Number Of Pregnant Women Research Articles

Opportunities of Interferon Therapy in Pregnant Women with Cervical Intraepithelial Neoplasia

Objective: Due to hormonal and immune response changes, pregnancy contributes to their adverse stimulating effect on the progress of already existing hyperplastic processes in the cervix. The resulting aggravation of severity in their clinical course and intensity of the pathological process relatively frequently leads to precancerous conditions and cervical cancer developing further on. Some authors note the upward trend in the number of pregnant women having been diagnosed with pre-cancer and cancer of the cervix, as women postpone their maternity decisions increasingly more often. Currently, the tactics of managing pregnant women with cervical dysplasia consists in dynamic observation, including cytological study, colposcopic assessment of the state of surface cervical epithelium taking into account physiological particularities which are characteristic of pregnancy. The use of interferon therapy in pregnant female patients with HPV-associated cervical neoplasia is also expedient owing to its positive effect for reducing the CIN progression frequency, the probability of infecting the fetus with human papillomavirus, and the frequency of perinatal complications. Methods: The study involved pregnant women in their second and third trimesters of gestation who have been diagnosed with cervical neoplasia (L-SIL, H-SIL). In comparison groups, behavior of cervical neoplasia was monitored against the background of the therapy conducted with interferon alpha-2b or without treatment. Results: Against the background of the therapy conducted with interferon alpha-2b drug, higher frequency of the pathological process improving and lower frequency of its progressing into more severe dysplasia forms have been registered in the pregnant women with HPV-associated cervical neoplasia. However, it must be noted that efficiency of the treatment is higher in the group of pregnant women with L-SIL than in the H-SIL female patients. Conclusion: In managing the CIN pregnant women, it is expedient to prescribe interferon therapy systemically and topically in the form of gel (Viferon®) which allows reducing inflammation, viral load, ensuring regression of L-SIL and stabilization of H-SIL.

Long-acting reversible contraceptives (LARCs) as harm reduction: a qualitative study exploring views of women with histories of opioid misuse

BackgroundThe sharp rise in opioid use disorder (OUD) among women coupled with disproportionally high rates of unintended pregnancy have led to a four-fold increase in the number of pregnant women with OUD in the United States over the past decade. Supporting intentional family planning can have multiple health benefits and reduce harms related to OUD but requires a comprehensive understanding of women’s perspectives of preventing unintended pregnancies. The purpose of this study was to comprehensively evaluate the knowledge, attitudes and experiences as they relate to seeking contraception, particularly LARCs, among women with active or recovered opioid misuse.MethodsIn-depth interviews and focus group discussions with 36 women with current or past opioid misuse were recorded and transcribed. Transcripts were coded by ≥ 2 investigators. Themes related to contraceptive care seeking were identified and contextualized within the Health Belief Model.ResultsOur analysis revealed seven interwoven themes that describe individual level factors associated with contraceptive care seeking in women with current or past opioid misuse: relationship with drugs, reproductive experiences and self-perceptions, sexual partner dynamics, access, awareness of options, healthcare attitudes/experiences, and perceptions of contraception efficacy/ side effects. Overall, perceived susceptibility and severity to unintended pregnancy varied, but most women perceived high benefits of contraception, particularly LARC. However, perceived barriers were too high for most to obtain desired contraception to support family planning intentions.ConclusionsThe individual-level factors identified should inform the design of integrated services to promote patient-centered contraceptive counseling as a form of harm reduction. Interventions should reduce barriers to contraceptive access, particularly LARCs, and establish counseling strategies that use open, non-judgmental communication, acknowledge the continuum of reproductive needs, explore perceived susceptibility to pregnancy, and utilize peer educators.

Sleep Disorders in Pregnancy, Influencing Factors and Quality of Life.

In our study, the frequency of sleep disturbances in pregnancy, the reasons underlying the low quality of sleep, clinical factors, and the effects on quality of life were investigated. The study was planned as a prospective study and included 189 pregnant women. Clinical features, laboratory results, socio-demographic status, obstetric and medical anamnesis were evaluated. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, the Berlin Questionnaire, Beck Depression Inventory, SF-36 quality-of-life questionnaire, and restless leg syndrome (RLS) diagnosis criteria were used for data collection. We investigated sleep disorders in 110 pregnant women (58.2%). A history of premenstrual syndrome and patients with hyperemesis gravidarum, obstructive sleep apnea syndrome, Vitamin B12 deficiency, and higher TSH levels in the laboratory were found to be associated with sleep disorders. Sleep disorders and daytime sleepiness were associated with depression, physical and social functioning, pain, and disturbance in general health perception. The number of pregnant women who had two or more RLS complaints was 84 (44%). The results of our study show that sleep disorders in pregnancy can be managed with easily applicable methods according to the risk factors and related problems.

Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

The Relationship of Knowledge, Attitude, and Mother Action About the Implementation of Early Breastfeeding Initiation

Based on a preliminary study conducted at the Anggalomoare Public Health Center, it shows that Antenatal Care (ANC) visits for third trimester pregnant women averaged 35 per month. The target achieved was only 62,5% of the target of 85%. The purpose of this study was to determine the relationship between the level of knowledge, attitudes and actions of mothers regarding the implementation of early breastfeeding initiation at Anggalomoare Public Health Center.This research is a survey research with a cross-sectional Study approach. The population of this study is the total number of pregnant women whose expected day of birth is in February, totaling 32 people. The sampling method was simple total population. The method of analysis used statistical tests, namely the chi square test and the Phi test.The results of this study indicate that there is a strong relationship between maternal knowledge and the implementation of early breastfeeding initiation (ρ-value=0,000; phi=0,674), there is a moderate relationship between maternal attitude and implementation of early breastfeeding initiation (ρ-value=0,002; phi=0,592), there is a strong enough relationship between maternal actions and implementation early initiation of breastfeeding (ρ-value=0,033; phi=0,516) at the Anggalomoare Health Center, Konawe Regency. It is hoped that the Puskesmas will always provide information for breastfeeding mothers and pregnant women about the importance of implementing early breastfeeding initiation. Information can be given through counseling to mothers during pregnancy, postpartum and while breastfeeding their children.

Pengaruh Inhalasi Peppermint dengan Mual Muntah Pada Ibu Hamil Trimester I

Based on the Lampung Province Health Profile in 2017, the high incidence of emesis gravidarum in pregnant women was 50- 90%, while hyperemesis gravidarum reached 10-15% in Lampung Province from the number of pregnant women who were 182,815 people. The research objective was to determine the effect of peppermint inhalation with nausea and vomiting in TM I pregnant women at BPM Hodijah Rejo Mulyo Village, Pasir Sakti District, East Lampung Regency in 2021. This research is quantitative research, with a quasi-experimental research design or quasi-experimental research. The subjects in this study were all pregnant women at BPM Hodijah with the object of TM I pregnant women who experienced nausea and vomiting. The research was conducted in January - February 2021 at PMB Hodijah. The results showed that the average nausea and vomiting before being given peppermint inhalation intervention was 8.90 after being given peppermint inhalation was 6.55 with a standard deviation value of 1.538, a minimum value of 4 and a maximum value of 9. There was an effect of inhalation of peppermint with nausea and vomiting in TM I pregnant women. In BPM Hodijah Rejo Mulyo Village, Pasir Sakti District, East Lampung Regency in 2021 with a P-value of 0,000. Suggestions that can be used as a reference in the learning process in the discussion of pregnant women with nausea and can be used as study material in providing treatment for pregnant women with nausea and vomiting.

Determinants of change in timely first antenatal booking among pregnant women in Ethiopia: A decomposition analysis.

BackgroundEven though maternal health was highly targeted in different global strategies, maternal mortality could not be decreased as was expected. Besides this, prior decomposition analysis to the possible cause of changes to timely first antenatal booking has not been conducted. Therefore, this study aimed to assess determinants of change in timely first antenatal booking among pregnant women in Ethiopia.MethodsThe study utilized three consecutive Ethiopia Demographic and Health Survey (EDHS) datasets which were collected through cross-sectional study design. The number of pregnant women who gave birth in 2005, 2011 and 2016 survey included in the analysis was 7,307, 7,908 and 7,590 respectively. The data were analyzed by using Stata/SE version 14.0. Logit-based decomposition analysis was done to identify contributing factors for change in timely first antenatal booking and statistical significance was determined by using P-value.ResultsThe trend of timely first antenatal booking was increased from 6% to 20% in the last ten years. The analysis revealed that 14% of the overall change was because of the change in women’s composition. Changes in the composition of women according to region, education and occupation status were the major sources of this change. The remaining, 86% of the change was due to differences in the coefficient. Mostly, the change in behaviors of the Oromia population, those who have lived in the rural areas and male household head were some of the contributing factors for the increase in timely first antenatal booking.ConclusionsThere was a significant increase in timely first antenatal booking among pregnant women in Ethiopia from 2005 to 2016 EDHS. The change in the women composition according to residency, education and occupation status of women and the difference in behaviors like: behavior of rural residents and male household head contributed to the majority of the change. Interventions targeting the male household head, rural residents and those women who lived in the Oromia region should be emphasized to increase further timely booking. In addition, promoting women in terms of education and creating job opportunities could be the other recalled intervention areas of the country.

Neonatal Outcomes in Pregnant Women Infected with COVID-19 in Babol, North of Iran: A Retrospective Study with Short-Term Follow-Up.

During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were 37 ± 3.19 weeks (30₊6-40) and 3077.50 ± 697.64 gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study.

The Effect Of Warm Foot Sound On Blood Pressure In Pregnant Women With Essential Hypertension

Preliminary surveys at Public Health Center Watubangga for the last 3 months, namely in October-December 2020, consists of 7 working areas, 4 villages and 3 urban villages. The number of pregnant women was 157, and those experiencing essential hypertension were 15 pregnant women. This study was to determine the effect of foot soaking in warm water on blood pressure in pregnant women with essential hypertension at the Watubangga Public Health Center. This study was a quasi-experimental study design one group Pre and Post test. The study population was all normal deliveries of 138 people. The sampling technique used was total sampling with a total sample of 15 respondents of pregnant women who experienced essential hypertension. The results of statistical tests with Wilcoxon show that there is an effect of warm foot soaking on blood pressure in pregnant women with essential hypertension at the Puskesmas Watubangga with a p-value in systole (0.001), while diastole has a p-value (0.001). The conclusion is that there is Soaking feet with warm water affecting blood pressure in pregnant women with essential hypertension at the Watubangga Health Center. It is hoped that This program can be applied to clinical midwifery practice, especially for pregnant women who have hypertension and can be a reference for further research.

Pre-conceptual counselling in cardiology patients: still work to do and still missed opportunities. A comparison between 2015 and 2019 in women with cardiac disease attending combined obstetric cardiology clinics. Should the European Guidelines change anything?

Women with underlying cardiac conditions have an increased risk of adverse pregnancy outcomes. Counselling reproductive age women with heart disease is important to assist them in deciding whether to pursue pregnancy, to ensure their best cardiovascular status prior to pregnancy, and that they understand the risks of pregnancy for them and baby. This also provides an opportunity to explore management strategies to reduce risks. For this growing cohort of women, there is a great need for pre-conceptual counselling.This retrospective comparative audit assessed new referrals and pre-conceptual counselling of women attending a joint obstetric-cardiology clinic at a tertiary maternity centre in a 12-month period of 2015-2016 compared with 2018-2019. This reflected the timing of the introduction of a multidisciplinary meeting prior to clinics and assessed the impact on referrals with the introduction of the European Society of Cardiology guidelines.Data were reviewed from 56 and 67 patients in respective audit periods. Patient's risk was stratified using modified World Health Organization classification.Less than 50% of women with pre-existing cardiac conditions had received pre-conceptual counselling, although half of them had risks clearly documented. The majority of patients had a recent electrocardiograph and echocardiogram performed prior to counselling, and there was a modest improvement in the number of appropriate functional tests performed between time points. One-third of patients in both cohorts were taking cardiac medications during pregnancy.There was a significant increase in the number of pregnant women with cardiac disease and in complexity according to modified World Health Organization risk classification. While there have been improvements, it is clear that further work to improve availability and documentation of pre-pregnancy counselling is needed.

Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity.

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

Risk factors and experiences of prepartum depression in urban- low-income settlement Nairobi Kenya: a mixed-method study

Background: Prepartum depression is common among pregnant women and has not been studied much in low and middle-income countries. Evidence shows that mental illnesses are prevalent in urban than in rural areas. The study objective was to determine the magnitude of prepartum depression, risk factors, and real-life experiences of depression among pregnant women. Method: A mixed-method cross-sectional study was conducted. It included 262 pregnant women attending antenatal clinics in two public health facilities in urban low-income settlement Nairobi, Kenya. Edinburgh Postnatal Depression Scale (EPDS) with cut-off >13 was used to classify clinical depressive illness. Further, a focus group discussion was conducted with 20 women identified with depression. Univariable analysis with Odd's Ratio was used to test associations. Variables with a p<0.05 in multivariable regression were considered significant. Result: Out of the 262 women, 33.6% were found to have prepartum depression as indicated by EPDS score of >13. Women's gestational age was statistically significantly associated with depression [OR 3.37; (95% C.I 1.60 - 7.10); p <0.001] Income levels <10,000 KES was statistically significantly associated with prepartum depression [OR 0.39; (95%; C.I 0.23 – 0.66); p <0.001]. Further, thematic analysis of qualitative indicated that poverty, lack of social support, domestic violence, and unfriendly health care were major contributors to prepartum depression. Conclusion: Significant numbers of pregnant women were found to experience depression. This prevalence rate indicates a high disease burden of women who live with depression, which is not diagnosed because screening of depression is not done in primary health care centers. This study calls for a need and consideration for screening for perinatal depression in primary health care facilities, mainly in resource-poor areas. Interventions targeting means of resolving conflicts in families are highly needed. Such steps would help achieve key sustainable development goals where maternal and child health remains key priority.

Timing and factors associated with early antenatal visits among pregnant women in west Gojjam, northwest Ethiopia

Background Early and appropriate antenatal care practices have the potential to save the lives of mothers and their children, and enable mothers to receive the full range of antenatal care services. However, in developing countries, including Ethiopia, a number of pregnant women do not attend antenatal care in the recommended time period. Therefore, this article assessed the timing and factors associated with early antenatal care visits in west Gojjam, northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among pregnant women attending antenatal care services in west Gojjam. Data on participants' sociodemographic, obostetric and reproductive health information were collected from 820 participants using a structured interviewer-administered pretested questionnaire. Bivariate and multivariate logistic regression analyses were used to identify variables associated with early antenatal care visits. Variables with P<0.05 were considered significant. A visit was considered ‘early’ if a pregnant woman attended their first antenatal care session within the first 12 weeks of gestation. Results Almost a third (31.5%) of mothers started antenatal care early. The mean gestational age at the first visit was 17 weeks (standard deviation±7.7), with a range of 3–36 weeks. In multivariate analysis, it was found that being nulliparous (adjusted odds ratio: 2.3; P=0.013), travel time to the health facility being less than 30 minutes (adjusted odds ratio: 6.1; P<0.001) and living in an urban area (adjusted odds ratio: 2.4; P=0.001) were significantly associated with attending antenatal care early. Conclusions Early first antenatal care attendance was low in the study area. It is important to decentralise the provision of antenatal care services at health posts through an outreach service, by strengthening the mobilisation, screening and early referral system through health extension workers and the women development army. This will allow more women to receive antenatal care from skilled providers.

Pregnancy and Cancer: Cellular Biology and Mechanisms Affecting the Placenta.

Simple SummaryThe main point of this review was to describe most of the mechanisms of the biology of trophoblast cells and neoplastic cells, which point out some similarities between them and the way in which both complex metabolic states could interfere with each other. We show the need for more studies about cancer during pregnancy. In addition, the magnitude of how tumour factors can interfere with the course of pregnancy and affect the foetus’s nutrition and health is the most important point that should be studied to better understand and improve treatment for this complex condition. In this context, we have highlighted the importance of maternal nutritional supplementation with leucine, a branched-chain amino acid that improves the placenta’s metabolism and protects the mother and foetus against the harmful effects of cancer during pregnancy.Cancer during pregnancy is rarely studied due to its low incidence (1:1000). However, as a result of different sociocultural and economic changes, women are postponing pregnancy, so the number of pregnant women with cancer has been increasing in recent years. The importance of studying cancer during pregnancy is not only based on maternal and foetal prognosis, but also on the evolutionary mechanisms of the cell biology of trophoblasts and neoplastic cells, which point out similarities between and suggest new fields for the study of cancer. Moreover, the magnitude of how cancer factors can affect trophoblastic cells, and vice versa, in altering the foetus’s nutrition and health is still a subject to be understood. In this context, the objective of this narrative review was to show that some researchers point out the importance of supplementing branched-chain amino acids, especially leucine, in experimental models of pregnancy associated with women with cancer. A leucine-rich diet may be an interesting strategy to preserve physiological placenta metabolism for protecting the mother and foetus from the harmful effects of cancer during pregnancy.

Gestational diabetes mellitus and progression to type 2 diabetes

Diabetes mellitus is a metabolic disease with life-threatening morbidity and with epidemic spread. This metabolic disorder affects an increasing number of pregnant women. General practitioners and obstetricians need to know how some occult maternal metabolic disorders could be revealed by pregnancy and how pregnancy could influence the fetal health and the long-term progression of maternal disease. Pregnancy is considered a stress test for life and diabetes mellitus is a good example to illustrate this correlation.

Outcomes of newborns to mothers with COVID-19

IntroductionCoronavirus disease 2019 (COVID-19) has spread rapidly across the world. Given the sharply increased infection rate, the number of pregnant women and children with COVID-19 is correspondingly on the rise. SARS-CoV-2 infection is transmitted through droplets; though hypothesized, other transmission routes have not been confirmed. As of now, it remains unclear whether and how SARS-CoV-2 can possibly be transmitted from the mother to the fetus. MethodThis study examines the medical records of 30 neonates born to women with COVID-19, the objective being to provide documented information on maternal-child transmission and infant outcomes. ResultsOut of the 30 newborns, 28 had negative PCR test results for SARS-CoV-2; among their mothers, fifteen had fever, nine had cough and twenty had delivered by cesarean section. The median birth term was 37wk2dy, and twenty of the neonates were male. Most of them were asymptomatic, except for the three who presented with shortness of breath. Two of them were intubated and both died, the first because of severe sepsis and the second due to severe hyaline membrane disease. As regards the two infected neonates, the first represents a probable case of congenital SARS-CoV-2 infection, which appears unlikely in the second case. The outcome for both of them was good, without any complications. ConclusionMaternal-fetal transmission of the SARS- CoV-2 virus was not detected in the majority of the reported cases, although two of 30 neonates had positive qRT-PCR test results. Our study supports the hypothesis that though it seldom actually occurs, in utero SARS-CoV-2 vertical transmission is possible.

Awareness of Neural Tube Defects in Family Physicians

Objective: The aim of this study was to measure the knowledge level of physicians working in family health centers about the conditions leading to neural tube defect (NTD) and preventive measures. Material and Methods: In this cross-sectional study, 406 general practitioners and family medicine specialists made a survey consisted of 13 questions. Chi-square, Fisher’s Exact test and Pearson chi-square analysis were applied as statistical methods. Results: A total of 406 physicians (family medicine specialists: 110, general practitioners: 296) participated in the study. 81.53% of the participants were working in a city and 18.47% were working in the countryside. The number of referral to general practitioners before pregnancy was significantly higher than that of family medicine specialists. (p<0.05). 36.95% of the respondents knew that the neural tube was closed in the first month of embryological life. Folic acid initiation rate was 99.26% for patients planning pregnancy. Initiation of vit B12 with folic acid was 28.33% in patients planning pregnancy. The rate of knowing that vitamin B12 deficiency causes NTD was 39.41% (family medicine specialists: 50%, general practitioners: 35.47%), and FMSs were statistically significant (p<0.05). Discussion: While the number of pregnant women who received folic acid only was sufficient, the number of pregnant women who took vitamin B12 with folic acid was very low. Family medicine specialists and general practitioners had insufficient knowledge that using vitamin B12 in combination with folic acid prevented NTD development. By preparing and implementing algorithms that can prevent NTDs, many life-long complications can be prevented.

Protocol for assessing feasibility, acceptability and fidelity of screening for antenatal depression (FAFSAD) by midwives in Blantyre District, Malawi

BackgroundDepression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District.MethodsThis will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District.DiscussionThis study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.

Pregnant women's opinions toward prenatal pretest genetic counseling in Japan.

In-person models of genetic counseling (GC) have been the common method in Japan for pregnant women to receive GC. However, recent increases in the number of pregnant women considering undergoing prenatal testing have made it challenging to retain individualized in-person care. To explore pregnant women’s opinions toward pretest GC models and the ideal time duration, a self-administered questionnaire survey was conducted for women at their first prenatal visit. A total of 114 valid respondents (93.4%) were included in the analyses. Of these, 80.7% of women preferred in-person GC, followed by classroom (9.6%), group (3.5%), and telegenetic-based GC (2.6%). Women with experience in undergoing prenatal testing significantly did not prefer in-person GC (p = 0.05). Sixty-two women (54.4%) preferred a duration of 15–29 min for pretest GC sessions, followed by 30–59 min (28.9%) and <15 min (14.9%). Women’s preference of ≥30 min in length was significantly associated with anhedonia, singleton pregnancies, acquaintance with people with trisomy 21, and awareness of prenatal testing. Women who were unaware of the need for agreement with the partner for prenatal testing and who did not know the average life expectancy of a trisomy 21 patient significantly preferred <15 min in length over other durations. While the majority of women preferred in-person GC for <30 min, their preferences varied by their background characteristics, experiences, attitudes, and knowledge. These findings will help establish a prenatal GC system offering a choice of GC models in Japan; however, further large-scale studies are needed to confirm these findings.

Perceived barriers to and suggested interventions for physical activity during pregnancy among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California

BackgroundThe American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women engage in at least 20 to 30 min of moderate-intensity physical activity on most days of the week. Regular exercise during pregnancy is associated with many benefits for the mother and the developing fetus; yet, a large number of pregnant women do not engage in the recommended amounts. This study aimed to investigate barriers to and interventions for physical activity among pregnant WIC participants in Southern California.MethodsWe conducted four focus groups (FGs) with pregnant low-income women aged 18 years or older in either their second or third trimester. FGs were conducted at a WIC center in Southern California. The FGs were held according to language (English vs. Spanish-speaking) and BMI category (normal weight vs. overweight and obese). A total of 28 women participated. We used ATLAS. ti. to analyze the focus group transcripts. The study adhered to the Consolidated Criteria for Reporting Qualitative Research.ResultsThe mean age of focus group participants was 28.9 years (SD = 6.6), and the majority were Latina. Intrapersonal barriers to physical activity were fatigue and lack of energy, pain and swelling, lack of childcare, medical restrictions and safety concerns, lack of knowledge about exercise safety, and lack of time. Interpersonal barriers included concerns and lack of support from partners and families, conflicting advice from friends and neighbors, and lack of advice on safe exercise from physicians. Women in all four groups suggested a community-based intervention where they can mingle with each other and share their challenges and concerns. Other suggestions to interventions differed among groups and reflected the women’s experiences and backgrounds. Specifically, to promote education, English-speaking women preferred a brochure while Spanish-speaking women preferred a video. Overweight women emphasized including children in their exercise activities to promote healthy behavior in youth.ConclusionsInterventions should be tailored to pregnant women’s needs. Primary care providers should provide reassurance and information to pregnant women and their partners on the type and frequency of safe exercise.