Risk Factors In Pregnant Women Research Articles

Prevalence of Gestational Diabetes (Type 2 Diabetes) and Their Risk Factors in Pregnant Women of Khairpur Mir’s Sindh, Pakistan

Introduction: Diabetes affects 415 million individuals globally, with 193 million undiagnosed diabetics. Type 2 diabetes affects more than 90% of diabetic patients. It causes microvascular and macrovascular problems that cause significant psychological and physical discomfort in both patients and caregivers and a significant financial burden on healthcare systems. Despite growing awareness of type 2 diabetes risk factors and evidence of effective preventative programmes, the disease's incidence and prevalence continue to climb globally. Methods: In this study, a population-based investigation was made among 60 pregnant women’s belonging to two different age groups ranges (18-38) and (36 to 45) and associated risk factors of the diabetes type 2 were screened out at Kausar Hospital, Khairpur city and Mehran Lab Khairpur, Sindh, Pakistan. Results: Results of this study revealed 31 (52%) positive cases and 29 (48%) negative cases of Diabetes type 2 using manual micro lab procedure and glucometer (Random and Fastening Glucose test). Glucometer. Furthermore, our study also revealed that 80% of positive cases were also experiencing various infections, whereas 20% were without any infection, Similarity 55% of the cases were also had their genetic-based Diabetes, whereas 45% caught this during their gestation period and 47% showed anger and 53% of the woman were in stress. Conclusion: Our study suggests that Maternal and fetal monitoring is required to minimize maternal and fetal /neonatal morbidity and perinatal mortality. After delivery, all women with GDM must be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria). Keywords: Gestational Diabetes type 2, Glucometer, Frequency, Prevalence, Khairpur mirs.

Venous thrombosis risk factors in pregnant women.

Venous thromboembolism (VTE) is the third most common cause of death on Earth after myocardial infarctions and strokes, according to the World Health Organization (WHO). Pregnancy is a unique condition of woman, when enormous changes occur in functioning of the most important systems of homeostasis in a relatively short time. These are physiological hypercoagulation, slowing of blood flow, increase in circulating blood volume, etc. However, while being physiological, these changes increase the risks of venous thromboembolism by almost 6 times. In some cases, there appears an imbalance or dissociation between the functioning of natural antithrombotic systems and the activation of coagulation as aconsequence of genetically or acquired determined causes (genetic thrombophilia, antiphospholipid syndrome, comorbidities, obstetric complications and other exogenous and endogenous factors). Accordingly, identification of risk factors, their systematization, and determination of VTE risks in pregnancy and puerperium is one of the mostimportant tasks of clinical medicine. Various recommendations have appeared for practitioners during the last 10-15 years on the basis of the risk factors analysis in order to prevent VTE in pregnant women more effectively. Nevertheless, none of these recommendations can yet take into account all risk factors, although convenient scoring systems have emerged for risk assessment and clear recommendations on anti-thrombotic prophylaxis regimens in risk groups in recent years. This article will review historical understanding of thrombosis in pregnant women, progress in understanding VTE risk factors in pregnant women, and available reserves in identifying new risk factors during pregnancy and puerperium in order to stratify risks more efficiently.

A cross-sectional evaluation of maternal and perinatal outcomes in pregnancies complicated with COVID-19

Background and Aim Pregnancy is considered a vulnerable period for women regarding increased risk of respiratory tract infections, altered immunity, and metabolic changes in their bodies. COVID-19 pandemic possesses a significant risk on pregnants, but the data on the disease course is insufficient. Therefore, this study aimed to evaluate the maternal and perinatal outcomes in pregnant women diagnosed with COVID-19. Methods This is a cross-sectional study that evaluated the hospital records of pregnant women admitted to the Obstetrics and Gynecology Department of 19 Mayıs University Hospital between 01/04/2020 to 30/12/2021. Outcome measures were gestational week at birth, basal gestational and labor characteristics, delivery complications, and perinatal and maternal COVID-19 outcomes. Results Analyses of the data of 98 patients revealed that median age of the mothers was 30 years; 26.5% were primigravid, 43.9% were nulliparous, and 29.6% were primiparous. Three had twin pregnancies, 52% of the births were preterm, 88% were cephalic presentation, and 95.9% were cesarean deliveries.The most common delivery complications were acute fetal distress (51%), preterm premature rupture of membranes (50%), and neonatal asphyxia (49%). Gestational characteristics were similar between treatment groups for COVID-19, but patients admitted to intensive care unit and applied mechanical ventilation (11.2%) had significantly more preterm births, and perinatal complications including acute fetal distress (p=0.030), PPROM (p<0.001), neonatal asphyxia (p=0.021), and lower APGAR scores (p=0.002). Conclusion COVID-19 is a significant risk factor for pregnant women. This study showed that COVID-19 and pregnancy may induce adverse effects on each other. The data provided here will contribute to the growing body of epidemiological and clinical evidence on the interactions between COVID-19 and pregnancies.

Predictive value of D-dimer and analysis of risk factors in pregnant women with suspected pulmonary embolism after cesarean section

BackgroundAcute pulmonary embolism (PE) is one of the leading causes of maternal mortality, and cesarean section is an established independent risk factor for PE. The diagnostic utility of D-dimer for PE in non-pregnant women has been well-established, but its role in women with suspected PE after cesarean section is unclear. Furthermore, the optimal threshold level in this patient population is unknown. Traditional D-dimer levels have low diagnostic specificity, resulting in many pregnant women being exposed to potentially harmful radiation despite negative diagnostic imaging results. This research aimed to optimize the clinical threshold for D-dimer to improve specificity while ensuring high sensitivity and to identify risk factors for PE after cesarean section.MethodsThis retrospective study of 289 women who underwent diagnostic imaging (ventilation/perfusion [V/Q] or computed tomographic pulmonary angiography [CTPA]) for suspected acute PE after cesarean delivery from 2010 to 2021 was conducted. Clinical data and laboratory indicators within 24 h postpartum including D-dimer levels were collected for analyses.ResultsThe final analysis included 125 patients, among whom 33 were diagnosed with acute PE (incidence of 11.42%, 95% confidence interval 7.7–15.1). The receiver operating characteristic curve analysis suggested that a D-dimer cut-off value of 800 ng/mL had specificity of 25.26% and sensitivity of 100% for detecting PE. The cut-off value was adjusted to 1000 ng/mL with a specificity of 34.74% and a sensitivity of 96.67%. Using a D-dimer cut-off value of 800 ng/mL (instead of the conventional value of 500 ng/mL) increased the number of patients excluded from suspected PE from 9.6 to 18.4% without additional false-negative results. Of note, a history of known thrombophilia was significantly more common in patients with PE than in those without (P < 0.05). No other independent risk factors were noted in our study.ConclusionsThe D-dimer cut-off value of 800 ng/mL ensures high sensitivity and increases specificity compared to the conventional threshold of 500 ng/mL. Utilizing this higher threshold can reduce the number of unnecessary CT and subsequently unnecessary radiation exposure, in women after cesarean delivery. Prospective studies should also be conducted to verify these results.

Serosurvey of anti-Toxocara antibodies and risk factors in adolescent and adult pregnant women of southeastern Brazil.

Toxocariasis is worldwide endemic parasitic anthropozoonosis with high risk to those in in vulnerable populations and particularly during pregnancy and childhood. Although the prevalence of anti-Toxocara spp. antibodies has been extensively studied, risk factors of pregnant women of different ages remains to be established. This study was designed to i) assess the presence of anti-Toxocara spp. antibodies in pregnant women that presented to the public health system in a city of southeastern Brazil, and ii) determine the risk factors for toxocariasis in adolescent and adult pregnant women. This cross-sectional study included 280 pregnant women (71 aged up to and including 17 years [adolescents] and 209 aged 18 years and older [adults]). Pregnant women voluntarily agreed to complete a socioeconomic questionnaire and provide serum samples. Anti-Toxocara IgG antibodies were screened by Enzyme-Linked Immunosorbent Assay (ELISA). Univariable and multivariable logistic regression models were performed to assess the risks for toxocariasis. Overall, 20.7% of pregnant women were seropositive (33.8% of adolescents and 16.3% of adults). Prevalence in pregnant adolescents was 2.6-fold higher than in adults (Odds ration [OR]: 2.63; 95% CI: 1.42–4.86, p = 0.003). Multivariate analysis revealed that contact with soil (p = 0.01; OR = 4.76) and being in the first trimester of pregnancy (p = 0.03; OR = 0.17) had significantly greater risk of toxocariasis for adolescents, and attainment of elementary through middle school education level (p = 0.05; OR = 8.33) was a risk factor in adult pregnant women. Toxocariasis is likely underreported and neglected in adolescent pregnant women; this age group should always be monitored for toxocariasis and correspondent clinical signs, particularly at late pregnancy.

&lt;i&gt;Toxoplasma gondii&lt;/i&gt; Infection in Pregnant Women: Seroprevalence and Associated Risk Factors in Ouagadougou, Burkina Faso

Toxoplasma gondii (T. gondii) infection can lead to abortion in pregnant women. Unfortunately, very limited information is available concerning the seroprevalence and associated risk factors in pregnant women in Burkina Faso. Therefore, the present study aimed to estimate the seroprevalence of T. gondii among pregnant women attending for antenatal care. A cross-sectional study was conducted containing 579 pregnant in Ouagadougou, Burkina Faso. Serological patterns were assessed by enzyme-linked fluorescent immunoassay and the study utilized univariate analysis to identify the potential risk factors for T. gondii infection. Of the 579 pregnant women investigated, 29.71% were tested as T. gondii-seropositive, with 25.91% seropositive for T. gondii IgG antibodies, 1.9% positive for IgM and 1.9% positive for both IgM and IgG. We found firstly that pregnant women consuming unpasteurized cow's milk had a significantly higher seroprevalence than individuals who did not consuming (30.15% vs 06.67%; p=0.0039). Then, age was associated with an increased risk of being seropositive for T. gondii, seroprevalence increases significantly with age, ranging from 18% for 15-25 year olds to 45% for those over 35 years old, pT. gondii (p=0.0065 and 0.023, respectively). The other risk factors like contact with soil, drinking water source, contact with cats and eating some under-cooked meat were not significantly associated with T. gondii infection. Altogether, our study showed that seroprevalence of T. gondii was mainly related to consumption of unpasteurized cow's milk, to patient age, to the number of pregnancies and to living children. The findings will provide key and baseline data for prevention and control of toxoplasmosis among pregnant women and other people.

Prevalence of Congenital Anomalies and Associated Risk Factors in Pregnant Women: A Narrative Review

A review on the prevalence of congenital anomalies and associated risk factors amid pregnant women. Congenital malformations are the most salient conviction of neonatal and perinatal deaths. Anomalies can be categorized according to the seriousness, systems involved. The classification of the congenital anomalies can be based on the ICD-10 classification for the congenital anomalies. Methods- Our initial step to construct a review article was to employ a literature review search, followed by Google scholar and PubMed databases, extracted articles were looked with the keywords such as prevalence, risk factors, congenital anomalies in pregnant women. Those published between 2015 to 2021and satisfying the admittance criteria were involved in the present review. Conclusion-Congenital anomalies are the uttermost prime cause of perinatal and neonatal death in the underdeveloped nations. Most common anomalies observed were with congenital heart defects. Regular antenatal checkups can slacken the pervasiveness of congenital anomalies.

A study of prevalence of anemia and associated risk factors in pregnant women of tribal community attending antenatal clinic at Trivandrum district, Kerala, India

Background: Anemia is a major preventable public health concern among the pregnant women worldwide. The present study aims at determining the prevalence of anemia among tribal pregnant women at Trivandrum district, Kerala and identifying its socioeconomic and gynaecological risk factors.Methods: A cross sectional study was conducted among tribal women attending antenatal clinics of Vithura and Kuttichal Government hospitals at Kerala, India. Sample size was calculated as 117. All consecutive subjects fitting the inclusion criteria were included in the study until the sample size was achieved. Patients were interviewed using a semi structured questionnaire which includes socio demographic, cultural and nutritional factors. Hemoglobin measurement was done while first antenatal visit using semi auto hemo-analyzer. Data obtained were analyzed using SPSS software. Statistical test used was either Chi-square test or student t-test.Results: The prevalence of anemia among the tribal pregnant women attending primary health care in Trivandrum during the study tenure was 53.33%. The prevalence of mild, moderate and severe anemia was observed as 26.66%, 25% and 1.66% respectively. The mean serum haemoglobin level among the study group was found to be 10.64 gm%. The major risk factors associated with anemia were figured out to be low body mass index, low family income, high parity, joint family, exposure to passive smoking and pan chewing, irregular intake of iron and folic acid supplements, hyperemesis and absence of deworming.Conclusions: Focus shall be given on creating awareness among tribal women regarding the need for dietary and lifestyle modification to decrease the prevalence of anemia among them.

Seroepidemiology of Toxoplasma gondii Among Pregnant Women Attending Antenatal Care in Northwest Ethiopia.

IntroductionToxoplasmosis is a life-threatening disease in pregnant women, having social and economic impacts due to congenital toxoplasmosis. However, in Ethiopia, it is neglected zoonotic disease, which requires screening and identifying risk factors in pregnant women to plan a public health intervention.MethodsThis institutional-based cross-sectional study was employed from March to April 2019 to estimate the seropositivity and assess potential risk factors for T. gondii among pregnant women attending antenatal care in four public hospitals in Northwest Ethiopia. Four hundred and one pregnant women were recruited to collect serum samples. Toxoplasma gondii antibodies were tested using Toxo-Latex slide agglutination test.ResultsThus, the overall seropositivity for T. gondii was found 70.8% (95% CI: 66.3–75.5). Multivariable logistic regression analysis showed that the average monthly income, occupational status, habits of handwashing practices after handling raw meat, water sources for drinking and agroclimatic situations revealed significant (p < 0.05) effects on seropositivity for T. gondii in pregnant women.ConclusionThis survey showed high seropositivity for T. gondii among pregnant women in Northwest Ethiopia. Therefore, further studies on bioassay, isolation and genotype of the pathogen are crucial. It also requires action to prevent and control the infection with T. gondii in pregnant women, which poses a potential threat to a foetus.

Management of SARS-CoV-2 infection in pregnancy

The SARS-CoV-2 infection, which originated from a market in Wuhan, China, spread rapidly, so on March 11, 2020, the WHO decreed that the outbreak became a pandemic. Over 90% of people infected with SARS-CoV-2 are either asymptomatic or have mild symptoms. However, there are cases that develop severe forms of the disease, from acute respiratory distress syndrome to septic shock with multiorgan failure and exitus. However, reports of pregnant women diagnosed with Covid-19 are low. Changes in the maternal organism in pregnancy, including immunity, respiratory system and hypercoagulability, but also various comorbidities, could be a risk factor for pregnant women to develop complications associated with COVID-19, with increased morbidity and mortality compared to the general population. The effects of SARS-CoV-2 infection on pregnancy are not sufficiently understood, nor are the effects of pregnancy on disease progression. Although the existence of the virus has been shown in biological samples such as the placenta, umbilical cord, or amniotic fluid, the maternal and fetal effects of the virus are not well known. Recent studies confirm the possibility of intrauterine maternal-fetal transmission of the virus, but also of specific antibodies. The possibility of infection by breastfeeding is not yet sufficiently investigated. We looked for data on the treatment and prophylaxis of SARS-CoV-2 infection during pregnancy, as well as on the choice of the optimal birth pathway in these women. The aim of this paper was to conduct a systematic review of the literature on pregnancy and birth management in patients infected with SARS-CoV-2 that could lead to an improvement in the quality of their medical care.

Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring.

Background: The aim of the study was to compare the continuous glucose monitoring (CGM)-determined glycaemic variability (GV) of pregnant women with gestational diabetes mellitus (GDM) and without GDM (CG; control group). The secondary aim was to evaluate the association between risk factors of diabetes in pregnancy and parameters of glyceamic control. Methods: Demographic, biometric and biochemical parameters were obtained for pregnant women (20–38 years old) who after an oral glucose tolerance test were examined by 7-day continuous glucose monitoring using a iPro®2 Professional CGM. Results: The differences in GV between women with GDM and CG compared by total area under glucose curve (total AUC, (mmol·day/L) was statistically significant (p = 0.006). Other parameters of glycaemic control such as mean glucose, standard deviation, coefficient of variation, J-index, % time-above target range 7.8 mmol/L (%TAR), % time-in range 3.5–7.8 mmol/L (%TIR), time-below target range 3.5 mmol/L (%TBR), glycated haemoglobin were not significantly different in the study groups. Risk factors (a family history of diabetes, pre-pregnancy BMI, higher weight gain and age) correlated with parameters of glycaemic control. Conclusions: We found a significant difference in GV of women with and without GDM by total AUC determined from CGM. TIR metrics were close to significance. Our work points at an increased GV in relation to the risk factors of GDM. Pregnant women with risk factors have higher probability of severe GV with its consequences on maternal and fetal health state.

Serological detection of human parvovirus B19 infection and associated risk factors among pregnant women in Jigawa State, Nigeria

ABSTRACT Human Parvovirus B19 (B19 V) infection is hyperendemic in Nigeria. Pregnant women are not classically immunocompromised but maybe physiologically immunosuppressed and susceptible to viral infection. However, there is a paucity of studies on the epidemiology of B19V in Jigawa State, Northwestern Nigeria. This study aims to determine the seroprevalence, sociodemographic, and risk factors of human B19V infection among present women attending antenatal clinics of Jahun General Hospital, Nigeria. Between 2 February and 30 June 2019, blood samples were collected from 200 consented pregnant women and analyzed for anti-B19V IgM and IgG using commercially available enzyme-linked immunosorbent assay (ELISA). Sociodemographic and risk factors of subjects were collated through pre-tested structured questionnaires. Data generated were statistically analyzed for the association of anti-B19V and subjects’ variables studied. Overall, the seroprevalence of anti-B19V IgM and IgG among pregnant women attending antenatal clinics of Jahun General Hospital, Nigeria was 6.0% and 22.5%, respectively. There was no significant association between the seroprevalence of anti-B19V IgM and anti-B19V IgG with all the sociodemographic variables and risk factors of pregnant women (P ˃0.05). However, pregnant women with a history of blood transfusion had a significant risk associated with seroprevalence of B19V IgM (OR = 5.95; 95% CI: 1.96–22.76; P = .009). Findings from this study revealed that a high proportion of the pregnant women were susceptible to B19V infection and anti-B19V IgG immunity decreased with age. Given the incidence of acute B19V infection, it is clinically important to continuously monitor their erythrocytes indices and screen their neonates for B19V infection and fetal complications.

Factors Affecting the Risk of Postpartum Hemorrhage in Pregnant Women in Tibet Health Facilities.

BackgroundPostpartum hemorrhage (PPH), the leading cause of maternal death, is defined as a blood loss >500 mL within 24 h after vaginal delivery or >1000 mL within 24 h after cesarean section. This study aimed to investigate the incidence of PPH and assess its risk factors in pregnant women in Tibet to provide a reference for clinicians in this region.Material/MethodsA total of 4796 pregnant women with gestational age ≥28 weeks who were admitted to hospitals in Tibet between December 2010 and December 2016 were involved in this study. Patient sociological and clinical data and pregnancy outcomes were collected. The related risk factors of PPH were analyzed by univariate and multivariable logistic regression. The area under the curve of the receiver operating characteristic curves was used to evaluate the effect of the PPH prediction model.ResultsPPH occurred in 95 women, with an incidence of 1.98%. The following factors were associated with higher risk for PPH: maternal age ≥35 (odds ratio [OR]=1.96; 95% confidence interval [CI], 1.18–3.27; P=0.010), history of preterm birth (OR=2.66; 95% CI, 1.60–4.42; P<0.001), cesarean section (OR=6.69; 95% CI, 4.30–10.40; P<0.001), neonatal weight >4 kg (OR=3.92; 95% CI, 1.75–8.81; P<0.001) and occurrence of neonatal asphyxia (OR=5.52; 95% CI, 2.22–13.74; P<0.001).ConclusionsMaternal age ≥35, history of preterm birth, cesarean section, newborn weight >4 kg, and neonatal asphyxia were risk factors of PPH, which can help evaluate PPH in Tibet.

Association of aryl hydrocarbon receptor transactivating activity, a potential biomarker for persistent organic pollutants, with the risk of gestational diabetes mellitus

Persistent organic pollutants(POPs) are suggested to be potential risk factors for gestational diabetes mellitus(GDM). We examined the hypothesis that the aryl hydrocarbon receptor trans-activating(AhRT) activity, a potential biomarker for the presence of POPs, could be a GDM risk factor in pregnant women. A total of 390 GDM and 100 normal pregnant(non-GDM) subjects in the Korea National Diabetes Program cohort voluntarily participated. We measured AhRT activity and concentrations of ATP and reactive oxygen in the serum collected at the screening of the participants for GDM using recombinant Hepa1c1c7 cells. Odds ratios(ORs) and 95% confidence intervals(CIs) were estimated using multivariable logistic regression models. The sensitivity and specificity of AhRT activity for GDM diagnostics were measured by receiver operating characteristic(ROC) analysis. Body mass index at pre-pregnancy and delivery and systolic blood pressure were significantly higher in the GDM group. AhRT activity was higher, and ATP concentrations were lower in the GDM group than the non-GDM group(P < 0.0001). AhRT activity was significantly higher in the GDM group(OR 29.3, 95% CI 10.9–79.1) compared with non-GDM(P < 0.0001). Serum glucose concentration at 1 h after a 50 g glucose challenge(glucose-50) was moderately correlated with AhRT activity(r2 = 0.387) and negatively correlated with ATP production(r2 = −0.650). In the ROC curve, AhRT activity had 70.9% sensitivity and 90.0% specificity for glucose-50, a GDM screening method. In conclusion, this study suggests that serum AhRT activity is positively associated with the risk of GDM.

Dimethylarginines correlate to common carotid artery wall layer dimensions and cardiovascular risk factors in pregnant women with/without preeclampsia: A group comparative study

ObjectivesAsymmetric- and symmetric dimethylarginines (ADMA, SDMA) are elevated in cardiovascular disease (CVD). Preeclampsia is a pregnancy-specific syndrome and is an independent risk factor for subsequent CVD. Aims were to investigate whether ADMA, SDMA levels and l-arginine/ADMA and l-arginine/SDMA ratios during pregnancy and their changes from pregnancy to postpartum are associated to arterial wall layer dimensions and cardiovascular risk factors in women with and without preeclampsia. Study designDimethylarginines were analyzed by LC–MS, and the common-carotid-artery (CCA) intima and media thicknesses were estimated using 22-MHz non-invasive ultrasonography in women with preeclampsia (cases = 48) and normal pregnancies (controls = 58) in similar gestational age, with reassessment one-year postpartum. A thick intima, thin media and high intima/media ratio (I/M) indicates a less healthy arterial wall. ResultsThe median age of cases and controls was 30 years. During pregnancy, women with preeclampsia had higher plasma ADMA, SDMA and lower l-arginine/ADMA and l-arginine/SDMA (all p < 0.01) than women with normal pregnancies. Further, ADMA, SDMA, l-arginine/ADMA and l-arginine/SDMA correlated to intima thickness (rs = 0.33/0.33/−0.33/−0.35 and p < 0.01), I/M (rs = 0.26/0.28/−0.22/−0.26 and p < 0.05) and mean arterial pressure (MAP) (rs = 0.43/0.42/−0.39/−0.40 and p < 0.0001). Changes in ADMA, SDMA and l-arginine/SDMA from pregnancy to postpartum correlated to changes in intima thickness (rs = 0.22/0.32/-0.21 and p < 0.05/<0.01/<0.05), I/M (rs = 0.22/0.31/0.08 and p < 0.05/<0.01/=0.43) and MAP (rs = 0.31/0.53/-0.25 and p < 0.01/<0.001/<0.05). No correlations were found for conventional CCA intima-media-thickness. ConclusionsDimethylarginines were associated to signs of adverse effects on arterial wall layer dimensions and cardiovascular risk factors in women with and without preeclampsia, during pregnancy and to their changes from pregnancy up to one-year postpartum.

Malaria infection and associated risk factors in pregnant women attending antenatal care clinics in Al Jabalian Locality, White Nile state, Sudan.

Pregnant women are more susceptible to malaria which is associated with adverse effects on pregnancy. It is one of the leading causes of maternal mortality in Sudan. The main aim of this study was to determine the prevalence rate of malaria in pregnant women. This cross sectional descriptive study was carried out in Al Jabalian and Kenana hospitals, White Nile State, Sudan. The data of the present study has been collected from 400 Sudanese pregnant women, during a period extending from 16th July 2018 to 25th October 2018. The overall the prevalence of malaria was 38.5% (154), Plasmodium falciparum was only malaria parasite observed in all samples. From 154 pregnant women infected with malaria, the third trimester had higher prevalence 53.9% (83), followed by the second trimester 31.8% (49) and the first trimester was 14.3% (22), P<0.0001. The multigravida had high infection with prevalence of 54.5% (84), secondgravida was 24.7% (38) and primigravida was 20.8% (32), P<0.0001. Significant association was noticed between the malaria parasite infection and occupation, ANC attendance and utility of mosquito net, P-value 0.05, 0.0024, 0.0010, respectively. However, no significant association was observed with education level and malaria infection. The study was recommended to promote diagnosis during pregnancy, take anti-malarial medicine as routine care to pregnant women and improve environmental sanitation.

Prevalence, Antimicrobial Susceptibility and Macrolide Molecular Study in Vaginal Group B Streptococcus: A Five-Year Study among Pregnant Women Attending Antenatal Clinics in a Tertiary Care Hospital in Tunisia

Group B Streptococcus (GBS) is an important perinatal pathogen. It is considered as a leading cause of stillbirth and early onset neonatal infections. The epidemiology of maternal GBS colonization is poorly understood in Tunisia. We investigated genital GBS carriage prevalence and its associated risk factors in pregnant women. Antibiotic susceptibility was evaluated for isolated strains; macrolide gene resistance and capsular serotyping were also performed.

Riskli Gebelerde Prenatal Bağlanma ve Risklerin Değerlendirilmesi

Amaç: Bu araştırma, gebeliğin herhangi bir döneminde riskli gebe olarak bildirilen gebelerin prenatal bağlanmalarını, bağlanmayı etkileyen faktörlerini ve risk faktörlerini değerlendirmek amacıyla planlanmıştır. Mataryel ve Metot: Bu kesitsel araştırma 2018 yılı içerisinde Kadıköy İlçe Sağlık Müdürlüğüne riskli gebe olarak bildirimi yapılmış ve henüz doğum yapmamış gebeler ile yürütülmüştür. Bir yıl içerisinde bildirilen 220 riskli gebe içerisinden, evreni belli olasılıklı örnekleme yöntemi ile örneklem hesaplaması yapılmış ve 105 riskli gebe çıkmıştır. Araştırmaya alınan riskli gebeler %95 Güven Aralığı ve basit rastgele örneklem yöntemi ile seçileceğinden %10 ret ve ulaşamama ihtimali göz önüne alınarak 115 riskli gebe ile araştırmayı kabul eden kişiler araştırma örneklemini oluşturmuştur. Bulgular: Araştırmaya katılan riskli gebelerin yaş ortalaması 33,65±4,80'dir (min:17, max:45). Kadınların yarıdan biraz fazlası (%51,9) 35 yaş üstüdür. Riskli gebelerin prenatal bağlanmalarına bakıldığı zaman ise bağlanma ölçeği ortalamasının 61,52±15,44 olduğu bulunmuş ve ölçeğin minimum puanı 21,00, maximum puanı 84,00 bulunmuştur. Riskli gebelerinin ölçek ortalaması gebelerin bağlanmalarının da orta düzeyin altında olduğunu göstermektedir. Riskli gebelerin ölü doğum yapmaları ile prenatal bağlanma arasında istatiksel bir ilişki bulunmuştur (z:-3,150, p: 0,002). Sonuç: Gebelikte yaşanılan sıkıntılar riskli gebelik olması ile birlikte daha fazla artmaktadır. Bu dönemde yetersiz bağlanmanın erken dönemde tespit edilmesi çok önemlidir. Bu dönemde bağlanmaya destekleyen veya engel olan faktörlerin belirlenerek gebenin anneliğe hazırlanması desteklenmelidir.

The Association Between Influenza Infection Rates and the Incidence of Orofacial Clefts in the United States

Objective: To investigate seasonal variation of orofacial clefts (OC) and measure association between United States (U.S.) influenza incidences and OC development for the purpose of identifying a potential modifiable risk factor for pregnant women. Design: Retrospective population-based observational study from 2004 to 2013. Setting: National Inpatient Sample Database (NIS), Wide-ranging Online Data for Epidemiologic Research (WONDER) Database, and National Respiratory and Enteric Virus Surveillance System’s (NRVESS) FluView database. Patients: U.S.-born infants with OC from 2004 to 2013 and monthly influenza incidence from 2003 to 2013. Main outcome measures: Using logistic regression, monthly odds ratios (OR) of OC were derived using January as baseline. Mixed-effects logistic regression was utilized to test association between national influenza and OC incidences. Results: There were 58 270 U.S. babies born with OC from 2004 to 2013. September births had the highest OC association (OR = 1.094, 95% CI = 1.051-1.138, E-value = 1.41), followed by June. For each additional influenza case per 1000 people, odds of OC event occurring during the 2nd month of pregnancy, or 7 months before delivery, was increased by 2.7 (OR = 2.659, CI = 1.456-4.856, E-value = 4.76). Odds of OC event occurring was decreased at the 3rd month of pregnancy, or 6 months before delivery by 7.8 (OR = 0.129, 95% CI = 0.068-0.246, E-value = 14.99). Conclusion: September and June births have the highest OC association. There is increased risk for OC with influenza occurring at the 2nd pregnancy month. Conversely, there are protective effects against OC with influenza occurring at the 3rd pregnancy month. These findings demonstrate an association between influenza rate and OC, suggesting a connection between maternal immune activation (mIA) and OC. Although further research is needed to determine the definitive link between the use of flu vaccines and OC occurrence, as well as the mechanism behind mIA secondary to influenza infection impacting OC incidence, this study presents a modifiable risk factor that could decrease the potential for mIA causing OC.

Study the Incidence, Types of Anemia and Associated Risk Factors in Pregnant Women

Background: Anemia is a global public health problem affecting both developing and developed countriesand more prevalent among pregnant women. Worldwide the main cause of anemia during pregnancy is irondeficiency, if remain untreated it might leads to increased risk for perinatal morbidity and mortality.Aim of the study: is to find an incidence of anemia among pregnant women along with types and severityto assess the association of various maternal characteristics with anemia forms.Materials and methods: One hundred twenty eight pregnant women were enrolled in this study. Seventyfive pregnant women were diagnosed with anemia while fifty three pregnant women without anemiaincluded in this study as a control subjects. Blood samples were collected to determine hemoglobin leveland complete blood counts (CBC).Results: The mean age was 27.76 years for 75 anemia pregnant women and mean of 26.08 years for 53control non- anemic pregnant women with no statically significant differences (P&gt;0.05). Most of anemicpregnant women had a pregnancy gap ? 1 year (51%) while most of non-anemic pregnant women had a gapof &gt; 3 years (62%) with highly significant differences between both groups (P&lt;0.01). Approximately halfof anemic pregnant women surveyed found to had a moderate anemia (Hb 7- 9.9 g/dl), one third (32%) ofpregnant women is multigravida with moderate anemia type and (62%) of anemic pregnant women foundto had Microcytic&amp; Hypochromic anemia. In the present study (80%) of pregnant women receiving ironsupplementation, also (73%) receiving folic acid supplement. Only (20%) receiving blood transfusion forsevere anemia type.Conclusion: The results of this research support the idea that the incidence of anemia is still high amongpregnant women and iron deficiency anemia is the most prevalent type with anemia became more pronouncedat third trimester of pregnancy and mostly with moderate severity type.