Issues In Pregnant Women Research Articles

Prevalence of thyroid dysfunction among pregnant women in the horn of Africa: A systematic review and Meta-analysis

BackgroundThyroid dysfunction ranks among the most prevalent endocrine disorders. This disorder during pregnancy has been linked to adverse effects on both the mother and the baby. However, there is a scarcity of data and inconsistent documentation regarding thyroid issues in pregnant women in low-income nations. ObjectiveThe aim of this systematic review and meta-analysis was to determine the general prevalence of thyroid disorders in pregnant women. MethodsTo identify relevant studies, a comprehensive search was conducted across Scopus, PubMed, Science Direct databases, and Google Scholar and repository registers from January 1, 2000 to December 31, 2023. Ten pertinent publications were chosen for the final meta-analysis. Relevant data was extracted using Microsoft Excel and analyzed using STATA software version 17, employing a random-effect model. Sensitivity analysis was conducted to evaluate each study's impact on the outcome, and Egger's test was utilized to detect publication bias. A trim-and-fill analysis was executed to adjust for bias in the effect estimate. Heterogeneity across studies was assessed using Cochran's Q statistic and I2 statistics. Subgroup analysis was carried by study design, country and publication year. ResultsIn this systematic review and meta-analysis, the prevalence of thyroid dysfunction among 2538 pregnant women was 12.0 % (95 % CI: 8.00 %–17.00 %). To account for the significant heterogeneity observed, a random effect model was utilized. Specifically, the prevalence of hypothyroidism in pregnant women was determined to be 10.00 % (95 % CI: 4.00–16.00 %) with a high level of heterogeneity (I2 = 94.27 %, p < 0.001). Notably, the sensitivity analysis conducted did not reveal any substantial impact on the overall pooled prevalence of thyroid dysfunction. ConclusionThe meta-analysis revealed a significantly higher rate of thyroid disorders among pregnant women compared to global estimates. To assess the effects of treating thyroid conditions on pregnancy outcomes and inform clinical decisions, it is recommended to implement cost-effective thyroid-stimulating hormone screening during pregnancy.

Exploring midwives' training needs and preferences for providing sexual health education for pregnant women: a mixed-methods study.

Background Numerous studies highlight a common inadequacy among midwives in addressing sexuality and sexual health issues in pregnant women. These findings underscore the crucial need for sexual health education for midwives. Nevertheless, the specific training needs and preferences regarding sexual health education for pregnant women among midwives remain largely unexplored in existing literature. The aim of this study was to explore midwives' training needs and preferences for providing sexual health education for pregnant women. Methods The research employed a mixed-methods, institution-based cross-sectional study design conducted from July to August 2021. Convenience sampling was applied for quantitative research, while purposive sampling was utilised for the qualitative component. Midwives from 19 hospitals in Guangdong Province were invited to participate in a questionnaire survey addressing training needs and preferences for sexual health education for pregnant women among midwives. Qualitative data analysis was performed using thematic analysis. Results A total of 462 midwives participated in the quantitative study, while 12 skilled midwives were involved in the qualitative component. A significant majority (82.5%) of midwives expressed a strong desire to engage in sexual health education. Online education emerged as the preferred mode of training among participants. Key areas of interest included reproductive health, sexual psychology, sex sociology, and education methods, underscoring a consistent demand for comprehensive sexual health education within the midwifery community. Conclusions Our study emphasises the pressing need for enhanced sexual health education for midwives and explores their preferences for future training.

Cost-effectiveness of screenings for mental health in pregnancy: A systematic review

Mental disorders posses significant obstacles both during and after pregnancy for many women. Birth weight, premature birth, perinatal and infant deaths, postpartum psychopathology, emotional difficulties, inappropriate behavior in children and adolescents, and adverse effects on other people are just a few of the negative impacts that mental disorders are linked to during pregnancy in that family. Women with mental disorders may experience issues after giving birth, affecting their health throughout pregnancy. Infections, including depression, frequently go undiagnosed and receive subpar treatment despite routine interactions with medical providers during pregnancy. Hormonal changes impact Mother's body movements; for example, she moves more slowly and gets exhausted more rapidly. Pregnant ladies who are in this scenario tend to become indolent. A systematic assessment of research findings on the effectiveness of economic evaluation of mental health screening instruments during pregnancy is frequently used to encourage early detection of mental health in pregnant women as maternal reactions become more sensitive, irritable, and irritable. These investigations mostly used the EPDS and PHQ-9. For the systematic review portion of this investigation, the PRISM ScR 2020 Flowchart was employed, and the A search of the literature was done using the databases Pubmed and Whiley. This article was assessed using the CHEC-Extended checklist. Two reports satisfied the inclusion criteria after an investigation of 890 chosen papers. The systematic review identified three themes: cost, effectiveness, and threshold. Given the variety of treatments used to treat mental health issues in pregnant women, it is clear that using two approaches rather than just one will result in greater cost-effectiveness

The Modification and Psychometric Test of Anemia Complication Prevention Instruments Based on The Health Belief Model

The high maternal mortality rate in middle-income countries is mostly caused by pregnancy complications, one of which is anemia in pregnancy. Behavioral instruments that use the health belief model are osteoporosis prevention, oral hygiene in pregnant women, and disaster preparedness. This instrument needs to be developed because based on previous literature searches it has not shown how the health belief model concept can be used to help pregnant women prevent anemia complications. This research aims to test the construct validity and reliability of the modified questionnaire for preventing anemia complications based on the health belief model. An internal validity test was conducted in Yogyakarta. Five specialists from different health fields - nurses, midwives, nutritionists, health promotion experts, and medical doctors- participated in the study. Some of the things that were done were as follows: 1) defining appropriate concepts and objectives; 2) defining and identifying domains; and 3) defining and creating items. 4) creating the measuring instrument, 5) finalizing the translation with the help of two native English speakers 7) preparing the test instrument for the content validity test, 6) running the validity test with five medical professionals, 7) Applying the Index of Content Validity (I-CVI) to the analyses. 8) Using Cronbach's alpha to conduct a reliability test on thirty pregnant women. The content validity index of the crucial indicator of behavioral prevention of consequences from anemia is one, and the relevance indicator also returns one, resulting in a total score of 0.99. Expert agreement in English has a kappa value of 0.442. Results of reliability using Cronbach's alpha of 0.807. The instrument for preventing anemia issues in pregnant women is valid and reliable, according to the study's findings.

Coverage and determinants of Intermittent Preventive Treatment in pregnancy (IPTp) in Cameroon, Guinea, Mali, and Nigeria.

Malaria poses a serious issue for pregnant women in African regions. It is crucial to comprehend the various factors that impact receiving IPTp during ANC checkups. These are important for the well-being of both pregnant mothers and their unborn children. Therefore, this study aims to investigate the determinants of IPTp coverage among women in Cameroon, Guinea, Mali, and Nigeria. This cross-sectional study utilized secondary data from the Malaria Indicator Surveys (MIS) across Cameroon, Guinea, Mali, and Nigeria, focusing on women who received IPTp during pregnancy with IPTp categorized dichotomously as "Yes" for ANC visits and "No" for other visits. Chi-squared tests were used to assess associations, and binary logistic regression was conducted to calculate adjusted odds ratios, confidence intervals, and p-values. Results were summarized in tables. We found IPTp coverage during ANC visits was highest in Cameroon (98.6%), followed by Guinea (97.7%), Mali (97.1%), and lowest in Nigeria (95.5%). In Guinea, rural women were less likely to receive IPTp than urban women (AOR: 0.16, 95% CI: 0.07-0.41, p<0.001). In Mali, women who received 3 or more doses were less likely to receive IPTp at ANC (AOR: 0.48, p<0.01). In Nigeria, personal transport increased IPTp uptake (AOR: 1.88, p<0.01). In Cameroon, malaria prevention messages improved IPTp coverage (AOR: 3.12, p<0.05). This study highlights significant disparities in IPTp uptake, with rural Mali and Guinea facing lower coverage. In Nigeria, personal transport improved IPTp uptake. Targeted interventions are needed to improve ANC services and ensure equitable IPTp access across the study regions.

The Role of Continuity of Care (CoC) in Supporting Pregnant Women at Risk of Chronic Energy Deficiency (CED) in Improving Nutritional Status: A Case Report

Background: Nutritional issues in pregnant women occur during the 1,000 Days of Life (HPK) period. If nutritional problems during pregnancy are not addressed, they can disrupt fetal development. The government has undertaken efforts such as providing supplementary feeding (PMT). This PMT activity should also be accompanied by nutritional education to promote behavioral change. Midwives are among the healthcare professionals who can provide comprehensive support. This support is aimed at optimizing continuous midwifery care, with the expectation of reducing the impact of Chronic Energy Deficiency (CED) on both pregnant women and their fetuses. Methods: This case report is compiled using a descriptive method with a case study approach. The researcher supported Continuity of Care (CoC) to one patient in the working area of the Surabaya Community Health Center, from the pregnancy period through to the postpartum period and the newborn phase. Case Presentation: A 20-year-old pregnant woman was identified as at risk for Chronic Energy Deficiency (CED) due to a measurement of Mid-Upper Arm Circumference (MUAC) &lt; 23.5 cm. The woman received continuous support, including monitoring her intake of prenatal vitamins, Antenatal Care (ANC) support, counseling, and nutritional education. By the end of the pregnancy, there was an increase in her MUAC, and she was no longer at risk of CED. Conclusion: With support in the form of monitoring and holistic, comprehensive, and collaborative midwifery care from the beginning of pregnancy, optimal care targets can be achieved. The role of support throughout the pregnancy and postpartum period has been carried out effectively, resulting in the mother being free from the risk of Chronic Energy Deficiency (CED) and the baby not experiencing Low Birth Weight (LBW).

Prevalence of psychosocial issues among pregnant women who do and do not use illicit substances.

The American College of Obstetricians and Gynecologists (ACOG) recommends providers screen their prenatal patients for 11 psychosocial issues because they affect patient mental and physical well-being. The prevalence and co-occurrence of these issues have rarely been compared among pregnant women who do and do not report recent illicit substance use. Seven psychosocial issues identified by ACOG were operationalized using National Survey on Drug Use and Health variables. We report weighted prevalence and adjusted risk ratios (ARR) for these issues in pregnant women who did versus did not report past-month illicit substance use. Pregnant women (n = 3,657) who reported past-month illicit substance use (6.3%; 95% CI [5.4-7.3]) had significantly higher prevalence of almost all psychosocial issues examined, including past-month cigarette smoking (44.9% versus 9.5%; ARR = 2.84, 95% CI [2.21-3.65]); past-month alcohol use, 36.1% versus 7.9%; ARR = 4.71 (3.59-6.18); serious past-month distress, 23.0% versus 5.0%; ARR = 3.51 (2.39-5.15); no health insurance, 11.7% versus 6.2%; ARR = 1.71 (1.07-2.74); and receipt of food stamps, 45.0% versus 24.0%; ARR = 1.40 (1.18-1.67). Moving 3 + times in the past year followed a similar pattern, but results were compatible with there being no difference, 10.6% versus 5.5%; ARR = 1.39 (0.86-2.25). The majority of pregnant women reporting illicit substance use endorsed experiencing ≥ 2 psychosocial issues while the majority of those who did not report illicit substance use did not endorse any. Pregnant women who use illicit substances experience higher prevalence and greater co-occurrence of psychosocial issues compared to those who do not, reinforcing recommendations for multidisciplinary approaches to care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

COVID-19 consequences to pregnant women

The outbreak of novel coronavirus disease (COVID-19) was observed in Wuhan, China, and had been exposed for the first time in 31st of December 2019. There is a rapid increase in the progression of this disease. This virus is similar in genetics to SARS-COV however different in structure. The clinical illustrations of COVID-19 include lower and upper respiratory tract infection and acute respiratory syndrome with life-threatening pneumonia. This virus causes disease in newborn babies to elders including all age groups. Respiratory infection occurs in pregnant women while most commonly affected by COVID-19. The coronavirus pandemic significantly increased worry, stress, and anxiety, which negatively affects the pregnant women emotionally. Worrying about their own and their unborn child's health, decreased expectations for prenatal care, being unable to get trustworthy information, and having less daily routines and social connections are all issues that negatively affected the pregnant women. The COVID-19 virus alters the immune response at the point where the mother and fetus meet, having an impact on both the mother and the newborn. It is critical to check suspected pregnant women during delivery due to the lack of accurate knowledge of influence on pregnancy by COVID-19. In confirmed cases, both the mother as well as the baby child should be closely monitored. This review highlights the fear, stress, anxiety, and Obstetrical issues in pregnant women during SARS and COVID-19 outbreak.

Vitamin D deficiency increases the risk of bacterial vaginosis during pregnancy: Evidence from a meta-analysis based on observational studies.

Bacterial vaginosis (BV) is the most common microbiological syndrome in women of childbearing age, causing numerous adverse health issues in pregnant women. Several observational studies have discussed the association between vitamin D deficiency and the risk of BV during pregnancy, but the results were inconclusive. Therefore, this meta-analysis aimed to explore the association between vitamin D deficiency and BV risk in pregnant women. We searched four databases, including PubMed, Embase, Cochrane Library, and Web of Science, from their inception to July 2022. Pooled odds ratios (OR) with corresponding 95% confidence intervals (CI) were estimated using random effects models. Additionally, we conducted subgroup analyses to identify the potential sources of between-study heterogeneity. Sensitivity analysis was performed using the method of exclusion, one study at a time. Publication bias was examined using Egger's test and funnel plot. A total of 14 studies from 13 articles including 4,793 participants were eligible for this meta-analysis. The outcome showed that vitamin D deficiency may increase the risk of BV during pregnancy by 54% (OR, 1.54; 95% CI, 1.25-1.91; P < 0.001). In subgroup analyses, positive associations were also found in studies that were: conducted in black women (OR, 1.56; 95% CI, 0.98-2.48; P = 0.060), focused on the first trimester of pregnancy (OR, 2.22; 95% CI, 1.35-3.64; P = 0.002), of high quality (OR, 3.05; 95% CI, 1.26-7.41; P = 0.014), and adjusted for confounders (OR, 1.28; 95% CI, 1.06-1.55; P = 0.012). Sensitivity analysis reported that BV risk during pregnancy resulting from vitamin D deficiency increased by 157% (OR, 2.57; 95% CI, 1.50-4.42; P = 0.001) when removing the first two high-weight studies. Publication bias was observed using Egger's test (t = 3.43, P = 0.005) and a visual funnel plot. This meta-analysis showed that vitamin D deficiency is positively associated with the risk of BV during pregnancy. Further high-quality prospective cohort studies are needed to determine whether vitamin D intake reduces the prevalence of BV in pregnant women.

Comprehensive Review of Fluorescence Applications in Gynecology.

Since the introduction of indocyanine green (ICG) as a fluorophore in near-infrared imaging, fluorescence visualization has become an essential tool in many fields of surgery. In the field of gynecology, recent new applications have been proposed and found their place in clinical practice. Different applications in gynecology were investigated, subcategorized, and overviewed concerning surgical applications and available dyes. Specific applications in which fluorescence-guided surgery was implemented in gynecology are described in this manuscript—namely, sentinel node biopsy, mesometrium visualization, angiography of different organs, safety issues in pregnant women, ureters visualization, detection of peritoneal metastases, targeted fluorophores for cancer detection, fluorescent contamination hysterectomy, lymphography for lower limb lymphedema prevention, tumor margin detection, endometriosis, and metastases mapping. With evolving technology, further innovative research on the new applications of fluorescence visualization in cancer surgery may help to establish these techniques as standards of high-quality surgery in gynecology. However, more investigations are necessary in order to assess if these innovative tools can also be effective to improve patient outcomes and quality of life in different gynecologic malignancies.

Racial/Ethnic Disparity in Suicidal Ideation, Suicide Attempt and Non-suicidal Intentional Self-harm Among Pregnant Women in the United States.

We examined the prevalence of suicidal ideation, suicide attempt and non-suicidal intentional self-harm among pregnant women in the United States stratified by race/ethnicity. Data on hospital admissions among pregnant women 15-49yearsduring 2016-2017 compiled in the Nationwide Inpatient Sample were used for this study. We assessed the prevalence and factors of suicidal ideation, suicide attempt and non-suicidal intentional self-harm among different race/ethnicities. The prevalence of suicidal ideation, suicide attempt and non-suicidal intentional self-harm was greatest among hospitalized Non-Hispanic (NH) Black pregnant women. As compared to pregnant women who were routinely discharged, those who died during the course of hospitalization had about eight times the odds for NH-Whites, four times the odds for NH-Blacks and five times the odds for Hispanics of suicidal ideation or attempt. Appropriate measures are needed for prompt diagnosis and management of mental health issues in pregnant women belonging to vulnerable sub-groups.

Assessment of mental health issues in pregnant women with fetal complications: Relation to attachment and anxiety.

Pregnancy period is important for all women. The aim of this study was to evaluate mental status, antenatal depression, attachment, and anxiety in pregnant women with fetal complications. Mothers who had been diagnosed with fetal complications during pregnancy were interviewed after the delivery of their babies. The results showed that anxiety and depression scores were significantly higher in the mothers who had received psychiatric support treatment. Maternal attachment scores were found low, depression scores were found high in mothers of children with congenital anomalies. According to the results of the study, a maternal attachment was low and depression was high in mothers with congenital anomalies. Possible psychological problems after birth can be prevented by psychotherapeutic nursing interventions during pregnancy to pregnant women who have babies with fetal anomalies.

Attitudes of Primary Pregnant Women Toward Preference of Birth Method in Dezful, Iran: A Cross-Sectional Study

Introduction: Choosing the birth method is a major issue for pregnant women that is affected by multifaceted physiological, psychological and socio-cultural factors.&#x0D; Aim(s): The aim research was performed to explore factors influencing pregnant women’s attitude toward birth method.&#x0D; Methods: This is a cross-sectional study on 220 healthy nulliparous pregnant women with uncomplicated pregnancies without any contraindication for vaginal birth in Medical Centers of Dezful, in the south west of Iran. Data collection tool was a questionnaire for factors affecting the choice of delivery method. Differences in attitude were compared between two groups of natural vaginal delivery preference and cesarean delivery preference. Statistical analysis was performed with SPSS Version 16.0 statistic software package. Descriptive statistics were used to report percentages, mean, and standard deviation, and t-test, chi-square were applied to analyze the data.&#x0D; Results: During the study period, 206 primary pregnant women were examined to determine the attitudinal influencing factors the birth method preference. 131 women (64%) chose the natural delivery method and 71 women (36%) chose the cesarean delivery method. In addition, the results showed a statistically significant difference between the two groups regarding the general attitude of the participants towards natural delivery (164.43 in the normal vaginal delivery (NVD) group versus 134.50 in the cesarean section (CS) group (p &lt; 0.001)).&#x0D; Conclusion: There is a direct relationship between the attitude of pregnant women towards vaginal birth and the tendency to normal vaginal delivery and cesarean section. Also, according to the results of the study of 8 components of attitudes, counseling sessions and prenatal training sessions can be identified based on counseling needs and be guided counseling sessions more purposefully.

Effectiveness of intermittent preventive treatment with Sulfadoxine-Pyrimethamine in pregnant women in San Pedro, Côte D’Ivoire

ABSTRACT Malaria remains a major public health issue for pregnant women. Côte d’Ivoire has adopted a series of measures aimed at combatting this plague, and these measures include administering Sulfadoxine-Pyrimethamine (SP) as an intermittent preventive treatment to pregnant women in the second and third terms. This cross-sectional study included a parturient population after informed written consent. We recruited women from the Terre Rouge maternity ward and the labor room of the Regional Medical Center of San-Pedro. Plasmodial DNA (desoxyribo nucleic acid) was extracted from Whatman filter papers with dried blood samples prepared from the venous, placental, and cord blood, utilizing Chelex 100. The extracts obtained were amplified by nested PCR. In all, 197 women were included, with an average age of 27-year-old (sd = 6.7 years old). The rates of the placental, venous and cord blood infections were 16, 2%, 15, 2% and 3, 6%, respectively. The women who took three doses of ITP were less infected at the cord (3, 2%), placental (10,6%) and venous level (13,8%). A statistically significant relationship between the number of doses and the rate of placental infection was established (p = 0.042). IPT reduces plasmodial infestation at the placental (OR = 0.4; CI = [0.2–1]), cord (OR = 0.8; CI = [0.2–3.7]) and venous (OR = 0.8; CI = [0.6–2.3]) level. In conclusion, the low frequency of placental, venous, and cord infestation in pregnant women who consistently followed a preventive treatment strategy clearly showed the efficiency of IPT against malaria during pregnancy.

Prenatal screening diagnosis and management in the era of coronavirus: the Sardinian experience.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new coronavirus, was first identified in December 2019 in Wuhan, China and spread rapidly, affecting many other countries. The disease is now referred to as coronavirus disease 2019 (COVID-19).The Italian government declared a state of emergency on 31st January 2020 and on 11th March World Health Organization (WHO) officially declared the COVID-19 outbreak a global pandemic. Although the COVID-19 incidence remained considerably lower in Sardinia than in the North Italy regions, which were the most affected, the field of prenatal screening and diagnosis was modified because of the emerging pandemic. Data on COVID-19 during pregnancy are so far limited. Since the beginning of the emergency, our Ob/Gyn Department at Microcitemico Hospital, Cagliari offered to pregnant patients all procedures considered essential by the Italian Ministry of Health. To evaluate the influence of the COVID-19 pandemic on the activities of our center, we compared the number of procedures performed from 10th March to 18th May 2020 with those of 2019. Despite the continuous local birth rate decline, during the 10-week pandemic period, we registered a 20% increment of 1st trimester combined screening and a slight rise of the number of invasive prenatal procedures with a further increase in chorionic villi sampling compared to amniocentesis. Noninvasive prenatal testing remained unvariated. The request for multifetal pregnancy reduction as a part of the growing tendency of voluntary termination of pregnancy in Sardinia increased. The COVID-19 pandemic provides many scientific opportunities for clinical research and study of psychological and ethical issues in pregnant women.

Aquatic Exercise to Treat Pregnancy Related Issues in Pregnant Women: A Systematic Review

Background: Wide ranges of physiological changes occur as a result of pregnancy in women that, in certain cases, may cause variety of psychological and physical problems in pregnant women. Aquatic exercises believed to be safe for pregnant women and believed to foster positive effect on psychophysical health. Current health care setting and nursing emphasizes on evidence based approaches when developing and implementing interventions to address health related issues of pregnant women.&#x0D; Purpose: This review sought to synthesize qualitatively the existing research evidences concerning association between aquatic exercises and psychophysical problems in pregnant women.&#x0D; Methods: A 1989 records were yielded as result of conducting a systematic search in nine research data bases. After undergoing rigorous screening and assessment procedure of eligibility, and quality appraisal, a total of seventeen research articles were ultimately selected to include in this review.&#x0D; Result: Out of seventeen admissible studies, ten studies found that aquatic exercises exerts positive impact to decreases variety of physical discomforts such as fatigue, pelvic pain, labor pain, and edema. The remaining seven studies presented beneficial effects of aquatic exercises for psychological factors such as body image, stress, depression, feelings, mood, distress, and anxiety in pregnant women. Moreover, among the seventeen studies, only two studies showed effectiveness of aquatic exercises to manage body weight and two studies found improvement in sleep during pregnancy. &#x0D; Conclusion: This review found some evidence in support of the efficacy of aquatic exercises to reduce physical discomfort and improve psychological factors in pregnant women. More studies essential to reach stronger conclusion. The existing evidence concerning effectiveness of this intervention for weight management and sleep health during pregnancy is insufficient.

Poor Women’s Access to Antenatal Care and Childbirth Services in Indonesia: Case Study in Five Districts

&lt;p&gt;The health of pregnant women often becomes an indicator of human development. On the other hand, the fact of the high maternal mortality rate, raises questions related to the government’s attention to the health of pregnant women, especially women in poor areas. This article focuses on poor women’s access to health services for antenatal care and childbirth in five regencies in Indonesia. The aspects studied include the availability of health services for antenatal care and childbirth, poor women’s access to these services, and supporting factors/actors and barriers to poor women’s access to health services. This article showed that the availability of health facilities is not always in line with the increased awareness of pregnant women to access these services. Road infrastructure condition, distance, and cost to access health service still remain a challenge. Meanwhile, the policy of incentives and disincentives to traditional birth attendants has an influence on the increasing number of pregnant women who check their pregnancies and childbirth at health facilities. Thus, health issues of pregnant women and safe childbirth require a different effort. Aspects of the local context and supporting infrastructure also require serious attention.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Genome-wide DNA methylation variation in maternal and cord blood of gestational diabetes population.

Gestational diabetes mellitus (GDM) has always been a concerning issue for pregnant women. In recent studies, GDM was found to be related to epigenetic modifications, which would alter gene expressions, thus affecting the patients' and their offspring's health, leading to a higher probability of developing metabolic syndromes and diabetes later in life. In this study, we collected both maternal and cord blood samples from 16 pregnant women and their newborns, including eight exposed to GDM. GDM was diagnosed via a 75g oral glucose tolerance test (OGTT) at 24-28weeks of pregnancy. DNA methylation was measured at 841,573 CpG sites via the Infinium HumanMethylationEPIC BeadChip. An Ingenuity Pathway Analysis was conducted afterwards to identify genes and pathways epigenetically affected by GDM. We identified the top 200 loci and their corresponding genes in the maternal blood group (n=151) and cord blood group (n=167), both of which were methylated differently in the GDM and unexposed group. Metabolic disease-related pathways and molecules, such as interleukin-6 and interleukin-10 were identified in both groups. These results suggested that GDM has epigenetic effects on both mother and their offspring, which might result in future metabolic syndromes or diabetes. The high-throughput platform enabled us to analyze methylation sites throughout the genome and identify the most promising genes and pathways associated with GDM.

Effect of a gymnastics program on sleep characteristics in pregnant women

ObjectiveThe quality and quantity of sleep represent important health issues in pregnant women. Sleep disturbances could be associated, beyond alteration of quality of life, with poor pregnancy outcome. Our aim was to investigate the effect of a regular, specific, medium-term physical training program on sleep characteristics in healthy pregnant women. Materials and methodsA total of 132 healthy pregnant women, with gestational age between 18 weeks and 22 weeks, were enrolled in a prospective study. They were allocated into two groups; the first group involved 79 women (average age, 29.4 years) who performed a specific gymnastics program of 10 weeks, and the second group involved 53 pregnant women (average age, 27.9 years) who did not perform gymnastics. All participants completed a comprehensive questionnaire at baseline and after 10 weeks concerning general data, sleep characteristics, and psycho-emotional status. The changes arising within a diverse set of characteristics were followed and compared for the two groups using parametric and nonparametric statistics. ResultsIn the control group, we observed significant worsening of 12 out of the 14 studied parameters during the 10-week period. In comparison with the women who did not perform gymnastics, women who performed specific gymnastics showed the following characteristics: (1) significantly less deterioration of psycho-emotional status (stress and anxiety levels); (2) the same general pattern of decrease in sleep quality, which is related to the progression of pregnancy; and (3) a significant attenuation of the worsening of several sleep characteristics, such as restless sleep, snoring, diurnal tiredness, and excessive daytime sleepiness. Nocturnal and diurnal sleep quantity increased significantly in both groups. ConclusionThe 10-week training program designed for pregnant women has an overall beneficial effect on sleep characteristics, not by improving them but by attenuating their general deterioration related to the progression of pregnancy. Our data strengthen the general recommendation regarding participation of pregnant women in specific exercise programs, mainly for maintaining their psycho-emotional and general well-being.

Reproductive and Maternal Health Challenges of Pregnant Women in Ethiopia: An Anthropological Appraisal

A very Poor attention is given to reproductive health issues of pregnant women in rural regions of African countries. Ethiopia is one of the countries in horn of Africa representing highest maternal mortality rate in the continent. The Government of Ethiopia has reformed health policy and program to promote community involvement in maternal health, promotion of emergency obstetric health care, health seeking behavior for optimal utilization of maternal health services by women during pregnancies. The women living in pastoralist and small land holders’ communities are exposed to high risks of reproductive health hazards. Material delays comprising of delay in making the decision for referral, delay in arriving at hospital and delay in receiving appropriate maternal health services are major contributing factors for growing maternal deaths in Ethiopia. The illiteracy of woman, exposure to frequent pregnancies at adolescent age, poor decision making power of women in patriarchal society, poor employment status of women are main predicators of low utilization of maternal services and high ,maternal death in rural regions of the country. This article is based on synthesis of research projects completed by different authors on multiple dimensions of maternal mortality in Ethiopia. The promotion of referral support service and bridging up the referral gaps would address issues of maternal mortality and growing unsafe abortions among young mothers in rural regions of the country. This paper examines critically different socio – cultural barriers that prevent women living in rural area for accessing appropriate utilization of maternal and health services and infrastructure available. Int. J. Soc. Sc. Manage. Vol. 4, Issue-1: 32-37