Antenatal Prevalence Research Articles

Prevalence Of Congenital Abnormalities On Routine Antenatal Ultrasonography During Second And Third Trimester Of Pregnancy: A Study In A District Hospital Of North East India

Background Prevalence of congenital anomalies varies greatly from country to country. It is reported about 2.5% in India. In India, congenital anomalies are responsible for 15% of perinatal mortality and for 10% to 15% of neonatal deaths. The main aim of the study is to evaluate the prevalence of the congenital anomalies and malformation patterns in our hospital population. Material & Method This is a cross-sectional study carried out in the ‘Radiology unit’ of ‘District Hospital, Gomati’, Tripura. The study population includes about 910 antenatal mothers in the second and third trimester, who were referred to ‘Radiology unit’ from the outpatient and inpatient departments of ‘Obstetrics and Gynaecology’ of the same hospital between September 2017 to February 2018 were included in the study. Data of Antenatal ultrasounds was statistically analyzed on structured data collection form to determine the prevalence of congenital anomaly in 2nd & 3rd trimester. Results: Total 910 numbers of 2nd and 3rd trimester prenatal ultrasonography (USG) were done. Out of these 18 numbers of congenital anomalies were detected. The antenatal prevalence of congenital anomalies was 1.97%. The mean maternal age and mean gestational age at diagnosis was 22.9 years and 27.7 weeks respectively. Genitourinary system defect was the commonest (27.77%), of which maximum number had pyelactasis i.e. 3 (16.66%) cases. Conclusion: Ultrasonography is a cost-effective, non-invasive and sensitive tool in detecting the congenital anomalies antenatally in the hands of an experienced radiologist. Besides the first-trimester USG, the second trimester scan is mandatory in detecting anomaly in the growing foetus, as the majority of congenital anomalies are detected between 20 and 22 weeks of pregnancy

Prevalence of Late Antenatal Booking and its Complications at Hayatabad Medical Complex

Background: Timely initiation of prenatal care is pivotal for maternal and fetal health, facilitating the early detection and management of potential pregnancy-related complications. Despite the known benefits, late antenatal booking remains a significant challenge, potentially leading to adverse pregnancy outcomes. This study investigates the prevalence of late antenatal booking and its associated complications, contributing to a broader understanding of its determinants and impacts. Objective: To explore the prevalence of late antenatal booking among pregnant women attending Hayatabad Medical Complex, Peshawar, and to identify the associated complications and factors contributing to late booking. Methods: This descriptive research study was conducted from August 2021 to July 2023, involving 1920 pregnant women aged 18 years and above, receiving antenatal care at the Gynaecology & Obstetric Department of Hayatabad Medical Complex, Peshawar. Participants were selected through systematic sampling. Data were collected using structured questionnaires covering demographic information, medical history, timing of antenatal care initiation, reasons for late booking, and awareness of potential complications. Late antenatal booking was defined as the initiation of care beyond 24 weeks of gestation. Statistical analysis was performed using SPSS version 25.0, employing descriptive statistics, Chi-squared tests, or Fisher's exact tests, with statistical significance set at p ≤ 0.05. Results: The study found a late antenatal booking prevalence of 16.67%. Preterm birth occurred in 26% of cases with late booking, and low birth weight was observed in 15.9% of infants born to these women. The highest rate of late booking was among women aged 36+ (25%) and those with higher education (22.1%). Major barriers to timely antenatal care included a lack of awareness (42.5%), financial constraints (31.2%), and fear of healthcare facilities (20.9%). Conditions such as maternal anemia and hypertension were more prevalent among women with late bookings, at rates of 12.5% for hypertension and significant incidences of placental abruption and intrauterine death. Conclusion: Late antenatal booking is associated with significant adverse pregnancy outcomes, highlighting the need for targeted public health campaigns and healthcare system improvements to promote early and regular antenatal care access. Addressing educational, economic, and perceptual barriers is essential for improving prenatal care utilization.

Understanding the trends of maternal mental health research in India through bibliometric analysis

Pregnancy-related mental health issues are more common in low and middle‐income countries (LMICs). Common mental health disorders are more prevalent among women than men. In LMIC countries, the prevalence of mental health disorders is higher, estimated at 15.6% among pregnant women and 19.8% among postpartum women. According to the studies, Antenatal depression prevalence in India ranged from 9.8% to 36.7%, while antenatal anxiety prevalence was 55.7%. This study performed bibliometric profiling to shed light on maternal mental health research conducted in India since 1979 and to present the research output in the field of maternal mental health in India. SCOPUS databases have been chosen for data retrieval due to their extensive coverage, high-impact journal inclusion and ease of access to quality publications. In total, 146 publications were found in the field. Maternal mental health research increased significantly in 2022. The peak number of publications occurred in 2022.There has been a lot of focus on maternal mental health. This is evidenced by the fact that there has been a significant increase in the number of scientific publications in India since 1979. The bibliometric indicators provided important information on the research contributions from different institutes and authors. The results of this study can serve as a reference for researchers and policymakers to plan future research.

Global prevalence of perinatal depression and anxiety duringthe COVID-19 pandemic: An umbrella review andmeta-analytic synthesis.

The prevalence of depression and anxiety symptoms in pregnant and postpartum women during the COVID-19 pandemic was assessed by several systematic reviews (SRs) and meta-analyses which provided contrasting and different results. We aimed to summarize the evidence relating to the global prevalence of anxiety and depression among pregnant and postpartum women during the COVID-19 pandemic. An umbrella review of SRs and meta-analyses was performed. Searches were conducted in electronic databases up to April 2023. SRs and meta-analyses reporting the prevalence of perinatal anxiety and depression during the COVID-19 pandemic were selected for eligibility. Primary studies extracted from eligible meta-analyses were included in the quantitative synthesis. The research protocol was registered on PROSPERO (CRD42020173125). A total of 25 SRs (198 primary studies) and 12 meta-analyses (129 primary studies) were included in the qualitative and quantitative synthesis, respectively. Studies involved data from five continents and 45 countries. The pooled prevalence of antenatal and postpartum depression was 29% (n = 55; 95% CI: 25%-33%) and 26% (n = 54; 95% CI: 23%-30%), respectively. In the case of anxiety, the pooled antenatal and postnatal prevalence was 31% (n = 44; 95% CI: 26%-37%; n = 16; 95% CI: 24%-39%). Differences emerged between continents, with Africa having the highest prevalence of perinatal depression and Oceania and Europe having the highest prevalence of antenatal and postnatal anxiety. The prevalence also varied depending on the assessment tools, especially for antenatal anxiety. A medium-high quality of the studies was observed. One SR assessed strength-of-evidence, reporting very low strength. During the COVID-19 pandemic, depression and anxiety were common, affecting almost one in three perinatal women globally. A high heterogeneity and a risk of publication bias were found, partially due to the variety of assessment tools and cut-offs. The results may not be generalized to minorities. Studies on the prevalence of clinical diagnoses are needed. Based on our results it is not possible to firmly affirm that the COVID-19 pandemic was the main factor that directly increased perinatal depression and anxiety during the past few years. Future studies should study other factors' impact.

Hepatitis B infection status among South Africans attending public health facilities over a five-year period: 2015 to 2019.

Hepatitis B, a potentially life-threatening viral infection of the liver, remains a global public health concern despite the availability of effective vaccines for over three decades. The aim of our study was to provide national data on active hepatitis B infections in the public health sector of South Africa. We conducted retrospective analyses on national laboratory data over the period 2015 to 2019. We identified 176,530 cases who tested positive for HBsAg (active infection) with a test positivity rate of 9.02%. Of these active infections, 11,355 (6.43%) were found to be chronically infected. We linked 24,839 (14.07%) and 2,461 (21.67%) HBeAg positive results to all active HBV infections and identified chronic infections respectively. Clearance of HBsAg was observed in 5,569 cases, inclusive of clearance in 135 chronic cases. Active HBV infections were significantly higher in men than women over the five years (p < 0.0001). Among individuals who were vaccine-eligible as infants (0 to 19 years old), we observed 4,981 active HBV infections, including 1,131 infections under five years old, majority of which (65.78%) were under one year old. In the under five-year age group, the HBsAg population positivity rate was 0.02% and test positivity rate was 4.83%. Among all women with active HBV infections (78,935), 85.17% were of reproductive age and of these, 13.73% were HBeAg positive. Without a birth dose of the HBV vaccine, lack of routine HBsAg screening at antenatal care, and HBsAg and HBeAg prevalence among women of reproductive age, it is likely that the majority of cases under five years old were vertically infected. Optimal HBV vaccine coverage, inclusive of a birth dose, is key to eliminating horizontal and vertical transmission of HBV. Early identification of HBV chronicity through real time data analysis is fundamental in reducing the risk of liver cirrhosis and hepatocellular carcinoma.

Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?

Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We aimed to i) extract and summarise existing national HBV prevalence estimates, ii) add a new estimate based on primary care data, and; iii) critique data sources from which estimates were derived. Methods: We undertook a narrative review, searching for national estimates of CHB case numbers in the UK (incorporating incidence, prevalence and/or test positivity data) across a range of overlapping sources, including governmental body reports, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals. An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. We also searched for diagnoses of HBV in the QResearch primary care database based on laboratory tests and standardised coding. Results: We identified six CHB case number estimates, of which three reported information concerning population subgroups, including number of infected individuals across age, sex and ethnicity categories. Estimates among sources reporting prevalence varied from 0.27% to 0.73%, congruent with an estimated antenatal CHB prevalence of <0.5%.Our estimate, based on QResearch data, suggests a population prevalence of ~0.05%, reflecting a substantial underestimation based on primary care records. Discussion: Estimates varied by sources of error, bias and missingness, data linkage, and "blind spots" in HBV diagnoses testing/registration. The UK HBV burden is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation and/or homelessness, ethnic minorities and people born in high-prevalence countries. This could lead to under- or over-estimation of population prevalence estimation.Multi-agency collaboration is required to fill evidence gaps.

An Equity Analysis of Zero-Dose Children in India Using the National Family Health Survey Data: Status, Challenges, and Next Steps.

Background While immunization programs across the world have made considerable progress, children and communities continue to be beyond the reach of healthcare services. Globally, they are now referred to as zero-dose (ZD) children (those who have not received a single dose of diphtheria, pertussis, and tetanus-containing vaccine). Pre-COVID-19 pandemic analyses suggest that nearly 50% of vaccine-preventable deaths occur among ZD children. Two-thirds of these children live in extremely poor households suffering from multiple deprivations including lack of access to reproductive health services, water, and sanitation. Hence, ZD childrenhave now been prioritized as a key cohort for identification and integration with the health systems as we build back from the pandemic. Methodology Extracting data from the last two National Family Health Survey (NFHS) rounds (NFHS 4, 2015-2016 and NFHS 5, 2019-2021), this study aims to ascertain the status of ZD children aged 12-23 months in India, the challenges, and the necessary action agenda going forward. Data were analyzed for equity determinants such as gender, place of residence, religion, birth order, caste, and mother's schooling. Key determinants included the change in ZD prevalence at the national, state, and district levels; variations across equity parameters and states with maximum improvements; and disparity across these indicators. A correlation analysis was also conducted to understand the nature of the association between ZD prevalence and critical maternal and child health indicators. Results The overall ZD prevalence between the two rounds was reduced by 4.1% (10.5-6.4%). A total of 26 states in the country reported a ZD prevalence of <10% in NFHS 5 compared to 18 in NFHS 4. In total, 324 districts reported a ZD prevalence of <5%, and 145 districts reported a prevalence of >10%. The equity parameters reflected a slow-footed reduction among ZD for girl children, across urban geographies, firstborn children, mothers with 12 or more years of schooling, and children in families with the highest wealth quintiles. A negative correlation accentuated between the two NFHS rounds was established between first-trimester registration, four or more antenatal visits, institutional deliveries, and ZD prevalence. Conclusions The findings point toward sustained improvement across key equity parameters, however, challenges do exist. Moreover, the impact of the pandemic on immunization programs across the globe and in India is bound to halt and reverse the progress and potentiate further inequities. It is thus imperative that continued and augmented efforts are continued to identify, integrate, and immunize ZD children, families, and communities.

Late antenatal care initiation and neonatal outcomes in an ethnically diverse maternal cohort

Abstract Background Ethnic minority status and maternal socio-economic deprivation are linked to delayed access to health care during pregnancy. The link between late antenatal care initiation and neonatal outcomes in settings with high ethnic diversity and social disadvantage is seldom explored. This study examined associations between late antenatal care initiation (first antenatal appointment &amp;gt;12 weeks gestation) and neonatal outcomes of preterm birth (&amp;lt;37 weeks gestation) and low birth weight (&amp;lt;2500 g) in an ethnically diverse socially disadvantaged maternal cohort. Methods A retrospective cross sectional study using routinely collected anonymous data of singleton births between April 2007 - March 2016 from a large UK National Health Service maternity unit in an ethnically diverse, socially disadvantaged area. Univariate and multivariate logistic regression models were used to examine the associations between late antenatal care initiation and prevalence of preterm birth and low birth weight. Results Of the 46,307 singleton births recorded, more than one third (34.8%) were to mothers from Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi mothers. Gestational week at first antenatal appointment was available for 99.31% births among which 79.2% had their first appointment at ≤ 12 weeks, 12% at 13-20 weeks, and 8.8% at &amp;gt; 20 weeks. Mothers who booked at 13+ weeks were significantly more likely to have a preterm and/or low birth weight baby. Compared to mothers who booked at ≤ 12 weeks, those booking at &amp;gt; 20 weeks were 4.08 times (95% CI: 3.29,5.07) as likely to have an extremely preterm baby (&amp;lt;28 weeks of gestation) and 3.12 (CI 2.66, 3.67) times as likely to have a baby born with extremely low birthweight (&amp;lt;1500g). Conclusions Mothers in ethnically diverse socially deprived areas who started antenatal care late were at increased risk of adverse neonatal outcomes. Targeted intervention programmes and services are needed to support these mothers. Key messages

Variations in sexual network connectivity may explain dramatic variations in sexually transmitted infection prevalence between populations and over time: a selected four-country analysis.

Background: The incidence of sexually transmitted infections (STIs) has been noted to vary dramatically between population groups and over time. Here, the hypothesis that changes in network connectivity underpin these changes is explored. Methods: The incidence/prevalence estimates of HIV, herpes simplex virus-2, syphilis, chlamydia, and gonorrhoea, as well as two markers of sexual network connectivity (partner concurrency and multiple partnering) by ethnic group and sexual orientation in Kenya, South Africa, the United Kingdom (UK) and the United States (USA) were extracted from published studies. Pearson's correlation was used to test the association between the markers of network connectivity and the incidence/prevalence of these five STIs. A literature review was performed to evaluate the possible causes of the increases and decreases in syphilis incidence over the past 60 years. Results: In each country, the five STIs were found to cluster in particular ethnic groups and sexual orientations and to be positively associated with the two markers of network connectivity. Syphilis incidence in the UK and USA was found to increase dramatically in the 1960s/1970s, decline in the 1980s and again increase in the late 1990s. These changes took place predominantly in men who have sex with men, and were preceded by corresponding changes in network connectivity. The large decline in antenatal syphilis prevalence in Kenya and South Africa in the 1990s were likewise preceded by declines in network connectivity. Conclusions: Although other explanatory variables are not controlled for, the present analysis is compatible with the hypothesis that differential network connectivity is a parsimonious explanation for variations in STI incidence over time and between populations.

Variations in sexual network connectivity may explain dramatic variations in sexually transmitted infection prevalence between populations and over time: a selected four-country analysis

Background: The incidence of sexually transmitted infections (STIs) has been noted to vary dramatically between population groups and over time. Here, the hypothesis that changes in network connectivity underpin these changes is explored. Methods: The incidence/prevalence estimates of HIV, herpes simplex virus-2, syphilis, chlamydia, and gonorrhoea, as well as two markers of sexual network connectivity (partner concurrency and multiple partnering) by ethnic group and sexual orientation in Kenya, South Africa, the United Kingdom (UK) and the United States (USA) were extracted from published studies. Pearson’s correlation was used to test the association between the markers of network connectivity and the incidence/prevalence of these five STIs. A literature review was performed to evaluate the possible causes of the increases and decreases in syphilis incidence over the past 60 years. Results: In each country, the five STIs were found to cluster in particular ethnic groups and sexual orientations and to be positively associated with the two markers of network connectivity. Syphilis incidence in the UK and USA was found to increase dramatically in the 1960s/1970s, decline in the 1980s and again increase in the late 1990s. These changes took place predominantly in men who have sex with men, and were preceded by corresponding changes in network connectivity. The large decline in antenatal syphilis prevalence in Kenya and South Africa in the 1990s were likewise preceded by declines in network connectivity. Conclusions: Although other explanatory variables are not controlled for, the present analysis is compatible with the hypothesis that differential network connectivity is a parsimonious explanation for variations in STI incidence over time and between populations.

Estimating the epidemiology of chronic Hepatitis B Virus (HBV) infection in the UK: what do we know and what are we missing?

Background: HBV is the leading global cause of cirrhosis and primary liver cancer. However, the UK HBV population has not been well characterised, and estimates of UK HBV prevalence and/or incidence vary widely between sources. We summarised datasets that are available to represent UK CHB epidemiology, considering differences between sources, and discussing deficiencies in current estimates. Methods: We searched for estimates of CHB case numbers in the UK (incorporating incidence and/or prevalence-like data) across a range of available sources, including UK-wide reports from government bodies, publications from independent bodies (including medical charities and non-governmental organisations) and articles in peer-reviewed scientific journals to collate estimated positivity rates. An alternative proxy for population prevalence was obtained via the UK antenatal screening programme which achieves over 95% coverage of pregnant women. Results: We identified six CHB case number estimates, of which three reported information concerning population subgroups, including number of infected individuals across age, sex and ethnicity categories. Estimates among sources reporting prevalence varied from 0.27% to 0.73%, congruent with an estimated antenatal CHB prevalence of <0.5%. Discussion: Estimates varied by sources of error, bias and missingness, data linkage, and substantial "blind spots" in consistent testing and registration of HBV diagnoses. The HBV burden in the UK is likely to be concentrated in vulnerable populations who may not be well represented in existing datasets including those experiencing socioeconomic deprivation, ethnic minorities, people experiencing homelessness and people born in high-prevalence countries. Together, these factors could lead to either under- or over-estimation of overall prevalence, and additional efforts are required to provide estimates that best reflect the whole population. Multi-parameter evidence synthesis and back-calculation model methods similar to those used to generate estimates of HCV ad HIV population-wide prevalence may be applicable to HBV.

Probable perinatal depression and social support among women enrolled in Malawi's Option B+ Program: A longitudinal analysis

BackgroundMalawi's PMTCT Option B+ program has expanded the reach of ART services among pregnant and breastfeeding women, but retention in lifelong HIV care remains challenging. Given that depression can undermine retention, it is important to understand how depression changes over the perinatal period, varies across treatment and retention groups, and could be buffered by social support. MethodsData are from an observational study conducted among women enrolled in Malawi's PMTCT Option B+ program. We used multilevel generalized linear models to estimate the odds of probable depression by time, treatment and retention group, and social support. Probable depression was assessed with the Edinburgh Postnatal Depression Scale and Patient Health Questionnaire-9. ResultsOf 468 women, 15% reported probable depression at antenatal enrollment and prevalence differed across newly diagnosed individuals, second line therapy users, and previous defaulters (18%, 21%, 5%, p = 0.001). Odds of probable perinatal depression decreased over time (OR per month: 0.87, 95% CI: 0.82–0.92) but were higher among those newly diagnosed (OR: 3.25, 95% CI: 1.59–6.65) and on second line therapy (OR: 3.39, 95% CI: 1.44–7.99) as compared to previous defaulters. Odds of probable postpartum depression were lower for participants with high social support (OR: 0.19, 95% CI: 0.09–0.39). LimitationsLack of diagnostic psychiatric evaluation precludes actual diagnosis of depression. ConclusionsProbable depression varied across the perinatal period and across treatment and retention groups. Social support was protective for postpartum depression among all participants. Depression screening and provision of social support should be considered in PMTCT programs.

The Prevalence of Antenatal Depression among Women in Medina, Saudi Arabia

Background: Antenatal depression is a recognized global burden. However, it has remained an ignored part of public health. Most of the maternal depression interventions have been directed towards post-natal depression.&#x0D; Purpose of the Study: The purpose of this study was to understand the third-trimester antenatal depression risk factors and prevalence among Saudi Arabian women.&#x0D; Method: This study employed cross-sectional study design from April 2020 to June 2020 and 201 participants were recruited for this study. The study was conducted at Medina in the Maternity and Children's Hospital (MCH) from April 2020 to June 2020. The inclusion criteria were pregnant women who visited the outpatient clinic of antenatal care in MCH. Pregnant women who had a known familial history or already been diagnosed with depression before pregnancy were excluded from this study. The collection of the data was through researcher administered questionnaire to the pregnant women meeting eligibility criteria who were visiting the clinic of antenatal care at the Maternity and Children's Hospital. Data were collected using a structured and validated Patient Health Questionnaire-9 (PHQ-9). All the collected data were analyzed using descriptive statistics, Anova and t-test statistics. &#x0D; Results: Antenatal depression among participants stands at 35.8% for normal/ minimal depression, 31.3% for mild depression, 3.9% for moderate depression, 5.5% for moderately severe, and 3.5% for severe depression. Antenatal depression was mostly prevalent in the third trimester.&#x0D; Conclusion: The antenatal depression prevalence among pregnant women in Medina is high. Screening for mental health problems and provision of supportive mental health services as a component of antenatal care services is recommended.

PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS DURING 2ND WAVE OF COVID-19 AMONG PREGNANT WOMEN IN A TERTIARY CARE HOSPITAL, LAHORE

Purpose of the study: Antenatal depression is a significant predictor for postnatal depression, and pregnant women with depressive symptoms have an increased risk of frequent non-scheduled medical and emergency visits. The purpose of this study is to evaluate the antenatal depression and its related factors and effects of the COVID-19 pandemic on the frequency of antenatal visits.&#x0D; Methodology: A descriptive cross-sectional study was conducted from July to September 2020 with 220 pregnant women from the Gynae Outpatient Department at the Tertiary Care Hospital of Lahore. Women aged 18–45 years with no pregnancy-related complications were included. The Patient Health Questionnaire-9 tool was used to screen for antenatal depression, and a self-structured questionnaire was developed to explore depression-related factors.&#x0D; Main Findings: Antenatal depression prevalence was found very high among pregnant women during the second wave of Covid-19 and pandemic did not affect regular antenatal visits of women.&#x0D; Applications of this study: Mental disorders are associated with several individuals and societal factors, including feelings of insecurity and hopelessness, exposure to violence, physical ill health, and rapid social change. The existing pandemic situation, working from home, temporary unemployment, home-schooling of children, lack of contact and social support, it is important to look after mental and physical health especially women in pregnancy who can suffer from more severe mental health problems and can affect ANC visits that directly related to maternal and child health.&#x0D; Novelty/Originality of this study: Depression in pregnancy is associated with severe complications and prevents patients from taking an active role in their healthcare. Women with depressive symptoms have an increased risk of frequent non-scheduled antenatal care (ANC) visits and emergency healthcare visits for pregnancy-related emergencies especially in the 2nd wave of COVID-19. It was very important to study the factors related to antenatal depression during this pandemic. Counselling and awareness may improve the physical and mental health of pregnant women.

A study on demographic and obstetric profile, its relation with present antenatal practices and prevalence of anaemia in pregnant women attending tertiary care hospital

Background: Antenatal care is the care of a woman during pregnancy. The primary aim of antenatal care is to achieve at the end of pregnancy a healthy mother and a healthy baby. To improve maternal health, barriers which limit access to quality maternal health services must be identified and addressed at all levels of health system. Objectives were to determine demographic and obstetric factors affecting utilization of ANC service and prevalence of anaemia among pregnant women.Methods: This is cross-sectional descriptive study carried out in tertiary care hospital, using structured questionnaire, interviews were conducted with married pregnant women age between 18-45 years, who visited ANC clinic. Total 170 pregnant women visited hospital during a period was included in study. Data was analysed using MS excel and Epi info. Chi –square test was applied.Results: Maximum number of study subjects (42.9%) from age 23-27 years. 66.5% were Hindu, 56.5% study subjects from joint family. 14.7% were illiterate. 45.3% were primigravida, 54.7% were multigravida. 71.1% study subjects were from third trimester of pregnancy. 94.7% were taken at least one dose of Tetanus Toxoids. Iron folic acid tablets were taken by 87.6%. Prevalence of anaemia was 55.8%.Conclusions: Majority of pregnant women came for antenatal check-up, but regularity was not seen in most of cases. The presence study has brought out no significant socio-cultural barrier like women’s literacy, socio economic class and parity of women affecting the utilization of services.

Perinatal suicidality: prevalence and correlates in a South African birth cohort.

Suicidal ideation and behaviour (SIB) in the perinatal period is prevalent in low- and middle-income countries (LMICs). Past work has been limited by reliance on self-rated scales, and there are few data on SIB severity in such settings. We collected cross-sectional data on SIB using a clinician-administered scale and explored risk factors associated with the presence of SIB and SIB severity. Data were collected from the Drakenstein Child Health Study cohort antenatally and at 6months postpartum. SIB was measured using the Mini International Neuropsychiatric Interview, and potential sociodemographic, psychosocial, and psychiatric risk factors were assessed. Multivariable analysis determined cross-sectional risk factors. Multinomial regressions determined predictors of SIB risk categories. Among 748 women, the antenatal SIB prevalence was 19.9% and postpartum 22.6%. SIB was associated with younger age (antepartum), PTSD (postpartum), and depression (ante- and postpartum). Depression and PTSD predicted belonging to the high-risk SIB group. The medium-risk group was more likely to have depression, alcohol use during pregnancy, and substance abuse. Depression, PTSD, food insecurity, recent intimate partner violence (IPV), and childhood trauma were associated with the low-risk group versus the no-risk group. Screening is needed for perinatal SIB. Associations of perinatal SIB with younger age and major depression are consistent with previous work. The association with PTSD is novel, and underscores the importance of assessment of trauma exposure and outcomes in this population. Different risk categories of SIB may have different causal pathways and require different interventions.

The prevalence of metabolic associated fatty liver detected by FibroScan® in women with gestational diabetes in a multiethnic population

AimsMetabolic associated fatty liver disease (MAFLD) is a leading cause of chronic liver disease and has been increasingly associated with gestational diabetes (GDM). This study aimed to assess the prevalence of MAFLD in women with GDM in the antenatal period. Methods108 pregnant women with GDM diagnosed on a 75-gram oral glucose tolerance test were enrolled from a multiethnic cohort attending a large obstetrics clinic in Sydney, Australia and had a single FibroScan® assessment after 24 weeks gestation to assess for hepatic steatosis and fibrosis. A control attenuated parameter (CAP) cut-off score of ≥ 233.5 dB/m was chosen to signify presence of hepatic steatosis which indicates MAFLD. Obstetric, anthropometric and metabolic measures were analysed. Results29 (26.9%) women had evidence of FibroScan®-detected MAFLD, whilst none had evidence of hepatic fibrosis. Increased maternal BMI (aOR 1.12, 95% CI: 1.04–1.20) was associated with the finding of MAFLD in this cohort. ConclusionsWe found a significant antenatal prevalence of FibroScan®-detected MAFLD in this cohort of multiethnic women with GDM. FibroScan® is a safe and rapid assessment tool which may have a role in screening for MAFLD in pregnancy in appropriate at-risk women.

Prevalence and Factors Associated with the Depressive and Anxiety Symptoms Amongst Antenatal Women

INTRODUCTION: There is a wide range of antenatal mental disorder prevalence, including depression, anxiety and worry across countries. Studies to determine the association between sociodemographic factors, social support and antenatal mental health disorders have since produced inconsistent results. The aim of this study was to determine the prevalence and factors associated with antenatal anxiety, worry and depression among pregnant women. MATERIALS AND METHODS: A total of 262 women who attended the antenatal clinic at any of the four. Mother and Child Health clinics in Kuantan, Pahang participated in this cross-sectional study. The social support, depression, anxiety and worry were measured using the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS), State-trait Anxiety Inventory (STAI) and Cambridge Worry Scale (CWS), respectively. RESULTS: Of these women, 20.2% had depressive symptoms, 22.5% had antenatal anxiety, and 79% had antenatal anxiety. Women with lower education background were at risk of antenatal depression whereas working and first-time mothers were at risk of experiencing worry in pregnancy. This study has proven that social support plays a significant role in alleviating worry during pregnancy. CONCLUSION: Considering that the high level of worry in pregnancy could result in negative pregnancy outcomes and postnatal depression, there should be a screening tool used to measure psychological wellbeing of the pregnant mother within the clinical practice. The element of social support should be included in the intervention targeting women with lower educational level, primiparous and working mothers.

Variations in sexual network connectivity may explain dramatic variations in sexually transmitted infection prevalence between populations and over time: a four-country analysis

Background: The incidence of sexually transmitted infections (STIs) has been noted to vary dramatically between population groups and over time. Here, the hypothesis that changes in network connectivity underpin these changes is explored. Methods: The incidence/prevalence estimates of HIV, herpes simplex virus-2, syphilis, chlamydia, and gonorrhoea, as well as two markers of sexual network connectivity (partner concurrency and multiple partnering) by ethnic group and sexual orientation in Kenya, South Africa, the United Kingdom (UK) and the United States (USA) were extracted from published studies. Pearson's correlation was used to test the association between the markers of network connectivity and the incidence/prevalence of these five STIs. A literature review was performed to evaluate the possible causes of the increases and decreases in syphilis incidence over the past 60 years. Results: In each country, the five STIs were found to cluster in particular ethnic groups and sexual orientations and to be positively associated with the two markers of network connectivity. Syphilis incidence in the UK and USA was found to increase dramatically in the 1960s/1970s, decline in the 1980s and again increase in the late 1990s. These changes took place predominantly in men who have sex with men, and were preceded by corresponding changes in network connectivity. The large decline in antenatal syphilis prevalence in Kenya and South Africa in the 1990s were likewise preceded by declines in network connectivity. Conclusions: Although other explanatory variables are not controlled for, the present analysis is compatible with the hypothesis that differential network connectivity is a parsimonious explanation for variations in STI incidence over time and between populations.

The updated South African National Guideline for the Prevention of Mother to Child Transmission of Communicable Infections (2019).

The updated South African National Guideline for the Prevention of Mother to Child Transmission of Communicable Infections (2019).