Prenatal Mothers Research Articles

Effectiveness of self-instructional module regarding Janani Shishu Suraksha Yojana among antenatal mothers in Rajasthan

Introduction: Strategies and interventions must be customised according to particular needs as well as circumstances and provide service under the Yojana in order to decline the Maternal Mortality Rate (MMR) as well as Infant Mortality Rate (IMR). As a result, service packages must be created for mother and her newborn. Therefore, the aim of this study was to increase mother's knowledge by providing a self-instructional module about the Janani Shishu Suraksha Yojna (JSSY). Methodology: A quantitative approach of single group, pre- post-test research design were used in this research. Using a purposive sampling technique, the researchers chose 80 pregnant women to participate in the study. Results: The findings show that the average knowledge score before the intervention was 17.65±1.3, and after the intervention, it increased to 25.63±0.85. Antenatal mothers' knowledge score improved considerably between the pre- and post-tests (p0.05). The pre-test knowledge scores were not significantly associated (p>0.05) with any prenatal mothers' demographic factors. Conclusion: Present research highlights that antenatal mother's knowledge towards JSSY is much needed among antenatal mothers for better and safe care of both mother and newborn.

Effectiveness of Self-Instructional Module on knowledge regarding High-Risk Pregnancy among Antenatal mothers

A high-risk pregnancy is one in which there is or will be an increased risk of morbidity or mortality for the mother, the fetus, or the baby before or after delivery. Between 20–30% of pregnancies in India are high-risk. Consequently, the purpose of the current study is to evaluate the impact of a self-instruction module on prenatal mothers' understanding about high-risk pregnancies. The study's pre-experimental research design was chosen. For this study, 63 prenatal mothers were chosen using the purposive sample method. Result: revealed that majority of the respondents (65.08%) had poor knowledge regarding high-risk pregnancy, (30.16%) had average knowledge and only (4.76%) had good level of knowledgepre-test. Whereas in post-test majority of the respondents (82.53%) had good knowledge and (17.46%) had average knowledge regarding high-risk pregnancy. The Paired‘t’ test value was 26.86 whichwas greater than table value at .05 level of significance. This shows that there is significant difference between the pre-test and post-test level of knowledge regardinghigh-risk pregnancyamong antenatal mothers. There was significant association found between the pre-test knowledge score regarding high-risk pregnancy among antenatal mothers with demographic variableslike educational status, type of family, previous knowledge and source of information regarding high-risk pregnancy. Conclusion: Study concluded with strong need for proper health education in improving knowledge regarding high-risk pregnancy among antenatal mothers.

Effectiveness of Planned Teaching Programme on knowledge regarding prenatal factors leading to mental disorders among prenatal mothers in selected areas of Bhopal

Effectiveness of Planned Teaching Programme on knowledge regarding prenatal factors leading to mental disorders among prenatal mothers in selected areas of Bhopal

Malaria Detection in Blood Smeared Images Using Convolutional Neural Networks

Abstract: With 200 million cases annually, malaria often claims more lives than crisis and deadly wars. Given the ineffectiveness of efforts to lower mortality rates, insufficient malaria diagnosis is one of the hurdles to a successful and efficient reduction in fatality. Hence, malaria is one of the major causes of deaths and diseases in many developing countries, where young children and prenatal mothers are the most impacted populations. The parasite called Plasmodium is the source for the potentially fatal disease named malaria. Highly trained and experienced microscopists observe minute blood smeared images to look for the parasite. Modern deep learning techniques could automate the completion of the required analysis. With the development of an independent, accurate, and useful model the demand for skilled staff can be significantly decreased. In this study, we offer a totally automated method and approach for the diagnosis and classification of malaria using microscopic blood-smeared pictures based on convolutional neural networks-(CNN).

Amino Acids, B Vitamins, and Choline May Independently and Collaboratively Influence the Incidence and Core Symptoms of Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a developmental disorder of variable severity, characterized by difficulties in social interaction, communication, and restricted or repetitive patterns of thought and behavior. In 2018, the incidence of ASD was 2.4 times higher than estimated in 2000. Behavior and brain development abnormalities are present in the complex disorder of ASD. Nutritional status plays a key role in the incidence and severity of the core symptoms of ASD. The aim of this study was to review the available peer-reviewed studies that evaluated the relationship between amino acids, choline, B vitamins, and ASD incidence and/or severity of symptoms. Through examining plasma profiles, urine samples, and dietary intake, researchers found that low choline, abnormal amino acid, and low B vitamin levels were present in children with ASD compared to those without ASD. The evidence supports the need for future research that implements simultaneous supplementation of all essential nutrients in individuals with ASD and among prenatal mothers. Future evidence could lead to scientific breakthroughs, ultimately reducing the rates of ASD incidence and severity of symptoms by applying nutritional interventions in at-risk populations.

The burden of soil-transmitted helminths infections among pregnant women in Maharashtra and Rajasthan states of India.

ABSTRACTContext:Soil-transmitted helminths (STH) infections are among the most common and widespread infections in developing countries where sanitation facilities are inadequate.Aims:This study aimed to estimate the prevalence of STH infections in prenatal mothers in two states in India.Settings and Design:A cross-sectional survey was conducted in Maharashtra and Rajasthan state of India. We randomly selected one municipal corporation and one rural block from a selected district in each state.Methods and Material:Out of 2400 contacted, 2206 pregnant women gave stool samples for microscopy for parasitological study. The response rate was 89.91%. Stool specimens were transported to an accredited lab and examined microscopically within 24 hrs.Results:Prevalence of STH was 8.34 (95%CI 7.22–9.57). The prevalence in rural and urban areas was 10.01% (95%CI 8.51–11.74) and 5.76% (95%CI 4.39–7.52), respectively. Ascaris lumbricoides (34.7%) were the most common, followed by Entamoeba histolytica (30.43%), and 20.1% were mixed infections. Higher age, walking barefoot, weight gain during pregnancy were significantly associated with STH (p < 0.05). The mean hemoglobin value in women with STH was significantly less (8.75 gm%; SD 4.04) compared to those without STH (10.23 gm%; SD 1.23) (p < 0.05), and average weight gain during pregnancy was significantly less among women with STH (3.80 kg; 4.11) compared to women without STH (8.45 kg; 2.83); (p = 0.000).Conclusion:The study provides valuable insights into the burden and intensity of STH in pregnant women that may support the policy recommendation for deworming during pregnancy.

Prenatal mother-father cortisol linkage predicts infant executive functions at 24 months.

The present study investigated associations between prenatal mother-father cortisol linkage and infant executive functions. Data come from an international sample (N = 358) of predominantly white and middle- to upper-class first-time parents. During late pregnancy, parents collected diurnal salivary cortisol samples and reported on levels of psychological stress. At 24 months, children completed a battery of executive function tasks. Parent cortisol linkage was operationalized as the time-dependent, within-dyad association between maternal and paternal diurnal cortisol. Results indicated that prenatal linkage was positively related to infant executive functions, suggesting that stronger mother-father cortisol linkage was associated with higher executive function scores. Additionally, this relation was moderated by paternal average cortisol levels such that executive function scores were lower when fathers had higher average cortisol levels and linkage was weak. This association suggests that elevated paternal cortisol amplifies the negative relation between lower cortisol linkage and lower infant executive function scores. Importantly, these findings were observed while controlling for observational measures of caregiving and self-report measures of psychosocial functioning and infant social-emotional behavior. These results suggest that prenatal linkage of mother's and father's stress physiology plays a potentially important part in programming and regulating infant neurocognitive development.

A New Exclusive Breastfeeding Booklet to Improve Self-Efficacy

Breastfeeding self-efficacy is defined as the mother’s belief in their ability to breastfeed the baby. Health education is important to increase the mother’s confidence. The purpose of this study was to test the effect of an exclusive breastfeeding booklet to increase breastfeeding self-efficacy in prenatal mothers until the postnatal period. This study was conducted using a quasi-experimental design. The results showed that providing a booklet for mothers increased self-efficacy towards exclusive breastfeeding with the mean after intervention was 60.97, p&lt;0.005. Our study suggests health care professionals provide health education and motivate mothers to improve their confidence with regards to breastfeeding for at least six months.&#x0D; &#x0D; Keywords: Breastfeeding self-efficacy, exclusive breastfeeding, health education

FAKTOR-FAKTOR YANG MEMPENGARUHI KEPATUHAN IBU HAMIL DALAM MENGKONSUMSI TABLET FE DI KECAMATAN MERAL BARAT KABUPATEN KARIMUN TAHUN 2017

It was documented that the incidence of anemia occured to 37.1% prenatal women in Indonesia. The higher rate moreover happened in Karimun district noted in 2016 reached 49.5% in which 35.1% cases happened in West Meral by Desember 2016. Hence, this study aims to determine the factors influencing the prenatal mothers compliance to take the fe tablet during the pregnancy. This research designed as an analytic survey research of cross sectional study approach. This study was conducted in West Meral dated from May to June 2017. As the population, the researchers took all third-trimester prenatal women, in which from all respondents, 43 respondents was taken as the sample through total sampling technique. The questionnaire was utilized as the research instrument where the data gathered further analyzed by univariate and bivariate Chi-Square statistical test. Based on the analysis, it is resulted 61.5% of prenatal women with good knowledge level routinely took the fe tablet, 58.6% mothers with negative attitude found not to take the fe tablet regularly, and 75% mothers whom did not get family support also not take the fe tablet frequently. These results portray that there no significant correlation of the knowledge level of the prenatal women compliance to their attitude and the family support in taking the fe tablet regularly during the pregnancy period. In the future, it is expected that the family to give their support to the prenatal mothers and also the health personnel to give advices about the important of the fe tablet during the pregnancy for both the mother and the infant.

ANALISA FAKTOR INDIKASI TINDAKAN SECTIO CAESAREA DI RUMAH SAKIT EMBUNG FATIMAH KOTA BATAM TAHUN 2016

The elevation rate on laboring with Sectio Caesarea (SC) procedures happens every year and according to WHO data during 2007-2008, there are 110,000 number of deliveries with SC in Asia. Regarding this issue, the concern on providing an accurate and proper treatments for performing the SC labors is to diminish the occurrence of the potential risks. This study aims to scrutinize the indication factors of the prenatal mothers with SC process of childbirth mainly at Embung Fatimah District Hospital of Batam in 2017. This study is a quantitative research using descriptive observational approach by taking the data from the patients’ Retrospective Medical Record. The data was gathered though survey method by completing the documentation forms. From the data record, it is found that 449 mothers (73.5%) have their delivery process with SC operation procedures. Further, the result reveals that the highest indication factor on SC is due to the previous labor by the SC as well which covers 80 respondents (17.82%), the second indication factor is the eclampsia risk with 78 respondents (17.37), and the baby position in the uterus with 66 respondents (14.70%). On the other hand, it is also discovered that there are other six indication factors such as mother’s self-request, Intrauterine Growth Restricted of the fetus (IUGR), mother with breast cancer, communicable disease, vacuum and hyperthyroid failure respectively happens to 1 prenatal mother or 0.22% of the total.

Marital Adjustment and Prenatal Breastfeeding Efficacy of First Time Mothers in A Low-Income Community in The Philippines

Introduction: All women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. This study aims to assess the level of marital satisfaction and its influence to prenatal breastfeeding self-efficacy in first time mothers during late pregnancy.Methods: A descriptive correlational was conducted among 128 simple randomized prim gravid women who agreed to participate and had prenatal care check-up in the health center at the time of data gathering. The instruments used were 15-item Marital Adjustment Test (MAT) to measure marital adjustment and 14-item Breastfeeding Self efficacy Scale-Short Form (BSES-SF) as a measure of breastfeeding self-efficacy. Pearson’s correlation coefficient was utilized to test the relationships between the sample’s marital adjustment scores to correlate with BFSE of the respondents. Fisher’s t test was utilized to determine the significance of correlations. A p-value of equal to or less than .05 was considered statistically significant.Results: The study revealed that the sampled mothers have a high level of marital adjustment score (112.05± 21.83). Prenatal mothers responded in the study were highly confident and have high self-efficacy in breastfeeding first child currently bearing (4.55±.51). Lastly, it was found that there is no significant correlation between marital adjustment and prenatal breastfeeding self-efficacy (β=-.052, p-value=.280).Conclusion: It was found that there is a high level of marital adjustment and breastfeeding self-efficacy among sampled mothers. However, there is no significant correlation between marital adjustment and prenatal breastfeeding self-efficacy. The study suggests incorporating co-parenting intervention involving father’s involvement and assistance with breastfeeding when creating interventions in breastfeeding.

PENGARUH SENAM HAMIL TERHADAP TINGKAT KECEMASAN PADA IBU PRENATAL TRIMESTER III DI RSIA CAHAYA BUNDA

Background: Anxiety is a feeling of discomfort, a feeling of fear caused by anticipation of danger. The impact of anxiety is bad for mother and fetus, so it needs to do intervention for resolving the anxiety. Pregnant gymnastics is one way to reduce anxiety in pregnant women. The purpose of this study knowing the effect of pregnancy exercise on the level of anxiety in prenatal mothers in the third trimester at the RSIA Cahaya Bunda Gerokgak Tabanan.Method: The desaign used the pre-experimental design of one pretest posttest group, the research subjects were prenatal mothers in the third trimester, with non probability sampling used a purposive sampling method. The research instrument with the HARS questionnaire. Statistical tests used the Wilcoxon Test, with a confidence level of 95% and p &lt;0.05.Results: The results of the pretest were moderate anxiety of 63.3% and severe anxiety 36.7%, after the intervention, the results of the posttest score were mild anxiety (60.0%), no anxiety (36.7%) and moderate anxiety (3.3%). The Wilcoxon analysis test results get a value of ? = 0,000 and the value of ? is smaller than ? (5%) or 0.05, it means there is a significant effect of pregnancy exercise on the level of anxiety in prenatal mothers in the third trimester.Conclusion: There was a decrease in the level of anxiety before the intervention was given and after the intervention was given, so that there was the influence of pregnancy exercise on the anxiety level of prenatal pregnant women in the third trimester. Keywords: Anxiety leve;, Pregnant gymnastic; Prenatal in the third trimester

HUBUNGAN PENGETAHUAN DAN PERILAKU BIDAN PRAKTEK MANDIRI TERHADAP PELAKSANAAN KELAS IBU HAMIL DI WILAYAH KERJA PUSKESMAS BATU AJI KOTA BATAM TAHUN 2017

One of the Indonesian government programs organized by the Ministry of Health is the pregnancy class for prenatal mothers attempted to enhance their knowledge as well as to change the attitude toward the childbirth process. The most common activity in a pregnancy class is discussing their guide book on delivery process. The purpose of this study to determine the correlation of the independent midwives’ knowledge levels and attitude on their pregnancy classes performance, mainly the ones at the service area of Batu Aji Health Center. As the research design, the researchers used cross-sectional approach to investigate 41 independent midwives as the respondents. The data was analyzed by Chi-Square statistical test. The result presents that 39% midwives have lack of knowledge on conducting the pregnancy class and 41.5% of them show less appropriate attitude on guiding the pregnancy class, besides, it is also found that 20% the performance of the pregnancy class they handled is still low. The Chi-Square test obtains the correlations by p-value = 0.017 for knowledge of the midwives and the class performance and p-value = 0.000 for the attitude of midwives and the class performance. Therefore, based on the findings, it can be concluded that the pregnancy classes handled by the independent midwives are considered to have low quality standard. For this reason, it is suggested that the independent midwives have to boost and advance their knowledge as well as attitude in coaching the pregnancy class in the future to be better.

Outcome of large- and small-for-gestational-age babies born to mothers with pre-pregnancy and gestational diabetes mellitus versus without diabetes mellitus

Introduction: The prevalence of diabetes mellitus (DM) is on the increase among general population and prenatal mothers. The feto-maternal outcome of mothers with DM varies with the type of DM, pre-pregnancy or gestational (PPDM and GDM), and glycemic control. Objective: The objective of this study is to assess the outcome of small- and large-for gestational-age (SGA and LGA) babies born to a cohort of mothers with PPDM and GDM and without DM. Materials and Methods: This cohort study was conducted in a tertiary care teaching hospital. A total of 480 mothers and their newborn babies were enrolled before 6 weeks of gestation and were categorized into PPDM, GDM, and no DM subgroups. Mothers were managed as per the standard protocols. Parameters observed were optimum/suboptimum glycemic control, neonatal weight, GA, morbidity, mortality, and neonatal intensive care unit (NICU) stay. Results: A total of 19.5% mothers had PPDM, including 70 mothers already diagnosed as DM, while 39% had GDM and 41.5% had no DM. The detection rate of PPDM was 5.6% and GDM was 17.5%. Majority of the mothers with PPDM and GDM required insulin and two-third had optimum glycemic control. Good glycemic control resulted in more appropriate-for-GA babies. SGA babies were more in PPDM group (54%), followed by GDM (26%) and non-DM (21%) subgroups, while LGA babies were less in these groups, i.e., 9.6%, 5.9%, and 0.5%, respectively. The following observations were statistically significant among PPDM compared to GDM: SGA (relative risk [RR] 2.1, 95% confidence interval [CI] 2.9–3.6), congenital anomalies (RR 3.3, 95% CI 5.1–8.8), and neonatal mortality (RR 4, 95% CI 2.1–3.2). Prematurity and NICU admission with longer stay were also more in PPDM. Macrosomia and birth injury were more in GDM. Hypoglycemia, longer NICU stay, and macrosomia were more with poor glycemic control. Conclusions: A change in profile with more SGA and less LGA babies was noted in this study. Differential short-term outcomes were noted, based on the onset of DM and glycemic control. Pre-pregnancy/early first-trimester screen followed by second and third trimester screens and optimum glycemic control, throughout pregnancy, is recommended.

Come and Knock on Our Door: Offenders’ Perspectives on Home Visits Through Ecological Theory

The use of home visits has a long and storied history in the United States from different disciplines, such as nursing, prenatal mothers, young families, health promotion, and community corrections. Ecological theory explains how formal actors play a role in the promotion in the health field through home visits, but does not address community corrections home visits. Through the use of 30 semi-structured interviews, this research seeks to expand the understanding of ecological theory by capturing the perceptions of offenders sentenced to home visits conducted by a sheriff's office. The findings suggest the participants supported the home visits by formal agents and, in general, the home visits created an atmosphere of respect between the participants and sheriff's office personnel. This study creates the context for future research to understand the role of formal agents in recidivism and evaluate the efficacy of home visits by community corrections agencies.

Short article: Hepatitis B virus status in children born to HIV/HBV coinfected women in a French hospital: a cross-sectional study.

We assessed hepatitis B virus (HBV) status in children born to HIV/HBV coinfected women with large access to antiretroviral therapy. All HIV/HBV coinfected pregnant women from 01 January 2000 to 01 January 2012 were included in the retrospective study (NCT02044068). Antiretroviral therapy during pregnancy and injection of HBV immunoglobulin/vaccine to newborns was recorded. We assessed HBV status of children aged at least 2 years. Twenty-one women (35 children) were studied. Twenty-six children (74%) had HBsAb: 22 had received immunoglobulin and 24 had received a complete vaccine (with immunoglobulin in 21 cases); their mothers had been administered lamivudine or tenofovir/emtricitabine during eight and nine pregnancies, respectively. Eight children (23%) were negative for HBsAg, HBsAb, and HBcAb: four (11.5%) had received immunoglobulin and a complete vaccine; in two children, it was not known whether they had received an immunoglobulin injection; in one child, the vaccine was incomplete; and in the last one, it was not known whether he had received immunoglobulin/vaccine. Their mothers had been administered lamivudine or tenofovir/emtricitabine during five and two pregnancies, respectively. No infant has chronic HBV infection (HBsAg) after prenatal mothers' antiretroviral therapy combined with a complete postnatal HBV protection. One child had HBcAb and HBsAb: it was not known whether she had received an immunoglobulin injection; the vaccine was incomplete. The mother had been administered lamivudine during the last trimester of pregnancy. Antiretroviral therapy in HBV/HIV coinfected women following current national HBV guidelines may prevent mother-to-child-transmission of HBV. Negativity of surrogate markers of vaccine-induced protection is frequent; large studies on long-term protection are needed.

An Israeli study of family expectations of future child temperament

Early emerging child temperament forms the basis for adult personality and has a multitude of developmental implications. Studies have shown that some aspects of temperament can be observed prenatally, and prenatal parent ratings predict postnatal child temperament, thereby influencing future family dynamics. Little research has examined prenatal mother–father agreement on predictions of temperament, or patterns of cross-dimension associations before birth. Parental expectations of their future child’s temperament were investigated in a sample of pregnant Israeli women and their partners. Three modified temperament questionnaires were used to investigate mother–father agreement and associations between temperament dimensions. There were few significant mean differences between mothers’ and fathers’ expectations of child temperament. Parent agreement within temperament dimensions, and associations across dimensions were consistent with the postnatal literature. Findings indicate that parent impressions of ...

Exploring the focus of prenatal information offered to pregnant mothers regarding newborn care in rural Uganda

BackgroundNeonatal death accounts for one fifth of all under-five mortality in Uganda. Suboptimal newborn care practices resulting from hypothermia, poor hygiene and delayed initiation of breastfeeding are leading predisposing factors. Evidence suggests focused educational prenatal care messages to mitigate these problems. However, there is a paucity of data on the interaction between the service provider and the prenatal service user. This study aims to understand the scope of educational information and current practices on newborn care from the perspectives of prenatal mothers and health workers.MethodsA qualitative descriptive methodology was used. In-depth interviews were conducted with lactating mothers (n = 31) of babies younger than five months old across Masindi in western Uganda. Additional interviews with health workers (n = 17) and their employers or trainers (n = 5) were conducted to strengthen our findings. Data were audio-taped and transcribed verbatim. A thematic content analysis was performed using NVivo 8.ResultsVertical programmes received more attention than education for newborn care during prenatal sessions. In addition, attitudinal and communication problems existed among health workers thereby largely ignoring the fundamental principles of patient autonomy and patient-centred care. The current newborn care practices were largely influenced by relatives’ cultural beliefs rather than by information provided during prenatal sessions. There is a variation in the training curriculum for health workers deployed to offer recommended prenatal and immediate newborn care in the different tiers of health care.ConclusionsFindings revealed serious deficiencies in prenatal care organisations in Masindi. Pregnant mothers remain inadequately prepared for childbirth and newborn care, despite their initiative to follow prenatal sessions. These findings call for realignment of prenatal care by integrating education on newborn care practices into routine antenatal care services and be based on principles of patient-centred care.

The epidemiologic study of premature infant brain injury diagnosed by magnetic resonance imaging

Backgound: Perinatal brain development undergoes dramatically changing in human life. Multiple insults in perinatal period such as hypoxia or and ischemia, infection and inflammation often cause different severity and patterns of brain injury such as ischemic injury or hemorrahgic injury. To explore the epidemiological rule and correlated risk factors of premature infant with brain injury we used MRI findings to define the diagnosis of brain injury. Methods: The study was prospectively performed on 358 preterm infants from 2008 to 2011at the neonatal intensive care unit of Shengjing Hospital of China Medical University. Detailed Clinical data of all subjects were recorded including: gender, gestation age, birth weight, and the following risk factors: precipiate labor, pregnancy-induced hypertension, fetal distress, multiple pregnancy, prenatal infection, placental abruption, placental previa, gestational diabetes mellitus, prenatal seroid administration, magnesium sulfate, resuscitation history, circulatory disorder, vaginal delivery, early-onset sepsis, mechanical ventilation, blood gas analysis(metabolic acidosis, hyperkalemia, hyponatremia and hypocalcemia). Conventional MRI and diffuse-weighted imaging (DWI) were performed iin 358 preterm infants using 3.0 Tesla MRI scanner. The infants were sedated for imaging with chloral hadrate (50mg/kg). Seriously ill intubated newborn infants were monitored by clinician during scanning and hand-ventilated, and pulse oximetry and electrocardiography were monitored during the procedure. The study protocol were approved by the ethic committee of our university and consented by their parents. All MRI scans were assessed by two radiologists who blinded to neonatal clinical data. The premature infants with brain injury were classified into two groups according to MRI findings: hemorrahgic brain injury and non-hemorrahgic injury (white matter damage). Statistic analyses were performed using SPSS (version 11.5). All data were described as mean±standard deviation. Students't test was used to evaluate the difference in numerical variables. The significance of the difference between premature infants with and without brain injury was tested using the Chi-square test. A logistic regression analysis was performed on factors which found to be significant in univariate analysis. A probability value of P<0.05 was considered statistically significant. Results: There were 128 premature infants with hemorrahgic brain injury (70.7%), and 96 with WMD (53.0%); 43 premature infants with hemorrahgic brain injury complicated with WMD. (23.7%). 21 risk factors were analyzed. Univariate analysis: precipitate labor (X 2=5.295, P=0.021), twin (X2 =4.576, P=0.003), prenatal infection (X2=7.922, P=0.005), circulatory disorder (X2 =5.710, P=0.0017), vaginal delivery (X2=53.624, P=0.000), metabolic acidosis (X2 =13.594, P=0.001), hyponatremia (X 2 =11.691, P=0.001), hypocalcemia (X2 =12.805, P=0.000) for premature infants with hemorrahgic brain were considered statistically significant; prenatal infation (X 2 =5.628, P=0.018), gestational diabetes mellitus (X 2=14.944, P=0.001), magnesium sulfate (X2 =9.248, P=0.002), resuscitation (X 2=6.362, P=0.012), circulatory disorder (X 2=6.341, P=0.012), vaginal delivery (X2 =17.029, P=0.000), metabolic acidosis (X2 =14.944, P=0.001), hyponatremia (X2 =20.242, P=0.000), hypocalcemia (X2 =32.595, P=0.000) for premature infants with WMD were considered statistically significant. Logistic regression analysis: prenatal infection (OR=4.738, 95% CI: 1.201, 18.685, P<0.05), vaginal delivery (OR=9.191, 95% CI: 4.699, 17.979, P<0.05), hyponatremia (OR=3.331, 95% CI: 1.506, 7.366, P<0.05) and hypocalcemia (OR=3.162, 95% CI: 1.325, 7.545, P<0.05) were risk factors for premature infants with hemorrhagic brain injury. Maternal diabetes mellitus(OR=5.211, 95% CI: 1.272, 21.341, P<0.05), vaginal delivery (or=3.078, 95% CI: 1.824, 5.194, P<0.05), hyponatremia (OR=3.331, 95% CI: 1.506, 7.366, P<0.05) and hypocalcemia (OR=4.713, 95% CI: 2.412,9.209, P<0.05) were risk factors for premature infants with WMD. While the prenatal use of magnesium sulfate (OR=0.375, 95% CI: 1.183, 0.766, P<0.05) was an its protective factor. In addition, we did not find the WMD prevalence difference between the premature infants with gestation age less than 34 weeks and the late preterm infants, even the severe diffusive WMD was not unusually found in the late premature infants. Early widespread and diffusive WMD on MRI-DWI often evolved into cystic PVL. Conclusions: Intrauterine exposure including prenatal mother suffering from infection, diabetes mellitus, pattern of delivery and postnatal electrolytes disturbance may contribute to premature brain injury. Prenatal magnesium administration could protect brain from insults. Hierarchy WMD in the premature infants may depend on the severity of insults, but not only on the brain developmental maturation.

What we learnt ‑ recruiting prenatal mothers to an RCT addressing the prevention of overweight in early childhood?

Objective: To identify and explore the experiences of recruiting prenatal women into a randomised control trial which involves a family‑focused early intervention program addressing the prevention of overweight and obesity over the first two years of life. Design: A number of open‑ended brainstorming sessions allowed the research nurses to self reflect on their recruitment experiences. These sessions were used to explore factors that impacted on recruitment. Setting: Recruitment for the trial took place in the antenatal clinics of two hospitals in south west Sydney (NSW Australia) from March 2007 ‑ March 2008 one of the most socially and economically disadvantaged areas of Sydney. Main Outcome measures: To gain insight into the issues surrounding recruitment of prenatal women and to identify the main themes that facilitated or impeded recruitment. Results: Findings suggested that recruitment to a randomised control trial in the prenatal period resulted in particular barriers. Three theme clusters were identified; engaging participants, content of informational material and organisational issues. Conclusion: Fostering stronger communication between research staff and clinical staff would have enabled easier identification of the target group and having access to the target population at earlier stages of pregnancy would have been beneficial. Recommendation: Having a rigorous recruitment plan, and evaluating recruitment strategies in future studies of this nature, would be central to understanding why prenatal women involve themselves in research trials. Obtaining the assistance of clinical and administration staff with recruitment strategies would also be strongly recommended.