Antenatal Care For Pregnant Women Research Articles

Effectiveness of mHealth Interventions for Monitoring Antenatal Care among Pregnant Women in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Antenatal care (ANC) is essential in maternal and child health since it provides care to pregnant women from conception through to labour in order to ensure a safe pregnancy and childbirth. In recent years, mobile health (mHealth) interventions have emerged as a promising solution to improve maternal and child health outcomes in low- and middle-income countries (LMICs). The present study aimed to conduct a systematic review and meta-analysis of trials to evaluate the effectiveness of mHealth interventions to monitor prenatal care among pregnant women in LMICs. A systematic literature review was conducted using the databases CINHAL, Embase, MEDLINE, and PsycINFO on the effectiveness of mHealth interventions in monitoring the antenatal care of pregnant women. The study selection, data extraction of the included articles, and quality appraisal were assessed. Our study included six studies considering 7886 participants. All articles were from low- and middle-income countries (LMICs). Antenatal mothers who used a mobile health intervention were more likely (RR = 1.66, 95%CI = 1.07-2.58, I2 = 98%) to attend ANC check-ups when compared with the women who did not use any mobile health applications or did not receive any short message services. mHealth technologies are being utilised more and more to increase care accessibility and improve maternal and fetal health. Policymakers should prioritise the integration of mHealth interventions into maternal healthcare services in LMICs, ensuring that they are cost-effective, accessible, and sustainable and that healthcare workers are trained to deliver these interventions effectively.

Factors associated with knowledge of mother-to-child transmission (MTCT) of HIV/AIDS among young adults in Indonesia: Analysis of IYARHS

Background: The prevalence of mother-to-child transmission (MTCT) of HIV/AIDS is increasing, particularly in low- and middle-income countries. Most previous studies focused on pregnant women in antenatal care, but this study examined the early phases of non-married women, which are young adults. Objective: This study aimed to examine the factors associated with knowledge MTCT of HIV/AIDS among young adults in Indonesia. Methods: This study used secondary data from the Special Indonesia Demographic Health Survey (IDHS), also known as the Indonesia Young Adult Reproductive Health Survey (IYARHS). The unit of analysis in this study is a non-married young adult aged 14 to 24 from 34 provinces in Indonesia. The final samples brought into the analysis were 9,600 women. The univariate analysis, bivariate analysis using the Chi-Square test, and multivariate analysis using binary logistic regression were done using the STATA 17 version licensed by the Institute for Population and Social Research, Mahidol University. Results: This study revealed that 33.75% of the respondents had poor knowledge of the MTCT of HIV/AIDS. Moreover, the factors found to be significantly associated with knowledge of MTCT of HIV/AIDS were age (19 to 24 years old), residence in an urban area, graduation from junior high school, senior high school, academy, and university, and also those who talked about sexual matters with friends. Conclusion: This study suggests supporting and encouraging related stakeholders in order to provide education about MTCT in the early years of adulthood so the prevention program can be applied more easily.

PENGARUH E-KIE TERHADAP TINGKAT PENGETAHUAN DAN KEPUASAN IBU HAMIL DALAM ANTENATAL CARE DI MASA PANDEMI COVID-19

Background: The Covid-19 pandemic that has occurred throughout the world affects all aspects, including health aspects. The Covid-19 pandemic is certainly an obstacle for the government to overcome the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia. Optimal Antenatal Care is one of the efforts to suppress MMR and IMR. The government recommends using online counseling to support antenatal care during the Covid-19 pandemic. Research objective: to determine the impact of e-KIE on the knowledge level and satisfaction of pregnant women in antenatal care during the Covid-19 pandemic. Research Methods: The design used was pre-experimental, namely one group pre-post test design to see the effect between the independent variables of the e-KIE method and the dependent variable, namely level of knowledge and satisfaction of pregnant women which were analyzed by marginal homogeneity. The research sample was selected by purposive sampling taken from the registration book (K1) with a population range of pregnant women from September to October 2021 totaling 37 respondents. Research results: there is a significant increase in the level of knowledge of pregnant women before and after e-KIE with a p value of 0.035 and an insignificant effect due to the compatibility between the expected value and the reality of pregnant women with a p value of 0.059. Conclusion: E-KIE significantly affects the level of knowledge of pregnant women and the e-KIE provided does not significantly affect the satisfaction of pregnant women in supporting dialogue/counseling in antenatal care during the Covid-19 pandemic.

Economic analysis of a new four-panel rapid screening test in antenatal care in Kenya, Rwanda, and Uganda

BackgroundWe performed an economic analysis of a new technology used in antenatal care (ANC) clinics, the ANC panel. Introduced in 2019–2020 in five Rwandan districts, the ANC panel screens for four infections [hepatitis B virus (HBV), human immunodeficiency virus (HIV), malaria, and syphilis] using blood from a single fingerstick. It increases the scope and sensitivity of screening over conventional testing.MethodsWe developed and applied an Excel-based economic and epidemiologic model to perform cost-effectiveness and cost-benefit analyses of this technology in Kenya, Rwanda, and Uganda. Costs include the ANC panel itself, its administration, and follow-up treatment. Effectiveness models predicted impacts on maternal and infant mortality and other outcomes. Key parameters are the baseline prevalence of each infection and the effectiveness of early treatment using observations from the Rwanda pilot, national and international literature, and expert opinion. For each parameter, we found the best estimate (with 95% confidence bound).ResultsThe ANC panel averted 92 (69–115) disability-adjusted life years (DALYs) per 1,000 pregnant women in ANC in Kenya, 54 (52–57) in Rwanda, and 258 (156–360) in Uganda. Net healthcare costs per woman ranged from $0.53 ($0.02-$4.21) in Kenya, $1.77 ($1.23-$5.60) in Rwanda, and negative $5.01 (-$6.45 to $0.48) in Uganda. Incremental cost-effectiveness ratios (ICERs) in dollars per DALY averted were $5.76 (-$3.50-$11.13) in Kenya, $32.62 ($17.54-$46.70) in Rwanda, and negative $19.40 (-$24.18 to -$15.42) in Uganda. Benefit-cost ratios were $17.48 ($15.90-$23.71) in Kenya, $6.20 ($5.91-$6.45) in Rwanda, and $25.36 ($16.88-$33.14) in Uganda. All results appear very favorable and cost-saving in Uganda.ConclusionThough subject to uncertainty, even our lowest estimates were still favorable. By combining field data and literature, the ANC model could be applied to other countries.

Hubungan Pengetahuan Tentang Tanda Bahaya Dalam Kehamilan Dengan Keteraturan Antenatal Care Di Puskesmas Batua Kecamatan Manggala Kota Makassar

The aim of this research is to determine the relationship between knowledge about danger signs in pregnancy and the regularity of Antenatal Care at the Batua Community Health Center, Manggala District. The research design used in this study is observational with a "Cross Sectional Study" approach, where the dependent variable and independent variables are collected simultaneously at the same time to obtain information about the relationship between pregnant women's knowledge about danger signs in pregnancy and the regularity of Antenatal Care. The population in this study were all 45 mothers who had their pregnancy checked. The sampling technique in this research was purposive sampling so that the sample obtained was 35 people. Data collection was obtained through questionnaires given directly to respondents. The data analysis techniques used are bivariate analysis and univariate analysis. The research results showed that knowledge of pregnant women about danger signs in pregnancy was mostly in the good category, namely 25 people (80.6%), the regularity of Antenatal Care among pregnant women was mostly in the regular category, namely 21 people (67.7%), and knowledge about danger signs in pregnancy. with the regularity of Antenatal Care for pregnant women at the Batua Community Health Center, Manggala District, Makassar City for the period February 2022 (p=0.003).

Maternal health literacy and adherence to recommended ANC contact among pregnant women in Indonesian

Maternal health literacy (MHL) equips pregnant women to seek timely Antenatal care (ANC). Through ANC, health workers can provide education that contributes to reducing the maternal mortality rate. This research aims to investigate the relationship between MHL and adherence to recommended ANC contacts and explore how mothers experience accessing ANC. The study design was a mixed-method study. A total of 305 pregnant women with various characteristics participated in this study. Quantitative data analysis used simple linear regression, while qualitative used Collaizi's strategy. The research found a positive relationship between MHL and adherence to recommended ANC contact with R2 = 0.18; F(1, 303) = 6.533, p < 0.05. Three themes represented the phenomenon of pregnant women in carrying out ANC: 1) perceptions about ANC, 2) challenges faced by pregnant women in accessing recommended ANC contact, and 3) supporting factors in doing routine ANC contact. Pregnant women with higher MHL have higher adherence to ANC contact. Health workers and policymakers can involve the results of this research in efforts to revise or make policies related to increasing pregnant women's ANC contacts.

Relationship Of Pregnant Mother Satisfaction In Antenatal Care Services With Motivation To Do Antenatal Care

Quality of health services provided by the government still has not or does not meet the expectations of patients and the public. This study aims to determine the relationship between the satisfaction of pregnant women at antenatal care with the motivation to do antenatal care. This research is an analytical study, which uses cross sectional design. The population in this study of pregnant women who do antenatal care in rural Puskesmas Gayaman Kabupaten Mojokerto is 58 people. The sample size in this study were 30 respondents. The sampling technique with a non-probability sampling techniques with the type of accidental sampling. Data collection techniques using primary data in the form of questionnaires and secondary data obtained from the KMS pregnant women. Techniques used in data analysis is Spearman Rank correlation. The study was conducted in Puskesmas Gayaman Kabupaten Mojokerto village on June 15 to June 29, 2022. The results of this study showed that pregnant women who feel very satisfied that as many as 23 respondents (76.7%), and pregnant women who have good motives as much as 26 respondents (86.7%). From the analysis of the data by Spearman Rank test, the result shows that the calculated ρ ρ table 0.5468 and 0.364, the price can be seen that ρ greater than ρ count table that means there is a correlation between the satisfaction of pregnant women at antenatal care with the motivation to do antenatal care.          Satisfaction of pregnant women in antenatal care of pregnant women affect the motivation to perform antenatal care. A good midwife services, facilities, friendly attitude of midwives, midwives skills in responding quickly to face the problems of patients so that respondents are motivated to come back. The motivation is called extrinsic motivation, namely the stimulation comes from outside or other people. Conclusions from this study are doing antenatal care satisfaction related to the motivation of doing antenatal care. Suggestions for health services in accordance with the result expected service quality can be maintained and further enhanced.

Assessing Focused Antenatal Care Awareness and Utilization Among Pregnant Women in Enugu State, Nigeria: A Cross-Sectional Survey.

Focused antenatal care (FANC) is a newer and better approach to antenatal care for pregnant women than the traditional model. FANC emphasizes individual assessment and decision-making by both the provider and the pregnant woman, resulting in better health outcomes for both mother and baby. Despite the adoption of FANC care in Nigeria, maternal mortality indices have not significantly decreased. This study aimed to assess the level of awareness and utilization of FANC among pregnant women in Nigeria, as well as the factors that influence its utilization. This study was conducted in Enugu, Nigeria, using the antenatal clinics of three major tertiary hospitals. A cross-sectional design was used, and a sample size of 300 pregnant women was selected using systematic random sampling. Data were collected using a structured, self-administered questionnaire and analyzed using IBM Statistical Package for Social Sciences (SPSS) version 26. The findings were presented using frequencies, tables, charts, and figures, and Fisher's exact test was used to determine the relationship between respondents' knowledge of focused antenatal care and their demographic factors. A study involving 300 pregnant women in Nigeria found that only 15% of them had heard of focused antenatal care (FANC) and just 7.3% had good knowledge of its components, which was attributed to the low level of education among the respondents (X2=16.68, p=0.001). Health talks during antenatal visits were the most common source of information on FANC. The study also revealed that late initiation of antenatal care (n=144, 48%) in current pregnancy and (n=106, 54.6%) among those previously pregnant, as well as insufficient attendance, were identified as risk factors for maternal mortality. Long waiting times (n=196, 65.3%) and overcrowded healthcare facilities (n=110, 36.7%) were the major causes of dissatisfaction with antenatal care services among the respondents. Pregnant women preferred delivering at tertiary hospitals or private hospitals due to the perceived better quality of care and personal preference. These findings could inform targeted interventions to improve knowledge and awareness of FANC among pregnant women, particularly those with lower levels of education. This study provides important insights into the low awareness and utilization of FANC among pregnant women in Enugu, Nigeria, highlighting the need for targeted interventions to improve knowledge and awareness of FANC. The study's findings have important implications for the development of maternal and child health policies and interventions aimed at improving the utilization of healthcare services during pregnancy and childbirth in Nigeria. Further research that includes qualitative methods could provide more nuanced information on pregnant women's experiences and perspectives on FANC.

Relationship of Parity, Maternal Age and Birth Weight with the Duration of the Second Stage of Labor

Background: second stage of labor begins when the cervix is fully dilated and ends with the birth of a baby. The duration of second stage of labor commonly lasts 2 hours for primigravida mothers and one hour for multigravida mothers. Prolonged labor is one of complications experienced by mothers in second stage of labor. Prolonged labor can cause several complications for both mothers and infants. Prolonged labor can harm both the mother and the infant. The harmful effects of complications during second stage of labor for mothers include the incidence of uterine atony, laceration, bleeding, infection, fatigue and shock and improving the birth rate with the C-section incision. Whereas the harmful effects of complications during second stage of labor for infants include asphyxiated, cerebral trauma caused by pressure on the head of the fetus, the injury due to action, and premature rupture of membranes. The severity of the injury increases continuously along with the longer of the duration of the labor process, and the risk of which rises quickly after 24 hours. The longer the labor, the higher the morbidity as well as the mortality. The stage of labor affected by all such factors mentioned is called the second stage of laborObjective: to find out the relationship of parity, maternal age, and birth weight with the duration of the second stage of labor.Methods: this study applied a quantitative research design using an analytical survey method through a cross sectional approach. The sample in this study was chosen using total sampling method with the purposive sampling technique, namely, that the sample was all maternity mothers who were coincidentally present at the time of the study at UPTD Karya Mukti Public Health Center in August 2021. Then, Chi-square statistical test was used to determine the relationship between independent variables and dependent variable.Results: of the 30 respondents, 20 respondents whose parity was not at risk (95.2%) experienced normal duration of second stage of labor, while 5 respondents (55.6%) whose parity was at risk experienced normal duration of second stage of labor. 21 respondents whose maternal age was not at risk (95.5%) experienced normal duration of second stage of labor, while 4 respondents whose maternal age was at risk (50%) experienced normal duration second stage of labor. 23 respondents (92%) with normal birth weight babies experienced normal duration of second stage of labor, while 2 respondents (40%)with large birth weight babies experienced normal duration of second stage of labor. The results of the Chi-square statistical test showed that there was a significant relationship between parity and the duration of the second stage of labor with the p-value of 0.019 £ 0.05 and the OR value of 9.157. There was a significant relationship between maternal age and the duration of the second stage of labor with the p-value of 0.011 £ 0.05 and the OR value of 5.387, and there was a significant relationship between birth weight and the duration of the second stage of labor with the p-value of 0.022 £ 0.05 and OR value of 3.405.Conclusions: there was a relationship between parity and the duration of second stage of labor. There was a relationship between maternal age and the duration of second stage of labor, and there was a relationship between birth weight and the duration of second stage of labor. Suggestions: It is hoped that health workers will further improve IEC (Information, Education, and Communication) regarding safe gestational age, safe parity and balanced nutrition as a form of antenatal care for pregnant women which is very influential, especially during the second stage of labor. In addition, for pregnant women, it is better to perform quality ANC to predict whether mothers will be likely to experience prolonged labor or not and also to prevent prolonged labor and other complications of pregnancy and labor. Then, based on the results of ANC tests, the mothers immediately referred to a more adequate hospitals/maternity hospitals to monitor the condition of their pregnancy so as to prevent the risk that will be faced by the mothers and fetus during labor. Keywords: Parity, Maternal Age, Birth Weight, Duration of Second Stage Labor

Inequality in time to first antenatal care visits and its predictors among pregnant women in India: an evidence from national family health survey

For countries with high maternal mortality and morbidity, on-time initiation of antenatal care (ANC) is indispensable. Therefore this paper aims for studying the median survival time (MST) of first ANC among pregnant women as well as understanding the contextual factors that influence a mother’s decision to access ANC services in India. The study used cross-sectional survey data obtained from the NFHS-4 conducted in 2015–2016. The MST of the timing of the first ANC visit was estimated using the Kaplan-Meir estimate. A multivariate Cox-proportional hazard regression model was used to identify the factors related to the timing of the first ANC visit with a 95% confidence interval (CI). Overall at least one ANC checkup was assessed by 60.15% of women and the median survival time for the first ANC checkup was found to be 4 months. Early initiation of ANC in pregnant women increased by 37% (AHR: 1.37, CI:1.34–1.39) for primary education, and 88% (AHR:1.88, CI:1.86–1.90) for secondary education compared to women having no formal education. Results of the current study revealed that the median survival time of the first ANC visit was 4 months in India which is delayed compared to recommendations of WHO. Therefore boosting the access and utilization of antenatal care coverage among pregnant women can ensure the best health outcomes for their pregnancy.

PENGEMBANGAN APLIKASI PELAYANAN ANTENATAL CARE BAGI IBU HAMIL DI ERA PANDEMI COVID -19 BERBASIS ANDROID DI KAB.BANGKA

The emergence of the COVID-19 pandemic has had an impact on the health service delivery system. The impact of COVID-19 could be greater on vulnerable populations including pregnant women. Pregnant women are afraid to go to health facilities for fear of contracting Covid, suggestions to postpone pregnancy checks and classes for pregnant women, as well as service uncertainty in terms of personnel and infrastructure including personal protective equipment. The aim of this research is to develop an Android-based ANC Service Application for Pregnant Women in the Pandemic Era. This research was carried out at PKM Kenangan, Bangka Regency in May-October 2021. The informants in this study were village midwives and pregnant women. This type of research is qualitative with a research and development approach. The data used in this study are secondary and primary data through Focus Group Discussion with purposive sampling. This research method is RnD (research and development sequential explanatory mixed methods, the first stage is quantitative research then qualitative research is carried out to strengthen the quantitative results. The data used in the quantitative research is secondary data from perinatal mortality and OVP recapitulation, while in qualitative research with interviews in depth by taking purposive sampling. The results showed that information related to the Corona Virus in pregnant women was still minimal and difficult to access, so it was necessary to have a special application related to information related to the Corona Virus in pregnant women. Based on these results, a blue print application model was created and the initial product was in the form of Android-based application regarding guidelines for prenatal care for pregnant women during the COVID-19 pandemic. The conclusion in this study is that information related to antenatal care for pregnant women during the Covid pandemic era is less sick. i antenatal care services for pregnant women during the Corona Virus pandemic 19.

Antenatal care experiences of uninfected pregnant women during the COVID-19 pandemic: A qualitative systematic review

BackgroundThere is a limited understanding of pregnant women's antenatal care experiences during the COVID-19 pandemic. PurposeTo review and synthesize qualitative studies on uninfected pregnant women's antenatal care experiences during the COVID-19 pandemic. MethodsFive databases were searched for qualitative studies published between January 2020 and January 2023. This study used a thematic synthesis of qualitative evidence and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Furthermore, this review was registered with PROSPERO and a quality appraisal was assessed. ResultsNine published qualitative studies were included in this review. The studies were conducted in eight countries and included 3,709 participants. Five themes were identified: (a) disruptions of normal antenatal care services, (b) feelings of uncertainty, (c) desire for sufficient spousal support, (d) coping strategies, and (e) trust in health care providers. Discussion and ConclusionThe themes can be utilized to reform current interventions for pregnant women by nurse-midwife managers and by health care policymakers to improve current practice and direct new research to prepare for future pandemics.

Perceived quality of antenatal care for pregnant women at a tertiary level hospital

Introduction: Antenatal care (ANC) helps in the effective management of pre-natal morbidities, and facilitates institutional delivery and postpartum care, that can improve maternal and newborn health. Patient perceived quality is defined as the subjective and dynamic perception of the extent to which expected health care is received by a person and it provides excellent feedback to healthcare providers. Aim of the study: This study aimed to describe the perceived Quality of antenatal care for pregnant women at tertiary level hospitals in Bangladesh. Methods: A descriptive study was conducted among 98 pregnant women who were attending the antenatal care unit at OPD in Dhaka medical college hospital, Dhaka. A convenience sampling technique was used to select study participants. Data was collected through face-to-face interviews through a structured questionnaire. Data were analyzed by using frequencies, percentages, the mean and standard deviation to describe the demographic characteristic. Inferential statistics two-sample t-tests and ANOVA were used. Result: The mean age of pregnant mothers was 24.87(4.67) years, (ranging from 18 to 38). The total mean score quality of antenatal care was 3.77 ±.939. Only physical examination regarding fundal assessment rate was very poor (35.7%). There was a significant difference between education and perceived quality of antenatal care (F= 4.571, p = 013). Conclusion: The results revealed that those who had more education; had a more perceived quality of antenatal care and those who got more than four visits, had a good quality of antenatal care. The results provide baseline information for providing antenatal care to pregnant women about increasing the rate of physical assessment. The authentic assessment helps to reduce maternal and infant mortality and morbidity which can help in achieving the SDGs3.

Analysis of factors that affect the utilization of antenatal care in developing countries: a systematic review

To explain the factors related to the implementation of antenatal care in developing countries. The systematic review was conducted in June 2020 and comprised literature search on Scopus, Cumulated Index to Nursing and Allied Health Literature, PubMed and Garba Rujukan Digital databases for cross-sectional, survey-based, prospective, mixed-method, correlational, experimental, longitudinal, cohort and case-control studies published after 2015 in either English or Indonesian. The studies included involved pregnant women and discussed the factors of implementing antenatal care in developing countries, and explained the factors related to the implementation of antenatal care in accordance with the World Health Organisation recommendation. The Population, Intervention, Comparison, Outcomes and Study framework was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Data was analysed using descriptive statistics with a narrative approach. Of the 9,733 studies initially found, 50(0.005%) were shortlisted for full-text review, and, of them, 15(30%) were reviewed and analysed. There were 3(20%) each from Pakistan and Ghana, 2(13.3%) each from Nepal and India, and 1(6.66%) each from Jordan, Egypt, Yemen, South Africa and Vietnam. Overall, 10(66.6%) were cross-sectional studies. There were five factors identified regarding antenatal care; behaviour intention, social support, accessibility of information, personal autonomy, and action situations, including economic status, availability of facility and transportation. Antenatal care in pregnant women in developing countries is influenced by several factors, and economic status and the availability of facilities and infrastructure optimise the use of such services.

Antenatal care of pregnant women during pandemic: a phenomenology study

To assess the experience of pregnant women related to antenatal care during the coronavirus disease-2019 pandemic. The qualitative interpretive phenomenology study was conducted from July to September 2022 in Lamongan General Hospital after approval from Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia. The sample comprised pregnant women at very high risk in the third trimester during the coronavirus disease-2019 pandemic. Data was collected from the medical records, and subsequently through semi-structured interviews. Data was analysed using the Braun and Clarke thematic analysis. Of the 19 subjects with a mean age of 33.3±4,91 years, 11 (58%) had studied up to high school level and 16(84%) were housewives. There were 5 themes that had a total of 14 sub-themes. The themes were fear of getting pregnant during a pandemic, afraid of losing her baby, losing the support system, adherence to health protocols, and differences in healthcare systems. Pregnancy during the pandemic had an impact on the physical and mental health of women and turned into a terrifying experience. Health workers need to pay attention to the physical and psychological conditions of pregnant women, including antenatal care services that must be provided at least six times directly or by using telemedicine.

Evaluation of the Anxiety and Depression Scores in Women with Uncomplicated Pregnancies in the Era of Coronavirus Disease 2019: The Experience of a Single Tertiary Center

Aim: The recent outbreak of coronavirus has become an extremely significant health issue on a global scale, and its impact on the psychological status of pregnant women is still under investigation. This study aimed to assess the anxiety and depression scores of uncomplicated pregnancies in the age of coronavirus disease 2019 (COVID-19).
 Materials and Method: A total of 98 pregnant women were included in the study. The patients were divided into three groups according to the trimesters of pregnancy. The 21-item Beck anxiety and Beck depression scales were completed by all participants. Anxiety and depression scores and the demographic information of the groups were compared.
 Results: The anxiety level of group 3 was found to be significantly higher than those of groups 2 and groups 1 (p < 0.001). The mean depression score of group 3 was significantly higher than that of group 1. The depression scores of patients from different educational levels were similar; however, it was observed that the higher educational level of patients was significantly correlated with higher anxiety scores (p < 0.001). 
 Conclusion: Our study showed that during COVID-19, the depression and anxiety scores of pregnant women approaching childbirth may be significantly higher than those of women with early pregnancies. The inclusion of psychological support in routine antenatal care for pregnant women in the third trimester should be considered to improve maternal and fetal outcomes.

EDUKASI IBU HAMIL TENTANG TANDA BAHAYA KEHAMILAN PADA WARGA DUSUN PONDOK BUAK DESA BATU KUMBUNG

Pregnancy is a natural and physiological process. Every woman who has healthy reproductive organs, if she has experienced menstruation and has sexual relations with a man whose reproductive organs are healthy, there is a very high possibility of pregnancy (Mandriwati, et al 2017). Normal pregnancy will take place within 40 weeks or 10 lunar months or 9 months according to the international calendar. Pregnancy is divided into 3 trimesters: 1. the first trimester lasts for 12 weeks, 2. the second trimester is 15 weeks (13 to 27 weeks) and 3. the third trimester is 13 weeks (28 to 40 weeks) (Prawirohardjo, 2014). Knowledge of pregnant women about the danger signs in pregnancy is one of the factors that can affect the alertness of pregnant women to the danger signs of pregnancy. To prevent the occurrence of danger in pregnancy, pregnant women need to have regular antenatal care checks at health facilities. This study aims to determine the relationship between knowledge of pregnancy danger signs and compliance with the implementation of antenatal care (ANC) in pregnant women. There is a strong relationship between knowledge of the danger signs of pregnancy and adherence to antenatal care for pregnant women in Pondok Buak Hamlet.

Point-of-Care Sexually Transmitted Infection Testing Improves HIV Preexposure Prophylaxis Initiation in Pregnant Women in Antenatal Care in Cape Town, South Africa, 2019 to 2021.

A study of HIV-uninfected pregnant women in South Africa found that women offered point-of-care sexually transmitted infection testing had higher odds of initiating HIV preexposure prophylaxis than women offered laboratory-based testing. Background Preexposure prophylaxis (PrEP) programs present a platform for diagnostic sexually transmitted infection (STI) testing in low- and middle-income countries, and availability of targeted STI testing has been hypothesized to influence PrEP use. We evaluated the association of STI testing modality and PrEP uptake among pregnant women in antenatal care. Methods We enrolled pregnant, HIV-uninfected women (16 years or older) at their first antenatal visit with follow-up through 12 months postpartum. Women were offered oral PrEP and tested for Chlamydia trachomatis and Neisseria gonorrhoeae using a point-of-care (POC; Cepheid, August 2019–November 2020) or laboratory-based (Thermofisher, December 2020–October 2021) test. We compared the proportion of women initiating and continuing PrEP by STI test adjusting for confounders. Results We evaluated 1194 women (median age, 26 years [interquartile range, 22–31 years]) with an STI result (46% POC and 54% laboratory-based). The prevalence of any STI was the same in POC-tested (28%) and laboratory-tested (28%) women—25% versus 23% for C. trachomatis (P = 0.35) and 7% versus 9% for N. gonorrhoeae (P = 0.11). Mean time from testing to result was 0 day for POC and 26 days for laboratory testing, and mean time from testing to treatment was 3 days for POC and 38 days for laboratory testing. Receiving a POC STI test was associated with higher PrEP initiation compared with women receiving a laboratory-based test (90% vs. 78%; adjusted odds ratio, 2.1; 95% confidence interval, 1.5–2.9), controlling for age, gravidity, STI diagnosis, intimate partner violence, gestational age, employment, HIV risk perception, and cohabiting status. Conclusions Point-of-care STI testing, offering same-day results and treatment initiation, may increase PrEP initiation among pregnant women in antenatal care.

Health Literacy Assessment Tool related to Antenatal Care (HLAT-ANC) for Pregnant Women: A Methodological Research from Turkey

Objective: It is important to provide adequate antenatal care (ANC) for the lowest maternal-
 fetal complications in pregnancy. The increase in the level of health literacy increases the
 quality of the ANC, and compliance with the follow-up. To develop a tool to evaluate health
 literacy (HL) levels of pregnant women in antenatal care (ANC).
 Methods: This study is methodological research conducted between 15.02.2016-01.07.2018.
 "Health Literacy Assessment Tool related to Antenatal Care (HLAT-ANC)" was developed.
 Its validity-reliability was tested by item analysis, exploratory factor analysis (EFA),
 concurrent criterion validity, intergroup dissociation, and confirmatory factor analysis (CFA),
 and determination of the Kuder-Richardson-20 (KR-20) coefficient.
 Results: The discrimination coefficients of the items in HLAT-ANC varied between 0.20-
 0.57 and factor loads between 0.34-0.85. It was determined that HLAT-ANC has KR-20≥0.85
 in each subdomain. The scores of fit criteria obtained in the confirmatory factor analysis were
 within acceptable limits.
 Conclusions: HLAT-ANC was found to be a valid and reliable scale.

Factors affecting women's access to antenatal care services

The aim of this study was to quantitatively investigate the antenatal care provided by healthcare physicians in a rural area of North East Anatolia, Turkey, and the effective factors. Patients who applied to a Second-tier health institution for delivery were asked how many times they went for a check-up during their pregnancy. In addition, the sociodemographic characteristics of the responding patients were recorded. In this study, the rate of pregnant women who received inadequate antenatal care was 41.0%. Examining the risk factors for inadequate antenatal care in pregnant women who attended fewer than four antenatal care visits revealed that the risk was 2,115 (confidence interval [CI] = 1.328–3.368) times higher for those receiving spousal education for <5. Longer years than those with ≥6 years of partner training. Pregnant women who received inadequate antenatal care in the North East Anatolia region preferred to visit Secondary and Tertiary healthcare institutions instead of visiting primary care physicians. In conclusion, it is necessary to establish a referral chain through health plans and expand Primary antenatal care services to reduce both maternal and neonatal mortality and morbidity.