Major Maternity Hospital Research Articles

Micronutrient Status in Pregnant Women after Metabolic Bariatric Surgery in the United Arab Emirates: A Prospective Study.

Metabolic bariatric surgery (MBS) helps reduce comorbidities, such as hypertension and gestational diabetes, and is more effective than diet management for women with obesity-related health issues. Vitamin B12, vitamin D, and iron play important roles in ensuring the health of a neonate. However, pregnancies occurring after MBS may face complications related to micronutrient deficiencies, particularly of vitamins B12 and D and iron. This study aimed to investigate the vitamin B12, vitamin D, ferritin, and iron status of pregnant women who underwent MBS compared with women without MBS history. The study included 217 pregnant women (105 with a history of MBS and 112 without a history of MBS) who visited a major maternity hospital in Abu Dhabi, United Arab Emirates (UAE) between July 2021 and November 2022. The maternal vitamin B12, vitamin D, iron, and ferritin levels were measured twice, initially during the first or second trimester and subsequently during the third trimester. The iron was measured once during the pregnancy. Vitamin B12 deficiency was higher among pregnant women with MBS history compared to non-bariatric pregnant women (24.4% vs. 3.9%, p < 0.001). Women with a history of MBS had a higher prevalence of vitamin D deficiency (62.3% vs. 37.7%, p < 0.002). Linear regression analysis indicated that vitamin B12 levels decreased by 55 pg/mL in women with a history of MBS and by 4.6 pg/mL with a unit increase in body mass index (kg/m2). Furthermore, vitamin D levels in women with a history of MBS decreased by 4.9 ng/mL during pregnancy. Metabolic bariatric surgery is associated with vitamin B12, vitamin D, and iron deficiencies during pregnancy.

Knowledge, Health Practices and Policies for Hepatitis for Midwifery and Nurses in Allied and District Hospital Faisalabad

Background: Hepatitis B Virus (HBV) is a critical global health concern with significant morbidity and mortality. Nurses and midwives, as frontline healthcare professionals, are particularly vulnerable to HBV infection. This study focuses on evaluating the knowledge, attitudes, and practices (KAP) related to HBV among these groups in Faisalabad, Pakistan, a region with limited existing research on this topic. Methods: A descriptive, cross-sectional study was conducted in two major public maternity hospitals in Faisalabad (District and Allied hospitals). A structured questionnaire, pre-tested for validity, was administered to assess the KAP towards HBV. Statistical analysis was performed using SPSS Version 21, applying chi-square tests to explore associations between categorical variables. Results: The study sampled 110 healthcare workers (nurses and midwives). Key findings included Knowledge to be 58.2% of participants had an average level of HBV knowledge, Attitudes to be A majority displayed a positive attitude towards HBV prevention, Practices to be 65.5% reported adhering to safe practices. However, a clear percentage of 51.8% had experienced needlestick injuries. Vaccination and PEP found to be only 40.9% completed the HBV vaccination series, and 50% held misconceptions regarding HBV post-exposure prophylaxis. Conclusion: The study reveals a considerable awareness of HBV among nurses and midwives in Faisalabad hospitals, yet highlights critical gaps in both knowledge, particularly concerning PEP, and practices, as evidenced by high rates of needlestick injuries and low vaccination completion. These findings call for intensified efforts in occupational safety, education on HBV, and increasing vaccination coverage among healthcare workers.

POST HOC ANALYSIS ON THE INCIDENCE OF CONGENITAL HEART DISEASE IN BAKU-AZERBAIJAN CALCULATED BY A PROSPECTIVE EPIDEMIOLOGY STUDY

Background: The incidence of Congenital Heart Disease (CHD)in Azerbaijan was firstly published following a prospective study, using Echo-2D as a study method, in 2019.&#x0D; Aim: Of this post hoc analysis of the first ever prospective epidemiology study that calculated incidence and types of CHD in Baku, Azerbaijan, is to verify the forms of diseases that will have and early clinical impact on the patients and the health system of the country.&#x0D; Population-method: From June 2016 to August 2018, 2570, term neonates were screened in 2 major state maternity hospitals in Baku. Their screening was randomized to equal females/males with not known previous obstetric alert regarding CHD. Scanning was done by two teams of pediatric cardiologists by using echo-2D. Each team was ‘blinded’ to the findings of each other. All scans were recorded, and a third senior physician reevaluated them.&#x0D; Results: From 2570 term neonates of the general population, they detected 47 CHD’s. From them, 17 were critical and severe-CHD and 7/47(14.9%) were of moderate complex. 17/47 (36.2%) were cyanotic and 30/47(63.8%) were non-cyanotic. The incidence of simple CHD was 25/47(53.2%). Analysis of the specific anatomy is presented in table1. The estimated incidence was 1.83%. As this incidence has been among the highest reported a post hoc analysis has clarified and presented an important clinical rate of 1.48% after redacting minimal defects without any clinical significance, as minor PDA’s, ASD II, VSD’s. A post hoc calculation of BAov, revealed an anatomical BAov incidence of 1.65% and a functional BAov incidence of 1.4%.&#x0D; Conclusions: This first-ever prospective epidemiology study in Azerbaijan involving a cohort equal to 1.65% of the annual living births of the country, estimated a high incidence of CHD. This is among the highest reported globally. The amount of critical and severe CHD after the post hoc analysis increased from 46.8% to 55.3%. The incidence of cyanotic CHD after the post hoc analysis increased from 36.2% to 42.1%. These high numbers are possibly related to an isolated population and conjugated marriage customs of the country. As this represented a state population health burden a post hoc analysis based on clinical important CHD minimized the calculated index nearby 20%.

Self-reported child maltreatment and cardiometabolic risk in 30-year-old adults.

Childhood maltreatment (CM) is associated with both dietary fat intake and obesity in later life. There is less information on associations with metabolic risk factors and specific types of CM such as physical, sexual and emotional abuse, as well as neglect. To assess the association between five types of self-reported CM and a range of obesity and metabolic indicators in a subsample of a birth cohort. This was a study of 1689 adults born in a major metropolitan maternity hospital in Australia and followed up 30 years later. Body mass index, bioimpedance and fasting lipid levels/insulin resistance were measured. Details on self-reported CM were collected using the Child Trauma Questionnaire. We adjusted for birth weight, parental income and relationship at participants' birth, as well as maternal age and alcohol or tobacco use. We also adjusted for participants' smoking, depression, educational level, marital and employment status at follow up. One-fifth reported maltreatment (n=362), most commonly emotional neglect (n=175), followed by emotional abuse (n=128), physical neglect (n=123), sexual (n=121) and physical abuse (n=116). On adjusted analyses, there were significant associations for CM, particularly neglect or emotional abuse, and one or more of the following outcomes: obesity, the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio and HDL levels. Results for other outcomes were more equivocal. Of child maltreatment types, emotional abuse and neglect show the strongest associations with obesity and several cardiometabolic risk factors, therefore highlighting the public health importance of early intervention to reduce childhood adversity.

Seroprevalence of SARS-CoV-2 virus antibodies and sociodemographic features of pregnant women in Mogadishu, Somalia: a cross-sectional survey study

ObjectiveRecent investigations have revealed that COVID-19 during pregnancy substantially increases the risk of harmful outcomes for mothers and neonates, including preterm death and stillbirth as well as severe maternal morbidity...

Health Behavior Changes among Maternity Nurses during the COVID-19 Pandemic: A Cross-Sectional Study

Background: Maternity nurses are frontline health professionals in the COVID-19 pandemic who may confront life-altering challenges. Studies that evaluated the impact of COVID-19 on maternity nurses’ daily lifestyles are limited. Objective: The aim of this study was to examine the changes in health-enhancing behaviors, such as eating habits and lifestyle behaviors, during the COVID-19 pandemic among nurses working in a maternity hospital. Methods: This was a cross-sectional study that surveyed maternity nurses working in a major government maternity hospital in Kuwait. Data were collected between January and February 2021. Results: A total of 336 participants completed the questionnaire. Normal weight was perceived by 88 (26.2%) of the participants, while 56 (16.7%) had a Body Mass Index indicating obesity. Weight gain during the pandemic was reported by 128 (38.1%) participants and 91 (27.1%) of the sample gained one to three kilograms. The findings showed low adherence to the Mediterranean diet 5.3 ± 2.5 points. Sleep hours decreased significantly during the crisis, with 113 (33.6%) of participants sleeping 7 to 9 hours during the COVID-19 situation compared to 136 (40.5%) before the pandemic (p 2 = 7.621, P = 0.006), felt hungry between meals 37 (50.7%) (X2 = 6.505, p = 0.011), and who reported changes in their appetite (X2 = 17.129, p < 0.001). Conclusion: Maternity nurses revealed low adherence with the healthy diet, with almost a third of participants having self-reported weight gain. Further, the sleeping patterns and the practicing of physical activities were negatively affected by COVID-19 pandemic.

Sero-prevalence and factors associated with past exposure to hepatitis E virus infection in pregnant women attending a major maternity hospital in Sri Lanka

The Sri Lankan Journal of Infectious Diseases (SLJID) is an open access, peer-reviewed, biannual journal published by the Sri Lankan Society for Microbiology (SSM). The Journal considers articles from all professional disciplines involved in the field of infectious diseases. The Journal has been in publication since 2011, is included in the DOAJ since 2018 and is a member of COPE since 2021. The SLJID practices a double-blind peer review policy. From 2022, the SLJID publishes accepted manuscripts online immediately after copy-editing, enabling rapid dissemination of scientific knowledge. The published articles are subsequently compiled into two issues in April and October. The SLJID does not charge any article processing or publication fee.

A review of gestational diabetes mellitus management, risk factors, maternal and neonatal outcomes in two major maternity hospitals in the United Arab Emirates: A report from Dubai.

This study was conducted in order to explore and analyze the status of gestational diabetes (GDM) amongst pregnant women in Dubai, United Arab Emirates (UAE); a country with high prevalence of diabetes. We aimed to describe GDM-associated risk factors and clinical outcomes of pregnant women and their neonates. Our objective was to contribute to the broader literature on reproductive health disparities and to inform efforts to improve GDM care at our region. Chart review of case records were used to collect data on both maternal and neonatal parameters and outcomes during the specified study period from two main maternity hospitals in Dubai. UAE national women with GDM were more prone to be obese or overweight compared to non-UAE women (p < 0.0001, and p < 0.0001 respectively). In addition, UAE national women with GDM had higher history of GDM in previous pregnancies (p < 0.0001) and more family history of diabetes (p < 0.0001).The neonate admission into NICU was significantly associated with cesarean section (p < 0.0001), twins (p < 0.0001), preeclampsia (p = 0.02), receiving MgSO4 (p = 0.02), birth weight less than 2500 g (p < 0.0001), low Apgar scores (p < 0.0001), baby with congenital anomaly (p < 0.0001), and neonatal hypoglycemia (p < 0.0001). Our results demonstrate that pregnant women with GDM who are UAE nationals and have higher parity need to be under special attention during their pregnancy in order to improve both maternal and neonatal outcomes.

Prevention and factors associated with anti-HCV carriage in pregnant women living in Cotonou

Introductionl´hépatite C est une infection dont la transmission mère-enfant est possible. L´objectif de ce travail était d´étudier la prévalence du portage des anticorps anti-VHC chez des femmes enceintes à Cotonou et d´identifier les facteurs qui y sont associés.Méthodesil s´est agi d´une étude transversale menée du 01/06/2018 au 01/09/2018 auprès de 253 gestantes reçues pour des soins prénatals dans quatre grandes maternités de Cotonou (Bénin). Les anticorps anti-VHC avaient été détectés par des tests rapides d´orientation diagnostique. Un échantillon de sang veineux avait été prélevé chez les gestantes avec anti-VHC positifs en vue de tests sérologiques de confirmation et d´un dépistage du diabète gestationnel.Résultatsla prévalence des anticorps anti-VHC était de 1,2% (3/253 gestantes). Les facteurs associés au portage du VHC n´avaient pu être identifiés compte tenu du faible nombre de cas positifs. Cependant, les gestantes porteuses des anticorps anti-VHC avaient une moyenne d´âge élevée (32 ± 3) comparativement au reste de la population (29,58 ± 5,5). Les facteurs de risque potentiels d´infection par le VHC retrouvés étaient les scarifications, le piercing, le tatouage, le partage du matériel de manucure, un antécédent d´intervention chirurgicale et de transfusion sanguine. La prévalence du diabète gestationnel dans notre étude était de 7,9% (20/253). Aucune association n´était trouvée entre le diabète gestationnel et l´hépatite C.Conclusionla prévalence des anticorps anti-VHC chez les gestantes à Cotonou était faible. Une étude d´envergure nationale s´avère nécessaire afin d´identifier les facteurs associés à cette infection.

Does child maltreatment predict alcohol use disorders in young adulthood? A cohort study of linked notifications and survey data

Most studies of the association between child maltreatment and subsequent problem alcohol use are retrospective. We studied the association of prospectively substantiated child maltreatment with problem alcohol use in adulthood. We used a prospective cohort record linkage correlational design using data from a statutory child protection agency of prospectively substantiated child maltreatment linked to a birth cohort from a major metropolitan maternity hospital. The Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Of the 3762 young people at the 21-year follow-up, 169 (4.5%) had a history of substantiated maltreatment by 16years. This was most commonly emotional abuse (n=90). The main outcome was heavy alcohol use at the 21-year follow-up, defined as four or more standard drinks per day. Secondary outcomes were life-time and 12-month diagnoses of alcohol use disorders in 2531 participants who completed the Composite International Diagnostic Interview-auto (CIDI-auto) version. Predictor variables were physical, sexual and emotional abuse, as well as neglect. At follow-up, 407 of the 3762 participants reported heavy alcohol use (10.8%). On adjusted analyses, participants who had experienced emotional abuse were significantly more likely to report heavy alcohol use at the time of interview (adjusted odds ratio=1.856; 95% confidence interval=1.038-3.319; P=0.037). Neglect was associated with a life-time CIDI diagnosis of an alcohol use disorder. Other types of child maltreatment were not significantly associated with any of the outcomes. Prospectively identified experience of childhood emotional abuse and neglect appears to be positively associated with problem alcohol use at age 21.

Exploring Obstetrical Interventions and Stratified Cesarean Section Rates Using the Robson Classification in Tertiary Care Hospitals in the United Arab Emirates.

The objective of the present study was to explore obstetric management in relation to clinical, maternal and child health outcomes by using the Robson classification system. Data was collected from obstetrics registries in tertiary care hospitals in Dubai, United Arab Emirates (UAE). The analysis of > 5,400 deliveries (60% of all the deliveries in 2016) in major maternity hospitals in Dubai showed that groups 5, 8 and 9 of Robson's classification were the largest contributors to the overall cesarean section (CS) rate and accounted for 30% of the total CS rate. The results indicate that labor was spontaneous in 2,221 (45%) of the women and was augmented or induced in almost 1,634 cases (33%). The birth indication rate was of 64% for normal vaginal delivery, of 24% for emergency CS, and of 9% for elective CS. The rate of vaginal birth after cesarean was 261 (6%), the rate of external cephalic version was 28 (0.7%), and the rate of induction was 1,168 (21.4%). The prevalence of the overall Cesarean section was 33%; with majority (53.5%) of it being repeated Cesarean section. The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.

Knowledge, Perception and Management of Pre-eclampsia among Health Care Providers in a Maternity Hospital.

Background:Morbidity and mortality of women and children associated with pre-eclampsia present major global health problems in low and middle income countries. The prevalence of pre-eclampsia in Nigeria ranges from 2% to 16.7%, with approximately 37,000 women dying from preeclampsia annually. This study examines knowledge, perception and management of preeclampsia among healthcare providers in a major maternity hospital in Lagos, southwest Nigeria.Methods:In this descriptive cross-sectional study, 110 health care providers comprising of 75 Nurses, 9 Consultant Physicians, and 26 General Medical Practitioners with varying years of service were selected using purposive sampling technique. Data were collected using a self-administered 36-item semi-structured questionnaire. Data were analysed using the Statistical Package for Social Sciences to generate descriptive and inferential statistics with level of significance set at 0.05.Results:Health care providers in the study had an average knowledge of pre-eclampsia with a mean score of 16.69±3.53. There was generally a good perception of pre-eclampsia with a mean sore of 28.31±3.71. The most-prevalent clinical management practices were emergency cesarean section (16%), magnesium sulphate infusion (29%), and fluid/electrolyte management (9%). Knowledge of pre-eclampsia and years of practice were significantly associated (F=3.31; p= 0.023).Conclusion and Global Health Implications:Gaps in the knowledge of causes, diagnoses, and treatment of pre-eclampsia may be attributable to lack of refresher trainings and absence of written practice guidelines on pre-eclampsia management. Health care providers at this hospital may benefit from training courses that include current nationally and internationally-approved management of pre-eclampsia.

Sleep Duration in Infants Was Not Associated With Myopia at 3 Years.

To investigate the association of sleep duration and quality at 12 months and myopia at 3 years. Cohort study. The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) birth cohort recruited pregnant women at 2 major public maternity hospitals (n = 1236). We included 376 children of Chinese, Malay, and Indian ethnicity who had completed caregiver questionnaires on the child's sleep at 12 months of age [Brief Infant Sleep Questionnaire (BISQ)] and also completed cycloplegic autorefraction and eye axial length (AL) measurement at 3 years of age. Data on total sleep duration and number of night wakings were collected by BISQ. Univariable and multivariable regression models adjusting for potential confounders (age, sex, ethnicity, parental myopia, maternal education level, outdoor time, near work, and height) were used. Thirteen (3.5%) participants were myopic and mean spherical equivalent (SE) was 0.89 diopters (D) (SD 0.88) at 3 years. Total sleep duration and number of night wakings at 12 months were not associated with SE at 3 years (P > 0.05). The total sleep duration (P = 0.07) and number of night wakings (P = 0.49) were not associated with AL in the multivariate model. Total sleep duration in tertile 2 was not associated with AL (P = 0.11) compared with tertile 1. Only total sleep duration in tertile 3 was associated with longer AL (P = 0.006), but there was no association with SE. Sleep duration and quality at 12 months of age were not associated with refractive error at 3 years.

Nitrogen dioxide air pollution and preterm birth in Shanghai, China

BackgroundNitrogen dioxide (NO2) is a typical indicator of traffic-related air pollution, and few studies with exposure assessment of high resolution have been conducted to explore its association with preterm birth in China. ObjectivesTo investigate the association between NO2 exposure based on a land use regression (LUR) model and preterm birth in Shanghai, China. MethodsA retrospective cohort study was performed among 25,493 singleton pregnancies in a major maternity hospital in Shanghai, China, from 2014 to 2015. A temporally adjusted LUR model was used to predict the prenatal exposure to NO2 based on residence address of each gravida. Logistic regression was performed to evaluate the associations of ambient NO2 exposure with preterm birth during six exposure periods, including the entire pregnancy, the first trimester, the second trimester, the third trimester, the last month, and the last week before delivery. Sensitivity analysis with a matched case-control design was conducted to test the robustness of the association between NO2 exposure and preterm birth. ResultsThe average NO2 concentrations during the entire pregnancy was 48.23 µg/m3 among all participants. A 10 µg/m3 increase in NO2 concentrations was associated with preterm birth, with an adjusted odds ratio of 1.03 (95% confidence interval [CI]: 0.96,1.10) for exposures during the entire pregnancy, 1.00 (95%CI: 0.95,1.06) in the first trimester, 1.01 (95%CI: 0.96,1.07) in the second trimester, 1.07 (95%CI: 1.02,1.13) in the third trimester, 1.10 (95%CI: 1.04,1.15) and 1.05 (95%CI: 1.00,1.09) in the month and week before delivery, respectively. The results of the matched case–control analysis were generally consistent with those of main analyses. ConclusionNO2 may increase the risk of preterm birth, especially for exposures during the third trimester, the month and the week before delivery in Shanghai, China.

The Indigenous Birthing in an Urban Setting study: the IBUS study

BackgroundWith persisting maternal and infant health disparities, new models of maternity care are needed to meet the needs of Aboriginal and Torres Strait Islander people in Australia. To date, there is limited evidence of successful and sustainable programs. Birthing on Country is a term used to describe an emerging evidence-based and community-led model of maternity care for Indigenous families; its impact requires evaluation.MethodsMixed-methods prospective birth cohort study comparing different models of care for women having Aboriginal and Torres Strait Islander babies at two major maternity hospitals in urban South East Queensland (2015–2019). Includes women’s surveys (approximately 20 weeks gestation, 36 weeks gestation, two and six months postnatal) and infant assessments (six months postnatal), clinical outcomes and cost comparison, and qualitative interviews with women and staff.DiscussionThis study aims to evaluate the feasibility, acceptability, sustainability, clinical and cost-effectiveness of a Birthing on Country model of care for Aboriginal and Torres Strait Islander families in an urban setting. If successful, findings will inform implementation of the model with similar communities.Trial registrationAustralian New Zealand Clinical Trial Registry #ACTRN12618001365257. Registered 14 August 2018 (retrospectively registered).

Seroprevalence of maternal HIV, hepatitis B, and syphilis in a major maternity hospital in North Kordofan, Sudan.

Routine infectious diseases screening of Sudanese pregnant women has been patchy due to scarcity of healthcare resources and social stigma. We sought to determine the seroprevalence of HIV, hepatitis B, and syphilis among pregnant women attending antenatal care (ANC) at El Obeid Maternity Hospital in western Sudan. We also explored the association between these infections and a set of socio-demographic and maternal variables. Unlinked anonymous testing for HIV-1/2 antibodies, hepatitis B surface antigen, and Treponema pallidum antibodies was performed on residual blood samples collected during routine ANC (August 2016-March 2017). Seroprevalence of HIV was 1.13% (5/444; 95% CI 0.37-2.61%), hepatitis B 2.93% (13/444; 95% CI 1.57-4.95%), and syphilis 7.43% (33/444; 95% CI 5.17-10.28%). On bivariate analysis, there were no statistically significant associations between hepatitis B, syphilis, or a composite outcome including any of the three infections and age, stage of pregnancy, gravidity, parity, previous mode of delivery, history of blood transfusion, or husband polygamy. Urgent action is needed to scale up routine maternal screening for HIV, hepatitis B, and syphilis on an opt-out basis. Further research into the socio-demographic and behavioural determinants of these infections as well as their clinical outcomes is needed.

Screening for Cytomegalovirus Infection During Pregnancy in a Teaching Hospital, Western province, Sri Lanka

Primary Cytomegalovirus (CMV) infection during pregnancy is a serious threat to the fetus. Although vertical transmission is likely to occur as a result of maternal infection, the rate of permanent sequelae is higher among infants born to mothers with primary CMV infection. Diagnosis of CMV infection among healthy adults generally relies on serological testing as most of them are asymptomatic. CMV infection in pregnancy is barely studied in Sri Lanka. This study aims in screening for CMV infection of selected pregnant population in a major maternity hospital and to describe associated factors with seropositivity. This study included 385 pregnant women in second trimester presented during a period of 6 months. Mothers with immunocompromised states were not recruited. Questionnaire was used to gather sociodemographic and clinical factors. All serum samples were tested for CMVIgG and IgG-avidity assay for seropositives. CMV-IgM test was carried out on samples with negative CMV-IgG and low/equivocal-avidity levels. All 3 seromarkers were tested using commercial Enzyme Linked Immunosorbent Assays. Data were analyzed by SPSS. Majority (97%) of the population were positive for CMV-IgG. CMV-avidity was low, equivocal or high in 0.25%, 2.75% and 97% of IgG seropositives respectively. Age, bad obstetric history and multiparity didn’t show association with IgG seropositivity. In conclusion, CMV seroprevalence was high in this study population with low rates of recent primary infection. Education regarding preventive measures for CMV infection in antenatal care has a value as some proportion were seronegative for CMV with prone to get new infections.

Milk Donor Blood Screening for HIV, Syphilis and Hepatitis B Markers in a Brazilian Human Milk Bank: Prevalence Time-trends Over the 2005- 2015 Period.

Human milk banking has been promoted to provide donated breast milk for at-risk children whose mothers cannot breastfeed them but this effort was hindered by the advent of HIV epidemic. To estimate the seroprevalence of HIV, syphilis and hepatitis B in the blood of human milk donors registered in a major maternity hospital in the northern region of the Santa Catarina State, Brazil. A retrospective study included serological tests for HIV, syphilis and hepatitis B screening of milk donor candidates in the 2005-2015 period. The 95% confidence intervals were calculated using the Poisson distribution. For HIV, the prevalence per 100.000 pregnant women was 155, 170 and zero over the three periods analyzed (2005-2009, 2010-2012 and 2013-2015), respectively. Syphilis prevalence per 100,000 pregnant women was 509, 460 and 1749 in the three periods analyzed. For the HBsAg marker of recent hepatitis B infection, the prevalence on the same scale was 254, 231 and 299, respectively, while the anti-HBc prevalence, a marker of lifetime risk for hepatitis B infection, was 7339 in the 2010-2012 period and 3874 in the 2013-2015 period. High prevalence of HIV, syphilis and hepatitis B was found for the 2005-2015 period among breastfeeding mothers who offered to donate their exceeding milk to a human milk bank in Brazil. Despite apparent elimination of the HIV by the end of the period, the decline was not statistically significant. There was no significant change in the acute hepatitis B prevalence over time but the increased syphilis prevalence in the most recent period was statistically significant.

Gestational diabetes mellitus and retinal microvasculature

BackgroundSmall-vessel dysfunction may be an important consequence of chronic hyperglycemia. We examined the association between gestational diabetes mellitus (GDM), a state of transient hyperglycemia during pregnancy, and retinal microvascular changes in pregnant women at 26–28 weeks of pregnancy.MethodsA total of 1136 pregnant women with singleton pregnancies were recruited during their first trimester at two major Singapore maternity hospitals in an on-going birth cohort study. Participants underwent an oral glucose tolerance test and retinal imaging at 26–28 weeks gestation (n = 542). We used the 1999 World Health Organization (WHO) criteria to define GDM: ≥7.0 mmol/L for fasting glucose and/or ≥7.8 mmol/L for 2-h post-glucose. Retinal microvasculature was measured using computer software (Singapore I Vessel Analyzer, SIVA version 3.0, Singapore Eye Research Institute, Singapore) from the retinal photographs.ResultsIn a multiple linear regression model adjusting for age, ethnicity and maternal education, mothers with GDM had narrower arteriolar caliber (−1.6 μm; 95% Confidence Interval [CI]: −3.1 μm, −0.2 μm), reduced arteriolar fractal dimension (−0.01 Df; 95% CI: −0.02 Df, −0.001 Df;), and larger arteriolar branching angle (1.8°; 95% CI: 0.3°, 3.3°) than mothers without GDM. After further adjusting for traditional risks of GDM, arteriolar branching angle remained significantly larger in mothers with GDM than those without GDM (2.0°; 95% CI: 0.5°, 3.6°).ConclusionsGDM was associated with a series of retinal arteriolar abnormalities, including narrower caliber, reduced fractal dimension and larger branching angle, suggesting that transient hyperglycemia during pregnancy may cause small-vessel dysfunction.

Effectiveness of Childbirth Education on Nulliparous Women’s Knowledge of Childbirth Preparation, Pregnancy Anxiety and Pregnancy Outcomes

Background: The emerging number of cesarean sections among nulliparous women due to high pregnancy-related anxiety is a major concern of maternity care providers. Childbirth preparations enable women to cope with pregnancy anxiety and enhance pregnancy outcomes. Limited studies evaluated the impact of childbirth educational interventions on pregnancy-specific anxiety and pregnancy outcomes. Objectives: The aim of this study was to evaluate the effectiveness of childbirth educational intervention on nulliparous women’s knowledge on childbirth preparation, pregnancy anxiety, and pregnancy outcomes. Methods: A randomized controlled trial approach with a two-group pretest/ posttest design was used among hundred nulliparous third trimester pregnant women. All participants were pretested for their knowledge on childbirth preparation and pregnancy anxiety level using knowledge questionnaire, state trait anxiety inventory, and pregnancy-specific anxiety inventory. The experimental group (n = 50) received three sessions of childbirth education. All participants were post- tested before delivery, and their pregnancy outcomes were noted from labor records. Data were collected from a major maternity hospital in Kerala, India. GLM repeated measures analysis and paired t-test were used for data analysis. Results: The experimental group demonstrated a significantly higher level of knowledge on childbirth preparation (P < 0.001), with high reported mean knowledge scores of (54.30 ± 3.86) childbirth preparation than the control group (31.08 ± 1.96). A lower mean scores of pregnancy-specific anxiety among experimental group (102 ± 4.65) (P < 0.001) compared to control group (139.96 ± 4.9) signifies the relevance of childbirth education in reducing pregnancy-specific anxiety. Significant reductions of caesarean birth (50%) among nulliparous women along with a 12% increase in newborn’s birth weights were the main positive birth outcomes. Conclusions: Childbirth education significantly reduced pregnancy-specific anxiety and the adverse pregnancy outcomes. The emerging number of cesarean sections on maternal request due to childbirth anxiety could be reduced by empowering nulliparous women through childbirth education.