Factors In Pregnant Women Research Articles

Abstract 12219: Social Vulnerability and Cardiometabolic Risk Factors in Pregnant Women in the United States

Background: In recent years, pregnancy-related mortality rates in the US have increased, with cardiovascular disease accounting for a third of all pregnancy-related mortality. The association between cardiometabolic (CM) health and social determinants of health have not been well understood. Objectives: We sought to investigate the relationship between social vulnerability and prevalence of CM risk factors in pregnant women in the US. Methods: In this cross-sectional analysis, we linked natality files including all pregnancies resulting in live births in the US (aggregated 2016-2020) with county-level social vulnerability index (SVI), a composite metric of social risk factors with four major domains: socioeconomic, household composition/disability, minority status/language, and housing type/transportation. We investigated the association between SVI and its subdomains with county-level prevalence of maternal pre-pregnancy diabetes, pre-pregnancy hypertension, tobacco use, and obesity. Results: A total of 18,953,511 pregnancies were analyzed across 577 counties. All CM risk factors were associated with SVI and/or its 4 subcomponents to varying degrees. Obesity was strongly associated with overall SVI (R=0.52, P<0.001) with an even stronger relationship with socioeconomic vulnerability (R=0.6, P<0.001) and household composition/disability (R=0.66, P<0.001). The rate of pre-pregnancy diabetes was associated with overall SVI (R=0.27, p<0.001), with similar association with socioeconomic vulnerability (R=0.26, P<0.001) and household composition/disability (R=0.28, P<0.001). Chronic hypertension was weakly associated with overall SVI (R=0.15, P<0.001) with similar association with socioeconomic vulnerability (R=0.19, P<0.001) and household composition/disability (R=0.22, P<0.001). Tobacco use was not associated with overall SVI (R=0.034, p=0.41), but was strongly associated with minority status/language (R=-0.71, P<0.001). Conclusion: Social vulnerability and its domains are associated with prevalence of CM risk factors in pregnant women in the US. Further studies are needed to investigate the impact of targeting social determinants of health to improve CM risk and mortality in pregnant women.

Physical activity level and associated factors among pregnant women: a population-based epidemiological study.

This research aimed to assess the level of physical activity and identify the associated factors in pregnant women assisted in primary health care in the city of Montes Claros, Minas Gerais (Brazil). This was an epidemiological, cross-sectional, analytical study, carried out with 1,279 pregnant women. Socioeconomic, occupational, obstetric, behavioral, social, health, and emotional variables were assessed using a questionnaire. The Physical Activity Questionnaire for Pregnant Women was also applied. Descriptive statistical analysis and multinominal logistic regression with a hierarchical model were performed. The prevalence of physical inactivity in the physical activity and leisure time dimensions was verified. A mild level of physical activity was associated with the variables such as age from 21 to 30 years and up to 20 years old, income above two minimum wages, salaried work, and maternal-fetal attachment at a medium/high level. Income from one to two minimum wages and above two wages, paid work and self-employment, anxiety and stress symptoms, and medium/high maternal-fetal attachment were associated with the moderate/vigorous level. Multifactorial aspects must be considered in health promotion strategies directed to the practice of physical activity by pregnant women.

Nível de atividade física e fatores associados entre gestantes: estudo epidemiológico de base populacional

Abstract This research aimed to assess the level of physical activity and identify the associated factors in pregnant women assisted in primary health care in the city of Montes Claros, Minas Gerais (Brazil). This was an epidemiological, cross-sectional, analytical study, carried out with 1,279 pregnant women. Socioeconomic, occupational, obstetric, behavioral, social, health, and emotional variables were assessed using a questionnaire. The Physical Activity Questionnaire for Pregnant Women was also applied. Descriptive statistical analysis and multinominal logistic regression with a hierarchical model were performed. The prevalence of physical inactivity in the physical activity and leisure time dimensions was verified. A mild level of physical activity was associated with the variables such as age from 21 to 30 years and up to 20 years old, income above two minimum wages, salaried work, and maternal-fetal attachment at a medium/high level. Income from one to two minimum wages and above two wages, paid work and self-employment, anxiety and stress symptoms, and medium/high maternal-fetal attachment were associated with the moderate/vigorous level. Multifactorial aspects must be considered in health promotion strategies directed to the practice of physical activity by pregnant women.

Adherence to the 10 steps for a healthy diet in pregnant women in Southeast Brazil

Introduction: Nutritional guidelines in prenatal care can influence the pregnant woman's eating behavior, reducing the risks for the mother-baby binomial. Objective: To analyze adherence to the 10 steps for healthy eating during pregnancy and its association with maternal and socioeconomic factors in pregnant women in Espírito Santo, Brazil. Methods: Data were obtained through an electronic questionnaire widely publicized on social networks. Socioeconomic, prenatal and eating behavior data were collected from 368 participants. The 10 Steps to Healthy Eating during pregnancy, adapted from the Brazilian Ministry of Health, using the Praise-Guide-Recommend System (EOR) were used as evaluation criteria. Pearson's chi-square test and Fisher's exact test were used to analyze differences between proportions. The binary logistic regression model was used to investigate the association between independent variables and steps towards healthy eating. A significance level of 5% and a confidence interval of 95% were adopted. Results: Most pregnant women reported adherence of 3 to 5 steps (78.5%), fitting into the O-Orientation category. It was observed that receiving nutritional guidance during prenatal care increased adherence in step 4 (OR: 1.99; 95%CI: 1.26-3.15), in step 5 (OR: 2.02; 95%CI: 1 .26-3.24) and step 9 (OR: 1.66; 95%CI: 1.66-2.58). Conclusion: The results suggest the need to strengthen prenatal actions, mainly related to guidelines on encouraging healthy and adequate eating habits.

Impact of COVID-19 on mental health of pregnant women in Punjab, Pakistan

Background: Maternal depression and anxiety can predispose the women to higher risk of complications. The COVID-19 pandemic is a unique stressor which may affect the mental and psychological well-being of pregnant women. Aim: To determine prevalence of depression and anxiety and related factors in pregnant women during COVID-19. Methods: This multicenter analytical cross-sectional study was carried out from August 2021 to December 2021 in six cities of Pakistan. Two stage sampling technique was used to include sample of 400 pregnant women. Patient Health Questionnaire-9 (PHQ-9) and Corona virus Anxiety Scale (CAS) were used to measure depression and anxiety level along with self-constructed questionnaire to record socio-demographic profile. Data entry and analysis was done in SPSS version 23. Association between variables was assessed by applying Chi square test and strength of association was measured by binary logistic regression. p-value ≤ 0.05 was taken as statistically significant. Results: Mean age of participants was 27.25±5.22 years. The mean gestational age was 23.5±9.6 weeks. About 37.1% had mild depression. Moderate depression was found in 7.8% and moderately severe depression in 0.5% participants. Significant association was found between depression and no physical activity (p value=0.02), not having spouse support (p value=0.03), perceived vulnerability to get COVID (p value=0.004) and fear of infection to baby (p value=0.05). Only 3.25% participants had dysfunctional anxiety. Conclusion: Findings of the study would be helpful for policy makers to launch health awareness campaigns about regular physical activity, role of social support and seeking medical advice for mental well-being during pregnancy. Keywords: COVID-19, Anxiety, Depression, Mental health, Pregnancy

Evaluation of sleep quality and related factors in pregnant women

Objective: Although the pregnancy period is a physiological process, it can disrupt the sleep pattern and quality with some changes it causes. In this study, it was aimed to determine sleep quality, affecting factors and sleep problems, if any, in pregnant women who applied to our outpatient clinic for follow-up.
 Materials and Methods: This study, which was designed in a descriptive style, was conducted on 256 pregnant women who applied to the outpatient clinic. The data form included personal information, factors affecting sleep quality, sleep problems and Pittsburg Sleep Quality Index. In addition to descriptive statistics, Mann-Whitney U and Kruskal Wallis tests were used to evaluate the data uploaded to the SPSS program. The error level was set to 0.05. 
 Results: The mean age of the pregnant women was 28.55. It was observed that the mean total PUKI score was 6.27±3.94 (0-18) and the mean sleep duration was 7.5 hours (3-14). Sleep quality was poor in 49.6% of the pregnant women. It was found that the sleep quality of pregnant women was poor in younger than 35 years old (p=0.026), education level of high school and above (p=0.010), who has gender expectetion (p=0.041) and not socially supported (p=0.009). The median weight gain in the third trimester was higher in pregnant women with poor sleep quality (p=0.022). It was determined that musculoskeletal pain, discomfort, frequent urination, swelling in the feet, pain/cramp in the legs and burning in the stomach during pregnancy affected sleep quality negatively. In pregnant women with poor sleep quality; problems such as shortening of sleep duration, difficulty in falling asleep, frequent interruption of sleep, difficulty in falling asleep again, waking up tired in the morning and waking up too early involuntarily were observed more frequently.
 Conclusion: About half of the pregnant women have poor sleep quality; physical complaints are effective on sleep quality. Sleep quality should be evaluated in all pregnant women and recommendations should be made for sleep hygiene.

Microscopic and ELISA Based Detection of Toxoplasma and its Associated Risk Factors in Pregnant Women of District Mardan

Toxoplasmosis caused by the protozoan parasite Toxoplasma gondii, the most prevalent disease worldwide. The infections in human are extremely dangerous if they happen during pregnancy because they may lead to miscarriage or congenital abnormalities, which predominantly affect the central nervous system. The main objective of current study was to identify the risk factors for toxoplasmosis and its prevalence among pregnant women in Mardan. The blood serum was tested using the ELISA and the latex agglutination test. Through interviews, sociodemographic and prospective risk factor data were gathered using a standardized questionnaire. Our findings, obtained from ELISA and latex agglutination tests, showed considerably higher toxoplasmosis rates of 23% and 11%, respectively. The geographic distribution of toxoplasma infection in district Mardan revealed a high prevalence in Shah Baig village through ELISA (28%) and latex test (12%) followed by Ibrahim Khan Killi (24%) and (16%), while lower cases were recorded through ELISA (20%) in Sheikh Yousaf Killi and Saleem Khan Killi. Compared to working women in the community (5.85 percent), the infection was more prevalent (18%) in non-occupational women/house wives. Moreover, it was also observed that abortion occurred to the woman who have been clinically diagnosed positive by ELISA and it reported 20% by ELISA and 11.4% by latex agglutination test. It was concluded that T. gondii infection were more prevalent in pregnant women of rural areas of Mardan as compared to the urban centers. Women and children were more vulnerable if they frequently interact with domestic animals and play in contaminated environment.

Assessment of Risk Factors in Pregnant Women in third Trimester in Baghdad City

Assessment of Risk Factors in Pregnant Women in third Trimester in Baghdad City

Factors associated with inadequate urinary iodine concentration among pregnant women in Mbeya region Tanzania.

Background: Insufficient and excessive iodine intake during pregnancy can lead to serious health problems. In Tanzania, information available on iodine status during pregnancy is minimal. The aim of this study was to assess the iodine status and its association with socio-demographic factors in pregnant women in the Mbeya region, Tanzania. Method: A cross sectional survey involving 420 pregnant women (n=420) registered in Reproductive and Child Health Clinics was conducted. Data were collected via interviews and laboratory analysis of urinary iodine concentration (UIC). Results: Median UIC was 279.4μg/L (+/-26.1) to 1915μg/L. Insufficient iodine intake (UIC below 150μg/L) was observed in 17.14% of participants, sufficient intake in 24.29% and 58.57% had intakes above the recommended level (>250μg/L). Pregnant women who consume fish had an increased risk of insufficient iodine [Adjusted OR7= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended primary education compared to non-formal education [Adjusted OR= 0.29 (95%CI 0.08-0.99)]. Pregnant women resident in Mbarali district aged between 35-49 years were associated with an increased risk of UIC above recommended level [Adjusted OR=4.09 (95%CI 1.85-9.010] and [Adjusted OR=2.51 (95%CI 0.99-6.330] respectively . Conclusion: This study demonstrated a significant relationship between geographical factors (residence in the Mbarali district) and excess median urine iodine concentration, in addition, this study also found an association between consumption of freshwater fish and insufficient mean urine iodine concentration as indicated by the World Health Organization recommendation. Therefore, educational programs on iodine intake are needed as attending primary education was found to be a protective factor for insufficient median urine iodine concentration.

Gestational Diabetes: Which Clinical (Pre)gestational Features Are Able to Predict Failure of Lifestyle Intervention?

BackgroundControversy exists regarding risk factors in pregnant women that might be associated with a higher probability of failure of lifestyle intervention in the treatment of gestational diabetes (GD). These pregnant women's risk factors may highlight the need for closer surveillance at an early stage of pregnancy.AimsTo identify predictors of pharmacological therapy need in early and late GD.MethodsThis was a retrospective observational study including women with GD diagnosed in the first (group 1) or second trimester (group 2) according to the criteria proposed by the International Association of Diabetes Pregnancy Study Group (IADPSG), singleton pregnancy and follow-up between January 2015 and December 2018, divided according to treatment (lifestyle intervention or pharmacological treatment (metformin and/or insulin)).ResultsA total of 278 and 273 women were included in groups 1 and 2, of which 48.6% and 55.3% underwent non-pharmacological treatment, respectively. In group 1, women requiring pharmacological therapy tended to be older and have previous GD or family history of diabetes, higher body mass index (BMI) and higher fasting blood glucose (FBG) levels. In group 2, pharmacological treatment need was associated with multiparity, previous GD, higher BMI, higher fasting glucose value in the oral glucose tolerance test (OGTT), and higher OGTT value at 60 minutes.The independent risk factors identified for pharmacological treatment requirement were maternal age (OR 1.10 (1.05-1.16), p<0.001), previous GD (OR 2.70 (1.10-6.58), p=0.029) and FBG (OR 1.07 (1.00-1.14), p=0.048) in group 1 while BMI (OR 1.07 (1.02-1.13), p=0.012) and fasting glucose value in the OGTT (OR 1.03 (1.01-1.05), p=0.006) were the factors identified in group 2. The cut-off values for FBG and fasting glucose value in the OGTT that predicted the necessity of pharmacological treatment were 95.50 mg/dL and 88.50 mg/dL, respectively.ConclusionsIn early GD, closer surveillance is necessary for older women with a previous GD and an FBG ≥ 95.50 mg/dL. In late GD, pre-gestational BMI and a fasting glucose value in the OGTT ≥ 88.50 mg/dL should prevail.

The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic

BackgroundThe onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant.MethodsPatients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother–child bonding were administered at T1 (delivery stay) and T2 (3–6 months postpartum).ResultsIn total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic.ConclusionObstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother–child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic.Clinical trial registration DRKS00022506

Comparison of Vitamin D Levels and Related Factors in Pregnant Women and Neonates Exposed to Second-Hand Smoke.

Introduction: Exposure to second-hand smoke, a significant public health issue today, may lead to various health problems, especially in pregnant women and their infants. Low vitamin D levels during pregnancy may lead to preeclampsia and gestational diabetes in the mother, while it may cause low birth weight and respiratory problems in the infant.Method: The study group consisted of 42 mothers, who smoked regularly, and their infants and 45 mothers (passive smokers), who were regularly exposed to second-hand smoke in their home environment, although they did not smoke, and their infants. Meanwhile, the control group consisted of 46 healthy mothers, who did not smoke and were not exposed to second-hand smoke at home, and their infants with similar gestational age and birth weight. Blood samples were taken as two different samples, from the mother and the baby, and 25-hydroxyvitamin D (25(OH)D) and related blood parameters were studied and compared statistically.Results: 25(OH)D, calcium, and magnesium levels of mothers who smoked were significantly lower than those who were exposed to second-hand smoke and those who did not. Moreover, the vitamin D levels of mothers and babies exposed to second-hand smoke in the non-smoker group were significantly lower than mothers and babies who were not exposed to second-hand smoke. In the babies of these three groups, a significant decrease was observed only in vitamin D levels.Conclusion: The present study shows that pregnant women and their infants exposed to second-hand smoke have lower vitamin D levels. Hence, more emphasis should be put on vitamin D monitoring and supplementation to prevent severe health problems in pregnant women and their infants exposed to tobacco smoke. Further studies are needed to assess the associated risks for maternal and fetal health as well as possible long-term implications for the infant.

A study of HBV infection and its risk factors in pregnant women in Zakho city, Iraq.

BackgroundDespite vaccine and antiviral treatment availability, hepatitis B virus (HBV) continues to circulate among pregnant women in Iraq. HBV spread is due to many factors. This study evaluated HBV prevalence among pregnant women and Syrian refugees residing in Zakho city, Iraq, and identified risk factors associated with infection.Materials and methodsDemographic data were collected from 2,054 pregnant women via a questionnaire assessing risk factors associated with HBV infection. Blood samples were collected for hepatitis B surface antigen (HBsAg) and were screened using an enzyme-linked immunosorbent assay.ResultsTests revealed that 1.1% of pregnant women in Zakho and 11.3% of Syrian refugees (p = 0.001) were positive for HBsAg. The average age of HBsAg-positive patients was 31.4286 ± 6.6746 years (p = 0.002). Average rates of parity and abortion in HBV-infected subjects were 3.5 ± 2.6874 and 0.1785 ± 0.5479, respectively (p = 0.044 and 0.012, respectively). The following were identified as associated risk factors for HBV infection: nationality, (Zakho versus the city centre), tattoos, and polygamy (p = 0.001, 0.03, 0.007, and 0.001, respectively). No significant associations between HBV prevalence and blood transfusion, prior injection history, dental procedures, or surgical procedures were found.ConclusionThe prevalence of HBV infection among Syrian refugees was higher than that of indigenous participants. Several risk factors were significantly associated with HBV positivity, which may facilitate effective preventive program implementation and decrease mother-to-child transmission risk. This will likely reduce infant and childhood HBV chronicity, and mortality rates.

Risk of Stunting in Newborns

The condition of the body being short and very short to exceed the deficit of -2 SD below the median length or height of the child is called Stunting. Stunting is also an impact caused by malnutrition from before pregnancy, during pregnancy or because there are comorbidities in pregnancy. Stunting can occur when a newborn is born. The length category of a newborn is based on the Regulation of the Minister of Health of the Republic of Indonesia Number 2 of 2020 concerning Child Anthropometric Standards. Assessment of the nutritional status of children, the length of the baby boy is said to be short (stunting) if 46 cm and said to be tall if 53.7 cm. Meanwhile, the length of a baby girl is categorized as short (stunting) if it is 45.4 cm and is said to be tall if it is 52.9 cm. Many factors affect stunting at the time of newborns, namely teenage pregnancy, KEK pregnant women, pre-pregnancy BMI, chronic hypertension, and maternal height. This study was conducted to determine the relationship between risk factors in pregnant women and the incidence of stunting in newborns. This study aims to determine the general description of risk factors in pregnant women and the relationship between maternal risk factors in newborns. This type of research is quantitative research with a retrospective design. The tools and materials in this study used secondary data in the cohort and RM in the Banjarnegara 2 Health Center area, with a population of all mothers giving birth at the Banjarnegara 2 Health Center in 2019. The sample was taken from the population, the researchers used purposive sampling with a total sample of 300 respondents. with the Che square test. The results of this study showed that most respondents with non-adolescent pregnancies were 292 (97.3%), pregnant women did not have SEZ 277 (92.3%), ideal BMI 286 (95.3%), not chronic hypertension (96%), high maternal body weight 150, 280 (93.3%) and 283 (94.3%). There is a relationship between teenage pregnancy, CED in pregnant women, pre-pregnancy BMI, and maternal height with the incidence of stunting in newborns with a p value of 0.00 or p value 0.05, which means that there is a relationship between these variables and the incidence of stunting. in newborns.

Multilevel Modelling of Individual, Community and Regional Level Factors Associated with Insecticide-Treated Net Usage among Pregnant Women in Ethiopia.

Background: Pregnant women who are infected with malaria usually have more severe symptoms and negative health outcomes than women who are not pregnant, with higher rates of miscarriage, intrauterine demise, premature delivery, low-birth-weight neonates, and neonatal death. Based on evidence from the 2016 Ethiopia Demographic and Health Survey, this study assessed the variation in insecticide-treated nets (ITNs) usage and its associated factors among pregnant women in Ethiopia. Methods: Data from a total of 1122 women who were pregnant at the time of the survey were included in the final analysis. Bivariate and multilevel analyses were conducted. Multilevel modeling with fixed and random coefficients was used to estimate the variation in pregnant women’s ITNs usage across communities (residence areas) and regions of Ethiopia. Results: Out of the total 1122 pregnant women, 58.37% slept under a net and 41.63% did not sleep under nets. Significant variations were observed in pregnant women’s ITNs usage across communities (residence areas) and regions of Ethiopia, with between variations in pregnant women’s ITNs usage across communities (residence areas) and regions. In addition, the region, place of residence, wealth index, educational level, and age of the women as well as whether they believed that mosquito bites cause malaria were significant factors in pregnant women’s usage of ITNs. Pregnant women in Ethiopia had moderate usage of ITNs with varied risk factors at the individual, community, and regional levels. Conclusion: Based on the factors identified, there is a need to implement and/or strengthen programs (e.g., regular sensitization) that intensify high coverage of ITNs for effective malaria prevention in Ethiopia, especially among pregnant women who do not use ITNs.

BACTERIA ASSOCIATED WITH URINARY TRACT INFECTION IN PREGNANT WOMEN WITH OVERVIEW OF THEIR ANTIBIOTIC SUSCEPTIBILITY TESTS

Urinary tract infection (UTI) is one of the most common health problems among pregnant women and the reason for morbidity during pregnancy in worldwide, most of them in developing countries. The causative agents include Escherichia coli, Klebsiella species, Staphylococcus aureus, Staphylococci, Proteusmirabilis, Enterococcus species, Pseudomonas aeruginosa, Enterobacter species, streptococci, and Citrobacter species. Risk factors in pregnant women is more in urinary tract infection (UTI). This current research aimed that which drug is resistance for pathogenic bacteria and their resistance gene patterns in pregnant women. The altogether predominance of urinary tract infections in pregnant women is approximately 13-18% overall. Gram-positive and gram-negative both bacteria were isolated. Which shows gram-negative bacteria (85%) and gram-positive bacteria were only 15%. E. coliis the most predominant bacteria among the study. And the antimicrobial susceptibility patters of these isolates showed high resistance towards nitrofurantoin, ciprofloxacin, and gentamycin. More sensitive towards amoxiclav, cefuroxime, etc., Pregnant women with Asymptomatic UTI consider E. coli, Klebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus arlettae, Enterococcus faecalis and showed resistance to most drugs. The frequent appearance of isolates from urine sample along with their resistance capability tests. The antibiotics can be prescribed based on side effect to prevent pregnant women in case of empirical treatment. In order to overcome the problem of UTI in pregnant women many researches are going on, currently, the drug resistant of UTI is leading to the new technologies and identification method of drug-resistant UTI helps to overcome the infection.

Risk Assessment for Birth Defects in Offspring of Chinese Pregnant Women.

Objective: This study aimed to develop a nomogram for the risk assessment of any type of birth defect in offspring using a large birth-defect database in Northwest China. Methods: This study was based on a birth-defect survey, which included 29,204 eligible women who were pregnant between 2010 and 2013 in the Shaanxi province of Northwest China. The participants from central Shaanxi province were assigned to the training group, while the subjects from the south and north of Shaanxi province were assigned to the external validation group. The primary outcome was the occurrence of any type of birth defect in the offspring. A multivariate logistic regression model was used to establish a prediction nomogram, while the discrimination and calibration were evaluated by external validation. Results: The multivariate analyses revealed that household registration, history of miscarriages, family history of birth defects, infection, taking medicine, pesticide exposure, folic acid supplementation, and single/twin pregnancy were significant factors in the occurrence of birth defects. The area under the receiver operating characteristic curve (AUC) in the prediction model was 0.682 (95% CI 0.653 to 0.710) in the training set. The validation set showed moderate discrimination, with an AUC of 0.651 (95% CI 0.614 to 0.689). Additionally, the prediction model had a good calibration (HL χ2 = 8.106, p= 0.323). Conclusions: We developed a nomogram risk model for any type of birth defect in a Chinese population based on important modifying factors in pregnant women. This risk-prediction model could be a tool for clinicians to assess the risk of birth defects and promote health education.

Analysis of Clinical Features and Risk Factors in Pregnant Women With Miliary Pulmonary Tuberculosis After In Vitro Fertilization Embryo Transfer.

PurposeMiliary pulmonary tuberculosis (TB) among pregnant women after in vitro fertilization embryo transfer (IVF-ET) causes poor outcomes but is rarely reported. This study analyzed the clinical characteristics and risk factors of these patients to provide hints for further studies.MethodThe demographic characteristics, clinical manifestations, radiologic features, treatment, and outcomes of six patients diagnosed from May 2012 to August 2021 in Xiangya Hospital and 69 patients that were reported in English or Chinese literature from January 1980 to August 2021 were retrospectively analyzed. Continuous variables were compared between groups by t-test or Mann–Whitney U test, and categorical variables were compared between groups by chi-square test or Fisher exact test. Univariate and multiple logistic regression analyses were used to determine the predictors of respiratory failure.ResultsA total of 75 patients were included. The average age of patients was about 30 years. All patients had tubal obstruction; 5 of them were diagnosed with pelvic TB before. Thirteen cases had a history of pulmonary or extrapulmonary TB, six out of them without any antituberculosis treatment history. All patients were in their first or second trimester during the onset of symptoms. The average interval between onset of symptoms and radiologic examination was about 21 days. The most common abnormalities on chest computed tomography scan were multiple nodules, pulmonary infiltrate, and consolidation. Merely 10 patients obtained bacteriological diagnosis by Mycobacterium tuberculosis culture or polymerase chain reaction test. The other patients were clinically diagnosed. All the patients received antituberculosis treatment. Although 44% of patients had fatal complications, all cases were cured or improved after antituberculosis treatment. Unfortunately, only eight fetuses survived (10.6%). The most frequent and severe complication was type I respiratory failure (20%). Patients with expectoration, dyspnea, coarse breath sounds, ground-glass opacity, and pulmonary infiltrate or consolidation were more likely to have respiratory failure (P < 0.05). Ground-glass opacity (OR = 48.545, 95% CI = 2.366–995.974, P = 0.012) and pulmonary infiltrate or consolidation (OR = 19.943, 95% CI = 2.159–184.213, P = 0.008) were independent predictors for respiratory failure.ConclusionTube infertility with underscreened or untreated TB is a risk factor for miliary TB during pregnancy after IVF-ET. Ground-glass opacity and pulmonary infiltrate or consolidation are predictors of respiratory failure. We demonstrate risk factors for incidence and complications to supply clues for future intervention and improve patient prognosis.

Activity To Prevent Risk Factors For Pregnant Mothers As Early As Possible in the Working Area of Pasar Ikan Health Center, Malabero Village, Bengkulu City

In 2020 in Bengkulu Province there were still 32 maternal deaths. Malabero is one of the villages in Teluk Segara District, Bengkulu City, which is located in the city center, is a fishing village area and includes the working area of the Pasar Ikan Health Center. There were 352 visits by pregnant women during 2020 at the Puskesmas (Bengkulu Health Office, 2021). The high number of pregnant women and the number of deaths due to complications require that health workers, especially midwives, are able to detect risk factors in pregnant women. High-risk pregnancies are pregnant women with various risk factors that can cause complications such as pain or bleeding, disability, discomfort during pregnancy and after delivery, can threaten the life of the mother and fetus. The community service team from FIKes Unived held active activities to prevent risk factors for pregnant women aimed at early detection of high-risk pregnancies. The method used in this service is by providing education using maternal and child health books (KIA). By holding this health education, it is hoped that pregnant women will be able to increase knowledge and prevention. Risk factors for pregnant women include age, parity, height, blood pressure, upper arm circumference, birth spacing, hemoglobin levels, body weight, history of pregnancy-delivery-partum, fetal position abnormalities, large fetal abnormalities.

Correlation of Blood Lipid and Serum Inflammatory Factor Levels With Hypertensive Disorder Complicating Pregnancy.

PurposeTo explore the changes of blood lipid and serum inflammatory factors in pregnant women with hypertensive disorder complicating pregnancy (HDP) and the relationship with disease development.Methods107 pregnant women with HDP who had regular prenatal examination in our hospital from July 2018 to July 2021 were selected as the research objects. According to the severity of the disease, they were divided into gestational hypertension group, mild preeclampsia group and severe preeclampsia group. 30 healthy pregnant women who underwent prenatal examination in the same period were selected as the healthy group. Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), lipoprotein-associated phospholipaseA2 (Lp-PLA2), C- reactive protein (CRP), interleukin -6 (IL-6), tumor necrosis factor-α (TNF-α) were measured. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of blood lipid and serum inflammatory factors in pregnant women with HDP.ResultsThe levels of serum TC, TG and LDL-C increased with the progression of HDP, the level of serum HDL-C decreased with the progression of HDP (P < 0.05). The levels of serum Lp-PLA2, CRP, IL-6 and TNF-α increased with the progression of HDP (P < 0.05). The AUC of serum TC, TG, HDL-C and LDL-C levels for predicting HDP were 0.759, 0.854, 0.770 and 0.785, respectively. The AUC of serum Lp-PLA2, CRP, IL-6 and TNF-α levels for predicting HDP were 0.873, 0.991, 0.966 and 0.999, respectively.ConclusionThe levels of blood lipid and serum inflammatory factor are closely related to HDP, which has certain value in predicting the occurrence and development of HDP.