Ailments In Pregnancy Research Articles

An Integrated Approach to Address Perinatal Mental Health Within an Obstetrics Practice.

Outpatient perinatal care providers (one certified nurse-midwife, one nurse practitioner, and one physician assistant) at a high-volume, suburban health system in southeastern Pennsylvania developed and implemented a care model to identify and care for patients at risk for perinatal and postpartum mental health conditions. The program, Women Adjusting to Various Emotional States (WAVES), was created to bring the most up-to-date, evidence-based treatment recommendations to patients while addressing the increased demand placed on the health care system by pregnant and postpartum patients in need of psychiatric services. WAVES is a specialized program offered for anyone who is pregnant or up to one year postpartum who is struggling with mental health symptoms or concerns. Perinatal mood and anxiety disorders have become one of the most prevalent pregnancy ailments, yet mental health is not always addressed during routine prenatal care visits. Common obstacles to patients obtaining mental health care during pregnancy include lack of access, clinician gaps in knowledge, and stigma surrounding diagnoses. WAVES offers a method to empower perinatal providers with the education and tools to address this need. The model outlines how to appropriately assess, diagnose, manage, or refer patients for mental health services. Patient feedback has been overwhelmingly positive, and this novel care model shows great promise for the future of perinatal care. The development of integrated programs like WAVES may be a valuable resource to help combat the perinatal mental health epidemic.

Mild differences in the role of somatic symptoms in depression networks in pregnancy and postpartum: A comparison with women outside peripartum

Depression is one of the most prevalent mental ailments in pregnancy. Many authors have discussed the appropriateness of somatic symptoms for depression assessment in pregnancy and postpartum. However, no study has examined the role of somatic symptoms in networks of pregnant and postpartum women compared to women outside peripartum. Here, we show that somatic symptoms are essential to depression assessment during pregnancy and postpartum. We compared networks of the nine PHQ-9 items across pregnant women (n = 894, Mage = 29.29), women in postpartum (n = 586, Mage = 29.83) and women outside peripartum (n = 1029, Mage = 24.87). While three of the five somatic symptoms in PHQ-9 were more present in pregnant women than in those outside the peripartum, the three networks were highly similar regarding the position of the somatic symptoms and their relation to the emotional-cognitive symptoms. Most depression symptoms in pregnant women were predicted by other depression symptoms to a lesser extent than in postpartum and outside peripartum. Other external variables are therefore needed to explain these sensations in pregnancy. In addition to the incidence of somatic symptoms, practitioners should ask pregnant women about their attributions of these.

Is belly dancing in pregnancy safe and beneficial? The views of two expert panels

This article describes a study of the impact of belly dancing on women’s experience of pregnancy, labour and birth. In order to identify the core movements of belly dancing suitable for pregnant women, an expert panel of belly dance teachers was convened. Next, based on the teachers’ consensus, a video demonstrating the core movements was produced. Finally, a second expert panel was convened, comprising midwives and childbirth educators, who were asked to comment on the video from their professional standpoints. The panel considered that the movements demonstrated were safe and would help with pregnancy ailments such as back-ache, pelvic discomfort, constipation, sleeplessness and anxiety and that belly dancing would assist pregnant women’s mental health, positive self-image and confidence in their bodies to give birth. The relational aspect of belly dancing in terms of building a sisterhood of women making the transition to motherhood was also noted.

A study to assess the knowledge regarding self-management of minor ailments in pregnancy among antenatal mothers

Pregnancy is one of the most precious, memorable and unique experience in each mother’s life. The pregnant mothers should understand the normal physiological changes that are occurring in their body during the stages of pregnancy and should take into account the health care and lifestyle considerations. With a view to that the investigators conducted a descriptive study to assess the knowledge regarding self-management of minor ailments among antenatal mothers attending antenatal OPD in selected hospital of Dadra and Nagar Haveli. A Structured questionnaire was prepared to assess the knowledge regarding self-management of minor ailments among 40 antenatal mothers. The findings of study shows that 2.5% of antenatal mothers have poor knowledge (0-50%), 75% mothers have average knowledge (50-75%) and 22.5% mothers have good knowledge (75-100%) regarding the minor ailments.

Clinical spectrum and outcome of pregnancy with liver diseases - A prospective study.

Liver diseases constitute a family of diseases in pregnancy which are less often studied individually. Spectrum of liver diseases directly or indirectly related to pregnancy comprise 3% of all pregnancies. The biggest challenge is to arrive at a diagnosis in such cases. With this study we aimed to study the prevalence of different Liver diseases in pregnancy in our population and its effect on fetomaternal outcome. This was a prospective observational study carried out from March 2018 to March 2020. A total of 184 pregnant women with diagnosis of some form of liver disease as evident from their symptoms, signs or biochemical investigations were included in study cohort. Primigravida accounted for majority of study cohort (44.02%). Approximately 90.21% belonged to 20-35 yrs. Age group. Intrahepatic cholestasis of pregnancy (IHCP) was the most common liver ailment (66.84%) followed by viral hepatitis (10.32%), Hyperemesis gravidarum (7.06%) and HELLP syndrome (6.52%). There was one case of Acute fatty liver of pregnancy (0.54%), four cases of Pre-eclampsia with liver dysfunction (2.17%), seven cases of Jaundice in pregnancy (3.80%) and 3 cases of pre-existing liver diseases (1.63%). 5 cases (2.71%) of antepartum eclampsia, 5 cases (2.71%) of postpartum eclampsia and 1 case (0.54%) of post-partum HELLP was seen. 33.33% patients were delivered early by induction or caesarean section because of liver dysfunction.14.67% required blood or blood products transfusion.1.63% had postpartum hemorrhage.1.08% mothers required intensive care admissions. Neonatal outcome was poor with 6.41% being growth restricted, 9.61% premature, 8.97% were intrauterine dead fetuses, 2.56% had early neonatal deaths and 7.05% needed neonatal intensive care unit admissions. Timely admission, quick diagnosis and appropriate management of patients with liver diseases in pregnancy can make a significant difference in mortality and morbidity rates due to liver ailments in pregnancy.

Sleep quality according to the Pittsburgh Sleep Quality Index in over 7000 pregnant women in Poland

The aim was to assess sleep quality in pregnant women, characterize sleep patterns in each trimester and to establish independent risk factors of poor sleep quality during gestation. A cross-sectional survey was conducted. The questionnaire included questions regarding sociodemographic data, information on the current pregnancy, sleep patterns and Pittsburgh Sleep Quality Index. 7202 respondents fulfilled the survey completely and only those were included. A total of 95.1% of the respondents in the first trimester, 93% in the second trimester and 94.8% in the third trimester had poor sleep quality. Significantly more women with poor sleep quality assessed their socioeconomic status as bad or sufficient (15.7 vs 8.8%; p < 0.001), stress level as higher (mean 4.7 points vs 3.9 points; p < 0.001), had lower relationship rating (mean 8.8 points vs 9.3 points; p < 0.001) or suffered from depression and anxiety disorders. Logistic regression revealed pregnancy ailments to be the strongest independent risk factors of poor sleep quality during gestation. Sleep disorders are common among pregnant women in Poland and increase significantly as the pregnancy progresses. Developing and introducing a simple and easily available screening tool to assess sleep quality in common practice might improve the quality of the health care of pregnant women.

Sleep Problems in Pregnancy—A Cross-Sectional Study in over 7000 Pregnant Women in Poland

The aim was to characterize sleep patterns in pregnant women in Poland and to analyze the relation between sociodemographic factors, pregnancy-related physical symptoms and sleep problems. A self-composed questionnaire, containing questions in Polish language, was distributed online via web pages and Facebook groups designed for pregnant women. The questionnaire included questions regarding sociodemographic data and information on the current pregnancy and sleep patterns over the past four weeks. Exactly 7207 respondents were included to the study. 77.09% reported sleep problems: nocturnal awakening (52.77%), sleep onset insomnia (20.23%), awakening too early (18.56%) and believed their sleep was too shallow (9.82%). Sleep onset insomnia (26.38%) and frequent awakening (62.88%) were most often reported in 3rd trimester, while daytime drowsiness (86.35%) and naps impeding daytime function (27.18%) in the 1st trimester of pregnancy. The analyzed demographic, socioeconomic and psychological issues had a small but significant influence on sleep problems occurrence (aOR 0.81–1.24). Time to conceive from 6 to 12 months of trying increased the risk of developing sleep problems during pregnancy (aOR 1.31). Pregnancy ailments increased the risk of sleep disturbances (aOR 1.53–2.59). Sleep disorders are prevalent among pregnant women in Poland. The evaluation of risk factors is essential in proper screening for sleep disorders in pregnant women.

Physical Activity Patterns among 9000 Pregnant Women in Poland: A Cross-Sectional Study.

The aim was to analyze the knowledge and experience of women regarding physical activity during their latest pregnancy. An anonymous questionnaire was completed electronically, in 2018, by 9345 women who gave birth at least once, with 52% of the women having performed exercises during pregnancy. Physically non-active respondents suffered from gestational hypertension (9.2% vs. 6.7%; p < 0.01) and gave birth prematurely (9% vs. 7%; p < 0.01) to newborns with a low birth weight significantly more often (6% vs. 3.6%; p < 0.001). Physically active women delivered vaginally more often (61% vs. 55%; p < 0.001) and were more likely to have a spontaneous onset of the delivery as compared with non-active women (73.8% vs. 70.7% p = 0.001). The women who were informed by gynaecologist about the beneficial influence of physical activity during pregnancy exercised significantly more often (67% vs. 44% p < 0.001). In addition, 13% of the women felt discrimination due to their physical activity during a pregnancy, 22% of respondents’ physical activity was not accepted by their environment, and 39.1% of the women were told by others to stop physical exercise because it was bad for the baby’s health. Physical activity during pregnancy is associated with improved fitness, decreased pregnancy ailments occurrence, and therefore influences the course of pregnancy and delivery in a positive way.

Acupuncture in pregnancy; primum non nocere.

It is thought that around 10% of pregnant women turn to acupuncture to alleviate troublesome pregnancy ailments: vomiting, pelvic, back and even labour pain, and to induce labour (Martensson et al., Midwifery 2011;27(1):87-92). Within this unregulated field the available literature is of insufficient quality to show whether acupuncture is either safe, or effective.

Community pharmacist counseling in early pregnancy-Results from the SafeStart feasibility study.

BackgroundCommunity pharmacists are available to counsel women in early pregnancy, but no studies have assessed the feasibility of such a service.ObjectiveTo test the feasibility of a pharmacist consultation in early pregnancy and to inform the design of a definitive trial.SettingSix community pharmacies in Norway from Oct. to Dec. 2017.MethodWe evaluated recruitment approaches and an automatic data preprocessing system (ADPS) to enroll, assign participants, and distribute questionnaires. Women (≥18 years) in early pregnancy were eligible for inclusion. Participants were assigned to a pharmacist consultation (intervention group) or standard care (control group). The intervention aimed to address each woman’s concerns and needs regarding medications and ailments in pregnancy, and was documented on a standard form. The women’s acceptability of the intervention was measured by a questionnaire.Main outcome measuresAppropriate recruitment approaches, workflow of the ADPS, and women’s acceptability of the intervention.ResultsOf the 35 participants recruited, 19 were recruited through Facebook. The ADPS worked well. Treatment of nausea and vomiting (NVP) (10/11) and general information about medications (8/11) were frequently discussed during the consultations (n = 11). The women reported high satisfaction with the consultation. Having the option of telephone and follow-up consultations was important to the women.ConclusionIt is feasible to provide community pharmacist consultations in early pregnancy. In a definitive study, the consultations should focus on NVP and general medication use and further explore social media as a recruiting tool. Both in-pharmacy and telephone consultations should be offered to deliver the intervention.

Social capital and health during pregnancy; an in-depth exploration from rural Sri Lanka

BackgroundDimensions of social capital relevant to health in pregnancy are sparsely described in the literature. This study explores dimensions of social capital and the mechanisms in which they could affect the health of rural Sri Lankan pregnant women.MethodsAn exploratory qualitative study of solicited diaries written by pregnant women on their social relationships, diary interviews and in-depth interviews with key informants was conducted. A framework approach for qualitative data analysis was used.ResultsPregnant women (41), from eight different communities completed diaries and 38 post-diary interviews. Sixteen key informant interviews were conducted with public health midwives and senior community dwellers. We identified ten cognitive and five structural constructs of social capital relevant to health in pregnancy. Domestic and neighborhood cohesion were the most commonly expressed constructs. Social support was limited to support from close family, friends and public health midwives. A high density of structural social capital was observed in the micro-communities. Membership in local community groups was not common. Four different pathways by which social capital could influence health in pregnancy were identified. These include micro-level cognitive social capital by promoting mental wellbeing; micro-level structural social capital by reducing minor ailments in pregnancy; micro-level social support mechanisms promoting physical and mental wellbeing through psychosocial resources and health systems at each level providing focused maternal care.ConclusionCurrent tools available may not contain the relevant constructs to capture the unique dimensions of social capital in pregnancy. Social capital can influence health during pregnancy, mainly through improved psychosocial resources generated by social cohesion in micro-communities and by the embedded neighborhood public health services.

Lessons learned from the London Exercise and Pregnant (LEAP) Smokers randomised controlled trial process evaluation: implications for the design of physical activity for smoking cessation interventions during pregnancy

BackgroundThe challenges of delivering interventions for pregnant smokers have been poorly documented. Also, the process of promoting a physical activity intervention for pregnant smokers has not been previously recorded. This study describes the experiences of researchers conducting a randomised controlled trial of physical activity as an aid to smoking cessation during pregnancy and explores how the effectiveness of future interventions could be improved.MethodsTwo focus groups, with independent facilitators, were conducted with six researchers who had enrolled pregnant smokers in the LEAP trial, provided the interventions, and administered the research measures. Topics included recruitment, retention and how the physical activity intervention for pregnant smokers was delivered and how it was adapted when necessary to suit the women. The focus groups were audio-recorded, transcribed verbatim and subjected to thematic analysis.ResultsFive themes emerged related to barriers or enablers to intervention delivery: (1) nature of the intervention; (2) personal characteristics of trial participants; (3) practical issues; (4) researchers’ engagement with participants; (5) training and support needs. Researchers perceived that participants may have been deterred by the intensive and generic nature of the intervention and the need to simultaneously quit smoking and increase physical activity. Women also appeared hampered by pregnancy ailments, social deprivation, and poor mental health. Researchers observed that their status as health professionals was valued by participants but it was challenging to maintain contact with participants. Training and support needs were identified for dealing with pregnant teenagers, participants’ friends and family, and post-natal return to smoking.ConclusionsFuture exercise interventions for smoking cessation in pregnancy may benefit by increased tailoring of the intervention to the characteristics of the women, including their psychological profile, socio-economic background, pregnancy ailments and exercise preferences. Delivering an effective physical activity intervention for smoking cessation in pregnancy may require more comprehensive training for those delivering the intervention, particularly with regard to dealing with teenage smokers and smokers’ friends and family, as well as for avoiding post-natal return to smoking.Trial registrationISRCTN48600346, date of registration: 21/07/2008.

Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis.

To identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence. A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle-Ottawa Scales. High- and upper-middle-income countries. Pregnant or postpartum women reporting their dietary intake during pregnancy. Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail. The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.

Pharmacists counselling of pregnant women: Web-based, comparative study between Serbia and Norway

ObjectivesTo describe, compare and evaluate whether pharmacists in two European countries, Serbia and Norway, give appropriate counselling for common ailments in pregnancy. DesignA cross sectional, web-based study. Participants and Settings: A study was conducted among Serbian and Norwegian pharmacists during two four-month study periods in 2012 respectively 2014. Participants were recruited through postal and electronic invitation facilitated by several pharmacy chains. Participation in the study was anonymous and voluntary. Measurement instrumentPharmacists were presented with the questionnaire that included five scenarios (back pain, heavy legs, nausea, cold and constipation in pregnancy) and were asked to give their advice about use of medicines, supplements (e.g. herbal products, vitamins, minerals), non-pharmacological treatment and referral to physician in each condition. FindingsIn total, 276 pharmacists, 119 in Serbia and 157 in Norway, accepted to participate in the study. Recommendation about medicines use ranged from 32% (heavy legs) to 71% (back pain) in Serbia and from 3% (heavy legs) to 92% (constipation) in Norway. Several pharmacists' recommendations on medicines and supplements use were inappropriate. Recommendation about non-pharmacological treatments ranged from 11% (nausea) to 50% (heavy legs) in Serbia and from 12% (constipation) to 63% (cold) in Norway. Approximately 12% of the Norwegian and Serbian pharmacists offered referral to a physician as only advice for nausea in pregnancy, indicating a lack of confidence in or knowledge about this common ailment in pregnancy. Key conclusions and implications for practiceLarge differences in counselling of pregnant women by pharmacists in Serbia and Norway were observed. Enhancement of pharmacists' knowledge about treatment of common ailments in pregnancy is needed and will enhance pharmacists' role in improving maternal health.

Attitudes and use of medicinal plants during pregnancy among women at health care centers in three regions of Mali, West-Africa.

BackgroundAlthough, medicinal plants have been important for women’s health historically, the knowledge about such use during pregnancy in developing countries is limited. This is the first quantitative, ethnobotanical study on Malian women’s use of and attitudes towards the use of medicinal plants during pregnancy.The aim of the study was to describe Malian women’s use of medicinal plants during pregnancy according to indications and to evaluate the potentially safety of such use. The overall aim was to preserve valuable information about medicinal plants for women’s reproductive health for the future.MethodsData was collected through structured interviews of 209 pregnant women or mothers in three health care centers in Mali. The women were interviewed about their uses of medicinal plants during pregnancy and their attitudes to such use. Nine specific medicinal plants commonly used in Mali and treatment of eleven common ailments in pregnancy were specifically queried about.ResultsIn total, 79.9 % had used medicinal plants during pregnancy. Only 17 women (8.5 %) had received a recommendation from a traditional practitioner (TP). The most commonly used medicinal plants were Lippia chevalieri (55.5 %), Combretum micranthum (39.7 %), Parkia biglobosa (12.0 %) and Vepris heterophylla (8.1 %). The most common reasons for use were for well-being (37.7 %), symptoms of malaria (37.1 %) and ”increased salt-elimination” (to reduce edema) (19.2 %). For treatment of symptoms of malaria and urinary tract infections during pregnancy, the women’s choices of medicinal plants agreed with those previously reported from interviews with TPs. Almost 30 % believed that medicinal plants had no adverse effects for the mother.ConclusionThis study showed an extensive use and knowledge of medicinal plants during pregnancy in three regions in Mali. However, exclusive use of medicinal plants as treatment of malaria and urinary tract infections during pregnancy may pose a health risk for the mother and her unborn child. A wider collaboration with TPs, with local communities and conventional health workers of the health care centers, on the safe use of medicinal plants, is important to promote safer pregnancies and better health care for pregnant women and their unborn infants in Mali.

Minor Ailments in Pregnancy Are Not a Minor Concern for Pregnant Women: A Morbidity Assessment Survey in Rural Sri Lanka

BackgroundAlthough maternal mortality has become a major focus on global public health agenda, maternal morbidity is a neglected area of research. The purpose of this paper is to present the burden of acute maternal illness during pregnancy.MethodsA cross sectional study was carried out in Anuradhapura district, Sri Lanka. Pregnant women residing in the Anuradhapura district with a gestational age more than 24 weeks through 36 weeks were recruited to the study using a two-stage cluster sampling technique. All pregnant women who consented participated in a detailed interview using a structured questionnaire. Self reported episodes of acute illness during pregnancy were the main outcome measures. Secondary outcomes were utilization of medical services and frequency of hospitalizations.ResultsNausea and vomiting during pregnancy (NVP) was experienced by 325 (69.7%) of the 466 pregnant women studied. Other common symptoms were backache (152, 32.6%), dizziness (112, 24.0%) and heartburn/regurgitation (107, 23.0%). Of the 421 pregnant women who reported ill health conditions 260 (61.8%) women sought medical treatment for these illnesses. Total number of episodes that needed treatment seeking were 373. Hospitalizations were reported by 83 (17.8%) pregnant women and the total number of hospitalizations was 109. The leading cause of hospitalization was NVP which accounted for 43.1% of total admissions and 49.1% of total days spent in hospitals.ConclusionsMinor maternal ill health conditions affecting day-to-day life have a major burden on pregnancy period. Evidence based management guidelines and health promotion strategies are needed to control and prevent these conditions, in order to provide comprehensive, good quality maternal health care.

Causes of respiratory ailments in pregnancy

ObjectiveDuring pregnancy, especially during its third trimester, most pregnant women reported respiratory discomfort (dyspnea), despite the absence of previously coexisting respiratory illnesses. The aim of this study was to determine the reason for this discomfort.Materials and methodsThe study included 24 women examined before and after childbirth. Evaluation of respiratory complains was made on the basis of the respiratory questionnaire of St. George's Hospital. The data were correlated with the results of static and dynamic spirometric tests performed before and after childbirth.ResultsPregnancy did not affect vital capacity (VC). Frequency of perceived symptoms correlated positively with IRV and the ratio IC/VC. A negative correlation was found between ERV and its derivative ERV/VC. There was no relationship between perceived discomfort and parameters of the flow-volume loop.ConclusionsThe extent of perceived respiratory discomfort (dyspnea) during pregnancy was primarily associated with a reduction in expiratory reserve (ERV).

TREATMENT-SEEKING PRACTICES FOR MALARIA IN PREGNANCY AMONG RURAL WOMEN IN MUKONO DISTRICT, UGANDA

Understanding treatment-seeking practices for malaria in pregnancy is necessary in designing effective programmes to address the high malaria morbidity in pregnancy. This study assessed women's perceptions on malaria in pregnancy, recognition of early signs of pregnancy and of malaria, and the cultural context in which treatment seeking takes place in Mukono District. Focus group discussions (FGD) and key informant interviews were conducted among pregnant women, non-pregnant women, adolescents and men. The results showed that malaria, locally known as omusujja, was perceived as the most common cause of ill health among pregnant women. Although malaria commonly presents with fever, some pregnant women feel hot in the womb with or without signs of fever and this illness, locally known as nabuguma, may lead to progressive weakness and occasionally to miscarriage and few respondents associated it with malaria. Primigravidae, adolescents and men were not considered at risk of omusujja or nabuguma. Similarly anaemia and low birth weight were not associated with malaria; in fact paleness was described as a normal sign of pregnancy. There are cultural and social pressures on married women to get pregnant and this forces them to conceal symptoms like feeling feverishness, backache, nausea, general weakness, loss of appetite and vomiting until they are sure these are due to pregnancy. Most women, however, could not differentiate symptoms of malaria from those of early pregnancy. There is a belief that omusujja is a normal sign of pregnancy and this is coupled with a strong cultural practice of using herbs and clays as a first resort to treat pregnancy ailments including malaria. The cultural beliefs and practices regarding delivery of twin and first births, coupled with the high cost of care, prevent women from delivering and using other services at health units.