Jordanian Pregnant Women Research Articles

Food safety knowledge and risk perception among pregnant women: A cross-sectional study in Jordan during the COVID-19 pandemic

BackgroundPregnant women are at a higher risk of food poisoning compared to the general population. This can be detrimental to both the mother and the fetus. This study aimed to assess the level of knowledge and risk perception of basic food safety and handling among pregnant women in Jordan amid the COVID-19 pandemic.MethodsA descriptive cross-sectional quantitative study among pregnant women in Jordan was conducted using an online questionnaire between November 2020 and January 2021. The survey included socio-demographic data, food safety knowledge, and risk perception questions as well as COVID-19 related questions. A total score for food safety awareness out of 50 was derived for each participant based on the sum of scores from all domains. Student t-test and Analysis of Variance (ANOVA) were conducted using SPSS (Version 26) to compare the mean sum of correct responses of every section (knowledge score) by sociodemographic characteristics.ResultsA total of 325 participants completed the web-based survey. Most of the participants reported receiving food safety-related information during pregnancy (64.9%). The mean total score for the participants was 23.3 ± 4.6 out of 50 (score percentage 46.6%). Participants were mostly aware of foodborne diseases (82.7%) followed by cleaning and sanitation (51.2%), and personal hygiene (49.1%). The least amount of awareness was observed in the cross-contamination (35.0%), food consumption and safety (35.0%), and temperature control (32.8%) domains. Older participants and those with higher education had significantly higher mean scores (p < 0.001). Most participants agreed that the pandemic had a positive impact on enhancing the measures taken to maintain food safety during the pandemic.ConclusionsThis study identified gaps in food safety-related knowledge. Educational programs for pregnant women need robust reinforcement within the community. Efficient educational approaches related to food safety should be provided by health care providers and local health authorities. While the COVID-19 pandemic persists, pregnant women must be well-educated about the virus and its prevention strategies to avoid being infected and ensure their baby's safety as well as their own.

Physical Intimate Partner Violence and Maternal Outcomes in a Hospital-Based Sample of Pregnant Women in Jordan.

The purpose of this study was to examine the effect of physical intimate partner violence on maternal pregnancy/ birth outcomes. A cross-sectional, descriptive, comparative design was used. Consecutively, 223 birthing women were chosen. Data was collected in 2014 using the Arabic World Health Organization's Domestic Violence Questionnaire. Results showed that women who had experienced physical violence during pregnancy had a significantly higher risk of pregnancyinduced hypertension, cesarean section, more pain killer use during birth, and excessive use of postnatal medication. Jordanian health policy makers should find a strategy to eliminate intimate partner violence and reduce its negative impact on women. The inclusion of intimate partner violence screening and identification for every pregnant woman is vital. Sufferers should receive a betterfocused care in order for early detection and treatment of complications that are related to intimate partner violence.

Self-esteem, stress, and depressive symptoms among Jordanian pregnant women: social support as a mediating factor

ABSTRACT This study purposed to assess the mediating role of social support between stress, depressive symptoms, and self-esteem among Jordanian pregnant women. Across-sectional study recruited a total of 538 pregnant Jordanian women using a cluster stratified random sampling technique, during the period from September 2019 to February 2020. The study used the following measures: The Perceived Stress Scale (PSS), Beck’s Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Multidimensional Social Support Scale (MSPSS). Descriptive statistics and inferential statistics were used to test the mediating effect of social support in terms of the association between depression and self-esteem. The results were considered significant if p ≤ .05. The findings showed that 75.6% of participants had moderate-to-high stress levels. High levels of stress, depressive symptoms, and low self-esteem were highly correlated with low social support (p < .05). Depressive symptoms predict the self-esteem (F(2, 537) = 158.631 p < .05). Social support significantly mediates the relationship between the depressive symptoms and self-esteem with p = .01. Thus, during the antenatal care, administration of screening tools to identify pregnant women with low social support levels and at risk of developing psychological difficulties would allow primary healthcare to promote for positive health outcomes for the mothers and the babies.

The impact of the coronavirus pandemic curfew on the psychosocial lives of pregnant women in Jordan

ObjectivesWorldwide the COVID-19 pandemic has negatively affected the health and psychosocial lives of people. International guidelines recommend special attention to pregnant women during pandemics and national emergencies. This study aimed to report the impact of the COVID-19 pandemic curfew on the psychosocial lives of pregnant women in Jordan. DesignA cross-sectional study was conducted and included women who were pregnant during the COVID-19 curfew in Jordan, which took place between mid-March and mid-June of 2020. SettingsA web-based survey that was posted on various social media platforms. ParticipantsWomen who at the time of the study were 18 years of age or more, were living in Jordan, and were pregnant during the curfew. Measurements and findingsData collected included women's characteristics, the impact of the curfew on the pregnancy, physical activity, and psychosocial lives and the barriers to seeking healthcare, in addition to pregnancy and delivery details, and changes in nutrition and supplements intake.A total of 877 women responded to the survey. The results showed that 21.1% of the respondents did not receive any antenatal care (ANC) during the curfew. The respondents also reported that the main barriers for seeking ANC included healthcare facilities being closed (85.2%), the need for travel permits (76.8%), financial difficulties (63.9%), and fear of catching the COVID-19 virus (60.1%). Furthermore, 93.3% reported that they had psychological stress, and 29.9% reported that they had at least one form of domestic violence. Statistically significant associations existed between various women's characteristics, obstetric, psychosocial factors, and the level of psychological stress. Key conclusionsThe COVID-19 pandemic curfew, which was applied in Jordan, resulted in a negative impact on the psychosocial lives of pregnant women. As a result, pregnant women did not receive optimal antenatal care and experienced higher degrees of psychological stress and domestic violence. Implications for practiceThe findings of our study may encourage national healthcare policymakers to ensure the provision of appropriate psychosocial support of pregnant women during large scale emergencies.

Impact of coronavirus 2019 pandemic on post-traumatic stress disorder symptoms among pregnant women in Jordan.

Objective:To examine the prevalence of psychological symptoms of the coronavirus disease 2019 outbreak among pregnant women and its association with gestational age and post-traumatic stress disorder symptoms.Methods:A cross-sectional study was conducted between June and November 2020 to assess the impact of the COVID-19 pandemic on mental health in pregnancy using the Impact of Event Scale-Revised. Pregnant women 18 years and older were recruited from antenatal and obstetrics clinics in Jordan. A total of 481 pregnant women participated in an online survey developed on Google Forms. A self-administered structured questionnaire was used to collect sociodemographic data, mental health information, and lifestyle changes. The Impact of Event Scale-Revised, the Perceived Support Scale, and the Mental Health Lifestyle Scale were administered. Variables related to sociodemographic information and dietary behavior and perception during the COVID-19 pandemic were also assessed.Results:The results showed that 58.6% of pregnant women reported the presence of post-traumatic stress disorder symptoms and women in the second trimester were more likely to show post-traumatic stress disorder symptoms compared with the first and third trimesters (p = 0.001). Moreover, a higher level of education, employment, poor dietary habits, and changes due to the pandemic were significantly associated with the Impact of Event Scale-Revised score and the presence of post-traumatic stress disorder symptoms.Conclusion:The COVID-19 pandemic was associated with high rates of psychological distress among pregnant women. Identifying mothers at risk of post-traumatic stress disorder symptoms may help improve maternity services and prevent adverse child outcomes.

Clinical predictive factors for vaginal delivery following induction of labour among pregnant women in Jordan

BackgroundInduction of labour (IOL) is an important and common clinical procedure in obstetrics. In the current study, we evaluate predictors of vaginal delivery in both nulliparous and multiparous women in north Jordan who were induced with vaginal prostaglandins.MethodA prospective study was conducted on 530 pregnant women at King Abdullah University Hospital (KAUH) in north Jordan. All pregnant mothers with singleton live fetuses, who had induction of labour (IOL) between July 2017 and June 2019, were included in the study. Mode of delivery, whether vaginal or caesarean, was the primary outcome. Several maternal and fetal variables were investigated. The safety and benefit of repeated dosage of vaginal prostaglandin E2 (PGE2) tablets, neonatal outcomes and factors that affect duration of labour were also evaluated.Pearson χ2 test was used to investigate the significance of association between categorical variables, while student’s t-test and ANOVA were applied to examine the mean differences between categorical and numerical variables. Linear regression analysis was utilized to study the relation between two continuous variables. A multivariate regression analysis was then performed. Significance level was considered at alpha less than 0.05.ResultsNulliparous women (N = 254) had significantly higher cesarean delivery rate (58.7% vs. 17.8%, p < 0.001) and longer duration of labour (16.1 ± 0.74 h vs. 11.0 ± 0.43 h, p < 0.001) than multiparous women (N = 276). In nulliparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop score; the mean Bishop score was 3.47 ± 0.12 in nulliparous women who had vaginal delivery vs. 3.06 ± 0.10 in women who had cesarean delivery (Adjusted odds ratio (AOR) = 1.2, 95% CI: 1.03–1.28, p = 0.03). In multiparous women, the rate of vaginal delivery was significantly higher in women with higher Bishop scores and lower in women with higher body mass index (BMI). The mean Bishop score was 3.97 ± 0.07 in multiparous women who had vaginal delivery vs. 3.56 ± 0.16 in women who had cesarean delivery (AOR = 1.5, 95% CI: 1.1–2.1, p = 0.01). The mean BMI was 30.24 ± 0.28 kg/m2 in multiparous women who had vaginal delivery vs. 32.36 ± 0.73 kg/m2 in women who had cesarean delivery (AOR = 0.89, 95% CI: 0.84–0.96, p = 0.005). 27% of nulliparous women who received more than two PGE2 tablets and 50% of multiparous women who received more than two PGE2 tablets had vaginal delivery with no significant increase in neonatal morbidity.ConclusionParity and cervical status are the main predictors of successful labour induction. Further studies are required to investigate the benefit of the use of additional doses of vaginal PGE2 above the recommended dose for IOL.

Intimate partner violence among Jordanian pregnant women and its predictors.

AimTo determine and compare the level of prevalence of intimate partner violence (IPV) at 12 months before pregnancy and during pregnancy and to identify the predictors of physical IPV.DesignA cross‐sectional, correlational design was used for data collection and analysis.MethodsConvenience sampling was used to recruit 247 women for the study. The women's IPV experience was measured by the Arabic version of the World Health Organization's Domestic Violence Questionnaire Screening Tool.ResultsThe women reported that they experienced substantial levels of different types of IPV during pregnancy: 93.1% control, 66% psychological, 31.2% physical and 8.9% sexual. The levels of psychological, physical and sexual IPV during pregnancy were statistically significantly lower than those before pregnancy. In the case of physical IPV, women's age and verbal fighting were independent positive predictors, while women's educational level, husbands' educational level and level of mutual understanding were independent negative predictors. It is therefore recommended that policymakers focus on providing marital advice and marriage counselling and on empowering women by education in order to tackle IPV during pregnancy.

Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities.

Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette-waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.

Toxoplasmosis prevention: knowledge and practices among pregnant women in Jordan

Toxoplasmosis prevention: knowledge and practices among pregnant women in Jordan

Exploring of Dietary Patterns, and Possible Association with Educational Level, among Jordanian Pregnant Women

Evaluating dietary patterns could provide an overall view of food and nutrient which consumed regularly. Better understanding of dietary patterns in pregnant women may be considered an acceptable mean to identify unhealthy dietary practices and the associations with undesirable pregnancy outcomes, which necessitates urgent intervention. This study aimed to determine the dietary pattern followed by Jordanian women during pregnancy in the second and third trimesters and to detect possible association between the dietary patterns and educational level. A total of 286 healthy, pregnant Jordanian women, aged ≥ 18 years with singleton pregnancies, completed the study. Sociodemographic, dietary, and physical activity data were collected using validated questionnaires. Dietary patterns were identified using a Principal Component Analysis. A multinomial logistic regression was used to estimate the effect of education level on dietary intake. Three dietary patterns were identified during the entire duration of pregnancy; ‘High-Fat, High-Sugar’, ‘Fruit and Vegetables', and ‘High Protein’ which explained about 32% of the variability of the study sample. Dietary patterns adopted by pregnant women during the second and third trimesters, separately, were able to explain about 40% of the variability during each trimester. Educational level showed associations with dietary patterns, in which ‘Fruit and Vegetables' and ‘Healthy’ patterns were remarkably manifested as the preferred pattern of consumption for the highly educated women during their third trimester. Different dietary patterns have been identified among Jordanian pregnant women throughout their pregnancy trimesters. Higher educational level could influence food choices. Fruit and Vegetables' and ‘Healthy’ patterns were the followed patterns among the highly educated women during their third trimester.

Knowledge, Attitude and Smoking Patterns Among Pregnant Women: A Jordanian Perspective.

Background:Smoking during pregnancy is one of the main modifiable factors associated with perinatal morbidity and mortality and maternal complications. Literature is scant regarding smoking habits of pregnant women in Jordan.Objectives:To investigate smoking patterns and attitudes of Jordanian pregnant women towards smoking.Methods:A cross-sectional survey of patterns and attitudes towards smoking among 436 mothers attending healthcare facilities in the Governorate of Irbid, Jordan, between August and September 2019.Results:Out of 436 pregnant women in the Governorate of Irbid, Jordan, 13 (2.9%) quit smoking once pregnancy was conformed, and 77 (17.6%) continued to smoke.Pregnant non-smokers believed that hookah and electronic cigarettes are as bad to health as cigarettes, while smokers believed that hookah and electronic cigarettes are less hazardous than cigarettes (5.19% versus 21.99%, p = 0.001, and 6.49% versus 19.37%, p = 0.009, respectively).Non-smokers were significantly more aware regarding the hazards of smoking on perinatal outcomes, such as abortion (31.94% versus 10.39%, p = 0.001), placental abruption (31.94% versus 10.39%, p = 0.001), intrauterine growth restriction and fetal malformations (36.65% versus 14.29%, p = 0.007), fetal death (30.89% versus 6.49, p < 0.001), neonatal pulmonary diseases (44.50% versus 24.68%, p = 0.024), neonatal asthma (47.12% versus 28.57%, p = 0.038), and ear diseases (42.41% versus 20.8%, p = 0.012).Conclusion:There is a high prevalence of smokers among pregnant women in Jordan. The level of awareness regarding long-term consequences of tobacco use remains low. Educational programs should include information about the hazards of all forms of smoking. Pregnancy provides a good opportunity for promoting smoking cessation.

The Effect of Health Education on Dietary Knowledge and Practices of Pregnant Women in Jordan: A Quasi-Experimental Study.

BackgroundEvidence reported inadequate dietary practices among pregnant women and recommended educating pregnant women about their diet to improve pregnancy outcomes. However, studies examining the effect of health education about dietary practices during pregnancy are lacking in Jordan.ObjectiveTo examine the effect of health education on the levels of dietary knowledge and practices among pregnant women in Jordan.MethodsA quasi-experimental design (pretest-posttest control group) was used. A consecutive sample of 195 pregnant women was recruited from four public health centers in Jordan; two health centers formed the intervention group (n=95) and two formed the control group (n=100). A structured questionnaire was used to assess dietary knowledge and practices before and after the intervention. The intervention group received health education for one month, while the control group received routine antenatal care. Data were collected from September to November 2019.ResultsAfter health education, the intervention group recorded significantly higher dietary knowledge score (mean= 19.30, SD= 0.88) compared to the control group score (mean= 14.36, SD= 2.11), p < 0.001. In addition, the intervention group reported significantly higher dietary practices score (mean= 8.70, SD= 1.16) compared to the control group score (mean= 7.02, SD= 1.66), p < 0.001. In particular, the intervention group recorded a significant increase in dietary knowledge score from the pretest (mean= 14.60, SD= 2.53) to posttest (mean= 19.30, SD= 0.88), as well as practices score from the pretest (mean= 6.69, SD= 1.97) to posttest (mean= 8.70, SD= 1.16), p < 0.001.ConclusionProviding health education concerning dietary knowledge and practices in the care of pregnant women may improve their knowledge and practices. Nurses and midwives in primary care centers have an essential role in assessing this knowledge and providing health education for pregnant women.

Intimate Partner Violence Against Pregnant Jordanian Women at the Time of COVID-19 Pandemic's Quarantine.

In Jordan, women experience considerable levels of different types of violence. The emerging data from different countries indicate that intimate partner violence (IPV) has intensified since the COVID-19 outbreak. The main purpose of the current study is to find out whether there is any difference in the incidence of IPV during and before the COVID-19 pandemic quarantine and whether any sociodemographical factors are related to the incidence of IPV against pregnant women during quarantine. A cross-sectional, correlational design was in this study. The snowball sampling technique was adopted to select the participants, which produced a nonrepresentative sample of 215 pregnant women. The participants completed the Arabic version of the World Health Organization's Domestic Violence Questionnaire Screening Tool (DVQST). We found that women were exposed to different types of IPV before and during the quarantine. The most prevalent form of IPV was control and humiliation (n 172, 80%) and the least prevalent was sexual violence ((n 33, 15.3%), (n 24, 11.2%), respectively). However, there were statistically significant lower DVQST scores during the COVID-19 quarantine than before the quarantine. All types of IPV are significantly correlated with each other and with relationship problems (marital conflict, verbal fighting, understanding each other). While the findings are not generalizable to the general population of pregnant women in Jordan because the sample consisted only of women of high socioeconomic status due to the use of a nonprobability sampling technique, national campaigns should be developed and implemented in order to reduce IPV and change community behaviors and attitudes toward violence against women. It is also recommended that policymakers develop plans to help pregnant women during quarantine by, for example, training care providers on how to access vulnerable women.

Factors Influencing Quality of Life Among Syrian Refugees Pregnant Women in Jordan: A Cross-Sectional Study

Factors Influencing Quality of Life Among Syrian Refugees Pregnant Women in Jordan: A Cross-Sectional Study

Food Group Intake of Pregnant Jordanian Women Based on the Three Pregnancy Trimesters.

Inadequate diets have adverse effects on maternal, fetal, and, possibly, childhood health. This cross-sectional study aimed to examine daily food group intake of pregnant Jordanian women during the three pregnancy trimesters and to compare these to the recommended servings of the five food groups reported by The United States Department of Agriculture and My Plate Plan. A total of 283 pregnant Jordanian women were recruited during their antenatal visits. Data were obtained by interviewer-administered structured questionnaires. Our results showed that 1.1% of participants consumed the recommended number of servings for all five food groups during pregnancy and 10.2% did not consume the minimum number of servings of the five food groups. Nearly half of the participants in the first trimester met the recommended daily servings for three food groups but only approximately two-third of participants met the minimum recommended daily servings for one or two food groups in the second and third trimesters. Consumption of grains and sweets was significantly higher in the third trimester compared with the first and second trimesters. Overall, the majority of pregnant Jordanian women in this study did not consume the recommended number of servings for all five food groups during pregnancy.

Pregnancy During COVID-19 Outbreak: The Impact of Lockdown in a Middle-Income Country on Antenatal Healthcare and Wellbeing.

IntroductionSince the emergence of coronavirus disease 2019 (COVID-19) as a major worldwide health threat, countries have implemented preventative measures to limit the spread of the disease and reduce the strain on their health services. The Hashemite Kingdom of Jordan is one of the countries where relatively strict lockdown measures were enforced. This study aims to evaluate the impact of the lockdown circumstances in Jordan on antenatal care services and health circumstances of pregnant women during this period.Participants and MethodsThis study involved a cross-sectional survey of Jordanian women who are currently pregnant. An electronic survey was distributed among pregnant women in Jordan. A total of 944 completed responses were returned and analyzed. The sample size was statistically determined to be representative of the population.ResultsThe results revealed a significant increase in the percentage of pregnant women not receiving antenatal care from 4% to 59.53% (p<0.001) during the lockdown period, despite the fact that some of these women were suffering from significant underlying medical conditions or serious pregnancy complications that require close antenatal surveillance. The survey also demonstrated that the lockdown circumstances impacted the physical, social, and mental wellbeing of the participants.ConclusionAlthough the lockdown measures in Jordan have succeeded so far in relative containment of COVID-19, this research suggests that significant disruption to antenatal services has occurred and that the lockdown has affected the wellbeing of pregnant women in a number of aspects, which has the potential to cause antenatal health issues that are not directly related to the spread of COVID-19, but rather are a side effect of the way in which the outbreak is managed.

Use of dietary supplements among pregnant women in the center of Jordan

BackgroundBalanced nutrition during pregnancy is necessary to meet the increasing demands of both maternal physiological changes and fetal growth. The present study aimed to investigate types of dietary supplements used by pregnant women living in central Jordan during the three pregnancy trimesters compared by socio-demographic factors. MethodsThis was a prospective observational study which was carried out at a major university hospital in the center of Jordan between March 2017 and December 2018. Two hundred and eighty five pregnant Jordanian women were conveniently recruited to take part in the study. Data was collected by an interviewer-administered structured questionnaire, and results were analyzed. ResultsThe findings showed that 96.8% of the recruited women used supplements during pregnancy. The most frequently used nutrients combined with multivitamins were iron (71.9%),vitamin D (64.2%) and folic acid (33%). Furthermore, the most frequently used single nutrients were calcium (67%), iron (55.8%), Vitamin D (47.8%), Folic acid (15.6%) and omega-3 fatty acids (6.3%). Intake of supplements varied in the three pregnancy trimesters. Use of vitamin D, calcium and iron-containing supplements were higher in the third trimester (85.6%, 89.2% and 91.4%, respectively) compared to the second trimester (62.5%, 67.7% and 77.1%, respectively) and the first trimester (8%, 4% and 8%, respectively) (P < .001). ConclusionCompliance with the intake of some nutrient supplements among pregnant Jordanian women living in the center of Jordan is acceptable, where 96.8% used dietary supplements. While 71.9%, 67%, 64.2% and 33% used Iron, calcium, Vitamin D and Folic acid respectively, more efforts are required to educate pregnant women and raise the awareness about the importance of supplement intake particularly in defiance cases in order to avoid maternal and fetal complications.

Adequacy of Nutrients Intake among Jordanian Pregnant Women in Comparison to Dietary Reference Intakes.

Objective: Maternal nutrition is considered an important pillar in the pregnancy outcomes for both mother and infant. A mother’s malnutrition and inadequate nutrient intake is associated with many undesirable pregnancy outcomes. Hence, assessing the nutritional status of the mother in the early stages of the pregnancy and preventing any inadequacy can preclude many health problems for both mother and infant. Therefore, this study aimed to assess the adequacy of nutrient intakes among Jordanian pregnant women as compared to their corresponding dietary reference intakes (DRIs). Methods: This cross-sectional study was conducted at a major University Hospital in Jordan. Three hundred pregnant women were invited to participate in the study and 286 agreed to participate. Fifty pregnant women were enrolled at week 9, then 96 pregnant women were at week 20 and 137 pregnant women were at week 30 of pregnancy. The participants completed the interview-based demographic questionnaire, pregnancy physical activity questionnaire, and quantitative food frequency questionnaire (FFQ). Results: The mean energy intake was 2768.9 ± 767.8 kcal/day and it was significantly higher in the 3rd trimester (p < 0.05). Women in the 3rd trimester consumed significantly more protein, carbohydrates, and sugar than women in the 1st and 2nd trimesters (p < 0.05). The pregnant women in the 3rd trimester consumed more sodium than women in the 1st and 2nd trimesters (p < 0.05). The vitamin K intake was significantly (p = 0.045) lower in the 2nd trimester than the 1st and 3rd trimesters. The calcium intake was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p = 0.021). The total micronutrient (vitamins B1, B2, B3, B6, B12, and D, calcium, and iron) intakes derived from dietary supplements and food sources throughout the 3 trimesters was significantly higher in the 3rd trimester than the 1st and 2nd trimesters (p < 0.05). The vitamin D, calcium, and iron intakes had the most significant increases between the 1st and 3rd trimesters (p < 0.001), while folic acid intake was significantly higher in the 1st trimester than the 2nd and 3rd trimester (p < 0.001). Most women exceeded the tolerable upper intake level (UL) for sodium in all trimesters, while 82% of women exceeded the UL of folic acid in the 1st trimester and from the supplement, not the diet. Conclusion: While the intake of some nutrients from food alone remains below the DRIs in the diets of pregnant women, the intake of other nutrients is above the UL. Raising the awareness of pregnant women about their diet and how a supplement intake can reduce the risk of inadequate intake for many micronutrients and improve their pregnancy outcomes is of great importance.

High prevalence of Group B Streptococcus colonization among pregnant women in Amman, Jordan

BackgroundLittle is known of the burden of Group B Streptococcus (GBS) colonization among pregnant women in Jordan. We conducted a pilot study to determine the prevalence of GBS among pregnant women in Amman, Jordan, where GBS testing is not routine. We also explored GBS serotypes and the performance of a rapid GBS antigen diagnostic test.MethodsWe collected vaginal-rectal swabs from women who presented for labor and delivery at Al-Bashir Hospital. Three methods were used to identify GBS: Strep B Rapid Test (Creative Diagnostics), blood agar media (Remel) with confirmed with BBL Streptocard acid latex test (Becton Dickinson), and CHROMagar StrepB (Remel). Results were read by a senior microbiologist. We defined our gold standard for GBS-positive as a positive blood agar culture confirmed by latex agglutination and positive CHROMagar. PCR testing determined serotype information. Demographic and clinical data were also collected.ResultsIn April and May 2015, 200 women were enrolled with a median age of 27 years (IQR: 23–32); 89.0% were Jordanian nationals and 71.9% completed secondary school. Median gestational age was 38 weeks (IQR: 37–40); most women reported prenatal care (median 9 visits; IQR: 8–12). Median parity was 2 births (IQR: 1–3). Pre-pregnancy median BMI was 24.1 (IQR: 21.5–28.0) and 14.5% reported an underlying medical condition. Obstetric complications included gestational hypertension (9.5%), gestational diabetes (6.0%), and UTI (53.5%), of which 84.5% reported treatment. Overall, 39 (19.5%) of women were GBS-positive on blood agar media and CHROMagar, while 67 (33.5%) were positive by rapid test (36% sensitivity, 67% specificity). Serotype information was available for 25 (64%) isolates: III (48%), Ia (24%), II (20%), and V (8%). No demographic or clinical differences were noted between GBS+ and GBS-negative women.ConclusionsNearly one in five women presenting for labor in Jordan was colonized with GBS, with serotype group III as the most common. The rapid GBS antigen diagnostic had low sensitivity and specificity. These results support expanded research in the region, including defining GBS resistance patterns, serotyping information, and risk factors. It also emphasizes the need for routine GBS testing and improved rapid GBS diagnostics for developing world settings.

Relative Validity and Reproducibility of a Food Frequency Questionnaire to Assess Food Group Intake in Pregnant Jordanian Women

BackgroundResearch on the relationship between maternal diet and pregnancy outcomes requires valid dietary assessment tools in pregnancy. ObjectiveThis study aimed to develop and examine the relative validity and reproducibility of a quantitative food frequency questionnaire (FFQ) to estimate food group intake in a sample of pregnant Jordanian women. DesignIn this validation study, food group intake from a culturally sensitive quantitative FFQ was compared with food group intake from three 24-hour dietary recalls. Participants and settingThe validation study was conducted from 2015 to 2017 at the maternity clinics in Jordan University Hospital among 131 healthy singleton pregnant Jordanian women. Of these women, 30 also took part in the reproducibility phase, which involved repeated completion of the FFQ in a time frame of 1 month. Pregnant women who had gestational diabetes, preeclampsia, and chronic diseases were excluded. Main outcome measuresRelative validity and reproducibility of a 117-item quantitative FFQ used to estimate usual food intake over a period of 1 month. Statistical analyses performedIntraclass correlation coefficients and weighted κ statistics were calculated to test the reproducibility between the two administrations of the FFQ. Pearson correlations were estimated to validate the FFQ against 24-hour dietary recalls. Cross-classification and Bland-Altman plots were used to examine the agreement between the two dietary assessment methods. ResultsThe intraclass correlation coefficients between the two FFQs ranged from 0.24 for legumes to 0.93 for processed meats. A moderate level of agreement was observed between two FFQs. De-attenuated and energy-adjusted correlations ranged from 0.08 for sweets and sugar to 0.93 for sugary drinks. On average, 50.9% and 45.2% of participants were classified by the FFQ and the 24-hour dietary recalls into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed satisfactory agreement between two methods for most food groups. ConclusionsThe FFQ showed moderate reproducibility and good relative validity for most food groups.