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Sample records for pregnancy prenatal care

  1. Korean women's attitudes toward pregnancy and prenatal care.

    Science.gov (United States)

    Pritham, U A; Sammons, L N

    1993-01-01

    A convenience sample of 40 native-born pregnant Korean women receiving prenatal care at a U.S. military facility in a major metropolitan area in Korea completed a questionnaire about attitudes toward pregnancy and prenatal care. Responses revealed a family life characterized by positive maternal and paternal perceptions of the pregnancy and less preference for a male child than we had anticipated. Traditional beliefs in Tae Mong, a conception dream, and Tae Kyo, rituals for safe childbirth, were followed. Food taboos, including protein sources, were reported. Attitudes toward prenatal care services, care providers, and maternal health habits are described.

  2. Prenatal Care Checkup

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  3. Prenatal Care.

    Science.gov (United States)

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. Office for Maternal and Child Health Services.

    This booklet is the first in a series of publications designed to provide parents with useful information about childrearing. Contents are organized into three parts. Part I focuses on the pregnancy, prenatal care, development of the baby, pregnant lifestyles, nutrition, common discomforts, and problems of pregnancy. Part II provides information…

  4. Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices

    OpenAIRE

    Green Chris G; Newburn-Cook Christine V; Heaman Maureen I; Elliott Lawrence J; Helewa Michael E

    2008-01-01

    Abstract Background The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to asse...

  5. Your First Prenatal Care Checkup

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Last reviewed: May, 2011 Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  6. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy Print ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  7. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy A ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  8. Association between body mass index and the timing of pregnancy recognition and entry into prenatal care.

    Science.gov (United States)

    Lynch, Courtney D; Tumin, Rachel; Prasad, Mona R

    2014-11-01

    To assess whether prepregnancy body mass index (BMI) is independently associated with the timing of pregnancy recognition and initiation of prenatal care. Data from 2009 to 2010 were obtained from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System. The 30 participating states contacted sampled mothers 2-4 months after delivery and had them complete the standardized Pregnancy Risk Assessment Monitoring System questionnaire. Prepregnancy BMI was calculated from the participants' self-reported prepregnancy weight and height. Timing of pregnancy recognition and initiation of prenatal care were also self-reported on the questionnaire. Among the 72,913 participants, 69,872 (96%) met the eligibility criteria for analysis. After adjustment for maternal race, ethnicity, smoking status in the 3 months before pregnancy, pregnancy intentions, insurance status, maternal age, marital status, maternal education, and parity, there was no association between prepregnancy BMI status and the week of pregnancy recognition. Obese women initiated prenatal care 0.20 weeks earlier on average compared with normal-weight women, although the difference was not clinically important (mean difference -0.20, 95% confidence interval [CI] -0.38 to -0.03). When examining the odds of receiving late or no prenatal care, there was no association with prepregnancy BMI. Uninsured women, however, reported initiating prenatal care almost 3 weeks later on average than privately insured women (mean difference 2.83, 95% CI 2.27-3.38) and had a more than fourfold increased odds of receiving late or no prenatal care (odds ratio 4.04, 95% CI 3.13-5.23). Prepregnancy BMI was not meaningfully associated with a delay in pregnancy recognition or with increased odds of receiving late or no prenatal care.

  9. Inadequate prenatal care and its association with adverse pregnancy outcomes: A comparison of indices

    Directory of Open Access Journals (Sweden)

    Green Chris G

    2008-05-01

    Full Text Available Abstract Background The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA], using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association. Methods We conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989. Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age. Results Rates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using R-GINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4. Both indices demonstrated heterogeneity (non-uniformity across gestational age strata, indicating the presence of effect modification by gestational age. Conclusion Selection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care

  10. Inadequate prenatal care and its association with adverse pregnancy outcomes: a comparison of indices.

    Science.gov (United States)

    Heaman, Maureen I; Newburn-Cook, Christine V; Green, Chris G; Elliott, Lawrence J; Helewa, Michael E

    2008-05-01

    The objectives of this study were to determine rates of prenatal care utilization in Winnipeg, Manitoba, Canada from 1991 to 2000; to compare two indices of prenatal care utilization in identifying the proportion of the population receiving inadequate prenatal care; to determine the association between inadequate prenatal care and adverse pregnancy outcomes (preterm birth, low birth weight [LBW], and small-for-gestational age [SGA]), using each of the indices; and, to assess whether or not, and to what extent, gestational age modifies this association. We conducted a population-based study of women having a hospital-based singleton live birth from 1991 to 2000 (N = 80,989). Data sources consisted of a linked mother-baby database and a physician claims file maintained by Manitoba Health. Rates of inadequate prenatal care were calculated using two indices, the R-GINDEX and the APNCU. Logistic regression analysis was used to determine the association between inadequate prenatal care and adverse pregnancy outcomes. Stratified analysis was then used to determine whether the association between inadequate prenatal care and LBW or SGA differed by gestational age. Rates of inadequate/no prenatal care ranged from 8.3% using APNCU to 8.9% using R-GINDEX. The association between inadequate prenatal care and preterm birth and LBW varied depending on the index used, with adjusted odds ratios (AOR) ranging from 1.0 to 1.3. In contrast, both indices revealed the same strength of association of inadequate prenatal care with SGA (AOR 1.4). Both indices demonstrated heterogeneity (non-uniformity) across gestational age strata, indicating the presence of effect modification by gestational age. Selection of a prenatal care utilization index requires careful consideration of its methodological underpinnings and limitations. The two indices compared in this study revealed different patterns of utilization of prenatal care, and should not be used interchangeably. Use of these indices to

  11. The impact of group prenatal care on pregnancy and postpartum weight trajectories.

    Science.gov (United States)

    Magriples, Urania; Boynton, Marcella H; Kershaw, Trace S; Lewis, Jessica; Rising, Sharon Schindler; Tobin, Jonathan N; Epel, Elissa; Ickovics, Jeannette R

    2015-11-01

    The objective of the study was to investigate whether group prenatal care (Centering Pregnancy Plus [CP+]) has an impact on pregnancy weight gain and postpartum weight loss trajectories and to determine whether prenatal depression and distress might moderate these trajectories. This was a secondary analysis of a cluster-randomized trial of CP+ in 14 Community Health Centers and hospitals in New York City. Participants were pregnant women aged 14-21 years (n = 984). Medical record review and 4 structured interviews were conducted: in the second and third trimesters and 6 and 12 months postpartum. Longitudinal mixed modeling was utilized to evaluate the weight change trajectories in the control and intervention groups. Prenatal distress and depression were also assessed to examine their impact on weight change. There were no significant differences between the intervention and control groups in baseline demographics. Thirty-five percent of the participants were overweight or obese, and more than 50% had excessive weight gain by Institute of Medicine standards. CP+ was associated with improved weight trajectories compared with controls (P prenatal care gained less weight during pregnancy and lost more weight postpartum. This effect was sustained among women who were categorized as obese based on prepregnancy body mass index (P Prenatal depression and distress were significantly associated with higher antepartum weight gain and postpartum weight retention. Women with the highest levels of depression and prenatal distress exhibited the greatest positive impact of group prenatal care on weight trajectories during pregnancy and through 12 months postpartum. Group prenatal care has a significant impact on weight gain trajectories in pregnancy and postpartum. The intervention also appeared to mitigate the effects of depression and prenatal distress on antepartum weight gain and postpartum weight retention. Targeted efforts are needed during and after pregnancy to improve

  12. Prenatal Care: Third Trimester Visits

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week During the third trimester, prenatal care might include vaginal exams to check the baby's ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art- ...

  13. Prenatal Care: Second Trimester Visits

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week During the second trimester, prenatal care includes routine lab tests and measurements of your ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art- ...

  14. Pregnancy, prenatal care, and delivery of mothers with disabilities in Korea.

    Science.gov (United States)

    Lim, Nam Gu; Lee, Jin Yong; Park, Ju Ok; Lee, Jung-A; Oh, Juhwan

    2015-02-01

    The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.

  15. Prenatal care, pregnancy outcomes, and postpartum birth control plans among pregnant women with opiate addictions.

    Science.gov (United States)

    Parlier, Anna Beth; Fagan, Blake; Ramage, Melinda; Galvin, Shelley

    2014-11-01

    To describe how effectively we provided adequate prenatal care and postpartum contraception to prevent repeat, unintended pregnancies to women using opiates or medication maintenance therapy (MMT) during pregnancy. We conducted a retrospective chart review of 94 women using opiates or MMT during 96 pregnancies while receiving prenatal care in the regional high-risk maternity care clinic between July 2010 and June 2012. We examined prenatal care usage, birth outcomes, and postpartum contraception using χ(2), Kruskal-Wallis, and binary logistic regression modeling. Patients were predominately white (93.6%), multiparous (75.5%), and in their 20s; 71 (74%) used MMT and 25 (26%) used prescribed or illicit opiates. Fewer than half (44% [46.2%]) received any documented prenatal counseling about postpartum contraception. Sixteen (17%) babies were premature. Sixty-four (66.7%) infants were diagnosed as having neonatal abstinence syndrome (NAS). Only 42 (43.8%) women attended their postpartum visits. Overall, 60 (62.5%) women received postpartum contraception. The only significant predictors of postpartum contraception use were preterm birth and postpartum appointment attendance. Alternative strategies for providing postpartum care should be explored because women using opiates or MMT during pregnancy are significantly more likely to use postpartum contraception if they attend their postpartum appointments.

  16. Preconception Care and Prenatal Care

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    ... at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications Preconception Care and Prenatal Care: Condition Information Skip sharing on social media links Share this: Page Content What is preconception ...

  17. Association Between Obesity During Pregnancy and the Adequacy of Prenatal Care.

    Science.gov (United States)

    Zozzaro-Smith, Paula E; Bacak, Stephen; Conway, Ciara; Park, Jennifer; Glantz, J Christopher; Thornburg, Loralei L

    2016-01-01

    In the United States, more than a third of women are obese [body mass index (BMI) ≥ 30]. Although obese populations utilize health care at increased rates and have higher health care costs than non-obese patients, the adequacy of prenatal care in this population is not well established and assumed to be suboptimal. We therefore evaluated adequacy of prenatal care among obese women. We utilized an electronic database including 7094 deliveries with pre-pregnancy BMI ≥ 18.5 from January 2009 through December 2011. Subjects were categorized as normal weight 18.5-24.9 kg/m2, overweight 25-29.9 kg/m2, and obese ≥30 kg/m2 (class I-II-III). Adequacy of prenatal care (PNC) was evaluated using the Kotelchuck Index (KI), corrected for gestational age at delivery. Adequate care was defined as KI "adequate" or "adequate plus," and non-adequate as "intermediate" or "inadequate." Chi square and logistic regression were used for comparisons. When compared to non-obese women, obese women were more likely to have adequate PNC (74.1 vs. 68.7%; OR 1.30, 95% CI 1.15-1.47). After adjusting for age, race, education, diabetes, hypertension, and practice type, obesity remained a significant predictor of adequate prenatal care (OR 1.29, 95% CI 1.14-1.46). While age and hypertension were not significant independent predictors of adequate PNC, college education, Caucasian, diabetes, and resident or MFM care had positive associations. Maternal obesity is associated with increased adequacy of prenatal care. Although some comorbidities associated with obesity increase utilization of prenatal services, this did not explain the improvement in PNC adequacy associated with obesity. Overweight and obese women are at a higher risk of pregnancy complications with obesity contributing to increased morbidity and mortality of the mother. Several studies have evaluated barriers to routine health care services, with obese parturients perceiving their weight to be a barrier to obtaining appropriate

  18. Prenatal care and pregnancy outcomes: A cross-sectional study in Luanda, Angola.

    Science.gov (United States)

    Nimi, Tazi; Fraga, Sílvia; Costa, Diogo; Campos, Paulo; Barros, Henrique

    2016-11-01

    To describe prenatal care in Angolan women delivered at a large tertiary care unit, and to explore the association between prenatal care and selected perinatal outcomes. We conducted a cross-sectional study between December 2012 and February 2013, involving 995 women aged 13-46years, delivered at Lucrécia Paím Maternity, Luanda. Trained interviewers collected information on timing, frequency, place, and satisfaction with prenatal care; sociodemographic and clinical characteristics; birth weight; and gestational age. Logistic regression models were fitted, and odds ratios with 95% confidence intervals (OR, 95%CI) estimated. Quantitatively inadequate prenatal care (care. More visits, both in primiparas and multiparas, were independently associated with more cesarean deliveries. After adjustment, having fewer than four visits was significantly associated with low birth weight (OR 2.00; 95% CI, 1.15-3.50) and preterm delivery (OR 2.74; 95% CI, 1.69-4.44 for 2-4 visits); similar associations were found regarding late entrance into care. Early entrance into prenatal care and the recommended number of visits are major determinants of mode of delivery and pregnancy outcomes, constituting targets to improve perinatal health. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Pregnancy care

    Science.gov (United States)

    ... Avoid all alcohol and drug use and limit caffeine. Quit smoking, if you smoke. Go for prenatal visits and tests: You will see your provider many times during your pregnancy for prenatal care. The number of visits and types of exams you receive will change, depending on where you ...

  20. Relationship between adequacy of prenatal care utilization index and pregnancy outcomes.

    Science.gov (United States)

    Tayebi, Tahereh; Zahrani, Shahnaz Turk; Mohammadpour, Rezaali

    2013-09-01

    Prenatal care is a comprehensive antepartum care program involving a coordinated approach to medical care and psychosocial support that is optimally offered before conception. Inadequate care during pregnancy can lead to undesirable outcomes, including preterm labor and low birth weight. One of these new, accurate, and comprehensive indicator measurements is adequacy of prenatal care utilization index. This study aimed to assess the adequacy of care and its relationship with preterm labor and low birth weight. This analytic historical cohort study was performed on 420 mothers who referred to health centers in Sari during 2010. Data were collected by interviews and questionnaires. Based on the adequacy of prenatal care utilization, this care was classified into four groups: intensive, adequate, intermediate, and inadequate. Data were analyzed using chi-square test, analysis of variance (ANOVA), Spearman correlation coefficient, and relative risk (RR). Of the 420 mothers who were studied, inadequate care was observed in 151 (36%) cases, which was the highest percentage of care. There was a significant relationship between the adequacy of prenatal care utilization and preterm labor and low birth weight (for both P inadequate care, the rate of preterm labor was RR = 1.36 times and the rate of low birth weight was RR = 1.08 times more than in adequate and intensive care. According to the programs that reduced the number of referrals of pregnant mothers (standardization protocol for mothers in Iran), this study confirms the efficacy of adequacy of prenatal care on reducing preterm labor and low birth weight. This study emphasizes on minimum care performance and the importance of conducting further studies to assess the relationship between quantities of care and other outcomes.

  1. Sexually transmitted diseases during pregnancy: screening, diagnostic, and treatment practices among prenatal care providers in Georgia.

    Science.gov (United States)

    Weisbord, J S; Koumans, E H; Toomey, K E; Grayson, C; Markowitz, L E

    2001-01-01

    Sexually transmitted diseases (STD) during pregnancy are associated with adverse outcomes. We conducted a prenatal care provider survey to determine STD screening, diagnosis, and treatment practices. Standard questionnaires were mailed to Georgia-licensed obstetrician/ gynecologists, family practitioners, and nurse-midwives (N = 3,082) in 1998. Of the 1,300 care providers who returned the survey, 565 (44%) provided prenatal care, 390 (57%) were male, and 396 (70%) were obstetrician/ gynecologists. Overall, 553 prenatal care providers (98%) reported screening all pregnant patients for syphilis, 551 (98%) for hepatitis B, 501 (89%) for trichomonas, 474 (84%) for human immunodeficiency virus (HIV), 401 (71%) for gonorrhea, 403 (71%) for chlamydia, 475 (84%) for group B streptococci, and 130 (23%) for bacterial vaginosis (BV) (high risk). Less than 10% used amplification tests for chlamydia or gonorrhea. Most providers used appropriate regimens to treat STD in pregnant women. A written office policy on testing for BV or HIV was associated with increased screening. Provider education is needed about diagnosis and treatment of STD during pregnancy.

  2. Assessment of weight gain during pregnancy in general prenatal care services in Brazil

    Directory of Open Access Journals (Sweden)

    Nucci Luciana Bertoldi

    2001-01-01

    Full Text Available Obesity is an emerging major health risk for women around the world. In this regard, little attention has been given to pregnancy, a moment of risk not only for major weight gain in these women, but also for macrosomia in their offspring. The objective of this study is to evaluate weight gain during pregnancy. Data pertains to a cohort of pregnant women attending general prenatal care clinics in six state capitals in Brazil, from 1991 to 1995. We studied women aged 20 years and over with singleton pregnancies and no diagnosis of diabetes outside pregnancy, enrolled at approximately 20 - 28 weeks of gestation. According to the Institute of Medicine criteria, 38% (95%CI: 36-40% of the women studied gained less and 29% (95%CI: 28-31% had more than the recommended total weight gain. These proportions vary according to pre-pregnancy nutritional status. Given the increasing epidemic of obesity, the high prevalence of overweight and obesity in Brazilian women prior to pregnancy, and the lack of achievement of recommended weight gain during pregnancy, more effective means of managing weight gain during pregnancy are necessary.

  3. Prenatal care and adverse pregnancy outcomes among women with schizophrenia: a nationwide population-based study in Taiwan.

    Science.gov (United States)

    Lin, Herng-Ching; Chen, Yi-Hua; Lee, Hsin-Chien

    2009-09-01

    To compare the number of prenatal care visits for women with and without schizophrenia and to explore the relationship between the level of prenatal care and adverse pregnancy outcomes (low birth weight [LBW], preterm gestation, and small-for-gestational-age [SGA] babies). We identified a total of 607 women who gave birth from 2001 to 2003, who had been diagnosed with schizophrenia (ICD-9-CM criteria) in the 2 years preceding the index delivery, together with 1,821 matched women as a comparison cohort. Multivariate logistic regression and Poisson regression analyses were performed for estimation. Results show women with schizophrenia had a significantly lower mean number of prenatal care visits (7.92 vs 8.72, P inadequate prenatal care. The results also show that after adjusting for other factors, schizophrenic women who received inadequate prenatal care were 2.47 (95% CI, 1.27-4.77; P = .007), 1.84 (95% CI, 1.02-3.37; P = .036), and 1.77 (95% CI, 1.15-2.73; P = .010) times more likely to have preterm births, LBW babies, and SGA babies, compared to schizophrenic women who received adequate care. We conclude that women with schizophrenia were more likely to receive inadequate prenatal care than women without this disorder. Schizophrenic women who received inadequate prenatal care had a higher risk of adverse pregnancy outcomes than schizophrenic women who received adequate care. Copyright 2009 Physicians Postgraduate Press, Inc.

  4. Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea

    Science.gov (United States)

    Lee, Sang Hyung; Lee, Seung Mi; Lim, Nam Gu; Kim, Hyun Joo; Bae, Sung-Hee; Ock, Minsu; Kim, Un-Na; Lee, Jin Yong; Jo, Min-Woo

    2016-01-01

    Abstract Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13–19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P teenage mothers had never received prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P Teenage mothers more often experienced preterm delivery and perineal laceration (P Teenage mothers (Teenage mothers had higher risk of inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001). PMID:27559960

  5. Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08.

    Science.gov (United States)

    Stulberg, Debra B; Cain, Loretta; Hasham Dahlquist, Irma; Lauderdale, Diane S

    2017-01-01

    Ectopic pregnancy causes significant maternal morbidity and mortality. Complications are more common among women with Medicaid or no insurance compared to those with private insurance. It is unknown whether preventive care prior to pregnancy and prenatal care, which are covered by Medicaid, would decrease complications if they were more fully utilised. Medicaid claims were used to identify a clinical cohort of women who experienced an ectopic pregnancy during 2004-08 among all female Medicaid enrolees from a large 14-state population, ages 15-44. Diagnosis and procedure codes were used to identify ectopic pregnancies and associated complications. The primary outcomes were complications associated with ectopic pregnancy: blood transfusion, sterilisation, or hospitalisation with length of stay greater than 2 days. Independent variables were documentation of preventive care within 1 year prior to the ectopic pregnancy and prenatal care within 4 months prior. Controlling for race, age, and state of residence, women's risks of any ectopic pregnancy complication were independently higher among those who did not receive any Medicaid-covered preventive care within 1 year before the ectopic pregnancy compared to those who did (RR 1.12, 95% confidence interval (CI) 1.09, 1.16), and among those who did not receive any Medicaid-covered prenatal care within 4 months prior, compared to those who did (RR 1.89, 95% CI 1.83, 1.96). Pre-pregnancy and prenatal care are independently associated with decreased risk of ectopic pregnancy complications among Medicaid beneficiaries. © 2016 John Wiley & Sons Ltd.

  6. [Pre-pregnancy nutritional status, maternal weight gain, prenatal care, and adverse perinatal outcomes among adolescent mothers].

    Science.gov (United States)

    Santos, Marta Maria Antonieta de Souza; Baião, Mirian Ribeiro; de Barros, Denise Cavalcante; Pinto, Alessandra de Almeida; Pedrosa, Priscila La Marca; Saunders, Claudia

    2012-03-01

    To identify the association between pre-gestational nutritional status, maternal weight gain, and prenatal care with low birth weight (LBW) and prematurity outcomes in infants of adolescent mothers. Cross-sectional study with 542 pairs of adolescent mothers and their children attending a public maternity hospital in Rio de Janeiro. Data were collected from medical records. To determine the association between independent variables and the outcomes studied, odds ratio (OR) and a 95% confidence interval (CI) were estimated With respect to pre-pregnancy nutritional status of adolescents, 87% had normal weight, 1% were underweight, 10% were overweight, and 2% obese. Inadequate total gestational weight gain (72%) exceeded adequacy (28%). Birth weight was favored with greater gestational weight gain, and reduced with late onset of prenatal care. The comparison between the low birth weight and normal birth weight groups revealed significant differences between variable means: interval between the past pregnancy and current pregnancy (p = 0.022), pre-gestational weight (p = 0.018); pre-gestational body mass index (p prenatal visits. Birth weight was associated with inter-gestational interval, pre-pregnancy weight and body mass index before pregnancy. The minimum frequency of six prenatal care visits was a protective factor against LBW and prematurity.

  7. The impact of Centering Pregnancy Group Prenatal Care on postpartum family planning.

    Science.gov (United States)

    Hale, Nathan; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah

    2014-01-01

    The objective of the study was to evaluate the impact of group prenatal care (GPNC) on postpartum family-planning utilization. A retrospective cohort of women continuously enrolled in Medicaid for 12 months (n = 3637) was used to examine differences in postpartum family-planning service utilization among women participating in GPNC (n = 570) and those receiving individual prenatal care (IPNC; n = 3067). Propensity scoring methods were used to derive a matched cohort for additional analysis of selected outcomes. Utilization of postpartum family-planning services was higher among women participating in GPNC than among women receiving IPNC at 4 points in time: 3 (7.72% vs 5.15%, P planning visits were highest among non-Hispanic black women at each interval, peaking with 31.84% by 12 months postpartum. After propensity score matching, positive associations between GPNC and postpartum family-planning service utilization remained consistent by 6 (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05-1.92), 9 (OR, 1.43; 95% CI, 1.08-1.90), and 12 (OR, 1.44; 95% CI, 1.10-1.90) months postpartum. These findings demonstrate the potential that GPNC has to positively influence women's health outcomes after pregnancy and to improve the utilization rate of preventive health services. Utilization of postpartum family-planning services was highest among non-Hispanic black women, further supporting evidence of the impact of GPNC in reducing health disparities. However, despite continuous Medicaid enrollment, postpartum utilization of family-planning services remained low among all women, regardless of the type of prenatal care they received. Copyright © 2014 Mosby, Inc. All rights reserved.

  8. Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study.

    Science.gov (United States)

    Adams, Sally H; Gregorich, Steven E; Rising, Sharon S; Hutchison, Margaret; Chung, Lisa H

    2017-07-01

    National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care. Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms. One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index

  9. Exploring the associations between intimate partner violence victimization during pregnancy and delayed entry into prenatal care: Evidence from a population-based study in Bangladesh.

    Science.gov (United States)

    Islam, Md Jahirul; Broidy, Lisa; Baird, Kathleen; Mazerolle, Paul

    2017-04-01

    Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and newborns. The aim of the study is to explore: 1) the influence of experiencing IPV during pregnancy on delayed entry into prenatal care; and 2) whether women's decision-making autonomy and the support for traditional gender roles act to mediate or moderate the relationship between IPV and delayed entry into prenatal care. cross-sectional survey. Multivariate logistic regression models were estimated that control for various socio-demographic and pregnancy related factors to assess whether women who experienced IPV during pregnancy were more likely to delay entry into prenatal care compared with women who had not experienced IPV. The influence of traditional gender roles acceptance and decision-making autonomy were examined both as independent variables and in interaction with IPV, to assess their role as potential mediators or moderators. Chandpur district, Bangladesh. the sample comprised of 426 Bangladeshi women, aged 15-49 years. Postpartum mothers who visited vaccinations centres to receive their children's vaccinations constitute the sampling frame. almost 70% of the women surveyed reported patterns consistent with delayed entry into prenatal care. Accounting for the influence of other covariates, women who experienced physical IPV during pregnancy were 2.61 times more likely (95% CI [1.33, 5.09]) to have delayed entry into prenatal care than their counterparts who did not report physical IPV. Neither sexual nor psychological IPV victimization during pregnancy was linked with late entry into prenatal care. Both gender role attitudes and levels of autonomy mediate the effect of IPV on prenatal care. the results suggest that the high rates of IPV in Bangladesh have effects that can compromise women's health seeking behaviour during pregnancy, putting them and their developing fetus at risk. Specifically, Bangladeshi women who experience physical IPV during

  10. Depressive symptoms and gestational length among pregnant adolescents: Cluster randomized control trial of CenteringPregnancy® plus group prenatal care.

    Science.gov (United States)

    Felder, Jennifer N; Epel, Elissa; Lewis, Jessica B; Cunningham, Shayna D; Tobin, Jonathan N; Rising, Sharon Schindler; Thomas, Melanie; Ickovics, Jeannette R

    2017-06-01

    Depressive symptoms are associated with preterm birth among adults. Pregnant adolescents have high rates of depressive symptoms and low rates of treatment; however, few interventions have targeted this vulnerable group. Objectives are to: (a) examine impact of CenteringPregnancy® Plus group prenatal care on perinatal depressive symptoms compared to individual prenatal care; and (b) determine effects of depressive symptoms on gestational age and preterm birth among pregnant adolescents. This cluster-randomized controlled trial was conducted in 14 community health centers and hospitals in New York City. Clinical sites were randomized to receive standard individual prenatal care (n = 7) or CenteringPregnancy® Plus group prenatal care (n = 7). Pregnant adolescents (ages 14-21, N = 1,135) completed the Center for Epidemiologic Studies Depression Scale during pregnancy (second and third trimesters) and postpartum (6 and 12 months). Gestational age was obtained from medical records, based on ultrasound dating. Intention to treat analyses were used to examine objectives. Adolescents at clinical sites randomized to CenteringPregnancy® Plus experienced greater reductions in perinatal depressive symptoms compared to those at clinical sites randomized to individual care (p = .003). Increased depressive symptoms from second to third pregnancy trimester were associated with shorter gestational age at delivery and preterm birth (prenatal care may be an effective nonpharmacological option for reducing depressive symptoms among perinatal adolescents. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Prenatal care effectiveness and utilization in Brazil.

    Science.gov (United States)

    Wehby, George L; Murray, Jeffrey C; Castilla, Eduardo E; Lopez-Camelo, Jorge S; Ohsfeldt, Robert L

    2009-05-01

    The impact of prenatal care use on birth outcomes has been understudied in South American countries. This study assessed the effects of various measures of prenatal care use on birth weight (BW) and gestational age outcomes using samples of infants born without and with common birth defects from Brazil, and evaluated the demand for prenatal care. Prenatal visits improved BW in the group without birth defects through increasing both fetal growth rate and gestational age, but prenatal care visits had an insignificant effect on BW in the group with birth defects when adjusting for gestational age. Prenatal care delay had no effects on BW in both infant groups but increased preterm birth risk in the group without birth defects. Inadequate care versus intermediate care also increased LBW risk in the group without birth effects. Quantile regression analyses revealed that prenatal care visits had larger effects at low compared with high BW quantiles. Several other prenatal factors and covariates such as multivitamin use and number of previous live births had significant effects on the studied outcomes. The number of prenatal care visits was significantly affected by several maternal health and fertility indicators. Significant geographic differences in utilization were observed as well. The study suggests that more frequent use of prenatal care can increase BW significantly in Brazil, especially among pregnancies that are uncomplicated with birth defects but that are at high risk for low birth weight. Further research is needed to understand the effects of prenatal care use for pregnancies that are complicated with birth defects.

  12. Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea: A nationwide epidemiological study.

    Science.gov (United States)

    Lee, Sang Hyung; Lee, Seung Mi; Lim, Nam Gu; Kim, Hyun Joo; Bae, Sung-Hee; Ock, Minsu; Kim, Un-Na; Lee, Jin Yong; Jo, Min-Woo

    2016-08-01

    Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13-19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001).

  13. Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

    Science.gov (United States)

    Alibekova, Raushan; Huang, Jian-Pei; Chen, Yi-Hua

    2013-01-01

    To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility. A retrospective cohort study. Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis. Women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83), 1.15 (95% CI, 1.08~1.24), 1.13 (95% CI, 1.08~1.18), and 1.08 (95% CI, 1.05~1.12) higher odds of having very low birth weight (VLBW) babies, preterm births, labor complications, and cesarean sections (CSs) compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care. Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.

  14. Adequate prenatal care reduces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Raushan Alibekova

    Full Text Available OBJECTIVES: To investigate the effects of various measures of prenatal care on adverse pregnancy outcomes in women with a history of infertility. STUDY DESIGN: A retrospective cohort study. METHODS: Data were derived by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Certificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women without infertility matched to the study sample by maternal age. A conditional logistic regression analysis was performed for the analysis. RESULTS: Women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83, 1.15 (95% CI, 1.08~1.24, 1.13 (95% CI, 1.08~1.18, and 1.08 (95% CI, 1.05~1.12 higher odds of having very low birth weight (VLBW babies, preterm births, labor complications, and cesarean sections (CSs compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of prenatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a VLBW baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile women with adequate care. CONCLUSIONS: Study findings suggest that adequate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility.

  15. The Role of Trust in CenteringPregnancy : Building Interpersonal Trust Relationships in Group-Based Prenatal Care in The Netherlands

    NARCIS (Netherlands)

    Kweekel, L.; Gerrits, T.; Rijnders, M.; Brown, P.R.

    2016-01-01

    Background CenteringPregnancy (CP) is a specific model of group-based prenatal care for women, implemented in 44 midwifery practices in The Netherlands since 2011. Women have evaluated CP positively, especially in terms of social support, and improvements have been made in birthweight and preterm-bi

  16. Relationship between prenatal care and maternal complications in women with preeclampsia: Implications for continuity and discontinuity of prenatal care

    Directory of Open Access Journals (Sweden)

    Ching-Ming Liu

    2012-12-01

    Conclusion: The types of prenatal care may be associated with different pregnancy outcomes and neonatal morbidity. Factors associated with inadequate prenatal care may be predictors of pregnancy outcome in pregnant women with pre-eclampsia.

  17. Factors associated with inadequate prenatal care in Ecuadorian women.

    Science.gov (United States)

    Paredes, I; Hidalgo, L; Chedraui, P; Palma, J; Eugenio, J

    2005-02-01

    Although inadequate prenatal care has been associated with adverse perinatal outcomes, reports on the factors associated with poor prenatal care in developing Latin American countries are scarce. To determine factors associated with inadequate prenatal care among women from low socioeconomic circumstances. Women delivered after a pregnancy duration of more than 20 weeks at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador, were surveyed. The questionnaire collected sociodemographic data and reasons for having inadequate prenatal care. Adequacy of prenatal care was measured with the Kessner index and correlated to the sociodemographic data. During the study period, 1016 pregnant women were surveyed. Among them, there were adolescents (23.7%), primigravidas (30.8%), and women with a high-risk pregnancy (29.3%). According to the Kessner index, prenatal care was considered adequate or inadequate in 24.5% and 75.5% of cases, respectively. Knowledge regarding the importance of adequate prenatal care and the effects of poor prenatal care was lower among women who had received inadequate prenatal care. The women that were considered to have had adequate prenatal care had at least one visit, and they were more often cared for by a specialist than women who considered having inadequate prenatal care. The three most important reasons associated to inadequate prenatal care in this series (n=767), were economic difficulties having to care for a small child, and transportation difficulties. Logistic regression analysis determined that women with undesired pregnancies who resided in rural areas and were para 5 or higher had an increased risk of inadequate prenatal care. On the other hand, an adverse outcome to a prior pregnancy (abortion, intrauterine fetal demise, or ectopic pregnancy) decreased this risk. Marital status and educational level were confounding factors. Although prenatal care at our institution is free, adequacy was thought to be low

  18. Prenatal diagnosis in multiple pregnancy.

    Science.gov (United States)

    Taylor, M J; Fisk, N M

    2000-08-01

    Fetal abnormality is more common in multiple than in singleton pregnancies. This, together with the requirement to consider the risks with at least two babies to sample correctly each fetus and to undertake accurately-targeted selective termination, amounts to a major challenge for obstetricians involved in prenatal diagnosis. Early determination of chorionicity should be routine, since this influences not only the genetic risks but also the invasive procedure chosen for karyotyping or genotyping. Assessment of nuchal translucency identifies individual fetuses at risk of trisomy. Contrary to expectation, invasive procedures in twins appear to have procedure-related miscarriage rates that are similar to those in singletons. Instead, contamination remains a concern at chorionic villus sampling. Elective late karyotyping of fetuses may have a role in some countries. Whereas management options for discordant fetal abnormality are relatively straightforward in dichorionic pregnancies, monochorionic pregnancies are at risk of co-twin sequelae after any single intrauterine death. Techniques have now been developed to occlude completely the cord vasculature by laser and/or ultrasound guided bipolar diathermy. Given the complexities associated with prenatal diagnosis, all invasive procedures in multiple pregnancies should be performed in tertiary referral centres. Copyright 2000 Harcourt Publishers Ltd.

  19. Barriers to adequate prenatal care utilization in American Samoa.

    Science.gov (United States)

    Hawley, Nicola L; Brown, Carolyn; Nu'usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2014-12-01

    The objective of this study is to describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Using data from prenatal clinic records, women (n = 692) were categorized according to the adequacy of prenatal care utilization index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way analysis of variance and independent samples t tests. Between 2001 and 2008 85.4 % of women received inadequate prenatal care. Parity (P = 0.02), maternal unemployment (P = 0.03), and both parents being unemployed (P = 0.03) were negatively associated with the timing of prenatal care initiation. Giving birth in 2007-2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 vs. 25.12 weeks; P prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007-2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population.

  20. Update on prenatal care.

    Science.gov (United States)

    Zolotor, Adam J; Carlough, Martha C

    2014-02-01

    Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor. Physicians should recommend folic acid supplementation to all women as early as possible, preferably before conception, to reduce the risk of neural tube defects. Administration of Rho(D) immune globulin markedly decreases the risk of alloimmunization in an RhD-negative woman carrying an RhD-positive fetus. Screening and treatment for iron deficiency anemia can reduce the risks of preterm labor, intrauterine growth retardation, and perinatal depression. Testing for aneuploidy and neural tube defects should be offered to all pregnant women with a discussion of the risks and benefits. Specific genetic testing should be based on the family histories of the patient and her partner. Physicians should recommend that pregnant women receive a vaccination for influenza, be screened for asymptomatic bacteriuria, and be tested for sexually transmitted infections. Testing for group B streptococcus should be performed between 35 and 37 weeks' gestation. If test results are positive or the patient has a history of group B streptococcus bacteriuria during pregnancy, intrapartum antibiotic prophylaxis should be administered to reduce the risk of infection in the infant. Intramuscular or vaginal progesterone should be considered in women with a history of spontaneous preterm labor, preterm premature rupture of membranes, or shortened cervical length (less than 2.5 cm). Screening for diabetes should be offered using a universal or a risk-based approach. Women at risk of preeclampsia should be offered low-dose aspirin prophylaxis, as well as calcium supplementation if dietary calcium intake is low. Induction of labor may be considered between 41 and 42 weeks' gestation.

  1. Barriers to adequate prenatal care utilization in American Samoa

    Science.gov (United States)

    Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

    2013-01-01

    Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; Pprenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

  2. Dental Care in Pregnancy

    Science.gov (United States)

    Share with Women Dental Care in Pregnancy Why is dental care in pregnancy important? During pregnancy, you are more likely to have problems ... There are 2 major reasons women can have dental problems during pregnancy: Pregnancy gingivitis— During pregnancy, changes ...

  3. The comparative effects of group prenatal care on psychosocial outcomes.

    Science.gov (United States)

    Heberlein, Emily C; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah; Farber, Naomi; Frongillo, Edward A

    2016-04-01

    To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89% completing the second survey (mean gestational age 32.7 weeks) and 84% completing the third survey (6 weeks' postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group

  4. Family structure and use of prenatal care.

    Science.gov (United States)

    Alves, Elisabete; Silva, Susana; Martins, Simone; Barros, Henrique

    2015-06-01

    This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

  5. Family structure and use of prenatal care

    Directory of Open Access Journals (Sweden)

    Elisabete Alves

    2015-06-01

    Full Text Available This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04, an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02, and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively. The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.

  6. Prenatal risk indicators of a prolonged pregnancy

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes Grabow; Olsen, Jørn

    2006-01-01

    BACKGROUND: Few prenatal risk factors of prolonged pregnancy, a pregnancy of 42 weeks or more, are known. The objective was to examine whether sociodemographic, reproductive, toxicologic, or medical health conditions were associated with the risk of prolonged pregnancy. METHODS: Data from the Dan...

  7. The Effect of Folic Acid Consumption (In Prenatal Care on Blood Pressure Change during Pregnancy in Urban and Rural Health Centers in Eastern Azerbaijan

    Directory of Open Access Journals (Sweden)

    Leila Rasoolpoor-Farzin

    2017-02-01

    Full Text Available Background and Objectives : Preeclampsia is one of the most threatening problems in pregnancy and potentially is followed by preterm birth, miscarriage, low birth weight and maternal mortality. Folic acid supplementation is commonly prescribed for women in child bearing age to reduce the prevalence of neural tube defects. However, its role in pre-eclampsia and hypertension is not proven and is debatable. The aim of this study was to evaluate the influence of folic acid on before pregnancy care on blood pressure in pregnancy. Material and Methods: This retrospective cohort study was conducted as census on all 1939 women referred to receive prenatal care between 2008 and 2013 in rural and urban healthcare centers in Sarab, Bostanabad and Khosroshahr. We compared blood pressure changes in two groups with folic acid consumption and another group, not consuming folic acid. Collected data were filled in the checklist and underwent statistical analysis of descriptive and analytical methods by SPSS 16. Results: The mean age of women in this study was 25.98±5.78 years. Ninety-two percent of mothers had regular consumption of folic acid during pregnancy. The peak period of high blood pressure was reported at weeks 37-35 with 8.2% in systolic blood pressure and diastolic blood pressure at week 37-35 and more than 37 weeks with 1.6%. Systolic and diastolic pressure in mothers taking folic acid was significantly lower (P Conclusion: Folic acid intake during pregnancy, as a part of prenatal care, significantly reduces the incidence of hypertension of pregnancy. During this period, folic acid intake can diminish pre-eclampsia and promote maternal and new born health.

  8. Later Prenatal Checkups

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Last reviewed: May, 2011 Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  9. Prenatal Care Services in Aydin Province

    Directory of Open Access Journals (Sweden)

    Erdal BESER

    2007-04-01

    Full Text Available Aim of the study was to evaluate the quality and quantity of prenatal care in Aydin province. It was a cross-sectional study. 195 women (pregnant/women at postpartum period living in the Aydin province participated in the study. Cluster and simple random sampling method was used in the selection of women from 10 health centers (one rural-one urban health station each. Data obtained by face to face interview technique. Turkey Demografic Health Survey criteria were used for evaluation of the quantity of prenatal care as “sufficient” or “insufficient” and quality of prenatal care was scored as “1-2”(bad, “3-4”(moderate and “5-6”(good. Chi-square, Mann Whitney-U and t tests were used for analysis. One fifth of each pregnant women who were in last trimester and 11.3% of women in postpartum period stated that they were not followed up by an health personnel during pregnancy. One third of pregnant women who were in last trimester and 58.5% of women in postpartum period said they weren’t visited by an health personnel in the first trimester. Besides, quality points of prenatal care were found low, both in pregnant women and women in post partum period. It was found that living in urban areas, high education level and presence of social security effected getting adequate prenatal care. The quality and quantity of prenatal care was found less than expected in Aydin province which is located in the western region of Turkey. It is necessary that, health personnel must be more sensitive to convey “adequate” prenatal care especially women who are living in rural areas, who have low educational level and who have no social security. [TAF Prev Med Bull 2007; 6(2.000: 137-141

  10. Prenatal Care Services in Aydin Province

    Directory of Open Access Journals (Sweden)

    Erdal BESER

    2007-04-01

    Full Text Available Aim of the study was to evaluate the quality and quantity of prenatal care in Aydin province. It was a cross-sectional study. 195 women (pregnant/women at postpartum period living in the Aydin province participated in the study. Cluster and simple random sampling method was used in the selection of women from 10 health centers (one rural-one urban health station each. Data obtained by face to face interview technique. Turkey Demografic Health Survey criteria were used for evaluation of the quantity of prenatal care as “sufficient” or “insufficient” and quality of prenatal care was scored as “1-2”(bad, “3-4”(moderate and “5-6”(good. Chi-square, Mann Whitney-U and t tests were used for analysis. One fifth of each pregnant women who were in last trimester and 11.3% of women in postpartum period stated that they were not followed up by an health personnel during pregnancy. One third of pregnant women who were in last trimester and 58.5% of women in postpartum period said they weren’t visited by an health personnel in the first trimester. Besides, quality points of prenatal care were found low, both in pregnant women and women in post partum period. It was found that living in urban areas, high education level and presence of social security effected getting adequate prenatal care. The quality and quantity of prenatal care was found less than expected in Aydin province which is located in the western region of Turkey. It is necessary that, health personnel must be more sensitive to convey “adequate” prenatal care especially women who are living in rural areas, who have low educational level and who have no social security. [TAF Prev Med Bull. 2007; 6(2: 137-141

  11. The Relationship between Prenatal Care, Personal Alcohol Abuse and Alcohol Abuse in the Home Environment

    Science.gov (United States)

    Grekin, Emily R.; Ondersma, Steven J.

    2009-01-01

    Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been…

  12. The Relationship between Prenatal Care, Personal Alcohol Abuse and Alcohol Abuse in the Home Environment

    Science.gov (United States)

    Grekin, Emily R.; Ondersma, Steven J.

    2009-01-01

    Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been…

  13. Problem in twin pregnancy: Findings of prenatal sonography and autopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Cho, Jeong Yeon; Song, Mi Jin; Min, Jee Yeon; Lee, Young Ho; Lee, Hak Jong; Chun, Yi Kyeong; Kim, Yee Jeong; Hong, Sung Ran [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2001-12-15

    Multifetal gestations are high risk pregnancies with higher perinatal morbidity and mortality. Multifetal gestations are subject to unique complications including conjoined twins, twin-to-twin transfusion syndrome (TTTS), acardiac twins, twin embization of co-twin demise and heterotopic pregnancies. Prenatal sonographic diagnosis of types and complications of multifetal gestations is important for antenatal care and prediction of fetal outcome. This study was performed to present the prenatal ultrasonographic findings and pathologic findings of the unique complications of twin pregnancy. Acardia is a lethal anomaly occurring in 1% of monozygotic twin. The acardiac twin has a parasitic existence and depends on the donor (pump) twin for its blood supply via placental anastomoses and retrograde perfusion of umbilical cord. This twin reversed arterial perfusion (TRAP) sequence is a most extreme manifestation on the TTTS. Doppler verification reversed flow in umbilical cord of the acardiac twin confirms the diagnosis.

  14. Relationship between prenatal care and maternal complications in women with preeclampsia: implications for continuity and discontinuity of prenatal care.

    Science.gov (United States)

    Liu, Ching-Ming; Chang, Shuenn-Dyh; Cheng, Po-Jen

    2012-12-01

    Prenatal care is associated with better pregnancy outcome and may be a patient safety issue. However, no studies have investigated the types and quality of prenatal care provided in northern Taiwan. This retrospective study assessed whether the hospital-based continuous prenatal care model at tertiary hospitals reduced the risk of perinatal morbidity and maternal complications in pre-eclampsia patients. Of 385 pre-eclampsia patients recruited from among 23,665 deliveries, 198 were classified as patients with little or no prenatal care who received traditional, individualized, and physician-based discontinuous prenatal care (community-based model), and 187 were classified as control patients who received tertiary hospital-based continuous prenatal care. The effects on perinatal outcome were significantly different between the two groups. The cases in the hospital-based care group were less likely to be associated with preterm delivery, low birth weight, very low birth weight, and intrauterine growth restriction. After adjustment of confounding factors, the factors associated with pregnant women who received little or no prenatal care by individualized physician groups were diastolic blood pressure ≥ 105 mmHg, serum aspartate transaminase level ≥ 150 IU/L, and low-birth-weight deliveries. This study also demonstrated the dose-response effect of inadequate, intermediate, adequate, and intensive prenatal care status on fetal birth weight and gestational periods (weeks to delivery). The types of prenatal care may be associated with different pregnancy outcomes and neonatal morbidity. Factors associated with inadequate prenatal care may be predictors of pregnancy outcome in pregnant women with pre-eclampsia. Copyright © 2012. Published by Elsevier B.V.

  15. Childhood maltreatment history, posttraumatic relational sequelae, and prenatal care utilization.

    Science.gov (United States)

    Bell, Sue Anne; Seng, Julia

    2013-07-01

    To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization. A post-hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes. Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan. This analysis included 467 diverse, nulliparous, English-speaking adult women expecting their first infants. Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records. Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care. When childhood maltreatment survivors were resilient or had used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD-affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  16. Gestational Weight Gain and Breastfeeding Outcomes in Group Prenatal Care.

    Science.gov (United States)

    Brumley, Jessica; Cain, M Ashley; Stern, Marilyn; Louis, Judette M

    2016-07-18

    This study sought to examine the differences in pregnancy outcomes with a focus on gestational weight gain for women attending group prenatal care compared to standard individual prenatal care. A matched case-control study was conducted including 65 women who chose group care and 130 women who chose standard individual care. Women were matched based on prepregnancy body mass index (BMI) category, eligibility for midwifery care, and age within 5 years. Women choosing group prenatal care and women choosing standard individual care had similar gestational weight gain, birth weight, gestational age at birth, and mode of birth. Women choosing group prenatal care did have a significantly higher rate of exclusive breastfeeding at 6 weeks postpartum (odds ratio [OR], 4.07; 95% confidence interval [CI], 1.81-9.15; P prenatal care participation resulted in equivalent gestational weight gain as well as pregnancy outcomes as compared to standard individual care. Breastfeeding rates were improved for women choosing group prenatal care. Randomized controlled trials are needed in order to eliminate selection bias. © 2016 by the American College of Nurse-Midwives.

  17. Pregnant teenagers' group: contributions to prenatal care.

    Science.gov (United States)

    Queiroz, Maria Veraci Oliveira; Menezes, Giselle Maria Duarte; Silva, Thaís Jormanna Pereira; Brasil, Eysler Gonçalves Maia; Silva, Raimunda Magalhães da

    2017-06-05

    To describe changes in nurses' care following the implementation of a group of pregnant teenagers in prenatal care based on the expectations and experiences of pregnant teenagers. Qualitative and descriptive study conducted from February to November 2013 at a Primary Care Unit in Fortaleza, Ceará, Brazil, through focus groups with 16 adolescents from the group of pregnant women in the second or third trimester of pregnancy. The analysis identified central ideas and units of meanings that formed the categories. The strategy of a group of pregnant teenagers, which provides a space for coexistence and the establishment of ties encourages these individuals to talk about their needs, re-signifying their ties. Educational strategies to promote self-care of pregnant teenagers and care for their babies involve the sharing of experiences, doubts and beliefs. Considerations and suggestions of the adolescents contributed to guide nurses' practice and provide a strategic space of care and support for pregnant adolescents in primary care.

  18. Choosing Your Prenatal Care Provider

    Science.gov (United States)

    ... on midwives. A family nurse practitioner (also called FNP) is a nurse with special education and training ... care of every member of your family. An FNP can take care of you during pregnancy and ...

  19. Determinants of the use of prenatal care in rural China: the role of care content.

    Science.gov (United States)

    Nwaru, Bright I; Wu, Zhuochun; Hemminki, Elina

    2012-01-01

    Several maternal demographic factors have been identified to influence the timing of starting prenatal care and its adequate use. However, how the content of prenatal care modifies these factors has not been studied previously. Using a representative sample collected for other purposes in rural China, we examined the factors predicting the uptake of prenatal care by taking into account the content of care (advice: on nutrition during pregnancy, diseases and pregnancy-related problems, and on child care after birth; and routine tests: blood pressure, blood tests, and ultrasound). We studied 1,479 women who answered a house-hold KAP (knowledge, attitude, and practice) survey (97% response rate) collected after a prenatal care intervention from 2001 to 2003 in 20 townships located in a county in Anhui Province. A multinomial logistic regression was used for the analysis. The most prominent factors that predicted late start of prenatal care and inadequate care were younger age, low maternal income, and having more than one child. When we adjusted for the content of care, the influence of these factors on the use of prenatal care attenuated to varying degrees: in some cases there was up to 20% reduction in the values of the risk estimates, while in other cases the statistical significance of the estimates were lost. It is important to take into account the content of prenatal care when assessing the factors predicting women's use of prenatal care.

  20. The relationship between social capital, social support and the adequate use of prenatal care.

    Science.gov (United States)

    Leal, Maria do Carmo; Pereira, Ana Paula Esteves; Lamarca, Gabriela de Almeida; Vettore, Mario Vianna

    2011-01-01

    This study investigated the relationship between social capital and social support and the adequate use of prenatal care. A follow-up study involving 1,485 pregnant women was conducted in two cities in the Rio de Janeiro State, Brazil. Demographic and socioeconomic characteristics, social support and social capital data were collected during the first trimester of pregnancy. The post-partum period included information on levels of prenatal care utilization, social networks, parity, obstetric and gestational risk and prenatal care attendance. Hierarchized multinomial logistic regression was used in the statistical analysis. Prenatal care use above adequate levels was associated with high social capital at the city level (aggregated social capital), socioeconomic status and working during pregnancy. Lower non-aggregated contextual and compositional social capital, gestational risk and pattern of prenatal care were associated with inadequate prenatal care utilization. Contextual social capital and social support were found to be social determinants for the appropriate use of prenatal care.

  1. Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) dissemination project: a science to prenatal care practice partnership.

    Science.gov (United States)

    Windsor, Richard; Clark, Jeannie; Cleary, Sean; Davis, Amanda; Thorn, Stephanie; Abroms, Lorien; Wedeles, John

    2014-01-01

    This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia-Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009-2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006-2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a ≥50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.

  2. Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy Adequação dos cuidados pré-natais como determinante da utilização de ácido fólico, ferro e vitaminas durante a gravidez

    OpenAIRE

    Nuno Lunet; Teresa Rodrigues; Sofia Correia; Henrique Barros

    2008-01-01

    This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR), computed by generalized binomial regression. A high proportion of women report...

  3. Relationship between prenatal care and maternal complications in women with preeclampsia: Implications for continuity and discontinuity of prenatal care

    OpenAIRE

    Ching-Ming Liu; Shuenn-Dyh Chang; Po-Jen Cheng

    2012-01-01

    Objective: Prenatal care is associated with better pregnancy outcome and may be a patient safety issue. However, no studies have investigated the types and quality of prenatal care provided in northern Taiwan. This retrospective study assessed whether the hospital-based continuous prenatal care model at tertiary hospitals reduced the risk of perinatal morbidity and maternal complications in pre-eclampsia patients. Materials and Methods: Of 385 pre-eclampsia patients recruited from among 23...

  4. Exercise during Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  5. Pregnancy Complications: Placenta Previa

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  6. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  7. Alcohol and Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  8. Exercise during Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  9. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  10. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  11. [Social factors associated with use of prenatal care in Ecuador].

    Science.gov (United States)

    Sánchez-Gómez, Amaya; Cevallos, William; Grijalva, Mario J; Silva-Ayçaguer, Luis C; Tamayo, Susana; Jacobson, Jerry O; Costales, Jaime A; Jiménez-Garcia, Rodrigo; Hernández-Barrera, Valentín; Serruya, Suzanne; Riera, Celia

    2016-11-01

    Prenatal care is a pillar of public health, enabling access to interventions including prevention of mother-to-child transmission of HIV and congenital syphilis. This paper describes social factors related to use of prenatal care in Ecuador. In 2011 and 2012, participant clinical history and interview information was analyzed from a national probability sample of 5 998 women presenting for delivery or miscarriage services in 15 healthcare facilities in Ecuador, to estimate prevalence of HIV, syphilis, and Chagas disease, and prenatal care coverage. The study found that 94.1% of women had attended at least one prenatal visit, but that attendance at no less than four visits was 73.1%. Furthermore, lower educational level, greater number of pregnancies, occupation in the agriculture or livestock sector, and membership in ethnic indigenous, Afro-Ecuadorian, or other minority groups were factors associated with lack of use (no prenatal visits) or insufficient use of prenatal care (fewer than four visits or first visit at >20 weeks gestation) in Ecuador. These results point to persistence of marked inequalities in access to and use of prenatal health services attributable to socioeconomic factors and to the need to strengthen strategies to address them, to reach the goal of universal prenatal care coverage.

  12. [Toxoplasmosis in pregnancy: prevention, prenatal diagnosis and treatment].

    Science.gov (United States)

    Hohlfeld, P; Biedermann, K; Extermann, P; Gyr, T

    1995-01-01

    Maternal infection with Toxoplasma gondii acquired during pregnancy occurs in more than 500 women per year in Switzerland. Systematic screening at the beginning of pregnancy allows the introduction of health education programs. The screening during pregnancy is performed to diagnose primary maternal infections and to propose prenatal diagnosis and treatment. The administration of specific antibiotherapy during pregnancy (spiramycine or the association of pyrimethamine and sulfonamides) significantly reduces the risk of fetal infection. Prenatal diagnosis of congenital toxoplasmosis is possible and reliable. It avoids unnecessary termination of pregnancy when the fetus is not infected and specific therapy in case of infection (association of pyrimethamine and sulfonamides). Prenatal treatment may be proposed without prenatal diagnosis as of the 16th week of gestation. In any case, prenatal treatment seems to reduce the incidence of severe congenital toxoplasmosis.

  13. The Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Adoption Scale: evaluating the diffusion of a tobacco treatment innovation to a statewide prenatal care program and providers.

    Science.gov (United States)

    Windsor, Richard; Cleary, Sean; Ramiah, Kalpana; Clark, Jeannie; Abroms, Lorien; Davis, Amanda

    2013-01-01

    When a new patient education program is being considered for adoption by a public health agency, it is essential to determine provider perceptions of its acceptability for routine use. In 2007, the West Virginia Bureau of Public Health Perinatal Program, Right From The Start (RFTS), decided to adopt the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program. RFTS is a statewide perinatal home visitation initiative delivered by designated care coordinators (DCCs). The authors developed the SCRIPT Adoption Scale (SAS) in the absence of a valid instrument to assess the perceived attributes of a tobacco treatment innovation among the RFTS DCC population. They evaluated the validity of the five constructs of the Rogers' Diffusion of Innovations model in an organization (relative advantage, compatibility, complexity, observability, and trialability) to predict SCRIPT use. After reviewing the literature and developing draft SAS forms, 2 expert panel reviews established the face and content validity of a 43-item SAS. It was administered to 90% (85/90) of the RFTS DCC population. Psychometric analyses confirmed the validity and reliability of a 28-item scale. All 28 items had factor loadings greater than 0.40 (range = 0.43-0.81). All SAS subscales were strongly correlated, r = 0.51 to 0.97, supporting the convergent validity of a 5-factor SAS. There was a significant association between the DCC SAS score and DCC SCRIPT Program Implementation Index supporting the SAS convergent (construct) validity (r = 0.38). The SAS internal consistencyr = 0.93 and stabilityr = 0.76. Although 2 specific subscales need to be improved, the SAS can be adapted by prenatal care programs to measure the attributes of adoption of new, evidence-based patient education and counseling methods.

  14. Social inequalities in use of prenatal care in Manitoba.

    Science.gov (United States)

    Heaman, Maureen I; Green, Chris G; Newburn-Cook, Christine V; Elliott, Lawrence J; Helewa, Michael E

    2007-10-01

    Analysis of regional variations in use of prenatal care to identify individual-level and neighbourhood-level determinants of inadequate prenatal care among women giving birth in the province of Manitoba. Data were obtained from Manitoba Health administrative databases and the 1996 Canadian Census. An index of prenatal care use was calculated for each singleton live birth from 1991 to 2000 (N = 149,291). Births were geocoded into 498 geographic districts, and a spatial analysis was conducted, consisting of data visualization, spatial clustering, and data modelling using Poisson regression. We found wide variation in rates of inadequate prenatal care across geographic areas, ranging from 1.1% to 21.5%. Higher rates of inadequate care were found in the inner-city of Winnipeg and in northern Manitoba. After adjusting for individual characteristics, the highest rates of inadequate prenatal care were among women living in neighbourhoods with the lowest average family income, the highest proportion of the population who were unemployed, the highest rates of recent immigrants, the highest percentage of the population reporting Aboriginal status, the highest percentage of single parent families, the highest percentage of the population with fewer than nine years of education, and the highest rates of women who smoked during pregnancy. Social inequalities exist in the use of prenatal care among Manitoba women, despite there being a universally funded health care system. Regional disparities in rates of inadequate prenatal care emphasize the need for further research to determine specific risk factors for inadequate prenatal care in socioeconomically disadvantaged neighbourhoods, followed by provision of effective targeted services.

  15. Adequacy of Prenatal Care and Gestational Weight Gain.

    Science.gov (United States)

    Yeo, SeonAe; Crandell, Jamie L; Jones-Vessey, Kathleen

    2016-02-01

    The goal of prenatal care is to maximize health outcomes for a woman and her fetus. We examined how prenatal care is associated with meeting the 2009 Institute of Medicine (IOM) guidelines for gestational weight gain. The study used deidentified birth certificate data supplied by the North Carolina State Center for Health Statistics. The sample included 197,354 women (≥18 years) who delivered singleton full-term infants in 2011 and 2012. A generalized multinomial model was used to identify how adequate prenatal care was associated with the odds of gaining excessive or insufficient weight during pregnancy according to the 2009 IOM guidelines. The model adjusted for prepregnancy body size, sociodemographic factors, and birth weight. A total of 197,354 women (≥18 years) delivered singleton full-term infants. The odds ratio (OR) for excessive weight gain was 2.44 (95% CI 2.37-2.50) in overweight and 2.33 (95% CI 2.27-2.40) in obese women compared with normal weight women. The OR for insufficient weight gain was 1.15 (95% CI 1.09-1.22) for underweight and 1.34 (95% CI 1.30-1.39) for obese women compared with normal weight women. Prenatal care at the inadequate or intermediate levels was associated with insufficient weight gain (OR: 1.32, 95% CI 1.27-1.38; OR: 1.15, 95% CI 1.09-1.21, respectively) compared with adequate prenatal care. Women with inadequate care were less likely to gain excessive weight (OR: 0.88, 95% CI 0.86-0.91). Whereas prenatal care was effective for preventing insufficient weight gain regardless of prepregnancy body size, educational background, and racial/ethnic group, there were no indications that adequate prenatal care was associated with reduced risk for excessive gestational weight gain. Further research is needed to improve prenatal care programs for preventing excess weight gain.

  16. Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil

    Directory of Open Access Journals (Sweden)

    de Souza Luiz

    2009-07-01

    Full Text Available Abstract Background The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil. Methods A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Results: Prenatal care coverage in Aracaju was high (98.3%, with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age Conclusion Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.

  17. Expectations and satisfaction of pregnant women: unveiling prenatal care in primary care

    Directory of Open Access Journals (Sweden)

    Alexandrina Aparecida Maciel Cardelli

    Full Text Available Objective.To analyze the perception of primiparous women about prenatal care in Basic Health Units in a municipality in southern Brazil. Methods. This is a qualitative research from the perspective of Social Representation Theory, from the following question: How has been the pre-natal care for you? Eighteen pregnant women were interviewed. Results. The analysis resulted in three categories: Expectation representation about prenatal care; Rescuing the care offered in prenatal consultation; Unveiling the (dis satisfaction with prenatal consultation. The prenatal care was apprehended as an essential moment for safe pregnancy, although centered on the doctor's figure and guarantee access to early laboratory and imaging tests. On the other hand, dissatisfaction was revealed from the reception at the entrance to the health unit to the consultations access, although some statements suggest timely satisfaction. Conclusion. Prenatal care did not meet the specific expectations of the study group and unveiled that the nurse did not supply it, as a member of the multidisciplinary team. The organization of the nursing work process in primary care, related to prenatal care, needs to be revisited to promote the effectiveness of its actions.

  18. Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil

    OpenAIRE

    de Souza Luiz; Almeida Maria; Lima Danilo DF; Bettiol Heloísa; Guimarães Alzira Maria DN; Ribeiro Eleonora RO; Silva Antônio; Gurgel Ricardo Q.

    2009-01-01

    Abstract Background The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance ...

  19. Social networks and the communication of norms about prenatal care in rural Mexico.

    Science.gov (United States)

    Lapinski, Maria Knight; Anderson, Jenn; Cruz, Shannon; Lapine, Peter

    2015-01-01

    Many normative beliefs are shared and learned through interpersonal communication, yet research on norms typically focuses on their effects rather than the communication that shapes them. This study focused on interpersonal communication during pregnancy to uncover (a) the nature of pregnancy-related communication and (b) normative information transmitted through such communication. Results from interviews with pregnant women living in rural Mexico revealed limited social networks; often, only a woman's mother or the baby's father were consulted about prenatal care decisions. However, women also indicated that communication with others during pregnancy provided important normative information regarding prenatal care. First, most referents believed that women should receive prenatal care (injunctive norm), which was conceptualized by participants as biomedical, nonmedical, or a blend of both. Second, family members often received prenatal care, whereas friends did not (descriptive norms). These findings highlight the key role of personal and social networks in shaping personal pregnancy-related beliefs and behaviors.

  20. Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil.

    Science.gov (United States)

    Ribeiro, Eleonora R O; Guimarães, Alzira Maria D N; Bettiol, Heloísa; Lima, Danilo D F; Almeida, Maria Luiza D; de Souza, Luiz; Silva, Antônio Augusto M; Gurgel, Ricardo Q

    2009-07-22

    The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil. A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use. Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.

  1. Prenatal care and subsequent birth intervals.

    Science.gov (United States)

    Teitler, Julien O; Das, Dhiman; Kruse, Lakota; Reichman, Nancy E

    2012-03-01

    Prenatal care generally includes contraceptive and health education that may help women to control their subsequent fertility. However, research has not examined whether receipt of prenatal care is associated with subsequent birthspacing. Longitudinally linked birth records from 113,662 New Jersey women who had had a first birth in 1996-2000 were used to examine associations between the timing and adequacy of prenatal care prior to a woman's first birth and the timing of her second birth. Multinomial logistic regression analyses adjusted for social and demographic characteristics, hospital and year of birth. Most women (85%) had initiated prenatal care during the first trimester. Women who had not obtained prenatal care until the second or third trimester, or at all, were more likely than those who had had first-trimester care to have a second child within 18 months, rather than in 18-59 months (odds ratios, 1.2-1.6). Similarly, women whose care had been inadequate were more likely than those who had had adequate care to have a short subsequent birth interval (1.2). The associations were robust to alternative measures of prenatal care and birth intervals, and were strongest for mothers with less than 16 years of education. Providers should capitalize on their limited encounters with mothers who initiate prenatal care late or use it sporadically to ensure that these women receive information about family planning. Copyright © 2012 by the Guttmacher Institute.

  2. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    OpenAIRE

    Feijen-de Jong, E.I.; Jansen, D. E. M. C.; Baarveld, F.; Boerleider, A.W.; Spelten, E.; Schellevis, F.; Reijneveld, S.A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in pr...

  3. Intrapartum considerations in prenatal care.

    Science.gov (United States)

    Ehrenberg, Hugh M

    2011-12-01

    The epidemic of obesity continues to grow undaunted, promising to affect the lives of more women of childbearing age. The challenges facing those charged with obstetrical care of the obese may require variation in care from forethought and planning, to consultation or referral for care at specialized centers. The routine management of late pregnancy must take into account the increase in risk for late fetal loss, failed induction and trial of labor after cesarean delivery, and postcesarean complications, such as wound-related morbidity and venous thromboembolism. Awareness of prolonged labor curves and the risk of shoulder dystocia must also be part of the management of labor. The data regarding many interventions attempted on behalf of these at risk gravidas are rudimentary but may allow for modifications in care that will positively impact outcomes for mother and child.

  4. Factors Influencing the Use of Prenatal Care: A Systematic Review

    Directory of Open Access Journals (Sweden)

    2016-01-01

    Full Text Available Background & aim: Prenatal care is a key strategy for achieving public health goals, primary healthcare objectives, and the Millennium Development Goals. The aim of this study was to investigate the factors influencing the use of prenatal care services in order to design suitable interventions and promote the use of these services. Methods:In this systematic quantitative literature review, studies published in years 2010-2014 were evaluated. For this purpose, two international electronic databases, i.e., Scopus and PubMed, were explored to find English-language articles by using relevant keywords; moreover, the reference lists of the articles were hand-searched. We reviewed all cross-sectional and prospective studies, which focused on factors associated with the use of prenatal care services within the specified period of time. Results: In total, 17 relevant articles were included in our review. The results showed that late initiation and inadequate use of prenatal care services are independently associated with multiple variables, including demographic characteristics, socioeconomic factors, predisposing cultural and religious factors, social support, factors related to healthcare providers, women’s awareness and attitude, unintended pregnancy, high-risk medical or obstetric history, and health behaviors. Conclusion: Based on the literature review, proper use of prenatal care cannot be achieved merely by establishing healthcare centers. Utilization of maternal health services may be achieved and improved via developing socioeconomic factors and addressing patients' basic needs including education and financial independence.

  5. FIRST-TRIMESTER PRENATAL-DIAGNOSIS IN TWIN PREGNANCIES

    NARCIS (Netherlands)

    CHRISTIAENS, GCML; Oosterwijk, JC; STIGTER, RH; DEUTZTERLOUW, PP; KNEPPERS, ALJ; BAKKER, E

    Two twin pregnancies at risk for a sex-linked disorder are described. Both pregnancies were dichorionic. Transabdominal sampling was chosen for prenatal diagnosis. Molecular genetic techniques raised suspicion with regard to the accuracy of the samples in one case. Second-trimester amniocentesis

  6. Complications arising in twin pregnancy: findings of prenatal ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Cho, Jeong Yeon; Lee, Young Ho; Song, Mi Jin; Min, Jee Yeon; Lee, Hak Jong; Han, Byoung Hee; Lee, Kyung Sang; Cho, Byung Jae; Chun, Yi Kyeong [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    Multifetal gestations are high-risk pregnancies involving higher perinatal morbidity and mortality, and are subject to unique complications including twin oligohydramnios- polyhydramnios sequence, twin-to-twin transfusion syndrome, acardiac twins, conjoined twins, co-twin demise, and heterotopic pregnancies. The purpose of this study is to describe the prenatal ultrasonographic and pathologic findings of these complications.

  7. Prenatal diagnosis of congenital malformations in 500 pregnancies

    NARCIS (Netherlands)

    Leschot, N.J.; Treffers, P.E.; Verjaal, M.; Weduwen, J.J. der; Bennebroek Gravenhorst, J.; Coelingh Bennink, H.J.T.

    1979-01-01

    The organization, techniques used and diagnostic findings of 500 prenatal diagnoses are reported in detail. In 15 cases the pregnancy was terminated because of abnormal laboratory findings. Follow-up of the remaining pregnancies revealed a perinatal mortality of 1.7%, and the risk of an abortion ind

  8. FIRST-TRIMESTER PRENATAL-DIAGNOSIS IN TWIN PREGNANCIES

    NARCIS (Netherlands)

    CHRISTIAENS, GCML; Oosterwijk, JC; STIGTER, RH; DEUTZTERLOUW, PP; KNEPPERS, ALJ; BAKKER, E

    1994-01-01

    Two twin pregnancies at risk for a sex-linked disorder are described. Both pregnancies were dichorionic. Transabdominal sampling was chosen for prenatal diagnosis. Molecular genetic techniques raised suspicion with regard to the accuracy of the samples in one case. Second-trimester amniocentesis con

  9. The Active Duty Primigravada’s Perception of Prenatal Care in the Military Health Care System

    Science.gov (United States)

    2007-11-02

    Concern, (2) Need for Information, (2A) Importance of Prenatal Classes, (2B) Greater Education and Support for Breastfeeding , (3) Preparation for...not previously experienced. The nine months of pregnancy allow the first time mother to adapt to the maternal role. This means a transition between two...Concern/Caring Theme Category 2: Need for Information Theme Cluster 2A: Prenatal Classes Theme Cluster 2B: Breastfeeding Theme Category 3: Preparation

  10. Pregnancy Complications: Cervical Insufficiency and Short Cervix

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  11. Thinking about Pregnancy After Premature Birth

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Last reviewed: January, 2013 Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  12. Pregnancy Complications: Group B Strep Infection

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  13. Healthy Choices: What to Eat during Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  14. Isotretinoin and Other Retinoids During Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  15. Comparative effectiveness of group and individual prenatal care on gestational weight gain.

    Science.gov (United States)

    Tanner-Smith, Emily E; Steinka-Fry, Katarzyna T; Gesell, Sabina B

    2014-09-01

    This study examined differences in gestational weight gain for women in CenteringPregnancy (CP) group prenatal care versus individually delivered prenatal care. We conducted a retrospective chart review and used propensity scores to form a matched sample of 393 women (76 % African-American, 13 % Latina, 11 % White; average age 22 years) receiving prenatal care at a community health center in the South. Women were matched on a wide range of demographic and medical background characteristics. Compared to the matched group of women receiving standard individual prenatal care, CP participants were less likely to have excessive gestational weight gain, regardless of their pre-pregnancy weight (b = -.99, 95 % CI [-1.92, -.06], RRR = .37). CP reduced the risk of excessive weight gain during pregnancy to 54 % of what it would have been in the standard model of prenatal care (NNT = 5). The beneficial effect of CP was largest for women who were overweight or obese prior to their pregnancy. Effects did not vary by gestational age at delivery. Post-hoc analyses provided no evidence of adverse effects on newborn birth weight outcomes. Group prenatal care had statistically and clinically significant beneficial effects on reducing excessive gestational weight gain relative to traditional individual prenatal care.

  16. Prenatal vitamin intake during pregnancy and offspring obesity.

    Science.gov (United States)

    Dougan, M M; Willett, W C; Michels, K B

    2015-01-01

    In animal studies, exposure to multivitamins may be associated with obesity in the offspring; however, data in humans are sparse. We therefore examined the association between prenatal vitamin intake during pregnancy and offspring obesity. We investigated the association between prenatal vitamin intake and obesity among 29,160 mother-daughter dyads in the Nurses' Health Study II. Mothers of participants provided information on prenatal vitamin use during pregnancy with the nurse daughter. Information on body fatness at ages 5 and 10, body mass index (BMI) at age 18, weight in 1989 and 2009, waist circumference, and height was obtained from the daughter. Polytomous logistic regression was used to predict BMI in early adulthood and adulthood, and body fatness in childhood. Linear regression was used to predict waist circumference in adulthood. In utero exposure to prenatal vitamins was not associated with body fatness, either in childhood or in adulthood. Women whose mothers took prenatal vitamins during pregnancy had a covariate-adjusted odds ratio (OR) of being obese in adulthood of 0.99 (95% confidence interval (CI) 0.92-1.05, P-value = 0.68) compared with women whose mothers did not take prenatal vitamins. Women whose mothers took prenatal vitamins during pregnancy had a covariate-adjusted OR of having the largest body shape at age 5 of 1.02 (95% CI 0.90-1.15, P-value = 0.78). In additional analyses, in utero exposure to prenatal vitamins was also unrelated to adult abdominal adiposity. Exposure to prenatal vitamins was not associated with body fatness either in childhood or in adulthood.

  17. Spontaneous pregnancy outcome after prenatal diagnosis of anencephaly.

    Science.gov (United States)

    Jaquier, M; Klein, A; Boltshauser, E

    2006-08-01

    Parents are usually told that many anencephalic offspring die in utero or soon after delivery, and many obstetricians offer elective termination of the pregnancy. Following the personal experience of the first author, a personal website was created with the intention of providing information and exchanging views with other parents confronted with a prenatal diagnosis of anencephaly. Data were collected from 211 pregnancies where the parents opted not to terminate pregnancy. These data revealed that polyhydramnios was a feature in 56 (26%) pregnancies, death in utero in 15 (7%) pregnancies, 72 (34%) babies were born prematurely (anencephaly is medically safe and should be considered as an option.

  18. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162

  19. Pregnancy anxiety and prenatal cortisol trajectories.

    Science.gov (United States)

    Kane, Heidi S; Dunkel Schetter, Christine; Glynn, Laura M; Hobel, Calvin J; Sandman, Curt A

    2014-07-01

    Pregnancy anxiety is a potent predictor of adverse birth and infant outcomes. The goal of the current study was to examine one potential mechanism whereby these effects may occur by testing associations between pregnancy anxiety and maternal salivary cortisol on 4 occasions during pregnancy in a sample of 448 women. Higher mean levels of pregnancy anxiety over the course of pregnancy predicted steeper increases in cortisol trajectories compared to lower pregnancy anxiety. Significant differences between cortisol trajectories emerged between 30 and 31 weeks of gestation. Results remained significant when adjusted for state anxiety and perceived stress. Neither changes in pregnancy anxiety over gestation, nor pregnancy anxiety specific to only a particular time in pregnancy predicted cortisol. These findings provide support for one way in which pregnancy anxiety may influence maternal physiology and contribute to a growing literature on the complex biological pathways linking pregnancy anxiety to birth and infant outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. The association between inadequate prenatal care and future healthcare use among offspring in the Bedouin population.

    Science.gov (United States)

    Estis-Deaton, Asia; Sheiner, Eyal; Wainstock, Tamar; Landau, Daniella; Walfisch, Asnat

    2017-08-30

    To evaluate the impact of inadequate prenatal care on long-term morbidity among the offspring of an ethnic minority population. A retrospective population-based cohort analysis was performed among all Bedouin women with singleton pregnancies who delivered in a tertiary medical center in Israel between January 1, 1991, and January 1, 2014. Morbidity was defined as pediatric hospitalization across six distinct disease categories before 18 years of age. The cumulative morbidity rates were compared for offspring born following pregnancies with either inadequate (prenatal care facility) or adequate prenatal care. Overall, 127 396 neonates were included; 19 173 (15.0%) were born following inadequate prenatal care. Pediatric hospitalizations for all morbidities other than cardiovascular ones were less frequent among the inadequate prenatal care group than the adequate prenatal care group (Pinadequate prenatal care group, with the exception of cardiovascular disease. Inadequate prenatal care correlated with reduced pediatric hospitalization rates among offspring, possibly owing to a lack of child healthcare service utilization within the Bedouin population. © 2017 International Federation of Gynecology and Obstetrics.

  1. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Directory of Open Access Journals (Sweden)

    Sword Wendy

    2012-04-01

    Full Text Available Abstract Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of

  2. Disparate patterns of prenatal care utilization stratified by medical and psychosocial risk.

    Science.gov (United States)

    Krans, Elizabeth E; Davis, Matthew M; Palladino, Christie L

    2013-05-01

    To evaluate patterns of prenatal care utilization stratified by medical and psychosocial risk. A retrospective cohort of 786 pregnant women who subsequently delivered live births from 1999 to 2003 at the University of Michigan were classified into high medical, high psychosocial, high medical and high psychosocial (dual high risk) and low-risk pregnancies. Chi-square and logistic regression analyses assessed the association between risk and prenatal care utilization using the Kotelchuck Index. Of 786 pregnancies, 202 (25.7%) were high medical risk, 178 (22.7%) were high psychosocial risk, 227 (28.9%) were dual high risk and 179 (22.8%) were low-risk. Over 31% of dual high risk and 25% of high medical risk pregnancies received "adequate plus" prenatal care versus 10% of high psychosocial risk pregnancies. In multivariate analyses, adjusted for risk, race and insurance, high psychosocial risk pregnancies (OR = 1.69; 95% CI 1.06-2.72) were significantly more likely to receive inadequate prenatal care than care of greater intensity. Many high psychosocial risk pregnancies do not receive adequate prenatal care.

  3. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    Science.gov (United States)

    Feijen-de Jong, Esther I; Jansen, Danielle E M C; Baarveld, Frank; Boerleider, Agatha W; Spelten, Evelien; Schellevis, François; Reijneveld, Sijmen A

    2015-06-01

    Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care. We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care. Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. The Relationship between Prenatal Parental Stress and Pregnancy Outcome.

    Science.gov (United States)

    Neihardt, Joanne E.

    To explore the relationship between prenatal parental stress and pregnancy outcome, this study investigated the hypothesis that parents of infants with defects would report greater amounts of stress in the year prior to their infant's birth than would parents of normally developing infants. Data on levels of parental stress were obtained from 37…

  5. Impact of early pregnancy on prenatal development in the pig

    NARCIS (Netherlands)

    Lende, van der T.

    1989-01-01

    In the present study aspects of the impact of early pregnancy on the average prenatal development per litter and on the within-litter weight distribution at birth have been investigated. The aims of the present study are given in the introduction (chapter 1). A brief review of the literatur

  6. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review.

    NARCIS (Netherlands)

    Boerleider, A.W.; Wiegers, T.A.; Manniën, J.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a

  7. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review

    NARCIS (Netherlands)

    Boerleider, A.W.; Wiegers, T.A.; Manniën, J.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a

  8. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review.

    NARCIS (Netherlands)

    Boerleider, A.W.; Wiegers, T.A.; Manniën, J.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a

  9. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review

    NARCIS (Netherlands)

    Boerleider, A.W.; Wiegers, T.A.; Manniën, J.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a s

  10. Using Community-Based Participatory Research to Investigate Meaningful Prenatal Care Among African American Women.

    Science.gov (United States)

    Nypaver, Cynthia F; Shambley-Ebron, Donna

    2016-11-01

    In the United States, African American babies die more than twice as often as White babies. The cause for this difference remains elusive, yet is likely complex with one factor being inadequate cultural care of pregnant African American women. The purpose of this study was to explore African American women's perspectives of meaningful prenatal care. Community-based participatory research was employed for this study using photovoice. The sample included 11 African American mothers in an urban community in Midwestern United States. Five themes were abstracted from the data: (1) Access to Care; (2) Soul Nourishment; (3) Companionship; (4) Help Me, Teach Me; and (5) The Future. Meaningful prenatal care is influenced by culture. African American women need physical, social, and soulful support to enhance meaningfulness of care during pregnancy. The findings support that meaningfulness of prenatal care for African American women may be enhanced by accessible and uniquely designed, culturally congruent models of prenatal care. © The Author(s) 2015.

  11. [Factors associated with the quality of prenatal care: an approach to premature birth].

    Science.gov (United States)

    Melo, Emiliana Cristina; Oliveira, Rosana Rosseto de; Mathias, Thais Aidar de Freitas

    2015-08-01

    To assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care. Cross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02). The indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09), non-white skin color (CI=1.11;2.51); unplanned pregnancy (CI=1.34;3.17) and multiparity (CI=1.17;4.03). Prenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

  12. New Mexico women with no prenatal care: reasons, outcomes, and nursing implications.

    Science.gov (United States)

    Higgins, P G; Burton, M

    1996-01-01

    A retrospective chart review was conducted to determine why women received no prenatal care during pregnancy and their subsequent maternal and neonatal outcomes. Five hundred and eighty medical records from 1990 through 1993 that were labeled as no care were reviewed. Actually, only 270 records had no care and of these, 92 had 156 recorded reasons as to why women did not receive prenatal care. These reasons were categorized into three types of barriers: attitudinal, sociodemographic, and system-related. The majority of the women were young, Hispanic, unmarried, between 20 and 29 years of age, and uninsured, and had one to three children. Overall, the women did not smoke cigarettes, drink alcohol, or use drugs during pregnancy. Overall, the women had good maternal and newborn outcomes. Results suggest a need to reevaluate the effect of prenatal care use on young Hispanic women.

  13. [Adequacy process of prenatal care according to the criteria of humanizing of prenatal care and childbirth program and stork network].

    Science.gov (United States)

    Martinelli, Katrini Guidolini; Santos Neto, Edson Theodoro Dos; Gama, Silvana Granado Nogueira da; Oliveira, Adauto Emmerich

    2014-02-01

    To evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal Care (PHPN) and of the procedures provided by the Stork Network of Unified Health System (SUS) in the microregion of Espirito Santo state, Brazil. A cross-sectional study was conducted in 2012-2013 by interviewing and analyzing the records of 742 women during the postpartum period and of their newborns in 7 hospitals in the region chosen for the research. The information was collected, processed and analyzed by the χ² and Fisher's exact test to determine the difference in proportion between the criteria adopted by the PHPN and the Stork Network and the place of residence, family income and type of coverage of prenatal service. The level of significance was set at 5%. The parameters showing the lowest adequacy rate were quick tests and repeated exams, with frequencies around 10 and 30%, respectively, in addition to educational activities (57.9%) and tetanus immunization (58.7%). In contrast, risk management (92.6%) and the fasting plasma glucose test (91.3%) showed the best results. Adequacy was 7.4% for the PHPN, 0.4% for the Stork Network, with respect to the parameters of normal risk pregnancies, and 0 for high risk pregnancies. There was a significant difference between puerperae according to housing location regarding the execution of serology for syphilis (VDRL), anti-HIV and repeated fasting glucose tests, and monthly income influenced the execution of blood type/Rh factor tests, VDRL, hematocrit and anti-HIV test. Prenatal care in the SUS proved to be inadequate regarding the procedures required by the PHPN and Stork Network in the micro-region of a state in southeastern Brazil, especially for women of lower income, PACS users and residents of rural areas.

  14. Good Health Before Pregnancy: Preconception Care

    Science.gov (United States)

    ... to start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements contain all the recommended daily vitamins and ... pregnant. Can the medications I take affect my pregnancy? Some medications, including vitamin supplements, over-the-counter medications, and herbal remedies, ...

  15. Referrals for dental care during pregnancy.

    Science.gov (United States)

    Kloetzel, Megan K; Huebner, Colleen E; Milgrom, Peter

    2011-01-01

    Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly.

  16. Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals

    Science.gov (United States)

    Laditka, Sarah B.; Laditka, James N.; Bennett, Kevin J.; Probst, Janice C.

    2005-01-01

    Pregnancy complications affect many women. It is likely that some complications can be avoided through routine primary and prenatal care of reasonable quality. The authors examined access to health care during pregnancy for mothers insured by Medicaid. The access indicator is potentially avoidable maternity complications (PAMCs). Potentially…

  17. Factors associated with the quality of prenatal care: an approach to premature birth

    Directory of Open Access Journals (Sweden)

    Emiliana Cristina Melo

    2015-08-01

    Full Text Available OBJECTIVETo assess the quality of prenatal care in mothers with premature and term births and identify maternal and gestational factors associated with inadequate prenatal care.METHODCross-sectional study collecting data with the pregnant card, hospital records and interviews with mothers living in Maringa-PR. Data were collected from 576 mothers and their born alive infants who were attended in the public service from October 2013 to February 2014, using three different evaluation criteria. The association of prenatal care quality with prematurity was performed by univariate analysis and occurred only at Kessner criteria (CI=1.79;8.02.RESULTSThe indicators that contributed most to the inadequacy of prenatal care were tests of hemoglobin, urine, and fetal presentation. After logistic regression analysis, maternal and gestational variables associated to inadequate prenatal care were combined prenatal (CI=2.93;11.09, non-white skin color (CI=1.11;2.51; unplanned pregnancy (CI=1.34;3.17 and multiparity (CI=1.17;4.03.CONCLUSIONPrenatal care must follow the minimum recommended protocols, more attention is required to black and brown women, multiparous and with unplanned pregnancies to prevent preterm birth and maternal and child morbimortality.

  18. Rethinking prenatal care within a social model of health: an exploratory study in Northern Ireland.

    Science.gov (United States)

    McNeill, Jenny A; Reiger, Kerreen M

    2015-01-01

    Implementation of maternity reform agendas remains limited by the dominance of a medical rather than social model of health. This article considers group prenatal care as a complex health intervention and explores its potential in the socially divided, postconflict communities of Northern Ireland. Using qualitative inquiry strategies, we sought key informants' views on existing prenatal care provision and on an innovative group care model (CenteringPregnancy®) as a social health initiative. We argue that taking account of the locally specific context is critical to introducing maternity care interventions to improve the health of women and their families and to contribute to community development.

  19. Association between prenatal care utilization and risk of preterm birth among Chinese women.

    Science.gov (United States)

    Zhang, Bin; Yang, Rong; Liang, Sheng-Wen; Wang, Jing; Chang, Jen Jen; Hu, Ke; Dong, Guang-Hui; Hu, Rong-Hua; Flick, Louise H; Zhang, Yi-Ming; Zhang, Dan; Li, Qing-Jie; Zheng, Tong-Zhang; Xu, Shun-Qing; Yang, Shao-Ping; Qian, Zheng-Min

    2017-08-01

    It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32-1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

  20. Prenatal Caffeine Exposure Impairs Pregnancy in Rats

    Directory of Open Access Journals (Sweden)

    Maryam Yadegari

    2016-12-01

    Full Text Available Background: In recent years, concerns have been raised about human reproductive disorders. Caffeine consumption is increasing by the world’s population and there is a relationship between caffeine intake and adverse reproductive outcomes. The aim of this study was to evaluate the effects of caffeine on implantation sites, number of live births, birth weight, crown-rump length (CRL and abnormality in pregnant rats. Materials and Methods: In this experimental study, 40 female albino rats (170-190 g were randomly divided into two experimental and two control groups (n=10/each group. In both experimental groups, animals received caffeine intraperitoneally (IP: 150 mg/kg/day on days 1-5 of pregnancy. In experimental group 1, treated animals were euthanized on day 7of pregnancy and the number of implantation sites was counted. In experimental group 2, treated animals maintained pregnant and after delivery, the number of live births, birth weight, CRL and abnormality of neonates were investigated. In control group, animals received IP injections of distilled water. Data were analyzed by independent t test. Results: Results showed that administration of caffeine significantly decreased the number of implantation sites, number of live births and CRL as compared with control group (P<0.05. There were no significant differences regarding birth weight and abnormality of neonate rats between experimental and control groups. Conclusion: These results suggest that caffeine caused anti-fertility effect and significantly decreased CRL in neonate rats.

  1. [Prenatal care and birth weight: an analysis in the context of family health basic units].

    Science.gov (United States)

    Pedraza, Dixis Figueroa; Rocha, Ana Carolina Dantas; Cardoso, Maria Vera Lúcia Moreira Leitão

    2013-08-01

    To characterize prenatal care and to evaluate the association of its adequacy with maternal, socioeconomic and environmental sanitation characteristics, as well as the influence of these factors on the birth weight of the children. The eligible population for the study consisted of all women who had children during 2009 and lived in the city of Queimadas at the time of data collection. Information was collected with a questionnaire applied to the mothers in Family Health Basic Units or in their residence. The prenatal care adequacy index (outcome variable) was defined as adequate when the mother attended six or more prenatal visits and began monitoring during the first trimester of pregnancy (inadequate prenatal care and a multiple linear regression model was used to estimate the effect of adequacy of prenatal care and maternal, socioeconomic and environmental sanitation variables on birth weight. The statistical program used was Rv2.10.0, with the level of significance set at p prenatal care. After adjustment for other predictors, maternal age of 19 years or less remained as an explanatory variable of inadequate prenatal care (OR 4.27, 95%CI 1.10 - 15.89). Even after controlling for variables, child's birth weight was negatively associated with water supply from a well/spring and burnt/buried garbage, accounting for weight reductions of the order of 563.8, 262.0 and 951.9 g, respectively. Adequate prenatal care can alleviate the influence of socioeconomic disparities related to health care. Even in this situation, teenage mothers are more likely to receive inadequate prenatal care and low birth weight is favored by improper sanitation conditions (such as water supply and garbage disposal).

  2. Prenatal Care: First Trimester Visits

    Science.gov (United States)

    ... mention even sensitive issues, such as domestic abuse, abortion or past drug use. Remember, the information you ... Your health care provider will use a fetal ultrasound to help confirm the date. Physical exam Your ...

  3. Caring for Pets When You're Pregnant

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Last reviewed: April, 2014 Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  4. Anencephaly: pitfalls in pregnancy outcome and relevance of the prenatal exam.

    Science.gov (United States)

    Tica, V I; Beghim, M; Tica, Irina; Zaher, M; Beghim, Esra

    2009-01-01

    Anencephaly is an embryological malformation of the central nervous system, invariable lethal, characterized by the absence of the brain and cranial vault and by other defects of the cranial structures. It has no cure but it can be detected during the pregnancy with ultrasonography. We present a rare case of a 15-year-old primipara, with no prenatal care, who delivered at 37 weeks an anencephalous female newborn. Ultrasonography avoided the confusion with a breach presentation, which, in conjunction with the prematurity, premature rupture of membranes and the young maternal age would have favored the cesarean section. The rarity of the case is increased by the singularity of the malformation. The importance of the prenatal care and genetic workup are stressed out in this embryologic pathology.

  5. Adequacy of prenatal care and neonatal mortality in infants born to mothers with and without antenatal high-risk conditions.

    Science.gov (United States)

    Chen, Xi-Kuan; Wen, Shi Wu; Yang, Qiuying; Walker, Mark C

    2007-04-01

    Previous studies have found that inadequate prenatal care was associated with increased neonatal mortality in the general pregnant women. To examine the association between adequacy of prenatal care and neonatal mortality in the presence and absence of antenatal high-risk conditions. We conducted a retrospective cohort study of infants based on 1995-2000 vital statistics data in the USA. The relative risk for neonatal death associated with adequacy of prenatal care was estimated by multivariate logistic regressions with adjustment of confounding factors. Inadequate prenatal care was associated with increased neonatal mortality when pregnancies were complicated by anaemia, cardiac disease, lung disease, chronic hypertension, diabetes, renal disease, pregnancy-induced hypertension, and previous preterm/small-for-gestational-age birth. The observed association also existed in the absence of these antenatal high-risk conditions. Overutilisation of prenatal care was associated with increased risk of neonatal deaths in both the presence and the absence of antenatal high-risk conditions. When gestational age at delivery and birthweight were further adjusted, the observed association between inadequate prenatal care and neonatal mortality was not significant in pregnancies with various high-risk conditions. Inadequate prenatal care is associated with increased neonatal death in both the presence and the absence of antenatal high-risk conditions. The observed association between inadequate prenatal care and neonatal mortality may be mediated by increased risk of preterm delivery and low birthweight in these pregnancies. Overutilisation of prenatal care is associated with potential risks for fetal and neonatal development, leading to increased neonatal mortality.

  6. Time of HIV Diagnosis and Engagement in Prenatal Care Impact Virologic Outcomes of Pregnant Women with HIV.

    Directory of Open Access Journals (Sweden)

    Florence M Momplaisir

    Full Text Available HIV suppression at parturition is beneficial for maternal, fetal and public health. To eliminate mother-to-child transmission of HIV, an understanding of missed opportunities for antiretroviral therapy (ART use during pregnancy and HIV suppression at delivery is required.We performed a retrospective analysis of 836 mother-to-child pairs involving 656 HIV-infected women in Philadelphia, 2005-2013. Multivariable regression examined associations between patient (age, race/ethnicity, insurance status, drug use and clinical factors such as adequacy of prenatal care measured by the Kessner index which classifies prenatal care as inadequate, intermediate, or adequate prenatal care; timing of HIV diagnosis; and the outcomes: receipt of ART during pregnancy and viral suppression at delivery.Overall, 25% of the sample was diagnosed with HIV during pregnancy; 39%, 38%, and 23% were adequately, intermediately, and inadequately engaged in prenatal care. Eight-five percent of mother-to-child pairs received ART during pregnancy but only 52% achieved suppression at delivery. Adjusting for patient factors, pairs diagnosed with HIV during pregnancy were less likely to receive ART (AOR 0.39, 95% CI 0.25-0.61 and achieve viral suppression (AOR 0.70, 95% CI 0.49-1.00 than those diagnosed before pregnancy. Similarly, women with inadequate prenatal care were less likely to receive ART (AOR 0.06, 95% CI 0.03-0.11 and achieve viral suppression (AOR 0.31, 95% CI 0.20-0.47 than those with adequate prenatal care.Targeted interventions to diagnose HIV prior to pregnancy and engage HIV-infected women in prenatal care have the potential to improve HIV related outcomes in the perinatal period.

  7. Time of HIV Diagnosis and Engagement in Prenatal Care Impact Virologic Outcomes of Pregnant Women with HIV.

    Science.gov (United States)

    Momplaisir, Florence M; Brady, Kathleen A; Fekete, Thomas; Thompson, Dana R; Diez Roux, Ana; Yehia, Baligh R

    2015-01-01

    HIV suppression at parturition is beneficial for maternal, fetal and public health. To eliminate mother-to-child transmission of HIV, an understanding of missed opportunities for antiretroviral therapy (ART) use during pregnancy and HIV suppression at delivery is required. We performed a retrospective analysis of 836 mother-to-child pairs involving 656 HIV-infected women in Philadelphia, 2005-2013. Multivariable regression examined associations between patient (age, race/ethnicity, insurance status, drug use) and clinical factors such as adequacy of prenatal care measured by the Kessner index which classifies prenatal care as inadequate, intermediate, or adequate prenatal care; timing of HIV diagnosis; and the outcomes: receipt of ART during pregnancy and viral suppression at delivery. Overall, 25% of the sample was diagnosed with HIV during pregnancy; 39%, 38%, and 23% were adequately, intermediately, and inadequately engaged in prenatal care. Eight-five percent of mother-to-child pairs received ART during pregnancy but only 52% achieved suppression at delivery. Adjusting for patient factors, pairs diagnosed with HIV during pregnancy were less likely to receive ART (AOR 0.39, 95% CI 0.25-0.61) and achieve viral suppression (AOR 0.70, 95% CI 0.49-1.00) than those diagnosed before pregnancy. Similarly, women with inadequate prenatal care were less likely to receive ART (AOR 0.06, 95% CI 0.03-0.11) and achieve viral suppression (AOR 0.31, 95% CI 0.20-0.47) than those with adequate prenatal care. Targeted interventions to diagnose HIV prior to pregnancy and engage HIV-infected women in prenatal care have the potential to improve HIV related outcomes in the perinatal period.

  8. Prenatal Care Initiation in Low-Income Hispanic Women: Risk and Protective Factors

    Science.gov (United States)

    Luecken, Linda J.; Purdom, Catherine L.; Howe, Rose

    2009-01-01

    Objectives: To examine the psychosocial risk (distress, stress, unintended pregnancy) and protective factors (social support, mastery, familism) associated with entry into prenatal care among low-income Hispanic women. Methods: Between April and September 2005, 483 postpartum Medicaid-eligible Hispanic women completed a survey at the hospital.…

  9. The clinical utility of non-invasive prenatal testing in pregnancies with ultrasound anomalies

    NARCIS (Netherlands)

    Beulen, Lean; Faas, Brigitte H W; Feenstra, Ilse; van Vugt, John M G; Bekker, Mireille N

    OBJECTIVE: This study aims to evaluate the application of non-invasive prenatal testing (NIPT) as an alternative to invasive diagnostic prenatal testing for pregnancies with abnormal ultrasound findings. METHOD: A retrospective analysis was performed of 251 single and multiple pregnancies at high

  10. Clinical utility of non-invasive prenatal testing in pregnancies with ultrasound anomalies

    NARCIS (Netherlands)

    Beulen, L.; Faas, B.H.W.; Feenstra, I.; Vugt, J.M.G. van; Bekker, M.N.

    2017-01-01

    OBJECTIVE: To evaluate the application of non-invasive prenatal testing (NIPT) as an alternative to invasive diagnostic prenatal testing in pregnancies with abnormal ultrasound findings. METHODS: This was a retrospective analysis of 251 singleton and multiple pregnancies at high risk for fetal

  11. [Effects of different home visit strategies on prenatal care in Southern Brazil].

    Science.gov (United States)

    Cesar, Juraci A; Mendoza-Sassi, Raul A; Ulmi, Eduardo F; Dall'Agnol, Marinel M; Neumann, Nelson A

    2008-11-01

    This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents, 116 to the group visited by volunteer leaders, and 108 to the control group. Pregnant women visited by community health agents began prenatal visits earlier than other groups, had more prenatal visits, lab tests, and clinical exams, and received more counseling on breastfeeding and iron supplementation. Participation by family members during medical consultations for pregnant women visited by volunteer leaders was higher than for community health agents. Pregnant women visited by community health agents received better prenatal care than the other groups. Home visits can improve the quality of prenatal care for poor women and increase participation by family members (mainly husbands) during the pregnancy.

  12. The Motivation-Facilitation Theory of Prenatal Care Access.

    Science.gov (United States)

    Phillippi, Julia C; Roman, Marian W

    2013-01-01

    Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care. © 2013 by the American College of Nurse‐Midwives.

  13. 产前护理需求及护理干预对高危妊娠孕妇的效果评价%Effect evaluation of prenatal care needs and study on nursing intervention on high risk pregnancy

    Institute of Scientific and Technical Information of China (English)

    杜丽芳

    2014-01-01

    目的:探讨高危妊娠孕妇的产前护理需求以及采用护理干预方案的临床效果。方法:2013年7月-2014年6月收治高危妊娠孕妇100例,首先通过问卷调查的方式了解护理需求;然后将其随机分为对照组(50例)和观察组(50例)。对照组采用常规护理方案,观察组在对照组的基础上进行护理干预。观察两组患者的护理效果。结果:在高危妊娠孕妇中,对胎儿发育情况的护理需求最高(72.0%);对社会支持的需求最低(4.0%)。观察组的T-AI指标和S-AI指标明显低于对照组,护理满意率明显高于对照组,差异具有统计学意义(P<0.05)。结论:了解高危妊娠孕妇的产前护理需求,并有针对性地实施护理干预,能够提高患者的护理满意度,改善身心状况,提高患者的生存质量,值得临床推广。%Objective:To explore the prenatal care needs of high risk pregnancy and the clinical effect of the nursing intervention program.Methods:100 cases of high-risk pregnant women were selected from July 2013 to June 2014.Care needs were investigated by questionnaire.Then they were randomly divided into the control group(50 cases) and the observation group(50 cases).The control group were given conventional nursing,and the observation group were given nursing intervention on the basis of the control group.We observed the effect of nursing care.Results:In the high-risk pregnant women,nursing demand for fetal development was the highest(72%);the demand for social support was the lowest(4%).In the observation group,T-AI index and S-AI index was significantly lower than the control group;nursing satisfaction rate was significantly higher than that in the control group;the difference was statistically significant(P<0.05). Conclusion:Understanding the prenatal care needs of high risk pregnancy and the implementation of targeted nursing intervention can improve the patients' satisfaction to nursing care

  14. Fetal programming of adult disease: implications for prenatal care.

    Science.gov (United States)

    Lau, Christopher; Rogers, John M; Desai, Mina; Ross, Michael G

    2011-04-01

    The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult health disorders, particularly metabolic syndrome, can be markedly influenced by prenatal and infant environmental exposures (ie, developmental programming). Low birth weight, together with infant catch-up growth, is associated with a significant risk of adult obesity and cardiovascular disease, as well as adverse effects on pulmonary, renal, and cerebral function. Conversely, exposure to maternal obesity or high birth weight also represents an increased risk for childhood and adult obesity. In addition, fetal exposure to select chemicals (eg, phytoestrogens) or environmental pollutants (eg, tobacco smoke) may affect the predisposition to adult disease. Animal models have confirmed human epidemiologic findings and provided insight into putative programming mechanisms, including altered organ development, cellular signaling responses, and epigenetic modifications (ie, control of gene expression without modification of DNA sequence). Prenatal care is transitioning to incorporate goals of optimizing maternal, fetal, and neonatal health to prevent or reduce adult-onset diseases. Guidelines regarding optimal pregnancy nutrition and weight gain, management of low- and high-fetal-weight pregnancies, use of maternal glucocorticoids, and newborn feeding strategies, among others, have yet to fully integrate long-term consequences on adult health.

  15. Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

    Science.gov (United States)

    Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

    2015-04-21

    Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

  16. Anguish, Yearning, and Identity: Toward a Better Understanding of the Pregnant Hispanic Woman's Prenatal Care Experience.

    Science.gov (United States)

    Fitzgerald, Elizabeth Moran; Cronin, Sherill Nones; Boccella, Sarah Hess

    2016-09-01

    The purpose of this phenomenological study was to seek a better understanding of needs and access issues among pregnant, low-income Hispanic women. Hispanic women who attended a community prenatal education program participated in follow-up focus groups to explore their experiences regarding prenatal education, pregnancy resources, access to, and satisfaction with, the care available to them. Focus groups were facilitated by a leader, bilingual in English and Spanish, with knowledge of the Hispanic culture. Sessions were audiotaped, then translated into English for transcription. Data were analyzed according to guidelines by Colaizzi and three themes emerged: pregnant Hispanic women experienced a sense of anguish (la angustia) from questions and unknowns rampant during pregnancy, leading to a yearning (el anhelo) to learn and understand more, but with a desire to do so without sacrificing native identity (la identidad). Implications of these themes for improving prenatal care for this population are explored.

  17. Nonuse of Prenatal Care: Implications for Social Work Involvement.

    Science.gov (United States)

    Bedics, Bonnie C.

    1994-01-01

    Interviewed 44 women who did not obtain prenatal care. Identified four categories of reasons for nonuse: women's lifestyles differed from mainstream; stressful events took priority over prenatal care; women attempted to receive care but were discouraged, turned away, or given poor information by service delivery system personnel; and women did not…

  18. Within prisons, is there an association between the quantity of prenatal care and infant birthweight?

    Science.gov (United States)

    Howard, David L; Strobino, Donna; Sherman, Susan; Crum, Rosa

    2008-07-01

    There is still controversy surrounding the effectiveness of prenatal care in reducing low birthweight. In addition, very few studies have assessed the relationship between prenatal care and infant birthweight among pregnant women within the prison system. We sought to ascertain whether there is an association between the quantity of prenatal care and infant birthweight among pregnant women within such a setting. We examined the prison medical records of 147 infants born to women delivering at term (37-41 weeks of gestation) between 1 January 2002 and 31 December 2004 who were incarcerated during pregnancy in Texas state prisons. Linear regression was used to evaluate the association between the number of prison prenatal care visits and infant birthweight while adjusting for potential confounders (age, gravidity, maternal education, maternal race, history of substance use, history of alcohol use, history of tobacco use and the presence of any chronic disease). We also adjusted for the interaction between the gestational age at admission to prison and the number of prison prenatal care visits. There was a statistically significant 120.5 g increase in adjusted mean birthweight with each additional prison prenatal care visit (P = 0.001) among study infants whose mothers entered prison during the first trimester. This trend was not observed among women who came in after the first trimester. There appears to be a positive association between the amount of prison prenatal care and infant birthweight among incarcerated pregnant women delivering at term, but this association appears to be limited to women entering prison during the first trimester of pregnancy.

  19. Intimate partner violence and utilization of prenatal care in the United States.

    Science.gov (United States)

    Cha, Susan; Masho, Saba W

    2014-03-01

    Over 1.5 million women are victims of physical, sexual, and emotional abuse by former or present intimate partners. Intimate partner violence (IPV) around pregnancy can lead to devastating health consequences to mothers and infants. While some research suggests that IPV negatively affects the utilization of health services like prenatal care (PNC), inconsistencies in the assessment of PNC utilization, timing of partner violence, and definitions of IPV yield conflicting results. The objective for the present study is to evaluate whether preconception IPV, prenatal IPV, or IPV in the preconception and/or prenatal period affects PNC utilization. This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS), which included 202,367 women who delivered a live birth in the United States. IPV victimization was measured using four items that addressed physical abuse by a current or former husband/partner in the 12 months before (preconception) and during (prenatal) pregnancy. Responses were categorized as preconception, prenatal, and preconception and/or prenatal IPV. The outcome was PNC adequacy categorized as inadequate, intermediate, adequate, and adequate plus based on the Adequacy of Prenatal Care Utilization index. Separate logistic regression models provided crude and adjusted odds ratios and 95% confidence intervals (CI). Over 6% of women reported preconception and/or prenatal IPV and 26% had less than adequate PNC. Women who reported abuse before and/or during pregnancy were more likely to have inadequate PNC (odds ratio [OR] = 1.4, 95% CI = [1.3, 1.6]). Similarly, women who experienced preconception or prenatal IPV were 30% more likely to have inadequate PNC (OR = 1.3, 95% CI = [1.2, 1.5]; OR = 1.3, 95% CI = [1.1, 1.7], respectively). Adequate PNC is essential in improving pregnancy outcomes; however, women in abusive relationships may face ongoing challenges and difficulties with obtaining appropriate care. Findings underscore a

  20. CenteringPregnancy Smiles: A Community Engagement to Develop and Implement a New Oral Health and Prenatal Care Model in Rural Kentucky

    Science.gov (United States)

    Kovarik, Robert E.; Skelton, Judith; Mullins, M. Raynor; Langston, LeAnn; Womack, Sara; Morris, Jack; Martin, Dan; Brooks, Robert; Ebersole, Jeffrey L.

    2009-01-01

    CenteringPregnancy Smiles[TM] (CPS) is a partnership between the University of Kentucky, Trover Health System, and Hopkins County Health Department. The purpose of the partnership is to: (1) establish an infrastructure to address health problems requiring research-based solutions, (2) develop a model for community partnership formation, and (3)…

  1. Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years.

    Science.gov (United States)

    Debiec, Katherine E; Paul, Kathleen J; Mitchell, Caroline M; Hitti, Jane E

    2010-08-01

    The aim of this study was to determine whether inadequate prenatal care is associated with increased risk of preterm birth among adolescents. We selected a random sample of women under age 20 years with singleton pregnancies delivering in Washington State between 1995 and 2006. Multivariate logistic regression was used to assess the association between prenatal care adequacy (percent of expected visits attended, adjusted for gestational age) and preterm birth. Of 30,000 subjects, 27,107 (90%) had complete data. Women without prenatal care had more than 7-fold higher risk of preterm birth (n = 84 [24.1%]; adjusted odds ratio [aOR], 7.4), compared with those attending 75-100% of recommended visits (n = 346 [3.9%]). Women with less than 25%, 25-49%, or 50-74% of expected prenatal visits were at significantly increased risk of preterm birth; risk decreased linearly as prenatal care increased (n = 60 [9.5%], 132 (5.9%], 288 [5%]; and aOR, 2.5, 1.5, and 1.3, respectively). Inadequate prenatal care is strongly associated with preterm birth among adolescents. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  2. Experiences of prenatal diagnosis and decision-making about termination of pregnancy: A qualitative study.

    Science.gov (United States)

    Hodgson, Jan; Pitt, Penelope; Metcalfe, Sylvia; Halliday, Jane; Menezes, Melody; Fisher, Jane; Hickerton, Chriselle; Petersen, Kerry; McClaren, Belinda

    2016-12-01

    Advances in genetic technologies and ultrasound screening techniques have increased the ability to predict and diagnose congenital anomalies during pregnancy. As a result more prospective parents than ever before will receive a prenatal diagnosis of a fetal abnormality. Little is known about how Australian women and men experience receiving a prenatal diagnosis and how they make their decision about whether or not to continue the pregnancy. This qualitative study aims to describe parental experiences and examine how best to provide support after a prenatal diagnosis. Individual in-depth interviews were conducted with 102 women and men approximately six weeks post-diagnosis of fetal abnormality. Data were elicited using a narrative, chronological approach and women (n = 75) and a sample of male partners (n = 27) were separately interviewed. Thematic analysis, involving a rigorous process of qualitative coding, enabled iterative development and validation of emergent themes. Participants identified that the shock of the diagnosis can be lessened when good care is delivered, by provision of: clear, accurate and respectful communication; empathic, non-judgemental, professional support; timely access to further testing and appointments; seamless interactions with services and administration; appropriate choices about invasive testing; acknowledgment of the enormity and unexpected nature of the diagnosis, and of the subsequent decision-making challenges; and discussion of the myriad feelings likely to emerge throughout the process. This study has demonstrated the importance of providing timely access to accurate information and supportive, non-judgemental care for women and their partners following prenatal diagnosis of a fetal abnormality. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  3. Prenatal care: associations with prenatal depressive symptoms and social support in low-income urban women.

    Science.gov (United States)

    Sidebottom, Abbey C; Hellerstedt, Wendy L; Harrison, Patricia A; Jones-Webb, Rhonda J

    2017-06-03

    We examined associations of depressive symptoms and social support with late and inadequate prenatal care in a low-income urban population. The sample was prenatal care patients at five community health centers. Measures of depressive symptoms, social support, and covariates were collected at prenatal care entry. Prenatal care entry and adequacy came from birth certificates. We examined outcomes of late prenatal care and less than adequate care in multivariable models. Among 2341 study participants, 16% had elevated depressive symptoms, 70% had moderate/poor social support, 21% had no/low partner support, 37% had late prenatal care, and 29% had less than adequate prenatal care. Women with both no/low partner support and elevated depressive symptoms were at highest risk of late care (AOR 1.85, CI 1.31, 2.60, p care (AOR 0.74, CI 0.54, 1.10, p = 0.051). Women with moderate/high depressive symptoms were less likely to experience less than adequate care compared to women with low symptoms (AOR 0.73, CI 0.56, 0.96, p = 0.022). Social support and partner support were negatively associated with indices of prenatal care use. Partner support was identified as protective for women with depressive symptoms with regard to late care. Study findings support public health initiatives focused on promoting models of care that address preconception and reproductive life planning. Practice-based implications include possible screening for social support and depression in preconception contexts.

  4. Current problems regarding abortion, prenatal genetic testing and managing pregnancy

    Directory of Open Access Journals (Sweden)

    Klajn-Tatić Vesna

    2011-01-01

    Full Text Available Current ethical and legal issues with regard to abortion, prenatal genetic testing and managing pregnancy are discussed in this paper. These problems are considered from the legal theory point of view as well as from the standpoint of the Serbian Law, the European Convention for the Protection of Human Rights and Fundamental Freedoms, European Court of Human Rights, legal regulations of several EU countries, the USA, Japan, and their judicial practice. First, the pregnancy termination standards that exist in Serbia are introduced. Then the following issues are explained separately: the pro life and pro choice approaches to abortion; abortion according to the legal approach as a way of survival; the moral and legal status of the fetus; prenatal genetic testing, and finally matters regarding managing pregnancy today. Moral and legal principals of autonomy, namely freedom of choice of the individual, privacy and self-determination give women the right to terminate unwanted pregnancies. In addition, the basic question is whether the right of the woman to abortion clashes with the rights of others. Firstly, with the right of the "fetus to life". Secondly, with the right of the state to intervene in the interest of protecting "the life of the fetus". Third, with the rights of the woman’s partner. The fetus has the moral right to life, but less in relation to the same right of the woman as well as in relation to her right to control her life and her physical and moral integrity. On the other hand, the value of the life of the fetus increases morally and legally with the maturity of gestation; from the third trimester, the interest of the state prevails in the protection of the "life of the fetus" except when the life or health of the pregnant woman are at risk. As regards the rights of the woman’s partner, namely the husband’s opinion, there is no legal significance. The law does not request his participation in the decision on abortion because

  5. Prenatal Care: A Content-Based ESL Curriculum.

    Science.gov (United States)

    Hassel, Elissa Anne

    A content-based curriculum in English as a Second Language (ESL) focusing on prenatal self-care is presented. The course was designed as a solution to the problem of inadequate prenatal care for limited-English-proficient Mexican immigrant women. The first three sections offer background information on and discussion of (1) content-based ESL…

  6. Women's perceptions of access to prenatal care in the United States: a literature review.

    Science.gov (United States)

    Phillippi, Julia C

    2009-01-01

    Women report many barriers to accessing prenatal care. This article reviews the literature from 1990 to the present on women's perceptions of access to prenatal care within the United States. Barriers can be classified into societal, maternal, and structural dimensions. Women may not be motivated to seek care, especially for unintended pregnancies. Societal and maternal reasons cited for poor motivation include a fear of medical procedures or disclosing the pregnancy to others, depression, and a belief that prenatal care is unnecessary. Structural barriers include long wait times, the location and hours of the clinic, language and attitude of the clinic staff and provider, the cost of services, and a lack of child-friendly facilities. Knowledge of women's views of access can help in development of policies to decrease barriers. Structural barriers could be reduced through changes in clinic policy and prenatal care format, and the creation of child-friendly waiting and examination rooms. Maternal and societal barriers can be addressed through community education. A focus in future research on facilitators of access can assist in creating open pathways to perinatal care for all women.

  7. Using focus groups and social marketing to strengthen promotion of group prenatal care.

    Science.gov (United States)

    Vonderheid, Susan C; Carrie, S Klima; Norr, Kathleen F; Grady, Mary Alice; Westdahl, Claire M

    2013-01-01

    Centering Pregnancy, an innovative group model of prenatal care, shows promise to reduce persistent adverse maternal-infant outcomes and contain costs. Because this innovation requires systemwide change, clinics reported needing support enrolling women into groups and obtaining organizational buy-in. This study used the 3-step social marketing communication strategy to help clinic staff identify key customers and customer-specific barriers to adopting or supporting Centering Pregnancy. They developed targeted information to reduce barriers and built skills in communicating with different customers through role-playing. Findings provide practical information for others to use this communication strategy to improve implementation of Centering Pregnancy.

  8. Women's opinions of legal requirements for drug testing in prenatal care.

    Science.gov (United States)

    Tucker Edmonds, Brownsyne; Mckenzie, Fatima; Austgen, MacKenzie B; Carroll, Aaron E; Meslin, Eric M

    2017-07-01

    To explore women's attitudes and perceptions regarding legal requirements for prenatal drug testing. Web-based survey of 500 US women (age 18-45) recruited from a market research survey panel. A 24-item questionnaire assessed their opinion of laws requiring doctors to routinely verbal screen and urine drug test patients during pregnancy; recommendations for consequences for positive drug tests during pregnancy; and opinion of laws requiring routine drug testing of newborns. Additional questions asked participants about the influence of such laws on their own care-seeking behaviors. Data were analyzed for associations between participant characteristics and survey responses using Pearson's chi-squared test. The majority of respondents (86%) stated they would support a law requiring verbal screening of all pregnant patients and 73% would support a law requiring universal urine drug testing in pregnancy. Fewer respondents were willing to support laws that required verbal screening or urine drug testing (68% and 61%, respectively) targeting only Medicaid recipients. Twenty-one percent of respondents indicated they would be offended if their doctors asked them about drug use and 14% indicated that mandatory drug testing would discourage prenatal care attendance. Women would be more supportive of policies requiring universal rather than targeted screening and testing for prenatal drug use. However, a noteworthy proportion of women would be discouraged from attending prenatal care - a reminder that drug testing policies may have detrimental effects on maternal child health.

  9. Why women want prenatal ultrasound in normal pregnancy

    DEFF Research Database (Denmark)

    Gudex, Claire; Nielsen, Bentt Løwe; Madsen, Monika

    2006-01-01

    Objectives To investigate women's reasons for requesting prenatal ultrasound in the absence of clinical indications. Methods A postal questionnaire was completed by 370 pregnant women with no apparent obstetric risk factors, who had expressed a desire to have ultrasound scanning in their current...... for ultrasound were to check for fetal abnormalities (60% of women) to see that all was normal (55%) and for own reassurance (44%). Lower income was related to wanting to see the baby (P=0.028) and wanting an ultrasound picture (P=0.017); higher income was related to checking that all was normal (P=0......-003) and for own reassurance (P=0.015). Women in their first pregnancy were more likely to want themselves and the father to see the baby (P=0.001); women who had given birth previously were more likely to want reassurance (P=0.002), as were women with a previous miscarriage or induced abortion. Women who believed...

  10. Predictors of inadequate prenatal care in methamphetamine-using mothers in New Zealand and the United States.

    Science.gov (United States)

    Wu, Min; Lagasse, Linda L; Wouldes, Trecia A; Arria, Amelia M; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M; Neal, Charles R; Huestis, Marilyn A; Dellagrotta, Sheri; Lester, Barry M

    2013-04-01

    This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology results and/or maternal report of MA use during pregnancy were used to identify MA use. Information about sociodemographics, prenatal care and prenatal substance use was collected by maternal interview. MA-use during pregnancy is associated with lower socioeconomic status, single marital status, and CPS referral in both NZ and the US. Compared to their non-using counterparts, MA-using mothers in the US had significantly higher rates of inadequate prenatal care. No association was found between inadequate care and MA-use in NZ. In the US, inadequate prenatal care was associated with CPS referral, but not in NZ. Referral to CPS for drug use only composed 40 % of all referrals in the US, but only 15 % of referrals in NZ. In our study population, prenatal MA-use and CPS referral eclipse maternal sociodemographics in explanatory power for inadequate prenatal care. The predominant effect of CPS referral in the US is especially interesting, and should encourage further research on whether the US policy of mandatory reporting discourages drug-using mothers from seeking antenatal care.

  11. Vaccinations during Pregnancy

    Science.gov (United States)

    ... X Home > Pregnancy > Prenatal care > Vaccinations and pregnancy Vaccinations and pregnancy E-mail to a friend Please ... date before you get pregnant. What is a vaccination? A vaccination is a shot that contains a ...

  12. Common Discomforts of Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Prenatal care > Common discomforts of pregnancy Common discomforts of pregnancy E-mail to a friend ... like back ache and being really tired are common and shouldn’t make you worry. For most ...

  13. Georgia prenatal care providers' perceptions of barriers to sexually transmitted disease screening.

    Science.gov (United States)

    Barnes, Rheta S; Anderson, Lynda A; Weisbord, Joanna S; Koumans, Emilia; Toomey, Kathleen E

    2003-09-01

    Evidence suggests that sexually transmitted disease (STD) screening during pregnancy is not optimal. No published studies have systematically examined barriers that hinder routine STD screening. This study examines prenatal care providers' perceptions about barriers to routine STD screening of pregnant women. Using a conceptual framework, four a priori barrier categories were developed: provider, patient, organizational, and structural. Responses to a question on barriers to STD screening in a 1998 mail survey of Georgia prenatal care providers were qualitatively classified into one of these categories. Of the 293 providers who responded, 71% identified structural barriers, with 52% citing inadequate reimbursement. These respondents were most likely to name barriers categorized as structural, not patient, provider, or organization issues. Efforts to improve STD screening of pregnant women should include a focus on structural level interventions, such as instituting health care policies that provide adequate reimbursement for routine STD screening during pregnancy.

  14. Oral-systemic health during pregnancy: exploring prenatal and oral health providers' information, motivation and behavioral skills.

    Science.gov (United States)

    Vamos, Cheryl A; Walsh, Margaret L; Thompson, Erika; Daley, Ellen M; Detman, Linda; DeBate, Rita

    2015-06-01

    Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.

  15. Breastfeeding: guidance received in prenatal care, delivery and postpartum care

    Directory of Open Access Journals (Sweden)

    Mayara Caroline Barbieri

    2014-07-01

    Full Text Available The aim of the study was to analyze the guidelines considering breastfeeding given by health professionals to women during prenatal care, delivery and postpartum care. Quantitative and descriptive work developed at Regional Pinheiros, Maringá-PR, from the registry in SisPreNatal, from May to August 2009. Data were collected through interviews conducted with parents at home, using a structured instrument. Participants were 36 mothers, most of whom received counseling for breastfeeding during prenatal (58.3%, maternity (87.6% and in nursing visits to newborn (84.6%. The prevalence of exclusive breastfeeding was 37.5%, even with the end of maternity leave. The rate is still below the recommended by the World Health Organization for exclusive breastfeeding. The present results may contribute to the monitoring of health actions and development of new strategies in the maintenance of exclusive breastfeeding.

  16. Infant care practices in rural China and their relation to prenatal care utilisation.

    Science.gov (United States)

    Nwaru, B I; Wu, Z; Hemminki, E

    2011-01-01

    Studies describing postpartum childcare practices and the influence of prenatal care on infant care outcomes in rural China are scarce. This study looked at data for 1479 women who had given birth during the preceding 2 years (median age of the child was 8 months). Data were available from a Knowledge, Attitude and Perception cross-sectional survey collected from 2001 to 2003, after a prenatal care intervention in Anhui County, China, with a response rate of 97%. Prenatal care utilisation was categorised using the Adequacy of Prenatal Care Utilisation index. Logistic regression was used to study the association between prenatal care utilisation and infant care practices. Mothers' uptake of breastfeeding, introduction of milk formula, cereal/porridge, meat and uptake of any immunisation were found to be in accordance with national recommendations. Intermediate prenatal care uptake was positively associated with never breastfeeding and early introduction of cereal/porridge. Inadequate care was positively associated with never breastfeeding, early introduction of milk formula and cereal/porridge, and early start of work after delivery. Initiation to prenatal care after the third month was positively associated with early introduction of milk formula and cereal/porridge. Having no prenatal care was positively associated with never breastfeeding and early introduction of milk formula. Mothers' uptake of infant care practices in this population was largely in accordance with national recommendations. Women with less than adequate utilisation of prenatal care and those who had initiated prenatal care late were less likely to follow recommendations on infant care.

  17. Modifying effect of prenatal care on the association between young maternal age and adverse birth outcomes.

    Science.gov (United States)

    Vieira, C L; Coeli, C M; Pinheiro, R S; Brandão, E R; Camargo, K R; Aguiar, F P

    2012-06-01

    The objectives were to investigate the prevalence of adverse birth outcomes according to maternal age range in the city of Rio de Janeiro, Brazil, in 2002, and to evaluate the association between maternal age range and adverse birth outcomes using additive interaction to determine whether adequate prenatal care can attenuate the harmful effect of young age on pregnancy outcomes. A cross-sectional analysis was performed in women up to 24 years of age who gave birth to live children in 2002 in the city of Rio de Janeiro. To evaluate adverse outcomes, the exposure variable was maternal age range, and the outcome variables were very preterm birth, low birth weight, prematurity, and low 5-minute Apgar score. The presence of interaction was investigated with the composite variable maternal age plus prenatal care. The proportions and respective 95% confidence intervals were calculated for adequate schooling, delivery in a public maternity hospital, and adequate prenatal care, and the outcomes according to maternal age range. The chi-square test was used. The association between age range and birth outcomes was evaluated with logistic models adjusted for schooling and type of hospital for each prenatal stratum and outcome. Attributable proportion was calculated in order to measure additive interaction. Of the 40,111 live births in the sample, 1.9% corresponded to children of mothers from 10-14 years of age, 38% from 15-19 years, and 59.9% from 20-24 years. An association between maternal age and adverse outcomes was observed only in adolescent mothers with inadequate prenatal care, and significant additive interaction was observed between prenatal care and maternal age for all the outcomes. Adolescent mothers and their newborns are exposed to greater risk of adverse outcomes when prenatal care fails to comply with current guidelines. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  18. Resident Fathers' Pregnancy Intentions, Prenatal Behaviors, and Links to Involvement with Infants

    Science.gov (United States)

    Bronte-Tinkew, Jacinta; Ryan, Suzanne; Carrano, Jennifer; Moore, Kristen A.

    2007-01-01

    Using data from the Early Childhood Longitudinal Study-Birth Cohort, 9-month resident father surveys (N= 6,816), this paper examines the association between male pregnancy intentions, prenatal behaviors, and postbirth father involvement. Findings indicate that prenatal behaviors are associated with five domains of father involvement. Men who did…

  19. Does underutilization of prenatal care explain the excess risk for stillbirth among women with migration background in Germany?

    Science.gov (United States)

    Reime, Birgit; Lindwedel, Ulrike; Ertl, Karin M; Jacob, Carina; Schücking, Beate; Wenzlaff, Paul

    2009-01-01

    To explore the role of utilization of prenatal care on the risk for stillbirth among women with migration background in Germany by comparing stillbirth rates of women from different origins characterized by adequate and inadequate utilization of prenatal care to German women with adequate utilization of care. Retrospective cohort study. Lower Saxony, Germany. Singletons born in 1990, 1995 and 1999 (n = 182,444). We analyzed perinatal data collected by obstetricians and midwives prospectively during pregnancy and after birth. The Adequacy of Prenatal Care Utilization Index was applied. Chi-squared tests and bivariate and multivariable logistic regression models were used. Stillbirth rates. In crude analyses, inadequate utilization of prenatal care (OR = 1.86, 95% CI 1.52, 2.28), and origin from Central and Eastern Europe (OR = 2.05, 95% CI 1.63, 2.58), the Mediterranean (OR = 1.77, 95% CI 1.38, 2.65), the Middle East (OR = 2.63, 95% CI 2.24, 3.09) and other countries (OR = 1.79, 95% CI 1.10, 2.89) were related to stillbirths. After adjustment for age, parity, smoking, inter-pregnancy interval, employment status and year of observation, compared to Germans with adequate utilization of prenatal care, women with adequate utilization of care from Central and Eastern Europe (OR = 1.74, 95% CI 1.33, 2.29) and the Middle East (OR = 1.98, 95% CI 1.64, 2.39) and women with inadequate utilization of prenatal care from the Mediterranean (OR = 3.00, 95% CI 1.71, 5.26) were at higher risk for stillbirths. There are inconsistent relation patterns between stillbirth, area of origin and utilization of prenatal care. Among women from the Mediterranean, increasing utilization of prenatal care may result in lower stillbirth rates.

  20. Application of Prenatal Care Needs and Intervention in the High-risk Pregnancy%高危妊娠孕妇中产前护理需求及干预措施分析

    Institute of Scientific and Technical Information of China (English)

    胡俊妹

    2015-01-01

    Objective To explore the prenatal nursing demands of high risk pregnant women and the effect of the intervention of nursing.Methods Forty cases of high risk pregnancy were selected from September 2014 to December 2014 and investigated the care demands by the questionnaire. Cases were divided into two groups including control group(20 cases)and observation group(20 cases). Conventional nursing were given to control group, and the observation group were given the nursing intervention on the basis of control group. Observing the effect of nursing care.Results The highest of nursing needs in the high risk pregnant women was the knowledge of high risk pregnancy(92.5%),the lowest was the demand of social support. In the observation group,T-AI index and S-AI index was significantly lower than the control group. The satisfaction of the nursing care showed that the observation group was significantly higher than the control group. All the differences were statistically significant (P﹤0.05).Conclusion Meeting the needs of pregnant women and the implementation of targeted intervention of nursing can significantly improve the satisfaction of patients and the quality of patients.%目的:了解高危妊娠孕妇对于产前护理的需求并对其进行的护理干预结果进行总结分析。方法选取我院与2014年9~12月间收治的40例高危妊娠孕妇,对其发放调查问卷来进行护理需求的相关调查并统计结果,并随机分为观察组和对照组。其中对照组行常规护理方法,对观察组则在行对照组相同的常规护理的基础上施加护理干预,观察两组患者的临床效果及患者的满意程度。结果在本例高危妊娠孕妇中,高危妊娠常识(92.5%)相关护理是孕妇最为关心的护理需求;而社会支持系统的需求(15.0%)则较低。用S-AI及T-AI评分的方式对患者进行评估,观察组相比对照组,两项分值降低,组间差异具有统计学意义(P﹤0.05

  1. Prenatal Care for Adolescents and attributes of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Maria Cristina Barbaro

    2014-01-01

    Full Text Available OBJECTIVE: evaluate prenatal care for adolescents in health units, in accordance with the attributes of Primary Health Care (PHC guidelines. METHOD: quantitative study conducted with health professionals, using the Primary Care Assessment Tool-Brazil to assess the presence and extent of PHC attributes. RESULTS: for all the participating units, the attribute Access scored =6.6; the attributes Longitudinality, Coordination (integration of care, Coordination (information systems and Integrality scored =6.6, and the Essential Score =6.6. Comparing basic units with family health units, the attribute scores were equally distributed; Accessibility scored =6.6, the others attributes scored =6.6; however, in the basic units, the Essential Score was =6.6 and, in the family health units, =6.6. CONCLUSION: expanding the coverage of family health units and the training of professionals can be considered strategies to qualify health care.

  2. Termination of pregnancy after prenatal diagnosis of spina bifida: a German perspective.

    Science.gov (United States)

    Domröse, Christian M; Bremer, Sandra; Buczek, Caroline; Geipel, Annegret; Berg, Christoph; Gembruch, Ulrich; Willruth, Arne

    2016-10-01

    To analyze fetal cases with spina bifida undergoing termination of pregnancy according to chromosomal analysis and further diagnosed sonographic findings. Retrospective analysis of cases with spina bifida leading to termination of pregnancy in a tertiary referral center from 2002 to 2011. In the study period, 246 cases of spina bifida were diagnosed in our center and 157 parents chose termination of pregnancy. The time of diagnosis was on average 2 days before the first presentation at our department (22 + 3, range: 12 + 3 - 33 + 3 weeks of gestation). Among 157 pregnancies with spina bifida and termination of pregnancy, further malformations could be detected in 46 (29.3 %) cases. An abnormal karyotype could be found in 13 (18.1 %). Severe ventriculomegaly or mild/moderate ventriculomegaly was present in 109 (69.4 %) and 29 (18.5 %) of the cases, respectively, while banana sign was detectable in 153 cases (97.5 %). In the majority, the upper lesion level was lumbar (71.3 %). In 67 cases (42.7 %), termination of pregnancy took place in or after the 24th week of gestation. Direct and indirect signs of spina bifida were detectable in nearly all cases independent of the gestational age. Therefore, the diagnosis could have been made in all cases with late termination. Implementation of a uniform prenatal care including first-trimester scan with potential signs for open spina bifida and second-trimester anomaly scan with indirect intracranial findings and direct detection of spinal lesion could lead to an earlier diagnosis and help to reduce late termination of pregnancy in neural tube defects.

  3. Pregnant at work: time for prenatal care providers to act.

    Science.gov (United States)

    Karkowsky, Chavi Eve; Morris, Liz

    2016-09-01

    Fifty years ago, when a woman became pregnant, she was expected to stop working. Today, however, most women who work are the primary, sole, or co-breadwinner for their families, and their earnings during pregnancy are often essential to their families' economic well-being. Medical data about working during pregnancy are sparse but generally show that both low-risk and high-risk women can tolerate work-related duties well, although some work accommodations (eg, providing a chair for sitting, allowing snacks, or modifying the work schedule) may be necessary. However, some employers refuse to accommodate pregnant women who need adjustments. This can result in a woman being forced to make the choice between working without accommodations and losing her income and health insurance or even her job. Prenatal care providers can play an important role by implementing changes in their own practice, shaping public policy, and conducting research to increase protections for pregnant women and to ensure that they receive medically recommended accommodations while continuing to earn income for their growing families.

  4. Assessing the effect on outcomes of public or private provision of prenatal care in Portugal.

    Science.gov (United States)

    Correia, Sofia; Rodrigues, Teresa; Barros, Henrique

    2015-07-01

    To evaluate whether public and private prenatal care users experience similar outcomes, taking into consideration maternal pre-pregnancy social and clinical risk. We studied 7,325 women who delivered single newborns at five public maternity units in Porto, Portugal. Health behaviors and prenatal care were self-reported; pregnancy complications and delivery data were retrieved from medical files. The odds of inadequate weight gain, continuing to smoke, gestational hypertension, gestational diabetes, caesarean section, preterm birth, low birthweight, and small- and large-for-gestational-age were estimated for public and private providers using logistic regression, stratified by pre-pregnancy risk profile, adjusted for maternal characteristics. 38 % of women used private prenatal care. Among low-risk women, public care users were more likely to gain excessive weight (OR 1.26; 95 % CI 1.06-1.57) and be diagnosed with gestational diabetes (OR 1.37; 95 % CI 1.01-1.86). They were less likely to have a caesarean (OR 0.63; 95 % CI 0.51-0.78) and more likely to deliver small-for-gestational-age babies (OR 1.48; 95 % CI 1.19-1.83). Outcomes were similar in high-risk women although preterm and pre-labor caesarean were less frequent in public care users (OR 0.64 95 % CI 0.45-0.91; OR 0.69 95 % CI 0.49-0.97). The amount of care was not significantly related to risk profile in either case. Public care users experienced similar outcomes to those using private care, despite higher pre-pregnancy disadvantage. Low-risk women need further attention if narrowing inequalities in birth outcomes remains a priority.

  5. Congenital toxoplasmosis and prenatal care state programs.

    Science.gov (United States)

    Avelino, Mariza M; Amaral, Waldemar N; Rodrigues, Isolina M X; Rassi, Alan R; Gomes, Maria B F; Costa, Tatiane L; Castro, Ana M

    2014-01-18

    Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the

  6. [Potential role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa].

    Science.gov (United States)

    Prual, A; De Bernis, L; El Joud, D Ould

    2002-02-01

    Prenatal care has been implemented in developing countries according to the same mode as applied in industrialized countries without considering its real effectiveness in reducing maternal and neonatal mortality. Several recent studies suggest that the goals should be revisited in order to implement a program of prenatal care based on real scientific evidence. Based on the current literature, we propose a potentially effective content for prenatal care adapted to the context of developing countries. Four antenatal consultations would be enough if appropriately timed at 12, 26, 32 and 36 weeks pregnancy. The purpose of these consultations would be: 1) to screen for three major risk factors, which, when recognized, lead to specific action: uterine, scare, malpresentation, premature rupture of the membranes; 2) to prevent and/or detect (and treat) specific complications of pregnancy: hypertension, infection (malaria, venereal disease, HIV, tetanus, urinary tract infection); anemia and trace element deficiencies, gestational diabetes mellitus; 3) to provide counseling, support and information for pregnant women and their families (including the partner) concerning: severe signs and symptoms of pregnancy and delivery, community organization of emergency transfer, delivery planning. These potentially effective actions can only have a real public health impact if implemented within an organized maternal health system with a functional network of delivery units, if truly quality care is given, and if the relationships between health care providers and the population are based on mutual respect. Sub-Saharan African women use prenatal care extensively when it is accessible; this opportunity must be used to implement evidence-based actions with appropriate and realistic goals.

  7. Evaluation of a community-based randomized controlled prenatal care trial in rural China.

    Science.gov (United States)

    Wu, Zhuochun; Viisainen, Kirsi; Wang, Ying; Hemminki, Elina

    2011-05-04

    A community-based randomized control prenatal care trial was performed in a rural county of China during 2000-2003. The purpose of this paper is to describe the trial implementation and the impact of the trial on the utilization of prenatal care and perinatal outcomes. In the study county, 10 townships (from a total of 55) were each paired with a control (20 study townships in total), with the criteria for pairing being the township's socioeconomic development, perinatal health, and maternal care utilization and provision. One of each township pair was randomly allocated to the intervention or control groups. The trial interventions were: 1) training township hospital midwives and instructing them in how to provide systematic maternal care, 2) informing women in the community of the importance of prenatal care, 3) if needed, providing basic medical instruments to the hospitals. A variety of data sources were used to describe the trial implementation (observations, group discussions, field notes, survey to women). The data on pregnancy and perinatal outcomes were from the original hand-written work-records in the village family planning centers of the study townships. Implementation of the intervention was deficient. The factors hindering the trial implementation included poor coordination between midwives and family planning officers, broader policy changes implemented by the provincial government during the trial, the decentralization of county governance, and the lack of government funding for maternal care. There was only little difference in the use of maternal care, in women's opinions related to maternal care or content of prenatal care, and no difference in the perinatal outcomes between the intervention and control townships. A community based randomized controlled trial could not be fully carried out in rural China as planned due to the changing political landscape, the complexity of the socio-economic situation and a lengthy planning stage. The study

  8. The effects of nursing case management on the utilization of prenatal care by Mexican-Americans in rural Oregon.

    Science.gov (United States)

    Thompson, M; Curry, M A; Burton, D

    1998-04-01

    This quasi-experimental, retrospective study used birth certificate and medical record data to evaluate the effectiveness of the Rural Oregon Minority Prenatal Program (ROMPP) in improving patterns of prenatal care utilization by rural-dwelling, low-income, Mexican-American women at risk of poor pregnancy outcomes. The ROMPP intervention provided nursing case management services and peer outreach to pregnant Mexican-American women in a rural Oregon community. The intervention group had more prenatal visits in months 2, 3, 4, 5, 6, and 7 than the comparison group (P cultural competency and sharpen their clinical focus on advocacy, marketing, facilitation of relationships between community groups, and community organizing.

  9. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case–control study

    Science.gov (United States)

    2014-01-01

    Background The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. Methods We conducted a case–control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Results Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, “not thinking straight”, and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one

  10. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

    Science.gov (United States)

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-07-15

    The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada's universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. We conducted a case-control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, "not thinking straight", and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one's health. Receiving incentives and getting

  11. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review.

    Science.gov (United States)

    Boerleider, Agatha W; Wiegers, Therese A; Manniën, Judith; Francke, Anneke L; Devillé, Walter L J M

    2013-03-27

    Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a systematic review of factors affecting non-western women's use of prenatal care (both medical care and prenatal classes) in industrialized western countries. Eleven databases (PubMed, Embase, PsycINFO, Cochrane, Sociological Abstracts, Web of Science, Women's Studies International, MIDIRS, CINAHL, Scopus and the NIVEL catalogue) were searched for relevant peer-reviewed articles from between 1995 and July 2012. Qualitative as well as quantitative studies were included. Quality was assessed using the Mixed Methods Appraisal Tool. Factors identified were classified as impeding or facilitating, and categorized according to a conceptual framework, an elaborated version of Andersen's healthcare utilization model. Sixteen articles provided relevant factors that were all categorized. A number of factors (migration, culture, position in host country, social network, expertise of the care provider and personal treatment and communication) were found to include both facilitating and impeding factors for non-western women's utilization of prenatal care. The category demographic, genetic and pregnancy characteristics and the category accessibility of care only included impeding factors.Lack of knowledge of the western healthcare system and poor language proficiency were the most frequently reported impeding factors. Provision of information and care in women's native languages was the most frequently reported facilitating factor. The factors found in this review provide specific indications for identifying non-western women who are at risk of not using prenatal care adequately and for developing interventions and appropriate policy aimed at improving their prenatal care utilization.

  12. [Study on the relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis].

    Science.gov (United States)

    Lu, Junling; Kuang, Jingxia; Cheng, Xiaolin

    2014-11-01

    To investigate the association between prenatal monitoring index in intrahepatic cholestasis of pregnancy and the perinatal prognosis, as well as the characteristics of perinatal situations. A retrospective study on the clinical data of 88 cases intrahepatic cholestasis of pregnancy and prognosis that were treated in our hospital from Jan. 2011 to Jan. 2014 was carried out. Relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis, together with the epidemiological features of infants were analyzed. The incidence rates of perinatal meconium stained amniotic fluid, asphyxia neonatorum, premature and fetal distress were significantly higher in the study group than those in the controls, with differences statistically significant (P intrahepatic cholestasis of pregnancy, with most frequently seen as meconium stained amniotic fluid. It was necessary to monitor the level of prenatal CG, ALT, AST, TBIL and TBA in puerperant in predicting the perinatal prognosis.

  13. Access to and utilization of prenatal care services in the Unified Health System of the city of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Domingues, Rosa Maria Soares Madeira; Leal, Maria do Carmo; Hartz, Zulmira Maria de Araujo; Dias, Marcos Augusto Bastos; Vettore, Marcelo Vianna

    2013-12-01

    Prenatal care consists of practices considered to be effective for the reduction of adverse perinatal outcomes. However, studies have demonstrated inequities in pregnant women's access to prenatal care, with worse outcomes among those with lower socioeconomic status. The objective of this study is to evaluate access to and utilization of prenatal services in the Sistema Único de Saúde (SUS - Unified Health System) in the city of Rio de Janeiro and to verify its association with the characteristics of pregnant women and health services. A cross-sectional study was conducted in 2007-2008, using interviews and the analysis of prenatal care cards of 2.353 pregnant women attending low risk prenatal care services of the SUS. A descriptive analysis of the reasons mentioned by women for the late start of prenatal care and hierarchical logistic regression for the identification of the factors associated with prenatal care use were performed. The absence of a diagnosis of pregnancy and poor access to services were the reasons most often reported for the late start of prenatal care. Earlier access was found among white pregnant women, who had a higher level of education, were primiparous and lived with a partner. The late start of prenatal care was the factor most associated with the inadequate number of consultations, also observed in pregnant adolescents. Black women had a lower level of adequacy of tests performed as well as a lower overall adequacy of prenatal care, considering the Programa de Humanização do Pré-Natal e Nascimento (PHPN - Prenatal and Delivery Humanization Program) recommendations. Strategies for the identification of pregnant women at a higher reproductive risk, reduction in organizational barriers to services and increase in access to family planning and early diagnosis of pregnancy should be prioritized.

  14. Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening

    DEFF Research Database (Denmark)

    Boyle, B; Morris, J K; McConkey, R

    2014-01-01

    OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14...

  15. Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes.

    Science.gov (United States)

    Till, Sara R; Everetts, David; Haas, David M

    2015-12-15

    Prenatal care is recommended during pregnancy as a method to improve neonatal and maternal outcomes. Improving the use of prenatal care is important, particularly for women at moderate to high risk of adverse outcomes. Incentives are sometimes utilized to encourage women to attend prenatal care visits. To determine whether incentives are an effective tool to increase utilization of timely prenatal care among women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015) and the reference lists of all retrieved studies. Randomized controlled trials (RCTs), quasi-RCTs, and cluster-RCTs that utilized direct incentives to pregnant women explicitly linked to initiation and frequency of prenatal care were included. Incentives could include cash, vouchers, coupons or products not generally offered to women as a standard of prenatal care. Comparisons were to no incentives and to incentives not linked directly to utilization of care. We also planned to compare different types of interventions, i.e. monetary versus products or services. Two review authors independently assessed studies for inclusion and methodological quality. Two review authors independently extracted data. Data were checked for accuracy. We identified 11 studies (19 reports), six of which we excluded. Five studies, involving 11,935 pregnancies were included, but only 1893 pregnancies contributed data regarding our specified outcomes. Incentives in the studies included cash, gift card, baby carrier, baby blanket or taxicab voucher and were compared with no incentives. Meta-analysis was performed for only one outcome 'Return for postpartum care' and this outcome was not pre-specified in our protocol. Other analyses were restricted to data from single studies.Trials were at a moderate risk of bias overall. Randomization and allocation were adequate and risk of selection bias was low in three studies and unclear in two studies. None of the studies were blinded to the

  16. Inadequate utilization of prenatal care in two Brazilian birth cohorts.

    Science.gov (United States)

    Coimbra, L C; Figueiredo, F P; Silva, A A M; Barbieri, M A; Bettiol, H; Caldas, A J M; Mochel, E G; Ribeiro, V S

    2007-09-01

    Data for two birth cohorts from two Brazilian municipalities, Ribeirão Preto in 1994 and São Luís in 1997/1998, were used to identify and compare factors associated with inadequate utilization of prenatal care and to identify factors capable of explaining the differences observed between the two cities. Prenatal care was defined as adequate or inadequate according to the recommendations of the Brazilian Ministry of Health. The chi-square test and Poisson regression were used to compare differences in the inadequacy of prenatal care utilization. The percentage of inadequacy was higher in São Luís (34.6%) than in Ribeirão Preto (16.9%). Practically the same variables were associated with inadequacy in both cities. Puerperae with lower educational level, without a companion or cohabiting, who delivered in public health units, younger than 20 years, multiparae and smokers, with low family income presented higher percentages of inadequate prenatal care utilization. However, the effects of some variables differed between the two cities. The risk for inadequate use of prenatal care was higher for women attended in the public health sector in São Luís and for cohabiting women in Ribeirão Preto. The effect of the remaining factors studied did not differ between cities. The category of admission accounted for 57.0% of the difference in the inadequate use of prenatal care between cities and marital status accounted for 45.3% of the difference. Even after adjustment for all variables, part of the difference in the inadequacy of prenatal care utilization remained unexplained.

  17. Perceptions about prenatal care: views of urban vulnerable groups

    Directory of Open Access Journals (Sweden)

    Hatcher Barbara

    2002-11-01

    Full Text Available Abstract Background In the United States, infant mortality rates remain more than twice as high for African Americans as compared to other racial groups. Lack of adherence to prenatal care schedules in vulnerable, hard to reach, urban, poor women is associated with high infant mortality, particularly for women who abuse substances, are homeless, or live in communities having high poverty and high infant mortality. This issue is of concern to the women, their partners, and members of their communities. Because they are not part of the system, these womens' views are often not included in other studies. Methods This qualitative study used focus groups with four distinct categories of people, to collect observations about prenatal care from various perspectives. The 169 subjects included homeless women; women with current or history of substance abuse; significant others of homeless women; and residents of a community with high infant mortality and poverty indices, and low incidence of adequate prenatal care. A process of coding and recoding using Ethnograph and counting ensured reliability and validity of the process of theme identification. Results Barriers and motivators to prenatal care were identified in focus groups. Pervasive issues identified were drug lifestyle, negative attitudes of health care providers and staff, and non-inclusion of male partners in the prenatal experience. Conclusions Designing prenatal care relevant to vulnerable women in urban communities takes creativity, thoughtfulness, and sensitivity. System changes recommended include increased attention to substance abuse treatment/prenatal care interaction, focus on provider/staff attitudes, and commitment to inclusion of male partners.

  18. Effects of prenatal stress on pregnancy and human development: mechanisms and pathways

    Science.gov (United States)

    Coussons-Read, Mary E

    2013-01-01

    A growing body of research shows that prenatal stress can have significant effects on pregnancy, maternal health and human development across the lifespan. These effects may occur directly through the influence of prenatal stress-related physiological changes on the developing fetus, or indirectly through the effects of prenatal stress on maternal health and pregnancy outcome which, in turn, affect infant health and development. Animal and human studies suggest that activation of the maternal stress response and resulting changes in endocrine and inflammatory activity play a role in the aetiology of these effects. Ongoing research is focusing on clarifying these mechanisms, understanding the role of racial and cultural factors in these effects, and examining the epigenetic and transgenerational influences of prenatal stress. PMID:27757157

  19. Migrant women's utilization of prenatal care: a systematic review.

    Science.gov (United States)

    Heaman, M; Bayrampour, H; Kingston, D; Blondel, B; Gissler, M; Roth, C; Alexander, S; Gagnon, A

    2013-07-01

    Our objectives were to determine whether migrant women in Western industrialized countries have higher odds of inadequate prenatal care (PNC) compared to receiving-country women and to summarize factors that are associated with inadequate PNC among migrant women in these countries. We conducted searches of electronic databases (MEDLINE, EMBASE, and PsycINFO), reference lists, known experts, and an existing database of the Reproductive Outcomes And Migration international research collaboration for articles published between January, 1995 and April, 2010. Title and abstract review and quality appraisal were conducted independently by 2 reviewers using established criteria, with consensus achieved through discussion. In this systematic review of 29 studies, the majority of studies demonstrated that migrant women were more likely to receive inadequate PNC than receiving-country women, with most reporting moderate to large effect sizes. Rates of inadequate PNC among migrant women varied widely by country of birth. Only three studies explored predictors of inadequate PNC among migrant women. These studies found that inadequate PNC among migrant women was associated with being less than 20 years of age, multiparous, single, having poor or fair language proficiency, education less than 5 years, an unplanned pregnancy, and not having health insurance. We concluded that migrant women as a whole were more likely to have inadequate PNC and the magnitude of this risk differed by country of origin. Few studies addressed predictors of PNC utilization in migrant women and this limits our ability to provide effective PNC in this population.

  20. Determinants of inadequate prenatal care utilization by African American women.

    Science.gov (United States)

    Johnson, Allan A; Hatcher, Barbara J; El-Khorazaty, M Nabil; Milligan, Renee A; Bhaskar, Brinda; Rodan, Margaret F; Richards, Leslie; Wingrove, Barbara K; Laryea, Haziel A

    2007-08-01

    A convenience sample of city-dwelling African American women (n=246) was interviewed during each woman's postpartum stay at one of five hospitals in Washington, D.C. to determine their perceptions of factors influencing their prenatal care utilization. The Kotelchuck Adequacy of Prenatal Care Utilization Index was used to classify prenatal care utilization as either adequate (Adequate Plus and Adequate groups combined) or inadequate (Intermediate and Inadequate groups combined). Of the 246 women studied, 40% (99) had adequate prenatal care utilization. Using Classification and Regression Trees analysis, the following risk groups for inadequate prenatal care utilization were identified: women who reported psychosocial problems as barriers and who were not participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) (percent adequate=8.8); women who reported psychosocial problems as barriers, were participants of the WIC program, and reported substance use (percent adequate=13.8); and women who reported psychosocial problems as barriers, were participants of the WIC program, denied substance use, and reported childcare problems as barriers (percent adequate=20.0).

  1. Gestational diabetes - self-care

    Science.gov (United States)

    Pregnancy - gestational diabetes; Prenatal care - gestational diabetes ... Gestational diabetes is high blood sugar (glucose) that happens during pregnancy. There are no symptoms in most cases. But ...

  2. Adequacy of prenatal care as a major determinant of folic acid, iron, and vitamin intake during pregnancy Adequação dos cuidados pré-natais como determinante da utilização de ácido fólico, ferro e vitaminas durante a gravidez

    Directory of Open Access Journals (Sweden)

    Nuno Lunet

    2008-05-01

    Full Text Available This study aimed to quantify the association between adequacy of prenatal care and prevalence of folic acid, iron, and multivitamin intake during pregnancy. Data were obtained on socio-demographics, prenatal care, pregnancy complications, and use of vitamin/mineral supplements for 836 women, using a postpartum interview. Associations with the use of vitamin/mineral supplements were quantified with risk ratios (RR, computed by generalized binomial regression. A high proportion of women reported the use of folic acid (81.9%, iron (55.4%, and multivitamins (76.2% as supplements during pregnancy. Use of supplements was independently associated with adequacy of prenatal care (adequate vs. inadequate: folic acid, RR = 2.28; 95%CI: 1.58-3.29; iron, RR = 1.99; 95%CI: 1.57-2.52, multivitamins, RR = 1.97; 95%CI: 1.54-2.51. Higher schooling was also associated with increased use of folic acid (RR = 1.42; 95%CI: 1.18-1.70, but not multivitamins (RR = 0.87; 95%CI: 0.77-0.98. Use of folic acid was less prevalent in single women (RR = 0.67; 95%CI: 0.48-0.95 and during unplanned pregnancies (RR = 0.81; 95%CI: 0.71-0.92. Adequacy of prenatal care is a major determinant of vitamin/mineral intake during pregnancy.Quantificar a associação entre a adequação dos cuidados pré-natais e a prevalência de utilização de ácido fólico, ferro e vitaminas durante a gravidez. Após o parto, 836 mulheres foram questionadas relativamente a características sócio-demográficas, utilização dos cuidados pré-natais, complicações durante a gravidez e utilização de suplementos vitamínicos/minerais. A associação entre as variáveis foi quantificada por meio de riscos relativos (RR calculados por regressão binomial generalizada. Uma elevada proporção de mulheres reportou ter tomado ácido fólico (81,9%, ferro (55,4% e multivitaminas (76,2% durante a gravidez. A utilização de suplementos esteve independentemente associada à adequação dos cuidados pr

  3. Predictors of Inadequate Prenatal Care in Methamphetamine-Using Mothers in New Zealand and the United States

    OpenAIRE

    WU, Min; LaGasse, Linda L.; Wouldes, Trecia A.; Arria, Amelia M.; Wilcox, Tara; Derauf, Chris; Newman, Elana; Shah, Rizwan; Smith, Lynne M.; Neal, Charles R.; Huestis, Marilyn A.; DellaGrotta, Sheri; Lester, Barry M.

    2013-01-01

    This study compared patterns of prenatal care among mothers who used methamphetamine (MA) during pregnancy and non-using mothers in the US and New Zealand (NZ), and evaluated associations among maternal drug use, child protective services (CPS) referral, and inadequate prenatal care in both countries. The sample consisted of 182 mothers in the MA-Exposed and 196 in the Comparison groups in the US, and 107 mothers in the MA-Exposed and 112 in the Comparison groups in NZ. Positive toxicology re...

  4. Getting more than they realized they needed: a qualitative study of women's experience of group prenatal care.

    Science.gov (United States)

    McNeil, Deborah A; Vekved, Monica; Dolan, Siobhan M; Siever, Jodi; Horn, Sarah; Tough, Suzanne C

    2012-03-21

    Pregnant women in Canada have traditionally received prenatal care individually from their physicians, with some women attending prenatal education classes. Group prenatal care is a departure from these practices providing a forum for women to experience medical care and child birth education simultaneously and in a group setting. Although other qualitative studies have described the experience of group prenatal care, this is the first which sought to understand the central meaning or core of the experience. The purpose of this study was to understand the central meaning of the experience of group prenatal care for women who participated in CenteringPregnancy through a maternity clinic in Calgary, Canada. The study used a phenomenological approach. Twelve women participated postpartum in a one-on-one interview and/or a group validation session between June 2009 and July 2010. Six themes emerged: (1) "getting more in one place at one time"; (2) "feeling supported"; (3) "learning and gaining meaningful information"; (4) "not feeling alone in the experience"; (5) "connecting"; and (6) "actively participating and taking on ownership of care". These themes contributed to the core phenomenon of women "getting more than they realized they needed". The active sharing among those in the group allowed women to have both their known and subconscious needs met. Women's experience of group prenatal care reflected strong elements of social support in that women had different types of needs met and felt supported. The findings also broadened the understanding of some aspects of social support beyond current theories. In a contemporary North American society, the results of this study indicate that women gain from group prenatal care in terms of empowerment, efficiency, social support and education in ways not routinely available through individual care. This model of care could play a key role in addressing women's needs and improving health outcomes.

  5. Getting more than they realized they needed: a qualitative study of women's experience of group prenatal care

    Directory of Open Access Journals (Sweden)

    McNeil Deborah A

    2012-03-01

    Full Text Available Abstract Background Pregnant women in Canada have traditionally received prenatal care individually from their physicians, with some women attending prenatal education classes. Group prenatal care is a departure from these practices providing a forum for women to experience medical care and child birth education simultaneously and in a group setting. Although other qualitative studies have described the experience of group prenatal care, this is the first which sought to understand the central meaning or core of the experience. The purpose of this study was to understand the central meaning of the experience of group prenatal care for women who participated in CenteringPregnancy through a maternity clinic in Calgary, Canada. Methods The study used a phenomenological approach. Twelve women participated postpartum in a one-on-one interview and/or a group validation session between June 2009 and July 2010. Results Six themes emerged: (1 "getting more in one place at one time"; (2 "feeling supported"; (3 "learning and gaining meaningful information"; (4 "not feeling alone in the experience"; (5 "connecting"; and (6 "actively participating and taking on ownership of care". These themes contributed to the core phenomenon of women "getting more than they realized they needed". The active sharing among those in the group allowed women to have both their known and subconscious needs met. Conclusions Women's experience of group prenatal care reflected strong elements of social support in that women had different types of needs met and felt supported. The findings also broadened the understanding of some aspects of social support beyond current theories. In a contemporary North American society, the results of this study indicate that women gain from group prenatal care in terms of empowerment, efficiency, social support and education in ways not routinely available through individual care. This model of care could play a key role in addressing women

  6. Prenatal diagnosis of hypoplastic left heart syndrome: impact of counseling patterns on parental perceptions and decisions regarding termination of pregnancy.

    Science.gov (United States)

    Hilton-Kamm, Debra; Chang, Ruey-Kang; Sklansky, Mark

    2012-12-01

    An online survey for parents of children with congenital heart disease (CHD) was developed to study parents' experiences at the time of diagnosis. The survey was distributed to online support groups. A total of 841 responses from parents of children with CHD were received during a 4-week period. The current study examined those respondents (211 [25 %]) who reported their child's diagnosis as hypoplastic left heart syndrome (HLHS). Among these, 138 (65 %) reported receiving the diagnosis prenatally. 32 % of those receiving a prenatal diagnosis reported that after they declined to terminate the pregnancy, termination was mentioned again by their physicians. Parents who had termination mentioned again after their initial decline reported significantly lower optimism regarding their child's life expectancy than those who did not have it mentioned again (66 vs. 94 %, p parents, when termination of pregnancy was mentioned after the parents declined it, or if the parents felt pressure to terminate, the parents perceived a lower chance of survival, felt less optimistic about their child's life expectancy, and were more likely to choose another PC for long-term follow-up care. Our study could not determine whether repeated discussions of the possibility for termination of pregnancy independently impacts parental optimism regarding prognosis or whether those who counsel with repeated discussions of termination tend to have more guarded notions of the prognosis of children with HLHS. Further study is warranted to identify the implications of counseling patterns on parental perceptions and decisions regarding termination of pregnancy.

  7. Facilitating access to prenatal care through an interprofessional student-run free clinic.

    Science.gov (United States)

    Danhausen, Kathleen; Joshi, Deepa; Quirk, Sarah; Miller, Robert; Fowler, Michael; Schorn, Mavis N

    2015-01-01

    Addressing the persistent challenge of inadequate prenatal care requires innovative solutions. Student-run free health centers are poised to rise to this challenge. The Shade Tree Clinic Early Pregnancy Program, jointly operated by university medical and nursing programs, functions as an ongoing access-to-care portal for pregnant women without health insurance. The clinic is run by medical students and nurse-midwifery students and uses a service-based learning model that allows students to work and learn in supervised, interprofessional teams while providing evidence-based prenatal care. All data reported in this paper were obtained from a retrospective chart review of women served by the prenatal clinic. These data are descriptive in nature, and include the patient demographics and services provided by the clinic to 152 women between the years of 2010-2013. During this time period, the clinic served a demographically diverse clientele. Approximately half lacked documentation of legal immigration status. The majority of women seeking care were in their first trimester of pregnancy and had previously given birth. Several women had medical or obstetric complications that required timely referral to specialist care; and many women received treatment for infection and other primary care concerns. Shade Tree Clinic provides the basic components of prenatal care and assists women with other medical needs. Women also receive help when applying for and accessing public maternity insurance, and the clinic facilitates entry to any necessary specialist care while that insurance is processed. In many cases, necessary and time-sensitive care would be delayed if Shade Tree Clinic's prenatal services were not available. In addition, the clinic presents a valuable opportunity for interprofessional socialization, increased respect, and improved collaboration between students in different but complementary professions, which is an important experience while we move to meet national

  8. Prenatal stress perception and coping strategies: Insights from a longitudinal prospective pregnancy cohort.

    Science.gov (United States)

    Goletzke, J; Kocalevent, R-D; Hansen, G; Rose, M; Becher, H; Hecher, K; Arck, P C; Diemert, A

    2017-11-01

    Prenatal distress has been linked to pregnancy complications and poor offspring's health, despite the fact that longitudinal assessments of various stress dimensions are still lacking. Hence, we aimed to assess perceived stress over the course of pregnancy. Moreover, we examined whether social support and coping styles are linked to prenatal stress trajectories. Data from 543 women participating in the PRINCE (Prenatal Identification of Children Health) study, a prospective population-based cohort study, was used for the present analyses. Once per trimester the women completed questionnaires regarding different psychometric measures, including the Perceived Stress Scale (PSS). Linear mixed regression models were used to examine perceived stress development longitudinally and to relate social support and coping styles to stress trajectories during pregnancy. A significant decrease of perceived stress was observed over the course of pregnancy. Stratifying the study sample according to parity, women delivering their first child had continuously lower perceived stress scores compared to women having already one or more children, and a significant decrease during pregnancy was exclusively observed in primiparous women. Both, positive coping strategies and higher perceived and received social support were independently associated with lower perceived stress, while evasive coping strategies were associated with higher levels of perceived stress. Our study reveals stress perception trajectories during pregnancies in primi- and multiparous women. Our findings underscore the need for intervention strategies aiming to improve social support and positive coping strategies especially in multiparous women in order to reduce the risks for adverse pregnancy outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Socio-demographic determinants and access to prenatal care in Italy.

    Science.gov (United States)

    Chiavarini, Manuela; Lanari, Donatella; Minelli, Liliana; Salmasi, Luca

    2014-04-15

    Many governments have made commitments to examine inequalities in healthcare access based on studies assessing the association between several socio-demographic factors and late initiation or fewer prenatal examinations. This study addressed the question of whether socio-demographic determinants were significant in explaining differences in prenatal care in one administrative region of Italy, Umbria. Data were obtained from the administrative source of the regional Standard Certificate of Live Births between 2005 and 2010, and were merged with Census data to include a socio-economic deprivation index. Standard and multilevel logistic regression models were used to analyze the magnitude of various individual-level maternal characteristics and socio-demographic indicators, such as nationality, employment status, education with respect to late access to the first examination, and low number of medical visits. The study involved approximately 37,000 women. The heterogeneous effects of socio-demographic variables were documented on the prenatal care indicators analyzed. A multivariate model showed that women born outside Italy had a higher probability of making their first visit later than the 12th week of pregnancy and low numbers of prenatal medical visits; the estimated odds ratio for the analyzed indicators range from 2.25 to 3.05. Inadequate prenatal healthcare use was also observed in younger and pluriparous women and those with low education; in addition, having a job improved the use of services, possibly through transmission of information of negative consequences due to delayed or few prenatal visits. Interestingly, this study found a substantial reduction in the number of pregnant women who do not use prenatal healthcare services properly. The aim of this research is to provide more accurate knowledge about the inadequate use of prenatal healthcare in Italy. Results highlight the existence of differences in healthcare use during pregnancy, especially for

  10. Pregnancy outcome and prenatal diagnosis of sex chromosome abnormalities in Hawaii, 1986-1999.

    Science.gov (United States)

    Forrester, Mathias B; Merz, Ruth D

    2003-06-15

    Sex chromosome abnormalities such as Turner syndrome, Klinefelter syndrome, triple X syndrome, and 47,XYY can be prenatally diagnosed and electively terminated. This investigation examined the pattern of pregnancy outcome of prenatally and postnatally diagnosed sex chromosome abnormalities in Hawaii during 1986-1999 and calculated prenatal diagnosis and subsequent elective termination rates for various factors. Data were obtained from a statewide population-based birth defects registry. The study included 205 detected sex chromosome abnormality cases of which 93 (45%) were live births, 18 (9%) late fetal deaths, 37 (18%) early fetal deaths, and 57 (28%) elective terminations. Pregnancy outcome distribution varied by type of sex chromosome abnormality. Prenatal diagnosis was reported for 132 (64%) of the cases, of which 46 (35%) were subsequently electively terminated. Eleven cases were elective terminations where the sex chromosome abnormality was diagnosed after delivery. Elective termination rates subsequent to prenatal diagnosis differed by sex chromosome abnormality, being highest for 45,X (54%), followed by 47,XXY (46%), 47,XYY (29%), and 47,XXX (17%). Although prenatal diagnosis rates increased significantly over the time period (P = 0.006), the subsequent elective termination rate declined slightly, albeit the trend was not statistically significant (P = 0.440). The prenatal diagnosis rate was highest for the 35-39-year maternal age group, although this age group did not have subsequent elective termination rates higher than other maternal age groups. Pregnancy outcome distribution and prenatal diagnosis and subsequent elective termination of sex chromosome abnormalities appeared to depend on the type of sex chromosome abnormality, year of delivery, and maternal age.

  11. Comprehensive Prenatal Care for Pregnant Teens.

    Science.gov (United States)

    Isberner, Fred; Wright, W. Russell

    1987-01-01

    This article describes a rural teenage pregnancy program and compares the pregnancy outcomes to 60 matched nonparticipants. The study determined a relationship existed between program participation and maternal complications, birth weight, gestational age, Apgar score, and perinatal morbidity. (Author/MT)

  12. Barriers and promoters of an evidenced-based smoking cessation counseling during prenatal care in Argentina and Uruguay.

    Science.gov (United States)

    Colomar, Mercedes; Tong, Van T; Morello, Paola; Farr, Sherry L; Lawsin, Catalina; Dietz, Patricia M; Aleman, Alicia; Berrueta, Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizán, José; Althabe, Fernando

    2015-07-01

    In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A's model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers', clinic directors', and pregnant smokers' opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches.

  13. Estado nutricional pré-gestacional, ganho de peso materno, condições da assistência pré-natal e desfechos perinatais adversos entre puérperas adolescentes Pre-pregnancy nutritional status, maternal weight gain, prenatal care, and adverse perinatal outcomes among adolescent mothers

    Directory of Open Access Journals (Sweden)

    Marta Maria Antonieta de Souza Santos

    2012-03-01

    Full Text Available OBJETIVO: Identificar associação entre estado nutricional pré-gestacional, ganho ponderal materno e condições do pré-natal com os desfechos prematuridade e baixo peso ao nascer (BPN em filhos de mães adolescentes. MÉTODOS: Estudo transversal com 542 pares de puérperas adolescentes e conceptos atendidos em uma maternidade pública do município do Rio de Janeiro (RJ. Os dados foram coletados em prontuários. Para verificar a associação entre as variáveis independentes e os desfechos estudados, foram estimados a odds ratio (OR e o intervalo de confiança (IC de 95%. RESULTADOS: Quanto ao estado nutricional pré-gestacional das adolescentes, 87% apresentavam eutrofia, 1% baixo peso, 10% sobrepeso e 2% obesidade. A inadequação do ganho de peso gestacional total (72% superou a adequação (28%. O peso ao nascer foi favorecido com maior ganho de peso gestacional e reduzido com início tardio do pré-natal (PN. A comparação entre os grupos de conceptos com baixo peso e com peso adequado ao nascer revelou diferenças significativas entre as médias das variáveis: intervalo entre a última gestação e a atual (p = 0,022; peso pré-gestacional (p = 0,018; índice de massa corporal pré-gestacional (p OBJECTIVE: To identify the association between pre-gestational nutritional status, maternal weight gain, and prenatal care with low birth weight (LBW and prematurity outcomes in infants of adolescent mothers. METHODS: Cross-sectional study with 542 pairs of adolescent mothers and their children attending a public maternity hospital in Rio de Janeiro. Data were collected from medical records. To determine the association between independent variables and the outcomes studied, odds ratio (OR and a 95% confidence interval (CI were estimated RESULTS: With respect to pre-pregnancy nutritional status of adolescents, 87% had normal weight, 1% were underweight, 10% were overweight, and 2% obese. Inadequate total gestational weight gain (72% exceeded

  14. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... From Puerto Rico Meet our National Ambassador for 2017 Read and share stories Become inspired by stories ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  15. Inadequate utilization of prenatal care in two Brazilian birth cohorts

    OpenAIRE

    L.C. Coimbra; Figueiredo,F.P.; Silva,A.A.M.; Barbieri, M A; Bettiol,H.; Caldas,A.J.M.; Mochel,E.G.; V.S. Ribeiro

    2007-01-01

    Data for two birth cohorts from two Brazilian municipalities, Ribeirão Preto in 1994 and São Luís in 1997/1998, were used to identify and compare factors associated with inadequate utilization of prenatal care and to identify factors capable of explaining the differences observed between the two cities. Prenatal care was defined as adequate or inadequate according to the recommendations of the Brazilian Ministry of Health. The chi-square test and Poisson regression were used to compare differ...

  16. Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil

    National Research Council Canada - National Science Library

    Ribeiro, Eleonora R O; Guimarães, Alzira Maria D N; Bettiol, Heloísa; Lima, Danilo D F; Almeida, Maria Luiza D; de Souza, Luiz; Silva, Antônio Augusto M; Gurgel, Ricardo Q

    2009-01-01

    .... The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil...

  17. Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub-Saharan Africa: a multicountry analysis of Demographic and Health Survey data.

    Science.gov (United States)

    Amo-Adjei, Joshua; Anamaale Tuoyire, Derek

    2016-12-01

    We analysed the extent of planned, mistimed and unwanted pregnancies and how they predict optimal use of prenatal (timing and number of antenatal) care services in 30 African countries. We pooled data from Demographic and Health Surveys conducted in 30 African countries between 2006 and 2015. We described the extent of mistimed and unwanted pregnancies and further used mixed effects logistic and Poisson regression estimation techniques to examine the impacts of planned, mistimed and unwanted pregnancies on the use of prenatal health services. In total, 73.65% of pregnancies in all countries were planned. Mistimed pregnancy ranged from 7.43% in Burkina Faso to 41.33% in Namibia. Unwanted pregnancies were most common in Swaziland (39.54%) and least common in Niger (0.74%). Timely (first trimester) initiation of ANC was 37% overall in all countries; the multicountry average number of ANC visits was optimal [4.1; 95% CI: 4.1-4.2] but with notable disparities between countries. Overall, mistimed and unwanted pregnancies were strongly associated with late ANC attendance and fewer visits women made in the pooled analysis. Unintended pregnancies are critical risks to achieving improved maternal health in respect of early and optimal ANC coverage for women in Africa. Programmes targeted at advancing coverage of ANC in Africa need to deploy contextually appropriate mechanisms to prevent unintended pregnancies. © 2016 John Wiley & Sons Ltd.

  18. Relationship between Revised Graduated Index (R-GINDEX) of prenatal care utilization & preterm labor and low birth weight.

    Science.gov (United States)

    Tayebi, Tahereh; Hamzehgardeshi, Zeinab; Ahmad Shirvani, Marjan; Dayhimi, Marjaneh; Danesh, Mahmonir

    2014-02-28

    Prenatal care refers to accurate and consistent performance of the principles important to maintain healthy pregnancy outcomes and also for mother and child health. One of the new indices to assess the adequacy of care is Revised Graduated Index of Prenatal Care Utilization (R-GINDEX).The study aims to assess the relationship between quantitative prenatal care factors and preterm labor and low birth weight using R-GINDEX. This historical cohort study has been conducted on 420 mothers during the first two years after delivery in 2010. The adequacy of care was calculated by R-GINDEX. Based on this index, participants have been divided into three care groups including inadequate, adequate and intensive care groups. A significant relationship has been found between R-GINDEX and preterm birth and low birth weight (Pinadequate care group (RR=3.93) and low birth weight (RR= 2.53) was higher than that of the adequate and intensive care group. The results showed that the quantity of prenatal care is effective in reducing preterm birth and low birth weight.

  19. Associations between prenatal arsenic exposure with adverse pregnancy outcome and child mortality.

    Science.gov (United States)

    Shih, Yu-Hsuan; Islam, Tariqul; Hore, Samar Kumar; Sarwar, Golam; Shahriar, Mohammad Hasan; Yunus, Mohammad; Graziano, Joseph H; Harjes, Judith; Baron, John A; Parvez, Faruque; Ahsan, Habibul; Argos, Maria

    2017-10-01

    Chronic arsenic exposure is a public health concern in many parts of the world, with elevated concentrations in groundwater posing a threat to millions of people. Arsenic is associated with various cancers and an array of chronic diseases; however, the relationship with adverse pregnancy outcomes and child mortality is less established. We evaluated associations between individual-level prenatal arsenic exposure with adverse pregnancy outcomes and child mortality in a pregnancy study among 498 women nested in a larger population-based cohort in rural Bangladesh. Creatinine-adjusted urinary total arsenic concentration, a comprehensive measure of exposure from water, food, and air sources, reflective of the prenatal period was available for participants. Self-reported pregnancy outcomes (livebirth, stillbirth, spontaneous/elective abortion) were ascertained. Generalized estimating equations, accounting for multiple pregnancies of participants, were used to estimate odds ratios and 95% confidence intervals in relation to adverse pregnancy outcomes. Vital status of livebirths was subsequently ascertained through November 2015. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals in relation to child mortality. We observed a significant association between prenatal arsenic exposure and the risk of stillbirth (greater than median; adjusted OR = 2.50; 95% CI = 1.04, 6.01). We also observed elevated risk of child mortality (greater than median; adjusted HR = 1.92; 95% CI = 0.78, 4.68) in relation to prenatal arsenic exposure. Prospective studies should continue to evaluate prenatal and early life health effects of arsenic exposure and arsenic remediation strategies for women of child-bearing age. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for ... a moment, please. You've saved this page It's been added to your dashboard . '; $("#video-display").html( ...

  1. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & birth Postpartum care Baby Caring for ... a moment, please. You've saved this page It's been added to your dashboard . '; $("#video-display").html( ...

  2. Integration of noninvasive prenatal prediction of fetal blood group into clinical prenatal care

    DEFF Research Database (Denmark)

    Clausen, Frederik Banch

    2014-01-01

    of the fetus and newborn to fetuses of immunized women. Prediction of the fetal RhD type has been very successful and is now integrated into clinical practice to assist in the management of the pregnancies of RhD immunized women. In addition, noninvasive prediction of the fetal RhD type can be applied to guide......Incompatibility of red blood cell blood group antigens between a pregnant woman and her fetus can cause maternal immunization and, consequently, hemolytic disease of the fetus and newborn. Noninvasive prenatal testing of cell-free fetal DNA can be used to assess the risk of hemolytic disease...

  3. Renal disease in pregnancy ambulatory issues.

    Science.gov (United States)

    Phelan, Sharon T

    2012-09-01

    Acute and chronic renal disease will complicate prenatal care. Normal physiological changes during pregnancy make the urinary tract system more vulnerable to infectious complications or worsening of preexisting disease. Much of the focus of prenatal care includes screening for these concerns both at the onset of prenatal care and through the pregnancy and postpartum course. With careful and attentive care, the pregnancy outcome for women with significant renal disease has improved and the occurrence of renal injury or obstetric complications due to infectious insults has decreased. This manuscript reviews the current ambulatory prenatal care as it relates to the urinary tract in pregnancy.

  4. The influence of prenatal screening and termination of pregnancy on perinatal mortality rates

    NARCIS (Netherlands)

    Pal-de Bruin, K.M. van der; Graafmans, W.; Biermans, M.C.J.; Richardus, J.H.; Zijlstra, A.G.; Reefhuis, J.; Mackenbach, J.P.; Verloove-Vanhorick, S.P.

    2002-01-01

    Objectives This study concerns the possible effect of practice of prenatal screening of congenital anomalies followed by termination of pregnancy on the perinatal mortality between European countries. Methods Data of nine region-specific EUROCAT registries from five European countries were used to c

  5. Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

    Science.gov (United States)

    Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

    2012-01-01

    The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

  6. Prenatal diagnosis of Meckel-Gruber syndrome in a pregnancy obtained with ICSI.

    Science.gov (United States)

    Celentano, Claudio; Prefumo, Federico; Liberati, Marco; Gallo, Giuseppina; Di Nisio, Quirino; Rotmensch, Sigfried

    2006-06-01

    The association of occipital encephalocele, cleft palate, postaxial polydactyly, polycystic kidneys, and hepatic cysts is well known as Meckel-Gruber syndrome (MGS). Nowadays, the diagnosis of MGS is usually performed prenatally by ultrasound findings. MGS was previously described following in vitro fertilization. We report a case of MGS diagnosed at 17 weeks in a pregnancy obtained with intra-cytoplasmic sperm injection (ICSI).

  7. Prenatal Profile of Cornelia de Lange Syndrome (CdLS): A Review of 53 Pregnancies

    Science.gov (United States)

    Clark, Dinah M.; Sherer, Ilana; Deardorff, Matthew A.; Byrne, Janice L.B.; Loomes, Kathleen M.; Nowaczyk, Malgorzata J.M.; Jackson, Laird G.; Krantz, Ian D.

    2012-01-01

    Cornelia de Lange Syndrome (CdLS) is a multisystem developmental disorder characterized by growth retardation, cognitive impairment, external and internal structural malformations, and characteristic facial features. Currently, there are no definitive prenatal screening measures that lead to the diagnosis of CdLS. In this study, documented prenatal findings in CdLS syndrome were analyzed towards the development of a prenatal profile predictive of CdLS. We reviewed 53 cases of CdLS (29 previously reported and 24 unreported) in which prenatal observations/findings were available. The review of these cases revealed a pattern of sonographic findings, including obvious associated structural defects, growth restriction, as well as a more subtle, but strikingly characteristic, facial profile, suggestive of a recognizable prenatal ultrasonographic profile for CdLS. In addition the maternal serum marker, PAPP-A, may be reduced and fetal nuchal translucency may be increased in some pregnancies when measured at an appropriate gestational age. In conclusion, CdLS can be prenatally diagnosed or readily ruled out in a family with a known mutation in a CdLS gene. The characteristic ultrasonographic profile may allow for prenatal diagnosis of CdLS in 1) subsequent pregnancies to a couple with a prior child with CdLS in whom a mutation has not been identified or 2) when there are unexplained pregnancy signs of fetal abnormality such as oligo- or polyhydramnios, a low maternal serum PAPP-A level and/or increased nuchal translucency, fetal growth retardation, or structural anomalies consistent with CdLS. PMID:22740382

  8. Identifying intimate partner violence at entry to prenatal care: clustering routine clinical information.

    Science.gov (United States)

    Anderson, Barbara A; Marshak, Helen Hopp; Hebbeler, Donna L

    2002-01-01

    Intimate partner violence (IPV) is the greatest trauma-related risk to American women. Pregnant women are no exception, and escalation of IPV frequently occurs during pregnancy. Many studies have linked IPV during pregnancy to adverse maternal and fetal outcomes. This study examined IPV at the beginning of prenatal care to identify correlates of routine entry-to-care information with responses on a validated IPV screening tool, the Abuse Assessment Screen. The purpose of the study was to identify specific data from routine, standard intake information, which could alert clinicians to the potential of violence even in the presence of a negative IPV score or no formally administered screening tool. The point prevalence of abuse, as measured by the Abuse Assessment Screen at entry to care, was slightly in excess of the national mean, reinforcing the need for continual assessment throughout pregnancy. Abused women in this study were more likely to be young, single, and without family or partner support. These women relied on friends for support, admitted to depression, and desired their pregnancies. The findings are consistent with previous studies. Further research needs to be conducted to determine if this cluster of findings at entry to care, with or without a positive score on an IPV screening tool, are consistent markers for an increased risk of IPV.

  9. Factors associated to the notification of congenital syphilis: an indicator of quality of prenatal care

    Directory of Open Access Journals (Sweden)

    Inacia Sátiro Xavier de França

    2015-07-01

    Full Text Available Objective: to analyze factors associated to the notification of congenital syphilis. Methods: a cross-sectional documentary, quantitative study, made through the National System of Notifiable Diseases. The study consisted of 113 notified cases. A data collection form was used and Chi-square and Fisher tests were made. Results: women had prenatal exams (80.2%, serologic testing before six months of pregnancy (46.7% and after (53.3%. There was an association for the variables race (p = 0.005 and serological test (p = 0.044. The treatment of the pregnant woman was inadequate (64.5% and the partner was not treated (85.7%. Conclusion: it was found that the number of cases is growing, increasing the possibility of children with severe sequelae. So improvements in prenatal care are still needed.

  10. Impact of educational strategies in low-risk prenatal care: systematic review of randomized clinical trials.

    Science.gov (United States)

    Silva, Esther Pereira da; Lima, Roberto Teixeira de; Osório, Mônica Maria

    2016-09-01

    This study aimed to analyze the impact of educational strategies developed in low-risk prenatal care on obstetric outcomes from a systematic literature review. This review consulted databases PubMed, Medline, SciELO and Lilacs, analyzing randomized clinical trials with the following birth outcomes: birth weight, prematurity and breastfeeding, using the following combination of keywords: pre-natal, antenatal visits, education, health education, pregnancy outcomes, birth weight, prematurity, breastfeeding and randomized clinical trial. Nine studies were included following quality evaluation. Actions prove to be more effective when extended to the postpartum period. Most of them occurred during home visits and had a positive impact on breastfeeding and birth weight. The establishment of groups of pregnant women contributed to lower prevalence of prematurity. Breastfeeding was found to be the outcome most sensitive to educational strategies. Educational practices during the prenatal period contributed to favorable obstetric outcomes as they minimized pregnant women concerns and anxiety during the pregnancy process, preparing them for childbirth and postpartum, and should be incorporated into health services' work process.

  11. The color of pain: racial iniquities in prenatal care and childbirth in Brazil.

    Science.gov (United States)

    Leal, Maria do Carmo; Gama, Silvana Granado Nogueira da; Pereira, Ana Paula Esteves; Pacheco, Vanessa Eufrauzino; Carmo, Cleber Nascimento do; Santos, Ricardo Ventura

    2017-07-24

    Few studies on the influence of race/color on pregnancy and birthcare experiences have been carried out in Brazil. Additionally, none of the existing studies are of national scope. This study sought to evaluate inequities in prenatal and childbirth care according to race/color using propensity score matching. The data comes from the study Birth in Brazil: National Survey into Labor and Birth, a national population study comprised of interviews and revisions of medical records that included 23,894 women in 2011/2012. We used logistic regressions to estimate odds ratios (OR) and respective 95% confidence intervals (95%CI) of race/color associated with the outcomes were analyzed. When compared with white-skinned women, black-skinned women were more likely to have inadequate prenatal care (OR = 1.6; 95%CI: 1.4-1.9), to not be linked to a maternity hospital for childbirth (OR = 1.2 95%CI: 1.1-1.4), to be without a companion (OR = 1.7; 95%CI: 1.4-2.0), to seek more than one hospital for childbirth (OR =1.3; 95%CI: 1.2-1.5), and less likely to receive local anesthesia for an episiotomy (OR = 1.5; 95%CI: 1.1-2.1). Brown-skinned women were also more likely to have inadequate prenatal care (OR = 1.2; 95%CI: 1.1-1.4) and to lack a companion (OR = 1.4; 95%CI: 1.3-1.6) when compared with white-skinned women. We identified racial disparities in care during pregnancy and childbirth, which displayed a gradient going from worst to best care provided to black, brown and white-skinned women.

  12. Prenatal decision-making in the second and third trimester in trisomy 21-affected pregnancies.

    Science.gov (United States)

    Weichert, Alexander; Braun, Thorsten; Deutinger, Christine; Henrich, Wolfgang; Kalache, Karim D; Neymeyer, Joerg

    2017-02-01

    Down syndrome (DS) is the most common chromosome abnormality among live-born infants and the most frequent genetic cause of intellectual disability. The majority of pregnancies affected by DS are terminated. The decision concerning whether or not to continue a pregnancy following the prenatal diagnosis of DS is complex and amongst others, motivated by attitudes towards termination, socioeconomic factors, and ultrasound findings. In Germany, termination of pregnancy (TOP) is a legal option, even during the later stages of gestation. The aim of the present study was to evaluate the pregnancy outcomes as well as possible factors that influence the decisions made by women with trisomy 21-affected pregnancies. In our study 112 pregnancies affected by trisomy 21 were included. Our data confirm that most patients are more likely to terminate a trisomy 21-affected pregnancy [76 (67.9%) vs. 36 (32.1%) continued pregnancies]. Beyond that we found that women who continued their pregnancy tended to be at an advanced stage in their pregnancy at the time of karyotyping. With regards to factors from their medical history as well as sonographic findings there was no identifiable single factor that could distinguish between women that opted to continue or terminate their pregnancy.

  13. Prenatal diagnosis of sickle-cell anemia in the first trimester of pregnancy.

    Science.gov (United States)

    Goossens, M; Dumez, Y; Kaplan, L; Lupker, M; Chabret, C; Henrion, R; Rosa, J

    1983-10-06

    To investigate the usefulness of chorionic biopsy for prenatal diagnosis of sickle-cell anemia by restriction-endonuclease analysis of fetal DNA, we studied 30 pregnancies before elective abortion. When the reproducibility of the technique for obtaining adequate DNA samples was established, we successfully applied the test to five pregnancies at risk for sickle-cell anemia. In two cases, sickle-cell disease of the fetus led to a decision to terminate the pregnancy. In three other cases, a normal or AS genotype was demonstrated. One normal infant has been born, and one other pregnancy is continuing normally. In one case in which fetal death was observed three weeks after sampling, placental abnormalities found on histologic examination were compatible with a chromosomal aberration. Our study shows that chorionic biopsy is feasible for the prenatal diagnosis of sickle-cell disease before the 10th gestational week. If subsequent experience demonstrates this technique to be safe enough for mother and fetus, the ability to test in early pregnancy may make prenatal diagnosis acceptable to more couples at risk for serious genetic disorders.

  14. [TURNING THE PYRAMID IN PRENATAL CARE].

    Science.gov (United States)

    Ohel-Shani, Iris; Daniel-Spiegel, Etty

    2015-10-01

    Most complications of pregnancy manifest towards the latter part of pregnancy. Nevertheless, present day diagnostic techniques, such as sonography, Doppler, biochemical screening tests, and the newly developed ability to study free fetal DNA in maternal blood, enables early identification of high risk groups for maternal and fetal morbidity, as well as fetal genetic and anatomical pathology. Dr. Nicolaides has coined this changing trend with the term "Turning the Pyramid". Early screening enables earlier and more directed follow-up with the application of relevant diagnostic tests. Obvious advantages include the potential to reduce maternal-fetal morbidity before it becomes apparent clinically. Additionally, the earlier diagnosis of fetal pathology, allows more time for parents and medical staff to assess the situation, and reach a decision regarding the continuation of the pregnancy. A possible drawback of such an approach, of early identification of high risk groups, is the uncertainty it arouses, sometimes for a long duration, with the accompanying apprehension and stress parents have to endure. A multidisciplinary team, consisting of specialists in fetal-maternal medicine, genetics, ultrasound, and perinatology, will be needed in order to best deal with the often complex information, which is becoming increasingly available at a very early stage of pregnancy.

  15. Association between maternal social deprivation and prenatal care utilization: the PreCARE cohort study.

    Science.gov (United States)

    Gonthier, Clémentine; Estellat, Candice; Deneux-Tharaux, Catherine; Blondel, Béatrice; Alfaiate, Toni; Schmitz, Thomas; Oury, Jean-François; Mandelbrot, Laurent; Luton, Dominique; Ravaud, Philippe; Azria, Elie

    2017-05-16

    Maternal social deprivation is associated with an increased risk of adverse maternal and perinatal outcomes. Inadequate prenatal care utilization (PCU) is likely to be an important intermediate factor. The health care system in France provides essential health services to all pregnant women irrespective of their socioeconomic status. Our aim was to assess the association between maternal social deprivation and PCU. The analysis was performed in the database of the multicenter prospective PreCARE cohort study. The population source consisted in all parturient women registered for delivery in 4 university hospital maternity units, Paris, France, from October 2010 to November 2011 (N = 10,419). This analysis selected women with singleton pregnancies that ended after 22 weeks of gestation (N = 9770). The associations between maternal deprivation (four variables first considered separately and then combined as a social deprivation index: social isolation, poor or insecure housing conditions, no work-related household income, and absence of standard health insurance) and inadequate PCU were tested through multivariate logistic regressions also adjusted for immigration characteristics and education level. Attendance at prenatal care was poor for 23.3% of the study population. Crude relative risks and confidence intervals for inadequate PCU were 1.6 [1.5-1.8], 2.3 [2.1-2.6], and 3.1 [2.8-3.4], for women with a deprivation index of 1, 2, and 3, respectively, compared to women with deprivation index of 0. Each of the four deprivation variables was significantly associated with an increased risk of inadequate PCU. Because of the interaction observed between inadequate PCU and mother's country of birth, we stratified for the latter before the multivariate analysis. After adjustment for the potential confounders, this social gradient remained for women born in France and North Africa. The prevalence of inadequate PCU among women born in sub-Saharan Africa was 34

  16. Reduced risk of inadequate prenatal care in the era after Medicaid expansions in California.

    Science.gov (United States)

    Hessol, Nancy A; Vittinghoff, Eric; Fuentes-Afflick, Elena

    2004-05-01

    To improve perinatal outcomes in the United States, access to prenatal care was expanded through Medicaid and women were encouraged to enter prenatal care early. The objective of this study was to determine if expanded eligibility for Medicaid increased use of prenatal care and reduced ethnic differences in use of prenatal care. We conducted secondary analysis of California birth certificate data for 1990, 1995, and 1998. We studied live-born singleton infants born to black, Asian, Latina, and white women (n = 1,483,951). Inadequate utilization of prenatal care. The proportion of live-born infants whose mothers had inadequate prenatal care decreased from 20% in 1990 to 14% in 1995 and 12% in 1998. In addition, the proportion of pregnant women with no insurance or who were self-paying fell from 13.1% in 1990 to 4.2% in 1995 and 3.6% in 1998 (P inadequate use of prenatal care and ethnic disparities in use of prenatal care were not fully explained by increases in Medicaid coverage. Since California expanded access to Medicaid-funded prenatal care, there has been a substantial reduction in inadequate use of prenatal care and fewer women have no insurance or are self-paying. To further reduce ethnic disparities in use of health services, new policies must be developed to remove nonfinancial barriers to early and continuous use of prenatal care.

  17. Prenatal care disparities and the migrant farm worker community.

    Science.gov (United States)

    Bircher, Heidi

    2009-01-01

    The pregnant migrant farm worker faces many barriers to accessing healthcare in the United States due to poverty, language/literacy issues, transportation difficulties, and geographic isolation. The advanced practice nurse has the opportunity to contribute solutions to the problems of lack of adequate prenatal care among the migrant farm worker community, if he/she is aware of the need and can institute novel models of care. This article describes the problem of migrant farm worker health and suggests ways that advanced practice nurses can provide cost effective, competent professional care to reduce or eliminate the obstacles to care for this population.

  18. Exploring the social determinants of racial/ethnic disparities in prenatal care utilization and maternal outcome.

    Science.gov (United States)

    Gadson, Alexis; Akpovi, Eloho; Mehta, Pooja K

    2017-08-01

    Rates of maternal morbidity and mortality are rising in the United States. Non-Hispanic Black women are at highest risk for these outcomes compared to those of other race/ethnicities. Black women are also more likely to be late to prenatal care or be inadequate users of prenatal care. Prenatal care can engage those at risk and potentially influence perinatal outcomes but further research on the link between prenatal care and maternal outcomes is needed. The objective of this article is to review literature illuminating the relationship between prenatal care utilization, social determinants of health, and racial disparities in maternal outcome. We present a theoretical framework connecting the complex factors that may link race, social context, prenatal care utilization, and maternal morbidity/mortality. Prenatal care innovations showing potential to engage with the social determinants of maternal health and address disparities and priorities for future research are reviewed. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Determinants of prenatal care use: evidence from 32 low-income countries across Asia, Sub-Saharan Africa and Latin America.

    Science.gov (United States)

    Guliani, Harminder; Sepehri, Ardeshir; Serieux, John

    2014-08-01

    While much has been written on the determinants of prenatal care attendance in low-income countries, comparatively little is known about the determinants of the frequency of prenatal visits in general and whether there are separate processes generating the decisions to use prenatal care and the frequency of use. Using the Demographic and Health Surveys data for 32 low-income countries (across Asia, Sub-Saharan Africa and Latin America) and appropriate two-part and multilevel models, this article empirically assesses the influence of a wide array of observed individual-, household- and community-level characteristics on a woman's decision to use prenatal care and the frequency of that use, while controlling for unobserved community level factors. The results suggest that, though both the decision to use care and the number of prenatal visits are influenced by a range of observed individual-, household- and community-level characteristics, the influence of these determinants vary in magnitude for prenatal care attendance and the frequency of prenatal visits. Despite remarkable consistency among regions in the association of individual, household and community indicators with prenatal care utilization, the estimated coefficients of the risk factors vary greatly across the three world regions. The strong influence of household wealth, education and regional poverty on the use of prenatal care suggests that safe motherhood programmes should be linked with the objectives of social development programmes such as poverty reduction, enhancing the status of women and increasing primary and secondary school enrolment rate among girls. Finally, the finding that teenage mothers and unmarried women and those with unintended pregnancies are less likely to use prenatal care and have fewer visits suggests that safe mother programmes need to pay particular attention to the disadvantaged and vulnerable subgroups of population whose reproductive health issues are often fraught with

  20. Discordance between prenatal cytogenetic diagnosis and outcome of pregnancy.

    Science.gov (United States)

    Loft, A; Tabor, A

    1984-01-01

    From 1.3.73 to 30.9.80 5580 women had an amniocentesis performed here or elsewhere; fetal chromosome analyses were carried out in this laboratory. We found 112 abnormal karyotypes (2 per cent) out of 5591 chromosome analyses. In 40 women (0.7 per cent) no cytogenetic diagnosis was obtained. Follow-up was successful in 99.5 per cent. Nine cases are reported in detail: Three cases had discrepancy between the karyotype in amniotic fluid and peripheral blood after delivery, two of these cases turned out to be 46,XX (male) while the third was prenatally determined as trisomy 21, but had a 46,XX karyotype at birth. Six cases had discrepancy between the karyotype in amniotic fluid and the phenotypic outcome at birth/abortion. One case was a prenatally undetected 45,X/46,XY mosaicism; one case was an unexplained 45,X male fetus; two cases were prenatally determined as trisomy 21, but at abortion a normal karyotype was determined and in two cases maternal cells were probably examined. The incidence of cytogenetic errors in this study was very low.

  1. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies.

    Science.gov (United States)

    Jacobs, Myrthe; Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M; Pell, Jill P

    2016-01-01

    Previous studies have demonstrated the influence of changes in the age at which women give birth, and of developments in prenatal screening and diagnosis on the number of pregnancies diagnosed and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors. The aims of this study were to examine the association between results of prenatal tests and pregnancy termination, and the proportion of foetuses with and without chromosomal anomalies referred for invasive diagnostic tests over time. Diagnostic information of 26,261 prenatal invasive tests from all genetic service laboratories in Scotland from 2000 to 2011 was linked to Scottish Morbidity Records to obtain details on pregnancy outcome. Binary logistic regression was carried out to test the associations of year and type of diagnosis with pregnancy termination, while controlling for maternal age, neighbourhood deprivation and parity. There were 24,155 (92.0%) with no chromosomal anomalies, 1,483 (5.6%) aneuploidy diagnoses, and 623 (2.4%) diagnoses of anomaly that was not aneuploidy (including translocations and single chromosome deletions). In comparison with negative test results, pregnancies diagnosed with trisomy were most likely to be terminated (adjusted OR 437.40, 95% CI 348.19-549.46) followed by other aneuploid anomalies (adjusted OR 95.94, 95% CI 69.21-133.01). During the study period, fewer pregnancies that were diagnosed with aneuploidy were terminated, including trisomy diagnoses (adjusted OR 0.44, 95% CI 0.26-0.73). Older women were less likely to terminate (OR 0.35, 95% CI 0.28, 0.42), and parity was also an independent predictor of termination. In keeping with previous findings, while the number of invasive diagnostic tests declined, the proportion of abnormal results increased from 6.09% to 10.88%. Systematic advances in

  2. The effect of social health insurance on prenatal care: the case of Ghana.

    Science.gov (United States)

    Abrokwah, Stephen O; Moser, Christine M; Norton, Edward C

    2014-12-01

    Many developing countries have introduced social health insurance programs to help address two of the United Nations' millennium development goals-reducing infant mortality and improving maternal health outcomes. By making modern health care more accessible and affordable, policymakers hope that more women will seek prenatal care and thereby improve health outcomes. This paper studies how Ghana's social health insurance program affects prenatal care use and out-of-pocket expenditures, using the two-part model to model prenatal care expenditures. We test whether Ghana's social health insurance improved prenatal care use, reduced out-of-pocket expenditures, and increased the number of prenatal care visits. District-level differences in the timing of implementation provide exogenous variation in access to health insurance, and therefore strong identification. Those with access to social health insurance have a higher probability of receiving care, a higher number of prenatal care visits, and lower out-of-pocket expenditures conditional on spending on care.

  3. Oregon's Coordinated Care Organizations and Their Effect on Prenatal Care Utilization Among Medicaid Enrollees.

    Science.gov (United States)

    Oakley, Lisa P; Harvey, S Marie; Yoon, Jangho; Luck, Jeff

    2017-07-12

    Introduction Previous studies indicate that inadequate prenatal care is more common among women covered by Medicaid compared with private insurance. Increasing the proportion of pregnant women who receive early and adequate prenatal care is a Healthy People 2020 goal. We examined the impact of the implementation of Oregon's accountable care organizations, Coordinated Care Organizations (CCOs), for Medicaid enrollees, on prenatal care utilization among Oregon women of reproductive age enrolled in Medicaid. Methods Using Medicaid eligibility data linked to unique birth records for 2011-2013, we used a pre-posttest treatment-control design that compared prenatal care utilization for women on Medicaid before and after CCO implementation to women never enrolled in Medicaid. Additional stratified analyses were conducted to explore differences in the effect of CCO implementation based on rurality, race, and ethnicity. Results After CCO implementation, mothers on Medicaid had a 13% increase in the odds of receiving first trimester care (OR 1.13, CI 1.04, 1.23). Non-Hispanic (OR 1.20, CI 1.09, 1.32), White (OR 1.20, CI 1.08, 1.33) and Asian (OR 2.03, CI 1.26, 3.27) women on Medicaid were more likely to receive initial prenatal care in the first trimester after CCO implementation and only Medicaid women in urban areas were more likely (OR 1.14, CI 1.05, 1.25) to initiate prenatal care in the first trimester. Conclusion Following Oregon's implementation of an innovative Medicaid coordinated care model, we found that women on Medicaid experienced a significant increase in receiving timely prenatal care.

  4. Group prenatal care for women with gestational diabetes (.).

    Science.gov (United States)

    Mazzoni, Sara E; Hill, Pamela K; Webster, Kelsey W; Heinrichs, Gretchen A; Hoffman, M Camille

    2016-09-01

    We aimed to determine if group prenatal care affects the progression to A2 gestational diabetes mellitus (GDM) when compared with conventional care for women with GDM. Prospective observational cohort of women diagnosed with GDM who attended group visits compared with a historical control group of women who received conventional obstetrical care in the year prior but would have met inclusion criteria for group care. The primary outcome was progression to A2 GDM. Secondary outcomes included antepartum, intrapartum and postpartum maternal outcomes and neonatal outcomes. A total of 165 subjects were included: 62 in group care and 103 in conventional care. Compared with patients with conventional care, group subjects were more likely to attend a postpartum visit (92% versus 66%; p = 0.002) and were almost 4 times more likely to receive recommended diabetes screening postpartum (OR 3.9, CI 1.8-8.6). Group subjects were much less likely to progress to A2 GDM (OR 0.15, CI 0.07-0.30). There were no differences in neonatal outcomes. Group prenatal care for women with diabetes is associated with decreased progression to A2 GDM and improved postpartum follow-up for appropriate diabetes screening without significantly affecting obstetrical or neonatal outcomes.

  5. A descriptive study of women presenting to an obstetric triage unit with no prenatal care.

    Science.gov (United States)

    Knight, Erin; Morris, Margaret; Heaman, Maureen

    2014-03-01

    To describe women presenting to an obstetric triage unit with no prenatal care (PNC), to identify gaps in care, and to compare care provided to World Health Organization (WHO) standards. We reviewed the charts of women who gave birth at Women's Hospital in Winnipeg and were discharged between April 1, 2008, and March 31, 2011, and identified those whose charts were coded with ICD-10 code Z35.3 (inadequate PNC) or who had fewer than 2 PNC visits. Three hundred eighty-two charts were identified, and sociodemographic characteristics, PNC history, investigations, and pregnancy outcomes were recorded. The care provided was compared with WHO guidelines. One hundred nine women presented to the obstetric triage unit with no PNC; 96 (88.1%) were in the third trimester. Only 39 women (35.8%) received subsequent PNC, with care falling short of WHO standards. Gaps in PNC included missing time-sensitive screening tests, mid-stream urine culture, and Chlamydia and gonorrhea testing. The mean maternal age was 26.1 years, and 93 women (85.3%) were multigravidas. More than one half of the women (51.4%) were involved with Child and Family Services, 64.2% smoked, 33.0% drank alcohol, and 32.1% used illicit drugs during pregnancy. Two thirds of the women (66.2%) lived in inner-city Winnipeg. Only 63.0% of neonates showed growth appropriate for gestational age. Two pregnancies ended in stillbirth; there was one neonatal death, and over one third of the births were preterm. Most women who present with no PNC do so late in pregnancy, proceed to deliver with little or no additional PNC, and have high rates of adverse outcomes. Thus, efforts to improve PNC must focus on facilitating earlier entry into care. This would also improve compliance with WHO guidelines for continuing care. Treatment protocols could improve gaps in obtaining urine culture and in Chlamydia and gonorrhea testing.

  6. A Partner's Guide to Pregnancy

    Science.gov (United States)

    ... growth problems. Women who are well supported during pregnancy may be less anxious and have less stress in the weeks after childbirth. You can be supportive by educating yourself about pregnancy, going with your partner to prenatal care appointments, ...

  7. High Blood Pressure in Pregnancy

    Science.gov (United States)

    ... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...

  8. Midwives unable to overcome language barriers in prenatal care

    Directory of Open Access Journals (Sweden)

    Mirjam P. Fransen

    2012-09-01

    Full Text Available

    Background: the present study aims to explore to what extent midwives experience barriers in providing information about prenatal screening for Down syndrome to women from diverse ethnic backgrounds, and to assess their competences to overcome these barriers.

    Methods: midwives from 24 Dutch midwifery practices in Rotterdam completed a structured webbased questionnaire (n=57. Data were obtained on perceived ethnic-related differences and barriers in providing information on prenatal screening, preparedness to provide cultural competent care, and the use of translated materials and professional translators. A group interview was conducted to further explore the results emerging from the questionnaire (n=23.

    Results: almost all midwives (95% experienced barriers in informing women from non-Western ethnic backgrounds about prenatal screening. Midwives especially felt incompetent to provide information to pregnant women that hardly speak and understand Dutch. In total 58% of the midwives reported that they never used translated information materials and 88% never used professional interpreters in providing information on prenatal screening. The main reasons for this underutilization were unawareness of the availability of translated materials and unfamiliarity with the use of professional interpreters.

    Conclusions: although language barriers were reported to be the main difficulty in providing cultural competent care to patients from diverse ethnic backgrounds, only a minority of the midwives used translated materials or professional interpreters. In order to enable all pregnant women to make an informed decision whether or not to participate in prenatal screening, midwives’ competences to address language barriers should be increased.

  9. [Abdominal pregnancy care. Case report].

    Science.gov (United States)

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  10. Determinants of prenatal health care utilisation by low-risk women : A prospective cohort study

    NARCIS (Netherlands)

    Feijen-de Jong, Esther I.; Jansen, Danielle E. M. C.; Baarveld, Frank; Boerleider, Agatha W.; Spelten, Evelien; Schellevis, Francois; Reijneveld, Sijmen A.

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the

  11. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; Boerleider, A.W.; Spelten, E.; Schellevis, F.; Reijneveld, S.A.

    2015-01-01

    Background: Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. Aim: We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. Methods: We used longitudinal data from the

  12. Sex chromosome trisomies in Europe: prevalence, prenatal detection and outcome of pregnancy

    DEFF Research Database (Denmark)

    Boyd, Patricia Anne; Loane, Maria; Garne, Ester

    2011-01-01

    This study aims to assess prevalence and pregnancy outcome for sex chromosome trisomies (SCTs) diagnosed prenatally or in the first year of life. Data held by the European Surveillance of Congenital Anomalies (EUROCAT) database on SCT cases delivered 2000-2005 from 19 population-based registries ...... to differences in screening policies as well as organizational and cultural factors.European Journal of Human Genetics advance online publication, 25 August 2010; doi:10.1038/ejhg.2010.148....

  13. Prenatal diagnosis of thalassemia and hemoglobinopathies in Thailand: experience from 100 pregnancies.

    Science.gov (United States)

    Fucharoen, S; Winichagoon, P; Thonglairoam, V; Siriboon, W; Siritanaratkul, N; Kanokpongsakdi, S; Vantanasiri, C

    1991-03-01

    In this review, we describe a simple strategy to detect the three severe thalassemic diseases commonly found in Thailand. Hb Bart's hydrops fetalis can be detected unambiguously by ultrasonography at 18-20 weeks of gestation or detected early in the first trimester by the gene amplification technique. Prenatal diagnosis for homozygous beta-thalassemia is better performed in the second trimester by in vitro protein synthesis. This is because the molecular defects of some beta-thalassemias are still unknown and homozygosity of the same mutation is low. In contrast, beta-thalassemia/Hb E is easily detected, in the first trimester, by direct visualization on electrophoresis or by dot blot analysis of enzymatically amplified DNA with a set of nonradioactively labeled oligonucleotide probes complementary to the most common mutations. We also found that the beta/gamma synthesis ratio in homozygous Hb E is similar to that of beta-thalassemia/Hb E and DNA analysis is the only method to distinguish these two conditions in the couple at risk of having either beta-thalassemia/Hb E or asymptomatic homozygous Hb E. In 100 pregnancies studied, the diagnoses were achieved in 96 pregnancies. Complications leading to fetal loss were found in 3 pregnancies: one woman developed amnionitis after fetal blood sampling; one had amniotic fluid leakage after the biopsy, and the third, carrying a normal fetus, aborted 10 days after fetal blood sampling with urinary tract infection and high fever. However, these figures are compatible with other reports and the risks are significantly lower than that of thalassemic disease the fetus is facing. One case of beta-thalassemia/Hb E was incorrectly diagnosed prenatally as being Hb E trait. In twenty-five pregnancies (25%) prenatally diagnosed to carry affected fetuses it was decided to have abortion. This study shows the feasibility of prenatal diagnosis for thalassemic diseases in Thailand which, in addition to screening and genetic counseling

  14. Prenatal diagnosis by chorionic villus sampling in multiple pregnancies prior to fetal reduction.

    Science.gov (United States)

    De Catte, L; Camus, M; Bonduelle, M; Liebaers, I; Foulon, W

    1998-05-01

    Ovulation induction and assisted-reproduction techniques have dramatically increased the incidence of high-risk multiple pregnancies over the past 10 years. Perinatal outcome may be improved by the use of multifetal reduction. The fetus to be reduced used to be selected only on technical grounds. We report on the results of prenatal diagnosis by chorionic villus sampling (CVS) during the first trimester in 32 multifetal pregnancies in which fetal reduction was requested. The mean gestational age at CVS was 10.5 weeks. Chromosomal analyses were available for all sampled fetuses, three of which were chromosomally abnormal. In 24 couples, fetal reduction to twin pregnancies was successfully carried out within 1 week after the CVS. In seven cases, the couples elected not to proceed with fetal reduction after receiving information that the chromosomal analysis was normal in all fetuses. Mean gestational ages at delivery were, respectively, 34.6 and 31.8 weeks in the reduced and the nonreduced groups (p = 0.04). No fetal losses occurred in either group; one neonatal death was observed after a preterm delivery because of preeclampsia in a twin pregnancy. Prenatal cytogenetic diagnosis during the first trimester in multiple pregnancies prior to fetal reduction appears to be feasible, accurate, and safe. Abnormal chromosomal results indicate the fetus(es) to be reduced. The parents' decisions not to proceed with the fetal reduction procedure, where chromosomal results in all the fetuses were normal, were unexpected.

  15. Genetic Counseling and Prenatal Diagnosis of Triploidy During the Second Trimester of Pregnancy

    Science.gov (United States)

    Kolarski, Milenko; Ahmetovic, Begzudin; Beres, Maja; Topic, Radomir; Nikic, Vedran; Kavecan, Ivana; Sabic, Semin

    2017-01-01

    Introduction: Triploidy is a lethal chromosomal numeric abnormality, characterized on extra haploid set of chromosomes. It occurs in 2 to 3% of conceptuses and accounts for approximately 20% of chromosomally abnormal first-trimester miscarriages. As such, triploidy is estimated to occur in 1 of 3,500 pregnancies at 12 weeks’, 1 in 30,000 at 16 weeks’, and 1 in 250,000 at 20 weeks’ gestation. Case report: We present a case of second-trimester triploidy diagnosed prenataly at our center. 28-years-old gravida with a first spontaneous pregnancy had early gestational hypertension. Ultrasound examination in 146/7 weeks’ gestation revealed asymmetric intrauterine growth retardation. We recommended biochemical maternal serum screening during second trimester of pregnancy (AFP, HCG, uE3). Result of biochemical screening was indication for cytogenetic analysis from amniotic fluid cells and we recommended early amniocentesis in 156/7 weeks’ gestation. Result showed abnormal karyotype of the fetus (69,XXX triploidy), and DNA analysis confirmed Type-2 Diginy. Parents decided to terminate this pregnancy, and it was done at 22 weeks’ gestation. Conclusion: We emphasize the importance of non-invasive prenatal exminationes-biochemical serum screening during second trimester of pregnancy, and ultrasound examinations in prenatal screening of syndroma Down and other chromosomal abnormalities. PMID:28790549

  16. Fragmentation of Care in Ectopic Pregnancy.

    Science.gov (United States)

    Stulberg, Debra B; Dahlquist, Irma; Jarosch, Christina; Lindau, Stacy T

    2016-05-01

    Ectopic pregnancy is an important cause of maternal morbidity and mortality. Women who experience fragmented care may undergo unnecessary delays to diagnosis and treatment. Based on ectopic pregnancy cases observed in clinical practice that raised our concern about fragmentation of care, we designed an exploratory study to describe the number, characteristics, and outcomes of fragmented care among patients with ectopic pregnancy at one urban academic hospital. Chart review with descriptive statistics. Fragmented care was defined as a patient being evaluated at an outside facility for possible ectopic pregnancy and transferred, referred, or discharged before receiving care at the study institution. Of 191 women seen for possible or definite ectopic pregnancy during the study period, 42 (22 %) met the study definition of fragmented care. The study was under-powered to observe statistically significant differences across groups, but we found concerning, non-significant trends: patients with fragmented care were more likely to be Medicaid recipients (65.9 vs. 58.8 %) and to experience a complication (23.8 vs. 18.1 %) compared to those with non-fragmented care. Most patients (n = 37) received no identifiable treatment prior to transfer and arrived to the study hospital with no communication to the receiving hospital from the outside provider (n = 34). Nine patients (21 %) presented with ruptured ectopic pregnancies. The fragmentation we observed in our study may contribute to previously identified socio-economic disparities in ectopic pregnancy outcomes. If future research confirms these findings, health information exchanges and regional coordination of care may be important strategies for reducing maternal mortality.

  17. Fetal blood sampling in twin pregnancies. Prenatal diagnosis and management of 19 cases.

    Science.gov (United States)

    Cox, W L; Forestier, F; Capella-Pavlovsky, M; Daffos, F

    1987-01-01

    Twin pregnancies pose particular problems in both prenatal diagnosis and obstetric management. We present 19 twin pregnancies that underwent fetal blood sampling (FBS). The indications were mostly similar to those for singleton pregnancies, with both fetuses being sampled. There was one indication specific to twin pregnancies; disseminated intravascular coagulation in the retained twin after the death-in-utero (DIU) of the other. In 5 cases, only 1 twin was sampled; in 2 because the second twin was female in the diagnosis of an X-linked disorder; in 1 because of technical failure, and in 2 the other twin had predeceased. Eight pregnancies continued after the FBS delivering 2 live, healthy infants, though 5 were delivered before 37 weeks of gestation. In 7 cases there was a discordance in the diagnosis between the twins. In 3 of these cases the affected fetus underwent selective termination by air embolism; in 2 cases the pregnancies were continued and the affected twin not resuscitated; 1 pregnancy is still in progress, and 1 patient had a non-medically supervised termination of both twins in another country. Two patients miscarried within a week of the FBS. Two patients had only 1 living twin at the time of FBS; 1 had a second DIU a month after the FBS and the other a neonatal death at 11 days of age in an infant with severe porencephaly. FBS is technically feasible for similar indications as for singleton pregnancies though discordance in diagnosis raises specific management problems.

  18. Protocols on prenatal care for pregnant women with Zika infection and children with microcephaly: nutritional approach

    Directory of Open Access Journals (Sweden)

    Rachel de Sá Barreto Luna Callou Cruz

    Full Text Available Abstract This summary aimed to synthesize the protocol guidelines of Pernambuco, the Ministry of Health and the Centers for Disease Control and Prevention which deal with health care related to Zika virus infection during pregnancy and the preliminary procedures for surveillance on microcephaly cases including nutritional care. With the increase of number of cases on this event since August, 2015, it was necessary to reorganize the prenatal care which is offered to pregnant women, including the protocols in order to reduce the chances of a possible contamination of the virus, to detect previously suspected cases as well as perform follow up on confirmed cases. The gaps in the knowledge of this morbidity, it should be noted that the information and recommendations are subject to revision due to possible incorporation of new knowledge and other evidence, as well as the need for adequacy of surveillance actions in new epidemiological scenarios. It is known that cases of nutritional deficiencies are capable of producing malformation of the Central Nervous System, including microcephaly. In the analysis of the protocols, there were no changes as to the nutritional recommendations already established for the low-risk pregnant women. The authors presented a hypothesis and conceptually, as a prevention measurement, the inclusion of prenatal care to prevent and control isolated or multiple deficiencies associated to microcephaly, such as protein, vitamin A, iodine, folate, B12, vitamin D, biotin, zinc and selenium.

  19. Neurocritical care complications of pregnancy and puerperum.

    Science.gov (United States)

    Frontera, Jennifer A; Ahmed, Wamda

    2014-12-01

    Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus.

  20. Inadequate syphilis screening among women with prenatal care in a community with a high syphilis incidence.

    Science.gov (United States)

    Trepka, Mary Jo; Bloom, Sharon A; Zhang, Guoyan; Kim, Sunny; Nobles, Robert E

    2006-11-01

    This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery. Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices. Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery. Attending a private clinic, having more than adequate prenatal care and having private insurance were associated with not being screened at least twice before delivery. Few women were screened according to standard recommendations, and provider or institutional-related factors affected adequacy of screening.

  1. Voluntary HIV counseling and testing during prenatal care in Brazil

    Directory of Open Access Journals (Sweden)

    Marcelo Zubaran Goldani

    2003-10-01

    Full Text Available OBJECTIVE: Voluntary HIV counseling and testing are provided to all Brazilian pregnant women with the purpose of reducing mother-to-child HIV transmission. The purpose of the study was to assess characteristics of HIV testing and identify factors associated with HIV counseling and testing. METHODS: A cross-sectional study was carried out comprising 1,658 mothers living in Porto Alegre, Brazil. Biological, reproductive and social variables were obtained from mothers by means of a standardized questionnaire. Being counseling about HIV testing was the dependent variable. Confidence intervals, chi-square test and hierarchical logistic model were used to determine the association between counseling and maternal variables. RESULTS: Of 1,658 mothers interviewed, 1,603 or 96.7% (95% CI: 95.7-97.5 underwent HIV testing, and 51 or 3.1% (95% CI: 2.3-4.0 were not tested. Four (0.2% refused to undergo testing after counseling. Of 51 women not tested in this study, 30 had undergone the testing previously. Of 1,603 women tested, 630 or 39.3% (95% CI: 36.9-41.7 received counseling, 947 or 59.2% (95% CI: 56.6-61.5 did not, and 26 (1.6% did not inform. Low income, lack of prenatal care, late beginning of prenatal care, use of rapid testing, and receiving prenatal in the public sector were variables independently associated with a lower probability of getting counseling about HIV testing. CONCLUSIONS: The study findings confirmed the high rate of prenatal HIV testing in Porto Alegre. However, women coming from less privileged social groups were less likely to receive information and benefit from counseling.

  2. Differentiating the barriers to adequate prenatal care in Missouri, 1987-88.

    OpenAIRE

    Sable, M R; Stockbauer, J W; Schramm, W F; Land, G H

    1990-01-01

    Inadequate prenatal care has previously been identified as a significant risk factor for women who have low birth weight infants and infants who die during the neonatal period. Postpartum interviews with 1,484 primarily low-income women were conducted during 1987-88 in three areas of Missouri with the highest rates of inadequate prenatal care. The purpose of the study was to identify barriers to prenatal care and to determine which barriers differentiated between women receiving adequate and ...

  3. Barriers and Promoters of an Evidenced-Based Smoking Cessation Counseling During Prenatal Care in Argentina and Uruguay

    Science.gov (United States)

    Tong, Van T.; Morello, Paola; Farr, Sherry L.; Lawsin, Catalina; Dietz, Patricia M.; Aleman, Alicia; Berrueta, Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizán, José; Althabe, Fernando

    2015-01-01

    In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A’s model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers’, clinic directors’, and pregnant smokers’ opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches. PMID:25500989

  4. Pregnant Women's Secondhand Smoke Exposure and Receipt of Screening and Brief Advice by Prenatal Care Providers in Argentina and Uruguay

    Science.gov (United States)

    Tong, Van T.; Morello, Paola; Alemán, Alicia; Johnson, Carolyn; Dietz, Patricia M.; Farr, Sherry L.; Mazzoni, Agustina; Berrueta, Mabel; Colomar, Mercedes; Ciganda, Alvaro; Becú, Ana; Gonzalez, Maria G. Bittar; Llambi, Laura; Gibbons, Luz; Smith, Ruben A.; Buekens, Pierre; Belizán, José M.; Althabe, Fernando

    2015-01-01

    Abstract Secondhand smoke (SHS) exposure has negative effects on maternal and infant health. SHS exposure among pregnant women in Argentina and Uruguay has not been previously described, nor has the proportion of those who have received screening and advice to avoid SHS during prenatal care. Women who attended one of 21 clusters of publicly-funded prenatal care clinics were interviewed regarding SHS exposure during pregnancy at their delivery hospitalization during 2011–2012. Analyses were conducted using SURVEYFREQ procedure in SAS version 9.3 to account for prenatal clinic clusters. Of 3,427 pregnant women, 43.4 % had a partner who smoked, 52.3 % lived with household members who smoked cigarettes, and 34.4 % had no or partial smoke-free home rule. Of 528 pregnant women who worked outside of the home, 21.6 % reported past month SHS exposure at work and 38.1 % reported no or partial smoke-free work policy. Overall, 35.9 % of women were exposed to SHS at home or work. In at least one prenatal care visit, 67.2 % of women were screened for SHS exposure, and 56.6 % received advice to avoid SHS. Also, 52.6 % of women always avoided SHS for their unborn baby's health. In summary, a third of pregnant women attending publicly-funded prenatal clinics were exposed to SHS, and only half of pregnant women always avoided SHS for their unborn baby's health. Provider screening and advice rates can be improved in these prenatal care settings, as all pregnant women should be screened and advised of the harms of SHS and how to avoid it. PMID:25427876

  5. Factors associated with iron deficiency in pregnant women seen at a public prenatal care service

    Directory of Open Access Journals (Sweden)

    Rosângela Maria Souza de Camargo

    2013-08-01

    Full Text Available OBJECTIVE: This study aimed to determine the frequency of iron deficiency and its association with socioeconomic, obstetric, and nutritional factors in pregnant women. METHODS: This cross-sectional study included women on the second trimester of pregnancy seen at a public prenatal care facility of Cuiabá, Mato Grosso, Brazil from May 2008 to May 2009. Socioeconomic, nutritional, and obstetric data were compared with markers of iron stores. RESULTS: During the study period, 146 pregnant women met the inclusion criteria. The frequency of anemia characterized by abnormal hemoglobin level, hematocrit, and mean corpuscular volume varied from 3% to 5%. However, 11% of the women had high transferrin levels and 39% had low ferritin levels. Before pregnancy, 21% of the women were underweight and 29% were overweight or obese. During pregnancy, the percentage of overweight or obese women rose to 40%. History of miscarriages, higher gestational age, and excess weight before pregnancy were associated with markers of iron stores at abnormal levels. Consumption of specific food groups was not associated with abnormal marker levels. CONCLUSION: Serum ferritin was the most sensitive indicator of iron deficiency. Excess weight and anemia were concomitant.

  6. Prenatal diagnosis of lethal osteogenesis imperfecta in twin pregnancy.

    Science.gov (United States)

    Morin, L R; Herlicoviez, M; Loisel, J C; Jacob, B; Feuilly, C; Stanescu, V

    1991-06-01

    Lethal osteogenesis imperfecta was diagnosed at 27 weeks amenorrea in one fetus of a bichorial twin pregnancy. Sonographic findings included: short-limb dwarfism, hypotrophy and hypoechoic bones. The affected fetus was so translucent that only the normal fetus could be seen on plain in utero radiography. The affected fetus died immediately after birth. Postmortem radiography and histology were typical of lethal osteogenesis imperfecta of type IIA. Aids to the etiological diagnosis of in utero dwarfism are presented. Sonographic features correlated with neonatal death are described.

  7. Effects of prenatal yoga on women's stress and immune function across pregnancy: A randomized controlled trial.

    Science.gov (United States)

    Chen, Pao-Ju; Yang, Luke; Chou, Cheng-Chen; Li, Chia-Chi; Chang, Yu-Cune; Liaw, Jen-Jiuan

    2017-04-01

    The effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks' gestation between women receiving prenatal yoga and those receiving routine prenatal care. For this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks' gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n=48) or control (n=46) groups using Clinstat block randomization. The 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care. In both groups, participants' salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks' gestation. The intervention group had lower salivary cortisol (pyoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p=0.018), and infants born to women in the intervention group weighed more than those born to the control group (pyoga significantly reduced pregnant women's stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function. Copyright © 2017. Published by Elsevier Ltd.

  8. Brugada Syndrome and Pregnancy: Highlights on Antenatal and Prenatal Management

    Directory of Open Access Journals (Sweden)

    Laura Giambanco

    2014-01-01

    Full Text Available Introduction. Brugada syndrome is characterized by a disruption of heart’s normal rhythm. It is an autosomal dominant disease due to a mutation of SNC5A gene. Its prevalence is low all over the world, but it is a lethal disease. Sudden cardiac death is the result of phenotypic manifestation of Brugada syndrome. Among asymptomatic Brugada patients, arrhythmia could be provoked by physical activity, fever, or pregnancy. About obstetrical management, very few data or reports have been published since this syndrome has been diagnosed in late 1992. Case Presentation. A 20-year-old pregnant woman at 13 weeks of gestation was referred to our department because of her familial history of sudden cardiac deaths. Brothers and sisters of her mother died of Brugada syndrome in childhood or older and live components of this family were carrier of mutation in Brugada gene. The pregnancy was uneventful. The patient gave birth vaginally without any arrhythmia. Strictly cardiological monitoring was performed during labour, delivery, and 12 hours of the postpartum. Conclusion. Even though patient at low risk may never have arrhythmia, some conditions could represent a Brugada trigger. The management could be very easy and uneventful. Otherwise it could be very difficult with need of ECMO or antiarrhythmics drugs or intracardiac device. Obstetrical management of Brugada pregnant women should be very strict and multidisciplinary in cooperation with cardiologist and anaesthesiologist and should provide an informed consent to the couple.

  9. The Influence of Group Versus Individual Prenatal Care on Phase of Labor at Hospital Admission.

    Science.gov (United States)

    Tilden, Ellen L; Emeis, Cathy L; Caughey, Aaron B; Weinstein, Sarah R; Futernick, Sarah B; Lee, Christopher S

    2016-07-01

    Group prenatal care, an alternate model of prenatal care delivery, has been associated with various improved perinatal outcomes in comparison to standard, individual prenatal care. One important maternity care process measure that has not been explored among women who receive group prenatal care versus standard prenatal care is the phase of labor (latent vs active) at hospital admission. A retrospective case-control study was conducted comparing 150 women who selected group prenatal care with certified nurse-midwives (CNMs) versus 225 women who chose standard prenatal care with CNMs. Analyses performed included descriptive statistics to compare groups and multivariate regression to evaluate the contribution of key covariates potentially influencing outcomes. Propensity scores were calculated and included in regression models. Women within this sample who received group prenatal care were more likely to be in active labor (≥ 4 cm of cervical dilatation) at hospital admission (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.03-2.99; P = .049) and were admitted to the hospital with significantly greater cervical dilatation (mean [standard deviation, SD] 5.7 [2.5] cm vs. 5.1 [2.3] cm, P = .005) compared with women who received standard prenatal care, controlling for potential confounding variables and propensity for group versus individual care selection. Group prenatal care may be an effective and safe intervention for decreasing latent labor hospital admission among low-risk women. Neither group prenatal care nor active labor hospital admission was associated with increased morbidity. © 2016 by the American College of Nurse-Midwives.

  10. [Inadequacy of the content of prenatal care and associated factors in a cohort in the northeast of Brazil].

    Science.gov (United States)

    Goudard, Marivanda Julia Furtado; Simões, Vanda Maria Ferreira; Batista, Rosângela Fernandes Lucena; Queiroz, Rejane Christine de Souza; Alves, Maria Tereza Seabra Soares de Brito E; Coimbra, Liberata Campos; Martins, Marília da Glória; Barbieri, Marco Antônio; Nathasje, Ian Favero

    2016-04-01

    The scope of this study was to analyze the content of prenatal care in São Luís, Maranhão, Brazil, and the factors associated with its inadequacy. A cross-sectional study was conducted based on data from the birth cohort of São Luís in 2010. The content of prenatal care was defined as inadequate when it did not meet the criteria of the Program for Humanization of Prenatal and Delivery Care, which establishes early initiation of prenatal care, minimum number of medical consultations, basic laboratory tests, tetanus vaccination and obstetric procedures. Poisson regression was used to observe associations of the variables with the outcome. The inadequacy rate was high (60.2%). The variables associated with inadequacy were: class C socioeconomic status (PR = 1.39; CI = 1.26-1.55); class D/E socioeconomic status (PR = 1.60; CI = 1.43-1.79); unqualified/unemployed mother (PR = 1.24; CI = 1.11-1.37); 5-8 years of schooling (PR = 1.12; CI = 1.06-1.19); 0-4 years of schooling (PR = 1.13; CI = 1.01-1.26); not being religious (PR = 1.10; CI = 1.04-1.17); alcohol use during pregnancy (PR = 1.13; CI = 1.06-1.20), and being attended by the public service (PR = 1.75; CI = 1.54-2.00). The results showed inadequacy and inequality of prenatal care, revealing that women of lower socioeconomic status received lower quality care.

  11. Knowledge of Toxoplasmosis among Doctors and Nurses Who Provide Prenatal Care in an Endemic Region

    Directory of Open Access Journals (Sweden)

    Laura Berriel da Silva

    2011-01-01

    Full Text Available Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy.

  12. Knowledge of toxoplasmosis among doctors and nurses who provide prenatal care in an endemic region.

    Science.gov (United States)

    da Silva, Laura Berriel; de Oliveira, Raquel de Vasconcelos Carvalhaes; da Silva, Marizete Pereira; Bueno, Wendy Fernandes; Amendoeira, Maria Regina Reis; de Souza Neves, Elizabeth

    2011-01-01

    Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC) transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy.

  13. Twin pregnancy

    DEFF Research Database (Denmark)

    Sperling, Lene; Tabor, A

    2001-01-01

    Determination of chorionicity is one of the most important issues in the management of twin pregnancy. Modern ultrasound equipment has made it possible to accurately assess placentation already in the first trimester with the lambda sign. With regard to prenatal diagnosis, it is important to know...... for clinicians caring for twin pregnancies....

  14. Social representations of postpartum women on prenatal care in primary health care

    Directory of Open Access Journals (Sweden)

    Eryjosy Marculino Guerreiro

    2013-11-01

    Full Text Available This article aimed at capturing the social representations of postpartum women on prenatal care in primary health care. This is a descriptive, qualitative study, guided by the Theory of Social Representations, developed in nine Family Health Centers, in Fortaleza, Ceará, Brazil, from May to July, 2012. 31 women on postpartum were interviewed through semi-structured interviews. The interviews were recorded, fully transcribed and processed through ALCESTE software - 2010 version. The results observed in the lexical analysis of the interviews revealed the distribution of contents in four classes. Classes 4 and 1 dealing with prenatal care were explored in this study. Social representations of users about the prenatal are anchored in the protocol dimension and socio-educational dimension. The implantation and the maintenance of activities are necessary in order to share knowledge and interaction among the users

  15. Prenatal screening for congenital malformations: diagnosis and ...

    African Journals Online (AJOL)

    care of the pregnancy in terms of antenatal care, and referral for birth as ... photographed and only represent a proportion of all the malformed ... KEY WORDS: foetal malformafion, newborn deaths, prenatal care, pregnancy terminafion. Figure 1. Case 1 ... multiple methods, including ultrasound, are combined to make a ...

  16. Maternal Fetal Attachment, Locus of Control and Adherence to STI/HIV Prevention and Prenatal Care Promotion Behaviors in Urban Women.

    Science.gov (United States)

    Kornfield, Sara L; Geller, Pamela A; Epperson, C Neill

    Young women of childbearing age are disproportionately affected by sexually transmitted infections (STIs) including HIV. In particular, young women have more frequent and more serious health problems from STI or HIV infection than men, and among women, African American women have especially high rates of infection. Pregnancy is an important time for beginning or continued STI and HIV prevention behaviors as discontinuing condom use when the contraceptive motivation is gone puts women and their fetuses at risk for contraction of STIs and HIV if they remain sexually active. There are many personal attributes that predict adherence to STI risk reduction behaviors including health related locus of control. The current study surveyed a group of 100 low-income, urban dwelling minority women during their pregnancies to determine whether maternal-fetal attachment, a characteristic specific to pregnancy, favorably influences pregnant women's health related locus of control such that women might be more inclined to engage in preventative STI/HIV risk reduction behaviors. Our findings revealed that while our sample has very high levels of MFA despite the high rate of unplanned pregnancy, condom use is not the method used to reduce the risk of contracting STIs/HIV. Rather, women are more likely to limit their number of sexual partners during pregnancy. While this is beneficial, pregnant women in non-monogamous relationships may discount the importance of condom use during pregnancy. Prenatal care providers can provide education about condom use as a beneficial prenatal care behavior similar to taking prenatal vitamins.

  17. Pregnancy 101: a call for reproductive and prenatal health education in college.

    Science.gov (United States)

    Delgado, Christine

    2013-02-01

    The objective of the study was to demonstrate the effectiveness of a college course in preconception health and prenatal development at improving reproductive health awareness in college students. Students enrolled in the course completed pretest and posttest assessments and a course evaluation. Students' self-perception of awareness of the positive and negative factors that can affect pregnancy increased from 13% at the beginning of the course to 89 and 93% at the end of the course, respectively. Correspondingly, students' knowledge of course-related information improved across nearly all areas assessed. The average score among students increased from 67 to 90% correct from pretest to posttest. Course evaluation results indicated that over 94% of students found the course to be beneficial and informative. College courses are a practical way to disseminate reproductive and prenatal health information. Educating college students in these areas has clear benefits to both individual students and society and, as such, merits increased attention in college curricula.

  18. Avaliando o conhecimento sobre pré-natal e situações de risco à gravidez entre gestantes residentes na periferia da cidade de Rio Grande, Rio Grande do Sul, Brasil Evaluation of knowledge on prenatal care and pregnancy risk among women living in a peripheral area of Rio Grande, Rio Grande do Sul State, Brazil

    Directory of Open Access Journals (Sweden)

    Raúl A. Mendoza-Sassi

    2007-09-01

    Full Text Available O objetivo deste artigo foi avaliar o conhecimento que gestantes têm sobre pré-natal e situações de risco à gravidez, todas residentes na periferia da cidade de Rio Grande, Rio Grande do Sul, Brasil. Foi realizado estudo transversal com aplicação domiciliar de questionário-padrão a todas as gestantes residentes na periferia da cidade de Rio Grande, por entrevistadores previamente treinados. Investigaram-se características demográficas, condições sócio-econômicas e reprodutivas, bem como conhecimento sobre pré-natal e situações de risco à gravidez. Foram entrevistadas 367 gestantes, oriundas de uma amostra não aleatória. Com exceção do exame de urina e teste para HIV referidos espontaneamente como necessários, os demais procedimentos foram referidos por não mais do que 30% delas. Toque vaginal, exames de mamas e citopatológico de colo uterino foram referidos em, no máximo, 7%. Somente dois terços mencionaram sangramento vaginal e dores abdominais como sinais de gravidade. Os demais sinais e sintomas foram referidos por, no máximo, um terço delas. Conclui-se que o conhecimento de exames durante o pré-natal, bem como de situações que indicam gravidade, esteve muito aquém do desejado. A melhoria desse nível de esclarecimento pode contribuir para a redução da morbi-mortalidade materno-infantil.The aim of this study was to assess knowledge on prenatal care and pregnancy risk among women in poor neighborhoods in the city of Rio Grande, Rio Grande do Sul State, Brazil. Data were collected using a cross-sectional design. A standard questionnaire was applied to all pregnant women from poor neighborhoods. Trained interviewers visited these women at home, covering demographic, socioeconomic, and reproductive data and knowledge concerning prenatal care and pregnancy risk factors. A total of 367 pregnant women were interviewed using non-random sampling. Except for urine tests and HIV testing, spontaneously reported as

  19. PRENATAL DIAGNOSIS AND SCREENING OF GENETIC ABNORMALITIES IN EARLY PREGNANCY

    Directory of Open Access Journals (Sweden)

    Jyothi Kiran Kohli

    2016-11-01

    Full Text Available BACKGROUND Genetic diseases are one of the major causes of hospital admissions due to disability and mortality particularly among children (1:5 children of hospital admission either partially/completely as distribution of genetic diseases is not related to socioeconomic background, which implies that developing world has a large number of genetic diseases largely left uncared for, i.e. overall incidence of foetal/neonatal loss due to genetic/genetic environmental causes are as follows: 1:50 newborns have major congenital abnormality, 1:100 have a unifactorial disorder, 1:200 have a major chromosomal abnormality before birth. Diagnosis of chromosomal anomalies in foetus is one of the most important challenges in modern perinatology as invasive or noninvasive methods. The aim of the study is to review on cytogenetic evaluation of CVS obtained (transcervically during first trimester of pregnancy by direct karyotyping of tissue. MATERIALS AND METHODS This study was conducted in 2001 in Department of Anatomy along with Obstetrics and Gynaecology Department, LNJP Hospital. 37 healthy cases with 6-12 weeks of gestational age coming for medical termination of pregnancy were included in the study. After written informed consent for procedure, ultrasound-guided transcervical chorionic villus sampling was done (Brambati’s method. Tissue procured was then processed for direct karyotyping and studied. Metaphase spreads were photographed and karyotypes prepared and studied. RESULTS Out of 37 pregnant females, 30 samples were successfully prepared and processed by Direct method out of which 23 were normal female (46, XX and 7 were normal male (46, XY. No normal anomaly was detected. Best biopsies were obtained with 8-12 weeks gestation. G Banding could not be performed as chromosome obtained were found to be resistant to banding. CONCLUSIONS To summarise chromosome preparations obtained from CVS by Direct method has advantage of providing sufficient number

  20. Inadequate prenatal care use among Canadian mothers: findings from the Maternity Experiences Survey.

    Science.gov (United States)

    Debessai, Y; Costanian, C; Roy, M; El-Sayed, M; Tamim, H

    2016-06-01

    This study aims to investigate predictors of inadequate prenatal care (PNC) use among pregnant women in Canada. Data for this secondary analysis was drawn from the Maternity Experiences Survey, a cross sectional, nationally representative survey that assessed peri- and post-natal experiences of mothers aged 15 and above in the Canadian provinces and territories. PNC use was measured by the Adequacy of Prenatal Care Utilization Index. Multivariate logistic regression analysis was conducted to determine socio-economic, demographic, maternal, delivery related and health service characteristics associated with inadequate PNC use. Prevalence of inadequate PNC was at 18.9%. Regression analysis revealed that mothers who were immigrants (odds ratio (OR)=1.40; 95% (confidence interval) CI: 1.13-1.74), primiparous (OR=1.22; 95% CI: 1.04-1.44), smoked (OR=1.33; 95% CI: 1.04-1.69) or consumed alcohol (OR=1.32; 95% CI: 1.03-1.68) during their pregnancy were more likely to receive inadequate PNC. Mothers with a family doctor as PNC provider versus those with an obstetrician (OR=1.26; 95% CI: 1.08-1.48) were more likely to have inadequate PNC. This is the first nationwide study in Canada to examine the factors associated with inadequate PNC use. Results of this study may help design interventions that target women with profiles of socio-demographic and behavioral risk to optimize their PNC use.

  1. Inadequate prenatal care use and breastfeeding practices in Canada: a national survey of women.

    Science.gov (United States)

    Costanian, Christy; Macpherson, Alison K; Tamim, Hala

    2016-05-05

    Previous studies have demonstrated that prenatal care (PNC) has an effect on women's breastfeeding practices. This study aims to examine the influence of adequacy of PNC initiation and services use on breastfeeding practices in Canada. Data for this secondary analysis was drawn from the Maternity Experiences Survey (MES), a cross sectional, nationally representative study that investigated the peri-and post-natal experiences of mothers, aged 15 and above, with singleton live births between 2005 and 2006 in the Canadian provinces and territories. Adequacy of PNC initiation and services use were measured by the Adequacy of Prenatal Care Utilization Index. The main outcomes were mother's intent to breastfeed, initiate breastfeeding, exclusively breastfeed, and terminate breastfeeding at 6 months. Multivariate logistic regression analysis assessed the adequacy of PNC initiation and service use on breastfeeding practices, while adjusting for socioeconomic, demographic, maternal, pregnancy and delivery related variables. Bootstrapping was performed to account for the complex sampling design. Around 75.0% of women intended to only breastfeed their child, with 90.0% initiating breastfeeding, while 6 month termination and exclusive breastfeeding rates were at 52.0% and 14.3%, respectively. Regression analysis showed no association between adequate PNC initiation or services use, and any breastfeeding practice. Mothers with either a family doctor or a midwife as PNC provider were significantly more likely to have better breastfeeding practices compared to an obstetrician. In Canada, provider type impacts a mother's breastfeeding decision and behavior rather than quantity and timing of PNC.

  2. Child maltreatment and foster care: unpacking the effects of prenatal and postnatal parental substance use.

    Science.gov (United States)

    Smith, Dana K; Johnson, Amber B; Pears, Katherine C; Fisher, Philip A; DeGarmo, David S

    2007-05-01

    Parental substance use is a well-documented risk for children. However, little is known about specific effects of prenatal and postnatal substance use on child maltreatment and foster care placement transitions. In this study, the authors unpacked unique effects of (a) prenatal and postnatal parental alcohol and drug use and (b) maternal and paternal substance use as predictors of child maltreatment and foster care placement transitions in a sample of 117 maltreated foster care children. Models were tested with structural equation path modeling. Results indicated that prenatal maternal alcohol use predicted child maltreatment and that combined prenatal maternal alcohol and drug use predicted foster care placement transitions. Prenatal maternal alcohol and drug use also predicted postnatal paternal alcohol and drug use, which in turn predicted foster care placement transitions. Findings highlight the potential integrative role that maternal and paternal substance use has on the risk for child maltreatment and foster care placement transitions.

  3. Cost analysis of prenatal care using the activity-based costing model: a pilot study.

    Science.gov (United States)

    Gesse, T; Golembeski, S; Potter, J

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

  4. Comparative Study of Prenatal Care Value in Incidence of Maternal and Fetal Complication in Preeclampsia and Eclampsia

    Directory of Open Access Journals (Sweden)

    M Aghahoseini

    2002-09-01

    Full Text Available Background: The preeclampsia/eclampsia is one of the most serious condition peculiar to pregnancy, which defined as occurrence of hypertension, proteinuria in pregnancy and convulsion in eclamptic women. There are major risk for eclamptic and pre eclamptic women due to maternal and fetal complications. Materials and Methods: In a prospective study, preeclamptic and eclamptic patients who were visited at Shariati hospital were divided into two groups due to having proper prenatal care or not. Maternal and fetal complication were studied in that two group. Maternal variables were included: incidence of preterm labor, eclampsia, mode of delivery, long term hospitalization, need for ICU, need to antihypertensive drugs over postportum, insistence of hypertension up to 6 weeks, postpartum trombocytosis, incidence of cesarean section due to abruptio placenta and IUGR, elevation of serum creatinine, incidence of HELLP syndrome and death of mother fetal variables were included incidence of IUGR and IUFD, pre term delivery and for need NICU. Relationship of demographic characteristics such as maternal age, parity, educational level, mode of delivery, presence of underlying disease, and educational level of person who referred the patient were studied. Results: These variables except of educational level, and referral level were there was statistically significant difference between incidence of all of variables, in exception of mode of delivery. That means incidence of complications is lower in group with adequate prenatal care. Conclusion: It seems that adequate pernatal care can reduce or obligate maternal and fetal complication in hypertensive disorders in pregnancy.

  5. Disparities and barriers encountered by immigrant Dominican mothers accessing prenatal care services in Puerto Rico.

    Science.gov (United States)

    Colón-Burgos, J F; Colón-Jordan, H M; Reyes-Ortiz, V E; Marin-Centeno, H A; Rios-Mota, R

    2014-08-01

    Inadequate access to prenatal services has been associated with higher rates of mother and child mortality and premature births in the general population. Thus, this paper aims to compare the utilization and adequacy of prenatal care services of Dominican immigrant mothers with that of Puerto Rican mothers. Data was extracted from birth certificates using a cohort from 1998 to 2002 (n = 252, 919). The Kotelchuck index for adequate prenatal care was used for comparison with socio-demographic characteristics of the population. Less than half of Dominican mothers (48.5 %) received adequate prenatal care compared to more than two-thirds (69.1 %) of Puerto Rican mothers (p care of Dominican mothers was 0.7 that of Puerto Rican mothers (p prenatal care services among migrant women and native Puerto Ricans.

  6. Inadequate use of prenatal services among Brazilian women: the role of maternal characteristics.

    Science.gov (United States)

    Bassani, Diego G; Surkan, Pamela J; Olinto, Maria Teresa A

    2009-03-01

    To improve the uptake of prenatal care, it is important to know how the use of prenatal care varies by maternal attitudes and social and demographic factors. Information about social and demographic variables, prenatal care, parity, pregnancy planning, abortion attempts, satisfaction with pregnancy and satisfaction with the relationship with the child's father was collected from 611 postpartum women in Porto Alegre in southern Brazil. Multinomial logistic regression was used to evaluate associations between these variables and whether the women's use of prenatal care was adequate, partially inadequate or inadequate. About 40% of women had inadequate or partially inadequate prenatal care. After adjustment for other covariates, including satisfaction with the pregnancy, women having an unplanned pregnancy were significantly more likely to have had inadequate care than women who had planned their pregnancy (odds ratio, 2.0). Not living with the child's father (2.8) and dissatisfaction with pregnancy (2.1) were also associated with inadequate use of prenatal care. Women having their second or higher order birth were significantly more likely to report inadequate use of prenatal care than women having their first birth (3.9-9.0). Household income was inversely associated with inadequate use of care. The study suggests that maternal attitudes may be important for adequate prenatal care. Interventions should be created to encourage women with negative maternal attitudes to use prenatal care and to ensure that they have access to the care they need.

  7. Prenatal vitamin use and vitamin D status during pregnancy, differences by race and overweight status.

    Science.gov (United States)

    Burris, H H; Thomas, A; Zera, C A; McElrath, T F

    2015-04-01

    We aimed to study whether prenatal vitamin (PNV) use protects against low 25-hydroxyvitamin D (25[OH]D) levels in all women and particularly in obese and black women who are both at risk of vitamin D deficiency and poor pregnancy outcomes. We studied 1019 women enrolled in a prospective study at Brigham and Women's Hospital in Boston, from 2007 to 2009. We used multivariable logistic regression to analyze associations of PNV use and odds of vitamin D deficiency defined as 25[OH]D levels vitamin D deficient. Lack of PNV use among black women was not associated with vitamin D deficiency (adjusted odds ratio (OR) 1.0, 95% confidence interval (CI) 0.4, 2.3) but was among white women (OR 3.5, 95% CI 2.1, 5.8) (interaction Pvitamin D supplementation during pregnancy should consider potential effect modification by race/ethnicity.

  8. Our children are not a diagnosis: the experience of parents who continue their pregnancy after a prenatal diagnosis of trisomy 13 or 18.

    Science.gov (United States)

    Guon, Jennifer; Wilfond, Benjamin S; Farlow, Barbara; Brazg, Tracy; Janvier, Annie

    2014-02-01

    Trisomy 13 and trisomy 18 (T13-18) are associated with high rates of perinatal death and with severe disability among survivors. Prenatal diagnosis (PND) may lead many women to terminate their pregnancy but some women choose to continue their pregnancy. We sent 503 invitations to answer a questionnaire to parents who belong to T13 and 18 internet support groups. Using mixed methods, we asked parents about their prenatal experience, their hopes, the life of their affected child, and their family experience. 332 parents answered questions about 272 children; 128 experienced PND. These parents, despite feeling pressure to terminate (61%) and being told that their baby would likely die before birth (94%), chose to continue the pregnancy. Their reasons included: moral beliefs (68%), child-centered reasons (64%), religious beliefs (48%), parent-centered reasons (28%), and practical reasons (6%). At the time of the diagnosis, most of these parents (80%) hoped to meet their child alive. By the time of birth, 25% chose a plan of full interventions. A choice of interventions at birth was associated with fewer major anomalies (P < 0.05). Parents describe "Special" healthcare providers as those who gave balanced and personalized information, respected their choice, and provided support. Parents make decisions to continue a pregnancy and choose a plan of care for their child according to their beliefs and their child's specific medical condition, respectively. Insights from parents' perspective can better enable healthcare providers to counsel and support families.

  9. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  10. Prevalence and predictors of inadequate prenatal care: a comparison of aboriginal and non-aboriginal women in Manitoba.

    Science.gov (United States)

    Heaman, Maureen I; Gupton, Annette L; Moffatt, Michael E

    2005-03-01

    Despite the importance of prenatal care, there are no national data and limited provincial data on use of prenatal care by women in Canada, nor is there much information on racial/ethnic disparities in access to prenatal care. This study describes and compares the prevalence and predictors of inadequate prenatal care among Aboriginal and non-Aboriginal women giving birth in Manitoba. Data were obtained from interviews with 652 postpartum women who delivered a live singleton infant in 2 tertiary hospitals in Winnipeg, Manitoba. We identified inadequate prenatal care, using the Kessner Adequacy of Prenatal Care Index. We used stratified analysis to describe effect-measure modification for predictors of inadequate prenatal care among the Aboriginal and non-Aboriginal subgroups. We conducted a multivariable logistic regression analysis for the total sample. A significantly higher proportion of Aboriginal women (15.7%) than non-Aboriginal women (3.6%) received inadequate prenatal care. After controlling for other factors, significant predictors of inadequate prenatal care included low income, low self-esteem, high levels of perceived stress, and Aboriginal background. Women who do not receive adequate prenatal care are more likely to live in poverty, experience highly stressed lives, have low levels of self-esteem, and be Aboriginal. Efforts to improve the provision of prenatal care should be directed toward these women. Racial/ethnic disparities in use of prenatal care need to be addressed.

  11. Retrospective review of prenatal care and perinatal outcomes in a group of uninsured pregnant women.

    Science.gov (United States)

    Jarvis, Catherine; Munoz, Marie; Graves, Lisa; Stephenson, Randolph; D'Souza, Vinita; Jimenez, Vania

    2011-03-01

    To assess the adequacy of prenatal care and perinatal outcomes for uninsured pregnant women at two primary care centres in Canada. We conducted a retrospective case comparison study of uninsured women presenting for prenatal care between 2004 and 2007 (n = 71). Control subjects (n = 72) were chosen from provincially insured women presenting for prenatal care during the same period. A modified Kotelchuck Index was used to assess adequacy of care. Frequency of routine prenatal testing (blood tests, ultrasound, cervical swabs, Pap testing, and genetic screening) was compared. Perinatal outcomes assessed included gestational age and birth weight. Uninsured pregnant women presented for initial care 13.6 weeks later than insured women (at 25.6 weeks vs. 12.0 weeks, P care providers (6.6 vs. 10.7, P = 0.05). Using a modified Kotelchuck Adequacy of Prenatal Care Utilization Index, uninsured women were more likely to be categorized as receiving "inadequate care" (uninsured 61.9% vs. insured 11.7%, P care of uninsured pregnant women in Canada. Women in this category presented late for prenatal care, were less likely to have adequate screening tests, and were more likely to receive "inadequate care" as defined by the modified Kotelchuck Index. This information may be valuable in helping to plan programs to improve access to timely and adequate medical care for uninsured pregnant women.

  12. [Oral health and pregnancy: promotion of oral health during the pre-natal training in the Latina province].

    Science.gov (United States)

    Capasso, F; La Penna, C; Carcione, P; Vestri, A; Polimeni, A; Ottolenghi, L

    2011-01-01

    The aim of this study, conducted in the Province of Latina, was to verify knowledge, attitudes, and lifestyles in relation to oral health in a sample of pregnant women, assessing their subjective perception of oral health, and highlight prenatal dental prevention need specialist in the area and provide adequate information on the importance of good oral hygiene in order to achieve a better health level both of the mother and the child. The study was conducted on a sample of pregnant women between the 26th and 39th gestational week, in the period from June to October 2009, during the childbirth training courses in the Province of Latina. Each patient was administered a questionnaire for the assessment of oral habits during pregnancy and for the definition of specific knowledge on and perception of themselves and their own oral condition. The survey shows that more than one third of the sample reported visiting a dentist only in case of pain, over half (56.9%) did not undergo any dental visit during the gestational period, only 24 subjects (33.3%) having applied to a dental hygienist for professional oral hygiene and that only 7 out of 72 women had been prescribed a dental checkup by a gynecologist. The study showed that knowledge about dental problems that may arise during pregnancy is insufficient to guarantee a good threshold to oral health care for the mother hence the need to promote information programs, oral health and pregnancy prevention and training in the territory mainly directed to health-care specialists (gynecologists and obstetricians) and to pregnant women.

  13. [PHQ-2 as First Screening Instrument of Prenatal Depression in Primary Health Care, Spain].

    Science.gov (United States)

    Rodríguez-Muñoz, María de la Fe; Castelao Legazpi, Pilar Carolina; Olivares Crespo, María Eugenia; Soto Balbuena, Cristina; Izquierdo Méndez, Nuria; Ferrer Barrientos, Francisco Javier; Huynh-Nhu, Le

    2017-01-30

    Prenatal depression is a major public health problem that is barely treated. Based on existing literature, depression during this period is associated with negative consequences for the mother and the baby. Therefore it is important to make an adequate screening in this population. The aim of this study was to determine the discriminant validity and cut-off of the Patient Health Questionnaire (PHQ-2) as a screening tool to identify the depression in pregnant women living in Spain. The sample included 1,019 female participants, aged between 19 and 45 years, who participated voluntarily, and received prenatal care during the first trimester. Participants completed a sociodemographic questionnaire, PHQ-2 andPHQ-9. The research has been developed within the Obstetrics and Gynecology department at two public hospitals in two different Spanish Regions. The research was conducted between 2014 and 2016 performing a ROC curve analysis to determine the discriminative capacity and cut-off for PHQ-2. 11,1 % out of 1019 participants were diagnosed with depression. The area under the curve of PHQ-2 was 0,84 p smaller than 0,001. With the cutoff 2 the sensitivity and specificity of 85,4 % and 79,5% respectively. A score Equal or greater than 2 is an appropriate cut-off in PHQ-2 to detect depression during pregnancy. The use of PHQ-2 could precede PHQ-9 as a brief screening tool for antenatal depression in obstetric settings.

  14. [Development and application of a new index for assessment of prenatal care].

    Science.gov (United States)

    Silva, Esther Pereira da; Lima, Roberto Teixeira; Costa, Maria José de Carvalho; Batista Filho, Malaquias

    2013-05-01

    To develop and apply a new instrument to evaluate prenatal care based on the guidelines of the Brazilian Humanization Program for Prenatal Care and Birth, including quantitative and qualitative elements distributed according to the evaluation triad of structure, process, and outcomes. An analytic, descriptive, quantitative cross-sectional study was carried out with 238 women receiving care in 44 primary care services in the city of João Pessoa, Northeast Brazil, between November 2010 and December 2011. Physicians and nurses involved in prenatal care were also interviewed. The instrument developed by the investigators contains 23 questions relating to structure, process and outcomes of pre-natal care. Based on the information collected, pre-natal care was classified according to an IPR/Pre-Natal index (Índice IPR/Pré-Natal, where I stands for infrastructure, P for work process and R for results). A value of 1 is attributed to each question if it complies with the criteria established for quality, or 2 if it does not comply. The percent of adequate answers in relation to the 23 total questions is used to classify prenatal care as: upper adequate (100% adequate answers); adequate (>75%); intermediate (51 to 74%); and inadequate (Prenatal Care Utilization (APNCU) indices. Questions relating to the work process contributed significantly to the classification of prenatal care as intermediate according to the IPR/Pre-Natal. IPR/Pre-Natal classification categories were consistent to detect prematurity, insufficient weight at birth and absence of exclusive breastfeeding. The IPR/Pre-Natal index effectively incorporated quantitative and qualitative elements for the assessment of pre-natal care.

  15. Control beliefs are related to smoking prevention in prenatal care.

    Science.gov (United States)

    Lemola, Sakari; Meyer-Leu, Yvonne; Samochowiec, Jakub; Grob, Alexander

    2013-10-01

    Smoking during pregnancy is one of the most important avoidable health risks for the unborn child. Gynaecologists and midwives play a fundamental role in the prevention of smoking during pregnancy. However, a large number of health care practitioners still do not address smoking in pregnant patients. We examined whether gynaecologists and midwives engage in screening and counselling of pregnant women and conducting interventions to prevent smoking during pregnancy. Further, we examined the role of gynaecologists' and midwives' control beliefs. Control beliefs involve efficacy expectations--the practitioner's confidence in his capacity to conduct prevention efforts adequately--and outcome expectations--the practitioner's expectation that such prevention efforts are successful in general. A total of 486 gynaecologists and 366 midwives completed a questionnaire on screening of smoking, counselling and other interventions they conduct to prevent smoking during pregnancy. Moreover, gynaecologists and midwives rated their control beliefs regarding their influence on pregnant patients' smoking habits. The majority of gynaecologists and midwives reported screening all pregnant patients regarding smoking, explaining the risks and recommending smoking cessation. By contrast, only a minority engages in more extensive prevention efforts. Strong control beliefs were predictive of a higher likelihood of screening and counselling, as well as of engaging in more extensive interventions. The findings point to the importance of strengthening gynaecologists' and midwives' control beliefs by professional education and training on smoking prevention. © 2012 John Wiley & Sons Ltd.

  16. Inadequate prenatal care utilization and associated factors in São Luís, Brazil.

    Science.gov (United States)

    Bernardes, Ariane Cristina Ferreira; da Silva, Raimundo Antonio; Coimbra, Liberata Campos; Alves, Maria Teresa Seabra Soares de Britto; Queiroz, Rejane Christine de Sousa; Batista, Rosângela Fernandes Lucena; Bettiol, Heloisa; Barbieri, Marco Antônio; da Silva, Antônio Augusto Moura

    2014-08-10

    Over the last decades there has been a reduction of social inequalities in Brazil, as well as a strong expansion of health services, including prenatal care. The objective of the present study was to estimate the rate of inadequate prenatal care utilization and its associated factors in São Luís, Brazil, in 2010 and to determine whether there was a reduction of inequity in prenatal care use by comparing the present data to those obtained from a previous cohort started in 1997/98. Data from the BRISA (Brazilian birth cohort studies of Ribeirão Preto and São Luís) population-based cohort, which started in 2010 (5067 women), were used. The outcome variable was the inadequate utilization of prenatal care, classified according to the recommendations of the Brazilian Ministry of Health. The explanatory variables were organized into three hierarchical levels based on the Andersen's behavioral model of the use of health services: predisposing, enabling and need factors. Only 2.0% of the women did not attend at least one prenatal care visit. The rate of inadequate prenatal care utilization was 36.7%. Despite an improved adequacy of prenatal care use from 47.3% in 1997/98 to 58.2% in 2010, social inequality persisted: both low maternal schooling (prevalence ratio (PR) = 2.78; 95% confidence interval (95% CI) 2.23-3.47 for 0 to 4 years of study) and low family income, less than 0.5 monthly minimum wage per capita (PR = 1.37; 95% CI 1.22-1. 54), continued to be associated with higher rates of inadequate prenatal care utilization. Racial disparity regarding adequate utilization of prenatal services was detected, with black (PR = 1.19; 95% CI 1.04-1.36) and mulatto (PR = 1.14; 95% CI 1.02-1.26) women showing higher rates of inadequate use. On the other hand, women covered by the FHP - Family Health Program (PR = 0.92; 95% CI 0.85-0.98) showed a lower rate of inadequate prenatal care utilization. Despite strong expansion of health services and expressive improvements in

  17. Infant mortality and prenatal care: contributions of the clinic in the light of Canguilhem and Foucault.

    Science.gov (United States)

    Figueiredo, Paula Pereira de; Lunardi Filho, Wilson Danilo; Lunardi, Valéria Lerch; Pimpão, Fernanda Demutti

    2012-01-01

    This review study aimed to verify how studies conducted in Brazil have related infant mortality to prenatal care and to present contributions of the clinic in the light of Canguilhem and Foucault for qualification of the care. An integrative literature review was conducted from searches in the databases SciELO, LILACS, MEDLINE and BDENF for the period 2000 to 2009. The relationship between infant mortality and prenatal care is related to the insufficient number of consultations or to the quality of the care provided. Even when the number of and routine consultations in the prenatal care were adequate, avoidable deaths were present. For the qualification of prenatal care, it is suggested that the clinical knowledge and other elements that comprise the process of human living are considered, in order that the clinical view is enlarged and articulated to the technologies available in the health system and, together, they are able to contribute to the reduction of infant mortality in Brazil.

  18. Evaluating the effect of educational intervention based on Theory of Planned Behavior on prenatal care of addicted pregnant women

    Directory of Open Access Journals (Sweden)

    Fatemeh Honari

    2016-04-01

    Full Text Available Background and Aim: Using drugs during pregnancy is one of the most important health concerns Prenatal care is crucial in addicted women and thus educational interventions are required. In the present study, the effectiveness of an educational intervention based on ‘Theory of Planned Behavior’ on prenatal care of addicted women was evaluated. Materials and Methods: This randomized field- trial study was performed on 46 pregnant addicted women who were randomly divided into equal experimental and control groups. The validity and reliability of the questionnaire used had been confirmed. before, immediately after, and two months after the intervention in both groups. The intervention consisted of 6 sessions, based on the theory of planned behavior, which was implemented for the experimental group. Data analysis was performed using. independent t- test, Anova and Fisher’s exact test. The obtained results were interpreted at the significant level 0.05. Results: It was found that a significant increase in the mean change in attitude, intention, and perceived behavioral control before and immediately after the intervention in the experimental group compared to the control one (P<0.05. Conclusion: The results of the study showed the effectiveness of the education based on the theory of planned behavior on the attitude, perceived behavioral control, and behavioral intention associated with prenatal care.

  19. Positive prenatal well-being: conceptualising and measuring mindfulness and gratitude in pregnancy.

    Science.gov (United States)

    O' Leary, Karen; Dockray, Samantha; Hammond, Sean

    2016-08-01

    Little research has examined the usefulness of positive well-being factors during pregnancy. Recent mindfulness research demonstrates that inconsistencies and the suitability of extant measures have yet to be examined in pregnancy. Effects of gratitude during pregnancy have yet to be examined despite consistently reported benefits in non-pregnant groups. The aims of this paper were to develop the Gratitude during Pregnancy (GDP) scale, validate the Mindfulness Awareness Attention Scale (MAAS) and examine the importance of gratitude and mindfulness during pregnancy. In study 1, 375 pregnant women completed gratitude and mindfulness measures. The one-factor structure of the MAAS was retained and demonstrated good reliability α = 0.88. Using exploratory factor analysis, an 18-item GDP scale was developed, demonstrating good reliability α = 0.89. The four GDP factors are as follows: general gratitude, physical changes, antenatal care and social support. In study 2, 87 pregnant women completed well-being questionnaires, including the GDP and MAAS. Gratitude correlated with positive affect, life satisfaction and pregnancy uplifts (p mindfulness correlated negatively with negative affect and pregnancy hassles (p mindfulness and gratitude and provide a reliable means to measure both constructs during pregnancy.

  20. Adequate and Ever Use of Prenatal Care in Fars Province 2000-2010

    Directory of Open Access Journals (Sweden)

    Aliyar Ahmadi

    2016-10-01

    Full Text Available Abstract Background: Prenatal care consists of a series of clinical visits and services offered to pregnant women throughout the antepartum period. Despite advances in the extent of prenatal care use in Iran, some women still avoid using these services. It is, therefore, very important to investigate the prevalence of prenatal care use, and to identify the factors associated with it. This study analyzes prenatal care use in Fars Province between 2000 and 2010, identifying the associations between women’s demographic and socio-economic characteristics and prenatal care use. Methods: The study is quantitative and based on secondary data drawn from IDHS 2000 and MIDHS 2010. The sample consisted of 765 individuals from Fars Province. The data were weighted to reflect the characteristics of the rural-urban population. Statistical analyses were carried out using SPSS-18. In the inferential analysis, bivariate and multivariate logistic regressions were applied. Results: It was indicated that both the quantity and quality of prenatal care increased during 2000–2010. Obstetricians and gynecologists became the primary reference point for women accessing healthcare during this period. Our study indicates that, in the final analytical model, the educational attainment (OR=1.32, P=0.035, urban place of residence (OR=10.49, P=0.003, sanitary and health status of households (OR=5.04, P<0.001, and knowledge of family planning (OR=1.14, P<0.001 were significantly related to the use of prenatal care. Conclusion: Women who do not have access to prenatal care are mainly from families with low socio-economic status. Thus socially vulnerable groups receive deficient prenatal care, indicating the need for government investment and planning in a comprehensive insurance system.

  1. Inadequate prenatal care utilization and associated factors in São Luís, Brazil

    OpenAIRE

    Bernardes,Ariane Cristina Ferreira; da Silva, Raimundo Antonio; Coimbra,Liberata Campos; Alves, Maria Teresa Seabra Soares de Britto; Queiroz,Rejane Christine de Sousa; Batista,Rosângela Fernandes Lucena; Bettiol,Heloisa; Barbieri,Marco Antônio; da Silva, Antônio Augusto Moura

    2014-01-01

    Background Over the last decades there has been a reduction of social inequalities in Brazil, as well as a strong expansion of health services, including prenatal care. The objective of the present study was to estimate the rate of inadequate prenatal care utilization and its associated factors in São Luís, Brazil, in 2010 and to determine whether there was a reduction of inequity in prenatal care use by comparing the present data to those obtained from a previous cohort started in 1997/98. M...

  2. [Do women from Seine-Saint-Denis have different prenatal care compared to other women in the region?].

    Science.gov (United States)

    Carayol, M; Bucourt, M; Cuesta, J; Blondel, B; Zeitlin, J

    2015-03-01

    We compared the care of pregnant women residing in Seine-Saint-Denis (SSD) to those resident elsewhere in Île-de-France because of the high rate of perinatal and infant mortality in this district. Data come from the French national perinatal surveys of 2003 and 2010 (n=969 in Seine-Saint-Denis, n=5636 other Île-de-France). We analyzed two indicators: inadequate prenatal care (late initiation, inadequate care and 29 % and 16 % did not know if they had been screened for Down's Syndrome. These rates were higher among migrant women but did not differ by place of residence (25 and 40 % respectively). For French citizens, residence in Seine-Saint-Denis was a risk factor for both indicators. A reflection on how to improve care during pregnancy should be initiated in Seine-Saint-Denis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. [Study on the relationship between frequencies of prenatal care and neonatal low birth weight in women of childbearing age from rural areas of Shaanxi province].

    Science.gov (United States)

    Li, J M; Liu, D M; Zhang, X F; Qu, P F; Yan, H

    2017-04-10

    Objective: To investigate the relationship between frequencies of prenatal care and neonatal low birth weight (LBW) among women of childbearing age from the rural areas of Shaanxi province. Methods: A questionnaire survey was conducted among the childbearing-aged women from the rural areas. Samples were selected through multi stage stratified random sampling method. The childbearing aged women were in pregnancy or having had definite outcomes of pregnancy. Measurement of data was described by median±standard deviation, and chi square test was used to compare the rates. Neonatal low birth weight and frequencies of prenatal care were dependent variables and independent variables grouped into the generalized Poisson regression model. Confounding factors were under control. Results: The overall incidence rate of LBW was 3.75% among 18 911 rural women of childbearing age during 2010-2013. Frequencies on pregnancy care were up to 15 times (0.70%), with a minimum of 0 (0.70%), an average of 5.65±2.74 times (including ≥10 times accounted for 12.37%; ≥7 times accounted for 28.52%; ≥5 times accounted for 62.80% and controlling confounding factors, results from the generalized Poisson regression analysis revealed that the difference was statistically significant when compared to the reference group. The incidence of neonatal LBW in the 7 group (OR=1.61, 95%CI:1.31-2.00) while in the prenatal care, among women of childbearing age.

  4. Towards prenatal biomonitoring in Nanjing, China: lead and cadmium levels in the duration of pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIU Kang-sheng; MAO Xiao-dong; HAO Jia-hu; SHI Juan; DAI Chun-fang; CHEN Wen-jun

    2013-01-01

    Background Prenatal lead and cadmium exposure will not only influence the mother's organ systems,but also will provide an environment that may influence the fetus and neonate in a harmful way.In the present study,we detected the blood lead levels (BLLS) and cadmium levels for the duration of pregnancy and 6-12 weeks after delivery and to analyze the influencing factors of BLLs in healthy pregnant women.Methods A cohort study survey was carried out.We recruited 174 healthy pregnant women without pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group,and 120 healthy non-pregnant women as the control group.Results The lead concentrations in the three pregnancy trimesters and in the postpartum period were:(5.98±2.43),(5.54±2.01),(5.59±1.97),and (6.76±1.74) μg/dl; and (6.75±2.13) μg/dl in the control group.The cadmium concentrations in the three pregnancy trimesters and postpartum period were 1.61±0.45,1.63±0.46,1.64±0.49,and 1.67±0.57.We found that the BLLs in the gravida group were lower than in the control group during all three trimesters.Occupations,supplement nutritional elements (dietary supplements and nutritional (food) elements),and the time of house painting could affect BLLs in pregnant women.Lead-related occupations,using cosmetics,and living in a house painted more recently than one year previously are risk factors of high BLLs among pregnant women,while calcium,iron,zinc,and milk supplements are protective factors.Conclusions These findings may help people,especially pregnant women,to reduce lead exposure via supplements of calcium,iron,zinc,and milk or avoiding contacting risk factors.

  5. "Not worth doing prenatal care": an ethnographic study of a low-income community

    Directory of Open Access Journals (Sweden)

    Patrícia L. F Santa Rosa

    2015-08-01

    Full Text Available Objective. The aim of this study was to explore the reasons why pregnant women do not seek prenatal care (PNC. Methodology. The ethnographic method was used in a low-income Brazilian community. Ethnographic interviews were performed with 11 postpartum women who did not seek PNC in their last pregnancy. Results. The cultural sub-themes used to express reasons for not seeking PNC included: "I found out I was pregnant too late and did not have enough time to receive PNC," "I did not receive PNC because I had to hide the pregnancy to avoid problems," "I had to address urgent issues and could not seek PNC," "The services are not good and going to the doctor when not ill is only for rich people," and cultural theme: "PNC is not worth pursuing: it is unnecessary and there are too many obstacles to receiving it." Conclusion. The main strategies that should be considered to increase adherence to PNC are better access and integrality through the use of adequate management criteria.

  6. [Introduction of rapid syphilis and HIV testing in prenatal care in Colombia: qualitative analysis].

    Science.gov (United States)

    Ochoa-Manjarrés, María Teresa; Gaitán-Duarte, Hernando Guillermo; Caicedo, Sidia; Gómez, Berta; Pérez, Freddy

    2016-12-01

    Interpret perceptions of Colombian health professionals concerning factors that obstruct and facilitate the introduction of rapid syphilis and HIV testing in prenatal care services. A qualitative study based on semi-structured interviews was carried out. A convenience sample was selected with 37 participants, who included health professionals involved in prenatal care services, programs for pregnant women, clinical laboratories, and directors of health care units or centers, as well as representatives from regional departments and the Ministry of Health. Colombia does not do widespread screening with rapid syphilis and HIV tests in prenatal care. The professionals interviewed stated they did not have prior experience in the use of rapid tests-except for laboratory staff-or in the course of action in response to a positive result. The insurance system hinders access to timely diagnosis and treatment. Health authorities perceive a need to review existing standards, strengthen the first level of care, and promote comprehensive prenatal care starting with contracts between insurers and health service institutional providers. Participants recommended staff training and integration between health-policymaking and academic entities for updating training programs. The market approach and the characteristics of the Colombian health system constitute the main barriers to implementation of rapid testing as a strategy for elimination of mother-to-child transmission of syphilis and HIV. Measures identified include making changes in contracts between insurers and health service institutional providers, adapting the timing and duration of prenatal care procedures, and training physicians and nurses involved in prenatal care.

  7. Variation in Excessive Fetal Growth across Levels of Prenatal Care among Women with Gestational Diabetes.

    Science.gov (United States)

    Hale, Nathan L; Probst, Janice C; Liu, Jihong; Bennett, Kevin J; Martin, Amy Brock; Glover, Saundra

    2011-10-01

    Examine the association between prenatal care and excessive fetal growth outcomes among mothers with gestational diabetes mellitus (GDM). We conducted a retrospective analysis of 2004-2007 singleton live births to South Carolina women, limited to those for whom both birth certificate and hospital discharge data were available (N = 179 957). Gestational diabetes mellitus was identified from birth certificate and/or hospital discharge claims. Measures of excessive fetal growth were large for gestational age (90th and 95th percentiles) and macrosomia (birth weight > 4500 g). The Adequacy of Prenatal Care Utilization index was used to measure prenatal care. Gestational diabetes mellitus was recorded for 6.9% of women in the study population. Women with GDM were more likely than other women to have an infant with excessive fetal growth, regardless of the level of prenatal care; however, there was a significant interaction between GDM status and levels of prenatal care. All women with GDM had increased odds for large infant outcomes. However, those receiving inadequate prenatal care were markedly more likely to experience excessive fetal growth outcomes (odds ratio = 1.38, confidence interval = 1.15-1.66) than women also with GDM and intermediate/adequate prenatal care. Similar patterns were noted for large for gestational age (95th) and macrosomia (total birth weight ≥ 4500 g). Observed associations suggest a link between inadequate prenatal care and a higher risk for excessive fetal growth among women with GDM. Further research is needed to clarify the nature of the association and suggest ways to get high-risk women into care sooner.

  8. Congenital hydrocephalus - prevalence, prenatal diagnosis and outcome of pregnancy in four European regions

    DEFF Research Database (Denmark)

    Garne, Ester; Loane, Maria; Addor, Marie-Claude

    2009-01-01

    OBJECTIVE: To describe prevalence, prenatal diagnosis and outcome for fetuses and infants with congenital hydrocephalus. METHODS: Data were taken from four European registries of congenital malformations (EUROCAT). The registries included are based on multiple sources of information and include...... information about livebirths, fetal deaths with GA>/=20weeks and terminations of pregnancy for fetal anomaly (TOPFA). All cases from the four registries diagnosed with congenital hydrocephalus and born in the period 1996-2003 were included in the study. Cases with hydrocephalus associated with neural tube...... defects were not included in the study. RESULTS: Eighty-seven cases with congenital hydrocephalus were identified during the study period giving an overall prevalence of 4.65 per 10,000 births. There were 41 livebirths (47%), four fetal deaths (5%) and 42 TOPFA (48%). Nine percent of all cases were from...

  9. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study

    National Research Council Canada - National Science Library

    Chen, Xi-Kuan; Wen, Shi Wu; Fleming, Nathalie; Demissie, Kitaw; Rhoads, George G; Walker, Mark

    2007-01-01

    Background Whether the association between teenage pregnancy and adverse birth outcomes could be explained by deleterious social environment, inadequate prenatal care, or biological immaturity remains controversial...

  10. Factors associated with lack of prenatal care in a large municipality.

    Science.gov (United States)

    Rosa, Cristiane Quadrado da; Silveira, Denise Silva da; Costa, Juvenal Soares Dias da

    2014-12-01

    OBJECTIVE To analyze the factors associated with a lack of prenatal care in a large municipality in southern Brazil. METHODS In this case-control age-matched study, 716 women were evaluated; of these, 179 did not receive prenatal care and 537 received prenatal care (controls). These women were identified using the Sistema Nacional de Informação sobre Nascidos Vivos (Live Birth Information System) of Pelotas, RS, Southern Brazil, between 2009 and 2010. Multivariate analysis was performed using conditional logistic regression to estimate the odds ratios (OR). RESULTS In the final model, the variables associated with a lack of prenatal care were the level of education, particularly when it was lesser than four years [OR 4.46; 95% confidence interval (CI) 1.92;10.36], being single (OR 3.61; 95%CI 1.85;7.04), and multiparity (OR 2.89; 95%CI 1.72;4.85). The prevalence of a lack of prenatal care among administrative regions varied between 0.7% and 3.9%. CONCLUSIONS The risk factors identified must be considered when planning actions for the inclusion of women in prenatal care by both the central management and healthcare teams. These indicated the municipal areas with greater deficits in prenatal care. The reorganization of the actions to identify women with risk factors in the community can be considered to be a starting point of this process. In addition, the integration of the activities of local programs that target the mother and child is essential to constantly identify pregnant women without prenatal care.

  11. Primary prevention of hemoglobinopathies by prenatal diagnosis and selective pregnancy termination in a Muslim country: Oman

    Directory of Open Access Journals (Sweden)

    Suha Mustafa Hassan

    2014-11-01

    Full Text Available Hemoglobinopathies (HBP are the most common genetic disorder in Oman and are in need of prevention programs due to the high incidence of β-thalassemia major and sickle cell disease. Prenatal diagnosis (PD and selective pregnancy termination is shown to be the most effective prevention tool for the control of HBP. However, PD is not available in Oman thus far because abortion is subject to religious, cultural and ethical issues. We have examined the attitude of a number of Omani HBP carrier couples towards prenatal diagnosis and selective abortion. We have interviewed 35 couples at risk visiting the main premarital clinic in Muscat between Jan 2011 and Jan 2012. Couples were interviewed using a pre-structured questionnaire. The majority would have accepted prenatal diagnosis (94% if the service would be available in the country but pregnancy termination was greatly influenced by religious values. 血红蛋白病(HBP)是一种在阿曼最常见的遗传性疾病,由于其高发的B型地中海贫血症及镰状细胞症,相关的预防措施对于这一国家来说,相当重要。产前诊断(PD)和选择性终止妊娠被证实是针对管控血红蛋白病(HBP)的最有效方法。然而,由于受到宗教、文化和伦理抵制堕胎的影响,产前诊断(PD)并不能在该国得以应用。我们对该国一部分血红蛋白病患夫妇做了一项关于产前诊断的意向调查。2011年一月至2012年一月,我们在马斯喀特(阿曼首都)的一家婚前诊所对35对夫妇做了相关的采访调查。调查的问卷是事先设置好的。大部分(94%)夫妇表示接受产前诊断如果相应的措施能得到广泛的普及,但是他们对于选择性终止妊娠的态度受到了其宗教价值观的极大影响。

  12. Immigrant Enclaves and Inadequate Prenatal Care among Mexican-origin Mothers.

    Science.gov (United States)

    Noah, Aggie J

    2017-09-01

    This study is an investigation of the relationships between residing in different types of ethnic enclave neighborhoods and inadequate use of prenatal care among Mexican-origin mothers. A unique dataset was created using National Center for Health Statistics 2008 restricted-use detailed natality files, the 2005-2009 American Community Survey, and the Department of Health and Human Services Area Resource file. Hierarchical modeling was used. Mexican-origin mothers' residential contexts are associated with the inadequacy of their prenatal care utilization beyond their individual characteristics. Specifically, residing in Mexican immigrant enclaves is associated with increased odds of having inadequate use of prenatal care. In contrast, residing in other types of ethnic enclaves (Mexican/Hispanic ethnic enclaves) and non-Hispanic white neighborhoods is associated with decreased odds of having inadequate utilization of prenatal care even after the inclusion of contextual-level controls for individual characteristics, neighborhood socioeconomic status, and the availability of healthcare infrastructure resources. Residing in immigrant enclaves is important for understanding the inadequacy of prenatal care utilization for Mexican-origin mothers. These findings have policy implications for designing place-based programs to target certain residential contexts where women are at greater risk of having inadequate use of prenatal care.

  13. Physical intimate partner violence during gestation as a risk factor for low quality of prenatal care.

    Science.gov (United States)

    Moraes, Claudia Leite; Arana, Flávia Dias Nogueira; Reichenheim, Michael Eduardo

    2010-08-01

    To evaluate physical intimate partner violence during gestation as an independent risk factor for low quality of prenatal care. A cross-sectional study was carried out at three public maternity wards of the municipality of Rio de Janeiro (Southeastern Brazil). The 528 puerperal women included in the study were selected by simple random sampling from all babies born at term in 2000. Prenatal care information was collected through the pregnant woman's card and face-to-face interviews. The Kotelchuck index was employed to assess the quality of prenatal care. In order to identify violence situations, the Brazilian version of the instrument Revised Conflict Tactics Scales was used. Non-conditional logistic regression was used to assess the effect of exposure, after controlling for confounding variables. Even after adjustment for socioeconomic, demographic, reproductive, and couple's lifestyle variables, physical intimate partner violence during gestation remained associated with low quality of prenatal care. Women exposed to physical violence during gestation had 2.2 times more chance of presenting inadequate prenatal care compared to those without history of physical violence. These findings point to the need of identifying family conflict situations since the beginning of prenatal care in order to address the issue and enable higher adherence to follow-up among victimized pregnant women.

  14. Pregnancy outcomes in prenatally diagnosed 47, XXX and 47, XYY syndromes: a 30-year French, retrospective, multicentre study.

    Science.gov (United States)

    Gruchy, Nicolas; Blondeel, Eleonore; Le Meur, Nathalie; Joly-Hélas, Géraldine; Chambon, Pascal; Till, Marianne; Herbaux, Martine; Vigouroux-Castera, Adeline; Coussement, Aurélie; Lespinasse, James; Amblard, Florence; Jimenez Pocquet, Mélanie; Lebel-Roy, Camille; Carré-Pigeon, Frédérique; Flori, Elisabeth; Mugneret, Francine; Jaillard, Sylvie; Yardin, Catherine; Harbuz, Radu; Collonge-Rame, Marie-Agnès; Vago, Philippe; Valduga, Mylène; Leporrier, Nathalie; Vialard, François

    2016-06-01

    Sex chromosome aneuploidies are frequently detected fortuitously in a prenatal diagnosis. Most cases of 47, XXX and 47, XYY syndromes are diagnosed in this context, and parents are thus faced with an unexpected situation. The objective of the present study was to characterize a French cohort of prenatally diagnosed cases of 47, XXX and 47, XYY and to evaluate the termination of pregnancy (TOP) rate before and after France's implementation of multidisciplinary centres for prenatal diagnosis in 1997. This retrospective study identified respectively 291 and 175 cases of prenatally diagnosed 47, XXX and 47, XYY between 1976 and 2012. For each case, the indication, maternal age, karyotype and outcome were recorded. Most diagnoses of the two conditions were fortuitous. The occurrence of 47, XXX was associated with advanced maternal age. The overall TOP rate was higher for 47, XXX (22.9%) than for 47, XYY (14.6%), although this difference was not statistically significant. However, the TOP rates fell significantly after 1997 (from 41.1% to 11.8% for 47, XXX and from 25.8% to 6.7% for 47, XYY). The TOP rates after prenatal diagnoses of 47, XXX and 47, XYY fell significantly after 1997, following France's implementation of multidisciplinary centres for prenatal diagnosis. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  15. Using Patient-Centered Care After a Prenatal Diagnosis of Trisomy 18 or Trisomy 13: A Review.

    Science.gov (United States)

    Haug, Shelly; Goldstein, Mitchell; Cummins, Denise; Fayard, Elba; Merritt, T Allen

    2017-04-01

    Patient-centered care (PCC) has been advocated by the Institute of Medicine to improve health care in the United States. Four concepts of PCC align with clinical ethics principles and are associated with enhanced patient/parent satisfaction. These concepts are dignity and respect, information sharing, participation, and collaboration. The objective of this article is to use the PCC approach as a framework for an extensive literature review evaluating the current status of counseling regarding prenatal diagnosis of trisomy 18 (T18) or trisomy 13 (T13) and to advocate PCC in the care of these infants. Extensive availability of prenatal screening and diagnostic testing has led to increased detection of chromosomal anomalies early in pregnancy. After diagnosis of T18 or T13, counseling and care have traditionally been based on assumptions that these aneuploidies are lethal or associated with poor quality of life, a view that is now being challenged. Recent evidence suggests that there is variability in outcomes that may be improved by postnatal interventions, and that quality-of-life assumptions are subjective. Parental advocacy for their infant's best interest mimics this variability as requests for resuscitation, neonatal intensive care, and surgical intervention are becoming more frequent. With new knowledge and increased parental advocacy, physicians face ethical decisions in formulating recommendations including interruption vs continuation of pregnancy, interventions to prolong life, and choices to offer medical or surgical procedures. We advocate a PCC approach, which has the potential to reduce harm when inadequate care and counseling strategies create conflicting values and uncertain outcomes between parents and caregivers in the treatment of infants with T18 and T13.

  16. Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.

    Science.gov (United States)

    Washington Cole, Katie O; Gudzune, Kimberly A; Bleich, Sara N; Cheskin, Lawrence J; Bennett, Wendy L; Cooper, Lisa A; Roter, Debra L

    2017-06-01

    To examine the association of women's body weight with provider communication during prenatal care. We coded audio recordings of prenatal visits between 22 providers and 117 of their patients using the Roter Interaction Analysis System. Multivariate, multilevel Poisson models were used to examine the relationship between patient pre-pregnancy body mass index and provider communication. Compared to women with normal weight, providers asked fewer lifestyle questions (IRR 0.66, 95% CI 0.44-0.99, p=0.04) and gave less lifestyle information (IRR 0.51, 95% CI 0.32-0.82, p=0.01) to women with overweight and obesity, respectively. Providers used fewer approval (IRR 0.68, 95% CI 0.51-0.91, p=0.01) and concern statements (IRR 0.68, 95% CI 0.53-0.86, p=0.002) when caring for women with overweight and fewer self-disclosure statements caring for women with obesity (IRR 0.40, 95% CI 0.19-0.84 p=0.02). Less lifestyle and rapport building communication for women with obesity may weaken patient-provider relationship during routine prenatal care. Interventions to increase use of patient-centered communication - especially for women with overweight and obesity - may improve prenatal care quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Alcohol use, injuries, and prenatal visits during three successive pregnancies among American Indian women on the Northern Plains who have children with fetal alcohol syndrome or incomplete fetal alcohol syndrome.

    Science.gov (United States)

    Kvigne, Valborg L; Leonardson, Gary R; Borzelleca, Joseph; Brock, Ellen; Neff-Smith, Martha; Welty, Thomas K

    2008-07-01

    The purpose of the study was to compare three sequential pregnancies of American Indian women who have children with FAS or children with incomplete FAS with women who did not have children with FAS. Two retrospective case-control studies were conducted of Northern Plains American Indian children with fetal alcohol syndrome (FAS) (Study 1) or incomplete FAS (Study 2) in 1981-1993. Three successive pregnancies ending in live births of 43 case mothers who had children with FAS, and 35 case mothers who had children with incomplete FAS were compared to the pregnancies of 86 and 70 control mothers who did not have children with FAS, respectively, in the two studies. Prenatal records were abstracted for the index child (child with FAS or incomplete FAS) and siblings born just before and just after the index child, and comparable prenatal records for the controls. Compared to the controls, significantly more case mothers used alcohol before and after all three pregnancies and during pregnancy with the before sibling and the index child. Mothers who had children with FAS reduced their alcohol use during the pregnancy following the birth of the index child. All Study 1 case mothers (100%) and 60% of Study 2 case mothers used alcohol during the pregnancy with the index child compared to 20 and 9% of respective control mothers. More study 1 case mothers experienced unintentional injuries (OR 9.50) and intentional injuries during the index pregnancy (OR 9.33) than the control mothers. Most case mothers began prenatal care in the second trimester. Alcohol use was documented before, during and after each of the three pregnancies. Women of child-bearing age should be screened for alcohol use whenever they present for medical services. Mothers who had a child with FAS decreased their alcohol consumption with the next pregnancy, a finding that supports the importance of prenatal screening throughout pregnancy. Women who receive medical care for injuries should be screened for

  18. Infant outcomes among women with Zika virus infection during pregnancy: results of a large prenatal Zika screening program.

    Science.gov (United States)

    Adhikari, Emily H; Nelson, David B; Johnson, Kathryn A; Jacobs, Sara; Rogers, Vanessa L; Roberts, Scott W; Sexton, Taylor; McIntire, Donald D; Casey, Brian M

    2017-03-01

    Zika virus infection during pregnancy is a known cause of congenital microcephaly and other neurologic morbidities. We present the results of a large-scale prenatal screening program in place at a single-center health care system since March 14, 2016. Our aims were to report the baseline prevalence of travel-associated Zika infection in our pregnant population, determine travel characteristics of women with evidence of Zika infection, and evaluate maternal and neonatal outcomes compared to women without evidence of Zika infection. This is a prospective, observational study of prenatal Zika virus screening in our health care system. We screened all pregnant women for recent travel to a Zika-affected area, and the serum was tested for those considered at risk for infection. We compared maternal demographic and travel characteristics and perinatal outcomes among women with positive and negative Zika virus tests during pregnancy. Comprehensive neurologic evaluation was performed on all infants delivered of women with evidence of possible Zika virus infection during pregnancy. Head circumference percentiles by gestational age were compared for infants delivered of women with positive and negative Zika virus test results. From March 14 through Oct. 1, 2016, a total of 14,161 pregnant women were screened for travel to a Zika-affected country. A total of 610 (4.3%) women reported travel, and test results were available in 547. Of these, evidence of possible Zika virus infection was found in 29 (5.3%). In our population, the prevalence of asymptomatic or symptomatic Zika virus infection among pregnant women was 2/1000. Women with evidence of Zika virus infection were more likely to have traveled from Central or South America (97% vs 12%, P Zika virus infection. Additionally, there was no difference in mean head circumference of infants born to women with positive vs negative Zika virus testing. No microcephalic infants born to women with Zika infection were identified

  19. Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy.

    Science.gov (United States)

    Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

    2016-03-01

    To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy.I n the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment.

  20. THE IMPORTANCE OF PATERNAL INVOLVEMENT DURING PRENATAL CARE: PERCEPTION OF THE MOTHER AND FATHER IN THE CITY OF CACERES – MT.

    Directory of Open Access Journals (Sweden)

    Taíse Neves Ferreira

    2014-05-01

    Full Text Available In society, pregnancy has always been treated as a uniquely female experience, however, it is observed that the concepts and functions predetermined for men and women in the family are in full transformation. Describe the importance of parental involvement in monitoring prenatal vision of father and pregnant. This is a descriptive and quantitative study. The research had as reference Strategies Family Health Cáceres - MT. Participants were 30 pregnant women and their companions. When asked whether women talked to his companions about the importance of paternal participation in prenatal care, 67% of women answered yes and 33% did not talk. It is important to note that prenatal quality is achieved through pipelines necessary for pregnant women and hospitable. Geared this progress is the father figure who demonstrates an interest in participating, however, the work prevent them from contributing effectively.

  1. Prenatal diet, nutrient intake and pregnancy outcome in urban Ecuadorian primiparas.

    Science.gov (United States)

    Weigel, M M; Nárváez, W M; López, A; Félix, C; López, P

    1991-03-01

    A nutritional survey was conducted in an urban public maternity hospital, Hospital Gineco-Obstétrico Isidro Ayora (HGOIA), located in Quito, Ecuador. Seventy-four primiparas in the third trimester of pregnancy were recruited to assess the influence of sociedemographic factors on food patterns and nutrient intake, and the interrelationship between prenatal nutrient intake, maternal weight gain and pregnancy outcome. Results of the regression analysis indicated that maternal education was the factor most strongly associated with nutrient intake, followed by monthly per capita income. Maternal nutrient intake was next analyzed and compared with the WHO (1974, 1985) and NRC (1980) recommended daily allowances. Results also indicated the average daily intake of energy, protein, phosphorus, vitamins C and A, thiamine, riboflavin, and niacin met or exceeded the recommended daily allowances. Dietary calcium and iron intake, however, were below recommendations. Sodium and fat intake were both relatively high. Higher dietary fat intake was associated with increased birth weight, while lower protein intake was associated with increased risk of delivering a low-birth weight baby. Maternal weight gain during the third trimester predicted baby birth weight and height but not head circumference.

  2. Prenatal management, pregnancy and pediatric outcomes in fetuses with septated cystic hygroma

    Directory of Open Access Journals (Sweden)

    C.Y. Sanhal

    2014-09-01

    Full Text Available It has been reported that, compared with simple increased nuchal translucency, fetal cases with septated cystic hygroma (CH are more likely to face perinatal handicaps. However, pediatric outcomes and proper prenatal counseling for this anomaly have not yet been truly defined. We performed this study to determine pregnancy and pediatric outcomes of fetuses with septated CH. We searched records for cases with septated CH and collected data for structural abnormalities, karyotype analysis, and pregnancy outcomes. Fetuses born with septated CH were also evaluated for their pediatric outcomes. Sixty-nine fetuses with septated CH were enrolled in the study. Results showed that chromosomal abnormalities were present in 28 fetuses (40.6%, and the most common aneuploidy was Turner syndrome (n=14, 20.3%; 16 (23.2% of the remaining cases, in which aneuploidy was not found, had coexistent structural malformations; 25 (36.2% cases had normal karyotype and morphology. The total number of live births and infants with unfavorable neurologic follow-up were 13 (18.8% and 2 (2.9%, respectively. Septated CH is associated with poor perinatal outcomes; therefore, karyotype analysis and ultrasonographic anomaly screening should be performed as initial steps, and expectant management should be offered to couples with euploid fetuses that have normal morphology.

  3. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5‐year‐old children

    National Research Council Canada - National Science Library

    Falgreen Eriksen, H‐L; Mortensen, EL; Kilburn, T; Underbjerg, M; Bertrand, J; Støvring, H; Wimberley, T; Grove, J; Kesmodel, US

    2012-01-01

    ..., Støvring H, Wimberley T, Grove J, Kesmodel U. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5‐year‐old children. BJOG 2012;119:1191–1200. Objective...

  4. How to measure prenatal stress? A systematic review of psychometric instruments to assess psychosocial stress during pregnancy.

    Science.gov (United States)

    Nast, Irina; Bolten, Margarete; Meinlschmidt, Gunther; Hellhammer, Dirk H

    2013-07-01

    A growing body of literature documents associations of maternal psychosocial stress during pregnancy with fetal, infant and child behaviour and development. However, findings across studies are often inconsistent, which may in part be due to differences in stress definitions and assessments. We systematically reviewed methods applied to assess maternal psychosocial stress during pregnancy in studies looking at associations with biobehavioural outcomes in the offspring. A systematic literature search was performed on Web of Science and PubMed for the time period between January 1999 and October 2009. Psychometric instruments assessing maternal psychosocial stress during pregnancy were identified and described if data on psychometric properties were available. We identified 115 publications that assessed psychosocial stress during pregnancy with validated methods. These publications applied overall 43 different instruments assessing constructs falling under seven categories, ordered according to their frequency of use: anxiety, depression, daily hassles, aspects of psychological symptomatology (not reduced to anxiety or depression), life events, specific socio-environmental stressors and stress related to pregnancy and parenting. If available, we provide information on validity and reliability of the instruments for samples of pregnant women. Within the 'prenatal stress' research, a broad range of instruments is applied to assess psychosocial stress during pregnancy. Prenatal stress research should take into consideration that the variety of methods in use might hamper the comparability of stress research results. In each category of stress constructs, one instrument with good psychometric properties in pregnant women is highlighted as the best currently available measure. © 2013 John Wiley & Sons Ltd.

  5. Nutritional guidance during prenatal care in public health services in Ribeirão Preto: discourse and care practice Orientación nutricional en el prenatal en servicio público de salud de la ciudad de Ribeirão Preto: el discurso y la práctica asistencial Orientação nutricional no pré-natal em serviços públicos de saúde no município de Ribeirão Preto: o discurso e a prática assistencial

    OpenAIRE

    Luzia Aparecida dos Santos; Fabiana Villela Mamede; Maria José Clapis; Juliana Villela Bueno Bernardi

    2006-01-01

    This study aimed to verify if pregnant women attended in prenatal care services at Basic Health Units in Ribeirão Preto-SP, Brazil, received nutritional guidance and if this guidance was pertinent to their nutritional status. Ninety-one pregnant women participated. The pregnant women were classified according to their nutritional condition, using a weight, height and pregnancy stage table established by the Brazilian Health Ministry's technical prenatal care manual. We found pregnant women wi...

  6. [Coverage characterization of pre-natal in Maranhão State, Brazil].

    Science.gov (United States)

    Costa, Geny Rose Cardoso; Chein, Maria Bethânia da Costa; Gama, Mônica Elinor Alves; Coelho, Leidyane Silva Caldas; da Costa, Andreia Susana Vieira; Cunha, Carlos Leonardo Figueiredo; Brito, Luciane Maria Oliveira

    2010-01-01

    The purpose of the study was to characterize the coverage of prenatal care in the State of Maranhão. A population-based study, descriptive in 30 municipalities of the State of Maranhão, with 2075 women of childbearing age, with previous pregnancy, from July 2008 to Januray 2009. The results demonstrated that the units of family health accounted for 45.9% of the care of pregnant women and that 46.8% reported carrying out consultations six or more prenatal care during last pregnancy and 64.6% started prenatal in the first three months of pregnancy. The coverage of prenatal care, without regard to adequacy, was 85.6%, however, when considering the coverage of adequate prenatal as established by Brazilian Health Ministry was 43.4%. Although coverage of prenatal above 80%, less than half is considered adequate, showing a gap in primary care quality.

  7. An Economic Analysis of Cell-Free DNA Non-Invasive Prenatal Testing in the US General Pregnancy Population.

    Directory of Open Access Journals (Sweden)

    Peter Benn

    Full Text Available Analyze the economic value of replacing conventional fetal aneuploidy screening approaches with non-invasive prenatal testing (NIPT in the general pregnancy population.Using decision-analysis modeling, we compared conventional screening to NIPT with cell-free DNA (cfDNA analysis in the annual US pregnancy population. Sensitivity and specificity for fetal aneuploidies, trisomy 21, trisomy 18, trisomy 13, and monosomy X, were estimated using published data and modeling of both first- and second trimester screening. Costs were assigned for each prenatal test component and for an affected birth. The overall cost to the healthcare system considered screening costs, the number of aneuploid cases detected, invasive procedures performed, procedure-related euploid losses, and affected pregnancies averted. Sensitivity analyses evaluated the effect of variation in parameters. Costs were reported in 2014 US Dollars.Replacing conventional screening with NIPT would reduce healthcare costs if it can be provided for $744 or less in the general pregnancy population. The most influential variables were timing of screening entry, screening costs, and pregnancy termination rates. Of the 13,176 affected pregnancies undergoing screening, NIPT detected 96.5% (12,717/13,176 of cases, compared with 85.9% (11,314/13,176 by conventional approaches. NIPT reduced invasive procedures by 60.0%, with NIPT and conventional methods resulting in 24,596 and 61,430 invasive procedures, respectively. The number of procedure-related euploid fetal losses was reduced by 73.5% (194/264 in the general screening population.Based on our analysis, universal application of NIPT would increase fetal aneuploidy detection rates and can be economically justified. Offering this testing to all pregnant women is associated with substantial prenatal healthcare benefits.

  8. Routine history as compared to audio computer-assisted self-interview for prenatal care history taking.

    Science.gov (United States)

    Mears, Molly; Coonrod, Dean V; Bay, R Curtis; Mills, Terry E; Watkins, Michelle C

    2005-09-01

    To compare endorsement rates obtained with audio computer-assisted self-interview versus routine prenatal history. A crosssectional study compared items captured with the routine history to those captured with a computer interview (computer screen displaying and computer audio reading questions, with responses entered by touch screen). The subjects were women (n=174) presenting to a public hospital clinic for prenatal care. The prevalence of positive responses using the computer interview was significantly greater (p history for induced abortion (16.8% versus 4.0%), lifetime smoking (12.8% versus 5.2%), intimate partner violence (10.0% versus 2.4%), ectopic pregnancy (5.2% versus 1.1%) and family history of mental retardation (6.7% versus 0.6%). Significant differences were not found for history of spontaneous abortion, hypertension, epilepsy, thyroid disease, smoking during pregnancy, gynecologic surgery, abnormal Pap test, neural tube defect or cystic fibrosis family history. However, in all cases, prevalence was equal or greater with the computer interview. Women were more likely to report sensitive and high-risk behavior, such as smoking history, intimate partner violence and elective abortion, with the computer interview. The computer interview displayed equal or increased patient reporting of positive responses and may therefore be an accurate method of obtaining an initial history.

  9. Maternal Health Care Services Access Index and Infant Survival in

    African Journals Online (AJOL)

    GB

    ... reduce in Nigeria. KEYWORDS: Infant mortality, Maternal health care, Pregnancy care, Delivery care, Nigeria ... not go for antenatal care, and as a result may not access other cares ...... Inadequate Use of Prenatal Services Among. Brazilian ...

  10. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    Science.gov (United States)

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  11. Dermatosparaxis (Ehlers-Danlos type VIIC): prenatal diagnosis following a previous pregnancy with unexpected skull fractures at delivery.

    Science.gov (United States)

    Solomons, Joyce; Coucke, Paul; Symoens, Sofie; Cohen, Marta C; Pope, F Michael; Wagner, Bart E; Sobey, Glenda; Black, Rebecca; Cilliers, Deirdre

    2013-05-01

    Dermatosparaxis Ehlers-Danlos syndrome (or EDS VIIC), a rare autosomal recessive connective tissue disorder, is characterized by extreme skin fragility, premature rupture of membranes in pregnancy, and spontaneous rupture of internal organs. Here we report a second patient with EDS VIIC presenting with congenital skull fractures and skin lacerations at birth, complications which may occur more frequently than previously thought in this condition. We also discuss the role of prenatal diagnosis in the management of a subsequent normal pregnancy. Copyright © 2012 Wiley Periodicals, Inc.

  12. The Importance of Geographic Data Aggregation in Assessing Disparities in American Indian Prenatal Care

    Science.gov (United States)

    Call, Kathleen Thiede; Blewett, Lynn A.

    2010-01-01

    Objectives. We sought to determine whether aggregate national data for American Indians/Alaska Natives (AIANs) mask geographic variation and substantial subnational disparities in prenatal care utilization. Methods. We used data for US births from 1995 to 1997 and from 2000 to 2002 to examine prenatal care utilization among AIAN and non-Hispanic White mothers. The indicators we studied were late entry into prenatal care and inadequate utilization of prenatal care. We calculated rates and disparities for each indicator at the national, regional, and state levels, and we examined whether estimates for regions and states differed significantly from national estimates. We then estimated state-specific changes in prevalence rates and disparity rates over time. Results. Prenatal care utilization varied by region and state for AIANs and non-Hispanic Whites. In the 12 states with the largest AIAN birth populations, disparities varied dramatically. In addition, some states demonstrated substantial reductions in disparities over time, and other states showed significant increases in disparities. Conclusions. Substantive conclusions about AIAN health care disparities should be geographically specific, and conclusions drawn at the national level may be unsuitable for policymaking and intervention at state and local levels. Efforts to accommodate the geographically specific data needs of AIAN health researchers and others interested in state-level comparisons are warranted. PMID:19910356

  13. Prenatal Stress as a Modifier of Associations between Phthalate Exposure and Reproductive Development: results from a Multicentre Pregnancy Cohort Study.

    Science.gov (United States)

    Barrett, Emily S; Parlett, Lauren E; Sathyanarayana, Sheela; Redmon, J Bruce; Nguyen, Ruby H N; Swan, Shanna H

    2016-03-01

    Prenatal phthalate exposure is associated with altered male reproductive tract development, and in particular, shorter anogenital distance (AGD). AGD, a sexually dimorphic index of prenatal androgen exposure, may also be altered by prenatal stress. How these exposures interact to impact AGD is unknown. Here, we examine the extent to which associations between prenatal phthalate exposure and infant AGD are modified by prenatal exposure to stressful life events (SLEs). Phthalate metabolites [including those of diethylhexyl phthalate (DEHP) and their molar sum (ΣDEHP)] were measured in first trimester urine from 738 pregnant women participating in The Infant Development and the Environment Study (TIDES). Women completed questionnaires on SLEs, and permitted infant AGD measurements at birth. Subjects were classified as 'lower' and 'higher' stress (0 first trimester SLEs vs. 1+).We estimated relationships between phthalate concentrations and AGD (by infant sex and stress group) using adjusted multiple regression interaction models. In the lower stress group, first trimester ΣDEHP was inversely associated with two measures of male AGD: anoscrotal distance (AGD-AS; β = -1.78; 95% CI -2.97, -0.59) and anopenile distance (AGD-AP; β = -1.61; 95% CI -3.01, -0.22). By contrast, associations in the higher stress group were mostly positive and non-significant in male infants. No associations were observed in girls. Associations between prenatal phthalate exposure and altered genital development were only apparent in sons of mothers who reported no SLEs during pregnancy. Prenatal stress and phthalates may interact to shape fetal development in ways that have not been previously explored. © 2015 John Wiley & Sons Ltd.

  14. Customer Quality during Prenatal Care in Health Care Centers in Tabriz City

    Directory of Open Access Journals (Sweden)

    Jafar Sadegh Tabrizi

    2015-07-01

    Full Text Available Background and Objectives :  Customer Quality (CQ refers to customer’s characteristics and is concerned with the knowledge, skills and confidence of health services customers who actively participate with health team in proper decision-making, appropriate activities and changing environment and health related behaviors. The purpose of this study was measuring customer quality of pregnant women during prenatal care. Materials and Methods :  This is a cross- sectional study which was conducted with the participation of 185 pregnant women who received prenatal care from urban health centers in Tabriz city. All participants were selected randomly from 40 health centers. Customer quality was measured based on CQMH-CQ questionnaire.  Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α = 0.714. Spss v.17 was used for data analysis. Results : According to the results, the mean score of customer quality among pregnant women was (11.29± 67.79   and only %14 of the participants reported the highest customer quality score and ability of continuity of care under stressful situations. There was a positive relationship between customer quality score and visiting midwife and a better evaluation of overall quality of care, but there was inverse relationship with early registration at health centers. Conclusion :  The participation of pregnant women in service delivery process and decision-making can promote costumer quality. Furthermore, training health care providers in empowering patients and using their abilities to improve quality of care and paying attention to patient-centered care will be helpful. ​

  15. Maternal socio-economic indices for prenatal care research in rural China.

    Science.gov (United States)

    Nwaru, Bright I; Klemetti, Reija; Kun, Huang; Hong, Wang; Yuan, Shen; Wu, Zhuochun; Hemminki, Elina

    2012-12-01

    The conceptualization and measurement of socio-economic status (SES) is difficult in developing settings. In the absence of SES indices for women in rural China, we constructed SES indices for prenatal care research, and examined their relation to perinatal care and outcomes. This study utilized data of 4364 rural women having recently given birth, collected by a cross-sectional survey in three rural Chinese provinces in 2007. Principal component analysis (PCA) was used to construct the SES indices and multilevel logistic regression was use to relate the indices to low birthweight, short exclusive breastfeeding (≤4 months), childbirth at the county or higher level health facility, caesarean section, inadequate prenatal care and no postnatal care. Three separate SES indices (wealth, occupational and educational indices) were obtained from the PCA analysis, capturing maternal, paternal and household SES characteristics. After adjusting for individual level factors, village and township wealth, higher levels of the indices were inversely associated with inadequate prenatal care. Higher occupational status was positively associated with short exclusive breastfeeding and childbirth at the county or higher level health facility, but inversely associated with no postnatal care. Higher educational status was positively associated with no postnatal care. Three SES indices (wealth, occupational and educational) were obtained from this study for prenatal care research. The indices gave mostly varying results on their associations with perinatal care and outcomes, indicating that SES measures may be outcome-specific.

  16. Pregnancy nutrition surveillance system.

    Science.gov (United States)

    2003-01-01

    The Pregnancy Nutrition Surveillance System is a useful tool in monitoring Healthy People 2010 objectives and is intended to provide a framework for analyzing data on the nutritional status and behavioral risk factors of pregnant women and the association to birth outcome. The data are useful to health professionals in providing prenatal care and developing programs to reduce pregnancy-related health risks.

  17. Pregnancy options counseling for adolescents: overcoming barriers to care and preserving preference.

    Science.gov (United States)

    Dobkin, Loren M; Perrucci, Alissa C; Dehlendorf, Christine

    2013-04-01

    Current clinical guidelines for counseling adolescent patients about their pregnancy options fail to give concrete suggestions for how to begin and hold conversations that support patient autonomy, provide accurate and unbiased information, and address barriers to care. Recent research suggests that relative to adult women, adolescents are at increased risk of being denied abortion because they present beyond facilities' gestational age limits. Counseling that neglects to address the structural and developmental challenges that adolescents face when seeking care may contribute to the risk of abortion denial as well as subsequent delays in prenatal care. The task of providing non-directive, patient-centered, evidence-based pregnancy options counseling to an adolescent while ensuring that she receives her chosen course of care in a timely manner is challenging. This article presents a shared decision-making framework and specific suggestions for healthcare providers to support adolescent patients in coming to their decision about whether to continue or terminate an unplanned pregnancy and access follow-up care within the current sociopolitical environment.

  18. [Do the quality of prenatal care have an impact on obstetrical outcomes?].

    Science.gov (United States)

    Léticée, N; Vendittelli, F; Ughetto, S; Janky, E

    2013-05-01

    To assess the rate of pregnant women not having accurate prenatal care utilization. The others goals were to assess the impact of an inadequate quantitative or qualitative prenatal care on obstetrical outcomes. Historical cohort study with a prospective data registration. Hospitalised patients at the maternity ward of the University Hospital of Pointe-à-Pitre were eligible if they gave birth after 22 weeks (or≥500g) at home, outside a maternity ward or in another maternity ward. Early postpartum maternal transfers were included but not medical abortions. The principal outcome was preterm birth (before 37 weeks' gestation). Patients without an appointment before 15weeks or without an appointment each month before their delivery represented 27.4% of women (n=2344). We stressed more preterm deliveries outside the maternity ward among the group with an inadequate prenatal care utilization vs. the other group (3,89% vs. 0,88%) (pinadequate quality prenatal care. Our study did not stress a difference concerning perinatal outcomes among women with an inadequate quantitative or qualitative prenatal care utilization. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Alcohol and pregnancy: Effects on maternal care, HPA axis function, and hippocampal neurogenesis in adult females.

    Science.gov (United States)

    Workman, Joanna L; Raineki, Charlis; Weinberg, Joanne; Galea, Liisa A M

    2015-07-01

    Chronic alcohol consumption negatively affects health, and has additional consequences if consumption occurs during pregnancy as prenatal alcohol exposure adversely affects offspring development. While much is known on the effects of prenatal alcohol exposure in offspring less is known about effects of alcohol in dams. Here, we examine whether chronic alcohol consumption during gestation alters maternal behavior, hippocampal neurogenesis and HPA axis activity in late postpartum female rats compared with nulliparous rats. Rats were assigned to alcohol, pair-fed or ad libitum control treatment groups for 21 days (for pregnant rats, this occurred gestation days 1-21). Maternal behavior was assessed throughout the postpartum period. Twenty-one days after alcohol exposure, we assessed doublecortin (DCX) (an endogenous protein expressed in immature neurons) expression in the dorsal and ventral hippocampus and HPA axis activity. Alcohol consumption during pregnancy reduced nursing and increased self-directed and negative behaviors, but spared licking and grooming behavior. Alcohol consumption increased corticosterone and adrenal mass only in nulliparous females. Surprisingly, alcohol consumption did not alter DCX-expressing cell density. However, postpartum females had fewer DCX-expressing cells (and of these cells more immature proliferating cells but fewer postmitotic cells) than nulliparous females. Collectively, these data suggest that alcohol consumption during pregnancy disrupts maternal care without affecting HPA function or neurogenesis in dams. Conversely, alcohol altered HPA function in nulliparous females only, suggesting that reproductive experience buffers the long-term effects of alcohol on the HPA axis.

  20. Prenatal Versus Postnatal Tobacco Smoke Exposure and Intensive Care Use in Children Hospitalized With Bronchiolitis.

    Science.gov (United States)

    Stevenson, Michelle D; Mansbach, Jonathan M; Mowad, Eugene; Dunn, Michelle; Clark, Sunday; Piedra, Pedro A; Sullivan, Ashley F; Camargo, Carlos A

    2016-07-01

    Among children hospitalized with bronchiolitis, we examined the associations between in utero exposure to maternal cigarette smoking, postnatal tobacco smoke exposure, and risk of admission to the intensive care unit (ICU). We performed a 16-center, prospective cohort study of hospitalized children aged bronchiolitis. For 3 consecutive years, from November 1, 2007 until March 31, 2010, site teams collected data from participating families, including information about prenatal maternal smoking and postnatal tobacco exposure. Analyses used chi-square, Fisher's exact, and Kruskal-Wallis tests and multivariable logistic regression. Among 2207 enrolled children, 216 (10%) had isolated in utero exposure to maternal smoking, 168 (8%) had isolated postnatal tobacco exposure, and 115 (5%) experienced both. Adjusting for age, sex, race, birth weight, viral etiology, apnea, initial severity of retractions, initial oxygen saturation, oral intake, and postnatal tobacco exposure, children with in utero exposure to maternal smoking had greater odds of being admitted to the ICU (adjusted odds ratio [aOR] 1.51, 95% confidence interval [CI] 1.14-2.00). Among children with in utero exposure to maternal smoking, those with additional postnatal tobacco exposure had a greater likelihood of ICU admission (aOR 1.95, 95% CI 1.13-3.37) compared to children without postnatal tobacco smoke exposure (aOR 1.47, 95% CI 1.05-2.04). Maternal cigarette smoking during pregnancy puts children hospitalized with bronchiolitis at significantly higher risk of intensive care use. Postnatal tobacco smoke exposure may exacerbate this risk. Health care providers should incorporate this information into counseling messages. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. Fatores associados à inadequação do uso da assistência pré-natal Factors associated with inadequacy of prenatal care utilization

    Directory of Open Access Journals (Sweden)

    Liberata C Coimbra

    2003-08-01

    Full Text Available OBJETIVO: Identificar fatores associados à inadequação do uso da assistência pré-natal em comunidade urbana. MÉTODOS: Foi realizado estudo transversal em amostra sistemática, estratificada por maternidades, de todos os nascimentos hospitalares do município de São Luís, MA, no período de março de 1997 a fevereiro de 1998. Foram avaliados indicadores socioeconômicos e demográficos, de saúde reprodutiva, morbidade na gravidez e utilização de serviços pré-natais. Utilizou-se questionário padronizado respondido pelas puérperas antes da alta hospitalar. A adequação do uso da assistência pré-natal foi analisada pelo índice "Adequacy of Prenatal Care Utilization" (APNCU e por um novo índice proposto, baseado nas recomendações do Ministério da Saúde, Brasil. RESULTADOS: Foram entrevistadas 2.831 puérperas, atendidas em dez unidades de saúde pública e privada. A inadequação do uso da assistência pré-natal foi de 49,2% pelo índice APNCU, e de 24,5% pelo novo índice proposto. Mulheres atendidas em serviços públicos de saúde, de baixa escolaridade e baixa renda familiar, sem companheiro ou com doença durante a gravidez, tiveram maiores percentuais de inadequação do uso do atendimento pré-natal, pelos dois índices analisados. Pelo novo índice proposto, maiores percentuais de inadequação foram associados à alta paridade e idade materna, enquanto baixa idade materna (OBJECTIVE: To identify factors associated with inadequacy of prenatal care utilization in urban community. METHODS: A cross-sectional study of a systematic sample stratified by maternity hospital, consisting of hospital births in the municipality of São Luís, Brazil, was carried out from March 1997 to February 1998. Socioeconomic and demographic factors, reproductive health, morbidity during pregnancy, and utilization of prenatal care services were studied. Mothers answered a standardized questionnaire before hospital discharge. The adequacy of

  2. Effect of prenatal counselling on compliance and outcomes of teenage pregnancy.

    Science.gov (United States)

    Mersal, F A; Esmat, O M; Khalil, G M

    2013-01-01

    To evaluate the effect of prenatal counselling on compliance for health promotion and pregnancy outcomes we conducted an experimental randomized control study on a sample of 86 teenage pregnant women attending the maternal and child health centre in Elkhosos village, Egypt. Data were collected pre-counselling, post-counselling and after delivery. At the post test, women in the study (counselling) group showed statistically significantly greater knowledge and compliance of health promotion (P < 0.001) than women in the control group. In the study group, 90.7% were full term at labour compared with 41.9% in the control group; 88.4% of the women in the study group had normal vaginal delivery compared with 76.7% of those in the control group. The health condition in 90.7% of the study group neonates was classified as good compared with only 46.5% in the control group. Only 9.3% of the study group babies had low birth weight compared with 32.6% of the control group babies (P = 0.008).

  3. Participation in prenatal screening tests and intentions concerning selective termination in Finnish maternity care

    DEFF Research Database (Denmark)

    Santalahti, P; Hemminki, E; Aro, A R

    1999-01-01

    AIMS: The study examined how prenatal screening tests are presented to women, factors associated with women's participation in screening, their experience of decision-making and intentions concerning pregnancy termination, and hospital data on rates of selective terminations. METHODS: Questionnai...... in screening and with intentions about selective termination, women's perceptions of lives of the disabled should receive more attention in future studies.......AIMS: The study examined how prenatal screening tests are presented to women, factors associated with women's participation in screening, their experience of decision-making and intentions concerning pregnancy termination, and hospital data on rates of selective terminations. METHODS...... asking about selective terminations following detected fetal disorders were sent in 1993 to all public hospitals with obstetrics or gynaecology departments (response rate 100%). RESULTS: The serum screening test had usually been offered to women as a free choice, but for 22% of them it was presented...

  4. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case–control study

    OpenAIRE

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-01-01

    Background The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neig...

  5. Unhappiness with the Fetal Gender is associated with Depression in Adult Pregnant Women Attending Prenatal Care in a Public Hospital in Durango, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2016-03-01

    Depression during pregnancy has been scantily studied in Mexican women. We aimed to determine the prevalence and correlates of depression in adult pregnant women attending a public hospital in the northern Mexican city of Durango, Mexico. Through a cross-sectional study design, we assessed depression in 270 adult pregnant women attended for prenatal care in a public hospital using a validated Mexican version of the Edinburg Postnatal Depression Scale in pregnancy and further confirmation by a psychiatric evaluation using the DSM-IV criteria for depression. Prevalence association with socio-demographic, clinical and psychosocial characteristics of the pregnant women was also investigated. Of the 270 pregnant women studied, 101 (37.4%) had EPDS scores equal to or higher than nine. Depression was confirmed in 56 (20.7%) women. Of them, 42 suffered from minor depression and 14 from major depression. Multivariate analysis of socio-demographic, clinical and psychosocial characteristics of the women showed that depression was associated with depression before pregnancy (OR = 3.36; 95% CI: 1.20-9.40; P=0.02), anxiety during pregnancy (OR = 9.38; 95% CI: 1.87-46.96; P=0.006), smoking (OR = 25.05; 95% CI: 1.77-353.07; P=0.01), unhappy with the fetal sex (OR = 8.53; 95% CI: 2.46-29.48; Pwomen studied had confirmed depression. This is the first report of an association of prenatal depression with unhappiness with the fetal sex. Factors associated with prenatal depression found in this study may help for the optimal design of preventive measures against prenatal depression.

  6. [Characteristics of pregnant women cared for in a visit to the prenatal outpatient nursing service: comparison of four decades].

    Science.gov (United States)

    Marques, Ana Gabriela B; Záchia, Suzana A; Schmidt, Maria Luiza S; Heldt, Elizeth

    2012-12-01

    The aim of the work was to identify characteristics of pregnant women cared for by an obstetric nurse in a visit to the prenatal outpatient nursing service and compare these over the period from 1972 to 2009. Sociodemographic and obstetric data were collected from the forms completed by the pregnant patients during their visit to the nursing service. A total of 1245 forms were analyzed 208 (16.7%) being from the 1970s, 323 (25.9%) from the 1980s, 329 (26.4%) from the 1990s, and 385 (30.0%) from year 2000. A significant difference was found between the previous decades and year 9000 in relation to the greater number of high-risk pregnancies, number of nursing consultations and obstetric ultrasounds performed during the prenatal exam. The characteristics of pregnant women were observed to change over time, as well as the care provided by the obstetric nurse during visits to the outpatient nursing service, remaining associated with the demands of patients and legal resolutions.

  7. The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

    Science.gov (United States)

    Han, Hyun Ho; Choi, Eun Jeong; Kim, Ji Min; Shin, Jong Chul

    2016-01-01

    Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy. PMID:27019808

  8. The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

    Directory of Open Access Journals (Sweden)

    Hyun Ho Han

    2016-03-01

    Full Text Available BackgroundThe prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center.MethodsThe multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation.ResultsThe abortion rate was 28% (3/11. The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91% reported that they were satisfied with the multidisciplinary management in our center.ConclusionsAlthough a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

  9. Inadequate prenatal care and maternal country of birth: a retrospective study of southeast Spain.

    Science.gov (United States)

    Martínez-García, Encarnación; Olvera-Porcel, M Carmen; de Dios Luna-Del Castillo, Juan; Jiménez-Mejías, Eladio; Amezcua-Prieto, Carmen; Bueno-Cavanillas, Aurora

    2012-12-01

    To quantify the association between the maternal country of birth and inadequacy in the use of prenatal care, and to identify factors that might explain this association. A retrospective case series was carried out in a public hospital in southern Spain, including 6873 women who delivered between 2005 and 2007. The maternal country of birth was categorised into four regional groups: Spain, Maghreb (north-west Africa), Eastern Europe and Others (non-Spain), while the use of prenatal care was quantified according to a modified Kotelchuck index: APNCU-1M and APNCU 2M. The effect of country of birth on inadequate prenatal care was analysed using a multiple logistic regression model designed to accommodate factors such as age, parity, previous miscarriages, and pre-gestational and gestational risks. Likelihood ratio tests were performed to assess any interactions. A significant association was found between maternal country of birth and inadequate prenatal care regardless of the index used. Under APNCU 1-M the strength of association was strongest for Eastern European origin (odds ratio (OR) 6.17, 95% confidence interval (CI) 5.2-7.32), followed by the Maghreb (OR: 5.58, 95% CI: 4.69-6.64). These associations remained virtually unchanged after adjusting for potential confounders. Interactions were observed between age and parity, with the highest risk of inadequacy seen among the Eastern European childbearing women over 34 years of age having 1-2 previous children (OR: 7.63, 95% CI: 3.65-15.92). Prenatal health care initiatives would benefit from the study of a larger number of variables to address the differences between different groups of women. We recommend the widespread use of standardised indices for the study of prenatal care utilisation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation : a prospective cohort study

    NARCIS (Netherlands)

    Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

    2015-01-01

    BACKGROUND: Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status.

  11. Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among

  12. Factors explaining inadequate prenatal care utilization by first and second generation non-western women in The Netherlands.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Wiegers, T.A.; Francke, A.L.; Devillé, W.L.J.M.

    2013-01-01

    Background: In many industrialized western countries non-western women constitute a substantial part of the prenatal care client population. In The Netherlands, these women have also been shown to be more likely to make inadequate use of prenatal care. Explanatory factors for this include, among oth

  13. Effectiveness of Bacterial Vaginosis Screening Program in Routine Prenatal Care and Its Effect on Decrease of Preterm Labor

    Directory of Open Access Journals (Sweden)

    Mehrnaz Mashoufi

    2012-09-01

    Full Text Available Background & Objectives : Bacterial vaginosis is a condition which is determined by changes in microbial ecosystem of vagina and is considered as a preventable risk factor for preterm delivery. This study was conducted to assess the effectiveness of bacterial vaginosis screening program in routine prenatal care and its effect on decreasing preterm labor.   Methods: This clinical trial study was conducted on 474 pregnant women at gestational stage between 2007 and 2008. The participants were randomly divided into 2 groups: intervention group and control group. Screening was performed in intervention group with Amsel's criteria (3 of 4 needed for diagnosis. Positive cases were given clindamycin cream (2% for one week. The outcome of the delivery was assessed in both groups afterward. Data were analyzed by SPSS11 software using descriptive statistics.   Results: There was no significant difference between two groups regarding pregnancy rank, wanted and unwanted pregnancy, insufficient weight gain, mother vaccination and complication of pregnancy. Bacterial vaginosis was observed in 17 out of 216 (8% in the intervention group and then treated. Prevalence of preterm delivery in the intervention and control groups were 3 (1.4% and 12 (4.7%, respectively. The relative risk was protective (RR: 0.3, DR: 0.033, NNT: 30.   Conclusion: Screening and treatment of bacterial vaginosis in pregnant women could significantly decrease the rate of preterm delivery.

  14. [Assessment of the adequacy of prenatal care according to family income in Aracaju, Sergipe State, Brazil, 2011].

    Science.gov (United States)

    Carvalho, Renata Alves da Silva; Santos, Victor Santana; Melo, Cláudia Moura de; Gurgel, Ricardo Queiroz; Oliveira, Cristiane Costa da Cunha

    2016-01-01

    to assess the adequacy of prenatal care offered to pregnant health service users in Aracaju, Sergipe State, Brazil, according to family income. this was a cross-sectional study with 322 women living in the city of Aracaju whose children were born in November and December 2011; data were collected using questionnaires, including number of consultations, technical and laboratory procedures recommended by the Brazilian Ministry of Health (MoH); adequacy of prenatal care was assessed according to MoH criteria; chi-square test was used to compare proportions between categorical variables. prenatal care was considered inadequate for 89.1% of women, with no statistical difference for inadequacy of prenatal care according to family income (p=0.323). low adequacy of prenatal care was found when applying MoH parameters, regardless of pregnant women's family income.

  15. Placental malaria and lack of prenatal care in an area of unstable malaria transmission in eastern Sudan.

    Science.gov (United States)

    Adam, Ishag; Adamt, Gamal K; Mohmmed, Ahmed A; Salih, Magdi M; Ibrahuim, Salah A; Ryan, C Anthony

    2009-06-01

    A cross-sectional study was conducted in Gadarif Hospital in eastern Sudan to determine the prevalence, and evaluate the risk factors, of placental malaria. Two hundred and thirty-six delivering women were enrolled in the study. Socio-demographic characteristics were gathered through questionnaires. Maternal hemoglobin was measured, ABO blood groups were determined, and placental histological examinations for malaria were performed. The birth weight of the newborn was also recorded. The mean (SD) maternal age was 25.5 (6.0) yr and the mean (SD) hemoglobin was 9.8 (0.9) g/dl. Placental histology showed acute malaria infections in 13 (5.5%) and chronic infections in 5 (2.1%) women; 28 (11.9%) of the placentas revealed past infection and 190 (80.5%) indicated no infection. Lack of prenatal care was significantly associated with placental infections (OR = 12.0, 95% CI = 2.3-16.2; P = 0.003). There was no significant association between placental malaria infections and maternal age, parity, and blood group. Thirty-two (13.5%) of these pregnancy outcomes resulted in low birthweight babies. There was, however, no significant association between placental malaria and low birth weight (OR = 2.0, 95% CI = 0.4-4.1; P = 0.1). Thus, placental malaria infections affect pregnant women in this area of eastern Sudan regardless of their age or parity. Prenatal care should be encouraged to reduce malaria in the area. Much more research regarding malaria and pregnancy is needed.

  16. Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Ozge Ozalp Yuregir

    2012-02-01

    Full Text Available Prenatal diagnosis is the process of determining the health or disease status of the fetus or embryo before birth. The purpose is early detection of diseases and early intervention when required. Prenatal genetic tests comprise of cytogenetic (chromosome assessment and molecular (DNA mutation analysis tests. Prenatal testing enables the early diagnosis of many diseases in risky pregnancies. Furthermore, in the event of a disease, diagnosing prenatally will facilitate the planning of necessary precautions and treatments, both before and after birth. Upon prenatal diagnosis of some diseases, termination of the pregnancy could be possible according to the family's wishes and within the legal frameworks. [Archives Medical Review Journal 2012; 21(1.000: 80-94

  17. Development of prenatal event history calendar for Black women.

    Science.gov (United States)

    Yi, Chin Hwa Gina; Lori, Jody; Martyn, Kristy

    2008-01-01

    To identify psychosocial factors that Black women think should be addressed in prenatal care assessment and develop a Prenatal Event History Calendar to assess these factors. A qualitative descriptive study. Two inner city hospital prenatal care clinics in Southeastern Michigan. Twenty-two Black women who had attended at least 2 prenatal care visits. Three focus groups were conducted using a semistructured interview guide. Using the constant comparative method of analysis (Glaser, 1978, 1992) themes were identified that were relevant to Black women during prenatal care visits. The women in this study wanted to talk with their providers about psychosocial factors and not just the physical aspects of pregnancy. To "go off the pregnancy" represents pregnant women's desire to discuss psychosocial factors that were important to them during prenatal care. Five themes emerged from the data and were used to develop categories for the Prenatal Event History Calendar: relationships, stress, routines, health history perceptions, and beliefs. One vital component of prenatal care assessment is assessing for psychosocial risk factors. Prenatal Event History Calendar was specifically developed to provide a comprehensive and contextually linked psychosocial risk assessment for use with pregnant Black women.

  18. Prenatal care utilization in New York City: comparison of measures and assessment of their significance for urban health.

    Science.gov (United States)

    Perloff, J D; Jaffee, K D

    1997-01-01

    This paper considers policy and programmatic consequences of shifting measurement of prenatal care utilization from the Kessner Index (KI) to the Adequacy of Prenatal Care Utilization Index (APNCUI). In gauging the adequacy of prenatal care utilization, the KI considers the timing of prenatal care initiation and the number of prenatal visits. The APNCUI also considers both timing of initiation and number of visits, but the approach taken to conceptualizing and measuring these two aspects of prenatal care utilization is more refined. We used birth certificates to calculate the KI and the APNGUI for 217,183 New York City (NYC) births in 1991-1992. We used cross-tabulations and bivariate odds ratios to compare the classifications resulting from the respective indexes. The APNCUI detected some important dimensions of the problem of inadequate prenatal care use that are not evident when using the KI. The proportion of births with inadequate use increases from 18% with the KI to 35% with the APNGUI. Groups of women at elevated risk for inadequate use are the same, but the KI understates significantly the risk for Hispanic women, teens, women who are less well educated, and those on WIC and Medicaid. The APNGUI yields a fuller picture of the degree to which some urban women are at risk for inadequate prenatal care use. Use of the APNGUI in quality assurance, monitoring, and research is recommended.

  19. Marijuana use in Pregnancy: Anaesthetic Implications

    African Journals Online (AJOL)

    Adele

    gesting drug use in pregnancy (including marijuana) include ab- sence of prenatal care, ... Clinical presentation. Marijuana affects every body system, although acute toxicity is ... The effects of cannabis exposure result in significant changes.

  20. PRENATAL CARE MODEL IN THE FAR SOUTH OF BRAZIL

    Directory of Open Access Journals (Sweden)

    Flávia Conceição Pohlmann

    2016-01-01

    Full Text Available Estudio tuvo como objetivo conocer el modelo de atención a la salud utilizado en el cuidado prenatal en unidades de la Estrategia Salud de la Familia. Presenta abordaje cualitativa y enfoque exploratorio y se llevó a cabo en tres unidades de la Estrategia Salud de la Familia en una ciudad del sur de Brasil. La recolección de datos se realizó a través de entrevistas individuales con 10 mujeres embarazadas que se encontraban en el tercer trimestre. Los resultados obtenidos se sometieron a análisis temático. Se elaboró d os categorías temáticas: la perpetuación del modelo biomédico en las consultas pre-natal y grupos de embarazadas como un instrumento para superar el modelo biomédico. Se ha demostrado que el modelo biomédico sigue siendo el más utilizado en la atención prenatal y la educación en salud desarrollado a través de grupos educativos se reafirma como una estrategia para superar el modelo biomédico.

  1. Antenatal care and pregnancy outcome in Ghana, the importance of ...

    African Journals Online (AJOL)

    Antenatal care and pregnancy outcome in Ghana, the importance of women\\'s education. ... African Journal of Food, Agriculture, Nutrition and Development ... The antenatal characteristics of 503 pregnant women attending maternal and child

  2. Preconception, prenatal and post-natal cares%孕前、孕期和产后保健

    Institute of Scientific and Technical Information of China (English)

    郁君; 周健

    2013-01-01

    ABSTRACT World Health Organization puts forward the tertiary prevention strategies of birth defects in order to reduce its occurrence. Among them, primary prevention refers to comprehensive intervention to prevent the birth defects in the preconception stage. The secondary prevention refers to screening in pregnancy and prenatal diagnosis to early find and intervene the serious fetal birth defects. This article describes the measures of preconception, prenatal and postpartum cares in detail.%  世界卫生组织提出出生缺陷的“三级预防”策略,以减少出生缺陷的发生,其中一级预防指的是孕前阶段综合干预预防出生缺陷,二级预防通过孕期筛查和产前诊断早期发现和早期干预胎儿严重的先天缺陷。该文详细描述了孕前和孕期保健的措施,对产后不可忽略的保健问题提出建议。

  3. Disparities in Access to Prenatal Care Services for African Immigrant Women in Spain.

    Science.gov (United States)

    Paz-Zulueta, María; Llorca, Javier; Santibáñez, Miguel

    2015-10-01

    This retrospective cohort study compares the utilization of prenatal care between African immigrant and native Spanish women. For 2007-2010, we identified 231 pregnant African immigrant women. The native-born population sample was obtained by simple random sampling in a 1:3 ratio. The Kessner Index (KI) and our Own Index (OI) were applied to rate prenatal care adequacy in three categories (adequate, intermediate, and inadequate). Odds ratios (ORs) were estimated using non-conditional logistic regression. Prenatal care was adequate according to the indexes (KI or OI) in 21.3 and 25.8% of North Africans and in 22.5 and 30.4% of sub-Saharan Africans. The ORs of inadequacy when adjusted for maternal age, social risk factors, and previous reproductive outcomes were 30.32 and 35.47 (KI or OI) in North and 64.43 and 67.93 in sub- Saharan Africans. These results suggest significant differences in obtaining adequate prenatal care between immigrant and native Spanish women.

  4. Routine Prenatal Care Visits by Provider Specialty in the United States, 2009-2010

    Science.gov (United States)

    ... in the United States, 2009–2010 Recommend on Facebook Tweet Share Compartir NCHS Data Brief No. 145, March 2014 On This Page Key findings The percentage of routine prenatal care visits at which women saw non-ob/gyn providers generally decreased with age. ...

  5. [Eugenics' extension in the Spanish health care system through the prenatal diagnosis].

    Science.gov (United States)

    Rodríguez Martín, Esteban

    2012-01-01

    The wide implantation of strategies of sifted or prenatal selection close to laws that protect the destruction of the human life before the childbirth in the whole world, they are giving place to an increasing number of eugenic abortions. In Spain, the law 2/2010 of the sexual and reproductive health and voluntary interruption of pregnancy there has supposed the liberalization of the eugenic abortion without term limit. In we make concrete, the sanitary national and international policies of prenatal selection of Down's Syndrome, which they chase to facilitate the total or partial destruction before the childbirth of this human group, submitting it to a few particular conditions of existence during his prenatal life in those who will be an object of a series of technologies of selection, they might be qualified of genocidal policies if we consider the definition of genocide given by United Nations. In consequence, the sanitary agent who takes part without objection in the above mentioned programs promoted by the principal agents, meets turned into a necessary cooperator of the abortion who justifies itself in the supposition of "foetal risk". We can conclude that we are present at an eugenic drift of the prenatal diagnosis that is opposite to the ethical beginning of the medical profession.

  6. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center

    DEFF Research Database (Denmark)

    Tan, YueQiu; Gao, Ya; Lin, Ge

    2016-01-01

    Objective: The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). Method: In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT......-test counseling. Results: In total of 565 cases, NIPT had a failure rate of 0.9% (5/565). Four cases of T21 were identified by NIPT and confirmed by karyotyping, resulting in 100% (95%CI 39.8%-100%) positive predictive value. Among 556 cases with NIPT negative results, 506 cases (91.0%) were confirmed by follow......-up of postnatal phenotypes, while 33 cases (5.9%) had adverse pregnant outcomes with unconfirmed reasons because of the lack of cytogenetic samples. The remaining 17 cases (3.1%) refused follow-up. No false negative result was reported. Conclusion: With apparently high positive predictive value and low false...

  7. Woman abuse and pregnancy outcome among women in Khoram Abad, Islamic Republic of Iran.

    Science.gov (United States)

    Khodakarami, N; Naji, H; Dashti, M G; Yazdjerdi, M

    2009-01-01

    We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women abused, 160 non-abused). Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour (dystocia), premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse.

  8. [Prenatal care and management of hypertension in pregnant women in the public healthcare system in Rio de Janeiro, Brazil].

    Science.gov (United States)

    Vettore, Marcelo Vianna; Dias, Marcos; Domingues, Rosa Maria Soares Madeira; Vettore, Mario Vianna; Leal, Maria do Carmo

    2011-05-01

    The aim of this study was to assess the adequacy of prenatal care for pregnant women with hypertension as compared to those at low risk. Adequate management of hypertension and associated factors were also investigated. A cross-sectional study was conducted with 1,947 women, 187 of whom with hypertension, in public prenatal care units in Rio de Janeiro, Brazil, in 2007-2008. Demographic and socioeconomic data, obstetric history, and information on adequacy of prenatal care were collected using interviews and prenatal care cards. Adequacy of management of hypertension was evaluated according to performance of health professionals and health services and women's individual characteristics. Chi-square and multivariate logistic regression were used to compare groups and identify factors associated with management of hypertension. Adequacy of prenatal care was 79% and did not differ between groups. Only 27% of pregnant women with hypertension received appropriate management, with poor professional performance. Hypertensive pregnant women with better prenatal care were those with previous neonatal deaths and/or stillbirths and those with 35 years of age and older. Despite adequate use of prenatal care, management of hypertension in pregnant women was inadequate.

  9. Socio-economic inequalities in health, habits and self-care during pregnancy in Spain.

    Science.gov (United States)

    Larrañaga, Isabel; Santa-Marina, Loreto; Begiristain, Haizea; Machón, Mónica; Vrijheid, Martine; Casas, Maribel; Tardón, Adonina; Fernández-Somoano, Ana; Llop, Sabrina; Rodriguez-Bernal, Clara L; Fernandez, Mariana F

    2013-09-01

    Socioeconomic disadvantage can be harmful for mother's health and can influence child's health long term. The aim of this study is to analyse social inequalities between pregnant women from four INMA (INfancia y Medio Ambiente) cohorts. The analysis included 2,607 pregnant women recruited between 2004 and 2008 from four INMA cohorts. Data on maternal characteristics were collected through two questionnaires completed in the first and third trimester of pregnancy. The relationship between socioeconomic status (SES) and maternal health, dietary intake, lifestyle habits and self-care related variables was modelled using logistic regression analysis. 33.5 % of women had a university level of education and 47 % had high occupational class. Women with higher SES reported healthier habits, fewer complications during pregnancy, better weight gain control and attended more prenatal appointments than women with lower SES. The risk of sedentary behaviour and passive smoking was higher among women with a lower level of education (OR = 1.7, 95 % CI 1.3-2.2 and OR = 1.6, 95 % CI 1.2-2.3, respectively) and with less skilled occupations (OR = 1.7, 95 % CI 1.4-2.0 and OR = 1.2, 95 % CI 1.0-1.5, respectively). Although both SES indicators-occupation and education-act as social determinants of diet, occupation was a more powerful determinant than education. For other lifestyle and self-caring variables, education was a more powerful predictor than occupation. Social inequalities were observed in health, habits and self-care during pregnancy. Proper care during pregnancy requires the control of common clinical variables and the knowledge of socioeconomic conditions of the pregnant women.

  10. Immigrant mothers and access to prenatal care: evidence from a regional population study in Italy.

    Science.gov (United States)

    Chiavarini, Manuela; Lanari, Donatella; Minelli, Liliana; Pieroni, Luca; Salmasi, Luca

    2016-02-09

    We addressed the question of whether use of adequate prenatal care differs between foreign-born and Italian mothers and estimated the extent to which unobservable characteristics bias results. This study is on primary care and especially on adequate access to prenatal healthcare services by immigrant mothers. Approximately 37,000 mothers of both Italian and foreign nationality were studied. Data were obtained from the Standard Certificate of Live Birth between 2005 and 2010 in Umbria. Estimates from the bivariate probit model indicate that immigrant mothers are three times more likely to make fewer than four prenatal visits (OR=3.35) and 1.66 times more likely to make a late first visit (OR=1.66). The effect is found to be strongest for Asian women. Standard probit models lead to underestimation of the probability of inadequate use of prenatal care services by immigrant women, whereas bivariate probit models, which allow us to consider immigrant status as an endogenous variable, estimated ORs to be three times larger than those obtained with univariate models. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: A population study of 2.6 million pregnancies

    Science.gov (United States)

    Class, Quetzal A.; Lichtenstein, Paul; Långström, Niklas; D'Onofrio, Brian M.

    2011-01-01

    Objective To identify the impact of timing of prenatal stress exposure on offspring risk for shortened gestational age (GA), preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) using a population-based sample. Methods Swedish longitudinal population registries were linked to study all individuals born in Sweden 1973–2004. Prenatal maternal stress exposure was defined as death of the father of the child or first degree relative of the mother. Using linear and logistic regression, timing of stress exposure was examined across pregnancy, by month, and by novel periods created based on month of stress exposure findings. Results A total of 2,618,777 live-born, singleton infants without congenital anomalies were included; 32,286 exposed to prenatal maternal stress. Examining associations between stress exposure and outcome by the month revealed that risk increases mid-gestation, particularly following months 5 and 6. Combining months 1–4, 5 and 6, and 7–9 as potential periods of differing vulnerability, it was found that stress during period 2 (months 5 and 6) was associated with the greatest risk for shortened GA (−0.52 days, SE=0.15, p=0.0006), PTB (OR=1.24, 99% CI=1.08–1.42), LBW (OR=1.38, 99% CI=1.19–1.61), and SGA (OR=1.25, 99% CI=1.05–1.49). Conclusions Risk for shortened GA, PTB, LBW, and SGA are greater following stress exposure during the 5th and/or 6th month of pregnancy. It may be beneficial to refine future analyses to these months. Possible mechanisms include alterations in the hypothalamic-pituitary-adrenal axis and associated stress-responsive molecular regulators. PMID:21321257

  12. Cuidados alternativos en la atención del embarazo en Jalisco, México Alternative care options for pregnancy in Jalisco, Mexico

    Directory of Open Access Journals (Sweden)

    Isabel Valadez

    2003-10-01

    Full Text Available En la atención prenatal se ha identificado la cultura de la madre como factor que influye en la utilización de los servicios de salud. Las creencias y prácticas de medicina tradicional y doméstica que realiza la mujer durante el embarazo pueden intervenir en la decisión de acudir a la atención médica. En una muestra no probabilística de 3.250 mujeres se identificaron los cuidados alternativos de atención al embarazo y se estableció su relación con un control prenatal satisfactorio. Para el análisis de asociación se dividió la variable de atención prenatal en (a satisfactoria y (b no satisfactoria de acuerdo a la Norma Oficial Mexicana. Se empleó la prueba de chi², el odds ratio y sus intervalos de confianza. Los cuidados alternativos resultaron asociados a una atención prenatal no satisfactoria. El entrenamiento psicoprofiláctico se comportó como factor protector. La cultura de la gestante es una configuración de significados y comportamientos, con mezcla de concepciones y prescripciones de la medicina doméstica, tradicional y académica, que varían según la etapa del embarazo, que pueden ser únicas o complementarias. Esta situación debe considerarse en los programas educativos en salud.The mother's culture has been identified as a factor in the use of health services for prenatal care. Beliefs and practices concerning traditional and domestic medicine used by women during pregnancy can play a role in the decision to seek medical care. In a non-probabilistic sample of 3,250 women, alternative care during pregnancy and its relationship to satisfactory prenatal care was studied. To analyze the association, the prenatal care variable was divided into (a satisfactory and (b unsatisfactory, according to a list of official Mexican standards. The chi-square test and odds ratio were applied, with p < 0.05. The association of alternative care with unsatisfactory prenatal care was established. Psycho-prophylactic training for

  13. Comparison of three prenatal risk scores in a series of low-risk pregnancies.

    Science.gov (United States)

    Kelly, R B; Acheson, L S; Zyzanski, S J

    1988-01-01

    Three prepartum obstetrical risk-scoring methods (Goodwin, Halliday, Hobel) were retrospectively applied to a consecutive series of 795 singleton pregnancies. The study population was low risk overall, with a perinatal mortality rate of 11 per 1000 and a primary cesarean section rate of 9.7%. The predictive ability of the scores was tested for individual outcomes as well as for a "combined measure" designed to group outcomes of clinical interest. Outcome variables examined included labor arrests, need for augmentation of labor, fetal heartrate abnormalities during labor, selection of or transfer to a more intensive level of care, indicated forceps delivery, cesarean section, resuscitation, Apgar scores, permanent injury, and perinatal deaths. Along with expected differences in sensitivity and specificity, there were differences among the three scores in performance as measured by positive and negative predictive value. Goodwin's system performed somewhat better overall. All three systems performed better in multiparous than in primiparous patients, but primiparas experienced more adverse outcomes.

  14. Key Concepts in Pregnancy of Unknown Location: Identifying Ectopic Pregnancy and Providing Patient-Centered Care.

    Science.gov (United States)

    Fields, Loren; Hathaway, Alison

    2017-03-01

    Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL. In some cases, the location of the pregnancy is never determined and the PUL is categorized as resolving or persisting. Evidence suggests expectant management is a safe and effective approach for most women with PUL and should be the mainstay of care. However, in the case of persisting PUL, continued concern for ectopic pregnancy remains. Strategies for deciding when to intervene when a woman has a PUL are reviewed. A variety of clinical tools, including serum beta human chorionic gonadotropin (β-hCG), repeat ultrasonography, dilation and curettage (D&C), and empiric methotrexate therapy are discussed. Finally, a proposal is made that women with persisting PUL can be presented with the option of choosing expectant management, diagnostic D&C, or empiric methotrexate treatment. © 2016 by the American College of Nurse-Midwives.

  15. Taking Care of Yourself Before Pregnancy

    Science.gov (United States)

    ... serious neural tube defects (NTDs): spina bifida and anencephaly. Both occur very early in pregnancy (as early ... before many women even know they’re pregnant.Anencephaly is when a baby is born without the ...

  16. Prenatal diagnostic procedures used in pregnancies with congenital malformations in 14 regions of Europe

    NARCIS (Netherlands)

    Garne, E; Loane, M; de Vigan, C; Scarano, G; de Walle, H; Gillerot, Y; Stoll, C; Addor, MC; Stone, D; Gener, B; Feijoo, M; Mosquera-Tenreiro, C; Gatt, M; Queisser-Luft, A; Baena, N; Dolk, H

    2004-01-01

    Objective To investigate outcomes of ultrasound investigations (US) and invasive diagnostic procedures in cases of congenital malformations (CM), and to compare the use of invasive prenatal test techniques (amniocentesis (AC) versus chorionic villus sampling (CVS)) among European populations. Design

  17. Prenatal care in a primary healthcare center for imprisoned pregnant women

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Silva Fochi

    2014-06-01

    Full Text Available This experience report aimed to describe the prenatal care undertaken in a primary care center in the non-metropolitan area of the State of São Paulo, offered to the female prison population. The data and related information refer to the period June 2010 – June 2012. The article describes the construction of the work process by the local team, the dynamics of providing the attendance, the human resources involved and the consultations undertaken. The prenatal care provided to the pregnant women made it possible to investigate the pluralized universe of imprisoned women and their needs resulting from the condition of being pregnant in the prison environment. Thus, decent attendance to the prison population’s health - a human and constitutional right - is considered important, so as to avoid physical, emotional and social problems, which in the pregnant woman may be passed on to her child.

  18. [Analysis of prenatal follow-up strategies for trisomy 21 affected pregnancies in France].

    Science.gov (United States)

    Dupont, J-M; Simon-Bouy, B; Zebina, A; Pessione, F; Royère, D; Doco-Fenzy, M

    2017-03-01

    The main objective of this study was to screen the prenatal follow-up of women with live birth trisomy 21 child in order to evaluate the proportion of prenatal screening failure versus cases where the women refused either the screening or the prenatal diagnosis of Down syndrome. This study covers the period of time from 2009 to 2012 when the national prenatal screening policy changed from second to first trimester and allows for a comparative assessment of the nationwide efficiency of the various maternal serum marker based strategies. All authorized cytogenetic laboratories sent required data for all cases of trisomy 21 diagnosed in FRANCE in new-borns (less than 1-year-old) from January 2010 to July 2013. A total of 1253 cases of trisomy 21 were diagnosed before 1 year of age whose mother did not had prenatal diagnosis. For 861 of them, information on the prenatal follow-up was available, with 72% of cases where a prenatal screening was organized either by maternal serum marker or by ultrasound. Results of the screening strategy was positive with maternal serum marker in 28% of cases (calculated risk≥1/250), positive because of abnormal ultrasound in 5% and negative with maternal marker screening (whatever the strategy used) in 67% of cases. Detection rate over the period of the study was 82%, with similar efficiency of first and second trimester strategies (83%) but significantly lower with sequential association of first trimester Nuchal translucency measurement and second trimester serum screening (70%). Switching from second trimester to first trimester screening strategy, with as many trisomy 21 foetuses diagnosed with half invasive procedures fulfilled national health policy objectives. Analysis of these data gives useful insights to elaborate a future screening policy involving cell-free foetal DNA sequencing. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Non-western women in maternity care in the Netherlands: Exploring 'inadequate' use of prenatal care and the experiences of care professionals

    NARCIS (Netherlands)

    Boerleider, A.W.

    2015-01-01

    Non-western women in the Netherlands are more likely to make inadequate use of prenatal care than native Dutch women. Furthermore, non-western women are diverse in origin which implies diversity in their needs and expectations for maternity care. This thesis examines the factors and reasons

  20. As dimensões do cuidado pré-natal na consulta de enfermagem Las dimensiones del cuidado prenatal en la consulta de enfermería The dimensions of prenatal care embodied in nursing consultation

    Directory of Open Access Journals (Sweden)

    Helena Eri Shimizu

    2009-06-01

    Full Text Available O estudo teve como objetivos analisar as representações sociais das gestantes acerca da gestação e a atenção recebida na consulta de enfermagem do pré-natal. Foram realizadas entrevistas semi-estruturadas com quinze gestantes, que foram analisados com o auxílio do software ALCEST. Identificaram-se três eixos temáticos: a vivência da gravidez, constituída pelas classes: o impacto e as mudanças provocadas pela gravidez, as orientações recebidas sobre a gravidez com as classes percepção da consulta de enfermagem e do planejamento familiar e os cuidados com o bebê com as classes como cuidar do recém nascido e como garantir uma boa amamentação. A consulta de enfermagem abarca as dimensões psicossociais dos cuidados com a gestante e com recém-nascido.Esto estudio objectivó analizar las representaciones sociales de las gestantes acerca de la atención recibida en la consulta de enfermería del prenatal. Estudio cualitativo de la atención recibida, realizado por medio de entrevistas semi-estructuradas y analizadas con auxilio del software ALCEST, con quince gestantes atendidas en la consulta de enfermería del programa de prenatal. Se identificaron tres ejes temáticos: la vivencia del embarazo, constituida por las clases: el impacto y los cambios provocados por el embarazo; las orientaciones recibidas sobre el embarazo, con las clases: percepción de la consulta de enfermería y del planeamiento familiar; y el los cuidados del bebé, con las clases: cómo cuidar al recién nacido y cómo garantizar un buen amamantamiento. La consulta de enfermería abarca diversas dimensiones psicosocial tanto de los cuidados durante la gestación como con el recién nacido.This study aimed at analyzing the social representation of pregnant women about pregnancy, regarding care provided in nursing consultations during the prenatal period. A qualitative study conducted by semi-structured interviews, with fifteen pregnant women at the nursing

  1. Use of different criteria to assess inadequate prenatal care: a population-based study in Southern Brazil

    National Research Council Canada - National Science Library

    Saavedra, Janaina Salomão; Cesar, Juraci A

    2015-01-01

    This study measured the prevalence of inadequate prenatal care and identified associated factors using different criteria in postpartum women in Rio Grande, Rio Grande do Sul State, Brazil, in 2010...

  2. The impact of national prenatal screening on the time of diagnosis and outcome of pregnancies affected with common trisomies, a cohort study in the Northern Netherlands

    NARCIS (Netherlands)

    Bouman, Katelijne; Bakker, Marian K.; Birnie, Erwin; ter Beek, Lies; Bilardo, Caterina M.; van Langen, Irene M.; de Walle, Hermien E. K.

    2017-01-01

    Background: To evaluate the impact of the introduction of prenatal screening on time of detection and pregnancy outcome for trisomy 21 (T21), trisomy 18 (T18) and trisomy 13 (T13). Methods: We performed a retrospective, population-based cohort study in the Northern Netherlands including 503 trisomy

  3. The impact of national prenatal screening on the time of diagnosis and outcome of pregnancies affected with common trisomies, a cohort study in the Northern Netherlands

    NARCIS (Netherlands)

    Bouman, Katelijne; Bakker, Marian K.; Birnie, Erwin; ter Beek, Lies; Bilardo, Caterina M.; van Langen, Irene M.; de Walle, Hermien E. K.

    2017-01-01

    Background: To evaluate the impact of the introduction of prenatal screening on time of detection and pregnancy outcome for trisomy 21 (T21), trisomy 18 (T18) and trisomy 13 (T13). Methods: We performed a retrospective, population-based cohort study in the Northern Netherlands including 503 trisomy

  4. Prenatal Evaluation of MicroRNA Expressions in Pregnancies with Down Syndrome

    Directory of Open Access Journals (Sweden)

    Biray Erturk

    2016-01-01

    Full Text Available Background. Currently, the data available on the utility of miRNAs in noninvasive prenatal testing is insufficient in the literature. We evaluated the expression levels of 14 miRNAs located on chromosome 21 in maternal plasma and their utility in noninvasive prenatal testing of Down Syndrome. Method. A total of 56 patients underwent invasive prenatal testing; 23 cases were carrying Down Syndrome affected fetuses, and 33 control cases carrying unaffected, normal karyotype fetuses were included for comparison. Indications for invasive prenatal testing were advanced maternal age, increased risk of Down Syndrome in screening tests, and abnormal finding in the sonographic examination. In both the study and control groups, all the pregnant women were at 17th and 18th week of gestation. miRNA expression levels were measured using real-time RT-PCR. Results. Significantly increased maternal plasma levels of miR-3156 and miR-99a were found in the women carrying a fetus with Down Syndrome. Conclusion. Our results provide a basis for multicenter studies with larger sample groups and microRNA profiles, particularly with the microRNAs which were found to be variably expressed in our study. Through this clinical research, the utility of microRNAs in noninvasive prenatal testing can be better explored in future studies.

  5. Pregnancy Outcome following Prenatal Diagnosis of Chromosomal Anomaly: A Record Linkage Study of 26,261 Pregnancies

    National Research Council Canada - National Science Library

    Jacobs, Myrthe; Cooper, Sally-Ann; McGowan, Ruth; Nelson, Scott M; Pell, Jill P

    2016-01-01

    ... and terminated with chromosomal anomalies. However, we are unaware of any population studies examining pregnancy terminations after diagnosis of chromosomal anomalies that has included all aneuploidies and the influence of maternal factors...

  6. Drivers of Prenatal Care Quality and Uptake of Supervised Delivery ...

    African Journals Online (AJOL)

    of supervised delivery services continues to be low due partly to poor quality of antenatal care (ANC). Aim: The .... At the time of conducting the study, average ... equipment and logistics are nominally available, it offers minimal confidence for ...

  7. Prior illicit drug use and missed prenatal vitamins predict nonadherence to antiretroviral therapy in pregnancy: adherence analysis A5084.

    Science.gov (United States)

    Cohn, Susan E; Umbleja, Triin; Mrus, Joseph; Bardeguez, Arlene D; Andersen, Janet W; Chesney, Margaret A

    2008-01-01

    Adherence to antiretroviral therapy (ART) in pregnancy is crucial to optimize its efficacy and minimize mother-to-child transmission. Our objective was to examine adherence patterns to ART and health behaviors during and after pregnancy among HIV-positive women enrolled in A5084, a prospective, observational, multisite study. Between 2002-2005, HIV-infected women between 20 and 34 weeks'gestation completed at least 1 self-reported adherence questionnaire antepartum (AP), and were followed through 12 weeks' postpartum (PP). Questionnaires also addressed tobacco, alcohol, and illicit drugs use. Adherence was defined as reporting not having missed any doses for more than 3 months. Exact McNemar's tests were used for paired binary data and exact logistic regression was used for predictors of nonadherence. We report on 149 women (55% black, 26% Hispanic, 32% less than 25 years, 9% with AIDS, 100% on ART). PP, 31 (21%) women stopped ART and 18 (12%) withdrew from the study. AP, 57% reported adherence to ART and PP, 45% (p = 0.03, n = 87). AP, 11% reported ongoing alcohol use and 23% tobacco use compared to 37% and 30% PP (p vitamins had 4.84 times higher odds (p = 0.001) of ART nonadherence. Women reporting a history of illicit drug use and/or having missed prenatal vitamins should be targeted for programs to enhance adherence to ART during pregnancy.

  8. The effect of prenatal and postnatal care on childhood obesity.

    Science.gov (United States)

    Seipel, Michael M O; Shafer, Kevin

    2013-07-01

    Childhood obesity continues to be a major public health problem in the United States. If this problem is unresolved, some children will be at risk for disorders such as type 2 diabetes, high blood pressure, and cancer and will become a high economic and social burden for society. Using the National Longitudinal Survey of Youth, Child and Young Adult sample (N = 6,643), this study examined the relationship between the effect of pre- and postnatal characteristics and obesity. The findings of this study show that the probability of childhood obesity can be lessened if pregnant women do not smoke and do not gain significant pregnancy-related weight. Moreover, breast feeding and health insurance were also found to be correlated to avoiding childhood obesity.

  9. Prenatal distress in Turkish pregnant women and factors associated with maternal prenatal distress.

    Science.gov (United States)

    Yuksel, Fatma; Akin, Semiha; Durna, Zehra

    2014-01-01

    To assess: (1) the prenatal distress level in Turkish pregnant women and (2) to examine the association between prenatal maternal distress and personal and pregnancy-specific factors. Pregnant women experience stress originating from a variety of pregnancy-specific issues, including physical symptoms and changes, changes in body image, physiological, social and emotional changes, parenting concerns, changes in relationships with significant others, medical problems, anxiety about labour and delivery, concerns about birth and the baby's health. A descriptive cross-sectional study. This study was conducted at a gynaecology clinic of a private hospital in Istanbul, Turkey within a 12-month period. The study sample comprised 522 pregnant women continuing their regular visits for prenatal care. Pregnancy Description Form and Turkish Version of Revised Version of Prenatal Distress Questionnaire [(NUPDQ)-17 Item Version] were used for data collection. Study sample was moderately distressed. Turkish pregnant women were mostly distressed and concerned about premature delivery, having an unhealthy baby, labour and delivery, feeling tired and having low energy during pregnancy. Prenatal distress in Turkish pregnant women was associated with personal and pregnancy-related characteristics. This study found that pregnant women need to be supported emotionally, physically and socially. A better understanding of prenatal maternal distress could assist in informing healthcare professionals about the provision of physically, emotionally, socially and behaviourally appropriate support for achieving a healthy pregnancy. It is crucial for pregnant women to be regularly assessed and educated for dealing successfully with concerns and fears about prenatal period, birth and postnatal period and about difficulties that women may encounter during their pregnancy. © 2013 Blackwell Publishing Ltd.

  10. Prenatal, Perinatal, and Neonatal Risk Factors for Specific Language Impairment: A Prospective Pregnancy Cohort Study

    Science.gov (United States)

    Whitehouse, Andrew J. O.; Shelton, W. M. R.; Ing, Caleb; Newnham, John P.

    2014-01-01

    Purpose: Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Method: Participants were members of the Raine Study, a prospective cohort…

  11. Prenatal, Perinatal, and Neonatal Risk Factors for Specific Language Impairment: A Prospective Pregnancy Cohort Study

    Science.gov (United States)

    Whitehouse, Andrew J. O.; Shelton, W. M. R.; Ing, Caleb; Newnham, John P.

    2014-01-01

    Purpose: Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Method: Participants were members of the Raine Study, a prospective cohort…

  12. Epidemiological profile of pregnant women and prenatal care quality in a healthcare center in Porto Alegre, Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Rosa Maria Teixeira Gomes

    2013-03-01

    Full Text Available Objective: To understand the profile and assess the quality of care received by pregnant women, who gave birth in 2008, attending the Panorama healthcare centre (HC in Porto Alegre, Rio Grande do Sul state (RS. Methods: A cross-sectional survey was carried out using pre-codified questionnaires applied at households and HCs investigating the mothers’ demographic reproductive characteristics and the healthcare received during antenatal period and delivery. Analysis consisted of frequency distribution of variables and their mean, median and standard deviations. Results: Amongst the 238 women interviewed, 20% were teenagers, 38% had at least nine years of schooling, three quarters were living with a partner and 40% had a paid job during gestational period; a quarter had family income of a minimum wage (average of US$ 350/month. Regarding their reproductive health, on average, menarche occurred at 13 years old, sexual intercourse started at 16 years old, 25% had already had an abortion and, by 19 years old, 60% had already given birth. Concerning prenatal care, 87% attended at least six medical appointments, three quarters started prenatal care in the first trimester of pregnancy and 85% received tetanus vaccine and iron supplementation during antenatal period. According to the Kessner Index modified by Takeda and Silveira, the antenatal care was considered adequate for 80% and 49% of all pregnant women, respectively. Conclusion: Panorama HC attends socioeconomic deprived pregnant women that started early antenatal care, performing a high amount of medical appointments, but, in general, the healthcare quality offered both during prenatal and delivery was unsatisfactory.

  13. Studies on the prenatal toxicity of toluene in rabbits following inhalation exposure and proposal of a pregnancy guidance value

    Energy Technology Data Exchange (ETDEWEB)

    Klimisch, H.J.; Hellwig, J. (BASF AG, Ludwigshafen am Rhein (Germany). Abt. fuer Toxikologie); Hofmann, A. (Merck (E.), Darmstadt (Germany). Inst. fuer Toxikologie)

    1992-07-01

    Prenatal toxicity of toluene was determined in two separate studies by inhalation exposure of Himalayan rabbits. In the first study 15 artificially inseminated females per group were exposed to 30, 100, or 300 ppm and in the second study 20 artificially inseminated females per group inhaled 100 or 500 ppm. In each case the rabbits were exposed for 6 hours per day from day 6 post-insemination (p.i.) to day 18 p.i. The respective controls inhaled conditioned clean air under the same exposure conditions. No signs of maternal toxicity were observed. All data obtained on gestational parameters were found to be within the variation range reported for this rabbit strain. The fetal external, soft tissue and skeletal findings, were seen in toluene exposed fetuses in a frequency similar to the corresponding and/or historical controls. Differences observed between the groups were not concentration dependent and were considered incidental rather than compound related. Therefore, toluene was not embryotoxic, fetotoxic, or teratogenic for rabbits exposed during the period of organogenesis. The highest concentration tested under these conditions (500 ppm) was found to be a no-observable-adverse-effect level (NOAEL) for both the adult and the fetal Himalayan rabbit. Based on these and previous results of animal studies of prenatal toxicity, a safety or uncertainty factor approach is considered for setting limits of exposure for women at workplaces. A pregnancy guidance value of 20 ppm is proposed. (orig.).

  14. How ADN students can learn prenatal (healthy) care.

    Science.gov (United States)

    Cranmer, J; Lajkowicz, C

    1989-01-01

    This article describes the problem-solving steps of how an unsupervised clinical experience can be successfully implemented at the ADN level so that large numbers of students can meet traditional clinical objectives in a nontraditional manner. Learning experiences covered are: patient teaching, interviewing, care planning - coordinated with theories of learning and program philosophy/purpose.

  15. Prenatal control of Hb Bart's disease in mainland China: can we do better?

    Science.gov (United States)

    He, Ping; Yang, Yu; Li, Ru; Li, Dong-Zhi

    2014-01-01

    The aim of the present study was to report a 3-year experience on the prenatal control of Hb Bart's (γ4) disease in Mainland China. All pregnancies with fetal Hb Bart's disease were included from January 2011 to December 2013. The main clinical characteristics of the affected pregnancies were reviewed, including maternal reproductive history, prenatal care in the current pregnancy, the gestation of pregnancy at the time of booking, the gestation at the time of prenatal diagnosis (PND), and the complications associated with the pregnancy. A total of 246 cases of fetal Hb Bart's disease were identified during the study period; among these, 177 (72.0%) were diagnosed in early gestation (≤24 weeks), and 69 (28.0%) in late gestation. Most (87.0%) of the patients presenting in late pregnancy had late or no prenatal care. Twenty (29.0%) had major obstetrical complications in patients presenting in late pregnancy, and five (5.0%) in patients presenting in relatively early pregnancy. The delay in PND deprived couples of opportunities to make informed decisions early in pregnancy. Efforts for designing and targeting strategies to improve the timeliness of prenatal care are urgently needed.

  16. Self-care practices developed by pregnant women in a prenatal outpatient clinic

    Directory of Open Access Journals (Sweden)

    Sueli Riul da Silva

    2014-12-01

    Full Text Available The objective of this descriptive, cross-sectional, quantitative study was to examine self-care practices developed by pregnant women in a prenatal outpatient clinic. Ninety-nine pregnant women participated. The survey was conducted in a public outpatient clinic in Minas Gerais. A questionnaire was administered. The responses were analyzed using descriptive statistics. The results indicated greater self-care in relation to consumption of toxic substances (alcohol and drugs, hygiene, rest and nutrition. Others, such as physical exercise, wearing sunscreen and breast care were not deemed as priorities by the participants. Most reported receiving self-care guidance from health professionals, especially physicians and nurses. Defining the nature of the theme could contribute to the reorganization of health services, in order to provide better strategies for delivering quality care to pregnant women, especially the development of educational practices. doi: 10.5216/ree.v16i4.21779.

  17. The Association between Prenatal Yoga and the Administration of Ritodrine Hydrochloride during Pregnancy: An Adjunct Study of the Japan Environment and Children's Study.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Kawanishi

    Full Text Available While the beneficial effects of prenatal yoga have been reported in recent years, little is known about its effectiveness in pregnant Japanese women. Despite several adverse effects, ritodrine hydrochloride is frequently prescribed to suppress preterm labor in Japan, and its usage may therefore indicate cases of preterm labor. This study aimed to clarify the association between prenatal yoga and ritodrine hydrochloride use during pregnancy.An observational study was conducted as an adjunct study by the Hokkaido unit of the Japan Environment and Children's Study. Information on prenatal yoga practice was collected using a self-questionnaire between March 21, 2012, and July 7, 2015, targeting women who had recently delivered. Ritodrine hydrochloride use was identified from medical records. A total of 2,692 women were analyzed using logistic regression models that adjusted for possible confounders.There were 567 (21.1% women who practiced prenatal yoga, which was associated with a lower risk of ritodrine hydrochloride use (adjusted odds ratio [OR] 0.77; 95% CI 0.61-0.98. This was especially evident in women with a total practice duration that exceeded 900 minutes throughout their pregnancy (adjusted OR 0.54; 95% CI 0.38-0.76. A sensitivity analysis that excluded patients with threatened abortion during the study period produced similar results.Prenatal yoga was associated with a lower risk of ritodrine hydrochloride use, particularly in women with more than 900 minutes of practice time over the course of their pregnancy. Prenatal yoga may be a beneficial option for pregnant women in the selection of alternative therapies.

  18. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    Iatrogenic twinning has become the main side-effect assisted reproduction treatment. We have evaluated the evidence for additional care that assisted-reproduction twins may require compared with spontaneous twins. Misacarriages are increased in women with tubal problems and after specific treatments. Assisted-reproduction twin pregnancies complicated by a vanishing twin after 8 weeks have an increased risk of preterm delivery and of low and very low birthweight compared with singleton assisted-reproduction pregnancies. Monozygotic twin pregnancies occur at a higher rate after assisted reproduction treatment and are associated with a higher risk of perinatal complications. The incidence of placenta praevia and vasa praevia is increased in assisted-reproduction twin pregnancies. Large cohort studies do not indicate a higher rate of fetal congenital malformations in assisted-reproduction twins. Overall, assisted-reproduction twins in healthy women assisted-reproduction twins is only increased in women with a pre-existing medical condition such as hypertensive disorders and diabetes and most of these risks can be avoided with single-embryo transfer. Following the birth of the first IVF baby, rumours started to spread in both the medical literature and the media about the long-term health effects for children born following assisted reproduction treatment. However, after more than 30 years, the most common complications associated with IVF treatment remain indirect and technical such as the failure of treatment and ovarian hyperstimulation. Iatrogenic twinning has become the main side-effect of assisted reproduction treatment and the increasing number of twin pregnancies, in particular in older women, has generated numerous debates on the need for additional healthcare provision. In this review, we have evaluated the evidence for additional care that assisted-conception twin pregnancies may require compared with spontaneous twin pregnancies. Twin pregnancies are

  19. Affordable Care Act standards for race and ethnicity mask disparities in maternal smoking during pregnancy.

    Science.gov (United States)

    Hawkins, Summer Sherburne; Cohen, Bruce B

    2014-08-01

    This study compared maternal smoking during pregnancy between the new Patient Protection and Affordable Care Act (ACA) data collection standards and Federal Office of Management and Budget (OMB) standards. Data were from the Massachusetts Standard Certificate of Live Births on 1,156,472 babies from 1996 to 2010. A parent reported whether the mother smoked during pregnancy (yes/no), her race (5 options) and, separately, her ethnicity (39 categories). Prenatal smoking rates were compared between the ACA and OMB standards. Detailed ethnicity from the birth certificate was then examined within all broad categories of the ACA standards: White, Black/African American, Other Hispanic, Other Asian/Pacific Islander, and Other categories. For Hispanic/Latina and Asian mothers, the ACA standards captured the variability in smoking across and within racial/ethnic groups more than the OMB standards. However, for White and Black/African American mothers, the broad ACA categories masked striking differences in prenatal smoking. While the overall prevalence among Whites was 10.2%, this ranged from 0.8% for Iranians to 21.0% for Cape Verdeans. Among Black/African Americans (7.6%), this ranged from 0.5% for Nigerians to 12.9% for African Americans. The ACA standards also combined ethnic groups with sizeable populations into Other Hispanics and Other Asian/Pacific Islanders. When population health surveys and other reporting tools are being revised, state and federal agencies should consider expanding all race/ethnicity categories to capture detailed ethnicity on everyone. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Prenatal Testing: Is It Right for You?

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week Prenatal testing, including screening and diagnostic tests, can provide valuable information about your baby's ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-testing/art- ...

  1. Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study.

    Science.gov (United States)

    Nwebube, Chineze; Glover, Vivette; Stewart, Lauren

    2017-05-08

    Prenatal anxiety and depression are distressing for the expectant mother and can have adverse effects on her fetus and subsequently, her child. This study aimed to determine whether listening to specially composed songs would be an effective intervention for reducing symptoms of prenatal anxiety and depression. Pregnant women were recruited online and randomly assigned to one of two groups: the music group (daily listening to specially composed songs) or control group (daily relaxation) for 12 weeks each. Self-report questionnaires were used to assess symptoms of State and Trait anxiety (Spielberger) and depression (Edinburgh Postnatal Depression Scale (EPDS)). Trait anxiety was measured as the primary outcome, while State anxiety and depression were the secondary outcomes. 111 participants were randomised to each group. 20 participants in the intervention group and 16 participants in the active control group completed the study. The music group demonstrated lower Trait Anxiety (p = .0001) (effect size 0.80), State Anxiety (p = .02) (effect size 0.64), and EPDS (p = .002) (effect size 0.92) scores at week 12 compared to baseline, by paired t test. There were no such changes in the control group. Though this pilot study had high levels of attrition, the results do suggest that regular listening to relaxing music should be explored further as an effective non-pharmacological means for reducing prenatal anxiety and depression. ClinicalTrials.gov NCT02776293 LV-001. Registered 17 May 2016. Retrospectively registered.

  2. Atenção pré-natal em Pelotas, Rio Grande do Sul, Brasil, 1993 Prenatal care in Pelotas, Rio Grande do Sul, Brazil, 1993

    Directory of Open Access Journals (Sweden)

    Ricardo Halpern

    1998-07-01

    Full Text Available Todos os 5304 nascimentos ocorridos nos hospitais de Pelotas, RS, em 1993, foram estudados. As crianças foram examinadas e suas mães entrevistadas através de um questionário estruturado, onde foram levantadas informações sobre condições demográficas, sócio-econômicas, história reprodutiva e assistência pré-natal. Quase a totalidade das mulheres (95% realizou acompanhamento durante a gestação. O número médio de consultas foi de 7 e a maioria das mulheres (85% iniciou o pré-natal antes do quinto mês de gestação. A ausência ao pré-natal foi maior entre as mulheres mais pobres, na maioria adolescentes ou com idade acima de 40 anos. A incidência de baixo peso ao nascer, no grupo que não fez pré-natal, foi de 2,5 vezes maior comparado com as mães que realizaram cinco ou mais consultas. Da mesma forma o coeficiente de mortalidade perinatal foi três vezes maior (50,6/1000 entre as mães que não realizaram pré-natal e aquelas que consultaram 5 ou mais vezes (15,8/1000. Em relação ao risco gestacional que as mães apresentavam, o estudo mostrou uma inversão nos cuidados, já que um quarto das mulheres de alto risco receberam uma atenção pré-natal considerada adequada, enquanto esta proporção era menos de 10% nas mães de risco gestacional mais baixo. Este estudo sugere a necessidade de modificações no atendimento pré-natal, com estratégias bem definidas para aquelas pacientes com alto risco gestacional.All 5304 births in the hospitals of Pelotas, Rio Grande do Sul, Brazil in 1993 were studied. Neonates were examined and their mothers were interviewed regarding sociodemographic conditions, family income, reproductive health, and medical care during pregnancy. Ninety-five per cent of women received prenatal care. The mean number of physician visits during pregnancy was 7 and the majority of the women (84.7% began visits before the fifth month of pregnancy. Women who did not receive prenatal care were from the

  3. [Strategies for development, follow-up, and assessment of care provided to women in the pregnancy-postnatal cycle].

    Science.gov (United States)

    Holanda, Cristyanne Samara Miranda de; Alchieri, João Carlos; Morais, Fátima Raquel Rosado; Maranhão, Técia Maria de Oliveira

    2015-06-01

    To describe the development of a questionnaire for assessment of prenatal, birth, and postnatal care (Inventário de Avaliação da Assistência ao Pré-natal, Parto e Puerpério, IAAPPP), which was designed taking into consideration the experience of users of a public obstetric service. This mixed methods research was performed in the city of Caicó, state of Rio Grande do Norte, Brazil. The study consisted of two phases: in phase 1, focal groups were organized with 19 users of the health care system for identification of relevant issues for assessment of the pregnancy-postnatal cycle. The first draft of the questionnaire was also designed and tested for validity with seven of the 19 focal group participants; a second draft was produced and retested. In phase 2, the intra-class correlation coefficient was calculated to determine reproducibility. A pilot test was carried out to determine the applicability of the survey and the final version of the IAAPPP was developed. Based on the focal group discussions, the inventory was organized into four domains: 1) socioeconomic information, 2) obstetric history, 3) description of current obstetric experience and 4) assessment of follow-up. Domains 3 and 4 were subdivided into prenatal care, birthcare, postnatal care, and pregnancy-postnatal cycle. The answers of the women who evaluated the instrument for domain 4 were strongly correlated (>0.8), indicating reproducibility of the IAAPPP. The methodological model allowed us to identify needs and demands of women in the pregnancy-postnatal cycle, and allowed us to design a questionnaire that can be applied to other regions with similar sociocultural characteristics.

  4. Prenatal care utilization in Mississippi: racial disparities and implications for unfavorable birth outcomes.

    Science.gov (United States)

    Cox, Reagan G; Zhang, Lei; Zotti, Marianne E; Graham, Juanita

    2011-10-01

    The objective of the study is to identify racial disparities in prenatal care (PNC) utilization and to examine the relationship between PNC and preterm birth (PTB), low birth weight (LBW) and infant mortality in Mississippi. Retrospective cohort from 1996 to 2003 linked Mississippi birth and infant death files was used. Analysis was limited to live-born singleton infants born to non-Hispanic white and black women (n = 292,776). PNC was classified by Kotelchuck's Adequacy of Prenatal Care Utilization Index. Factors associated with PTB, LBW and infant death were identified using multiple logistic regression after controlling for maternal age, education, marital status, place of residence, tobacco use and medical risk. About one in five Mississippi women had less than adequate PNC, and racial disparities in PNC utilization were observed. Black women delayed PNC, received too few visits, and were more likely to have either "inadequate PNC" (P care" (P inadequate PNC compared to white women. Regardless of race, "no care" and "inadequate PNC" were strong risk factors for PTB, LBW and infant death. We provide empirical evidence to support the existence of racial disparities in PNC utilization and infant birth outcomes in Mississippi. Further study is needed to explain racial differences in PNC utilization. However, this study suggests that public health interventions designed to improve PNC utilization among women might reduce unfavorable birth outcomes especially infant mortality.

  5. Implementation of an electronic genomic and family health history tool in primary prenatal care.

    Science.gov (United States)

    Edelman, Emily A; Lin, Bruce K; Doksum, Teresa; Drohan, Brian; Edelson, Vaughn; Dolan, Siobhan M; Hughes, Kevin S; O'Leary, James; Galvin, Shelley L; Degroat, Nicole; Pardanani, Setul; Feero, W Gregory; Adams, Claire; Jones, Renee; Scott, Joan

    2014-03-01

    "The Pregnancy and Health Profile," (PHP) is a free genetic risk assessment software tool for primary prenatal providers that collects patient-entered family (FHH), personal, and obstetrical health history, performs risk assessment, and presents the provider with clinical decision support during the prenatal encounter. The tool is freely available for download at www.hughesriskapps.net. We evaluated the implementation of PHP in four geographically diverse clinical sites. Retrospective chart reviews were conducted for patients seen prior to the study period and for patients who used the PHP to collect data on documentation of FHH, discussion of cystic fibrosis (CF) and hemoglobinopathy (HB) carrier screening, and CF and HB interventions (tests, referrals). Five hundred pre-implementation phase and 618 implementation phase charts were reviewed. Documentation of a 3-generation FHH or pedigree improved at three sites; patient race/ethnicity at three sites, father of the baby (FOB) race/ethnicity at all sites, and ancestry for the patient and FOB at three sites (P < 0.001-0001). CF counseling improved for implementation phase patients at one site (8% vs. 48%, P < 0.0001) and CF screening/referrals at two (2% vs. 14%, P < 0.0001; 6% vs. 14%; P = 0.05). Counseling and intervention rates did not increase for HB. This preliminary study suggests that the PHP can improve documentation of FHH, race, and ancestry, as well as the compliance with current CF counseling and intervention guidelines in some prenatal clinics. Future evaluation of the PHP should include testing in a larger number of clinical environments, assessment of additional performance measures, and evaluation of the system's overall clinical utility.

  6. Human prenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Filkins, K.; Russo, R.J.

    1985-01-01

    The multiauthor text is written as a ''guide to rationalize and clarify certain aspects of diagnosis, general counseling and intervention'' for ''health professionals who provide care to pregnant women.'' The text is not aimed at the ultrasonographer but rather at the physicians who are clinically responsible for patient management. Chapters of relevance to radiologists include an overview of prenatal screening and counseling, diagnosis of neural tube defects, ultrasonographic (US) scanning of fetal disorders in the first and second trimesters of pregnancy, US scanning in the third trimester, multiple gestation and selective termination, fetal echo and Doppler studies, and fetal therapy. Also included are overviews of virtually all currently utilized prenatal diagnostic techniques including amniocentesis, fetal blood sampling, fetoscopy, recombinant DNA detection of hemoglobinopathies, chorionic villus sampling, embryoscopy, legal issues, and diagnosis of Mendelian disorders by DNA analysis.

  7. Female farmworkers' health during pregnancy: health care providers' perspectives.

    Science.gov (United States)

    Kelley, Maureen A; Flocks, Joan D; Economos, Jeannie; McCauley, Linda A

    2013-07-01

    Pregnant farmworkers and their fetuses are at increased risk of negative health outcomes due to environmental and occupational factors at their workplaces. Health care providers who serve farm communities can positively affect workers' health through the informed care they deliver. Yet, interviews with rural health care providers reveal limited knowledge about agricultural work or occupational and environmental health risks during pregnancy. Professional associations, government organizations, academic institutions, and practice settings must renew their efforts to ensure that environmental and occupational health education, especially as it relates to women and their children, is incorporated into academic and practice environments.

  8. PRENATAL DIAGNOSIS IN ORGANIC ACIDEMIA

    Directory of Open Access Journals (Sweden)

    Hedieh SANEIFARD

    2012-03-01

    Full Text Available Organic acidemias are the group of metabolic disorders which define by high anion gap metabolic acidosis, hypo or hyperglycemia & hyperammonemia.Because of the severity of disease in children and its fatality in severe form of disease and also need for life long treatment, prenatal diagnosis is an important diagnostic tool.Three approaches to prenatal diagnosis may be possible, including measurement of analytes in amniotic fluid or use of cells obtained by Choronic Villus sampling (CVS or amniocentesis to either assay enzyme activity or extract DNA for molecular genetic testing.Biochemical genetic testing: Prenatal diagnosis for pregnancies at increased risk for propionic acidemia, methylmalonic acidemia, biotin-unresponsive3-methylcrotonyl-CoA carboxylase deficiency, glutaric acidemia type 1, ketothiolase deficiency, methylmalonic aciduria and homocystinuria, cblC type, and isovaleric acidemia is possible by analysis of amniotic fluid if highly accurate quantitative methods are used to measure the appropriate analytes. Amniocentesis is usually performed at approximately 15 to 18 weeks gestation.Prenatal diagnosis for pregnancies at increased risk for MSUD is possible by measurement of enzyme activity in fetal cells obtained by chorionic villous sampling(CVS at approximately ten to 12 weeks gestation or amniocentesis usually performed at approximately 15 to 18 weeks gestation.(If cells from CVS are used, extreme care must be taken to assure that they are fetal rather than maternal cells.Molecular genetic testing:Prenatal diagnosis for pregnancies at increased risk for all disorders is possible by analysis of DNA extracted from fetal cells obtained by amniocentesis usually performed at approximately 15 to 18 weeks of gestation or chorionic villous sampling (CVS at approximately ten to 12 weeks of gestation. Both disease-causing allels of an affected family member must be identified before prenatal testing.Preimplantation genetic diagnosis (PGD

  9. Zorg rond zwangerschap, bevalling en kraambed in Wageningen 1979 [Care for pregnancy, delivery, childbed in city of Wageningen 1979

    NARCIS (Netherlands)

    Brouwer, M.

    1981-01-01

    Description of situation concerning care of pregnancy, childbirth and childbed in Wageningen, the Netherlands. Diagnosis of pregnancy / supervision of pregnancy ( zwangerschapsbegeleiding ) / place of delivery / maternity home / controls of pregnancy / gymnastics course for parents / evaluation of

  10. Zorg rond zwangerschap, bevalling en kraambed in Wageningen 1979 [Care for pregnancy, delivery, childbed in city of Wageningen 1979

    NARCIS (Netherlands)

    Brouwer, M.

    1979-01-01

    Description of situation concerning care of pregnancy, childbirth and childbed in Wageningen, the Netherlands. Diagnosis of pregnancy / supervision of pregnancy ( zwangerschapsbegeleiding ) / place of delivery / maternity home / controls of pregnancy / gymnastics course for parents / evaluation of p

  11. A Longitudinal Study of Changes in Prenatal Care Utilization Between First and Second Births and Low Birth Weight.

    Science.gov (United States)

    Loftus, Christine T; Stewart, Orion T; Hensley, Mark D; Enquobahrie, Daniel A; Hawes, Stephen E

    2015-12-01

    Because previous analyses of prenatal care (PNC) utilization and risk of low birth weight (LBW) may have been influenced by selection bias, we conducted a study using longitudinal data of women with repeat pregnancies. We analyzed Washington State birth certificates of first and second live births (2003-2012). We estimated relative risk (RR) of LBW at second birth associated with Kotelchuck Index PNC level among women stratified by level of PNC in their first birth (n = 67,571). Among women with inadequate PNC prior to their first birth (n = 10,355), women with intermediate or adequate PNC before their second birth (n = 7464) had a reduced risk of LBW (adjusted RR 0.61, 95% CI: 0.48, 0.78) compared to those whose PNC level remained inadequate. Likewise, among women with intermediate or adequate PNC prior to their first birth (n = 57,216), those with inadequate PNC before the second birth (n = 7095) had higher risk of LBW (adjusted RR 1.59, 95% CI: 1.36, 1.85) compared to those who remained at intermediate or adequate PNC. Our findings support the hypothesis that PNC decreases LBW risk at second birth, independent of factors related to the utilization of PNC at first birth.

  12. 患精神疾病孕妇的产前护理%Prenatal Care to Pregnant Women Mental Illness

    Institute of Scientific and Technical Information of China (English)

    陈艳红

    2014-01-01

    探讨患有精神疾病患者的产前护理方式。患有精神疾病者来自外界一些不稳定危险因素。如院家庭、生活及社会。还有自身对妊娠的认识不足等综合因素。可能影响孕妇顺利分娩。所以制定切实可行的护理模式对顺利分娩至关重要。%To investigate the prenatal care of patients with mental disorders. Those with mental disorders from the outside of some unstable factors. Such as: family, life and society,and the lack of understanding of the comprehensive factors such as pregnancy. Pregnant women may af ect the smooth delivery. So the development of nursing model feasible is essential to the smooth delivery.

  13. Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

    Science.gov (United States)

    Earnshaw, Valerie; Lewis, Jessica B.; Kershaw, Trace S.; Magriples, Urania; Stasko, Emily; Rising, Sharon Schindler; Cassells, Andrea; Cunningham, Shayna; Bernstein, Peter; Tobin, Jonathan N.

    2016-01-01

    Objectives. We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes. Methods. We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008–2012). We analyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys. Results. In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change. PMID:26691105

  14. Primary healthcare worker knowledge related to prenatal and immediate newborn care: a cross sectional study in Masindi, Uganda.

    Science.gov (United States)

    Ayiasi, Richard Mangwi; Criel, Bart; Orach, Christopher Garimoi; Nabiwemba, Elizabeth; Kolsteren, Patrick

    2014-02-11

    Global neonatal mortality remains unacceptably high. Health workers who attend to prenatal and postnatal mothers need to be knowledgeable in preventive and curative care for pregnant women and their newborn babies. This study aimed to determine the level of knowledge related to prenatal and immediate newborn care among primary healthcare workers in Masindi, Uganda. A cross-sectional study was conducted. Interviews comprised of 25 multiple-choice questions were administered to health workers who were deployed to offer prenatal and postnatal care in Masindi in November 2011. Questions were related to four domains of knowledge: prenatal care, immediate newborn care, management of neonatal infections and identifying and stabilizing Low-Birth Weight (LBW) babies. Corresponding composite variables were derived; level of knowledge among health workers dichotomized as 'adequate' or 'inadequate'. The chi-square statistic test was used to examine associations with independent variables including level of training (nursing assistant, general nurse or midwife), level of care (hospital/health centre level IV or health centre level III/II) and years of service (five years or less, six years or more). 183 health workers were interviewed: general nurses (39.3%), midwives (21.9%) and nursing assistants (38.8%). Respectively, 53.6%, 46.5%, 7.1% and 56.3% were considered to have adequate knowledge in prenatal care, newborn care, management of neonatal infections and identifying/stabilizing LBW babies. Being a general nurse was significantly associated with having adequate knowledge in identifying and stabilizing LBW babies (p care being hospital/health centre level IV was not significantly associated with having adequate knowledge in prenatal or newborn care with reference to health centres of level III/II. Knowledge regarding prenatal and newborn care among primary healthcare workers in Masindi was very low. The highest deficit of knowledge was in management of neonatal infections

  15. Prenatal diagnostics in TESA/PESA pregnancies in Denmark 1995-2007: a shift from invasive procedures to nuchal translucency examination

    DEFF Research Database (Denmark)

    Fedder, Jens; Erb, Karin; Humaidan, Peter

    2011-01-01

    Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction of the pr......Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction...... of the procedure in 1995 until December 2007. Four hundred and fifty pregnancies resulted in the birth of 553 children. Of the Danish subpopulation 115 (34.2%) received nuchal translucency examination (NT) and 43 (12.8%) received invasive prenatal diagnostics (IPD). IPD was carried out in 11 out of 23 couples (48...

  16. Culture in Prenatal Development: Parental Attitudes, Availability of Care, Expectations, Values, and Nutrition

    Science.gov (United States)

    Bravo, Irene M.; Noya, Melissa

    2014-01-01

    Background: Culture is a universal phenomenon, but most interest about culture during pregnancy has focused on medical care, neglecting psychological aspects of normative development. Objective: The purpose of this article was to examine normative gestational experiences using the framework of a broaden and build model of culture, positive…

  17. Culture in Prenatal Development: Parental Attitudes, Availability of Care, Expectations, Values, and Nutrition

    Science.gov (United States)

    Bravo, Irene M.; Noya, Melissa

    2014-01-01

    Background: Culture is a universal phenomenon, but most interest about culture during pregnancy has focused on medical care, neglecting psychological aspects of normative development. Objective: The purpose of this article was to examine normative gestational experiences using the framework of a broaden and build model of culture, positive…

  18. Effect of iron content on the tolerability of prenatal multivitamins in pregnancy

    Directory of Open Access Journals (Sweden)

    Einarson Tom R

    2008-05-01

    Full Text Available Abstract Background Gastrointestinal irritability can deter pregnant women from starting or continuing prenatal multivitamin supplementation. In a previous study, suboptimal tolerability was observed among pregnant women taking a large tablet (18 mm × 8 mm × 8 mm multivitamin with high elemental iron content (60 mg as ferrous fumarate. The objective of the present study was to compare rates of adherence and reported adverse events among pregnant women who were randomized to commence supplementation with a small-tablet prenatal multivitamin, containing either low or high iron content. Methods Pregnant women who called the Motherisk Program (Hospital for Sick Children, Toronto and had not started taking or had discontinued any multivitamin due to adverse events were included in this prospective, randomized, open-label, 2-arm study. Women were randomized to take a small-size (16 mm × 9 mm × 4 mm, low elemental iron content (35 mg as ferrous fumarate multivitamin ('35 mg' group; or a small-size (5 mm radius, 5 mm thickness, high elemental iron content (60 mg as ferrous sulphate multivitamin ('60 mg' group. Follow-up interviews documented pill intake and adverse events. Rates of adherence and adverse events were compared between groups using chi-squared tests and Kaplan-Meier survival curves. Results Of 167 randomized women, 92 in the '35 mg' group and 75 in the '60 mg' group were included in the analysis. Despite ideal conditions and regular follow-ups, mean adherence based on pill intake recall, in both groups was approximately 50%. No statistically significant difference was detected in proportions of women who actually started taking either multivitamin. Among those who started, no difference was detected in rates of adherence or reported adverse events. Conclusion The present results suggest that iron content is not a major determinant of adherence to prenatal multivitamins. Combined with our previous study, tablet size may be the more

  19. What is patient-centered care really? Voices of Hispanic prenatal patients.

    Science.gov (United States)

    Bergman, Alicia A; Connaughton, Stacey L

    2013-01-01

    Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients' voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients' understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling.

  20. Prenatal care according to the NOM-007 norm, which relates to maternal morbidity in a health center in San Luis Potosí (2008

    Directory of Open Access Journals (Sweden)

    Lucila P. Acosta R

    2012-02-01

    Full Text Available Mother and child mortality reflects the level of social and economic development of a country; therefore, reproductive health is a sanitary priority. Mortality prevention depends directly on the coverage and quality of health services. Objective: to assess the compliance of prenatal care with the NOM 007 norm and its correlation with maternal morbidity in a health center located in San Luis Potosí, Mexico. Methodology: a descriptive, correlational, and quantitative study in which the units of analysis were the medical records of 571 pregnant women cared for during 2008. In order to prove the hypothesis, Pearson’s r was used. The p value was ≤ 0.05. Results: ages ranged from 13 to 43 years. Additionally, 37.1% of the patients were teenagers and 44.3 % began receiving attention during the second trimester of their pregnancy; 38.2 % attended at least five medical appointments, and 46.4 % had morbidity. For the latter group, urinary infection was the most common condition (224 cases. Prenatal attention was adequate in 2.6 % of the cases according to the actions performed. Health promotion actions were the least frequent. Conclusion: the level of compliance with the NOM 007 norm for prenatal care was considered inadequate in 97.4 % of the cases and was consistent with maternal morbidity (87.5-100 %. This could be related to more frequent appointments for some women and with late treatment, which resulted in less time to perform said actions. Contrary to expectations, greater compliance meant higher maternal morbidity (r = 0.318, p < 0.000.

  1. Prenatal Diagnosis of Non-Syndromic Congenital Heart Defects

    Science.gov (United States)

    Ailes, Elizabeth C.; Gilboa, Suzanne M.; Riehle-Colarusso, Tiffany; Johnson, Candice Y.; Hobbs, Charlotte A.; Correa, Adolfo; Honein, Margaret A.

    2015-01-01

    Objectives Congenital heart defects (CHDs) occur in nearly 1% of live births. We sought to assess factors associated with prenatal CHD diagnosis in the National Birth Defects Prevention Study (NBDPS). Methods We analyzed data from mothers with CHD-affected pregnancies from 1998–2005. Prenatal CHD diagnosis was defined as affirmative responses to questions about abnormal prenatal ultrasounds and/or fetal echocardiography obtained during a structured telephone interview. Results Fifteen percent (1,097/7,299) of women with CHD-affected pregnancies (excluding recognized syndromes and single-gene disorders) reported receiving a prenatal CHD diagnosis. Prenatal CHD diagnosis was positively associated with advanced maternal age, family history of CHD, type 1 or type 2 diabetes, twin or higher order gestation, CHD complexity and presence of extracardiac defects. Prenatal CHD diagnosis was inversely associated with maternal Hispanic race/ethnicity, prepregnancy overweight or obesity, and pre-existing hypertension. Prenatal CHD diagnosis varied by time to NBDPS interview and NBDPS study site. Conclusions Further work is warranted to identify reasons for the observed variability in maternal reports of prenatal CHD diagnosis and the extent to which differences in health literacy or health system factors such as access to specialized prenatal care and/or fetal echocardiography may account for such variability. PMID:24222433

  2. Pulmonary Hypertension in Pregnancy: Critical Care Management

    OpenAIRE

    Bassily-Marcus, Adel M.; Carol Yuan; John Oropello; Anthony Manasia; Roopa Kohli-Seth; Ernest Benjamin

    2012-01-01

    Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Im...

  3. Prenatal psychosocial risk assessment using event history calendars with Black women.

    Science.gov (United States)

    Munro, Michelle L; Dahlem, Chin Hwa Y; Lori, Jody R; Martyn, Kristy K

    2012-01-01

    To explore the clinical acceptability and perceptions of use of a prenatal event history calendar (EHC) for prenatal psychosocial risk assessment in Black pregnant women. A qualitative descriptive study focused on interviews and prenatal EHCs completed by Black pregnant women. Inner city hospital prenatal care clinic in Southeastern Michigan. Thirty 18-35 year old pregnant Black women receiving prenatal care at the participating clinic. Women completed the prenatal EHCs and their perceptions of its use were obtained through face to face interviews. The constant comparative method of analysis (Glaser, 1978, 1992) revealed themes from participants' descriptions about use of a prenatal EHC for prenatal psychosocial risk assessment. Three main themes emerged describing how the prenatal EHC enhanced communication. The prenatal EHC provided "an opening" for disclosure, "an understanding with you," and a way for providers to "know you, your life, and future plans." The participants' completed prenatal EHCs included information regarding their pre-pregnancies, trimester histories, and future plans. These completed prenatal EHCs showed patterns of change in life events and behaviors that included worries, stressors, and risk behaviors. The participants perceived the prenatal EHC as an easy to use tool that should be used to improve communication with health care providers. The prenatal EHC allows the patient and provider to "start on the same page" and provides an additional avenue for discussion of sensitive psychosocial issues with Black pregnant women. As a clinical tool, the prenatal EHC facilitated patient-provider communication for pregnant women often marked by health disparities. The prenatal EHC is a clinically acceptable tool to assess for psychosocial risk factors of Black women in a prenatal clinical setting. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  4. Pulmonary Hypertension in Pregnancy: Critical Care Management

    Directory of Open Access Journals (Sweden)

    Adel M. Bassily-Marcus

    2012-01-01

    Full Text Available Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

  5. Prenatal depressive symptoms and abnormalities of glucose tolerance during pregnancy among Hispanic women.

    Science.gov (United States)

    Ertel, Karen A; Silveira, Marushka; Pekow, Penelope; Braun, Barry; Manson, JoAnn E; Solomon, Caren G; Markenson, Glenn; Chasan-Taber, Lisa

    2014-02-01

    The aim of this study is to prospectively examine the association between maternal depressive symptoms in early pregnancy and risk of abnormal glucose tolerance (AGT) and impaired glucose tolerance (IGT) in mid-pregnancy. We evaluated this association among 934 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. Depressive symptoms were assessed in early pregnancy using the 10-item Edinburgh Postnatal Depression Scale. Scores ≥13 indicated at least probable minor depression and scores ≥15 indicated probable major depression. AGT and IGT were diagnosed using American Diabetes Association criteria. In early pregnancy, 247 (26.5 %) participants experienced at least minor depression and 163 (17.4 %) experienced major depression. A total of 123 (13.2 %) were classified with AGT and 56 (6.0 %) were classified with IGT. In fully-adjusted models, the odds ratio for AGT associated with minor depression was 1.20 (95 % CI 0.77-1.89) and for major depression was 1.34 (95 % CI 0.81-2.23). The odds ratio for IGT associated with minor depression was 1.22 (95 % CI 0.62-2.40) and for major depression was 1.53 (95 % CI 0.73-3.22). We did not observe an association with continuous screening glucose measures. Findings in this prospective cohort of Hispanic women did not indicate a statistically significant association between minor or major depression in early pregnancy and AGT or screening glucose values in mid-pregnancy. Due to the small number of cases of IGT, our ability to evaluate the association between depression and IGT risk was constrained.

  6. Smoking during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  7. Cystic Fibrosis and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  8. Pregnancy Complications: Chlamydia

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  9. Pregnancy Complications: Syphilis

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  10. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  11. Abuse during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  12. Radiation and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  13. Mercury and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  14. Pregnancy Complications: Gonorrhea

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  15. Alcohol during Pregnancy

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    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  16. Pregnancy Complications: Salmonellosis

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  17. Pregnancy Complications: Genital Herpes

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  18. Street Drugs and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  19. Pregnancy week by week

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  20. Getting Fit Before Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  1. Heroin and Pregnancy

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    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  2. Prescription Opioids during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  3. Weight Gain during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  4. Cravings during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  5. The need to include obstetric nurses in prenatal care visits in the public health system

    Directory of Open Access Journals (Sweden)

    Selma Aparecida Lagrosa Garcia

    2010-06-01

    Full Text Available Objective: To investigate, with a qualitative approach, the role of Obstetric Nurses at the primary level of care given to women’s health as a vital component of the multidisciplinary team, which today is fundamental for providing care, prevention as well as health education and promotion, especially in programs whose activities are geared towards primary care of pregnant, parturient, and puerpera women. Methods: Brazilian laws and the determinations of Nursing Councils in reference to the activities of the obstetric nurse were researched, including the nurse’s responsibilities and limits. The bibliographic search was conducted in health-related journals, lay publications, and the Internet. Results: The conflicts between professional physicians and nurses were discussed. Conclusions: It was concluded that the activities of the nurse, conducting low-risk prenatal clinical visits in the basic healthcare network, has legal and ethical support and provides true benefit to the clients.

  6. Working Towards Safe Motherhood: Delays and Barriers to Prenatal Care for Women in Rural and Peri-Urban Areas of Georgia.

    Science.gov (United States)

    Meyer, Erika; Hennink, Monique; Rochat, Roger; Julian, Zoë; Pinto, Meredith; Zertuche, Adrienne D; Spelke, Bridget; Dott, Andrew; Cota, Pat

    2016-07-01

    Objectives Georgia has the highest rate of maternal mortality in the United States, and ranks 40th for infant mortality. The Georgia Maternal and Infant Health Research Group was formed to investigate and address the shortage of obstetric care providers outside the Atlanta area. Because access to prenatal care (PNC) can improve maternal and infant health outcomes, we used qualitative methods to identify the access barriers experienced by women who live in rural and peri-urban areas of the state. Methods We conducted semi-structured, in-depth interviews with 24 mothers who gave birth between July and August 2013, and who live in either shortage or non-shortage obstetric care service areas. We also conducted key informant interviews with four perinatal case managers, and analyzed all data using applied thematic analysis. We then utilized Thaddeus and Maine's "Three Delays to Care" theoretical framework structure to describe the recognized barriers to care. Results We identified delays in a woman's decision to seek PNC (such as awareness of pregnancy and stigma); delays in accessing an appropriate healthcare facility (such as choosing a doctor and receiving insurance coverage); and delays in receiving adequate and appropriate care (such as continuity of care and communication). Moreover, many participants perceived low self-worth and believed this influenced their PNC exchanges. Conclusion As a means of supporting Georgia's pregnant women who face barriers and delays to PNC, these data provide a rationale for developing contextually relevant solutions to both mothers and their providers.

  7. Is the Presence of the Father of the Baby during First Prenatal Ultrasound Study Visit Associated with Improved Pregnancy Outcomes in Adolescents and Young Adults?

    Science.gov (United States)

    Lazebnik, Rina; Kuper-Sassé, Margaret

    2016-01-01

    This study examined whether the presence of the father of the baby (FOB) at the first prenatal ultrasound study (US) visit of pregnant adolescents and young adults (AYA) is a marker for improved pregnancy outcomes. Charts of 400 pregnant AYA aged 14–22 years seen at an academic maternity hospital were assessed retrospectively for support persons brought to prenatal US visits. Logistic regression analysis was used to examine the association between FOB presence and gestational age and birth weight. Of 400 charts with support person recorded, 298 charts with first US visit data, singleton birth, and complete gestational data available were analyzed. FOB was present at 30.2% of visits, while the parent of the mother was present at 34.2% of visits. With FOB present, 3.3% of infants were born preterm (gestational age < 37 weeks) compared with 10.5% of infants with FOB absent (p = 0.04). Patients with FOB present also had significantly earlier gestational age at the first US visit (15 weeks) than those who did not (19 weeks; p = 0.02). For AYA, the presence of FOB at initial prenatal US visits is a predictor of improved pregnancy outcome and likely represents increased support during the pregnancy.

  8. Fatores preditivos de hipertensão gestacional em adolescentes primíparas: análise do pré-natal, da MAPA e da microalbuminúria Predictive factors for pregnancy hypertension in primiparous adolescents: analysis of prenatal care, ABPM and microalbuminuria

    Directory of Open Access Journals (Sweden)

    Regina Coeli Marques de Carvalho

    2006-10-01

    sensibilidade de 80% e especificidade de 60% para o desenvolvimento de HG. CONCLUSÃO: A pesquisa de fatores de preditividade de HG em adolescentes primíparas se demonstrou de fácil aplicabilidade e útil para estratificar gestantes de alto risco no desenvolvimento de HG.OBJECTIVE: To quantify PH prevalence in primiparous adolescents; define predictive factors for the occurrence of PH and its impact on newborns. METHODS: We followed 29 primiparous adolescents from the prenatal period through the 12th week of the puerperium, with a mean of sixteen years of age, served at the Outpatient Facility for Adolescents of Maternidade Escola Assis Chateaubriand (MEAC of Universidade Federal do Ceará (Fortaleza, Brazil. The pregnant adolescents were divided into two groups, that is, those who remained normotensive (Group I and those who developed PH (Group II. The variables investigated in the assessment of the value of predictability for the development of PH were anthropometric measures, socioeconomic aspects, smoking habit, inheritance for SAH (father/mother, prenatal tests requested in the first prenatal care visit in addition to microalbuminuria and ambulatory blood pressure monitoring (ABPM in the 28th week of gestation. The pregnant adolescents were followed up at delivery and late puerperium (12th week after the puerperium. The newborns to the mothers included in our study were assessed at birth according to the Apgar score and the Capurro method, for weight, height and perinatal hypoxia. RESULTS: The prevalence of PH was 51.7%. Inheritance for SAH presented the highest predictive value for PH with an odds ratio of 10.99. Diastolic arterial pressure equal to or above 70 mmHg at the gestational age of 35 weeks was statistically significant as a predictive value for PH. At ABPM we found a predictive value for PH: diastolic pressure load during alertness, diastolic and systolic pressure load during night sleep, pressure variability and maximum diastolic pressure during sleep

  9. Determinants of inadequate weight gain in pregnancy.

    Science.gov (United States)

    Popa, Alina Delia; Niţă, Otilia; Popescu, Raluca Maria; Gherasim, Andreea; Arhire, Lidia luliana; Mihalache, Laura; Graur, Mariana

    2014-01-01

    The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Vodă Obstetrics and Gynecology Clinical Hospital, Iaşi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.

  10. Explanatory factors for first and second-generation non-western women’s inadequate prenatal care utilisation: a prospective cohort study.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Stenus, C.M.V. van; Wiegers, T.A.; Feijen-de Jong, E.I.; Spelten, E.R.; Devillé, W.L.J.M.

    2015-01-01

    Background: Little research into non-western women’s prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women’s prenatal care utilisation and its explanatory factors according to generational status.

  11. Explanatory factors for first and second-generation non-western women’s inadequate prenatal care utilisation: a prospective cohort study.

    NARCIS (Netherlands)

    Boerleider, A.W.; Manniën, J.; Stenus, C.M.V. van; Wiegers, T.A.; Feijen-de Jong, E.I.; Spelten, E.R.; Devillé, W.L.J.M.

    2015-01-01

    Background: Little research into non-western women’s prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women’s prenatal care utilisation and its explanatory factors according to generational status. Me

  12. Prenatal care: difficulties experienced by nurses Atención prenatal: dificultades vivenciadas por las enfermeras Assistência pré-natal: dificuldades vivenciadas pelas enfermeiras

    Directory of Open Access Journals (Sweden)

    Leila Maria Geromel Dotto

    2006-10-01

    Full Text Available This study aimed to identify the difficulties nurses experience at the start of their professional life in prenatal care activities. Data were collected through interviews with 25 nurses who accompanied prenatal care in the basic health network of Rio Branco-AC, Brazil and were grouped according to the frequency and level of difficulty they mentioned. We observed that nurses did not demonstrate difficulties in a series of important prenatal care activities at the start of their professional life. However, they reported different levels of difficulties in other activities. Furthermore, the participants pointed out difficulties in activities that require knowledge (knowing as well as abilities (know-how. This study also indicated flaws in undergraduate formation with respect to prenatal care, involving theoretical aspects as well as exclusively practical activities.La finalidad de este estudio fue identificar las dificultades vividas por las enfermeras en el inicio de su vida profesional, en las actividades relacionadas con la atención prenatal. Los datos fueron recopilados a través de entrevistas con 25 enfermeras que acompañaban el prenatal en la red básica de salud del municipio de Rio Branco-AC, Brasil, y fueron agrupados según la frecuencia y el grado de dificultad mencionado por ellas. Constatamos que las enfermeras no presentaron dificultades en una serie de actividades importantes en la atención prenatal, en el inicio de su vida profesional. Sin embargo, relataron que enfrentaron dificultades en otras. Estas dificultades se mostraron como siendo de diferentes grados. Señalaron dificultades en actividades que exigen conocimientos (saber, y también en actividades que necesitan de habilidades (saber-hacer. El estudio todavía indicó fallas en la formación de pregrado respecto a la atención al prenatal, tanto para aspectos teóricos como para actividades exclusivamente prácticas.Este estudo teve como objetivo identificar as

  13. Prenatal Diagnosis of Cantrell's Pentalogy Associated with Agenesis of Left Limb in a Twin Pregnancy

    Science.gov (United States)

    Cakiroglu, Yigit; Doger, Emek; Babaoglu, Kadir; Caliskan, Eray; Yucesoy, Gulseren

    2014-01-01

    Pentalogy of Cantrell is a rare malformation described in the literature. We report a case of pentalogy of Cantrell associated with left limb deficiency in a twin pregnancy. The fetus with multiple anomalies revealed kyphosis, ectopia cordis, and a large defect with protruding liver and bowel loops at 12 weeks and 3 days of gestational age on ultrasound scan. The other fetus was ultrasonographically normal. We diagnosed a case of pentalogy of Cantrell in a twin pregnancy after exclusion of limb body wall complex, body stalk anomaly, and amniotic band syndrome and after delivery of the fetuses. Macroscopic examinations were ectopia cordis, extrusion of the abdominal organs without membranes surrounding, and agenesis of the left limb. PMID:24782934

  14. Representing and intervening: 'doing' good care in first trimester prenatal knowledge production and decision-making

    DEFF Research Database (Denmark)

    Schwennesen, Nete; Koch, Lene

    2012-01-01

    attention to the active engagement of health professionals in this process. Current professional and policy debate over the use of prenatal testing emphasises the need for informed choice making and for services that provide prospective parents with what is referred to as 'non-directive counselling...... modes of 'doing' good care: attuning expectations and knowledge, allowing resistance and providing situated influence in the relationship between the pregnant woman and the professional. Such practices may not be seen as immediately compatible with the non-directive ethos, but they express ways...... of reducing emotional suffering and supporting a pregnant woman's ability to make meaningful choices on the basis of uncertain knowledge. As such, these practices can be seen as representing another (caring) solution to the problem of paternalism and authoritarian power. In opposition to an ethics aiming...

  15. How racial and ethnic groupings may mask disparities: the importance of separating Pacific Islanders from Asians in prenatal care data.

    Science.gov (United States)

    Sarnquist, Clea C; Grieb, Erin Moix; Maldonado, Yvonne A

    2010-07-01

    To understand racial/ethnic differences in prenatal care receipt among Pacific Islanders and Asians, who are often combined into a single A/PI category. Retrospective, population-based data were collected by the Vital Statistics branch of the California Department of Health Services. Approximately 2.6 million records of all live California births with a birth certificate in 2000-2004 were included. Analysis focused on prenatal care receipt and population characteristics associated with lack of adequate prenatal care, especially among Asian and Pacific Islander groups. Pacific Islanders (n = 11,962) were the most likely, compared to any other racial/ethnic group, to have inadequate prenatal care (OR = 2.9, 95% CIs 2.8-3.1), even when controlling for factors known to affect care receipt, specifically maternal age, educational attainment, parity, insurance, geographical region of residence, and maternal place of birth. In contrast, Asian women (n = 295,741) received care closer to that of the White reference group (OR = 1.5, 95% CIs 1.5-1.5). Among Pacific Islanders, Samoans (OR = 3.0, 95% CIs 2.7-3.4) were at particular risk of inadequate care compared to other PI sub-groups. Pacific Islander women received less adequate prenatal care than women of other racial/ethnic groups. The common practice of combining Asians and Pacific Islanders into a single A/PI category may mask needs in the Pacific Islander community. Therefore, in order to continue to reduce health disparities, it may be necessary to collect separate data on these two distinct populations in order to be able to appropriately direct programs and resources.

  16. [Post-renal transplant pregnancy: a project to plan carefully].

    Science.gov (United States)

    Trubian, Alessandra; Zaza, Gianluca; Rugiu, Carlo; Tomei, Paola; Lupo, Antonio

    2012-01-01

    Kidney transplant is the best treatment for end-stage renal disease (ESRD) as it improves the quality of life and reduces the mortality risk for most patients compared with maintenance dialysis. Additionally, evidence from the literature suggests that renal function, endocrine status and libido rapidly improve after kidney transplant, and one in 50 women of childbearing age become pregnant. Therefore, it seems clear that pregnancy after transplant is a great challenge for physicians involved in this field. The available information on pregnancy outcomes is largely derived from case reports and single-center series, which are unlikely to be representative. Moreover, poor results are less likely to be reported. Many of the reports on long-term outcome show the results of past medical, obstetric, and neonatal care, which may be very different from current practice. Attempts are being made to provide more up-to-date, representative data through national transplantation pregnancy registries. A great number of researchers worldwide have analyzed the biological and endocrinological machinery associated with this event. Additionally, several strategies have been introduced to avoid unplanned pregnancies and to minimize maternal and fetal complications in renal transplant recipients. It seems evident that the return to fertility soon after transplant is often associated with unplanned pregnancy, which can expose both mother and fetus to considerable risks. This underpins the necessity to recommend contraceptive counseling and start clinical follow-up in order to early identify possible pregnancy-related risk factors. In general, pregnancy should not be recommended within the first year after kidney transplant because the risk of acute rejection is greatest and immunosuppressive therapy the most aggressive. It should be planned when organ function and immunosuppressive therapy are stabilized and there is no sign of rejection, hypertension, or chronic infection. Additionally

  17. Prospective recruitment of women receiving prenatal care from diverse provider arrangements: a potential strategy.

    Science.gov (United States)

    Handler, A; Rosenberg, D; Johnson, T; Raube, K; Kelley, M A

    1997-09-01

    This study describes the use of a Medicaid managed care list to prospectively recruit into a research project pregnant women receiving care from a variety of providers. A list of women enrolled in Medicaid managed care was used to recruit pregnant African-American and Latina women into a study of prenatal care satisfaction. Due to privacy concerns, the researchers were not able to directly access names from the list. Instead, a managed care contract agency sent recruitment letters to 1009 pregnant African-American and Latina Medicaid recipients. Response rates by ethnicity and several other key variables are calculated. The biases associated with this method of recruiting pregnant women from a variety of providers are discussed. Thirty-five percent of the women contacted returned consent forms and agreed to have researchers approach them; the response rate for African-American women was 43% and for Latinas was 29% (p providers. While the use of a prospectively generated list of pregnant Medicaid recipients to recruit low-income pregnant women into a research study may be associated with some selection bias, the potential cost savings, decreased effort, and diminished recall bias may make their use a feasible sampling alternative, particularly when the researcher desires to recruit women seeking care from a variety of provider arrangements.

  18. Prenatal meditation influences infant behaviors.

    Science.gov (United States)

    Chan, Ka Po

    2014-11-01

    Meditation is important in facilitating health. Pregnancy health has been shown to have significant consequences for infant behaviors. In view of limited studies on meditation and infant temperament, this study aims to explore the effects of prenatal meditation on these aspects. The conceptual framework was based on the postulation of positive relationships between prenatal meditation and infant health. A randomized control quantitative study was carried out at Obstetric Unit, Queen Elizabeth Hospital in Hong Kong. 64 pregnant Chinese women were recruited for intervention and 59 were for control. Outcome measures were cord blood cortisol, infant salivary cortisol, and Carey Infant Temperament Questionnaire. Cord blood cortisol level of babies was higher in the intervention group (pmeditation can influence fetal health. Carey Infant Temperament Questionnaire showed that the infants of intervention group have better temperament (pmeditation in relation to child health. Present study concludes the positive effects of prenatal meditation on infant behaviors and recommends that pregnancy care providers should provide prenatal meditation to pregnant women.

  19. [Use of different criteria to assess inadequate prenatal care: a population-based study in Southern Brazil].

    Science.gov (United States)

    Saavedra, Janaina Salomão; Cesar, Juraci A

    2015-05-01

    This study measured the prevalence of inadequate prenatal care and identified associated factors using different criteria in postpartum women in Rio Grande, Rio Grande do Sul State, Brazil, in 2010. A standardized questionnaire was applied within 24 hours after delivery to all mothers of children born in the two local hospitals. We used the chi-square test to compare proportions and Poisson regression with robust variance in the multivariate analysis. The study interviewed 2,395 mothers (97.2% of the total). The rates of inadequate prenatal care were 28%, 27%, and 58% according to the criteria proposed by Takeda, Coimbra et al., and Silveira et al., respectively, with large differences across categories. Poor mothers showed the highest prevalence ratio for inadequate prenatal care. After adjustment, nearly all the model's variables were significantly associated with inadequate care according to the Takeda and Coimbra et al. criteria, but few were associated when the Silveira et al. criteria were used. The study showed that the criteria proposed by Silveira et al. were more robust, and that it is necessary to improve quality of prenatal care, especially for poor mothers.

  20. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil - ECCAGE study

    Directory of Open Access Journals (Sweden)

    Nunes Maria A

    2010-08-01

    Full Text Available Abstract Background Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. Methods/Design This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. Discussion This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available

  1. Healthy Pregnancies. Healthy Moms, Healthy Kids: A Series on Maternal and Child Health in Colorado

    Science.gov (United States)

    Colorado Children's Campaign, 2011

    2011-01-01

    A woman's behaviors during pregnancy can have a significant influence on her baby's healthy development. Women who smoke or drink alcohol during pregnancy, go without prenatal care or suffer from poor nutrition are more likely to experience complications during pregnancy or childbirth, and their babies are at increased risk for developing a number…

  2. Inadequate Utilization of Prenatal Care Services, Socioeconomic Status, and Educational Attainment Are Associated with Low Birth Weight in Zimbabwe.

    Science.gov (United States)

    Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael; Shah, Vaibhav

    2017-01-01

    Globally, low birth weight (LBW) remains a leading cause of neonatal and infant mortality and poses significant challenges toward the progress of achieving infant mortality-related goals. Experience from developed countries shows that two major causes of LBW (premature delivery and intrauterine growth restriction) can be averted to a great extent by adequate utilization of maternal health-care services, during pregnancy. In this study, we attempt to measure the prevalence of LBW in Zimbabwe and explore the association between adequate utilization of prenatal care (PNC) services and LBW in Zimbabwe. We also explore other possible associations with LBW. This study was based on nationally representative, cross-sectional data from Multiple Indicator Cluster Survey round 5, conducted in 2014. Participants included 3,221 mothers from both rural and urban areas. The participants were selected regardless of their current pregnancy status. Sample characteristics were presented using descriptive statistics. Association between utilization status of ANC and LBW was measured by chi-square (bivariate) test and logistic regression methods. Prevalence of LBW was 12.8%. There was 11% reduction in the odds of having LBW babies for participants from urban area when compared with rural area (AOR = 0.897; 95% CI = 0.707-1.138). When compared to women with higher education, those having primary/below primary and secondary level qualification had higher odds of experiencing LBW babies by 73 and 56%, respectively. Participants who had less than four PNC/ANC visits had 34% higher odds (AOR = 1.340; 95% CI = 1.065-1.685) than those with at least four visits, and those who had given birth more than once, had 38% lower odds (AOR = 0.620; 95% CI = 0.493-0.780) of giving birth to LBW babies when compared to those who had given birth only once. The findings of this study have programmatic and policy implications for low-resource nations and suggest that promoting access

  3. Pregnancy outcome after genetic counselling for prenatal diagnosis of unexpected chromosomal anomaly.

    Science.gov (United States)

    Clementi, Maurizio; Di Gianantonio, Elena; Ponchia, Rossella; Petrella, Marilena; Andrisani, Alessandra; Tenconi, Romano

    2006-01-01

    Couples undergoing invasive prenatal diagnosis (PD) are informed and concerned mainly about autosomal trisomies. However, unexpected chromosomal abnormalities (UCA) are a frequent finding at PD. We have analysed the psychological and practical consequences in the couples counselled in our centre because of the identification of foetal UCA at PD. The study was carried out on a sample of 52 couples referred for genetic counselling in the period 1997-2000. The couples underwent a structured interview and two self-report instruments to measure anxiety and psychological characteristics. The couples have been divided into three groups: (1) low risk - without or with negligible risk, (2) mild risk - with mild risk or mild clinical phenotype and (3) sex chromosome anomaly. All couples received the diagnosis of chromosomal anomaly from the obstetrician without any other comments and were referred to our service for genetic counselling. Most couples felt fear (11/17 in the LR group, 5/7 in the MR group and 12/21 in the SCA group), while sadness was lower frequently felt by those parents-to-be in the LR group. Our study suggests that a specific counselling that mentions the possibility of UCA is mandatory before PD, and the cost-benefit estimate of PD should take into account the psychological implications of UCA detection.

  4. Mitigating Prenatal Zika Virus Infection in the Americas.

    Science.gov (United States)

    Ndeffo-Mbah, Martial L; Parpia, Alyssa S; Galvani, Alison P

    2016-10-18

    Because of the risk for Zika virus infection in the Americas and the links between infection and microcephaly, other serious neurologic conditions, and fetal death, health ministries across the region have advised women to delay pregnancy. However, the effectiveness of this policy in reducing prenatal Zika virus infection has yet to be quantified. To evaluate the effectiveness of pregnancy-delay policies on the incidence and prevalence of prenatal Zika virus infection. Vector-borne Zika virus transmission model fitted to epidemiologic data from 2015 to 2016 on Zika virus infection in Colombia. Colombia, August 2015 to July 2017. Population of Colombia, stratified by sex, age, and pregnancy status. Recommendations to delay pregnancy by 3, 6, 9, 12, or 24 months, at different levels of adherence. Weekly and cumulative incidence of prenatal infections and microcephaly cases. With 50% adherence to recommendations to delay pregnancy by 9 to 24 months, the cumulative incidence of prenatal Zika virus infections is likely to decrease by 17% to 44%, whereas recommendations to delay pregnancy by 6 or fewer months are likely to increase prenatal infections by 2% to 7%. This paradoxical exacerbation of prenatal Zika virus exposure is due to an elevated risk for pregnancies to shift toward the peak of the outbreak. Sexual transmission was not explicitly accounted for in the model because of limited data but was implicitly subsumed within the overall transmission rate, which was calibrated to observed incidence. Pregnancy delays can have a substantial effect on reducing cases of microcephaly but risks exacerbating the Zika virus outbreak if the duration is not sufficient. Duration of the delay, population adherence, and the timing of initiation of the intervention must be carefully considered. National Institutes of Health.

  5. The value of routine mid-trimester ultrasound in low-risk pregnancies at primary care level

    Directory of Open Access Journals (Sweden)

    EJ Buchmann

    2008-12-01

    Full Text Available This study investigated the effect of routine second-trimester ultrasound scanning on obstetric management and pregnancy outcomes. This was an open cluster, randomised, controlled trial. Clusters of women with low-risk pregnancies presenting in the second trimester were randomised to receive an ultrasound scan followed by usual antenatal care, or to an unscanned control group undergoing conventional antenatal care only. Out of the 962 women randomised, follow-up was successful for 804 (83.6%, with 416 allocated to the ultrasound scan group and 388 controls. There were no significant differences between the ultrasound scan group and the control group in terms of prenatal hospitalisation, mode of delivery, miscarriage, perinatal mortality rate and low birthweight rate. Ultrasound dating was associated with a lower rate of induction of labour for post-term pregnancy (1.4% vs. 3.6%; P=0.049. However, ultrasound scanning in low-risk pregnancies was not associated with improvements in pregnancy outcome. Opsomming Hierdie studie het die effek van roetine mid-trimester ultraklankskandering op swangerskapsorg en –uitkomste ondersoek. Dit was ’n oop tros, lukrake, beheerde proef. Groepe vroue met laerisikoswanger- skap in die midtrimester is lukraak toegewys vir ’n ultraklank-skandering, gevolg deur voorgeskrewe voorgeboor-tesorg, of vir ’n kontrolegroep wat voorgeboortesorg volgens nasionaal voorgeskrewe protokol sonder skandering ontvang het. Van die 962 vroue wat aan die steekproef deelgeneem het kon data vir 804 (83.6% suksesvol opgevolg word, met 416 in die ultraklankgroep en 388 in die kontrolegroep. Geen beduidende verskille is tussen die twee groepe gevind ten opsigte van voorgeboorte-hospitalisasie, geboortemetode, miskraamstatistiek, perinatale komplikasies of laegeboortegewig nie. Ultraklankdatering van swangerskappe is met minder kraaminduksie (1.4% teen 3.6%; P=0.049 vir natrimesterswangerskap geassosieer. Roetine

  6. Patterns of compliance with prenatal iron supplementation among Peruvian women.

    Science.gov (United States)

    Zavaleta, Nelly; Caulfield, Laura E; Figueroa, Alberto; Chen, Ping

    2014-04-01

    Prenatal iron supplementation is recommended to control anaemia during pregnancy. Low compliance and side effects have been claimed as the main obstacles for adequate impact of the supplementation. As part of a double-blind supplementation study carried out in a hospital located in a shantytown in Lima, Peru, we monitored compliance throughout pregnancy and evaluated factors associated with variation in compliance over time. Overall, 985 pregnant women were enrolled in a supplementation study that was administered through their prenatal care from 10 to 24 weeks of gestation until 4 weeks postpartum. They received 60 mg iron and 250 µg folate with or without 15 mg zinc. Women had monthly care visits and were also visited weekly to query regarding compliance, overall health status, and potential positive and negative effects of supplement consumption. Median compliance was 79% (inter-quartile range: 65-89%) over pregnancy, and the median number of tablets consumed was 106 (81-133). Primpara had lower average compliance; positive health reports were associated with greater compliance, and negative reports were associated with lower compliance. There was no difference by type of supplement. Women with low initial compliance did achieve high compliance by the end of pregnancy, and women who reported forgetting to take the supplements did have lower compliance. Compliance was positively associated with haemoglobin concentration at the end of pregnancy. In conclusion, women comply highly with prenatal supplementation within a prenatal care model in which supplies are maintained and reinforcing messages are provided. © 2012 John Wiley & Sons Ltd.

  7. Using the Health Belief Model to Illustrate Factors That Influence Risk Assessment during Pregnancy and Implications for Prenatal Education about Endocrine Disruptors

    Science.gov (United States)

    Qiu, Xing; Chen, Shaw-Ree; Barrett, Emily S.; Velez, Marissa; Conn, Kelly; Heinert, Sara

    2014-01-01

    Endocrine disrupting chemicals (EDCs) such as Bisphenol A (BPA) and phthalates are ubiquitous in our environment and a growing body of research indicates that EDCs may adversely affect human development. Fetal development is particularly susceptible to EDC exposure, and prenatal care providers are being asked to educate women about the risks of…

  8. Using the Health Belief Model to Illustrate Factors That Influence Risk Assessment during Pregnancy and Implications for Prenatal Education about Endocrine Disruptors

    Science.gov (United States)

    Qiu, Xing; Chen, Shaw-Ree; Barrett, Emily S.; Velez, Marissa; Conn, Kelly; Heinert, Sara

    2014-01-01

    Endocrine disrupting chemicals (EDCs) such as Bisphenol A (BPA) and phthalates are ubiquitous in our environment and a growing body of research indicates that EDCs may adversely affect human development. Fetal development is particularly susceptible to EDC exposure, and prenatal care providers are being asked to educate women about the risks of…

  9. Inadequate prenatal care and elevated blood lead levels among children born in Providence, Rhode Island: a population-based study.

    Science.gov (United States)

    Greene, Anna; Morello-Frosch, Rachel; Shenassa, Edmond D

    2006-01-01

    This study was conducted to determine whether children born to mothers receiving inadequate prenatal care are at an increased risk for having an elevated blood lead level during early childhood. The authors conducted a population-based study of children born in Providence, Rhode Island, from 1997 to 2001 whose mothers had received adequate, intermediate, or inadequate prenatal care. The children's blood lead levels were compared between groups using bivariate and logistic regression. To understand the regulatory implications and public health impact of changing the definition of an elevated blood lead level, "elevated" was defined as 5 microg/dL, 10 microg/dL, and 15 microg/dL. Children born to mothers who received inadequate prenatal care were at an elevated risk for having an elevated blood lead level later in life. This relationship remained statistically significant for each definition of elevated blood lead level and after controlling for other socio-economic status measures and birthweight (at 5 microg/dL, odds ratio [OR] = 1.36, 95% confidence interval [CI] 1.09, 1.68, p = 0.006; at 10 microg/dL, OR = 1.68, 95% CI 1.26, 2.24, p prenatal care provision could help identify women possibly experiencing ongoing lead exposure and help reduce or prevent exposures to their offspring.

  10. Diferenciais socioeconômicos na realização de exame de urina no pré-natal Socioeconomic differentials in performing urinalysis during prenatal care

    Directory of Open Access Journals (Sweden)

    Mariângela F Silveira

    2008-06-01

    Full Text Available OBJETIVO: A importância do exame de urina na rotina do pré-natal deve-se à infecção do trato urinário na gestante, uma importante causa de parto prematuro e morbidade neonatal. O objetivo do estudo foi analisar fatores associados à solicitação de exames de urina durante a gestação. MÉTODOS: Durante o ano de 2004, 4.163 mulheres residentes na zona urbana de Pelotas (RS e que haviam realizado pré-natal foram entrevistadas ao darem à luz nos hospitais da cidade. A prevalência da não realização do exame de urina na gestação foi analisada segundo variáveis socioeconômicas, demográficas e de atenção pré-natal. Após análise bivariada, foi realizada regressão logística para identificar fatores associados com o desfecho, controlando para possíveis fatores de confusão, ao nível de significância de pOBJECTIVE: Urinalysis is an essential component of the prenatal routine, as urinary tract infections during pregnancy may lead to preterm delivery and neonatal morbidity. The objective of the study was to analyze factors associated to the solicitation of urinalysis during pregnancy. METHODS: During 2004, 4,163 women living in the urban area of Pelotas (Southern Brazil and who had received prenatal care were interviewed after delivery in the maternity hospitals of the city. Prevalence of the non-performance of urinalysis was analyzed in relation to socioeconomic and demographic variables, as well as to characteristics of prenatal care. After a bivariate analysis, logistic regression was conducted to identify factors associated with the outcome, controlling for possible confusion factors at a 5% level of significance. RESULTS: The prevalence of not having had the test was 3%. The multivariate analysis showed that black skin color, poverty, low schooling, being unmarried and having fewer than six prenatal visits were associated with a higher probability of not carrying out the test. Women who were black, poor and with low

  11. Stress: pregnancy considerations.

    Science.gov (United States)

    Cardwell, Michael S

    2013-02-01

    Stress-induced pregnancy complications represent a significant cause of maternal and perinatal morbidity and mortality due to preterm labor, low-birth-weight babies, pregnancy-induced hypertension, and neuropsychological developmental delays of affected offspring. Psychosocial factors such as socioeconomic status, work status, marital status, level of education, access to prenatal care, substance abuse, ethnicity, cultural background, and quality of relationships with partners and parents have been identified as determinants of stress during pregnancy. The biopsychosocial model of health and disease aptly explains the interactions of these psychosocial factors in the genesis of stress-induced pregnancy complications. Prenatal screening and intervention for relevant biopsychosocial risk factors may be useful in preventing stress-related perinatal complications. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to describe how stress is manifested biologically, discuss stress and its impact from the biopsychosocial model of health and disease, recognize how stress may lead to pregnancy complications such as preterm labor, preeclampsia, and low-birth-weight infants, explain how stress may impact the neuropsychological development of children whose mothers experienced perinatal stress, and demonstrate how prenatal screening and appropriate interventions may reduce perinatal stress and associated pregnancy complications.

  12. Pregnancy Rates among Juvenile Justice Girls in Two Randomized Controlled Trials of Multidimensional Treatment Foster Care

    Science.gov (United States)

    Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia

    2009-01-01

    Preventing adolescent pregnancy is a national research priority that has had limited success. In the present study, the authors examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (13-17…

  13. Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands

    NARCIS (Netherlands)

    Schutte, J. M.; Schuitemaker, N. W. E.; van Roosmalen, J.; Steegers, E. A. P.

    2008-01-01

    Objective To review the standard of care in cases of maternal mortality due to hypertensive diseases in pregnancy and to make recommendations for its improvement. Design Care given to women with hypertensive disease in pregnancy was audited and substandard care factors identified. Setting Confidenti

  14. Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands

    NARCIS (Netherlands)

    Schutte, J. M.; Schuitemaker, N. W. E.; van Roosmalen, J.; Steegers, E. A. P.

    Objective To review the standard of care in cases of maternal mortality due to hypertensive diseases in pregnancy and to make recommendations for its improvement. Design Care given to women with hypertensive disease in pregnancy was audited and substandard care factors identified. Setting

  15. Prenatal Diagnosis of Amniotic Band Syndrome in the Third Trimester of Pregnancy using 3D Ultrasound

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    Luciano Marcondes Machado Nardozza

    2012-01-01

    Full Text Available Amniotic band syndrome is characterized by a build-up of bands and strings of fibrous tissue that adhere to the fetus and can compress parts of the fetus, thus causing malformations and even limb amputation while the fetus is still in the uterus. The clinical manifestations are extremely variable and their extent may range from a single abnormality, like a constriction ring, to multiple abnormalities. Such abnormalities are generally diagnosed at the end of the first or the beginning of the second trimester using two-dimensional ultrasonography (2DUS. Three-dimensional ultrasonography (3DUS in rendering mode allows spatial analysis of the fetus and amniotic band, thus enabling better comprehension of this pathological condition and better counseling for the parents. There has not previously been any evidence to show that 3DUS would be useful in cases of late diagnosis (third trimester of amniotic band syndrome. In the present case, a primigravid woman underwent her second obstetric ultrasound scan in the 34 th week, from which we observed two bands in contact with the right forearm, but with normal movement of this limb and its fingers. 3DUS made it possible to see the spatial relationship of these bands to the fetal body, thereby confirming their adherence to the limb. After the birth, the prenatal diagnosis of amniotic band syndrome without limb constriction was confirmed. A surgical procedure was carried out on the third day after birth to excise the bands, and the newborn was then discharged in a good general condition.

  16. Perceptions of barriers, facilitators and motivators related to use of prenatal care: A qualitative descriptive study of inner-city women in Winnipeg, Canada.

    Science.gov (United States)

    Heaman, Maureen I; Sword, Wendy; Elliott, Lawrence; Moffatt, Michael; Helewa, Michael E; Morris, Heather; Tjaden, Lynda; Gregory, Patricia; Cook, Catherine

    2015-01-01

    The objective of this qualitative descriptive study was to explore the perceptions of women living in inner-city Winnipeg, Canada, about barriers, facilitators, and motivators related to their use of prenatal care. Individual, semi-structured interviews were conducted in person with 26 pregnant or postpartum women living in inner-city neighborhoods with high rates of inadequate prenatal care. Interviews averaged 67 min in length. Recruitment of participants continued until data saturation was achieved. Inductive content analysis was used to identify themes and subthemes under four broad topics of interest (barriers, facilitators, motivators, and suggestions). Sword's socio-ecological model of health services use provided the theoretical framework for the research. This model conceptualizes service use as a product of two interacting systems: the personal and situational attributes of potential users and the characteristics of health services. Half of the women in our sample were single and half self-identified as Aboriginal. Participants discussed several personal and system-related barriers affecting use of prenatal care, such as problems with transportation and child care, lack of prenatal care providers, and inaccessible services. Facilitating factors included transportation assistance, convenient location of services, positive care provider qualities, and tangible rewards. Women were motivated to attend prenatal care to gain knowledge and skills and to have a healthy baby. Consistent with the theoretical framework, women's utilization of prenatal care was a product of two interacting systems, with several barriers related to personal and situational factors affecting women's lives, while other barriers were related to problems with service delivery and the broader healthcare system. Overcoming barriers to prenatal care and capitalizing on factors that motivate women to seek prenatal care despite difficult living circumstances may help improve use of prenatal

  17. Perceptions of barriers, facilitators and motivators related to use of prenatal care: A qualitative descriptive study of inner-city women in Winnipeg, Canada

    Directory of Open Access Journals (Sweden)

    Maureen I Heaman

    2015-12-01

    Full Text Available Objective: The objective of this qualitative descriptive study was to explore the perceptions of women living in inner-city Winnipeg, Canada, about barriers, facilitators, and motivators related to their use of prenatal care. Methods: Individual, semi-structured interviews were conducted in person with 26 pregnant or postpartum women living in inner-city neighborhoods with high rates of inadequate prenatal care. Interviews averaged 67 min in length. Recruitment of participants continued until data saturation was achieved. Inductive content analysis was used to identify themes and subthemes under four broad topics of interest (barriers, facilitators, motivators, and suggestions. Sword’s socio-ecological model of health services use provided the theoretical framework for the research. This model conceptualizes service use as a product of two interacting systems: the personal and situational attributes of potential users and the characteristics of health services. Results: Half of the women in our sample were single and half self-identified as Aboriginal. Participants discussed several personal and system-related barriers affecting use of prenatal care, such as problems with transportation and child care, lack of prenatal care providers, and inaccessible services. Facilitating factors included transportation assistance, convenient location of services, positive care provider qualities, and tangible rewards. Women were motivated to attend prenatal care to gain knowledge and skills and to have a healthy baby. Conclusion: Consistent with the theoretical framework, women’s utilization of prenatal care was a product of two interacting systems, with several barriers related to personal and situational factors affecting women’s lives, while other barriers were related to problems with service delivery and the broader healthcare system. Overcoming barriers to prenatal care and capitalizing on factors that motivate women to seek prenatal care

  18. Pregnancy Rates Among Juvenile Justice Girls in Two RCTs of Multidimensional Treatment Foster Care

    OpenAIRE

    Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia

    2009-01-01

    Preventing adolescent pregnancy is a national research priority that has had limited success. The present study examined whether Multidimensional Treatment Foster Care (MTFC) relative to intervention services as usual (group care [GC]) decreased pregnancy rates among juvenile justice girls mandated to out-of-home care. Girls (ages 13–17) with histories of criminal referrals (Mdn = 10) were randomly assigned to MTFC (n = 81) or GC (n = 85) as part of two randomized controlled trials. Pregnancy...

  19. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

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    Chen Chi-Liang

    2008-03-01

    Full Text Available Abstract Background Taiwan's National Health Insurance (NHI, implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in

  20. Group based prenatal care in a low-and high risk population in the Netherlands: a study protocol for a stepped wedge cluster randomized controlled trial.

    Science.gov (United States)

    van Zwicht, Birgit S; Crone, Matty R; van Lith, Jan M M; Rijnders, Marlies E B

    2016-11-15

    CenteringPregnancy (CP) is a multifaceted group based care-model integrated in routine prenatal care, combining health assessment, education, and support. CP has shown some positive results on perinatal outcomes. However, the effects are less obvious when limited to the results of randomized controlled trials: as there are few trials and there is a variation in reported outcomes. Furthermore, former research was mostly conducted in the United States of America and in specific (often high risk) populations. Our study aims to evaluate the effects of CP in the Netherlands in a general population of pregnant women (low and high risk). Furthermore we aim to explore the mechanisms leading to the eventual effects by measuring potential mediating factors. We will perform a stepped wedge cluster randomized controlled trial, in a Western region in the Netherlands. Inclusion criteria are control period will receive individual care, women in the intervention period (starting at the randomized time-point) will be offered the choice between individual care or CP. Primary outcomes are maternal and neonatal morbidity, retrieved from a national routine database. Secondary outcomes are health behavior, psychosocial outcomes, satisfaction, health care utilization and process outcomes, collected through self-administered questionnaires, group-evaluations and individual interviews. We will conduct intention-to-treat analyses. Also a per protocol analysis will be performed comparing the three subgroups: control group, CP-participants and non-CP-participants, using multilevel techniques to account for clustering effects. This study contributes to the evidence regarding the effect of CP and gives a first indication of the effect and implementation of CP in both low and high-risk pregnancies in a high-income Western society other than the USA. Also, measuring factors that are hypothesized to mediate the effect of CP will enable to explain the mechanisms that lead to effects on maternal and

  1. Disparities in Prenatal Care Utilization Among U.S. Versus Foreign-Born Women with Chronic Conditions.

    Science.gov (United States)

    Goldfarb, Samantha S; Smith, Whitney; Epstein, Anne E; Burrows, Stevie; Wingate, Martha

    2016-05-25

    We examined disparities in prenatal care utilization (PNCU) among U.S. and foreign-born women with chronic conditions. We performed a cross-sectional analyses using data from 2011 to 2012 National Center for Health Statistics Natality Files (n = 6,644,577) to examine the association between maternal nativity (U.S. vs. foreign-born), presence of a chronic condition (diabetes or hypertensive disorder) and PNCU. After adjustment for selected maternal characteristics, overall and among those with chronic conditions, foreign-born women reported significantly lower odds of intensive and adequate PNCU and higher odds of intermediate and inadequate PNCU than U.S.-born women. Few differences in report of no care were found by maternal nativity. These findings suggest that foreign-born women may be receiving some form of prenatal care, but adequacy of care is likely to be lower compared to U.S.-born counterparts, even among those with chronic conditions.

  2. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  3. Study of obstetric and fetal outcome of twin pregnancy in a tertiary care centre

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    Gurpreet Kaur Nandmer

    2015-12-01

    Conclusions: Twin pregnancies are high risk pregnancies with more maternal and fetal complications. The use of antenatal care services, identification and anticipation of complications, intrapartum management and good NICU facilities will help to improve maternal and neonatal outcome in twin pregnancies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1789-1792

  4. Effectiveness of Continuum of Care—Linking Pre-Pregnancy Care and Pregnancy Care to Improve Neonatal and Perinatal Mortality: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Kikuchi, Kimiyo; Okawa, Sumiyo; Zamawe, Collins O. F.; Shibanuma, Akira; Nanishi, Keiko; Iwamoto, Azusa; Saw, Yu Mon; Jimba, Masamine

    2016-01-01

    In an era of Sustainable Development Goals, maternal, newborn, and child health still require improvement. Continuum of care is considered key to improving the health status of these populations. The continuum of care is a series of care strategies starting from pre-pregnancy to motherhood-childhood. The effectiveness of such linkage between the pregnancy, birth, and postnatal periods has been demonstrated. However, almost no study has assessed the impact of linkage that starts from pre-pregnancy to pregnancy care on maternal and child health. The present study attempts to fill this gap by assessing the effectiveness of the care linkage between pre-pregnancy and pregnancy care for reducing neonatal, perinatal, and maternal mortality in low- and middle-income countries. We performed a systematic review and meta-analysis of randomized and quasi-randomized controlled trials in low- and middle-income countries. The outcome variables were neonatal, perinatal, and maternal mortality. We searched databases such as PubMed/Medline, POPLINE, EBSCO/CINAHL, and ISI Web of Science for the period 2000–2014, using broad search terms (e.g., pre-pregnancy OR adolescent OR mother), combined with search terms specific for interventions, (e.g., family planning OR contraception OR spacing). From the 1,325 retrieved articles, five studies were finally analyzed. The meta-analysis showed that interventions linking pre-pregnancy and pregnancy care effectively reduced neonatal mortality (risk ratio [RR]: 0.79; 95% confidence interval [CI]: 0.71–0.89, I2 = 62%) and perinatal mortality (RR: 0.84; 95% CI: 0.75–0.94, I2 = 73%), but did not show an effect on maternal mortality. Neonatal and perinatal mortality could be reduced by linking pre-pregnancy and pregnancy care. This linkage of pre-pregnancy and pregnancy cares is an essential component of continuum of care to improve newborn health. Review Registration PROSPERO International prospective register of systematic reviews (CRD

  5. Intimate Partner Violence during Pregnancy and Mothers' Child Abuse Potential

    Science.gov (United States)

    Casanueva, Cecilia E.; Martin, Sandra L.

    2007-01-01

    This research examines whether women who have experienced intimate partner violence (IPV) during pregnancy have a higher child abuse potential than women who have not experienced IPV. Data were analyzed from a longitudinal investigation of IPV during pregnancy. This study recruited 88 pregnant women during prenatal care and followed them for 1 1/2…

  6. Intimate Partner Violence during Pregnancy and Mothers' Child Abuse Potential

    Science.gov (United States)

    Casanueva, Cecilia E.; Martin, Sandra L.

    2007-01-01

    This research examines whether women who have experienced intimate partner violence (IPV) during pregnancy have a higher child abuse potential than women who have not experienced IPV. Data were analyzed from a longitudinal investigation of IPV during pregnancy. This study recruited 88 pregnant women during prenatal care and followed them for 1 1/2…

  7. Teen pregnancy: an update.

    Science.gov (United States)

    McCracken, Katherine A; Loveless, Meredith

    2014-10-01

    To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention as one of its top six priorities, which is increasing research and intervention data. Long-acting contraceptive methods are acceptable to teens and have been shown to reduce teen birth rates. Pregnant teens need special attention to counseling on pregnancy options and reducing risk during pregnancy with regular prenatal care. Postpartum teens should be encouraged and supported to breastfeed, monitored for depression, and have access to reliable contraception to avoid repeat undesired pregnancy. This review highlights important issues for all providers caring for female adolescents and those who may encounter teen pregnancy. Foremost prevention of teen pregnancy by comprehensive sexual education and access to contraception is the priority. Educating patients and healthcare providers about safety and efficacy of long-acting reversible contraception is a good step to reducing undesired teen pregnancies. Rates of postpartum depression are greater in adolescents than in adults, and adolescent mothers need to be screened and monitored for depression. Strategies to avoid another undesired pregnancy shortly after delivery should be implemented.

  8. Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers.

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    Heaman, Maureen I; Sword, Wendy; Elliott, Lawrence; Moffatt, Michael; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2015-01-16

    Socioeconomic disparities in the use of prenatal care (PNC) exist even where care is universally available and publicly funded. Few studies have sought the perspectives of health care providers to understand and address this problem. The purpose of this study was to elicit the experiential knowledge of PNC providers in inner-city Winnipeg, Canada regarding their perceptions of the barriers and facilitators to PNC for the clients they serve and their suggestions on how PNC services might be improved to reduce disparities in utilization. A descriptive exploratory qualitative design was used. Semi-structured interviews were conducted with 24 health care providers serving women in inner-city neighborhoods with high rates of inadequate PNC. Content analysis was used to code the interviews based on broad categories (barriers, facilitators, suggestions). Emerging themes and subthemes were then developed and revised through the use of comparative analysis. Many of the barriers identified related to personal challenges faced by inner-city women (e.g., child care, transportation, addictions, lack of support). Other barriers related to aspects of service provision: caregiver qualities (lack of time, negative behaviors), health system barriers (shortage of providers), and program/service characteristics (distance, long waits, short visits). Suggestions to improve care mirrored the facilitators identified and included ideas to make PNC more accessible and convenient, and more responsive to the complex needs of this population. The broad scope of our findings reflects a socio-ecological approach to understanding the many determinants that influence whether or not inner-city women use PNC services. A shift to community-based PNC supported by a multidisciplinary team and expanded midwifery services has potential to address many of the barriers identified in our study.

  9. Provider adherence to recommended prenatal care content: does it differ for obese women?

    Science.gov (United States)

    Kominiarek, Michelle A; Rankin, Kristin; Handler, Arden

    2014-07-01

    The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5%, p = 0.02) and depression screening (2.0 vs. 11.4%, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ≥20 lbs (aOR 5.5, 95% CI 1.3-23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain.

  10. Intensive care and pregnancy: Epidemiology and general principles of management of obstetrics ICU patients during pregnancy.

    Science.gov (United States)

    Zieleskiewicz, Laurent; Chantry, Anne; Duclos, Gary; Bourgoin, Aurelie; Mignon, Alexandre; Deneux-Tharaux, Catherine; Leone, Marc

    2016-10-01

    In developed countries, the rate of obstetric ICU admissions (admission during pregnancy or the postpartum period) is between 0.5 and 4 per 1000 deliveries and the overall case-fatality rate is about 2%. The most two common causes of obstetric ICU admissions concerned direct obstetric pathologies: obstetric hemorrhage and hypertensive disorders of pregnancy. This review summarized the principles of management of critically ill pregnant patient. Its imply taking care of two patients in the same time. A coordinated multidisciplinary team including intensivists, anesthesiologists, obstetricians, pediatricians and pharmacists is therefore necessary. This team must work effectively together with regular staff aiming to evaluate daily the need to maintain the patient in intensive care unit or to prompt delivery. Keeping mother and baby together and fetal well-being must be balanced with the need of specialized advanced life support for the mother. The maternal physiological changes imply various consequences on management. The uterus aorto-caval compression implies tilting left the parturient. In case of cardiac arrest, uterus displacement and urgent cesarean delivery are needed. The high risk of aspiration and difficult tracheal intubation must be anticipated. Even during acute respiratory distress syndrome, hypoxemia and permissive hypercapnia must be avoided due to their negative impact on the fetus. Careful analysis of the benefit-risk ratio is needed before all drug administration. Streptococcal toxic shock syndrome and perineal fasciitis must be feared and a high level of suspicion of sepsis must be maintained. Finally the potential benefits of an ultrasound-based management are detailed.

  11. The role of prenatal care and social risk factors in the relationship between immigrant status and neonatal morbidity: a retrospective cohort study.

    Science.gov (United States)

    Paz-Zulueta, María; Llorca, Javier; Sarabia-Lavín, Raquel; Bolumar, Francisco; Rioja, Luis; Delgado, Abraham; Santibáñez, Miguel

    2015-01-01

    Literature evaluating association between neonatal morbidity and immigrant status presents contradictory results. Poorer compliance with prenatal care and greater social risk factors among immigrants could play roles as major confounding variables, thus explaining contradictions. We examined whether prenatal care and social risk factors are confounding variables in the relationship between immigrant status and neonatal morbidity. Retrospective cohort study: 231 pregnant African immigrant women were recruited from 2007-2010 in northern Spain. A Spanish population sample was obtained by simple random sampling at 1:3 ratio. Immigrant status (Spanish, Sub-Saharan and Northern African), prenatal care (Kessner Index adequate, intermediate or inadequate), and social risk factors were treated as independent variables. Low birth weight (LBW prenatal care and social risk factors, associations became protective: adjusted OR for preterm birth = 0.42 (95% CI: 0.14-1.32); LBW = 0.48 (95% CI: 0.15-1.52). Poor compliance with prenatal care was the main independent risk factor associated with both preterm birth (adjusted OR inadequate care = 17.05; 95% CI: 3.92-74.24) and LBW (adjusted OR inadequate care = 6.25; 95% CI: 1.28-30.46). Social risk was an important independent risk factor associated with LBW (adjusted OR = 5.42; 95% CI: 1.58-18.62). Prenatal care and social risk factors were major confounding variables in the relationship between immigrant status and neonatal morbidity.

  12. Prenatal Vitamins: Why They Matter, How to Choose

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week Wonder if you need to take prenatal vitamins? Which brand is best? Or what ... 2016 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art- ...

  13. Economic inequalities in maternal health care: prenatal care and skilled birth attendance in India, 1992-2006.

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    Praveen Kumar Pathak

    Full Text Available BACKGROUND: The use of maternal health care is limited in India despite several programmatic efforts for its improvement since the late 1980's. The use of maternal health care is typically patterned on socioeconomic and cultural contours. However, there is no clear perspective about how socioeconomic differences over time have contributed towards the use of maternal health care in India. METHODOLOGY/PRINCIPAL FINDINGS: Using data from three rounds of National Family Health Survey (NFHS conducted during 1992-2006, we analyse the trends and patterns in utilization of prenatal care (PNC in first trimester with four or more antenatal care visits and skilled birth attendance (SBA among poor and nonpoor mothers, disaggregated by area of residence in India and three contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In addition, we investigate the relative contribution of public and private health facilities in meeting the demand for SBA, especially among poor mothers. We also examine the role of salient socioeconomic, demographic and cultural factors in influencing aforementioned outcomes. Bivariate analyses, concentration curve and concentration index, logistic regression and multinomial logistic regression models are used to understand the trends, patterns and predictors of the two outcome variables. Results indicate sluggish progress in utilization of PNC and SBA in India and selected provinces during 1992-2006. Enormous inequalities in utilization of PNC and SBA were observed largely to the disadvantage of the poor. Multivariate analysis suggests growing inequalities in utilization of the two outcomes across different economic groups. CONCLUSIONS: The use of PNC and SBA remains disproportionately lower among poor mothers in India irrespective of area of residence and province. Despite several governmental efforts to increase access and coverage of delivery services to poor, it is clear that the poor (a do not use SBA and (b

  14. Effect of E-learning on primigravida women's satisfaction and awareness concerning prenatal care.

    Science.gov (United States)

    Mohamadirizi, Soheila; Bahadoran, Parvin; Fahami, Fariba

    2014-01-01

    E-learning, in addition to promotion of patients' level of awareness, causes a more efficient way to increase patient-personnel interaction and provision of patients' educational content. In a quasi-experimental study, 100 primigravida women, referring to Navab Safavi health care center affiliated to Isfahan University of Medical Sciences, were selected through convenient sampling. The subjects received education via E-learning or booklet education methods for four weeks. Questionnaire of satisfaction with the awareness of prenatal care was completed by both groups before and 4-6 weeks after education. Data were analyzed by student t-test and paired t-test through SPSS with a significance level of P control groups, respectively (P = 0.034). E-learning can cause an increase in the level of primigravida women's satisfaction and awareness. Therefore, conducting such education, as an efficient learning method, is recommended as it needs less time, has lower costs, and does not need any special equipment.

  15. THE ISSUE OF PREGNANCY AND DELIVERY WITH PRENATAL INFECTION OF THE FETUS, HEALTH STATUS OF BABIES ON THE FIRST YEARS OF LIFE

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    L.V. Vasilenko

    2007-09-01

    Full Text Available Pregnancy and delivery of 27 women with prenatal infection of the fetus, neonatal period of the babies with prenatal pneumonia, health status of up to 2 children were researched in retrospect. Women with inflammation of the genitals (78,6% and extragenital pathology of the inflammatory genesis (36,3% had prenatal infection of the fetus. In the early neonatal period every baby had cerebral ischemia, every third child had haemorrhages in different cerebral structures. All babies have been transferred to children's hospital for treatment where the rehabilitation was carried out during 1-2,5 months. Infantile cerebral paralysis, hydrocephaly, epilepsy, epileptoid attacks were detected in 8 babies on the first year of life (29,6%. 5 babies (18,5% had atrophy of discs of optic nerves, retinal angiopathy. All babies with local pathology of the central nervous system were premature born on the 26-32 week. Majority has herniae of different localization (55,5%, congenital dysplasia of the hip joint (74%, 26 babies (96,2% were on the books because of anaemiae, pneumoniae, bronchites, pyelonephrites, septicaemiae. Using the received data we can draw a conclusion: in order to reduce perinatal complications in the maternal organism, in the organism of newborn baby and baby on the first year of life it is necessary to sanify the birth canal, to do preclinical diagnostics and preventive therapy of the prematurely born, gestosis, fetoplacental insufficiency.

  16. [Prenatal care and risk factors associated with premature birth and low birth weight in the a capital in the Brazilian Northeast].

    Science.gov (United States)

    Gonzaga, Isabel Clarisse Albuquerque; Santos, Sheila Lima Diogenes; Silva, Ana Roberta Vilarouca da; Campelo, Viriato

    2016-06-01

    The main determinants of the risk of mortality in the neonatal period are low birth weight and premature birth. The study sought to analyze the adequacy of prenatal care and risk factors associated with premature birth and low birth weight in a northeastern Brazilian capital. This is a case-control study. A model for adequacy of prenatal conditions composed of four indicators was created. Descriptive statistics for univariate analysis were used; as well as Wald linear trend tests, Student's t and chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis with p prenatal care, variable indicator III remained significant, showing that mothers who had inadequate prenatal care had an increased chance for the occurrence of the outcome, highlighting the need for adequate public health policies of care for pregnant women in the municipality under scrutiny.

  17. Desigualdades socioeconómicas relacionadas con el cuidado y el control del embarazo Socioeconomic inequalities in the provision and uptake of prenatal care

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    Gemma Cano-Serral

    2006-02-01

    1994 and 2003. Methods: Cross-sectional study of women in Barcelona who delivered a child without birth defects. Information was obtained from hospital medical records and a personal interview with women included in the Barcelona Birth Defects Registry, containing a random sample of 2% of all pregnant women in the city (n = 2299. Dependent variables: number of obstetric visits, the trimester of the first visit, the number of obstetric ultrasound scans, the fifth-month diagnostic ultrasound scan, invasive procedures, prenatal folic acid intake, pregnancy planning, smoking and smoking cessation. The independent variables were maternal age and social class. Logistic regression models were filted for each dependent variable. Results: In social classes with manual occupations, there was a higher proportion of pregnant women who attended less than six obstetric visits and who attended the first obstetric visit after the first trimester. Moreover, these women were less likely to have undergone an invasive procedure, to have taken folic acid supplements, to have planned the pregnancy, to be non-smokers and to stop smoking. In the more privileged classes, there was a higher proportion of women who attended more than 12 obstetric visits and who underwent more than three ultrasound scans. Conclusions: Socioeconomic inequalities were found in the provision and uptake of prenatal care in Barcelona. Uptake was greater in the more advantaged social classes but excessive medicalization was found in all classes. Rationalizing the use of healthcare resources and reducing excessive medicalization would reduce inequalities in prenatal care in Barcelona.

  18. RE-AIM evaluation of the Alcohol and Pregnancy Project: educational resources to inform health professionals about prenatal alcohol exposure and fetal alcohol spectrum disorder.

    Science.gov (United States)

    Payne, Janet M; France, Kathryn E; Henley, Nadine; D'Antoine, Heather A; Bartu, Anne E; O'Leary, Colleen M; Elliott, Elizabeth J; Bower, Carol; Geelhoed, Elizabeth

    2011-03-01

    The objective was to evaluate the Alcohol and Pregnancy Project that provided health professionals in Western Australia (WA) with educational resources to inform them about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder (FASD). The authors developed, produced, and distributed educational resources to 3,348 health professionals in WA. Six months later, they surveyed 1,483 of these health professionals. The authors used the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to evaluate the project. The educational resources were effective in producing a 31% increase in the proportion of health professionals who routinely provided pregnant women with information about the consequences of drinking alcohol during pregnancy. One hundred percent of the settings adopted the project, it reached 96.3% of the target population, it was implemented as intended, and the resources were maintained (http://www.ichr.uwa.edu.au/alcoholandpregnancy). The educational resources for health professionals have potential to contribute to reducing prenatal alcohol exposure and FASD.

  19. Frecuencia de control prenatal inadecuado y de factores asociados a su ocurrencia: Frequency of inadequate prenatal care and associated factors

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    Claudia Arispe

    2011-10-01

    Full Text Available Objetivo: Determinar la frecuencia de pacientes con control prenatal (CPN inadecuado y los factores asociados a dicho evento. Material y métodos: Se realizó un estudio descriptivo transversal donde se entrevistó a puérperas en el Hospital Nacional Cayetano Heredia entre agosto 2010 y enero 2011, y se revisó la historia clínica y carnet materno perinatal (CLAP. Se definió CPN inadecuado al incumplimiento del número mínimo y cronograma de visitas propuesto por el Ministerio de Salud. Se compararon factores epidemiológicos, maternos y socioeconómicos entre grupos de gestantes con CPN adecuado e inadecuado.Resultados: Se incluyeron 384 puérperas, 66,05% recibieron 6 ó más controles prenatales y sólo 7,36% tuvo CPN adecuado. Ciento cuarenta y cinco puérperas tuvieron su primer CPN antes de las 12 semanas. Los factores que se presentaron con mayor frecuencia en el grupo de CPN inadecuado fueron paridad mayor a 2 (p=0,02 y no