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Sample records for prevent unwanted pregnancies

  1. Uniting to prevent unwanted pregnancies.

    Science.gov (United States)

    Lynch, D

    1994-02-18

    In reading the column of Cal Thomas entitled "Speaking Truth to Power" it becomes clear that the forces aligned against each other on the issue of reproductive choice should work together in order to reduce the number of unwanted pregnancies. An estimated 400 million women are unable to limit their family size for economic reasons. More are inhibited by social or religious constraints. When family planning (FP) services are available, and the status and education levels of women are raised, abortion rates decrease. This is demonstrated in the Netherlands, where legal abortions and contraception are available. The abortion rate is less than 5/1000 women there, one of the lowest worldwide. Latin America, where abortion is illegal and FP services are lacking, has abortion rates of 30-60/1000. Furthermore, these illegal abortions usually have a tragic effect on the woman's health. Of an estimated 6 million pregnancies annually in the United States, approximately half are unintended. Of these, about 1.6 million are aborted. Of the women in the United States who become pregnant annually, 82% are unmarried, 25% are under 20 years of age, and 33% make less than $11,000 yearly. If industrialized nations made contraceptives and FP services available to the poor worldwide, the quality of life on earth would increase. Human misery, anarchy, and resource depletion would decrease. State and local governments should increase support of domestic FP activities, while the federal government should raise its funding of international FP services. In order to reach the goals set by the 1989 Amsterdam Declaration, which was signed by the US, the annual contribution of the United States needs to be doubled. 4% of the US foreign aid budget, $720 million, is less than 0.1% of its $1.5 trillion budget. This amounts to less than $3 per US citizen.

  2. Women’s experiences of unwanted pregnancy

    OpenAIRE

    Foroughossadat Mortazavi; Maryam Damghanian; Zahra Mottaghi; Mohammad Shariati

    2012-01-01

    Background: Despite expanded coverage of family planning in Iran, unwanted pregnancy is a common problem. The aim of this study was to explore women’s experiences of unwanted pregnancy in Shahroud public health centers.Methods: Purposive Sampling was conducted by means of focus group discussions (FGDs) and in-depth interviews and by a semi-constructed questionnaire in this qualitative research. Five (FGDs) with 23 women in third trimester in pregnancy and 4 in-depth interviews with women with...

  3. Knowledge and attitude of young people regarding HIV prevention and unwanted pregnancy in Bobo-Dioulasso, Burkina Faso

    Science.gov (United States)

    Come Yélian Adohinzin, Clétus; Meda, Nicolas; Anicet Ouédraogo, Georges; Gaston Belem, Adrien Marie; Sombié, Issiaka; Berthé, Abdramane; Bakwin Kandala, Ngianga; Damienne Avimadjenon, Georgette; Fond-Harmant, Laurence

    2016-10-19

    Introduction: Despite health education efforts, young people are still faced with major health problems. The objective of this study was to assess the knowledge and attitude regarding HIV prevention and unwanted pregnancy among young people in Bobo-Dioulasso, Burkina Faso. Methods: Based on two-level sampling, representing 94,947 households in the Bobo-Dioulasso municipality, 573 young people between the ages of 15 and 24 years were interviewed. This data collection was conducted from September 2014 to January 2015 in the three districts of the municipality. A questionnaire was used to assess the knowledge and attitudes of young people. Results: The interviewees had a poor knowledge about HIV transmission and prevention and contraception Very few young people (9%) had complete knowledge about the modes of transmission and 5% had no knowledge. Persistent misperceptions about the effectiveness of condoms (25%) and contraception (32%) did not prevent some young people from using them (79% used condoms and 46% used contraceptives). Knowledge and attitudes of young people regarding HIV and contraception varied according to age, sex, education level and type of parental supervision. Conclusion: A significant proportion of young people still has incomplete knowledge about HIV/AIDS and contraception. Actions designed to reinforce the knowledge of young people are of paramount importance. The capacities of parents and healthcare providers also need to be reinforced to improve the quality of relationship with young people.

  4. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

    Directory of Open Access Journals (Sweden)

    Justin T Clark

    Full Text Available The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  5. Unintended and unwanted pregnancy in St. Lucia.

    Science.gov (United States)

    Denton, A B; Chase, W M; Scott, K

    1994-09-01

    Among 200 mothers interviewed in St. Lucia, 82.5% described their pregnancy as unintended and 44% as unwanted; 80% of women having an intended pregnancy and 94.6% having an unintended pregnancy were unmarried and 18.5% were teenagers. Mothers of unintended pregnancies were significantly younger, were of significantly higher parity and had begun sexual relations at a significantly earlier age than mothers of intended pregnancies; and, unlike mothers of planned pregnancies, their desired interpregnancy interval was significantly longer than the actual interval. These results and the sporadic and ineffective use of contraception in St. Lucia emphasize the need for improvements in fertility regulation in that country.

  6. Unwanted pregnancy and mental health.

    Science.gov (United States)

    1974-04-11

    This article deals with a study carried out in Glasgow of 132 referrals for psychiatric opinion on termination of pregnancy with a follow-up 9 months later. A questionnaire was completed by the consultant at the time of examination and a follow-up letter was sent to the patient's family doctor 9 months later. Of the 132 women, 84 were given an abortion and 48 were refused. Of the 84 recommended for abortion, 53 were married, 25 single, and 6 widowed or divorced. 19 were childless and 65 had 1 or more children. 25% were Roman Catholic. Continuing psychiatric symptoms were noted in 8, but only in 4 did they seem to result from the abortion. Severe social problems were recorded in 9 but they had existed in 7 before and probably would have worsened had the abortion not been carried out. Only 14 went to their general practitioner for contraceptive advice. Of the 48 patients refused an abortion, only 25 continued the pregnancy to term. 15 had abortions privately. Definite psychiatric sequelae occurred in 3 cases, none needing psychiatric referral. Social problems arose in 4 cases. There was apparently no evidence of psychiatric complications following abortion, but in the group refused abortion, there were cases of depression and social distress.

  7. Study of Contraceptives Used in Unwanted Pregnancies

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    S Aghababaei

    2010-09-01

    Full Text Available Introduction: Unintended pregnancy is a worldwide problem that affects women, their families, and society. Unintended pregnancy can result from contraceptive failure, non-use or use mistake of contraceptive Methods: This study examined the Frequency and pattern of contraceptive method use in unintended pregnancy women reffering to health and medical center of Hamadan medical science university in Iran. Design and setting: A descriptive study was conducted at health and medical center of Hamadan medical science in Iran. Data were collected using a questionnaire in 2006 from a convenience sample of 900 unintended pregnancy women . The survey included measures of demographic variables, type and pattern of contraceptive method use. Data were analyzed by Chi square and t-test using SPSS. Results: Of the 900 participants, 93.9% had used contraceptive methods. The most common contraceptive method use in unintended pregnancy women were oral contraceptive pills 38.1% , natural method 31.9%, condom 19.8%, breastfeeding 4.4%, IUD 3.6%, emergency 1.9% and rhythm 0.4%. The most common problem in contraceptive use were irregular and incorrectly use in hormonal methods and condom users, no control in IUD users and mistake in date calculation in rhythmic users. Conclusion: The majority of participants had used contraceptive methods but have unintended pregnancy. More education is needed in this subject.

  8. Factors Affecting Unwanted Pregnancies in Urban Areas of Kohgiloyeh and Boyer Ahmad Province in 2008

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    Z Tabeshfar

    2011-08-01

    Full Text Available Introduction & Objective: Unwanted pregnancies and its complications are one of the most important global problems related to mothers. The aim of the present study was to determine the factors affecting unwanted pregnancies in urban areas of the Kohgiloyeh and Boyer Ahmad province. Materials & Methods: In this case – control study conducted at Yasuj University of Medical Sciences in 2008 ,350 women were chosen as the case group, and 700 women as the control group. During the study, data collection forms were completed by each group. Subsequently, the collected data was analyzed using SPSS version 16 by using the logistic regression, univariate, and multivariate analysis. Results: According to the results of univariate analysis, the variables husband’s education in primary school , age of the last child under one, uncertain prevention methods and receiving means of prevention from the private sector revealed that significant differences existed between the two groups (P Value<0/05. Finally, the multivariate analysis beetwen husband education variables, age of the last child , prevention methods, and receiving a contraceptive device, a significant correlation was observed with unwanted pregnancy(P Value<0/05. Conclusion: Results of this study determined that three variables (contraceptive method, the place of obtaining means, and level of her husband education are the most important variables which affect the chance of increasing of unwanted pregnancy in users of contraceptive methods.

  9. Social issues around advanced unwanted pregnancies in rural single women.

    Science.gov (United States)

    Chhabra, S; Palaparthy, S; Mishra, S

    2009-05-01

    This study covers issues on advanced unwanted pregnancies in rural single women in South-east Asia, with reference to age, education, occupation, person responsible (i.e. baby's father) and reasons for delay in seeking assistance. It describes single women with pregnancy beyond the time for abortion, as set by the Indian abortion law. The study involved 314 girls/women and was set in the Mahatma Gandhi Institute of Medical Sciences, Sevagram, India. The girls/women were admitted, provided with free facilities and had their babies looked after by hospital staff until given up for adoption, or otherwise. The outcomes of the study showed that most individuals (71.01%) were rural, less-literate, working girls. In 94.26% of cases, the baby's father was known; 24 (7.64%) reported rape (13 by a known person). A total of 66 individuals (21.02%) did not inform their parents about the pregnancy for up to 5 months. Five (1.59%) went to unqualified medical practitioners and 16.56% to private practitioners who did not give their services. A total of 47 (14.96%) had waited for the person responsible for their pregnancy before seeking assistance. There was a total of 315 babies born to 310 mothers (five twins); four absconded undelivered; 13 absconded after delivery (two with their babies, 11 leaving babies). The study found that pregnancies were often caused by rape and girls/women with no knowledge of abortion laws, shyness, fear, lack of desired privacy, lack of resources, misleading management at periphery all went beyond 20 weeks. Mostly, the babies were not accepted--the girls married the babies' fathers, but left their babies. Emergency contraception for unprotected sexual intercourse is essential.

  10. Inhibitors and Facilitators of Unwanted Adolescent Pregnancy in Iran and the World: A Review

    Directory of Open Access Journals (Sweden)

    Farzaneh Rashidi Fakari

    2017-07-01

    Full Text Available Background: Approximately 16 million adolescent girls aged 15 to 19 years and 1 million teenage girls less than 15 years of age become pregnant worldwide annually, and the majority of these pregnancies are unintended. Unwanted adolescent pregnancy coupled with impaired and inadequate physical and mental health can lead to slow progression of the community and the short- and long-term negative consequences. Aim: This study aimed to investigate the inhibitors and facilitators of unwanted adolescent pregnancy in Iran and across the globe. Method: The current narrative review was conducted using the keywords of "pregnancy", "unwanted", and "adolescent" in both Persian and English articles published from 2000 to 2016. The searched databases included Google Scholar, PubMed, Elsevier, Scopus, ProQuest, Irandoc, Scientific Information Database (SID, and Magiran. Results: Twenty-nine articles related to the study objectives were selected. Our investigations indicated that the inhibitors of unwanted adolescent pregnancy could be classified into four main categories of abstinence, religious beliefs, adolescent employment program, and parent-adolescent relationship. Further, the facilitators of unwanted adolescent pregnancy were categorized into eight categories of pornography on the Internet and media, peer pressure, lack of knowledge and information, drug and alcohol abuse, violence, adherence to fashion in clothing, economic and income status and family structure. Implications for Practice: The findings of this review revealed that more studies were conducted to explore the facilitators of unwanted adolescent pregnancy in comparison with inhibitors. Shortage of knowledge and information among adolescents plays a major role in unwanted adolescent pregnancy. However, a definitive judgment on the contribution of each factor to unwanted adolescent pregnancy requires further in-depth studies.

  11. Prediction of unwanted pregnancies using logistic regression, probit regression and discriminant analysis.

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    Ebrahimzadeh, Farzad; Hajizadeh, Ebrahim; Vahabi, Nasim; Almasian, Mohammad; Bakhteyar, Katayoon

    2015-01-01

    Unwanted pregnancy not intended by at least one of the parents has undesirable consequences for the family and the society. In the present study, three classification models were used and compared to predict unwanted pregnancies in an urban population. In this cross-sectional study, 887 pregnant mothers referring to health centers in Khorramabad, Iran, in 2012 were selected by the stratified and cluster sampling; relevant variables were measured and for prediction of unwanted pregnancy, logistic regression, discriminant analysis, and probit regression models and SPSS software version 21 were used. To compare these models, indicators such as sensitivity, specificity, the area under the ROC curve, and the percentage of correct predictions were used. The prevalence of unwanted pregnancies was 25.3%. The logistic and probit regression models indicated that parity and pregnancy spacing, contraceptive methods, household income and number of living male children were related to unwanted pregnancy. The performance of the models based on the area under the ROC curve was 0.735, 0.733, and 0.680 for logistic regression, probit regression, and linear discriminant analysis, respectively. Given the relatively high prevalence of unwanted pregnancies in Khorramabad, it seems necessary to revise family planning programs. Despite the similar accuracy of the models, if the researcher is interested in the interpretability of the results, the use of the logistic regression model is recommended.

  12. Relationship between Unwanted Pregnancy and Health-Related Quality of Life in Pregnant Women.

    Science.gov (United States)

    Ali, Azizi

    2016-06-01

    To determine the relationship between unwanted pregnancy and health-related quality of life in pregnant women. Case-control study. Department of Community Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran, from October 2013 to July 2014. Of the pregnant women who presented to primary healthcare centers of Kermanshah, Iran to receive prenatal care at 6 - 10 weeks of their pregnancy, those with unwanted pregnancy were selected as cases and those with wanted pregnancy were selected as control group. The selection process was done using multi-stage stratified random sampling. Frequency matching was applied to match the two groups. Quality of life was measured by the SF-36 questionnaire and was compared by the t-test. Relationship power between pregnancy type (wanted or unwanted pregnancy) and impairment of quality of life subscales as the outcome was assessed using odds ratio (OR). Frequency distribution of matched variables was not statistically different between the two studied groups. Mean scores of mental component summary and physical component summary as well as eight subscales (physical functioning, role, bodily pain, general health, vitality, social functioning, role emotional, and mental health) were lower in the unwanted pregnancy group compared to women with wanted pregnancy (p < 0.001). The highest high impairment odds ratio was highest for the mental component summary (MCS) (OR = 9.19; 95% CI = 5.17- 16.32) and vitality subscale (OR = 5.2; 95% CI = 2.89- 9.33). Mental health of the pregnant women with unwanted pregnancy is affected more than their physical health. Mental health in women with unwanted pregnancy is 9.19 times more likely to be reduced. Among mental health subscales, vitality (energy/fatigue) showed the highest decrease.

  13. Relationship Between Unwanted Pregnancy And Health-related Quality Of Life In Pregnant Women

    International Nuclear Information System (INIS)

    Ali, A.

    2016-01-01

    Objective: To determine the relationship between unwanted pregnancy and health-related quality of life in pregnant women. Study Design: Case-control study. Place and Duration of Study: Department of Community Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran, from October 2013 to July 2014. Methodology: Of the pregnant women who presented to primary healthcare centers of Kermanshah, Iran to receive prenatal care at 6 - 10 weeks of their pregnancy, those with unwanted pregnancy were selected as cases and those with wanted pregnancy were selected as control group. The selection process was done using multi-stage stratified random sampling. Frequency matching was applied to match the two groups. Quality of life was measured by the SF-36 questionnaire and was compared by the t-test. Relationship power between pregnancy type (wanted or unwanted pregnancy) and impairment of quality of life subscales as the outcome was assessed using odds ratio (OR). Result: Frequency distribution of matched variables was not statistically different between the two studied groups. Mean scores of mental component summary and physical component summary as well as eight subscales (physical functioning, role, bodily pain, general health, vitality, social functioning, role emotional, and mental health) were lower in the unwanted pregnancy group compared to women with wanted pregnancy (p < 0.001). The highest high impairment odds ratio was highest for the mental component summary (MCS) (OR = 9.19; 95 percentage CI = 5.17- 16.32) and vitality subscale (OR = 5.2; 95 percentage CI = 2.89- 9.33). Conclusion: Mental health of the pregnant women with unwanted pregnancy is affected more than their physical health. Mental health in women with unwanted pregnancy is 9.19 times more likely to be reduced. Among mental health subscales, vitality (energy/fatigue) showed the highest decrease. (author)

  14. Unwanted pregnancy: The outer boundary of "treatment injury" in the New Zealand accident compensation scheme.

    Science.gov (United States)

    Tobin, Rosemary

    2015-09-01

    The New Zealand accident compensation scheme has undergone many changes over the years and these changes are reflected in the way unwanted pregnancy claims have been dealt with under the regime. The New Zealand Supreme Court has now confirmed that pregnancy as a result of medical misadventure can be classified as a personal injury under the scheme with the result that the woman patient is entitled to the benefits of the scheme and may not pursue a common law claim against the medical practitioner. This article analyses two recent decisions in the context of consideration of the changing fortunes of the unwanted pregnancy claims.

  15. Investigating social consequences of unwanted pregnancy and unsafe abortion in Malawi: the role of stigma.

    Science.gov (United States)

    Levandowski, Brooke A; Kalilani-Phiri, Linda; Kachale, Fannie; Awah, Paschal; Kangaude, Godfrey; Mhango, Chisale

    2012-09-01

    Malawian women in all sectors of society are suffering from social implications of unwanted pregnancy and unsafe abortion. Unwanted pregnancies occur among women who have limited access to family planning and safe abortion. A legally restrictive setting for safe abortion services leads many women to unsafe abortion, which has consequences for them and their families. In-depth interviews were conducted with 485 Malawian stakeholders belonging to different political and social structures. Interviewees identified the impact of unwanted pregnancy and unsafe abortion to be the greatest on young women. Premarital and extramarital pregnancies were highly stigmatized; stigma directly related to abortion was also found. Community-level discussions need to focus on reduction of stigma. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. 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.

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    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.

  17. Unwanted pregnancies and Contraception in Chronic Renal Failure: A Case Report and Review of the Literature

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    Batuhan Özmen

    2006-06-01

    Full Text Available Pregnancy is a rare condition in patients requiring dialysis with end-stage chronic renal disease (CRD. However successful pregnancies were reported in CRD, patients are encountering with great number of complications and aggressive acceleration\tof CRD by achieving pregnancy. The most crucial topic is unwanted pregnancies of these patients due to high complication rates described in the literature. Thus many authors were discussing safety of contraception in CRD patients requiring dialysis (hemodialysis, peritoneal dialysis and in patients with renal transplant. In this report medical termination of a twenty-two weeks gestational age unwanted pregnancy that was complicated with aggressive hypertension and severe renal insufficiency under\tdialysis in a 38 years-old end-stage CRD patient was reported.

  18. Sexual Orientation Disparities in Mistimed and Unwanted Pregnancy Among Adult Women.

    Science.gov (United States)

    Everett, Bethany G; McCabe, Katharine F; Hughes, Tonda L

    2017-09-01

    Many sexual minority women, regardless of sexual identity, engage in heterosexual behavior across the life course, which provides them opportunities to experience an unintended pregnancy. In addition, sexual minority women are more likely than others to report characteristics that may make them vulnerable to unintended pregnancy. Little research, however, has examined whether the risk of unintended pregnancy is elevated among these women. Using data from the 2006-2010 National Survey of Family Growth, logistic regression models were fitted to examine sexual orientation disparities in mistimed and unwanted pregnancies among 9,807 women aged 20-45; mixed-effects hazard models assessed disparities in the intention status of 5,238 pregnancies among these women by maternal sexual orientation. Compared with heterosexual women reporting only male partners, heterosexual women who have sex with women had higher odds of reporting a mistimed pregnancy (odds ratio, 1.4), and bisexual women had higher odds of reporting an unwanted pregnancy (1.8). When compared with pregnancies reported by heterosexual women with only male partners, those reported by heterosexual women who have sex with women were more likely to be mistimed (hazard ratio, 1.7), and those reported by bisexual and lesbian women were more likely to be unwanted (1.7-4.4). Compared with heterosexuals who have sex with men only, adult sexual minority women are at equal or greater risk of reporting an unintended pregnancy. More research addressing the reproductive health care needs of sexual minority women is needed to develop strategies to improve family planning for this population. Copyright © 2017 by the Guttmacher Institute.

  19. Determinants of unwanted pregnancies in India using matched case-control designs

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    Dixit Priyanka

    2012-08-01

    Full Text Available Abstract Background In India, while the total fertility rate has been declined from 3.39 in 1992–93 to 2.68 in 2005–06, the prevalence of unintended pregnancy is still stagnant over the same period. A review of existing literature shows that within the country, there are variations in fertility preferences between different regions. Also there is a strong argument that the availability of a health facility at the village level plays an important role in reshaping the fertility behavior of women. Keeping in mind the fact that there is no information at the village level (which is the lowest geographical boundary in the recent round of National Family Health Survey (NFHS-3, the specific objective of this study is to examine the impact of individual and household level variables on unwanted pregnancies without controlling the village level variation. Further, once the village level variation (i.e. unobserved variation has been controlled, it is necessary to study whether there has been any alteration in the contribution of factors from earlier results of without adjusting the village level variation. Methods This paper attempts to examine the associated factors of unwanted pregnancies, without matching the village and after matching the village, by using the matched case–control design. Nationwide data from India’s latest NFHS-3 conducted during 2005–06 was used for the present study. Frequency and pair wise matching has been applied in the present paper and conditional logistic regression analysis was used to work out the models and to find out the factors associated with unwanted pregnancies. Results A major finding of this study was that 1:3 case–control study (without matching the village shows that women belonging to non Hindu/Muslim religion, Scheduled Tribe, women who have experienced child loss and if the previous birth interval is 24 through 36 months were significant predictors of unwanted pregnancy. However, this

  20. Characteristics of Women with Unwanted Pregnancies and Reasons for Contraceptive Methods Discontination: Sample of Rural Area

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    Semra Ay

    2012-06-01

    Full Text Available AIM: The aim of the study was to explore the prevalence and characteristics of women with unwanted pregnancy in rural area and to examine pregnant women’s contraceptive method preferences, satisfaction with the methods and reason the methods discontinuation. METHOD: This study was carried out in Manisa city rural area between the dates of January and June 2011 in women who agreed to participate in the study. The sample of the research is composed of 239 pregnant women. The research was a descriptive, cross-sectional and field study and the data was collected by using questionnaire which was prepared by researcher. Data was gathered through the face to face interview with the women at their home. Statistical analyses were undertaken using SPSS version 11.5. Descriptive analysis, Pearson’s Chi-square (χ² test, fisher exact test, and t-test were used statistical evaluation. RESULTS: Of the 239 pregnancies, 64 (26.8% were unwanted pregnancies. The mean age of women was respectively 25.0±5.0, and 29.0±5.4 years, for wanted, and unwanted pregnancies. Women with unwanted pregnancies were older, less educated, they had less educated husbands, had low income level, had more pregnancies, deliveries, had less than two years interval between their births. Unwanted pregnancies were observed in women using the coitus interrupts method (%53.1, effective contraceptive methods (%54.3 and not using any method (%16.3 (p<0.05. The most reasons for discontinuation were reported pregnant women as follows: side effects of methods, disapproval for husband, pregnancy occurs using the method, believe for ineffective contraceptive methods. CONCLUSION: In order to reduce the number of unwanted pregnancies and wanted abortions which reversely affect the women healthy; an appropriate contraception method must be employed. Health care providers should identify women with unwanted pregnancy to understand women's concerns and experiences using contraception. This

  1. Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women.

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    Christofides, Nicola J; Jewkes, Rachel K; Dunkle, Kristin L; McCarty, Frances; Jama Shai, Nwabisa; Nduna, Mzikazi; Sterk, Claire

    2014-01-01

    partners doubled the odds of reporting both an unplanned and unwanted pregnancy (OR 2.58 95% CI 1.07-6.25, and OR 2.21 95% CI 1.13-4.29). Although some of the measures of gender inequity were not associated with unplanned and unwanted pregnancies, there is evidence of the role of both gender power and socioeconomic status. This was evident in teenage girls who experienced physical violence being more likely to have an unwanted pregnancy. Interventions to prevent teenage pregnancies need to be tailored by socioeconomic status because some teenagers may see having a pregnancy as a way to have a more secure future. Interventions that engage with relationship dynamics of teenagers are essential if unwanted and unplanned pregnancies are to be prevented.

  2. Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow-up among a cohort of young South African women

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    Nicola J. Christofides

    2014-08-01

    that the teenage girl and her boyfriend were mutual main partners doubled the odds of reporting both an unplanned and unwanted pregnancy (OR 2.58 95% CI 1.07–6.25, and OR 2.21 95% CI 1.13–4.29. Conclusion: Although some of the measures of gender inequity were not associated with unplanned and unwanted pregnancies, there is evidence of the role of both gender power and socioeconomic status. This was evident in teenage girls who experienced physical violence being more likely to have an unwanted pregnancy. Interventions to prevent teenage pregnancies need to be tailored by socioeconomic status because some teenagers may see having a pregnancy as a way to have a more secure future. Interventions that engage with relationship dynamics of teenagers are essential if unwanted and unplanned pregnancies are to be prevented.

  3. Scaling up postabortion contraceptive service--results from a study conducted among women having unwanted pregnancies in urban and rural Tanzania

    DEFF Research Database (Denmark)

    Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose

    2005-01-01

    Tanzania and 42% in rural Tanzania stated that their pregnancy was unwanted. Contraceptive acceptance among women with unwanted pregnancies was high; 93% in urban Tanzania and 71% in rural Tanzania left with a contraceptive method. CONCLUSION: The high proportion of women with unwanted pregnancies in urban...... and rural Tanzania underlines the need of scaling up postabortion contraceptive service....

  4. [Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods].

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    Núñez-Urquiza, Rosa María; Hernández-Prado, Bernardo; García-Barrios, Cecilia; González, Dolores; Walker, Dylis

    2003-01-01

    To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR = 3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR = 2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical

  5. Estimation of the workload added on the health system due to unwanted pregnancies and Children born of these pregnancies in kohgiloyeh Boyrahmad province 2010-2011

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    zebaneh Tabeshfar

    2015-02-01

    Results: An overall 350 unwanted pregnancy cases were identified. Assuming the same unwanted pregnancies in the first half and the second year of 2009 total of 21,140 times the equivalent of 3696 hours of extra work visit were added to the labor working primary health care centers in the city. Conclusion: Unwanted pregnancies resulting in increased staff workload of health centers, and if not provided with sufficient manpower, it may lead to the reduction of maternal and child health care qualities of these centers.

  6. Primary prevention of adolescent pregnancy.

    Science.gov (United States)

    Schinke, S P; Blythe, B J; Gilchrist, L D; Burt, G A

    1981-01-01

    Teenage pregnancy is associated with many health, emotional and socioeconomic problems including higher rates of anemia, labor complications, mortality, legal and social struggles and hhigher divorce rates. Professional social workers need strategies to help teenagers avoid early, unwanted pregnancy. This paper offers promising experential and research backing for a primary prevention group work strategy for all adolescents. Social and health programs overlook educational, cognitive anc interpersonal factors biasing youths' ability to comprehend and regulate contraception. Primary prevention to assist adolescents in thinking analytically about their sexual behavior must stress problem solving and decision-making as well as facts about human reproduction and birth control. To implement decisions, youths also need interpersonal communication skills. Small groups are ideal for delivering cognitive-behavioral primary prevention. This approach is based on the premise that youths become pregnant not because of a lack of relevant information, but because they lack cognitive and behavioral skills necessary to use information. Group work involving role-playing helps develop communication skills. Results from 2 field studies describe short-term and longitudinal benefits of the prevention strategy. Professionals can reach significant numbers of youth in this way. By treating sexual issues and the risk of pregnancy as normal in adolescence, social workers can introduce information and pertinent skills to all teenagers. No one is singled out as deviant and the group format enables young people to discuss taboo topics, discovering what the norms are and gradually learning how to deal with peers, family members, techers and others. Adolescents in primary prevention groups gained knowledge, cognitive skills and communication acumen. Improved attitudes toward family planning, increased regular contraception and less unsafe sex resulted from this cognitive-behavioral approach

  7. From unwanted pregnancy to safe abortion: Sharing information about abortion in Asia through animation.

    Science.gov (United States)

    Krishnan, Shweta; Dalvie, Suchitra

    2015-05-01

    Although unsafe abortion continues to be a leading cause of maternal mortality in many countries in Asia, the right to safe abortion remains highly stigmatized across the region. The Asia Safe Abortion Partnership, a regional network advocating for safe abortion, produced an animated short film entitled From Unwanted Pregnancy to Safe Abortion to show in conferences, schools and meetings in order to share knowledge about the barriers to safe abortion in Asia and to facilitate conversations on the right to safe abortion. This paper describes the making of this film, its objectives, content, dissemination and how it has been used. Our experience highlights the advantages of using animated films in addressing highly politicized and sensitive issues like abortion. Animation helped to create powerful advocacy material that does not homogenize the experiences of women across a diverse region, and at the same time emphasize the need for joint activities that express solidarity. Copyright © 2015. Published by Elsevier Ltd.

  8. Abortion and mental health : A longitudinal study of common mental disorders among women who terminated an unwanted pregnancy

    OpenAIRE

    van Ditzhuijzen, J.M.

    2017-01-01

    In the last decade there has been renewed interest in the question whether termination of an unwanted pregnancy is linked to subsequent mental health disorders. Most research in this field is characterized by methodological limitations, and conclusions often remain disputable. To offer insight in the mental health of women who have abortions, both before and after the pregnancy termination, a prospective longitudinal cohort study was conducted, the “Dutch Abortion and Mental Health Study” (DA...

  9. Abortion and mental health : A longitudinal study of common mental disorders among women who terminated an unwanted pregnancy

    NARCIS (Netherlands)

    van Ditzhuijzen, J.M.

    2017-01-01

    In the last decade there has been renewed interest in the question whether termination of an unwanted pregnancy is linked to subsequent mental health disorders. Most research in this field is characterized by methodological limitations, and conclusions often remain disputable. To offer insight in

  10. HIV, unwanted pregnancy and abortion--where is the human rights approach?

    Science.gov (United States)

    de Bruyn, Maria

    2012-12-01

    The HIV/AIDS field is addressing how legal and policy restrictions affect access to health promotion and care, e.g., in relation to criminalization of HIV transmission, drug use and sex work. Work to address the reproductive rights of women living with HIV, particularly regarding unwanted pregnancy and abortion, has nevertheless lagged behind, despite its potential to contribute to broader advocacy for access to comprehensive reproductive health information and services for all women. It is in that context that this paper examines abortion in relation to the rights of women and girls living with HIV. The paper first presents findings from recent research on HIV-positive women's reasons for seeking abortions and experiences with abortion-related care. This is followed by a discussion of abortion in relation to human rights and how this has been both addressed and neglected in policy and guidance related to the reproductive health of women living with HIV. The concluding remarks offer recommendations for expanding efforts to provide comprehensive, human rights-based sexual and reproductive health care to women living with HIV by including abortion-related information and services. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  11. Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence.

    Science.gov (United States)

    Fergusson, David M; Horwood, L John; Boden, Joseph M

    2013-09-01

    There have been debates about the linkages between abortion and mental health. Few reviews have considered the extent to which abortion has therapeutic benefits that mitigate the mental health risks of abortion. The aim of this review was to conduct a re-appraisal of the evidence to examine the research hypothesis that abortion reduces rates of mental health problems in women having unwanted or unintended pregnancy. Analysis of recent reviews (Coleman, 2011; National Collaborating Centre for Mental Health, 2011) identified eight publications reporting 14 adjusted odds ratios (AORs) spanning five outcome domains: anxiety; depression; alcohol misuse; illicit drug use/misuse; and suicidal behaviour. For each outcome, pooled AORs were estimated using a random-effects model. There was consistent evidence to show that abortion was not associated with a reduction in rates of mental health problems (p>0.75). Abortion was associated with small to moderate increases in risks of anxiety (AOR 1.28, 95% CI 0.97-1.70; pabortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy. There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems.

  12. Teen pregnancy prevention: current perspectives.

    Science.gov (United States)

    Lavin, Claudia; Cox, Joanne E

    2012-08-01

    Teen pregnancy has been subject of public concern for many years. In the United States, despite nearly 2 decades of declining teen pregnancy and birth rates, the problem persists, with significant disparities present across racial groups and in state-specific rates. This review examines recent trends, pregnancy prevention initiatives and family planning policies that address the special needs of vulnerable youth. Unintended teen pregnancies impose potentially serious social and health burdens on teen parents and their children, as well as costs to society. Trends in teen pregnancy and birth rates show continued decline, but state and racial disparities have widened. Demographic factors and policy changes have contributed to these disparities. Research supports comprehensive pregnancy prevention initiatives that are multifaceted and promote consistent and correct use of effective methods of contraception for youth at risk of becoming pregnant. There is strong consensus that effective teen pregnancy prevention strategies should be multifaceted, focusing on delay of sexual activity especially in younger teens while promoting consistent and correct use of effective methods of contraception for those youth who are or plan to be sexually active. There is a need for further research to identify effective interventions for vulnerable populations.

  13. CDC Vital Signs: Preventing Teen Pregnancy

    Science.gov (United States)

    ... Press Kit Read the MMWR Science Clips Preventing Teen Pregnancy A Key Role for Health Care Providers Language: ... Battles: Teen Pregnancy Prevention Status Reports (PSRs): Teen Pregnancy FastStats: Teen Births Vital Signs – Preventing Teen Pregnancy [PODCAST – 1: ...

  14. Prevention of Infection in Pregnancy

    Directory of Open Access Journals (Sweden)

    William J. Ledger

    1997-01-01

    Full Text Available We believe the prevention of infection-related adverse pregnancy outcome is the most important focus for obstetricians today. An emphasis upon immunization of susceptible women, prevention of transmissible disease by modification of patient behavior, and identification and treatment of silent infections should become standards of practice. This will require educational initiatives for physicians and their patients as well as continued clinical trials to determine costs and effectiveness.

  15. Unwanted pregnancy, pregnancy loss, and other risk factors for intimate partner violence in the Democratic Republic of the Congo.

    Science.gov (United States)

    Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Ntenda, Peter A M; Chuang, Ying-Chih

    2017-11-07

    The Democratic Republic of the Congo (DRC) has one of the highest rates of violence against women in the world; however, few studies have focused on this issue. In this study, we assessed the interrelationship among intimate partner violence (IPV), unintended pregnancy, pregnancy loss, and other sociodemographic factors in the DRC. Our analyses were based on data from the DRC demographic and health survey, conducted from November 2013 to February 2014. We constructed generalized estimating equation models to analyze the data from a sample of 5,120 married women. Our results showed that having a husband or partner who exhibited controlling behaviors, women who justified wife-beating, having a mother who had experienced IPV, and having a husband or partner who consumed alcohol were positively associated with IPV, whereas decision-making autonomy among women was negatively associated with IPV. In the community, the proportion of women who had experienced IPV and that of those who had completed secondary or higher education were positively and negatively associated with any IPV type, respectively. In addition, emotional IPV and any IPV type were positively associated with pregnancy loss. Our results indicate the necessity of implementing programs targeting gender equality at both individual and community levels.

  16. Risk factors and the choice of long-acting reversible contraception following medical abortion: effect on subsequent induced abortion and unwanted pregnancy.

    Science.gov (United States)

    Korjamo, Riina; Heikinheimo, Oskari; Mentula, Maarit

    2018-04-01

    To analyse the post-abortion effect of long-acting reversible contraception (LARC) plans and initiation on the risk of subsequent unwanted pregnancy and abortion. retrospective cohort study of 666 women who underwent medical abortion between January-May 2013 at Helsinki University Hospital, Finland. Altogether 159 (23.8%) women planning post-abortion use of levonorgestrel-releasing intrauterine system (LNG-IUS) participated in a randomized study and had an opportunity to receive the LNG-IUS free-of-charge from the hospital. The other 507 (76.2%) women planned and obtained their contraception according to clinical routine. Demographics, planned contraception, and LARC initiation at the time of the index abortion were collected. Data on subsequent abortions were retrieved from the Finnish Abortion Register and electronic patient files until the end of 2014. During the 21 months ([median], IQR 20-22) follow-up, 54(8.1%) women requested subsequent abortions. When adjusted for age, previous pregnancies, deliveries, induced abortions and gestational-age, planning LARC for post-abortion contraception failed to prevent subsequent abortion (33 abortions/360 women, 9.2%) compared to other contraceptive plans (21/306, 6.9%) (HR 1.22, 95% CI 0.68-2.17). However, verified LARC initiation decreased the abortion rate (4 abortions/177 women, 2.3%) compared to women with uncertain LARC initiation status (50/489, 10.2%) (HR 0.17, 95% CI 0.06-0.48). When adjusted for LARC initiation status, age abortion (27 abortions/283 women, 9.5%) compared to women ≥25 years (27/383, 7.0%, HR1.95, 95% CI 1.04-3.67). Initiation of LARC as part of abortion service at the time of medical abortion is an important means to prevent subsequent abortion, especially among young women.

  17. Evaluating a Pregnancy and STI Prevention Programme in Rural, At-Risk, Middle School Girls in the USA

    Science.gov (United States)

    Hill, Julie C.; Lynne-Landsman, Sarah D.; Graber, Julia A.; Johnson, Kelly J.

    2016-01-01

    Objective: Young people in urban areas are often the focus of pregnancy and sexually transmitted infection (STI) prevention programmes because of their high risk of unwanted pregnancy and contracting an STI. Young people in rural areas are far less studied but also have a high risk of similar outcomes. This study evaluates Giving Our Girls…

  18. Unwanted Tattoos

    Science.gov (United States)

    ... to Choose the Best Skin Care Products Unwanted Tattoos Tattoos are no longer considered permanent and irreversible ... and don'ts for tattoos . Why remove a tattoo A variety of social, cultural and physical life ...

  19. Preventing Illegitimate Teenage Pregnancy Through Systems Interaction

    Science.gov (United States)

    Jarvis, D. L.

    1971-01-01

    Social workers, Cooperating with doctors, nurses, hospital social workers and educators in other helping systems, conducted a demonstration project described here, aimed at preventing illegitimate teenage pregnancy. (Author)

  20. Preventing urinary incontinence during pregnancy and postpartum

    DEFF Research Database (Denmark)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-01-01

    focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized...... (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations......: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy...

  1. Native Teen Voices: adolescent pregnancy prevention recommendations.

    Science.gov (United States)

    Garwick, Ann W; Rhodes, Kristine L; Peterson-Hickey, Melanie; Hellerstedt, Wendy L

    2008-01-01

    American Indian adolescent pregnancy rates are high, yet little is known about how Native youth view primary pregnancy prevention. The aim was to identify pregnancy prevention strategies from the perspectives of both male and female urban Native youth to inform program development. Native Teen Voices (NTV) was a community-based participatory action research study in Minneapolis and St. Paul, Minnesota. Twenty focus groups were held with 148 Native youth who had never been involved in a pregnancy. Groups were stratified by age (13-15 and 16-18 years) and sex. Participants were asked what they would do to prevent adolescent pregnancy if they were in charge of programs for Native youth. Content analyses were used to identify and categorize the range and types of participants' recommendations within and across the age and sex cohorts. Participants in all cohorts emphasized the following themes: show the consequences of adolescent pregnancy; enhance and develop more pregnancy prevention programs for Native youth in schools and community-based organizations; improve access to contraceptives; discuss teen pregnancy with Native youth; and use key messages and media to reach Native youth. Native youth perceived limited access to comprehensive pregnancy prevention education, community-based programs and contraceptives. They suggested a variety of venues and mechanisms to address gaps in sexual health services and emphasized enhancing school-based resources and involving knowledgeable Native peers and elders in school and community-based adolescent pregnancy prevention initiatives. A few recommendations varied by age and sex, consistent with differences in cognitive and emotional development.

  2. Legal liability for failure to prevent pregnancy (wrongful pregnancy

    Directory of Open Access Journals (Sweden)

    Lodewicus Charl Coetzee

    2017-05-01

    Full Text Available Can the conception of a child ever constitute damage recoverable in law? This article considers the liability of healthcare practitioners for failing to prevent a pregnancy. Developments leading to the recognition of wrongful pregnancy as a cause of (legal action in South Africa (SA, are briefly outlined. The salient points of the relevant judgments by SA courts are set out to expose the rationale underlying the judgments and to highlight that recognition of liability for wrongful pregnancy resulted from an application of fair and equitable principles of general application. Conduct that could expose practitioners to liability is identified from reported cases and inferred from general principles laid down in case law.

  3. Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China

    Directory of Open Access Journals (Sweden)

    Ravari Shahrzad

    2009-04-01

    Full Text Available Abstract Background To explore any association between the timing of the initiation of sexual activity and sexual behaviors and risks among university students in China. Methods Data were derived from a cross-sectional study on sexual behavior among university students conducted in Ningbo municipality, China, at the end of 2003. Students completed a self-administered, structured questionnaire. Of 1981 sexually active male students, 1908 (96.3% completed the item for timing of the initiation of sexual activity and were included in bivariate trend analyses and multiple logistic regression analyses to compare the association between this timing and sexual behavior and risks. Results Male early sexual initiators had a significantly higher risk profile, including a significantly higher proportion reporting non-regular partners (i.e., casual or commercial partners, multiple partners, diagnosis with a sexually transmitted disease (STD, partner history of pregnancy, partner history of induced abortion, and less condom and oral contraceptive use, compared with late initiators. Multivariate analyses confirmed the increased likelihood of these risks in early initiators versus late initiators, other than partner type during the last year. Conclusion Our results showed that, compared to late initiators, people who initiated sexual activity early engaged in more risky behaviors that could lead to elevated risks of unwanted pregnancies and STDs or human immunodeficiency virus infection. Sex-education strategies should be focused on an earlier age, should include advice on delaying the age of first sexual activity, and should target young people who continue to take sexual risks.

  4. Preventing Pregnancy in Younger Teens PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, more than 305,000 teens ages 15 to 19 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.

  5. Preventing Pregnancy in Younger Teens PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-04-08

    This 60 second public service announcement is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, more than 305,000 teens ages 15 to 19 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.  Created: 4/8/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/8/2014.

  6. Preventing Teen Pregnancy PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    This 60 second public service announcement is based on the April 2015 CDC Vital Signs report. Teen births in the U.S. have declined, but still, more than 273,000 infants were born to teens ages 15 to 19 in 2013. Learn about the most effective types of birth control.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  7. Prevention of preterm delivery in twin pregnancy

    DEFF Research Database (Denmark)

    Rode, Line; Tabor, Ann

    2014-01-01

    The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2...... sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore......, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies....

  8. Embarazo no deseado en adolescentes, y utilización de métodos anticonceptivos posparto Unwanted adolescent pregnancy and post-partum utilization of contraceptive methods

    Directory of Open Access Journals (Sweden)

    Rosa María Núñez-Urquiza

    2003-01-01

    potencial de cobertura aún no alcanzado entre el grupo de adolescentes, especialmente entre las que viven en áreas suburbanas y entre las no derechohabientes de la seguridad social. Asimismo, sugiere la necesidad de insistir en la promoción de la utilización de métodos anticonceptivos posparto en este grupo considerado de alto riesgo reproductivo. Además, se evidencia la necesidad de investigar sobre métodos de educación sexual y reproductiva que puedan introducirse en el sistema escolar desde el nivel primario.OBJECTIVE: To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. MATERIAL AND METHODS: A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. RESULTS: Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE and unwanted pregnancy (adjusted OR=3.03, 95% CI (1.31, 7. An association was also found between living in an urban community (adjusted OR=2.16, 95% CI (1.08, 4.33 and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive

  9. Preventing Alcohol-Exposed Pregnancy among American-Indian Youth

    Science.gov (United States)

    Jensen, Jamie; Kenyon, DenYelle Baete; Hanson, Jessica D.

    2016-01-01

    Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur preconceptually, either by reducing alcohol intake in women planning pregnancy or at risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American-Indian (AI) women is…

  10. Study of Continuance Rate and Related Causes of Discontinuance of Pregnancy Prevention Methods among Women in Yazd

    Directory of Open Access Journals (Sweden)

    H Fallahzadeh

    2008-04-01

    Full Text Available Introduction: From maturity to menopause, women are worried about pregnancy. Abstinence from sex or use of pregnancy prevention methods are choices for them. As abstinence is impossible, the only remaining choice is use of pregnancy prevention methods. Effective control of pregnancy is really essential for the health of mother and infant and also control of unplanned increase in population. Regarding the importance of continuance rate of pregnancy prevention methods (OCP, IUD, Condom &DMPA & the reasons for their disruption, this study was carried out with the aim of determining the continuance rate and reasons for discontinuance of pregnancy prevention methods in Yazd women. Methods: This was a cross-sectional study. Six urban health care centers of Yazd were selected as study clusters and information of 15-49 year old women using the pregnancy prevention methods (OCP, IUD, Condom& injection was collected via a questionnaire. The data collected was analyzed by Coplan- Mayer statistic method and variance analysis test. Results: Pregnancy prevention methods were most prevalent in the 25-34 years old age group (57%. Mean duration of pregnancy prevention method usage was 27.98 months using Caplan-mayer method with a median of 24 months. 86.3% for 6 months, 72.8% for 12 months, 62.5% for 18 months, 47.9% for 24 months, 39.9% for 30 months and 37% for 37 months had used four certain methods of pregnancy prevention (OCP, IUD, Condom and Injection. The reasons of discontinuance were disease (15.6% for OCPS, bleeding (27% for IUD, unwanted pregnancy (21% for Condoms and also disease (75% for Injection method. Discussion: According to the results, not only education programs regarding family planning before starting each pregnancy prevention method to women is recommended, but a complete incentive consultation about these methods is essential. This educational & consultation programs should be implemented initially for women using OCP method.

  11. Preventing urinary incontinence during pregnancy and postpartum: a review.

    Science.gov (United States)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-06-01

    Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease.

  12. Adolescent pregnancy. Teen perspectives on prevention.

    Science.gov (United States)

    Aquilino, M L; Bragadottir, H

    2000-01-01

    To elicit the views of teens concerning effective strategies to prevent pregnancy. Qualitative methods and a focus group approach were used. The sample consisted of male and female adolescents, 14 to 19 years of age, in grades 9 to 12, who volunteered to participate in the study. Seven groups of teens met with the investigator twice over 2 consecutive weeks. Instruments included a Screening Questionnaire and Focus Group Discussion Guidelines. Teens were concerned about teen pregnancy, and supported a comprehensive approach to sex education beginning in the early elementary grades, with age and developmentally appropriate content and reinforcement from late grade school through high school. Generally, teens thought that teaching abstinence in grade school followed by contraception education in junior high and high school was a realistic strategy for pregnancy prevention. They wanted to discuss sexual feelings as well as the mechanical aspects of sex. Finally, they did not want to be told not to have sex, but rather wanted to be guided in their own decision making. Teens wanted parents and other adults to be involved in helping them understand sexuality and make decisions about sexual behavior. Nurses who work with families need to understand why teens are becoming pregnant, provide opportunities for teens to discuss sexual behavior, and educate parents on sexual development and parent-child communication. Nurses also need to let parents and teens know that they are a resource for information, guidance, and health services related to sexual development and behavior.

  13. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy?

    Science.gov (United States)

    Xiong, Xu; Buekens, Pierre; Goldenberg, Robert L; Offenbacher, Steven; Qian, Xu

    2011-08-01

    Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes. Copyright © 2011 Mosby, Inc. All rights reserved.

  14. Prevalence and Prevention of Malaria in Pregnancy in Edo State ...

    African Journals Online (AJOL)

    Erah

    Prevention used against malaria in pregnancy is a sure safe guard against maternal morbidity/mortality and should be ... This acquired anti- malarial immunity ... her family by reducing malaria related ... complications arising during pregnancy,.

  15. Mobile Phone Apps for the Prevention of Unintended Pregnancy: A Systematic Review and Content Analysis.

    Science.gov (United States)

    Mangone, Emily Rose; Lebrun, Victoria; Muessig, Kathryn E

    2016-01-19

    Over 50% of pregnancies in the United States are unintended, meaning that the pregnancy is mistimed, unplanned, or unwanted. Unintended pregnancy increases health risks for mother and child, leads to high economic costs for society, and increases social disparities. Mobile phone ownership is rapidly increasing, providing opportunities to reach at-risk populations with reproductive health information and tailored unintended pregnancy prevention interventions through mobile phone apps. However, apps that offer support for unintended pregnancy prevention remain unevaluated. To identify, describe, and evaluate mobile phone apps that purport to help users prevent unintended pregnancy. We conducted an extensive search of the Apple iTunes and Android Google Play stores for apps that explicitly included or advertised pregnancy prevention or decision-making support in the context of fertility information/tracking, birth control reminders, contraceptive information, pregnancy decision-making, abortion information or counseling, sexual communication/negotiation, and pregnancy tests. We excluded apps that targeted medical professionals or that cost more than US $1.99. Eligible apps were downloaded and categorized by primary purpose. Data extraction was performed on a minimum of 143 attributes in 3 domains: (1) pregnancy prevention best practices, (2) contraceptive methods and clinical services, and (3) user interface. Apps were assigned points for their inclusion of features overall and for pregnancy prevention best practices and contraceptive information. Our search identified 6805 app descriptions in iTunes and Google Play. Of these, 218 unique apps met inclusion criteria and were included in the review. Apps were grouped into 9 categories: fertility trackers (n=72), centers and resources (n=38), birth control reminders (n=35), general sexual and reproductive health (SRH) information (n=17), SRH information targeted specifically to young adults (YA) (n=16), contraceptive

  16. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    Science.gov (United States)

    ... A-Glance Project Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend on Facebook Tweet ... their risk for HIV , other STDs , and unintended pregnancy . The National HIV/AIDS Strategy calls for all Americans to be ...

  17. Periodontal treatment for preventing adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush

    2015-01-01

    OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (periodontal treatment was not efficacious for any of the outcomes...

  18. Interventions for preventing unintended pregnancies among adolescents.

    Science.gov (United States)

    Oringanje, Chioma; Meremikwu, Martin M; Eko, Hokehe; Esu, Ekpereonne; Meremikwu, Anne; Ehiri, John E

    2016-02-03

    Unintended pregnancy among adolescents represents an important public health challenge in high-income countries, as well as middle- and low-income countries. Numerous prevention strategies such as health education, skills-building and improving accessibility to contraceptives have been employed by countries across the world, in an effort to address this problem. However, there is uncertainty regarding the effects of these interventions, hence the need to review the evidence-base. To assess the effects of primary prevention interventions (school-based, community/home-based, clinic-based, and faith-based) on unintended pregnancies among adolescents. We searched all relevant studies regardless of language or publication status up to November 2015. We searched the Cochrane Fertility Regulation Group Specialised trial register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015 Issue 11), MEDLINE, EMBASE, LILACS, Social Science Citation Index and Science Citation Index, Dissertations Abstracts Online, The Gray Literature Network, HealthStar, PsycINFO, CINAHL and POPLINE and the reference lists of articles. We included both individual and cluster randomised controlled trials (RCTs) evaluating any interventions that aimed to increase knowledge and attitudes relating to risk of unintended pregnancies, promote delay in the initiation of sexual intercourse and encourage consistent use of birth control methods to reduce unintended pregnancies in adolescents aged 10 years to 19 years. Two authors independently assessed trial eligibility and risk of bias, and extracted data. Where appropriate, binary outcomes were pooled using a random-effects model with a 95% confidence interval (Cl). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. We included 53 RCTs that enrolled 105,368 adolescents. Participants were ethnically diverse. Eighteen studies randomised individuals, 32

  19. Women's perspectives on falls and fall prevention during pregnancy.

    Science.gov (United States)

    Brewin, Dorothy; Naninni, Angela

    2014-01-01

    Falls are the leading cause of unintentional injury in women. During pregnancy, even a minor fall can result in adverse consequences. Evidence to inform effective and developmentally appropriate pregnancy fall prevention programs is lacking. Early research on pregnancy fall prevention suggests that exercise may reduce falls. However, acceptability and effectiveness of pregnancy fall prevention programs are untested. To better understand postpartum women's perspective and preferences on fall prevention strategies during pregnancy to formulate an intervention. Focus groups and individual interviews were conducted with 31 postpartum women using descriptive qualitative methodology. Discussion of falls during pregnancy and fall prevention strategies was guided by a focus group protocol and enhanced by 1- to 3-minute videos on proposed interventions. Focus groups were audio recorded, transcribed, and analyzed using NVivo 10 software. Emerging themes were environmental circumstances and physical changes of pregnancy leading to a fall, prevention strategies, barriers, safety concerns, and marketing a fall prevention program. Wet surfaces and inappropriate footwear commonly contributed to falls. Women preferred direct provider counseling and programs including yoga and Pilates. Fall prevention strategies tailored to pregnant women are needed. Perspectives of postpartum women support fall prevention through provider counseling and individual or supervised exercise programs.

  20. Preventing adolescent pregnancy with social and cognitive skills.

    Science.gov (United States)

    Barth, R P; Fetro, J V; Leland, N; Volkan, K

    1992-04-01

    A 15-session sex education program was delivered by teachers to 586 10th graders using techniques based on social learning theory, including modeling, in-class and out-of-class practice of skills for abstaining from sexual intercourse, and for contraception. Knowledge about reproduction and birth control, intentions to use skills to avoid pregnancy, and communication with parents about pregnancy prevention were significantly greater at posttest and 6-month follow-up for the trained group than for the control group. Members of the trained group tended to use birth control more often, especially those who started to have sexual intercourse subsequent to the program. No differences in the frequency of sexual intercourse, pregnancy scares, or pregnancies were found. Satisfaction with the program was high. Although skill training by itself may not be sufficient to significantly prevent pregnancies, this program offers promise of being a useful component of combined school, home, and community activities to prevent pregnancy.

  1. Toxoplasmosis in pregnancy: prevention, screening, and treatment.

    Science.gov (United States)

    Paquet, Caroline; Yudin, Mark H

    2013-01-01

    One of the major consequences of pregnant women becoming infected by Toxoplasma gondii is vertical transmission to the fetus. Although rare, congenital toxoplasmosis can cause severe neurological or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies. Prenatal care must include education about prevention of toxoplasmosis. The low prevalence of the disease in the Canadian population and limitations in diagnosis and therapy limit the effectiveness of screening strategies. Therefore, routine screening is not currently recommended. To review the prevention, diagnosis, and management of toxoplasmosis in pregnancy. OUTCOMES evaluated include the effect of screening on diagnosis of congenital toxoplasmosis and the efficacy of prophylaxis and treatment. The Cochrane Library and Medline were searched for articles published in English from 1990 to the present related to toxoplasmosis and pregnancy. Additional articles were identified through references of these articles. The quality of evidence is rated and recommendations made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table). Guideline implementation should assist the practitioner in developing an approach to screening for and treatment of toxoplasmosis in pregnancy. Patients will benefit from appropriate management of this condition. The Society of Obstetricians and Gynaecologists of Canada. 1. Routine universal screening should not be performed for pregnant women at low risk. Serologic screening should be offered only to pregnant women considered to be at risk for primary Toxoplasma gondii infection. (II-3E) 2. Suspected recent infection in a pregnant woman should be confirmed before intervention by having samples tested at a toxoplasmosis reference laboratory, using tests that are as accurate as possible and correctly interpreted. (II-2B) 3. If acute infection is suspected, repeat testing should be performed within 2 to 3 weeks, and consideration

  2. Prevention and management of maternal obesity in pregnancy

    Directory of Open Access Journals (Sweden)

    E. Alexopoulou

    2017-03-01

    Full Text Available Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal development of pregnancy. Moreover every obese pregnant woman should be informed about the importance of calorie - intake regulation and weight reduction both before and after pregnancy. Additional therapeutic options are bariatric surgical procedures that a woman can have before pregnancy and anticoagulation therapy during pregnancy. This article attempts brief review on the current scientific knowledge that exists about the role of nutrition and physical activity in controlling the weight of obese pregnant women and its beneficial contribution to the health of both the mother and the newborn.

  3. Prevention and management of maternal obesity in pregnancy

    OpenAIRE

    E. Alexopoulou; N. Giannousi; I. K. Thanasas

    2017-01-01

    Nowadays obesity is one of the most important nutritional problems with features contemporary epidemic which concerns not only the developed but also the developing countries. Obesity during pregnancy associate with maternal and perinatal risks that make the management of obesity, before and during pregnancy imperative. The best and most effective treatment of obesity in pregnancy is prevention. A healthy diet and regular exercise of pregnant woman is crucial for the normal dev...

  4. Cranberry in prevention of urinary tract Infections in pregnancy

    OpenAIRE

    Miranda-Machado Pablo Andrés

    2011-01-01

    The urinary infection tract is the most common infectious complication in pregnancy.The aim was to conduct a literature review of the evidence on effectiveness, safetyand cost effectiveness of cranberry products in preventing urinary tract infection inpregnancy. Studies suggest a potential protective effect of cranberry products againsturinary tract infection in pregnancy and there is no documented evidence of danger orcontraindication in pregnancy or lactation. The cost effectiveness of cran...

  5. Teenage Pregnancy Prevention and Adolescents' Sexual Outcomes: An Experiential Approach

    Science.gov (United States)

    Somers, Cheryl L.

    2006-01-01

    This study evaluates the effectiveness of an experiential approach to teen pregnancy (TP) prevention called "Baby Think It Over," a computerized infant simulator, on adolescents' attitudes and behaviors regarding teen pregnancy and sexuality. Recently, a more realistic model called "Real Care Baby" was developed. The small amount of research on…

  6. Information and preventive measures can reduce absenteeism during pregnancy

    NARCIS (Netherlands)

    Hooftman, W.; Houtman, I.L.D.

    2007-01-01

    Working during pregnancy may expose women to several risk factors. According to recent findings of the National Survey on Working Conditions, information at an early stage on the consequences of the pregnancy for the working capacity of pregnant women, as well as implementing preventive measures,

  7. Multisectoral approaches to early pregnancy prevention in colleges ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Multisectoral approaches to early pregnancy prevention in colleges in Togo. The goal of this program is to generate knowledge about the early pregnancy phenomenon through operational research, and to develop multisectoral strategies focusing on teens, in conjunction with stakeholders in the education, health and legal ...

  8. Listening to youth: teen perspectives on pregnancy prevention.

    Science.gov (United States)

    Hacker, K A; Amare, Y; Strunk, N; Horst, L

    2000-04-01

    To ascertain views of public high school students on preventing teen pregnancy. The authors hypothesized that students at varying risk for pregnancy (e.g., abstinent, consistent contraceptors, inconsistent contraceptors) would have differing views which would have implications for future pregnancy prevention programming. A 75-question anonymous survey designed for this study was administered in six Boston high schools. The sample consisted of 49% females and 51% males in 10th and 11th grades from diverse racial and ethnic backgrounds. One thousand surveys were received and analyzed using Chi-square tests to assess statistically significant differences in student responses. Sixty-three percent of the students had had sexual intercourse: 72% of males and 54% of females. Of these, 35% were consistent contraceptors and 65% were inconsistent. Students believed that having more information on pregnancy and birth control (52%), education about relationships (33%), parental communication (32%), improved contraceptive access (31%), and education about parenting realities (30%) would prevent teen pregnancy. Abstinent teens were more likely (58%) to say that information on pregnancy and birth control was important (pbirth control (p school, and health arenas can prevent pregnancy. Abstinent, consistent contraceptors, and inconsistent contraceptors have different preferences regarding strategies. This information has important implications for educational content and policy discussions.

  9. Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda.

    Science.gov (United States)

    Moos, Merry K; Bartholomew, Neva E; Lohr, Kathleen N

    2003-02-01

    Unintended pregnancies account for about half of all pregnancies in the United States and, in 1995, numbered nearly 3 million pregnancies. They pose appreciable medical, emotional, social and financial costs on women, their families and society. The US is not attaining national goals to decrease unintended pregnancies, and little is known about effective means for reducing unintended pregnancy rates in adults or adolescents.To examine the evidence about the effectiveness, benefits and harms of counseling in a clinical setting to prevent unintended pregnancy in adults and adolescents and to use the evidence to propose a research agenda.We identified English-language articles from comprehensive searches of the MEDLINE, CINAHL, PsychLit and other databases from 1985 through May 2000; the main clinical search terms included pregnancy (mistimed, unintended, unplanned, unwanted), family planning, contraceptive behavior, counseling, sex counseling, and knowledge, attitudes and behavior. We also used published systematic reviews, hand searching of relevant articles, the second Guide to Clinical Preventive Services and extensive peer review to identify important articles not otherwise found and to assure completeness. Of 673 abstracts examined, we retained 354 for full article review; of these, we used 74 for the systematic evidence review and abstracted data from 13 articles for evidence tables. Four studies addressed the effectiveness of counseling in a clinical setting in changing knowledge, skills and attitudes about contraception and pregnancy; all had poor internal validity and generalizability and collectively did not provide definitive guidance about effective counseling strategies. Nine studies (three in teenage populations) addressed the relationship of knowledge on contraceptive use and adherence. Knowledge of correct contraceptive methods may be positively associated with appropriate use, but reservations about the method itself, partner support of the method

  10. Preventing Teenage Pregnancy: A Team Approach

    OpenAIRE

    Anderson, Cheryl

    1986-01-01

    By age 16 one in three adolescents have experienced sexual intercourse. Because one-third of these sexually active teens never use contraception, they have a five-times greater risk of pregnancy than teenagers who take contraceptive measures. In 1982, one in 23 Canadian teenage girls became pregnant. Teenagers' reasons for not using contraceptives include fear of parents learning about their sexual activity, lack of knowledge about contraception, and lack of self-esteem. Parents, educators an...

  11. Empowering teenagers to prevent pregnancy: lessons from South Africa.

    Science.gov (United States)

    Jewkes, Rachel; Morrell, Robert; Christofides, Nicola

    2009-10-01

    Reducing rates of teenage pregnancy is an important part of the agenda of action for meeting most of the Millenium Development Goals. South Africa has important lessons for other countries in this regard as the rate of teenage pregnancy is high but has declined very substantially over the last twenty years. The country experiences waves of moral panic about teenage pregnancy, with assertions that current problems are rooted in accepting or even encouraging the sexual appetites of young people rather than sternly disciplining them. In this paper, we argue that the key to success in teenage pregnancy reduction has been an empowering social policy agenda that has sought to work with young people, making them aware of their rights and the risks of sexual intercourse. Furthermore, family responses and education policy have greatly reduced the potential negative impact of teenage pregnancy on the lives of teenage girls. There is tremendous scope for further progress in reducing teenage pregnancy and we argue that this lies in paying more attention to issues of gender and sexuality, including the terms and conditions under which teenagers have sex. There needs to be critical reflection and engagement with men and boys on issues of masculinity, including their role in child rearing, as well as examination within families of their engagement with supporting pregnancy prevention and responses to pregnancies.

  12. [Educational intervention for preventing unwanted pregnancies and sexually-transmitted diseases among teenagers in the city of Toledo, Spain].

    Science.gov (United States)

    Callejas Pérez, Sonsoles; Fernández Martínez, Beatriz; Méndez Muñoz, Paloma; León Martín, M Teresa; Fábrega Alarcón, Carmen; Villarín Castro, Alejandro; Rodríguez Rodríguez, Oscar; de Quirós Lorenzana, Rodrigo Bernaldo; Fortuny Tasias, Ana; López de Castro, Francisco; Fernández Rodríguez, Olga

    2005-01-01

    No-one doubts the need of effectively providing teenagers with information about birth control and sexually-transmitted diseases. This study is aimed at evaluating the results of an educational intervention related to these matters. Before-and-after study of an educational intervention (based on lectures and handing out documentation) without a control group. A questionnaire was passed out before and after the intervention to assess changes in knowledge and attitudes of the 4th-year Compulsory Secondary Education students at five schools in Toledo. The questionnaire was answered by 238 of the 268 students. The average age was 15.59. A total of 54.66% were females. In all, 24.03% had had some sexual relation. The birth control method used most often was the condom (98.24%). The girls more refuse more unprotected relations (76.5% vs. 48.6%; pbirth control methods and AIDS transmission and a more positive attitude regarding HIV.

  13. Exposure to violence among women with unwanted pregnancies and the association with post-traumatic stress disorder, symptoms of anxiety and depression.

    Science.gov (United States)

    Tinglöf, Soile; Högberg, Ulf; Lundell, Inger Wallin; Svanberg, Agneta Skoog

    2015-06-01

    The objective was to examine lifetime exposure to violence, physical and sexual, among women seeking termination of pregnancy (TOP) and its association with socio-demographic factors, PTSD, symptoms of anxiety and depression. The design of the study was a Swedish multi-centre study targeting women requesting TOP. All women requesting TOP with a gestational length less than 12 pregnancy weeks were approached for participation in the study. The questionnaire comprised the following research instruments: Screen Questionnaire-Post traumatic Stress Disorder (SQ-PTSD) and Hospital Anxiety and Depression Scale (HADS). The response rate was 57% and the final sample was 1514 women. Descriptive and analytic statistics were applied. Lifetime exposure to violence was common among women seeking abortion. Exposure to violence was associated with low education, single marital status, smoking and high alcohol consumption. Exposure to violence was associated with the occurrence of signs of PTSD and symptoms of anxiety and depression. Among those having PTSD, all had been exposed to sexual violence and almost all had been exposed to physical violence, while for those with symptoms of anxiety and depression almost half had been exposed to either physical or sexual violence. Exposure to physical and sexual abuse was common among women requesting TOP, and was strongly associated with the occurrence of PTSD, symptoms of anxiety and depression. This underscores the importance for health professionals to recognize and offer support to those women exposed to violence. Copyright © 2014. Published by Elsevier B.V.

  14. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological

  15. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  16. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2012-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  17. Vital Signs-Preventing Pregnancy in Younger Teens

    Centers for Disease Control (CDC) Podcasts

    This podcast is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, in 2012, more than 86,000 teens ages 15 to 17 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.

  18. Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

    OpenAIRE

    Figueiredo, A; Gomes, G; Campos, A

    2012-01-01

    Objectives: Literature review of classification, epidemiology, pathophysiology, microbiology, clinical presentation, diagnosis, complications, treatment and prevention of urinary tract infections (UTI) in pregnancy. Data Sources and Review Methods: Bibliographic research in Medline, through PubMed and Medscape, of systematic reviews, observational studies, clinical guidelines, meta-analyses and randomized controlled trials published between January 1992 and December 2010. Results: Asymp...

  19. Does antenatal care attendance prevent anemia in pregnancy at term?

    African Journals Online (AJOL)

    Background: Anemia in pregnancy is one of the public health problems in the developed and developing world. If uncontrolled it is a major indirect cause of maternal and perinatal morbidity and mortality. This is worst in settings with poor prenatal practices. Quality prenatal interventions therefore are expected to prevent or ...

  20. Vital Signs-Preventing Pregnancy in Younger Teens

    Centers for Disease Control (CDC) Podcasts

    2014-04-08

    This podcast is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, in 2012, more than 86,000 teens ages 15 to 17 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.  Created: 4/8/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/8/2014.

  1. The prevention of teenage pregnancy in adolescent's view

    OpenAIRE

    Fiedler, Milla Wildemberg; Araújo, Alisson; Souza, Márcia Christina Caetano de

    2015-01-01

    The objective of the research is to understand the vision of adolescents on the prevention of adolescent pregnancy in a school in the municipality of Divinópolis, Minas Gerais. This is a descriptive study, exploratory, with a qualitative approach, with 14 adolescents. Semistructured interviews. Data were analyzed and interpreted by discourse analysis. The analysis of the reports of the subjects interviewed originated four empirical categories: perception about the importance of preventing tee...

  2. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria.

    Science.gov (United States)

    Amoran, Olorunfemi E

    2012-07-30

    Teenagers younger than 15 are five times more likely to die during pregnancy or childbirth than women in their twenties and mortality rates for their infants are higher as well. This study was therefore designed to determine the recent prevalence and identify factors associated with teenage pregnancy in a rural town in Nigeria. This study is an analytical comparative cross-sectional study. A total sample of all pregnant women attending the primary health care in Sagamu local government area, Ogun State within a 2 months period were recruited into the study. A total of 225 pregnant women were recruited into the study. The prevalence of teenage pregnancy was 22.9%. Teenagers [48.2%] reported more unwanted pregnancy when compared with the older age group [13.6%] [OR = 5.91, C.I = 2.83-12.43]. About half 33 [41.1%] of the teenage pregnant women and 28.6% of the older pregnant women did not know how to correctly use condom to prevent pregnancy [OR = 0.57, C.I = 0.29-1.13]. Predictors of teenage pregnancy were low social class (OR = 2.25, C.I = 1.31-3.85], Religion (OR = 0.44, C.I = 0.21-0.91], being a student (OR = 3.27, C.I = 1.02-10.46) and having a white collar job (OR = 0.09, C.I = 0.01-0.81). The study concludes that employment in an established organization (white collar job) is highly protective against teenage pregnancy while students are becoming increasingly prone to early pregnancy. Government should structure employment in low income countries in such a way as to give a quota to adolescents who are unable to continue their education.

  3. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria

    Directory of Open Access Journals (Sweden)

    Amoran Olorunfemi E

    2012-07-01

    Full Text Available Abstract Introduction Teenagers younger than 15 are five times more likely to die during pregnancy or childbirth than women in their twenties and mortality rates for their infants are higher as well. This study was therefore designed to determine the recent prevalence and identify factors associated with teenage pregnancy in a rural town in Nigeria. Methods This study is an analytical comparative cross-sectional study. A total sample of all pregnant women attending the primary health care in Sagamu local government area, Ogun State within a 2 months period were recruited into the study. Results A total of 225 pregnant women were recruited into the study. The prevalence of teenage pregnancy was 22.9%. Teenagers [48.2%] reported more unwanted pregnancy when compared with the older age group [13.6%] [OR = 5.91, C.I = 2.83-12.43]. About half 33 [41.1%] of the teenage pregnant women and 28.6% of the older pregnant women did not know how to correctly use condom to prevent pregnancy [OR = 0.57, C.I = 0.29-1.13]. Predictors of teenage pregnancy were low social class (OR = 2.25, C.I = 1.31-3.85], Religion (OR = 0.44, C.I = 0.21-0.91], being a student (OR = 3.27, C.I = 1.02-10.46 and having a white collar job (OR = 0.09, C.I = 0.01-0.81. Conclusion The study concludes that employment in an established organization (white collar job is highly protective against teenage pregnancy while students are becoming increasingly prone to early pregnancy. Government should structure employment in low income countries in such a way as to give a quota to adolescents who are unable to continue their education.

  4. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Hansen, Kristian Schultz; Bygbjerg, Ib Christian

    2008-01-01

    The main objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive health workers and adolescent peer mobilisers could administer intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) to pregnant women. The study w...

  5. Vital Signs-Preventing Teen Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    This podcast is based on the April 2015 CDC Vital Signs report. Teen births in the U.S. have declined, but still, more than 273,000 infants were born to teens ages 15 to 19 in 2013. Learn about the most effective types of birth control.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  6. Undocumented migrants lack access to pregnancy care and prevention

    Directory of Open Access Journals (Sweden)

    Andreoli Nicole

    2008-03-01

    Full Text Available Abstract Background Illegal migration is an increasing problem worldwide and the so-called undocumented migrants encounter major problems in access to prevention and health care. The objective of the study was to compare the use of preventive measures and pregnancy care of undocumented pregnant migrants with those of women from the general population of Geneva, Switzerland. Methods Prospective cohort study including pregnant undocumented migrants presenting to the University hospital from February 2005 to October 2006. The control group consisted of a systematic sample of pregnant women with legal residency permit wishing to deliver at the same public hospital during the same time period. Results 161 undocumented and 233 control women were included in the study. Mean ages were 29.4 y (SD 5.8 and 31.1 y (SD 4.8 (p Conclusion Compared to women who are legal residents of Geneva, undocumented migrants have more unintended pregnancies and delayed prenatal care, use fewer preventive measures and are exposed to more violence during pregnancy. Not having a legal residency permit therefore suggests a particular vulnerability for pregnant women. This study underscores the need for better access to prenatal care and routine screening for violence exposure during pregnancy for undocumented migrants. Furthermore, health care systems should provide language- and culturally-appropriate education on contraception, family planning and cervical cancer screening.

  7. Intermittent preventive treatment of malaria in pregnancy

    DEFF Research Database (Denmark)

    Mbonye, A.K.; Bygbjerg, Ib Christian; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non-randomized comm......OBJECTIVE: To assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. METHODS: A non......-randomized community trial was implemented in 21 community clusters (intervention) and four clusters where health units provided routine IPTp (control). The primary outcome measures were access and adherence to IPTp, number of malaria episodes, prevalence of anaemia, and birth weight. Numbers of live births, abortions......, still births, and maternal and child deaths were secondary endpoints. FINDINGS: 1404 (67.5%) of 2081 with the new delivery system received two doses of sulfadoxine-pyrimethamine versus 281 (39.9%) of 704 with health units (P malaria episodes decreased from 906 (49...

  8. The cost-effectiveness of multi-purpose HIV and pregnancy prevention technologies in South Africa.

    Science.gov (United States)

    Quaife, Matthew; Terris-Prestholt, Fern; Eakle, Robyn; Cabrera Escobar, Maria A; Kilbourne-Brook, Maggie; Mvundura, Mercy; Meyer-Rath, Gesine; Delany-Moretlwe, Sinead; Vickerman, Peter

    2018-03-01

    A number of antiretroviral HIV prevention products are efficacious in preventing HIV infection. However, the sexual and reproductive health needs of many women extend beyond HIV prevention, and research is ongoing to develop multi-purpose prevention technologies (MPTs) that offer dual HIV and pregnancy protection. We do not yet know if these products will be an efficient use of constrained health resources. In this paper, we estimate the cost-effectiveness of combinations of candidate multi-purpose prevention technologies (MPTs), in South Africa among general population women and female sex workers (FSWs). We combined a cost model with a static model of product impact based on incidence data in South Africa to estimate the cost-effectiveness of five candidate co-formulated or co-provided MPTs: oral PrEP, intravaginal ring, injectable ARV, microbicide gel and SILCS diaphragm used in concert with gel. We accounted for the preferences of end-users by predicting uptake using a discrete choice experiment (DCE). Product availability and protection were systematically varied in five potential rollout scenarios. The impact model estimated the number of infections averted through decreased incidence due to product use over one year. The comparator for each scenario was current levels of male condom use, while a health system perspective was used to estimate discounted lifetime treatment costs averted per HIV infection. Product benefit was estimated in disability-adjusted life years (DALYs) averted. Benefits from contraception were incorporated through adjusting the uptake of these products based on the DCE and through estimating the costs averted from avoiding unwanted pregnancies. We explore the additional impact of STI protection through increased uptake in a sensitivity analysis. At central incidence rates, all single- and multi-purpose scenarios modelled were cost-effective among FSWs and women aged 16-24, at a governmental willingness-to-pay threshold of $1175/DALY

  9. Optimizing individual iron deficiency prevention strategies in physiological pregnancy

    Directory of Open Access Journals (Sweden)

    Kramarskiy V.A.

    2018-04-01

    Full Text Available Sideropenia by the end of pregnancy takes place in all mothers without exception. Moreover, the selective administration of iron preparations, in contrast to the routine, makes it possible to avoid hemochromatosis, frequency of which in the general population makes from 0.5 to 13 %. The aim of the study was to optimize the individual strategy for the prevention of iron deficiency in physiological pregnancy. A prospective pre-experimental study was conducted, the criterion of inclusion in which was the mother’s extragenital and obstetrical pathology during the first half of pregnancy, a burdened obstetric and gynecological anamnesis. The study group of 98 women with a physiological pregnancy in the period of 20 to 24 weeks was recruited by simple ran- dom selection. Serum ferritin, hemoglobin, and serum iron were used to estimate iron deficiency. In the latent stage of iron deficiency against a background of monthly correction with Fenules ® in a dose of 90 mg of elemental iron per day, there was a significant increase in ferritin and iron in the blood rotor. In healthy mothers, during the gestational period of 20–24 weeks, a regularity arises in the replenishment of iron status, especially in the case of repeated pregnancy, which is successfully satisfied during the month of Fenules ® intake in doses of 45 mg or 90 mg per day with a serum ferritin level of, respectively, 30 up to 70 μg/l or less than 30 μg/l.

  10. Teenage pregnancy prevention: the role of young men.

    Science.gov (United States)

    Vargas, Gabriela; Borus, Joshua; Charlton, Brittany M

    2017-08-01

    Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention. Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged. Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.

  11. A Clustered Randomized Controlled Trial of the Positive Prevention PLUS Adolescent Pregnancy Prevention Program.

    Science.gov (United States)

    LaChausse, Robert G

    2016-09-01

    To determine the impact of Positive Prevention PLUS, a school-based adolescent pregnancy prevention program on delaying sexual intercourse, birth control use, and pregnancy. I randomly assigned a diverse sample of ninth grade students in 21 suburban public high schools in California into treatment (n = 2483) and control (n = 1784) groups that participated in a clustered randomized controlled trial. Between October 2013 and May 2014, participants completed baseline and 6-month follow-up surveys regarding sexual behavior and pregnancy. Participants in the treatment group were offered Positive Prevention PLUS, an 11-lesson adolescent pregnancy prevention program. The program had statistically significant impacts on delaying sexual intercourse and increasing the use of birth control. However, I detected no program effect on pregnancy rates at 6-month follow-up. The Positive Prevention PLUS program demonstrated positive impacts on adolescent sexual behavior. This suggests that programs that focus on having students practice risk reduction skills may delay sexual activity and increase birth control use.

  12. Not Just Another Single Issue: Teen Pregnancy Prevention's Link to Other Critical Social Issues.

    Science.gov (United States)

    National Campaign To Prevent Teen Pregnancy, Washington, DC.

    This report discusses critical social issues linked to teen pregnancy, explaining that teen pregnancy prevention should be viewed as working to improve these social issues. After providing general background on teen pregnancy, the report offers five fact sheets: (1) "Teen Pregnancy, Welfare Dependency, and Poverty" (continuing to reduce…

  13. Interventions for preventing and treating hyperthyroidism in pregnancy.

    Science.gov (United States)

    Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

    2010-09-08

    Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 July 2010). We intended to include randomised controlled trials comparing antithyroid treatments in pregnant women with hyperthyroidism. Two review authors would have assessed trial eligibility and risk of bias, and extracted data. No trials were located. As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid drugs for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil.

  14. Interventions for preventing and treating hyperthyroidism in pregnancy

    Science.gov (United States)

    Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

    2014-01-01

    Background Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. Objectives To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (28 July 2010). Selection criteria We intended to include randomised controlled trials comparing antithyroid treatments in pregnant women with hyperthyroidism. Data collection and analysis Two review authors would have assessed trial eligibility and risk of bias, and extracted data. Main results No trials were located. Authors’ conclusions As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid drugs for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil. PMID:20824882

  15. Removal of unwanted fluid

    Science.gov (United States)

    Subudhi, Sudhakar; Sreenivas, K. R.; Arakeri, Jaywant H.

    2013-01-01

    This work is concerned with the removal of unwanted fluid through the source-sink pair. The source consists of fluid issuing out of a nozzle in the form of a jet and the sink is a pipe that is kept some distance from the source pipe. Of concern is the percentage of source fluid sucked through the sink. The experiments have been carried in a large glass water tank. The source nozzle diameter is 6 mm and the sink pipe diameter is either 10 or 20 mm. The horizontal and vertical separations and angles between these source and sink pipes are adjustable. The flow was visualized using KMnO4 dye, planer laser induced fluorescence and particle streak photographs. To obtain the effectiveness (that is percentage of source fluid entering the sink pipe), titration method is used. The velocity profiles with and without the sink were obtained using particle image velocimetry. The sink flow rate to obtain a certain effectiveness increase dramatically with lateral separation. The sink diameter and the angle between source and the sink axes don't influence effectiveness as much as the lateral separation.

  16. Using Film Clips to Teach Teen Pregnancy Prevention: "The Gloucester 18" at a Teen Summit

    Science.gov (United States)

    Herrman, Judith W.; Moore, Christopher C.; Anthony, Becky

    2012-01-01

    Teaching pregnancy prevention to large groups offers many challenges. This article describes the use of film clips, with guided discussion, to teach pregnancy prevention. In order to analyze the costs associated with teen pregnancy, a film clip discussion session based with the film "The Gloucester 18" was the keynote of a youth summit. The lesson…

  17. Girls' Participation in Sports: An Important Tool in Teen Pregnancy Prevention. Policy Brief.

    Science.gov (United States)

    Solomon, Nancy M.

    This policy brief highlights the interrelationship between sports participation and teen pregnancy prevention, noting barriers that have prevented sports from being utilized in teen pregnancy prevention. Discrimination against girls and women in school sports persists 30 years after Congress enacted Title IX, and this prevents girls and young…

  18. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2008-01-01

    and other discriminatory socio-cultural values on pregnancy; target users, perceptions and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential...... and cost-effectiveness analyses of the randomised controlled trials carried out in selected geographical settings. Such studies fail to elucidate the economic, psychosocial, managerial, organization and other contextual systemic factors influencing the operational effectiveness, compliance and coverage...... in Africa. RESULTS: The importance of IPTp in preventing unnecessary anaemia, morbidity and mortality in pregnancy and improving childbirth outcomes is highly acknowledged, although the following factors appear to be the main constraints to IPTp service delivery and uptake: cost of accessing ANC; myths...

  19. Contraceptive Use, Unwanted Pregnancies and Abortions among ...

    African Journals Online (AJOL)

    USER

    Mean age was 27.0±8.1 years, 851 (50.4%) were single and 1005 (59.6%) qualified hairdressers. 817 (56.8%) of ... Attainment of secondary school education was a predictor of contraceptive .... On the whole, 1438 (85.2%) had ever had sex and a total of 604 .... advantage of protection from sexually transmitted diseases8.

  20. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2011-01-01

    Introduction Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. The vast biomedical literature on malaria prevention focuses more on the epidemiological...... of the recommended interventions. Objective To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors in Africa...... discriminatory socio-cultural values on and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential ANC services; implementing IPTp, bednets, HIV...

  1. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    Science.gov (United States)

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  2. Sustaining Teen Pregnancy Prevention Programs in Schools: Needs and Barriers Identified by School Leaders

    Science.gov (United States)

    Craft, Lesley R.; Brandt, Heather M.; Prince, Mary

    2016-01-01

    Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…

  3. Thyroid screening in pregnancy - a compulsory preventive activity

    Directory of Open Access Journals (Sweden)

    Scrinic Olesea

    2015-08-01

    Full Text Available Obiectives: To assess the prevalence of thyroid dysfunction in a group of pregnant women, originating from Dobrogea region of southeastern Romania, considered to be an area without iodine deficiency, including the Black Sea area. Materials and methods: We enrolled 324 pregnant women in different trimesters of pregnancy. Each case was reviewed by a detailed madical history, clinical examination and by serum dosage of thyroid hormones: TSH, FT4, and the antithyroidperoxidase. They were evaluated by comparison with trimester -specific reference range for TSH recommended by American Thyroid Association, then the results were compared with those obtained using the manufacturers reference range. Abortion rate was also analysed. Results: The prevalence of thyroid dysfunction was different in all the 3 trimesters: subclinical hypothyroidism being the most frequently approx. 24% of all cases; 7% of pregnant women had overt hypothyroidism. Incidence of thyrotoxicosis in entire study cases was approx. 5.5%. The most frecvent thyroid autoimune disorders were Hashimoto thyroiditis: 42 % - I trimester, 26,6% in II trimester and about 12,5 % in III-trimester; Graves disease have an incidence of only 0,9 % (n=3.The difference between reference methods eluded a lower number of cases using manufactures reference range for TSH (P< 0,001, but higher for recommended trimester - specific TSH value, confirming the undervalueted hypothesis. The risk of misclassifying the hypothyroidism is between 3 %-8 %. Conclusion: Necessity for thyroid hormone dosage periodic/trimesterly/ in pregnancy is a preventive measure. The reference values for hormonal dosage requires trimester-specific assessment. The possibility of hormonal disorders during pregnancy is common. The need for specific therapy at diagnosis depends on the nature of hormonal disorder. Further precautions are needed in pregnant women with known autoimmune thyroid disorder or newly diagnosed

  4. Interventions for preventing recurrent urinary tract infection during pregnancy.

    Science.gov (United States)

    Schneeberger, Caroline; Geerlings, Suzanne E; Middleton, Philippa; Crowther, Caroline A

    2012-11-14

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological (antibiotics) or non-pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far little is known about the best way to prevent RUTI in pregnant women. To assess the effects of interventions for preventing recurrent urinary tract infections in pregnant women.The primary maternal outcomes were RUTI before birth (variously defined) and preterm birth (before 37 weeks). The primary infant outcomes were small-for-gestational age and total mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (8 June 2012) and reference lists of retrieved articles. Published, unpublished and ongoing randomised controlled trials (RCTs), quasi-RCTs, clustered-randomised trials and abstracts of any intervention (pharmacological and non-pharmacological) for preventing RUTI during pregnancy (compared with another intervention, placebo or with usual care). Two review authors independently evaluated the one identified trial for inclusion and assessed trial quality. Two review authors extracted data. Data were checked for accuracy. The review included one trial involving 200 women. The trial compared a daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.31 to 2.53, one study, 167 women), recurrent urinary tract infection before birth (RR 0.30, 95% CI 0.06 to 1.38; one study 167 women) and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; one study 147 women). The

  5. Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas

    Directory of Open Access Journals (Sweden)

    Massougbodji Achille

    2007-12-01

    Full Text Available Abstract Malaria in pregnancy is one of the major causes of maternal morbidity and adverse birth outcomes. In high transmission areas, its prevention has recently changed, moving from a weekly or bimonthly chemoprophylaxis to intermittent preventive treatment (IPTp. IPTp consists in the administration of a single curative dose of an efficacious anti-malarial drug at least twice during pregnancy – regardless of whether the woman is infected or not. The drug is administered under supervision during antenatal care visits. Sulphadoxine-pyrimethamine (SP is the drug currently recommended by the WHO. While SP-IPTp seems an adequate strategy, there are many issues still to be explored to optimize it. This paper reviewed data on IPTp efficacy and discussed how to improve it. In particular, the determination of both the optimal number of doses and time of administration of the drug is essential, and this has not yet been done. As both foetal growth and deleterious effects of malaria are maximum in late pregnancy women should particularly be protected during this period. Monitoring of IPTp efficacy should be applied to all women, and not only to primi- and secondigravidae, as it has not been definitively established that multigravidae are not at risk for malaria morbidity and mortality. In HIV-positive women, there is an urgent need for specific information on drug administration patterns (need for higher doses, possible interference with sulpha-based prophylaxis of opportunistic infections. Because of the growing level of resistance of parasites to SP, alternative drugs for IPTp are urgently needed. Mefloquine is presently one of the most attractive options because of its long half life, high efficacy in sub-Saharan Africa and safety during pregnancy. Also, efforts should be made to increase IPTp coverage by improving the practices of health care workers, the motivation of women and their perception of malaria complications in pregnancy. Because IPTp

  6. Practitioners' Perspectives on Cultural Sensitivity in Latina/o Teen Pregnancy Prevention

    Science.gov (United States)

    Wilkinson-Lee, Ada M.; Russell, Stephen T.; Lee, Faye C. H.

    2006-01-01

    This study examined practitioners' understandings of cultural sensitivity in the context of pregnancy prevention programs for Latina teens. Fifty-eight practitioners from teen pregnancy prevention programs in California were interviewed in a guided conversation format. Three themes emerged in our analysis. First, practitioners' definitions of…

  7. Preventing Unplanned Pregnancy and Completing College: An Evaluation of Online Lessons. 2nd Edition

    Science.gov (United States)

    Antonishak, Jill; Connolly, Chelsey

    2014-01-01

    The National Campaign to Prevent Teen and Unplanned Pregnancy published free online lessons that help students take action to prevent unplanned pregnancy and complete their education. From the fall of 2012 to the spring of 2014, approximately 2,800 students took the online lessons and participated in pre- and post-lesson evaluation surveys at four…

  8. Effectiveness of Secondary Pregnancy Prevention Programs: A Meta-Analysis

    Science.gov (United States)

    Corcoran, Jacqueline; Pillai, Vijayan K.

    2007-01-01

    Because subsequent pregnancy in teen parents often worsens the impact of adolescent parenting; therefore, a common goal of teenage parent programs has been to reduce repeat pregnancy. To examine the impact of this goal, a meta-analysis was conducted on 16 control-comparison group studies that evaluated the effect of teenage pregnancy and parenting…

  9. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.

    Science.gov (United States)

    Alfirevic, Zarko; Stampalija, Tamara; Medley, Nancy

    2017-06-06

    Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome. We searched Cochrane Pregnancy and Childbirth's Trials Register (30 June 2016) and reference lists of identified studies. We included all randomised trials of cervical suturing in singleton pregnancies. Cervical stitch was carried out when the pregnancy was considered to be of sufficiently high risk due to a woman's history, a finding of short cervix on ultrasound or other indication determined by physical exam. We included any study that compared cerclage with either no treatment or any alternative intervention. We planned to include cluster-randomised studies but not cross-over trials. We excluded quasi-randomised studies. We included studies reported in abstract form only. Three review authors independently assessed trials for inclusion. Two review authors independently assessed risk of bias and extracted data. We resolved discrepancies by discussion. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. This updated review includes a total of 15 trials (3490 women); three trials were added for this update (152 women). Cerclage versus no cerclageOverall, cerclage probably leads to a reduced risk of perinatal death when compared with no cerclage, although the confidence interval (CI) crosses the line of no effect (RR 0.82, 95% CI 0.65 to 1.04; 10 studies, 2927 women; moderate quality evidence). Considering

  10. Access to information and decision making on teenage pregnancy prevention by females in Tshwane

    OpenAIRE

    J.P.F. Masemola-Yende; Sanah M. Mataboge

    2015-01-01

    Background: The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. Objective: To explore and describe access to information and decision making...

  11. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members

    OpenAIRE

    McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete

    2015-01-01

    Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Nort...

  12. Pre-exposure prophylaxis for HIV-1 prevention does not diminish the pregnancy prevention effectiveness of hormonal contraception.

    Science.gov (United States)

    Murnane, Pamela M; Heffron, Renee; Ronald, Allan; Bukusi, Elizabeth A; Donnell, Deborah; Mugo, Nelly R; Were, Edwin; Mujugira, Andrew; Kiarie, James; Celum, Connie; Baeten, Jared M

    2014-07-31

    For women at risk of HIV-1, effective contraception and effective HIV-1 prevention are global priorities. In a clinical trial of pre-exposure prophylaxis (PrEP) for HIV-1 prevention in HIV-1-serodiscordant couples, we estimated the effectiveness of hormonal contraceptives (oral contraceptive pills, injectable depot medroxyprogesterone acetate, and hormonal implants) for pregnancy prevention relative to no contraception among 1785 HIV-1-uninfected women followed up to 36 months. We compared the effectiveness of each method among women assigned PrEP versus placebo. Contraception was not required for participation, but was offered on-site and was recorded monthly; incident pregnancy was determined by monthly urine testing. For women using no contraception, overall pregnancy incidence was 15.4% per year. Women reporting oral contraceptive use had comparable pregnancy incidence to women using no contraception, and this lack of contraceptive effectiveness was similar for those assigned PrEP and placebo (17.7 and 10.0% incidence per year, respectively; P-value for difference in effect by PrEP use = 0.24). Women reporting injectable contraception had reduced pregnancy incidence compared to those reporting no contraception, which did not differ by arm (PrEP 5.1%, placebo 5.3% per year; P-value for difference = 0.47). Contraceptive effectiveness was highest among women using implants (pregnancy incidence <1% per year in both arms). PrEP had no adverse impact on hormonal contraceptive effectiveness for pregnancy prevention. As seen previously in similar populations, women reporting contraceptive pill use had little protection from pregnancy, possibly due to poor adherence. Injectable or implantable hormonal contraception and PrEP provide effective prevention for pregnancy and HIV-1.

  13. Parental Support for Teenage Pregnancy Prevention Programmes in South Carolina Public Middle Schools

    Science.gov (United States)

    Rose, India; Prince, Mary; Flynn, Shannon; Kershner, Sarah; Taylor, Doug

    2014-01-01

    Teenage pregnancy is a major public health issue in the USA; this is especially true in the state of South Carolina (SC). Research shows that well developed, good-quality teenage pregnancy prevention (TPP) programmes can be effective in modifying young people's sexual behaviour. While several quantitative studies have examined parents' perceptions…

  14. Prevention of the Teenage Pregnancy Epidemic: A Social Learning Theory Approach.

    Science.gov (United States)

    Hagenhoff, Carol; And Others

    1987-01-01

    The review provides a social learning model for explaining adolescent sexual behavior and use/nonuse of contraceptives. The model explains behavior patterns responsible for epidemic rates of teenage pregnancies, suggests research that will result in prevention of teenage pregnancies, and incorporates a range of social/cultural factors. (DB)

  15. Updated Findings from the HHS Teen Pregnancy Prevention Evidence Review: January 2011 Through April 2013

    OpenAIRE

    Brian Goesling; Joanne Lee; Julieta Lugo-Gil; Timothy Novak

    2014-01-01

    Since 2009, the U.S. Department of Health and Human Services (HHS) has sponsored an ongoing systematic review of the teen pregnancy prevention research literature to help identify programs with evidence of effectiveness in reducing teen pregnancy, sexually transmitted infections (STIs), and associated sexual risk behaviors.

  16. Preventing Youth Pregnancy: Dialogue and Deliberation in a Science Museum Exhibit

    Science.gov (United States)

    Navas-Iannini, Ana Maria; Pedretti, Erminia

    2017-01-01

    In this article, we explore how visitors engage with a science museum exhibit that displays controversial topics. Through a case study methodology, we focus on the Brazilian exhibit "Preventing Youth Pregnancy" that delves into teen pregnancy, sexual practices, and sexually transmitted diseases. Using the lens of science communication…

  17. Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

    International Nuclear Information System (INIS)

    Hassan, J.A.; Anbareen, T.

    2011-01-01

    Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

  18. Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, J A; Anbareen, T [Dow University of Health Sciences, Karachi (Pakistan). Dept. of Gynae; Anbareen, T [Hamdard University Hospital, Karachi (Pakistan)

    2011-01-15

    Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

  19. Access to information and decision making on teenage pregnancy prevention by females in Tshwane.

    Science.gov (United States)

    Masemola-Yende, J P F; Mataboge, Sanah M

    2015-11-05

    The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa. In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semistructured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens. Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information. Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy.

  20. Prevention of Hypertensive Disorders of Pregnancy : a Novel Application of the Polypill Concept

    NARCIS (Netherlands)

    Browne, J L; Klipstein-Grobusch, K; Franx, A; Grobbee, D E

    Nearly all of the annual 287,000 global maternal deaths are preventable. Hypertensive disorders of pregnancy (HDP) are among the major causes. A novel fixed-dose combination pill or polypill to prevent cardiovascular disease is a promising strategy for prevention of HDP. The aim of this study was to

  1. Why We Need Evidence-Based, Community-Wide Approaches for Prevention of Teen Pregnancy.

    Science.gov (United States)

    Barfield, Wanda D; Warner, Lee; Kappeler, Evelyn

    2017-03-01

    Teen pregnancy and childbearing have declined over the past two decades to historic lows. The most recent declines have occurred during a time of coordinated national efforts focused on teen pregnancy. This article highlights a federal partnership to reduce teen pregnancy through the implementation of innovative, evidence-based approaches in affected communities, with a focus on reaching African-American and Latino/Hispanic youth. This initiative has the potential to transform the design and implementation of future teen pregnancy prevention efforts and provide a model that can be replicated in communities across the nation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Adoption of an Evidence-Based Teen Pregnancy Prevention Curriculum: A Case Study in a South Carolina School District

    Science.gov (United States)

    Workman, Lauren M.; Flynn, Shannon; Kenison, Kelli; Prince, Mary

    2015-01-01

    Continued efforts are needed to reduce teenage pregnancy in the United States. Implementation of evidence-based curricula in schools is one strategy toward meeting this goal. In 2010, the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) received funding to implement a teen pregnancy prevention (TPP) curriculum. Congruent with South…

  3. [Effectiveness of educational interventions for the prevention of pregnancy in adolescents].

    Science.gov (United States)

    Sanz-Martos, Sebastián; López-Medina, Isabel M; Álvarez-García, Cristina; Álvarez-Nieto, Carmen

    2018-06-11

    To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. Systematic review. The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P>.05) for any of the results analysed in this review. There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Anti-D administration in pregnancy for preventing Rhesus alloimmunisation.

    Science.gov (United States)

    McBain, Rosemary D; Crowther, Caroline A; Middleton, Philippa

    2015-09-03

    During pregnancy, a Rhesus negative (Rh-negative) woman may develop antibodies when her fetus is Rhesus positive (Rh-positive). These antibodies may harm Rh-positive babies. To assess the effects of antenatal anti-D immunoglobulin on the incidence of Rhesus D alloimmunisation when given to Rh-negative women without anti-D antibodies. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. Randomised trials in Rh-negative women without anti-D antibodies given anti-D after 28 weeks of pregnancy, compared with no treatment, placebo or a different regimen of anti-D. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included two trials involving over 4500 women, comparing anti-D prophylaxis with no anti-D during pregnancy in this review. Overall, the trials were judged to be at moderate to high risk of bias. The quality of the evidence for pre-specified outcomes was also assessed using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach.In regards to primary review outcomes, there did not appear to be a clear difference in the risks of immunisation when women who received anti-D at 28 and 34 weeks' gestation were compared with women who were not given antenatal anti-D: risk ratio (RR) for incidence of Rhesus D alloimmunisation during pregnancy was 0.42 (95% confidence interval (CI) 0.15 to 1.17, two trials, 3902 women; GRADE: low quality evidence); at birth of a Rh-positive infant the RR was 0.42 (95% CI 0.15 to 1.17, two trials, 2297 women); and within 12 months after birth of a Rh-positive infant the average RR was 0.39 (95% CI 0.10 to 1.62, two trials, 2048 women; Tau²: 0.47; I²: 39%; GRADE: low quality evidence). Neither of the trials reported on incidence of Rhesus D alloimmunisation in subsequent pregnancies.Considering secondary outcomes, in one trial, women receiving anti

  5. Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

    Science.gov (United States)

    Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

    2013-12-31

    While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

  6. Screening and treatment of asymptomatic bacteriuria in pregnancy prevent pyelonephritis.

    Science.gov (United States)

    Gratacós, E; Torres, P J; Vila, J; Alonso, P L; Cararach, V

    1994-06-01

    Although asymptomatic bacteriuria during pregnancy is associated with an increased risk of developing pyelonephritis, the effectiveness of screening programs to reduce this risk is controversial. A sharp reduction in the annual incidence of pyelonephritis (1.8% to 0.6%, P asymptomatic bacteriuria among pregnant women followed at a large teaching hospital. The data provide retrospective and prospective evidence that screening and treatment programs for asymptomatic bacteriuria during pregnancy reduce the risk of pyelonephritis in a population with a moderate to high prevalence of bacteriuria.

  7. Molar Pregnancy

    Science.gov (United States)

    ... weeks of pregnancy Ovarian cysts Anemia Overactive thyroid (hyperthyroidism) Causes A molar pregnancy is caused by an ... have this complication than a partial molar pregnancy. Prevention If you've had a molar pregnancy, talk ...

  8. Beyond Evidence-Based Interventions for Teen Pregnancy Prevention

    OpenAIRE

    Emily Scribner-O'Pray

    2017-01-01

    This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs); whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.

  9. Should drinking during pregnancy be criminalised to prevent fetal ...

    African Journals Online (AJOL)

    2016-05-26

    May 26, 2016 ... done to the child during pregnancy because she was not a legal 'person' while in the womb. So a crime of grievous bodily harm could not have been committed against her, as a fetus is not a 'person'.[25]. Alcohol is not a banned or illegal substance in SA, although its sale, advertising and use are subject to ...

  10. Beyond Evidence-Based Interventions for Teen Pregnancy Prevention

    Directory of Open Access Journals (Sweden)

    Emily Scribner-O'Pray

    2017-04-01

    Full Text Available This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs; whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.

  11. Early Fatherhood: A Mapping of the Evidence Base Relating to Pregnancy Prevention and Parenting Support

    Science.gov (United States)

    Trivedi, D.; Brooks, F.; Bunn, F.; Graham, M.

    2009-01-01

    Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual…

  12. Screening for Syphilis Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2004 U. S. Preventive Services Task Force statement about screening for syphilis in pregnancy. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits of screening, the harms of screening, and the harms of treatment

  13. Causes of unintended pregnancy among adolescents in Addis Abeba, Ethiopia

    OpenAIRE

    Nalenga, Georges Z.

    2012-01-01

    Unintended pregnancy among adolescents represents an important public health challenge in many countries, especially in developing countries. Numerous prevention strategies have been employed by countries across the world, in an effort to address this problem. However, the adolescent unwanted pregnancy still increasing in Africa, particularly in Ethiopia. It is why the researcher would like to assess the risk factors influencing the raise of this issue. The aim of the study was to identify...

  14. Evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothers.

    Science.gov (United States)

    Patchen, Loral; Letourneau, Kathryn; Berggren, Erica

    2013-01-01

    This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.

  15. Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

    Directory of Open Access Journals (Sweden)

    Susan Philliber

    2015-09-01

    Full Text Available This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

  16. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

    2009-01-01

    . SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

  17. Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template.

    Science.gov (United States)

    Beigi, Richard H; Noguchi, Lisa; Brown, Gina; Piper, Jeanna; Watts, D Heather

    2016-07-01

    Evidence-based guidance regarding use of nearly all pharmaceuticals by pregnant and lactating women is limited. Models for performing research may assist in filling these knowledge gaps. Internationally, reproductive age women are at high risk of human immunodeficiency virus (HIV) acquisition. Susceptibility to HIV infection may be increased during pregnancy, and risk of maternal-child transmission is increased with incident HIV infection during pregnancy and lactation. A multidisciplinary meeting of experts was convened at the United States National Institutes of Health to consider paradigms for drug research in pregnancy and lactation applicable to HIV prevention. This report summarizes the meeting proceedings and describes a framework for research on candidate HIV prevention agent use during pregnancy and lactation that may also have broader applications to other pharmaceutical products.

  18. Integrating Pregnancy Prevention Into an HIV Counseling and Testing Program in Pediatric Primary Care.

    Science.gov (United States)

    Wheeler, Noah J; Upadhya, Krishna K; Tawe, Marie-Sophie; Tomaszewski, Kathy; Arrington-Sanders, Renata; Marcell, Arik V

    2018-04-11

    Certified health educator (CHE)-based HIV counseling and testing typically focus on HIV and sexually transmitted infection (STI) prevention only. A quality improvement initiative examined integrating assessment of reproductive life plans, counseling about pregnancy prevention, and contraception referral into a CHE-based HIV testing program. Between February 2014 and January 2017, in one urban pediatric primary care clinic serving patients aged 0-25, CHEs assessed sexual history, HIV risk, short-term (i.e., the next 6-12 months) pregnancy desire, and current contraception method and satisfaction among patients aged 13-25 who had ever had vaginal sex, using a standardized questionnaire. Data were analyzed using a de-identified administrative dataset that also tracked referrals to initiate contraception and actual method initiation. Of 1,211 patients, most (96%) reported no short-term pregnancy or partner pregnancy desire. Use of less effective or no contraception, as well as method dissatisfaction, was common. A high proportion of female patients referred to new methods opted for more effective methods (62%) and initiated these methods (76%); a high proportion of male patients opted for receipt of condoms (67%). Patients reporting short-term pregnancy desire reported higher rates of previous pregnancy and STIs. Program findings highlight the potential benefit of integrating assessment for and counseling about pregnancy prevention in a CHE-based HIV testing program. This can more effectively address the needs of patients with concomitant risks of STI/HIV and unintended pregnancy, and link patients who do not desire pregnancy to more effective methods. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. The Zika virus and pregnancy: evidence, management, and prevention.

    Science.gov (United States)

    Citil Dogan, Ayse; Wayne, Sandra; Bauer, Samuel; Ogunyemi, Dotun; Kulkharni, Santosh K; Maulik, Devika; Carpenter, Christopher F; Bahado-Singh, Ray O

    2017-02-01

    To comprehensively review the available evidence and existing consensus reports and guidelines regarding the pregnancy and reproductive implications of the mosquito-transmitted Zika virus (ZIKV) infection. A primary focus was to provide pertinent information to aid clinicians in the management of pregnancies at risk for, exposed to, or with confirmed ZIKV infection. An extensive literature review was performed using Pubmed. Practice guidelines and consensus reports were accessed from international, national, and professional organizations' websites. The clinical articles for ZIKV infection testing varied from case reports to small epidemiologic studies. A ZIKV epidemic has been declared in several countries in the Americas. Fifty-two travel-associated ZIKV infection cases have been reported throughout the USA (as of February 10, 2016). The consequences of congenital fetal/newborn ZIKV infection could potentially have devastating consequences including miscarriage, fetal death, and major anomalies such as microcephaly, brain and brain-stem defects, and long-term neurologic sequelae. While not definitive, current evidence suggests the existence of nonvector-borne transmission through sexual activity with an infected male partner. For women at risk for sexual transmission, condom use is advised, especially during pregnancy. While ZIKV infection appears to be a mild disease in the general population the potential consequences to the fetus and newborn could be profound. Management guidelines are currently evolving and will be significantly impacted as new evidence develops. It is therefore imperative that obstetric health-care providers keep abreast of this rapidly evolving information landscape that has so far characterized this outbreak.

  20. Measures Taken to Prevent Zika Virus Infection During Pregnancy - Puerto Rico, 2016.

    Science.gov (United States)

    D'Angelo, Denise V; Salvesen von Essen, Beatriz; Lamias, Mark J; Shulman, Holly; Hernandez-Virella, Wanda I; Taraporewalla, Aspy J; Vargas, Manuel I; Harrison, Leslie; Ellington, Sascha R; Soto, Leslianne; Williams, Tanya; Rodriguez, Aurea; Shapiro-Mendoza, Carrie K; Rivera, Brenda; Cox, Shanna; Pazol, Karen; Rice, Marion E; Dee, Deborah L; Romero, Lisa; Lathrop, Eva; Barfield, Wanda; Smith, Ruben A; Jamieson, Denise J; Honein, Margaret A; Deseda, Carmen; Warner, Lee

    2017-06-09

    Zika virus infection during pregnancy remains a serious health threat in Puerto Rico. Infection during pregnancy can cause microcephaly, brain abnormalities, and other severe birth defects (1). From January 1, 2016 through March 29, 2017, Puerto Rico reported approximately 3,300 pregnant women with laboratory evidence of possible Zika virus infection (2). There is currently no vaccine or intervention to prevent the adverse effects of Zika virus infection during pregnancy; therefore, prevention has been the focus of public health activities, especially for pregnant women (3). CDC and the Puerto Rico Department of Health analyzed data from the Pregnancy Risk Assessment Monitoring System Zika Postpartum Emergency Response (PRAMS-ZPER) survey conducted from August through December 2016 among Puerto Rico residents with a live birth. Most women (98.1%) reported using at least one measure to avoid mosquitos in their home environment. However, only 45.8% of women reported wearing mosquito repellent daily, and 11.5% reported wearing pants and shirts with long sleeves daily. Approximately one third (38.5%) reported abstaining from sex or using condoms consistently throughout pregnancy. Overall, 76.9% of women reported having been tested for Zika virus by their health care provider during the first or second trimester of pregnancy. These results can be used to assess and refine Zika virus infection prevention messaging and interventions for pregnant women and to reinforce measures to promote prenatal testing for Zika.

  1. Implementation of a prospective pregnancy registry for antiretroviral based HIV prevention trials.

    Science.gov (United States)

    Mhlanga, Felix G; Noguchi, Lisa; Balkus, Jennifer E; Kabwigu, Samuel; Scheckter, Rachel; Piper, Jeanna; Watts, Heather; O'Rourke, Colin; Torjesen, Kristine; Brown, Elizabeth R; Hillier, Sharon L; Beigi, Richard

    2018-02-01

    Safety data on pregnancy and fetal outcomes among women in HIV prevention trials are urgently needed to inform use of effective antiretroviral agents for HIV prevention. We describe an effective, efficient, and novel method to prospectively collect perinatal safety data concurrent with on-going parent clinical trials. The Microbicide Trials Network (MTN)-016 study is a multinational prospective pregnancy exposure registry designed to capture pregnancy and neonatal outcomes. Studies currently contributing data to this registry included phase I and II safety trials with planned exposures to candidate HIV prevention agents, as well as phase IIB and III efficacy trials capturing data on pregnancy and infant outcomes following inadvertent fetal exposure during study participation. To date, participants from two phase I studies and two effectiveness trials have participated in MTN-016, resulting in 420 pregnant women and 381 infants enrolled. Infant retention has been high, with 329 of 381 (86%) infants completing the 12-month follow-up visit. In a research setting context, it is feasible to establish and implement a prospective, multinational HIV chemoprophylaxis pregnancy registry that will generate pregnancy exposure data in a robust fashion.

  2. Access to information and decision making on teenage pregnancy prevention by females in Tshwane

    Directory of Open Access Journals (Sweden)

    J.P.F. Masemola-Yende

    2015-11-01

    Full Text Available Background: The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. Objective: To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa. Method: In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semistructured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens. Results: Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information. Conclusion: Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy.

  3. A Systematic Review of Apps using Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP).

    Science.gov (United States)

    Chen, Elizabeth; Mangone, Emily Rose

    2016-11-10

    Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps. This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support. We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist. Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of

  4. Social Determinants and Teen Pregnancy Prevention: Exploring the Role of Nontraditional Partnerships.

    Science.gov (United States)

    Fuller, Taleria R; White, Carla P; Chu, Jocelyn; Dean, Deborah; Clemmons, Naomi; Chaparro, Carmen; Thames, Jessica L; Henderson, Anitra Belle; King, Pebbles

    2018-01-01

    Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adolescent Health funded state- and community-based organizations to develop and implement the Teen Pregnancy Prevention Community-Wide Initiative. This effort approached teen pregnancy from an SDOH perspective, by identifying contextual factors that influence teen pregnancy and other adverse sexual health outcomes among vulnerable youth. Strategies included, but were not limited to, conducting a root cause analysis and establishing nontraditional partnerships to address determinants identified by community members. This article describes the value of an SDOH approach for achieving health equity, explains the integration of such an approach into community-level teen pregnancy prevention activities, and highlights two project partners' efforts to establish and nurture nontraditional partnerships to address specific SDOH.

  5. The COX-2 inhibitor meloxicam prevents pregnancy when administered as an emergency contraceptive to nonhuman primates.

    Science.gov (United States)

    McCann, Nicole C; Lynch, Terrie J; Kim, Soon Ok; Duffy, Diane M

    2013-12-01

    Cyclooxygenase-2 (COX-2) inhibitors reduce prostaglandin synthesis and disrupt essential reproductive processes. Ultrasound studies in women demonstrated that oral COX-2 inhibitors can delay or prevent follicle collapse associated with ovulation. The goal of this study was to determine if oral administration of a COX-2 inhibitor can inhibit reproductive function with sufficient efficacy to prevent pregnancy in primates. The COX-2 inhibitor meloxicam (or vehicle) was administered orally to proven fertile female cynomolgus macaques using one emergency contraceptive model and three monthly contraceptive models. In the emergency contraceptive model, females were bred with a proven fertile male once 2±1 days before ovulation, returned to the females' home cage, and then received 5 days of meloxicam treatment. In the monthly contraceptive models, females were co-caged for breeding with a proven fertile male for a total of 5 days beginning 2±1 days before ovulation. Animals received meloxicam treatment (1) cycle days 5-22, or (2) every day, or (3) each day of the 5-day breeding period. Female were then assessed for pregnancy. The pregnancy rate with meloxicam administration using the emergency contraception model was 6.5%, significantly lower than the pregnancy rate of 33.3% when vehicle without meloxicam was administered. Pregnancy rates with the three monthly contraceptive models (75%-100%) were not consistent with preventing pregnancy. Oral COX-2 inhibitor administration can prevent pregnancy after a single instance of breeding in primates. While meloxicam may be ineffective for regular contraception, pharmacological inhibition of COX-2 may be an effective method of emergency contraception for women. COX-2 inhibitors can interfere with ovulation, but the contraceptive efficacy of drugs of this class has not been directly tested. This study, conducted in nonhuman primates, is the first to suggest that a COX-2 inhibitor may be effective as an emergency contraceptive.

  6. Progesterone for the prevention of preterm birth in women with multiple pregnancies: the AMPHIA trial

    Directory of Open Access Journals (Sweden)

    Scheepers Hubertina CJ

    2007-06-01

    Full Text Available Abstract Background 15% of multiple pregnancies ends in a preterm delivery, which can lead to mortality and severe long term neonatal morbidity. At present, no generally accepted strategy for the prevention of preterm birth in multiple pregnancies exists. Prophylactic administration of 17-alpha hydroxyprogesterone caproate (17OHPC has proven to be effective in the prevention of preterm birth in women with singleton pregnancies with a previous preterm delivery. At present, there are no data on the effectiveness of progesterone in the prevention of preterm birth in multiple pregnancies. Methods/Design We aim to investigate the hypothesis that 17OHPC will reduce the incidence of the composite neonatal morbidity of neonates by reducing the early preterm birth rate in multiple pregnancies. Women with a multiple pregnancy at a gestational age between 15 and 20 weeks of gestation will be entered in a placebo-controlled, double blinded randomised study comparing weekly 250 mg 17OHPC intramuscular injections from 16–20 weeks up to 36 weeks of gestation versus placebo. At study entry, cervical length will be measured. The primary outcome is composite bad neonatal condition (perinatal death or severe morbidity. Secondary outcome measures are time to delivery, preterm birth rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal morbidity, maternal admission days for preterm labour and costs. We need to include 660 women to indicate a reduction in bad neonatal outcome from 15% to 8%. Analysis will be by intention to treat. We will also analyse whether the treatment effect is dependent on cervical length. Discussion This trial will provide evidence as to whether or not 17OHPC-treatment is an effective means of preventing bad neonatal outcome due to preterm birth in multiple pregnancies. Trial registration Current Controlled Trials ISRCTN40512715

  7. Comprehensive care and pregnancy: The unmet care needs of pregnant women with a history of rape

    Science.gov (United States)

    Munro, Michelle L.; Rietz, Melissa Foster

    2013-01-01

    This paper proposes a framework for assessing the unmet needs of rape survivors during pregnancy based on the Sexual Assault Nurse Examiner (SANE) practice level theory and an empirical exploration of rape survivors’ health status in pregnancy via a secondary analysis. Our findings indicate that there may be unmet needs in pregnancy related to all five post-assault comprehensive care components: (1) physical care, (2) pregnancy prevention, (3) sexually transmitted infection screening, (4) psychological care, and (5) legal care. Rape history and its current impact on the survivor predicted somatic disorders, substance use, unwanted pregnancy, infections, posttraumatic stress disorder, and recent abuse. PMID:23215990

  8. [Venous thromboembolism prevention in pregnancy and the postpartum period in Primary and Specialized Care].

    Science.gov (United States)

    Gallo-Vallejo, J L; Naveiro-Fuentes, M; Puertas-Prieto, A; Gallo-Vallejo, F J

    2017-09-01

    After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Practical Approaches to Evaluating Progress and Outcomes in Community-Wide Teen Pregnancy Prevention Initiatives.

    Science.gov (United States)

    Tevendale, Heather D; Condron, D Susanne; Garraza, Lucas Godoy; House, L Duane; Romero, Lisa M; Brooks, Megan A M; Walrath, Christine

    2017-03-01

    This paper presents an overview of the key evaluation components for a set of community-wide teen pregnancy prevention initiatives. We first describe the performance measures selected to assess progress toward meeting short-term objectives on the reach and quality of implementation of evidence-based teen pregnancy prevention interventions and adolescent reproductive health services. Next, we describe an evaluation that will compare teen birth rates in intervention communities relative to synthetic control communities. Synthetic controls are developed via a data-driven technique that constructs control communities by combining information from a pool of communities that are similar to the intervention community. Finally, we share lessons learned thus far in the evaluation of the project, with a focus on those lessons that may be valuable for local communities evaluating efforts to reduce teen pregnancy. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  11. Mediation Analysis of an Adolescent HIV/STI/Pregnancy Prevention Intervention

    Science.gov (United States)

    Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.

    2014-01-01

    Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…

  12. Comparing School-Based Teen Pregnancy Prevention Programming: Mixed Outcomes in an At-Risk State

    Science.gov (United States)

    Oman, Roy F.; Merritt, Breanca T.; Fluhr, Janene; Williams, Jean M.

    2015-01-01

    Background: The purpose of this study is to compare the effectiveness of a national comprehensive teen pregnancy prevention (TPP) intervention to a national abstinence-only TPP intervention on middle school students' knowledge, attitudes, and behaviors related to teen sexual behaviors in a state with high teen birth rates. Methods: Pre- and…

  13. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy

    NARCIS (Netherlands)

    Hommerich, Lena; von Oertzen, Christa; Bedu-Addo, George; Holmberg, Ville; Acquah, Patrick A.; Eggelte, Teunis A.; Bienzle, Ulrich; Mockenhaupt, Frank P.

    2007-01-01

    Intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) has been adopted as policy by many countries in sub-Saharan Africa. However, data on the post-implementation effectiveness of this measure are scarce. Clinical and parasitological parameters were assessed among

  14. Influence of Professional Preparation and Class Structure on HIV, STD, and Pregnancy Prevention Education

    Science.gov (United States)

    Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.

    2014-01-01

    Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…

  15. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  16. The role of nutrition in caries prevention and maintenance of oral health during pregnancy

    OpenAIRE

    Jevtić Marija; Pantelinac Jelena; Jovanović-Ilić Tatjana; Petrović Vasa; Grgić Olja; Blažić Larisa

    2015-01-01

    Introduction. Pregnancy may pose an increased risk for the development of caries and other oral health problems. Continuous screening of oral health status, implementing appropriate preventive measures (particularly oral hygiene, healthy diet plans and education) is of paramount importance not only for oral health but also for the general health status of the future mother and her offspring. Effects of Food on Caries Development. Caries prevention through h...

  17. Teen Pregnancy and Childbearing

    Science.gov (United States)

    ... Pregnancy has sub items, Reproductive Health & Teen Pregnancy Contraceptive Use STDs Teen Pregnancy & Childbearing Teen Pregnancy Prevention Program Trends Negative Impacts Strategies & Approaches for Prevention Engaging Adolescent Males in Prevention Tips for Parents of Teens ...

  18. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and hea...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  19. Malaria prevention in pregnancy among traditional birth attendants ...

    African Journals Online (AJOL)

    Background: Malaria accounts for approximately 1 million deaths annually and about 300,000 deaths in Nigeria alone. Pregnant women are particularly vulnerable to adverse consequences of malaria. The National Malaria Policy has adopted the use of Intermittent Preventive Treatment and Insecticide Treated Net for ...

  20. Evaluation of an infant simulator intervention for teen pregnancy prevention.

    Science.gov (United States)

    Herrman, Judith W; Waterhouse, Julie K; Chiquoine, Julie

    2011-01-01

    To evaluate the effectiveness of simulation as a strategy to influence teens' perceptions of pregnancy and parenting. This pilot study was a preexperimental, one group pre/posttest design. The school-based wellness center of a high school was the setting for the weekly sessions and the pre/posttest administration. Sample members participated in 6 weekly Baby Think it Over (BTIO) classes and an infant simulator experience. The final sample included 79 teens age 14 to 18 years who attended one of eight BTIO sessions. We used the Thoughts on Teen Parenting Survey (TTPS) to assess the perceptions of teens with regard to the costs and rewards associated with teen parenting. The TTPS yields a composite score of the teen attitudes toward the teen parenting experience and eight subscale scores that assess different areas of teen life. No significant differences were found in the mean pre/posttest scores or in correlations of the demographic data and mean scores. Two significant differences in pre/posttest subscale scores were in the areas of friends and personal characteristics. The results of this study suggest that the effectiveness of using infant simulators to influence the perceptions of teens about the reality of teen parenting is minimal. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  1. Contraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trial.

    Science.gov (United States)

    Akello, Carolyne A; Bunge, Katherine E; Nakabiito, Clemensia; Mirembe, Brenda G; Fowler, Mary Glenn; Mishra, Anupam; Marrazzo, Jeanne; Chirenje, Zvavahera M; Celum, Connie; Balkus, Jennifer E

    2017-06-01

    Recent HIV prevention trials required use of effective contraceptive methods to fulfill eligibility for enrollment. We compared pregnancy rates in a subset of participants enrolled in the Microbicide Trials Network protocol (MTN-003), a randomized trial of chemoprophylaxis to prevent HIV acquisition among women aged 18-45 years who initiated depot medroxyprogesterone acetate (DMPA) or combined oral contraceptives (COCs) at enrollment, relative to those already using DMPA or COCs. Data were analyzed from MTN-003 participants from Uganda. Before enrollment, information on contraceptive type and initiation date was obtained. Urine pregnancy tests were performed at monthly follow-up visits. Cox proportional hazards models were used to compare pregnancy incidence among new users (initiated ≤60 days before enrollment) and established users (initiated >60 days before enrollment). Of 322 women enrolled, 296 were COC or DMPA users, 82 (28%) were new users, and 214 (72%) were established users. Pregnancy incidence was higher among new contraceptive users compared to established users (20.70% vs. 10.55%; adjusted hazard ratio [HR] = 1.66; 95% confidence interval [95% CI] 0.93-2.96). Among DMPA users, pregnancy incidence was 10.20% in new users versus 3.48% in established users (HR = 2.56; 95% CI 0.86-7.65). Among new COC users, pregnancy incidence was 42.67% in new users versus 23.67% in established COC users (adjusted HR = 1.74; 95% CI 0.87-3.48). New contraceptive users, regardless of method, at the Uganda MTN-003 site had an increased pregnancy risk compared to established users, which may be due to contraceptive initiation primarily for trial eligibility. New users may benefit from intensive contraceptive counseling and additional contraceptive options, including longer acting reversible contraceptives.

  2. Contraceptive Use Effectiveness and Pregnancy Prevention Information Preferences Among Heterosexual and Sexual Minority College Women.

    Science.gov (United States)

    Blunt-Vinti, Heather D; Thompson, Erika L; Griner, Stacey B

    2018-04-14

    Previous research shows that sexual minority women have higher rates of unintended pregnancy than heterosexual women, but has not considered the wide range of contraceptive method effectiveness when exploring this disparity. We examine contraceptive use effectiveness and desire for pregnancy prevention information among college women across sexual orientation identity as a risk factor for unintended pregnancy. Using the National College Health Assessment Fall-2015 dataset, restricted to women who reported engaging in vaginal sex and not wanting to be pregnant (N = 6,486), logistic regression models estimated the odds of contraceptive method effectiveness and desire for pregnancy prevention information by sexual orientation. Most women (57%) reported using a moderately effective contraceptive method (e.g., pill, patch, ring, shot) at last vaginal sex. Compared with heterosexual women, bisexual (adjusted odds ratio [aOR], 0.48; 95% confidence interval [CI], 0.37-0.62), lesbian (aOR, 0.03; 95% CI, 0.02-0.06), pansexual/queer (aOR, 0.38; 95% CI, 0.25-.56) and other (aOR, 0.50; 95% CI, 0.30-0.81) women were significantly less likely to have used a moderately effective method compared with no method. Only 9% of the sample used a highly effective method; asexual (aOR, 0.58; 95% CI, 0.37-0.92) and lesbian (aOR, 0.07; 95% CI, 0.03-0.20) women were significantly less likely than heterosexual women to have used these methods. Pansexual/queer and bisexual women were more likely than heterosexual women to desire pregnancy prevention information. Several groups of sexual minority women were less likely than heterosexual women to use highly or moderately effective contraceptive methods, putting them at increased risk for unintended pregnancy, but desired pregnancy prevention information. These findings bring attention to the importance of patient-centered sexual and reproductive care to reduce unintended pregnancy. Copyright © 2018 Jacobs Institute of Women's Health. Published

  3. Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?

    Science.gov (United States)

    Hudson, Angela L

    2012-10-01

    Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. HIV, other STD, and pregnancy prevention education in public secondary schools -- 45 states, 2008-2010.

    Science.gov (United States)

    2012-04-06

    In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.

  5. Born too soon: care before and between pregnancy to prevent preterm births: from evidence to action.

    Science.gov (United States)

    Dean, Sohni V; Mason, Elizabeth; Howson, Christopher P; Lassi, Zohra S; Imam, Ayesha M; Bhutta, Zulfiqar A

    2013-01-01

    Providing care to adolescent girls and women before and between pregnancies improves their own health and wellbeing, as well as pregnancy and newborn outcomes, and can also reduce the rates of preterm birth. This paper has reviewed the evidence-based interventions and services for preventing preterm births, reported the findings from research priority exercise, and prescribed actions for taking this call further. Certain factors in the preconception period have been shown to increase the risk for prematurity and, therefore, preconception care services for all women of reproductive age should address these risk factors through preventing adolescent pregnancy, preventing unintended pregnancies, promoting optimal birth spacing, optimizing pre-pregnancy weight and nutritional status (including a folic acid-containing multivitamin supplement) and ensuring that all adolescent girls have received complete vaccination. Preconception care must also address risk factors that may be applicable to only some women. These include screening for and management of chronic diseases, especially diabetes; sexually-transmitted infections; tobacco and smoke exposure; mental health disorders, notably depression; and intimate partner violence. The approach to research in preconception care to prevent preterm births should include a cycle of development and delivery research that evaluates how best to scale up coverage of existing evidence-based interventions, epidemiologic research that assesses the impact of implementing these interventions and discovery science that better elucidates the complex causal pathway of preterm birth and helps to develop new screening and intervention tools. In addition to research, policy and financial investment is crucial to increasing opportunities to implement preconception care, and rates of prematurity should be included as a tracking indicator in global and national maternal child health assessments.

  6. Excessive or unwanted hair in women

    Science.gov (United States)

    Hypertrichosis; Hirsutism; Hair - excessive (women); Excessive hair in women; Hair - women - excessive or unwanted ... Women normally produce low levels of male hormones (androgens). If your body makes too much of this ...

  7. Pregnancy, contraceptive use, and HIV acquisition in HPTN 039: relevance for HIV prevention trials among African women.

    Science.gov (United States)

    Reid, Stewart E; Dai, James Y; Wang, Jing; Sichalwe, Bupe N; Akpomiemie, Godspower; Cowan, Frances M; Delany-Moretlwe, Sinead; Baeten, Jared M; Hughes, James P; Wald, Anna; Celum, Connie

    2010-04-01

    Biomedical HIV prevention trials enroll sexually active women at risk of HIV and often discontinue study product during pregnancy. We assessed risk factors for pregnancy and HIV acquisition, and the effect of pregnancy on time off study drug in HIV Prevention Trials Network 039. A total of 1358 HIV negative, herpes simplex virus type 2-seropositive women from South Africa, Zambia, and Zimbabwe were enrolled and followed for up to 18 months. A total of 228 pregnancies occurred; time off study drug due to pregnancy accounted for 4% of woman-years of follow-up among women. Being pregnant was not associated with increased HIV risk (hazard ratio 0.64, 95% confidence interval 0.23-1.80, P = 0.40). However, younger age was associated with increased risk for both pregnancy and HIV. There was no association between condom use as a sole contraceptive and reduced pregnancy incidence; hormonal contraception was not associated with increased HIV risk. Bacterial vaginosis at study entry was associated with increased HIV risk (hazard ratio 2.03, P = 0.02). Pregnancy resulted in only a small amount of woman-time off study drug. Young women are at high risk for HIV and are an appropriate population for HIV prevention trials but also have higher risk of pregnancy. Condom use was not associated with reduced incidence of pregnancy.

  8. Implementation of Community-Wide Teen Pregnancy Prevention Initiatives: Focus on Partnerships.

    Science.gov (United States)

    Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H

    2017-03-01

    Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. Pregnancy

    Science.gov (United States)

    ... current.html ACOG Committee on Obstetric Practice and Society for Maternal-Fetal Medicine. (2013; Reaffirmed 2015). Committee Opinion No. 579. Definition of term pregnancy. Retrieved May 20, 2016, from ...

  10. Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy.

    Science.gov (United States)

    Fernández, Leónides; Cárdenas, Nivia; Arroyo, Rebeca; Manzano, Susana; Jiménez, Esther; Martín, Virginia; Rodríguez, Juan Miguel

    2016-03-01

    Previous studies have shown that oral administration of lactobacilli can be an efficient approach to treat lactational infectious mastitis. In this trial, we have evaluated the potential of Lactobacillus salivarius PS2 to prevent this condition when orally administered during late pregnancy to women who had experienced infectious mastitis after previous pregnancies. In this study, 108 pregnant women were randomly assigned to one of 2 groups. Those in the probiotic group (n = 55) ingested daily 9 log10 colony-forming units of L. salivarius PS2 from approximately week 30 of pregnancy until delivery, whereas those in the placebo group (n = 53) received a placebo. The occurrence of mastitis was evaluated during the first 3 months after delivery. Globally, 44 of 108 women (41%) developed mastitis; however, the percentage of women with mastitis in the probiotic group (25% [n = 14]) was significantly lower than in the control group (57% [n = 30]). When mastitis occurred, the milk bacterial counts in the probiotic group were significantly lower than those obtained in the placebo group. Oral administration of L. salivarius PS2 during late pregnancy appears to be an efficient method to prevent infectious mastitis in a susceptible population. NCT01505361. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  11. Anaemia Prevention In Pregnancy Among Antenatal Clinic Attendees In A General Hospital In Lagos.

    Science.gov (United States)

    Yesufu, B M; Olatona, F A; Abiola, A O; Ibrahim, M T O

    2013-01-01

    Anemia is the world's second leading cause of disability and thus one of the most serious global public health problems. The World Health Organization (WHO) estimates that an average of 56% of pregnant women in developing countries, are anaemic. This study was conducted to. determine the knowledge, attitude and practices of prevention of anaemia in pregnancy amongst pregnant women attending the Antenatal Clinic at Ifako-Ijaiye General Hospital. The design was cross-sectional descriptive study. Simple random sampling method was used to select two hundred and twenty respondents (220). A pretested, structured, interviewer administered questionnaires were used for data collection. Majority (95%) of the respondents was aware of anemia in pregnancy but the mean knowledge score was 56.5%. Less than half (46.3%) of the respondents thought that contraceptives could help prevent anemia in pregnancy by reducing closely spaced pregnancies. Only 31.8% were compliant with the use of iron supplements. About one third (33.2%) didn't combine drinking tea with meals while 47.3% of the respondents didn't use iron supplements with milk products. The study showed that most of the respondents had a moderate level of knowledge, and positive attitude towards contraceptive use but a high proportion were not compliant with the daily use of iron supplements. It is recommended that health education of women as well as close family members should be reinforced to improve the compliance with supplements.

  12. A decade of malaria during pregnancy in Brazil: what has been done concerning prevention and management

    Directory of Open Access Journals (Sweden)

    Paola Marchesini

    2014-08-01

    Full Text Available In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012 using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

  13. Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality

    Directory of Open Access Journals (Sweden)

    Giliana M. Maxwell

    2016-04-01

    Full Text Available Background: Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. Aim: The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Setting: The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. Methodology: A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Results: Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. Conclusion: The conclusion drawn was that learners are aware of the measures for preventing TP. Keywords

  14. The Family Festival Prevention Model: Findings from a Pilot of a Teenage Pregnancy Prevention Programme Conceptualised by and for Mexican American Communities

    Science.gov (United States)

    Murphy-Erby, Yvette; Stauss, Kim; Koh, Eun

    2015-01-01

    Despite an overall reduction in teenage pregnancy rates in the USA, the decrease for young women of Mexican heritage in the USA has been less significant than the decrease for their White and African-American peers. Furthermore, the availability of teenage pregnancy prevention models that are conceptualised specifically for people of Mexican…

  15. Effects of a teenage pregnancy prevention program in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Taylor, Myra; Jinabhai, Champak; Dlamini, Siyabonga; Sathiparsad, Reshma; Eggers, Matthijs S; De Vries, Hein

    2014-01-01

    Researchers aimed to determine the effects of a teenage pregnancy (TP) prevention program for 816 high school students attending 16 KwaZulu-Natal, South African schools through a randomized control trial. Data were collected at baseline and at the 8-month follow-up in 2009. Results were calculated using multivariate analyses of program effects employing Mplus 6, and indicated significantly healthier attitudes, including intentions to abstain from sex whilst at school, plans to communicate with partners about teenage pregnancy, and increased reports of condom use. Researchers thus provide some support for the effectiveness of a TP prevention program that should be further strengthened in a comprehensive approach that includes schools and families.

  16. Essential competencies in nursing education for prevention and care related to unintended pregnancy.

    Science.gov (United States)

    Hewitt, Caroline; Cappiello, Joyce

    2015-01-01

    To identify the essential competencies for prevention and care related to unintended pregnancy to develop program outcomes for nursing curricula. Modified Delphi study. National. Eighty-five nurse experts, including academic faculty and advanced practice nurses providing sexual and reproductive health care in primary or specialty care settings. Expert panelists completed a three-round Delphi study using an electronic survey. Eighty-five panelists completed the first round survey, and 72 panelists completed all three rounds. Twenty-seven items achieved consensus of at least 75% of the experts by the third round to comprise the educational competencies. Through an iterative process, experts in prevention and care related to unintended pregnancy reached consensus on 27 core educational competencies for nursing education. The competencies provide a framework for curricular development in an important area of nursing education. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  17. Shifting the paradigm in Oregon from teen pregnancy prevention to youth sexual health.

    Science.gov (United States)

    Nystrom, Robert J; Duke, Jessica E A; Victor, Brad

    2013-01-01

    Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being. During 2005, the Oregon Governor's Office requested that an ad hoc committee of state agency and private partners develop recommendations for the next phase of teen pregnancy prevention. As a result of that collaborative effort, engagement of young people, and community input, the Oregon Youth Sexual Health Plan was released in 2009. The plan focuses on development of young people and embraces sexuality as a natural part of adolescent development. The plan's five goals and eight objectives guide the work of state agencies and partners addressing youth sexual health. Oregon's development of a statewide plan can serve as a framework for other states and entities to address all aspects of youth sexual health.

  18. Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation.

    Science.gov (United States)

    Nezlek, J B; Galano, J

    1993-09-01

    This paper presents the results of a study of state-wide adolescent pregnancy prevention coalitions. Key informants in five states throughout the southern United States were given semi-structured interviews regarding the adolescent pregnancy prevention coalitions in their states. From these interviews and other documents, conclusions were drawn regarding the nature and importance of the environments within which these coalitions operate, the universe of activities in which coalitions engage, and the stages of development of these coalitions. Katz and Kahn's model of social organizations served as the basis for understanding coalitions in terms of these three considerations. Future research should consider the utility of organizational models that can explain more fully the organization--committee hybrid structure that tends to characterize these coalitions.

  19. Preventative Valve-Sparing Aortic Root Replacement and Pregnancy Outcome in Marfan Syndrome

    OpenAIRE

    Sokol, Vesna; Zlopaša, Gordan; Herman, Mislav; Planinić, Pavao; Micevska, Ana

    2012-01-01

    In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with ...

  20. Optimizing Prevention of HIV and Unplanned Pregnancy in Discordant African Couples.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Haddad, Lisa B; Khu, Naw Htee; Brill, Ilene; Onwubiko, Udodirim; Chomba, Elwyn; Tichacek, Amanda; Allen, Susan

    2017-08-01

    Dual method use, which combines condoms with a more effective modern contraceptive to optimize prevention of HIV and unplanned pregnancy, is underutilized in high-risk heterosexual couples. Heterosexual HIV-discordant Zambian couples were enrolled from couples' voluntary HIV counseling and testing services into an open cohort with 3-monthly follow-up (1994-2012). Relative to dual method use, defined as consistent condom use plus modern contraception, we examine predictors of (1) condom-only use (suboptimal pregnancy prevention) or (2) modern contraceptive use with inconsistent condom use (effective pregnancy prevention and suboptimal HIV prevention). Among 3,049 couples, dual method use occurred in 28% of intervals in M+F- and 23% in M-F+, p HIV+ (adjusted hazard ratio, aHR = 1.15); baseline oral contraceptive pill (aHR = 0.76), injectable (aHR = 0.48), or implant (aHR = 0.60) use; woman's age (aHR = 1.04 per 5 years) and lifetime number of sex partners (aHR = 1.01); postpartum periods (aHR = 1.25); and HIV stage of the index partner III/IV versus I (aHR = 1.10). Predictors (p HIV+ male circumcision (aHR = 1.51), while time-varying implant use was associated with more consistent condom use (aHR = 0.80). Three-quarters of follow-up intervals did not include dual method use. This highlights the need for counseling to reduce unintended pregnancy and HIV transmission and enable safer conception.

  1. The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

    Science.gov (United States)

    Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

    2017-01-01

    We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

  2. Early fatherhood: a mapping of the evidence base relating to pregnancy prevention and parenting support.

    Science.gov (United States)

    Trivedi, D; Brooks, F; Bunn, F; Graham, M

    2009-12-01

    Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual health programmes that are most effective from the perspective of young men. We conducted a systematic mapping to identify studies involving young men aimed at preventing teenage pregnancy, improving outcomes for teenage fathers or exploring the perspectives of young men around pregnancy and fatherhood. We searched a wide range of electronic databases from January 1996 to August 2008. Three quantitative and 15 qualitative studies were identified, of which nine were UK based. Key themes related to the inappropriateness of current sexual health promotion to respond to the needs of young men. While young men often possessed very similar ideals to young women, existing programmes were problematic when they negatively stereotyped young men and ineffectively addressed models of masculinity or the difficulties young men may have forming meaningful relationships. Further investigations are required on programme development for young men, particularly on sexual health promotion interventions for 'looked-after' young men and those from unstable childhoods.

  3. Teen Pregnancy Prevention: Implementation of a Multicomponent, Community-Wide Approach.

    Science.gov (United States)

    Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala

    2017-03-01

    This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. Preventing malaria in pregnancy through community-directed interventions: evidence from Akwa Ibom State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ishola Gbenga

    2011-08-01

    Full Text Available Abstract Background Despite massive anti-malaria campaigns across the subcontinent, effective access to intermittent preventive treatment (IPTp and insecticide-treated nets (ITNs among pregnant women remain low in large parts of sub-Saharan Africa. The slow uptake of malaria prevention products appears to reflect lack of knowledge and resistance to behavioural change, as well as poor access to resources, and limited support of programmes by local communities and authorities. Methods A recent community-based programme in Akwa Ibom State, Nigeria, is analysed to determine the degree to which community-directed interventions can improve access to malaria prevention in pregnancy. Six local government areas in Southern Nigeria were selected for a malaria in pregnancy prevention intervention. Three of these local government areas were selected for a complementary community-directed intervention (CDI programme. Under the CDI programme, volunteer community-directed distributors (CDDs were appointed by each village and kindred in the treatment areas and trained to deliver ITNs and IPTp drugs as well as basic counseling services to pregnant women. Findings Relative to women in the control area, an additional 7.4 percent of women slept under a net during pregnancy in the treatment areas (95% CI [0.035, 0.115], p-value Conclusion The presented results suggest that the inclusion of community-based programmes can substantially increase effective access to malaria prevention, and also increase access to formal health care access in general, and antenatal care attendance in particular in combination with supply side interventions. Given the relatively modest financial commitments they require, community-directed programmes appear to be a cost-effective way to improve malaria prevention; the participatory approach underlying CDI programmes also promises to strengthen ties between the formal health sector and local communities.

  5. Consequences of being Rhesus D immunized during pregnancy and how to optimize new prevention strategies.

    Science.gov (United States)

    Tiblad, Eleonor; Westgren, Magnus; Pasupathy, Dharmintra; Karlsson, Anita; Wikman, Agneta T

    2013-09-01

    To analyze the timing of Rhesus D (RhD) immunization in pregnancy and the consequences for the index pregnancy and for subsequent pregnancies to be able to optimize the design of antenatal screening and prevention programs. Retrospective cohort study. Stockholm county, Sweden. All RhD immunized pregnant women 1990-2008 before the introduction of routine antenatal anti-D prophylaxis. Data were collected from transfusion medicine registers and databases, medical records, the Swedish Medical Birth Register and the National Perinatal Quality Register and entered into a standardized database before analysis. The order of pregnancy and trimester when immunization occurred and treatment of hemolytic disease of the fetus and newborn. A total of 290 RhD immunized women were included in the study. In 147/290 (51%) of the women, sensitization occurred with their first-born child and in 96/290 (33%) it occurred with their second-born child. Anti-D antibodies developed during the second or third trimester in 212/290 (73%) and in 61/290 (21%) at term or after delivery. In subsequent pregnancies 56% (144/259) of the neonates required treatment for hemolytic disease of the fetus and newborn. Based on our study, at least half of the cases could potentially have been avoided by routine antenatal anti-D prophylaxis in the beginning of the third trimester. To optimize the beneficial effects of new prevention programs, we propose providing anti-D prophylaxis in gestational week 28-30 selectively to all RhD-negative women with RhD-positive fetuses. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. How do levonorgestrel-only emergency contraceptive pills prevent pregnancy? Some considerations.

    Science.gov (United States)

    Mozzanega, Bruno; Cosmi, Erich

    2011-06-01

    Controversial opinions exist about the possible mechanisms throughout emergency contraception prevents pregnancy. Recently, the International Federation of Gynaecology and Obstetrics and the International Consortium for Emergency Contraception released a Joint Statement declaring that 'inhibition or delay of ovulation should be their primary and possibly only mechanism of action'. They still added that 'Review of the evidence suggests that LNG-ECPs cannot prevent implantation'. Concerning levonorgestrel-only emergency contraceptive pills effects on ovulation, the Statement based on seven reference papers which considered a total of only 142 patients, divided into still different subgroups. Basing on their same references we got quite different conclusions.

  7. An overview of unwanted female hair.

    Science.gov (United States)

    Blume-Peytavi, U

    2011-12-01

    Unwanted facial hair (UFH) is an important but often overlooked issue, with over 40% of women experiencing some degree of UFH. In the female population a wide spectrum of unwanted hair concerns is represented - from biologically normal but undesirable to excessive unwanted hair with an underlying pathology. While women may seek to manage unwanted hair across their bodies, UFH is a particular concern, due to its negative impact on perceived femininity. There may not always be a direct correlation between degree of severity diagnosed objectively by the physician and level of concern and impact upon the patient. This review discusses the spectrum of facial hair experience and outlines the clinical approach to unwanted hair management including UFH. It highlights the importance of a treatment regimen which should respond to the causation factors and needs of the individual. This will lead to a holistic treatment approach including evaluation of the implementation of emotional coping strategies and on-going support, lifestyle modifications, pharmacological interventions (to address underlying pathologies) and the use of cosmetic hair removal methods as either a stand-alone or adjunct treatment as appropriate to the individual. © 2011 The Author. BJD © 2011 British Association of Dermatologists.

  8. Preventive Treatments of Iron Deficiency Anaemia in Pregnancy: A Review of Their Effectiveness and Implications for Health System Strengthening

    Directory of Open Access Journals (Sweden)

    Kayode O. Osungbade

    2012-01-01

    Full Text Available Objectives. We conducted a review of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy in developing countries and highlighted their constraints as well as interventions required to strengthen the health services. Methods. Literature from Pubmed (MEDLINE, AJOL, Google Scholar, and Cochrane database was reviewed. Results. Evidence-based preventive treatment options for iron deficiency anaemia in pregnancy include prophylaxis iron supplements and food fortification with iron. Evidence abounds on their effectiveness in reducing the prevalence of iron deficiency anaemia in pregnancy. However, these prospects are threatened by side effects of iron supplements, low utilization of maternal health service in developing countries, partial implementation of preventive treatments, and weak infrastructure and political commitment to implement mass fortification of local staple foods by national governments. Conclusion. Sustainability of effectiveness of preventive treatments of iron deficiency anaemia in pregnancy could be achieved if the identified threats are adequately addressed.

  9. Impact of the CHOICES Intervention in Preventing Alcohol-Exposed Pregnancies in American Indian Women.

    Science.gov (United States)

    Hanson, Jessica D; Nelson, Morgan E; Jensen, Jamie L; Willman, Amy; Jacobs-Knight, Jacque; Ingersoll, Karen

    2017-04-01

    Fetal alcohol spectrum disorders (FASD) comprise a continuum of lifelong outcomes in those born prenatally exposed to alcohol. Although studies have shown no differences in rates by race, FASD is of particular concern for American Indian communities. One tribally run prevention program is the Oglala Sioux Tribe (OST) CHOICES Program, which is modeled after the evidence-based CHOICES program that was focused on preconceptional prevention of alcohol-exposed pregnancy (AEP) by reducing risky drinking in women at risk for pregnancy and/or preventing unintended pregnancy. The OST CHOICES Program was made culturally appropriate for American Indian women and implemented with 3 communities, 2 on the reservation and 1 off. Data on drinking, sexual activity, and contraception use were collected at baseline and 3 and 6 months postintervention. Data were analyzed using descriptive statistics, 1-way analysis of variance, and a random intercept generalized estimating equation model. A total of 193 nonpregnant American Indian women enrolled in the OST CHOICES Program, and all were at risk for AEP because of binge drinking and being at risk for an unintended pregnancy. Fifty-one percent of participants completed both 3- and 6-month follow-ups. Models showed a significant decrease in AEP risk from baseline at both 3- and 6-month follow-ups, indicating the significant impact of the OST CHOICES intervention. Women in the OST CHOICES Program were more likely to reduce their risk for AEP by utilizing contraception, rather than decreasing binge drinking. Even with minor changes to make the CHOICES intervention culturally and linguistically appropriate and the potential threats to program validity those changes entail, we found a significant impact in reducing AEP risk. This highlights the capacity for the CHOICES intervention to be implemented in a wide variety of settings and populations. Copyright © 2017 by the Research Society on Alcoholism.

  10. Lessons Learned From a Community–Academic Partnership Addressing Adolescent Pregnancy Prevention in Filipino American Families

    Science.gov (United States)

    Javier, Joyce R.; Chamberlain, Lisa J.; Rivera, Kahealani K.; Gonzalez, Sarah E.; Mendoza, Fernando S.; Huffman, Lynne C.

    2014-01-01

    Background Filipino Americans have more adolescent pregnancies than other Asian-Pacific Islanders (APIs). Few community–academic collaborations have addressed adolescent pregnancy prevention in this community. Objectives We sought to describe the lessons learned from and impact of a community-based teen pregnancy prevention program for Filipino Americans implemented by a Filipina pediatrics resident. Methods We formed a community–academic partnership between the Filipino Youth Coalition, a community-based organization (CBO) in San Jose, California, and the Stanford School of Medicine’s Pediatric Advocacy Program. We developed a culturally tailored parent–teen conference addressing adolescent pregnancy prevention in Filipino Americans. We qualitatively and quantitatively evaluated this intervention by collecting both pre- and post-conference data using a convenience sample design. Lessons Learned Engaging particular aspects of Filipino culture (i.e., religion and intergenerational differences) helped to make this community–academic partnership successful. For physicians-in-training who are conducting community-based participatory research (CBPR), project challenges may include difficulties in building and maintaining academic–community relationships, struggles to promote sustainability, and conflicting goals of “community insiders” and “academic outsiders.” Authors offer insights and implications for residents interested in practicing CBPR. Conclusion CBPR is a key tool for exploring health issues in understudied populations. CBPR experiences can provide meaningful educational opportunities for physicians-in-training and can build sustained capacity in CBOs. They can also help residents to develop analytic skills, directly affect the health of the communities they serve, and, for minority physicians, give back to the communities they call home. PMID:21169708

  11. Mind-body interventions during pregnancy for preventing or treating women's anxiety.

    Science.gov (United States)

    Marc, Isabelle; Toureche, Narimane; Ernst, Edzard; Hodnett, Ellen D; Blanchet, Claudine; Dodin, Sylvie; Njoya, Merlin M

    2011-07-06

    Anxiety during pregnancy is a common problem. Anxiety and stress could have consequences on the course of the pregnancy and the later development of the child. Anxiety responds well to treatments such as cognitive behavioral therapy and/or medication. Non-pharmacological interventions such as mind-body interventions, known to decrease anxiety in several clinical situations, might be offered for treating and preventing anxiety during pregnancy. To assess the benefits of mind-body interventions during pregnancy in preventing or treating women's anxiety and in influencing perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2010), MEDLINE (1950 to 30 November 2010), EMBASE (1974 to 30 November 2010), the National Center for Complementary and Alternative Medicine (NCCAM) (1 December 2010), ClinicalTrials.gov (December 2010) and Current Controlled Trials (1 December 2010), searched the reference lists of selected studies and contacted professionals and authors in the field. Randomized controlled trials, involving pregnant women of any age at any time from conception to one month after birth, comparing mind-body interventions with a control group. Mind-body interventions include: autogenic training, biofeedback, hypnotherapy, imagery, meditation, prayer, auto-suggestion, tai-chi and yoga. Control group includes: standard care, other pharmacological or non-pharmacological interventions, other types of mind-body interventions or no treatment at all. Three review authors independently assessed trials for inclusion all assessed risk of bias for each included study. We extracted data independently using an agreed form and checked it for accuracy. We included eight trials (556 participants), evaluating hypnotherapy (one trial), imagery (five trials), autogenic training (one trial) and yoga (one trial). Due to the small number of studies per intervention and to the diversity of outcome measurements, we performed no meta

  12. A single-dose live-attenuated vaccine prevents Zika virus pregnancy transmission and testis damage.

    Science.gov (United States)

    Shan, Chao; Muruato, Antonio E; Jagger, Brett W; Richner, Justin; Nunes, Bruno T D; Medeiros, Daniele B A; Xie, Xuping; Nunes, Jannyce G C; Morabito, Kaitlyn M; Kong, Wing-Pui; Pierson, Theodore C; Barrett, Alan D; Weaver, Scott C; Rossi, Shannan L; Vasconcelos, Pedro F C; Graham, Barney S; Diamond, Michael S; Shi, Pei-Yong

    2017-09-22

    Zika virus infection during pregnancy can cause congenital abnormities or fetal demise. The persistence of Zika virus in the male reproductive system poses a risk of sexual transmission. Here we demonstrate that live-attenuated Zika virus vaccine candidates containing deletions in the 3' untranslated region of the Zika virus genome (ZIKV-3'UTR-LAV) prevent viral transmission during pregnancy and testis damage in mice, as well as infection of nonhuman primates. After a single-dose vaccination, pregnant mice challenged with Zika virus at embryonic day 6 and evaluated at embryonic day 13 show markedly diminished levels of viral RNA in maternal, placental, and fetal tissues. Vaccinated male mice challenged with Zika virus were protected against testis infection, injury, and oligospermia. A single immunization of rhesus macaques elicited a rapid and robust antibody response, conferring complete protection upon challenge. Furthermore, the ZIKV-3'UTR-LAV vaccine candidates have a desirable safety profile. These results suggest that further development of ZIKV-3'UTR-LAV is warranted for humans.Zika virus infection can result in congenital disorders and cause disease in adults, and there is currently no approved vaccine. Here Shan et al. show that a single dose of a live-attenuated Zika vaccine prevents infection, testis damage and transmission to the fetus during pregnancy in different animal models.

  13. Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality.

    Science.gov (United States)

    Maxwell, Giliana M; Radzilani-Makatu, Makondelele; Takalani, James F

    2016-04-01

    Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. The conclusion drawn was that learners are aware of the measures for preventing TP.

  14. Unsafe abortions and unwanted pregnancies contribute to maternal ...

    African Journals Online (AJOL)

    the province to sensitise the community and health workers to the problem of ... at the 'home' level for all maternal deaths and abortion .... employment or religion. In cases of ..... equipment, lack of phones and lack of readily available transport ...

  15. Undue inducement, or unfair exclusion: considering a case study of pregnancy in an HIV prevention trial.

    Science.gov (United States)

    Haire, Bridget G; Folayan, Morenike Oluwatoyin

    2017-12-01

    In their recent paper'Undue inducement: a case study in CAPRISA 008', Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not 'unduly induced' to participate by the offer of an experimental product. This paper argues that while the authors' conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy (regardless of whether those risks may be willingly assumed by pregnant women themselves). We suggest that the critical research ethics question raised by Mngadi et al 's case study is not 'undue inducement', but the exclusion of pregnant women from research studies where the risks are acceptable to the potential participant, and benefits likely. We also suggest that current regulatory paradigms regarding pregnancy are both overly paternalistic and value the fetus over the mother. In order to ensure timely provision of new HIV prevention agents, we argue that there is a need for expeditious testing of proven effective agents in pregnancy, with due consideration given to situations where preliminary efficacy data exist but fall short of licensure standards. This requires a paradigm shift from researchers, funders, regulators and ethical review bodies towards practices that critically examine the legitimacy of the exclusion of pregnant women on a study-by-study basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Behavioral Interventions for Preventing Sexually Transmitted Infections and Unintended Pregnancies: An Overview of Systematic Reviews.

    Science.gov (United States)

    Macaya Pascual, A; Ferreres Riera, J R; Campoy Sánchez, A

    2016-05-01

    Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  17. Historical context for the creation of the Office of Adolescent Health and the Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Kappeler, Evelyn M; Farb, Amy Feldman

    2014-03-01

    In Fiscal Year 2010, Federal funds were dedicated to support evidence-based approaches to effectively target teen pregnancy prevention and resulted in the establishment of the Office of Adolescent Health (OAH) and the Teen Pregnancy Prevention (TPP) Program. Through the tiered TPP Program, OAH supports replication and evaluation of programs using models whose effectiveness has been demonstrated through rigorous evaluation and the development and testing of promising or innovative pregnancy prevention strategies and approaches. This article documents the creation of OAH and the development of the TPP Program, the identification of a TPP evidence base, current program and evaluation efforts at OAH, and government coordination and partnerships related to reducing teen pregnancy. This article is of interest to those working to improve the health and wellbeing of adolescents. Published by Elsevier Inc.

  18. Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy.

    Science.gov (United States)

    Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena

    2013-10-01

    Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring. © 2013 International Life Sciences Institute.

  19. Adolescent Female Text Messaging Preferences to Prevent Pregnancy After an Emergency Department Visit: A Qualitative Analysis.

    Science.gov (United States)

    Chernick, Lauren Stephanie; Schnall, Rebecca; Stockwell, Melissa S; Castaño, Paula M; Higgins, Tracy; Westhoff, Carolyn; Santelli, John; Dayan, Peter S

    2016-09-29

    Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females. We conducted semistructured, open-ended interviews in one urban ED in the United States with adolescent females aged 14-19 years. Eligible subjects were adolescents who were sexually active in the past 3 months, presented to the ED for a reproductive health complaint, owned a mobile phone, and did not use effective contraception. Using an interview guide, enrollment continued until saturation of key themes. The investigators designed sample text messages using the Health Beliefs Model and participants viewed these on a mobile phone. The team recorded, transcribed, and coded interviews based on thematic analysis using the qualitative analysis software NVivo and Excel. Participants (n=14) were predominantly Hispanic (13/14; 93%), insured (13/14; 93%), ED users in the past year (12/14; 86%), and frequent text users (10/14; 71% had sent or received >30 texts per day). All were interested in receiving text messages from the ED about pregnancy prevention, favoring messages that were "brief," "professional," and "nonaccusatory." Respondents favored texts with links to websites, repeated information regarding places to receive "confidential" care, and focused information on contraception options and misconceptions. Preferences for text message frequency varied from daily to monthly, with random hours of delivery to maintain "surprise." No participant feared that text

  20. Economic Evaluation of a Comprehensive Teenage Pregnancy Prevention Program: Pilot Program

    Science.gov (United States)

    Rosenthal, Marjorie S.; Ross, Joseph S.; Bilodeau, RoseAnne; Richter, Rosemary S.; Palley, Jane E.; Bradley, Elizabeth H.

    2011-01-01

    Background Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic are effective in reducing births among enrolled teenagers. However, there have been limited data on costs and cost-effectiveness of such programs. Objectives To use a community-based participatory research approach, to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Methods Using data from 1997-2003, we conducted an in-time intervention analysis to determine program cost-benefit while teenagers were enrolled and then used an extrapolation analysis to estimate accyrred economibc benefits and cost-benefit up to age 30. Results The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage females, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1,599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 on average, with social benefits outweighing total social costs by age 20.1. Conclusions We estimate that this comprehensive teenage pregnancy prevention program would provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost-effectiveness of similarly comprehensive programs when implemented more widely in high-risk neighborhoods. PMID:19896030

  1. Short-Term Impact of a Teen Pregnancy-Prevention Intervention Implemented in Group Homes.

    Science.gov (United States)

    Oman, Roy F; Vesely, Sara K; Green, Jennifer; Fluhr, Janene; Williams, Jean

    2016-11-01

    Youth living in group home settings are at significantly greater risk for sexual risk behaviors; however, there are no sexual health programs designed specifically for these youth. The study's purpose was to assess the effectiveness of a teen pregnancy-prevention program for youth living in group home foster care settings and other out-of-home placements. The study design was a cluster randomized controlled trial involving youth (N = 1,037) recruited from 44 residential group homes located in California, Maryland, and Oklahoma. Within each state, youth (mean age = 16.2 years; 82% male; 37% Hispanic, 20% African-American, 20% white, and 17% multiracial) in half the group homes were randomly assigned to the intervention group (n = 40 clusters) and the other half were randomly assigned to a control group that offered "usual care" (n = 40 clusters). The intervention (i.e., Power Through Choices [PTC]) was a 10-session, age-appropriate, and medically accurate sexual health education program. Compared to the control group, youth in the PTC intervention showed significantly greater improvements (p attitude areas, all three self-efficacy areas, and two of three behavioral intention areas. This is the first published randomized controlled trial of a teen pregnancy-prevention program designed for youth living in foster care settings and other out-of-home placements. The numerous significant improvements in short-term outcomes are encouraging and provide preliminary evidence that the PTC program is an effective pregnancy-prevention program. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

    Science.gov (United States)

    Kelsey, Meredith; Layzer, Jean

    2014-03-01

    This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  3. A novel intravaginal ring to prevent HIV-1, HSV-2, HPV, and unintended pregnancy.

    Science.gov (United States)

    Ugaonkar, Shweta R; Wesenberg, Asa; Wilk, Jolanta; Seidor, Samantha; Mizenina, Olga; Kizima, Larisa; Rodriguez, Aixa; Zhang, Shimin; Levendosky, Keith; Kenney, Jessica; Aravantinou, Meropi; Derby, Nina; Grasperge, Brooke; Gettie, Agegnehu; Blanchard, James; Kumar, Narender; Roberts, Kevin; Robbiani, Melissa; Fernández-Romero, José A; Zydowsky, Thomas M

    2015-09-10

    Women urgently need a self-initiated, multipurpose prevention technology (MPT) that simultaneously reduces their risk of acquiring HIV-1, HSV-2, and HPV (latter two associated with increased risk of HIV-1 acquisition) and prevents unintended pregnancy. Here, we describe a novel core-matrix intravaginal ring (IVR), the MZCL IVR, which effectively delivered the MZC combination microbicide and a contraceptive. The MZCL IVR contains four active pharmaceutical ingredients (APIs): MIV-150 (targets HIV-1), zinc acetate (ZA; targets HIV-1 and HSV-2), carrageenan (CG; targets HPV and HSV-2), and levonorgestrel (LNG; targets unintended pregnancy). The elastomeric IVR body (matrix) was produced by hot melt extrusion of the non-water swellable elastomer, ethylene vinyl acetate (EVA-28), containing the hydrophobic small molecules, MIV-150 and LNG. The solid hydrophilic core, embedded within the IVR by compression, contained the small molecule ZA and the macromolecule CG. Hydrated ZA/CG from the core was released by diffusion via a pore on the IVR while the MIV-150/LNG diffused from the matrix continuously for 94 days (d) in vitro and up to 28 d (study period) in macaques. The APIs released in vitro and in vivo were active against HIV-1ADA-M, HSV-2, and HPV16 PsV in cell-based assays. Serum LNG was at levels associated with local contraceptive effects. The results demonstrate proof-of-concept of a novel core-matrix IVR for sustained and simultaneous delivery of diverse molecules for the prevention of HIV, HSV-2 and HPV acquisition, as well as unintended pregnancy. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Economic evaluation of a comprehensive teenage pregnancy prevention program: pilot program.

    Science.gov (United States)

    Rosenthal, Marjorie S; Ross, Joseph S; Bilodeau, Roseanne; Richter, Rosemary S; Palley, Jane E; Bradley, Elizabeth H

    2009-12-01

    Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled teenagers. However, there have been limited data on the costs and cost effectiveness of such programs. The study used a community-based participatory research approach to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Using data from 1997-2003, an in-time intervention analysis was conducted to determine program cost-benefit while teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost-benefit up to age 30 years. The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years. This comprehensive teenage pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.

  5. Prevention of unnecessary pregnancy terminations by counselling women on drug, chemical, and radiation exposure during the first trimester

    International Nuclear Information System (INIS)

    Koren, G.; Pastuszak, A.

    1990-01-01

    As part of a new approach to counselling pregnant women concerned about antenatal exposure to drugs, chemicals, or radiation, we measured their tendency to terminate their pregnancy by using a visual analogue scale (VAS). Analysis of 78 cases where women had less than 50% tendency to continue pregnancy before they were advised by us reveals that 61 decided to continue their pregnancy after the consultation (57 normal, healthy infants, four miscarriages) and 17 terminated. Women who continued their pregnancy significantly changed their tendency after we discussed relevant information with them (from 34.3 +/- 2.5% to 84.5 +/- 3.3%, P less than 0.00001), whereas most of those who eventually terminated pregnancy did not change their tendency to continue pregnancy beyond the 50% mark (from 24.8 +/- 5.4% to 45.1 +/- 9.8%) (P greater than 0.1). Only two of the women who terminated their pregnancy were exposed to teratogenic drugs; however, in most other cases, other obvious reasons, unrelated to the exposure in question, were identified by the women as leading reasons for termination. An appropriate intervention in early pregnancy can prevent unnecessary pregnancy terminations by correcting misinformation and thereby decreasing the unrealistically high perception of risk by women exposed to nonteratogens

  6. Preventative valve-sparing aortic root replacement and pregnancy outcome in Marfan syndrome.

    Science.gov (United States)

    Sokol, Vesna; Zlopasa, Gordan; Herman, Mislav; Planinić, Pavao; Micevska, Ana

    2012-06-01

    In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with prosthetic valve/tube graft. It provides excellent survival with low rates of aortic - valve related complications.

  7. From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Farb, Amy Feldman; Burrus, Barri; Wallace, Ina F; Wilson, Ellen K; Peele, John E

    2014-03-01

    The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress. Published by Elsevier Inc.

  8. Understanding gender roles in teen pregnancy prevention among American Indian youth.

    Science.gov (United States)

    Hanson, Jessica D; McMahon, Tracey R; Griese, Emily R; Kenyon, DenYelle Baete

    2014-11-01

    To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include redefinitions of gender norms within AI teen pregnancy prevention program.

  9. Cost-effectiveness of intermittent preventive treatment of malaria in pregnancy in southern Mozambique.

    Directory of Open Access Journals (Sweden)

    Elisa Sicuri

    2010-10-01

    Full Text Available Malaria in pregnancy is a public health problem for endemic countries. Economic evaluations of malaria preventive strategies in pregnancy are needed to guide health policies.This analysis was carried out in the context of a trial of malaria intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP, where both intervention groups received an insecticide treated net through the antenatal clinic (ANC in Mozambique. The cost-effectiveness of IPTp-SP on maternal clinical malaria and neonatal survival was estimated. Correlation and threshold analyses were undertaken to assess the main factors affecting the economic outcomes and the cut-off values beyond which the intervention is no longer cost-effective. In 2007 US$, the incremental cost-effectiveness ratio (ICER for maternal malaria was 41.46 US$ (95% CI 20.5, 96.7 per disability-adjusted life-year (DALY averted. The ICER per DALY averted due to the reduction in neonatal mortality was 1.08 US$ (95% CI 0.43, 3.48. The ICER including both the effect on the mother and on the newborn was 1.02 US$ (95% CI 0.42, 3.21 per DALY averted. Efficacy was the main factor affecting the economic evaluation of IPTp-SP. The intervention remained cost-effective with an increase in drug cost per dose up to 11 times in the case of maternal malaria and 183 times in the case of neonatal mortality.IPTp-SP was highly cost-effective for both prevention of maternal malaria and reduction of neonatal mortality in Mozambique. These findings are likely to hold for other settings where IPTp-SP is implemented through ANC visits. The intervention remained cost-effective even with a significant increase in drug and other intervention costs. Improvements in the protective efficacy of the intervention would increase its cost-effectiveness. Provision of IPTp with a more effective, although more expensive drug than SP may still remain a cost-effective public health measure to prevent malaria in pregnancy

  10. Efficacy of malaria prevention during pregnancy in an area of low and unstable transmission

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Clarke, Siân E; Hutchison, Coll L.

    2011-01-01

    -randomised placebo-controlled trial involving 5775 women of all parities examined the effect of IPTp, ITNs alone, or ITNs used in combination with IPTp on maternal anaemia and low birth weight (LBW) in a highland area of southwestern Uganda. The overall prevalence of malaria infection, maternal anaemia and LBW...... services was observed. With ITNs offering a number of advantages over IPTp, yet showing comparable efficacy, we discuss why ITNs could be an appropriate preventive strategy for malaria control during pregnancy in areas of low and unstable transmission....

  11. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Syphilis during pregnancy: a preventable threat to maternal-fetal health.

    Science.gov (United States)

    Rac, Martha W F; Revell, Paula A; Eppes, Catherine S

    2017-04-01

    Syphilis remains the most common congenital infection worldwide and has tremendous consequences for the mother and her developing fetus if left untreated. Recently, there has been an increase in the number of congenital syphilis cases in the United States. Thus, recognition and appropriate treatment of reproductive-age women must be a priority. Testing should be performed at initiation of prenatal care and twice during the third trimester in high-risk patients. There are 2 diagnostic algorithms available and physicians should be aware of which algorithm is utilized by their testing laboratory. Women testing positive for syphilis should undergo a history and physical exam as well as testing for other sexually transmitted infections, including HIV. Serofast syphilis can occur in patients with previous adequate treatment but persistent low nontreponemal titers (Syphilis can infect the fetus in all stages of the disease regardless of trimester and can sometimes be detected with ultrasound >20 weeks. The most common findings include hepatomegaly and placentomegaly, but also elevated peak systolic velocity in the middle cerebral artery (indicative of fetal anemia), ascites, and hydrops fetalis. Pregnancies with ultrasound abnormalities are at higher risk of compromise during syphilotherapy as well as fetal treatment failure. Thus, we recommend a pretreatment ultrasound in viable pregnancies when feasible. The only recommended treatment during pregnancy is benzathine penicillin G and it should be administered according to maternal stage of infection per Centers for Disease Control and Prevention guidelines. Women with a penicillin allergy should be desensitized and then treated with penicillin appropriate for their stage of syphilis. The Jarisch-Herxheimer reaction occurs in up to 44% of gravidas and can cause contractions, fetal heart rate abnormalities, and even stillbirth in the most severely affected pregnancies. We recommend all viable pregnancies receive the first

  13. Community-Based Promotional Campaign to Improve Uptake of Intermittent Preventive Antimalarial Treatment in Pregnancy in Burkina Faso

    NARCIS (Netherlands)

    Gies, Sabine; Coulibaly, Sheick O.; Ky, Clotilde; Ouattara, Florence T.; Brabin, Bernard J.; d'Alessandro, Umberto

    2009-01-01

    Malaria preventive strategies in pregnancy were assessed in a health center randomized trial comparing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) with and without community based promotional activities in rural Burkina Faso. The study involved 2,240 secundigravidae

  14. Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

    Science.gov (United States)

    Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

    2014-01-01

    Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

  15. Intermittent Preventive Treatment for Malaria in Pregnancy: Optimization of Target Concentrations of Dihydroartemisinin-Piperaquine.

    Science.gov (United States)

    Savic, Rada M; Jagannathan, Prasanna; Kajubi, Richard; Huang, Liusheng; Zhang, Nan; Were, Moses; Kakuru, Abel; Muhindo, Mary K; Mwebaza, Norah; Wallender, Erika; Clark, Tamara D; Opira, Bishop; Kamya, Moses; Havlir, Diane V; Rosenthal, Philip J; Dorsey, Grant; Aweeka, Francesca T

    2018-03-14

    Dihydroartemsinin-piperaquine is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine exposure, malaria risk, and adverse birth outcomes informs optimal dosing strategies. HIV-uninfected pregnant women were enrolled in a placebo-controlled trial of IPTp at 12-20 weeks gestation and randomized to: sulfadoxine-pyrimethamine every 8 weeks (n=106), dihydroartemsinin-piperaquine every 8 weeks (n=94), or dihydroartemsinin-piperaquine every 4 weeks (n=100) during pregnancy. Pharmacokinetic sampling for piperaquine was performed every 4 weeks, and an intensive pharmacokinetic sub-study was performed in 30 women at 28 weeks gestation. Concentration-effect relationships were assessed between exposure to piperaquine; the prevalence of P. falciparum infection during pregnancy; outcomes at delivery including placental malaria, low birthweight, and preterm birth; and risks for toxicity. Simulations of new dosing scenarios were performed. Model-defined piperaquine target venous plasma concentrations of 13.9 ng/ml provided 99% protection from P. falciparum infection during pregnancy. Each 10 day increase in time>target piperaquine concentrations was associated with reduced odds of placental parasitemia (0∙67, P<0.0001), preterm birth (0.74, P<0.01), and low birthweight (0.74, P<0.05), though increases in piperaquine concentrations were associated with QTc prolongation (5 msec increase per 100 ng/ml). Modeling suggests that daily or weekly administration of lower dosages of piperaquine, compared to standard dosing, will maintain piperaquine trough levels above target concentrations with reduced piperaquine peak levels, potentially limiting toxicity. The protective efficacy of IPTp with dihydroartemsinin-piperaquine was strongly associated with higher drug exposure. Studies of the efficacy and safety of alternative dihydroartemsinin-piperaquine IPTp dosing strategies are warranted. NCT02163447.

  16. Legal Briefing: Unwanted Cesareans and Obstetric Violence.

    Science.gov (United States)

    Pope, Thaddeus Mason

    2017-01-01

    A capacitated pregnant woman has a nearly unqualified right to refuse a cesarean section. Her right to say "no" takes precedence over clinicians' preferences and even over clinicians' concerns about fetal health. Leading medical societies, human rights organizations, and appellate courts have all endorsed this principle. Nevertheless, clinicians continue to limit reproductive liberty by forcing and coercing women to have unwanted cesareans. This "Legal Briefing" reviews recent court cases involving this type of obstetric violence. I have organized these court cases into the following six categories: 1. Epidemic of Unwanted Cesareans 2. Court-Ordered Cesareans 3. Physician-Coerced Cesareans 4. Physician-Ordered Cesareans 5. Cesareans for Incapacitated Patients 6. Cesareans for Patients in a Vegetative State or Who Are Brain Dead. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

  17. Preventing Pregnancy in Kenya Through Distribution and Use of the CycleBeads Mobile Application.

    Science.gov (United States)

    Shelus, Victoria; Ashcroft, Nicki; Burgess, Sarah; Giuffrida, Monica; Jennings, Victoria

    2017-09-01

    Given the proportion of Kenyan women not using hormonal contraceptives, the country appears to have a substantial need for a modern, natural family planning option. The CycleBeads® mobile phone application (app), a digital platform for the Standard Days Method® of family planning, could help address this issue. After the CycleBeads app was promoted in Kenya in May-June 2015, a three-month pilot study was conducted to collect quantitative and qualitative data from 185 female app users. Chi-square testing, binary logistic regression and thematic content analysis were used to assess whether the app brought new users to family planning, to understand users' experiences and to assess how user experiences vary by distribution channel. Participants learned about the app through nongovernmental organizations (17%), via digital media (33%) or from family or friends (50%). Most used the app to track their periods (54%) or prevent pregnancy (37%); a few used it to plan a pregnancy (7%) or for other reasons (2%). The main reason for choosing the Standard Days Method was fear of side effects from hormonal methods (64%). The majority of women found the app and method easy to use (53%). Among those preventing pregnancy, 42% had never before used a method. By midline, all participants knew when fertile days occurred, and most (97%) knew the method's cycle-length requirements. Women reported high rates of condom use (88%), abstinence (68%) and withdrawal (46%) on fertile days. Offering the CycleBeads app to support women in use of the Standard Days Method may expand family planning options, reduce unmet need and make family planning more widely available.

  18. High-sodium intake prevents pregnancy-induced decrease of blood pressure in the rat.

    Science.gov (United States)

    Beauséjour, Annie; Auger, Karine; St-Louis, Jean; Brochu, Michéle

    2003-07-01

    Despite an increase of circulatory volume and of renin-angiotensin-aldosterone system (RAAS) activity, pregnancy is paradoxically accompanied by a decrease in blood pressure. We have reported that the decrease in blood pressure was maintained in pregnant rats despite overactivation of RAAS following reduction in sodium intake. The purpose of this study was to evaluate the impact of the opposite condition, e.g., decreased activation of RAAS during pregnancy in the rat. To do so, 0.9% or 1.8% NaCl in drinking water was given to nonpregnant and pregnant Sprague-Dawley rats for 7 days (last week of gestation). Increased sodium intakes (between 10- and 20-fold) produced reduction of plasma renin activity and aldosterone in both nonpregnant and pregnant rats. Systolic blood pressure was not affected in nonpregnant rats. However, in pregnant rats, 0.9% sodium supplement prevented the decreased blood pressure. Moreover, an increase of systolic blood pressure was obtained in pregnant rats receiving 1.8% NaCl. The 0.9% sodium supplement did not affect plasma and fetal parameters. However, 1.8% NaCl supplement has larger effects during gestation as shown by increased plasma sodium concentration, hematocrit level, negative water balance, proteinuria, and intrauterine growth restriction. With both sodium supplements, decreased AT1 mRNA levels in the kidney and in the placenta were observed. Our results showed that a high-sodium intake prevents the pregnancy-induced decrease of blood pressure in rats. Nonpregnant rats were able to maintain homeostasis but not the pregnant ones in response to sodium load. Furthermore, pregnant rats on a high-sodium intake (1.8% NaCl) showed some physiological responses that resemble manifestations observed in preeclampsia.

  19. Azithromycin-chloroquine and the intermittent preventive treatment of malaria in pregnancy

    Directory of Open Access Journals (Sweden)

    Greenwood Brian

    2008-12-01

    Full Text Available Abstract In the high malaria-transmission settings of sub-Saharan Africa, malaria in pregnancy is an important cause of maternal, perinatal and neonatal morbidity. Intermittent preventive treatment of malaria in pregnancy (IPTp with sulphadoxine-pyrimethamine (SP reduces the incidence of low birth-weight, pre-term delivery, intrauterine growth-retardation and maternal anaemia. However, the public health benefits of IPTp are declining due to SP resistance. The combination of azithromycin and chloroquine is a potential alternative to SP for IPTp. This review summarizes key in vitro and in vivo evidence of azithromycin and chloroquine activity against Plasmodium falciparum and Plasmodium vivax, as well as the anticipated secondary benefits that may result from their combined use in IPTp, including the cure and prevention of many sexually transmitted diseases. Drug costs and the necessity for external financing are discussed along with a range of issues related to drug resistance and surveillance. Several scientific and programmatic questions of interest to policymakers and programme managers are also presented that would need to be addressed before azithromycin-chloroquine could be adopted for use in IPTp.

  20. Women’s perception of accuracy of ultrasound dating in late pregnancy: a challenge to prevention of prolonged pregnancy in a resource-poor Nigerian setting

    Directory of Open Access Journals (Sweden)

    Ugwu EO

    2014-02-01

    Full Text Available Emmanuel O Ugwu,1 Godwin U Odoh,1 Cyril C Dim,1 Samuel N Obi,1 Euzebus C Ezugwu,1 Innocent I Okafor21Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Parklane, Enugu, NigeriaBackground: Expected date of delivery (EDD is estimated from the last menstrual period (LMP or ultrasound scan. Conflicts between these estimates especially on the part of the physician and his/her patient could pose a challenge to prevention of prolonged pregnancy. The objective of this study was to determine the perception and acceptability of menstrual dating (EDD derived from LMP with regard to timing of labor induction for postdatism by pregnant women who have a late pregnancy (≥23 weeks’ gestation ultrasound scan.Methods: This cross-sectional study included 443 consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, 2013 to March 31, 2013.Results: The mean age of the women was 27.9±2.41 (range 17–45 years. Most ultrasound scans (90.8%, 357/389 were carried out in late pregnancy, and 41.9% (167/389 were self-referred. The majority of the respondents (51.7%, 229/443 did not accept induction of labor for postdatism at a certain menstrual dating-derived gestational age of 40 weeks plus 10 days if the late pregnancy ultrasound scan dating was less. Predictors of this poor attitude to timing of induction of labor for postdatism included low educational level, low social class, and poor knowledge of the limitations of ultrasound scan dating in late pregnancy (P<0.05.Conclusion: The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy

  1. Strategies to Build Readiness in Community Mobilization Efforts for Implementation in a Multi-Year Teen Pregnancy Prevention Initiative.

    Science.gov (United States)

    Bhuiya, Nazmim; House, L Duane; Desmarais, Jeffrey; Fletcher, Erica; Conlin, Maeve; Perez-McAdoo, Sarah; Waggett, Jessica; Tendulkar, Shalini A

    2017-03-01

    This paper describes an assessment of community readiness to implement a community-wide teen pregnancy prevention initiative, Youth First, and presents strategies used to enhance this readiness as informed by the assessment. Twenty-five community stakeholder interviews were conducted to assess four domains of readiness: (1) attitudes, perception, and knowledge of teen pregnancy; (2) perceived level of readiness; (3) resources, existing and current efforts; and (4) leadership. Interview transcripts were coded and analyzed to identify key themes. Stakeholders acknowledged teen pregnancy as an issue but lacked contextual information. They also perceived the community as ready to address the issue and recognized some organizations already championing efforts. However, many key players were not involved, and ongoing data collection to assess teen pregnancy and prevention efforts was limited. Though many stakeholders were ready to engage in teen pregnancy prevention efforts, they required additional information and training to appropriately address the issue. In response to the assessment findings, several strategies were applied to address readiness and build Youth First partners' capacity to implement the community-wide initiative. Thus, to successfully implement community-wide prevention efforts, it is valuable to assess the level of community readiness to address health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Discrepancies in the laws on identifying foetal sex and terminating a pregnancy in India.

    Science.gov (United States)

    Rahman, Talha A; Siddiqui, Ayesha T

    2007-01-01

    Laws that regulate the identification of a foetus and the termination of a pregnancy in India are shaped by their social context. The Medical Termination of Pregnancy Act, 1971, discriminates against unmarried women by not recognising that unwanted pregnancies in unmarried women could result in at least as much anguish and suffering as that experienced by married women. While the MTP Act permits the abortion of foetuses with disabilities, the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act's ban on identifying the foetus's sex prevents the use of sex-detection to identify foetuses at high risk of sex-linked diseases.

  3. Enhancing teen pregnancy prevention in local communities: capacity building using the interactive systems framework.

    Science.gov (United States)

    Duffy, Jennifer L; Prince, Mary Severson; Johnson, Erin E; Alton, Forrest L; Flynn, Shannon; Faye, Amy Mattison; Padgett, Polly Edwards; Rollison, Chris; Becker, Dana; Hinzey, Angela L

    2012-12-01

    Getting To Outcomes (GTO), an innovative framework for planning, implementing, evaluating, and sustaining interventions has been shown to be effective in helping community-based organizations (CBOs) introduce science-based approaches into their prevention work. However, the Interactive Systems Framework (ISF) suggests that adopting innovations like GTO requires a significant amount of capacity building through training and technical assistance (T/TA). In this study, 11 CBOs and three schools in South Carolina entered into a 3 year program of intense and proactive T/TA based on the ISF to learn how to apply an adaptation of GTO (Promoting Science-Based Approaches-Getting To Outcomes, PSBA-GTO) to their teen pregnancy prevention programs. Using semi-structured interviews, the partnering organizations were assessed at three points in time, pre-T/TA, 12 months, and post T/TA (30 months) for their performance of the steps of GTO in their work. The seven organizations which participated in T/TA until the end of the project received an average of 76 h of TA and 112 h of training per organization. Interview results showed increased performance of all 10 steps of PSBA-GTO by these organizations when conducting their teen pregnancy programs. These results suggest targeted and proactive T/TA can successfully bridge the gap between research and practice by using a three part delivery system, as prescribed in the ISF, which relies on an intermediary prevention support system to ensure accurate and effective translation of research to the everyday work of community-based practitioners.

  4. Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention.

    Science.gov (United States)

    Naing, Zin W; Scott, Gillian M; Shand, Antonia; Hamilton, Stuart T; van Zuylen, Wendy J; Basha, James; Hall, Beverly; Craig, Maria E; Rawlinson, William D

    2016-02-01

    Human cytomegalovirus (CMV) is under-recognised, despite being the leading infectious cause of congenital malformation, affecting ~0.3% of Australian live births. Approximately 11% of infants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital CMV infection may cause severe long-term sequelae, including progressive sensorineural hearing loss and developmental delay in 40-58% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal CMV infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for CMV-specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal CMV infection, amniocentesis with CMV-PCR performed on amniotic fluid, undertaken after 21-22 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital CMV infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed-onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. Recognition of the importance of CMV in pregnancy and in neonates is increasingly needed, particularly as therapeutic and preventive interventions expand for this serious problem. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  5. THE ROLE OF NUTRITION IN CARIES PREVENTION AND MAINTENANCE OF ORAL HEALTH DURING PREGNANCY.

    Science.gov (United States)

    Jevtić, Marija; Pantelinaci, Jelena; Jovanović Ilić, Tatjana; Petrović, Vasa; Grgić, Olja; Blazić, Larisa

    2015-01-01

    Pregnancy may pose an increased risk for the development of caries and other oral health problems. Continuous screening of oral health status, implementing appropriate preventive measures (particularly oral hygiene, healthy diet plans and education) is of paramount importance not only for oral health but also for the general health status of the future mother and her offspring. EFFECTS OF FOOD ON CARIES DEVELOPMENT: Caries prevention through healthy diet implicates the reduction in frequency and amount of intake of cariogenic food, above all ofrefined carbohydrates, i.e. sugars and sweets. Foods known to have caries-prophylactic effects should predominate in healthy diet plans. They mainly include solid foods, which have mechanical effects on teeth cleaning, as well as foods providing sufficient amounts of vitamins (A, C, D) and a variety of elements and compounds (calcium, phosphates, fluorides) favoring the preservation and remineralization of tooth structures. EDUCATION OF PREGNANT WOMEN ON HEALHY DEIT: In accomplishing these goals, education and direct positive communication between the educator and the pregnant woman play a crucial role. Educative approach is always individual and determined by the patient's specific cultural and socioeconomic features and status, as well as her habits, motivation and willingness to accept relevant recommendations. Accomplishing the aforementioned goals requires the appropriate organization and professional competence within the preventive dental service and its close cooperation with the relevant medical institutions and social support in the framework of public health protection. Preserving of oral health during pregnancy is predominantly influenced by the following factors: 1) healthy diet, 2) oral hygiene, 3) patients' education, 4) regular control of oral health, 5) appropriate organization of dental services and 6) community engagement.

  6. Lifestyle intervention to prevent obesity during pregnancy: Implications and recommendations for research and implementation.

    Science.gov (United States)

    Hill, Briony; McPhie, Skye; Moran, Lisa J; Harrison, Paul; Huang, Terry T-K; Teede, Helena; Skouteris, Helen

    2017-06-01

    Maternal obesity and excessive gestational weight gain (GWG) are significant contributors to the global obesity epidemic. However, isolated lifestyle interventions to address this in pregnancy appear to have only modest benefit and responses can be variable. This paper aims to address the question of why the success of lifestyle interventions to prevent excessive GWG is suboptimal and variable. We suggest that there are inherent barriers to lifestyle change within pregnancy as a life stage, including the short window available for habit formation; the choice for women not to prioritise their weight; competing demands including physiological, financial, relationship, and social situations; and lack of self-efficacy among healthcare professionals on this topic. In order to address this problem, we propose that just like all successful public health approaches seeking to change behaviour, individual lifestyle interventions must be provided in the context of a supportive environment that enables, incentivises and rewards healthy changes. Future research should focus on a systems approach that integrates the needs of individuals with the context within which they exist. Borrowing from the social marketing principle of 'audience segmentation', we also need to truly understand the needs of individuals to design appropriately tailored interventions. This approach should also be applied to the preconception period for comprehensive prevention approaches. Additionally, relevant policy needs to reflect the changing evidence-based climate. Interventions in the clinical setting need to be integrally linked to multipronged obesity prevention efforts in the community, so that healthy weight goals are reinforced throughout the system. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Teenage Pregnancy and Perinatal Outcomes: Experience from ...

    African Journals Online (AJOL)

    Context: Teenage pregnancy is known as a risk factor for preterm birth, low birth weight and perinatal deaths, thus considered public health problem. In South Africa, most teenage pregnancy is found within the context of unstable relationship and unplanned or unwanted pregnancies. A high rate of teenage pregnancy is ...

  8. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Lisa B Haddad

    Full Text Available Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART clinic.200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.Most women (95% did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy. Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  9. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Science.gov (United States)

    Haddad, Lisa B; Feldacker, Caryl; Jamieson, Denise J; Tweya, Hannock; Cwiak, Carrie; Chaweza, Thomas; Mlundira, Linly; Chiwoko, Jane; Samala, Bernadette; Kachale, Fanny; Bryant, Amy G; Hosseinipour, Mina C; Stuart, Gretchen S; Hoffman, Irving; Phiri, Sam

    2015-01-01

    Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic. 200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010. Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage. High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  10. Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme.

    Science.gov (United States)

    Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin

    2016-06-01

    Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  11. Prevention and treatment of allergic asthma in pregnancy: from conventional drugs to new therapeutical approaches.

    Science.gov (United States)

    Cadavid, Angela P; Bannenberg, Gérard L; Arck, Petra C; Fitzgerald, Justine S; Markert, Udo R

    2011-05-01

    Different conventional anti-asthmatic and anti-allergic drugs are commonly used in pregnancy, including inhaled corticosteroids, long- and short-acting β-agonists, leukotriene modifiers, cromolyn, and theophylline. Alternatively, immunotherapy with allergens before and during pregnancy is accepted as a causal treatment of allergies, but the allergy specifity and severity in combination with a variety of application protocols and procedures cause wide heterogenity of this treatment principle. Furthermore, the pharmacokinetic characteristics and the US Food and Drug Administration (FDA) classification of conventional anti-allergic drugs and immunological implications of immunotherapy are summarized in this review, and insights on fetal programming of allergies are introduced. We propose a potential perspective of treatment with anti-inflammatory and pro-resolving mediators, such as lipoxins, resolvins and protectins; these are lipid mediators physiologically generated during the immune response from arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid. This proposal fits with the recently appreciated approaches to allergy prevention for the newborn child by a balanced maternal nutrition and omega-3 long-chain polyunsaturated fatty acid consumption.

  12. School-based interventions for preventing Hiv, sexually transmitted infections, and pregnancy in adolescents

    Science.gov (United States)

    Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

    2016-01-01

    Background School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. Search methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. Selection criteria We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Data collection and analysis Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. Main results We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in

  13. [Mexican adolescentes' goals as determinants in the prevention of early pregnancies].

    Science.gov (United States)

    Atienzo, Erika E; Campero, Lourdes; Lozada, Ana Lilia; Herrera, Cristina

    2014-01-01

    This study aims to explore adolescents' intentions related to the early formation of a family. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974). Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents' expectations for their child's education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13). In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

  14. The Effectiveness of Ginger in the Prevention of Nausea and Vomiting during Pregnancy and Chemotherapy

    Science.gov (United States)

    Lete, Iñaki; Allué, José

    2016-01-01

    The rhizomes of Zingiber officinale (ginger) have been used since ancient times as a traditional remedy for gastrointestinal complaints. The most active ingredients in ginger are the pungent principles, particularly gingerols and shogaols. Various preclinical and clinical studies have evaluated ginger as an effective and safe treatment for nausea and vomiting in the context of pregnancy and as an adjuvant treatment for chemotherapy-induced nausea and vomiting. Here, we provide an update and analysis of ginger use for the prevention of nausea and vomiting, with a focus on the types and presentations of ginger available. We also examine the pharmacokinetic properties of ginger and highlight the type and posology of ginger and its metabolites. PMID:27053918

  15. Achieving penetration and participation in Diabetes After Pregnancy prevention interventions following gestational diabetes

    DEFF Research Database (Denmark)

    Dasgupta, Kaberi; Terkildsen Maindal, Helle; Kragelund Nielsen, Karoline

    2018-01-01

    and/or telephone contact CONCLUSIONS: Although penetration and participation reporting is sub-optimal, penetration generally is high while participation is variable. Leveraging and structuring recruitment within standard GDM care and settings appears to be important to engage women in DAP prevention...... (enrolled/invited) rates were calculated after data extraction. RESULTS: Among 2,859 records, 33 intervention studies were identified, among which 16 had sufficient information to calculate penetration or participation. Penetration proportion (n=9 studies) was between 85-100% for two-thirds of studies...... included. Participation proportion (n=16 studies) varied substantially; when recruitment occurred during pregnancy or early postpartum participation was 40% or more, especially if face-to-face contact was used within the GDM care setting, compared to under 15% in mid/late postpartum with mailed invitation...

  16. Mexican adolescents’ goals as determinants in the prevention of early pregnancies

    Directory of Open Access Journals (Sweden)

    Erika E Atienzo

    2014-05-01

    Full Text Available Objective. This study aims to explore adolescents’ intentions related to the early formation of a family. Materials and methods. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974. Results. Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents’ expectations for their child’s education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13. Conclusions. In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

  17. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy

    Directory of Open Access Journals (Sweden)

    Eggelte Teunis A

    2007-11-01

    Full Text Available Abstract Background Intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP has been adopted as policy by many countries in sub-Saharan Africa. However, data on the post-implementation effectiveness of this measure are scarce. Methods Clinical and parasitological parameters were assessed among women delivering at a district hospital in rural southern Ghana in the year 2000 when pyrimethamine chemoprophylaxis was recommended (n = 839 and in 2006 (n = 226, approximately one year after the implementation of IPTp-SP. Examinations were performed in an identical manner in 2000 and 2006 including the detection of placental Plasmodium falciparum infection by microscopy, histidine-rich protein 2, and PCR. Results In 2006, 77% of the women reported to have taken IPTp-SP at least once (26%, twice; 24%, thrice. In 2006 as compared to 2000, placental P. falciparum infection was reduced by 43–57% (P P = 0.0009, and median birth weight was 130 g higher (P = 0.02. In 2006, likewise, women who had taken ≥ 1 dose of IPTp-SP revealed less infection and anaemia and their children tended to have higher birth weights as compared to women who had not used IPTp-SP. However, placental P. falciparum infection was still observed in 11% (microscopy to 26% (PCR of those women who had taken three doses of IPTp-SP. Conclusion In southern Ghana, placental malaria and maternal anaemia have declined substantially and birth weight has increased after the implementation of IPTp-SP. Likely, these effects can further be increased by improving IPTp-SP coverage and adherence. However, the remnant prevalence of infection in women having taken three doses of IPTp-SP suggests that additional antimalarial measures are needed to prevent malaria in pregnancy in this region.

  18. A randomized trial of motivational interviewing and facilitated contraceptive access to prevent rapid repeat pregnancy among adolescent mothers.

    Science.gov (United States)

    Stevens, Jack; Lutz, Robyn; Osuagwu, Ngozi; Rotz, Dana; Goesling, Brian

    2017-10-01

    Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low-income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic. The impact of this program on rapid repeat pregnancies at 18 months after enrollment was evaluated. Five hundred ninety-eight adolescent females were enrolled from 7 obstetrics-gynecology clinics and 5 postpartum units of a large hospital system in a Midwestern city. Each participant was enrolled at least 28 weeks pregnant or less than 9 weeks postpartum. Each participant was randomized to either the Teen Options to Prevent Pregnancy intervention or a usual-care control condition. Intervention participants averaged 4.5 hours of assistance. Participants were contacted by blinded research staff at 6 and 18 months to complete self-report surveys. Differences in outcomes between the intervention and control groups were assessed using ordinary least-squares regression. There was an 18.1% absolute reduction in self-reported repeat pregnancy in the intervention group relative to the control group (20.5% vs 38.6%%; P Teen Options to Prevent Pregnancy program represents one of the few evidence-based interventions to reduce rapid repeat teen pregnancy. This relatively brief intervention may be a viable alternative to more time-intensive programs that adolescent mothers may be unable or unwilling to receive. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Interest in multipurpose prevention technologies to prevent HIV/STIs and unintended pregnancy among young women in the United States.

    Science.gov (United States)

    Hynes, Jenna S; Sales, Jessica M; Sheth, Anandi N; Lathrop, Eva; Haddad, Lisa B

    2018-03-01

    High rates of sexually transmitted infections (STIs) and unintended pregnancy suggest a role for multipurpose prevention technologies (MPTs) designed to combine contraception and infection prophylaxis into one unified method. This study aims to determine factors associated with interest in MPTs among US women. We administered a national cross-sectional survey via MTurk. Eligibility criteria included female gender, age 18-29 years, residence in the USA, and sexual activity with a male partner in the past three months. In total, 835 surveys were suitable for analysis. Bivariable and multivariable logistic regressions were performed to determine factors associated with interest in MPTs. Eighty-three percent of women were interested in MPTs. Factors associated with interest included oral sex in the past three months (aOR 1.87, 95% CI 1.07, 3.53), recent use of oral contraceptive pills (OCPs; aOR 1.78, 95% CI 1.08, 2.93), HIV test within one year (aOR 2.10, 95% CI 1.29, 3.40), and increased STI worry score (aOR 1.98, 95% CI 1.36, 2.86). No use of contraception in the past three months was associated with decreased interest in MPTs (aOR 0.31, 95% CI 0.17, 0.58). HIV risk factors including race were not associated with MPT interest. Our data show that young, sexually active, US women are interested in MPTs. Women who used contraception, specifically OCPs, or evidenced concern for infection were most likely to be interested in such a product. Women reporting unsafe sexual habits were less likely to be interested, highlighting the importance of HIV/STI prevention education. Women in the USA are interested in multipurpose prevention technologies, particularly those women who currently use contraception or are concerned about their risk of infection. Our results emphasize the importance of moving forward with MPT development as well as continued HIV/STI prevention education. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Hill, Jenny; Hoyt, Jenna; van Eijk, Anna Maria; D'Mello-Guyett, Lauren; ter Kuile, Feiko O.; Steketee, Rick; Smith, Helen; Webster, Jayne

    2013-01-01

    Malaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization-recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is low. We conducted

  1. Effectiveness of antenatal clinics to deliver intermittent preventive treatment and insecticide treated nets for the control of malaria in pregnancy in Kenya

    NARCIS (Netherlands)

    Hill, Jenny; Dellicour, Stephanie; Bruce, Jane; Ouma, Peter; Smedley, James; Otieno, Peter; Ombock, Maurice; Kariuki, Simon; Desai, Meghna; Hamel, Mary J.; ter Kuile, Feiko O.; Webster, Jayne

    2013-01-01

    Malaria in pregnancy can have devastating consequences for mother and baby. Coverage with the WHO prevention strategy for sub-Saharan Africa of intermittent-preventive-treatment (IPTp) with two doses of sulphadoxine-pyrimethamine (SP) and insecticide-treated-nets (ITNs) in pregnancy is low. We

  2. Young Women's Lived Experience of Participating in a Positive Youth Development Programme: The "Teens & Toddlers" Pregnancy Prevention Intervention

    Science.gov (United States)

    Sorhaindo, Annik; Mitchell, Kirstin; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Bonell, Chris

    2016-01-01

    Purpose: Evaluation of the Teens & Toddlers (T&T) positive youth development (PYD) and teenage pregnancy prevention programme suggested that the intervention had minimal effectiveness partly due to its unclear theory of change. The purpose of this paper is to examine the lived experiences of young women participating in the programme to…

  3. A Participatory Action Research Approach to Developing Youth-Friendly Strategies for the Prevention of Teenage Pregnancy

    Science.gov (United States)

    Wood, Lesley; Hendricks, Farah

    2017-01-01

    Teenage pregnancy among school-going youth is a concern worldwide, but in socially-economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target…

  4. Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

    Science.gov (United States)

    Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

    2017-01-01

    Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

  5. Short-Term Impact of Safer Choices: A Multicomponent, School-Based HIV, Other STD, and Pregnancy Prevention Program.

    Science.gov (United States)

    Coyle, Karin; Basen-Engquist, Karen; Kirby, Douglas; Parcel, Guy; Banspach, Stephen; Harrist, Ronald; Baumler, Elizabeth; Weil, Marsha

    1999-01-01

    Evaluated the effectiveness of the first year of "Safer Choices," a two-year, multicomponent HIV, STD, and pregnancy-prevention program for high school students based on social theory. Student self-report surveys indicated that "Safer Choices" succeeded in reducing selected risk behaviors and in enhancing selected protective…

  6. A new strategy and its effect on adherence to intermittent preventive treatment of malaria in pregnancy in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Yanow, Stephanie; Birungi, Josephine

    2013-01-01

    Few women in Uganda access intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). Previous studies have shown that high costs, frequent stock-out of drugs, supplies and poor quality of care are the greatest hindrance for women to access health services...

  7. Assessing Capacity to Promote Science-Based Programs: A Key Informant Study of State Teen Pregnancy Prevention Organizations

    Science.gov (United States)

    Saunders, Edward; Sabri, Bushra; Huberman, Barbara; Klaus, T. W.; Davis, Laura

    2011-01-01

    The purpose of this qualitative study was to identify significant external and internal challenges that state organization leaders face in promoting science-based teen pregnancy prevention programs within their states. The state organization administrators were chosen because their organizations were funded by the U.S. Centers for Disease Control…

  8. Diet or exercise, or both, for preventing excessive weight gain in pregnancy.

    Science.gov (United States)

    Muktabhant, Benja; Lawrie, Theresa A; Lumbiganon, Pisake; Laopaiboon, Malinee

    2015-06-15

    This is an update of a Cochrane review first published in 2012, Issue 4. Excessive weight gain during pregnancy is associated with poor maternal and neonatal outcomes including gestational diabetes, hypertension, caesarean section, macrosomia, and stillbirth. Diet or exercise interventions, or both, may reduce excessive gestational weight gain (GWG) and associated poor outcomes; however, evidence from the original review was inconclusive. To evaluate the effectiveness of diet or exercise, or both, interventions for preventing excessive weight gain during pregnancy and associated pregnancy complications. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (5 November 2014), contacted investigators of the previously identified ongoing studies and scanned reference lists of retrieved studies. Randomised controlled trials (RCTs) of diet or exercise, or both, interventions for preventing excessive weight gain in pregnancy. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We organised RCTs according to the type of interventions and pooled data using the random-effects model in the Review Manager software. We also performed subgroup analyses according to the initial risk of adverse effects related to poor weight control. We performed sensitivity analysis to assess the robustness of the findings. We included 65 RCTs, out of which 49 RCTs involving 11,444 women contributed data to quantitative meta-analysis. Twenty studies were at moderate-to-high risk of bias. Study interventions involved mainly diet only, exercise only, and combined diet and exercise interventions, usually compared with standard care. Study methods varied widely; therefore, we estimated the average effect across studies and performed sensitivity analysis, where appropriate, by excluding outliers and studies at high risk of bias.Diet or exercise, or both, interventions reduced the risk of excessive GWG on

  9. Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy.

    Science.gov (United States)

    Doku, David Teye; Zankawah, Mumuni Mukaila; Adu-Gyamfi, Addae Boateng

    2016-10-10

    The burden of malaria in terms of morbidity and mortality is huge is Sub-Saharan Africa, particularly among pregnant women. Among the measures to curb down this burden include intermittent preventive treatment (IPT) and effective case management. These strategies were adopted by Ghana and implemented since 2003; however, there is still high dropout rate in IPT coverage. This study sought to investigate factors contributing to high dropout rate between IPT1 and IPT3 in the Tamale Metropolis, one of the health facilities with the highest IPT dropout rates in Ghana. Survey, in-depth interviews and short ethnographic techniques were conducted among pregnant women, antenatal care (ANC) health workers and heads of health facilities to investigate factors which account for dropout rate of intermittent treatment of malaria. Shortage of sulphadoxine pyrimethamine (SP), inadequate supply of portable water for administration of SP, unavailability of IPT during outreach services, lack of knowledge by ANC staff about the dropout rate in their area of jurisdiction and poor attitude of some health workers were identified as barriers to achieving high IPT3 coverage. Late ANC visit, provider and logistical barriers account for the women's missed opportunities to prevent malaria in pregnancy through IPT. Addressing the above barriers will contribute to saving lives and ensuring progress towards the goal of combating malaria as well as reducing maternal, neonatal and child mortalities.

  10. Influence of regularity of checkups during pregnancy on prevalence of asymptomatic bacteriuria and maternal behaviors regarding urinary infection prevention.

    Science.gov (United States)

    Babic, U; Opric, D; Perovic, M; Dmitrovic, A; MihailoviC, S; Kocijancic, D; Radakovic, J; Dugalic, M Gojnic

    2015-01-01

    T0 investigate how the regularity of checkups in pregnancy influences maternal behavior regarding habits in prevention of urinary tract infection (UTI), the level of information, and finally the prevalence of asymptomatic bacteriuria (AB). This study included 223 women with regular and 220 women with irregular checkups in pregnancy were given the questionnaire on the following issues: frequency of sexual intercourses during pregnancy, the regularity of bathing and changing of underwear, the direction of washing the genital region after urinating, the regularity of antenatal visits to gynecologist, and the subjective experience concerning the quality of the information received by the healthcare provider. AB was present significantly more frequent in group of participants with irregular controls during pregnancy compared to group with regular checkups in pregnancy. The prevalence of AB was higher in those women who had irregular prenatal checkups. Maternal behaviors related with the risk of urinary infections are more frequent among women with irregular prenatal care. Results of the present study emphasize the importance of regular prenatal care in AB prevention.

  11. Hydroxychloroquine for the prevention of fetal growth restriction and prematurity in lupus pregnancy: A systematic review and meta-analysis.

    Science.gov (United States)

    Vivien, Guillotin; Alice, Bouhet; Thomas, Barnetche; Christophe, Richez; Marie-Elise, Truchetet; Julien, Seneschal; Pierre, Duffau; Estibaliz, Lazaro

    2018-04-06

    Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that primarily affects women of childbearing age. While the impact of hydroxychloroquine (HCQ) on SLE activity and neonatal lupus occurrence has been evaluated in several studies, its role on prematurity and intrauterine growth restriction (IUGR) remains uncertain. The aim of this study was to assess the impact of HCQ exposure on prematurity and IUGR during pregnancy in women with SLE. We conducted a systematic review and a meta-analysis comparing prematurity and IUGR in SLE pregnancies exposed or not exposed to HCQ. The odds ratio of IUGR and prematurity were calculated and compared between pregnancies in each group according HCQ treatment. Six studies were included (3 descriptive cohort studies and 3 case series) totalling 870 pregnancies. Of the SLE pregnancies, 308 were exposed to HCQ and were compared to 562 not exposed to HCQ. There was no statistical difference for prematurity or IUGR between groups. This meta-analysis failed to prove the efficacy of HCQ in the prevention of prematurity as well as IUGR during SLE pregnancies. Due to the heterogeneity of the studies, these results should be interpreted cautiously. Copyright © 2018 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  12. Unwanted facial hair: affects, effects and solutions.

    Science.gov (United States)

    Blume-Peytavi, U; Gieler, U; Hoffmann, R; Lavery, S; Shapiro, J

    2007-01-01

    The following is a review of a satellite symposium held at the EHRS Meeting in June 2006. U.B.P. reminded the audience that unwanted facial hair (UFH) is an important issue; over 40% of the women in the general population have some degree of UFH, and its psychological and psychosocial impact should not be underestimated. The treatment of UFH involves many different disciplines, and the symposium offered the latest thinking in different aspects of the disorder. S.L. outlined the current concepts surrounding polycystic ovarian syndrome, and U.G. addressed the psychological aspects of UFH. J.S. described the current treatment options for UFH, followed by U.B.P.'s evidence-based therapy review. Finally, R.H. reviewed the latest trial results with Trichoscan, a method being investigated for assessing UFH removal. Copyright (c) 2007 S. Karger AG, Basel.

  13. Trends in youth reports of sexual solicitations, harassment and unwanted exposure to pornography on the Internet.

    Science.gov (United States)

    Mitchell, Kimberly J; Wolak, Janis; Finkelhor, David

    2007-02-01

    This study was designed to track trends in reports of unwanted sexual solicitations, harassment, and unwanted exposure to pornography via the Internet between 2000 and 2005 across various demographic sub-groups of youth. Cross-sectional data was collected in two equivalent national telephone surveys of 1500 Internet users, ages 10 through 17 years. Bivariate and multivariate analyses were used to determine whether the percentage of youth reporting specific unwanted Internet experiences had changed in 2005, as compared with 2000. The overall incidence and 5-year trends of reporting unwanted sexual solicitations, harassment, and unwanted exposure to pornography varied by age, gender, race, and household income. In particular, the decline in the percentage of youth reporting sexual solicitations was apparent for both boys and girls, all age groups, but not among minority youth and those living in less affluent households. The increase in harassment among particular sub-groups of youth was largely explained by increases in amount of Internet use over the past five years. The increase in unwanted exposure to pornography was particularly apparent among 10- to 12-year-olds, 16- to 17-year-olds, boys, and White, non-Hispanic youth. The decline in the percentage of youth reporting sexual solicitations may be the effect of education and law enforcement activity on this issue in the intervening years. Targeted prevention efforts for minority youth and those living in less affluent households need to be developed. The rise in unwanted pornography exposure may reflect technological changes such as digital photography, faster Internet connections and computer storage capacities, as well as the more aggressive marketing strategies of pornography merchants.

  14. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes.

    Science.gov (United States)

    Crawford, Tineke J; Crowther, Caroline A; Alsweiler, Jane; Brown, Julie

    2015-12-17

    Gestational diabetes, glucose intolerance with onset or first recognition during pregnancy, is a rising problem worldwide. Both non-pharmacological and pharmacological approaches to the prevention of gestational diabetes have been, and continue to be explored. Myo-inositol, an isomer of inositol, is a naturally occurring sugar commonly found in cereals, corn, legumes and meat. It is one of the intracellular mediators of the insulin signal and correlated with insulin sensitivity in type 2 diabetes. The potential beneficial effect on improving insulin sensitivity suggests that myo-inositol may be useful for women in preventing gestational diabetes. To assess if antenatal dietary supplementation with myo-inositol is safe and effective, for the mother and fetus, in preventing gestational diabetes. We searched the Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, WHO ICTRP (2 November 2015) and reference lists of retrieved studies. We sought published and unpublished randomised controlled trials, including conference abstracts, assessing the effects of myo-inositol for the prevention of gestational diabetes mellitus (GDM). Quasi-randomised and cross-over trials were not eligible for inclusion, but cluster designs were eligible. Participants in the trials were pregnant women. Women with pre-existing type 1 or type 2 diabetes were excluded. Trials that compared the administration of any dose of myo-inositol, alone or in a combination preparation were eligible for inclusion. Trials that used no treatment, placebo or another intervention as the comparator were eligible for inclusion. Two review authors independently assessed trials for inclusion, risk of bias and extracted the data. Data were checked for accuracy. We included four randomised controlled trials (all conducted in Italy) reporting on 567 women who were less than 11 weeks' to 24 weeks' pregnant at the start of the trials. The trials had small sample sizes and one trial only reported an

  15. Human immunodeficiency virus (HIV) in pregnancy: a review of the guidelines for preventing mother-to-child transmission in Malaysia.

    Science.gov (United States)

    Azwa, Iskandar; Khong, Su Yen

    2012-12-01

    Mother-to-child transmission (MTCT) of human immunodefi ciency virus (HIV) is a devastating consequence of HIV infection during pregnancy and is largely preventable. Evidence-based interventions such as universal antenatal screening, provision of antiretroviral therapy, delivery by elective caesarean section and avoidance of breastfeeding have ensured that the rates of MTCT remain low in Malaysia. This review discusses the most recent advances in the management of HIV infection in pregnancy with emphasis on antiretroviral treatment strategies and obstetric care in a middle income country.

  16. High rates of parasite recrudescence following intermittent preventive treatment with sulphadoxine-pyrimethamine during pregnancy in Benin

    DEFF Research Database (Denmark)

    Moussiliou, Azizath; Sissinto-Savi De Tove, Yolande; Doritchamou, Justin

    2013-01-01

    the second dose. Women with persistent parasitaemia had an increased prevalence of anaemia (P = 0.03). CONCLUSION: The data presented here, highlight the inability of SP to ensure optimal antiplasmodial protection in late pregnancy, and invite urgent consideration of an alternative drug or strategy.......BACKGROUND: Despite widespread parasite resistance to sulphadoxine-pyrimethamine (SP) its use for intermittent preventative treatment during pregnancy remains the policy in Benin and throughout most of sub-Saharan Africa. METHODS: In a prospective study, 982 pregnant women were recruited in Benin...

  17. 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。

  18. The Impact of State Abortion Policies on Teen Pregnancy Rates

    Science.gov (United States)

    Medoff, Marshall

    2010-01-01

    The availability of abortion provides insurance against unwanted pregnancies since abortion is the only birth control method which allows women to avoid an unwanted birth once they are pregnant. Restrictive state abortion policies, which increase the cost of obtaining an abortion, may increase women's incentive to alter their pregnancy avoidance…

  19. Extended Foster Care for Transition-Age Youth: An Opportunity for Pregnancy Prevention and Parenting Support.

    Science.gov (United States)

    Putnam-Hornstein, Emily; Hammond, Ivy; Eastman, Andrea Lane; McCroskey, Jacquelyn; Webster, Daniel

    2016-04-01

    This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal legislation extending foster care beyond age 18 years. Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N = 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ethnicity. One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years. Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Organization and staffing barriers to parent involvement in teen pregnancy prevention programs: challenges for community partnerships.

    Science.gov (United States)

    Flores, Janet E; Montgomery, Susanne; Lee, Jerry W

    2005-09-01

    To evaluate parent involvement in a Southern California teen pregnancy prevention community partnership project. Researchers expected to find parent and family-related participation barriers similar to those described in the family support literature, which they could address with program modifications. Three phases of qualitative evaluation occurred: key informant interviews and focus groups with youth and parents; focus groups with service providers; and key informant interviews with service providers, their supervisor, and the collaborative coordinator. Theory-based, open-ended question guides directed the interviews and focus groups, and transcriptions were coded and themed using grounded theory methods. Parents and youth sought ways to improve connections and communication with each other, and parents welcomed parenting education from the project. Unexpectedly, the major obstacles to parent participation identified in this project were largely organizational, and included the assignment of parent involvement tasks to agencies lacking capacities to work effectively with parents, inadequate administrative support for staff, and the absence of an effective system for communicating concerns and resolving conflicts among collaborative partners. Youth serving agencies may not be the best partners to implement effective parent involvement or family support interventions. Collaborative leadership must identify appropriate partners, engender their cooperation, and support their staff to further the overall goals of the collaborative.

  1. Melatonin prevents neural tube defects in the offspring of diabetic pregnancy.

    Science.gov (United States)

    Liu, Shangming; Guo, Yuji; Yuan, Qiuhuan; Pan, Yan; Wang, Liyan; Liu, Qian; Wang, Fuwu; Wang, Jingjing; Hao, Aijun

    2015-11-01

    Melatonin, an endogenous neurohormone secreted by the pineal gland, has a variety of physiological functions and neuroprotective effects. However, its protective role on the neural tube defects (NTDs) was not very clear. The aim of this study was to investigate the effects of melatonin on the incidence of NTDs (including anencephaly, encephalocele, and spina bifida) of offspring from diabetic pregnant mice as well as its underlying mechanisms. Pregnant mice were given 10 mg/kg melatonin by daily i.p. injection from embryonic day (E) 0.5 until being killed on E11.5. Here, we showed that melatonin decreased the NTDs (especially exencephaly) rate of embryos exposed to maternal diabetes. Melatonin stimulated proliferation of neural stem cells (NSCs) under hyperglycemic condition through the extracellular regulated protein kinases (ERK) pathway. Furthermore, as a direct free radical scavenger, melatonin decreased apoptosis of NSCs exposed to hyperglycemia. In the light of these findings, it suggests that melatonin supplementation may play an important role in the prevention of neural malformations in diabetic pregnancy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. "Let the Circle be Unbroken" helps African-Americans prevent teen pregnancy.

    Science.gov (United States)

    Okwumabua, T M; Okwumabua, J O; Elliott, V

    1998-01-01

    Strategies must be developed to address the high rate of adolescent pregnancy among Blacks in the US and the adverse consequences of premature parenting. A number of programs and strategies have been developed and are being implemented in various sites across the US. The "Let the Circle Be Unbroken: Rites of Passage" program is an effort to incorporate an Afrocentric conceptual model into a prevention program. It involves adapting socialization processes often observed in African cultures, which openly acknowledge the need to formally help adolescents during their transition from childhood to adulthood. That socialization process tends to be a cultural experience which requires that ideology, education, training, and culture be taught before an activity or celebration marking the successful transition from one stage of development to another. The "Rites of Passage" approach follows these basic premises to teach adolescents the knowledge and skills needed to become responsible community members and spiritually mature adults. It is specifically designed to help young people build self-esteem; enhance self-image; develop leadership skills, cultural awareness, and appreciation; and make healthy, productive, and self-affirming life choices.

  3. Prevention of unintended pregnancy and use of contraception?important factors for preconception care

    OpenAIRE

    Kallner, Helena Kopp; Danielsson, Kristina Gemzell

    2016-01-01

    Preservation of fertility and optimizing health before pregnancy is becoming increasingly important in societies where childbirth often is postponed. Research shows that as women postpone childbirth they achieve higher levels of education and higher incomes. This leads to advantages for their children and for society. However, as women postpone childbearing they are at risk for contracting conditions which may affect fertility and/or pregnancies, pregnancy outcome, and the newborn child. Prec...

  4. [Sexual responsibility: a key concept in the prevention of AIDS, abortion and adolescent pregnancies].

    Science.gov (United States)

    Luco, A

    1992-01-01

    Worldwide, approximately 300,000 people have AIDS, and there are 50-100 infections for each case. Responsible sexual behavior is crucial for prevention, since sexual transmission is the principal route of contracting AIDS. The major causes of maternal mortality in the 15-39 year age group in Latin America are complications from induced abortion which is also responsible for 40% of global maternal mortality, i.e., 200,000 women die because of induced abortion complications out of 500,000 women who succumb to pregnancy- and birth-related caused annually. In the 1980s 38% of deaths in Chile were related to abortion of women who died in reproductive age. In developing countries almost 50% of hospital admissions occur because of abortion sequelae. Infant mortality is higher in 20-year old mothers giving birth compared with the 20-29 age group. 40,000 children are born/year in Chile to mothers 20. In 1980 these births made up 16.7% of all births. 45% of births of mothers 20 are illegitimate. These young mothers are often unprepared for the parental role: 80% of children hospitalized for malnutrition were children of adolescent mothers according to a survey. The Catholic Church's view opposing contraceptives and sexuality outside of marriage conflicts with contemporary opinion backed by mass media favoring sexuality as leading to personal enrichment and advocating contraception. More than 60% of boys and more than 30% of girls start sexual relations 20. Young people do not use contraceptives because of misinformation, difficulty in getting appropriate information, and male machismo. AIDS prevention mandate sex education stressing responsible sexuality with abstinence, condom use, and monogamy.

  5. Lack of Thromboxane Synthase Prevents Hypertension and Fetal Growth Restriction after High Salt Treatment during Pregnancy.

    Directory of Open Access Journals (Sweden)

    Chen-Hsueh Pai

    Full Text Available Preeclampsia (PE is a potentially fatal pregnancy-related hypertensive disorder characterized by poor placenta development that can cause fetal growth restriction. PE-associated pathologies, including thrombosis, hypertension, and impaired placental development, may result from imbalances between thromboxane A2 (TXA2 and prostacyclin. Low-dose aspirin, which selectively inhibits TXA2 production, is used to prevent high-risk PE. However, the role of TXA2 in aspirin-mediated protective effects in women with PE is not understood fully. In this study, we examined the role of prostanoids in PE using human samples and an induced PE mouse model. We demonstrated that the administration of salted drinking water (2.7% NaCl to wild-type mice resulted in elevated placental TXA2 synthase (TXAS and plasma TXA2, but not prostacyclin, levels, which was also found in our clinical PE placenta samples. The high salt-treated wild-type pregnant mice had shown unchanged maternal body weight, hypertension (MAP increase 15 mmHg, and decreased pup weight (~50% and size (~24%, but these adverse effects were ameliorated in TXAS knockout (KO mice. Moreover, increased expression of interleukin-1β and downstream phosphorylated-p38-mitogen-activated protein kinase were concordant with apoptosis induction in the placentas of salt water-treated wild-type mice. These alterations were not observed in TXAS KO mice. Together, our data suggest that TXA2 depletion has anti-PE effects due to the prevention of hypertension and placental damage through downregulation of the interleukin-1β pathway.

  6. Progestogens to prevent preterm birth in twin pregnancies: an individual participant data meta-analysis of randomized trials

    Directory of Open Access Journals (Sweden)

    Schuit Ewoud

    2012-03-01

    Full Text Available Abstract Background Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix or to determine adverse effects for rare outcomes such as intrauterine death. Methods/design We propose an individual participant data meta-analysis of high quality randomized, double-blind, placebo-controlled trials of progestogen treatment in women with a twin pregnancy. The primary outcome will be adverse perinatal outcome (a composite measure of perinatal mortality and significant neonatal morbidity. Missing data will be imputed within each original study, before data of the individual studies are pooled. The effects of 17-hydroxyprogesterone caproate or vaginal progesterone treatment in women with twin pregnancies will be estimated by means of a random effects log-binomial model. Analyses will be adjusted for variables used in stratified randomization as appropriate. Pre-specified subgroup analysis will be performed to explore the effect of progestogen treatment in high-risk groups. Discussion Combining individual patient data from different randomized trials has potential to provide valuable, clinically useful information regarding the benefits and potential harms of progestogens in women with twin pregnancy overall and in relevant subgroups.

  7. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  8. Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention

    Directory of Open Access Journals (Sweden)

    Barucca Valentina

    2009-04-01

    Full Text Available Abstract Herpes simplex virus (HSV infection is one of the most common viral sexually transmitted diseases worldwide. The first time infection of the mother may lead to severe illness in pregnancy and may be associated with virus transmission from mother to foetus/newborn. Since the incidence of this sexually transmitted infection continues to rise and because the greatest incidence of herpes simplex virus infections occur in women of reproductive age, the risk of maternal transmission of the virus to the foetus or neonate has become a major health concern. On these purposes the Authors of this review looked for the medical literature and pertinent publications to define the status of art regarding the epidemiology, the diagnosis, the therapy and the prevention of HSV in pregnant women and neonate. Special emphasis is placed upon the importance of genital herpes simplex virus infection in pregnancy and on the its prevention to avoid neonatal HSV infections.

  9. An Evaluation of a School-Based Teenage Pregnancy Prevention Program Using a Logic Model Framework

    Science.gov (United States)

    Hulton, Linda J.

    2007-01-01

    Teenage pregnancy and the subsequent social morbidities associated with unintended pregnancies are complex issues facing school nurses in their daily work. In contemporary practice, school nurses are being held to higher standards of accountability and being asked to demonstrate the effective outcomes of their interventions. The purpose of this…

  10. What Can Be Done to Prevent Smoking in Pregnancy? A Literature Review

    Science.gov (United States)

    Bull, Leona

    2003-01-01

    Smoking in pregnancy is a serious health risk to mother and baby that is associated with premature birth, low birth weight and respiratory disorders. Recently it has become apparent that smoking in pregnancy can have long-term consequences for the child, including learning difficulties, elevated risk of diabetes, obesity and asthma. Over the past…

  11. Pessary placement in the prevention of preterm birth in multiple pregnancies: a propensity score analysis

    NARCIS (Netherlands)

    Monfrance, Maurice J. M.; Schuit, Ewoud; Groenwold, Rolf H.; Oudijk, Martijn A.; de Graaf, Irene M.; Bax, Caroline J.; Bekedam, Dick J.; Mol, Ben Willem; Langenveld, Josje

    2016-01-01

    In asymptomatic women with a multiple pregnancy and short cervix prophylactic use of a cervical pessary might reduce preterm birth. We assessed the possible treatment effects of pessary use in pregnancy duration and for poor perinatal outcome. This cohort study was performed between December 2012

  12. Pessary placement in the prevention of preterm birth in multiple pregnancies : a propensity score analysis

    NARCIS (Netherlands)

    Monfrance, Maurice J M; Schuit, Ewoud; Groenwold, Rolf H; Oudijk, Martijn A; de Graaf, Irene M; Bax, Caroline J; Bekedam, Dick J; Mol, Ben Willem; Langenveld, Josje

    OBJECTIVE: In asymptomatic women with a multiple pregnancy and short cervix prophylactic use of a cervical pessary might reduce preterm birth. We assessed the possible treatment effects of pessary use in pregnancy duration and for poor perinatal outcome. STUDY DESIGN: This cohort study was performed

  13. Sexual Attitudes and Behavior of Guatemalan Teenagers: Considerations for Prevention of Adolescent Pregnancy.

    Science.gov (United States)

    Berganza, Carlos E.; And Others

    1989-01-01

    Conducted 2 studies to explore prevalence of adolescence pregnancy in Guatemala and identify level of contraception. In first study found 89 percent of male and 38 percent of female adolescents (N=850) had experienced coitus. In the second study found pregnancy rate of minors (N=551) in a gynecology clinic was highest for adolescents aged 13-14.…

  14. Baby Think It Over: Using Role-Play To Prevent Teen Pregnancy.

    Science.gov (United States)

    Out, Jennifer W.; Lafreniere, Kathryn D.

    2001-01-01

    Examined the effectiveness of Baby Think It Over (BTIO), an infant simulation program that seeks to modify attitudes toward teen pregnancy and teen parenting. After experiencing BTIO, teens in the intervention group were more likely to accurately access their personal risk for an unplanned pregnancy than were teens in the comparison group. (Author)

  15. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members

    Science.gov (United States)

    McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete

    2015-01-01

    Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program…

  16. A systematic review of non-antibiotic measures for the prevention of urinary tract infections in pregnancy.

    Science.gov (United States)

    Ghouri, Flavia; Hollywood, Amelia; Ryan, Kath

    2018-04-13

    Urinary tract infections (UTIs) are common in pregnancy and account for the highest proportion of primary care antibiotic prescriptions issued to pregnant women in the UK. It is well known that antibiotic use is associated with increased antimicrobial resistance and therefore measures to minimise antibiotic use for UTI prevention have been studied. The efficacy and safety of these measures in pregnancy have not been addressed and therefore the aim of this study was to systematically review the literature to identify and evaluate potential measures to prevent UTIs in pregnant women. Ten databases (EMBASE, AMED, BNI, CINAHL, Medline, PubMed, PsycINFO, Cochrane Trials, Scopus and Science Direct) were systematically searched in July 2017 for studies reporting non-antibiotic measures to prevent UTIs in pregnancy. The terms ("urinary tract infection" or UTI or bacteriuria or cystitis) AND (prevention) AND (pregnan*) were used. The quality of the publications was appraised using the Critical Appraisal Skills Programme (CASP) checklists for cohort study, case-control study and randomised controlled trial. The results were synthesised using a textual narrative approach. Search results yielded 3276 publications and after reviewing titles and removing duplicates, 57 full text articles were assessed for eligibility and eight were included in the review. Five different approaches (hygiene measures, cranberry juice, immunisation, ascorbic acid and Canephron® N) have been identified, all of which are reported to be safe in pregnancy. The quality of the evidence varied considerably and only hygiene measures were supported by evidence to be recommended in practice. Future work needs to concentrate on strengthening the evidence base through improved design and reporting of studies with a focus on immunisation, ascorbic acid and Canephron® N.

  17. Do Health Promotion Messages Integrate Unintended Pregnancy and STI Prevention? A Content Analysis of Online Information for Adolescents and Young Adults.

    Science.gov (United States)

    Steiner, Riley J; Rasberry, Catherine N; Sales, Jessica M; Gaydos, Laura M; Pazol, Karen; Kramer, Michael; Swartzendruber, Andrea

    2018-04-20

    Recently there have been calls to strengthen integration of unintended pregnancy and sexually transmitted infection (STI) prevention messages, spurred by increasing use of long-acting reversible contraception. To assess the extent to which public health/clinical messages about unintended pregnancy prevention also address STI prevention, we conducted a content analysis of web-based health promotion information for young people. Websites identified through a systematic Google search were eligible for inclusion if they were operated by a United States-based organization with a mission related to public health/clinical services and the URL included: 1) original content; 2) about sexual and reproductive health; 3) explicitly for adolescents and/or young adults. Using defined protocols, URLs were screened and content was selected and analyzed thematically. Many of the 32 eligible websites presented information about pregnancy and STI prevention separately. Concurrent discussion of the two topics was often limited to statements about (1) strategies that can prevent both outcomes (abstinence, condoms only, condoms plus moderate or highly effective contraceptive methods) and (2) contraceptive methods that confer no STI protection. We also identified framing of condom use with moderate or highly effective contraceptive method for back-up pregnancy prevention but not STI prevention. STI prevention methods in addition to condoms, such as STI/HIV testing, vaccination, or pre-exposure or post-exposure prophylaxis, were typically not addressed with pregnancy prevention information. There may be missed opportunities for promoting STI prevention online in the context of increasing awareness of and access to a full range of contraceptive methods. Strengthening messages that integrate pregnancy and STI prevention may include: describing STI prevention strategies when noting that birth control methods do not prevent STIs; promoting a full complement of STI prevention strategies; and

  18. The kidney in pregnancy: A journey of three decades.

    Science.gov (United States)

    Prakash, J

    2012-05-01

    The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the eclampsia or hemolysis, elevated liver enzymes levels, and low platelets count (HELLP) syndrome accounted for about 40% of cases of acute kidney injury (AKI) in pregnancy. Preeclampsia/eclampsia was the cause of acute renal failure (ARF) in 38.3% of the cases. Preeclampsia was the most common (91.7%) cause of hypertension during pregnancy, and chronic hypertension was present in 8.3% of patients. We observed urinary tract infection (UTI) in 9% of pregnancies. Sepsis resulting from pyelonephritis can progress to endotoxic shock, disseminated intravascular coagulation, and AKI. The incidence of premature delivery and low birth weight is higher in women with UTI. The incidence of AKI in pregnancy with respect to total ARF cases has decreased over the last 30 years from 25% in 1980s to 5% in 2000s. Septic abortion-related ARF decreased from 9% to 3%. Prevention of unwanted pregnancy and avoidance of septic abortion are key to eliminate abortion-associated ARF in early pregnancy. The two most common causes of ARF in third trimester and postpartum periods were puerperal sepsis and preeclampsia/HELLP syndrome. Pregnancy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome and acute fatty liver of pregnancy were rare causes of ARF. Despite decreasing incidence, AKI remains a serious complication during pregnancy.

  19. Prevention of influenza-related illness in young infants by maternal vaccination during pregnancy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marta C Nunes

    2018-01-01

    Full Text Available The influenza virus circulates yearly and causes global epidemics. Influenza infection affects all age groups and causes mild to severe illness, and young infants are at particular risk for serious disease. The most effective measure to prevent influenza disease is vaccination; however, no vaccine is licensed for use in infants younger than 6 months old. Thus, there is a crucial need for other preventive strategies in this high-risk age group. Influenza vaccination during pregnancy protects both the mothers and the young infants against influenza infection. Vaccination during pregnancy boosts the maternal antibodies and increases the transfer of immunoglobulin G from the mother to the fetus through the placenta, which confers protection against infection in infants too young to be vaccinated. Data from clinical trials and observational studies did not demonstrate adverse effects to the mother, the fetus, or the infant after maternal influenza vaccination. We present the current data on the effectiveness and safety of influenza vaccination during pregnancy in preventing disease in the young infant.

  20. A community-based delivery system of intermittent preventive treatment of malaria in pregnancy and its effect on use of essential maternity care at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, I C; Magnussen, Pascal

    2007-01-01

    Community delivery of intermittent preventive treatment of malaria in pregnancy (IPTp) is one potential option that could mitigate malaria in pregnancy. However, there is concern that this approach may lead to complacency among women with low access to essential care at health units. A non-random...

  1. Community-based distribution of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy improved coverage but reduced antenatal attendance in southern Malawi

    NARCIS (Netherlands)

    Msyamboza, K. P.; Savage, E. J.; Kazembe, P. N.; Gies, S.; Kalanda, G.; D'Alessandro, U.; Brabin, B. J.

    2009-01-01

    To evaluate the impact of a 2-year programme for community-based delivery of sulfadoxine-pyremethamine (SP) on intermittent preventive treatment during pregnancy coverage, antenatal clinic attendance and pregnancy outcome. Fourteen intervention and 12 control villages in the catchment areas of

  2. Physical, emotional and sexual violence during pregnancy in Malatya, Turkey.

    Science.gov (United States)

    Karaoglu, Leyla; Celbis, Osman; Ercan, Cihan; Ilgar, Mehtap; Pehlivan, Erkan; Gunes, Gulsen; Genc, Metin F; Egri, Mucahit

    2006-04-01

    In Turkey, violence against women was established as a critical area of concern related to women and various prevention strategies have been developed since 1980. There are limited numbers of studies on violence during pregnancy in the country. This study was performed to determine the prevalence of physical, emotional and sexual violence during pregnancy in Malatya province and the associated factors. A cross-sectional interview survey was conducted among pregnant women living in Malatya province between October 2003 and May 2004. Stratified probability-proportional-to-size sampling methodology was used for selecting the study population. A total of 824 pregnant women from 60 clusters were studied. Association between violence prevalences and womens' sociodemographic, fertility and behavioural characteristics were evaluated. During pregnancy 31.7% of women were exposed to any form of violence. Emotional violence was the most frequently reported form (26.7%), followed by sexual (9.7%) and physical violence (8.1%). Regular smoking [odds ratio (OR) 1.6], unwanted pregnancy (OR 1.8), living in urban area (OR 1.5), low education level of husband (OR 1.7), low family income (OR 1.9) and being in second trimester (OR 1.4) were determined to be the main predictors of overall violence during pregnancy. Violence during pregnancy is a common public health problem in Malatya. Low education level in partners, low family income, husband's unemployment, urban settlement, unwanted pregnancy and smoking should alert health staff towards violence at pregnancy and training of health personnel on the subject is recommended.

  3. Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Marseille, Elliot; Mirzazadeh, Ali; Biggs, M Antonia; P Miller, Amanda; Horvath, Hacsi; Lightfoot, Marguerita; Malekinejad, Mohsen; Kahn, James G

    2018-05-01

    School-based programs have been a mainstay of youth pregnancy prevention efforts in the USA. We conducted a systematic review and meta-analysis to assess their effectiveness. Eligible studies evaluated the effect on pregnancy rates of programs delivered in elementary, middle, or high schools in the USA and Canada, published between January 1985 and September 2016. The primary outcome was pregnancy; secondary outcomes were delay in sexual initiation, condom use, and oral contraception use. Randomized controlled trials (RCTs) and non-RCTs with comparator groups were eligible. We developed a comprehensive search strategy, applied to major bibliographic databases, article bibliographies, gray literature, and contact with authors. We calculated risk ratios (RR) with 95% confidence intervals (CI) for each outcome and pooled data in random effects meta-analysis. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess evidence quality. Ten RCTs and 11 non-RCTs conducted from 1984 to 2016 yielded 30 unique pooled comparisons for pregnancy, of which 24 were not statistically significant. Six showed statistically significant changes in pregnancy rates: two with increased risk (RR 1.30, 95% CI 1.02-1.65; and RR 1.39, 95% CI 1.10-1.75) and four with decreased risk ranging from RR 0.56, 95% CI 0.41-0.77, to RR 0.75, 95% CI 0.58-0.96. All studies were at high risk of bias, and the quality of evidence was low or very low. Identified evidence indicated no consistent difference in rates of pregnancies between intervention recipients and controls.

  4. Factors associated with unintended pregnancy in Yamagata, Japan.

    Science.gov (United States)

    Goto, Aya; Yasumura, Seiji; Reich, Michael R; Fukao, Akira

    2002-04-01

    Data on unintended pregnancy are scarce in Japan. The purpose of this study is to examine the association of sociodemographic, reproductive, and other health behavioral factors with unintended pregnancy. A survey was conducted from May through November 1999 in Yamagata, Japan. We distributed anonymous self-administered questionnaires to cervical and breast cancer screening participants aged 35-49 years. There were 564 eligible women, and the number of respondents was 421 (74.6%). The proportion of women who had experienced unintended pregnancy was 46.2%, and 40.1% of them had repeated experiences. Among 312 pre-menopausal married women who did not want to become pregnant, 15.4% were not using any contraception. Factors that were significantly associated with the experience of unintended pregnancy were age of husband being 4 or more years older [Odds ratio (OR) = 1.83], and age at initiation of sexual intercourse (OR = 1.86) and marriage during teens (OR = 11.14). Analysis of 1255 pregnancies that the subjects had experienced showed that 51.2% and 25.9% of mistimed and unwanted pregnancies occurred as a result of no contraceptive use, and 39.5% and 71.1% of these ended in abortions. The number of past unintended pregnancies was significantly (p counseling for the prevention of repeated unintended pregnancies.

  5. High-Stakes Systematic Reviews: A Case Study From the Field of Teen Pregnancy Prevention.

    Science.gov (United States)

    Goesling, Brian; Oberlander, Sarah; Trivits, Lisa

    2016-08-19

    Systematic reviews help policy makers and practitioners make sense of research findings in a particular program, policy, or practice area by synthesizing evidence across multiple studies. However, the link between review findings and practical decision-making is rarely one-to-one. Policy makers and practitioners may use systematic review findings to help guide their decisions, but they may also rely on other information sources or personal judgment. To describe a recent effort by the U.S. federal government to narrow the gap between review findings and practical decision-making. The Teen Pregnancy Prevention (TPP) Evidence Review was launched by the U.S. Department of Health and Human Services (HHS) in 2009 as a systematic review of the TPP literature. HHS has used the review findings to determine eligibility for federal funding for TPP programs, marking one of the first attempts to directly link systematic review findings with federal funding decisions. The high stakes attached to the review findings required special considerations in designing and conducting the review. To provide a sound basis for federal funding decisions, the review had to meet accepted methodological standards. However, the review team also had to account for practical constraints of the funding legislation and needs of the federal agencies responsible for administering the grant programs. The review team also had to develop a transparent process for both releasing the review findings and updating them over time. Prospective review authors and sponsors must recognize both the strengths and limitations of this approach before applying it in other areas. © The Author(s) 2016.

  6. Prevention of thrombosis in pregnancy: how practical are consensus derived clinical practice guidelines?

    LENUS (Irish Health Repository)

    Hayes-Ryan, D

    2012-11-01

    Thromboembolic disease (TED) has, for many years, consistently been identified as one of the leading causes of direct maternal mortality. In November 2009, the RCOG published a guideline on the prevention of TED that has been rapidly adopted by hospital trusts in the UK. The aim of our study was to determine the number and profile of women in our population that would require treatment with low molecular weight heparin (LMWH) and the cost implications of such treatment if these guidelines were implemented. A retrospective review of the first 100 women who delivered at the Coombe Women & Infants University Hospital (CWIUH) in 2010 was conducted and risk stratification applied at the relevant time points. A total of 51% were deemed to be at intermediate or high risk of TED at some point during pregnancy. In 35 of the 51 women (70%), this risk was attributable to factors such as age>35 years, parity≥3, BMI>30 kg\\/m2 or cigarette smoking. In our obstetric population, the percentage of women with these risk factors was: 25.5%, 8.5%, 19% and 16.7%, respectively. Implementation of this guideline would increase the hospital annual expenditure on LMWH by a factor of 17. The strategy of attributing risk by accumulating factors that individually have a low risk of TED and are prevalent in the population needs to be re-visited. The cost of implementation of these guidelines is not inconsiderable in the absence of data to indicate that clinical outcome is improved with their implementation.

  7. What public school teachers teach about preventing pregnancy, AIDS and sexually transmitted diseases.

    Science.gov (United States)

    Forrest, J D; Silverman, J

    1989-01-01

    Ninety-three percent of public school teachers in five specialties-biology, health education, home economics, physical education and school nursing--who teach grades 7-12 report that their schools offer sex education or AIDS education in some form. Almost all the teachers believe that a wide range of topics related to the prevention of pregnancy, AIDS and other sexually transmitted diseases (STDs) should be taught in the public schools, and most believe these topics should be covered by grades 7-8 at the latest. In practice, however, sex education tends not to occur until the ninth or 10th grades. Moreover, there is often a gap between what teachers think should be taught and what actually is taught. For example, virtually all the teachers say that school sex education should cover sexual decision-making, abstinence and birth control methods, but only 82-84 percent of the teachers are in schools that provide instruction in those topics. The largest gap occurs in connection with sources of birth control methods: Ninety-seven percent of teachers say that sex education classes should address where students can go to obtain a method, but only 48 percent are in schools where this is done. Forty-five percent of teachers in the five specialties currently provide sex education in some form. The messages they most want to give to their students are responsibility regarding sexual relationships and parenthood, the importance of abstinence and ways of resisting pressures to become sexually active, and information about AIDS and other STDs.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. [Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].

    Science.gov (United States)

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernández, Antonio; Péres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, María Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.). Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.

    Science.gov (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A; Atallah, Alvaro N; Duley, Lelia; Torloni, Maria R

    2014-06-24

    Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 March 2013) and contacted study authors for more data where possible. We updated the search in May 2014 and added the results to the 'Awaiting Classification' section of the review. Randomised controlled trials (RCTs) comparing high-dose (at least 1 g daily of calcium) or low-dose calcium supplementation during pregnancy with placebo or no calcium. We assessed eligibility and trial quality, extracted and double-entered data. High-dose calcium supplementation (≥1 g/day)We included 14 studies in the review, however one study contributed no data. We included 13 high-quality studies in our meta-analyses (15,730 women). The average risk of high blood pressure (BP) was reduced with calcium supplementation compared with placebo (12 trials, 15,470 women: risk ratio (RR) 0.65, 95% confidence interval (CI) 0.53 to 0.81; I² = 74%). There was also a significant reduction in the risk of pre-eclampsia associated with calcium supplementation (13 trials, 15,730 women: RR 0.45, 95% CI 0.31 to 0.65; I² = 70%). The effect was greatest for women with low calcium diets (eight trials, 10,678 women: average RR 0.36, 95% CI 0.20 to 0.65; I² = 76%) and women at high risk of pre-eclampsia (five trials, 587 women: average RR 0.22, 95% CI 0.12 to 0.42; I² = 0%). These data should be interpreted with caution because of the possibility of small-study effect or publication bias.The composite outcome maternal death or serious morbidity was reduced (four trials, 9732 women; RR 0.80, 95% CI 0.65 to 0.97; I² = 0%). Maternal deaths were not significantly different (one trial of 8312 women: calcium

  10. School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.

    Science.gov (United States)

    Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

    2016-11-08

    School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America

  11. Prevention of pregnancy complications in iran following implementing a national educational program.

    Directory of Open Access Journals (Sweden)

    Maryam Moghani Lankarani

    2014-09-01

    Full Text Available To determine the impact of a national intervention program on some pregnancy complications in Iran.This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies and post- (3,958 pregnancies measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants.The following pregnancy complications were reduced significantly as compared to before intervention: 1 bleeding or spotting, 2 urinary tract complications, 3 blurred vision and severe headache, 4 premature labor pain, 5 anemia, 6 severe vomiting, 7 inappropriate weight gain, 8 endometritis, 9 urinary incontinence, 10 breast abscess or mastitis, 11 wound infection, and 12 bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1 hypertension, 2 fever and chills, 3 convulsion, shock, and loss of consciousness, and 4 obstetric fistula.National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries.

  12. Effectiveness of Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine against Submicroscopic falciparum Malaria in Central Region, Ghana

    Directory of Open Access Journals (Sweden)

    Ekene K. Nwaefuna

    2015-01-01

    Full Text Available Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR (submicroscopic malaria are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%, were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP users while 234 (36.4% were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872 and 9.7% (67/688 of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07–0.23, p=0.005 reduced the prevalence of submicroscopic malaria as more nonusers (51/234 than users (16/454 were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02–0.22, p=0.006. These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy.

  13. Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction.

    Science.gov (United States)

    Harvey, Marie-Andrée

    2003-06-01

    To review the literature on the origin, anatomical rationale, techniques, and evidence-based effectiveness of peripartum pelvic floor exercises (PFEs) in the prevention of pelvic floor problems including urinary and anal incontinence, and prolapse. Literature was reviewed for background information. MEDLINE, EMBASE, CINAHL, and proceedings of scientific meetings were searched for evidence-based data. A comprehensive literature search was performed to find all studies that involved the use of antepartum and/or postpartum PFEs. For the MEDLINE (1966 to 2002) and CINAHL (1980 to 2002) searches, the following key words were used: urinary incontinence (prevention and control, rehabilitation, therapy), fecal incontinence, exercise or exercise therapy, Kegel, muscle contraction, muscle tonus, muscle development, pelvic floor, pregnancy, puerperium, puerperal disorders. For the EMBASE (1980 to 2002) search, the following key words were used: micturition disorder (prevention, rehab, disease management, therapy), fecal incontinence, labour complication, pregnancy disorder, puerperal disorder, antepartum care, pregnancy, kinesiotherapy, exercise, pelvic floor, bladder. A manual search was performed of available abstracts presented at the annual scientific meetings of the International Continence Society (1997, 1999 to 2002), American Urogynecologic Association (1997 to 1998, 2000 to 2002), and International Urogynecological Association (1997, 1999 to 2002). Twelve studies evaluating the role of antepartum PFE were found, of which 3 randomized controlled trials (RCTs) comparing PFEs for the prevention of urinary incontinence to controls were included. Twelve studies evaluating postpartum PFEs for prevention of urinary incontinence were reviewed, of which 4 RCTs were included. Five studies evaluating postpartum PFEs for the prevention of anal incontinence were reviewed, of which 4 RCTs were included. Participants in the studies were primiparous women. DATA TABULATION AND

  14. Pregnancy incidence and risk factors among women participating in vaginal microbicide trials for HIV prevention: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alfred Musekiwa

    Full Text Available INTRODUCTION: Pregnancy is contraindicated in vaginal microbicide trials for the prevention of HIV infection in women due to the unknown maternal and fetal safety of the microbicides. Women who become pregnant are taken off the microbicide during pregnancy period but this result in reduction of the power of the trials. Strategies to reduce the pregnancy rates require an understanding of the incidence and associated risk factors of pregnancy in microbicide trials. This systematic review estimates the overall incidence rate of pregnancy in microbicide trials and describes the associated risk factors. METHODS: A comprehensive literature search was carried out to identify eligible studies from electronic databases and other sources. Two review authors independently selected studies and extracted relevant data from included studies. Meta-analysis of incidence rates of pregnancy was carried out and risk factors of pregnancy were reported narratively. RESULTS: Fifteen studies reporting data from 10 microbicide trials (N=27,384 participants were included. A total of 4,107 participants (15.0% fell pregnant and a meta-analysis of incidence rates of pregnancy from 8 microbicide trials (N=25,551 yielded an overall incidence rate of 23.37 (95%CI: 17.78 to 28.96 pregnancies per 100 woman-years. However, significant heterogeneity was detected. Hormonal injectable, intra-uterine device (IUD or implants or sterilization, older age, more years of education and condom use were associated with lower pregnancy. On the other hand, living with a man, history of pregnancy, self and partner desire for future baby, oral contraceptive use, increased number of unprotected sexual acts and inconsistent use of condoms were associated with higher pregnancy. CONCLUSIONS: The incidence rate of pregnancy in microbicide trials is high and strategies for its reduction are urgently required in order to improve the sample size and power of these trials.

  15. Abortion and Crime: Unwanted Children and Out-of-Wedlock Births

    OpenAIRE

    John R. Lott, Jr.; John Whitley

    2001-01-01

    Abortion may prevent the birth of ''unwanted'' children, who would have relatively small investments in human capital and a higher probability of crime. On the other hand, some research suggests that legalizing abortion increases out-of-wedlock births and single parent families, which implies the opposite impact on investments in human capital and thus crime. The question is: what is the net impact? We find evidence that legalizing abortion increased murder rates by around about 0.5 to 7 perc...

  16. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  17. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus

    2016-01-01

    BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...... of care in the private sector that provides almost a half of health services in Uganda. METHODS: A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy...... the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector...

  18. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  19. The potential role of HPV vaccination in the prevention of infectious complications of pregnancy

    DEFF Research Database (Denmark)

    Bonde, Ulla; Jøergensen, Jan Stener; Mogensen, Ole

    2014-01-01

    There is now incontrovertible evidence that HPV is the cause of almost all cases of genital warts, cervical dysplasia and cervical cancer. Moreover the current review of the recent literature on HPV in relation to pregnancy found strong indications that HPV plays an important role in adverse...... outcomes of pregnancy. HPV may contribute to infertility and may increase the risk of miscarriage. Recent studies indicate a significant rate of vertical transmission of HPV between mother and child but whether the mode of delivery makes a difference to the risk of transmission remains unknown. HPV...

  20. A risky boundary: Unwanted sexual behaviour among youth

    OpenAIRE

    Bruijn, Paula de; Burrie, Ingrid; Wel, Frits van

    2006-01-01

    The aim of this research was to explore unwanted sexual behaviour amongs young people. Sexual aggression was operationalized at three levels: ‘‘verbal’’, ‘‘non-verbal/intimidating’’ and ‘‘physically violent’’. A total of 1,700 Dutch adolescents completed a questionnaire that included six clusters of possible determinants of unwanted sexual behaviour: background characteristics, personality characteristics, family environment, school environment, friends and deviant behaviour and sexuality and...

  1. Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis.

    Science.gov (United States)

    Norman, Jane E; Mackenzie, Fiona; Owen, Philip; Mactier, Helen; Hanretty, Kevin; Cooper, Sarah; Calder, Andrew; Mires, Gary; Danielian, Peter; Sturgiss, Stephen; MacLennan, Graeme; Tydeman, Graham; Thornton, Steven; Martin, Bill; Thornton, James G; Neilson, James P; Norrie, John

    2009-06-13

    Women with twin pregnancy are at high risk for spontaneous preterm delivery. Progesterone seems to be effective in reducing preterm birth in selected high-risk singleton pregnancies, albeit with no significant reduction in perinatal mortality and little evidence of neonatal benefit. We investigated the use of progesterone for prevention of preterm birth in twin pregnancy. In this double-blind, placebo-controlled trial, 500 women with twin pregnancy were recruited from nine UK National Health Service clinics specialising in the management of twin pregnancy. Women were randomised, by permuted blocks of randomly mixed sizes, either to daily vaginal progesterone gel 90 mg (n=250) or to placebo gel (n=250) for 10 weeks from 24 weeks' gestation. All study personnel and participants were masked to treatment assignment for the duration of the study. The primary outcome was delivery or intrauterine death before 34 weeks' gestation. Analysis was by intention to treat. Additionally we undertook a meta-analysis of published and unpublished data to establish the efficacy of progesterone in prevention of early (<34 weeks' gestation) preterm birth or intrauterine death in women with twin pregnancy. This study is registered, number ISRCTN35782581. Three participants in each group were lost to follow-up, leaving 247 analysed per group. The combined proportion of intrauterine death or delivery before 34 weeks of pregnancy was 24.7% (61/247) in the progesterone group and 19.4% (48/247) in the placebo group (odds ratio [OR] 1.36, 95% CI 0.89-2.09; p=0.16). The rate of adverse events did not differ between the two groups. The meta-analysis confirmed that progesterone does not prevent early preterm birth in women with twin pregnancy (pooled OR 1.16, 95% CI 0.89-1.51). Progesterone, administered vaginally, does not prevent preterm birth in women with twin pregnancy. Chief Scientist Office of the Scottish Government Health Directorate.

  2. Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight: A Randomized Clinical Trial.

    Science.gov (United States)

    Bacchi, Mariano; Mottola, Michelle F; Perales, Maria; Refoyo, Ignacio; Barakat, Ruben

    2018-03-01

    The aim of the present study was to examine the influence of a supervised and regular program of aquatic activities throughout gestation on maternal weight gain and birth weight. A randomized clinical trial. Instituto de Obstetricia, Ginecología y Fertilidad Ghisoni (Buenos Aires, Argentina). One hundred eleven pregnant women were analyzed (31.6 ± 3.8 years). All women had uncomplicated and singleton pregnancies; 49 were allocated to the exercise group (EG) and 62 to the control group (CG). The intervention program consisted of 3 weekly sessions of aerobic and resistance aquatic activities from weeks 10 to 12 until weeks 38 to 39 of gestation. Maternal weight gain, birth weight, and other maternal and fetal outcomes were obtained by hospital records. Student unpaired t test and χ 2 test were used; P values ≤.05 indicated statistical significance. Cohen's d was used to determinate the effect size. There was a higher percentage of women with excessive maternal weight gain in the CG (45.2%; n = 28) than in the EG (24.5%; n = 12; odds ratio = 0.39; 95% confidence interval: 0.17-0.89; P = .02). Birth weight and other pregnancy outcomes showed no differences between groups. Three weekly sessions of water activities throughout pregnancy prevents excessive maternal weight gain and preserves birth weight. The clinicaltrial.gov identifier: NCT 02602106.

  3. Preventing cardiovascular disease after hypertensive disorders of pregnancy : Searching for the how and when

    NARCIS (Netherlands)

    Groenhof, T. Katrien J.; van Rijn, Bas B.; Franx, Arie; Roeters Van Lennep, Jeanine E.; Bots, Michiel L.; Lely, A. Titia

    2017-01-01

    Background: Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be organized.

  4. Preventing cardiovascular disease after hypertensive disorders of pregnancy: Searching for the how and when

    NARCIS (Netherlands)

    Groenhof, T.K.J. (T Katrien J); B.B. van Rijn (Bas); A. Franx (Arie); J.E. Roeters van Lennep (Jeanine); M.L. Bots (Michiel); A.T. Lely (Titia)

    2017-01-01

    textabstractBackground: Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be

  5. Preventing High-Risk Sexual Behavior, Sexually Transmitted Diseases, and Pregnancy among Adolescents.

    Science.gov (United States)

    Sagrestano, Lynda M.; Paikoff, Roberta L.

    Adolescent sexual activity and the resulting pregnancy and transmission of sexually transmitted diseases have been on the rise during the past several decades. This chapter addresses each of the three objectives regarding sexual behavior outlined in the Healthy People 2000 initiative. Background data and trends in adolescent sexual behavior are…

  6. Mefloquine prophylaxis prevents malaria during pregnancy: a double-blind, placebo-controlled study

    NARCIS (Netherlands)

    Nosten, F.; ter Kuile, F.; Maelankiri, L.; Chongsuphajaisiddhi, T.; Nopdonrattakoon, L.; Tangkitchot, S.; Boudreau, E.; Bunnag, D.; White, N. J.

    1994-01-01

    A double-blind, placebo-controlled study of mefloquine antimalarial prophylaxis in pregnancy (> 20 weeks of gestation) was conducted in 339 Karen women living in an area of multidrug-resistant malaria transmission on the Thai-Burmese border. Mefloquine gave > or = 86% (95% confidence interval [CI],

  7. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Josefsen, Knud; Haupt-Jorgensen, Martin

    2016-01-01

    Studies have documented that the pathogenesis of autoimmune diabetes is influenced by the intake of gluten. Aims. To investigate the importance of gluten exposure during pregnancy and the subsequent development of autoimmune diabetes in offspring. Methods. Nonobese diabetic mice were divided into...

  8. Intermittent preventive therapy in pregnancy and incidence of low birth weight in malaria-endemic countries

    DEFF Research Database (Denmark)

    Cates, Jordan E.; Westreich, Daniel; Unger, Holger W.

    2018-01-01

    Objectives. To estimate the impact of hypothetical antimalarial and nutritional interventions (which reduce the prevalence of low midupper arm circumference [MUAC]) on the incidence of low birth weight (LBW). Methods. We analyzed data from 14 633 pregnancies from 13 studies conducted across Africa...

  9. Classroom Goal Structures and HIV and Pregnancy Prevention Education in Rural High School Health Classrooms

    Science.gov (United States)

    Anderman, Eric M.; Cupp, Pamela K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann

    2011-01-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV and pregnancy instruction, 3 months after instruction, and 1 year after instruction). Results indicated…

  10. Possibilities in Anaemia Prevention during Pregnancy through the Basic Health Care System

    Science.gov (United States)

    Karácsony, Ilona; Albrecht, Hanna; Brantmüller, Éva

    2015-01-01

    In case of pregnancies, one of the most common pathological conditions in internal medicine is aneamia with iron-deficiency. Furthermore, iron deficiency may also affect the mother and the fetus negatively. We wanted to find out which group of expectant mothers are mostly affected, which factors influence the development of aneamia. It was also…

  11. Effect of sulfadoxine-pyrimethamine resistance on the efficacy of intermittent preventive therapy for malaria control during pregnancy: a systematic review

    NARCIS (Netherlands)

    ter Kuile, Feiko O.; van Eijk, Annemieke M.; Filler, Scott J.

    2007-01-01

    In malaria-endemic regions, strategies to control malaria during pregnancy rely on case management of malaria illness and anemia, and preventive measures such as insecticide-treated nets and intermittent preventive therapy (IPT). To determine the effect of increasing resistance to

  12. Teenage pregnancy.

    Science.gov (United States)

    Molina Cartes, Ramiro; González Araya, Electra

    2012-01-01

    Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested. Copyright © 2012 S. Karger AG, Basel.

  13. Antenatal interventions for preventing the transmission of cytomegalovirus (CMV) from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant.

    LENUS (Irish Health Repository)

    McCarthy, Fergus P

    2012-01-31

    BACKGROUND: Cytomegalovirus (CMV) is a herpesvirus and the most common cause of congenital infection in developed countries. Congenital CMV infection can have devastating consequences to the fetus. The high incidence and the serious morbidity associated with congenital CMV infection emphasise the need for effective interventions to prevent the antenatal transmission of CMV infection. OBJECTIVES: The aim of this review was to assess the benefits and harms of interventions used during pregnancy to prevent mother to fetus transmission of CMV infection. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group\\'s Trials Register (31 December 2010). SELECTION CRITERIA: All randomised controlled trials (RCTs) and quasi RCTs investigating antenatal interventions for preventing the transmission of CMV from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion. MAIN RESULTS: We identified six studies from the search. None of these studies met the pre-defined criteria for inclusion in this review. AUTHORS\\' CONCLUSIONS: To date, no RCTs are available that examine antenatal interventions for preventing the transmission of CMV from the infected mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. Further research is needed to assess the efficacy of interventions aimed at preventing the transmission of CMV from the mother to fetus during pregnancy including a long-term follow-up of exposed infants and a cost effective analysis.

  14. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    Science.gov (United States)

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  15. Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding.

    Science.gov (United States)

    Morrison, Susan; John-Stewart, Grace; Egessa, John J; Mubezi, Sezi; Kusemererwa, Sylvia; Bii, Dennis K; Bulya, Nulu; Mugume, Francis; Campbell, James D; Wangisi, Jonathan; Bukusi, Elizabeth A; Celum, Connie; Baeten, Jared M

    2015-01-01

    During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART), despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.

  16. Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding.

    Directory of Open Access Journals (Sweden)

    Susan Morrison

    Full Text Available During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART, despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.

  17. Do screening-preventative interventions in asymptomatic pregnancies reduce the risk of preterm delivery--a critical appraisal of the literature.

    Science.gov (United States)

    Varma, Rajesh; Gupta, Janesh K; James, David K; Kilby, Mark D

    2006-08-01

    Recent research has suggested that women who experience preterm delivery (PTD) may be identified earlier in pregnancy and before onset of symptoms. Interventions commenced at this earlier asymptomatic stage may offer an opportunity to prevent PTD or lengthen gestation sufficiently to reduce adverse perinatal outcome. Our objective was to examine the evidence that supports or refutes this approach to preventing PTD. We therefore conducted a systematic search and critical appraisal of the identified literature. We found evidence that introducing screening-preventative strategies for asymptomatic pregnancies may reduce the rate of PTD. Evidence for screening and selective treatment exists for: asymptomatic bacteriuria; bacterial vaginosis in low-risk population groups; elective cervical cerclage in high-risk pregnancies; indicated cervical cerclage in women with short cervical length on ultrasound; prophylactic progesterone supplementation in high-risk pregnancies, and smoking cessation. However, for most other strategies, such as increased antenatal attendance, or routine administration of prophylactic micronutrients, the evidence is inconsistent and conflicting. Information on neonatal outcomes apart from PTD (such as serious neonatal morbidity and mortality) was found to be lacking in most studies. It was therefore not possible to establish whether preventing PTD or prolonging gestation would correlate to improved perinatal outcome, and this lessened the potential clinical usefulness of any proposed preventative strategy. No studies were found that evaluated the effectiveness of combining screening-preventative strategies. The review concludes with a suggested an antenatal management plan designed to prevent PTD based on current practice and the evidence presented in this article.

  18. Young Women's Ratings of Three Placebo Multipurpose Prevention Technologies for HIV and Pregnancy Prevention in a Randomized, Cross-Over Study in Kenya and South Africa.

    Science.gov (United States)

    Minnis, Alexandra M; Roberts, Sarah T; Agot, Kawango; Weinrib, Rachel; Ahmed, Khatija; Manenzhe, Kgahlisho; Owino, Fredrick; van der Straten, Ariane

    2018-03-20

    End-user input is critical to inform development of multipurpose prevention technology (MPT) products that prevent HIV and pregnancy. The TRIO Study, conducted in Kenya and South Africa, enrolled 277 HIV-negative women aged 18-30 in a randomized cross-over study to use each placebo MPT (daily oral tablets, monthly injections, and monthly vaginal ring) for one month. At the end of each month, participants rated how much they liked using the product on a 5-point Likert scale (5 = liked very much). We compared mean ratings using paired t-tests and examined sociodemographic-, attribute-, and behavior-related characteristics associated with ratings using multivariable linear regression and data from in-depth interviews. After use, mean ratings were significantly higher for injections [4.3 (SD = 1.0)] compared with tablets [3.0 (SD = 1.3)] and rings [3.3 (SD = 1.4)] (p < 0.001); mean ratings for rings were significantly higher than for tablets (p = 0.013). Mean ratings of a hypothetical active MPT increased for all products after the one-month period of use, with the greatest increase for rings, the least familiar product. In multivariable analysis, acceptability of key product attributes (e.g., product look) were associated with a significant increase of ≥ 1 point in the mean rating across all three products (p ≤ 0.001). Perceived ability to use the product without partner knowledge was associated with a higher mean rating for rings (b = 0.50; p = 0.006). The acceptability of product attributes contributed significantly to the rating of all products, highlighting the value of choice in pregnancy and HIV prevention to accommodate diverse users.

  19. Factors influencing utilization of intermittent preventive treatment for pregnancy in the Gushegu district, Ghana, 2013.

    Science.gov (United States)

    Stephen, Atasige Awin-Irigu; Wurapa, Frederick; Afari, Edwin Andrew; Sackey, Samuel Oko; Malm, Keaziah Laurencia; Nyarko, Kofi Mensah

    2016-01-01

    The coverage of adequate (≥2 doses) IPTp-SP in Ghana is below the national target of 80% and that is a threat to reducing the incidence of malaria in pregnancy. The primary objective of the study was to determine the client and facility related factors associated with adequate uptake of IPTp-SP and suggest approaches for increased uptake. A cross sectional study was conducted among ANC clients and staff in Gushegu, questionnaires was administered to 330 conveniently sampled nursing mothers and all ANC staff present. A checklist and observation were used to collect health facility data. Data was analyzed descriptively and associations between the related factors and adequate uptake of IPTp-SP were determined. A total of 91.5% and 8.5% of respondents took adequate (≥2doses) and inadequate (≤1dose) IPTp-SP respectively. 85.4% respondents were early first ANC attendance and 80% were multiple gravidae. Mean ANC visits was 5.0 (standard deviation = 2.2). The key determinants for inadequate uptake of IPTp were Unemployment [OR= 4.9 95% CI (1.9-13.1], single gravidae [OR= 3.4 95% CI (1.5-7.6)] and late first ANC visit [OR= 6.8 95% CI (3.0-15.4)]. DOT practice, good staff attitude and health talk at the facility were observed and confirmed by ANC clients as satisfactory. adequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose. Adequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose.

  20. Disposal of unwanted pesticides in Stellenbosch, South Africa

    International Nuclear Information System (INIS)

    Aqiel Dalvie, Mohamed; Africa, Algernon; London, Leslie

    2006-01-01

    Background: Unwanted pesticides in developing countries are major environmental health threats. This study followed-up a previous audit of unwanted and obsolete pesticides on farms in a rural district of South Africa six years after a National Retrieval Project (NPR) was undertaken. Methods: A descriptive survey of 37 farms that had been in possession of unwanted pesticides in a 1995 survey and a purposive sample of 34 neighbouring farms, was carried out. The survey data included farm details; details of unwanted pesticide stocks, volumes of empty containers and safety and hygiene of pesticide stores. In addition, management was asked if they had been informed about and participated in the 1997 NPR and similarly whether they were aware of the retrieval planned by the African Stockpiles Programme (ASP). Results: Forty (56%) farms were in possession of obsolete pesticides of which 24 (59%) were farms that had unwanted stocks in the previous survey. There were more than 9 tonnes of these pesticides, 50% more than in the previous survey, including 20 chemicals banned, withdrawn or restricted in South Africa or classified as WHO Class I toxicity. Over 2800 kg of pesticides (30%) were not identifiable. None of the farms participated in the NPR, although 47 knew of the initiative. Only six farmers (9%) knew of the ASP initiative. Fifty-nine farms (83%) had empty containers on the premises. Most pesticide stores (67%) had floors contaminated with chemicals. Conclusion: The survey found that despite the NPR, the problem of unwanted pesticides in the study area and probably throughout South Africa has deteriorated. National and international policies should control the problem at source and encourage more sustainable agriculture

  1. [The prevention of depression in pregnancy and the post-partum: when to intervene?].

    Science.gov (United States)

    Iapichino, Elena; Quartieri Bollani, Marta; Cauli, Gilla; Gala, Costanzo

    2012-06-01

    The aim of this paper is to describe the presence of anxious-depressive symptoms and risk factors and discuss the method of intervention used with women in pregnancy and post-partum. The mood of the woman was assessed by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), personality traits with the Vulnerable Personality Style Questionnaire (VPSQ) and social support through the Social Provisions Scale (PPS). 50 women have completed the evaluation. In line with the international literature, the presence of anxiety-depressive symptoms is accompanied by the presence of multiple risk factors, in particular the familiar seems to be a predisposing factor.

  2. Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women

    DEFF Research Database (Denmark)

    Tanentsapf, Ida; Heitmann, Berit L; Adegboye, Amanda R A

    2011-01-01

    Excessive weight gain during pregnancy and subsequent postpartum weight retention may contribute to the epidemic of obesity among women of childbearing age. Preventing excessive gestational weight gain (GWG) to optimize maternal, fetal and infant wellbeing is therefore of great importance. A number...... of dietary interventions in this area has been conducted with inconsistent results, which has made it difficult to identify effective strategies to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. The primary objective of this review was to evaluate the effect...

  3. Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

    Science.gov (United States)

    Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

    2016-11-05

    Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one

  4. UNWANTED BEHAVIOUR AMONG YOUTH: INFLUENCE OF DIGITAL MEDIA CONSUMPTION

    Directory of Open Access Journals (Sweden)

    Mateja Rek

    2016-09-01

    Full Text Available In many cases of unwanted behaviour that we analysed (for instance in case of cheating on school tests, beating, being bullied, conflicts with parents, gambling, intentionally damaging or destroying property we found a statistically significant effect of the extent of digital media use on incidence of such behaviour. Youth, who are large digital media users, behave in such socially unwanted ways more often compared to smaller media users. A dominant share of youth isn’t involved in violent behaviour or vandalism at all. However, the incidence of violence or vandalism in the large media users group is significantly higher compared to low and medium users group.

  5. Daily cranberry juice for the prevention of asymptomatic bacteriuria in pregnancy: a randomized, controlled pilot study.

    Science.gov (United States)

    Wing, Deborah A; Rumney, Pamela J; Preslicka, Christine W; Chung, Judith H

    2008-10-01

    We compared the effects of daily cranberry juice cocktail to those of placebo during pregnancy on asymptomatic bacteriuria and symptomatic urinary tract infections. A total of 188 women were randomized to cranberry or placebo in 3 treatment arms of A-cranberry 3 times daily (58), B-cranberry at breakfast then placebo at lunch and dinner (67), and C-placebo 3 times daily (63). After 27.7% (52 of 188) of the subjects were enrolled in the study the dosing regimens were changed to twice daily dosing to improve compliance. There were 27 urinary tract infections in 18 subjects in this cohort, with 6 in 4 group A subjects, 10 in 7 group B subjects and 11 in 7 group C subjects (p = 0.71). There was a 57% and 41% reduction in the frequency of asymptomatic bacteriuria and all urinary tract infections, respectively, in the multiple daily dosing group. However, this study was not sufficiently powered at the alpha 0.05 level (CI 0.14-1.39 and 0.22-1.60, respectively, incidence rate ratios). Of 188 subjects 73 (38.8%) withdrew, most for gastrointestinal upset. These data suggest there may be a protective effect of cranberry ingestion against asymptomatic bacteriuria and symptomatic urinary tract infections in pregnancy. Further studies are planned to evaluate this effect.

  6. Multidisciplinary management of ornithine transcarbamylase (OTC) deficiency in pregnancy: essential to prevent hyperammonemic complications

    Science.gov (United States)

    Lamb, Stephanie; Aye, Christina Yi Ling; Murphy, Elaine; Mackillop, Lucy

    2013-01-01

    Ornithine transcarbamylase (OTC) deficiency is the most common inborn error in the metabolism of the urea cycle with an incidence of 1 in 14 000 live births. Pregnancy can trigger potentially fatal hyperammonemic crises. We report a successful pregnancy in a 29-year-old primiparous patient with a known diagnosis of OTC deficiency since infancy. Hyperammonemic complications were avoided due to careful multidisciplinary management which included a detailed antenatal, intrapartum and postnatal plan. Management principles include avoidance of triggers, a low-protein diet and medications which promote the removal of nitrogen by alternative pathways. Triggers include metabolic stress such as febrile illness, particularly gastroenteritis, fasting and any protein loading. In our case the patient, in addition to a restricted protein intake, was prescribed sodium benzoate 4 g four times a day, sodium phenylbutyrate 2 g four times a day and arginine 500 mg four times a day to aid excretion of ammonia and reduce flux through the urea cycle. PMID:23283608

  7. The parent-adolescent relationship education (PARE) program: a curriculum for prevention of STDs and pregnancy in middle school youth.

    Science.gov (United States)

    Lederman, Regina P; Mian, Tahir S

    2003-01-01

    The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs). The program includes content about reproduction, STDs and Acquired Immune Deficiency Syndrome (AIDS), contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills. A randomized treatment or control group design is used to assign parent-child dyads to an experimental education group (social learning) or an attention-control group (traditional didactic teaching). Three post-program maintenance or booster sessions are held at 6-month intervals and at times prior to peak teen conception periods to reinforce the knowledge and skills learned. Pre- and posttests for parents and students assess group differences in parental involvement and communication, contraception, sex attitudes and intentions, sex behaviors (initiation of sexual intercourse, frequency, number of partners, contraceptive practices, refusal skills), and the incidence of pregnancy.

  8. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

  9. Office of Adolescent Health medical accuracy review process--helping ensure the medical accuracy of Teen Pregnancy Prevention Program materials.

    Science.gov (United States)

    Jensen, Jo Anne G; Moreno, Elizabeth L; Rice, Tara M

    2014-03-01

    The Office of Adolescent Health (OAH) developed a systematic approach to review for medical accuracy the educational materials proposed for use in Teen Pregnancy Prevention (TPP) programs. This process is also used by the Administration on Children, Youth, and Families (ACYF) for review of materials used in the Personal Responsibility Education Innovative Strategies (PREIS) Program. This article describes the review process, explaining the methodology, the team implementing the reviews, and the process for distributing review findings and implementing changes. Provided also is the definition of "medically accurate and complete" as used in the programs, and a description of what constitutes "complete" information when discussing sexually transmitted infections and birth control methods. The article is of interest to program providers, curriculum developers and purveyors, and those who are interested in providing medically accurate and complete information to adolescents. Published by Elsevier Inc.

  10. Cost effectiveness of intermittent screening followed by treatment versus intermittent preventive treatment during pregnancy in West Africa

    DEFF Research Database (Denmark)

    Fernandes, Silke; Sicuri, Elisa; Halimatou, Diawara

    2016-01-01

    $/DALY averted. Simulations show that cost-effectiveness of ISTp-AL increases as the efficacy of IPTp-SP decreases, though the specific threshold at which ISTp-AL becomes cost-effective depends on assumptions about the contribution of bed nets to malaria control, bed net coverage and the willingness......-to-pay threshold used.  Conclusions: At SP efficacy levels currently observed in the trial settings it would not be cost-effective to switch from IPTp-SP to ISTp-AL, mainly due to the substantially higher costs of ISTp-AL and limited difference in outcomes. The modelling results indicate thresholds below which IPT......Background: Emergence of high-grade sulfadoxine-pyrimethamine (SP) resistance in parts of Africa has led to growing concerns about the efficacy of intermittent preventive treatment of malaria during pregnancy (IPTp) with SP. The incremental cost-effectiveness of intermittent screening and treatment...

  11. Empowering adolescent girls in Sub-Saharan Africa to prevent unintended pregnancy and HIV: A critical research gap.

    Science.gov (United States)

    Phillips, Sharon J; Mbizvo, Michael T

    2016-01-01

    The need to prevent early pregnancy and HIV among adolescent girls in Sub-Saharan Africa has been recognized increasingly over recent years. Although extensive work has been done to determine appropriate interventions for girls in high-income countries, very little evidence is available to guide programmatic interventions in Sub-Saharan Africa. The available evidence has been equivocal regarding improved outcomes. While knowledge and self-reported behaviors frequently change with interventions, including those performed at the community level, educational programs, and direct contraceptive provision, downstream outcomes rarely reflect a significant effect of the interventions; however, provision of financial or other interventions to incentivize continued school enrollment are a promising development. We suggest directions for future research to fill this critical gap in the literature. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Pilot Study to Evaluate Compliance and Tolerability of Cranberry Capsules in Pregnancy for the Prevention of Asymptomatic Bacteriuria.

    Science.gov (United States)

    Wing, Deborah A; Rumney, Pamela J; Hindra, Sasha; Guzman, Lizette; Le, Jennifer; Nageotte, Michael

    2015-11-01

    To evaluate the compliance with and tolerability of daily cranberry capsule ingestion for asymptomatic bacteriuria (ASB) prevention in pregnancy. A total of 49 pregnant women from two sites were randomly assigned to cranberry or matching placebo, two doses daily, at gestational ages less than 16 weeks. Patients were followed monthly for urinary tract infection until delivery. Up to seven monthly visits were scheduled for each patient. Delivery data were evaluated. Of 38 evaluable patients, the mean compliance rate over the study period was 82% (range, 20%-100%). This compliance rate and the 74% of patients achieving good (≥75%) compliance were similar between those who received cranberry capsules and placebo. Compliance evaluation revealed that most patients stopped capsule consumption after 34-38 weeks of participation. Multivariate logistic regression and longitudinal analysis showed a significant interaction time effect with cranberry treatment. However, cranberry consumption was not a significant predictor of gastrointestinal intolerance or study withdrawal. Although 30% of patients withdrew for various reasons, only 1 withdrew because of intolerance to the cranberry capsules. Loss to follow-up was mostly due to provider change (9 of 49 [18%]) and therapy disinterest (4 of 49 [8%]). Seven cases of ASB occurred in 5 patients: 2 of 24 (8%) in the cranberry group and 3 of 25 (12%) in the placebo group. No cases of cystitis or pyelonephritis were observed. One third of pregnant women could not complete the study protocol for various reasons. Compliance with and tolerability of cranberry capsule ingestion appear good; these capsules provide a potentially effective means to prevent ASB in pregnancy. Further studies with large samples are necessary to confirm the findings.

  13. Adolescent Pregnancy Decision-Making: Are Parents Important?

    Science.gov (United States)

    Rosen, Raye Hudson

    1980-01-01

    This paper examines the extent to which teenagers involve their parents in decision making on the resolution of unwanted conceptions, even though legalization of abortion allows them to terminate their pregnancies without parental knowledge. (RMH)

  14. A Risky Boundary: Unwanted Sexual Behaviour among Youth

    Science.gov (United States)

    de Bruijn, Paula; Burrie, Ingrid; van Wel, Frits

    2006-01-01

    The aim of this research was to explore unwanted sexual behaviour amongst young people. Sexual aggression was operationalized at three levels: "verbal", "non-verbal/intimidating" and "physically violent". A total of 1,700 Dutch adolescents completed a questionnaire that included six clusters of possible determinants…

  15. A risky boundary : Unwanted sexual behaviour among youth

    NARCIS (Netherlands)

    Bruijn, Paula de; Burrie, Ingrid; Wel, Frits van

    2006-01-01

    The aim of this research was to explore unwanted sexual behaviour amongs young people. Sexual aggression was operationalized at three levels: ‘‘verbal’’, ‘‘non-verbal/intimidating’’ and ‘‘physically violent’’. A total of 1,700 Dutch adolescents completed a questionnaire that included six clusters of

  16. Failure rate of no-scalpel vasectomy in prevention of pregnancy in Shiraz, Southern Iran

    Directory of Open Access Journals (Sweden)

    S Shakeri

    2006-07-01

    Full Text Available BACKGROUND: Bilateral vasectomy is the most effective method of male contraception but there are still some reports on its failure. This study was undertaken to determine the failure rate of the no-scalpel vasectomy in Shiraz Vasectomy Center, Southern Iran. METHODS: From 2001 to 2003, 3900 no-scalpel vasectomies were done in Nader Kazemi Health Center. The records were studied for any failure in the method. Presence of any live sperm 6 months after surgery or any report of pregnancy post-vasectomy were considered as vasectomy failure. RESULTS:Among 3900 cases, 2928 patients had a complete follow up file while failure in the method was visible among 109 (3.72% cases. CONCLUSION: The low failure rate of no-scalpel method indicated its high efficacy to control the fertility in males but there is still need of performance by expert surgeons in well organized centers. KEYWORDS: Iran, no-scalpel vasectomy, failure rate.

  17. Computer-Assisted Motivational Interviewing Intervention to Facilitate Teen Pregnancy Prevention and Fitness Behavior Changes: A Randomized Trial for Young Men.

    Science.gov (United States)

    Bell, David L; Garbers, Samantha; Catallozzi, Marina; Hum, R Stanley; Nechitilo, Meredith; McKeague, Ian W; Koumans, Emilia H; House, L Duane; Rosenthal, Susan L; Gold, Melanie A

    2018-03-01

    Despite recent declines, teen unintended pregnancy and sexually transmitted infections in the United States remain at levels higher than comparable nations. Initiatives to prevent teen pregnancy have focused primarily on female adolescents; how to effectively engage young men to reduce their risk of fathering a teen pregnancy has not been well studied. We proposed to adapt an innovative computer-assisted motivational interviewing (CAMI) intervention, originally designed and tested with young women, for use with young men, aged 15-24 years, to reduce their risk of fathering a teen pregnancy. This manuscript describes the design of a CAMI intervention for young men aimed at preventing teen pregnancy and improving fitness. This randomized controlled trial will recruit 945 sexually active young men between the ages of 15 and 24 years from three health centers in New York City. Participants will be assigned by permuted block randomization to two study arms: one aimed at reducing involvement in unintended teen pregnancy (CAMI-teen pregnancy prevention) and the other at improving overall fitness (CAMI-Fitness). Except for topic, both intervention arms will provide four sessions of Motivational Interviewing coaching and use a mobile app to track behavior and set goals. We will assess young men's sexual and reproductive health behaviors and fitness at baseline, 12, 24, 36, and 64 weeks using a mobile device app created for the study. Pending ongoing study. Results from the study are expected to enhance our understanding of the efficacy of CAMI to enhance young men's reproductive health and fitness behaviors. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

  18. Acute kidney injury in pregnancy-specific disorders

    Directory of Open Access Journals (Sweden)

    J Prakash

    2017-01-01

    Full Text Available The incidence of acute kidney injury in pregnancy (P-AKI has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre. During the first trimester of gestation, AKI develops most often due to septic abortion or hyperemesis gravidarum. Septic abortion related AKI with respect to total AKI decreased from 9% to 5% in our study. Prevention of unwanted pregnancy and avoidance of septic abortion are keys to eliminate abortion associated AKI in early pregnancy. However, we have not seen AKI on account of hyperemesis gravidarum over a period of 33 years at our center. In the third trimester, the differential diagnosis of AKI in association with pregnancy specific conditions namely preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies of pregnancy (P-TMA is more challenging, because these 3 conditions share several clinical features of thrombotic microangiopathy which makes the diagnosis very difficult on clinical grounds. It is imperative to distinguish these conditions to make appropriate therapeutic decisions. Typically, AFLP and HELLP syndrome improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for pregnancy associated thrombotic microangioathies (P-TMA. We observed that preclampsia/eclampsia is the most common cause of AKI in late third trimester and postpartum periods followed by puerperal sepsis and postpartum hemorrhage. Pregnancy-associated thrombotic microangiopathies (aHUS/TTP and AFLP are rare causes of AKI during pregnancy in developing countries.

  19. Acute Kidney Injury in Pregnancy-specific Disorders.

    Science.gov (United States)

    Prakash, J; Ganiger, V C

    2017-01-01

    The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre. During the first trimester of gestation, AKI develops most often due to septic abortion or hyperemesis gravidarum. Septic abortion related AKI with respect to total AKI decreased from 9% to 5% in our study. Prevention of unwanted pregnancy and avoidance of septic abortion are keys to eliminate abortion associated AKI in early pregnancy. However, we have not seen AKI on account of hyperemesis gravidarum over a period of 33 years at our center. In the third trimester, the differential diagnosis of AKI in association with pregnancy specific conditions namely preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies of pregnancy (P-TMA) is more challenging, because these 3 conditions share several clinical features of thrombotic microangiopathy which makes the diagnosis very difficult on clinical grounds. It is imperative to distinguish these conditions to make appropriate therapeutic decisions. Typically, AFLP and HELLP syndrome improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for pregnancy associated thrombotic microangioathies (P-TMA). We observed that preclampsia/eclampsia is the most common cause of AKI in late third trimester and postpartum periods followed by puerperal sepsis and postpartum hemorrhage. Pregnancy-associated thrombotic microangiopathies (aHUS/TTP) and AFLP are rare causes of AKI during pregnancy in developing countries.

  20. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... harming your baby. Jump To: Am I at Risk? The risk of developing a blood clot during pregnancy is ... prevent blood clots during pregnancy: Be aware of risk factors. Know your family history. Make sure your ...

  1. Alcohol during Pregnancy

    Science.gov (United States)

    ... Disease Control and Prevention (CDC) National Council on Alcoholism and Drug Dependence (NCADD) Substance Abuse and Mental Health Services Administration (SAMSHA) Last reviewed: April, 2016 Pregnancy Is it safe? Other Pregnancy topics ') document.write(' ...

  2. Anemia and Pregnancy

    Science.gov (United States)

    ... Advocacy Toolkit Home For Patients Blood Disorders Anemia Anemia and Pregnancy Your body goes through significant changes ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...

  3. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: a randomised controlled non-inferiority trial.

    Directory of Open Access Journals (Sweden)

    Harry Tagbor

    2010-12-01

    Full Text Available The effectiveness of intermittent preventive treatment of malaria in pregnancy (IPTp may be compromised by the spread of resistance to sulphadoxine/pyrimethamine (SP across Africa. But little information exists on alternative drugs for IPTp or alternative strategies for the prevention of malaria in pregnancy. Therefore, we have investigated whether screening with a rapid diagnostic test and treatment of those who are positive (IST at routine antenatal clinic attendances is as effective and as safe as SP-IPTp in pregnant women.During antenatal clinic sessions in six health facilities in Ghana held between March 2007 and September 2007, 3333 pregnant women who satisfied inclusion criteria were randomised into three intervention arms (1 standard SP-IPTp, (2 IST and treatment with SP or (3 IST and treatment with amodiaquine+artesunate (AQ+AS. All women received a long-lasting insecticide treated net. Study women had a maximum of three scheduled follow-up visits following enrollment. Haemoglobin concentration and peripheral parasitaemia were assessed between 36 and 40 weeks of gestation. Birth weight was measured at delivery or within 72 hours for babies delivered at home. Parasite prevalence at enrollment in primigravidae and in multigravidae was 29.6% and 10.2% respectively. At 36-40 weeks of gestation the prevalence of asymptomatic parasitaemia was 12.1% in study women overall and was very similar in all treatment groups. The risk of third trimester severe anaemia or low birth weight did not differ significantly between the three treatment groups regardless of gravidity. IST with AQ+AS or SP was not inferior to SP-IPTp in reducing the risk of low birth weight (RD  =  -1.17[95%CI; -4.39-1.02] for IST-SP vs. SP-IPTp and RD = 0.78[95%CI; -2.11-3.68] for IST-AQAS vs. SP-IPTp; third trimester severe anaemia (RD = 0.29[95%CI; -0.69-1.30] for IST-SP vs. SP-IPTp and RD  =  -0.36[95%CI;-1.12-0.44] for IST-AQAS vs. SP-IPTp.The results of this study

  4. Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

    Science.gov (United States)

    Smith, Tamara; Clark, Judith F; Nigg, Claudio R

    2015-01-01

    Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

  5. Enhancement of "Reducing the Risk" for the 21st Century: Improvement to a Curriculum Developed to Prevent Teen Pregnancy and STI Transmission

    Science.gov (United States)

    Langley, Cheri; Barbee, Anita P.; Antle, Becky; Christensen, Dana; Archuleta, Adrian; Sar, Bibhuti K.; Karam, Eli; van Zyl, Riaan; Cunningham, Michael R.; Borders, Kevin

    2015-01-01

    To ensure that "Reducing the Risk," a successful teen pregnancy prevention education curriculum, remains relevant for today's youth, covers all information youth need to know in order to make better choices, and is delivered in a standardized way, adaptations were made and enhancements were added. This article describes results of a…

  6. Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV, and Sexually Transmitted Infections. Second Edition. Executive Summary

    Science.gov (United States)

    Alford, Sue

    2008-01-01

    Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, U.S. teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews…

  7. Peer education: the effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

    NARCIS (Netherlands)

    Mens, Petra F.; Scheelbeek, Pauline Fd; Al Atabbi, Hind; Enato, Ehijie Fo

    2011-01-01

    There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among women of

  8. Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

    NARCIS (Netherlands)

    Mens, P.F.; Scheelbeek, P.F.D.; Al Atabbi, H.; Enato, E.F.O.

    2011-01-01

    Background: There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among

  9. Pragmatic controlled trial to prevent childhood obesity in maternity and child health care clinics: pregnancy and infant weight outcomes (The VACOPP Study)

    OpenAIRE

    Mustila, Taina; Raitanen, Jani; Keskinen, P?ivi; Saari, Antti; Luoto, Riitta

    2013-01-01

    Background According to current evidence, the prevention of obesity should start early in life. Even the prenatal environment may expose a child to unhealthy weight gain; maternal gestational diabetes is known to be among the prenatal risk factors conducive to obesity. Here we report the effects of antenatal dietary and physical activity counselling on pregnancy and infant weight gain outcomes. Methods The study was a non-randomised controlled pragmatic trial aiming to prevent childhood obesi...

  10. Taking a Teen Pregnancy Prevention Program to the Home: The AIM 4 Teen Moms Experience, Implementation Report

    OpenAIRE

    Subuhi Asheer; Ellen Kisker

    2014-01-01

    This report discusses findings from the first 18 months of a program implementation evaluation of AIM 4 Teen Moms, a teen pregnancy intervention designed to delay rapid repeat pregnancies among parenting teen mothers in Los Angeles.

  11. Periodontal disease in pregnancy: review of the evidence and prevention strategies.

    Science.gov (United States)

    Lachat, Maryanne F; Solnik, Antoinette Lipani; Nana, Anjali D; Citron, Tracie L

    2011-01-01

    This article reviews the current research on periodontal disease and treatment and its potential impact on maternal and newborn outcomes and provides recommendations for care management and prevention. These guidelines will be helpful for nurse professionals who are in a unique position to counsel pregnant women to improve the oral health of expectant mothers.

  12. User and Provider Acceptability of Intermittent Screening and Treatment and Intermittent Preventive Treatment with Dihydroartemisinin-Piperaquine to Prevent Malaria in Pregnancy in Western Kenya.

    Directory of Open Access Journals (Sweden)

    Jenny Hill

    Full Text Available The World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp with sulphadoxine-pyrimethamine (SP alongside long-lasting insecticide-treated nets (LLIN and case management for reducing the risks associated with malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. Due to increasing Plasmodium falciparum resistance to SP, the search for alternative drugs or strategies to control malaria in pregnancy is a priority. We assessed the acceptability among pregnant women and health providers of intermittent screening and treatment (ISTp and IPTp with dihydroartemisinin-piperaquine (DP as alternative strategies in the context of an un-blinded clinical trial.Qualitative data were collected through ten focus group discussions with women participating in a randomized controlled trial to evaluate ISTp or IPTp with DP (multi-day regimen versus IPTp with SP (single dose in western Kenya. Individual in-depth interviews were conducted with 26 health providers working in the trial facilities and trial staff.Women appreciated the advantages of being tested with a rapid diagnostic test (RDT at every ANC visit (although a few women disliked finger pricks and accepted that they would not receive any antimalarial when tested RDT-negative. There were differences in women's experiences of the efficacy of antimalarials between the trial arms, with more women in the IPTp-SP arm reporting they had experienced malaria episodes. Side effects were experienced among women taking DP and SP. Although women and trial staff reported adherence to the full DP regimen within the trial, health providers were not confident that women would adhere to multi-day regimens in non-trial settings. Health providers recognized the advantages of ISTp in reducing unnecessary exposure to drugs, but lacked confidence in the reliability of RDTs compared to microscopy.Our findings indicate that, within a trial context, ISTp-DP and IPTp

  13. Linking two opposites of pregnancy loss: Induced abortion and infertility in Yoruba society, Nigeria.

    Science.gov (United States)

    Koster, Winny

    2010-11-01

    Involuntary infertility and induced abortion exist on opposite sides of the spectrum: the first being the unwanted loss of childbearing potential while the second is the intentional termination of pregnancy. However, this paper proposes that these two poles of pregnancy loss are in fact related in Yoruba society, Nigeria. This argument is supported by qualitative and quantitative data drawn from an applied research project in communities and health institutions of Lagos State, from 1996 to 1999, where a total of 693 women recounted 1114 personal abortion experiences, and 233 women shared their experiences of fertility problems. Study statistics show that 37% of secondary infertility was most probably the result of induced abortion and that half of women with abortion complications interviewed in a referral hospital will have fertility problems. This paper provides insight into the reasons why single and married women decide to abort, and use unsafe methods, despite awareness of the serious health risks, including infertility. This is paradoxical given that fear of infertility is a major reason why women do not use modern contraceptives when trying to prevent unwanted pregnancy. By analysing the relations between infertility and abortion within the socio-cultural, economic, and services-related structures that influence women's decisions, this paper suggests ways of addressing the problems related to both types of pregnancy loss. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Stakeholder Education for Community-Wide Health Initiatives: A Focus on Teen Pregnancy Prevention.

    Science.gov (United States)

    Finley, Cara; Suellentrop, Katherine; Griesse, Rebecca; House, Lawrence Duane; Brittain, Anna

    2018-01-01

    Teen pregnancies and births continue to decline due in part to implementation of evidence-based interventions and clinical strategies. While local stakeholder education is also thought to be critical to this success, little is known about what types of strategies work best to engage stakeholders. With the goal of identifying and describing evidence-based or best practice strategies for stakeholder education in community-based public health initiatives, we conducted a systematic literature review of strategies used for effective stakeholder education. Over 400 articles were initially retrieved; 59 articles met inclusion criteria. Strategies were grouped into four steps that communities can use to support stakeholder education efforts: identify stakeholder needs and resources, develop a plan, develop tailored and compelling messaging, and use implementation strategies. These strategies lay a framework for high-quality stakeholder education. In future research, it is important to prioritize evaluating specific activities taken to raise awareness, educate, and engage a community in community-wide public health efforts.

  15. [Assessment of nutritional education and iron supplement impact on prevention of pregnancy anemia].

    Science.gov (United States)

    Parra, Beatriz Elena; Manjarrés, Luz Mariela; Gómez, Alba Lucía; Alzate, Dora María; Jaramillo, María Clemencia

    2005-06-01

    Iron and folic acid deficiencies are the major causes of health problems among pregnant women and children, with a significant negative impact on economic and social development. From April 2002 to April 2003 at the Gilberto Mejía Mejía Hospital (Rionegro, Antioquia), the prenatal program was assessed for its impact on a cohort of pregnant women concerning knowledge of the following nutritional parameters: iron and folic acid functions, their source foods and bioavailability, supplement intake and tolerance, and globular indexes. A sample of 42 pregnant women was subjected to a nutritional education program along with the administration of a supplement consisting of 60 mg elemental iron, 400 microg folic acid, and 70 mg vitamin C. This formulation was prepared specifically for the study by Laboratorio Profesional Farmacéutico, LAPROFF. The effect of the educational program was measured by knowledge changes about how patient behaviours affect nutrient bioavailability via source foods intake, as well as recognition of the tolerance limits of supplements and potential effect of non-adherance. The physiological status of each patient was measured by three hematologic variables--hemoglobin, hematocrit, and ferritin. A positive understanding of how to improve nutritional practices was observed. With the supplements, 94.4% of women did not show anaemia at the end of pregnancy. These results agree with those in other, similar populations and indicate that implementation of prenatal control programs by educational and supplement administration is worthwhile.

  16. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: a multicentre randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Raquel González

    2014-09-01

    Full Text Available Intermittent preventive treatment in pregnancy (IPTp with sulfadoxine-pyrimethamine (SP is recommended by WHO to prevent malaria in African pregnant women. The spread of SP parasite resistance has raised concerns regarding long-term use for IPT. Mefloquine (MQ is the most promising of available alternatives to SP based on safety profile, long half-life, and high efficacy in Africa. We evaluated the safety and efficacy of MQ for IPTp compared to those of SP in HIV-negative women.A total of 4,749 pregnant women were enrolled in an open-label randomized clinical trial conducted in Benin, Gabon, Mozambique, and Tanzania comparing two-dose MQ or SP for IPTp and MQ tolerability of two different regimens. The study arms were: (1 SP, (2 single dose MQ (15 mg/kg, and (3 split-dose MQ in the context of long lasting insecticide treated nets. There was no difference on low birth weight prevalence (primary study outcome between groups (360/2,778 [13.0%] for MQ group and 177/1,398 (12.7% for SP group; risk ratio [RR], 1.02 (95% CI 0.86-1.22; p=0.80 in the ITT analysis. Women receiving MQ had reduced risks of parasitemia (63/1,372 [4.6%] in the SP group and 88/2,737 [3.2%] in the MQ group; RR, 0.70 [95% CI 0.51-0.96]; p=0.03 and anemia at delivery (609/1,380 [44.1%] in the SP group and 1,110/2743 [40.5%] in the MQ group; RR, 0.92 [95% CI 0.85-0.99]; p=0.03, and reduced incidence of clinical malaria (96/551.8 malaria episodes person/year [PYAR] in the SP group and 130/1,103.2 episodes PYAR in the MQ group; RR, 0.67 [95% CI 0.52-0.88]; p=0.004 and all-cause outpatient attendances during pregnancy (850/557.8 outpatients visits PYAR in the SP group and 1,480/1,110.1 visits PYAR in the MQ group; RR, 0.86 [0.78-0.95]; p=0.003. There were no differences in the prevalence of placental infection and adverse pregnancy outcomes between groups. Tolerability was poorer in the two MQ groups compared to SP. The most frequently reported related adverse events were dizziness

  17. Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: an open-label pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rickard Kristen

    2011-03-01

    Full Text Available Abstract Background Although the connection between ascending infection and preterm birth is undisputed, research focused on finding effective treatments has been disappointing. However evidence that eradication of Candida in pregnancy may reduce the risk of preterm birth is emerging. We conducted a pilot study to assess the feasibility of conducting a large randomized controlled trial to determine whether treatment of asymptomatic candidiasis in early pregnancy reduces the incidence of preterm birth. Methods We used a prospective, randomized, open-label, blinded-endpoint (PROBE study design. Pregnant women presenting at Candida were randomized to 6-days of clotrimazole vaginal pessaries (100mg or usual care (screening result is not revealed, no treatment. The primary outcomes were the rate of asymptomatic vaginal candidiasis, participation and follow-up. The proposed primary trial outcome of spontaneous preterm birth Results Of 779 women approached, 500 (64% participated in candidiasis screening, and 98 (19.6% had asymptomatic vaginal candidiasis and were randomized to clotrimazole or usual care. Women were not inconvenienced by participation in the study, laboratory testing and medication dispensing were problem-free, and the follow-up rate was 99%. There was a tendency towards a reduction in spontaneous preterm birth among women with asymptomatic candidiasis who were treated with clotrimazole RR = 0.33, 95%CI 0.04-3.03. Conclusions A large, adequately powered, randomized trial of clotrimazole to prevent preterm birth in women with asymptomatic candidiasis is both feasible and warranted. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609001052224

  18. Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Yu, Ying; Xie, Rongrong; Shen, Cainuo; Shu, Lianting

    2018-06-01

    Exercise showed some potential in preventing gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the impact of exercise during pregnancy on gestational diabetes mellitus. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the influence of exercise during pregnancy on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus. Meta-analysis was performed using random-effect model. Six RCTs involving 2164 patients were included in the meta-analysis. Compared with control intervention, exercise intervention was associated with significantly decreased incidence of gestational diabetes mellitus (Std. mean difference = 0.59; 95%CI = 0.39-.88; p = .01), but had no effect on gestational age at birth (Std. mean difference = -0.03; 95%CI = -0.12 to 0.07; p = .60), the number of preterm birth (OR = 0.85; 95%CI = 0.43-1.66; p = .63), glucose 2-h post-OGTT (Std. mean difference = -1.02; 95%CI = -2.75 to 0.71; p = .25), birth weight (Std. mean difference = -0.13; 95%CI = -0.26 to 0.01; p = .06), and Apgar score less than 7 (OR = .78; 95%CI = 0.21-2.91; p = .71). Compared to control intervention, exercise intervention could significantly decrease the risk of gestational diabetes mellitus, but showed no impact on gestational age at birth, preterm birth, glucose 2-h post-OGTT, birth weight, and Apgar score less than 7.

  19. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy.

    Science.gov (United States)

    Rawlinson, William D; Boppana, Suresh B; Fowler, Karen B; Kimberlin, David W; Lazzarotto, Tiziana; Alain, Sophie; Daly, Kate; Doutré, Sara; Gibson, Laura; Giles, Michelle L; Greenlee, Janelle; Hamilton, Stuart T; Harrison, Gail J; Hui, Lisa; Jones, Cheryl A; Palasanthiran, Pamela; Schleiss, Mark R; Shand, Antonia W; van Zuylen, Wendy J

    2017-06-01

    Congenital cytomegalovirus is the most frequent, yet under-recognised, infectious cause of newborn malformation in developed countries. Despite its clinical and public health importance, questions remain regarding the best diagnostic methods for identifying maternal and neonatal infection, and regarding optimal prevention and therapeutic strategies for infected mothers and neonates. The absence of guidelines impairs global efforts to decrease the effect of congenital cytomegalovirus. Data in the literature suggest that congenital cytomegalovirus infection remains a research priority, but data are yet to be translated into clinical practice. An informal International Congenital Cytomegalovirus Recommendations Group was convened in 2015 to address these questions and to provide recommendations for prevention, diagnosis, and treatment. On the basis of consensus discussions and a review of the literature, we do not support universal screening of mothers and the routine use of cytomegalovirus immunoglobulin for prophylaxis or treatment of infected mothers. However, treatment guidelines for infected neonates were recommended. Consideration must be given to universal neonatal screening for cytomegalovirus to facilitate early detection and intervention for sensorineural hearing loss and developmental delay, where appropriate. The group agreed that education and prevention strategies for mothers were beneficial, and that recommendations will need continual updating as further data become available. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The Independent Importance of Pre-pregnancy Weight and Gestational Weight Gain for the Prevention of Large-for Gestational Age Brazilian Newborns.

    Science.gov (United States)

    Mastroeni, Marco F; Czarnobay, Sandra A; Kroll, Caroline; Figueirêdo, Katherinne B W; Mastroeni, Silmara S B S; Silva, Jean C; Khan, Mohammad K A; Loehr, Sarah; Veugelers, Paul J

    2017-04-01

    Objectives To study the independent effect of pre-pregnancy weight, gestational weight gain (GWG), and other important risk factors on newborn birth weight. Methods Baseline data of 435 adult women and their singletons born between January and February 2012 at a public hospital in Brazil were used. Logistic regression was applied to determine the independent importance of pre-pregnancy weight and GWG for large for gestational age (LGA) newborns. Results Among all mothers, 37.9 % were overweight and obese before pregnancy and 45.3 % experienced excessive GWG. Among the newborns, 24.4 % were classified as LGA. Univariate analysis showed an association of family income, GWG, pre-pregnancy BMI and excessive GWG with LGA newborns. Smoking before and during pregnancy was associated with a decreased likelihood of giving birth to an LGA newborn compared to mothers who did not smoke. After adjustment for confounding variables, age at birth of first child, GWG, HbA1c and pre-pregnancy weight-GWG were significant and independent determinants of giving birth to an LGA newborn. Mothers with pre-pregnancy overweight and excessive GWG were more likely to deliver an LGA newborn (OR 2.54, P weight and experienced adequate GWG. Conclusions for Practice Age at first birth of child, GWG, HbA1c and pre-pregnancy overweight combined with excessive GWG are independent determinants of LGA newborns. The results of this study suggest that both primary prevention of overweight in women of childbearing age and management of GWG may be important strategies to reduce the number of LGA newborns and, consequently, the long-term public health burden of obesity.

  1. The combined effect of determinants on coverage of intermittent preventive treatment of malaria during pregnancy in the Kilombero Valley, Tanzania

    Directory of Open Access Journals (Sweden)

    Schellenberg Joanna

    2011-05-01

    Full Text Available Abstract Background Intermittent preventive treatment during pregnancy (IPTp at routine antenatal care (ANC clinics is an important and efficacious intervention to reduce adverse health outcomes of malaria infections during pregnancy. However, coverage for the recommended two IPTp doses is still far below the 80% target in Tanzania. This paper investigates the combined impact of pregnant women's timing of ANC attendance, health workers' IPTp delivery and different delivery schedules of national IPTp guidelines on IPTp coverage. Methods Data on pregnant women's ANC attendance and health workers' IPTp delivery were collected from ANC card records during structured exit interviews with ANC attendees and through semi-structured interviews with health workers in south-eastern Tanzania. Women's timing of ANC visits and health worker's timing of IPTp delivery were analyzed in relation to the different national IPTp schedules and the outcome on IPTp coverage was modelled. Results Among all women eligible for IPTp, 79% received a first dose of IPTp and 27% were given a second dose. Although pregnant women initiated ANC attendance late, their timing was in line with the national guidelines recommending IPTp delivery between 20-24 weeks and 28-32 weeks of gestation. Only 15% of the women delayed to the extent of being too late to be eligible for a first dose of IPTp. Less than 1% of women started ANC attendance after 32 weeks of gestation. During the second IPTp delivery period health workers delivered IPTp to significantly less women than during the first one (55% vs. 73% contributing to low second dose coverage. Simplified IPTp guidelines for front-line health workers as recommended by WHO could lead to a 20 percentage point increase in IPTp coverage. Conclusions This study suggests that facility and policy factors are greater barriers to IPTp coverage than women's timing of ANC attendance. To maximize the benefit of the IPTp intervention, revision of

  2. [Sodium intake during pregnancy].

    Science.gov (United States)

    Delemarre, F M; Franx, A; Knuist, M; Steegers, E A

    1999-10-23

    International studies have yielded contradictory results on efficacy of a sodium-restricted diet during pregnancy in preventing and curing hypertension of pregnancy. In the Netherlands three studies have been performed to investigate the value of dietary sodium restriction in pregnancy; they concerned epidemiology, prevention and treatment. Midwives often prescribed this dietary intervention. Urinary sodium excretion was not related to blood pressure changes in pregnancy. Dietary sodium restriction from the third month of pregnancy onwards did not reduce the incidence of pregnancy-induced hypertension. Maternal side effects were a decreased intake of nutrients, decreased maternal weight gain, lowered plasma volume and stimulation of the renin-angiotensin-aldosterone system. A dietary sodium restriction in women with early symptoms of pregnancy-induced hypertension showed no therapeutic effect on blood pressure. There is no place for dietary sodium restriction in the prevention or treatment of hypertension in pregnancy.

  3. Preventing cardiovascular disease after hypertensive disorders of pregnancy: Searching for the how and when.

    Science.gov (United States)

    Groenhof, T Katrien J; van Rijn, Bas B; Franx, Arie; Roeters van Lennep, Jeanine E; Bots, Michiel L; Lely, A Titia

    2017-11-01

    Background Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be organized. Design Systematic review and meta-regression analysis. Methods The aim of our study was to provide an overview of existing knowledge on the changes over time in three major modifiable components of cardiovascular risk assessment after HDP: blood pressure, glucose homeostasis and lipid levels. Data from 44 studies and up to 6904 women with a history of a HDP were compared with risk factor levels reported for women of corresponding age in the National Health And Nutrition Examination Survey, Estudio Epidemiólogico de la Insuficiencia Renal en España and Hong Kong cohorts ( N = 27,803). Results Compared with the reference cohort, women with a HDP presented with higher mean blood pressure. Hypertension was present in a higher rate among women with a previous HDP from 15 years postpartum onwards. At 15 years postpartum (±age 45), one in five women with a history of a HDP suffer from hypertension. No differences in glucose homeostasis parameters or lipid levels were observed. Conclusions Based on our analysis, it is not possible to point out a time point to commence screening for cardiovascular risk factors in women after a HDP. We recommend redirection of future research towards the development of a stepwise approach identifying the women with the highest cardiovascular risk.

  4. “THE BOYS GET THE PLEASURE THE GIRLS GET THE PAIN" : The views of teenage girls in Kenya concerning the causes and prevention of teenage pregnancy

    OpenAIRE

    Matheka, Robert

    2012-01-01

    The purpose of this study was to find out teenagers’ views concerning the causes and prevention of teenage pregnancy in Nguluni located in Kenya. The aim was to get important information that can be used by partners and stakeholders who have a role in reducing teenage pregnancy. This study was qualitative through participation of 40 female students aged 13-16 from a local mixed day high school. Narrative study was used to collect data where participants wrote essays. Data was analysed by cont...

  5. Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

    Science.gov (United States)

    Daley, Alison Moriarty

    2012-01-01

    This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.

  6. Signos Vitales-Prevención de embarazos en adolescentes (Preventing Teen Pregnancy)

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    Este podcast se basa en la edición de abril del 2015 del informe Signos Vitales de los CDC. En los Estados Unidos ha descendido la tasa de nacimientos en adolescentes, sin embargo, en el 2013 nacieron más de 273 000 bebés de madres adolescentes de entre 15 y 19 años. Infórmese sobre los tipos de anticonceptivos más eficaces.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  7. Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission

    Science.gov (United States)

    Hatcher, Abigail M; Woollett, Nataly; Pallitto, Christina C; Mokoatle, Keneuoe; Stöckl, Heidi; MacPhail, Catherine; Delany-Moretlwe, Sinead; García-Moreno, Claudia

    2014-01-01

    Introduction Prevention of mother-to-child transmission (PMTCT) has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV) may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. Methods We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13) alongside qualitative interviews with health care providers (n=10), district health managers (n=10) and pregnant abused women (n=5). Data were analysed in Nvivo10 using a team-based approach to thematic coding. Findings We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are “bringing” the disease into the relationship. IPV worsened HIV-related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV-related health via mental health, as women described feeling depressed and anxious due to the violence. IPV led to secondary HIV risk as women experienced forced sex, often with little power to negotiate condom use. Pregnant women described staying silent about condom negotiation in order to stay physically safe during pregnancy. Conclusions IPV is a crucial issue in the lives of pregnant women and has bidirectional links with HIV-related health. IPV may worsen access to PMTCT and secondary prevention behaviours

  8. Pregnant women's attitudes about topical microbicides for the prevention and treatment of bacterial vaginosis during pregnancy.

    Science.gov (United States)

    Catallozzi, Marina; Fraiz, Lauren Dapena; Hargreaves, Katharine M; Zimet, Gregory D; Stanberry, Lawrence R; Ratner, Adam J; Gelber, Shari E; Rosenthal, Susan L

    2017-08-01

    We sought to understand pregnant women's product preference and likelihood of use of topical microbicides for bacterial vaginosis (BV) prevention and treatment. Pregnant women (N = 196) in a obstetrics clinic completed a survey between June 2014 and January 2015 about vaginal product use for BV. This cross-sectional study explored product preferences, likelihood of product use for BV management and father of the baby (FOB) involvement. Most participants were under 30 (68%) and underrepresented minorities (47% Hispanic, 21% African-American). Most women preferred the gel (69%). Only 30% were likely to use either product for prevention of BV; 76% if high risk for BV; 83% treatment of BV. Anticipated FOB involvement in decision-making included that 46% would ask his opinion, 38% would inform him of the decision and 7% would need approval. Most (87%) would ask the FOB for reminders and 66% for insertion help. Those under 30 were more likely to agree to ask the FOB for reminders (p Product preferences may be less critical than risk perception. Involvement of the FOB in decision-making may be vital.

  9. Feasibility and effectiveness of unintended pregnancy prevention with low-dose mifepristone combined with misoprostol before expected menstruation.

    Science.gov (United States)

    Li, Cui-Lan; Chen, Dun-Jin; Deng, Yi-Fan; Song, Li-Ping; Mo, Xue-Tang; Liu, Kai-Jie

    2015-12-01

    /138). Two women (1.5%, 2/138) had ongoing pregnancy that was subsequently terminated surgically. The overall bleeding induction rate within 7 days was 98.3% (639/650), with 100% (138/138) in pregnant participants and 97.9% (501/512) in non-pregnant participants. Most pregnant and non-pregnant participants experienced no significant menstrual disturbance during the treatment [96.3% (131/136) versus 97.6% (489/501)] or post-treatment [97.8% (133/136) versus 98.4% (493/501)] menstrual cycle. The general rate of satisfaction with the treatment was 96.7% (618/639). Generally, 36.0% (230/639) of participants preferred to use the regimen as a routine contraception method versus the 64.0% (409/639) who preferred to use it as a remedy for pregnancy prevention after unprotected sex (P menstruation can be efficacious and highly acceptable to maintain or restore non-pregnant status, which may have potential for routine contraception. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Prevention of Allergy: From Immunology of Pregnancy To Infant Feeding in the First Months of Life

    Directory of Open Access Journals (Sweden)

    Sergey E. Ukraintsev

    2016-01-01

    Full Text Available The continued increase in the incidence of allergic diseases in children population generates reasonable interest of allergists. The article describes the basic mechanisms of immunological response in light of the allergy risk modulation in children. It discusses a new approach to the prescription of hypoallergenic diets for healthy pregnant and lactating women to prevent allergies in children. A separate section examines the influence of the infant feeding mode in the first months of life on the risk of formation of allergies as a child grows, as well as key mechanisms for the formation of the oral tolerance phenomenon. The results from the study of immunological processes that underlie the phenomenon of oral tolerance confirm the ability to reduce the risk of formation of cow's milk protein allergy in formula-fed infants by using formulas based on hydrolysed protein.

  11. Prevention of perinatal group B streptococcal disease: screening during a pregnancy

    Directory of Open Access Journals (Sweden)

    Rosella Bruno

    2012-12-01

    Full Text Available The prevention of perinatal group B streptococcal (GBS disease is based on the screening of all pregnant women at 35-37 weeks’ gestation for vaginal and rectal GBS colonization. The colonized women receive intrapartum antibiotic prophylaxis. Our study reports the different rates of maternal GBS colonization between April 2008 and March 2011. We have collected 3430 samples by swabbing both the lower vagina and rectum and we have employed two different laboratory methods: direct agar plating and selective enrichment broth. The rates of maternal GBS colonization increased from 10.5% during 2008-2009, to 12.2% during 2009-2010 and to 14.4% during 2010-2011, when we have introduced the Todd Hewitt broth. Our results show that the use of an enrichment broth improves detection of GBS carriers women.

  12. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  13. Stop or go? Preventive cognitive therapy with guided tapering of antidepressants during pregnancy: study protocol of a pragmatic multicentre non-inferiority randomized controlled trial.

    Science.gov (United States)

    Molenaar, Nina M; Brouwer, Marlies E; Bockting, Claudi L H; Bonsel, Gouke J; van der Veere, Christine N; Torij, Hanneke W; Hoogendijk, Witte J G; Duvekot, Johannes J; Burger, Huibert; Lambregtse-van den Berg, Mijke P

    2016-03-18

    Approximately 6.2 % of women in the USA and 3.7 % of women in the UK, use Selective Serotonin Reuptake Inhibitors (SSRIs) during their pregnancies because of depression and/or anxiety. In the Netherlands, this prevalence is around 2 %. Nonetheless, SSRI use during pregnancy is still controversial. On the one hand SSRIs may be toxic to the intrauterine developing child, while on the other hand relapse or recurrence of depression during pregnancy poses risks for both mother and child. Among patients and professionals there is an urgent need for evidence from randomized studies to make rational decisions regarding continuation or tapering of SSRIs during pregnancy. At present, no such studies exist. 'Stop or Go' is a pragmatic multicentre randomized non-inferiority trial among 200 pregnant women with a gestational age of less than 16 weeks who use SSRIs without clinically relevant depressive symptoms. Women allocated to the intervention group will receive preventive cognitive therapy with gradual, guided discontinuation of SSRIs under medical management (STOP). Women in the control group will continue the use of SSRIs (GO). Primary outcome will be the (cumulative) incidence of relapse or recurrence of maternal depressive disorder (as assessed by the Structured Clinical Interview for DSM disorders) during pregnancy and up to three months postpartum. Secondary outcomes will be child outcome (neonatal outcomes and psychomotor and behavioural outcomes up to 24 months postpartum), and health-care costs. Total study duration for participants will be therefore be 30 months. We specified a non-inferiority margin of 15 % difference in relapse risk. This study is the first to investigate the effect of guided tapering of SSRIs with preventive cognitive therapy from early pregnancy onwards as compared to continuation of SSRIs during pregnancy. We will study the effects on both mother and child with a pragmatic approach. Additionally, the study examines cost effectiveness. If non

  14. Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study.

    Science.gov (United States)

    Menaca, Arantza; Pell, Christopher; Manda-Taylor, Lucinda; Chatio, Samuel; Afrah, Nana A; Were, Florence; Hodgson, Abraham; Ouma, Peter; Kalilani, Linda; Tagbor, Harry; Pool, Robert

    2013-07-22

    In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting Mi

  15. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  16. Predicting Optimal Dihydroartemisinin-Piperaquine Regimens to Prevent Malaria During Pregnancy for Human Immunodeficiency Virus-Infected Women Receiving Efavirenz.

    Science.gov (United States)

    Wallender, Erika; Vucicevic, Katarina; Jagannathan, Prasanna; Huang, Liusheng; Natureeba, Paul; Kakuru, Abel; Muhindo, Mary; Nakalembe, Mirium; Havlir, Diane; Kamya, Moses; Aweeka, Francesca; Dorsey, Grant; Rosenthal, Philip J; Savic, Radojka M

    2018-03-05

    A monthly treatment course of dihydroartemisinin-piperaquine (DHA-PQ) effectively prevents malaria during pregnancy. However, a drug-drug interaction pharmacokinetic (PK) study found that pregnant human immunodeficiency virus (HIV)-infected women receiving efavirenz-based antiretroviral therapy (ART) had markedly reduced piperaquine (PQ) exposure. This suggests the need for alternative DHA-PQ chemoprevention regimens in this population. Eighty-three HIV-infected pregnant women who received monthly DHA-PQ and efavirenz contributed longitudinal PK and corrected QT interval (QTc) (n = 25) data. Population PK and PK-QTc models for PQ were developed to consider the benefits (protective PQ coverage) and risks (QTc prolongation) of alternative DHA-PQ chemoprevention regimens. Protective PQ coverage was defined as maintaining a concentration >10 ng/mL for >95% of the chemoprevention period. PQ clearance was 4540 L/day. With monthly DHA-PQ (2880 mg PQ), 96% of women, respectively. All regimens were safe, with ≤2% of women predicted to have ≥30 msec QTc increase. For HIV-infected pregnant women receiving efavirenz, low daily DHA-PQ dosing was predicted to improve protection against parasitemia and reduce risk of toxicity compared to monthly dosing. NCT02282293. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  17. Urinary Tract Infection as a Preventable Cause of Pregnancy Complications: Opportunities, Challenges, and a Global Call to Action

    OpenAIRE

    Gilbert, Nicole M.; O'Brien, Valerie P.; Hultgren, Scott; Macones, George; Lewis, Warren G.; Lewis, Amanda L.

    2013-01-01

    The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in...

  18. Lost opportunities to prevent early onset type 2 diabetes mellitus after a pregnancy complicated by gestational diabetes.

    Science.gov (United States)

    Bernstein, Judith A; McCloskey, Lois; Gebel, Christina M; Iverson, Ronald E; Lee-Parritz, Aviva

    2016-01-01

    Gestational diabetes mellitus (GDM) greatly increases the risk of developing diabetes in the decade after delivery, but few women receive appropriately timed postpartum glucose testing (PPGT) or a referral to primary care (PC) for continued monitoring. This qualitative study was designed to identify barriers and facilitators to testing and referral from patient and providers' perspectives. We interviewed patients and clinicians in depth about knowledge, values, priorities, challenges, and recommendations for increasing PPGT rates and PC linkage. Interviews were coded with NVIVO data analysis software, and analyzed using an implementation science framework. Women reported motivation to address GDM for the health of the fetus. Most women did not anticipate future diabetes for themselves, and focused on delivery outcomes rather than future health risks. Patients sought and received reassurance from clinicians, and were unlikely to discuss early onset following GDM or preventive measures. PPGT barriers described by patients included provider not mentioning the test or setting it up, transportation difficulties, work responsibilities, fatigue, concerns about fasting while breastfeeding, and timing of the test after discharge from obstetrics, and no referral to PC for follow-up. Practitioners described limited communication among multiple care providers during pregnancy and delivery, systems issues, and separation of obstetrics from PC. Patients' barriers to PPGT included low motivation for self-care, structural obstacles, and competing priorities. Providers reported the need to balance risk with reassurance, and identified systems failures related to test timing, limitations of electronic medical record systems (EMR), lack of referrals to PC, and inadequate communication between specialties. Prevention of early onset has great potential for medical cost savings and improvements in quality of life.

  19. Maternal vitamin D supplementation during pregnancy prevents vitamin D deficiency in the newborn: an open-label randomized controlled trial.

    Science.gov (United States)

    Rodda, C P; Benson, J E; Vincent, A J; Whitehead, C L; Polykov, A; Vollenhoven, B

    2015-09-01

    To determine whether maternal vitamin D supplementation, in the vitamin D deficient mother, prevents neonatal vitamin D deficiency. Open-label randomized controlled trial. Metropolitan Melbourne, Australia, tertiary hospital routine antenatal outpatient clinic. Seventy-eight women with singleton pregnancies with vitamin D deficiency/insufficiency (serum 25-OH Vit D l) at their first antenatal appointment at 12-16-week gestation were recruited. Participants were randomized to vitamin D supplementation (2000-4000 IU cholecalciferol) orally daily until delivery or no supplementation. The primary outcome was neonatal serum 25-OH vit D concentration at delivery. The secondary outcome was maternal serum 25-OH vit D concentration at delivery. Baseline mean maternal serum 25-OH vit D concentrations were similar (P = 0·9) between treatment (32 nmol/l, 95% confidence interval 26-39 nmol/l) and control groups (33 nmol/l, 95% CI 26-39 nmol/l). Umbilical cord serum 25-OH vit D concentrations at delivery were higher (P l, 95% CI; 70-91 nmol/l) compared with neonates of control group mothers (42 nmol/l, 95% CI; 34-50 nmol/l) with a strongly positive correlation between maternal serum 25-OH Vit D and umbilical cord serum 25-OH vit D concentrations at delivery (Spearman rank correlation coefficient 0·88; P l, 95% CI; 62-81 nmol/l) compared with the control group (36 nmol/l, 95% CI; 29-42 nmol/l). Vitamin D supplementation of vitamin D deficient pregnant women prevents neonatal vitamin D deficiency. © 2015 John Wiley & Sons Ltd.

  20. Reuse of single-dose nevirapine in subsequent pregnancies for the prevention of mother-to-child HIV transmission in Lusaka, Zambia: A cohort study

    Directory of Open Access Journals (Sweden)

    Sinkala Moses

    2008-12-01

    Full Text Available Abstract Background Single-dose nevirapine (SDNVP for the prevention of mother-to-child HIV transmission (PMTCT results in the selection of resistance mutants among HIV-infected mothers. The effects of these mutations on the efficacy of SDNVP use in a subsequent pregnancy are not well understood. Methods We compared risks of perinatal HIV transmission between multiparous women who had previously received a dose of SDNVP (exposed and those that had not (unexposed and who were given SDNVP for the index pregnancy within a PMTCT clinical study. We also compared transmission risks among exposed and unexposed women who had two consecutive pregnancies within the trial. Logistic regression modeling was used to adjust for possible confounders. Results Transmission risks did not differ between 59 SDNVP-exposed and 782 unexposed women in unadjusted analysis or after adjustment for viral load and disease stage (adjusted odds ratio 0.6, 95% confidence interval [CI] 0.2 to 2.0. Among 43 women who had two consecutive pregnancies during the study, transmission risks were 7% (95% CI 1% to 19% at both the first (unexposed and second (exposed delivery. The results were unchanged, if infant death was included as an outcome. Conclusion These data suggest that the efficacy of SDNVP may not be diminished when reused in subsequent pregnancies.

  1. Asthma and Pregnancy: Possible to prevent complications?- With Special reference to the impact of obesity and type of airwayinflammation

    Science.gov (United States)

    Ali, Zarqa

    2017-12-01

    Background Asthma is a serious global health issue and the most prevalent chronic disorder among Danish pregnant women. Exacerbations of asthma during pregnancy have been associated with increased risk of adverse pregnancy and perinatal outcomes, and by that making asthma a potential serious medical condition during pregnancy. Monitoring of asthma every four to six weeks is recommended during pregnancy, although evidence is lacking that following this recommendation will improve pregnancy outcome and, not least, be beneficial for all pregnant women with asthma. Aim The overall aim of the present thesis was to gain more knowledge of the interaction between asthma and pregnancy. The specific research questions were to identify pregnancies with low risk of an exacerbation during pregnancy, to identify risk factors for an exacerbation during pregnancy, and to compare the adverse pregnancy and perinatal outcomes in women without asthma and women with asthma monitored closely as recommended during pregnancy. Methods In study I and II, determinants of pregnancies with low risk of an exacerbation and maternal pregnancy-related risk factors for an exacerbations were investigated in a large prospective cohort study with 1.283 women with asthma. The Management of Asthma during Pregnancy (MAP) was initiated in 2007, and all pregnant women referred to Hvidovre Hospital have since then received an invitation to participate. Women were followed-up every four weeks with assessment of asthma control and adjustment of medication if necessary. In study III, the potential differences in airway hyperresponsiveness and airway inflammation, in participants (n=50) from the MAP cohort, were investigated in a post-partum examination. In study IV, the effect of maternal asthma on obstetrical and perinatal outcomes was investigated in a large case-control study, with 938 cases i.e. women with asthma from the MAP cohort, and 2.778 controls i.e. women without asthma. Results No history of pre-pregnancy

  2. [RELEVANT PRINCIPLES IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF TOXOPLASMOSIS DURING PREGNANCY].

    Science.gov (United States)

    Merzlova, N B; Serova, I A; Yagodina, A Yu

    2015-01-01

    A retrospective survey of the prevalence of TORCH infections among pregnant women was performed in the perinatal center, M. A. Tverye Military Sanitary Unit Nine (Perm), in June 2010 to December 2013. The survey covered 2060 women: they were all examined for cytomegalovirus, herpes simplex virus, and Toxoplasma. Antibodies to Toxoplasma gondii were detected in 28.68% (591/2060); 98.62% were found to have antibodies to herpes simplex; antibodies to cytomegalovirus were identified in 87.13% (1795/2060). Acute maternal toxoplasmosis was diagnosed by seroconversion or determination of IgM anti-Toxoplasma gondii antibodies, in the presence of a low avidity index and a four-fold increase in antibody titers, by simultaneously studying paired serum samples obtained at a 2-week interval. To confirm fetal infection, amniotic fluid PCR examination should be performed after 18 weeks' gestation. No consensus of opinion as to the principles of treatment for toxoplasmosis in pregnant women makes relevant the long-term results of antibacterial and antiprotozoal treatment cycles varying in duration and intensity. The prevention of acute toxoplasmosis in pregnant women ensures the principle of a mother's personal responsibility for infection safety of a newborn infant, which is informationally provided in health and safety fundamentals course and pregravid preparation schools.

  3. A comparison between girls' and boys' experiences of unwanted sexual behaviour in secondary schools

    NARCIS (Netherlands)

    Timmerman, G

    Background This study examines gender differences (and similarities) in the context, meaning and effects of unwanted sexual behaviour in secondary schools. Purpose First, the study's purpose is exploration of variables that discriminate between girls' and boys' experiences of unwanted sexual

  4. Cost-effectiveness of antiviral therapy during late pregnancy to prevent perinatal transmission of hepatitis B virus

    Directory of Open Access Journals (Sweden)

    Wenjun Wang

    2016-03-01

    Full Text Available Background. Hepatitis B virus (HBV infections are perinatally transmitted from chronically infected mothers. Supplemental antiviral therapy during late pregnancy with lamivudine (LAM, telbivudine (LdT, or tenofovir (TDF can substantially reduce perinatal HBV transmission compared to postnatal immunoprophylaxis (IP alone. However, the cost-effectiveness of these measures is not clear. Aim. This study evaluated the cost-effectiveness from a societal perspective of supplemental antiviral agents for preventing perinatal HBV transmission in mothers with high viral load (>6 log10 copies/mL. Methods. A systematic review and network meta-analysis were performed for the risk of perinatal HBV transmission with antiviral therapies. A decision analysis was conducted to evaluate the clinical and economic outcomes in China of four competing strategies: postnatal IP alone (strategy IP, or in combination with perinatal LAM (strategy LAM + IP, LdT (strategy LdT + IP, or TDF (strategy TDF + IP. Antiviral treatments were administered from week 28 of gestation to 4 weeks after birth. Outcomes included treatment-related costs, number of infections, and quality-adjusted life years (QALYs. One- and two-way sensitivity analyses were performed to identify influential clinical and cost-related variables. Probabilistic sensitivity analyses were used to estimate the probabilities of being cost-effective for each strategy. Results. LdT + IP and TDF + IP averted the most infections and HBV-related deaths, and gained the most QALYs. IP and TDF + IP were dominated as they resulted in less or equal QALYs with higher associated costs. LdT + IP had an incremental $2,891 per QALY gained (95% CI [$932–$20,372] compared to LAM + IP (GDP per capita for China in 2013 was $6,800. One-way sensitivity analyses showed that the cost-effectiveness of LdT + IP was only sensitive to the relative risk of HBV transmission comparing LdT + IP with LAM + IP. Probabilistic sensitivity analyses

  5. Long-Term Improvements in Knowledge and Psychosocial Factors of a Teen Pregnancy Prevention Intervention Implemented in Group Homes.

    Science.gov (United States)

    Green, Jennifer; Oman, Roy F; Lu, Minggen; Clements-Nolle, Kristen D

    2017-06-01

    Youth in out-of-home care have higher rates of sexual risk behaviors and pregnancy than youth nationally. This study aimed to determine if Power Through Choices (PTC), a teen pregnancy prevention program developed for youth in out-of-home care, significantly improves knowledge and psychosocial outcomes regarding HIV and sexually transmitted infections (STIs), sexual activity and contraception methods, long term. A cluster randomized controlled trial was conducted with 1,036 ethnically diverse youths (aged 13-18 years) recruited from 44 residential group homes in three states. Intervention participants received the 10-session PTC intervention; control participants received usual care. Participants were administered self-report surveys at baseline, after intervention, 6 and 12 months after the intervention. Survey items assessed knowledge, attitudes, self-efficacy, and behavioral intentions regarding HIV and STIs, sexual activity and contraception methods. Random intercept logistic regression analyses were used to assess differences between the intervention and control groups. Compared with youth in the control group, youth in the PTC intervention demonstrated significant improvements in knowledge about anatomy and fertility (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] = 1.03-1.11), HIV and STIs (AOR = 1.03, 95% CI = 1.002-1.07), and methods of protection (AOR = 1.06, 95% CI = 1.03-1.09), as well as self-efficacy regarding self-efficacy to communicate with a partner (AOR = 1.14, 95% CI = 1.04-1.26), plan for protected sex and avoid unprotected sex (AOR = 1.16, 95% CI = 1.04-1.28), and where to get methods of birth control (AOR = 1.13, 95% CI = 1.01-1.26) 12 months after the intervention. Findings suggest that the PTC intervention can have positive long-term knowledge and psychosocial effects regarding contraception methods on youth in out-of-home care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by

  6. Intermittent preventive sulfadoxine-pyrimethamine treatment of primigravidae reduces levels of plasma immunoglobulin G, which protects against pregnancy-associated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Staalsoe, Trine; Shulman, Caroline E; Dorman, Edgar K

    2004-01-01

    Pregnancy-associated malaria (PAM) is an important cause of maternal and neonatal suffering. It is caused by Plasmodium falciparum capable of inhabiting the placenta through expression of particular variant surface antigens (VSA) with affinity for proteoglycans such as chondroitin sulfate A....... Protective immunity to PAM develops following exposure to parasites inhabiting the placenta, and primigravidae are therefore particularly susceptible to PAM. The adverse consequences of PAM in primigravidae are preventable by intermittent preventive treatment (IPTp), where women are given antimalarials...... at specified intervals during pregnancy, but this may interfere with acquisition of protective PAM immunity. We found that Kenyan primigravidae receiving sulfadoxine-pyrimethamine IPTp had significantly lower levels of immunoglobulin G (IgG) with specificity for the type of parasite-encoded VSA-called VSA(PAM...

  7. A non-inferiority, individually randomized trial of intermittent screening and treatment versus intermittent preventive treatment in the control of malaria in pregnancy

    DEFF Research Database (Denmark)

    Tagbor, Harry; Cairns, Matthew; Bojang, Kalifa

    2015-01-01

    BACKGROUND: The efficacy of intermittent preventive treatment for malaria with sulfadoxine-pyrimethamine (IPTp-SP) in pregnancy is threatened in parts of Africa by the emergence and spread of resistance to SP. Intermittent screening with a rapid diagnostic test (RDT) and treatment of positive women...... with malaria parasitemia between routine antenatal clinics (310 vs 182 episodes, rate difference: 49.4 per 1,000 pregnancies [95% CI 30.5, 68.3], but the number of hospital admissions for malaria was similar in the two groups. CONCLUSIONS: Despite low levels of resistance to SP in the study areas, ISTp......-AL performed as well as IPTp-SP. In the absence of an effective alternative medication to SP for IPTp, ISTp-AL is a potential alternative to IPTp in areas where SP resistance is high. It may also have a role in areas where malaria transmission is low and for the prevention of malaria in HIV positive women...

  8. Preventing unsafe abortion and limiting its consequences: what can be done?

    Science.gov (United States)

    Misago, C

    1994-12-01

    The continued illegality of induced abortion in Latin America has led to substantial, preventable maternal mortality and morbidity. The first strategy for preventing unsafe clandestine abortion is to reduce the incidence of unwanted pregnancy through measures such as improved access to effective contraception, post-abortion family planning counseling, health education campaigns aimed at promoting condom use among young people, involvement of men in family planning decision making, biomedical research on safer and more effective male and female contraceptive methods, and empowering women to demand the use of condoms or avoid unwanted intercourse. The second strategy is to reduce abortion-related mortality and morbidity through more effective clinical management of incomplete illegal abortions, introduction of menstrual regulation services, formation of women's solidarity groups aimed at discouraging the practice of self-induced abortion, and, ultimately, abortion legalization.

  9. A new strategy and its effect on adherence to intermittent preventive treatment of malaria in pregnancy in Uganda.

    Science.gov (United States)

    Mbonye, Anthony K; Yanow, Stephanie; Birungi, Josephine; Magnussen, Pascal

    2013-09-21

    Few women in Uganda access intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). Previous studies have shown that high costs, frequent stock-out of drugs, supplies and poor quality of care are the greatest hindrance for women to access health services. In order to increase adherence to IPTp, we conceptualised an intervention that offset delivery care costs through providing a mama kit, created awareness on health benefits of IPTp and built trust between the provider and the client. The new strategy was conceived along four constructs namely: 1) creating awareness by training midwives to explain the benefits of SP and the importance of adhering to the two doses of SP as IPTp to all pregnant women who attended ANC and consented to the study. Midwives were trained for two days in customer care and to provide a friendly environment. The pregnant women were also informed of the benefits of attending ANC and delivering at health facilities. 2) Each woman was promised a mama kit during ANC; 3) trust was built by showing the mama kit to each woman and branding it with her name; 4) keeping the promise by providing the mama kit when women came to deliver. The strategy to increase adherence to two doses of SP and encourage women to deliver at health facilities was implemented at two health facilities in Mukono district (Kawolo hospital and Mukono health centre IV). The inclusion criteria were women who: i) consented to the study and ii) were in the second trimester of pregnancy. All pregnant women in the second trimester (4-6 months gestation) who attended ANC and consented to participate in the study were informed of the benefits of SP, the importance of delivering at health facilities, were advised to attend the scheduled visits, promised a mama kit and ensured the kit was available at delivery. The primary outcome was the proportion of pregnant women adhering to a two dose SP regimen. A total of 2,276 women received the first

  10. "It's better for me to drink, at least the stress is going away": perspectives on alcohol use during pregnancy among South African women attending drinking establishments.

    Science.gov (United States)

    Watt, Melissa H; Eaton, Lisa A; Choi, Karmel W; Velloza, Jennifer; Kalichman, Seth C; Skinner, Donald; Sikkema, Kathleen J

    2014-09-01

    The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who drink during pregnancy is lacking. Convenience sampling in alcohol-serving venues was used to identify women who were currently pregnant (n = 12) or recently post-partum (n = 12) and reported drinking during the pregnancy period. In-depth qualitative interviews were conducted between April and August 2013. Interviews explored drinking narratives, with textual data analyzed for themes related to factors that contributed to drinking during pregnancy. All but one woman reported her pregnancy as unplanned. The majority sustained or increased drinking after pregnancy recognition, with patterns typically including multiple days of binge drinking per week. Analysis of the textual data revealed five primary factors that contributed to drinking during pregnancy: 1) women used alcohol as a strategy to cope with stressors and negative emotions, including those associated with pregnancy; 2) women drank as a way to retain social connection, often during a difficult period of life transition; 3) social norms in women's peer groups supported drinking during pregnancy; 4) women lacked attachment to the pregnancy or were resistant to motherhood; and 5) women were driven physiologically by alcohol addiction. Our data suggest that alcohol-serving settings are important sites to identify and target women at risk of drinking during pregnancy. Intervention approaches to reduce alcohol use during pregnancy should include counseling and contraception to prevent unwanted pregnancies, mental health and coping interventions targeting pregnant women, peer-based interventions to change norms around perinatal drinking, and treatment for alcohol dependence during pregnancy. Our findings suggest that innovative interventions that go beyond the

  11. “It's better for me to drink, at least the stress is going away”: Perspectives on alcohol use during pregnancy among South African women attending drinking establishments

    Science.gov (United States)

    Watt, Melissa H.; Eaton, Lisa A.; Choi, Karmel W.; Velloza, Jennifer; Kalichman, Seth C.; Skinner, Donald; Sikkema, Kathleen J.

    2014-01-01

    The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who drink during pregnancy is lacking. Convenience sampling in alcohol-serving venues was used to identify women who were currently pregnant (n=12) or recently post-partum (n=12) and reported drinking during the pregnancy period. In-depth qualitative interviews were conducted between April and August 2013. Interviews explored drinking narratives, with textual data analyzed for themes related to factors that contributed to drinking during pregnancy. All but one woman reported her pregnancy as unplanned. The majority sustained or increased drinking after pregnancy recognition, with patterns typically including multiple days of binge drinking per week. Analysis of the textual data revealed five primary factors that contributed to drinking during pregnancy: 1) women used alcohol as a strategy to cope with stressors and negative emotions, including those associated with pregnancy; 2) women drank as a way to retain social connection, often during a difficult period of life transition; 3) social norms in women's peer groups supported drinking during pregnancy; 4) women lacked attachment to the pregnancy or were resistant to motherhood; and 5) women were driven physiologically by alcohol addiction. Our data suggest that alcohol-serving settings are important sites to identify and target women at risk of drinking during pregnancy. Intervention approaches to reduce alcohol use during pregnancy should include counseling and contraception to prevent unwanted pregnancies, mental health and coping interventions targeting pregnant women, peer-based interventions to change norms around perinatal drinking, and treatment for alcohol dependence during pregnancy. Our findings suggest that innovative interventions that go beyond the

  12. Helping Clinicians Prevent Pregnancy among Sexually Active Adolescents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use.

    Science.gov (United States)

    Godfrey, Emily M

    2015-08-01

    The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.

  13. Gender norms in South Africa: Implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution

    Science.gov (United States)

    Mantell, Joanne E.; Needham, Sarah L.; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M.; Mabude, Zonke; Beksinska, Mags; Stein, Zena A.; Milford, Cecilia

    2009-01-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women’s ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students who are a relatively ‘privileged’ group, there is little information on gender norms that might shape responses to HIV prevention programmes. To elicit gender norms regarding women’s and men’s roles, condom and contraceptive use, sexual communication, and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students so as to understand how norms might be used to buttress HIV and pregnancy prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women’s rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women’s freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women’s protection against unintended pregnancy and HIV/STIs. PMID:19247859

  14. Gender norms in South Africa: implications for HIV and pregnancy prevention among African and Indian women students at a South African tertiary institution.

    Science.gov (United States)

    Mantell, Joanne E; Needham, Sarah L; Smit, Jennifer Ann; Hoffman, Susie; Cebekhulu, Queen; Adams-Skinner, Jessica; Exner, Theresa M; Mabude, Zonke; Beksinska, Mags; Stein, Zena A; Milford, Cecilia

    2009-02-01

    In post-Apartheid South Africa, women are constitutionally guaranteed protections and freedoms that were previously unknown to them. These freedoms may have positive implications for women's ability to negotiate sexual protection with partners and hence prevent unintended pregnancy and decrease their risk of HIV. Among tertiary institution students, who are a relatively 'privileged' group, there is little information on gender norms that might shape responses to HIV-prevention programmes. To elicit gender norms regarding women's and men's roles, condom and contraceptive use, sexual communication and sexual pleasure, we conducted 10 semi-structured focus group discussions with African and Indian female tertiary institution students in order to understand how norms might be used to buttress HIV- and pregnancy-prevention. Participants reported dramatic changes in the structure of gender norms and relations with the formal recognition of women's rights in the post-Apartheid context. These generational shifts in norms are supported by other research in South Africa. At the same time, women recognized the co-existence of traditional constructions of gender that operate to constrain women's freedom. The perceived changes that have taken place provide an entry point for intervention, particularly for reinforcing emerging gender norms that promote women's protection against unintended pregnancy and HIV/STIs.

  15. Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine-pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis

    NARCIS (Netherlands)

    Kayentao, Kassoum; Garner, Paul; van Eijk, Anne Maria; Naidoo, Inbarani; Roper, Cally; Mulokozi, Abdunoor; MacArthur, John R.; Luntamo, Mari; Ashorn, Per; Doumbo, Ogobara K.; ter Kuile, Feiko O.

    2013-01-01

    Intermittent preventive therapy with sulfadoxine-pyrimethamine to control malaria during pregnancy is used in 37 countries in sub-Saharan Africa, and 31 of those countries use the standard 2-dose regimen. However, 2 doses may not provide protection during the last 4 to 10 weeks of pregnancy, a

  16. Sexual risk during pregnancy and postpartum periods among HIV-infected and -uninfected South African women: Implications for primary and secondary HIV prevention interventions.

    Science.gov (United States)

    Joseph Davey, Dvora; Farley, Elise; Gomba, Yolanda; Coates, Thomas; Myer, Landon

    2018-01-01

    HIV acquisition in pregnancy and breastfeeding contributes significantly toward pediatric HIV infection. However, little is known about how sexual behavior changes during pregnancy and postpartum periods which will help develop targeted HIV prevention and transmission interventions, including pre-exposure prophylaxis (PrEP). Cross-sectional study in HIV-infected and uninfected pregnant and postpartum women in Cape Town, South Africa. Interviewers collected survey data on demographic, sexual behaviors, and alcohol use among pregnant and post-partum women. We report descriptive results of sexual behavior by trimester and postpartum period, and results of multivariable logistic regression stratified by pregnancy status. We enrolled 377 pregnant and postpartum women (56% pregnant, 40% HIV-infected). During pregnancy, 98% of women reported vaginal sex (8% anal sex, 44% oral sex) vs. 35% and 88% during the periods 0-6 and 7-12 months postpartum, respectively (p1 partner in the past 12-months compared to postpartum women (18% vs. 13%, respectively, p6-months postpartum (13 mean sex acts in first trimester; 17 mean sex acts >6-months postpartum). Pregnant women had increased odds of reporting condomless sex at last sex (aOR = 2.96;95%CI = 1.84-4.78) and ever having condomless sex in past 3-months (aOR = 2.65;95%CI = 1.30-5.44) adjusting for age, HIV status, and sex frequency compared to postpartum women. We identified that sexual behaviors and risk behaviors were high and changing during pregnancy and postpartum periods, presenting challenges to primary and secondary HIV prevention efforts, including PrEP delivery to pregnant and breastfeeding women.

  17. Impact of folate supplementation on the efficacy of sulfadoxine/pyrimethamine in preventing malaria in pregnancy: the potential of 5-methyl-tetrahydrofolate.

    Science.gov (United States)

    Nzila, Alexis; Okombo, John; Molloy, Anne M

    2014-02-01

    Malaria remains the leading cause of mortality and morbidity in children under the age of 5 years and pregnant women. To counterbalance the malaria burden in pregnancy, an intermittent preventive treatment strategy has been developed. This is based on the use of the antifolate sulfadoxine/pyrimethamine, taken at specified intervals during pregnancy, and reports show that this approach reduces the malaria burden in pregnancy. Pregnancy is also associated with the risk of neural tube defects (NTDs), especially in women with low folate status, and folic acid supplementation is recommended in pregnancy to lower the risk of NTDs. Thus, in malaria-endemic areas, pregnant women have to take both antifolate medication to prevent malaria and folic acid to lower the risk of NTDs. However, the concomitant use of folate and antifolate is associated with a decrease in antifolate efficacy, exposing pregnant women to malaria. Thus, there is genuine concern that this strategy may not be appropriate. We have reviewed work carried out on malaria folate metabolism and antifolate efficacy in the context of folate supplementation. This review shows that: (i) the folate supplementation effect on antifolate efficacy is dose-dependent, and folic acid doses required to protect pregnant women from NTDs will not decrease antifolate activity; and (ii) 5-methyl-tetrahydrofolate, the predominant form of folate in the blood circulation, could be administered (even at high dose) concomitantly with antifolate without affecting antifolate efficacy. Thus, strategies exist to protect pregnant women from malaria while maintaining adequate folate levels in the body to reduce the occurrence of NTDs.

  18. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... blood clots are treated with an anticoagulant, a medicine that prevents the blood from clotting. Certain anticoagulants are safe to use during pregnancy. back to top Are Blood Clots Preventable? There ...

  19. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

    Directory of Open Access Journals (Sweden)

    Kathryn Hohman-Billmeier

    2016-12-01

    Full Text Available In 2010, Alaska Department of Health and Social Services (DHSS received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14–19 instead of the original curriculum intended age range of 12–14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a the professional growth of peer educators and development of peer education, (b difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  20. Moving beyond quantity of participation in process evaluation of an intervention to prevent excessive pregnancy weight gain

    Directory of Open Access Journals (Sweden)

    Paul Keriann H

    2013-02-01

    Full Text Available Abstract Background Few lifestyle interventions have successfully prevented excessive gestational weight gain. Understanding the program processes through which successful interventions achieve outcomes is important for the design of effective programs. The objective of this study was to evaluate the effect of the quantity and quality of participation in a healthy lifestyle intervention on risk of excessive gestational weight gain. Findings Pregnant women (N = 179 received five newsletters about weight, nutrition, and exercise plus postcards on which they were asked to set related goals and return to investigators. The quantity of participation (dose was defined as low for returning few or some vs. high for many postcards (N = 89, 49.7%. Quality of participation was low for setting few vs. high for some or many appropriate goals (N = 92, 51.4%. Fisher’s exact tests and multivariate logistic regression were used to analyze the effect of participation variables on the proportion with excessive weight gain. Quantity and quality of participation alone were each not significantly associated with excessive gestational weight gain, while quality of participation among those with high-levels of participation approached significance (p = 0.07. The odds of gaining excessively was decreased when women had both a high quantity and quality of participation (OR = 0.04, 95% CI = 0.005, 0.30. Conclusions Both quantity and quality of participation are important program process measures in evaluations of lifestyle interventions to promote healthy weight gain during pregnancy.

  1. Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care

    Directory of Open Access Journals (Sweden)

    Weiderpass Elisabete

    2008-08-01

    Full Text Available Abstract Background Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study. Methods A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1 recruitment and participation, 2 completion of data collection, 3 realization of the intervention and 4 the public health nurses' experiences. Results 1 The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrolment was 77% and the drop-out rate 15%. 2 In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3 In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4 The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study. Conclusion The study protocol was mostly feasible to implement, which

  2. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska.

    Science.gov (United States)

    Hohman-Billmeier, Kathryn; Nye, Margaret; Martin, Stephanie

    2016-01-01

    In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14-19 instead of the original curriculum intended age range of 12-14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a) the professional growth of peer educators and development of peer education, (b) difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c) the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  3. Perceived benefits and proposed solutions for teen pregnancy: qualitative interviews with youth care workers.

    Science.gov (United States)

    Boustani, Maya Mroué; Frazier, Stacy L; Hartley, Chelsey; Meinzer, Michael; Hedemann, Erin

    2015-01-01

    The purpose of this article is to examine youth care workers' perceptions of the specific and unique sexual health needs of youth at risk for foster care. Semistructured interviews were conducted with youth care workers (N = 10) at a shelter for youth in or at risk for foster care. Youth care workers perceive that youth have unique experiences and needs related to sexual health programming and pregnancy prevention. Reflecting a great deal of family dysfunction, 3 themes emerged that revealed perceived benefits of teen pregnancy: youths' effort to prove themselves as adults, opportunity to secure their relationship with a partner, and desire to create an emotional connection with a baby. Lack of knowledge and accumulation of risk factors were viewed as most problematic. Current pregnancy prevention programs assume teen pregnancies are unwanted and emphasize the costs of sexual risk taking. Current findings suggest that sexual health programming for youth in or at risk for foster care should account for 3 perceived benefits of teen pregnancy. New opportunities for improving the reach and effectiveness of intervention for youth in or at risk for foster care are discussed.

  4. Preventing smoking during pregnancy: the importance of maternal knowledge of the health hazards and of the treatment options available

    Directory of Open Access Journals (Sweden)

    André Luís Bertani

    2015-04-01

    Full Text Available OBJECTIVE: To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women. METHODS: A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers. RESULTS: Of the 61 pregnant women evaluated, 25 (40.9% were smokers (mean age, 26.4 ± 7.4 years, 24 (39.3% were former smokers (26.4 ± 8.3 years, and 12 (19.8% were never-smokers (25.1 ± 7.2 years. Thirty-nine women (63.9% reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5% were aware of the pulmonary consequences of smoking; only 2 (4.1% were aware of the cardiovascular risks; 23 (46.9% believed that smoking does not harm the fetus or newborn infant; 21 (42.9% drank alcohol during pregnancy; 18 (36.7% reported increased cigarette consumption when drinking; 25 (51.0% had smoked flavored cigarettes; and 12 (24.5% had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%, as well as being the form most preferred (by 49.2%. CONCLUSIONS: Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, in order to promote

  5. Vitamin D treatment during pregnancy prevents autism-related phenotypes in a mouse model of maternal immune activation.

    Science.gov (United States)

    Vuillermot, Stephanie; Luan, Wei; Meyer, Urs; Eyles, Darryl

    2017-01-01

    animal model. This work raises the possibility that early dietary supplementation with vitamin D may open new avenues for a successful attenuation or even prevention of neurodevelopmental disorders following maternal inflammation during pregnancy.

  6. Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model.

    Directory of Open Access Journals (Sweden)

    Patrick G T Walker

    2017-02-01

    Full Text Available Malaria transmission has declined substantially in the 21st century, but pregnant women in areas of sustained transmission still require protection to prevent the adverse pregnancy and birth outcomes associated with malaria in pregnancy (MiP. A recent call to action has been issued to address the continuing low coverage of intermittent preventive treatment of malaria in pregnancy (IPTp. This call has, however, been questioned by some, in part due to concerns about resistance to sulphadoxine-pyrimethamine (SP, the only drug currently recommended for IPTp.Using an existing mathematical model of MiP, we combined estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with SP (IPTp-SP across Africa. Using estimates of the relationship between SP resistance mutations and the parasitological efficacy of SP during pregnancy, we estimated the varying impact of IPTp-SP across Africa and the incremental value of enhancing IPTp-SP uptake to match current antenatal care (ANC coverage. The risks of MiP and malaria-attributable low birthweight (mLBW in unprotected pregnancies (i.e., those not using insecticide-treated nets [ITNs] leading to live births fell by 37% (33%-41% 95% credible interval [crI] and 31% (27%-34% 95% crI, respectively, from 2000 to 2015 across endemic areas in sub-Saharan Africa. However, these gains are fragile, and coverage is far from optimal. In 2015, 9.5 million (8.3 million-10.4 million 95% crI of 30.6 million pregnancies in these areas would still have been infected with Plasmodium falciparum without intervention, leading to 750,000 (390,000-1.1 million 95% crI mLBW deliveries. In all, 6.6 million (5.6 million-7.3 million 95% crI of these 9.5 million (69.3% pregnancies at risk of infection (and 53.4% [16.3 million/30.6 million] of all pregnancies occurred in settings with near-perfect SP curative efficacy (>99% based on the most recent

  7. Control Cross-sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-catheterization and Review of Literature.

    Science.gov (United States)

    Michau, Adélie; Dinh, Aurélien; Denys, Pierre; Levy, Jonathan; Chartier-Kastler, Emmanuel; Bernard, Louis; Dommergues, Marc; Nizard, Jacky

    2016-05-01

    To assess the efficacy and safety of a weekly oral cycling antibiotic (WOCA) strategy to prevent UTI in women. We performed a monocentric, comparative, retrospective, cross-sectional study on pregnant women under clean intermittent self catheterization between January 2008 and December 2014. WOCA consisted the administration of a single-dose antibiotic, alternating antibiotic A and B once every 2 weeks, according to previous urine cultures. Twenty-five women carried out 30 pregnancies. Thirteen pregnancies (43.3%) were in the WOCA group (WCG) strategy and 17 were in the non-WOCA group (NWCG) (56.7%). In the 19 (63.3%) pregnancies with urinary tract infection (UTI), 5 (38.4%) were in WCG, 14 (82.3%) were not (P = .023). There were more cystitis in NWCG (76.5% vs 23.1% P = .009) but more colonization in WCG (46.2% vs 5.8% P = .025). UTIs were due to Escherichia coli, Enterobacter cloacae, and Klebsiella pneumoniae. There was a nonsignificant increase in preterm birth in NWCG (35.3% vs 7.7% P = .10), no small for gestational age neonates, and no significant difference for the mode of delivery, birthweight, and neonatal outcome. According to our result, WOCA seems safe and effective on symptomatic UTI frequency and could be promoted to help physicians to manage specific risks in pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Pregnancy Loss

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy loss Pregnancy loss is a harsh reality faced ... have successful pregnancies. Expand all | Collapse all Why pregnancy loss happens As many as 10 to 15 ...

  9. Adherence to intermittent preventive treatment for malaria with sulphadoxine-pyrimethamine and outcome of pregnancy among parturients in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Onyebuchi AK

    2014-04-01

    Full Text Available Azubike Kanario Onyebuchi,1 Lucky Osaheni Lawani,2 Chukwuemeka Anthony Iyoke,3 Chukwudi Robinson Onoh,1 Nwabunike Ekene Okeke4 1Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria; 2School of Postgraduate Studies, Department of Community Medicine, University of Nigeria; 3Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria; 4Department of Obstetrics and Gynecology, Mile Four Catholic Hospital, Abakaliki, Nigeria Background: Intermittent preventive treatment of malaria for pregnant women (IPTp is a very important strategy for the control of malaria in pregnancy in malaria-endemic tropical countries, where mosquito bites easily occur during evening outdoor activities. Issues related to provision, cost, and acceptability may affect the use of IPTp in some developing countries. The aim of the study was to assess the uptake and adherence to sulphadoxine-pyrimethamine-based intermittent preventive treatment of malaria during pregnancy and the relationship of IPTp use to pregnancy outcomes in two major obstetric centers in South East Nigeria. Methods: This was a prospective descriptive study involving women who received antenatal and delivery services. All recruited women were followed-up from booking until delivery, and statistical analysis was done with Epi Info version 7. Results: A total of 516 parturients were studied. The mean gestational age at booking was 21.8±6.9 weeks while the mean number of antenatal visits throughout the pregnancy was 5.5±3.1. The rate of uptake of at least one dose of prescribed IPTp was 72.1% (367/516. Of the 367 who took prescribed IPTp, adherence to second doses of IPTp was 59.7% (219/367, and only 4.9% (18/367 took a third dose. Clinical malaria occurred in 85% (127/149 of women who did not receive IPTp at all compared to 20.5% of those who received at least one dose of IPTp. All those who had clinical malaria despite IPTp had only one

  10. Prevent Infections in Pregnancy

    Science.gov (United States)

    ... eating Gardening or touching dirt or soil Handling pets Being around people who are sick Getting saliva (spit) on your ... or around your home. If you have a pet rodent, like a hamster or guinea pig, have ... yourself from them. Some people that have HIV, hepatitis B, or an STD ...

  11. The Unintended Consequences of Intended Pregnancies: Youth, Condom Use, and HIV Transmission in Mozambique

    Science.gov (United States)

    Speizer, Ilene S.; White, Justin S.

    2008-01-01

    Although unwanted pregnancies can cause social and economic problems for Sub-Saharan African youth, the consequences of "intended" adolescent pregnancies have gone unnoticed. Rarely do studies recognize that youth who desire a pregnancy are less likely to practice safe sex and, therefore, are at greater risk of contracting sexually…

  12. Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Carol Gamble

    2007-03-01

    Full Text Available BACKGROUND: Protection from malaria with insecticide-treated bednets (ITNs during pregnancy is widely advocated, but evidence of benefit has been inconsistent. We undertook a systematic review of randomised trials. METHODS AND FINDINGS: Three cluster-randomised and two individually randomised trials met the inclusion criteria; four from Africa (n = 6,418 and one from Thailand (n = 223. In Africa, ITNs compared to no nets increased mean birth weight by 55 g (95% confidence interval [CI] 21-88, reduced low birth weight by 23% (relative risk [RR] 0.77, 95% CI 0.61-0.98, and reduced miscarriages/stillbirths by 33% (RR 0.67, 0.47-0.97 in the first few pregnancies. Placental parasitaemia was reduced by 23% in all gravidae (RR 0.77, 0.66-0.90. The effects were apparent in the cluster-randomised trials and the one individually randomised trial in Africa. The trial in Thailand, which randomised individuals to ITNs or untreated nets, showed reductions in anaemia and fetal loss in all gravidae, but not reductions in clinical malaria or low birth weight. CONCLUSIONS: ITNs used throughout pregnancy or from mid-pregnancy onwards have a beneficial impact on pregnancy outcome in malaria-endemic Africa in the first few pregnancies. The potential impact of ITNs in pregnant women and their newborns in malaria regions outside Africa requires further research.

  13. An exploration of pregnant teenagers' views of the future and their decisions to continue or terminate their pregnancy: implications for nursing care.

    Science.gov (United States)

    Bell, Emily R; Glover, Lesley; Alexander, Tim

    2014-09-01

    To explore teenagers' views of the future in relation to their choices to continue or terminate pregnancy. Despite recent decreases in the numbers of teenage pregnancies, across the world, the teenage pregnancy rate remains high. Consideration of views of the future (future orientation) appears to play an important part in teenage girls' decisions to continue with pregnancy. To date, no study has explored this in teenage pregnant girls at the time they make their decision to continue with or terminate their pregnancy. Cross-sectional mixed methods design. Three groups were included: termination of pregnancy (n = 19), antenatal (n = 9) and never pregnant (n = 23). Participants were 13-18 years old. The termination of pregnancy and antenatal groups were interviewed, and the never pregnant group completed postal questionnaires. Groups differed in individual aspects of future orientation, that is, education, career and family, and reasons for pregnancy resolution choice. The termination group had more clearly developed and longer-term plans for the future with a focus on career. The never pregnant group shared aspects of their future orientation with both the antenatal and termination of pregnancy groups. The impact of negative discourses about teenage pregnancy from others was identified as a significant issue. How pregnant teenage girls view the future has a relationship with their decision to terminate or continue with their pregnancy. The findings suggest that working with teenage girls to clarify their views of the future may be useful both in preventing future unwanted pregnancy and in supporting teenagers in making pregnancy decisions. Supporting pregnant teenagers in distancing themselves from negative stereotypes of teenage mothers may also be beneficial. © 2013 John Wiley & Sons Ltd.

  14. Treatment with constitutive androstane receptor ligand during pregnancy prevents insulin resistance in offspring from high-fat diet-induced obese pregnant mice.

    Science.gov (United States)

    Masuyama, Hisashi; Hiramatsu, Yuji

    2012-07-15

    The constitutive androstane receptor (CAR) has been reported to decrease insulin resistance even during pregnancy, while exposure to a high-fat diet (HFD) in utero in mice can induce a type 2 diabetes phenotype that can be transmitted to the progeny. Therefore, we examined whether treatment with a CAR ligand during pregnancy could prevent hypertension, insulin resistance, and hyperlipidemia in the offspring from HFD-induced obese pregnant mice (OH mice). We employed four groups of offspring from HFD-fed and control diet-fed pregnant mice with or without treatment with a CAR ligand. Treatment with a CAR ligand during pregnancy improved glucose tolerance and the levels of triglyceride and adipocytokine and restored the changes induced by HFD with amelioration of hypertension in the adult OH mice. This treatment also increased adiponectin mRNA expression, suppressed leptin expression in adipose tissues of OH mice, and abolished the effect of HFD on the epigenetic modifications of the genes encoding adiponectin and leptin in the offspring during immaturity and adulthood. Our data suggest that CAR might be a potential therapeutic target to prevent metabolic syndrome in adulthood of offspring exposed to an HFD in utero.

  15. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women.

    Science.gov (United States)

    Wang, Chen; Wei, Yumei; Zhang, Xiaoming; Zhang, Yue; Xu, Qianqian; Sun, Yiying; Su, Shiping; Zhang, Li; Liu, Chunhong; Feng, Yaru; Shou, Chong; Guelfi, Kym J; Newnham, John P; Yang, Huixia

    2017-04-01

    Obesity and being overweight are becoming epidemic, and indeed, the proportion of such women of reproductive age has increased in recent times. Being overweight or obese prior to pregnancy is a risk factor for gestational diabetes mellitus, and increases the risk of adverse pregnancy outcome for both mothers and their offspring. Furthermore, the combination of gestational diabetes mellitus with obesity/overweight status may increase the risk of adverse pregnancy outcome attributable to either factor alone. Regular exercise has the potential to reduce the risk of developing gestational diabetes mellitus and can be used during pregnancy; however, its efficacy remain controversial. At present, most exercise training interventions are implemented on Caucasian women and in the second trimester, and there is a paucity of studies focusing on overweight/obese pregnant women. We sought to test the efficacy of regular exercise in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight/obese pregnant women. This was a prospective randomized clinical trial in which nonsmoking women age >18 years with a singleton pregnancy who met the criteria for overweight/obese status (body mass index 24≤28 kg/m 2 ) and had an uncomplicated pregnancy at exercise or a control group. Patients did not have contraindications to physical activity. Patients allocated to the exercise group were assigned to exercise 3 times per week (at least 30 min/session with a rating of perceived exertion between 12-14) via a cycling program begun within 3 days of randomization until 37 weeks of gestation. Those in the control group continued their usual daily activities. Both groups received standard prenatal care, albeit without special dietary recommendations. The primary outcome was incidence of gestational diabetes mellitus. From December 2014 through July 2016, 300 singleton women at 10 weeks' gestational age and with a mean prepregnancy body mass index of 26.78 ± 2.75 kg/m 2 were

  16. Safety of skin care products during pregnancy

    OpenAIRE

    Bozzo, Pina; Chua-Gocheco, Angela; Einarson, Adrienne

    2011-01-01

    Question Many of my female patients complain about acne, unwanted hair growth, and other skin problems that have only developed since they became pregnant. Are products used for these types of benign skin conditions safe to use in pregnancy, as it is understandable that women want to look their best at this important time in their lives?

  17. Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis.

    Science.gov (United States)

    Roy, Tapan Kumar; Singh, Brijesh P

    2016-01-01

    Unwanted birth is an important public health concern due to its negative association with adverse outcomes of mothers and children as well as socioeconomic development of a country. Although a number of studies have been investigated the determinants of unwanted births through logistic regression analysis, an extensive assessment using path model is lacking. In the current study, we applied path analysis to know the important covariates for unwanted births in Bangladesh. The study used data extracted from Bangladesh Demographic and Health Survey (BDHS) 2011. It considered sub-sample consisted of 7,972 women who had given most recent births five years preceding the date of interview or who were currently pregnant at survey time. Correlation analysis was used to find out the significant association with unwanted births. This study provided the factors affecting unwanted births in Bangladesh. The path model was used to determine the direct, indirect and total effects of socio-demographic factors on unwanted births. The result exhibited that more than one-tenth of the recent births were unwanted in Bangladesh. The differentials of unwanted births were women's age, education, age at marriage, religion, socioeconomic status, exposure of mass-media and use of family planning. In correlation analysis, it showed that unwanted births were positively correlated with women age and place of residence and these relationships were significant. On the contrary, unwanted births were inversely significantly correlated with education and social status. The total effects of endogenous variables such as women age, place of residence and use of family planning methods had favorable effect on unwanted births. Policymakers and program planners need to design programs and services carefully to reduce unwanted births in Bangladesh, especially, service should focus on helping those groups of women who were identified in the analysis as being at increased risks of unwanted births- older women

  18. Correlates of Unwanted Births in Bangladesh: A Study through Path Analysis.

    Directory of Open Access Journals (Sweden)

    Tapan Kumar Roy

    Full Text Available Unwanted birth is an important public health concern due to its negative association with adverse outcomes of mothers and children as well as socioeconomic development of a country. Although a number of studies have been investigated the determinants of unwanted births through logistic regression analysis, an extensive assessment using path model is lacking. In the current study, we applied path analysis to know the important covariates for unwanted births in Bangladesh.The study used data extracted from Bangladesh Demographic and Health Survey (BDHS 2011. It considered sub-sample consisted of 7,972 women who had given most recent births five years preceding the date of interview or who were currently pregnant at survey time. Correlation analysis was used to find out the significant association with unwanted births. This study provided the factors affecting unwanted births in Bangladesh. The path model was used to determine the direct, indirect and total effects of socio-demographic factors on unwanted births.The result exhibited that more than one-tenth of the recent births were unwanted in Bangladesh. The differentials of unwanted births were women's age, education, age at marriage, religion, socioeconomic status, exposure of mass-media and use of family planning. In correlation analysis, it showed that unwanted births were positively correlated with women age and place of residence and these relationships were significant. On the contrary, unwanted births were inversely significantly correlated with education and social status. The total effects of endogenous variables such as women age, place of residence and use of family planning methods had favorable effect on unwanted births.Policymakers and program planners need to design programs and services carefully to reduce unwanted births in Bangladesh, especially, service should focus on helping those groups of women who were identified in the analysis as being at increased risks of unwanted

  19. The emergency contraceptive drug, levonorgestrel: a review of post-coital oral and peri-coital vaginal administration for prevention of pregnancy.

    Science.gov (United States)

    Sarkar, N N

    2011-11-01

    The objective of our study was the evaluation and elucidation of levonorgestrel (LNG) as emergency contraception (EC) administered through oral and vaginal routes. Data regarding post-coital oral and peri-coital vaginal application of LNG were extracted from the literature through MEDLINE database service for years 2001-2010. It was found that a single dose of 1.5 mg LNG or two doses of 0.75 mg LNG 12 h apart were used for EC. Currently, LNG is also on trial for vaginal application as EC in Carraguard gel for 'dual protection'. The oral or vaginal dose of 1.5 mg LNG resulted in peak plasma concentration, C(max) 19.2 or 3.21 ng/ml, with shorter time, T(max) 1.4 or 6.6 h, and greater AUC, 152.7 or 52.5 ng.h/ml, with shorter half-life, 25 or 32 h, respectively. LNG EC inhibited mid-cycle LH surge and delayed or prevented ovulation when administered before ovulation. Mechanism of action of LNG EC appeared to inhibit or delay ovulation. The risk of pregnancy was 4.12%. A single dose of 1.5 mg LNG could reduce the pregnancy rate to 0.7%. Occurrence of ectopic pregnancy following failure of LNG EC was reported. This EC caused no serious adverse effects but was associated with menstrual disturbance. Although widely acceptable, the cost and short-supply to rural areas pose a barrier to access EC for the poor and rural-dwellers, respectively. It was concluded that unlike post-coital oral administration, peri-coital vaginal application of 1.5 mg LNG needs further study to be an alternative option for women to use it for prevention of pregnancy.

  20. Vesicovaginal Fistula Repair During Pregnancy

    African Journals Online (AJOL)

    Vesicovaginal Fistula Repair During Pregnancy: A Case Report ... Abstract. We report a repair of Vesicovaginal fistula during pregnancy that was aimed at preventing another spontaneous ... practices that encourage teenage marriage and girl.

  1. Sub-optimal delivery of intermittent preventive treatment for malaria in pregnancy in Nigeria: influence of provider factors

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    Onoka Chima A

    2012-09-01

    Full Text Available Abstract Background The level of access to intermittent preventive treatment for malaria in pregnancy (IPTp in Nigeria is still low despite relatively high antenatal care coverage in the study area. This paper presents information on provider factors that affect the delivery of IPTp in Nigeria. Methods Data were collected from heads of maternal health units of 28 public and six private health facilities offering antenatal care (ANC services in two districts in Enugu State, south-east Nigeria. Provider knowledge of guidelines for IPTp was assessed with regard to four components: the drug used for IPTp, time of first dose administration, of second dose administration, and the strategy for sulphadoxine-pyrimethamine (SP administration (directly observed treatment, DOT. Provider practices regarding IPTp and facility-related factors that may explain observations such as availability of SP and water were also examined. Results Only five (14.7% of all 34 providers had correct knowledge of all four recommendations for provision of IPTp. None of them was a private provider. DOT strategy was practiced in only one and six private and public providers respectively. Overall, 22 providers supplied women with SP in the facility and women were allowed to take it at home. The most common reason for doing so amongst public providers was that women were required to come for antenatal care on empty stomachs to enhance the validity of manual fundal height estimation. Two private providers did not think it was necessary to use the DOT strategy because they assumed that women would take their drugs at home. Availability of SP and water in the facility, and concerns about side effects were not considered impediments to delivery of IPTp. Conclusion There was low level of knowledge of the guidelines for implementation of IPTp by all providers, especially those in the private sector. This had negative effects such as non-practice of DOT strategy by most of the providers

  2. Intermittent Preventive Therapy for Malaria During Pregnancy Using 2 vs 3 or More Doses of Sulfadoxine-Pyrimethamine and Risk of Low Birth Weight in Africa

    Science.gov (United States)

    Kayentao, Kassoum; Garner, Paul; van Eijk, Anne Maria; Naidoo, Inbarani; Roper, Cally; Mulokozi, Abdunoor; MacArthur, John R.; Luntamo, Mari; Ashorn, Per; Doumbo, Ogobara K.; ter Kuile, Feiko O.

    2015-01-01

    Importance Intermittent preventive therapy with sulfadoxine-pyrimethamine to control malaria during pregnancy is used in 37 countries in sub-Saharan Africa, and 31 of those countries use the standard 2-dose regimen. However, 2 doses may not provide protection during the last 4 to 10 weeks of pregnancy, a pivotal period for fetal weight gain. Objective To perform a systematic review and meta-analysis of trials to determine whether regimens containing 3 or more doses of sulfadoxine-pyrimethamine for intermittent preventive therapy during pregnancy are associated with a higher birth weight or lower risk of low birth weight (LBW) (<2500 g) than standard 2-dose regimens. Data Sources and Study Selection ISI Web of Knowledge, EMBASE, SCOPUS, PubMed, LILACS, the Malaria in Pregnancy Library, Cochrane CENTRAL, and trial registries from their inception to December 2012, without language restriction. Eligible studies included randomized and quasi-randomized trials of intermittent preventive therapy during pregnancy with sulfadoxine-pyrimethamine monotherapy. Data Extraction Data were independently abstracted by 2 investigators. Relative risk (RR), mean differences, and 95% CIs were calculated with random-effects models. Results Of 241 screened studies, 7 trials of 6281 pregnancies were included. The median birth weight in the 2-dose group was 2870 g (range, 2722–3239 g) and on average 56 g higher (95% CI, 29–83 g; I2=0%) in the ≥3-dose group. Three or more doses were associated with fewer LBW births (RR,0.80; 95% CI, 0.69–0.94; I2=0%), with a median LBW risk per 1000 women in the 2-dose group (assumed control group risk) of 167 per 1000 vs 134 per 1000 in the ≥3-dose group (absolute risk reduction, 33 per 1000 [95% CI, 10–52]; number needed to treat=31). The association was consistent across a wide range of sulfadoxine-pyrimethamine resistance (0% to 96% dihydropteroate-synthase K540E mutations). There was no evidence of small-study bias. The ≥3-dose group had

  3. Trying to prevent abortion.

    Science.gov (United States)

    Bromham, D R; Oloto, E J

    1997-06-01

    It is known that, since antiquity, women confronted with an unwanted pregnancy have used abortion as a means of resolving their dilemma. Although undoubtedly widely used in all historical ages, abortion has come to be regarded as an event preferably avoided because of the impact on the women concerned as well as considerations for fetal life. Policies to reduce numbers and rates of abortion must acknowledge certain observations. Criminalization does not prevent abortion but increases maternal risks. A society's 'openness' in discussing sexual matters inversely correlates with abortion rates. Correlation between contraceptive use and abortion is also inverse but relates most closely to the efficacy of contraceptive methods used. 'Revolution' in the range of contraceptive methods used will have an equivalent impact on abortion rates. Secondary or emergency contraceptive methods have a considerable role to play in the reduction of abortion numbers. Good sex (and 'relationships') education programs may delay sexual debut, increase contraceptive usage and be associated with reduced abortion. Finally, interaction between socioeconomic factors and the choice between abortion and ongoing pregnancy are complex. Abortion is not necessarily chosen by those least able to support a child financially.

  4. 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.

  5. Condom Availability in Schools: A Practical Approach to the Prevention of Sexually Transmitted Infection/HIV and Unintended Pregnancy.

    Science.gov (United States)

    2017-06-01

    Adolescents and young adults are highly impacted by sexually transmitted infections (STIs) and unplanned pregnancy in the United States and globally. Consistent and correct use of male latex condoms is associated with protection against both STIs and pregnancy. Providing adolescents and young adults with access to free condoms in schools may increase the use of condoms by improving condom availability, eliminating cost, and decreasing embarrassment associated with purchasing condoms. Studies demonstrate that condom availability in schools is associated with the increased use of condoms and improved overall sexual health. The Society for Adolescent Health and Medicine encourages schools to make condoms available to students as part of efforts to decrease rates of STIs and unplanned pregnancy in adolescents and young adults. The Society for Adolescent Health and Medicine also encourages health care providers to advocate for and support the availability of condoms in local schools. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Who's that girl? A qualitative analysis of adolescent girls' views on factors associated with teenage pregnancies in Bolgatanga, Ghana.

    Science.gov (United States)

    Krugu, J K; Mevissen, F E F; Prinsen, A; Ruiter, R A C

    2016-04-14

    Adolescent pregnancy remains a public health concern, with diverse serious consequences, including increased health risk for mother and child, lost opportunities for personal development, social exclusion, and low socioeconomic attainments. Especially in Africa, teenage pregnancy rates are high. It is important to find out how girls without pregnancy experience differ in their contraceptive decision-making processes as compared with their previously studied peers with pregnancy experience to address the high rate of teenage pregnancies. We conducted semi-structured in-depth interviews with never been pregnant girls (N = 20) in Bolgatanga, Ghana, to explore the psychosocial and environmental factors influencing the sexual decision making of adolescents. Themes such as relationships, sex, pregnancy, family planning and psychosocial determinants (knowledge, attitudes, self-efficacy, norms, risk perceptions) derived from empirical studies and theories related to sexuality behavior guided the development of the interview protocol. Results showed that the girls did talk about sexuality with their mothers at home and did receive some form of sexual and reproductive health education, including the use of condoms discussions in school. Participants reported high awareness of pregnancy risk related to unprotected sex, were positive about using condoms and indicated strong self-efficacy beliefs towards negotiating condom use. The girls also formulated clear future goals, including coping plans such as ways to prevent unwanted pregnancies to reach these targets. On the other hand, their attitudes towards family planning (i.e., contraceptives other than condoms) were negative, and they hold boys responsible for buying condoms. An open parental communication on sexuality issues at home, comprehensive sex education in school and attitude, self-efficacy, risk perception towards contraception, alongside with goal-setting, seem to be protective factors in adolescent girls

  7. THE RELATIONSHIP BETWEEN SOCIAL, POLICY AND PHYSICAL VENUE FEATURES AND SOCIAL COHESION ON CONDOM USE FOR PREGNANCY PREVENTION AMONG SEX WORKERS: A SAFER INDOOR WORK ENVIRONMENT SCALE

    Science.gov (United States)

    Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate

    2015-01-01

    Background This study aims to: report on a newly developed ‘Safer Indoor Work Environmental Scale’ that characterizes the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers’ (SWs’) condom use for pregnancy prevention. Methods Drawing on a prospective open cohort of female SWs working in indoor venues, a newly-developed ‘Safer Indoor Work Environment Scale’ was used to build six multivariable models with generalized estimating equations (GEE), to determine the independent effects of social, policy and venue-based features and social cohesion on condom use. Results Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (Adjusted Odds Ratio (AOR)=1.09; 95% Confidence Interval (95%CI) 1.01–1.17) access to sexual and reproductive health services/supplies (AOR=1.10; 95%CI 1.00–1.20) access to drug harm reduction (AOR=1.13; 95%CI 1.01–1.28), and social cohesion among workers (AOR=1.05; 95%CI 1.03–1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95%CI 0.99–1.29). Conclusion The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalization of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (e.g., legal and regulatory frameworks; labour standards) to support safer sex workplaces. PMID:25678713

  8. The relationship between social, policy and physical venue features and social cohesion on condom use for pregnancy prevention among sex workers: a safer indoor work environment scale.

    Science.gov (United States)

    Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate

    2015-07-01

    This study aims to report on a newly developed Safer Indoor Work Environmental Scale that characterises the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers' (SWs') condom use for pregnancy prevention. Drawing on a prospective open cohort of female SWs working in indoor venues, a newly developed Safer Indoor Work Environment Scale was used to build six multivariable models with generalised estimating equations (GEE), to determine the independent effects of social, policy and physical venue-based features and social cohesion on condom use. Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (adjusted OR (AOR)=1.09; 95% CI 1.01 to 1.17), access to sexual and reproductive health services/supplies (AOR=1.10; 95% CI 1.00 to 1.20), access to drug harm reduction (AOR=1.13; 95% CI 1.01 to 1.28) and social cohesion among workers (AOR=1.05; 95% CI 1.03 to 1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95% CI 0.99 to 1.29). The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalisation of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (eg, legal and regulatory frameworks; labour standards) to support safer sex workplaces. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Factors Affecting Unplanned Pregnancy in Semnan Province, Iran

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    Hajieh Razeghi

    2018-04-01

    Full Text Available Background & aim: Despite the success of family planning programs in Iran in the recent decades, considerable proportions of pregnancies are still unintended and can be a cause of poor mental and physical health of the mother and child. The aim of this study was to investigate some important factors affecting uplanned pregnancies among married women in Semnan province, one of the developed provinces of Iran with below replacement fertility level. Methods: The data for this study were drawn from a cross-sectional survey conducted in Semnan province in 2014. A total of 363 married women within the age range of 15-49 years who were pregnant or had the history of at least one delivery were considered. The study sample was selected using multi-stage stratified sampling method. The data were collected using a self-structured questionnaire with 90 items and Cronbach's alpha coefficient of 0.88. Data analysis was performed in SPSS (version 20 using Crammer’s V coefficients and Chi-square tests. Logistic regression analysis was also applied to model the risk of unintended pregnancies based on selected covariates. Results: According to the results, around 18.2% of the pregnancies were unplanned, 7.7% and 10.5% of which were mistimed and unwanted, respectively. Based on the logistic regression analysis, birth cohort, number of children ever born, and contraceptive methods had significant effects on the risk of unintended pregnancies. Furthermore, about 48% of the women experiencing unintended pregnancy were using a traditional contraceptive method before or at the time of the conception.   Conclusion: As the findings indicated, the women who used contraceptive method, as well as those with higher number of children and younger birth cohorts had higher risk of unplanned pregnancies. It should be noted that the majority of unplanned pregnancies among the women in younger birth cohort were mistimed pregnancies. So it is recommended to continue offering

  10. Estimating HIV Incidence during Pregnancy and Knowledge of Prevention of Mother-to-Child Transmission with an Ad Hoc Analysis of Potential Cofactors

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    Thomas Obinchemti Egbe

    2016-01-01

    Full Text Available Background. We determined the incidence of HIV seroconversion during the second and third trimesters of pregnancy and ad hoc potential cofactors associated with HIV seroconversion after having an HIV-negative result antenatally. We also studied knowledge of PMTCT among pregnant women in seven health facilities in Fako Division, South West Region, Cameroon. Method. During the period between September 12 and December 4, 2011, we recruited a cohort of 477 HIV-negative pregnant women by cluster sampling. Data collection was with a pretested interviewer-administered questionnaire. Sociodemographic information, knowledge of PMTCT, and methods of HIV prevention were obtained from the study population and we did Voluntary Counselling and Testing (VCT for HIV. Results. The incidence rate of HIV seroconversion during pregnancy was 6.8/100 woman-years. Ninety percent of the participants did not use condoms throughout pregnancy but had a good knowledge of PMTCT of HIV. Only 31.9% of participants knew their HIV status before the booking visit and 33% did not know the HIV status of their partners. Conclusion. The incidence rate of HIV seroconversion in the Fako Division, Cameroon, was 6.8/100 woman-years. No risk factors associated with HIV seroconversion were identified among the study participants because of lack of power to do so.

  11. Estimating HIV Incidence during Pregnancy and Knowledge of Prevention of Mother-to-Child Transmission with an Ad Hoc Analysis of Potential Cofactors.

    Science.gov (United States)

    Egbe, Thomas Obinchemti; Tazinya, Rose-Mary Asong; Halle-Ekane, Gregory Edie; Egbe, Eta-Nkongho; Achidi, Eric Akum

    2016-01-01

    We determined the incidence of HIV seroconversion during the second and third trimesters of pregnancy and ad hoc potential cofactors associated with HIV seroconversion after having an HIV-negative result antenatally. We also studied knowledge of PMTCT among pregnant women in seven health facilities in Fako Division, South West Region, Cameroon. During the period between September 12 and December 4, 2011, we recruited a cohort of 477 HIV-negative pregnant women by cluster sampling. Data collection was with a pretested interviewer-administered questionnaire. Sociodemographic information, knowledge of PMTCT, and methods of HIV prevention were obtained from the study population and we did Voluntary Counselling and Testing (VCT) for HIV. The incidence rate of HIV seroconversion during pregnancy was 6.8/100 woman-years. Ninety percent of the participants did not use condoms throughout pregnancy but had a good knowledge of PMTCT of HIV. Only 31.9% of participants knew their HIV status before the booking visit and 33% did not know the HIV status of their partners. The incidence rate of HIV seroconversion in the Fako Division, Cameroon, was 6.8/100 woman-years. No risk factors associated with HIV seroconversion were identified among the study participants because of lack of power to do so.

  12. Prevention of Mother-to-Child Transmission of HIV in Option B+ Era: Uptake and Adherence During Pregnancy in Western Uganda.

    Science.gov (United States)

    Schnack, Alexandra; Rempis, Eva; Decker, Sarah; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie

    2016-03-01

    Since 2012, lifelong antiretroviral therapy for all HIV-positive pregnant women ("Option B+") is recommended by WHO for the prevention of mother-to-child transmission of HIV (PMTCT). Many sub-Saharan African countries have since introduced this regimen, but to date, longer-term outcome evaluations are scarce. We conducted an observational study in Fort Portal Municipality, Uganda, to describe uptake and adherence of Option B+ during pregnancy. HIV-positive women approaching antenatal care (ANC) services in two hospitals were enrolled and followed-up at monthly routine ANC visits until delivery. At each visit, next to sociodemographic and clinical data, we assessed drug adherence through pill counts. In total, 124 HIV-positive pregnant women were enrolled in our study; from these, 80.8% had not been aware of their positive serostatus before. Forty-five PMTCT clients (36.3%) never returned to ANC after their first visit. Protective factors (p HIV status knowledge, status disclosure before or at first ANC visit, and tertiary education. Among those clients starting Option B+, the median adherence during pregnancy was 95.7% pill intake. Rather low adherence (pregnancy. Healthcare providers should place high emphasis on individual PMTCT counseling at first ANC encounter, and pay special attention to those women previously unaware of their HIV status. However, after initial uptake, high adherence seems to be feasible for Option B+.

  13. Pregnant adolescent self-care in the prevention of risk factors of Hypertensive Disorders in Pregnancy (HDP - doi:10.5020/18061230.2007.p173

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    Zélia Maria de Sousa Araújo Santos

    2012-01-01

    Full Text Available Adolescent pregnancy is considered a problem for public health, due to the high mortality related to hypertensive disorders in pregnancy – HDP. This was a descriptive study with the aim of analyzing the pregnant adolescent self-care in the prevention of HDP risk factors. It was carried out in the Nucleus of Integrated Medical Attention – NAMI, in Fortaleza – Ceará, with twenty women from the Dendê Community, taken care of in the prenatal ambulatory of that institution, during the months of September and October, 2005. The data were collected by means of interview. The pregnant adolescents informed precarious socio-economic conditions, low schooling and other risk factors for HDP, beyond the age: black color, familiar history, arterial hypertension (AH, diabetes mellitus, renal illness and emotional conflicts. The knowledge on the prevention of risk factors was restricted to five (25% pregnant adolescents; however it was reduced to fragmented information, and the preventive behaviors related to feeding habit, smoke and alcoholism cessation, and physical exercise. Therefore, it was evidenced among the adolescents the unsatisfactory exercise of self-care activities, aiming at preventing HDP risk factors; that beyond the age, they presented other predisposing factors to this disorders; that they were susceptible to preventive behaviors and/or control, as in the case of chronic-degenerative illnesses – AH and diabetes mellitus. Probably, this behavior was associated to the elementary and fragmented knowledge, and the absence or the deficiency of family participation in health promotion actions, mainly in those inherent to the prenatal follow-up.

  14. All4You! A Randomized Trial of an HIV, Other STDs, and Pregnancy Prevention Intervention for Alternative School Students

    Science.gov (United States)

    Coyle, Karin K.; Kirby, Douglas B.; Robin, Leah E.; Banspach, Stephen W.; Baumler, Elizabeth; Glassman, Jill R.

    2006-01-01

    This study evaluated All4You!, a theoretically based curriculum designed to reduce sexual risk behaviors associated with HIV, other STDs, and unintended pregnancy among students in alternative schools. The study featured a randomized controlled trial involving 24 community day schools in northern California. A cohort of 988 students was assessed…

  15. Effects of a Teen Pregnancy Prevention Program on Teens' Attitudes toward Sexuality: A Latent Trait Modeling Approach

    Science.gov (United States)

    Thomas, Charles L.; Dimitrov, Dimiter M.

    2007-01-01

    The purpose of this study was to examine the effects of program interventions in a school-based teen pregnancy program on hypothesized constructs underlying teens' attitudes toward sexuality. An important task related to this purpose was the validation of the constructs and their stability from pre- to postintervention measures. Data from 1,136…

  16. Timing of intermittent preventive treatment for malaria during pregnancy and the implications of current policy on early uptake in north-east Tanzania

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    Chambo Pili

    2008-05-01

    Full Text Available Abstract Background Intermittent preventive treatment (IPTp is efficacious in reducing the adverse outcomes associated with pregnancy-associated malaria, however uptake of the recommended two doses is low in Tanzania, and little is known of the timepoint during pregnancy at which it is delivered. This study investigated the timing of delivery of IPTp to pregnant women attending antenatal clinics (ANC, and the potential determinants of timely uptake. Methods Structured interviews were conducted with staff and pregnant women at antenatal clinics in northeast Tanzania, and antenatal consultations were observed. Facility-based and individual factors were analysed for any correlation with timing of IPTp uptake. Results Almost half the women interviewed first attended ANC during or before the fourth month of gestation, however 86% of these early attendees did not receive IPTp on their first visit. The timing of IPTp delivery complied closely with the national guidelines which stipulate giving the first dose at 20–24 weeks gestation. Uptake of at least one dose of IPTp among women who had reached this gestation age was 67%, although this varied considerably between clinics. At one facility, IPTp was not delivered because SP was out of stock. Conclusion Early uptake of IPTp was found to be hampered by factors external to health worker performance or women's individual preferences. These include insufficient drug stocks and an apparent lack of information to health workers on the reasoning for continued use of SP for IPTp when it has been replaced as a first-line treatment. In addition, an unexpectedly high proportion of women attend antenatal clinics before 20 weeks of pregnancy. While current policy denies the use of IPTp at this time, there is emerging, but incomplete, evidence that malaria in early pregnancy may contribute considerably to the burden of pregnancy-related malaria. Current policy may thus result in a missed opportunity for maximising

  17. A Pilot Randomized Controlled Trial of a Technology-Based Approach for Preventing Excess Weight Gain during Pregnancy among Women with Overweight

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    Ariana M. Chao

    2017-11-01

    Full Text Available ObjectiveOverweight/obesity and excess weight gain during pregnancy are associated with adverse maternal and neonatal outcomes. Few interventions have been effective in limiting gestational weight gain among women with overweight or obesity. This pilot, randomized clinical trial compared treatment as usual (TAU to a lifestyle modification program delivered via phone for the prevention of excess gestational weight gain in women who had overweight or obesity.MethodsParticipants included 41 pregnant women with a body mass index (BMI ≥ 25 kg/m2 (mean age = 28.7 ± 5.8 years; mean pre-gravid BMI = 31.2 ± 6.2 kg/m2; 54% black, 39% white. The intervention group (n = 20 received weekly telephone counseling sessions and used WiFi scales to monitor their weight from weeks 16 to 36 of pregnancy. We compared differences in weight and birth outcomes for the intervention vs. the TAU group (n = 21.ResultsThe intervention and TAU groups did not differ with respect to: gestational weight gain (15.5 ± 5.3 vs. 13.3 ± 6.8 kg, respectively; proportion gaining above the 2009 Institute of Medicine recommended weight range (83 vs. 70%; and weight gain from pre-pregnancy weight to 6 weeks postpartum (4.8 ± 4.6 vs. 3.0 ± 5.5 kg. Other birth and health outcomes also did not differ.ConclusionA telemedicine intervention designed to decrease logistical burden on participants was not more successful in reducing excessive weight gain during pregnancy as compared to TAU. Future studies should examine more intensive forms of remote treatment beginning earlier in pregnancy as well as interventions promoting a healthy weight prior to pregnancy.

  18. Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey.

    Science.gov (United States)

    Rowe, Heather; Holton, Sara; Kirkman, Maggie; Bayly, Christine; Jordan, Lynne; McNamee, Kathleen; McBain, John; Sinnott, Vikki; Fisher, Jane

    2016-04-01

    Mistimed, unexpected or unwanted pregnancies occur in Australia, despite widespread contraception use. The objective was to estimate prevalence and ascertain modifiable social factors for prevention of unintended pregnancy. National population-based survey of women and men aged 18-51 years recruited from a random sample of electors on the Australian Electoral Roll in 2013. Data were weighted to reduce non-response bias. Factors associated with unintended pregnancy were identified in multivariable analyses. Data from 2,235 completed questionnaires were analysed (Women: 69%; Men: 31%). Of those ever pregnant or partner in pregnancy (59%), 40% had experienced an unintended pregnancy. Adjusting for other risks, ever having experienced sexual coercion (AOR, 95%CI=Women 1.948; 1.458-2.601; Men 1.657, 1.014-2.708); socioeconomic disadvantage (AOR, 95%CI=Women 1.808, 1.373, 2.381; Men 1.360, 1.004-1.841), living in a rural area (AOR, 95%CI=Women 1.403, 1.056-1.864; Men 1.583, 1.161-2.159), and for men being born overseas (AOR, 95%CI 1.989, 1.317-3.002) were significantly associated with unintended pregnancy. Experiences of sexual coercion, social disadvantage, rural residence and overseas birth are independently associated with unintended pregnancy in Australia. Public health policy and health service initiatives should prioritise prevention of sexual coercion, reduction of social inequality and reduction of geographic inequality for those in rural areas. © 2015 Public Health Association of Australia.

  19. Ultrasound pregnancy

    Science.gov (United States)

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; ...

  20. Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

    Directory of Open Access Journals (Sweden)

    Al Atabbi Hind

    2011-08-01

    Full Text Available Abstract Background There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among women of child bearing age. Methods 1105 women of child bearing age were interviewed in their households using a structured questionnaire about their knowledge of malaria in general, MIP and use of preventive measures. Thereafter, a peer education campaign was launched to raise the level of knowledge in the community. The interviews were repeated after the campaign and the responses between the pre- and post-intervention were compared. Results In the pre-assessment women on average answered 64.8% of the question on malaria and its possibility to prevent malaria correctly. The peer education campaign had a significant impact in raising the level of knowledge among the women; after the campaign the respondents answered on average 73.8% of the questions correctly. Stratified analysis on pre and post assessment scores for malaria in general (68.8 & 72.9% and MIP (61.7 & 76.3% showed also significant increase. Uptake of bed nets was reported to be low: 11.6% Conclusion Peer education led to a significant increase in knowledge of malaria and its prevention but we could not asses its influence on the use of preventive measures.

  1. Examination of the Relationship between Psychosocial Mediators and Intervention Effects in It’s Your Game: An Effective HIV/STI/Pregnancy Prevention Intervention for Middle School Students

    Directory of Open Access Journals (Sweden)

    Elizabeth Baumler

    2012-01-01

    Full Text Available A set of mediation analyses were carried out in this study using data from It’s Your Game. . .Keep It Real (IYG, a successful HIV/STI/pregnancy prevention program. The IYG study evaluated a skill and normbased. HIV/STI/pregnancy prevention program that was implemented from 2004 to 2007 among 907 urban low-income middle school youth in Houston, TX, USA. Analyses were carried out to investigate the degree to which a set of proposed psychosocial measures of behavioral knowledge, perceived self-efficacy, behavioral, and normative beliefs, and perceived risky situations, all targeted by the intervention, mediated the intervention’s effectiveness in reducing initiation of sex. The mediation process was assessed by examining the significance and size of the estimated effects from the mediating pathways. The findings from this study provide evidence that the majority of the psychosocial mediators targeted by the IYG intervention are indeed related to the desired behavior and provide evidence that the conceptual theory underlying the targeted psychosocial mediators in the intervention is appropriate. Two of the psychosocial mediators significantly mediated the intervention effect, knowledge of STI signs and symptoms and refusal self-efficacy. This study suggests that the underlying causal mechanisms of action of these interventions are complex and warrant further analyses.

  2. Anti-bacterial activity of intermittent preventive treatment of malaria in pregnancy: comparative in vitro study of sulphadoxine-pyrimethamine, mefloquine, and azithromycin

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    Mombo-Ngoma Ghyslain

    2010-10-01

    Full Text Available Abstract Background Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (SP is recommended for the prevention of malaria in pregnancy in sub-Saharan Africa. Increasing drug resistance necessitates the urgent evaluation of alternative drugs. Currently, the most promising candidates in clinical development are mefloquine and azithromycin. Besides the anti-malarial activity, SP is also a potent antibiotic and incurs significant anti-microbial activity when given as IPTp - though systematic clinical evaluation of this action is still lacking. Methods In this study, the intrinsic anti-bacterial activity of mefloquine and azithromycin was assessed in comparison to sulphadoxine-pyrimethamine against bacterial pathogens with clinical importance in pregnancy in a standard microdilution assay. Results SP was highly active against Staphylococcus aureus and Streptococcus pneumoniae. All tested Gram-positive bacteria, except Enterococcus faecalis, were sensitive to azithromycin. Additionally, azithromycin was active against Neisseria gonorrhoeae. Mefloquine showed good activity against pneumococci but lower in vitro action against all other tested pathogens. Conclusion These data indicate important differences in the spectrum of anti-bacterial activity for the evaluated anti-malarial drugs. Given the large scale use of IPTp in Africa, the need for prospective clinical trials evaluating the impact of antibiotic activity of anti-malarials on maternal and foetal health and on the risk of promoting specific drug resistance of bacterial pathogens is discussed.

  3. Pregnancy Loss and Miscarriage

    Science.gov (United States)

    ... Bulletins-Gynecology/Early-Pregnancy-Loss What are common symptoms? Causes and Risks How is it diagnosed? Is there a way to prevent? Related A-Z Topics High-Risk Pregnancy Polycystic Ovary Syndrome (PCOS) Stillbirth NICHD News Spotlights Release: Anti-HIV ...

  4. Pregnancy Complications: Placental Abruption

    Science.gov (United States)

    ... at risk? Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ... high blood pressure, not smoking or using street drugs, and always wearing a seatbelt when riding in a car. ... complications Preterm labor & premature birth The newborn intensive ...

  5. Conduct Disorder Symptoms and Subsequent Pregnancy, Child-Birth and Abortion: A Population-Based Longitudinal Study of Adolescents

    Science.gov (United States)

    Pedersen, Willy; Mastekaasa, Arne

    2011-01-01

    Research on teenage pregnancy and abortion has primarily focused on socio-economic disadvantage. However, a few studies suggest that risk of unwanted pregnancy is related to conduct disorder symptoms. We examined the relationship between level of conduct disorder symptoms at age 15 and subsequent pregnancy, child-birth and abortion. A…

  6. Urinary tract infection as a preventable cause of pregnancy complications: opportunities, challenges, and a global call to action.

    Science.gov (United States)

    Gilbert, Nicole M; O'Brien, Valerie P; Hultgren, Scott; Macones, George; Lewis, Warren G; Lewis, Amanda L

    2013-09-01

    The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in more developed countries. A global analysis of the etiologies of UTI revealed familiar culprits as well as emerging threats. Screening and treatment of UTI have improved birth outcomes in several more developed countries and would likely improve maternal and neonatal health worldwide. However, challenges of implementation in resource-poor settings must be overcome. We review the nature of the barriers occurring at each step of the screening and treatment pipeline and highlight steps necessary to overcome these obstacles. It is our hope that the information compiled here will increase awareness of the global significance of UTI in maternal and neonatal health and embolden governments, nongovernmental organizations, and researchers to do their part to make urine screening and UTI treatment a reality for all pregnant women.

  7. Prevention and management of genital herpes simplex infection during pregnancy and delivery: Guidelines from the French College of Gynaecologists and Obstetricians (CNGOF).

    Science.gov (United States)

    Sénat, Marie-Victoire; Anselem, Olivia; Picone, Olivier; Renesme, Laurent; Sananès, Nicolas; Vauloup-Fellous, Christelle; Sellier, Yann; Laplace, Jean-Pierre; Sentilhes, Loïc

    2018-05-01

    Identify measures to diagnose, prevent, and treat genital herpes infection during pregnancy and childbirth as well as neonatal herpes infection. Bibliographic search from the Medline and Cochrane Library databases and review of international clinical practice guidelines. Genital herpes lesions are most often due to HSV-2 (LE2). The risk of HSV seroconversion during pregnancy is 1-5% (LE2). Genital herpes lesions during pregnancy in a woman with a history of genital herpes is a recurrence. In this situation, there is no need for virologic confirmation (Grade B). In pregnant women with genital lesions who report they have not previously had genital herpes, virological confirmation by PCR and identifying the specific IgG type is necessary (professional consensus). A first episode of genital herpes during pregnancy should be treated with aciclovir (200 mg 5 times daily) or valaciclovir (1000 mg twice daily) for 5-10 days (Grade C), and recurrent herpes during pregnancy with aciclovir (200 mg 5 times daily) or valaciclovir (500 mg twice daily) (Grade C). The risk of neonatal herpes is estimated at between 25% and 44% if a non primary and primary first genital herpes episode is ongoing at delivery (LE2) and 1% for a recurrence (LE3). Antiviral prophylaxis should be offered to women with either a first or recurrent episode of genital herpes during pregnancy from 36 weeks of gestation until delivery (Grade B). Routine prophylaxis is not recommended for women with a history of genital herpes but no recurrence during pregnancy (professional consensus). A cesarean delivery is recommended if a first episode of genital herpes is suspected (or confirmed) at the onset of labor (Grade B) or if it occured less than 6 weeks before delivery (professional consensus) or in the event of premature rupture of the membranes at term. When a recurrence of genital herpes is underway at the onset of labor, cesarean delivery is most likely to be considered when the membranes are

  8. Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine during pregnancy in Burkina Faso: effect of adding a third dose to the standard two-dose regimen on low birth weight, anaemia and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Roberfroid Dominique

    2010-11-01

    Full Text Available Abstract Background Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP is being implemented in most malaria endemic countries as a standard two-doses regimen as it reduces the risk of low birth weight (LBW and the prevalence of maternal anaemia. Nevertheless, where the risk of infection close to delivery is high because of intense transmission, a third IPTp-SP dose may further reduce the negative effects of malaria on pregnancy outcome. Methods Pregnant women in the 2nd or 3rd trimester were randomized to receive either 2 (SP2 or 3 doses (SP3 of SP. Trained field workers paid home visits to the women for drug administration according to a predefined drug delivery schedule. Women were encouraged to attend their scheduled ANC visits and to deliver at the health facilities where the new-born was weighed. The prevalence of LBW ( Results Data from 1274 singleton pregnancies were analysed (641 in the SP3 and 633 in the SP2 group. The uptake of the intervention appeared to be low. Though the prevalence of LBW in both intervention groups was similar (adjusted Incident Rate Ratio, AIRR = 0.92, 95%CI: 0.69-1.24 in the ITT analysis, the risk of severe anaemia was significantly lower in the SP3 group compared to the SP2 group (AIRR = 0.38, 95%CI: 0.16 - 0.90. The PP analysis showed a trend of reduced risk of LBW, severe anaemia and premature delivery in the SP3 group, albeit the difference between two and three IPTp-SP did not reach statistical significance. Conclusion The risk of LBW and severe anaemia tended to be lower in the SP3 group, though this was not statistically significant, probably due to the low uptake of the intervention which reduced the power of the study. Further studies are needed for establishing whether a third SP dose has a real benefit in preventing the negative effects of malaria in pregnancy in settings where transmission is markedly seasonal.

  9. Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine during pregnancy in Burkina Faso: effect of adding a third dose to the standard two-dose regimen on low birth weight, anaemia and pregnancy outcomes.

    Science.gov (United States)

    Valea, Innocent; Tinto, Halidou; Drabo, Maxime K; Huybregts, Lieven; Henry, Marie-Claire; Roberfroid, Dominique; Guiguemde, Robert T; Kolsteren, Patrick; D'Alessandro, Umberto

    2010-11-12

    Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) is being implemented in most malaria endemic countries as a standard two-doses regimen as it reduces the risk of low birth weight (LBW) and the prevalence of maternal anaemia. Nevertheless, where the risk of infection close to delivery is high because of intense transmission, a third IPTp-SP dose may further reduce the negative effects of malaria on pregnancy outcome. Pregnant women in the 2nd or 3rd trimester were randomized to receive either 2 (SP2) or 3 doses (SP3) of SP. Trained field workers paid home visits to the women for drug administration according to a predefined drug delivery schedule. Women were encouraged to attend their scheduled ANC visits and to deliver at the health facilities where the new-born was weighed. The prevalence of LBW (anaemia (Hb pregnancies were analysed (641 in the SP3 and 633 in the SP2 group). The uptake of the intervention appeared to be low. Though the prevalence of LBW in both intervention groups was similar (adjusted Incident Rate Ratio, AIRR = 0.92, 95%CI: 0.69-1.24) in the ITT analysis, the risk of severe anaemia was significantly lower in the SP3 group compared to the SP2 group (AIRR = 0.38, 95%CI: 0.16 - 0.90). The PP analysis showed a trend of reduced risk of LBW, severe anaemia and premature delivery in the SP3 group, albeit the difference between two and three IPTp-SP did not reach statistical significance. The risk of LBW and severe anaemia tended to be lower in the SP3 group, though this was not statistically significant, probably due to the low uptake of the intervention which reduced the power of the study. Further studies are needed for establishing whether a third SP dose has a real benefit in preventing the negative effects of malaria in pregnancy in settings where transmission is markedly seasonal.

  10. Cancer during Pregnancy

    Science.gov (United States)

    ... Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog About Us You are here Home > Navigating Cancer Care > Dating, Sex, and Reproduction > Cancer During Pregnancy Request Permissions Cancer ...

  11. Nutrition during Pregnancy

    Science.gov (United States)

    ... meals during pregnancy? The United States Department of Agriculture has made it easier to plan meals during ... of folic acid daily to help prevent major birth defects of the fetal brain and spine called ...

  12. Intervención psicoeducativa tutorial en la prevención del embarazo precoz / Tutorial psycho-educative intervention for preventing pregnancy in teenagers

    Directory of Open Access Journals (Sweden)

    Ubillús, S. P

    2016-01-01

    integral system of prevention of adolescent’s pregnancy contributing to the reduction of early pregnancy. It emphasizes the tutorial character on the basis of human rights, gender equality and education of values. The general layout constitutes a framework for sexual education of adolescents by means of tutors and suited to students’ needs contributing to early pregnancy prevention.

  13. PREGNANCY LOSS IN MARES

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    Tibary A

    2015-12-01

    Full Text Available Pregnancy loss is an important aspect of equine practice due to the economic and emotional loss that it engenders. Pregnancy loss is often divided in two categories: early pregnancy loss (EPL or embryonic death (ED (first 42 days and fetal losses (after 42 days. Diagnosis of the causes of pregnancy loss is often very challenging. Many of the causes of EPL remain poorly documented but studies on embryo development and embryo-uterine interaction have been able to shed some light on predisposing factors. Fetal losses or abortions are dominated by infectious causes and particularly bacterial placentitis. Detailed reviews of pregnancy loss were recently published by the authors (Tibary et al., 2012; Tibary and Pearson, 2012; Tibary et al., 2014. The objective of this paper is to provide an overview of the epidemiology, etiology, diagnosis and prevention of pregnancy loss in the mare.

  14. Barriers and Facilitators for the Use of a Medical Mobile App to Prevent Work-Related Risks in Pregnancy: A Qualitative Analysis.

    Science.gov (United States)

    Velu, Adeline V; van Beukering, Monique Dm; Schaafsma, Frederieke G; Frings-Dresen, Monique Hw; Mol, Ben Wj; van der Post, Joris Am; Kok, Marjolein

    2017-08-22

    The number of women participating in the labor market in Europe has increased over the last several decades. At the same time, there is growing evidence that certain conditions of employment during pregnancy may have a negative influence on pregnancy outcomes. In order to better inform pregnant women, we aim to develop an app to help assess the health risk as a result of personal and work-related factors and provide personal advice for these women and their health care providers. The aim of this study was to compose a thematic overview of the perceived facilitators and barriers according to pregnant women, medical professionals, and employers for the use of a mobile app in obstetrical care to prevent occupational-related pregnancy complications. Two multidisciplinary focus group meetings with in total 14 participants were conducted with pregnant women, occupational physicians, general practitioners, midwives, obstetricians, and representatives of trade unions and employer organizations. Transcripts were analyzed by qualitatively coding procedures and constant comparative methods. We identified 24 potential facilitators and 12 potential barriers for the use of the app in 4 categories: content of the app, the app as a mean to provide information, ease of use, and external factors. The 3 main facilitators identified were the need for a good interaction between the app and the user, apps were viewed as a more practical source of information, and the information should be understandable, according to the existing guidelines, and well-dosed. The 2 main barriers for use were extensive battery and memory use of the smartphone and sending frequent push notifications. The results of this study are important considerations in the developing process of a medical app implementing a guideline or evidence-based information in practice. ©Adeline V Velu, Monique DM van Beukering, Frederieke G Schaafsma, Monique HW Frings-Dresen, Ben WJ Mol, Joris AM van der Post, Marjolein Kok

  15. The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight and obese women: A quasi-experimental study.

    Science.gov (United States)

    Sun, Yu; Zhao, Hong

    2016-05-01

    Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with substantially elevated risk of adverse health outcomes for both mothers and offspring. This quasi-experimental trial was conducted to assess whether a lifestyle intervention in early pregnancy can reduce the incidence of GDM and excessive gestational weight (GWG) gain among Chinese overweight women. Convenience samples of 74 women in gestational weeks 8-12 with a BMI ≥ 24 kg/m(2) were enrolled. They were divided into intervention (N=37) or control group (N=37) according to the time sequence of seeing the doctor. The intervention group was provided with exercise, dietary, weight gain counseling and detailed plans at weeks 8-12 and every month in the second trimester. In addition, each counseling session included a personalized feedback based on their 5-day-records. Follow-up phone calls or emails were conducted every week between antenatal visits. The control group was just provided with exercise, dietary and weight gain counseling at weeks 8-12, besides the usual health education provided at the O&G outpatient department. The lifestyle intervention resulted in a lower incidence of gestational diabetes in the intervention group (9/32, 28.1%) compared with the control group (19/34, 55.9%), p=0.023. Women in the intervention group gained much less weight (6.86 ± 2.31 versus 10.08 ± 3.84 kg, p=0.000) at the end of second trimester. Lifestyle intervention in early pregnancy can reduce the incidence of GDM and prevent excessive maternal weight gain in overweight and obese pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011: A secondary analysis of PRAMS data.

    Science.gov (United States)

    Gauthreaux, Christina; Negron, Jenesis; Castellanos, Daniel; Ward-Peterson, Melissa; Castro, Grettel; Rodríguez de la Vega, Pura; Acuña, Juan Manuel

    2017-02-01

    Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD.A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS' complex sampling design.Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1-1.3), 30% (AOR = 1.3; 95% CI: 1.2-1.4), and 50% (AOR = 1.5; 95% CI: 1.3-1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of pregnancy (AOR = 1.6; 95% CI: 1.4-2.0).We found that women with mistimed or unwanted pregnancies were more likely to experience symptoms of PPD. Our findings support the current US Preventive Services Task Force and American Academy of

  17. SUPPLEMENTATION WITH VITAMINS C AND E DURING PREGNANCY FOR THE PREVENTION OF PREECLAMPSIA AND OTHER ADVERSE MATERNAL AND PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND METAANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustín; ROMERO, Roberto; KUSANOVIC, Juan Pedro; HASSAN, Sonia

    2011-01-01

    OBJECTIVE To determine whether supplementation with vitamins C and E during pregnancy reduces the risk of preeclampsia and other adverse maternal and perinatal outcomes. STUDY DESIGN Systematic review and metaanalysis of randomized controlled trials. RESULTS Nine trials involving a total of 19,810 women were included. Overall, there were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (9.6% versus 9.6%; relative risk 1.00, 95% confidence interval 0.92–1.09). Similar results were obtained when subgroup analyses were restricted to women at high risk or low/moderate risk for preeclampsia. Women supplemented with vitamins C and E were at increased risk of developing gestational hypertension and premature rupture of membranes, and a decreased risk of abruptio placentae. There were no significant differences between the vitamin and placebo groups in the risk of other adverse maternal or fetal/perinatal outcomes. CONCLUSION Supplementation with vitamins C and E during pregnancy does not prevent preeclampsia. PMID:21529757

  18. Analysis of preventability of hypertensive disorder in pregnancy-related maternal death using the nationwide registration system of maternal deaths in Japan.

    Science.gov (United States)

    Katsuragi, Shinji; Tanaka, Hiroaki; Hasegawa, Junichi; Nakamura, Masamitsu; Kanayama, Naohiro; Nakata, Masahiko; Murakoshi, Takeshi; Yoshimatsu, Jun; Osato, Kazuhiro; Tanaka, Kayo; Sekizawa, Akihiko; Ishiwata, Isamu; Ikeda, Tomoaki

    2018-04-26

    Hypertensive disorder of pregnancy (HDP) is a major cause of maternal death. The goal of this study was to investigate factors associated with maternal death due to HDP. HDP-related maternal deaths in Japan reported to the Committee of the Ministry of Health, Labor and Welfare from 2010 to 2015 were examined. Out of 47 cases of HDP, 30 were identified as the major cause of maternal death. The median maternal age was 34 years (range 24-45) and the mortality in women aged ≥40 years was seven times higher that than in women aged deaths in Japan. Mothers aged ≥40 years are most at risk for HDP-related maternal death. Major concerns for preventabilities were late hospitalization, maternal transportation, and termination of pregnancy for term or near-term HDP. Regular vital checks and prompt lowering of BP were lacked during labor in most cases. HELLP syndrome should be managed at a general hospital with sufficient medical resources.

  19. Elevated dietary magnesium during pregnancy and postnatal life prevents ectopic mineralization in Enpp1asj mice, a model for generalized arterial calcification of infancy.

    Science.gov (United States)

    Kingman, Joshua; Uitto, Jouni; Li, Qiaoli

    2017-06-13

    Generalized arterial calcification of infancy (GACI) is an autosomal recessive disorder caused by mutations in the ENPP1 gene. It is characterized by mineralization of the arterial blood vessels, often diagnosed prenatally, and associated with death in early childhood. There is no effective treatment for this devastating disorder. We previously characterized the Enpp1asjmutant mouse as a model of GACI, and we have now explored the effect of elevated dietary magnesium (five-fold) in pregnant mothers and continuing for the first 14 weeks of postnatal life. The mothers were kept on either control diet or experimental diet supplemented with magnesium. Upon weaning at 4 weeks of age the pups were placed either on control diet or high magnesium diet. The degree of mineralization was assessed at 14 weeks of age by histopathology and a chemical calcium assay in muzzle skin, kidney and aorta. Mice placed on high magnesium diet showed little, if any, evidence of mineralization when their corresponding mothers were also placed on diet enriched with magnesium during pregnancy and nursing. The reduced ectopic mineralization in these mice was accompanied by increased calcium and magnesium content in the urine, suggesting that magnesium competes calcium-phosphate binding thereby preventing the mineral deposition. These results have implications for dietary management of pregnancies in which the fetus is suspected of having GACI. Moreover, augmenting a diet with high magnesium may be beneficial for other ectopic mineralization diseases, including nephrocalcinosis.

  20. Making Pono Choices: a collaborative approach to developing a culturally responsive teen pregnancy and sexually transmitted infections prevention curriculum in Hawai'i.

    Science.gov (United States)

    Manaseri, Holly; Uehara, Denise; Roberts, Kelly

    2014-12-01

    The overall extent of evidence-based culturally responsive health education programs targeting ethnic minority groups in Hawai'i is limited. The few that do exist were adapted from models developed with other majority ethnic groups in mind and may not always be appropriate for Native Hawaiian or Pacific Islander youth (Okamoto et al. in J Alcohol Drug Educ 54(1):56-75, 2010; Helm and Baker in J Ethn Cult Divers Soc Work 20(2):131-149, 2011; Po'a-Kekuawela et al. in J Ethn Cult Divers Soc Work 18(3):242-258, 2009). The need for a culturally responsive, evidence-based health curriculum is clear considering the large disparities reported among Hawaiian youth in health, academic achievement, and other identified risk factors. School-based health interventions are an opportunity not only to improve the physical well being of students, but also to increase their ability to learn and succeed in school. The University of Hawai'i at Manoa-Center on Disability Studies (UH-CDS) received a highly competitive grant from the US Office of Adolescent Health to develop a teen pregnancy and sexually transmitted infection (STI) prevention curriculum for Hawai'i middle school youth. The authors will detail a collaborative process that led to a culturally responsive sexual health curriculum for middle school youth designed to meet the rigorous standards of an evidenced-based review and more importantly reduce teen pregnancies and STI transmission.

  1. Reproductive health in eight navies: a comparative report on education, prevention services, and policies on pregnancy, maternity/paternity leaves, and childcare.

    Science.gov (United States)

    Fjord, Lakshmi; Ames, Genevieve

    2009-03-01

    As occupational cultures, navies are remarkable for an ability to achieve far-reaching cultural and behavioral effects by both sweeping and incremental policy changes. Therefore, navy policies for reproductive health education and services, childcare, and maternity and paternity leaves have potential to be at the vanguard of gender parity efforts to successfully integrate women into once male-only occupations. This article provides summaries of reproductive health education programs, pregnancy prevention services, and policies currently in effect in eight navies where women work alongside male peers as sailors and officers. Our objective is to bring together comparative data that is hard to find by other means, which may prove useful to researchers, policy-makers, and naval personnel. Project methodology involved questionnaires sent to naval attaches stationed in embassies in Washington, DC, who referred sections to their appropriate departments. The results are quotations from completed questionnaires and policies sent from the navies of Germany, Latvia, the Netherlands, Norway, South Africa, Spain, the United Kingdom, and the United States. Policies under review include sexual conduct, pregnancy, and maternity and paternity leaves. We also report the latest available statistical data regarding women in these navies, such as numbers of women, percentages of navy women vs. total military women, and dates of women's inclusion as naval personnel.

  2. Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

    Science.gov (United States)

    Smith, James M; Moss, John A; Srinivasan, Priya; Butkyavichene, Irina; Gunawardana, Manjula; Fanter, Rob; Miller, Christine S; Sanchez, Debbie; Yang, Flora; Ellis, Shanon; Zhang, Jining; Marzinke, Mark A; Hendrix, Craig W; Kapoor, Amita; Baum, Marc M

    2017-01-01

    Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs) delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs) can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2) to prevent HIV, acyclovir (ACV) to prevent HSV, and etonogestrel (ENG) in combination with ethinyl estradiol (EE), FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6) over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1) for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing) 0.63; and ENG (low releasing) 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1) may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high-risk populations.

  3. Novel multipurpose pod-intravaginal ring for the prevention of HIV, HSV, and unintended pregnancy: Pharmacokinetic evaluation in a macaque model.

    Directory of Open Access Journals (Sweden)

    James M Smith

    Full Text Available Globally, women bear an uneven burden for sexual HIV acquisition. Results from two clinical trials evaluating intravaginal rings (IVRs delivering the antiretroviral agent dapivirine have shown that protection from HIV infection can be achieved with this modality, but high adherence is essential. Multipurpose prevention technologies (MPTs can potentially increase product adherence by offering protection against multiple vaginally transmitted infections and unintended pregnancy. Here we describe a coitally independent, long-acting pod-IVR MPT that could potentially prevent HIV and HSV infection as well as unintended pregnancy. The pharmacokinetics of MPT pod-IVRs delivering tenofovir alafenamide hemifumarate (TAF2 to prevent HIV, acyclovir (ACV to prevent HSV, and etonogestrel (ENG in combination with ethinyl estradiol (EE, FDA-approved hormonal contraceptives, were evaluated in pigtailed macaques (N = 6 over 35 days. Pod IVRs were exchanged at 14 days with the only modification being lower ENG release rates in the second IVR. Plasma progesterone was monitored weekly to determine the effect of ENG/EE on menstrual cycle. The mean in vivo release rates (mg d-1 for the two formulations over 30 days ranged as follows: TAF2 0.35-0.40; ACV 0.56-0.70; EE 0.03-0.08; ENG (high releasing 0.63; and ENG (low releasing 0.05. Mean peak progesterone levels were 4.4 ± 1.8 ng mL-1 prior to IVR insertion and 0.075 ± 0.064 ng mL-1 for 5 weeks after insertion, suggesting that systemic EE/ENG levels were sufficient to suppress menstruation. The TAF2 and ACV release rates and resulting vaginal tissue drug concentrations (medians: TFV, 2.4 ng mg-1; ACV, 0.2 ng mg-1 may be sufficient to protect against HIV and HSV infection, respectively. This proof of principle study demonstrates that MPT-pod IVRs could serve as a potent biomedical prevention tool to protect women's sexual and reproductive health and may increase adherence to HIV PrEP even among younger high

  4. Intermittent preventive treatment of malaria in pregnancy: evaluation of a new delivery approach and the policy implications for malaria control in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, Ib; Magnussen, Pascal

    2007-01-01

    The impact of intermittent preventive treatment (IPT) on malaria in pregnancy is well known. In countries where this policy is implemented, poor access and low compliance to this intervention has been widely reported. A study was designed to assess a new approach to deliver IPT to pregnant women...... through traditional birth attendants (TBAs), drug-shop vendors (DSVs), community reproductive health workers (CRHWs) and adolescent peer mobilisers (APMs); and compared this approach with IPT at health units. We evaluated this approach to assess user perceptions, its acceptability and sustainability....... Results show that the new approach increased access and compliance to IPT. Mean gestational age at first dose of IPT was 21.0 weeks with the community approaches versus 23.1 weeks at health units, P>0.0001. Health units accessed a high proportion of adolescents, 28.4%, versus 25.0% at the new approaches...

  5. Intermittent preventive treatment of malaria in pregnancy: a community-based delivery system and its effect on parasitemia, anemia and low birth weight in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, Ib; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: The main objective of the study was to assess the impact of a community-based delivery system of intermittent preventive treatment (IPT) for malaria in pregnancy with sulfadoxine-pyrimethamine (SP) on access, parasitemia, anemia and low birth weight as primary outcome measures. METHODS.......0001). At both health units and the community-based approaches, IPT increased mean hemoglobin by 6.7% (panemia from 5.7% to 3.1% (p.... This intervention was acceptable to 89.6% of the women at the community-based approaches intending to use IPT in the future, while 48.1% of them had recommended it to other women. CONCLUSIONS: The community-based approaches increased access and adherence to IPT with an effect on anemia, severe anemia, parasitemia...

  6. Appraisal on the prevalence of malaria and anaemia in pregnancy and factors influencing uptake of intermittent preventive therapy with sulfadoxine-pyrimethamine in Kibaha district, Tanzania.

    Science.gov (United States)

    Tarimo, S Donath

    2007-10-01

    To appraise the prevalence of malaria and anaemia in antenatal mothers; and explore the factors influencing coverage of intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) under operational conditions in the national programme for malaria control in pregnancy. Descriptive cross-sectional survey. The reproductive and child health clinic in Kibaha district hospital, Tanzania SUBECTS: Pregnant mothers on routine antenatal visits Prevalence of malaria (peripheral parasitaemia) and anaemia, coverage of IPT with SP and the factors influencing coverage. A total of 395 mothers were recruited; 27.3% had malaria. Moderate anaemia i.e. haemoglobin (Hb) level 8. -10.9 g/dl was detected in 56.7% of mothers; 34.2% had severe anaemia (Hb 8.0 g/dl was strongly associated with negative parasitaemia while Hb < 8.0 gidl was strongly associated with positive parasitaemia. About a third (40.0%) of the mothers did not receive SP for IPT

  7. Views on unwanted effects of leave-on emollients and experiences msurrounding their incidence

    OpenAIRE

    Oakley, Robert; Lawton, Sandra

    2016-01-01

    Background: The mainstay treatment for eczema is leave-on emollients. The aim of this study was to find out more about unwanted effects that have been reported with their use, as little is known due to a lack of formal reporting.\\ud \\ud Aims: To gain a greater understanding of eczema patients’ experiences of unwanted effects such as stinging, what influence unwanted effects had on their therapy, why subsequent variations in leave-on emollient adherence followed and what patients desire in the...

  8. Unwanted facial hair removal with laser treatment improves quality of life of patients.

    Science.gov (United States)

    Maziar, Ali; Farsi, Nader; Mandegarfard, Manijeh; Babakoohi, Shahab; Gorouhi, Farzam; Dowlati, Yahya; Firooz, Alireza

    2010-02-01

    Unwanted facial hair can have adverse psychological effects on women and reduce their quality of life. To assess the effects of unwanted facial hair removal with laser on improving quality of life. In this study, 70 patients treated for unwanted facial hair by laser were assessed by Dermatology Life Quality Index (DLQI) questionnaire on admission and 3 months later after three sessions of laser treatment. The DLQI score before treatment was 9.42 +/- 5.99, which was reduced to 3.12 +/- 3.40 after laser treatment (p facial hair removal with laser can improve the quality of life of patients.

  9. Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: Results of an economic evaluation alongside a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Oostdam Nicolette

    2012-07-01

    Full Text Available Abstract Background The prevalence of gestational diabetes mellitus (GDM is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is cost-effective from a societal perspective as compared to standard care. Methods A randomised controlled trial (RCT and simultaneous economic evaluation of the FitFor2 program were conducted. Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62 or to standard care (n = 59. The exercise program consisted of two sessions of aerobic and strengthening exercises per week. Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight. Quality of life was measured using the EuroQol 5-D and quality-adjusted life-years (QALYs were calculated. Resource utilization and sick leave data were collected by questionnaires. Data were analysed according to the intention-to-treat principle. Missing data were imputed using multiple imputations. Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost-effectiveness ratios. Results There were no statistically significant differences in any outcome measure. During pregnancy, total health care costs and costs of productivity losses were statistically non-significant (mean difference €1308; 95%CI €-229 - €3204. The cost-effectiveness analyses showed that the exercise program was not cost-effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs. Conclusion The twice-weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost-effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of

  10. Pregnancy prevention among American Indian men ages 18 to 24: the role of mental health and intention to use birth control.

    Science.gov (United States)

    Rink, Elizabeth; FourStar, Kris; Medicine Elk, Jarrett; Dick, Rebecca; Jewett, Lacey; Gesink, Dionne

    2012-01-01

    The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.

  11. Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: results of an economic evaluation alongside a randomised controlled trial.

    Science.gov (United States)

    Oostdam, Nicolette; Bosmans, Judith; Wouters, Maurice G A J; Eekhoff, Elisabeth M W; van Mechelen, Willem; van Poppel, Mireille N M

    2012-07-04

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is cost-effective from a societal perspective as compared to standard care. A randomised controlled trial (RCT) and simultaneous economic evaluation of the FitFor2 program were conducted. Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62) or to standard care (n = 59). The exercise program consisted of two sessions of aerobic and strengthening exercises per week. Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight. Quality of life was measured using the EuroQol 5-D and quality-adjusted life-years (QALYs) were calculated. Resource utilization and sick leave data were collected by questionnaires. Data were analysed according to the intention-to-treat principle. Missing data were imputed using multiple imputations. Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost-effectiveness ratios. There were no statistically significant differences in any outcome measure. During pregnancy, total health care costs and costs of productivity losses were statistically non-significant (mean difference €1308; 95%CI €-229 - €3204). The cost-effectiveness analyses showed that the exercise program was not cost-effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs. The twice-weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost-effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of GDM cannot be recommended. NTR1139.

  12. Prevalence of pregnancy anxiety and associated factors

    Directory of Open Access Journals (Sweden)

    Girija Kalayil Madhavanprabhakaran

    2015-01-01

    Conclusion: During the transition to motherhood, the risk factors and timing of heightened pregnancy-specific anxiety differ. Higher prevalence of pregnancy anxiety among nulliparous and younger pregnant women necessitates an integrated routine screening of PSA during prenatal care. Early detection, prevention and management of pregnancy anxiety will enable women to cope with the challenges of pregnancy.

  13. Social support and pregnancy: II. Its relationship with depressive symptoms among Japanese women.

    Science.gov (United States)

    Kitamura, T; Toda, M A; Shima, S; Sugawara, K; Sugawara, M

    1998-02-01

    In a questionnaire survey among 1329 first-trimester pregnant women, both the husband support measures and unwanted pregnancy ('stressor' agent in pregnancy) showed significant effects on an elevated score of the cognitive disturbance subscale of the Zung's self-rating depression scale (SDS), while only unwanted pregnancies showed an effect on an elevated score of the dysphoric mood subscale of the SDS. However, no interaction was observed between the husband support measures and unwanted pregnancy, therefore the effect of the husband's social support on the cognitive disturbance score was not that of a buffer, but rather a main effector. Finally, multiple regression analyses showed that the dysphoric mood score was preceded by unwanted pregnancy, premenstrual irritability, public self-consciousness, and maternal overprotection; while the cognitive disturbance score was preceded by unwanted pregnancy, husband reduced 'given' and 'giving' support, maternal reduced care and overprotection, paternal reduced care, low annual income, low private self-consciousness, and smoking. These findings suggest that the husband's support for a pregnant woman is effective only in reducing cognitive symptoms, and that different symptomatic constellations have different sets of psychosocial correlates.

  14. Reducing or Eliminating Polysorbate Induced Anaphylaxis and Unwanted Immunogenicity in Biotherapeutics

    Directory of Open Access Journals (Sweden)

    Edward Maggio

    2017-09-01

    Full Text Available The increasing use of biotherapeutics across a growing spectrum of neoplastic, autoimmune, and inflammatory diseases has resulted in a corresponding increase in hypersensitivity reactions. The origins of anaphylaxis are often attributed to undefined intrinsic properties of the biotherapeutic protein itself, ignoring the broader potential negative contributions of functional excipients, in particular polyoxyethylene containing surfactants such as polysorbate 80 and polysorbate 20 (Tween 80 and Tween 20. These surfactants allow biotherapeutics to meet the stringent challenges of extended shelf-life, increased solubility, protein aggregation prevention, reduced administration volume, and satisfactory reconstitution properties in the case of lyophilized biotherapeutics. The potential negative impact of certain functional excipients on product performance characteristics such as anaphylaxis and immunogenicity is often overlooked. While regulatory authorities understandably focus heavily on comparable efficacy in evaluating biosimilars, similar efficacy does not necessarily imply a similar safety profile between the originator and biosimilar products. Both unwanted immunogenicity and anaphylaxis do comprise major components of safety assessment, however, few if any attempts are made to differentiate drug-related from excipient-related anaphylaxis. Replacement of anaphylactogenic and immunogenic functional excipients with equally effective but safer alternatives will allow biotherapeutic developers to differentiate their biotherapeutic, biosimilar, or biobetter from the large number of nearly identical competitor products, simultaneously providing a substantial commercial benefit as well as critical clinical benefits for all concerned – patients, physicians, and third party payers.

  15. Infection and acute respiratory distress syndrome during pregnancy: a case series of preventable maternal deaths from southern India.

    Science.gov (United States)

    Vasudeva, Akhila; Bhat, Rajeshwari G; Ramachandran, Amar; Kumar, Pratap

    2013-02-01

    Acute respiratory distress syndrome (ARDS) is common among women admitted to obstetric intensive care units, and it contributes significantly, both directly and indirectly, to maternal deaths. We present a case series of ARDS in pregnant women caused by non-obstetric causes. The women were treated at a tertiary hospital in southern India. The striking features were delayed referral from the primary care unit and the lack of a primary diagnosis or treatment. Undiagnosed rheumatic heart disease, anemia, and malaria and H1N1 epidemics contributed to these cases of ARDS and maternal death. It is necessary to increase the awareness of evidence-based uniform protocols to tackle common medical complaints during pregnancy. Copyright © 2012 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  16. Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis.

    Science.gov (United States)

    Hill, Jenny; Hoyt, Jenna; van Eijk, Anna Maria; D'Mello-Guyett, Lauren; Ter Kuile, Feiko O; Steketee, Rick; Smith, Helen; Webster, Jayne

    2013-01-01

    Malaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization-recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is low. We conducted a systematic review to explore factors affecting delivery, access, and use of IPTp and ITNs among healthcare providers and women. We searched the Malaria in Pregnancy Library and Global Health Database from 1 January 1990 to 23 April 2013, without language restriction. Data extraction was performed by two investigators independently, and data was appraised for quality and content. Data on barriers and facilitators, and the effect of interventions, were explored using content analysis and narrative synthesis. We conducted a meta-analysis of determinants of IPTp and ITN uptake using random effects models, and performed subgroup analysis to evaluate consistency across interventions and study populations, countries, and enrolment sites. We did not perform a meta-ethnography of qualitative data. Ninety-eight articles were included, of which 20 were intervention studies. Key barriers to the provision of IPTp and ITNs were unclear policy and guidance on IPTp; general healthcare system issues, such as stockouts and user fees; health facility issues stemming from poor organisation, leading to poor quality of care; poor healthcare provider performance, including confusion over the timing of each IPTp dose; and women's poor antenatal attendance, affecting IPTp uptake. Key determinants of IPTp coverage were education, knowledge about malaria/IPTp, socio-economic status, parity, and number and timing of antenatal clinic visits. Key determinants of ITN coverage were employment status, education, knowledge about malaria/ITNs, age, and marital status. Predictors showed regional variations. Delivery of ITNs through antenatal clinics presents fewer problems than delivery of IPTp. Many

  17. Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jenny Hill

    Full Text Available Malaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization-recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp and insecticide-treated nets (ITNs is low. We conducted a systematic review to explore factors affecting delivery, access, and use of IPTp and ITNs among healthcare providers and women.We searched the Malaria in Pregnancy Library and Global Health Database from 1 January 1990 to 23 April 2013, without language restriction. Data extraction was performed by two investigators independently, and data was appraised for quality and content. Data on barriers and facilitators, and the effect of interventions, were explored using content analysis and narrative synthesis. We conducted a meta-analysis of determinants of IPTp and ITN uptake using random effects models, and performed subgroup analysis to evaluate consistency across interventions and study populations, countries, and enrolment sites. We did not perform a meta-ethnography of qualitative data. Ninety-eight articles were included, of which 20 were intervention studies. Key barriers to the provision of IPTp and ITNs were unclear policy and guidance on IPTp; general healthcare system issues, such as stockouts and user fees; health facility issues stemming from poor organisation, leading to poor quality of care; poor healthcare provider performance, including confusion over the timing of each IPTp dose; and women's poor antenatal attendance, affecting IPTp uptake. Key determinants of IPTp coverage were education, knowledge about malaria/IPTp, socio-economic status, parity, and number and timing of antenatal clinic visits. Key determinants of ITN coverage were employment status, education, knowledge about malaria/ITNs, age, and marital status. Predictors showed regional variations.Delivery of ITNs through antenatal clinics presents fewer problems than delivery

  18. Effectiveness of Peer Education Interventions for HIV Prevention, Adolescent Pregnancy Prevention and Sexual Health Promotion for Young People: A Systematic Review of European Studies

    Science.gov (United States)

    Tolli, M. V.

    2012-01-01

    Peer education remains a popular strategy for health promotion and prevention, but evidence of its effectiveness is still limited. This article presents a systematic review of peer education interventions in the European Union that were published between January 1999 and May 2010. The objective of the review is to determine the effectiveness of…

  19. COUNTERMEASURE FOR MINIMIZE UNWANTED ALARM OF AUTOMATIC FIRE NOTIFICATION SYSTEM IN THE REPUBLIC OF KOREA

    Directory of Open Access Journals (Sweden)

    Hasung Kong

    2015-01-01

    Full Text Available In this article investigated the cause of error through survey to building officials for minimizing the unwanted alarm of automatic fire notification and suggested countermeasure for minimizing the unwanted alarm. The main cause of the unwanted alarm is defective fire detector, interlocking with automatic fire detection system, lack in fire safety warden’s ability, worn-out fire detect receiving system. The countermeasure for minimizing unwanted alarm is firstly, tightening up the standard of model approval, Secondly, interlocking with cross-section circuit method fire extinguishing system or realizing automatic fire notification system interlocking with home network, thirdly, tightening up licensing examination of fire safety warden, lastly, it suggested term of use rule of fire detect receiving system. 

  20. COUNTERMEASURE FOR MINIMIZE UNWANTED ALARM OF AUTOMATIC FIRE NOTIFICATION SYSTEM IN THE REPUBLIC OF KOREA

    Directory of Open Access Journals (Sweden)

    Hasung Kong

    2015-01-01

    Full Text Available In this article investigated the cause of error through survey to building officials for minimizing the unwanted alarm of automatic fire notification and suggested countermeasure for minimizing the unwanted alarm. The main cause of the unwanted alarm is defective fire detector, interlocking with automatic fire detection system, lack in fire safety warden’s ability, worn-out fire detect receiving system. The countermeasure for minimizing unwanted alarm is firstly, tightening up the standard of model approval, Secondly, interlocking with cross-section circuit method fire extinguishing system or realizing automatic fire notification system interlocking with home network, thirdly, tightening up licensing examination of fire safety warden, lastly, it suggested term of use rule of fire detect receiving system.

  1. The extent of unwanted infrared photoacoustic signals from polymer sampling tubings exposed to ultraviolet radiation

    NARCIS (Netherlands)

    Bicanic, D.; Solyom, A.; Angeli, G.; Wegh, H.; Postumus, M.; Jalink, H.

    1995-01-01

    The extent of unwanted photoacoustic (PA) signals due to volatiles released from various polymer tubing materials [transparent, red and black polyethylene (PE), polymer of tetrafluorethylene (PTFE) and copolymer of tetrafluorethylene and hexafluorethylene (FEP)] when exposed to 245 nm radiation was

  2. Preventing Teen Pregnancy: Coordinating Community Efforts. Hearing before the Subcommittee on Human Resources and Intergovernmental Relations of the Committee on Government Reform and Oversight. House of Representatives, One Hundred Fourth Congress, Second Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Government Reform and Oversight.

    The Subcommittee on Human Resources and Intergovernmental Relations of the House of Representatives Committee on Government Reform and Oversight met to consider the causes of and solutions to teen pregnancy and the role of community organizations in prevention efforts. Opening remarks by Representative Christopher Shays were followed by statements…

  3. El poder de los padres: Lo que los padres deben saber y hacer para ayudar a prevenir el embarazo en los adolescentes (Parent Power: What Parents Need to Know and Do to Help Prevent Teen Pregnancy).

    Science.gov (United States)

    National Campaign To Prevent Teen Pregnancy, Washington, DC.

    This guide discusses the importance of parent influence in preventing teen pregnancy, offering insights from research regarding: closeness between parents and their children; parent-child communication; parental attitudes and values about abstinence and/or the dangers of unprotected sex; parents' reluctance to discuss the issue; parental…

  4. Implementation of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in Kisumu, western Kenya

    NARCIS (Netherlands)

    van Eijk, Anna M.; Ayisi, John G.; ter Kuile, Feiko O.; Slutsker, L.; Otieno, Juliana A.; Misore, Ambrose O.; Odondi, J. O.; Rosen, Daniel H.; Kager, Piet A.; Steketee, Rick W.; Nahlen, Bernard L.

    2004-01-01

    OBJECTIVE In 1998, the Kenyan Ministry of Health introduced intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP), one treatment dose in the second trimester (16-27 weeks) and one treatment dose between 28 and 34 weeks of gestational age, for the control of malaria in

  5. Estimates of Intraclass Correlation Coefficients from Longitudinal Group-Randomized Trials of Adolescent HIV/STI/Pregnancy Prevention Programs

    Science.gov (United States)

    Glassman, Jill R.; Potter, Susan C.; Baumler, Elizabeth R.; Coyle, Karin K.

    2015-01-01

    Introduction: Group-randomized trials (GRTs) are one of the most rigorous methods for evaluating the effectiveness of group-based health risk prevention programs. Efficiently designing GRTs with a sample size that is sufficient for meeting the trial's power and precision goals while not wasting resources exceeding them requires estimates of the…

  6. The INeS study: prevention of multiple pregnancies: a randomised controlled trial comparing IUI COH versus IVF e SET versus MNC IVF in couples with unexplained or mild male subfertility.

    Science.gov (United States)

    Bensdorp, Alexandra J; Slappendel, Els; Koks, Carolien; Oosterhuis, Jur; Hoek, Annemieke; Hompes, Peter; Broekmans, Frank; Verhoeve, Harold; de Bruin, Jan Peter; van Weert, Janne Meije; Traas, Maaike; Maas, Jacques; Beckers, Nicole; Repping, Sjoerd; Mol, Ben W; van der Veen, Fulco; van Wely, Madelon

    2009-12-18

    Multiple pregnancies are high risk pregnancies with higher chances of maternal and neonatal mortality and morbidity. In the past decades the number of multiple pregnancies has increased. This trend is partly due to the fact that women start family planning at an increased age, but also due to the increased use of ART.Couples with unexplained or mild male subfertility generally receive intrauterine insemination IUI with controlled hormonal stimulation (IUI COH). The cumulative pregnancy rate is 40%, with a 10% multiple pregnancy rate.This study aims to reveal whether alternative treatments such as IVF elective Single Embryo Transfer (IVF e SET) or Modified Natural Cycle IVF (MNC IVF) can reduce the number of multiple pregnancy rates, but uphold similar pregnancy rates as IUI COH in couples with mild male or unexplained subfertility. Secondly, the aim is to perform a cost effective analyses and assess treatment preference of these couples. We plan a multicentre randomised controlled clinical trial in the Netherlands comparing six cycles of intra-uterine insemination with controlled ovarian hyperstimulation or six cycles of Modified Natural Cycle (MNC) IVF or three cycles with IVF-elective Single Embryo Transfer (eSET) plus cryo-cycles within a time frame of 12 months.Couples with unexplained subfertility or mild male subfertility and a poor prognosis for treatment independent pregnancy will be included. Women with anovulatory cycles, severe endometriosis, double sided tubal pathology or serious endocrine illness will be excluded.Our primary outcome is the birth of a healthy singleton. Secondary outcomes are multiple pregnancy, treatment costs, and patient experiences in each treatment arm. The analysis will be performed according tot the intention to treat principle. We will test for non-inferiority of the three arms with respect to live birth. As we accept a 12.5% loss in pregnancy rate in one of the two IVF arms to prevent multiple pregnancies, we need 200 couples

  7. The INeS study: prevention of multiple pregnancies: a randomised controlled trial comparing IUI COH versus IVF e SET versus MNC IVF in couples with unexplained or mild male subfertility

    Directory of Open Access Journals (Sweden)

    Beckers Nicole

    2009-12-01

    to prevent multiple pregnancies, we need 200 couples per arm (600 couples in total. Discussion Determining the safest and most cost-effective treatment will ensure optimal chances of pregnancy for subfertile couples with substantially diminished perinatal and maternal complications. Should patients find the most cost-effective treatment acceptable or even preferable, this could imply the need for a world wide shift in the primary treatment. Trial registration Current Controlled Trials ISRCTN 52843371

  8. Sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention. Combined contraceptive practices among urban African-American early adolescents.

    Science.gov (United States)

    Stanton, B F; Li, X; Galbraith, J; Feigelman, S; Kaljee, L

    1996-01-01

    To evaluate the success of efforts to educate youth not only to use prescription contraceptives to avoid pregnancy, but also to use condoms to avoid sexually transmitted diseases, including infection with the human immunodeficiency virus. Longitudinal study of 383 African-American youth aged 9 to 15 years enrolled in a randomized, controlled trial of an acquired immunodeficiency syndrome (AIDS) risk reduction intervention. Data about contraceptive practices were obtained at baseline and 6, 12, and 18 months later using a culturally and developmentally appropriate risk assessment tool administered with "talking" computers (Macintosh, Apple Computer Inc, Cupertino, Calif). Approximately three fourths of sexually active youth used some form of contraception in each 6-month round, with almost half of the youth using combinations of contraceptives. Among all youth at baseline and among control youth throughout the study, more than half used condoms and more than two thirds who used oral contraceptives also used condoms. Receipt of an AIDS education intervention was associated with use of more effective contraceptive practices (eg, condoms and another prescription or nonprescription method of birth control). After receiving the intervention, more than 80% of the youth who used oral contraceptives also used condoms. Contraceptive practices showed considerable stability. Knowledge about AIDS was positively associated with use of more effective contraceptive methods. Many youth are using condoms and prescription birth control simultaneously, and these use rates can be increased through AIDS education interventions.

  9. Laparoscopic temporary bilateral uterine artery occlusion with silicone tubing to prevent hemorrhage during vacuum aspiration of cesarean scar pregnancies.

    Science.gov (United States)

    Wang, Lingling; Sun, Lingbin; Wang, Lijun; Chen, Huifang; Ouyang, Xue; Qiu, Huiling

    2015-11-01

    The aim of this study was to determine the feasibility and effects of temporary bilateral uterine artery occlusion with silicone tubing on blood loss during vacuum aspiration of cesarean scar pregnancies (CSP). Six patients with CSP underwent removal of gestational masses via vacuum aspiration. At the beginning of the procedure, all patients underwent laparoscopic temporary bilateral uterine artery occlusion with tubing. The main measurements were the operating time, operative blood loss, Doppler examination of the uterine arteries, and complications of procedure. The median operation time was 99 min, the median time needed to put the tubing in place (the time from the opening of the retroperitoneum to positioning of the tubing) was 45.5 min and the median time of bilateral uterine artery occlusion with tubing was 32.5 min. The median blood loss was 97.5 mL, and none of the patients required blood transfusion. Doppler examination showed no difference in the pre- and postoperative resistance or pulsatility indices of the uterine vessels. There were no conspicuous complications. The serum ß-human chorionic gonadotrophin level decreased to normal within 14-27 days after the operation. Laparoscopic temporary bilateral uterine artery occlusion with silicone tubing is an effective, minimally invasive procedure for reducing blood loss during vacuum aspiration in patients with CSP. © 2015 Japan Society of Obstetrics and Gynecology.

  10. The Tablets, Ring, Injections as Options (TRIO) study: what young African women chose and used for future HIV and pregnancy prevention.

    Science.gov (United States)

    van der Straten, Ariane; Agot, Kawango; Ahmed, Khatija; Weinrib, Rachel; Browne, Erica N; Manenzhe, Kgahlisho; Owino, Fredrick; Schwartz, Jill; Minnis, Alexandra

    2018-03-01

    Preventing HIV and unintended pregnancies are key global health priorities. To inform product rollout and to understand attributes of future multipurpose prevention technologies (MPT) associated with preference and use, we evaluated three placebo delivery forms: daily oral tablets, a monthly vaginal ring, and two monthly intramuscular injections in TRIO, a five-month study among young Kenyan and South African women. HIV-negative, sexually active, non-pregnant women aged 18 to 30 were enrolled and randomized to use each placebo delivery form for one month (stage 1). Then, participants chose one product to use for two additional months (stage 2). We assessed safety, product ranking, choice, and use. We examined demographic and behavioural correlates of choice and, reciprocally, unwillingness to use in the future with logistic regression models. 277 women enrolled, 249 completed stage 1 and 246 completed stage 2. Median age was 23 years, 49% were Kenyan and 51% were South African. Three participants became pregnant during the study and one participant HIV-seroconverted. There were 18 product-related adverse events, six tablets-related, 11 ring-related, and one injection-related. After trying each product, 85% preferred a TRIO product over condoms. Injections were chosen most (64%, 95% confidence interval (CI) 58%, 70%; p < 0.001), and by more South Africans than Kenyans (odds ratio (OR) 2.01, 95% CI: 1.17, 3.43; p = 0.01). There was no significant difference in choosing tablets versus ring (21%, 95% CI: 16%, 26% vs. 15%, 95% CI: 11%, 20%; p = 0.11). Tablet and ring adherence, based on direct observations and self-reports, improved over time. However, participants' self-reported use of tablets did not match objective data from the electronic dose monitoring device. Participants were fully compliant with injections. In this population at risk for HIV and pregnancy, all participants agreed to choose and use a placebo MPT delivery form. A majority of participants

  11. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-infected women receiving cotrimoxazole prophylaxis: a multicenter randomized placebo-controlled trial.

    Directory of Open Access Journals (Sweden)

    Raquel González

    2014-09-01

    Full Text Available BACKGROUND: Intermittent preventive treatment in pregnancy (IPTp with sulfadoxine-pyrimethamine (SP is recommended for malaria prevention in HIV-negative pregnant women, but it is contraindicated in HIV-infected women taking daily cotrimoxazole prophylaxis (CTXp because of potential added risk of adverse effects associated with taking two antifolate drugs simultaneously. We studied the safety and efficacy of mefloquine (MQ in women receiving CTXp and long-lasting insecticide treated nets (LLITNs. METHODS AND FINDINGS: A total of 1,071 HIV-infected women from Kenya, Mozambique, and Tanzania were randomized to receive either three doses of IPTp-MQ (15 mg/kg or placebo given at least one month apart; all received CTXp and a LLITN. IPTp-MQ was associated with reduced rates of maternal parasitemia (risk ratio [RR], 0.47 [95% CI 0.27-0.82]; p=0.008, placental malaria (RR, 0.52 [95% CI 0.29-0.90]; p=0.021, and reduced incidence of non-obstetric hospital admissions (RR, 0.59 [95% CI 0.37-0.95]; p=0.031 in the intention to treat (ITT analysis. There were no differences in the prevalence of adverse pregnancy outcomes between groups. Drug tolerability was poorer in the MQ group compared to the control group (29.6% referred dizziness and 23.9% vomiting after the first IPTp-MQ administration. HIV viral load at delivery was higher in the MQ group compared to the control group (p=0.048 in the ATP analysis. The frequency of perinatal mother to child transmission of HIV was increased in women who received MQ (RR, 1.95 [95% CI 1.14-3.33]; p=0.015. The main limitation of the latter finding relates to the exploratory nature of this part of the analysis. CONCLUSIONS: An effective antimalarial added to CTXp and LLITNs in HIV-infected pregnant women can improve malaria prevention, as well as maternal health through reduction in hospital admissions. However, MQ was not well tolerated, limiting its potential for IPTp and indicating the need to find alternatives with

  12. Commentary The proposed legislation on termination of pregnancy ...

    African Journals Online (AJOL)

    unborn child, sidelining both male (parental) responsibility and the responsibility of society to .... The resulting unwanted pregnancies leave women and girls with the ... once again pay the price for “man-made” choices. There is no provision in ...

  13. Effectiveness of semen washing to prevent HIV transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis

    Science.gov (United States)

    Zafer, Maryam; Horvath, Hacsi; Mmeje, Okeoma; van der Poel, Sheryl; Semprini, Augusto; Rutherford, George; Brown, Joelle

    2015-01-01

    Objective To evaluate the effectiveness of semen washing in HIV-discordant couples in which the male partner is infected Design Systematic review and meta-analysis Setting All countries Patient(s) Forty single-arm, open label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen Intervention(s) Semen washing followed by IUI, IVF, or IVF/ICSI Main outcome measure(s) Primary outcome: HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy Result(s) No HIV transmission occurred in 11,585 cycles of assisted reproduction using washed semen among 3,994 women (95% confidence interval [CI] = 0–0.0001). Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women following 2,863 cycles of assisted reproduction using washed semen (95%CI= 0–0.0006). Studies that measured HIV transmission to infants reported no cases of vertical transmission (0/1,026, 95% CI= 0–0.0029). Overall, 56.3% (2,357/4,184, 95%CI=54.8%–57.8%) of couples achieved a clinical pregnancy using washed semen. Conclusion(s) Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized, controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help further reduce the spread of HIV. PMID:26688556

  14. Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis.

    Science.gov (United States)

    Zafer, Maryam; Horvath, Hacsi; Mmeje, Okeoma; van der Poel, Sheryl; Semprini, Augusto E; Rutherford, George; Brown, Joelle

    2016-03-01

    To evaluate the effectiveness of semen washing in human immunodeficiency virus (HIV)-discordant couples in which the male partner is infected. Systematic review and meta-analysis. Not applicable. Forty single-arm open-label studies among HIV-discordant couples that underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) using washed semen. Semen washing followed by IUI, IVF, or IVF/ICSI. HIV transmission to HIV-uninfected women; secondary outcomes: HIV transmission to newborns and proportion of couples achieving a clinical pregnancy. No HIV transmission occurred in 11,585 cycles of assisted reproduction with the use of washed semen among 3,994 women. Among the subset of HIV-infected men without plasma viral suppression at the time of semen washing, no HIV seroconversions occurred among 1,023 women after 2,863 cycles of assisted reproduction with the use of washed semen. Studies that measured HIV transmission to infants reported no cases of vertical transmission. Overall, 56.3% of couples (2,357/4,184) achieved a clinical pregnancy with the use of washed semen. Semen washing appears to significantly reduce the risk of transmission in HIV-discordant couples desiring children, regardless of viral suppression in the male partner. There are no randomized controlled studies or studies from low-income countries, especially those with a large burden of HIV. Continued development of lower-cost semen washing and assisted reproduction technologies is needed. Integration of semen washing into HIV prevention interventions could help to further reduce the spread of HIV. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Estimating the Availability of Potential Homes for Unwanted Horses in the United States

    Science.gov (United States)

    Weiss, Emily; Dolan, Emily D.; Mohan-Gibbons, Heather; Gramann, Shannon; Slater, Margaret R.

    2017-01-01

    Simple Summary There are approximately 200,000 unwanted horses annually in the United States. Many are shipped to slaughter, enter rescue facilities, or are held on federal lands. This study aimed to estimate a potential number of available homes for unwanted horses in order to examine broadly the viability of pursuing re-homing policies as an option for the thousands of unwanted horses in the U.S. The results of this survey suggest there could be an estimated 1.2 million homes who have both the perceived resources and desire to house an unwanted horse. This number exceeds the approximately 200,000 unwanted horses living each year in the United States. These data suggest that efforts to reduce unwanted horses could involve matching such horses with adoptive homes and enhancing opportunities to keep horses in the homes they already have. Abstract There are approximately 200,000 unwanted horses annually in the United States. This study aimed to better understand the potential homes for horses that need to be re-homed. Using an independent survey company through an Omnibus telephone (land and cell) survey, we interviewed a nationally projectable sample of 3036 adults (using both landline and cellular phone numbers) to learn of their interest and capacity to adopt a horse. Potential adopters with interest in horses with medical and/or behavioral problems and self-assessed perceived capacity to adopt, constituted 0.92% of the total sample. Extrapolating the results of this survey using U.S. Census data, suggests there could be an estimated 1.25 million households who have both the self-reported and perceived resources and desire to house an unwanted horse. This number exceeds the estimated number of unwanted horses living each year in the United States. This study points to opportunities and need to increase communication and support between individuals and organizations that have unwanted horses to facilitate re-homing with people in their community willing to adopt

  16. Implementation of intermittent preventive treatment in pregnancy with sulphadoxine/pyrimethamine (IPTp-SP at a district health centre in rural Senegal

    Directory of Open Access Journals (Sweden)

    Vaillant Michel

    2008-11-01

    Full Text Available Abstract Background Intermittent preventive treatment with sulphadoxine-pyrimethamine (SP is recommended for reducing the risk of malaria in pregnancy and its consequences on mothers and babies (IPTp-SP. Indicators of implementation and effects of IPTp-SP were collected in a rural clinic in Southern Senegal. Methods Women seen routinely at the antenatal clinic (ANC of a rural dispensary during 2000–2007. Deployment of IPTp-SP started in January 2004. Inspection of antenatal and outpatient clinic registries of the corresponding period. Results Between 1st January 2000 and 30th April 2007, 1,781 women of all gravitidities and parities attended the ANC with 965 deliveries (606 and 398 respectively since 1st January 2004, when IPTp-SP was started. 69% of women were seen ≥ 3 times; 95% received at least one dose and 70% two doses of SP (from 61% in 2004 to 86% in 2007. The first visit, first and second dose of SP occurred at a median week 20, 22 and 31. The probability of receiving two doses was > 80% with ≥ 3 antenatal visits and a first dose of SP by week 20. The prevalence of maternal malaria was low and similar pre- (0.7% and during IPTp (0.8%. Effects on of low birth weight (LBW, Unfavourable pregnancy outcomes numbered 72 (7.5% of pregnancies with known outcome, including 30 abortions and 42 later deaths (late foetal deaths, stillbirth, peri-natal of which 13 with one or more malformations (1.35% of all recorded deliveries. Conclusion The implementation of IPTp-SP was high. Early attendance to ANC favours completion of IPTp-SP. The record keeping system in place is amenable to data extraction and linkage. A model was developed that predicts optimal compliance to two SP doses, and could be tested in other settings. Maternal malaria was infrequent and unaffected by IPTp-SP. The risk of LBW was lower during IPT implementation but the difference was non-significant and could have other explanations.

  17. Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Mori, Amani Thomas; Kampata, Linda; Musonda, Patrick; Johansson, Kjell Arne; Robberstad, Bjarne; Sandøy, Ingvild

    2017-12-19

    Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be

  18. Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

    Science.gov (United States)

    House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

    2017-03-01

    To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Enhancing a Teen Pregnancy Prevention Program with text messaging: engaging minority youth to develop TOP ® Plus Text.

    Science.gov (United States)

    Devine, Sharon; Bull, Sheana; Dreisbach, Susan; Shlay, Judith

    2014-03-01

    To develop and pilot a theory-based, mobile phone texting component attractive to minority youth as a supplement to the Teen Outreach Program(®), a youth development program for reducing teen pregnancy and school dropout. We conducted iterative formative research with minority youth in multiple focus groups to explore interest in texting and reaction to text messages. We piloted a month-long version of TOP(®) Plus Text with 96 teens at four sites and conducted a computer-based survey immediately after enrollment and at the end of the pilot that collected information about teens' values, social support, self-efficacy, and behaviors relating to school performance, trouble with the law, and sexual activity. After each of the first three weekly sessions we collected satisfaction measures. Upon completion of the pilot we conducted exit interviews with twelve purposively selected pilot participants. We successfully recruited and enrolled minority youth into the pilot. Teens were enthusiastic about text messages complementing TOP(®). Results also revealed barriers: access to text-capable mobile phones, retention as measured by completion of the post-pilot survey, and a need to be attentive to teen literacy. Piloting helped identify improvements for implementation including offering text messages through multiple platforms so youth without access to a mobile phone could receive messages; rewording texts to allow youth to express opinions without feeling judged; and collecting multiple types of contact information to improve follow-up. Thoughtful attention to social and behavioral theory and investment in iterative formative research with extensive consultation with teens can lead to an engaging texting curriculum that enhances and complements TOP(®). Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Macintosh C