Health Care For Pregnant Women Research Articles

Why does the number of antenatal care visits in Ethiopia remain low?: A Bayesian multilevel approach.

Antenatal care (ANC) visit is a proxy for maternal and neonatal health. The ANC is a key indicator of access and utilization of health care for pregnant women. Recently, eight times ANC visits have been recommended during the pregnancy period. However, nearly 57% of women received less than four ANC visits in Ethiopia. Therefore, the objective of this study is to identify factors associated withthe number of ANC visits in Ethiopia. A community-based cross-sectional study design was conducted from March 21 to June 28/2019. Data were collected using interviewer-administered questionnaires from reproductive age groups. A stratified cluster sampling was used to select enumeration areas, households, and women from selected households. A Bayesian multilevel negative binomial model was applied for the analysis of this study. There is an intra-class correlation (ICC) = 23.42% and 25.51% for the null and final model, respectively. Data were analyzed using the STATA version 17.0. The adjusted incidence risk ratio (IRR) with 95% credible intervals (CrI) was used to declare the association. A total of 3915 pregnant women were included in this study. The mean(SD) age of the participants was 28.7 (.11) years. Nearly one-fourth (26.5%) of pregnant women did not have ANC visits, and 3% had eight-time ANC visits in Ethiopia. In the adjusted model, the age of the women 25-28 years (IRR:1.13; 95% CrI: 1.11, 1.16), 29-33 years (IRR: 1.15; 95% CrI: 1.15, 1.16), ≥34 years (IRR:1.14; 95% CrI: 1.12, 1.17), being a primary school (IRR: 1.22, 95% CrI: 1.21, 1.22), secondary school and above (IRR: 1.26, 95% CrI: 1.26, 1.26), delivered in health facility (IRR: 1.93; 95% CrI: 1.92, 1.93), delivered with cesarian section (IRR: 1.18; 95% CrI: 1.18, 1.19), multiple (twin) pregnancy (IRR: 1.11; 95% CrI: 1.10, 1.12), richest (IRR:1.23; 95% CrI: 1.23, 1.24), rich family (IRR: 1.34, 95% CrI: 1.30, 1.37), middle income (IRR: 1.29, 95% CrI: 1.28, 1.31), and poor family (IRR = 1.28, 95% CrI:1.28, 1.29) were shown to have significant association with higher number of ANC vists, while, households with total family size of ≥ 5 (IRR: 0.92; 95% CrI: 0.91, 0.92), and being a rural resident (IRR: 0.92, 95% CrI: 0.92, 0.94) were shown to have a significant association with the lower number of ANC visits. Overall, 26.5% of pregnant women do not have ANC visits during their pregnancy, and 3% of women have eight-time ANC visits. This result is much lower as compared to WHO's recommendation, which states that all pregnant women should have at least eight ANC visits. In this study, the ages of the women 25-28, 29-33, and ≥34 years, being a primary school, secondary school, and above, delivered in a health facility, delivered with caesarian section, multiple pregnancies, rich, middle and poor wealth index, were significantly associated with the higher number of ANC visits, while households with large family size and rural residence were significantly associated with a lower number of ANC visits in Ethiopia.

IoT-based Pregnant Mother Contraction Monitoring System Design

Pregnancy is an important stage in a woman's life that requires special monitoring and care to ensure the well-being of both mother and fetus. The presence of uterine contractions is an im-portant indicator of imminent labour, and prompt monitoring is essential to spot difficulties and ensure a safe delivery. This study aims to track contractions in pregnant women to improve pre-natal and labour care. Real-time monitoring, recording and analysis of uterine contractions. This research is a type of RD research with the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation. The result of this tool is that it can precisely track contraction activity and send information to the IoT network. Through an easy-to-use mobile app, this in-formation can be accessed by medical staff caring for pregnant women and pregnant women themselves. To provide continuous monitoring, provide early notification of alarming changes, and facilitate rapid medical response, this monitoring system utilizes IoT technology. This can ease the burden on medical institutions, lower the possibility of difficulties during labour, and provide a sense of security for pregnant women. As an innovative and effective tool, the Inter-net of Things-based Maternal Contraction Monitoring System is anticipated to improve prenatal and delivery healthcare, reduce maternal and infant mortality, and monitor contractions in preg-nant women. The healthcare of pregnant women around the world could be significantly im-proved with the successful implementation of this approach.

Attitudes of Gynecologists on Oral Health Care During the Pregnancy in the Republic of North Macedonia

Objective: The aim of the study was to determine the attitudes and the knowledge of gynecologists in the Republic of North Macedonia on oral health care during the pregnancy.
 Materials and methods: The specialists and residents of obstetrics and gynecology in Republic of North Macedonia were involved in this cross-sectional study. The survey was conducted by a questionnaire which consisted the questions on general demographic data and issues related to the attitudes of gynecologists to oral health care of pregnant women. The data were collected from January to May 2022 using Google Form, a link to which questionnaire was send via available social media platforms.
 Results: Out of the total number of 120 respondents, 86 (71.64%) were specialists and 34(28.33%) residents of obstetrics and gynecology. As many as 116 (96.67%) gynecologists answered that they advise their patients to visit the dentist for an examination. However, of these 116 gynecologists, 16 (13.33%) responded by advising their patients to postpone a visit to the dentist until the end of the pregnancy. 79 (65.83%) gynecologists answered that their patients complained of gingival bleeding during pregnancy. 48 (40.33%) gynecologists answered that their patients complained about tooth mobility during pregnancy. When respondents were asked where they get information about the connection between oral health and pregnancy, only 27 respondents answered correctly that they receive information from all the above sources. Only 7 (5.83%) respondents, 5 specialists and 2 residents of obstetrics and gynecology know that breastfeeding a child can cause dental caries.
 Conclusion: Additional collaboration between gynecologists and doctors of dental medicine is essential in order for every pregnant woman to receive a satisfactory level of dental care and proper education on the preservation of oral health.

Perinatal Networks: Ensuring Regional Care of Pregnant Woman and Newborns

Health care of pregnant women and their newborns is facing major challenges due to the decline in birth rate and shortage of specialists. In the current discussion about future concepts, the centralization associated with minimum quantities and the necessary safeguarding of care in the area are often construed as conflicting goals. Instead, concepts are needed to guarantee that pregnant women and their children will continue to receive care close to home. The example of the saxony center for feto/neonatal health is used to show how partners in a region can jointly ensure care during pregnancy, birth and the neonatal period on a supra-local and cross-hospital basis. The close cooperation of maximum care providers with regional partners enables comprehensive health care. At the same time, this cooperation enables hospitals to remain attractive employers in structurally weak regions and to provide comprehensive care for young families in need of medical services related to pregnancy and birth through good family and social integration close to home and work. The overriding goals of the saxony center for feto/neonatal health are optimal, guideline-based, interdisciplinary and intersectoral care of pregnant women and premature or sick newborns in the region.

Factors associated with the knowledge of obstetric danger signs among pregnant women attending primary health care antenatal care clinics in Abha city.

Knowledge of obstetric danger signs would equip women to make the right decisions and appropriate actions timely to have better health care assistance which will impose a significant impact on maternal mortality and morbidity. Hence, this study aimed to know the factors associated with the knowledge of obstetric danger signs among pregnant women who attend the primary health care clinics, which is considered as the first gate to seek health care for pregnant women during antenatal checkups. This is a cross-sectional study conducted among 400 pregnant women selected by simple random sampling technique who were attending antenatal clinics at primary health care centers at Abha City by using an interview-based questionnaire.cores of <50%, 50-75%, and >75% were considered to be poor, intermediate, and good scores. Frequencies and percentages were used for descriptive variables, whereas for association, tests of significance (Chi square, t-test, and F-test) were applied. Almost 70.8% of participants received health information on obstetric danger signs. The main sources of information were the Internet (23%), family, relatives or friends (17%), and health care providers. The highest participants' correct responses regarding obstetric danger signs were related to severe vaginal bleeding (93.5%), convulsions (76.8%), and decreased fetal movements (76.5%). Proportions of participants with poor knowledge showed an inverse and significant increase with their educational levels (P < 0.001). The highest percentage of poor knowledge grade was observed among participants with no children (54.6%). Participants who received previous information on danger signs had significantly better knowledge grades than those who have not received previous information (P < 0.001). Women's knowledge was suboptimal regarding obstetric danger signs. 30% of women did not receive information about danger signs. Health education provided on obstetric danger signs to pregnant women should be enforced to those who are illiterate, are unemployed, have a low family income, and are with no or less previous pregnancies.

Resilience of hospital and allied infrastructure during pandemic and post pandemic periods for maternal health care of pregnant women and infants in Tamil Nadu, India - A counterfactual analysis.

COVID-19 has impacted the healthcare system across the globe. The study will span three pandemic waves in 2020, 2021, and 2022. The goal is to learn how the pandemic affects antenatal care (ANC) and emergency delivery care for pregnant women in Tamil Nadu, India, and how medical services respond. The study employs counterfactual analysis to evaluate the causal impact of the pandemic. A feedforward in combination with a simple auto-regressive neural network (AR-Net) is used to predict the daily number of calls for ambulance services (CAS). Three categories of the daily CAS count between January 2016 and December 2022 are utilised. The total CAS includes all types of medical emergencies; the second group pertains to planned ANC for high-risk pregnant women and the third group comprises CAS from pregnant women for medical emergencies. The second wave's infection and mortality rates were up to six times higher than the first. The phases in wave-II, post-wave-II, wave-III, and post-wave-III experienced a significant increase in both total IFT (inter-facility transfer) and total non-IFT calls covering all emergencies relative to the counterfactual, as evidenced by reported effect sizes of 1 and a range of 0.65 to 0.85, respectively. This highlights overwhelmed health services. In Tamil Nadu, neither emergency prenatal care nor planned prenatal care was affected by the pandemic. In contrast, the increase in actual emergency-related IFT calls during wave-II, post-wave-II, wave-III, and post-wave-III was 62%, 160%, 141%, and 165%, respectively, relative to the counterfactual. During the same time periods, the mean daily CAS related to prenatal care increased by 47%, 51%, 38%, and 38%, respectively, compared to pre-pandemic levels. The expansion of ambulance services and increased awareness of these services during wave II and the ensuing phases of Covid-19 pandemic have enhanced emergency care delivery for all, including obstetric and neonatal cohorts.

Description of Dental and Oral Health Maintenance Behavior of Pregnant Women at Bhayangkara General Hospital, Palu City, Central Sulawesi

Development in the field of dental and oral health is one part of overall health development which has a great responsibility towards increasing the value of dental and oral health status in the community. Dental health efforts need to be reviewed from environmental aspects, education, public awareness and dental health management, including prevention and treatment. In order to get good results, in dental health efforts it is necessary to know the problems associated with the process of tooth decay/caries. This study aims to determine the Behavioral Description of Dental and Oral Health Care for Pregnant Women at Bhayangkara General Hospital, Palu City. This study used a descriptive method with a cross-sectional design, namely direct observation and total sampling. According to the results of data collection, a sample of 30 people was obtained. The results of this study are that pregnant women brush their teeth in a day showing 1 time a day with a total of 19 people obtaining a percentage of 64%, for 2 times a day with a total of 7 people obtaining a percentage of 23%, and for 3 times a day with a total 4 people with a percentage of 13%. those who brushed their teeth every bath and shower in the afternoon with a total of 5 people got a percentage of 16%, those who brushed their teeth every time they wanted to sleep with a total of 4 people got a percentage of 13.3%, those who brushed their teeth before eating with a total of 15 people got a percentage of 50% and those who brushed Indeterminate teeth with a total of 6 get a percentage of 20%. The conclusion is that the behavior of maintaining dental health in pregnant women at Bhayangkara General Hospital, Palu City is still not good, seen from the frequency of brushing their teeth only once a day and the time to brush their teeth, namely before eating.

Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study.

Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

Community Radio in India: A Model of Participatory Communication inIndia

Community Radio in India: A Model of Participatory Communication inIndia

Social and cognitive vulnerability to COVID-19-related stress in pregnancy: A case-matched-control study of antenatal mental health

Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key to identifying women at risk for deteriorating peripartum mental health. N = 742 pregnant women and N = 742 age and country-matched controls from the COVID-19 Risks Across the Lifespan Study were included. Using a case-match control design allowed us to explore whether the cognitive vulnerability profiles would differ between pregnant and non-pregnant women. The findings showed that COVID-19-related stress was associated with heightened levels of depression and anxiety during pregnancy. Its impact was greatest in women with cognitive (i.e., higher intolerance of uncertainty and tendency to worry) and social (i.e., higher level of self-reported loneliness) vulnerabilities. Importantly, our data show that the mental health impacts of the pandemic were greater in pregnant women compared to women who were not pregnant, especially those with cognitive and social vulnerabilities. The results highlight the urgent need to prioritize mental health care for pregnant women to mitigate the impact of COVID-19-related stress on women's postpartum mental health and their infants' well-being.

Health care seeking behaviors of pregnant women in rural Amhara, Ethiopia: a qualitative study of perceptions of pregnant women, community members, and health care providers.

in Ethiopia, increasing access to basic antenatal and neonatal health services may improve maternal and newborn survival. This study examined perceptions regarding antenatal health seeking behaviors from pregnant women, their families, community members, and health care providers in rural Amhara, Ethiopia. the study was conducted in four rural districts of the Amhara region of Ethiopia. A total of forty participants who were living and working within the catchment areas of the selected health centres were interviewed from October 3rd through October 14th, 2018. A phenomenological qualitative study design was used to understand participants' perceptions and experiences about pregnant women's health care seeking behaviors. early disclosure of pregnancy status was not common in the study area. However, the data from the present study further provided new information, suggesting that some women did disclose their pregnancy status early but preferentially only to their partners and close relatives. Most women did not seek care unless sick or experienced new discomfort or pain. Some reasons for the low utilization of available antenatal services include long distance to health facilities, lack of transportation, difficult topography, and discomfort with male providers. despite the rapid expansion of health posts and deployment of health extension workers since 2003, there are still critical barriers to accessing facility-based care that limit women's health care seeking practices.

Healthcare of pregnant women with diabetes during the COVID-19 pandemic: a Southern Brazilian cross-sectional panel data.

To evaluate the indirect effects of the COVID-19 pandemic on the care of women with pregnancies complicated by gestational or pre-existing diabetes, and their maternal-fetal outcomes. A cross-sectional panel data conducted in a University Hospital in Southern Brazil. Maternal-fetal outcomes and predictors of care from 235 pregnant women with type 1, type 2, or gestational diabetes were evaluated. Two time periods were compared: six months preceding the pandemic, in 2019, and the COVID-19 period from September 2020 to March 2021. Comparisons were performed using analysis of variance, Mann-Whitney U, Fisher's exact and T-tests. Risks were calculated using the Poisson regression with robust estimates. Maternal age was lower (32.1±6.8 vs. 34.4±6.6, p=0.009) and rates of depression/anxiety were higher (16.5 vs. 7.4%, p=0.046) in the group evaluated during the COVID-19. Neonatal hypoglycemia (RR 4.04; 95% CI 1.37-11.98, p=0.012), and SGA rates (RR 4.29; 95% CI 1.93-9.54, p<0.001) were higher in the group assessed before the pandemic. Despite economic, social and structural impacts of the pandemic, parameters of maternal care were similar; diabetes control improved, and neonatal hypoglycemia and SGA rates were lower among pregnant women with diabetes during the pandemic.

Pregnancy in women on chronic dialysis in the last decade (2010-2020): a systematic review.

Pregnant women with end-stage renal disease on chronic dialysis are at a high risk of maternal and foetal complications. Over the years, the prognosis of their pregnancies has improved with advances in dialysis treatments and maternal and neonatal care. We conducted this systematic review to examine the recent data on maternal and foetal outcomes in pregnant women with end-stage renal failure on chronic dialysis over the last decade. We made a systematic review of studies on pregnant women on chronic dialysis published between 1 January 2010 and 31 December 2020. We searched the following electronic databases: Medline via PubMed, Embase and the Cochrane Library, with search strategies for each database. We checked the titles and abstracts identified by the search equation, and two independent reviewers assessed the articles retrieved. For each study, the two reviewers separately recorded the data from each selected article on a standardized data extraction form. For each article, we recorded relevant general information on the study, patient demographic characteristics, dialysis schedule, pregnancy complications and outcomes, maternal complications, and foetal and neonatal outcomes. The literature search yielded 1668 potentially relevant abstracts. After reviewing the titles, abstracts and full text, we identified 14 studies according to the inclusion criteria. All studies were observational, nine of them were retrospective and eight were from a single-centre experience. The total number of women included in these studies was 2364 (range 8-2008) and the total number of pregnancies was 2754 (range 8-2352). The patients' ages ranged from 15 to 45 years. Obesity was observed in 808 (34.2%) women and ranged from 1 to 778. Haemodialysis was the predominant modality with 2551 (92.6%) pregnancies, and 203 (7.4%) on peritoneal dialysis. Overall, 68 out of 402 (16.9%) spontaneous miscarriages, 21 out of 402 (5.2%) therapeutic abortions and 26 (8.3%) stillbirths among 313 (stillbirths and live births) were recorded. The mean or median gestational age at delivery ranged from 25.2 to 36 weeks. The main maternal complications were preeclampsia 11.9%, hypertension 7.7% and anaemia 3.9%. Live births represented 287 (71.4%) out of 402 pregnancies, birth weight ranged from 590 to 3500g and preterm birth was the main, most common complication in all studies, ranging from 50% to 100%. Intrauterine growth restriction was present in 5.9% and small-for-gestational-age was reported in 18.9% of neonates. There were 22 (7.6%) neonatal deaths among 287 live births and 48 (15.3%) perinatal deaths among 313 total births (stillbirths and live births). Presumably, considering the increase in the number of publications and the total number of pregnancies reported therein, the frequency of pregnancy in patients with end-stage chronic kidney disease treated by chronic dialysis has increased. However, the practice of treating pregnant women on dialysis differs significantly among countries. These findings highlight the need to standardize the definition of outcomes and healthcare for pregnant women on dialysis.

Resveratrol’s neural protective effects for the injured embryoid body and cerebral organoid

ObjectiveResveratrol (RSV) is a polyphenol compound found in grapes, veratrum and other plants. It has been reported that RSV has anti-inflammatory, anti-oxidant, anti-cancer and other pharmacological effects. However, the impacts of RSV on development of nervous system are not understood well. The study aims to investigate RSV’s neuroprotective effect during development and to provide a health care for pregnant women and their fetuses with RSV supplementation.MethodsIn this study, we induced human induced pluripotent stem cells (hiPSCs) to form the embryoid bodies (EBs) and cerebral organoids (COs) with 3 dimensional (3D) culture. In the meantime, D-galactose (D-gal, 5 mg/ml) was used to make nervous injury model, and on the other hand, RSV with various doses, such as 2 μm/L, 10 μm/L, 50 μm/L, were applied to understand its neuroprotection. Therefore, the cultures were divided into control group, D-gal nervous injury group and RSV intervention groups. After that, the diameters of EBs and COs were measured regularly under a reverted microscope. In the meantime, the neural proliferation, cell apoptosis and the differentiation of germ layers were detected via immunofluorescence.Results(1) D-gal could delay the development of EBs and COs; (2) RSV could rescue the atrophy of EBs and COs caused by D-gal; (3) RSV showed its neuroprotection, through promoting the neural cell proliferation, inhibiting apoptosis and accelerating the differentiation of germ layers.ConclusionRSV has a neuroprotective effect on the development of the nervous system, suggesting RSV supplementation may be necessary during the health care of pregnancy and childhood.

Present Situation and the Future Development of Web-Based Prenatal Education in China: Cross-sectional Web-Based Survey.

BackgroundPregnancy serves as an important chapter in the life of women since more attention needs to be paid to both their physical and psychological health during this period. Adequate prenatal knowledge plays a key role in ensuring the health and safety of not only the pregnant women but also their fetuses and the entire family. With the development of information technology, web-based prenatal education has been brought into focus owing to its accessibility to comprehensive information, with high-quality information available to improve the quality of the overall gestation period, labor process, perinatal outcomes, and fetal outcomes.ObjectiveThis study aims to investigate the present situation of web-based prenatal education and to predict the future research direction of web-based prenatal education in China, thereby providing insights into improving the quality of health care of pregnant women.MethodsA national cross-sectional study was conducted on 590,912 pregnant women in 31 provincial administrations of mainland China between August 2018 and August 2019. These pregnant women were initially recruited from local hospitals across the nation during antenatal and postnatal periods via a web-based education school. Demographic information and course completion status (including the categories and the number of courses they completed) of all the participants were collected.ResultsA total of 590,912 pregnant women participated in the web-based prenatal education in 2018. Among them, 188,508 (31.90%) participants were excluded because they did not complete any course, while 17,807 (3.01%) actively participated in web-based prenatal education and completed more than 100 courses. There were 5 categories of web-based courses; almost half of the pregnant women attended the courses on first and second trimesters (293,262/590,912, 49.63% and 298,168/590,912, 50.46%, respectively). We found that pregnant women were more concerned about the gestational diet, fetal-related knowledge, and other precautions before the labor.ConclusionsIn the era of digitalization where information is rapidly disseminated, web-based prenatal education could become a more convenient, productive, and effective pathway for pregnant women since it could help them obtain adequate and optimal pregnancy-related information and gain more intellectual awareness about their pregnancy or preparation for pregnancy.

Effect of Slow Pranayama on Heart Rate Variability in Pregnant Women with Preeclampsia

Background and Aim: Hypertension is one of the common medical problems encountered in 10% of all pregnancies. Pre-eclampsia (PE), a hypertensive disorder during pregnancy has adverse pregnancy and cardiovascular (CV) outcomes. Though anti-hypertensive drugs are used in the management of pregnancy induced hypertension, termination of pregnancy alone offers complete cure. Hence optimizing the health care for pregnant women is an important step to achieve sustainable development objectives, prevention and treatment of hypertensive disorders. While studies have shown the beneficial effects of yoga on high-risk pregnancies, this randomized control trial investigated the effect of slow pranayamas on heart rate variability and CV risks in pregnant women diagnosed with preeclampsia. Methods: A total of 101 pregnant women who were diagnosed with pre-eclampsia were recruited from Women and Children Hospital, JIPMER and were randomized into yoga and control groups. The yoga group (n=48) received standard anti-hypertensive medication along with slow pranayamas, 2 times a day for 4 weeks between 20-34 weeks of gestation. The control group (n=53) received only standard anti-hypertensive medications during the same period. Heart rate, blood pressure and heart rate variability were assessed before and after 4 weeks. Results: Significant decrease in heart rate and blood pressure was seen in in pranayama group compared to control group. Also, LFnu and LF-HF ratio decreased significantly and HFnu increased significantly in pranayama group compared to control group. Conclusion: Four-week practice of slow pranayamas significantly improved the parasympathetic activity and decreased the sympathetic activity and reduced CV risks in preeclamptic pregnant women.

Pregnant women's perceptions of physical activity: Adaptation of the pregnancy physical activity questionnaire in Dubai, a multicultural society.

Background: There are major health benefits of physical activity (PA) during pregnancy, yet there is scant data about a woman’s knowledge and understanding of these benefits globally.Design and Methods: We aimed to evaluate the knowledge, attitude, and practice of pregnant women in the United Arab Emirates concerning exercise. We wanted to investigate why some women exercise while others do not exercise during pregnancy. We used a cross-sectional study using a paper-based questionnaire involving pregnant women at antenatal clinics in the Dubai health Authority. The Modified form of Pregnancy Physical Activity Questionnaire (PPAQ) was adapted in both Arabic and English and used in this study.Results: Women aging 25-35 that had a higher educational level, were employed, having 1 or 2 previous pregnancies, and having better knowledge on the benefits of Physical Activity (PA) during pregnancy had better exercise profiles.Conclusions: Our results demonstrate that the majority of the women that participated in our study were shown to have low PA during pregnancy. Better education and communication of the benefits of PA during pregnancy are needed to improve exercise among pregnant women in the UAE population. We found that improved education of women specific to PA with involvement of a healthcare provider were associated with an increase in PA during pregnancy. Significance for public health Our findings show a tremendous need for educating women on Physical Activity (PA) during pregnancy in primary health care and maternity clinics. These efforts have to be part of an organizational strategic plan. We recommend more campaigns on the benefits of PA for pregnant women. More efforts are needed to assess the barriers that could be solved and corrected within our health care for pregnant women. Promoting a cost-effective intervention in our antenatal care clinics could decrease maternal-fetal complications that are associated with a sedentary lifestyle.

Glosa do postanowień Europejskiego Trybunału Praw Człowieka w sprawach Grimmark vs. Szwecja oraz Steen vs. Szwecja z dnia 11 lutego 2020 r. – sprzeciw sumienia położnych

The commented decisions concern the issue of freedom of conscience in the midwifery profession and the possibility of its restriction by the state in connection with the need to ensure access to health care for pregnant women, in particular those choosing to terminate their pregnancy. The European Court of Human Rights, breaking with the previous line of jurisprudence, ruled that where the possibility of termination of pregnancy is provided for by national law and implemented within the framework of the health care system, a person intending to exercise the profession of midwife, which entails, inter alia, the obligation to participate in abortion procedures, cannot exempt herself from this obligation on the grounds of conscientious objection. The author disagrees with the position of the Court and with the reasoning presented by it, which led it to declare the complaints as manifestly unfounded.

Analysis of extrauterine growth retardation and related risk factors in 132 premature infants.

Objectives:To understand the incidence and related risk factors of extrauterine growth retardation (EUGR) in preterm infants.Methods:The clinical data of 132 premature infants hospitalized in the neonatal ward of Maternity and Child Health Care of Zaozhuang from July 2019 to June 2020 were collected. Children were divided into groups according to their birth gestational age (<32 weeks, 32~35 weeks and >35 weeks) and birth weight (<1-500 g, 1,500~2,500 g and >2,500 g). Treatment during hospitalization and follow-up after discharge were investigated by retrospective analysis. Incidence of EUGR in premature infants at discharge and the related risk factors leading to this complication, demonstrated by logistic multivariate regression analysis, were summarized.Results:When evaluated according to weight, length and head circumference, incidence of EUGR at discharge in premature infants were 36.36%, 41.67% and 21.97% respectively. Smaller gestational age and lower birth weight significantly correlated with higher incidence of EUGR at discharge (P<0.05). Logistic regression analysis showed that small gestational age, low birth weight, intrauterine growth retardation, late first intestinal feeding, digestive system complications and respiratory system complications were independent risk factors for EUGR in premature infants discharged from hospital (P<0.05).Conclusions:The incidence of EUGR in premature infants at discharge is relatively high. Strengthening perinatal health care for pregnant women, reducing the incidence of intrauterine growth retardation and preterm birth, giving intestinal feeding as soon as possible after birth, and actively participating in preventing and treating postnatal complications are effective ways to reduce the incidence of EUGR at discharge.

Evaluation of SIMESON, a training program to improve access to quality health care for pregnant women and newborn in different healthcare facilities of northern Bangladesh.

AimThe study aims to explore the current knowledge and skills of healthcare providers already trained by SIMESON (simulation for essential skills for obstetrical and neonatal care), in reviewing perinatal health situations including current status of healthcare facilities and cost estimation.DesignIt was an observational study.MethodsCost estimation following both quantitative and qualitative approaches was also attempted.ResultKnowledge and skills of 88 healthcare providers about the provision of normal delivery and immediate postpartum care, management of postpartum haemorrhage (PPH), retained placenta and use of bag and mask ventilation to help a baby breathe were found to be considerably strengthened following SIMESON training. During the 6 months after training, there were 477 PPH cases managed successfully with only one death; neonatal deaths observed were 6.6/1,000 live births; twice the number of facility deliveries; and 80% use rate of Ambu bag for helping baby breathe. The estimated cost per trainee was 395.68 USD, and 5.85 USD per beneficiary.