Term Pregnant Mothers Research Articles

Effects of maternal blood selenium and zinc levels on mitochondrial DNA copy number at term and in-turn their effect on the birthweight of the baby

Introduction and Aim: The micronutrients such as selenium and zinc have the antioxidant property. They are cofactors of antioxidant enzymes, regulate the inflammatory response by counterbalancing the oxidative stress. Reduced maternal selenium and zinc levels have been shown to be associated with early pregnancy loss and low birthweight. The aim is to study the effects of maternal blood selenium and zinc levels on mitochondrial DNA copy number at term and in-turn their effect on the birth weight of the baby. Methods: An Institutional ethical clearance was obtained and the present hospital based cross sectional study was conducted in the OBG department of a medical college of North Karnataka between December 2019 to February 2022. Results: A total of 150 term pregnant women participated in the study. There was a slightly increased serum level of zinc and selenium found in the term pregnant mothers who gave birth to normal birth weight babies when compared to low-birth-weight babies, though this difference was not statistically significant. Median (IQR) values of Delta CT values of Mitochondrial DNA copy number in low-birth-weight babies were 3.07(1.7-5.74) and in normal birth weight babies was 3.71 (0.83-4.4). The difference in median values was not statistically significant (p=0.57). We observed a positive correlation between the maternal zinc, selenium, and mitochondrial DNA copy number with birth weight of the baby. Though the correlation between Delta CT means and birthweight of the baby is found to be statistically significant. Conclusion: In the present study, apparently healthy pregnant women participated. The serum selenium and zinc levels were found to be within normal limits according to lab reference values. There was an increase in Mitochondrial DNA copy number in the present study and it was positively correlated with the birthweight of the baby.

STUDY ON PATTERN OF UTILIZATION AND FACTORS DETERMINING UTILIZATION OF ANC SERVICES AMONG PREGNANT WOMEN IN GWALIOR CITY, MADHYA PRADESH, INDIA

Background: Globally only 64% of women receive antenatal (prenatal) care services for four or more times throughout their pregnancy. According to National family health survey (NFHS)-5, 58.1% of pregnant women had at least four ANC visits to avail ANC services. Quality health care during pregnancy and childbirth can prevent many pregnancies related deaths. The objective of the present study was to examine utilization of antenatal care services among the study subjects and nd out its determinants, including out of pocket expenditure incurred on management of the pregnancies. Methods: The study was conducted in a tertiary care teaching hospital among full term pregnant mothers and those who had recently delivered. Purposive sampling method was used and sample size of 368 was calculated. Results: The study brought out that 100% women had their registration, 75.5% of them within 12 weeks of pregnancy. Majority of the women (69.5%) preferred private health care facility clinic for antenatal check-up. However, the utilization of various government schemes in place for the benet of pregnant mothers were underutilized (26.6%). The study also revealed that 16.0% of the families suffered catastrophic expenditure as the cost of treatment on antenatal care and treatment went beyond household budget and they had to borrow money for the treatment. Conclusions: A signicant association was found between number of antenatal visits and increasing age, higher socio-economic status, higher educational status, Hindu religion, place of residence (urban), nuclear type of family and early registration.

Effects of Short Birth Interval on Birth Outcomes among Term Pregnant Mothers in Labor

Short birth interval is a global public health problem that remains challenging in Ethiopia. This study aimed to determine the effects of short birth interval on birth outcomes among term pregnant mothers in labor in Nekemte, Ethiopia. An institution-based prospective cohort-study with a convenient sampling technique was conducted from February 01 to March 30, 2016. A total of 207 term pregnant mothers were enrolled with the ratio of 1:2 women with short birth intervals and actualbirth intervals. The data collected using a structured questionnaire was analyzed by SPSS version 20. Women with short birth intervals were more likely to have premature rupture of membrane, prolonged labor, preeclampsia, and risk of malposition or malpresentation compared to women with actual birth intervals. Women with short birth intervals also had babies with low birth weight, low APGAR score, respiratory distress, risk of having early age for gestational growth, early neonatal death, and anemicnewborn babies compared to women with actual birth intervals. Therefore, the findings of this study revealed that short birth intervals had a significant influence on both maternal and neonatal health outcomes.

Iodine Status and Thyroid Functions of Turkish and Syrian Mother-Newborn Dyads in a County of Istanbul

Background: Inappropriate iodine intake can result in thyroid disorders in mothers and newborns in addition to their adverse effects on prenatal and postnatal developmental processes. Determination of median urinary iodine concentration (MUIC) is an established tool for monitoring of iodine nutrition. Aim: The aim of this cross-sectional study was to investigate iodine status by measuring the MUIC and serum TSH and free T4 levels of Turkish and Syrian mother-newborn dyads in a county of Istanbul. Methods: In a tertiary care center, in the Turkish and Syrian, low-risk, term-pregnant mothers and their newborns, urine samples were collected from mothers and newborns within first 24 hours after birth. For the measurements of TSH and free T4, blood samples were obtained from mothers at admission to labor and delivery unit and from newborns on day 5 of neonatal life. Results: In the study population of mothers, mild iodine deficiency was more prominent with an incidence of about 18%, followed by moderate and severe forms with an incidence of about 5% and 0.5%, respectively. Turkish and Syrian mothers had similar incidence of mild, moderate, and severe iodine deficiencies. The incidence of iodine deficiency of newborns were 41%. Overall, in the Turkish and Syrian participants, there were no prominent correlations between the MUICs of mothers and newborns. Regarding serum TSH and free T4 levels, the median TSH concentration of Turkish mothers was significantly lower (p 0.05). Considering TSH values of newborns, in 40 of them, there was higher TSH values requiring attention during neonatal follow-up. They had mild and moderate but not severe form of TSH elevation. Conclusion: Despite the mandatory salt iodization and official health care support for all mothers and newborns, daily iodine supplementation during pregnancy and breastfeeding seems to be a helpful measure to prevent the adverse effects of iodine deficiency to newborns and children. Funding Statement: This study was supported by a grant of Turk Pediatri Kurumu Dernegi (the Association of Turkish Pediatrics Institution). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Association of Turkish Pediatrics Institution. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: The study was approved by the Human Research Ethics Committee (Registry No. 464). All participants provided written informed consent.

Study of utilization of antenatal care services and its determinants among pregnant women admitted in a tertiary care hospital in Mangaluru, Karnataka, India

Background: Globally only 64% of women receive antenatal (prenatal) care four or more times throughout their pregnancy. National family health survey (NFHS) -4, brings out that in India, 21% of pregnant women utilized full ANC, ranging from 2.3-65.9% across the states. Quality health care during pregnancy and childbirth can prevent many pregnancy related deaths. The objective of the present study was to examine utilization of antenatal care services among the study subjects and find out its determinants, including out of pocket expenditure incurred on management of the pregnancies.Methods: The study was conducted in a tertiary care teaching hospital among full term pregnant mothers and those who had recently delivered. Purposive sampling method was used and sample size of 368 was calculated.Results: The study brought out that 100% women had their registration, 75.5% of them within 12 weeks of pregnancy. Majority of the women (69.5%) preferred private health care facility clinic for antenatal check-up. However, the utilization of various government schemes in place for the benefit of pregnant mothers were underutilized (26.6%).The study also revealed that 16.0% of the families suffered catastrophic expenditure as the cost of treatment on antenatal care and treatment went beyond household budget and they had to borrow money for the treatment.Conclusions: A significant association was found between number of antenatal visits and increasing age, higher socio-economic status, higher educational status, Hindu religion, place of residence (urban), nuclear type of family and early registration.

Neonatal survival and determinants of mortality in Aroresa district, Southern Ethiopia: a prospective cohort study

BackgroundThe first 28 days of aliveness are the biggest challenge mentioned for the continuity of life for children. In Ethiopia, despite a significant reduction in under-five mortality during the last 15 years, neonatal mortality remains a public health problem accounting for 47% of under-five mortality. Understanding neonatal survival and risk factors for neonatal mortality could help devising tailored interventions. The aim of this study was to determine the neonatal survival and risk factors for neonatal mortality in Aroresa district, Southern Ethiopia.MethodsA community based prospective follow up study was conducted among a cohort of term pregnant mothers and neonates delivered from January 1/2018 to March 30/2018. A total of 586 term pregnant mothers were selected with a multistage sampling technique and 584 neonates were followed-up for a total of 28 days, with 12 twin pairs. Data were coded, entered cleaned and analyzed using SPSS version 22. Kaplan–Meier survival curve was used to show pattern of neonatal death in 28 days. Independent and adjusted relationships of different predictors with neonates’ survival were assessed with Cox regression model. The risk of mortality was explored and presented with hazard ratio and 95% confidence interval and P-value less than 0.05 were considered as significant.ResultThe overall neonatal mortality was 41 per 1000 live births. Hazards of neonatal mortality was high for neonates with complications (AHR = 3.643; 95% CI, 1.36–9.77), male neonates (AHR = 2.71; 95% CI, 1.03–7.09), neonates that mothers perceived to be small (AHR = 3.46; 95% CI, 1.119–10.704), neonates who had initiated exclusive breast feeding (EBF) after 1 h (AHR = 3.572; 95% CI, 1.255–10.165) and mothers who had no postnatal care (AHR = 3.07; 95% CI, 1.16–8.12).ConclusionNeonatal mortality in the study area was 4.1% which was high and immediate action should be taken towards achieving the Sustainable Development Goals. To improve neonatal survival, high impact interventions such as promotion of maternal service utilization, essential newborn care and early initiation of exclusive breast feeding were recommended.

Prevalence, Aetiology, Maternal and Neonatal Outcome of Term Mothers with Anaemia, Presenting to a Tertiary Care Unit for Confinement in Sri Lanka

Objective: To describe the proportion of women presenting with undiagnosed anaemia at confinement and to explore associations between anaemia and socio economic factors, dietary pattern and compare maternal and neonatal outcome among term mothers with anaemia compared to non-anaemic pregnant women at a tertiary care centre in Sri Lanka. Method: A comparative cross-sectional study was performed by recruiting anaemic and non-anaemic term mothers who delivered at the Teaching Hospital Peradeniya during the period March 2018-March 2019. Pregnant mothers whose haemoglobin level was less than 10.5 g/dl were considered as anaemic and compared with the mothers whose haemoglobin level was above this level. With written consent, demographic data, etiological factors, maternal and neonatal outcomes of term mothers were evaluated by an interview and blood samples were withdrawn to carry out anaemia related investigations. Results: Among 2854 pregnancies, a total of 234 (8.19%) term pregnant mothers were anaemic and they were and compared with 199 non-anaemic mothers. Out of the anaemic mothers (Hb < 105 g/l), 133 (56.76%) had moderate anaemia, 100 (42.79%) had mild anaemia and 1 mother (0.45%) had severe anaemia. Low monthly family income was significantly associated with the incidence of anaemia. Anaemia was also associated with low weekly consumption of red meat (OR 8.994; 95% CI, 5.74 - 14.09, p < 0.05) and high weekly tea intake (OR 0.217; 95% CI 0.144 - 0.327, p < 0.05). Among anaemic mothers, 215 (67.44%) had low serum ferritin (<30 ng/mL) while most of them were diagnosed with iron deficiency anaemia (58.24%) (n = 113) based on haemoglobin. Most anaemic mothers had undergone elective caesarean section (46.26%) while vaginal deliveries (33.33%) were common among non-anamic group. Conclusions: A moderate prevalence of anaemia among term pregnant women in Peradeniya, Sri Lanka was observed and was associated with low socio economic status, low consumption of tea and poor nutrition lacking in red meat.

Effects of umbilical cord milking compared to differed cord clamping in term infants, a randomized controlled trial

Introduction: Differed cord clamping (DCC) at delivery is currently recommended to increase neonatal haemoglobin levels (Hb) and reduce the risk of infant anemia. It needs waiting for two to three minutes, which is considered to be associated with most of its unwanted effects. An alternative could be umbilical cord milking (UCM) with early clamping. Although effects of UCM have been assessed in preterm neonates such evidence is sparse for term neonates. Objectives: To evaluate whether the effects on Hb, bilirubin and haemodynamic parameters in infants, and blood loss in the mother are better with UCM than with DCC during elective caesarean delivery at term. Methods: Sixty term pregnant mothers undergoing elective caesarean delivery (CD) in Teaching Hospital Kandy, from 1st February to 31st March 2015 were randomized to UCM and DCC. The UCM group had the umbilical cord milked towards the umbilicus of the baby in a standard method soon after delivery. The DCC group had the umbilical cord clamped after two minutes of delivery or once the cord pulsations had ceased. Neonatal Hb, bilirubin and haemodynamic parameters, and maternal blood loss were assessed within 48 hours of delivery. Results: Thirty three participants underwent UCM while 27 participants underwent DCC. Main indications for the CD were past CD (47%), failed induction (12%), past bad obstetric history (10%), maternal medical conditions (8%) and suspected gross cephalo pelvic disproportion (8%). All CD were performed under spinal aneasthesia. There were no significant differences between the UCM and DCC groups with regard to mean neonatal Hb (17.6g/dl, sd 2.0 vs 17.4g/dl, sd 2.4, p=0.67), mean neonatal total bilirubin (111.8 mmol/l, sd 47.6 vs 123.0mmol/l, sd 35.0, p=0.69) and mean maternal decrease in Hb (1.0g/dl, sd 0.7 vs 1.3g/dl, sd 1.0, p=0.37). All the neonates had birth APGAR of 10 at 5 minutes. The volume of blood remaining in the placenta was significantly higher in the UCM group (29.5ml, sd 20.3 vs 19.5ml, sd 13.1, p=0.03). Conclusions: Neonatal and maternal outcomes are not better with UCM than with DCC during elective CD.

Tingkat Pengetahuan Ibu Hamil Trimester II Tentang Kebutuhan Nutrisi

Background : Pregnant mothers’ nutritional status is partly influenced by knowledge level. Early study signaled that there were 47,25 % of pregnant mothers who suffered Chronic Energy Deficiency and the result of interviews found out that 7 out of 10 pregnant mothers had insufficient understanding about nutritional need. This fact encouraged the researcher to hold a study about the knowledge level of second term pregnant mothers about nutritional need in Sanden Community Health Center, Bantul, Yogyakarta&#x0D; Objective : To uncover the knowledge level of second term pregnant mothers about nutritional intake need in Sanden Community Health Center, Bantul, Yogyakarta&#x0D; Method : This was a quantitative descriptive study. Population in this study was Second Term pregnant mothers who underwent pregnancy examination in Sanden Community Health Center, Bantul, Yogyakarta, during June – July 2014. 30 respondents were sorted with Incidental Sampling technique. Data collecting used primary data and the instrument used was closed questionnaire.&#x0D; Result : This study finally categorized the knowledge level of pregnant mothers in Good category (33,3 %), Sufficient category (60,0 %), and Poor category (6,7 %).&#x0D; Conclusion : The knowledge level of second term pregnant mothers about nutritional need were categorized as enough so that it is recommended that pregnant mothers improve their understanding about nutritional need during pregnancy.&#x0D; Suggestion : Midwives in Community Health Centre are supposed to hold dissemination about nutritional need during pregnancy so that it may prevent any Chronic Energy Deficiency.

The prevalence of Group B Streptococus recto-vaginal colonization and antimicrobial susceptibility pattern in pregnant mothers at two hospitals of Addis Ababa, Ethiopia.

BackgroundGroup B streptococcus (GBS) has been implicated in adverse pregnancy outcomes. GBS recto-vaginal colonization rates significantly vary among different communities and geographic locations. Limited data is available on the prevalence and effects of GBS recto-vaginal colonization among pregnant mothers in developing countries like Ethiopia.ObjectiveTo assess the prevalence of GBS recto-vaginal colonization among near term pregnant mothers and the antimicrobial susceptibility pattern of the isolates.MethodsA cross sectional descriptive study was conducted on pregnant mothers at gestational age of 35–37 weeks attending Ante Natal Clinics at Ghandi Memorial (GMH) and Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa. Samples from lower genital tract and rectum were collected and cultured for GBS on CHROM agar Strep B.ResultsTwenty two of the 300 pregnant mothers (7.2%) studied were found to have positive GBS recto-vaginal culture. Twelve isolates (55%) were sensitive to penicillin while 20 (91%) were sensitive to ampicilline. All isolates except one were sensitive to Erythromycin.ConclusionThe study showed recto-vaginal GBS colonization among near term pregnant mothers is reasonably high in our community calling for the need to screen mothers near term and provide appropriate antimicrobial prophylaxis to prevent potential adverse maternal and neonatal outcome.

Foetal response to music and voice

To examine whether prenatal exposure to music and voice alters foetal behaviour and whether foetal response to music differs from human voice. A prospective observational study was conducted in 20 normal term pregnant mothers. Ten foetuses were exposed to music and voice for 15 s at different sound pressure levels to find out the optimal setting for the auditory stimulation. Music, voice and sham were played to another 10 foetuses via a headphone on the maternal abdomen. The sound pressure level was 105 db and 94 db for music and voice, respectively. Computerised assessment of foetal heart rate and activity were recorded. 90 actocardiograms were obtained for the whole group. One way anova followed by posthoc (Student-Newman-Keuls method) analysis was used to find if there is significant difference in foetal response to music and voice versus sham. Foetuses responded with heart rate acceleration and motor response to both music and voice. This was statistically significant compared to sham. There was no significant difference between the foetal heart rate acceleration to music and voice. Prenatal exposure to music and voice alters the foetal behaviour. No difference was detected in foetal response to music and voice.

Vaginal and Intracervical Prostaglandin E2For Cervical Ripening: A Doppler Study of Hemodynamic Effects

The hemodynamic effects of vaginally and intracervically administered prostaglandin E2 gel were evaluated by pulsed wave color Doppler ultrasound. Twenty term pregnant mothers were recruited. Mothers were randomized to receive either vaginal or intracervical prostaglandin E2 gel. The hemodynamics was assessed by repeated color Doppler velocimetry of the uterine artery and fetal umbilical and middle cerebral arteries; analysis of variance was used to test statistical significance. In the uterine artery a statistically significant rise (P < or = 0.001) of the pulsatility index (PI) was observed. A slightly higher rise of the PI was observed after intracervical administration, but the difference between the groups was not statistically significant (P = 0.4). The fetal PI remained unchanged both in the umbilical and cerebral vessels throughout the study. The rise in the uterine artery PI is probably caused by an increase in the uterine tone as prostaglandins of the E series usually cause vasodilation. No detectable fetal effects were evident.

Excessive Physical Work during Pregnancy and Birth Weight

The effect of excessive physical work during pregnancy on birth weight was studied in 329 full term pregnant mothers with no complication of pregnancy and no associated disease delivering at Jinnah Postgraduate Medical Centre, Karachi. Birth weight was influenced by excessive physical work amongst mothers on diet deficient in calories according to calorie allowance recommended by WHO but not in mothers on recommended calories.