Maternal Health Risk Factors Research Articles

The Effects of Acknowledgment of Paternity and Marital Status on Infant Morbidity and Mortality [ID 2683463

INTRODUCTION: Research shows that maternal behavior during the perinatal period has a significant effect on neonatal outcomes and that instability in the social support structure can cause undue perinatal stress. With unmarried women accounting for nearly one in three births in the United States, this analysis reviewed how marital status and paternity acknowledgment (AOP) affected infant morbidity and mortality utilizing national 2017–2019 data from the CDC-WONDER databases. METHODS: A series of chi-squared analysis and logistic regressions were performed to assess for differences in infant outcomes between married women, unmarried women with AOP, and unmarried women without AOP, as well as assess the effect of socioeconomic covariates. RESULTS: Results demonstrated that marital and AOP status had significant correlation on frequency of preterm birth, low birth weight, newborn need for assisted ventilation, antibiotics for suspected sepsis, and neonatal intensive care unit admission (P<.0001). Additionally, there were significant differences in Apgar scores found at 5 and 10 minutes for AOP and at 5 minutes for marital status. Furthermore, significant differences in rate of prenatal complication related infant mortality, as well as overall infant mortality up to 1 year of age were seen. These trends persisted when accounting for mother's age, race, nativity, education, insurance status, and select maternal health risk factors. CONCLUSION: It is evident that infants born to unmarried women and women without AOP are at increased risk for development of complex infant morbidity and mortality. This suggests that increased monitoring, precautions, and social support may be indicated. Further studies are needed to evaluate the role of paternal and other support during pregnancy.

Anemia and Underweight among Married Women in Yemen; Evidence from Yemen Demographic Health Survey (YDHS-2013)

Background: Women in conflict are vulnerable to health and nutrition risks. Anemia and underweight are the common risks faced by women particularly in war torn countries. Yemen is one of the most affected places that has a fragile public health system due to the conflict. Increasing conflict has put women’s health and wellbeing at risk and has severely affected their nutritional development. Therefore, this study aims to examine the association between underweight and anemia with different risk factors among married women in Yemen.
 Methods: This study used the data from Yemen demographic health survey-2013 (YDHS-2013) of married women aged 15-59 year. Bivariate and multivariate logistic models were used to study the association between anemia and underweight with various socio-economic and maternal health risk factors.
 Results: A positive and significant association of socio-economic and maternal health risk factors was found with anemia and underweight. Women belonging to more prosperous groups had the lowest odds of underweight [OR=0.30, P<0.001)] and anemia [OR=0.61, P<0.001). The study also examined some key risk factors like breast feeding, iron supplements and contraceptive use among women and found a positive and significant association of these risk factors with underweight and anemia.
 Conclusions: Nutritional challenges have to be addressed especially in the country like Yemen. The results clearly indicate that women in Yemen are facing acute nutritional risks of underweight and anemia. Therefore, policy interventions are required to address their nutritional needs and also empower them economically to minimize these nutritional risks. Moreover, nutrition related interventions are required to attain the targets for sustainable development goals in Yemen.

Patterns of risk exposure in first 1,000 days of life and health, behavior, and education-related problems at age 4.5: evidence from Growing Up in New Zealand, a longitudinal cohort study

BackgroundChildren who are high priority candidates for early intervention need to be identified to reduce their risk for experiencing problems in development. Those exposed to multiple risk factors are more likely to exhibit problems in development than those exposed to a single or no risk factor. We examined the longitudinal associations between persistence and timing of exposure to cumulative risk (CR) on three occasions by age 2 and problems in development at age 4.5 in health, behavior, and education-related domains.MethodsData are from Growing Up in New Zealand (NZ), a prospective longitudinal study of a birth cohort first assessed during their last trimester in 2009–10 and followed at ages 9 months and 2 and 4.5 years. All women with an expected delivery date in a 12-month period who resided within a defined region were invited to participate, with no additional eligibility criteria. Exposure was measured for 12 sociodemographic and maternal health risk factors at third trimester and ages 9 months and 2 years, from which developmental trajectories were constructed capturing persistence and timing of CR exposure. Ten developmental outcomes were measured at age 4.5 to classify problems in overall health status, obesity, and injuries; internalizing and externalizing behavior problems; and letter naming, counting forward and backward, and expectations for starting school and completing education.ResultsAnalyses of data from 6156 children (49% female, 33% Non-European ethnicity) who participated in the 4.5-age assessment uniformly showed associations between exposure to more than consistently zero CR across early development and higher prevalence of being classified with problems for 9 of 10 outcomes. Persistent exposure to a CR ≥ 4 was generally associated with a higher prevalence of problems for 7 of 10 outcomes, whereas the timing of first exposure to CR ≥ 4 showed a less consistent association with problem outcomes.ConclusionsThese findings are concerning because over 50% of NZ children are exposed to at least one of these risk factors at some point in early development. Routine screening of most of these risk factors during pregnancy is feasible and can identify priority candidates for intervention.

Risk factors affecting maternal health outcomes in Rivers State of Nigeria: Towards the PRISMA model.

Existing research suggests that Nigeria accounts for about 23% of the world's maternal mortality ratio, with negative impacts on women's wellbeing and the country's socio-economic development. The underlying risk factors can be categorized into political influences, poor access to healthcare, inadequate utilization of health facilities, poor family planning support and complex pregnancy-related illness. Yet, the complex interrelations amongst the factors makes it difficult to ascertain the riskiest ones that affect women's reproduction and child death, with the existing intervening strategies failing to address the problem. This study identifies maternal health risk factors and prioritizes their management in Rivers State of Nigeria, using the Prevention and Recovery Information System for Monitoring and Analysis (PRISMA) model. Taking a quantitative turn, we applied exploratory factor analysis to analyze 174 returned questionnaires from healthcare professionals working in Rivers State and used the results to establish relationships between maternal health risk factors, prioritizing the riskiest factors. The outcomes indicate that the PRISMA model provides an effective framework for identifying and managing maternal mortality risks that can enable healthcare experts and managers to address the avoidable risk factors and mitigate the unavoidable patient-related risk factors in Nigeria. The implications for theory, practice and policy are discussed.

Incidence and Risks of Congenital Anomalies of Kidney and Urinary Tract in Newborns: A Population-Based Case-Control Study in Taiwan.

Congenital anomalies of the kidney and urinary tract (CAKUT) are 1 of the major factors in young adults needing renal replacement therapy, but there is little extensive assessment of their incidence and risk factors. This study aimed to evaluate trends in the incidence of and risk factors for CAKUT among all births in Taiwan.This population-based case-control study design was conducted using the Taiwan national births registry, which contains detailed information about maternal health and characteristics of newborns, supplied by health professionals. Of 1,603,794 newborns registered between 2004 and 2014, 668 infants were reported to have CAKUT. Newborns without congenital anomalies were matched with CAKUT cases by birth year, month, and Apgar score in a ratio of 5:1. Odds ratio (OR) and 95% confidence interval (CI) for developing CAKUT were calculated using a conditional multivariate logistic regression model.The incidence of CAKUT was approximately 4.2 per 10,000 births. The adjusted ORs for CAKUT in newborns associated with maternal age of 20 to 29 (OR, 2.18; 95% CI, 1.11-4.28), or 30 to 39 (OR, 2.29; 95% CI, 1.17-4.51), maternal gestational diabetes (OR, 2.22, 95% CI, 1.06-4.67), maternal thalassemia/hemochromatosis (OR, 2.67; 95% CI, 1.35-5.27), polyhydramnios or oligohydramnios (OR, 9.16; 95% CI, 5.46-15.37), birth parity >1 (OR, 0.27; 95% CI, 0.15-0.50), having a gestational age <37 weeks (OR, 1.48; 95% CI, 1.23-1.78), and being a boy (OR, 1.83; 95% CI, 1.53-2.19). Infants of mother with gestational diabetes were more likely to have congenital anomalies, small gestational age (<37 weeks) and low birth weight.CAKUT are associated with several maternal health risk factors. As Taiwan has the highest prevalence and incidence rates of end-stage renal disease in the world, these findings strongly support the need to develop professional guidelines for prenatal counseling and management of women at risk of adverse birth outcomes, to prevent kidney disease progression and reduce complications.

Effects of perinatal meditation on pregnant Chinese women in Hong Kong: A randomized controlled trial

Objective: To assess the effects of Perinatal Meditation on pregnant Chinese women in Hong Kong. Design: A prospective longitudinal randomized control quantitative study. Data were collected using the Prenatal Distress Questionnaire, Prenatal Coping Inventory, Edinburgh Postnatal Depression Scale, Body-Mind-Spirit Well-Being Inventory (BMSWBI) and salivary cortisol. Data were collected during first visit, 36 th weeks pregnant, 5 th weeks and 5 th months after delivery. Settings: Perinatal meditation program (Eastern Based Meditative Intervention, EBMI) for pregnant Chinese women in Hong Kong who were attending the hospital clinic for routine perinatal care. Participants: 64 pregnant Chinese women were recruited for intervention and 59 were for control. 36 cases were classified as Frequent Practice (FP) in intervention group. Results: Quantitative results showed statistically significant increase in positive appraisal ( p &lt; .05) at 36th weeks, difference in evening salivary cortisol ( p &lt; .05) and decreased in physical distress ( p &lt; .05) at 5th weeks postpartum in the Frequent Practice (FP) group. Conclusions: Frequency of practice of meditation is directly related to its effects. Perinatal meditation can help pregnant women to reduce perinatal stress through its effect on coping mechanism and improves physical discomfort in postnatal period which are risk factors for maternal health, fetal health and child health. Perinatal meditation can be added into present perinatal counselling and perinatal program to promote maternal health, child health and family health.

Pregnancy and birth in an indigenous Huichol community: from structural violence to structural policy responses

Mexico's indigenous regions are characterised by socio-economic marginalisation and poor health outcomes and the Maternal Mortality Rate in indigenous communities continues to be around six times higher than the national rate. Using as a case study the Huichol community of North-Western Mexico we will discuss how institutional health and welfare programmes which aim to address accepted risk factors for maternal health are undermined by a series of structural barriers which put indigenous women especially in harm's way. Semi-structured interviews and observational data were gathered between 2009 and 2011 in highland communities and on coastal tobacco plantations to where a large number of this ethnic group migrate. Many Huichol women birth alone, and to facilitate this process they maintain a low nutritional intake to reduce their infant's growth and seek spiritual guidance during pregnancy from a shaman. These practices are reinforced by feelings of shame and humiliation encountered when using institutional health provision. These are some of the structural barriers to care that need to be addressed. Effective interventions could include addressing the training of health professionals, focusing on educational inequalities and the structural determinants of poverty whilst designing locally specific programmes that encourage acceptance of available health care.

Health Care Providers' Perceptions of Maternal Health Concerns in the Solomon Islands.

The objective of this study was to explore the maternal health risk factors and sentinel events among women in the Solomon Islands, from the viewpoints of health care providers in the Solomon Islands. Three focus group interviews were conducted in July and August 2011 at a secondary referral hospital in an urban area. The study consisted of 10 registered nurses and 11 skilled birth assistants. Thematic analysis was used for this qualitative data analysis. Six major themes were emerged from the data: (a) environmental hazard: malaria, (b) malnutrition: iron deficiency anemia, (c) adolescent pregnancy, (d) betel nut chewing, (e) cultural beliefs influencing women's health, and (f) difficulty accessing health care services. The results of this study provide a useful first step toward identifying specific maternal health risks among women in the Solomon Islands. The findings may assist the health sector and midwives/antenatal educators to better understand the health risks and reduce the disease burden among pregnant women in South Pacific countries. The results may also contribute to the development of policies to improve maternal health and to accelerate progress toward the fifth target goal of UNICEF's Millennium Development Goals.

Embarazo en mujeres en situación de prostitución: autocuidado y prácticas de riesgo. Estudio cualitativo. Bogotá, Colombia 2006

RESUMENObjetivos: identificar las prácticas de autocuidado de mujeres embarazadas en situación de prostitución, de la zona de alto impacto de las localidades Santa Fe y los Mártires, de Bogotá D.C., así como las condiciones en que se presenta el embarazo y las posibles prácticas de riesgo.Métodos: del 24 de julio al 31 de octubre de 2006, se realizó una aproximación cualitativa, con perspectiva de género, a las condiciones en las que viven sus embarazos, riesgos maternos y comportamientos de autocuidado, un grupo de 12 mujeres en situación de prostitución de las zonas de alto impacto de las localidades Santa Fe y los Mártires, de Bogotá D.C. Se obtuvo la información mediante entrevistas a profundidad, grabadas y posteriormente transcritas, previa aprobación verbal y escrita. El análisis de la información fue realizado con el apoyo del software Atlas Ti 5.0.Resultados: se encontraron riesgos asociados a sexo inseguro y embarazo no deseado; las prácticas de autocuidado se reducen al uso del condón con los clientes, más no con sus parejas. Las mujeres reportan disminución de la actividad sexual, cambio en algunas prácticas sexuales y disminución del consumo de alcohol, tabaco y substancias psicoactivas. Siete de las 12 mujeres no usaban anticoncepción; dos atribuyen su embarazo a fallas del condón.Conclusiones: más que considerar su actividad un riesgo para su embarazo, su embarazo "pone en riesgo" su actividad. En este grupo se encuentran varios factores de riesgo que amenazan la salud materna, por ello se recomienda la educación enfocada en anticoncepción, autocuidado y empoderamiento.

Health Effects of Pesticide Use Among Indonesian Women Farmers

ABSTRACT This retrospective cohort of 161 female spray operators and 352 age-matched women rice farmer controls was conducted in West Sumatra Indonesia. It was designed to assess the reproductive impacts of pesticide use. Exposure was determined through detailed field observations and interviews about historical pesticide use. Data was gathered on socio-economic characteristics, maternal health risk factors and reproductive outcomes by teams of local midwives trained for the study. Reproductive outcomes were compared between the exposed and nonexposed cohorts as well as those pregnancies among the sprayers before and after commencing pesticide use. The rates of stillbirths, abortions, early neonatal deaths, and low birth weight were not greater among the pesticide users. Although there were more cases of undocumented birth defects, the difference was not significant. Controlling for other independently associated maternal risk factors and socio-economic factors did not alter the results.

Health Effects of Pesticide Use Among Indonesian Women Farmers

ABSTRACT This retrospective cohort of 161 female spray operators and 352 age-matched women rice farmer controls was conducted in West Sumatra Indonesia. It was designed to assess the reproductive impacts of pesticide use. Exposure was determined through detailed field observations and interviews about historical pesticide use. Data was gathered on socio-economic characteristics, maternal health risk factors and reproductive outcomes by teams of local midwives trained for the study. Reproductive outcomes were compared between the exposed and nonexposed cohorts as well as those pregnancies among the sprayers before and after commencing pesticide use. The rates of stillbirths, abortions, early neonatal deaths, and low birth weight were not greater among the pesticide users. Although there were more cases of undocumented birth defects, the difference was not significant. Controlling for other independently associated maternal risk factors and socio-economic factors did not alter the results.