Pregnancy Period Research Articles

Respectful maternity care during childbirth: Experiences and observation among mothers in a tertiary-care institute in Manipur.

Respectful maternity care (RMC) refers to the humane and dignified treatment of a childbearing woman throughout her pregnancy, childbirth and immediate postpartum period. Disrespect and abuse of women during labour, childbirth and immediate postpartum period in health facilities is one of the reasons which deter them from further utilizing maternal healthcare services. The present study was thus undertaken to determine to what extent RMC practices are being followed in a health facility in Manipur. A cross-sectional study was conducted from May 2022 to August 2022 in a Health facility among women coming for institutional delivery along with direct observations of the labour room. The study tool comprises a semistructured questionnaire related to respectful maternity care which was adapted from the Person-Centered Maternity Care Scale, a validated instrument. The direct observation method was carried out using a checklist adapted from a standardized tool developed by the United States Agency for International Development (USAID). Descriptive statistics were generated and approval of the study was obtained from the Institutional Ethics Committee. A total of 336 (99.1%) women reported at least one form of disrespect or abuse during childbirth. Maximum abuse (91.4%) was reported in the facility and environment domain. Direct observation done on 22 deliveries in the labour room found that 72.7% of the women experienced at least one form of disrespect and abuse. Two (9.1%) women were observed to face physical force or abusive behaviour. Almost all the women reported at least one form of disrespect or abuse during childbirth. There is a need to improve the health facilities and women need to be treated with dignity and respect as it is being violated according to the findings in many studies as with ours.

Maternal Experiences during Pregnancy, Delivery, and Breastfeeding Practices: A Community-based Analytical Cross-sectional Study.

Evidence on variation in the information provided to mothers during antenatal and postnatal periods, its influence on breastfeeding awareness, and practice in urban and rural settings of India is scarce. The aim of the study was to assess the variation in mothers experience during pregnancy, delivery, and maternity period across settings and its influence on breastfeeding practices in the first six months of infants' life. A community-based analytical cross-sectional study was carried out in urban and rural settings of Coimbatore, Tamil Nadu, among 800 mothers who had delivered between one year and six months before the date of the survey using simple random sampling. The proportion of mothers with less than four antenatal visits were significantly higher in urban areas (urban vs rural, 11.4% vs 6.2%). The mean scores for positive experiences during pregnancy (MD -0.99, 95% CI -1.31 to -0.69), experiences during birth and maternity period (MD -0.59, 95% CI -0.83 to -0.35) were significantly lower in the urban areas compared to rural areas. The prevalence of exclusive breastfeeding was 75.8% and 85.0% in urban and rural areas, respectively. Mothers not satisfied with experiences during delivery and maternity period (OR 1.69, 95% CI 1.18 to 2.42) and from urban areas (OR 1.81, 95% CI 1.27 to 2.59) were at significantly increased risk of nonexclusive breastfeeding. The present study showed that mothers from urban areas were not provided with appropriate, adequate, and timely information by the healthcare providers. It is the need of the hour to train and motivate healthcare providers regarding maternal awareness of antenatal, intranatal, and postnatal care practices including breastfeeding and infant care.

The Correlation Between Preconception Body Mass Index And Upper Arm Circumference With The Incidence Of Anemia In Third-Trimester Pregnant Women In The Working Area Of Waru Public Health Center

Anemia during pregnancy is a condition in which the body of pregnant woman experiences reduction in hemoglobin levels due to iron deficiency during pregnancy period, potentially causing complications. This research aims to determine the relationship between preconception body mass index (BMI) and upper arm circumference (UAC) with the occurrence of anemia in third-trimester pregnant women in the Waru Public Health Center working area. The method employed is quantitative analytic observational, using cross-sectional study design, and using secondary data taken from maternal antenatal care (ANC) records. Respondents were 94 third trimester pregnant women selected through simple random sampling technique. Data were analyzed using the chi-square test and calculation of the odds ratio (OR). The results indicated a prevalence of 53.2% for anemia occurring in third-trimester pregnant women in the Waru Public Health Center. Analysis using chi-square obtained p-value = 0.045 and OR = 2.329 for preconception body mass index (BMI) with the occurrence of anemia in third-trimester pregnancy, p-value = 0.276 and OR = 2.864 for preconception upper arm circumference (UAC) with the occurrence of anemia in third-trimester pregnancy. These results showed that there is a association between preconception body mass index (BMI) and the occurrence of anemia in third-trimester pregnancy, while there is no association between preconception upper arm circumference (UAC) and the occurrence of anemia in third-trimester pregnancy. It is expected that women of reproductive age who are preparing for pregnancy will maintain a normal nutritional status during the preconception period to prevent pregnancy anemia as an early intervention.

Improving Maternal Health and Birth Outcomes Through FreshRx: A Food-Is-Medicine Intervention.

Food insecurity has far-reaching consequences for health and well-being, especially during pregnancy and postpartum periods. This study examines a food-is-medicine approach that aimed to reduce food insecurity, maternal stress, depression, anxiety, preterm labor, and low birthweight. Pre-post interventional study of FreshRx: Nourishing Healthy Starts, a pregnancy focused food-is-medicine program led by a local hunger relief organization and obstetrics department. St. Louis, Missouri, a Midwestern U.S. city with higher-than-average infant mortality, low birthweight, and preterm birth rates. Participants (N = 125) recruited from a local obstetrics clinic had pregnancies earlier than 24weeks gestation; spoke English; and were enrolled in Medicaid. At baseline, 67.0% reported very low food security and none reported high food security, while 34.7% indicated depressive symptoms. FreshRx included weekly deliveries of fresh food meal kits, nutrition counseling and education, care coordination, and supportive services. 18-Question U.S. Household Food Security Survey, Edinburgh Postnatal Depression Scale, birthweight, gestational age. Single arm pre-post analysis. Average gestational age of 38.2weeks (n = 84) and birthweight of 6.7 pounds (n = 81) were higher than rates for the general population in the area. For study participants who completed a sixty-day post-partum assessment, 13% (n = 45) indicated maternal depression (P < .01). Food-is-medicine interventions may be an efficient, effective, and equitable tool for improving birth and maternal health outcomes.

Prevalence and risk factors of thrombocytopenia during the third trimester of pregnancy

Background and objective: Thrombocytopenia, described as a platelet count of less than 150,000 mm3, is a common diagnosis during the period of pregnancy, existing in 7–12% of pregnancies. Mild thrombocytopenia occurs if platelet counts are less than 100,000 mm3, while moderate thrombocytopenia is between 50,000 and 100,000 mm3, and severe thrombocytopenia occurs if platelet counts are less than 50,000 mm3. It could be connected to physiologic changes or pathological diseases; some of them have an impact on pregnancy and may offer a serious risk to both the mother and the unborn child. This study sought to estimate the proportions of the underlying causes as well as the prevalence of thrombocytopenia among pregnant women visiting the antenatal care center in Erbil. Methods: A cross-sectional study was performed in a maternity teaching hospital in Erbil city, Kurdistan region, Iraq. A convenience sample of 600 pregnant women was used from 28 weeks to 40 weeks of gestation. Over a period of 1 year, starting in January 2021 and ending in December 2021. Results: The prevalence of thrombocytopenia among the 600 cases was 24.8%, but the majority (75.2%) had a normal platelet count; the degrees of thrombocytopenia were severe in 1.8% of the cases, mild in 8.3%, and moderate in 14.7% of the cases. Conclusion: A statistically significant association between preeclampsia and HELLP syndrome has been reported as a serious condition that leads to thrombocytopenia. High serum albumin levels in pregnant women related to hypertension had a major impact on the number of platelet counts and should be considered a severe disease.

A case of phyllodes tumor with rapid growth during pregnancy and lactation period: a case report

BackgroundThe age of onset of the phyllodes tumor is generally in the late 40 s, and diagnosis and treatment during pregnancy and lactation are rare. We herein present a case of a phyllodes tumor that rapidly increased in size during the pregnancy and lactation period.Case presentationA 39-year-old woman was referred to our hospital with a mass in the right breast that increased in size during the pregnancy and lactation period. On ultrasound (5 week postpartum), a well-defined lobulated mass with internal septations and fluid retention was observed. Magnetic resonance imaging of the breast at 8 week postpartum revealed a 70-mm-sized smooth-margin mass with multilocular cystic components. Marked proliferation of stromal cells with high cell density was observed in a biopsy specimen taken at the previous hospital. We diagnosed the mass as a phyllodes tumor of borderline malignancy and excised it at 13 week postpartum. The excised tumor was 85 mm in diameter and its interior was filled with a milk-like substance. Histologically, there was only a mild increase in stromal cell density but fibrosis with associated degeneration was prominent. The final diagnosis was benign phyllodes tumor with degeneration.ConclusionsWe report a case of a phyllodes tumor that rapidly increased in size during pregnancy and the lactation period. The accumulation of a milk-like substance was thought to be responsible for the rapid growth of the tumor.

Pre-Pregnancy Obesity and Infants' Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden?

Pre-pregnancy obesity is a significant public health concern with profound implications for maternal and child health. The burgeoning evidence suggests that maternal obesity prior to conception is intricately linked with an increased risk of gestational complications, as well as with adverse neonatal outcomes. Furthermore, the long and short-term health of offspring, including the risk of early motor development impairment, obesity, and metabolic syndrome in childhood and adulthood, may be adversely affected as well. Addressing pre-pregnancy obesity is critical for improving overall maternal and child health outcomes, and therefore, the aim of this study was to evaluate the connections linking pre-pregnancy obesity with infants' motor development within the first twelve months of infants' lives. This study included 200 mother-infant pairs divided into two groups based on their pre-pregnancy body mass index values. To assess infants' early motor development, we used the Alberta Infant Motor Scale (AIMS) and evaluated the parameters of infants' early motor development at the ages of three, six, nine, and twelve months. Pre-pregnancy overweight/obesity was significantly associated with excessive gestational weight gain (p < 0.001), fetal macrosomia (p = 0.022), and a family history of diabetes and cardiovascular diseases (p = 0.048 and p = 0.041, respectively), as well as with all observed parameters of early motor development at the ages of three, six, nine, and twelve months: AIMS 3 months total (p < 0.001), AIMS 6 months total (p < 0.001), AIMS 9 months total (p < 0.001), and AIMS 12 months total (p < 0.001). Furthermore, pre-pregnancy overweight/obesity was a significant predictor for AIMS 6 months total (p = 0.043) and AIMS 6 months supination (p = 0.017). Pre-pregnancy obesity is a critical determinant of pregnancy outcomes and offspring early motor development, with possible far-reaching implications for children's long-term well-being. Addressing this issue requires a comprehensive approach that includes preconception weight management, targeted interventions during the pregnancy and postpartum periods, and ongoing research to better understand the underlying mechanisms and develop effective strategies for prevention and management.

Prevalence of Cognitive Impairments In Postpartum Period Among Young Adult Female's

This study aims to determine the prevalence of cognitive impairments in postpartum period among young adult female’s. Pregnancy and postpartum period are the most crucial phases of women’s life. During and after pregnancy, a women’s body undergoes numerous changes such as physical, physiological, emotional, social, hormonal and psychological, this changes may contribute to some negative impacts on women’s neuro-psychologocal state, due to which they may experience a range of emotions, from joy and fulfilment to anxiety, forgetfulness, sadness, often referred to as the “Mommy Brain” phenomenon. A cross-sectional study was carried out. The study sample included 50 females’ in early post-partum phase and 50 females’ in late post-partum phase, they were selected based on the inclusion and exclusion criteria. Convenient sampling was done. Ethical approval was taken prior to the study. Memory and cognitive functions was assessed using Everyday Memory Questionnaire-Revised (EMQ-R), and Mini-Mental Status Examination Scale (MMSE), we also assessed post-partum quality of life using Maternal Postpartum Quality of Life-Instrument (MPQOL). Appropriate statistical tests were used to analyse the data. Mean, SD, coefficient of correlation and percentage distribution of cognitive impairment were tested. Results of the study showed significant difference between two groups. On MMSE, subjects in the late postpartum phase performed better as compared to the subjects in early postpartum phase, on EMQ-R subjects in the early postpartum phase experienced higher levels of memory impairments. On MPQOL, the late postpartum group had a higher mean score on the MPQOL (Maternal Postpartum Quality of Life) compared to the early postpartum group. This implies that women in the late postpartum phase reported a better quality of life related to maternal aspects compared to those in the early postpartum phase. Accordingly, it was determined that a significant portion of postpartum women’s experience some level of cognitive impairment, though the severity varies.

Sleep pattern and disorders among pregnant women in Ibadan, Southwest Nigeria

BackgroundSleep is essential for pregnant women’s and the offspring’s health and wellbeing. Poor sleep and disorders have been linked with adverse fetal outcomes and delivery conditions. However, pregnant women often experience several forms of sleep disruption, which has been scarcely reported in low and middle-income countries (LMIC), including Nigeria where the influence of lifestyle factors has also been lacking. We investigated sleep patterns and disorders and the associated factors among pregnant women in Southwest, Nigeria.MethodA cross-sectional study was conducted among five hundred (500) pregnant women attending Adeoyo Maternity Teaching Hospital. A semi-structured questionnaire was used to examine different domains of sleep and associated disorders, namely sleep quality (Pittsburgh Sleep Quality Index (> 5 and ≤ 5)), insomnia (Insomnia Severity Index (> 8 and ≤ 8)), restless leg syndrome (Restless Leg Syndrome Rating Scale (> 10 and ≤ 10). Significant covariates such as physical activity, minimum dietary diversity, smoking and alcohol intake were also assessed. We conducted bivariate and multivariate analysis at p < 0.05 significance level.ResultsThe mean age of participants was 30.4 ± 4.8 years. The pattern of sleep disorder in pregnant were poor sleep quality (50%), restless leg syndrome (58.2%) and insomnia (33.4%). Being currently married (AOR = 6.13; 95% CI: (1.65–22.23)), increasing gestational age: second trimester (AOR = 8.25;95% CI: (1.78–38.17)) to third trimester (AOR = 10.98; 95% CI: (2.44–49.48)) increased the odds of poor sleep quality. Factors associated with restless leg syndrome were marital status [AOR = 3.60; 95% CI; (1.25–10.35)], religion, rigorous physical activities [AOR = 1.52; 95% CI: (1.05–2.21)] and alcohol consumption [AOR = 3.51; 95% CI: (1.00–12.27)]. Factors associated with insomnia were maternal age [AOR = 1.83; 95% CI: (1.11–3.01)], income [AOR = 2.99 (1.26–7.16)] and rigorous physical activity [AOR = 2.55 (1.61–4.02)].ConclusionPoor sleep quality, restless leg syndrome and insomnia were typical among pregnant women in Ibadan, Southwest Nigeria. Thus, awareness and education on the importance of sleep and its risk and protective factors, such as alcohol consumption, smoking, rigorous activity and spousal and family support, should be increased to reduce poor sleep quality and sleep disorders (restless leg syndrome and insomnia) during the pregnancy period.

Placenta: an old organ with new functions.

The transition from oviparity to viviparity and the establishment of feto-maternal communications introduced the placenta as the major anatomical site to provide nutrients, gases, and hormones to the developing fetus. The placenta has endocrine functions, orchestrates maternal adaptations to pregnancy at different periods of pregnancy, and acts as a selective barrier to minimize exposure of developing fetus to xenobiotics, pathogens, and parasites. Despite the fact that this ancient organ is central for establishment of a normal pregnancy in eutherians, the placenta remains one of the least studied organs. The first step of pregnancy, embryo implantation, is finely regulated by the trophoectoderm, the precursor of all trophoblast cells. There is a bidirectional communication between placenta and endometrium leading to decidualization, a critical step for maintenance of pregnancy. There are three-direction interactions between the placenta, maternal immune cells, and the endometrium for adaptation of endometrial immune system to the allogeneic fetus. While 65% of all systemically expressed human proteins have been found in the placenta tissues, it expresses numerous placenta-specific proteins, whose expression are dramatically changed in gestational diseases and could serve as biomarkers for early detection of gestational diseases. Surprisingly, placentation and carcinogenesis exhibit numerous shared features in metabolism and cell behavior, proteins and molecular signatures, signaling pathways, and tissue microenvironment, which proposes the concept of "cancer as ectopic trophoblastic cells". By extensive researches in this novel field, a handful of cancer biomarkers has been discovered. This review paper, which has been inspired in part by our extensive experiences during the past couple of years, highlights new aspects of placental functions with emphasis on its immunomodulatory role in establishment of a successful pregnancy and on a potential link between placentation and carcinogenesis.

Influence of maternal and neonatal continuum of care on the risk of intergenerational cycle of stunting: a cross-sectional study

ObjectivesThis study aimed to analyse the influence of the continuum of care during pregnancy and neonatal periods on the risk of intergenerational cycle of stunting.DesignThis study was a cross-sectional study,...

Incidence and Risk Factors of Perianal Pathology during Pregnancy and Postpartum Period: A Prospective Cohort Study.

We aimed to identify the incidence and risk factors of perianal pathology during pregnancy and the postpartum period. A prospective cohort study was conducted in three institutions in Lithuania. A total of 190 patients were examined and interviewed three times (<12, 18-20 weeks of gestation, and during the first 2 months after delivery). They completed a questionnaire including demographic, obstetric, coloproctological, and birth data. A total of 73 (34.59%) women developed hemorrhoidal disease after delivery, and 120 (56.87%) developed perianal pathology. Multivariate analysis identified a neonatal birth weight ≥3380 g (OR 4.22; 95% CI 1.83-9.71, p < 0.001) and consumption of eggs (OR 3.10; 95% CI 1.13-8.53, p = 0.028) or cereals (OR 2.87; 95% CI 1.32-6.25, p = 0.008) several times per week as significant risk factors for hemorrhoidal disease. Neonatal birth weight ≥3380 g (OR 3.95; 95% CI 1.47-10.59, p = 0.006), maternal BMI ≥ 21.48 (OR 3.58; 95% CI 1.51-8.47, p = 0.004), the duration of the second labor period ≥38 min (OR 2.81; 95% CI 1.09-7.23, p = 0.032), and consumption of flour products several times per week (OR 2.77; 95% CI 1.10-6.98, p = 0.030) were associated with a higher risk of perianal pathology. Daily consumption of fruits and vegetables (OR 0.35; 95% CI 0.15-0.81, p = 0.014) and less frequent consumption of eggs were protective factors (OR 0.18; 95% CI 0.06-0.56, p = 0.003). Perianal diseases, especially hemorrhoidal disease, are common during pregnancy and the postpartum period. A neonatal birth weight ≥ 3380 g, a maternal BMI of ≥21.48, duration of the second labor period of ≥38 min, and consumption of flour products and cereals several times a week are risk factors for developing these diseases.

Maternal exposure to ambient ozone and fetal conotruncal heart defects in China: A multicenter cohort study

BackgroundThe relationships between maternal genetic and environmental exposure and conotruncal heart defects (CTDs) have been extensively investigated. Nevertheless, there is limited knowledge regarding the impact of ozone (O3) on the risk of CTDs. ObjectiveTo explore the correlation between maternal exposure to O3 and CTDs in China. MethodsPregnant women who underwent fetal echocardiography at Beijing Anzhen Hospital between January 2013 and December 2021 were enrolled. Their sociodemographic characteristics and lifestyle information, along with fetal data, were systematically collected. Fetal echocardiography was used to detect CTDs. Maternal exposure to ambient O3 during the embryonic period, the first trimester, the three months preceding the last menstrual period, and the perinatal period was estimated using residential addresses or hospital addresses associated with prenatal visits. The concentration of O3 was divided by quartiles, with the first quartile serving as a reference. Adjusted logistic regression models were employed to examine the associations between every 10 μg/m3 increase or quartile increase in ambient O3 exposure and CTDs. ResultsAmong 24,278 subjects, 1069 exhibited fetuses with CTDs. Maternal exposure to ambient O3 during three pregnancy periods was associated with increased CTD risk. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.271 (1.189–1.360) per 10 μg/m3 increase in O3 during the perinatal period. For each quartile of O3, the risk increased with increasing exposure concentration, particularly during the perinatal period (OR = 2.206 for quartile 2, 2.367 for quartile 3, and 3.378 for quartile 4, all P<0.05). ConclusionsElevated maternal exposure to O3 during pregnancy, particularly in the perinatal period, is linked to an increased risk of fetal CTDs. Further longitudinal analyses are needed to validate these results.

Pregnancy period and early-life risk factors for inflammatory bowel disease: a Northern Finland birth cohort 1966 study

BackgroundThe pathogenesis of inflammatory bowel disease (IBD) has not been fully elucidated. The aim of this study was to analyze the pregnancy period, perinatal period, and infancy period risk factors for IBD in a well-characterized birth cohort from Northern Finland.MethodsThe Northern Finland Birth Cohort 1966 (NFBC1966) population comprises mothers living in the two northernmost provinces of Finland, Oulu, and Lapland, with dates of delivery between Jan 1st and Dec 31st, 1966 (12 055 mothers, 12 058 live-born children, 96.3% of all births during 1966). IBD patients were identified using hospital registries (from 1966 to 2020) and Social Insurance Institution (SII) registry reimbursement data for IBD drugs (from 1978 to 2016). The data were analyzed by Fisher’s exact test and logistic regression.ResultsIn total, 6972 individuals provided informed consent for the use of combined SII and hospital registry data. Of those, 154 (2.1%) had IBD (113 [1.6%] had ulcerative colitis (UC), and 41 (0.6%) had Crohn’s disease (CD)). According to multivariate analysis, maternal smoking > 10 cigarettes/day during pregnancy was associated with a nearly 6-fold increased risk of CD in the offspring (OR 5.78, 95% CI 1.70–17.3). Breastfeeding (OR = 0.18, 95% CI 0.08–0.44) and iron supplementation during the first year of life (OR = 0.43, 95% CI 0.21–0.89) were negatively associated with CD.ConclusionsSmoking during pregnancy was associated with the risk of CD while Breastfeeding and oral iron supplementation at infancy were negatively associated with the risk of CD later in life.

Pregnant and postpartum women’s experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis

BackgroundPregnant and postpartum women’s experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic.MethodsA qualitative evidence synthesis of studies relating to women’s experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings.ResultsSixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment.ConclusionsThe findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.

Clinical understanding of Garbhini Paricharya : Routine care for pregnant women through Ayurveda

Introduction: Ayurveda classics give importance to caring of mother before, during and after pregnancy. Care during nine months of pregnancy is termed as Antenatal care or Garbhini Paricharya. Garbini Paricharya is one of its concepts explaining the importance of establishment of health of a woman before delivery; directing physicians and Gharbhini to adopt certain recommendation of Aahara, Vihara &amp; Yoga and Pranayama. Material &amp; Method: Literature is collected by Brihatrayi and Laghutrayi, all available Ayurvedic classic, modern available texts, magazines, journals, and research papers. Result: Garbhini Paricharya as described in Ayurveda classics is unique and specific. So by following proper Ayurvedic Gharbhini Paricharya would result in proper development of foetus and prepare pregnant women for Sukhprasava physically, psychologically and spiritually. Discussion: Now present modern and busy working life women are facing many complications and other health related issue after conceiving and during the pregnancy period. Thousand year of ago our classical texts Ayurveda described most important Gharbhini Paricharya for Gharbhini. It is totally scientific and too much beneficial for foetus and mother both. The concept of prenatal care is now highlighted in modern science, which is mentioned in Ayurveda thousands of years ago.

Neutrophil-lymphocyte and Platelet-lymphocyte Ratios of Pregnant Women Living with HIV/AIDS

Background: Chronic inflammation, a factor for high mortality, persists throughout the pregnancy period of women living with human immunodeficiency Virus (HIV).&#x0D; Aim: To determine whether pregnancy alone or the combined effects of HIV and pregnancy are the sources of the inflammation, this study evaluated the predictive variables for inflammation, lymphocyte ratio (NLR), and Platelet-Lymphocyte Ratio (PLR).&#x0D; Materials and Methods: A population of 128 women, aged 15-49 years were grouped into 4; Group A- 32 HIV positive and pregnant, Group B- 32 HIV negative and pregnant, Group C- 32 HIV positive not pregnant, Group D- 32 HIV negative not pregnant (control group). Differential white blood cell and platelet count methods were used to determine the neutrophil (N), Lymphocyte (L) and platelet (P) counts. The ratio calculation method was used to derive the NLR and PLR.&#x0D; Results: NLR was significantly higher for group A (2.62±0.41) compared to groups B (2.25 ± 0.18); C (0.95 ± 0.07); D (1.68 ± 0.19) at p ≤ 0.00. However, the NLR of groups A and B (p ≤ 0.05) were not significantly different, PLR was significantly higher for group A (9.86±1.12) compared to groups B (6.65 ± 1.12); C (5.35 ± 0.47); D (6.34 ± 0.43). There was no significant difference in blood pressure across the groups, significant difference was however observed in their Body Mass Index.&#x0D; Conclusion: Hence, Inflammation may have been caused by pregnancy alone.

Analysis of Electrocardiograms and Behavior in Mice from Pregnancy to Lactation Period.

Changes in the mother-offspring relationship are presumably accompanied by dynamic changes in the autonomic nervous system. Although temporal measurements of autonomic activity have been performed in human mothers and infants, the analysis of long-term changes remains unexplored. Mouse mothers can form social bonds with their pups and have a short period of pregnancy and lactation, which makes them useful for the examination of physiological changes from pregnancy to pup-rearing. Therefore, a telemetry system was used for several weeks to measure the changes in the autonomic nervous system and the behavior of mouse mothers. The current results showed that an electrocardiogram (ECG) could be stably recorded regardless of the movements of mothers and parturition. ECG analysis showed that the heart rate gradually decreased from pregnancy to lactation, and sympathetic activity sharply increased as the pups developed. Furthermore, the simultaneous recording of behavior and ECG in the home cage enabled us to understand the behavior-dependent influences on the ECG, thereby revealing the characteristics of autonomic nervous activity during each behavior. Thus, the present experimental method helps to understand how the physiological characteristics of mothers change from pregnancy through pup rearing, supporting the healthy development of pups.

Obstetric violence and racism: analysis of scientific production from an intersectional perspective

This study aimed to investigate obstetric violence as a phenomenon arising from racism and its intersectionality, as factors suffered during the pregnancy and puerperal period in hospital institutions in several countries. To this end, systematic literature review research was used as a method, as well as the PRISMA protocol perspective was adopted for data collection. References were recruited from the databases, using the descriptors “obstetric violence” and “racism” or “intersectionality”. The search resulted in 1126 articles which, when applying the eligibility criteria, reached the volume of 3 (three) works. Based on the findings, two categories were constructed, “Intersectionality (race, gender and social class)” and “Obstetric violence”. As a result, there was a shortage in national and international journals dedicated to Health Sciences. Such absences or insufficiencies may indicate the non-consolidation of black women's health as thematic and research fields, related to the low degree of penetration in research institutions debates about racism, its impacts on health and ways of coping.

Resources, relationships, and resilience: The psychosocial experiences of women with lower limb absence during pregnancy and postpartum

BackgroundThere is limited research on the unique needs of women with lower limb absence (LLA) during pregnancy and postpartum. The lack of information can negatively impact women's physical and emotional experiences. ObjectiveThe purpose of this study is to explore the psychosocial experiences of individuals with LLA through the pregnancy and postpartum periods, and to provide information to women and health care providers (HCPs) on what they can expect. MethodsSemi-structured interviews were conducted with 19 women with LLA who had been pregnant in the previous 10 years. Interviews were analyzed using thematic analysis. ResultsParticipants experienced uncertainty due to a lack of information and limited resources related to pregnancy and LLA. While most women had strong support networks including family, other mothers with LLA and HCPs, some women faced stigma or judgement from HCPs and people in their social networks. Some women had periods where they struggled mentally due to a temporary loss of independence. Despite these challenges, they demonstrated tremendous resilience and noted that their ability to adapt helped them to navigate the difficulties they experienced in the perinatal period (PNP). ConclusionThere is an immediate need to fill the ‘information gap’ about pregnancy and LLA. We recommend the development of support networks, informational guidelines, and further education for HCPs to better support women with LLA through the PNP. Further research is warranted to gain a better understanding of the mental health experiences of women with LLA in the PNP.