusión: los criterios actuales para definir SRIS, en la mujer gestante, no parecenser los más adecuados de acuerdo a los resultados de este estudio.
Polo-Mendoza Eduy; Rojas-Suárez José Antonio; Marzán-Esquivel Antonio; Paternina-Caicedo Ángel; Bello Laura Margarita; De La Peña-Martínez Jairo
PURPOSE: To evaluate habits of sun exposure and sun protection of pregnant women in a public hospital, to assess orientation about photo protection during the prenatal care, and to detect the presence of melasma and its impact on their quality of life. METHODS: A descriptive cross sectional study conducted among women of 18 years old and older, after delivery, who participated in a program of prenatal care in the South Region of Brazil. The sample was non-probabilistic by convenience. Data collection occurred from July to August 2011 through direct interview using a structured questionnaire to obtain personal information and photo protection habits during pregnancy, skin assessment and photographic record of lesions through informed consent. The skin was classified per Fitzpatrick's phototypes and the melasma was diagnosed clinically. In the patients with melasma, the MELASQoL-PB version was applied. The analysis was performed using Statistica, version 8.0, and the significance level of p<0.05. RESULTS: In the sample (109 mothers) predominated white women (60.6% phototype III), young (average age 24.4 years SD=6.1) and housewives (59.6%). The majority (80%) stayed exposed to sunlight for 1-2 hours per day between 10 am and 3 pm, and from those (72%) did not apply any photoprotection due to lack of sunscreen habit. Other physical means of sun protection were used by 15% of these patients. Information during prenatal care about the risks of sun exposure was reported by 34% of the mothers interviewed. There was a trend toward a significant association between prenatal guidance and daily use of sunscreen (p=0.088). About 20% of mothers had melasma. The average score MELASQol-PB (25) showed a negative impact on quality of life of these patients. CONCLUSION: In these women, sun exposure occurred at inappropriate times, without proper guidance and without the use of an effective sunscreen. The mothers with melasma complained about the appearance of their skin, frustration and embarrassment.
Purim KS; Avelar MF
BACKGROUND: Control of malaria during pregnancy remains a major public health challenge in developing countries. Microscopic parasite detection represents a pivotal step in malaria control, while modern molecular techniques are deemed to improve detection rates markedly. AIMS: This study aimed to investigate the frequency of submicroscopic and multiple Plasmodium falciparum (P. falciparum) infections during pregnancy, using the P. falciparum merozoite surface protein1 (MSP-1) gene as a polymorphic marker. MATERIALS AND METHODS: The study was a cross-sectional, analytical study that was conducted at Omdurman Maternity Hospital, Sudan, between July 2003 and December 2004. Following informed consent, 836 pregnant women between the ages of 16-47 years with different gestational ages were enrolled in the study. Thin and thick blood films were stained with Giemsa and examined by experienced microscopists. Parasite DNA was extracted using Chelex method. Nested polymerase chain reaction (PCR) assays specific for P. falciparum were carried out to detect infections below the threshold of microscopy and to genotype different strains in the samples using merozoite surface protein-1. RESULTS: More than a quarter of the study participants (219/836; 26.2%) were smear-positive for malaria infection. The results of the PCR-based assays showed that 41.8 % (257/617) of the smear-negative women were PCR positive and therefore had submicroscopic infections. The mean number of genetically different P. falciparum parasites detected was 2.7 (range 1-9). The multiplicity of infection identified by at least two alleles of MSP-1 was significantly higher among paucigravidae (45.6%) compared to multigravidae (28.9%), with mean number of alleles of 2.4 and 1.9, respectively (p=0.009). This likely indicates the gradual acquisition of immunity. CONCLUSION: Conventional microscopy underestimates the actual extent of malaria infections during pregnancy in endemic regions. Multiplicity of infection may be an important factor in the gradual acquisition of strain-specific immunity.
Omer S; Khalil E; Ali H; Sharief A
Full Text Available Background: Control of malaria during pregnancy remains a major public health challenge in developing countries. Microscopic parasite detection represents a pivotal step in malaria control, while modern molecular techniques are deemed to improve detection rates markedly. Aims: This study aimed to investigate the frequency of submicroscopic and multiple Plasmodium falciparum (P. falciparum) infections during pregnancy, using the P. falciparum merozoite surface protein1 (MSP-1) gene as a polymorphic marker. Materials and Methods: The study was a cross-sectional, analytical study that was conducted at Omdurman Maternity Hospital, Sudan, between July 2003 and December 2004. Following informed consent, 836 pregnant women between the ages of 16-47 years with different gestational ages were enrolled in the study. Thin and thick blood films were stained with Giemsa and examined by experienced microscopists. Parasite DNA was extracted using Chelex method. Nested polymerase chain reaction (PCR) assays specific for P. falciparum were carried out to detect infections below the threshold of microscopy and to genotype different strains in the samples using merozoite surface protein-1. Results: More than a quarter of the study participants (219/836; 26.2%) were smear-positive for malaria infection. The results of the PCR-based assays showed that 41.8 % (257/617) of the smear-negative women were PCR positive and therefore had submicroscopic infections. The mean number of genetically different P. falciparum parasites detected was 2.7 (range 1–9). The multiplicity of infection identified by at least two alleles of MSP-1 was significantly higher among paucigravidae (45.6%) compared to multigravidae (28.9%), with mean number of alleles of 2.4 and 1.9, respectively (p=0.009). This likely indicates the gradual acquisition of immunity. Conclusion: Conventional microscopy underestimates the actual extent of malaria infections during pregnancy in endemic regions. Multiplicity of infection may be an important factor in the gradual acquisition of strain-specific immunity.
Samia Omer; Eltahir Khalil; Hashim Ali; Abdalla SharieF
Data of etiology characteristics of uroinfections with pregnant women are presented treated at University Hospital of Obstetrics and Gynecology "Maichin dom" in three periods. Gram negative species of microorganisms (E. coli, proteus, Klebsiella) are the agens of uroinfections in 95.4% of cases in the period 1988/89. After 10-year period gram (-) are the uroinfection in 66.1% of the cases. The growing etiologycal importance of Gram positive species of microorganisms (S. aureus, Enterococcus, GBS) is 33,9% in the period 1997/98 and it is preserved in june 2001/may 2003 too. In cases of long lasting hospitalization or after repeated treatment with antibiotics the probability grows that the agents of uroinfections be polyresistant strains. In the period june 2001/may 2003 in 7% of the cases polyresistant E. coli are isolated, in 2.6% MRSaureus, in 7.6% Ampicillin - R Enterococcus spp. That suggest exact identification of the agen and therapy according to sensitivity to antibiotics.
Shopova E; Dimitrov A; Nikolov A
Data of etiology characteristics of uroinfections with pregnant women are presented treated at University Hospital of Obstetrics and Gynecology "Maichin dom" in three periods. Gram negative species of microorganisms (E. coli, proteus, Klebsiella) are the agens of uroinfections in 95.4% of cases in the period 1988/89. After 10-year period gram (-) are the uroinfection in 66.1% of the cases. The growing etiologycal importance of Gram positive species of microorganisms (S. aureus, Enterococcus, GBS) is 33,9% in the period 1997/98 and it is preserved in june 2001/may 2003 too. In cases of long lasting hospitalization or after repeated treatment with antibiotics the probability grows that the agents of uroinfections be polyresistant strains. In the period june 2001/may 2003 in 7% of the cases polyresistant E. coli are isolated, in 2.6% MRSaureus, in 7.6% Ampicillin - R Enterococcus spp. That suggest exact identification of the agen and therapy according to sensitivity to antibiotics. PMID:15341251
Shopova, E; Dimitrov, A; Nikolov, A
The purpose of this research is to study the fetal head circumference (HC) biometry for local population. Retrospective study was selected, done at Hospital Pulau Pinang and 5551 files of pregnant women were collected. The HC mean values of this study (HCmean) was compared with other published studies to see whether there was any difference between the various populations in the world. Comparison of means, regression analysis and paired sample t-test in SPSS software version 11.5 were used in the analysis. A total of 9874 HC data (mm) were recorded for gestational age (GA) of 12 to 41 weeks. The HC growth rate in second trimester (11.32 mm/week) has decreased to nearly half than in third trimester (5.53 mm/week). The HCmean was found to be highly significant difference (SD) than other 9 studies and only lower than HC values of USA, UK and Zimbabwe populations. The HC values of German show close similarity with HCmean. From 45 comparisons done, more than three-quarter of the comparisons resulted as SD (37) compared to insignificant differences (8). Consequently, each country should have their own standard HC of fetus biometry of the various gestations for their own population.
Ramli, Remsen Maizan; Jaafar, M. S.; Ismail, N. E.; Saltani, Hend A. A.; Ahmad, A. L.; Bermakai, M. Yahaya
Full Text Available Objective: to adherence to antiretroviral therapy by pregnant women living with HIV / AIDS and its determinants advantages and constraints. Method: this is about an exploratory descriptive study, from qualitative approach, using socioeconomic data collection questionnaire and open interviews in depth, content analysis to establish the themes. The study was approved by the Ethics in Research of the Mother and Child Hospital (protocol number 023/07). Results: the material was sorted and grouped into two themes: “HIV/AIDS: infection dramatically worldwide” and “Pregnancy and Seropositivity: a challenge that is solvable”, each divided into subcategories for better understanding and analysis of data. Conclusions: the study presents results consistent with the profile of HIV/AIDS in the country with regard to internalization, pauperization and discovery of the diagnosis, confirming the pregnancy period as appropriate to the knowledge of their HIV status. Adherence to treatment in pregnancy is justified by the desire not to transmit the infection to their child. Descriptors: HIV seropositivity; psychology social; pregnancy; medication adherence.
Paula Saraiva Duailibe Barbosa, Loise Dantas Fonseca Ribeiro, Maria Eliane Liégio Matão, Pedro Humberto Faria Campos, Denismar Borges Miranda
Full Text Available The vitamin A status of 101 pregnant women attending clinic at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria was assessed based on 24 h dietary recall, serum retinol concentration, history of night blindness, physical appearance and clinical eye signs. The study revealed that the mean dietary vitamin A intake of the respondents (2645.31 ±188.91 ?g RE) and their mean serum retinol concentration (31.18 ±2.94 ?g dL-1) were significantly (p-1) than those who had above 50% intake from preformed sources (49.54 ±42.63 ?g dL-1) and those with about equal intake from both sources (55.75 ±30.80 ?g dL-1). There was a significant (p-1), through the second trimester (35.12 ±4.72 ?g dL-1), to the third trimester (21.54 ±1.46 ?g dL-1) of pregnancy.
Ima O. Williams; Okon U. Eka; Essien U. Essien
BACKGROUND: Toxoplasmosis is a common parasitic infection caused by an obligate intracellular protozoan, Toxoplasma gondii. If primary toxoplasmosis occurs during pregnancy about one third of the cases could lead to congenital toxoplasmosis, with subsequent pathological effects. This study aimed at determining the seroprevalence of T. gondii among pregnant women in Jimma town, Southwest Ethiopia. METHODS: A community based cross-sectional study was conducted to assess the seroprevalence and associated factors in pregnant women from August to September, 2011. A total of 201 study participants were included in this study. Data on socio-demographic and predisposing factors were collected from each study participant. Moreover, venous blood specimens were collected following Standard Operating Procedures. All the collected specimens were tested for IgM and IgG anti-T. gondii antibodies by enzyme-linked immunosorbent assay (ELISA). RESULTS: The overall seroprevalence of T. gondii in the study area was 83.6%. One hundred and sixty three (81.1%) of the pregnant women were IgG seropositive, five (2.5%) were IgM seropositive. Three of the 5 pregnant women were positive for both IgG and IgM. Presence of domestic cat at home showed significant association with anti-T. gondii seropositivity (OR?=?5.82, 95% CI: 1.61- 20.99; p?0.05). CONCLUSION: The seroprevalence of T. gondii antibodies was high among the pregnant women. Pregnant women having domestic cat at their home were at higher risk of T. gondii infection. Hence, health education and awareness on the disease and its transmission to women of reproductive age group in general and pregnant women in particular should be created during antenatal follow up to reduce the risk of T. gondii infection in pregnant women.
Zemene E; Yewhalaw D; Abera S; Belay T; Samuel A; Zeynudin A
Full Text Available Abstract Background Toxoplasmosis is a common parasitic infection caused by an obligate intracellular protozoan, Toxoplasma gondii. If primary toxoplasmosis occurs during pregnancy about one third of the cases could lead to congenital toxoplasmosis, with subsequent pathological effects. This study aimed at determining the seroprevalence of T. gondii among pregnant women in Jimma town, Southwest Ethiopia. Methods A community based cross-sectional study was conducted to assess the seroprevalence and associated factors in pregnant women from August to September, 2011. A total of 201 study participants were included in this study. Data on socio-demographic and predisposing factors were collected from each study participant. Moreover, venous blood specimens were collected following Standard Operating Procedures. All the collected specimens were tested for IgM and IgG anti-T. gondii antibodies by enzyme-linked immunosorbent assay (ELISA). Results The overall seroprevalence of T. gondii in the study area was 83.6%. One hundred and sixty three (81.1%) of the pregnant women were IgG seropositive, five (2.5%) were IgM seropositive. Three of the 5 pregnant women were positive for both IgG and IgM. Presence of domestic cat at home showed significant association with anti-T. gondii seropositivity (OR?=?5.82, 95% CI: 1.61- 20.99; p? Conclusion The seroprevalence of T. gondii antibodies was high among the pregnant women. Pregnant women having domestic cat at their home were at higher risk of T. gondii infection. Hence, health education and awareness on the disease and its transmission to women of reproductive age group in general and pregnant women in particular should be created during antenatal follow up to reduce the risk of T. gondii infection in pregnant women.
Zemene Endalew; Yewhalaw Delenasaw; Abera Solomon; Belay Tariku; Samuel Abdi; Zeynudin Ahmed
INTRODUCTION: In 2004, The Danish National Board of Health introduced new guidelines for prenatal screening and diagnosis. Subsequently, all pregnant women in Denmark have been offered a maternal serum screening and a nuchal translucency measurement (NTM). The results are combined to a single risk estimate of carrying a Down syndrome child. All pregnant women are also offered a late second trimester scan for fetal abnormalities. Pregnant woman should be fully informed to enable them to make an informed choice. We explored the role of information in the pregnant women's understanding and decision-making for the NTM. MATERIALS AND METHODS: 26 consenting pregnant women were interviewed after their first visit to their GP and again after the late ultrasound scan. Our results are mainly based on the first interviews and the 24 participants who chose to have a NTM. RESULTS: The pregnant women consider a fetal scan as an attractive routine procedure during pregnancy. Apart from the information about prenatal examinations given by the GP, the pregnant women do not subsequently seek further information. The most important motives for wanting to have the NTM are 1) assurance, 2) choice, 3) expectations of the scan being a happy event, and 4) the idea that the examinations are approved by the Danish health care system. DISCUSSION: The decision to have a NTM is motivated by expectations that exceed the specific medical aim of the examination and the content of the information provided. The pregnant women believe in a link between knowledge and anxiety, and therefore do not wish to "know too much". Our results show that the pregnant woman's conception of the information provided and her motives for having a NTM are based on strategies and rationales that hinder an informed choice.
Lou S; Dahl K; Risør MB; Hvidman LE; Thomsen SG; Jørgensen FS; Olesen F; Kjaergaard H; Kesmodel U
INTRODUCTION: In 2004, The Danish National Board of Health introduced new guidelines for prenatal screening and diagnosis. Subsequently, all pregnant women in Denmark have been offered a maternal serum screening and a nuchal translucency measurement (NTM). The results are combined to a single risk estimate of carrying a Down syndrome child. All pregnant women are also offered a late second trimester scan for fetal abnormalities. Pregnant woman should be fully informed to enable them to make an informed choice. We explored the role of information in the pregnant women's understanding and decision-making for the NTM. MATERIALS AND METHODS: 26 consenting pregnant women were interviewed after their first visit to their GP and again after the late ultrasound scan. Our results are mainly based on the first interviews and the 24 participants who chose to have a NTM. RESULTS: The pregnant women consider a fetal scan as an attractive routine procedure during pregnancy. Apart from the information about prenatal examinations given by the GP, the pregnant women do not subsequently seek further information. The most important motives for wanting to have the NTM are 1) assurance, 2) choice, 3) expectations of the scan being a happy event, and 4) the idea that the examinations are approved by the Danish health care system. DISCUSSION: The decision to have a NTM is motivated by expectations that exceed the specific medical aim of the examination and the content of the information provided. The pregnant women believe in a link between knowledge and anxiety, and therefore do not wish to "know too much". Our results show that the pregnant woman's conception of the information provided and her motives for having a NTM are based on strategies and rationales that hinder an informed choice.
Lou, S; Dahl, K
Spontaneous abortion is the most common adverse pregnancy outcome, and stress has been suggested to be important factor. We hypothesized that those female pregnant women with previous spontaneous abortion will have higher anxiety and depression than female pregnant women without previous spontaneous abortion and controls (healthy non-pregnant women). Age and socio-demographic parameters did not differ significantly between the three groups of participants. Anxiety and depression levels were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. There were no significant differences in the scores on Beck Depression Inventory between three groups of participants at the week 10 of gestation-1st assessment and week 20 of gestation-2nd assessment. Contrary of these results, pregnant women with history of spontaneous abortion have had statistically significant higher anxiety score than pregnant women without history of spontaneous abortion and control group-non-pregnant women, on both assessment of anxiety. Negative correlations between months passed form the last spontaneous abortion and anxiety on both assessment, emphasize the role of psychological support for the women who have experienced spontaneous abortion.
Marcinko VM; Marcinko D; Dordevi? V; Oreskovi? S
Full Text Available Group B Streptococcus (GBS) is the most common cause of life-threatening infection in neonates. Guidelines from CDC recommend universal screening of pregnant women for rectovaginal GBS colonization. The objective of this study was to compare the performance of a combined enrichment/PCR based method targeting the atr gene in relation to culture using enrichment with selective broth medium (standard method) to identify the presence of GBS in pregnant women. Rectovaginal GBS samples from women at ?36 weeks of pregnancy were obtained with a swab and analyzed by the two methods. A total of 89 samples were evaluated. The prevalence of positive results for GBS detection was considerable higher when assessed by the combined enrichment/PCR method than with the standard method (35.9% versus 22.5%, respectively). The results demonstrated that the use of selective enrichment broth followed by PCR targeting the atr gene is a highly sensitive, specific and accurate test for GBS screening in pregnant women, allowing the detection of the bacteria even in lightly colonized patients. This PCR methodology may provide a useful diagnostic tool for GBS detection and contributes for a more accurate and effective intrapartum antibiotic and lower newborn mortality and morbidity.
F.M. Munari; F. De-Paris; G.D. Salton; P.S Lora; P Giovanella; A.B.M.P Machado; L.S. Laybauer; K.R.P. Oliveira; C Ferri; J.L.S. Silveira; C.C.F.C Laurino; R.M. Xavier; A.L Barth; S Echeverrigaray; J.P. Laurino
Full Text Available Abstract in english Group B Streptococcus (GBS) is the most common cause of life-threatening infection in neonates. Guidelines from CDC recommend universal screening of pregnant women for rectovaginal GBS colonization. The objective of this study was to compare the performance of a combined enrichment/PCR based method targeting the atr gene in relation to culture using enrichment with selective broth medium (standard method) to identify the presence of GBS in pregnant women. Rectovaginal GBS (more) samples from women at ?36 weeks of pregnancy were obtained with a swab and analyzed by the two methods. A total of 89 samples were evaluated. The prevalence of positive results for GBS detection was considerable higher when assessed by the combined enrichment/PCR method than with the standard method (35.9% versus 22.5%, respectively). The results demonstrated that the use of selective enrichment broth followed by PCR targeting the atr gene is a highly sensitive, specific and accurate test for GBS screening in pregnant women, allowing the detection of the bacteria even in lightly colonized patients. This PCR methodology may provide a useful diagnostic tool for GBS detection and contributes for a more accurate and effective intrapartum antibiotic and lower newborn mortality and morbidity.
Munari, F.M.; De-Paris, F.; Salton, G.D.; Lora, P.S; Giovanella, P; Machado, A.B.M.P; Laybauer, L.S.; Oliveira, K.R.P.; Ferri, C; Silveira, J.L.S.; Laurino, C.C.F.C; Xavier, R.M.; Barth, A.L; Echeverrigaray, S; Laurino, J.P.
Full Text Available The main purpose of this study is the comparison due to Iron deficiency in the villages of Gorgan city. Forty eight and 361 non-pregnant women were be classified in two groups for comparing among 415 women of 18-35 years old were chosen by compound sampling. After sampling, hematological examination was done by using Coulter counter in 9000 model and measuring of the serum iron and Total Iron Binding Capacity (TIBC) were performed by using spectrophotometery. In the pregnant women, serum Iron less than 30 mic g dL-1, Hemoglobin less than 11 g dL-1, Transferrin Saturation (TS) less than 16% were be consider as anemia point and in non-pregnant women, this point is the serum iron less than 40 mic g dL-1, hemoglobin less than 12 g dL-1 and TS less than 16%. In pregnant women, the prevalence of the anemia on the basis of serum iron index, TS and Hb in seen 24.2, 42.4, 18.2%, respectively and in non-pregnant women is 21.2, 34.55 and 20.98%. In pregnant and non-pregnant women, the Mean Corpuscular Volume (MCV) is 83.48 and 85.34 Flit. There is a significant statistical differences on base of mean of Mean Corpuscular Hemoglobin (MCH) and MCV among non-pregnant and pregnant women in 1st, 2nd and 3rd trimester (p<0.005). On the time of the sampling, 33% of pregnant and 8.4% of non-pregnant women have used Iron compounds. The results of this study shows in pregnancy period, supplement of the iron is necessary and person`s need must be evaluated before prescribing drug.
G.R. Veghari; A.R. Mansourian; A.J. Marjani
This study examined the determinants of blood lead (BPb) in 513 pregnant women in Mexico City: 311 from public hospital prenatal clinics, representing primarily women of low socioeconomic status (SES), and 202 from private hospitals, primarily women of high SES. Overall, BPb levels ranged from 1.38 ...
Farias, P; Borja-Aburto, V H; Rios, C; Hertz-Picciotto, I; Rojas-Lopez, M; Chavez-Ayala, R
RU 486 is a synthetic steroid which acts as an antiprogestin at the receptor level. The clinical usefulness of the compound for menstrual regulation and termination of early pregnancy is currently being evaluated. The aim of the present study was to determine the plasma levels of RU 486 following the oral administration of the compound to 42 pregnant and 10 non-pregnant women. The levels of RU 486 were measured by a radioimmunoassay method which uses chromatography on Sephadex LH 20 columns. The identity of the compound assayed as RU 486 was confirmed, but the presence of small amounts of two highly cross-reacting metabolites (monodemethyl and didemethyl RU 486) in the analyzed fractions could not be excluded. Following the ingestion of a single tablet containing 25 and 50 mg of the compound, a peak plasma value of approximately 3.5 to 4.0 mumol/l in both the pregnant and non-pregnant subjects was reached one to two hours later. The half-lives of elimination were about 20 hours in both the pregnant and the non-pregnant women. Following the repeated oral administration of 50, 100 or 200 mg of RU 486 daily for four days, maximum plasma levels of 2.9, 4.5 and 5.4 mumol/l, respectively, were found. Thus, the increase in plasma levels was not directly proportional to the increase in the dose. No accumulation of RU 486 in the plasma was found, even when the duration of treatment was prolonged to six days. The data partly explain the reported lack of relation between ingested dose and frequency of induced abortion and they may be useful for designing future studies on the use of compound to prevent implantation, induce menstruation or terminate an early pregnancy.
Swahn, M.L.; Wang, G.; Aedo, A.R.; Cekan, S.Z.; Bygdeman, M.
RU 486 is a synthetic steroid which acts as an antiprogestin at the receptor level. The clinical usefulness of the compound for menstrual regulation and termination of early pregnancy is currently being evaluated. The aim of the present study was to determine the plasma levels of RU 486 following the oral administration of the compound to 42 pregnant and 10 non-pregnant women. The levels of RU 486 were measured by a radioimmunoassay method which uses chromatography on Sephadex LH 20 columns. The identity of the compound assayed as RU 486 was confirmed, but the presence of small amounts of two highly cross-reacting metabolites (monodemethyl and didemethyl RU 486) in the analyzed fractions could not be excluded. Following the ingestion of a single tablet containing 25 and 50 mg of the compound, a peak plasma value of approximately 3.5 to 4.0 mumol/l in both the pregnant and non-pregnant subjects was reached one to two hours later. The half-lives of elimination were about 20 hours in both the pregnant and the non-pregnant women. Following the repeated oral administration of 50, 100 or 200 mg of RU 486 daily for four days, maximum plasma levels of 2.9, 4.5 and 5.4 mumol/l, respectively, were found. Thus, the increase in plasma levels was not directly proportional to the increase in the dose. No accumulation of RU 486 in the plasma was found, even when the duration of treatment was prolonged to six days. The data partly explain the reported lack of relation between ingested dose and frequency of induced abortion and they may be useful for designing future studies on the use of compound to prevent implantation, induce menstruation or terminate an early pregnancy
OBJECTIVES: The paper describes the formative research conducted toward developing a health behavior change program for underserved pregnant women. It is provided as an example to guide researchers, academics, and practitioners on how to incorporate dissemination in all aspects of project planning and implementation. DESIGN AND SAMPLE: A series of formative research was conducted, including an advisory council, expert interviews, 6 focus groups and 5 usability interviews with the target population (n=53), key informant interviews, expert reviews of the pilot program, and a pilot test (n=87). A total of 140 underserved pregnant women were recruited from Community Health Center Inc. in Connecticut. RESULTS: The extensive formative research served to lay the foundation for the development of a healthy pregnancy behavior change program. The pilot test exemplified the feasibility and acceptability of the program. CONCLUSION: Successful adoption of interventions depends upon strong formative research, participatory research methods, interdisciplinary collaboration, and a commitment to dissemination from project inception. The development of the intervention discussed serves as a useful and practical example for others working in health care and behavioral medicine to improve the overall health and well-being of the underserved.
Prochaska JM; Mauriello L; Dyment S; Gökbayrak S
OBJECTIVE: To evaluate the relation between maternal serum folate status and blood mercury in pregnant Korean women. METHODS: The nutritional status of folate and the blood mercury concentration were measured in pregnant Korean women who participated in a multicenter prospective study from 2006 through 2011. We analyzed existing blood mercury data based on serum folate status at two gestational time points (mid and late pregnancy, n = 1105 and 841, respectively). RESULTS: Serum folate concentrations in pregnant women were negatively associated with blood mercury concentrations at mid and late pregnancy (P trend = 0.012 and 0.002, respectively). A general linear model developed after adjusting for covariates indicated a significant negative association between the two at mid and late pregnancy. CONCLUSION: We found a negative association between serum folate and blood mercury concentrations in pregnant Korean women.
Kim H; Kim KN; Hwang JY; Ha EH; Park H; Ha M; Kim Y; Hong YC; Chang N
We explored views toward and use of malaria prevention and treatment measures among pregnant women in Jharkhand, India. We conducted 32 in-depth interviews and six focus group discussions (total = 73 respondents) with pregnant women in urban, semi-urban, and rural locations in a region with moderate intensity malaria transmission. Most respondents ranked malaria as an important health issue affecting pregnant women, had partially correct understanding of malaria transmission and prevention, and reported using potentially effective prevention methods, usually untreated bed nets. However, most conveyed misinformation and described using unproven prevention and/or treatment methods. Many described using different ineffective traditional malaria remedies. The majority also showed willingness to try new prevention methods and take medications if doctor-prescribed. Misconceptions and use of unproven prevention and treatment methods are common among pregnant women in eastern India. Policy makers should focus on improving knowledge and availability of effective malaria control strategies in this population.
Sabin LL; Rizal A; Brooks MI; Singh MP; Tuchman J; Wylie BJ; Joyce KM; Yeboah-Antwi K; Singh N; Hamer DH
Full Text Available This study was conducted to determine the knowledge, attitude and beliefs about safe motherhood practices amongst pregnant women residing in the urban slum of the city of Jaipur, India.The study recruited 100 pregnant women from one of the urban slums of a selected district. A pre-tested questionnaire was administered on the selected sample. Overall, the results show low levels of awareness among rural pregnant women. Two major axes of investigation were used - age and education. In both instances, no significant differences for knowledge levels was found amongst pregnant women.The findings indicate that appropriate communication strategies should be designed and implemented amongst the most vulnerable section of society, especially through health education campaigns, in order to have a constructive outcome in the near future.
Manju Sharma; Sudhanshu Sharma
Untreated perinatal substance abuse is associated with serious adverse maternal and neonatal outcomes. Historically, many barriers have prevented pregnant women from seeking treatment. Early Start (ES) breaks new ground by sidestepping these barriers with a fully integrated service delivery model.
Taillac, Cosette; Goler, Nancy; Armstrong, Mary Anne; Haley, Kathleen; Osejo, Veronica
OBJECTIVE: Assessment of serum magnesium levels among pregnant women in a rural community. DESIGN: A community-based cross-sectional study. SETTING: Investigation was conducted in six villages of a rural block of District Faridabad, Haryana State, India. SUBJECTS: In total, 283 pregnant women with pregnancy duration of 28 weeks and more were enrolled for the detailed study. Blood from the antecubital vein was drawn and serum magnesium levels were estimated by the atomic absorption spectrophotometric method. RESULTS: In all, 44% of the pregnant women had serum levels less than the normal level (1.80 mg/dl). There was a significant decrease (P=0.01) in serum magnesium levels with the increase in parity. CONCLUSION: A high prevalence of magnesium deficiency was found among the pregnant women.
Pathak P; Kapoor SK; Kapil U; Dwivedi SN
Full Text Available Maternal mortality in childbirth in developing countries is still high. The study describes the qualitative methods used to examine the knowledge, attitude, beliefs and behaviour related to nutrition and nutritional supplementation of pregnant women. The role of village midwives and cadres’ in relation to nutrition education resulted in improving nutritional behaviour of pregnant women to some extent, but poverty and culture restricted the ability of pregnant women to access better food. The study shows that the position of pregnant woman is low within the hierarchy of both the health care system and the power structures of the broader community. Husbands, mothers-in-law, village midwives, cadres and village leaders all have more power in determining nutrition during pregnancy. However, some women tried to eat better and more nutritious food in secret, thereby subverting culture and the authority of husbands and mothers-in-law.
Background The main transmission route of the hepatitis B virus (HBV) is mother to child transmission and contributes significantly to chronic HBV infection. Even though immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine is administrated to neonates whose mothers are hepatitis B surface antigen (HBsAg) positive, about 10% of the neonates suffer from HBV infection in their early life. Objectives To survey chronic HBV infection among pregnant women and their infants and analyze the reason for immunoprophylaxis failure. Methods Serum HBsAg was tested in all pregnant women. HBVDNA and other serum HBV markers including hepatitis B e antigen (HBeAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs) were tested among HBsAg positive pregnant women. All infants whose mothers were HBsAg positive were vaccinated with a standard immunoprophylaxis. Serum HBV markers and HBVDNA were tested among these infants at 7 months of age. HBV genotypes were analyzed among the infants and pregnant women who were HBVDNA positive. Results The prevalence of HBsAg, anti-HBc and anti-HBs among 4,536 pregnant women was 5.49%, 29.65% and 58.55%, respectively. The prevalence of HBsAg, anti-HBc and anti-HBs among pregnant women older than 20 years of age was significantly different compared to pregnant women younger than 20 years of age (4.54, 5.69 and 0.61 times, prevalence older vs. younger, respectively. P107 IU/ml. Among the infants whose mothers were HBsAg positive, 214 (85.94%) infants were anti-HBs positive. There were 12 (4.82%) infants who were HBsAg and HBVDNA positive, and all 12 of these infants mothers were HBeAg positive and had HBVDNA >107 IU/ml. Genotypes B and C were present among 165 pregnant women and genotype C was present in 85 pregnant women. There were 12 infants who were HBsAg positive and had the same HBV genotypes as their mothers. There was a significant difference in genotypes between the pregnant women whose infants were infected with HBV compared to those without HBV infection (P < 0.05). Conclusions There was a significant decline in HBsAg prevalence among pregnant women and their infants in Shenyang. Genotype C might be a risk factor for mother to child transmission of HBV.
BACKGROUND: striae gravidarum affects the quality of life (QOL) of Japanese pregnant women. Many pregnant women use skin moisturisers to prevent striae gravidarum. However, the relationship between these preventive steps and QOL remains unclear. OBJECTIVE: to evaluate the moisturising effect and QOL of pregnant women in an urban prefecture in central Japan with preventive steps against striae gravidarum. DESIGN AND METHOD: cross-sectional study. Pregnant women at 36 weeks of gestation were recruited at antenatal examinations. SETTING: four private clinics in an urban prefecture in central Japan. PARTICIPANTS: 156 pregnant women consisting of 83 primiparae and 73 multiparae were analysed. MEASUREMENTS: a self-administered questionnaire, the severity of striae gravidarum assessed by Davey's score and the dermatology-specific QOL were assessed by Skindex29. The water content in the stratum corneum of each woman's abdomen was measured with a Moisture checker. The Ethical Committee of Osaka University Medical School approved the study. FINDINGS: the prevalence of striae gravidarum was 37.8% and 121 (77.6%), including 76 (91.6%) primiparae and 45 (61.6%) multiparae, said they used a cream and/or lotion in an attempt to prevent striae gravidarum. The water content in the stratum corneum of the abdominal wall increased significantly after using cream and/or lotion (p=0.001). The severity and presence of striae gravidarum were not correlated with the preventive steps or water content in the stratum corneum of the abdominal wall (p=0.330 and p=0.835). Pregnant women who took the preventive steps showed higher scores for emotion on Skindex29 than those who did not (p=0.002). Although pregnant women with striae gravidarum showed a lower QOL for emotion than those without striae gravidarum (p=0.045), those who took the preventive steps maintained a similar level of QOL for emotion regardless of striae gravidarum. There have been few trials evaluating the QOL of pregnant women with striae gravidarum so a comparison of results among studies and determination of an appropriate sample size could not be conducted. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: preventive steps increase the amount of water content in the stratum corneum but this does not prevent striae gravidarum. Although pregnant women with striae gravidarum showed a lower QOL for emotion, the preventive steps were correlated with the level of QOL for emotion in pregnant women with striae gravidarum. Midwives need to absorb such information and recommend moisturising skin care for pregnant women.
Yamaguchi K; Suganuma N; Ohashi K
Full Text Available Introduction The purpose of this study was to determine national and state-specific estimates of dental care use among adult pregnant women in the United States using data from two 12-month periods. The study also determined person-level characteristics that may predict a lack of dental care use within this subgroup. Methods Responses were analyzed from 4619 pregnant women aged 18 to 44 years who participated in the 1999 and 2002 state-based Behavioral Risk Factor Surveillance System. Dental care use was defined as having a dental visit or a dental cleaning in the 12 months preceding the interview. State-specific estimates were adjusted to the 2000 U.S. population distribution. Multivariable regression analysis was used to evaluate person-level characteristics that may predict not obtaining dental care during this period. Results Overall, 70% of pregnant women in 1999 and 2002 had received dental care in the previous 12 months. Age-adjusted estimates ranged from 36% (Nevada) to 89% (Vermont) to 91% (Puerto Rico). In 19 states, 75% or more of pregnant women had obtained dental care in the previous 12 months (age-adjusted figure). Most pregnant women with dental care were non-Hispanic white and married, and they had a greater than high school education. Income and smoking status were significant predictors for not using dental care. Conclusion In several states, more than 70% of pregnant women reported a dental visit or dental cleaning during the previous 12 months. Relative to the general population, pregnant women are as likely to receive dental care, but certain subgroups need to do much better. However, these estimates may be biased toward a population with a higher socioeconomic status and may not represent dental care use among pregnant women in the general U.S. population.
Peggy Timothé, DDS, MPH; Paul I. Eke, PhD, MPH, PhD; Scott M. Presson, DDS, MPH; Dolores M. Malvitz, DrPH
The prevalence of antibodies against herpes simplex virus type 2 (anti-HSV-2) among pregnant women in Norway is not known. To study the prevalence of anti-HSV-2, a random sample of 961 women was drawn from a study population of 35,940 pregnant women in Norway during 1992-94. 27% (256/961) had anti-HSV-2. The prevalence increased with age. 17% of the 20-24-year-olds and 34% of the 35 year-old or older had anti-HSV-2. The presence of antibodies also varied geographically, from 18% in the south to 39% in the north of Norway. Among women with repeated anti-HSV-2 tests during pregnancy, 2.6% of the seronegative women seroconverted (16/623). HSV-2 infection is common among pregnant women in Norway. The public health implications of this infection need to be clarified.
Eskild A; Jeansson S; Jenum PA
We sought to describe the impact of pica, the craving for and intentional ingestion of substances not defined as food, as a risk factor for lead poisoning in New York City (NYC) pregnant women. In order to describe pregnant women with elevated blood lead levels (BLLs) who report pica, NYC health department data from 491 cases of lead-poisoned pregnant women from January 2001 to June 2009 were reviewed. Descriptive frequencies were obtained for women reporting pica. Data were compared between women reporting and not reporting pica. In NYC, of the 43 (9%) lead-poisoned pregnant women reporting pica, 42 (97.7%) were immigrants and 28 (64.6%) had consumed soil. Compared to lead-poisoned pregnant women not reporting pica, women reporting pica had higher peak BLLs (29.5 vs. 23.8 ?g/dL, P = 0.0001), were more likely to have had a BLL ? 45 ?g/dL (OR = 3.3, 95% CI, 1.25, 8.68) and receive chelation (OR = 10.88, 95% CI, 1.49, 79.25), more likely to have emigrated from Mexico (OR = 3.05, 95% CI, 1.38–6.72), and less likely to have completed high school (OR = indeterminate; 0 vs. 34%; P = 0.003). Among NYC lead-poisoned pregnant women, pica was associated with higher peak BLLs. Providers in NYC, and possibly other urban settings, should be vigilant and question pregnant women, especially immigrants, about pica and strongly consider testing this at-risk population for lead poisoning.
Thihalolipavan S; Candalla BM; Ehrlich J
Full Text Available Abstract Background Studies on salivary variables and pregnancy in Latin America are scarce. This study aimed to compare salivary flow rate, pH, and concentrations of calcium, phosphate, and sIgA of unstimulated whole saliva in pregnant and non-pregnant Brazilians. Methods Cross-sectional study. Sample was composed by 22 pregnant and 22 non-pregnant women attending the Obstetrics and Gynecology Clinics, São Lucas Hospital, in Porto Alegre city, South region of Brazil. Unstimulated whole saliva was collected to determine salivary flow rate, pH, and biochemical composition. Data were analyzed by Student t test and ANCOVA (two-tailed ? = 0.05). Results No difference was found for salivary flow rates and concentrations of total calcium and phosphate between pregnant and non-pregnant women (p > 0.05). Pregnant women had lower pH (6.7) than non-pregnant women (7.5) (p Conclusion Some of the tested variables of unstimulated whole saliva were different between pregnant and non-pregnant Brazilians in this sample. Overall, the values of the tested salivary parameters were within the range of international references of normality.
Rockenbach Maria I; Marinho Sandra A; Veeck Elaine B; Lindemann Laura; Shinkai Rosemary S
Full Text Available ntroduction: The establishment of National Integrated Health System in Uruguay from 2007 led to changes in the financing of the Collective Health Care Institutions (IAMC). They charge the National Health Fund (FONASA) for their partners from social security (SS) a health fee consists of: a) A risk-adjusted capita (94%)b) A component for compliance with performance (6%), depending on the fulfillment of three goals of care. Goal 1 is a component of the child under 1 year and a component of the pregnant woman. For both components were established institutional baseline (July 2007-September 2008) in the control patients in both age groups. This motif COMPLIANCE quarterly reports with a fee of $48/user FONASA/month for average baseline compliment. Las for children and pregnant women were monitored for IAMC CUDAM 64% and 59% respectively.This institution has 42,000 users, 95% derived from SS, featuring 45 births, 585 children <1 year and 405 pregnant women tested monthly.Objectives: Evaluate two years (July-September 2010):a) The mean percentages of compliance for children and pregnant CUDAM with medical controlb) Relationship between income through the FONASA insitucional for goal 1 and children and pregnant women in medical management during the quarter.Methods: a retrospective study of children and pregnant women with medical control CUDAM. In turn, each target has 6 indicators (N: children, F: females). Child: N1 and N2: derivation and acquisition of the newborn, N3: controls as a guideline, N4: current vaccination, N5: ultrasound hip and pregnant, N6: accreditation in good feeding practices for infants and young children and pregnant women. Pregnant woman: M1 controls as a guideline, M2: leaf perinatal information system, M3: HIV and VDRL performed, M4: uptake in 1 st quarter, M5 and M6: dental checkup during pregnancy and postpartum.Results: The mean percentages of compliance for children and pregnant women increased to 92% (164 additional children) and 88% (117 additional pregnant) respectively. Insitucional monthly income for the goal 1 was $1,915,200 (US$1 = $20).Average income/month was $1,637 and $2,364 per child and pregnant women respectively. We conclude that the target incentive payment of 1 allowed to significantly improve the indicators of child and maternal control of CUDAM.
Marcelo Morales; Jorge Fernandez
Full Text Available Research question: What is the prevalence of HIV infection among rural pregnant women? Objectives: To know the prevalence of HIV infection and anaemia among pregnant women. Study design: Cross-sectional. Setting: Primary Health Centres namely Kinaye, Vantamuri and Handiganur. Participants: 716 pregnant women residing in three Primary Health Centres and availing PPTCT services at KLE’s Dr. Prabhakar Kore Hospital & MRC, Belgaum. Results: The study revealed that, the prevalence rate of HIV infection in antenatal mothers was 0.70%. Out of 716 pregnant women studied, 508 (70.95%) were anaemic and 208 (29.05%) were not anaemic. Among 508 anaemic pregnant women, 211 (41.54%) had mild anaemia, 211 (41.54%) had moderate anaemia and 86 (16.92%) had severe anaemia. About 17.73% of the pregnant women belonged to high-risk group. Conclusion: The economic and demographic consequences of the spread of HIV/AIDS are inexorable and awesome. Development of programmes with an integrated approach to inducing behavioral change, promoting use of condoms and controlling STD’s may reduce the infectivity of HIV transmitters and the susceptibility of HIV exposed persons. In this era of AIDS, there is a need to express care and compassion rather than fear, hostility or alienation.
G.S. Ashtagi *, C.S. Metgud, P.R. Walvekar and V.A. Naik
BACKGROUND: The psychological health in obese women during pregnancy has been poorly studied. OBJECTIVE: To compare levels of anxiety and depressed mood during pregnancy in obese versus normal-weight women. METHODS: 63 obese pregnant women and 156 normal-weight controls were included prospectively before 15 weeks of gestation. Levels of state and trait anxiety and depressed mood were measured during the first, second and third trimester of pregnancy. A linear mixed-effect model with repeated measures was used to evaluate group differences. RESULTS: The levels of state anxiety significantly increased from trimester 1 to trimester 3 in obese pregnant women (beta = 3.70; p = 0.007), while this parameter remained constant throughout pregnancy in normal-weight women. Levels of trait anxiety and depressed mood significantly decreased from trimester 1 to trimester 2 in controls, but not in obese pregnant women. Variables such as maternal education, ethnicity, marital state, psychological history and miscarriages, parity and smoking behaviour had significant effects on anxiety and/or depressed moods during pregnancy. Obese pregnant women show higher levels of anxiety and depressive symptomatology compared to normal-weight pregnant women. CONCLUSION: Interventional programmes aiming at preventing the deleterious influence of maternal obesity on perinatal outcomes should include a psycho-educational program specifically tailored to this high-risk group.
Bogaerts AF; Devlieger R; Nuyts E; Witters I; Gyselaers W; Guelinckx I; Van den Bergh BR
The aim of the research was to define the influence of a single physical exercise class on mood states of pregnant women and to establish the socio-demographic and personality predictors of mood changes. The sample was comprised of a total of 109 pregnant women aged 19-37 years. Of the group, 62 women participated in physical exercise for pregnant women (the experimental group) and 47 women participated in traditional childbirth education classes (the control group). Emotional states were assessed with the UWIST Mood Adjective Checklist; personality traits were measured with the NEO-FFI, LOT-R and STAI questionnaires. Socio-demographic data were collected with a survey developed by the authors. A single physical exercise class improved the emotional state of pregnant women significantly more than a traditional childbirth education class. Within the experimental group, a significant improvement of mood was observed in all dimensions, while in the control group only hedonic tone increased. Greater improvements in mood can be expected in a group of women who are younger, less optimistic, and who evaluate their health better but physical fitness worse. As a single session of exercise helps improve the mood of pregnant women, this may be an effective strategy to prevent the deterioration of mood state during pregnancy. PMID:23646888
Guszkowska, Monika; Langwald, Marta; Dudziak, Diana; Zaremba, Agnieszka
The aim of the research was to define the influence of a single physical exercise class on mood states of pregnant women and to establish the socio-demographic and personality predictors of mood changes. The sample was comprised of a total of 109 pregnant women aged 19-37 years. Of the group, 62 women participated in physical exercise for pregnant women (the experimental group) and 47 women participated in traditional childbirth education classes (the control group). Emotional states were assessed with the UWIST Mood Adjective Checklist; personality traits were measured with the NEO-FFI, LOT-R and STAI questionnaires. Socio-demographic data were collected with a survey developed by the authors. A single physical exercise class improved the emotional state of pregnant women significantly more than a traditional childbirth education class. Within the experimental group, a significant improvement of mood was observed in all dimensions, while in the control group only hedonic tone increased. Greater improvements in mood can be expected in a group of women who are younger, less optimistic, and who evaluate their health better but physical fitness worse. As a single session of exercise helps improve the mood of pregnant women, this may be an effective strategy to prevent the deterioration of mood state during pregnancy.
Guszkowska M; Langwald M; Dudziak D; Zaremba A
OBJECTIVE: To characterize the intake of folic acid (FA) and other micronutrients in medicinal form in a group of pregnant women in Colombia. METHODS: Descriptive observational study. Information was obtained from interviews of pregnant women and from the clinical records of their prenatal check-ups and/or delivery in four cities in Colombia. The sample consisted of 1 637 women seen in 15 institutions. RESULTS: A total of 1 315 pregnant women (80.3%) were advised to take FA, and 84% received a prescription, 90.3% of whom adhered to the treatment. FA was provided to 85.6% of them by their health insurance company and 10.7% purchased it themselves. The prescription was appropriate for 0.2% of the women; its use was entirely appropriate for 0.2% of the pregnant women and totally inappropriate for 41.9%. Other micronutrients were recommended to 1 192 women (72.8%), 77.6% of whom received the advice from their physician, with 88.7% adhering to the treatment. CONCLUSIONS: FA and other micronutrients are inappropriately recommended to pregnant women and taken without assessing their individual needs. The usefulness of programs that promote mass consumption of micronutrients in medicinal form during pregnancy should be reexamined. These programs seem not to recognize the fundamental causes of the population's nutritional problems.
Holguín-Hernández E; Orozco-Díaz JG
Full Text Available Background & objectives: Little information exists on the compliance of pregnant women to malaria managementin malaria endemic countries. This study was designed to access knowledge, attitude, perception and homemanagement of malaria among consenting pregnant women attending antenatal care (ANC) clinic.Methods: In total, 350 pregnant women were randomly recruited during their ANC Clinic in Lagos. Structuredquestionnaires were administered in a two-stages research design; first during their early months of ANC visitand the second approximately 1–2 months before delivery. Information on occupation, parity, symptoms used torecognise malaria, treatment sources, control measures, knowledge factors, anti-vector measures, health-seekingpractices, malaria parasitaemia and packed cell volume (PCV) were recorded.Results: The results revealed that 78.9% of the pregnant women identified infected mosquitoes as the cause ofmalaria while 86% of the pregnant women identified stagnant water as its breeding sites. Knowledge of thebenefit of insecticide-treated mosquito bednets was less prominent as most of the selected subjects decried itshigh market price. Our data also showed that educational programme targeted on potential mothers is beneficial.Overall, 27.4% (96/350) of the pregnant women had peripheral malaria infection with 88.5% (85/96) of theparasite positive women infected with Plasmodium falciparum and 11.5% (11/96) with P. malariae. PCV rangedfrom 20–40% (median 33.9%) with 25.7% (90/350) of the pregnant women being anaemic with PCV <33%. Wefound an association between malaria infection and occupation, and this association was not influenced byparity.Interpretation & conclusion: Our findings revealed that improvement in knowledge and education of women ofchild-bearing age has an influential impact on malaria control
N.C. Iriemenam, A.O. Dosunmu, W.A. Oyibo & A.F. Fagbenro-Beyioku
Full Text Available Abstract Second Generation sub-population HIV Surveillance was undertaken in Kashgar City and Shache County, Xinjiang, Peoples Republic of China between December 2003 and January 2004, targeting injecting and mixed method drug users and pregnant and postnatal women. The study aimed to determine the extent to which the epidemic is shifting from a concentrated stage to a more generalised epidemic. One hundred and forty two (142) exclusively injecting drug users (66) and mixed method drug users (injecting and non-injecting-76) participated in this survey. Eight hundred and two (802) pregnant and postnatal women participated in the survey. In Kashgar City and Shache County the serum prevalence of HIV amongst injecting drug users was 56.06%, for mixed method drug users 48.68% and 0.38% in pregnant women. In Shache County HIV infection rates were significantly lower in drug user groups and amongst pregnant and post-natal women, at 2.22% and 0% respectively. The behavioral survey indicated that 15% of injecting drug users have shared needles (however sero prevalence and knowledge in relation to access to clean needles and syringes suggests that this may not reflect the actual situation). Knowledge of prevention of transmission strategies (not sharing needles and condom utilisation) is similar between both groups at 60–70%. However it appears that this knowledge has not significantly impacted on behavior such as needle sharing and condom utilisation. In Kashgar City and Shache County there have been very few interventions to support HIV/AIDS prevention, care and control. The results from this survey will inform future directions and the development and implementation of targeted interventions including targeted information dissemination and harm reduction strategies. This survey was funded by the Xinjiang HIV/AIDS Prevention and Care Project, a bilateral project jointly implemented by the Government of the People's Republic of China and the Government of Australia.
Mingjian Ni; Wheeler KM; Cheng J; Yonghai Dong; Chen W; Fitzwarryne C; Wang J
The authors treated successfully a patient who ingested along with three members of the family the mushroom Amanita phalloides and was in the 24th week of gestation. She gave birth to a healthy infant. The authors discuss the incidence and contemporary treatment of cytotoxic, cyclopeptide (phalloid, hepatotoxic) intoxications, incl. those with Amanita phalloides during pregnancy. They present case-histories and an account on amatoxin intoxications in pregnant women published so far in the literature, and experience with the treatment of a 18-year-old pregnant woman. They reflect whether termination of pregnancy is indicated in pregnant women intoxicated with Amanita phalloides.
Jaros F; Kascák M
OBJECTIVE: Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi. DESIGN: Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell–Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when ,12 ng/ml. SETTING: Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo. SUBJECTS: Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls. RESULTS: Overall median UIC in pregnant women was 138 (interquartile range: 105–172) mg/l, indicating iodine deficiency, whereas postpartum and nonpregnant women had adequate iodine intake: median UIC5144mg/l and 204mg/l,respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255mg/l, 70mg/l and 88mg/l in the rural area; 306mg/l, 166mg/l and 68mg/l in the semi-urban area; and 203mg/l, 174mg/l and 99mg/l in the urban area. Fe was insufficient in 39% of pregnant women compared with 21% of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40%, 12% and 18% in the rural, semi-urban and urban areas, respectively. CONCLUSIONS: Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.
Habimana L; Twite KE; Wallemacq P; De Nayer P; Daumerie C; Donnen P; Kalenga MK; Robert A
The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant patients compared with non-pregnant patients. We reviewed the cases of 41 pregnant and 62 non-pregnant women who developed ureteral stones and were treated with URS in our center between April 2005 and September 2011. A semi-rigid 9.5 F ureteroscope was used. The calculi were fragmented with pneumatic lithotripsy or a holmium laser, and if necessary, a double-J (JJ) stent was inserted during the procedure. Among the pregnant women, the mean gestation period was 23.22 ± 4.61 weeks (range 13-34), and the mean number of pregnancies per patient was 3 ± 2.02 (range 1-10). The mean ages of the pregnant and non-pregnant patients were 27.41 ± 5.79 and 28.54 ± 7.94 years, respectively (p = 0.734). There were no statistically significant differences in stone localization, anesthesia type, stone diameter, methods of stone manipulation, JJ stent insertion rate, hospitalization length, or operative times between the two groups. For pregnant and non-pregnant patients, the stone-free rates achieved in a single session were 87.8 and 85.5 %, respectively (p = 0.737). There was no statistically significant difference in preoperative and postoperative complication rates between the two groups. The positive urine culture rate was statistically significantly higher for pregnant patients than non-pregnant patients (29.3 vs. 11.3 %; p = 0.021). We did not observe any serious obstetric complications. URS is a safe and reasonable treatment option for pregnant patients with ureteral stones refractory to medical treatment during pregnancy.
Bozkurt Y; Soylemez H; Atar M; Sancaktutar AA; Penbegul N; Hatipoglu NK; Bodakc? MN; Evsen MS
BACKGROUND: Pesticides have been shown to disrupt neurodevelopment in laboratory animals and in human populations. To date, there have been no studies on exposure to pesticides in pregnant women in Israel, despite reports of widespread exposure in other populations of pregnant women and the importance of evaluating exposure in this susceptible sub-population. METHODS: We measured urinary concentrations of organophosphorus (OP) insecticide metabolites and plasma concentrations of OP and other pesticides in 20 pregnant women, recruited in Jerusalem, Israel in 2006, and collected questionnaire data on demographic factors and consumer habits from these women. We compared geometric mean concentrations in subgroups using the Mann-Whitney U-test for independent samples. We compared creatinine-adjusted OP pesticide metabolite concentrations, as well as plasma pesticide concentrations, with other populations of pregnant women. RESULTS: Creatinine-adjusted total dimethyl (DM) metabolite concentrations were between 4 and 6 times higher in this population compared to other populations of pregnant women in the United States while total diethyl (DE) metabolite concentrations were lower. Dimethylphosphate (DMP) was detected in 74% of the urine samples whereas dimethylthiophosphate (DMTP) was detected in 90% of the urine samples. The carbamate bendiocarb was detected in 89% of the plasma samples, while the OP insecticide chlorpyrifos was detected in 42% of the samples. Mean plasma concentrations of bendiocarb and chlorpyrifos in our sample were 4.4 and 3.9 times higher, respectively, than that of an urban minority cohort from New York City. Twelve women (63%) reported using some form of household pest control during their pregnancy and five (26%) reported using household pest control during the past month. Women with a graduate degree had significantly higher geometric mean concentrations of total urinary DM metabolite concentrations compared to other women (P=0.006). Finally, one woman in the study had exceptionally high concentrations of DMP, DMTP, DMDTP compared to the other women in the study, despite reporting no current occupational exposure to OP pesticides and no other significant exposure sources. CONCLUSIONS: Pregnant women in the Jerusalem area are exposed to OP pesticides and to the carbamate pesticide bendiocarb. It is unclear why total DM metabolites concentrations were much higher in this population compared to other populations of pregnant women in the United States and Netherlands. Finally, the finding of very high DM metabolite concentrations in one woman who reported being moved from her regular laboratory work to administrative work upon becoming pregnant, raises questions about the adequacy of measures to protect pregnant women from pesticide exposures during pregnancy.
Berman T; Hochner-Celnikier D; Barr DB; Needham LL; Amitai Y; Wormser U; Richter E
Full Text Available Abstract Background Haematological changes associated with malaria in pregnancy are not well documented, and have focused predominantly on anaemia. Examined here is thrombocytopaenia in pregnant women infected with Plasmodium falciparum or Plasmodium vivax in a low transmission area on the north-western border of Thailand. Methods In this observational study we reviewed the platelet counts from routine complete blood count (CBC) in a cohort of healthy and malaria infected Karen pregnant women attending weekly antenatal clinics. A platelet count of 75,000/?L was the threshold at 2 standard deviations below the mean for healthy pregnant women used to indicate thrombocytopenia. Differences in platelet counts in non-pregnant and pregnant women were compared after matching for age, symptoms, malaria species and parasitaemia. Results In total 974 pregnant women had 1,558 CBC measurements between February 2004 and September 2006. The median platelet counts (/?L) were significantly lower in patients with an episode of falciparum 134,000 [11,000–690,000] (N = 694) or vivax malaria 184,000 [23,000–891,000] (N = 523) compared to healthy pregnant women 256,000 [64,000–781,000] (N = 255), P Plasmodium falciparum and P. vivax caused a 34% (95% CI 24–47) and 22% (95% CI 8–36) reduction in platelet count, respectively. Pregnant compared to non pregnant women were at higher risk OR = 2.27 (95%CI 1.16–4.4) P = 0.017, for thrombocytopaenia. Platelets counts were higher in first compared with subsequent malaria infections within the same pregnancy. Malaria associated thrombocytopaenia had a median [range] time for recovery of 7 234567891011121314 days which did not differ by antimalarial treatment (P = 0.86), or species (P = 0.63) and was not associated with active bleeding. Conclusion Pregnant women become more thrombocytopenic than non-pregnant women with acute uncomplicated malaria. Uncomplicated malaria associated thrombocytopaenia is seldom severe. Prompt antimalarial treatment resulted in normalization of platelet counts within a week.
Tan Saw; McGready Rose; Zwang Julien; Pimanpanarak Mupawjay; Sriprawat Kanlaya; Thwai Kyaw; Moo Yoe; Ashley Elizabeth A; Edwards Bridget; Singhasivanon Pratap; White Nicholas J; Nosten François
Full Text Available Background: Malaria parasitemia among pregnant women is associated with complications to mother and the unborn fetus. There is paucity of data on asymptomatic malaria parasitemia, particularly in the northwest region of Nigeria. The objectives of this study were to determine the prevalence of malaria parasitemia in asymptomatic pregnant women and to estimate the packed cell volume (PCV) of this group of pregnant women. Materials and Methods: This was a cross-sectional, descriptive study of only well pregnant women recruited consecutively at the time of booking for antenatal care. Thick film microscopy and qualitative immunoassay test for malaria parasite (MP) were performed for all the women. PCV estimation was also done using the micro-centrifuge method and comparison was made for women with parasitemia with those without MP. Some socio-demographic variables were also analyzed. Chi-square test was used to test for significance and a P-value less than 0.05 was considered statistically significant. Results: Two hundred and twenty-five healthy pregnant women were studied. Seven women (3.1%) had MP by direct microscopy while 11 (4.8%) were MP positive with the qualitative immunoassay test. One hundred and eighty-five (82%) of the women were literate while 128 (57%) used insecticide treated mosquito nets in their homes. The mean PCV of the women with positive MP was 30.57 ± 2.26 as against 32.89 ± 2.45 for those without parasitemia (P Conclusion: The prevalence of asymptomatic malaria parasitemia in the study group was low but there was associated anemia in those with parasitemia. The use of intermittent preventive treatment is recommended for all pregnant women including those who are asymptomatic to forestall complications like maternal anemia.
Isah Aliyu; Amanabo Momoh; Ekele Bissallah
Smoking in pregnancy is unequivocally harmful to both foetal and maternal health. Earlier investigations in Norway among pregnant women who smoke have demonstrated a prevalence of smoking of around 40% and that some women stop smoking as soon as the pregnancy is confirmed (around 20%). This investigation reports only 16% smokers among pregnant women registered at 18th week of pregnancy in the two municipalities of Asker and Baerum. Average daily consumption was 8.6 cigarettes, and 65% of the women stated that they smoked more than five cigarettes per day. 97% expressed a positive interest in quitting smoking, and 76% had tried to quit earlier. 77% had a partner who was a daily smoker. An assessment of level of education showed that 82% had completed 12 years of schooling and 23% reached a higher educational level. We conclude that the relatively low incidence of daily smoking among pregnant women in these two municipalities should inspire the initiation of active intervention programmes.
Valbø A; Kristoffersen M
Sick leave among pregnant women has been studied. A large majority of employed women were granted certification of illness, mainly in the last trimester of pregnancy. The average period of absence was 9.6 weeks. 15-20% of the pregnant women received prolonged certification of illness, with an average absence from work of 18 weeks. The most common medical causes of sick leave were health problems associated with painful conditions in the back and pelvic region. There are indications that the amount of absence from work due to illness is growing among pregnant women. We discussed the reasons for this development. Granted absence from work, with compensation for loss of salary during the last weeks of pregnancy could contribute to "demedicalize" the need of leave of absence from work for most women.
Grünfeld B; Qvigstad E
Insulin resistance (IR) has been reported to play an important role in recurrent spontaneous abortion (RSA) among patients with polycystic ovary syndrome (PCOS). However, scanted materials exist regarding the independent effect of IR on RSA. The aim of this study is to investigate the status of IR in first trimester pregnant patients with normal pre-pregnant glucose tolerance and history of RSA. This two-center case-control study enrolled totally 626 first trimester pregnant women including 161 patients with a history of recurrent spontaneous abortion, who were pre-pregnantly glucose-tolerant according to oral glucose tolerance test (OGTT), and 465 women with no history of abnormal pregnancies of any kind. Clinical, biochemical and hormonal parameters were simultaneously measured in all participants. Serum beta-HCG, estradiol, progesterone, fasting plasma glucose and fasting plasma insulin levels, as well, the calculated homeostasis model assessment of insulin resistance index (HOMA-IR), fasting plasma glucose/insulin ratio(G/I) and pregnancy outcome were analyzed and compared. Serum beta-HCG and progesterone were found to be significantly lower in RSA group compared to controls. Subjects in RSA group were found to have higher HOMA-IR and lower G/I ratio than those in control group. Serum beta-HCG and progesterone were negatively correlated with HOMA-IR, and positively with G/I ratio even after adjustment for BMI. The spontaneous abortion rate within first trimester pregnancy of RSA patients was significantly higher than that in controls. In conclusion, woman with recurrent spontaneous abortion and normal pre-pregnant glucose metabolism tends to be more insulin resistant during first trimester pregnancy than healthy controls, no matter whether she has PCOS or not. Insulin resistance might be one of the direct causes that lead to recurrent abortion.
Hong Y; Xie QX; Chen CY; Yang C; Li YZ; Chen DM; Xie MQ
AIMS: To assess real self and ideal self in pregnant and postpartum women with symptoms of perinatal depression in the area of psychological needs and topical scales. METHODS: The study involved 239 pregnant women whose gestational age ranged between 32 and 40 weeks, and 105 postpartum women (2 to 5 days after childbirth). The Edinburgh Postnatal Depression Scale questionnaire was used as a screening test for antenatal and postnatal depressive symptoms. Personality profiles were assessed using the Adjective Check List test. RESULTS: Pregnant and postpartum women with symptoms of perinatal depression varied in their self-assessment of a number of their real psychological needs, while they presented similar scores with respect to their ideal (expected) self. The differences between pregnant and postpartum women correspond to changes in roles and activities related to pregnancy and the postpartum period; women presenting more passive attitudes in pregnancy become more active in the postpartum period. Apositive change in the real self-image related to motherhood in the postpartum period occurs despite depressive disorders. CONCLUSION: Numerous significant differences between the ideal and real self in both pregnant and postpartum women with perinatal depressive symptoms demonstrate their lack of self-acceptance, which requires individualised psychological intervention.
Podolska MZ; Majkowicz M; Bidzan M; Koz?owska U; Smutek J; Podolski J
INTRODUCTION: Since 2004, all pregnant women in Denmark have been offered prenatal screening. The aim of this study was to investigate how the Danish National Board of Health's information pamphlet adressed to pregnant women was perceived by young female readers. MATERIAL AND METHODS: Five women aged 23-26 years were interviewed. At the time of the interview, none of the women were pregnant or had previously been pregnant. The five individual interviews were carried out using a semi-structured interview guide. They were recorded, transcribed and analysed using Steinar Kvale's theory of meaning condensation. RESULTS: After reading the pamphlet, the informants became worried, anxious or frightened about the risk of giving birth to a seriously ill or handicapped child. They all wanted a risk estimation in order to be reassured that they were going to have a healthy child. The existence of a screening programme was perceived as an indication of risk. CONCLUSION: In its present form, the information pamphlet of the Danish National Board of Health suggests a yes rather than a no regarding participation in prenatal screening. This is reprehensible, partly because the aim of the pamphlet was to strengthen the self-determination of pregnant women, and partly because the benefits of participation in the screening programme do not clearly outweigh the corresponding drawbacks for the individual pregnant woman.
Jensen P; Brodersen J
INTRODUCTION: Smoking during pregnancy is the leading preventable cause of poor pregnancy outcomes in the United States. In population studies and nationwide surveys, pregnant smokers report more illicit drug use than pregnant nonsmokers. The purpose of this study was to examine the prevalence of illicit drug use among pregnant women enrolled in clinical trials for smoking cessation. METHODS: Urine specimens from 115 pregnant women were tested for illicit drug use during a study intake visit (~10th week of pregnancy) and during the final antepartum (FAP) smoking-status assessment (~28th week of pregnancy). Participants smoked about 18 cigarettes/day prepregnancy, were generally young (<25 years), Caucasian, with a high school education and without private insurance. RESULTS: About 34% of specimens from the intake visit and 25% of those from the FAP assessment tested positive for an illicit drug. The most common drug detected was marijuana (90% of positive specimens), followed by opioids (18%), cocaine (5%), benzodiazepines (3%), and methadone (3%). None tested positive for amphetamines. The majority of women (53%) who tested positive for an illicit substance at intake also tested positive at the FAP assessment. CONCLUSIONS: Approximately a quarter to a third of pregnant women enrolled in these smoking-cessation trials were determined to be using illicit drugs, with marijuana use being the most prevalent. Those providing smoking-cessation services to pregnant women may want to be prepared to assist with obtaining services for other drug use as well.
Gaalema DE; Higgins ST; Pepin CS; Heil SH; Bernstein IM
Objective: The aim of this study was to analyze homocysteine levels in maternal serum in women with pregnancies complicated by preeclampsia and/or IUGR. Patients and methods: The study was carried out on 49 pregnant patients with normotensive pregnancies complicated by intrauterine fetal growth rest...
Marzena Laskowska; Jan Oleszczuk
OBJECTIVE: To determine and report the rate and pattern of HIV testing among pregnant women receiving ambulatory prenatal care, and the total number of positive cases in pregnant women in Managua, Nicaragua. METHODS: A retrospective epidemiological review was conducted to assess HIV testing rates among pregnant women in Managua attending district-level health centers in 2010 and 2011, with a focus on a single district (District 6.1). RESULTS: A total of 39.4% of pregnant women receiving prenatal care at Managua health centers in 2010 received an HIV test, and this number increased to 49.8% in 2011 (P < 0.001; phi statistic, 0.10). In 2010, 27 pregnant women in Managua were found to be HIV positive, corresponding to 0.17% of those who were tested. In 2011, 31 tested positive (0.12% of those who were tested). Comparisons between 2010 and 2011 at the District 6.1 level reflect an increase in women who received HIV tests from 24.2% in 2010 to 49.3% in 2011 (P < 0.001; phi statistic, 0.26). In District 6.1, two pregnant women were identified as HIV positive in 2010 and three in 2011, corresponding to 0.32% and 0.13% of pregnant women tested, respectively. CONCLUSIONS: Despite significant improvements in HIV testing rates from 2010 to 2011, the numbers tested remain below the goal recommended by the Pan American Health Organization (PAHO) in order to achieve virtual elimination of mother-to-child transmission by 2015 (> 95%). Patterns of testing demonstrated increased rates coinciding with a health fair in District 6.1, but effects were short-lived. Therefore, new approaches are necessary to bolster prenatal HIV screening efforts within Managua and District 6.1 in Nicaragua.
Colasanti J; Lorio Rugama M; Lifschitz K; Largaespada M; Flores-Lopéz B; Dodd C; Feaster DJ; Pereyra M; Metsch LR
OBJECTIVES: To study the trends of the HIV epidemic and risk factors associated with HIV in a rural area of India. We utilized HIV prevalence among young pregnant women as an indicator of population trends in HIV infection. METHODS: This was an observational study of pregnant women aged less than 25 years who were counseled and tested for HIV infection in a rural hospital between August 2007 and June 2011. Information on age, education, occupation, and community were collected prospectively from all of the women. RESULTS: The HIV prevalence in young pregnant women decreased from 1.22% in 2007 to 0.35% in 2011. Comparing the periods 2007-2009 and 2010-2011, a reduction in HIV prevalence was seen in all subgroups except in women from forward castes. Women whose job was not related to agriculture and women who had only completed primary education were more likely to be HIV-infected. CONCLUSIONS: These results indirectly indicate that the incidence of HIV infection is decreasing in this rural setting. However, an increase in the HIV prevalence in women from forward castes was observed. In rural areas, HIV testing of pregnant women who have only completed primary education or who are working in a field not related to agriculture should be encouraged, because of their higher risk of HIV infection.
Alvarez-Uria G; Midde M; Naik PK
Full Text Available Abstract Background Improvements in antenatal vitamin D status may have maternal-infant health benefits. To inform the design of prenatal vitamin D3 trials, we conducted a pharmacokinetic study of single-dose vitamin D3 supplementation in women of reproductive age. Methods A single oral vitamin D3 dose (70,000 IU) was administered to 34 non-pregnant and 27 pregnant women (27 to 30 weeks gestation) enrolled in Dhaka, Bangladesh (23°N). The primary pharmacokinetic outcome measure was the change in serum 25-hydroxyvitamin D concentration over time, estimated using model-independent pharmacokinetic parameters. Results Baseline mean serum 25-hydroxyvitamin D concentration was 54 nmol/L (95% CI 47, 62) in non-pregnant participants and 39 nmol/L (95% CI 34, 45) in pregnant women. Mean peak rise in serum 25-hydroxyvitamin D concentration above baseline was similar in non-pregnant and pregnant women (28 nmol/L and 32 nmol/L, respectively). However, the rate of rise was slightly slower in pregnant women (i.e., lower 25-hydroxyvitamin D on day 2 and higher 25-hydroxyvitamin D on day 21 versus non-pregnant participants). Overall, average 25-hydroxyvitamin D concentration was 19 nmol/L above baseline during the first month. Supplementation did not induce hypercalcemia, and there were no supplement-related adverse events. Conclusions The response to a single 70,000 IU dose of vitamin D3 was similar in pregnant and non-pregnant women in Dhaka and consistent with previous studies in non-pregnant adults. These preliminary data support the further investigation of antenatal vitamin D3 regimens involving doses of ?70,000 IU in regions where maternal-infant vitamin D deficiency is common. Trial registration ClinicalTrials.gov (NCT00938600)
Roth Daniel E; Al Mahmud Abdullah; Raqib Rubhana; Black Robert E; Baqui Abdullah H
Background: Despite notable progress in the fight against iodine deficiency disorders in the Democratic Republic of Congo, a recent study has shown that pregnant women in Lubumbashi were still iodine deficient. Our objective was to assess thyroid function in this population. Methods: In a cross-sectional study conducted in maternity units from three different socioeconomic areas in Lubumbashi, serum thyrotropin, free thyroxine, thyroglobulin, and thyroperoxidase (TPO) antibodies were measured in 225 pregnant women attending antenatal visits, in 75 women who recently delivered, and in 75 non-pregnant controls. The outcome was the prevalence of thyroid dysfunction. Results: Median values in pregnant women, women who recently delivered, and non-pregnant women were: 1.80, 2.80 and 1.54 mIU/L for thyrotropin (p<0.001); 0.85, 1.11 and 1.16 ng/dL for free thyroxine (p<0.001); and 13.3, 9.5 and 10.4 ng/mL for thyroglobulin (p=0.01). The prevalence of thyroid dysfunction in pregnant women, in women who recently delivered, and in non-pregnant women were: 31%, 8%, and 20% for isolated hypothyroxinemia (p<0.001); 12%, 24%, and 5% for subclinical hypothyroidism (p=0.002); 8%, 3%, and 3%, for overt hypothyroidism (p=0.09); and 5%, 13%, and 4%, for positive thyroperoxidase antibodies (p=0.03). In multiple logistic regression, women who were pregnant or who recently delivered, who lived in a poor socioeconomic area, and who had low urinary iodine concentration were more likely to have an increased serum thyrotropin: OR = 3.43 (95% CI: 1.23 - 9.53) for pregnancy, OR = 4.49 (95% CI: 1.66 - 15.01) for postpartum period, OR = 3.68 (95% CI: 1.85 - 7.35) for semi-urban area, and OR = 0.44 (95% CI: 0.19 - 0.96) for urinary iodine concentration ? 250 µg/L. Conclusions: Our results show that there is a high prevalence of thyroid dysfunction in pregnant women of Lubumbashi, and this high prevalence is associated with iodine deficiency. To prevent obstetrical adverse outcomes and neurological damage in children, iodine supplementation is needed before conception or in early pregnancy in Lubumbashi.
Habimana L; Twite KE; Daumerie C; Wallemacq P; Donnen P; Kalenga MK; Robert A
Full Text Available Standard weight gained during pregnant period is an important indication of good health of pregnant women. This study tries to point out health status of urban pregnant women of Bangladesh with respect to weight gained during pregnant period and Body Mass Index (BMI) of pregnant women. The analysis shows that health status of study population is satisfactory in context of Bangladesh though lag behind compared to neighbour country like India and other developed countries. This study also shows that the overall relative change of BMI with respect to gestational age is significant though it is insignificant in first trimester and significant in both second and third trimester.
M.N. Islam; M.O. Ullah; M.T. Uddin
OBJECTIVE: To assess iodine status and the factors that influence iodine status among a cohort of pregnant women living in Gippsland. DESIGN, PARTICIPANTS AND SETTING: Cross-sectional study of 86 pregnant women (at ? 28 weeks' gestation) conducted in hospital antenatal care services and private obstetrician clinics across the Gippsland region of Victoria, Australia, from 13 January 2009 to 17 February 2010. MAIN OUTCOME MEASURES: Overall proportion of pregnant women with a urinary iodine concentration (UIC) > 150 ?g/L; proportion of pregnant women with a UIC >150 ?g/L after the mandatory iodine fortification of bread; use of supplements containing iodine; intake of foods known to be good sources of iodine; intake of bread. RESULTS: The percentage of pregnant women with UIC >150 ?g/L (indicative of iodine sufficiency) was 28%. There was no statistically significant difference in UICs before and since iodine fortification of bread. The median UIC before fortification was 96 ?g/L (interquartile range [IQR], 45-153 ?g/L) and since fortification was 95.5 ?g/L (IQR, 60-156 ?g/L). The dietary intake of iodine-rich food (including bread) and the use of appropriate supplements was insufficient to meet the increased iodine requirements during pregnancy. CONCLUSIONS: The UICs in this cohort of pregnant women are of concern, and seem unlikely to be improved by the national iodine fortification program. Pregnant women in Gippsland urgently need effective iodine education programs and encouragement to either consume iodine-rich foods or take appropriate supplements.
Rahman A; Savige GS; Deacon NJ; Chesters JE; Panther BC
Full Text Available The investigation is dedicated to the study of the pathological alterations of cervical epithelium of uterus, proliferative activity in the lesion focuses and the improvement of cytological diagnosis of the state of cervical epithelium of uterus. The correlation between the proliferative processes in abnormal epithelium of uterine cervix and some pathological factors of the pregnant women organism was studied. The criteria for prognosis of the cervical epithelial dysplasia in pregnant women were elaborated on this basis of our data. The pathological processes in cervical epithelium were revealed in 309 pregnant women in the first trimester (mean age of women was 26,17±0,83 years). The hormonal state of pregnant women was studied on the basis of colpocytological picture and the colpocytological types which indicate the unfavorable prognosis with a certain degree of validity were determined. The mathematic model for all cytological groups of pregnant women for prognosis of inflammatory processes, epithelial dysplasia and preinvasive cervical cancer was created. The simple and comprehensible prognostic scheme for diagnosis of epithelial dysplasia and preinvasive cervical cancer was developed.
Preparation for delivery lies in the mother's psychological comfort in the birth process. The mother's mood during pregnancy can impact on the development of the baby both during pregnancy and after birth. Assessing women for psychosocial risk factors and symptoms of distress gives the opportunity to provide appropriate services during regular pregnancy checks. To investigate the effect of psychological suggestion therapy on the birth process, a specially designed, prospective study of psychological suggestion ("insubstantial comfort") was undertaken in 208 pregnant women. In this paper a model of psychological preparation of pregnant women is analyzed. Antenatal psychosocial assessment may increase the clinician's awareness of psychosocial risk. The antenatal care training was very effective in reducing the impact of stress on pregnant women. Introduction of modern methods of an estimation of the psychological status of pregnant women has allowed using the differentiated approach for labour. Our results demonstrate the necessity of psychological help for pregnant women with the purpose of preservation their reproductive health. The investigation showed that the complex of psychological preparation for delivery normalizes psycho emotional status, decreases the quantity of complication of pregnancy and labour. Further studies with better sample size and statistical power are required to further explore this important public health issue.
Mamdova GM; Zhakhmalova IA; Makashvili LG
Preparation for delivery lies in the mother's psychological comfort in the birth process. The mother's mood during pregnancy can impact on the development of the baby both during pregnancy and after birth. Assessing women for psychosocial risk factors and symptoms of distress gives the opportunity to provide appropriate services during regular pregnancy checks. To investigate the effect of psychological suggestion therapy on the birth process, a specially designed, prospective study of psychological suggestion ("insubstantial comfort") was undertaken in 208 pregnant women. In this paper a model of psychological preparation of pregnant women is analyzed. Antenatal psychosocial assessment may increase the clinician's awareness of psychosocial risk. The antenatal care training was very effective in reducing the impact of stress on pregnant women. Introduction of modern methods of an estimation of the psychological status of pregnant women has allowed using the differentiated approach for labour. Our results demonstrate the necessity of psychological help for pregnant women with the purpose of preservation their reproductive health. The investigation showed that the complex of psychological preparation for delivery normalizes psycho emotional status, decreases the quantity of complication of pregnancy and labour. Further studies with better sample size and statistical power are required to further explore this important public health issue. PMID:19202211
Mamdova, G M; Zhakhmalova, I A; Makashvili, L G
Full Text Available Abstract in english The aim of this study was to evaluate associations between seropositivity for IgG and IgM anti-Toxoplasma gondii antibodies and socio-economic and environmental variables in pregnant women of Londrina, state of Paraná, Brazil. We interviewed 492 pregnant women, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti-T. gondii antibodies by chemiluminescence. A confirmatory diagnosis of acute infection was ma (more) de by an IgG avidity test. Titres of specific IgG anti-T. gondii were obtained by IFAT. Seropositivity for IgG anti-T. gondii antibodies was observed in 242 women (49.2%) and, of these, six pregnant women (1.2%) showed seropositivity for IgM. Age group, level of education, per capita income, presence of a cat in the house and a habit of eating green vegetables were all factors associated with a greater chance of infection with T. gondii. This study showed that 250 (50.8%) pregnant women were susceptible to T. gondii and considered to be at high risk for toxoplasmosis during pregnancy. Based on the results obtained, is critical to establish a program of health surveillance for toxoplasmosis, in order to contribute to diagnosis and early treatment during the prenatal period. It is also necessary to introduce measures to prevent the Toxoplasma infection in seronegative pregnant women.
Lopes, FMR; Mitsuka-Breganó, R; Gonçalves, DD; Freire, RL; Karigyo, CJT; Wedy, GF; Matsuo, T; Reiche, EMV; Morimoto, HK; Capobiango, JD; Inoue, IT; Garcia, JL; Navarro, IT
Full Text Available The aim of this study was to evaluate associations between seropositivity for IgG and IgM anti-Toxoplasma gondii antibodies and socio-economic and environmental variables in pregnant women of Londrina, state of Paraná, Brazil. We interviewed 492 pregnant women, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti-T. gondii antibodies by chemiluminescence. A confirmatory diagnosis of acute infection was made by an IgG avidity test. Titres of specific IgG anti-T. gondii were obtained by IFAT. Seropositivity for IgG anti-T. gondii antibodies was observed in 242 women (49.2%) and, of these, six pregnant women (1.2%) showed seropositivity for IgM. Age group, level of education, per capita income, presence of a cat in the house and a habit of eating green vegetables were all factors associated with a greater chance of infection with T. gondii. This study showed that 250 (50.8%) pregnant women were susceptible to T. gondii and considered to be at high risk for toxoplasmosis during pregnancy. Based on the results obtained, is critical to establish a program of health surveillance for toxoplasmosis, in order to contribute to diagnosis and early treatment during the prenatal period. It is also necessary to introduce measures to prevent the Toxoplasma infection in seronegative pregnant women.
FMR Lopes; R Mitsuka-Breganó; DD Gonçalves; RL Freire; CJT Karigyo; GF Wedy; T Matsuo; EMV Reiche; HK Morimoto; JD Capobiango; IT Inoue; JL Garcia; IT Navarro
Full Text Available Abstract Background Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. Methods Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. Results Four (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3). Conclusion A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.
Hjerkinn Bjørg; Lindbæk Morten; Rosvold Elin
BACKGROUND: Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. METHODS: Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. RESULTS: Four (4.5 percent) of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7) or being victims of rape (O.R. 5.3). CONCLUSION: A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.
Hjerkinn B; Lindbaek M; Rosvold EO
Background. Pregnant and breastfeeding women are at risk for folate deficiency. Folate supplementation has been shown to be associated with enhanced markers of folate status. However, dose-response analyses for adult women are still lacking. Objective. To assess the dose-response relationship betwe...
Berti, Cristiana; Fekete, Katalin; Dullemeijer, Carla; Trovato, Monica; Souverein, Olga W.; Cavelaars, Adriënne
OBJECTIVE: This study was designed to investigate if health and nutrition messages given to pregnant women at Bwaila hospital in Lilongwe, Malawi were understood and used and if the messages made the women health and nutrition literate. STUDY DESIGN: A cross sectional study where data was collected...