Pregnant Saudi Women Research Articles

Knowledge, Attitudes, and Practices among Pregnant Saudi Women during the COVID-19 Pandemic: A Cross-Sectional Analysis

Emerging global infections, such as coronavirus disease (COVID-19), pose serious public health threats, especially for vulnerable groups, including pregnant women. Knowledge about the disease, attitudes toward disease prevention, and preventative practices can help curb the spread of disease and limit mortality as well. To determine knowledge, attitudes, and practices (KAP) among a cohort of Saudi women who were either pregnant during the pandemic or pregnant at the time of data collection. A cr

Evaluation of risk stratification and adherence to venous thromboembolism prophylaxis among hospitalized obstetric women: Retrospective case file review at East Jeddah Hospital during 2018-2019.

BACKGROUND:Venous thromboembolism (VTE) is associated with substantial mortality as well as morbidity and is largely preventable among hospitalized obstetric women. However, thromboprophylaxis is underutilized in most hospitalized patients.OBJECTIVES:To evaluate VTE risk and adherence to local thromboprophylaxis protocol among hospitalized pre- and postnatal women.METHODS:This retrospective study was conducted at East Jeddah Hospital, Jeddah, Saudi Arabia, in 2020. The electronic record database of the hospitalized pregnant Saudi women during the years 2018 and 2019 was reviewed. Based on the local hospital protocol, the risk stratification was reassessed by researchers, and the hospital adherence to the prophylaxis was reviewed separately for antenatal and postnatal women.RESULTS:One thousand and ninety-five electronic records (539 antenatal and 556 postnatal) were reviewed. The postnatal group showed a significantly higher risk compared with an antenatal group (62.2% vs. 11.7%) (P = 0.000). There was a highly significant difference between risk categories assessment by the physicians and the researchers in both groups (P = 0.000). Thromboprophylaxis was overutilized in the low risk (5% heparin and 41.4% heparin and mechanical devices for antenatal and 17.08% heparin and 6.1% heparin and a mechanical device for the postnatal group) and underutilized in intermediate groups (50% no prophylaxis in antenatal and 51.5% mechanical devices in the postnatal group). There was less adherence to documentation in postnatal as compared to antenatal group (83.6% vs. 95%, P = 0.000) for risk documentation and 85.3% versus 91.5% for physician signature (P = 0.001). Thromboprophylaxis was ordered for 21.3% of antenatal (12.2 heparin, 3.5% mechanical, and 5.6% both) and 23.7% of postnatal patients (16.5 heparin, 2% mechanical, and 5.2% both). There were no reported VTE events or bleeding complications.CONCLUSION:There was a considerable VTE risk among hospitalized obstetric patients which peaked during the postnatal period. Physicians showed good compliance to local VTE protocol with no reported VTE events or drug-induced bleeding. However, the implementation of prophylaxis is associated with both under and overutilization. There is a need for increasing the physicians’ awareness of optimizing VTE risk assessment and documentation for hospitalized obstetric patients.

Prospective Risk Factors of Toxoplasmosis Seropositivity in Pregnant Women: The Fundamental Role of Community Healthcare Education

Background: The present study conducted a survey on awareness of toxoplasmosis infection, with an emphasis on risk factors, and an assessment of toxoplasmosis prevalence in pregnant women in Al-Kharj province of KSA. Methods and Results: A cross-sectional study with a qualitative approach was carried out from August 2018 to February 2019. The study recruited all pregnant women who attended maternity and children’s outpatient clinics. The non-probability sampling approach was used to select 345 blood samples from study subjects. T. gondii-specific IgG and IgM antibodies were identified using ELISA. Each participant enrolled in the study was provided with a validated questionnaire to fill out by an assistant of the laboratory technician or an antenatal care nurse. In addition to socio-demographic data, simple closed-ended questions about established risk factors for T. gondii exposure were included in the questionnaire items, and answers were listed in a three-point Likert scale (agree, disagree, I am not sure). The overall prevalence of T. gondii-specific antibodies among study subjects was 12.75%; 29(8.40%) women were positive for IgG only, 9(2.6%) - for IgM, and 6(1.7%) - for both IgG and IgM antibodies. About 41.4% of participants were in the first trimester of pregnancy; among them 31(9%) were positive for T. gondii antibodies. 82.8% of pregnant women had chronic infection in the first trimester, while 44.4% of those women also had an acute infection. The number of respondents to the questionnaire was 345 participants with a response rate of about 100%. It is important to note that 81.5% of women were unaware that toxoplasmosis is dangerous, and two-thirds of them didn't know the dangerous complications for the fetus and newborn. Conclusion: The current study concludes that there is a low prevalence of toxoplasmosis among Saudi pregnant women in Al-Kharj province. A general program must be implemented to increase population awareness, especially among the at-risk populations.

Assessing the Knowledge of Analgesic Drugs Utilization during Pregnancy among Women in Saudi Arabia: A Cross-Sectional Study.

Background: Pain is a common compensation mechanism in pregnant women that they may face during gestation due to physiological changes. Paracetamol and non-steroidal anti-inflammatory drugs are the most administered analgesic drugs worldwide. Therefore, safety and efficacy are important measures for the use of analgesics during pregnancy. Objective: Assess the knowledge of analgesic drug utilization among Saudi pregnant women. Method: We conducted a self-administered survey with an electronic questionnaire via Google Drive among a sample of 406 Saudi women. Results: About half of the respondents took analgesics during the first trimester, and 52.5% of women have used analgesics at least once without any medical advice during their gestation. Most participants agreed that paracetamol is the safest and effective analgesic drug during pregnancy, yet 61.8% of women are not aware that analgesics could be detrimental to the fetus if inappropriately administered in the third trimester. Conclusion: Participants have a good perception of the safest and most effective analgesic drug during pregnancy, but they have poor knowledge about analgesics’ side effects.

Intimate Partner Violence Among Pregnant Saudi Women: Prevalence, Risk Factors, and Attitudes

Intimate partner violence (IPV) during pregnancy has become a focus of attention in recent years, owing to its relatively high prevalence, its impact on maternal and fetal health, and its cumulative effects over time. This study aims to determine the magnitude and characteristics of IPV among pregnant Saudi Arabian women, to identify the factors that increase the risk, and to assess the willingness of abused women to report IPV. This is a cross-sectional, community-based survey of pregnant women in the Eastern Province of Saudi Arabia. A modified Abuse Assessment Score (AAS) questionnaire was used. Sociodemographic data were collected. Data related to willingness to report IPV, including reasons for declining to report IPV, were also collected. A total of 1,330 women completed the three parts of the survey. In total, 345 (25.9%) women reported emotional abuse during pregnancy, whereas 72 (5.4%)reported physical abuse and 180 (13.5%) reported sexual abuse. In emotional abuse, a significant association was found between having more children (p = .001), having a lower education (p = .05), having a lower income (p = .04), and being abused. In physical abuse during pregnancy, no significant associations were found between all variables and being abused. However, in reporting sexual abuse among women during pregnancy, a significant increase in the risk was found in those with four or more children (p = .01) and those who are employed (p = .01). More than two-thirds (71.2%) of abused pregnant women were unwilling to report the abusive acts to a medical authority. IPV is common among pregnant Saudi women. Emotional abuse is the commonest form of IPV, affecting one in four women. More than two-thirds of abused women were unwilling to report their partner’s abusive acts. Screening for IPV may encourage women to seek help and improve both maternal and fetal health.

The validation and cross-cultural adaptation of the Arabic version of the pregnancy physical activity questionnaire.

Objectives:To translate the pregnancy physical activity questionnaire (PPAQ) into Arabic language, cross-culturally adapt and test its reliability and validity among Saudi pregnant women.Methods:Pregnancy physical activity questionnaire, which consisted of 36 items, was translated to Arabic following the World Health Organization’s guidelines for tool translation (forward translation, expert panel and back translation, pretesting and cognitive interviewing, and final version), followed by validation by experts. This is a cross-sectional study and data were collected from 118 healthy pregnant Saudi women from May to June 2019. Validity included content validity indices (CVI) and construct validity by Rasch analysis. Reliability was assessed by test-retest reliability and Cronbach’s alpha coefficient.Results:The mean age of the participants was 30.15 ± 5.59 years; 38.2% of them had normal pre-gestational body mass index (n=45). The median of total energy expenditure in physical activity was 356.1 METs.h/week (IQR=162.3-648.3). Item content validity index was good ranging between 0.8-1. Rasch analysis showed good construct validity and excellent reliability for all types of physical activity (>0.89).Conclusion:This Arabic PPAQ is a reliable and valid tool that can be used in Arab countries.

Platelet Count and Platelet Indices in Pregnant Saudi Women with Gestational Diabetes Mellitus

Platelet Count and Platelet Indices in Pregnant Saudi Women with Gestational Diabetes Mellitus

Knowledge, attitude, and barriers of seasonal influenza vaccination among pregnant women visiting primary healthcare centers in Al-Ahsa, Saudi Arabia. 2019/2020.

Background:The seasonal influenza vaccine is beneficial for both the pregnant women and their infants. It is considered as primary prevention for pregnant women and it decreases the serious outcomes when infection does occur. The present study was conducted to evaluate the knowledge, attitude, and barriers linked to uptake of seasonal influenza vaccine among pregnant women visiting primary healthcare centers (PHCs) in Al-Ahsa region of Saudi Arabia.Methods:A cross-sectional study done in Al-Ahsa with a target population of 410 Saudi pregnant women who attend antenatal care (ANC) clinics in PHCs in Al-Ahsa. The selection of participants was made by using multistage random sampling. A self-administered questionnaire was used as an instrument for data collection.Results:Two-thirds of the participants (66.1%) stated that they were not offered the flu vaccine by any doctor. Sixty percent of the participants (60.6%) show lack of knowledge regarding flu vaccine during pregnancy. One hundred and fifty-four of the participants (61.1%) have negative attitude toward the flu vaccine uptake during pregnancy. Concern regarding the side effects of the vaccine was the most mentioned barrier (80.9%).Conclusions:The uptake rate of influenza vaccine among pregnant women visiting Al-Ahsa PHCs is considerably low. In order to improve the uptake, we recommend increasing awareness among physicians working in PHCs of the importance of vaccination, enhancing the knowledge of women in childbearing age about influenza and its vaccine, and emphasizing the need to provide the influenza vaccine as part of routine ANC.

Use of Plastics with Hot Food among Saudi Pregnant Women Is Associated with Increased Concentrations of A1C, Thyroid-Stimulating Hormone, and Homocysteine and Decreased Concentrations of Vitamins and Minerals.

Data regarding association between the use of plastics with hot food and levels of vitamins and minerals, and other biochemical parameters are lacking. Cross-sectional data for 740 healthy pregnant Saudi women were collected from 21 health care centres and 2 hospitals from Madinah, Saudi Arabia. Detailed data regarding the frequency of plastic use with hot food were collected, and laboratory analyses of thyroid-stimulating hormone (TSH), homocysteine (HCY), glycated A1C (A1C), and selected vitamins and minerals were also done. Daily use of plastics with hot food was frequently reported among young mothers (p = 0.002). Plastic use with hot food on a daily basis was positively associated with TSH, HCY, and A1C, while it was negatively associated with concentrations of vitamin E, zinc, and selenium. Future research should address the complex hormonal and metabolic abnormalities that are linked to the release of certain components associated with the use of plastics with hot food. Interventions are urgently needed to eliminate the use of plastics with hot food to prevent health complications that may result from the long-term use of these materials.

Factors Associated with Thyroid Disorders and Iodine Adequacy in Pregnant Saudi Women.

Little is known about iodine adequacy and gestational thyroid disorders (GTDs) in Saudi Arabia. This study measured the rates of GTDs and iodine adequacy in 810 healthy Saudi women. Concentrations of serum thyroid hormones and 24-h urine iodine (24-h UIC), and GTDs were diagnosed according to the American Thyroid Association guidelines. Dietary and socioeconomic data to determine factors associated with GTDs and iodine insufficiency were collected. GTDs were detected in 265 women (32.7%) as follows: subclinical (SCH; 20.2%) and overt (OH; 5.8%) hypothyroidism, isolated hypothyroxinemia (ISH; 4.7%) and hyperthyroidism (2%). The SCH (109.2μg/L; IQR: 77.2-149.7), OH (95.3μg/L; IQR: 74.3-130.5) and ISH (107.3μg/L; IQR: 65.5-133.1) groups had median 24-h UIC below the WHO recommended limit, whereas the euthyroid (191.4μg/L; IQR: 170.03-219.8) and hyperthyroid (159.5μg/L; IQR: 152.9-238.3) groups were iodine sufficient. Numbers of pregnancies, less education, not consuming iodized salt and not using iodine supplements increased risk of hypothyroidism and ISH. Contrariwise, interval ≥ 3years from last pregnancy and higher 24-h UIC decreased odds of hypothyroidism and ISH. Moreover, dairy products and egg consumption were markedly lower in all GTD groups. Dairy products and seafood consumption correlated independently with 24-h UIC of the study participants, whereas consuming yogurt, eggs, redfish and shellfish protected against GTDs. In conclusion, GTDs appear to be prevalent in pregnant Saudi women and the hypothyroid and hypothyroxinemia groups had iodine insufficiency. However, consuming iodized salt, iodine supplements, dairy products, seafoods and eggs may protect against GTDs.

Obesity, gestational weight gain, and polyunsaturated fatty acids profile in pregnant Saudi women.

Obesity and excessive gestational weight gain (GWG) are associated with a deficiency of essential fatty acids, affecting maternal health during and after pregnancy. Therefore, it is of interest to identify the associations of pre-pregnancy body mass index (BMI) and GWG with lipid profiles in Saudi women after giving birth. Hence, a cross-sectional study of 238 pregnant women aged 20-40 years was conducted at the King Abdul Aziz Hospital, in Al-Ahsa Governorate-Saudi Arabia. Thus, socio-demographic and anthropometric data were collected using a structured questionnaire. Poly-unsaturated fatty acids (PUFAs), saturated fatty acids (SFAs), and monounsaturated fatty acids (MUFAs) levels were assessed from blood samples collected after the women gave birth. The participants generally consumed diets low in omega-3 and omega-6 PUFAs and high in SFAs and MUFAs. Among them, 51% had university degrees, only 20.4% were employed, and 50% had pre-pregnancy overweight/obesity. Women with overweight/obesity had a higher omega-6 to omega-3 PUFA ratio than women with normal weight. Overweight, obesity, and excessive GWG were not associated with higher levels of total n-3 PUFAs, docosahexaenoic acid, and α-linolenic acid but were associated with higher levels of total n-6 PUFAs and linoleic acid. Women with obesity had significantly higher SFA and MUFA levels than women with normal weight, whereas women with excessive GWG were twice as likely to have higher SFA levels than women with adequate GWG. We show that a higher pre-pregnancy BMI and excessive GWG were significantly associated with abnormal lipid profiles in Saudi women after giving birth. We believe that future studies will help explore these associations in detail.

Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia

BackgroundDespite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA.MethodsSpot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/non-lactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100–199 μg/L) and pregnant (150–249 μg/L) women were applied.ResultsThe median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83–143.55) was at the lowermost WHO recommended cut-off, whereas the pregnant group was iodine deficient (112.99 μg/L; IQR: 81.01–185.57). Moreover, the median UIC was below adequacy across the different trimesters. The use of non-iodised salt significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118–3.766) and pregnant women (OR = 3.813; 95%CI: 1.992–7.297), whereas taking iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172–0.771 and OR = 0.002; 95%CI: 0.001–0.005, respectively). Passive smoking was also an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097–3.014) and pregnant (OR = 1.653; 95%CI: 1.043–2.618) groups. Additionally, BMI correlated independently and significantly with median UIC in the non-pregnant and pregnant populations. However, multiparity (OR = 3.091; 95%CI: 1.707–5.598) and earning below the minimum wage (2.520; 95%CI: 1.038–6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women.ConclusionsThis study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous consequences of iodine deficiency on maternal-foetal health.

SUN-431 Case Finding Versus Routine Screening of Thyroid Dysfunction in Pregnancy

Background:Thyroid dysfunction in pregnancy is associated several adverse outcomes. This has triggered a debate about whether universal screening should be implemented. Despite recommendations against universal screening, the clinical practice of many caregivers may differ. We aimed to assess the sensitivity of using targeted high-risk case finding for diagnosing thyroid dysfunction in pregnancy compared to routine screening in pregnant Saudi women, and to evaluate if gestational diabetes (GDM) specifically affected the risk.Methods:A cross-sectional study in two hospitals under the Ministry of National Guards Health affairs of Saudi Arabia; King Abdulaziz Hospital, Al-Ahsa, and Imam Abdulrahman bin Faisal Hospital, Dammam. Pregnant ladies attending the Family medicine, Obstetrics and Gynecology, and Endocrinology clinics in both hospitals were assessed by the caring physician based on a check list for risk stratification for thyroid dysfunction as per the 2012 Endocrine society clinical practice guidelines for management of thyroid dysfunction in pregnancy. Presence of one risk factor defined high risk. All patients had a routine serum TSH measured as universal screening is commonly practiced in both institutions, the physician doing the risk stratification was not aware of the TSH result. Sensitivity and specificity for the case finding approach was calculated using and abnormal TSH value as the gold standard for presence of thyroid dysfunction. The institutions lab reference TSH 0.35 – 4.94 mIU/L was used as cutoff.Results:1571 pregnant women were included in the study; mean age 29.3± 6.2 years, 396 (23.5%) were primigravida. The mean TSH value was 1.898 ± 1.459 mlU/L. 1178 (75%) pregnant women had an indication for screening based on presence of at least one risk factor, of which 95 (8.1%) tested abnormal for TSH. 393 women had no risk factors, of which 379 (96.4%) had normal TSH, (Chi square 9.3, p-value 0.002). [Sensitivity 87.2%, (95%CI 79.4% – 92.8%), Specificity 25.9%, (95%CI 23.7% – 28.3%)]. Total abnormal TSH values was 109 (6.9%), 43 were abnormal high (i.e. hypothyroid); of which 40 screened positive by case finding approach [Sensitivity 93.02%, (95%CI 80.9% – 98.5%), Specificity 25.52%, (95%CI 23.4% – 27.8%)]. Moreover, 178 (11.3%) women screened positive for GDM at some stage in pregnancy out of which only 5 (2.8%) had an abnormal TSH value, while of the 1393 pregnant women who screened negative for GDM 1289 (92.5%) had a normal TSH value, (Chi square 5.3, p-value 0.02). [Sensitivity 4.6%, (95%CI 1.5% – 10.4%), Specificity 88.2%, (95%CI 86.4% – 89.8%)].Conclusion:Targeted high-risk case finding predicts thyroid dysfunction in pregnant Saudi women with high sensitivity supporting its utility in screening our pregnant population. Gestational diabetes is highly prevalent in Saudi women, but does not increase risk of thyroid dysfunction in pregnancy.

Early-Pregnancy Metabolic Syndrome and Subsequent Incidence in Gestational Diabetes Mellitus in Arab Women.

Introduction: This study aimed to investigate the association between components of metabolic syndrome (MetS) at first trimester and development of Gestational diabetes mellitus (GDM) in 498 Saudi pregnant women.Materials and Methods: Biochemical and anthropometric parameters were determined at the first trimester and MetS components were defined. Participants were screened for GDM at follow up according to International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. The main outcome measures were development of GDM and GDM risk vs. MetS components at first trimester.Results: One hundred twenty three (24.7%) were diagnosed with GDM according to IADPSG criteria. GDM risk was significantly higher for participants with hypertriglyceridemia at 1st trimester even after adjusting for age, BMI and parity (OR: 1.82; CI: 1.1–3.7, p = 0.04). Furthermore, the odds of hyperglycemia at 1st trimester was significantly higher in GDM than in non-GDM participants even after adjustments (OR: 2.13, 95% CI: 1.1 to 4.3, p = 0.038). The receiver operating characteristic (ROC) for predicting GDM revealed an area under the curve (AUC) of 0.69 (95% CI: 0.64 to 0.74, p < 0.001) and 0.71 (95% CI: 0.65 to 0.77, p < 0.001) for first-trimester hyperglycemia and hypertriglyceridemia respectively.Conclusions: The incidence of GDM in Saudi pregnant women was strongly associated with hyperglycemia and hypertriglyceridemia at first trimester. These findings are of clinical importance, as an assessment of MetS in early pregnancy can identify women at higher risk of developing GDM.

Plasma concentrations of vitamin A and E and risk of dysglycemia in first-trimester pregnant Saudi women

BackgroundExisting evidence suggest that low concentrations of vitamin A and E may have a contribution to the development of diabetes complications; however, data regarding the status of vitamin A and E among individuals with prediabetes are lacking. This study aimed to examine the association of plasma concentrations of vitamin A and E with the glycemic control status among first trimester pregnant Saudi women.MethodsIn this cross-sectional study, 1102 first trimester pregnant Saudi women were recruited from antenatal clinics. Sociodemographic and anthropometric information were collected, and laboratory analyses of blood glycated hemoglobin (A1C) and plasma vitamins A and E were performed. Subjects were classified as normoglycemic, prediabetic, or undiagnosed diabetic. Multinomial regression models adjusted for age estimated the adjusted odds ratios (aORs) and [95% confidence intervals (CIs)].ResultsAmong the sample, 78.8% (n = 868) had normal glycemic control, while 19.1% (n = 211) had prediabetes and 2.1% (n = 23) had undiagnosed diabetes. Plasma concentrations of vitamin A and E of prediabetic participants were at a level midway between that of normoglycemic and diabetic participants (p < 0.01). Compared to subjects with normoglycemic status, those with higher concentrations of vitamin A and E had lower odds of being prediabetic (aOR = 0.27 [0.21–0.35] and aOR = 0.95 [0.94–0.96], respectively) or diabetic (aOR = 0.18 [0.13–0.24] and aOR = 0.93 [0.92–0.94], respectively).ConclusionsOur findings indicate a possible contribution of vitamins A and E to the progression of prediabetes to diabetes. Future longitudinal studies are needed to elucidate the association between the antioxidant status and dysglycemia. Clinicians should monitor the glycemic and the antioxidant status closely and provide dietary guidance where needed.

Knowledge and awareness of folic acid usage in Saudi pregnant women in Riyadh city from 2019-2020.

Background:Folic acid (FA) supplementation is an important intervention to avoid nutritional deficiencies during pregnancy and later on will have an effect on mother and fetus. Inadequate dietary intake will lead to nutritional deficiency which further requires to depend on supplementation. FA is one of the vital nutrients which is mandatory for improving pregnancy outcomes. Previous studies have documented the pregnant women who know about supplementation of FA but not consuming during pregnancy will lead to complications in their neonates. This study aimed to inspect the knowledge and awareness about supplementation of FA in Saudi pregnant women and to compare present study results with other prior studies carried out in the Saudi population.Methods:In this study, we have opted 406 Saudi pregnant women with the age range of 18–65 years of age through questionnaire-based research, was further assessed for FA supplementation usage during the pregnancy. Involved pregnant women have filled questionnaire and signed the consent form.Results:The results of this study showed 38% of women were pregnant during 31–40 years of the age range. Almost 96% of pregnant women have awareness about FA supplementation during pregnancies, and 5.9% of women had histories for not using FA supplementation and had abnormal offspring. The current study questionnaire survey confirms 55.7% of pregnant women have information about FA supplementations. Nearly 89% of women have used FA in their previous pregnancies.Conclusion:Saudi pregnant women has good knowledge and awareness about the usage of FA supplementation during pregnancy. Limited efforts should be implemented national wide in all the hospitals and clinics to improve the awareness about maternal nutrition during pregnancy. Nutritional counselling should be conducted in remote areas to get a perception in Saudi Arabia.

Prevalence of symptoms and risk of obstructive sleep apnea in Saudi pregnant women.

BACKGROUND:This case-control study aimed to assess the prevalence of symptoms and risk of obstructive sleep apnea (OSA) among Saudi pregnant women.METHODS:The study included consecutive Saudi pregnant women attending the antenatal service between July 2015 and December 2016. Pregnant women were compared with an age-matched group of nonpregnant women. OSA symptoms and risk were assessed using a validated Arabic version of the Berlin questionnaire (BQ).RESULTS:The study included 742 pregnant women and 742 age-matched nonpregnant women. At the time of the survey, 8.2% were in the first trimester; 33.4% in the second trimester; and 58.4%in third trimester. Snoring was reported by 14% of pregnant women, and 5% reported breathing pauses during sleep. Based on the BQ stratification for risk of OSA, 19.3% of pregnant women and 16.6% of the control group were at high risk for OSA. A comparison between the high OSA-risk and low OSA-risk pregnant women revealed that the pregnant women in high risk group were older (30.9 ± 5.9 years vs. 29 ± 5.4 years, P = 0.001), had a higher body mass index (BMI) (34.3 ± 5.2 kg/m2 vs. 28.7 ± 5.8 kg/m2, P < 0.001), and higher parity (1.9 ± 2 vs. 1.5 ± 1.7, P = 0.020). A multivariate logistic regression analysis revealed the following independent variables, BMI (odds ratio [OR] 1.173 [95% confidence interval [CI] 1.129–1.219],P < 0.001), pregnancy-induced hypertension (OR 7.85 [95% CI 1.691–36.447], P = 0.013), and the presence of restless legs syndrome (OR 2.209 [95% CI 1.332–3.279],P < 0.001).CONCLUSIONS:OSA symptoms and risk were relatively common among Saudi pregnant women. Increasing the awareness among physicians about this association is essential to improve early detection of the disorder.

Prevalence of restless legs syndrome among pregnant women: A case-control study.

BACKGROUND:This cross-sectional case–control study aimed to assess the prevalence of restless legs syndrome (RLS) and its correlates and severity among Arab (Saudi) pregnant women attending antenatal care clinics.METHODS:We interviewed 742 consecutive pregnant women attending antenatal clinics face-to-face using the International RLS Study Group (IRLSSG) criteria. We assessed the severity of RLS using the IRLSSG severity scale for RLS (IRLS). A similar number of age-matched nonpregnant women were enrolled in a control group.RESULTS:Among the cases, 104 (14%) were in the first trimester, 232 (31.3%) in the second trimester, and 406 (54.7%) in the third trimester. The RLS prevalence in cases and controls was 30% and 26.5%, respectively, (P = 0.134). Among cases, severe/very severe RLS was diagnosed in 25% and mild/moderate in 75%, compared with 15% of controls having severe/very severe RLS and 85% having mild/moderate RLS (P < 0.001). Multivariate binary logistic regression analysis identified the following parameters as independent predictors of RLS: parity (odds ratio [OR] 1.113 [confidence intervals [CI] 1.012–1.223], P = 0.027), anemia (OR 1.452 [1.033–2.042], P = 0.03), diabetes mellitus (OR 1.734 [CI 1.084–2.774], P = 0.022), Vitamin D deficiency (OR 2.376 [CI 1.488–3.794],P < 0.001), and smoking (OR 3.839 [CI 1.463–10.074], P = 0.006). None of the cases had been diagnosed or treated for RLS in the antenatal clinics.CONCLUSION:RLS is common, but underdiagnosed, among Saudi pregnant women and nonpregnant women of childbearing age. The study revealed that RLS during pregnancy is linked to parity, anemia, diabetes mellitus, Vitamin D deficiency, and smoking.

Group B streptococcus colonization, antibiotic susceptibility, and serotype distribution among Saudi pregnant women

BackgroundGroup B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases. This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women.Materials and MethodsIn this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular gene-based multiplex polymerase chain reaction assays.ResultsSixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes.ConclusionThis study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Association of gestational diabetes mellitus with vitamin D deficiency among Saudi pregnant women: A case-control study

Background: Prevalence of gestational diabetes mellitus (GDM) and 25-hydroxyvitamin D (vitamin D) deficiency is high in Saudi Arabia. Whether GDM is associated with low vitamin D level or not is still under debate, and the literature regarding this association is deficient in Saudi Arabia. GDM is associated with an adverse pregnancy outcome; therefore, the current study was conducted on Saudi pregnant women to evaluate this relationship.Subjects and methods: This case-control study was conducted in the antenatal clinic at King Fahad Medical City, Riyadh, from February 2015 till February 2017. The Study included 300 pregnant women, of which 100 were GDM cases, and 200 were controls (i.e., without GDM). Cases and control were matched for age, parity, body mass index, gestational age, family history of diabetes mellitus. Vitamin D levels were obtained between 24 to 28 weeks of gestation along with Oral Glucose Tolerance Test (OGTT).Results: The levels of vitamin D among pregnant Saudi women were sufficient in 13%, insufficient in 51%, and deficient in 36%. It was evident that Vitamin D deficiency (<25 nmol/L) was associated with 3 times more abnormal OGTT. Patients with vitamin D deficiency had a 2.3 times greater risk for developing GDM than those having normal levels. There was no difference among cases and controls regarding, demographic variables like age parity BMI and previous history of GDM.Conclusion: An inverse relationship between GDM development and maternal vitamin D deficiency.