Antenatal Care Program Research Articles

Non-adherence to antenatal iron supplementation and its determinants among pregnant women in 35 sub-saharan African countries: a generalized linear mixed-effects modeling with robust Poisson regression analysis

BackgroundDespite the integration of iron supplementation into routine antenatal care programs as a nutritional intervention to prevent anemia in pregnant women, the use of this supplement for the recommended duration remains low in sub-Saharan Africa (SSA). Evidence on maternal compliance with iron supplementation at the SSA level is lacking and most of the previous studies have been limited to specific geographic areas. Therefore, the current study used large population survey data from 35 SSA countries to estimate the pooled prevalence of non-adherence and its determinants.MethodsA secondary analysis was conducted using data from the demographic and health surveys across 35 SSA countries. After excluding women with missing data on the outcome variable, a weighted sample of 158,941 women who received iron supplementation during their recent pregnancy was included in the analysis. Forest plot was used to present the pooled and country-level rates of non-adherence to antenatal iron supplementation. A multilevel mixed-effects Poisson regression with robust variance was done to identify determinants of non-adherence.ResultsThe pooled prevalence of non-compliance to iron supplementation in SSA was 65.1% [95% CI: 64.9 − 65.3%], with the lowest level in Zambia (18%) and the highest in Burundi (97%). The analysis revealed that living in rural areas (aPR: 1.16, 95% CI: 1.13–1.19), lack of access to mass media (aPR: 1.10, 95% CI: 1.09–1.12), low household wealth (aPR: 1.11, 95% CI: 1.09–1.14), late (aPR: 1.19, 95% CI: 1.17–1.20) and frequent ANC visit (aPR: 1.28, 95% CI: 1.26, 1.29), women’s employment status (aPR: 1.05, 95% CI: 1.03–1.06), husband illiteracy (aPR: 1.12, 95% CI: 1.10–1.13), and distance to a health facilities (aPR: 1.03, 95% CI: 1.01–1.05) were associated higher prevalence of non-adherence. Conversely, older maternal age was associated lower prevalence of non-compliance (aPR: 0.96, 95% CI: 0.94–0.97).ConclusionMore than six out of ten pregnant women in SSA do not take iron supplements for the recommended period, with substantial variations across the countries. The level of non-adherence was significantly varied by women’s sociodemographic and reproductive characteristics. This urges the need for strengthening community health interventions and other existing programs to reach women in rural and economically disadvantaged settings. Furthermore, promoting antenatal care services through mass media and community-based health education strategies is key for scaling up the utilization of the supplement. Our results also suggest the importance of establishing the community-based distribution of iron supplements to address women with limited access to the healthcare system.

Magnitude and factors associated with low birth weight among newborns in public health facilities of Mekelle City, northern Ethiopia: a multi-center study.

Low birth weight is a key determinant of child survival, significantly influencing rates of infant and childhood mortality, morbidity, and disability. While some studies have been conducted in our region, there is still a gap in evidence regarding the maternal characteristics associated with low birth weight. Hence, this study aimed to determine the proportion of newborns with low birth weight and determinant factors, particularly focusing on maternal characteristics. A facility-based cross-sectional study was conducted from 21 March to 20 April 2020 involving mothers and their newborns at selected public health facilities in Mekelle City. The sample included 447 participants, with two public hospitals and three health centers chosen by a lottery method. Systematic random sampling was applied to select mother-newborn pairs. Data were collected using a structured, interviewer-administered questionnaire and analyzed using the Statistical Package for Social Sciences version 21. Bivariate and multivariate logistic regression analyses, with a 95% confidence interval (CI), were used to identify factors associated with low birth weight. The study included 447 mothers of newborns, achieving a 100% response rate. The proportion of low birth weight was 14.3%. Significant factors associated with low birth weight included attending the first antenatal care (ANC) visit in the third trimester [adjusted odds ratio (AOR) = 3.66, 95% CI: 1.28-10.44], not receiving additional nutrition during pregnancy (AOR = 4.16, 95% CI: 1.38-12.58), experiencing obstetric complications during the current pregnancy (AOR = 7.72, 95% CI: 2.76-21.59), and a gestational age at birth of less than 37 weeks (AOR = 5.36, 95% CI: 1.96-14.67). This study revealed a substantial incidence of low birth weight. The initiation of the first antenatal care visit in the third trimester, failure to supplement nutrition during pregnancy, the occurrence of obstetric complications during pregnancy, and a gestational age at birth less than 37 weeks were all found to be significantly correlated with this condition. It is recommended that policymakers strengthen maternal and child health services, especially through the focused ANC program, to improve outcomes. Health facilities should promote awareness of the importance of initiating ANC visits early, with an emphasis on nutritional counseling throughout pregnancy.

Emergency contraceptive pill awareness in Bangladesh: missed opportunities in antenatal care and family welfare assistant visits

BackgroundDespite high coverage of antenatal care (ANC) and family welfare assistant (FWA) visits, emergency contraceptive pill (ECP) awareness is critically low in Bangladesh. We aim to investigate the missed opportunities in generating ECP awareness through ANC and FWA visit programs; and assess the missed opportunities and sociodemographic discrimination in receiving family planning (FP) counseling during ANC.MethodsWe used data from the nationwide Bangladesh Demographic and Health Survey 2017–18. Sample includes 5012 reproductive-aged women who gave live birth in the last 3 years preceding the survey. We used mixed-effect multiple logistic regression considering women nested within clusters to conclude.ResultsNationally, 79% of women who gave live birth in the last 3 years preceding the survey were unaware of ECP. The estimated missed opportunities in generating ECP awareness was 59.5% in ANC, 0.9% in FWA visits, and 12.3% in both ANC and FWA visits. While FWA visit was not associated with ECP awareness, receiving FP counseling during ANC was significantly associated. About 88.4% of women remained unexposed to FP counseling through ANC during their last pregnancy. Missed opportunities in FP counseling during ANC was 80.4% of which 72% points were from qualified providers. The odds of missed opportunities was not associated with provider type, rather significantly increased among women with low education, lower parity, and poor socioeconomic status.ConclusionsThis study highlights the fragile status of FP counseling during ANC and FWA visits in generating ECP awareness. A prominent provider bias is excluding women of the disadvantageous sociodemographic group from receiving FP counseling.

Cost-effectiveness analysis of proactive home visits compared with site-based community health worker care on antenatal care outcomes in Mali: a cluster-randomised trial

IntroductionDespite recommendations from the WHO, antenatal care (ANC) coverage remains low in many low-income and middle-income countries (LMICs). Community health workers (CHWs) can play an important role in expanding ANC...

IMPACTOS DA DEPRESSÃO PÓS-PARTO NA AMAMENTAÇÃO EXCLUSIVA: UMA REVISÃO INTEGRATIVA

Postpartum depression (PPD) is a psychological disorder that significantly affects the mentalhealth of women during the postpartum period, impacting, exclusive breastfeeding (EBF),which should be maintained during the first six months of the baby's life. This study aimed to identify the main symptoms of PPD that can hinder exclusive breastfeeding. The specific objectives included: evaluating the impact of PPD on the duration and exclusivity of breastfeeding; highlighting the influence of PPD on early weaning; and exposing the symptomatology associated with PPD. The methodology used was an integrative review of articles published between 2019 and 2023, analyzing the risk factors related to PPD, as well as the psychological, physical, and social impacts on women. The findings indicate that conditions such as low education levels, socioeconomic vulnerability, and lack of social and maritalsupport are strongly associated with the development of PPD, which directly compromises the mothers' ability to provide exclusive breastfeeding to their children. The results emphasize the importance of early interventions, such as adequate psychological support, family support networks, and awareness actions by healthcare professionals. In conclusion, public policies focused on maternal and child health should be strengthened, with an emphasis on the prevention and management of PPD, aiming to ensure the overall well-being of mothers and their babies. The implementation of antenatal care programs and emotional support can helpreduce the adverse effects of PPD.

A decade later: Assessing pregnant women's perspectives on non-invasive prenatal testing (NIPT) in Saudi Arabia

Since its introduction a decade ago, non-invasive prenatal testing (NIPT) has been recognized as a highly accurate and safe screening option for expecting mothers, with its efficacy hinging on awareness, perceptions, and understanding of the test. We surveyed pregnant women in Saudi Arabia between December 2023 and February 2024 to assess the knowledge and acceptability of NIPT among them. A total of 212 pregnant women from various risk levels, socioeconomic statuses, and trimesters participated in the study, which was carried out at King Saud University Medical City (KSUMC) via online forms. This study investigated factors affecting attitudes towards NIPT, including financial burden. Data were analyzed with descriptive statistics and chi-square tests to assess correlations. The survey revealed a significant lack of awareness about NIPT, with 64.6 % of participants unfamiliar with the test and 93.3 % answering knowledge-related questions incorrectly. Although 74.1 % were willing to undergo NIPT if it were free, only 30 % were willing to pay 1500 SAR (400 USD). These findings underscore the need for targeted knowledge translation efforts to enhance awareness and understanding of NIPT among pregnant women, highlighting the importance of addressing financial barriers and increasing educational outreach. Further research and interventions are needed to promote the uptake of NIPT and enhance the quality of antenatal care programs in Saudi Arabia.

Implementation and Baseline Evaluation of an Evidence-Based Group Antenatal Care Program in Two Nigerian States.

Northern Nigeria has had historically low antenatal care (ANC) utilization rates with poor health outcomes. Previous studies have shown that group antenatal care (gANC) improves ANC behavior and pregnancy outcomes. The gANC has been adopted in Kaduna and Kano States, Nigeria. This paper presents baseline findings from the implementation of the gANC program in Kaduna and Kano States, Nigeria, based on data collected from 1269 and 1200 pregnant women, respectively, from March to April 2024. Analyses of sociodemographic and pregnancy behavior data were performed. Participants were mostly between the age of 19 and 31 years, married or living with a partner, with over 50% having their own businesses. Over 62% and 34% had completed secondary- or higher-level education, with 60% and 80% living in urban areas in Kaduna and Kano States, respectively. In Kano State, >60% of the women had their last delivery at home, with 41.6% not assisted by a skilled birth attendant. In Kaduna, >63% delivered in the hospital and >50% had skilled attendance during labor. Almost half had not used contraceptives previously. This study has provided baseline evaluation data for the implementation of gANC in two states in Nigeria. Subsequent longitudinal data will examine the impact of gANC utilization on perinatal outcomes and contraceptive behavior to inform the scaling of the program in the country.

Effect of an educational intervention program on pregnant women’s ability to cope with childbirth pain in Western Kenya

INTRODUCTION Childbirth pain has remained a major challenge to women of child-bearing age over the years. Studies have shown that most women are not aware of the coping strategies to employ during childbirth. Severe childbirth pain can lead to adverse maternal and neonatal outcomes. Therefore, it is imperative to develop safe and innovative methods to cope with childbirth pain. The study aimed to investigate the effects of an educational program on women's ability to cope with childbirth pain in the context of lower and middle-income countries. MATERIALS AND METHODS A Quasi-experimental design was used to assess the impact of an educational intervention built on self-efficacy theory. Pregnant mothers were recruited at antenatal care services and were assigned to either the control group or the intervention group. The intervention group received two sessions of 2 hours each of the intervention between the 32nd– 35th weeks of gestation. Follow-up and evaluation on outcome measures were conducted within 48 hours after delivery. The strength of pain was measured by the visual analogue pain scale and the Mac-Gill pain questionnaire. RESULTS Findings indicate that relative to the control group, the intervention group was significantly more likely to demonstrate lower perceived pain both on the visual analogue scale (P<0.001) and the McGill pain questionnaire (P<0.001). Further analysis revealed that the non-intervention group had increased severe pain [OR=3.099,95% CI (1.080-8.887), P=0.035], unbearable pain [OR=27.930,95% CI (9.354-83.399), P=<0001], while permanent employment reduced unbearable pain [OR=0.038 95% CI (0.003-0.549), P=0.016]. CONCLUSION AND RECOMMENDATIONS The educational intervention program was effective in decreasing pain intensity and severity during childbirth. Training programs should be integrated into the antenatal care program and offered to mothers during the third trimester of pregnancy to enhance women's coping skills during childbirth.

Double burden of gestational diabetes and pregnancy-induced hypertension in Ethiopia: A systematic review and meta-analysis of observational studies.

The coexistence of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) amplifies the risk of maternal and perinatal mortality and complications, leading to more severe adverse pregnancy outcomes. This systematic review and meta-analysis aimed to assess the double burden of GDM and PIH (GDM/PIH) among pregnant women in Ethiopia. A comprehensive systematic search was conducted in the databases of PubMed, Cochrane Library, Science Direct, Embase, and Google Scholar, covering studies published up to May 14, 2023. The analysis was carried out using JBI SUMARI and STATA version 17. Subgroup analyses were computed to demonstrate heterogeneity. A sensitivity analysis was performed to examine the impact of a single study on the overall estimate. Publication bias was assessed through inspection of the funnel plot and statistically using Egger's regression test. Of 168 retrieved studies, 15 with a total of 6391 participants were deemed eligible. The pooled prevalence of GDM/PIH co-occurrence among pregnant women in Ethiopia was 3.76% (95% CI; 3.29-4.24). No publication bias was reported, and sensitivity analysis suggested that excluded studies did not significantly alter the pooled prevalence of GDM/PIH co-occurrence. A statistically significant association between GDM and PIH was observed, with pregnant women with GDM being three times more likely to develop PIH compared to those without GDM (OR = 3.44; 95% CI; 2.15-5.53). This systematic review and meta-analysis revealed a high dual burden of GDM and PIH among pregnant women in Ethiopia, with a significant association between the two morbidities. These findings emphasize the critical need for comprehensive antenatal care programs in Ethiopia to adequately address and monitor both GDM and PIH for improved maternal and perinatal health outcomes.

Support from midwives and spouse on antenatal care visit adherence in health centers among primigravida pregnant women

Background: The maternal mortality rate in Indonesia remains high. A strategy to reduce this number is through the implementation of antenatal care (ANC) programs, which are essential for pregnant women. The issue at hand is the low number of ANC visits at the Sragen Community Health Center, where out of 1,022 targets, 896 pregnant women did not meet the minimum service standard target in 2022. ANC visits are closely related to various factors, such as knowledge, attitude, access, and external support factors. This study focuses on external support factors that influence pregnant women to attend ANC visits, including support from husbands and midwives. Purpose: To determine the relationship between husband and midwife support and antenatal care visits among primigravida pregnant women. Method: This quantitative research with a cross-sectional design was conducted in October 2023 at the Sragen Community Health Center. The study population consisted of 100 primigravida women who had ANC visits from January to August 2023, with a sample size of 84 pregnant women selected using total sampling techniques based on the Lemeshow formula. The research instrument used was a questionnaire. Data were analyzed using bivariate Chi-Square tests processed with SPSS version 20. Results: There is a significant relationship between husband support and ANC visits among primigravida women, with a P-value of <0.001. Similarly, statistical tests showed a significant relationship between midwife support and ANC visits among primigravida women, with a p-value of <0.001. Conclusion: Both husband and midwife support are highly beneficial, with average support levels above 80%. The highest percentage of husband support was in the emotional aspect (83%), and the highest percentage of midwife support was in the instrumental aspect (83.3%). High levels of husband and midwife support can promote pregnant women to attend ANC visits regularly, while low support can result in reluctance to do so.

Analysis of Risk Factors Associated with the Incidence of Placenta Accreta at an Indonesian Tertiary Hospital

Highlights:1. The increased incidence of placenta accreta is contributed significantly by parity classification, a history of cesarean section, body mass index, and interbirth interval.2. The findings of this study can be used as an additional reference in determining the risk of placenta accreta in pregnant women, specifically as an input in screening and antenatal care programs for pregnant women to provide early detection and appropriate management. Abstract The incidence of placenta accreta during pregnancy constitutes a serious problem in reproductive health. This complication has increased significantly over the last few decades, especially in developed countries where cesarean deliveries have also risen. Placenta accreta spectrum can cause very severe bleeding and potentially lead to other serious complications. The purpose of this study was to analyze the risk factors associated with the incidence of placenta accreta in women giving birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. This quantitative study used an analytical observational research design, specifically the case-control approach. The study sample was all mothers who gave birth at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, between 2019 and 2023. In addition to a univariate analysis, the data were subjected to bivariate analysis using a two-sample independent t-test or Mann-Whitney test for ordinal data and for nominal data using the Chi-square test as well as multivariate analysis using logistic regression (p<0.05). The results showed that parity, a history of cesarean section, body mass index, and interbirth interval were the variables identified as significantly associated with placenta accreta. According to the logistic regression analysis, parity, a history of cesarean section, and a history of curettage were identified as the primary determinants of placenta accreta incidence. The classification of parity was found to have the most significant relationship to the incidence of placenta accreta. This study concluded that parity classification, a history of cesarean section, body mass index, and interbirth interval are the significant risk factors contributing to the increased incidence of placenta accreta at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

The impact of antenatal cluster management on maternal delivery and postpartum rehabilitation

ObjectivePregnancy care can improve maternal pregnancy outcomes. Cluster nursing, an evidence-based, patient-centered model, enhances pregnancy care, can provide patients with high-quality nursing services, has been widely used in clinical practice in recent years. However, most previous studies evaluated cluster nursing program only for a single clinical scenario. In this study, we developed and implemented a antenatal cluster care program for various prenatal issues faced by puerpera to analyze its application effect.MethodsThis is a historical before and after control study. 89 expectant mothers who had their prenatal information files registered in the outpatient department of a grade III, level A hospital from June 2020 to September 2021 were finally enrolled in observation group, and received prenatal cluster management. Another set of 89 expectant mothers from January 2019 to December 2019 were included in the control group and received traditional routine prenatal management. The effect of cluster nursing management on maternal delivery and postpartum rehabilitation was evaluated and compared between the two groups.ResultsCompared with the control group, the observation group had a significantly higher natural delivery rate, better neonatal prognosis, higher rates of exclusive breastfeeding, lower incidence of postpartum complications, shorter postpartum hospital stay, better postpartum health status, and higher satisfaction with nursing services. Compared with before intervention, the SAS and SDS scores of the observation group showed significant improvement after intervention.ConclusionAntenatal cluster care is beneficial to improve maternal and neonatal outcomes, and can have positive effects on natural pregnancy and breastfeeding, while improving the multimedia health education ability of medical care and emphasizing the importance of social support.

One size does not fit all: Perspectives from Swedish midwives on fetal movement counselling

ProblemMigration continues to play a role in determining health outcomes related to pregnancy and childbirth in Sweden. BackgroundMigrant women have, compared to Swedish-born women, increased risks of adverse birth outcomes. Previous research suggests that migrant women seek care for decreased fetal movements less than Swedish-born women. Given these documented risks, understanding midwives’ perspectives in this context is crucial to address maternal health inequities. AimTo explore midwives’ experiences conveying information about fetal movement to migrant women in antenatal healthcare settings. MethodsSemi-structured, individual interviews with midwives (n=15) experienced in providing information about fetal movements to migrant women. The interviews were analysed using reflexive thematic analysis. FindingsThe midwives’ efforts to compensate for the deficiencies within the antenatal healthcare organisation and to ensure that all women received access to information and care regarding fetal movements are described in four themes: (a) building a trusting relationship; (b) empowering women through guidance and support; (c) overcoming communication challenges; and d) navigating safety measures. DiscussionOur findings suggest that the standard antenatal care programme does not support midwives to provide holistic and individualised care that aligns with midwifery care philosophy. ConclusionTo reduce health inequities for migrant women, this study highlights the need for more flexible guidelines within the standard antenatal care programme. These guidelines should prioritise the individual woman’s needs over institutional protocols, acknowledge the midwife-woman relationship as the core of midwifery practice and support midwives to build a partnership with women through continuity of care.

25(OH) Vitamin D Status among Females with Preeclampsia/Eclampsia: A Long-term Plight Readdressed

Background: Preeclampsia is a life-threatening multisystem disorder of pregnancy which has been observed in 2%–10% of pregnancies. The prevalence of Vitamin D deficiency ranges from 15% to 80%. Deficiency of Vitamin D is associated with the development of preeclampsia. This study was done to find out the prevalence of Vitamin D deficiency among preeclamptic/eclamptic and normal pregnant females, to establish Vitamin D deficiency as a causal factor of preeclampsia, and to elucidate the relation between 25 (OH) Vitamin D status and the severe preeclampsia. Materials and Methods: Blood samples were collected from 50 normotensives (controls) and 50 hypertensive pregnant females with preeclampsia/eclampsia (cases), and 25 (OH) Vitamin D level was measured by chemiluminescence Immunoassay. Results: Among the preeclamptic/eclamptic group, 32 (64%) were noted with Vitamin D deficiency and 18 (36%) with Vitamin D insufficiency. In the control group, 30 (60%) pregnant women showed Vitamin D deficiency, 19 (38%) with Vitamin D insufficiency, and a sufficient level of Vitamin D was observed in one woman (2%). Conclusion: Although it is difficult to demonstrate the correlation between Vitamin D levels and preeclampsia, there is a widespread global prevalence of Vitamin D deficiency during pregnancy. Hence, Vitamin D supplementation can be included routinely in the antenatal care program in India.

Obstetric Analgesia in Saudi Arabia: A Cross-sectional Study of Labour Pain Management Preferences and Satisfaction among Women

Abstract Introduction: Labour pain management is a crucial aspect of obstetrics, significantly impacting the maternal experience during childbirth. Effective analgesia is not only vital for comfort but also influences the overall outcome of labour. This study aims to assess the preferences and satisfaction levels of Saudi Arabian women regarding obstetric analgesia. Despite various pain management methods such as epidural analgesia, there is a notable gap in knowledge and awareness among pregnant women in Saudi Arabia. Understanding these preferences and satisfaction levels is essential for enhancing maternal care and pain management strategies. Methods: This cross-sectional study recruited Saudi Arabian women in labour from multiple hospitals across the country. A structured questionnaire, developed specifically for this research, collected data on obstetric analgesia preferences, satisfaction levels and socio-demographic factors. Statistical analysis was conducted using SPSS 28.0, employing correlation analysis, regression analysis and Chi-square tests to examine the relationships between variables and test hypotheses. Categorical variables were characterised using counts and percentages, whereas numerical variables were summarised using descriptive statistics. Results: The study found varying levels of awareness and preference regarding obstetric analgesia among Saudi Arabian women. Significant factors influencing these preferences included socio-demographic variables such as income and education levels. The satisfaction levels with different analgesia methods also varied, with epidural analgesia emerging as a preferred option for many participants. These results indicated a need for improved antenatal education and awareness programmes regarding labour pain management options. Conclusion: The study highlights the importance of understanding the preferences and satisfaction levels of Saudi Arabian women in labour to provide appropriate pain relief and enhance the overall birthing experience. It underscores the need for comprehensive antenatal care programmes that incorporate education on various labour pain relief methods, particularly epidural analgesia. The findings also suggest tailoring pain management strategies to meet the cultural and individual needs of women in Saudi Arabia, thereby improving maternal care quality and satisfaction during labour.

Adaptation of a New Maternal Vaccination to the National Antenatal Care Program among Obstetricians and the Impact on the Patient’s Acceptance after the COVID-19 Pandemic

Abstract The idea of maternal immunization has attracted significant interest in recent years; however, its adaptation has been slower than expected. The coronavirus disease 2019 (COVID-19) pandemic has shed light on the importance of the role of healthcare providers and the weight they place on society to encourage and introduce the concept of maternal immunization to a higher level. Aim of the Study: To examine the impact of the COVID-19 pandemic on physicians’ attitudes towards the immunization protocol of the adaptation of a newly introduced maternal immunization vaccine for tetanus, diphtheria and acellular pertussis (TDAP) to pregnant women between 27 and 36 weeks of gestation in the Kingdom of Saudi Arabia. Method: This was a retrospective observational study conducted between February 2021 and December 2021. Initially, the rate of antenatal utilization of the TDAP vaccine was assessed for 3 months by our booked patients. Another assessment of vaccine uptake was conducted after another 3 months, where more education and encouragement to healthcare providers was provided at the same hospital. Results: The initial adaptation of the TDAP vaccination by both healthcare providers and patients was below expectation [100 out of 716 patients (approximately 14%)]. After further education and involvement of the doctors in the national maternal vaccination program, the second round of assessment of 1928 patients showed that 749 patients received the vaccine with an uptake rate of 38.85%. These findings suggest the pivotal role of doctors during the COVID-19 pandemic in enhancing the adaptation of the new maternal vaccination. When more doctors were convinced of the importance of maternal immunization and offered it to their patients, there was a significant improvement in the utilization of the vaccine.

FETO/Maternal Complications in Iron Deficiency Anemia during Pregnancy and Labor

Background: Iron deficiency anemia (IDA) is a prevalent nutritional disorder globally, especially in developing countries, impacting both maternal and fetal health. The condition exacerbates the risk of adverse pregnancy outcomes, including increased morbidity and mortality rates. Objective: This study aimed to examine the prevalence and impact of IDA on feto-maternal health during pregnancy and labor, as well as to evaluate the efficacy of antenatal care programs in managing this condition. Methods: A six-month cross-sectional study was conducted at Shaikh Zayad Hospital, Larkana, from October 2021 to March 2022. Fifty pregnant women, ranging from primigravida to multigravida, were recruited through emergency and outpatient departments. Comprehensive data collection included demographic information, clinical history, and a full spectrum of laboratory tests for IDA. The severity of anemia and related complications were assessed, and the collected data were analyzed using SPSS version 25. Results: Of the participants, 74% suffered from moderate anemia, while 12% and 14% had mild and severe anemia, respectively. Serum ferritin levels indicated iron deficiency in 40% of the women, with an elevated total iron-binding capacity (TIBC) in 60% of cases. Maternal complications were prevalent, with 52% encountering unspecified emergency conditions and 16% experiencing postpartum hemorrhage. Fetal complications included intrauterine growth restriction (30%), intrauterine death (18%), and neonatal death (10%). Conclusion: IDA presents a significant health risk during pregnancy, correlated with a high incidence of maternal and fetal complications. This study emphasizes the importance of proactive management and monitoring of iron levels throughout pregnancy. Establishing comprehensive antenatal care that includes nutritional education and iron supplementation is crucial for preventing IDA and improving pregnancy outcomes.

PENDAMPINGAN KELAS IBU HAMIL DALAM MEMBERIKAN MOTIVASI ANC BERKUALITAS, UPAYA PENINGKATAN KESEHATAN IBU DAN JANIN

Complications of pregnancy and childbirth as a cause of maternal death can be prevented by carrying out regular antenatal care (ANC) visits. Antenatal care is a comprehensive and quality antenatal service provided to all pregnant women. These services can be provided by doctors, midwives, nurses and other medical personnel who are trained and professional. The Indonesian government has made a policy for an integrated antenatal care program of quality and quantity, namely that antenatal care must implement the "7T" service standard with a minimum visit frequency of 4 times during pregnancy. Antenatal services can also be used to provide information to pregnant women and their families to carry out appropriate treatment and immediately have their pregnancy checked if there are danger signs during pregnancy. Factors that influence the health behavior of pregnant women when visiting ANC are divided into predisposing factors, enabling factors and reinforcing factors. Predisposing factors consist of age, education level, occupation, parity, knowledge and attitudes of pregnant women. Enabling factors include distance from residence, family income, and existing information media facilities. Meanwhile, strengthening factors include husband's support, family support, and attitudes and support from health workers..

Impact of the COVID-19 Pandemic on Rate of Complete Treatment for Syphilis among Pregnant Women in Indochina: A Preliminary Report

Abstract Background: The COVID-19 outbreak has had a negative influence on common public health services in a number of ways. The authors of this particular study discuss the impact of the COVID-19 pandemic on antenatal care programs used to treat syphilis in pregnant women in areas where the illness is a major problem. Materials and Methods: In Southeast Asia, where syphilis is extremely prevalent, data on the treatment of syphilis among pregnant women in accordance with normal prenatal care programs are examined. Results: The total treatment rate has decreased as compared to the period before COVID-19. Conclusion: According to the regular antenatal care program, the COVID-19 pandemic had an impact on how pregnant women were treated for syphilis in the research area. The reduced coverage is a severe issue that has to be effectively addressed.

Effect of Short, Animated Video Storytelling on Maternal Knowledge and Satisfaction in the Perinatal Period in South Africa: Randomized Controlled Trial.

Innovative mobile health (mHealth) interventions can improve maternal knowledge, thereby supporting national efforts to reduce preventable maternal and child mortality in South Africa. Studies have documented a potential role for mobile video content to support perinatal health messaging, enhance maternal satisfaction, and overcome literacy barriers. Short, animated storytelling (SAS) is an innovative, emerging approach to mHealth messaging. We aimed to measure the effect of SAS videos on maternal knowledge and user satisfaction for mothers enrolled in antenatal care programs at 2 public health facilities in the Tshwane District of South Africa. We used a randomized controlled trial with a nested evaluation of user satisfaction. Participants were randomized 1:1 into Standard-of-Care (SOC) Control, and SAS Intervention groups. The intervention videos were delivered through WhatsApp, and 1 month later, participants responded to telephone surveys assessing their knowledge. The intervention group then participated in a nested evaluation of user satisfaction. We surveyed 204 participants. Of them, 49.5% (101/204) were aged between 25 and 34 years. Almost all participants self-identified as Black, with the majority (190/204, 93.2%) having completed secondary school. The mean overall knowledge score was 21.92/28. We observed a slight increase of 0.28 (95% uncertainty interval [UI] -0.58 to 1.16) in the overall knowledge score in the intervention arm. We found that those with secondary education or above scored higher than those with only primary education by 2.24 (95% UI 0.76-4.01). Participants aged 35 years or older also scored higher than the youngest age group (18-24 years) by 1.83 (95% CI 0.39-3.33). Finally, the nested user satisfaction evaluation revealed high maternal satisfaction (4.71/5) with the SAS video series. While the SAS videos resulted in high user satisfaction, measured knowledge gains were small within a participant population that was already receiving perinatal health messages through antenatal clinics. The higher knowledge scores observed in older participants with higher education levels suggest that boosting maternal knowledge in younger mothers with lower education levels should continue to be a public health priority in South Africa. Given the high maternal satisfaction among the SAS video-users in this study, policy makers should consider integrating similar approaches into existing, broad-reaching perinatal health programs, such as MomConnect, to boost satisfaction and potentially enhance maternal engagement. While previous studies have shown the promise of animated video health education, most of this research has been conducted in high-income countries. More research in underresourced settings is urgently needed, especially as access to mobile technology increases in the Global South. Future studies should explore the effect of SAS videos on maternal knowledge in hard-to-reach populations with limited access to antenatal care, although real-world logistical challenges persist when implementing studies in underresourced South African populations. Pan African Clinical Trials Registry PACTR202203673222680; https://tinyurl.com/362cpuny.