Pregnant Thai Women Research Articles

Exploring Women’s Experiences of Amniocentesis: A Qualitative Content Analysis

Background: The decision and experience of high-risk pregnant women to undergo amniocentesis can depend on their setting, context, social structures, and significant others, including cultural values and beliefs. What is less understood is women’s experience with decision-making, which may contribute to their anxiety during and after amniocentesis. This study aimed to explore the decision-making experiences of Thai pregnant women undergoing amniocentesis. Materials and Methods: A qualitative content analysis approach was employed to collect and analyze data. Purposive sampling and in-depth interviews were conducted between July and October 2021 with 15 Thai high-risk pregnant women after undergoing amniocentesis. Data analysis involved multiple readings of transcriptions to discern themes and understanding of the women’s stories. Results: Four themes of decision-making experiences were identified: (1) “Shocked, worried, and questioned why the risk was high”; (2) “Does my baby have Down syndrome? I want to know”; (3) “Worried”; and (4) “Relief from anxiety.” Conclusions: Women’s experiences with amniocentesis involved uncertain positive and negative feelings through the journey of undergoing, waiting, and receiving the test results. The nurses and nurse-midwives played an important role in counseling Thai pregnant women about whether to undergo amniocentesis.

Add-on hemoperfusion in SARS-CoV-2-infected pregnant patients: a case series

BackgroundPregnant women are more likely to have a higher severity of illness after being infected with coronavirus disease 2019 compared with the general population, particularly in the hyperinflammatory phase. However, immunomodulatory drugs are contraindicated and have been associated with an increased risk of fetal abnormalities. Therefore, we are reporting our experience with the use of HA330 hemoperfusion in combination with standard therapy in severe to critical coronavirus disease 2019 cases among pregnant patients.Case presentationFrom January 2020 to December 2021, four pregnant Thai women were treated with hemoperfusion using a cytokine adsorptive technique. The patients’ ages ranged from 21 to 36 years old, and their gestational ages at the time of admission ranged from 18 to 38 weeks. Two patients required intubation. Extracorporeal blood purification with an adsorptive cartridge (HA330®, Jafron, China) was applied as an adjunctive strategy to standard therapy approximately one week after the onset of symptoms, and most patients received three sessions of hemoperfusion. The baseline C-reactive protein level was greater than 80 mg/dL. The results showed that hemoperfusion could decrease the C-reactive protein level by approximately 80% and improve oxygenation. The newborns were delivered by Cesarean section without complications. Neither mortality nor serious adverse events related to hemoperfusion occurred.ConclusionThis report may help ensure the use of the hemoperfusion strategy in pregnant patients during a cytokine storm. However, a larger cohort is needed to confirm its safety and efficacy.

A causal model of eating behaviors among Thai pregnant women working in industrial factories

Abstract Objective This study aimed to examine the causal model of eating behaviors among pregnant women working in industrial factories. Methods This cross-sectional study was conducted on 210 participants, attending 4 healthcare centers, at a tertiary care hospital in Chonburi province, Thailand. Data were collected using 7 questionnaires: demographic form, eating behavior questionnaire, perceived benefits of the healthy eating questionnaire, perceived barriers to the healthy eating questionnaire, perceived self-efficacy questionnaire, social support questionnaire, and accessibility to healthy foods questionnaire. Descriptive statistics and path analysis were used for data analysis. Results The participants had relatively high mean scores for eating behaviors. The final model fitted well with the data χ2 = 12.86, df = 10, P = 0.23; χ2/df = 1.29; comparative fit index (CFI) = 0.98; goodness-of-fit index (GFI) = 0.98; adjusted goodness-of-fit index (AGFI) = 0.95; root mean square error of approximation (RMSEA) = 0.04. Four factors—perceived benefits (β = 0.13, P < 0.05), perceived self-efficacy in healthy eating (β = 0.22, P < 0.001), pregnancy planning (β = 0.28, P < 0.001), and accessibility to healthy foods in the factory (β = 0.12, P < 0.05)—positively affected eating behavior, while only perceived barriers to healthy eating had a negative effect on eating behavior (β = −0.24, P < 0.001). All the above factors explained 27.2% of the variance in eating behaviors. Conclusions Nurses or healthcare providers can apply these findings to create an eating behavior modification program, focusing on pregnancy planning, behavior-specific variables, and interpersonal and situational influence, to promote the nutritional status of pregnant women working in industrial factories.

Chromosomal abnormalities study for anembryonic pregnancy by BACs-on-Beads technique

ObjectiveThis study evaluated the BACs-on-Beads™ (BoBs) efficiency assay in detecting chromosomal anomalies in products of conception (POC) specimens associated with anembryonic pregnancy (AP) among Thai pregnant women. MethodRetrospective analysis applied the BoBs™ assay to examine AP samples from 2010 to 2022. The incidences of AP with chromosomal abnormalities were reported. ResultAssessment of villi from anembryonic pregnancy samples found normal chromosome complement in 50% of the cases, while the remainder showed chromosomal abnormalities. Trisomy 16 was found in 15% of the cases and trisomies 22, 15, and 19 in 9.6%, 3.8%, and 3.8%, respectively. Advanced maternal age was associated with a higher incidence of aneuploidy. ConclusionThe BoBs™ assay effectively detected diverse chromosomal abnormalities in villi samples from POC. The diagnostic utility of the BoBs™ assay was highlighted in identifying chromosomal irregularities in AP cases. Trisomy 16 possessed the most chromosomal abnormalities in the AP samples.

Enhancing Immunization Uptake for Influenza and Pertussis in Thai Pregnant Women through Educational Sessions

Objective: To describe influenza and pertussis vaccine uptake among pregnant women before and after receiving an educational session. Materials and Methods: An interventional study was conducted at a tertiary care hospital and a specialized obstetric hospital in Thailand. In the first phase, the medical records of the non-intervention pregnant women received antenatal care (ANC) at the study sites were reviewed. In the second phase, the pregnant women completed a questionnaire about their knowledge and factors for vaccine acceptance then enrolled into the intervention, received an educational session. The vaccine uptake between phases were compared using chi-square test. Potential factors of vaccine acceptance were examined using multivariate logistic regression. Results: Between May 2019 and July 2020, 785 pregnant women were enrolled with 375 in the non-intervention group and 410 in the intervention group. The median age of the pregnant women was 30 years (IQR of 26 to 34). Influenza vaccine uptake among the non-intervention group was 55.5% compared to 65.6% in the intervention group (p=0.004). The factor for influenza vaccine acceptance was the total number of visits at the ANC clinic at ten times or more (OR 1.38, 95% CI 1.04 to 1.84, p=0.03). Pertussis vaccine uptake was 52.8% in the non-intervention group compared to 67.0% in the intervention group (p=0.001). The factor for pertussis vaccine acceptance was receiving ANC at the tertiary care hospital (aOR 6.73, 95% CI 4.42 to 10.27). The most common reasons for not getting the vaccine were the concern of vaccine safety with 25.6% for influenza vaccine and 26.3% for pertussis vaccine. Conclusion: The educational session increased the vaccine uptake for influenza and pertussis in Thai pregnant women. Keywords: Immunization; Influenza; Pertussis; Pregnancy; Education

Oral dydrogesterone for prevention of miscarriage in threatened miscarriage: a randomized, double-blind, placebo-controlled trial

Objective To determine the effectiveness of oral dydrogesterone in preventing miscarriage in threatened miscarriage. Methods A randomized, controlled trial study was conducted among pregnant Thai women at the gestational age of six to less than 20 weeks who visited King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand with threatened miscarriage from August 2021 to August 2022. These pregnant women were randomized to receive oral dydrogesterone 20 mg per day or placebo twice a day until one week after vaginal bleeding stopped or otherwise for a maximum of six weeks. Results A total of 100 pregnancies were recruited. Fifty of them were assigned to receive oral dydrogesterone and 50 were assigned to receive placebo. The rate of continuing pregnancy beyond 20 weeks of gestational age was 90.0% (45 out of 50 women) in the dydrogesterone group and 86.0% (43 out of 50 women) in the placebo group (p = 0.538). The incidence of adverse events did not differ significantly between the groups. Conclusion Oral dydrogesterone 20 mg/day could not prevent miscarriages in women with threatened miscarriage.

Effects of an animated educational video on knowledge of cell-free DNA screening among Thai pregnant women: a randomized control trial

BackgroundIn developing countries, pregnant women have insufficient knowledge about cell-free DNA screening. Reports from developed countries have found that various tools in prenatal genetic counseling can improve the knowledge of pregnant women who undergo cell-free DNA screening. Data are limited from developing countries where women have different baseline socio-educational backgrounds. The objective of this study was to compare the effects of an animated educational video combined with traditional counseling versus traditional counseling alone in changing pregnant women’s knowledge of cell-free DNA screening.MethodsThis study was a randomized control trial at an antenatal clinic. Eligible subjects who were Thai pregnant women, were randomized to either view or not view the 4-minute animated educational video explaining cell-free DNA screening. Both groups received traditional counseling. The women were asked to complete a Thai questionnaire assessing knowledge of the screening before and after intervention. The questionnaire consisted of three sections: demographic data of the research participants and their existing awareness about cell-free DNA testing; performance and limitations of cell-free DNA screening; and participants’ attitudes toward the positive screening. Primary outcome was the change in knowledge scores. Secondary outcomes were attitudes toward positive screening test, levels of satisfaction with counseling, and screening acceptance rates.ResultsData from 83 women in the video group and 82 in the non-video group were analyzed. The knowledge score (range 0–18) change after counseling was significantly higher in the video group than the non-video group (+ 7.1 ± 3.3 vs + 4.2 ± 2.5; p = 0.03). There were no significant differences in attitudes toward positive screening test (p = 0.83), levels of satisfaction (p = 0.24), or screening acceptance rates (p = 0.15) between the groups.ConclusionsAdding the video to traditional counseling was better than traditional counseling alone in improving pregnant women’s knowledge about cell-free DNA screening.Trial registrationThe study was retrospectively registered with the Thai Clinical Trials Registry (TCTR20210917001, 17/09/2021).

Possible Association between Genetic Diversity of Hepatitis B Virus and Its Effect on the Detection Rate of Hepatitis B Virus DNA in the Placenta and Fetus.

Background: The prevalence of HBV infection and HBV genotypes varies from country to country, and the role of HBV genotypes in the presence of HBV in the placenta and fetus has never been explored. This study was conducted to (1) identify HBV genotypes, and their frequencies, that infected Northern Thai pregnant women; (2) evaluate the association between HBV genotypes and the detection rate of HBV DNA in the placenta and fetus; (3) evaluate the association between specific mutations of the HBV genome and HBV DNA detection in placental tissue; and (4) identify the mutation of the HBV genome that might occur between maternal blood, placenta, and cord blood. Methods: Stored samples of the maternal blood, placental tissue, and cord blood that were collected from 145 HBsAg-positive pregnant Thai women were analyzed to identify HBV DNA. Results: Approximately 25% of infected mothers had fetal HBV DNA detection, including cases with concomitant HBV DNA detection in the placenta (77.3%). A total of 11.7% of cases with placental detection had no HBV DNA detection in the maternal blood, indicating that the placenta could be a site of HBV accumulation. Of the 31 HBV-positive blood samples detected by nested PCR, the detected strains were subgenotype C1 (77.4%), subgenotype B9 (9.7%), and subgenotype C2, B2, B4, and recombinant B4/C2 (3.2% for each). Genotype B had a trend in increased risk of placental HBV DNA detection compared to genotype C, with a relative risk of 1.40 (95% CI: 1.07-1.84). No specific point mutation had a significant effect on HBV DNA detection in placental tissue. Mutation of C454T tended to enhance HBV DNA detection in placental tissue, whereas T400A tended to have a lower detection rate. No mutation was detected in different sample types collected from the same cases. Conclusions: HBV DNA detection in the fetus was identified in approximately 25% of HBV-positive mothers, associated with the presence of HBV in the placenta in most cases. The placenta could possibly be a site of HBV accumulation. Subgenotype C1 was the most common subgenotype, followed by subgenotype B9. HBV genotype B possibly had a higher trend in intrauterine detection than HBV genotype C. Mutation is unlikely to occur during intrauterine exposure.

Prevalence of Snoring in Pregnancy and Its Maternal-Fetal Outcomes at Vajira Hospital

Background: Snoring is an important symptom that is associated with obstructive sleep apnea and increases the risk of adverse pregnancy outcomes. In Thailand, the prevalence of snoring during pregnancy is uncertain. Determining the prevalence and characteristics may reduce the prevalence of snoring and improve pregnancy outcomes. Objective: The primary outcome was to determine the prevalence of snoring in Thai pregnant women in the third trimester, including pregnancy and chronic onset. The secondary outcome was to investigate the associations between pregnancy outcome and habitual snorer or those identified as high risk by the Thai Berlin Questionnaire. Materials and Methods: Three hundred eighty-two singleton pregnant women aged at least 18 years and at least 33 weeks of gestational age were recruited from the antenatal care clinic at Vajira Hospital, Navamindradhiraj University, between November 2021 and September 2022 and filled out the Thai Berlin Questionnaire. The 382 pregnant women were identified the presence of snoring or high risk of OSA in the previous month. Medical records, including demographic information and pregnancy outcomes, were collected, and analyzed. Results: The prevalence of snoring was 31.4% in the third trimester of pregnancy of which 27% were pregnancy onset snoring and 4.4% were chronic onset snoring. Habitual snoring was significantly different from non-snoring in regard to the requirement for positive-pressure ventilation in newborns (aOR 6.67, 95% CI 1.2 to 35.54). The high risk group had significantly more pregnancy induced hypertension than the low risk group (aOR 5.96, 95% CI 2.15 to 16.5), gestational hypertension (aOR 13.6, 95% CI 2.1 to 86.8), preeclampsia (aOR 4.07, 95% CI 1.09 to 15.2), severe preeclampsia (aOR 4.9, 95% CI 1.15 to 20.93), preterm birth (aOR 6.21, 95% CI 1.58 to 24.42), and low birth weight of newborn (aOR 6.09, 95% CI 2.5 to 14.87). Conclusion: The prevalence of snoring among Thai pregnant women was comparable to previous Western studies. Screening pregnant women at risk of the symptom may provide an early chance to lower the prevalence of snoring and adverse pregnancy outcomes. Keywords: Snoring; Snoring in pregnancy; Pregnancy outcomes

Immunogenicity and reactogenicity of heterologous COVID-19 vaccination in pregnant women

ABSTRACT This open-labeled non-inferiority trial evaluated immunogenicity and reactogenicity of heterologous and homologous COVID-19 vaccination schedules in pregnant Thai women. 18–45-year-old pregnant women with no history of COVID-19 infection or vaccination and a gestational age of ≥12 weeks were randomized 1:1:1 into three two-dose primary series scheduled 4 weeks apart: BNT162b2-BNT162b2 (Group 1), ChAdOx1-BNT162b2 (Group 2), and CoronaVac-BNT162b2 (Group 3). Serum antibody responses, maternal and cord blood antibody levels at delivery, and adverse events (AEs) following vaccination until delivery were assessed. The 124 enrolled participants had a median age of 31 (interquartile range [IQR] 26.0–35.5) years and gestational age of 23.5 (IQR 18.0–30.0) weeks. No significant difference in anti-receptor binding domain (RBD) IgG were observed across arms at 2 weeks after the second dose. Neutralizing antibody geometric mean titers against the ancestral Wuhan strain were highest in Group 3 (258.22, 95% CI [187.53, 355.56]), followed by Groups 1 (187.47, 95% CI [135.15, 260.03]) and 2 (166.63, 95% CI [124.60, 222.84]). Cord blood anti-RBD IgG was correlated with, and equal to or higher than, maternal levels at delivery (r = 0.719, P < .001) and inversely correlated with elapsed time after the second vaccination (r = −0.366, P < .001). No significant difference in cord blood antibody levels between groups were observed. Local and systemic AEs were mild-to-moderate and more frequent in Group 2. Heterologous schedules of CoronaVac-BNT162b2 or ChAdOx1-BNT162b2 induced immunogenicity on-par with BNT162b2-BNT162b2 and may be considered as alternative schedules for primary series in pregnant women in mRNA-limited vaccine settings.

Combined maternal risk factors and the Quadruple test to predict late-onset preeclampsia in pregnant Thai women

BackgroundThis study aimed to evaluate the predictive power of a model combining maternal risk factors and the Quadruple screen test for late-onset preeclampsia (PE).MethodsAll pregnant women that received the Quadruple test for Down syndrome at 15+ 0-20+ 6 weeks’ gestation were recruited. Maternal serum α-fetoprotein, β-human chorionic gonadotropin, unconjugated estriol, and inhibin A were measured as multiples of the median. A logistic regression model was used to identify predictors associated with late-onset PE with severe features. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to assess the model’s predictive ability.ResultsFifty-five of the 2,000 pregnant women had PE, and 31 of 55 women had late-onset PE. Multivariate analysis identified maternal age ≥ 35 years, inhibin A, history of previous PE, history of infertile, cardiac disease, chronic hypertension, and thyroid disease as significant risk factors. The area under the curve of the receiver operating characteristic curve was 0.78. The likelihood ratio to predict late-onset PE was 49.4 (total score > 60).ConclusionsOur model combining serum inhibin A with maternal risk factors was useful in predicting late-onset PE. Close monitoring of these patients is recommended.

Knowledge, attitude and acceptability regarding antenatal perineal massage in Thai pregnant women.

Antenatal perineal massage for obstetric anal sphincter injury prevention is not routinely performed in Thailand. Due to the cultural conservatism in the country, attitudes and acceptability need to be evaluated before procedure implementation. This research was conducted to evaluate knowledge, attitudes, and acceptability of antenatal perineal massage and identify associated factors for acceptability in antenatal perineal massage among Thai pregnant women. A cross-sectional study was conducted in the antenatal clinic at King Chulalongkorn Memorial Hospital, Bangkok, Thailand between July 2021 and June 2022. Thai women with singleton pregnancies at 22weeks or more of gestation without an indication for cesarean section were enrolled. Knowledge, attitudes, and acceptability of antenatal perineal massage were assessed using a self-administered questionnaire. In-depth interviews with pregnant women who were not interested in antenatal perineal massage were also completed. A total of 144 pregnant women were enrolled with 119 participants (83%) having an accepting attitude about antenatal perineal massage. Results on knowledge included 22 (15%) participants aware of this practice, 46 participants (31.9%) knew it should be practiced after GA 34weeks, 52 participants (36.1%) knew the massage should be maintained for 5-10min, and 37 participants (25.7%) knew it should be performed daily. Factors associated with acceptability of antenatal perineal massage were prior interest in perineal massage and trust in the benefit of the perineal massage in facilitating vaginal delivery. Reasons for disagreeing in antenatal perineal massage included never hearing of perineal massage, concern about pregnancy complications, fear of pain, believing it to be a useless procedure, and previous successful vaginal delivery. We found high acceptability for antenatal perineal massage. This program should be routinely explained and offered to Thai pregnant women to prevent severe perineal trauma and postpartum complications.

Cross-cultural adaptation and content validation of the Infant Feeding Intentions Scale for Thai pregnant women.

This study aimed to validate a translated and culturally adapted version of the Infant Feeding Intentions (IFI) Scale for use in Thailand. Prenatal breastfeeding intention is a strong indicator of breastfeeding initiation. The stronger the intention to breastfeed among pregnant women, the more likely breastfeeding will be initiated after childbirth and continue for an extended period. There are currently no IFI scales that have been validated for use in Thailand. The translation of the IFI scale from English to Thai was conducted through a six-stage approach that included initial translation, synthesis of translations, back-translation, expert committee review for content validity, reliability testing, and submission of the translated IFI to notify the scale developers. Both Item and Scale Content Validity Indices equaled 1, scored by five experts, who also validated the content for cross-cultural adaptation. The final Thai IFI (T-IFI) scale demonstrated high content validity. A total of 30 Thai pregnant women participated in the reliability testing. The Cronbach's alpha of the 5-item T-IFI scale was 0.857, which indicated satisfactory internal consistency. The T-IFI scale demonstrated high content validity and was culturally appropriate for use in a Thai-speaking population. It has potential to strengthen assessments of prenatal infant feeding intention among pregnant women in Thailand.

Convergent Validity of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire (PHQ-9) in Pregnant and Postpartum Women: Their Construct Correlations with Functional Disability

This study aimed to evaluate the convergent validity of the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ-9) in Thai pregnant and postpartum women, using the 12-item WHO Disability Assessment Schedule (WHODAS) as the reference standard. Participants completed the EPDS, PHQ-9, and WHODAS during the third trimester of pregnancy (over 28 weeks in gestational age) and six weeks postpartum. The sample included 186 and 136 participants for the antenatal and postpartum data analyses, respectively. The antenatal and postpartum data showed moderate correlations between both the EPDS and the PHQ-9 scores and the WHODAS scores (Spearman's correlation coefficients = 0.53-0.66, p < 0.001). The EPDS and PHQ-9 were moderately accurate in distinguishing disability (WHODAS score ≥ 10) from non-disability (WHODAS score < 10) in pregnant and postpartum participants, but the area under the curve of the PHQ-9 receiver operating characteristic curves in postpartum participants was significantly larger than that of the EPDS, with a difference (95% CI; p-value) of 0.08 (0.16, 0.01; p = 0.044). In conclusion, the EPDS and PHQ-9 are valid for assessing PND-related disability in pregnant and postpartum women. The PHQ-9 may perform better than the EPDS in distinguishing disability from non-disability in postpartum women.

The genetic polymorphisms and levels of adipokines and adipocytokines that influence the risk of developing gestational diabetes mellitus in Thai pregnant women

IntroductionAberrant immune and inflammatory response is thought to be involved in the pathogenesis of gestational diabetes mellitus (GDM). ObjectiveTo investigate the genetic polymorphisms and levels of adipokines/adipocytokines that influence the risk of developing GDM in Thai women. Research design & methodsThis case-control recruited 400 pregnant Thai women. A total of 12 gene polymorphisms at ADIPOQ, adipsin, lipocalin-2, PAI-1, resistin, IL-1β, IL-4, IL-17A, TGF-β, IL-10, IL-6, and TNF-α were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay and RNase H2 enzyme-based amplification (rhAmp) SNP assay. Serum levels of adipokines/adipocytokines were evaluated using Luminex assays. ResultsMean age, weight before and during pregnancy, body mass index before and during pregnancy, blood pressure, gestational age at blood collection, and median 50 g glucose challenge test were significantly higher in GDM women than control. Significantly lower adiponectin and higher IL-4 levels were found in GDM compared to controls (p = 0.001 and p = 0.03, respectively). The genotype frequencies of IL-17A (rs3819025) were significantly different between GDM and controls (p = 0.01). Using additive models, IL-17A (rs3819025) and.TNF-α (rs1800629) were found to be independently associated with increased risk of GDM (odds ratio [OR]: 2.867; 95 % confidence interval [CI]: 1.171–7.017; p = 0.021; and OR: 12.163; 95 %CI: 1.368–108.153; p = 0.025, respectively). In GDM with IL-17A (rs3819025), there was a significant negative correlation with lipocalin-2 and PAI-1 levels (p = 0.038 and p = 0.004, respectively). ConclusionThe results of this study highlight the need for genetic testing to predict/prevent GDM, and the importance of evaluating adipokine/adipocytokine levels in Thai GDM women.

Cross-cultural adaptation and content validation of the Infant Feeding Intentions Scale for Thai pregnant women

Cross-cultural adaptation and content validation of the Infant Feeding Intentions Scale for Thai pregnant women

The construction and validation of a lead exposure screening tool for pregnant women in Thailand (ThaiL8Is)

ObjectivesTo construct, validate, and implement a new screening tool for lead exposure in Thai pregnant women. MethodsA cross-sectional study that included three processes: screening tool development, validation, and implementation. The participants were pregnant women who had received antenatal care at district health promotion hospitals. There were 100 pregnant women in Nakhon Si Thammarat province during the validation process, and 30 pregnant women in Phang Nga province during the implementation process. Blood lead levels (BLLs) were analysed by atomic absorption spectrophotometry. The sensitivity and specificity of the screening instrument, as well as the Area Under the Curve (AUC), demonstrate its validity. ResultsThere were 80 BLL-related items found through the collection of primary and secondary data and examined for validity and inter-rater reliability by five experts. Six items were excluded because the values were less than the criteria set. Seventy-four items remained with the Item Content Validity Index (I-CVI) = 0.80–1.00, the Content Validity Index Average (S-CVI/Ave) = 0.91, and Kappa scores = 0.76–1.00. After using 74 items collected on pregnant women, only 31 items were included in the validation process. Following that, the pooled eight items with cut-off point scores of 1 had the highest validity, which included systolic blood pressure, diastolic blood pressure, urine sugar, haemoglobin level, occupation, drinking coffee, using chemical products, and education level (ThaiL8Is). The ThaiL8Is in the validation process yielded sensitivity = 80.9%, specificity = 69.8%, and an AUC (95%CI) = 0.78 (0.69–0.87). The implementation process has confirmed the validity of the screening tool; sensitivity = 78.9%, specificity = 81.8%, and the AUC (95%CI) = 0.80 (0.63–0.97). ConclusionsThe ThaiL8Is a valid screening tool for Thai pregnant women. ThaiL8Is' sensitivity in detecting the risk groups for lead exposure can be enhanced by a combination of biochemical markers used in routine prenatal screening. It can be used to screen pregnant women for early indicators of lead exposure prior to a blood lead test.

Knowledge Attitude and Practice of Postpartum Parturients Towards Cervical Cancer and Cervical Cancer Screening; Is Lack of Knowledge the Misleading Scapegoat?

Objective:The aim of this study was to assess knowledge, attitude, and practices towards cervical cancer screening among postpartum subjects. Study design:This cross-sectional study was conducted at inpatient obstetrics ward at Thammasat University Hospital (TUH), Thailand. The period of study was between July 2020 and July 2021. Subjects were term Thai pregnant women who had age between 20 and 45 years old and delivered at TUH. Demographic characters, knowledge, attitude and practices regarding cervical cancer screening were collected. Results:A total of 388 parturient was recruited into the study. Average age was 31 years old. Around 90 percent of subjects knew that every woman age between 21and 65 years old with or without children should be screened for cervical cancer despite having only 46.6 percent (181/388) of subjects that underwent postpartum cervical cancer screening. Almost half of the participant agreed that risky sexual behavior of both genders was not the cause of cervical cancer. Despite the availability of the HPV vaccine throughout the country, only 74.2 percent acknowledged that HPV was the cause and only 70.4% heard about the HPV vaccine. The mean attitude about the cervical cancer was relatively high with the mean of 3.19±0.46. Although the higher the score the better the attitude toward the statement, there were several correlations of having such attitude. Conclusion: Attention to postpartum cervical cancer screening was quite low even though high knowledge of cervical cancer and screening. Scant knowledge was not all of the troubles that we believed long time ago.

Acceptance of COVID-19 vaccination during pregnancy among Thai pregnant women and their spouses: a prospective survey

BackgroundVaccination is one of the most reliable interventions against coronavirus disease 2019 (COVID-19). Although pregnant women’s attitudes toward COVID-19 vaccination are well studied, husbands’ views toward COVID-19 vaccination for these women have not been surveyed. We aimed to determine the rates and associated factors of accepting attitudes toward COVID-19 vaccination during pregnancy among Thai pregnant women and their spouses and to evaluate the actual rate of vaccination during pregnancy among these women.MethodsA prospective survey was conducted at a tertiary care center in Bangkok, Thailand. A total of 176 Thai pregnant woman/husband dyads who attended our antenatal care clinic between 1 July 2021 and 30 September 2021 were consecutively recruited for evaluations of their accepting attitudes toward COVID-19 vaccination during pregnancy. After delivery, data on COVID-19 vaccination during pregnancy among pregnant women were extracted from the hospital’s electronic database.ResultsAfter exclusion of five pregnant women with prepregnancy COVID-19 vaccination, 171 women and 176 male partners were included. The rates of accepting attitudes toward COVID-19 vaccination during pregnancy were 60.8% and 61.4%, respectively. Multivariate analysis showed that having a husband who favored COVID-19 vaccination for his wife was independently associated with COVID-19 vaccine acceptance among pregnant women (adjusted odds ratio 4.82; 95% confidence interval 2.34, 9.94). However, confidence in vaccine safety was an associated factor of the husband’s willingness to have his wife vaccinated for COVID-19 during pregnancy (adjusted odds ratio 12.56; 95% confidence interval 2.35, 67.18). The actual rate of vaccination during pregnancy was 88.3%.ConclusionsAlthough the rates of accepting attitudes toward COVID-19 vaccination during pregnancy among Thai pregnant women and their spouses were modest, the actual rate of being vaccinated during pregnancy was high.

Relationship of anthropometric measurements with glycated hemoglobin and 1-h blood glucose after 50 g glucose challenge test in pregnant women: A longitudinal cohort study in Southern Thailand.

To assess correlations of anthropometric measurements with glycated hemoglobin (HbA1c) and 1-h blood glucose after a 50 g glucose challenge test during the first and late second trimesters and explore their relationships of anthropometric measurements with neonatal birth weight. A longitudinal study was conducted among pregnant Thai women with gestational age ≤14 weeks. Anthropometric measurements, using body mass index, body compositions, and circumferences, and skinfold thickness, were measured at four-time points: ≤14, 18-22, 24-28, and 30-34 weeks of gestation. HbA1c and 1-h blood glucose were examined at ≤14 and 24-28 weeks. Neonatal birth weight was recorded. Of 312 women, HbA1c was more correlated with anthropometric measurements during pregnancy than 1-h blood glucose. At 24-28 weeks, women with high/very high body fat percentage were more likely to have higher HbA1c. Women with high subscapular skinfold thickness were more likely to have higher 1-h blood glucose at ≤14 and 24-28 weeks. High hip circumference significantly increased neonatal birth weights. Anthropometric measurements were longitudinally correlated with HbA1c and 1-h blood glucose, higher in the late second than first trimesters, as well as neonatal birth weight. The mechanisms to explain the relationship of different anthropometric measurements are required to be further studied.