Pregnant Women In Community Research Articles

Current Situation and Suggestions of Information Management of High-risk Pregnant Women in Community

Current Situation and Suggestions of Information Management of High-risk Pregnant Women in Community

Preparation for birth and complication readiness: rural-urban disparities among pregnant women in communities in Enugu State, Nigeria.

birth preparedness and complication readiness (BPCR) is a key component of safe motherhood programs. The study aimed to determine the rural-urban disparities in BPCR and its predictors among pregnant women. this study was a community-based comparative cross-sectional study carried out among 366 pregnant women living in rural and urban areas in Enugu State, Nigeria. A multistage sampling technique was used to select the participants. Data analysis was carried out using descriptive statistics and inferential statistics at a significant level of p < 0.05. among the respondents, 213 (58.2%) had good knowledge of the components of BPCR. However, a significantly higher proportion of those in urban areas had better knowledge of these components than those in rural areas (p=0.01). Generally, there was a poor practice of BPCR among both groups of respondents. However, between both groups of respondents, good practice of BPCR was statistically significantly higher in respondents from urban areas 69 (37.7%) than those in rural areas 47 (25.7%) (X2=6.108, p=0.013). Several factors were found to be associated with good practice of BPCR among the respondents however, the only predictor of good practice of BPCR among the urban respondents was being aware of free maternal and child health services in the State while for the rural respondents, it was having an assisted delivery in the last stages of pregnancy. there are rural-urban disparities in BPCR. Most pregnant women are knowledgeable about its components but the majority do not practice it appropriately.

Self-reported acute febrile illness, malaria and anemia among pregnant women in communities surrounding the Lagoon of Lagos, South-west Nigeria.

Background: Maternal febrile illness is often linked with undesirable adverse consequences of pregnancy and of fetal development. Objective: The objective of this study was to assess the prevalence of malaria parasitemia and anemia among pregnant women who gave a self-report of febrile illness within 48 hours of presentation at antenatal clinics in semi-urban Lagoon communities in Lagos, Southwest Nigeria where malaria preventive strategies have been carried out. Subjects and methods: A total of 113 pregnant women receiving antenatal care at two secondary-level health facilities in Ikorodu Local Government Area of Lagos State, were recruited into this crosssectional. Relevant information such as age, gravidity, trimester of pregnancy, febrile illness within the past 48 hours and use of malaria commodities were extracted from them. Laboratory analysis was conducted for anemia and malaria parasitemia. Results: In all, 32 (28.3%), 32 (28.3%) and 49 (43.4%) of the study subjects were pregnant for the first time, second time and many times respectively. The overall means (± sd) of age (years) and of PCV (%) were 29.9 (5.8) and 30.0 (6.3) respectively while the mean age of those in 1st 2nd and >2 pregnancies were 26.8 (5.2), 27.3 (3.7) and 33.7 (5.1) years respectively. Also, 38 (33.6%) of the 113 study subjects gave a self-report of febrile illness (SERFI) 48 hours prior to presentation at Antenatal clinic. Laboratory investigation showed that 22 (19.5%) of the study subjects were malaria parasite positive, whose mean Packed Cell Volume (26.8 ± 6.6%) was significantly lower (t=2.64, P-value=0.007) than that of the 91 (80.5%) without malaria parasitemia (30.8 ± 6.0%). The mean (± sd) PCV% of the 38 pregnant women who gave a SERFI (28.4 ± 5.2) was significantly lower (t=-2.13, P-value=0.018) than that of the 75 (66.4%) who did not (30.9 ± 6.6). Women in their first pregnancy were over 2½ times as likely to present with febrile illness than those in their second or more pregnancies (χ²=5.36, Pvalue= 0.02, OR=2.65, 995% CI: 1.15, 6.27). In all 36.8%, 27.8% and 40.0% of those in 1st, 2nd and 3rd trimester presented with febrile illness. Very few of the study subjects slept under Long-lasting Insecticide-treated nets (LLINs) night before the survey or used Sulphadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment of malaria in pregnancy (IPTpp). Conclusion: The prevalence of malaria and anemia among those who gave SERFI in pregnancy was moderately high in Ikorodu Local Government Area of Lagos State, Nigeria. More penetrating stronger health education should be given to pregnant women to report within 24-48 hours of any febrile illness in pregnancy. Efforts should also be intensified to identify cause(s) of maternal febrile illness to reduce maternal and neonatal morbidity and mortality in semi-urban settings of Lagos State specifically and throughout Nigeria in general.

Assessment of iodine status among pregnant women in a rural community in ghana - a cross sectional study.

BackgroundPregnancy is associated with parallel increase in both iodine, and thyroid hormone requirements suggesting that, there may be the need for additional iodine intake during this period to prevent potential iodine insufficiency. Medically, an excess or reduced intake of this micronutrient has negative effects on the individual’s health. This study aimed at identifying the pattern of iodine levels among pregnant women at Kissi, Ghana.MethodA cross-sectional study was carried out among pregnant women on antenatal care at Kissi Health Centre (KHC) which serves the rural town with a population of about 4,500, located in the Komenda/Edina/Eguafo/Abirem (KEEA) municipality in the Central Region of Ghana. Demographic information, iodated salt usage and other pertinent information such as tobacco use were captured using a questionnaire. In addition, urine iodine concentration was estimated through the Ammonium per sulfate method after collecting on-the-spot urine samples.ResultsPrevalence of iodine deficiency in pregnant women was 42.5 %. Of the 80 participants who were on iodized salt, only 16.25 % had mild iodine deficiency with none suffering from moderate or severe iodine deficiency. Of the 40 participants who did not use iodized salt, 35 %, 30 %, and 30 % suffered from severe, moderate and mild iodine deficiency respectively.ConclusionThe high prevalence of iodine deficiency reported in this study suggests that urgent national measures are required to correct iodine insufficiency in pregnant women in these communities.

Trends in HIV Prevalence in Pregnant Women in Rural South Africa.

Despite substantial progress in the delivery of HIV prevention programs, some communities continue to experience high rates of HIV infection. We report on temporal trends in HIV prevalence in pregnant women in a community in rural KwaZulu-Natal in South Africa. Annual, anonymous cross-sectional HIV sero-prevalence surveys were conducted between 2001 and 2013 among first visit prenatal clinic attendees. The time periods 2001 to 2003 were defined as pre-antiretroviral therapy (ART), 2004 to 2008 as early ART, and 2009 to 2013 as contemporary ART roll-out, to correspond with the substantial scale-up of ART program. Overall, HIV prevalence rose from 35.3% [95% confidence interval (CI): 32.3 to 38.3] pre-ART (2001-2003) to 39.0% (95% CI: 36.8 to 41.1) in the early ART (2004-2008) to 39.3% (95% CI: 37.2 to 41.4) in the contemporary ART (2009-2013) roll-out periods. In teenage women (<20 years), HIV prevalence declined from 22.5% (95% CI: 17.5 to 27.5) to 20.7% (95% CI: 17.5 to 23.8) and to 17.2% (95% CI: 14.3 to 20.2) over the similar ART roll-out periods (P = 0.046). Prevalence increased significantly in women 30 years and older (P < 0.001) over the same time period largely because of survival after ART scale up. Teenage girls with male partners of age 20-24 and ≥ 25 years had a 1.7-fold (95% CI: 1.3-2.4; P = 0.001) and 3-fold (95% CI: 2.1 to 4.3; P < 0.001) higher HIV prevalence respectively. Notwithstanding the encouraging decline in teenagers, the ongoing high HIV prevalence in pregnant women in this rural community, despite prevention and treatment programs, is deeply concerning. Targeted interventions for teenagers, especially for those in age-disparate relationships, are needed to impact this HIV epidemic trajectory.

Vaccines for women for preventing neonatal tetanus.

Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin that stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), CENTRAL (The Cochrane Library 2015, Issue 1), PubMed (1966 to 28 January 2015), EMBASE (1974 to 28 January 2015) and reference lists of retrieved studies. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of reproductive age on numbers of neonatal tetanus cases and deaths. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two effectiveness trials (9823 infants) and one safety trial (48 mothers) were included. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. For our primary outcomes, there was no high-quality evidence according to GRADE assessments.One study (1182 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. A single dose did not provide significant protection against neonatal tetanus deaths, (risk ratio (RR) 0.57, 95% confidence interval (CI) 0.26 to 1.24; 494 infants; GRADE: low-quality evidence). However, a two- or three-dose course did provide protection against neonatal deaths, (RR 0.02, 95% CI 0.00 to 0.30; 688 infants; GRADE: moderate-quality evidence). Administration of a two- or three-dose course resulted in significant protection when all causes of death are considered as an outcome (RR 0.31, 95% CI 0.17 to 0.55; 688 infants; GRADE: moderate-quality evidence). No effect was detected on causes of death other than tetanus. Cases of neonatal tetanus after at least one dose of tetanus toxoid were reduced in the tetanus toxoid group, (RR 0.20, 95% CI 0.10 to 0.40; 1182 infants; GRADE: moderate-quality evidence).Another study, involving 8641 children, assessed the effectiveness of tetanus-diphtheria toxoid in comparison with cholera toxoid in preventing neonatal mortality after one or two doses. Neonatal mortality was reduced in the tetanus-diphtheria toxoid group (RR 0.68, 95% CI 0.56 to 0.82). In preventing deaths at four to 14 days, neonatal mortality was reduced again in the tetanus-diphtheria toxoid group (RR 0.38, 95% CI 0.27 to 0.55). The quality of evidence as assessed using GRADE was found to be low.The third small trial assessed that pain at injection site was reported more frequently among pregnant women who received tetanus diphtheria acellular pertussis than placebo (RR 5.68, 95% CI 1.54 to 20.94; GRADE: moderate-quality evidence). Available evidence supports the implementation of immunisation practices on women of reproductive age or pregnant women in communities with similar, or higher, levels of risk of neonatal tetanus, to the two study sites.

Predictors of anxiety among pregnant New Zealand women hospitalised for complications and a community comparison group

Objectiveto investigate predictors of anxiety for women experiencing hospitalisation during pregnancy and a comparison group of pregnant women (with or without medical complications) in the community. Designcorrelational, cross-sectional observational questionnaire study. Settingregional antenatal inpatient unit and community-based settings in New Zealand in 2009 and 2010. Participants118 pregnant women in hospital and 114 pregnant women in community. Measurements and findingswomen in hospital and community groups completed a battery of questionnaires on pregnancy and health history, life events, anxiety, optimism, coping, and relationship factors. Midwives caring for the women provided ratings of health status and psychological distress. Both groups of women had scores on state anxiety significantly above local norms; women in the hospital were significantly higher than those in the community on state anxiety and worry about their pregnancy. The groups did not differ on factors such as life events, optimism, and coping self-efficacy. Ratings of health and distress made by women and their midwives showed poor agreement. Predictors of acute anxiety differed across the groups: for hospitalised women, anxiety was predicted by their rating of their health and their dispositional optimism; for women in the community, anxiety was predicted by stressful life events, dispositional optimism, and coping self-efficacy. Key conclusionsmany women hospitalised during pregnancy are extremely anxious, and those most vulnerable are those who are less optimistic and see their health as poor. Health care professionals may not be aware of how anxious women are, and women and their hospital caregivers had poor agreement on ratings of the woman׳s health status. Implications for research and practicewomen hospitalised during pregnancy are at risk for high levels of anxiety. Midwives are well placed to help women by recognising their distress, supporting informed optimism, and guiding women toward realistic coping strategies and using existing social support networks. Research is needed on strategies for implementation and effectiveness of brief interventions to support women to manage anxiety and stress during pregnancy both in hospital and in the community.

ESBL-producing Enterobacteriaceae colonization among pregnant women in community in Madagascar

ESBL-producing Enterobacteriaceae colonization among pregnant women in community in Madagascar

Cochrane review: Vaccines for women to prevent neonatal tetanus

AbstractBackgroundTetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant and/or non‐pregnant women with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde‐treated toxin which stimulates the production of antitoxin.ObjectivesTo assess the effectiveness of tetanus toxoid, administered to women of childbearing age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus.Search strategyWe searched the Cochrane Pregnancy and Childbirth Group Trials Register (December 2004) , The Cochrane Library (Issue 1, 2005), MEDLINE (1966 to December 2004), EMBASE (1974 to December 2004). We also used the results from handsearching and consultations with manufacturers and authors.Selection criteriaRandomised or quasi‐randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of childbearing age on numbers of neonatal tetanus cases and deaths.Data collection and analysisThree review authors independently assessed trials for inclusion, data extraction and trial quality.Main resultsTwo trials (10,560 infants) were included. One study (1919 infants) assessed the effectiveness of tetanus toxoid in preventing neonatal tetanus deaths. After a single dose, the relative risk (RR) was 0.57 (95% confidence interval (CI) 0.26 to 1.24), and the vaccine effectiveness was 43%. With a two or three dose course, the RR was 0.02 (95% CI 0.00 to 0.30); vaccine effectiveness was 98%. No effect was detected on causes of death other than tetanus. The RR of cases of neonatal tetanus after at least one dose of tetanus toxoid was 0.20 (95% CI 0.10 to 0.40); vaccine effectiveness was 80%. Another study, involving 8641 children, assessed the effectiveness of tetanus‐diptheria toxoid in preventing neonatal mortality after one or two doses. The RR was 0.68 (95% CI 0.56 to 0.82); vaccine effectiveness was 32%. In preventing deaths at 4 to 14 days, the RR was 0.38 (95% CI 0.27 to 0.55), and vaccine effectiveness 62% (95% CI 45% to 73%).Authors' conclusionsAvailable evidence supports the implementation of immunisation practices on women of childbearing age or pregnant women in communities with similar, or higher, levels of risk of neonatal tetanus, to the two study sites. More information is needed on possible interference of vaccination by malaria chemoprophylaxis on the roles of malnutrition and vitamin A deficiency, and on the quality of tetanus toxoid production and storage.Plain language summaryVaccinating childbearing women against tetanus rather than influenza or cholera appears to decrease incidence of tetanus in newborn babies but possible adverse effects not assessedNeonatal tetanus is an infection causing rigidity, muscle spasm and often death in newborn babies. It is quite common in income‐poor countries and comes from insufficient protection being passed from mother to baby in utero together with infection getting into the baby through the umbilical cord stump. The review of studies assessing vaccinating women of childbearing age showed fewer cases of neonatal tetanus when two or three doses were used, but no potential adverse effects were assessed. Administrative and operational aspects also need to be of good quality for vaccination programmes to be effective.