Health Outcomes For Pregnant Women Research Articles

The effect of diabetes education on maternal and neonatal outcomes in pregnant women diagnosed with gestational diabetes

BackgroundEducation during pregnancy is important for the development of the pregnant woman’s ability to adapt to change and for a healthy birth. In this study, we aimed to examine the effects of education through a diabetes education program on maternal and newborn health in women diagnosed with gestational diabetes.Materials and methodsIn our study, we compared the maternal and neonatal health outcomes of pregnant women who participated in the diabetes education program and were diagnosed with gestational diabetes with the outcomes of pregnant women who did not participate in the diabetes education program and were diagnosed with gestational diabetes. The study included patients who were diagnosed with diabetes between 24and 26 weeks gestation at a tertiary education and research hospital and who underwent a 75-gram OGTT test. Age, BMI, parity, method of delivery, weight gain during pregnancy, newborn birth weight, gestational age and Apgar scores were compared.ResultsThe study included 119 patients and analyzed maternal-neonatal outcomes. There were no statistically significant differences in age (33 ± 5.7 versus 31 ± 5.2), body mass index (BMI) (32.2 vs. 31.2), gravidity, parity, number of miscarriages, mode of delivery, family history of diabetes, smoking, prenatal corticosteroid use, and gestational age at delivery. The HbA1c value (p: 0.013), the total weight gain during pregnancy (p: 0.015), the need for insulin treatment (p: 0.002), and the birth weight (0.005) were significantly higher in the group without diabetes education.ConclusionIn our study, diabetic school education was associated with lower HbA1c levels, less weight gain and less need for insulin therapy. When the results were categorized by insulin use, it was found that in patients using insulin, those who received diabetic school education had fewer macrosomic fetuses, whereas in patients not using insulin, those who received diabetic school education had lower maternal weight gain during pregnancy.

Influence of prenatal aquatic activities on fetal outcomes and maternal physical and mental outcomes: a systematic review and meta-analysis

BackgroundAquatic activities are becoming increasingly popular as a form of exercise during pregnancy. However, the effects of these activities on the physical and mental health outcomes of pregnant women during and after pregnancy as well as fetal outcomes remain unclear. This meta-analysis evaluated the current evidence regarding the effects of aquatic activities during pregnancy on neonatal and maternal outcomes.MethodsThree databases (PubMed, Cochrane Central electronic database, Embase) were searched from inception to July 17, 2024 for randomized controlled trials (RCTs) comparing the effects of aquatic activities versus standard prenatal care or no exercise on neonatal and maternal outcomes. Pooled outcome measures were determined using random-effects models.ResultsTen RCTs including 1949 patients met the criteria for inclusion in this meta-analysis. The results showed that prenatal aquatic activities could significantly improve maternal weight control (mean difference [MD]= -0.91, 95% confidence interval [CI]= -1.64 to -0.18, P = 0.01, I2 = 0.00%), improve maternal quality of life (standard mean difference [SMD] = 0.16, 95%CI = 0.03 to 0.28, P = 0.01, I2 = 0.00%), and extend fetal birth length (MD = 0.48, 95%CI = 0.10 to 0.87, P = 0.01, I2 = 0.00%) compared with standard prenatal care or no exercise, while no significant differences were observed in fetal birth weight, Apgar score at 1 min, Apgar score at 5 min, pH of umbilical cord blood, gestational age, rate of preterm delivery, incidence of postnatal depression and mode of delivery.ConclusionsPrenatal aquatic activities can significantly improve maternal weight control and quality of life during pregnancy, and may promote longer birth length. However, additional studies are needed to confirm these findings.

Complex interplays: Asthma management and maternal‑fetal outcomes in pregnancy (Review).

Asthma, a common chronic respiratory condition, poses unique challenges in pregnancy, impacting both maternal and fetal health. Of note, 8-13% of pregnant women suffer from asthma, a condition that can worsen, stabilize, or improve during pregnancy. These fluctuations necessitate a nuanced management strategy to ensure the health of both the mother and fetus. Adverse outcomes, such as preeclampsia, gestational diabetes and increased cesarean delivery rates are associated with poorly controlled asthma. From a fetal perspective, the risks include preterm birth and a low birth weight. Physiological changes in pregnancy, such as an increased tidal volume and altered drug metabolism due to increased blood volume, complicate the management of asthma. The safety of asthma medications during pregnancy remains a significant concern, with ongoing research into their teratogenic effects. Recent advancements in treatment include the development of biologics and the increased use of personalized medicine, integrating pharmacogenomics and immunological profiling to tailor treatments to individual needs. Digital health tools have also emerged, enabling improved patient monitoring and management. The present review highlights the complex interplay between asthma management and pregnancy outcomes, advocating for comprehensive care approaches that consider the dynamic physiological changes during pregnancy. It underscores the need for ongoing research into the safety of medication and innovative therapeutic strategies to improve health outcomes for pregnant women with asthma and their babies.

Premarital Screening Uncovers Alarming Health Risks in Iraq

Background: Premarital screening programs, implemented globally since the 1970s, aim to improve reproductive health outcomes by identifying potential genetic and infectious risks before marriage. Specific Background: In July 2013, the Thi-Qar Governorate in Iraq introduced a premarital screening program to enhance health outcomes for pregnant women and their offspring. However, regional data on the efficacy and impact of such programs remain limited. Knowledge Gap: The prevalence and distribution of blood disorders and infectious diseases among couples in this region, and their implications for public health, have not been extensively documented. Aims: This study evaluates the pathophysiological status of couples undergoing premarital screening in Nasiriyah, Iraq, focusing on the prevalence of blood disorders and infectious diseases. Results: Data from 14,190 individuals (7095 couples) collected from January to December 2023 revealed significant health concerns: 34.40% had hemoglobin levels below 12 gm/dl, and notable percentages carried thalassemia and sickle cell anemia genes. Gender-specific analysis showed that all males tested positive for HIV, while significant proportions of females tested positive for HCV and T. palladium. No significant differences were found in the ABO blood system. Novelty: This study provides comprehensive, region-specific data on premarital screening outcomes in Iraq, highlighting significant disparities in disease prevalence between sexes and compared to other regions. Implications: The findings underscore the importance of enhancing premarital screening programs and integrating educational and preventive measures. Future research should include longitudinal studies to assess the long-term impact of these screenings and explore the benefits of incorporating genetic counseling to further mitigate hereditary and infectious risks. Highlights: High prevalence of blood disorders and infections in couples. Gender differences: all males positive for HIV, significant female infections. Need for improved education and prevention measures. Keywords: Premarital Screening, Hemoglobinopathies, Infectious Diseases, Nasiriyah, Iraq

Malaria Prevalence Rates among Pregnant Women in East Africa: National and Regional Perspectives

Malaria remains a critical public health issue in East Africa, with pregnant women particularly vulnerable to its severe consequences. This review examines the prevalence rates of malaria among pregnant women, providing a comprehensive analysis of national and regional perspectives as well as urban-rural and age-specific variations. By integrating national data with regional insights, the review highlights overarching trends and identifies specific hotspots where malaria transmission is most intense. The study reveals that while national data can guide broad resource allocation and policy decisions, regional data is crucial for pinpointing high-risk areas and tailoring localised interventions. We examine the impact of seasonal variations on pregnant women, including increased transmission during rainy seasons and the geographic distribution of high-risk areas and hotspots. The review also explores the influence of socioeconomic factors, education, housing conditions, and biological determinants on malaria risk among pregnant women. Additionally, it addresses the challenges associated with diagnosing malaria, including the limitations of conventional methods and the need for more sensitive diagnostic tools. The impact of malaria during different trimesters of pregnancy and the complications arising from coinfections, particularly with HIV, receive special attention. The review underscores the necessity of integrated care approaches, improved diagnostic infrastructure, and targeted interventions to mitigate the effects of malaria on maternal and foetal health. The findings advocate for a comprehensive strategy that encompasses geographic and seasonal variations, addresses risk factors, and integrates robust diagnostic and treatment approaches to reduce malaria prevalence and improve health outcomes for pregnant women in East Africa. Keywords: malaria, pregnant women, East Africa, national and regional perspectives

Role of magnesium sulfate in pregnancy: A comprehensive review of benefits and risks

Magnesium sulfate is a versatile therapeutic agent in maternal-fetal medicine, and its use during pregnancy has led to various clinical scenarios. This comprehensive review examines the multifaceted role of magnesium sulfate, addressing its benefits and potential risks. The mineral compound is limited for its efficacy in preventing and managing preeclampsia and eclampsia, providing neuroprotection for preterm infants, delaying preterm labor, and offering potential advantages in maternal and fetal health. However, its administration is complex, encompassing a range of maternal and fetal side effects and long-term implications. The decision to utilize magnesium sulfate during pregnancy necessitates a balanced assessment of its advantages and disadvantages, underscored by patient-centered care and shared decision-making. Future research and practice guidelines include pursuing personalized medicine, optimal dosing and administration, long-term follow-up, global health initiatives, and ethical considerations. The evolving landscape of research and emerging insights will continue to enhance maternal care and contribute to improved health outcomes for pregnant women and their infants.

Maternal health service utilization in the Jimma Zone, Ethiopia: results from a baseline study for mobile phone messaging interventions

BackgroundOver the last 20 years, global healthcare has placed a major focus on improving the survival rates of mothers and children, recognizing the potential to prevent a significant number of deaths resulting from pregnancy and childbirth. Nevertheless, there remains an ongoing obstacle to the insufficient utilization of critical obstetric services to achieve optimal health outcomes for pregnant women. This study aimed to assess the magnitude and determinants of maternal healthcare use in the Jimma Zone, Ethiopia.MethodsData were obtained from a household survey as part of the baseline assessment of a cluster randomized controlled trial. The study participants comprised 588 women in early pregnancy, specifically those with a gestational age of less than 20 weeks. Logistic regression analysis was employed to identify factors associated with the use of maternal health services. Adjusted odds ratios (AORs) were used to assess the strength of the associations, with significance level set at a p-value ≤ 0.05.ResultsThe overall prevalence of maternal health service utilization was 87.9% (CI: 85.1, 90.4) for antenatal care, 74.7% (CI: 73.2, 79.9) for health facility delivery, and 60.4% (CI: 56.4, 64.3) for postnatal care. Multivariable logistic analysis revealed that maternal health service use was significantly influenced by access to health facilities (AOR: 6.6; 95% CI: 2.39, 18.16), financial hardship (AOR: 3; 95% CI: 1.97, 4.61), perceived respectful care (AOR: 2.3; 95% CI: 1.07, 5.11), perceived privacy of service provisions (AOR: 2.4; 95% CI: 1.47, 4.06), and attitudes toward maternal service use (AOR: 2.2; 95% CI: 1.48, 3.24).ConclusionsThe study revealed slightly higher rates of antenatal care, facility delivery, and postpartum care utilization. However, there was a low proportion of early antenatal care initiation, and high rates of antenatal care dropout. Mobile phone-based messaging intervention may enhance maternal health service use by addressing factors such as lack of access, economic challenges, disrespectful care, no privacy of procedures, and unfavorable attitudes.

A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.

Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the mother, fetus, and newborn child. However, maternal-perinatal cost-utility analyses (CUAs) often only consider either maternal or child health outcomes. Challenges include, but are not limited to, measuring fetal, newborn, and infant health outcomes, and assessing their impact on maternal HRQoL. It is also important to recognize the impact of maternal-perinatal health on family members' HRQoL (i.e., family spillover effects) and to incorporate these effects in maternal-perinatal CUAs. The aim was to systematically review the methods used to include health outcomes of pregnant women, fetuses, and children and to incorporate family spillover effects in maternal-perinatal CUAs. A literature search was conducted in Medline, Embase, EconLit, Cochrane Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Network of Agencies for Health Technology Assessment (INAHTA), and the Pediatric Economic Database Evaluation (PEDE) databases from inception to 2020 to identify maternal-perinatal CUAs that included health outcomes for pregnant women, fetuses, and/or children. The search was updated to December 2022 using PEDE. Data describing how the health outcomes of mothers, fetuses, and children were measured, incorporated, and reported along with the data on family spillover effects were extracted. Out of 174 maternal-perinatal CUAs identified, 62 considered the health outcomes of pregnant women, and children. Among the 54 quality-adjusted life year (QALY)-based CUAs, 12 included fetal health outcomes, the impact of fetal loss on mothers' HRQoL, and the impact of neonatal demise on mothers' HRQoL. Four studies considered fetal health outcomes and the effects of fetal loss on mothers' HRQoL. One study included fetal health outcomes and the impact of neonatal demise on maternal HRQoL. Furthermore, six studies considered the impact of neonatal demise on maternal HRQoL, while four included fetal health outcomes. One study included the impact of fetal loss on maternal HRQoL. The remaining 26 only included the health outcomes of pregnant women and children. Among the eight disability-adjusted life year (DALY)-based CUAs, two measured fetal health outcomes. Out of 174 studies, only one study included family spillover effects. The most common measurement approach was to measure the health outcomes of pregnant women and children separately. Various approaches were used to assess fetal losses in terms of QALYs or DALYs and their impact on HRQoL of mothers. The most common integration approach was to sum the QALYs or DALYs for pregnant women and children. Most studies reported combined QALYs and incremental QALYs, or DALYs and incremental DALYs, at the family level for pregnant women and children. Approximately one-third of maternal-perinatal CUAs included the health outcomes of pregnant women, fetuses, and/or children. Future CUAs of maternal-perinatal interventions, conducted from a societal perspective, should aim to incorporate health outcomes for mothers, fetuses, and children when appropriate. The various approaches used within these CUAs highlight the need for standardized measurement and integration methods, potentially leading to rigorous and standardized inclusion practices, providing higher-quality evidence to better inform decision-makers about the costs and benefits of maternal-perinatal interventions. Health Technology Assessment agencies may consider providing guidance for interventions affecting future lives in future updates.

A concurrent mixed-method study exploring the experiences of interprofessional collaboration among Canadian midwives and obstetricians.

This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. A concurrent mixed-methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. Eighteen RMs across Canada completed a demographic survey and the Midwifery-Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery-Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi-structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife-physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician-midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter-Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. This study provides support for the Midwifery-Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. The authors adhered to Consolidated criteria for reporting qualitative research (COREQ).

Prevalence and determinants of utilizing skilled birth attendance during home delivery of pregnant women in India: Evidence from the Indian Demographic and Health Survey 2015-16.

Utilization of skilled birth attendance during home delivery of pregnant women is proven to reduce complications during and after childbirth. Though the utilization of skilled birth attendance (SBA) during home delivery has increased significantly in recent times, the rate of utilizing skilled birth attendance is still low in several regions across India. The objective of this study is to analyze the prevalence and to identify the determinants of the utilization of skilled birth attendance during home delivery of pregnant women in India. To conduct this study, data and information from the Indian Demographic and Health Survey 2015-16 have been utilized. The sample size for this study is a weighted sample of 41,171 women. The sample consisted of women who had given a live birth in the three years preceding the survey. For women with more than one child, only the first live birth was considered. The binary logistic regression model and the log-binary logistic regression analysis have been applied as the adjusted odds ratios (AORs) with 95% confidence intervals for identifying the determinants of home-based skilled birth attendance during delivery. That allows us to select the most appropriate model for our study objective by ensuring that the determinants of skilled birth attendance for home delivery are accurately assessed based on the characteristics of the data. The analyses show that only 18.8% of women had utilized skilled birth attendance during delivery. Women residing in urban areas are more likely to utilize skilled birth attendance during home delivery (AOR: 1.14; 95% CI: 1.08-1.20). Women having higher education levels are associated with increased use of SBA during home delivery (AOR: 1.15; 95% CI: 1.04-1.28). Exposure to media is associated with increased utilization of SBA (AOR: 1.17; 95% CI: 1.11-1.23). Overweight women are also more likely to avail the SBA during home delivery (AOR: 1.11; 95% CI: 1.03-1.19). Women belonging to affluent households have higher odds of utilizing skilled birth attendance (AOR: 1.41; 95% CI: 1.33-1.49). Having 3+ tetanus injections is associated with the utilization of SBA (AOR: 1.56; 95% CI: 1.43-1.69). Women having 4+ antenatal care visits were more likely to utilize SBA (AOR: 1.81; 95% CI: 1.71-1.92). Women belonging to the Hindu religion were 1.12 times more likely to utilize SBA (AOR: 1.12; 95% CI: 1.07-1.18). Women with 1 to 3 birth orders were 1.40 times more likely to utilize skilled birth attendance during home delivery (AOR: 1.40; 95% CI: 1.30-1.51). The percentage of women utilizing skilled birth attendance during home delivery is still very low which is a matter of serious concern. Several factors have been found to be associated with the utilization of SBA during home delivery in India. As skilled birth attendance has significant positive health outcomes for pregnant women and newborns, efforts to increase the rate of SBA utilization during home delivery should be undertaken.

Utilization of iron-folic acid supplementation and related factors in pregnant women in Leka Dulecha District, East Wollega Zone, Western Ethiopia: The case study.

To treat neural tube closure abnormalities and maternal anemia during pregnancy, iron and folic acid (FA) supplements are typically necessary. Ethiopian Ministry of Health plan to increase the numbers of pregnant women who take iron and FA supplements from 11% to 50%, and by 2029, to 90% by 2024. Hence, the main objective of this study was to investigate the degree of iron-folic acid supplementation (IFAS) and associated factors among pregnant women receiving antenatal care at Leka Dulecha Woreda public health facilities from May 1 to October 31, 2022. In this study, about 316 pregnant women who visited Leka Dulecha prenatal care services were selected. A facility-based cross-sectional study was conducted. Multivariable logistic regression was utilized to examine parameters associated with the utilization of IFAS. These findings suggest that maternal educational status (adjusted odds ratio, AOR = 2.00, 95% confidence interval, CI [1.5, 3.05]), the timing of the first prenatal consultation (AOR = 1.93, 95% CI [1.47, 2.62]), having a good understanding of anemia (AOR = 1.50, 95% CI [1.00, 2.11]), and a history of anemia during the current pregnancy (AOR = 1.60, 95% CI [1.11, 3.16]) are important factors to consider when promoting adherence to iron-FA supplementation among pregnant women. It is crucial for healthcare providers to address these factors to improve the overall health outcomes for pregnant women attending Leka Delecha Health Facility.

The Implications of Socioeconomic Status by ZIP Code on Maternal-Fetal Morbidity and Mortality in San Antonio, Texas.

Introduction Over the past 20 years, the number of pregnancy-related fatalities in the United States has been on the rise. Increases in maternal and fetal mortality have been attributed to low socioeconomic status (SES). This raises the question of whether all geographical locations are proportionally affected by this upward trend in pregnancy-related fatalities. San Antonio is one of the largest cities in the United States and is known for its economic segregation. This study aims to compare the maternal and fetal health outcomes of mothers from diverse socioeconomic backgrounds in San Antonio, Texas. Methods To analyze the relationship between pregnancy-related mortality rates and SES in San Antonio, Texas, the International Classification of Diseases (ICD)-10 codes for maternal and fetal demise and their associated risk factors were identified. The ICD-10 codes were used to compare the health outcomes of pregnant women from the highest SES ZIP Code (78255, median income $124,397) to women from the lowest SES ZIP Code (78207, median income $25,415) using the Texas Inpatient Public Use Data File for 2016, which contains information on 93-97% of all hospital discharges in San Antonio, Texas. Results Notably, pregnant women from the high SES ZIP Code were admitted to the hospital from clinics or a physician's office (68.8%), while pregnant women from the low SES ZIP Code were admitted to the hospital from non-healthcare facilities like home or workplace (62.5%). In addition, a greater percentage of patients from the low SES ZIP Code were Black (4.3% vs 1.3%) or Hispanic (88.5% vs 35.1%). Compared to women from the high SES ZIP Code, women from the low SES ZIP Code experienced more fetal deaths and a higher prevalence of maternal and fetal risk factors such as obesity (47.6% vs 32.5%), asthma (1.7% vs 1.3%), hypertension (0.8% vs 0%), substance abuse (0.5% vs 0%), diabetes mellitus (9.8% vs 7.8%), preeclampsia (7.7% vs 2.6%), and multiple C-sections (35.5% vs 28.6%). Finally, fetal mortality rates were higher in the low SES ZIP Code (1.1% vs 0%). Although there were no statistically significant maternal or fetal mortality differences between the ZIP Codes, the trend suggests that women's health outcomes in San Antonio are not equitable. Discussion Analysis reveals disproportionate health outcomes for women in south San Antonio. Further investigation is warranted to better understand the role social and medical factors play in these results. Investigating the relationship between SES and pregnancy-related mortality can help to better inform healthcare providers and identify ways to improve women's health outcomes in San Antonio, Texas.

Gestational Diabetes and Poor Healthcare Affordability Among Pregnant Women: A Double Whammy!

The prevalence of Gestational Diabetes Mellitus (GDM) is increasing at a rapid pace globally. This is concerning because GDM can lead to serious health problems like Type 2 Diabetes, Cardiovascular Diseases, and Depression in both the mother and her baby. GDM also increases healthcare expenditure during and after pregnancy and this is particularly worrisome for women belonging to households with poor healthcare affordability. Given the rising prevalence of GDM and its adverse impact, it is crucial to identify its risk factors and explore the factors associated with healthcare affordability among pregnant women. Our work attempts to identify the association between lifestyle (exercise, fruit, and vegetable consumption), sociodemographic factors, and Gestational Diabetes. Second, attempts to investigate the determinants of Health care affordability among pregnant women. Multivariate stepwise logistic regression is used for investigation purposes. We found Depression, higher BMI, and lower fruit intake to be associated with higher odds of GDM among pregnant women. Whereas the presence of GDM, lower socioeconomic position, absence of health insurance, and single motherhood were found to be associated with poor healthcare affordability. Lifestyle and mental health are associated with the GDM risk in pregnant women. Marital status, health insurance, and socioeconomic position are associated with healthcare affordability among pregnant women. The study can aid in better health outcomes for pregnant women and the creation of inclusive health policies.

The Effect of mHealth Interventions on Women's Health Outcomes: A Systematic Review of Randomized Controlled Trials

Introduction: Mobile health (mHealth) is an emerging technology with great potential for improving people's health. Due to its availability, this technology can create more motivation to improve women's health by providing safe, coordinated, and effective health care. Considering the importance of women's health, the present study was conducted to systematically investigate the impact of mHealth interventions on women's health outcomes. Method: The present study was conducted as a systematic review of clinical trial studies in English. PubMed, Scopus, Science Direct, the Cochrane Library, and ClinicalTrials.gov databases were reviewed according to the inclusion criteria from 2011 to 2021. Results : A total of 28 articles were included in the study. mHealth tools, such as applications, text messages, voice or video calls, and wearable devices, were found to have multiple functions in this study, including providing information, reminders, education, and practical recommendations to improve the lifestyles of pregnant women in various areas. The study results indicated that in 82% of the studies, mHealth tools were effective in improving health outcomes for pregnant women, while in 18% of the studies, the intervention results did not differ from the standard method. Conclusion: mHealth interventions can have a positive effect on improving the health of pregnant women, including their lifestyle, knowledge, and attitude regarding their own and their baby's health. However, in all these studies, high heterogeneity limits the certainty of the evidence for these findings. Therefore, future studies should identify the context in which mHealth can be more effective for women's health.

The Effects of a Mindfulness-Based Intervention on Mental Health Outcomes in Pregnant Woman: A Systematic Review and Meta-Analysis.

Pregnancy stress, anxiety, and depression increase the risk of short-term and long-term health problems for the mother and fetus. Mindfulness-based intervention (MBI) is one of the most popular, nonpharmacological interventions used to treat mental health problems. The results of prior research indicate MBI has a less consistent effect on mental health problems in pregnant women. The purpose of this systematic review and meta-analysis was to clarify and determine the effect of MBI on mental health outcomes in pregnant women. Six databases, including Embase, Ovid MEDLINE, CINAHL, EBSCOhost, Cochrane Library, and ScienceDirect, were searched from their dates of inception to November 2021. Google Scholar was also used for the literature inquiry. The inclusion criteria followed the PICO (Patient/Problem, Intervention, Comparison, and Outcome) model in terms of only including studies that used mindfulness therapy, reported mental health outcomes, and applied randomized controlled trial and quasi-experimental approaches. The Cochrane risk of bias tool was applied to evaluate the quality of the studies. Review Manager 5 software with random effect with a standardized mean difference (SMD) was used to analyze level of effect. Thirteen studies (10 randomized controlled trials and three quasi-experimental studies) were included. MBI was found to have a small effect on mental health outcomes in pregnant women (p < .0001, SMDs = -0.48, 95% CI [-0.74, -0.22], I2 = 87%). Specifically, MBI had moderate effects on stress and anxiety (SMDs = -0.59, 95% CI [-1.09, -0.09], and SMDs = -0.55, 95% CI [-1.00, -0.10], respectively) and no significant effect on depression (SMDs = -0.33, 95% CI [-0.74, 0.08]). MBIs have a small but notable effect on mental health in pregnant women. The high heterogeneity found in this review may reflect the different types and durations of interventions used. Notably, none of the studies in the review examined intervention effects by trimester. Future research should use larger sample sizes and assess the effects of therapy for each trimester of pregnancy.

Efficacy of mHealth Interventions for Improving Maternal and Neonatal Outcomes Among Pregnant Women With Hypertensive Disorders: Protocol for a Systematic Review.

Hypertension is one of the most prevalent medical conditions that arise during pregnancy, resulting in maternal and neonatal complications. Mobile health (mHealth) has emerged as an innovative intervention for delivering maternal and child health care services. The evidence on the effectiveness of mHealth interventions in improving the health outcomes of pregnant women with hypertensive disorders is lacking. Therefore, there is a need for evidence synthesis using systematic review methods to address this evidence gap. This review aims to determine the efficacy of mHealth interventions in improving maternal and neonatal outcomes among pregnant women with hypertensive disorders. The review will answer the following research questions: (1) What are the types of mHealth interventions used in pregnant women with hypertensive disorders? (2) Are the various mHealth interventions effective in improving maternal and neonatal health outcomes, health behaviors, and their knowledge of the disease? and (3) Are mHealth interventions effective in supporting health care providers to make health care decisions for pregnant women with hypertensive disorders? This review will include randomized controlled trials, nonrandomized controlled trials, and cohort studies focusing on mHealth interventions for pregnant women with hypertensive disorders. Studies reporting health care providers use of mHealth interventions in caring for pregnant women with hypertensive disorders will be included. The search strategy will be tailored to each database using database-specific search terms. The search will be conducted in PubMed-MEDLINE, ProQuest, CINAHL, Scopus, Web of Science, and CENTRAL. Other literature sources, such as trial registries and bibliographies of relevant studies, will be additionally searched. Studies published in English from January 2000 to January 2023 will be included. A total of 2 review authors will independently perform the data extraction and the quality appraisal. For quality appraisal of randomized controlled trials, the Cochrane Risk of Bias 2 tool will be used. The Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-1) tool will be used for nonrandomized controlled trials, and the Critical Appraisal Skills Programme checklist for cohort studies will be used. Any disagreements between the 2 reviewers will be resolved through discussion and a third reviewer if required. A meta-analysis will be performed based on the availability of the data. As per the protocol, the study methodology was followed, and 2 independent reviewers conducted the search in 6 databases and clinical registries. Currently, the review is in the full-text screening stage. The review will publish the results in the first quarter of 2024. The evidence synthesized from this systematic review will help guide future research, support health care decisions, and inform policy makers on the effectiveness of mHealth interventions in improving the maternal and neonatal outcomes of pregnant women with hypertensive disorders. PRR1-10.2196/51792.

Evaluation of Pharmacotherapy Standards During Pregnancy Among Jordanian Pharmacy Colleges Graduates

Background: Pharmacists' knowledge of medication risks and benefits during pregnancy, as well as their competence in making appropriate therapeutic decisions to optimize medication use among pregnant women, is crucial. This study aims to evaluate the knowledge of Jordanian pharmacists regarding medication risks and safety during pregnancy and assess their abilities to make appropriate therapeutic decisions and optimize medication use. Methods: A self-administered questionnaire was sent to 400 randomly selected pharmacists practicing in Amman, Jordan. A validated questionnaire, consisting of six sections with predefined options, was employed. Results: A total of 233 pharmacists completed the questionnaire, resulting in a response rate of 58.2%. Nearly 73.4% of pharmacists (N = 171) correctly identified the drug of choice for hypertension during pregnancy. Over 70% of pharmacists (N = 169) determined the correct dose of aspirin to prevent preeclampsia. About 50% of pharmacists exhibited limited knowledge regarding drug risks and safety during pregnancy. There was a significant difference in the pharmacists' scores on all tests based on their marital status and years of experience (p = 0.04 and p = 0.01, respectively). Among pharmacists, 79.8% stated that they studied pharmacotherapy during pregnancy in their undergraduate courses. Conclusion: Pharmacists have demonstrated an inadequate level of preparedness in providing appropriate pharmaceutical care for pregnant women. Therefore, there is an urgent need to collaborate between national health authorities and academic institutions to empower pharmacists and enhance their knowledge and skills necessary to improve the health outcomes of pregnant women.

Deep hybrid model for maternal health risk classification in pregnancy: synergy of ANN and random forest.

Maternal health is a critical aspect of public health that affects the wellbeing of both mothers and infants. Despite medical advancements, maternal mortality rates remain high, particularly in developing countries. AI-based models provide new ways to analyze and interpret medical data, which can ultimately improve maternal and fetal health outcomes. This study proposes a deep hybrid model for maternal health risk classification in pregnancy, which utilizes the strengths of artificial neural networks (ANN) and random forest (RF) algorithms. The proposed model combines the two algorithms to improve the accuracy and efficiency of risk classification in pregnant women. The dataset used in this study consists of features such as age, systolic and diastolic blood pressure, blood sugar, body temperature, and heart rate. The dataset is divided into training and testing sets, with 75% of the data used for training and 25% used for testing. The output of the ANN and RF classifier is considered, and a maximum probability voting system selects the output with the highest probability as the most correct. Performance is evaluated using various metrics, such as accuracy, precision, recall, and F1 score. Results showed that the proposed model achieves 95% accuracy, 97% precision, 97% recall, and an F1 score of 0.97 on the testing dataset. The deep hybrid model proposed in this study has the potential to improve the accuracy and efficiency of maternal health risk classification in pregnancy, leading to better health outcomes for pregnant women and their babies. Future research could explore the generalizability of this model to other populations, incorporate unstructured medical data, and evaluate its feasibility for clinical use.

Virtual Reality Headset Simulating a Nature Environment to Improve Health Outcomes in Pregnant Women: A Randomized-Controlled Trial.

The single-blind randomized-controlled experimental study aimed to determine the effects of watching nature images through virtual reality (VR) headset on stress, anxiety, and attachment levels of pregnant women with preterm birth threats (PBTs). The participants were 131 primiparous pregnant women admitted to the perinatology clinic due to PBT between April 5, 2022 and July 20, 2022. The intervention group watched videos containing nature images accompanied by nature sounds in six sessions through VR headset three times daily for 2 days. Each session lasted for 5 min. The data were accumulated with the Information Form, Stress Subscale of Depression Anxiety Stress Scale-21, State Anxiety Inventory, Prenatal Attachment Inventory, and Information Form of Satisfaction Level of VR Headset. State anxiety and stress levels of pregnant women in intervention group were statistically significantly lower than those in controls. There was no difference in prenatal attachment levels concerning intragroup comparisons of intervention group.

Human milk EV-miRNAs: a novel biomarker for air pollution exposure during pregnancy

Exposure to ambient and near-roadway air pollution during pregnancy has been linked with several adverse health outcomes for pregnant women and their babies. Emerging research indicates that microRNA (miRNA) expression can be altered by exposure to air pollutants in a variety of tissues. Additionally, miRNAs from breast tissue and circulating miRNAs have previously been proposed as a biomarker for breast cancer diagnosis and prognosis. Therefore, this study sought to evaluate the associations between pregnancy exposures to ambient (PM10, PM2.5, NO2, O3) and near-roadway air pollution (total NO x , freeway NO x , non-freeway NO x ) with breast milk extracellular vesicle miRNA (EV-miRNA), measured at 1-month postpartum, in a cohort of 108 Latina women living in Southern California. We found that PM10 exposure during pregnancy was positively associated with hsa-miR-200c-3p, hsa-miR-200b-3p, and hsa-let-7c-5p, and was negatively associated with hsa-miR-378d. We also found that pregnancy PM2.5 exposure was positively associated with hsa-miR-200c-3p and hsa-miR-200b-3p. First and second trimester exposure to PM10 and PM2.5 was associated with several EV-miRNAs with putative messenger RNA targets related to cancer. This study provides preliminary evidence that air pollution exposure during pregnancy is associated with human milk EV-miRNA expression.