Young Pregnant Women Research Articles

CLINICAL COURSE OF SEVERE AND CRITICAL CORONAVIRUS INFECTION COVID-19 AMONG PREGNANT WOMEN

Background. The COVID-19 pandemic, which spread in 2020, is a global problem that humanity has faced. Women during gestation are 3 times more likely to be admitted to the intensive care unit, 2.9 times more likely to need invasive ventilation, 2.4 times more likely to need extracorporeal membrane oxygenation, and 1.7 times more likely to have fatal outcomes than non-pregnant women Materials and methods. We conducted a retrospective analysis of the birth histories of 92 pregnant women and postpartum women with COVID-19 coronavirus infection at the clinical sites of the Scientific Center for Obstetrics, Gynecology and Perinatology, perinatal centers in the space of 2020. Results. All patients with coronavirus infection COVID-19 were young pregnant women from the age of 20 to 42 years, at a gestational age of 12 to 41 weeks, of which at full term (38-41 weeks) — 17 (18.5%), at a period of 30-37 weeks — 45 (48.9%), 21-29 weeks — 25 (27.2%), at 12-17 weeks — 5 (5.4%). One-way analysis of variance (ANOVA) has shown that there are statistically relevant differences in the days of hospitalization among the patients, depending on the parity of births (p<0.05). Complications during pregnancy on the part of the fetus were: a threatening state of the fetus was observed among 5 (5.4%), intrauterine fetal death - in 22 (23.9%), premature separation of the normally located placenta (PSNLP) was observed among 3 (3.3%), miscarriage among 2 (2.2%), therapeutic abortion - 1 (1.1%); 28 children (34.2%) were born prematurely, with birth weight from 510g (at 22 weeks) to 3100g (at 37 weeks). Conclusions. Thus, pregnant women with severe and critically severe forms of COVID-19 were predominantly urban residents, at a gestational age of 30 to 37 weeks, and were multiparous. The risk of complications did not depend on the number of previous births, highlighting the need for special attention to this patient category regardless of their obstetric history.

Determinants of micronutrient supplementation during pregnancy among women in three sub-Saharan African countries: a multilevel logistic regression model.

Poor maternal nutrition during pregnancy is a common cause of poor maternal and infant outcomes. Micronutrient deficiencies are common among pregnant women in low- and middle-income countries, including sub-Saharan Africa. Pregnant women are recommended to take micronutrients like iron or folic acid and deworming medication during pregnancy. Therefore, this study was conducted to assess micronutrient intake and its associated factors among pregnant women in three countries using the most recent demographic and health survey. We used data from the most recent demographic and health surveys, which were carried out between 2019 and 2022 in three sub-Saharan African countries. The study included a weighted sample of 13,568 reproductive-age women who had given birth within the five years prior to the survey. Utilizing multilevel logistic regression, the factors associated with the dependent variable were identified. Model comparison and fitness were assessed using the deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Ultimately, factors were deemed statistically significant if they had a p-value less than 0.05. The pooled prevalence of micronutrient intake among pregnant women during pregnancy of last birth was 77.56% (95% CI: 76.85%-78.25%). Factors like age [AOR = 1.78; 95% CI (1.14, 2.77)], educational status [AOR = 1.49; 95% CI (1.23, 1.79)], marital status [AOR = 0.66; 95% CI (0.58, 0.75)], working status [AOR = 1.17; 95% CI (1.01, 1.34)], media exposure [AOR = 1.20; 95% CI (1.05, 1.38)], preceding birth interval [AOR = 1.17; 95% CI (1.01, 1.34)], number of ANC visits [AOR = 1.65; 95% CI (1.29, 2.10)], and residence [AOR = 1.19; 95% CI (1.03, 1.37)] were significantly associated with micronutrient intake among pregnant women. More than three-fourths of the study subjects were micronutrient supplemented during their pregnancy. Improving women's education, disseminating nutrition information through media, providing more attention to young pregnant women who live in rural areas, increasing the number of ANC visits, and women's empowerment are strongly recommended.

AKI in a Young Pregnant Woman with Hypertriglyceridemia-Induced Severe Acute Pancreatitis Treated with Urgent Plasma Exchange

AKI in a Young Pregnant Woman with Hypertriglyceridemia-Induced Severe Acute Pancreatitis Treated with Urgent Plasma Exchange

Correlates of Hepatitis B infection in pregnant women attending antenatal clinics in Wa Municipality, Ghana.

Despite the availability of an effective vaccine against viral hepatitis B infection, it remains prevalent, highly transmissible especially through mother-to-child, life-threatening, and a major public health challenge. A positive Hepatitis B e-Antigen (HBeAg) mother has a 90% risk of transmitting the virus to the unborn child in the perinatal period. This study sought to determine the prevalence and risk of Hepatitis B infection among pregnant women in the Wa Municipality of Ghana. A cross-sectional study employing systematic random sampling was conducted among 183 consented pregnant women who went for antenatal care in nine health facilities in the Wa Municipality. A structured validated questionnaire was used to collect information about socio-demographic and obstetric characteristics, awareness of Hepatitis B Virus (HBV) transmission and its prevention. Blood samples (3.0 mls) were collected from each participant to test for HBV serum markers using a Wondfo One Step HBV rapid immunochromatographic assay (Catalog number W003) for the Hepatitis B surface antigen (HBsAg). We conducted descriptive statistics including the prevalence and used multivariable logistic regression to determine the risk of Hepatitis B among study participants. Data was analysed using Stata/SE 15. About 20.2% of the 183 pregnant women screened tested positive for HBsAg. Generally, compared with younger pregnant women, older (> = 25) pregnant women were >9 times less likely to test positive for both chronic Hepatitis B core antibody (HBcAb) and (HBeAg) Hepatitis B infections. However, pregnant women in polygamous relationship were more likely to test positive for both (HBcAb) and (HBsAg and HBeAg) Hepatitis B infections compared with those in monogamous relationship. In a multivariable analysis, pregnant women in a polygamous relationships were about 5 times more likely to test positive for HBsAg (AOR = 4.61, 95% CI: 2.06-9.89) and HBcAb (AOR = 4.89, 95% CI:1.52-6.81) and HBeAg (AOR = 4.62, 95% CI:1.21-6.39) compared with those in a monogamous relationship. This study highlights a high HBsAg prevalence among pregnant women with those in polygamous relationship and younger age more likely to test positive. Facility and community-based health services should emphasize the need for regular screening, education, and vaccination of pregnant women, especially those at high risk, to prevent mother-to-child transmission of viral hepatitis B.

Abstract MP27: Pregnant Women of Advanced Maternal Age Have Higher Central Artery Stiffness Than Younger Pregnant Women

The frequency of women undergoing pregnancy at advanced maternal age (AMA, ≥35 years) is increasing in developed countries, including the United States. AMA is associated with an increased risk of adverse pregnancy outcomes such as gestational hypertension, preeclampsia, and preterm birth. Increased risk for adverse pregnancy outcomes at AMA may be mediated in part by altered arterial structure and function or inadequate maternal arterial adaptations during pregnancy. Therefore, we examined central artery stiffness and endothelial function across healthy pregnancy (i.e. no comorbid maternal or fetal conditions, born at term) in women who had enrolled in a longitudinal study between March 2015 and January 2020. We hypothesized that women at AMA (age ≥35 years, mean±SE: 36±0 years, n=18) would have higher arterial stiffness and lower endothelial function compared with younger women (age 21-30 years, mean±SE: 27±0 years, n=51) across pregnancy. Hemodynamic and arterial function measures were collected in the first (6-13 weeks), second (18-26 weeks), and third (27-37 weeks) trimesters and postpartum (4-14 weeks after the delivery). Brachial artery blood pressure was assessed in the supine position and central artery stiffness was assessed via carotid-femoral (aortic) pulse wave velocity (cfPWV) and carotid β-stiffness index. Endothelial function was determined via brachial artery flow-mediated dilation (FMD). Brachial artery systolic, diastolic, and mean blood pressures were not different between AMA and younger women across pregnancy or postpartum (all P >0.05). The AMA group had higher cfPWV ( P <0.01) and carotid β-stiffness index ( P <0.01) across pregnancy and postpartum compared to the younger group. cfPWV decreased among younger women at the second and third trimesters compared with the first trimester ( P <0.01), while cfPWV among women of AMA did not change ( P =0.07). There were no differences in FMD between AMA and younger women across pregnancy or postpartum ( P =0.96). These results demonstrate that healthy women of AMA have increased central artery stiffness, but no difference in endothelial function, compared to younger pregnant women across pregnancy, and that the normal decrease in aortic stiffness is blunted in pregnant women of AMA compared to younger women. The sustained higher central artery stiffness throughout pregnancy among women of AMA may contribute to increased risk of pregnancy complications and future CVD risk in these women.

Anemia in young pregnant women: A cross-sectional study in Indonesia

Background: The prevalence of anemia among pregnant women in Indonesian remains high at 48.9%, with the highest rates observed among young mothers aged 15-24 years. Anemia is associated with adverse outcomes for both mothers and their children. Understanding the determinants of anemia in young mothers is crucial for taking preventive measures. However, there are currently no national studies in Indonesia on the prevalence and risk factors of anemia in pregnant women aged 15 to 24 years.Objective: To measure the prevalence and factors associated with anemia in young pregnant women in Indonesia.Methods: This cross-sectional study utilized on secondary data from the 2018 Basic Health Research (Riset Kesehatan Dasar= Riskesdas). The subject of this research were pregnant women aged 15 to 24 years who participated in Riskesdas 2018 and had independent variables data including hemoglobin measurement data, age, education, residence, occupation, travel time to health facilities, age at first pregnancy, ownership of the maternal and child health (MCH) handbook, history of previous abortion, gestational age, number of iron supplement tablets, supplementary feeding, and chronic energy deficiency. Univariate analysis was conducted to analyse the subject characteristics and hemoglobin data, while chi-square and logistic regression were used to determine factors associated with anemia in young pregnant women Results: The study found that 36.2% of young pregnant women had anemia. The incidence of anemia was associated with gestational age but not with other factors. Pregnancy in the first trimester poses the highest risk compared to other trimesters (cOR=3.89; 95%CI:1.47-10.30; p=0.006), as confirmed by multivariate analysis (aOR=4.44; 95%CI: 1.41-13.95; p=0.01).Conclusion: Anemia affects 36.2% of pregnant women aged 15 to 24 years in Indonesia. The risk of anemia in young pregnant women is significantly associated with gestational age with the first trimester being the most critical period.

Comparative analysis of the effectiveness of antibiotic therapy and combined administration of antibiotics, lactobacilli, and proanthocyanidins for asymptomatic bacteriuria in young pregnant women: A randomized prospective study

Background. Asymptomatic bacteriuria in pregnant women is not accompanied by visible symptoms; however, it involves the risk of serious complications, including gestational pyelonephritis and/or preterm labor, thereby threatening the health of both mother and child. This condition raises particular concern in light of the growing global problem of antibiotic resistance causing traditional therapies to be less effective or futile. Therefore, a study into alternative medicine approaches to asymptomatic bacteriuria in pregnant women appears highly relevant in terms of developing new solutions for managing this condition while minimizing maternal and child health risks and preventing the spread of antibiotic resistance.Objectives. To conduct a comparative analysis of the effectiveness of antibiotic therapy and combined administration of antibiotics, lactobacilli, and proanthocyanidins for asymptomatic bacteriuria in young pregnant women.Methods. 50 pregnant women aged 15 to 17 and diagnosed with asymptomatic bacteriuria participated in a randomized prospective study. Patients were randomly divided into two groups depending on the treatment. Group 1 received standard antibiotic therapy; group 2 received a combination of antibiotics with lactobacilli and proanthocyanidins. Treatment was carried out in the Republican Clinical Perinatal Center, the Republic of Bashkortostan. Patients were enrolled in the study from February 2021 to January 2022. The observation period included several stages: 10 days after treatment (first control), 30 days after treatment (second control), and 2 months after delivery (final control). The condition of the urinary tract was assessed depending on bacterial concentration, with the diagnosis of asymptomatic bacteriuria being made in case of a 105 CFE/mL (colony forming units of bacteria per milliliter of urine). The endpoint of the study was considered to be the cure of pregnant women from asymptomatic bacteriuria, which was determined by the absence of bacteria in the urine 10 days after the therapy, as well as a recurrence-free period for two months after delivery. Statistical data processing was carried out using Statistica 10.0 (StatSoft, USA) for Windows and Microsoft Excel (Microsoft, USA). A statistical level with p ≤ 0.05 was considered significant.Results. Treatment outcomes showed a significant reduction in bacteriuria and recurrent infection, especially in the group receiving the combined therapy. No bacteriuria was reported in 36 % of patients in group 1 and 76 % in group 2 (Yates’ chi-squared test, p = 0.011). The incidence of preterm labor appeared lower in the combined therapy group (4 % for group 2 and 12 % for group 1). Complications were recorded in 11 young pregnant women of group 1 (44 %) and in 3 women of group 2 (12 %). Statistical analysis indicated significant differences between the groups in terms of complication rate after treatment (Fisher’s exact test, p = 0.015).Conclusion. Combined therapy including antibiotics, lactobacilli, and proanthocyanidins demonstrates high effectiveness as an alternative to conventional treatments of asymptomatic bacteriuria in pregnant women. Due to this approach, bacteriuria as well as recurrence rate decreases, thereby contributing to a more stable health status.

Identifying pregnant and postpartum women’s priorities for enhancing nutrition support through social needs programmes in a resource-constrained urban community in South Africa

BackgroundMalnutrition remains a pressing public health concern for mothers and children in South Africa. Despite the government’s multisectoral response, unaddressed social needs prevent some mothers getting full benefit from interventions, spanning financial planning, income stability, housing, access to government services, social support, and provision of affordable, nutritious foods. Engaging with mothers and prioritising their concerns is important if we wish to overcome obstacles to women benefiting from government nutrition interventions. This study aimed to identify the programmes that women perceived as a priority in addressing the social needs of mothers of young infants and pregnant women to enhance nutrition in a resource-constrained urban township in South Africa.MethodsA cross-sectional study employed a quantitative preference elicitation survey, administered to 210 mothers and pregnant women from five primary healthcare facilities in Soweto. The survey tool was developed with the community to identify unmet social needs and potential solutions, which were synthesised with findings from the literature. The survey described 15 programmes, grouped into three delivery levels: clinics, community, and government. Participants were required to rank programme options in two stages. First, they selected their top two programmes within each delivery level. Subsequently, they allocated stickers to indicate the strength of their preference among the top programmes across the levels. Rankings were analysed using descriptive statistics.ResultsThe highest priority was given to five programmes. Two delivered at the community level: Women’s economic empowerment groups and Job search assistance, two at the clinic level: Social needs assessment and referral, and Prescription-based food, and one at the government level: Free quality childcare. The lowest-ranked programmes were two clinic-based programmes, specifically Maternal nutrition groups and Couple antenatal education.ConclusionWomen expressed strong views about which programmes should be prioritised to support mothers and pregnant women in addressing their social needs and improving nutrition. Key areas included providing support with job searching and entrepreneurship, accessing childcare and the healthy foods recommended at clinics, as well as finding information on available community and government services. Leveraging multisectoral collaboration, aligned policy objectives, efficient public financing, and strengthened implementation capacity will be pivotal in delivering these programmes.

High Prevalence of Syphilis among Young Pregnant Women in the Brazilian Amazon: A Cross-Sectional Study Based on Clinical Records in a Public Health Reference Unit in the City of Belém.

Syphilis remains a significant global public health concern, and one of its consequences in pregnant women is the potential occurrence of congenital syphilis due to Treponema pallidum infection. This study determined the prevalence of syphilis among pregnant women undergoing prenatal care in a neighborhood on the outskirts of the city of Belém, Brazilian Amazon. This cross-sectional study used data from clinical records of 611 pregnant women who underwent prenatal care at a public health unit in 2019 and 2020. The reagent result for VDRL was used as an indicator of syphilis. Odds Ratio and chi-square tests were used to evaluate the association of information from pregnant women with syphilis. The overall prevalence of syphilis was 5.2 % (32/611; 95 % CI: 3.5-7.0 %). Age under 23 years was identified as a risk factor for syphilis. The prevalence of syphilis among pregnant women in the outskirts of Belém is high, especially among younger women. There is an urgent need to intensify innovative sexual and reproductive health education initiatives and emphasize the importance of consistent practice of preventive measures against syphilis and other STIs in the Amazon region, especially in the young population.

Home-based care practices on prevention of malaria in children under 5 years: A narrative review.

Malaria is a major threat to lives in developing countries, especially in Africa. A lot of measures have been tried to curb the increased mortality and morbidity associated with malaria. A lot of resources have been channeled to control the devastating effects of malaria in these parts of the world. The aim of this paper is to discuss home-based care practices on prevention of malaria in children under 5 years. By cutting back on bushes and upholding good hygiene and sanitation, malaria in young children can be prevented in homes. This lessens disease and transmission while also assisting in death prevention and disease reduction. In Africa, Uganda is the third most affected country by malaria, which is a major cause of high morbidity and mortality in young children and pregnant women. This has forced the Government of Uganda and implementing partners, including the Global Fund and the Roll Back Malaria initiative, to redouble efforts to increase the use of insecticide-treated mosquito nets. Effective use of insecticide-treated bed nets is necessary to eliminate the above serious sequelae in children under 5 years old. Households and especially caregivers apply the use of impregnated mosquito nets and cleaning of surrounding bushes. According to research results, the use of indoor residual spray nets and insecticide-impregnated nets has significantly contributed to the prevention of malaria in children.

Preconception underweight and the risk of offspring congenital heart diseases in young pregnant women: Evidence from the China Birth Cohort Study.

Maternal obesity is a highly suggestive risk factor of offspring congenital heart diseases (CHD). However, the risk of offspring CHD associated with maternal underweight has rarely been mentioned. Therefore, this study aimed to explore the effect of preconception underweight on offspring CHD. From November 2017 to August 2021, 132 386 pregnant women were enrolled in a birth cohort study in China in early pregnancy, and completed follow-up until delivery (or miscarriage/termination). Offspring CHD was diagnosed by prenatal ultrasound examination in both live births and stillbirths. Log-binomial regression and restricted cubic spline were used to estimate the risk of offspring CHD associated with preconception body mass index (BMI). A generalized additive model was used to explore the modification effect of maternal age on the association between preconception BMI and offspring CHD. A total of 129 096 pregnant women were included in the analysis. The incidence of CHD in the underweight, normal weight, overweight, and obesity groups were 117/17 313 (0.68%), 556/85 695 (0.65%), 128/19 936 (0.64%), 47/6152 (0.76%), respectively. Both underweight and obesity before pregnancy marginally increased the risk of offspring CHD. The association between preconception BMI and offspring CHD varied by maternal age, with low preconception BMI associated with a significantly higher risk of offspring CHD in women <24 years (RR 2.32, 95% CI: 1.07-5.01 for 17 vs 21 kg/m2). Preconception underweight was associated with an increased risk of offspring CHD in young pregnant women. Therefore, weight gain is important to prevent offspring CHD, especially for young women with low preconception BMI.

LARYNGOPHARYNGEAL RECONSTRUCTION IN A PREGNANT WOMAN: A CLINICAL CASE

Relevance: Cancer in pregnancy is a very serious clinical condition that seriously affects women and their families, as well as the medical staff who provide care. Diagnostic and therapeutic solutions must balance the appropriate treatment with the risk to the fetus. In developed countries, cancer in pregnant women has become more common over the past 30 years due to an increase in the number of older women giving birth. Melanoma, lymphoma, leukemia, and cancers of the breast, cervix, ovaries, gastrointestinal tract, and genitourinary system are the most common malignant neoplasms in pregnant women. Head and neck cancers are rare in pregnancy. A total of 3 cases of locally advanced laryngopharyngeal cancer were recorded in patients aged 23 to 28 years in 2017-2023 at the State Clinical Hospital of the Akimat of Astana Multidisciplinary Medical Center. This article describes a case of advanced squamous cell carcinoma of the laryngeal region in a young pregnant woman and also discusses the diagnosis and treatment of head and neck cancer in pregnant women. The study aimed to describe a clinical case of squamous cell carcinoma of the larynx in a pregnant patient. Methods: The description of a clinical case presents data from laboratory, instrumental, and physical research methods of a pregnant patient with hypopharynx squamous cell carcinoma, who was examined, treated, and followed up at the State Clinical Hospital of the Akimat of Astana Multidisciplinary Medical Center. The patient was diagnosed with IVA laryngopharyngeal cancer T4aN2cM0. Grade III dysphagia. Laryngeal stenosis. Grade II cachexia” and received three courses of neoadjuvant polychemotherapy. Then, she underwent surgical intervention in the volume of laryngopharyngectomy and reconstructive surgery using a free radial flap and was administered adjuvant external beam radiation therapy. Results: The article presents the results of laryngopharyngectomy for locally advanced squamous cell carcinoma of the hypopharynx. The postoperative period was without complications, the patient was discharged 14 days after surgery in satisfactory condition and continued adjuvant radiation therapy. Conclusions: The reviewed clinical case demonstrates the importance of an integrated approach to treating laryngopharyngeal cancer, including effective reconstruction of postoperative defects using free fasciocutaneous flaps.

Psychosocial dimension of adolescent pregnancy: a phenomenological study on life experiences

ABSTRACT Aim This study aimed to assess the lived experiences of adolescent pregnant young women, with a specific focus on the psychosocial aspect of adolescent pregnancy, using a phenomenological approach. Design Employing the phenomenological research method, semi-structured in-depth interviews were conducted between 3 August and 18 August 2023 with 15 young women (mean age = 21.86 years; SD = 1.06) living in a province in eastern Turkey who had undergone adolescent pregnancy 3–5 years before. Methods The criterion sampling method, a form of purposive sampling, was used to form the sample group. Interviews were carried out until data saturation was reached. All interviews were recorded and transcribed, and thematic analysis was utilised to analyse the data. The study adhered to the COREQ checklist for reporting. Results Through data analysis, three main categories (reflections on adolescent pregnancy, challenges due to adolescent pregnancy, and effects of adolescent pregnancy) and nine sub-themes (emotions, roles and responsibilities, perception of social support, cognitive, emotional, behavioural, mental, physical, and social) emerged. Conclusion Our study highlights the adverse psychosocial impact of adolescent pregnancy on young women. Young women who got married at an early age before attaining full physical, social, and psychological maturity grappled with the substantial burdens of adolescent pregnancy and adjusting to their new roles. The study’s implications are significant, emphasising the necessity of addressing the psychosocial facets of adolescent marriage and pregnancy, and gaining valuable insights for the future.

Prevalence and Predictors of Anxiety and Depression among Perinatal Women in Tertiary Care Hospital: A Cross-Sectional Study

Abstract Introduction The perinatal period is a critical time in a woman's life. The impact of perinatal mental disorders includes new evidence of an increase in their prevalence among young pregnant women. Perinatal mental disorders are one of the most common and undertreated morbidities. Early detection of perinatal mental illness may be supported by evidence on risk factors. Our study aimed to identify the prevalence and risk factors of anxiety and depression and to determine the association between them. Materials and Methods A prospective observational questionnaire-based study was conducted in the obstetrics and gynecology department of a tertiary care hospital for a duration of 6 months. With random sampling, 741 participants were recruited for the study based on inclusion and exclusion criteria. The data were analyzed using SPSS version 28. Results The prevalence of perinatal anxiety and depression was found to be 48.5 and 32.2%, respectively. We discovered a substantial link between perinatal depression and anxiety, with an odds ratio of 3.9. The predictors are gestational age, postpartum age, comorbid conditions, morning sickness, sleep disturbance, sleep duration, loss of appetite, loss of interest in their favorite food, type of family, and presence of risk in their pregnancy. Conclusion Early screening and intervention may drastically and significantly reduce mental disorders existing in the pregnant population. So as health care professionals, we suggest that screening and counseling for depression and anxiety could be included as routine processes in antenatal care.

Insights into the Transmission, Host Range, Genomics, Vaccination, and Current Epidemiology of the Monkeypox Virus.

This review delves into the historical context, current epidemiological landscape, genomics, and pathobiology of monkeypox virus (MPXV). Furthermore, it elucidates the present vaccination status and strategies to curb the spread of monkeypox. Monkeypox, caused by the Orthopoxvirus known as MPXV, is a zoonotic ailment. MPXV can be transmitted from person to person through respiratory droplets during prolonged face-to-face interactions. While many cases of monkeypox are self-limiting, vulnerable groups such as young children, pregnant women, and immunocompromised individuals may experience severe manifestations. Diagnosis predominantly relies on clinical presentations, complemented by laboratory techniques like RT-PCR. Although treatment is often not required, severe cases necessitate antiviral medications like tecovirimat, cidofovir, and brincidofovir. Vaccination, particularly using the smallpox vaccine, has proven instrumental in outbreak control, exhibiting an efficacy of at least 85% against mpox as evidenced by data from Africa. Mitigating transmission requires measures like wearing surgical masks, adequately covering skin lesions, and avoiding handling wild animals.

Screening of substance use in pregnancy: A Danish cross-sectional study.

There is a paucity of objectively verified data on substance use among Danish pregnant women. We estimated the prevalence of substance use including alcohol and nicotine among the general population of Danish pregnant women. In this anonymous, national, cross-sectional, descriptive study, pregnant women were invited when attending an ultrasound scan between November 2019 and December 2020 at nine Danish hospitals. Women submitted a urine sample and filled out a questionnaire. Urine samples were screened on-site with a qualitative urine dipstick for 15 substances including alcohol, nicotine, opioids, amphetamines, cannabis, and benzodiazepines. All screen-positive urine samples underwent secondary quantitative analyses with gold standard, liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results were compared to questionnaire information to analyze the validity of self-reporting and to examine possible cross-reactions. A total of 1903 of 2154 invited pregnant women participated (88.3%). The prevalence of dipstick-positive urine samples was 25.0%. 44.0% of these were confirmed positive, resulting in a total confirmed prevalence of 10.8%. The prevalence of nicotine use was 10.1%-and for all other substances, <0.5%. Nicotine use was more prevalent among younger pregnant women, while other substance use appeared evenly distributed over age groups. Self-reporting of use of nicotine products was high (71.1%), but low for cannabis and alcohol intake (0% and 33.3%, respectively). Prescription medication explained almost all cases of oxycodone, methylphenidate, and benzodiazepine use. Substance use among pregnant women consisted mainly of nicotine. Dipstick screening involved risks of false negatives and false positives. Except for alcohol intake and cannabis use, dipstick analyses did not seem to provide further information than self-reporting. LC-MS/MS analyses remain gold standard, and future role of dipstick screenings should be discussed.

Determinants of tobacco use among pregnant women in sub-Saharan Africa. A multilevel mixed-effect logistic regression model.

Although it is known that maternal tobacco use during pregnancy substantially declined in higher-income countries, information on the magnitude and determinants of tobacco use among pregnant women in sub-Saharan Africa (SSA) remains limited. Establishing evidence on maternal tobacco during pregnancy is crucial for guiding targeted interventions in SSA. This study aimed to determine the overall prevalence of tobacco use and its determinants among pregnant women in SSA countries. The study used data from Demographic and Health Surveys conducted in 33 countries across SSA from 2010 and 2021. Our analysis included a total weighted sample of 40,291 pregnant women. A multilevel logistic regression model was used to identify factors associated with maternal tobacco use during pregnancy. The measure of association between explanatory variables and the outcome was reported using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The pooled prevalence of tobacco use among pregnant women in SSA was 1.76% (95% CI: 1.41, 2.12). Our findings showed that pregnant women in the age groups of 25-34 years (AOR 1.44; 95% CI: 1.14, 1.82) and 35+ years (AOR 2.18; 95% CI: 1.68, 2.83) had higher odds of tobacco use during pregnancy. Pregnant women who attained primary education (AOR 0.57; 95% CI: 0.46, 0.70) and secondary or higher education (AOR 0.39; 95% CI: 0.30, 0.53) were associated with lower odds of tobacco use. Similarly, pregnant women who resided in households with a high wealth index (AOR 0.36; 95% CI: 0.55 0.90) and those with media exposure (AOR 0.81; 95% CI: 0.67, 0.99) were less likely to use tobacco during pregnancy. This study revealed that the overall prevalence of maternal tobacco use during pregnancy was relatively low in SSA, but some countries exhibited higher estimates. To address this, it is crucial to implement targeted smoking prevention and cessation strategies, particularly for young pregnant women, those facing socioeconomic disadvantages, and those with lower educational status.

Genetic association of the xenobiotic biotransformation system with the risk of death of the gestational sac in primigravida women living in an industrial city

Introduction. Every second conception in the population ends in failure, in 20% of the cases the cause is a non-developing pregnancy. In the overall structure of early reproductive losses, missed miscarriage accounts for 80%. The development of this pathology is influenced by both endogenous and exogenous factors. Exogenous factors with a teratogenic effect lead to the occurrence of mutations and the formation of an abnormal embryo, which is poorly predicted. The peculiarities of the biotransformation system of xenobiotics of the maternal organism directly affect the severity of the impact of these factors on the embryo. Materials and methods. A survey of eighty six young primigravida women living in Novokuznetsk was conducted. 33 of them were diagnosed with the gestational sac death, 53 women had a standard developed pregnancy. Variants of the GSTM1 and GSTT1 genes of the second phase of the xenobiotic biotransformation system were determined in these groups by polymerase chain reaction. Results. Novokuznetsk, a city with a critically high level of environmental pollution, has recorded a 20–fold increase in the number of missed miscarriages over the past 25 years. A statistically reliable association of deletion polymorphisms of the genes of the second phase of the xenobiotic biotransformation system with the death of the gestational sac - GSTM1 (χ2 – 5.37; OR – 3.18) and GSTT1 (χ2 – 10.85; OR – 16.64) was revealed, while the normal alleles were associated with a successful outcome of pregnancy - GSTM1 (χ2 – 5.37; OR – 0.13) and GSTT1 (χ2 – 10.85; OR – 0.06). Limitations. The study was of a pilot nature, so it is advisable to increase the sample in the future. Conclusion. The dependence between the activity of enzymes of the second phase of the xenobiotic biotransformation system and the increased risk of miscarriage of the first pregnancy in young women living in the conditions of ecological distress was revealed. The results of the study make it possible to predict possible pregnancy complications and elaborate algorithms for full-fledged pregravid preparation.

Evaluation of urea breath test as a diagnostic tool for Helicobacter pylori infection in adult dyspeptic patients

In this editorial, we discuss the article in the World Journal of Gastroenterology . The article conducts a meta-analysis of the diagnostic accuracy of the urea breath test (UBT), a non-invasive method for detecting Helicobacter pylori (H. pylori) infection in humans. It is based on radionuclide-labeled urea. Various methods, both invasive and non-invasive, are available for diagnosing H. pylori infection, including endoscopy with biopsy, serology for immunoglobulin titers, stool antigen analysis, and UBT. Several guidelines recommend UBTs as the primary choice for diagnosing H. pylori infection and for reexamining after eradication therapy. It is used to be the first choice non-invasive test due to their high accuracy, specificity, rapid results, and simplicity. Moreover, its performance remains unaffected by the distribution of H. pylori in the stomach, allowing a high flow of patients to be tested. Despite its widespread use, the performance characteristics of UBT have been inconsistently described and remain incompletely defined. There are two UBTs available with Food and Drug Administration approval: The 13C and 14C tests. Both tests are affordable and can provide real-time results. Physicians may prefer the 13C test because it is non-radioactive, compared to 14C which uses a radioactive isotope, especially in young children and pregnant women. Although there was heterogeneity among the studies regarding the diagnostic accuracy of both UBTs, 13C-UBT consistently outperforms the 14C-UBT. This makes the 13C-UBT the preferred diagnostic approach. Furthermore, the provided findings of the meta-analysis emphasize the significance of precise considerations when choosing urea dosage, assessment timing, and measurement techniques for both the 13C-UBT and 14C-UBT, to enhance diagnostic precision.

Young women's social support networks during pregnancy in Soweto, South Africa.

Although studies from high-income countries have examined social support during pregnancy, it remains unclear what type of support is received by expectant mothers from low- and middle-income country settings. To explore young women's social support networks during pregnancy in Soweto, South Africa. This study was undertaken in an academic hospital based in the Southwestern Townships (Soweto), Johannesburg, in Gauteng province, South Africa. An exploratory descriptive qualitative approach was employed. Eighteen (18) young pregnant women were recruited using a purposive sampling approach. In-depth interviews were conducted, and data were analysed using inductive thematic analysis. Analysis of the data resulted in the development of two superordinate themes namely; (1) relationships during pregnancy and (2) network involvement. Involvement of the various social networks contributed greatly to the young women having a greater sense of potential parental efficacy and increased acceptance of their pregnancies. Pregnant women who receive sufficient social support from immediate networks have increased potential to embrace and give attention to pregnancy-related changes. Focusing on less-examined characteristics that could enhance pregnant women's health could help in the reduction of deaths that arise because of pregnancy complications and contribute in globally accelerating increased accessibility to adequate reproductive health.Contribution: This study's findings emphasise the necessity for policymakers and healthcare providers to educate the broader community about the importance of partner, family and peer support to minimise risks that may affect pregnancy care and wellbeing of mothers.