Pregnancy Visit Research Articles

OR11-2 A Lifestyle Program Targeting Women with Obesity and Infertility Improves Their Fertility: A Randomized Controlled Trial

Obesity reduces fertility and the effectiveness of fertility treatments in women, in addition to increasing pregnancy complications and programming of childhood obesity. Since studies have suggested that weight loss and lifestyle management could improve the fertility of women with obesity, obesity management with lifestyle modification is recommended for these women. Objectives: To evaluate the impacts of a lifestyle program in women with obesity and infertility on: 1) fertility outcomes, and 2) anthropometric and lifestyle measures. Methods: Women with obesity and infertility consulting at the fertility clinic of an academic hospital were randomized to the lifestyle program group (LPG) or control group (CG). Women in the CG began usual fertility care directly. Those in the LPG received the lifestyle intervention alone, without fertility treatments, for the first 6 months, and then in association with fertility treatments, if not pregnant. The lifestyle intervention combined individual and group sessions with a nutritionist and a kinesiologist in order to support progressive and sustainable lifestyle modifications. Per-protocol analyses including women who completed at least 6 months of the trial, or became pregnant, are presented. The maximal duration of follow-up, and intervention in the LPG, was 18 months or the end of pregnancy. Proportions were compared using chi-squared tests and means, using Student’s t tests. Results: Among 130 randomized women, 108 completed at least 6 months of the study or became pregnant (83%, 51 LPG and 57 CG). In these women, the lifestyle program increased by 58% the pregnancy rate as compared to controls (60.8% vs 38.6%, p=0.021) and almost tripled the proportion of women who conceived spontaneously, without fertility treatments (33.3% vs 12.3%, p=0.009). The lifestyle program also increased the live birth rate by 39% (51.0% vs 36.8%), although this was not statistically significant (p=0.139). When comparing participants with measures at 6 months of follow-up or at first pregnancy visit if before 6 months (75%, 46 LPG; 51 CG), women in the LPG lost significantly more % of weight (-3.4 ± 4.5% vs -0.89 ± 3.7, p=0.003), waist circumference (-2.9 ± 4.3 cm vs -0.97 ± 4.4, p=0.036) and % of fat mass (-1.3 ± 2.1% vs -0.47 ± 1.3%, p=0.033) compared to the CG. They also improved significantly more their lifestyle habits than the CG (healthy eating index: +18.2 ± 13.7 points vs +5.3 ± 12.4, p<0.001; total leisure activity’s energy expenditure: +0.77 ± 1.63 kcal/kg/day vs +0.17 ± 1.26 kcal/kg/day, p=0.044). Conclusion: A lifestyle program targeting women with obesity seeking fertility treatments improves not only their anthropometry and lifestyle habits, but most importantly, their chances of conceiving, especially spontaneously, in comparison to standard fertility treatments alone. Such impact could significantly reduce the costs associated with fertility treatments. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Inadequate prenatal care utilization among women with and without methadone-treated opioid use disorders in Taiwan

AimsThe present study aims to investigate the utilization pattern of prenatal care and correlates for women with opioid use disorders (OUD) in Taiwan. MethodUsing the data linkage between the Methadone Maintenance Treatment (MMT) register with national health insurance, national birth notification system, and birth registration system, we identified 1712 pregnancies with 20 or more gestational weeks from women enrolled in the MMT (heroin-exposed: receiving no methadone treatment during pregnancy, n = 1053 by 882 women; methadone-treated: receiving methadone for at least one day during pregnancy, n = 659 by 574 women) and their 1:10 matched pregnancies from 17,060 women without substance use disorder in the period of 2004-2013. The generalized linear mixed models with negative binomial and logit distributions were performed to evaluate the relationship between individual sociodemographic, health, and addiction treatment characteristics with the number of prenatal visits and receiving prenatal care in the first trimester (i.e., early entry). FindingsEighteen percent of pregnancies by women with OUD received no prenatal services and 21% had started prenatal care in the first trimester as compared with 1% and 46% in pregnancies by women without substance use disorders. For pregnancies by women with OUD, methadone treatment was not linked associated with prenatal care visits (adjusted relative risk [aRR] = 1.02; 95% = 0.92, 1.12). For methadone-treated pregnancies, treatment enrollment before pregnancy and spousal methadone treatment elevated prenatal visits by 8% and 18% (0.48 and 1.08 visits, respectively). Additionally, HIV infection (adjusted odds ratio [aOR] = 0.30, 95% CI = 0.10, 0.83) and prior delivery (aOR = 0.05, 95% CI = 0.01, 0.19) significantly reduced the odds of early entry into prenatal care. ConclusionIntegrating addiction treatment programs with prenatal care is urgently needed to increase adequate prenatal care for pregnant women with OUD, especially the multiparous ones.

The role of women’s empowerment and male engagement in pregnancy healthcare seeking behaviors in western Kenya

ABSTRACTWe sought to understand whether women’s empowerment and male partner engagement were associated with use of antenatal care (ANC). Women presenting for ANC in Nyanza province of Kenya between June 2015 and May 2016, were approached for participation. A total of 137 pregnant women and 96 male partners completed baseline assessments. Women’s empowerment was measured using the modified Sexual Relationship Power Scale. ANC use measures included timing of the first ANC visit and number of visits. Male engagement was based on whether a husband reported accompanying his wife to one or more antenatal visits during the pregnancy. Multiple linear and logistic regression analyses were used to identify factors independently related to use and timing of ANC. Women with higher mean empowerment scores were likely to have more than one ANC visit in the index pregnancy [Adjusted Odds Ratio (AOR) = 2.8, 95% Confidence Interval (CI): 1.1–7.3], but empowerment was not associated with early ANC use. Women who were more empowered were less likely to have a husband who reported attending an ANC visit with his wife (AOR = 0.1, 95% CI: 0.03–0.8). Women’s empowerment is important and may be related to ANC use and engagement of male partners in complex ways.

Peningkatan Ketepatan Klasifikasi dengan Metode Bootstrap Aggregating pada Regresi Logistik Ordinal

&#x0D; Baby's birth weight is influenced by characteristics of pregnant women such as age, parity, education level, pregnancy visit, and gestational age. Classification of the birth weight of a baby is grouped into several groups, namely low birth weight babies, normal baby weight and excess baby weight. The classification method with ordinal logistic regression provides an unstable parameter estimation, which means that if there is a change in the data set causes a significant change in the model. So that to obtain a stable parameter estimation in the ordinal logistic regression model is used aggregating (bagging) bootstrap approach. This study aims to improve the classification of ordinal logistic regression by using bagging on a baby's birth weight. The classification results with bagging ordinal logistic regression were able to reduce classification errors by 20.237% with 76.67% classification accuracy

Intended Pregnancy as a Predictor of Good Knowledge on Birth Preparedness and Complication Readiness: the Case of Northern Ethiopia Pregnant Mothers.

Background Maternal mortality remains unacceptably high in developing countries. One key strategy to reduce such mortality is utilization of birth preparedness and complication readiness (BP/CR) and creating awareness of BP/CR is an important step for pregnant women, their families, and the community. However, there was limited to no evidence regarding the community's awareness on BP/CR in the study area. Therefore, this study aimed to assess knowledge on BP/CR and associated factors among pregnant women in Debremarkos town, Northwest Ethiopia, 2017. Methods A Community based cross-sectional study was conducted from July 1 to 30/2017. A total of 441 pregnant women were included in the study. Structured and pretested questionnaire was administered through face to face interview to collect the data. Simple random sampling technique was used to select the study participants. The data were entered in to Epinfo version 7.0 and then exported to SPSS version 20.0 for analysis. Both bivariate and multivariable logistic regression model were fitted. Crude and adjusted odds ratio with 95 % confidence interval have been computed and variables with p-value < 0.05 were considered statistically significance. Results. The proportion of pregnant women having good knowledge on birth preparedness and complication readiness was found to be 45.2 with 95%CI (40.4, 50.0). In the multivariable analysis, having history of childbirth (AOR=2.17;95%CI:1.18,4.00), having intended pregnancy (AOR=2.13;95%CI: 1.16, 3.90), being governmental employee ( AOR=6.50; 95%CI: 2.50, 16.87), and having Antenatal care visits (AOR=5.50; 95%CI:2.2,13.70) were factors which were independently and significantly associated with good knowledge on birth preparedness and complication readiness. Conclusion Proportion of pregnant women having good knowledge on birth preparedness and complication readiness was low. Putting emphasis on intended pregnancy and antenatal care visit was recommended.

Pemeriksaan Antenatal Care (ANC) terhadap Penyakit Menular pada Ibu Hamil di Puskesmas Kampung Harapan, Kabupaten Jayapura

Antenatal Care (ANC) is an effort to improve maternal and child health in Indonesia. ANC activities was done to avoid the level of vulnerability of pregnant women, although to date the maternal and infant mortality rates are still high. The low level of maternal knowledge and lack of husband's support to stimulate mothers to regularly do ANC causes low maternal participation in pregnancy visits. Some ANC examinations that are quite important because they are very influential on mother and child, for examples are the examination of syphilis, Human Immunodeficiency Virus (HIV), blood pressure and urine protein. This study aims to record the ANC examinations performed on pregnant women. This study was conducted at the Kampung Harapan Health Center Jayapura Regency from December 2017 to January 2018. The samples in this study are 30 people. Research method with Laboratory Exploratory Approach in the form of Treponerna Pallidum Haemagglutination Assay (TPHA) and Rapid Diagnostic Test (RDT), Blood Pressure Examination and 6% Acetic Acid Method. The results showed that 10% of sample is positive of syphilis and 10% of it was HIV positive. In addition, the results of the observations also showed that 47% of sample were known to have low blood pressure, while 53% of them had normal blood pressure. Examination of urine protein showed good results or 100% negative. Key words: antenatal care, syphilis, HIV, blood pressure, and urine protein.Â

The Profile of Reproductive Age Women Causes of Low Birth Weight (LBW) Baby Incidence in South East Asia 2005-2014

Low birth weight (LBW) accounts for the highest percentage of causes of neonatal death. The purpose of this study was to identify family profiles that influence the incidence of LBW throughout Southeast Asia. The sample in this study were women aged 19-29 years. The data used were secondary data published by Measure Demografic Health Survey (DHS) in 2005-2014. Women's profiles identified included maternal factors (area of residence, education, age, economic status, marital status, parity, location of delivery), health service factors (iron consumption, pregnancy visit / ANC). The results showed that the incidence of LBW occurs a lot with the profile of respondents who have rural areas, even though they have high economic status. Most respondents who gave birth to LBW had secondary and low education, with unmarried marital status and low partner education. In addition, there were still many respondents who were not obedient to antenatal visits and consume less iron. However, some had given birth at local health services, although there were still respondents who had a lot of parity. Researchers suggest that women, especially women of childbearing age, want to pay attention to the risk factors for the incidence of LBW, including consumption of iron and delivery in health services so that the incidence of LBW can be suppressed. Keyword: family profile, Southeast Asia, LBW, women of childbearing age

The Role Of Partnership Of Integrated Service Post Cadre In The Continuity Of Pregnancy Visit Based On Perception Of Pregnant Women In The Working Area Of Sendang Community Health Center Cirebon District

Background: The Maternal and Child Health Program is a priority part in efforts to improve health status in Indonesia. The 4th pregnancy visit coverage is one of the evaluation indicators in the fifth Millennium Development Goal (MDGs). In the scope of the MDGs it was stated that the target in 2015 was 95% (Basic Health Research, 2013). The frequency of antenatal care at least 4 times during the pregnancy period is 83.5% (Basic Health Research, 2013). Meanwhile, the Sendang Community Health Center has 155 integrated service post cadres the frequency of 1-1-2 or fourth antenatal visits at Sendang Community Health Care Cirebon Regency in January - March 2015 by 23%.&#x0D; Purpose: This study aims to analyze the role of integrated service post cadre partnerships in the continuity of pregnancy visit based on perception of pregnant mother at the Sendang Community Health Center in Cirebon Regency.&#x0D; Method: The type of research used is correlational with a prospective approach. The study population was all pregnant women who performed first pregnancy visit at the Sendang Community Health Center. The total sample is 76 people with total sampling technique. Primary data was obtained using a questionnaire, while secondary data was obtained from the ANC cohort register. Secondary data is entered into the checklist. Data was collected during the period from March to August 2015 in the work area of ​​Sendang Community Health Center, Cirebon district. Statistical tests use Spearman's Rho Correlation with a significance level of 95% or 0.05 and two tailed.&#x0D; Result: The results showed that most (81.6%) respondents played active partnerships in pregnant women both before, during and after integrated service post days in antenatal care based on perceptions of pregnant women, more than half of respondents (55.2%) made continuous pregnancy visits according to the schedule from first to fourth pregnancy visit, there is a weak positive correlation between the role of partnerships of integrated service post cadres in the continuity of fourth pregnancy visits based on the perception of pregnant women in the work area of ​​Sendang Community Health Center in Cirebon District (ρ value = 0.003; α = 0.05).&#x0D; Conclusion: The role partnerships of integrated service post cadres is one of the supporters in the fourth pregnancy visit of pregnant women to carry out pregnancy examinations. Therefore, there is an increase in the management of integrated service post cadres through coaching, giving motivation and appreciation, as well as evaluating their participation in ANC services by health workers and local health center leaders. In addition, home visits and counseling are needed for pregnant women and their families since the beginning of pregnancy in an effort to increase fourth visits during pregnancy.

Clan-involved approaches to increasing antenatal care use in a rural minority area of China: implementation research.

This study aimed to test a model which involved clans and health providers to increase antenatal care attendance in rural minority areas of China with high HIV prevalence. Formative research was conducted to determine barriers and facilitators to antenatal care use. A strategy involving clans in addressing the barriers identified was developed. Implementation of the new strategy was done through three plan-do-study-act (PDSA) cycles, lasting four months each. Awareness and uptake of antenatal care increased significantly after the intervention. The proportion of post-partum women who used any antenatal care increased from 21.3% to 64.5% (p<0.001), and the proportion who knew that antenatal care is necessary increased from 77.8% to 89.8% (p<0.001). The proportion of pregnant women who attended antenatal care (p<0.001) and the proportion of pregnant women who went for a first antenatal care visit in early pregnancy (p<0.001) all showed increasing trends during the study period. Involving clans in antenatal care programmes in rural minority areas of China had an impact on antenatal care use. A quality improvement approach incorporating PDSA cycles can help local health authorities make context-specific, evidence-informed decisions to improve uptake of health services.

The associations between prenatal exposure to triclocarban, phenols and parabens with gestational age and birth weight in northern Puerto Rico

BackgroundPrenatal exposure to certain xenobiotics has been associated with adverse birth outcomes. We examined the associations of triclocarban, phenols and parabens in a cohort of 922 pregnant women in Puerto Rico, the Puerto Rico Testsite for Exploring Contamination Threats Program (PROTECT). Methods: Urinary triclocarban, phenols and parabens were measured at three time points in pregnancy (visit 1: 16–20 weeks, visit 2: 20–24 weeks, visit 3: 24–28 weeks gestation). Multiple linear regression (MLR) models were conducted to regress gestational age and birthweight z-scores against each woman's log average concentrations of exposure biomarkers. Logistic regression models were conducted to calculate odds of preterm birth, small or large for gestational age (SGA and LGA) in association with each of the exposure biomarkers. An interaction term between the average urinary biomarker concentration and infant sex was included in models to identify effect modification. The results were additionally stratified by study visit to look for windows of vulnerability. Results were transformed into the change in the birth outcome for an inter-quartile-range difference in biomarker concentration (Δ). Results: Average benzophenone-3, methyl- and propyl-paraben concentrations were associated with an increase in gestational age [(Δ 1.90 days; 95% CI: 0.54, 3.26); (Δ 1.63; 95% CI: 0.37, 2.89); (Δ 2.06; 95% CI: 0.63, 3.48), respectively]. Triclocarban was associated with a suggestive 2-day decrease in gestational age (Δ − 1.96; 95% CI: −4.11, 0.19). Bisphenol A measured at visit 1 was associated with a suggestive increase in gestational age (Δ 1.37; 95% CI: −0.05, 2.79). Triclosan was positively associated with gestational age among males, and negatively associated with gestational age among females. Methyl-, butyl- and propyl-paraben were associated with significant 0.50–0.66 decreased odds of SGA. BPS was associated with an increase in the odds of SGA at visit 3, and a suggestive increase in the odds of LGA at visit 1. Conclusion: Benzophenone-3, methyl-paraben and propyl-paraben were associated with an increase in gestational age. Concentrations of triclocarban, which were much higher than reported in other populations, were associated with a suggestive decrease in gestational age. The direction of the association between triclosan and gestational age differed by infant sex. Parabens were associated with a decrease in SGA, and BPS was associated with both SGA and LGA depending on the study visit. Further studies are required to substantiate these findings.

The pattern of gestational weight gains among Chinese women: a repeated measure analysis

This study aimed to investigate the pattern of gestational weight gain (GWG) among Chinese women. We included pregnant women, who delivered at a referral medical center in China and had no pre-specified adverse pregnancy outcomes. We collected weight data across all pregnancy visits, and used the two-level spline linear model to fit for the pattern of GWG according to pre-pregnancy BMI categories. In total, 4,567 pregnant women with 47,699 repeated measures were eligible. For those who were underweight, normal and overweight before pregnancy, the interquartile ranges (25th to 75th quartiles) of GWG between 14 and 36 gestational weeks were 12.9–17.7 kg, 12.6–17.3 kg and 11.7–16.8 kg, and the corresponding rates of GWG were 2.62 kg/month, 2.56 kg/month and 2.37 kg/month. For underweight and normal women, the rates of GWG were similar before 14 weeks (0.57 and 0.58 kg/month) and after 36 weeks (1.69 and 1.70 kg/month); however, the rates of GWG were higher for overweight women (0.66 kg/month before 14 weeks and 1.89 kg/month after 36 weeks). In summary, the pattern of GWG among Chinese pregnant women is generally consistent with the IOM recommendation, particularly for those who are normal or underweight. Modifications are, however, warranted for overweight pregnant women.

Missed Opportunities to Address Pregnancy Prevention With Young Men in Primary Care.

Young men (aged 15-24 years) have pregnancy prevention needs, yet little is known about whether they perceive they learn about pregnancy prevention in primary care. A sample of 190 young men seen in primary care in one city from April 2014 to September 2016 were assessed on perceived learning about pregnancy prevention, background and visit characteristics, pregnancy prevention care receipt, and contraception needs at last sex. The majority of participants were non-Hispanic black (92%), aged 15 to 19 years (54%), seen for a physical examination (52%), and established patients (87%). Few participants perceived they learned about pregnancy prevention (32%), regardless of sexual activity (33% among sexually active participants, 26% among never sexually active). Poisson regression models determined that perceived learning about pregnancy prevention was independently associated with young men's pregnancy prevention care receipt and contraception needs at last sex. Findings highlight the need to improve providers' delivery of pregnancy prevention services to young men.

Karakteristik Ibu Hamil yang tidak Melakukan Kunjungan Ulang Pemeriksaan Kehamilan Keempat (K4)

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Background. The indicator used to describe the failure of the maternal health service program is the coverage of the examination of pregnant women on health services as measured by the first pregnancy visit and the fourth pregnancy visit. &lt;strong&gt;Purpose:&lt;/strong&gt; This study purposes to describe the characteristics of pregnant women who did not re-visit the fourth pregnancy checkup at the Bungin Health Center in West Lampung Regency. &lt;strong&gt;Method:&lt;/strong&gt; This study is a descriptive study with a cross sectional approach. The research sample was 152 pregnant women taken using simple random sampling technique. The variables studied were age, education, employment, parity and distance of home to health facilities. Data collection was sourced from cohorts of pregnant women who were analyzed univariately to see the proportion of mothers who did not do fourth repeat visit. &lt;strong&gt;Result:&lt;/strong&gt; Pregnant women who did not make a fourth repeat visit with the highest characteristics were at high risk of 67%, low education was 48%, not working 70% of people, primiparous and multiparous were 42%, and had a distance from home living near health facilities 67.1% of people. &lt;strong&gt;Conclusion:&lt;/strong&gt; The tendency of pregnant women not to make a fourth pregnancy visit with characteristics of high-risk age, low education, unemployment, primiparas and multiparas.&lt;/em&gt;&lt;/p&gt;

A Longitudinal Study of Thyroid Markers Across Pregnancy and the Risk of Gestational Diabetes.

T3 is the biologically active thyroid hormone involved in glucose metabolism. The free T3 (fT3)/free T4 (fT4) ratio, a marker indicating conversion of fT4 to fT3, is also implicated in glucose homeostasis. To examine associations of fT3 and the fT3/fT4 ratio with gestational diabetes mellitus (GDM). In a case-control study, thyroid markers (fT3, fT4, TSH) were measured and the fT3/fT4 ratio was derived across four visits in pregnancy, including first (gestational weeks 10 to 14) and second (weeks 15 to 26) trimester. Conditional logistic regression adjusting for thyroid autoimmunity status and major GDM risk factors estimated trimester-specific associations of thyroid markers with subsequent GDM risk. Twelve US clinical centers. One hundred seven GDM cases and 214 non-GDM controls from a multiracial pregnancy cohort of 2802 women. GDM diagnosis ascertained from medical records. Both fT3 and the fT3/fT4 ratio were positively associated with GDM: adjusted OR (95% CI) comparing the highest vs lowest fT3 quartile was 4.25 (1.67, 10.80) at the first trimester and 3.89 (1.50, 10.10) at the second trimester. Similarly, the corresponding risk estimates for the fT3/fT4 ratio were 8.63 (2.87, 26.00) and 13.60 (3.97, 46.30) at the first and second trimester, respectively. Neither TSH nor fT4 was significantly associated with GDM. Higher fT3 levels, potentially resulting from de novo synthesis or increased fT4 to fT3 conversion, may be an indicator of GDM risk starting early in pregnancy.

Prospective longitudinal study of the pregnancy DNA methylome: the US Pregnancy, Race, Environment, Genes (PREG) study

PurposeThe goal of the Pregnancy, Race, Environment, Genes study was to understand how social and environmental determinants of health (SEDH), pregnancy-specific environments (PSE) and biological processes influence the timing of...

Risk factors of gestational diabetes mellitus using results of a prospective population-based study in Iranian pregnant women

AimsEarly identification of at-risk groups is an important step in preventing gestational diabetes and its subsequent side effects. This study aimed to evaluate the risk factors of gestational diabetes based on the International Association of Diabetes and Pregnancy Study Groups criteria in Ahvaz. Material and MethodsIn a cross-sectional case control study, 520 pregnant women involving life after gestational diabetes Ahvaz cohort study (LAGAs) were investigated for risk factors of gestational diabetes mellitus. ResultThe prevalence of overweight and obesity were 40% and25.8% in the GMD group and in 35.8% and 16.2% in the control group respectively (p = 0.002). According to NCEP-ATP III criteria, 16.9% of women with GDM and 6.9% of mothers in the control group had metabolic syndrome in first visit of pregnancy (p < 0.001. Logistic regression showed that there is a significant relationship between maternal age[OR = 1.05(95% CI, 1.01–1.10)] (p = 0.01), previous GDM [OR = 5.60(95% CI, 2.21–14.18)] (p = 0.001), positive family history of diabetes[OR = 1.86(95% CI, 1.19–2.94)] (p = 0.006), pre-pregnancy BMI [OR = 1.05(95% CI, 1.007–1.11)] (p = 0.04) and metabolic syndrome in first visit of pregnancy[OR = 2.34 (95% CI, 1.038–5.30)] (p = 0.04) with GDM. ConclusionFactors including maternal age, previous GDM, family history of diabetes, pre-pregnancy BMI reported in previous studies around the world. A significant association between metabolic syndrome in the first visit of pregnancy and GDM is novel finding of this study. Therefore screening of pre-pregnancy metabolic syndrome in women at risk of gestational diabetes is recommended.

HUBUNGAN PARITAS DENGAN SIKAP IBU HAMIL TENTANG KUNJUNGAN KEHAMILAN K1 MURNI DI DESA TANAMERAH KECAMATAN SARONGGI KABUPATEN SUMENEP

Pure K1 coverage is an indicator to know the reach of ANC services to achieve the optimum degree of health especially in pregnancy examination in order to recognize early complications. In fact, there are still many pregnant women who do not do Pure K1, such as coverage of K1 Murni in Tanamerah Village Working Area of ​​UPT Puskesmas Saronggi 53% from target 87% until November. The purpose of this research is to know the relation of parity with attitude of pregnant mother about visit of Antenatal care K1 Murni.&#x0D; The research design was correlational analitic with cross sectional study approach. The population is 46 pregnant women in Tanamerah Saronggi Village from April to May 2014.Total population is 46 respondents. Variable independent is parity and variable dependent is the attitude of pregnant mother in doing visit of pregnancy of K1 Murni. Methods of collecting data in the form of questionnaires and cohorts and then analyzed by statistical test Rank Rank Wilcoxone with α = 0.05.&#x0D; Most of pregnant women had more than 1 (Multipara), 34 respondents (73,9%) and most pregnant women were negative about Pure K1 pregnancy, 33 respondents (71,7%). With significance test (p) 0.002 which means p &lt;α.&#x0D; Based on the research results can be concluded there is a parity relationship with the attitude of pregnant women to visit pregnancy K1 Murni in Tanamerah Village Work Area UPT Puskesmas Saronggi District Saronggi Sumenep Regency.&#x0D; Pregnant women and families should increase their willingness and awareness to check their pregnancy according to ANC standard.

Abstract MP69: How Well Do Cardiovascular Risk Factors Before and During Pregnancy Correlate? The International Childhood Cardiovascular Cohort (i3C) Consortium

Background: Pregnancy complications such as gestational diabetes and pre-eclampsia predict later cardiovascular (CV) outcomes. However, it still is not clear whether pregnancy complications unmask preexisting impairments or instigate lasting injury. If pre-pregnancy and during-pregnancy CV risk factors are strongly correlated, it becomes more plausible that pregnancy unmasks an existing problem than creating a new one. Methods: Data from the i3C Consortium, a group of studies assessing the relationship between child/adolescent CV risk factors and adult outcomes, were used. 290 women from four cohorts had data on the same risk factor (blood pressure, lipids, glucose) from visits both prior to and during pregnancy. Correlation coefficients between the pre- and during pregnancy measures were calculated, and the mean difference between the measures modeled with adjustment for age, BMI, race, smoking, and study. Differences by gestational age and time between the pre-pregnancy visit and pregnancy visit were also examined. Results: All measures were strongly correlated at pre- and during-pregnancy visits (p&lt;0.01), with r of between 0.3 and 0.55. The exception was glucose (r=0.11, p=0.15). These relationships held after adjustment for confounders. Interactions with gestational age indicated stronger correlations with measurements taken in the first and second trimesters than the third. The correlation did not differ by the time elapsed between the pre-pregnancy and pregnancy visits. Conclusions: Pre- and during-pregnancy CV risk factors are moderately well correlated. It is likely that women who develop pregnancy complications enter the pregnancy with higher risk rather than pregnancy inducing new vascular effects.

Commonly occurring adverse birth outcomes and maternal depression: a longitudinal study

ObjectivesLittle is known about whether commonly occurring adverse birth outcomes have a long-term impact on the mental health of mothers. The aim of this study was to investigate whether commonly occurring adverse birth outcomes predicted mothers' depressive-symptom trajectories over a 27-year period following the birth of a baby. Study designLongitudinal study. MethodsParticipants comprised a sub-group of women from the longitudinal cohort of the Mater and University of Queensland Study of Pregnancy. Maternal depression was measured at six time points from the first clinic visit of an index pregnancy to 27 years after birth. A semi-parametric mixture model was used to identify three symptom trajectories of low-stable, moderate-stable and moderate-rising depression. Multinomial logistic regression was then used to determine whether a number of commonly occurring birth outcomes predicted moderate-stable and/or moderate-rising depression trajectories over the subsequent 27 years. Sociodemographic and behavioural factors were used to adjust for possible confounding. ResultsAfter adjustment for potential confounders, none of the adverse birth outcomes predicted subsequent maternal depression trajectories. Teenage pregnancy, not completing high school, low family income, obesity, poorer quality partnership and not exercising, measured at women's first clinic visit, and small social networks at three to five days after birth, were significantly associated with women's moderate-rising depressive-symptoms trajectory over 27 years. ConclusionsCommonly occurring adverse birth outcomes do not predict long-term depressive trajectories. A number of sociodemographic and behavioural factors present at the index pregnancy predict women's long-term pattern of depression throughout their reproductive life course.

Are the Level of Knowledge and Practices of Pregnant Women Regarding Folic Acid Supplementation Still Inadequate? A Cross-Sectional Study in a Middle Eastern Urban Setting

ABSTRACTThis observational cross-sectional study aimed to examine the knowledge and practices of pregnant women in North Lebanon regarding periconceptional folic acid (FA) supplementation. A convenience sample of pregnant women attending gynecology clinics in North Lebanon was recruited between May and September 2013. Data were collected from a face-to-face interview performed by a trained local dietician as well as from review of obstetric charts. A total of 465 women were included in the study. Only 37 (7.9%) were aware of the role of FA in preventing birth defects, while 129 (27.7%) were able to identify one food item rich in FA or folate. Only 125 (26.9%) were taking FA supplementation before pregnancy. While 440 (94.6%) participants were taking FA supplements during pregnancy, 158 (34%) were receiving an inadequate dose. Adequate preconceptional supplementation of FA was significantly associated with the women's level of education (p =.008), planned pregnancy (p <.0001), and gynecologic visit before pregnancy (p <.0001). Moreover, young age (p =.003) and small number of children (p =.019) were significant predictors of adequate supplementation during pregnancy. Our study revealed deficient knowledge and inadequate intake of FA supplements before and during pregnancy.