Prevention Of Pregnancy Complications Research Articles

The association between dietary habits and self-care behavior of pregnant women with pregnancy complications

Pregnancy as a sensitive period has a critical effect on the mother and infant's life. It is well understood that dietary habits and mother awareness can improve health status and prevent pregnancy complications such as gestational diabetes, pre-eclampsia, and nausea and vomiting. The current study was conducted to investigate the association between dietary habits and self-care behaviors with pregnancy complications. This cross-sectional study was conducted across 300 pregnant women in their third trimester referred to healthcare centers and Yas hospital in Tehran, Iran. Dietary habits and self-care behaviors were assessed by valid and reliable questionnaires. Dietary intake and physical activity were evaluated using valid and reliable Food Frequency Questionnaires and Pregnancy Physical Activity questionnaires, respectively. Women with self-care behaviors had a lower rate of pre-eclampsia (P = 0.9). Regarding food habits, pregnant women who ate their meals faster had a non-significantly higher rate of gestational diabetes and pre-eclampsia. Pregnant women who consumed red meat on a daily frequency had a significantly higher rate of nausea and vomiting (OR 1.85; 95% CI 1.05–3.28, P = 0.03). Also, there was a significant positive association between the mother's pre-pregnancy BMI and gestational diabetes and pre-eclampsia [(OR 2.03; 95% CI 1.03–3.98, P = 0.03) and (OR 4.23; 95% CI 1.12–16.0, P = 0.03) respectively]. There was no significant association between pregnant women's dietary habits and GDM and pre-eclampsia. However, pregnant women with pre-pregnancy overweight and obesity had increased odds of gestational diabetes and pre-eclampsia significantly.

Literacy on Pregnancy Complications: Causal Factors and Prevention

Purpose: This study investigates the role of maternal health literacy in preventing pregnancy complications and evaluates the effectiveness of various educational interventions designed to enhance health literacy. Research Design and Methodology: Utilizing a quantitative design, this research involved pre-and post-tests to measure changes in knowledge, skills, and attitudes among diverse demographic participants. Participants were divided into control and experimental groups. Educational interventions were implemented, including prenatal classes, online courses, and community workshops. Data were collected through surveys and analyzed using statistical methods. Findings and Discussion: The study revealed a significant correlation between increased health literacy and reduced pregnancy complications such as pre-eclampsia, gestational diabetes, and preterm labor. This positive correlation underscores the potential for improved maternal and child health outcomes. Educational interventions significantly enhanced health literacy, with different models showing varied effectiveness based on accessibility and engagement. These findings align with the Health Belief Model and Self-Determination Theory, reinforcing the positive impact of health literacy on maternal and child health outcomes. Implications: The research underscores the importance of tailored educational interventions in promoting maternal and child health. Policymakers and healthcare providers should prioritize developing comprehensive, accessible, culturally sensitive health education programs. Addressing socio-economic disparities and providing continuous support is crucial to ensuring that all mothers and children have equal access to healthcare and can benefit from improved health literacy. Future research should explore long-term impacts and innovative educational technologies to enhance maternal health outcomes further.

Virtual pregnancies: predicting and preventing pregnancy complications with digital twins

Virtual pregnancies: predicting and preventing pregnancy complications with digital twins

COVID-19 Vaccination in the First Trimester and Major Structural Birth Defects Among Live Births

COVID-19 vaccination is recommended throughout pregnancy to prevent pregnancy complications and adverse birth outcomes associated with COVID-19 disease. To date, data on birth defects after first-trimester vaccination are limited. To evaluate the associated risks for selected major structural birth defects among live-born infants after first-trimester receipt of a messenger RNA (mRNA) COVID-19 vaccine. This was a retrospective cohort study of singleton pregnancies with estimated last menstrual period (LMP) between September 13, 2020, and April 3, 2021, and ending in live birth from March 5, 2021, to January 25, 2022. Included were data from 8 health systems in California, Oregon, Washington, Colorado, Minnesota, and Wisconsin in the Vaccine Safety Datalink. Receipt of 1 or 2 mRNA COVID-19 vaccine doses in the first trimester, as part of the primary series. Selected major structural birth defects among live-born infants, identified from electronic health data using validated algorithms, with neural tube defects confirmed via medical record review. Among 42 156 eligible pregnancies (mean [SD] maternal age, 30.9 [5.0] years) 7632 (18.1%) received an mRNA COVID-19 vaccine in the first trimester. Of 34 524 pregnancies without a first-trimester COVID-19 vaccination, 2045 (5.9%) were vaccinated before pregnancy, 13 494 (39.1%) during the second or third trimester, and 18 985 (55.0%) were unvaccinated before or during pregnancy. Compared with pregnant people unvaccinated in the first trimester, those vaccinated in the first trimester were older (mean [SD] age, 32.3 [4.5] years vs 30.6 [5.1] years) and differed by LMP date. After applying stabilized inverse probability weighting, differences in baseline characteristics between vaccinated and unvaccinated pregnant persons in the first trimester were negligible (standardized mean difference <0.20). Selected major structural birth defects occurred in 113 infants (1.48%) after first-trimester mRNA COVID-19 vaccination and in 488 infants (1.41%) without first-trimester vaccine exposure; the adjusted prevalence ratio was 1.02 (95% CI, 0.78-1.33). In secondary analyses, with major structural birth defect outcomes grouped by organ system, no significant differences between infants vaccinated or unvaccinated in the first trimester were identified. In this multisite cohort study, among live-born infants, first-trimester mRNA COVID-19 vaccine exposure was not associated with an increased risk for selected major structural birth defects.

Factors Affecting The Incidence of Anemia in Pregnancy During The COVID-19 Pandemic

Anemia during pregnancy carries the risk of premature birth, low birth weight, and fetus malformations and can impose additional costs on society and families. The prevalence of anemia would be the best indicator to monitor pregnant women’s health and prevent pregnancy complications. The COVID-19 pandemic has impacted pregnant women. The prevalence of anemia in pregnancy increased from 38.33% in 2019 to 49.21% in 2020. In the COVID-19 pandemic situation with social activity restrictions, decreasing family income, and limited access to health services, suffering from COVID-19 are risk factors for increasing the incidence of anemia in pregnancy. This study aimed to determine factors affecting the incidence of anemia in pregnancy during the COVID-19 pandemic in Karangrejo District, Magetan Regency. This study was an observational analytic study with a cross-sectional study design. The sample was selected by purposive sampling with a sample size of 52 study subjects. Data were analyzed using logistic regression analysis with SPSS. Factors that increased the incidence of anemia in pregnancy during the COVID-19 pandemic were pregnancy interval (OR=17.67; CI 95%= 1.01 to 116.00; p=0.049), gestational age (OR=11.39; CI 95% 1.12-116.00; p= 0,040), animal protein intake (OR= 0.25; CI 95% 0.03 – 2.38; p= 0,044), iron supplementation (OR= 108.47; CI 95% 2.36 – 4978.68; p= 0,016), consumption of tea (OR=36,89; CI95% 1.57 to 868.41; p=0.025). Mothers’ education, family income, parity, frequency of ANC visits, and COVID-19 morbidity do not significantly affect the incidence of anemia in pregnancy. There were effects of pregnancy interval, gestational age, animal protein intake, iron supplementation, and consumption of tea on the incidence of anemia in pregnancy during the COVID-19 in Karangrejo District, Magetan Regency. Keywords: anemia;pregnancy;COVID-19

PEMBERDAYAAN KELOMPOK SUAMI SIAGA PADA PERILAKU PERAWATAN KEHAMILAN (ANC) UNTUK PENCEGAHAN KOMPLIKASI KEHAMILAN USIA DINI DI WILAYAH PUSKESMAS BUKIT RAWI

Teenage pregnancy (early age) is one of the important problems in the 21st century. There are more than 16 million children in the world born to mothers aged 15-19 years. Indonesia is one of the regions with the highest presentation of early marriage in the world with a rank of 37 and the second highest in ASEAN. Central Kalimantan Province is ranked second in early pregnancy, with an increasing incidence of pregnancy complications based on data reported by one of the Referral Hospitals in Central Kalimantan Province. The evaluation was carried out using questionnaires on knowledge in the prevention of pregnancy complications. There was an increase in husbands' knowledge after empowerment, before empowerment was carried out there were 2 people (10%) in the good category, 12 people (60%) in the sufficient category and there were 8 people (30%) who were included in the less category. After the formation of the standby husband group, there was an increase in knowledge in the good category of 17 people (85%), in the sufficient category of 2 people (10%) and in the category of less than 1 person (5%). Husband empowerment can increase husband's knowledge in early detection of pregnancy complications. The establishment of an early pregnancy pregnancy alert group requires monitoring and supervision from the Puskesmas Bukit Rawi.

EVALUATION OF LIPID AND THYROID STATUS IN PREGNANCY AND ITS EFFECT ON NEONATAL OUTCOME

Objective: Maternal nutritional status is essential for the achievement of maternal and fetal growth. Blood lipid concentrations have been associated with adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension, and high birth weight. As blood lipids are not routinely measured during pregnancy, there is limited information on what is considered normal during pregnancy. In early pregnancy, there is an increase in fat buildup associated with increased fat concentration in blood, lipoprotein, and apolipoprotein in plasma increased significantly during pregnancy. This study was aimed at the analysis of lipid profile and thyroid profile in second- and third-trimester pregnant women, with the incidence of hypertension and their possible effect on neonatal outcome. Methods: Blood samples were collected from the Beri Maternity Hospital, Amritsar, and were analyzed for biochemical investigation, namely lipid profile and thyroid profile. Results: The levels of total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very LDL have been significantly increased in third-trimester pregnant women as compared to second-trimester pregnant women. However, the level of HDL diminished in the third trimester as compared to the second trimester. Thyroid-stimulating hormone (TSH) levels increased in third-trimester pregnant women. Conclusion: Our findings highlighted the importance of maternal lipid metabolism in preventing pregnancy complications and adverse birth outcomes as human gestation is associated with an “atherogenic” lipid profile which could act as a potential risk factor for pre-eclampsia and endothelial cell dysfunction if further enhanced than the normal limits. Increased blood lipid concentrations during pregnancy are altered by maternal body mass index. This study will help in understanding baseline lipid parameters in the second and third trimesters among pregnant women. Excessive dietary nutrition intake and inadequate physical activity during pregnancy may be important contributors of dyslipidemia which can lead to complications.

Визначення особливостей перебігу вагітності та пологів, стану плода і новонародженого у вагітних після застосування допоміжних репродуктивних технологій (дані ретроспективного аналізу)

The rapid growth in the number of infertile couples leads to the development of assisted reproductive technologies (ART). Among the most common forms of infertility are tubo-peritoneal, endocrine, and caused by the male factor, and prevention of pregnancy complications caused by ART treatment cycles becomes one of the main tasks of practicing clinicians. Purpose - to determine the features of the course of pregnancy and childbirth; to assess the condition of the fetus and newborn in pregnant women after the application of ART to improve the perinatal outcomes of pregnancy and childbirth. Materials and methods. A retrospective clinical and statistical analysis of 334 histories of pregnancy and childbirth of women, as well as medical records of newborns from women, was conducted over the past five years, which formed the ART group - 221 history of pregnancy and childbirth, and the group of spontaneous pregnancy - 113 history of pregnancy and childbirth. Results. The structure of the subjects was statistically significant dominated by pregnant women over the age of 35 years and pregnant women in late reproductive age. The main characteristics of women after the ART application were a statistically significant predominance of somatic and gynecological pathology. The structure of pregnancy complications in women after ART application was dominated by threatening late spontaneous miscarriages, isthmic-cervical insufficiency and vaginitis, and in the structure of labor complications - anomalies of labor activity and premature rupture of fetal membranes. Among newborns from women in the ART group, perinatal mortality was 18.0%. Conclusions. The revealed features of somatic and gynecological anamnesis, as well as aspects of the course of pregnancy and childbirth and the condition of newborns in women after ART application are the basis for an in-depth examination of this category of pregnant women in order to improve approaches to predicting, diagnosing and optimizing preventive measures, as well as to improve the perinatal consequences of pregnancy and childbirth. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. No conflict of interests was declared by the authors.

PEMANFAATAN BUKU KIA OLEH IBU HAMIL DALAM UPAYA PENCEGAHAN KOMPLIKASI KEHAMILAN DI PUSKESMAS MURUNG PUDAK

Every day there are 830 women die from preventable causes related to pregnancy and childbirth. The preliminary study found 21 pregnant women with complications, there were 10 pregnant women who did not know how to overcome pregnancy complications and there were 11 pregnant women who did not understand what to do in the event of an obstetric emergency, even though it was all in the MCH book they had. The purpose of the study was to determine the use of maternal and child health books (MCH) by pregnant women in an effort to prevent pregnancy complications at the Murung Pudak Health Center in 2022. This research method is with descriptive-analytical methods. The design or design used in this study is a cross-sectional study research design. The results of the research in the category of Maternal Knowledge About the Utilization of MCH Books were obtained from 37 respondents, 34 respondents (91.9%) with the Good Category, 3 respondents (8.1%) with the Sufficient Category while the less category did not exist in terms of knowledge of the use of MCH books in efforts to prevent pregnancy complications.

An interpretation for Chinese expert consensus on how to manage pregnant women of advanced maternal age with scarred uterus

Deferral of marriage and child-bearing age as well as high occurrence of uterine surgery history such as cesarean section and myomectomy in women who are about to have babies are challenging obstetrical health care worldwide, since pregnancy at advanced maternal age and pregnancy with scarred uterus are both high-risk pregnancy. In China, one-child policy had been implemented for three decades and contributes to high cesarean section rates. With family planning policy turning to two and three-child, there are rising pregnancy at advanced maternal age with scarred uterus. A clinical management scheme can help obstetricians a lot to assess risks, prevent pregnancy complications and manage pregnancy in an organized manner. However, there are insufficient studies on relevant clinical issues for the specific population, and there is no consensus or practice guidelines until now. We have developed Chinese expert consensus based on our pioneering research findings on the prevention and treatment strategy for major pregnancy complications in women of advanced maternal age. We formulate the consensus comprising general management scheme to standardize clinical care, practical risk scoring systems to early warn major pregnancy complications, and nationwide expert recommendations to be in accordance with evidence-based appraisal method. Consecutive supervision along with stratified management are highly emphasized. We interpret the consensus containing up-to-date literature review, research findings interpretation and most concerned questions discussion. This consensus interpretation helps standardize how to manage pregnant women of advanced maternal age with scarred uterus and improve the maternal-fetal outcomes.

Epidemiological description of the risk factors for obstetric emergencies in cross-referral cases at Dr. Soetomo Regional Public Hospital during the COVID-19 pandemic from 2020 to 2021

Link Of Video Abstract: https://youtu.be/zIVTZc6xl_8 Introduction: Emergency obstetric referrals are crucial for preventing pregnancy complications that may escalate into severe, life-threatening conditions, ultimately resulting in fatalities. The pandemic influenced the obstetric referral system of healthcare services. Specifically, Dr. Soetomo Regional Public Hospital recorded 107 cross-referral cases in 2020 and 58 in 2021 with obstetric risk factors. In this study, we analyze these obstetric emergency cross-referral cases during the pandemic at the hospital. This study aims to provide an epidemiological description of cross-referral cases with risk factors for obstetric emergencies at Dr. Soetomo Regional Public Hospital during the COVID-19 pandemic from 2020 to 2021. Methods: An analytical descriptive research design, employing a case study approach, was used to analyze cross-referral cases with risk factors for obstetric emergencies over the pandemic period. The research subjects encompassed all obstetric emergency cross-referral cases at Dr. Soetomo Regional Public Hospital during the pandemic, with a total sampling technique applied to select cases that met specific inclusion and exclusion criteria. Results: The analysis of emergency obstetric referrals revealed a significant relationship between the patient’s age and their risk factor categories for obstetric emergencies (p &lt; 0.001). Furthermore, a significant correlation was found between the delayed referral phases and the risk factors for obstetric emergencies (p &lt; 0.001). A significant correlation was observed concerning the need for Intensive Care Unit (ICU) care. The analysis also demonstrated a significant relationship between obstetric emergencies and birth weight as well as APGAR score (p &lt; 0.05). Conclusion: This study reveals a compelling relationship between the risk factors for obstetric emergencies and the variables such as age, methods of vaginal delivery, delayed referral phases, birth weights, and APGAR scores during the COVID-19 pandemic.

Telehealth Improves Pregnancy Health Care: Literature Review

In Southeast Asia, Indonesia has the highest maternal mortality rate. The Indonesian government has made a policy of limiting the visits of pregnant women during the COVID-19 pandemic. Telehealth is a solution that is widely used to facilitate health services during a pandemic and to develop applications that support prenatal health care. This research is a literature review. The electronic databases used are PubMed, Proquest, Cochrane Library, Clinical Key, and BJOG. Research topic: telehealth in pregnancy, publications 2017–2022, full text available. The MeSH terms “telehealth,” “pregnancy apps,” “mobile health,” “mHealth,” and “eHealth” were employed.. The results of database extraction were obtained for 12 articles from 396 articles. Telehealth improves antenatal care visits, compliance, knowledge, and readiness for childbirth. This review highlights the lack of evidence-based research in developing telehealth to prevent pregnancy complications.

Knowledge about Nutrition and Testing Gestational Hypertension in Multiple Pregnancies

Background: Hypertensive disorders in pregnancy (HDP) are a leading contributor to maternal, fetal, and newborn death all over the world, including in Indonesia. Routine pregnancy check-ups and nutritional status can prevent pregnancy complications due to HDP.Objective: To increase health workers’ knowledge about the importance of blood pressure check-ups and adequate nutrition during multiple pregnancies.Methods: The PKM material was delivered through online seminars with 20 employees and their families at Asri Medical Center Hospital. The material provided included knowledge about women's health, multiple pregnancies, nutrition for pregnant women, as well as hypertension in pregnancy, and their management. Pretest and posttest was conducted. The analysis method used Wilcoxon Signed Rank test.Results: The analysis showed a 25% increase in knowledge from the results of the pretest of 75% to a total of 100% at the time of the posttest (p &lt; 0.05), which suggests that there is a difference in the respondents’ knowledge levels about the importance of nutrition and examination of hypertension in multiple pregnancies.Conclusion: There is a significant difference in knowledge about the importance of nutrition and examination of hypertension in multiple pregnancies before and after the seminar at AMC Muhammadiyah Hospital.

Relationship between gestational weight gain during different phases and maternal complications or neonatal outcomes.

Improper gestational weight gain (GWG) causes many adverse obstetrical and neonatal outcomes. This study evaluates the relationship between weight gain in different phases and maternal outcomes or neonatal outcomes. Finally, this study recruited 2,608 women delivered at Fujian Provincial Maternity and Child Health, affiliated hospital of Fujian Medical University from December 2017 to January 2019. To evaluate the relationship between maternal outcome and neonatal outcome, the participants were divided into four groups based on their baseline BMI and weight gain in the second/third trimester of pregnancy. This study demonstrated that neonate weight, small-for-gestational-age infants, macrosomia, neonatal death, cesarean delivery, and GDM significantly differed across the baseline BMI, weight gain in the second and third trimester. The umbilical cord's abnormality, bulging membrane, abruptio placentae, and postpartum hemorrhage were significantly related to baseline BMI. Furthermore, gestational hypertension and pre-eclampsia/eclampsia were significantly correlated with baseline BMI and weight gain in the second trimester. The maternal and infant outcomes are different, and the GWG curves are significantly different. Finally, multivariate regression analysis showed that baseline BMI and weight gain in the second/third trimester were the independent risk factors for GDM and macrosomia. Also, baseline BMI and weight gain in the third trimester were the independent risk factors for developing gestational hypertension and pre-eclampsia/eclampsia, respectively. The baseline BMI and weight gain in the second/third trimester are significant with maternal outcomes and neonatal outcomes to a varying degree. Thus, maintaining appropriate baseline BMI and weight gain in different phases are essential in preventing pregnancy complications and maternal and neonatal prognosis.

The effectiveness of CRP and leukocyte examinations as a detection of risk factors for pre-eclampsia in pregnant women

Introduction: Preeclampsia is an important problem in obstetrics because it is a pregnancy complication often found and results in high morbidity and mortality in both mother and baby. Preeclampsia is one of the complications of pregnancy that needs to be detected or monitored for symptoms, because in addition to being risky for the mother, it will also have an impact on the occurrence of preterm birth and even further impact, namely fetal death in the womb. This study aimed to determine the effectiveness of CRP and leukocyte examination to detect preeclampsia. Method: This research was conducted at the Jagir Health Center Surabaya in March-July 2022. The research used case control with 30 pregnant women as samples divided into 15 as a control group of normal pregnant women and 15 pregnant women with preeclampsia. Result: The results showed that of the 15 respondents who had preeclampsia more than half (60%) had high leukocyte and CRP levels, the remaining less than half (40%) had normal CRP and leukocyte levels. While in the control group more than half (67%) had normal CRP and leukocyte levels and less than half (33%) had normal CRP and leukocyte levels. The results of data analysis showed p value 0.001 (&lt;0.005), which means there is a relationship between the CRP and leukocytes on the incidence of preeclampsia. Conclusion: Examination of CRP levels and leukocyte count proved effective for detecting the incidence of preeclampsia in pregnant women. It is expected that pregnant women carry out routine pregnancy checks and health workers are expected to routinely carry out early detection to prevent pregnancy complications such as preeclampsia

Readability of iPledge materials for isotretinoin education in English and Spanish.

iPledge is a program meant to reduce the incidence of pregnancy in patients using isotretinoin, a teratogenic acne medication. Adherence to the iPledge program is essential in preventing pregnancy complications among isotretinoin users. We present an analysis of the readability of both English and Spanish patient education materials published by iPledge. Readability grade levels for twelve iPledge documents were compared using both Lexile and graph-based methods (English: Fry; Spanish: Gilliam-Peña-Mountain). In both English and Spanish, aggregate Lexile grade levels are written below the 6th grade level; however, approximately one-third of pages are written above the 6th grade level. Aggregate graph-based grade levels are written above the 6th grade level as well. This suggests that iPledge materials should be rewritten at a lower grade level. Doing so may allow more patients to understand and utilize the important information presented in iPledge.

PS-BPR03-10: A CASE OF A WOMAN WITH IGA NEPHROPATHY PRESENTING DURING PREGNANCY

Background: Pregnancy has an influence on autoimmune diseases course and many autoimmune diseases go into remission during pregnancy. The details of the autoimmune mechanism of IgA nephropathy have not been elucidated. The disease activity of IgA nephropathy commonly is stable during pregnancy, however, IgA nephropathy is at high risk of pregnancy complications even if renal function is preserved, and prevention of pregnancy complications are important in pregnant woman with IgA nephropathy. Case: A 29 year-old woman, gravida 2, para 0, no history of abnormal urine analysis before pregnancy, presented preeclampsia at 32 weeks pregnancy, and an emergency cesarean section was performed at 32 weeks and 5 days pregnancy. After delivery, microscopic hematuria persisted. Renal biopsy was performed 1 year and 9 months after delivery, and IgA nephropathy was diagnosed. Tonsillectomy was performed for IgA nephropathy, and the patient's renal function did not deteriorate during the follow-up period. In the second pregnancy, low-dose-aspirin was administered from the first trimester, and full term infants delivered without any pregnancy complications. Conclusion: IgA nephropathy can become apparent in pregnancy. Postpartum evaluation of urinalysis is important for the early detection of the primary renal disease. In pregnant woman with IgA nephropathy, stabilization of the disease state and administration of low-dose aspirin are very important for outcome of pregnancy and maternal renal prognosis.

Prevalence and risk factors for delayed antenatal care visits in Rwanda: an analysis of secondary data from Rwanda demographic health survey 2019-2020.

antenatal care (ANC) delivers services to prevent pregnancy complications and provides counseling for birth, and emergency preparedness. Having ANC on time has life-saving potential for the child and mother. Despite improvements in health infrastructure, human resources, and health insurance, hindrances to early ANC visits still exist in Rwanda. This study aimed to investigate the burden and factors associated with delayed ANC visits in Rwanda so that policymakers can develop strategies to promote early ANC visits. this is a cross-sectional study using Rwanda demographic health survey (RDHS) 2019-2020 that included 6,039 women that had had a pregnancy in the 5 years preceding the survey. Descriptive analysis was used to determine the prevalence and a multivariable logistic regression model using manual backward stepwise regression was used to identify risk factors for delayed ANC in Rwanda. STATA 16 statistical software was used for all the analyses. the prevalence of delayed ANC in Rwanda was 41% and the risk factors include: the number of children 4-6 (AOR = 1.4, 95% CI: 1.2-1.6) and 7 or more children (AOR = 1.5, 95% CI: 1.5-2.1) versus less than 3 children, unwanted pregnancy (AOR = 1.7, 95% CI: 1.5-2.0), not covered by health insurance (AOR = 14, 95% CI: 1.2-1.6), woman´s education level: no education (AOR 2.6, 95% CI: 1.6-4.1), primary education (AOR 2.5, 95% CI: 1.6-3.7), secondary education (AOR 2.2, 95% CI: 1.5-3.2), woman´s occupation: informal (AOR 2.3 95% CI: 1.5-3.7) and unemployment (AOR 2.3. 95% CI: 1.4-3.7). Conclusion: based on the findings from our study, family planning services should be made available to all women of childbearing age to prevent unwanted pregnancies; female education should be considered a priority, promotion of health insurance coverage and community-based education about reproductive health to encourage the early seeking of care among women of childbearing age.

The relationship between poor glycaemic control at different time points of gestational diabetes mellitus and pregnancy outcomes

We aimed to identify the complications of gestational diabetes mellitus (GDM) associated with poor control of fasting plasma glucose (FPG) and postload plasma glucose (PPG) on the 75-g oral glucose tolerance test (OGTT). This retrospective study included 997 singleton pregnancy GDM patients who were assigned to poor or good glycaemic control groups. Multivariate analysis indicated that poor FPG control and poor PPG control were both independent predictors of hypertensive disorder complicating pregnancy (HDCP) (odd ratio (OR) of 2.551 (95% CI [1.146–5.682], p = .022) and OR of 2.084 (95% [1.115–3.894], p = .021) compared with good glycaemic control groups, respectively). Poor PPG control promoted the rate of caesarean delivery (1.534 (95% CI [1.063–2.214]), p = .022), whereas good PPG control increased the risk of premature rupture of membranes (PROM) (0.373 (95% CI [0.228–0.611]), p < .001). Conclusively, poor control FPG and PPG dissimilarly affect pregnancy complications in GDM; these findings may help clinicians in the effective implementation of measures to prevent pregnancy complications in GDM. IMPACT STATEMENT What is already known on this subject? Previous studies displayed that GDM patients with 2-h PPG elevated at 24–28 week of gestation had a 2.254-fold increased risk of postpartum dysglycaemia. Abnormal plasma glucose in GDM mother increased the probability of childhood obesity in the offspring. With the implementation of China’s second-child policy, the incidence of GDM is rising. What do the results of this study add? Our results indicated that the older patients with GDM, the greater the risk of abnormal plasma glucose control. In addition, maternal age and prenatal BMI were notably correlated with poor plasma glucose control of FPG and PPG, respectively. We also found that both poor FPG and PPG control notably increased the incidence of HDCP in pregnant women. The incidence of PROM was higher in the good PPG control group compared with the poor PPG control group. What are the implications of these findings for clinical practice and/or further research? This study displayed that the effects of poor FPG and PPG control on pregnancy complications and newborn outcomes were heterogeneous, which might be related to the specificity of plasma glucose metabolism at different time points. Good glycaemic control, especially PPG control, was of great significance for improving pregnancy complications and perinatal conditions.

The effectiveness of family empowerment model on early detection ability of risk pregnancy during the COVID-19 pandemic

Introduction: Many pregnant women and their families are lack to carry out the examination to detect earlier about high-risk pregnancies. Family empowerment models can improve the ability of families to early detection of pregnancy during the COVID-19 pandemic. This study aims to analyze the effectiveness of the family empowerment model on the ability to detect early pregnancy at risk during the COVID-19 pandemic. Methods: This study used an explanatory survey with a cross-sectional study approach and interventions of the family empowerment model on early detection ability of risk pregnancy. Sampling using the Probability sampling method with simple random sampling, a sample size of 100. Independent variables are interventions of the family empowerment model, while dependent variables of early detection ability of risk pregnancy during the covid-19 pandemic. Data collection instrument using questionnaires. The research data were analyzed using Structural Equation Modeling (SEM) based on variance or SEM-based components, known as Partial Least Squares (PLS). Results: The influence of personal factors, resource factors, cognitive behavioral factors, interpersonal factors, filial values, and commitments showed t-statistics &gt; 1.96 and p-values &lt;0.05. This means that there is a significant effect on all of these variables on family empowerment. The resulting coefficient is positive 0.080 so it can be said that better family empowerment tends to increase the ability of families in early detect high-risk pregnancies. That means there is a family empowerment model that makes participants feel more responsive, and alert, pay attention to self-care, and immediately check with health workers if there are danger signs. Conclusion: After being given the family empowerment model intervention almost all respondents were good in the ability to detect early pregnancy at risk during the COVID-19 pandemic contributed to increasing family involvement in intensive care for pregnant women to prevent pregnancy complications.