Young Pregnant Women Research Articles

Potential congenital transmission of Chagas disease in the second generation of young pregnant women who attended prenatal in the department of Cordillera, Paraguay

Trypanosoma cruzi es el agente causal de la enfermedad de Chagas. En Paraguay se estima que existen 165.000 personas infectadas y actualmente la principal vía de transmisión es la congénita, con una prevalencia del 5% y con alrededor de 400 niños infectados nacidos por año. El departamento de Cordillera es área endémica de la Región Oriental del país, donde se implementó el Programa de Control Prenatal de Chagas en el año 1995. El objetivo de este estudio fue inferir sobre la potencial transmisión congénita de la enfermedad de Chagas en jóvenes embarazadas de segunda generación de Cordillera que asistieron a su control prenatal en el período 2010-2012, 15 años después de la implementación del Programa de Control Prenatal. De 9.588 embarazadas; 482 fueron seropositivas (5%); 2,74% en el grupo de 12 a 19 años, 4,93% de 20 a 30 años, 8,03% de 31 a 40 años y 16,11% de 41 a 48 años. Para estimar el origen de la transmisión congénita de segunda generación se tuvo en cuenta a las 72 seropositivas de 12 a 19 años y según la base de datos de las respectivas madres 61 eran seropositivas. Con esta información se estima que la transmisión a embarazadas de segunda generación de 12 a 19 años fue congénita en un 85% indicando una transmisión congénita muy significativa en la población de estudio. Esta información ayudaría al Programa Nacional de Chagas en el fortalecimiento del control de la transmisión congénita de la enfermedad de Chagas en el país.

The consequence of 12 weeks of Pilates exercise on the quality of sleep and life of pregnant women

Aim: As one of the most critical periods in women's lives, pregnancy affects their physical, mental, and functional conditions. These changes can affect the quality of life and sleep of pregnant women. The main purpose of this study is to investigate the effect of Pilates exercises on 140 young pregnant women between the ages of 20-40. Methods: This randomized double-blind clinical trial study was done between September 2023 and March 2024, including 60 pregnant women in case group and 90 control subjects of similar age and body mass index (BMI). This study investigated the effect of 12 weeks of pilates exercises on the quality of women's sleep and life. Quality of life was measured by the short-form 36 (SF-36) and quality of sleep by the Pittsburgh Sleep Quality Index (PSQI). People were randomly divided into intervention and control groups. Pregnant women in the intervention group were required to participate in two pilates sessions per week for 12 weeks from the 20th week of pregnancy. Results: Our results found that quality of life levels were statistically significant higher than case group after intervention compared to control group (p<0.05; 67.19 vs. 54.94). Also, a statistically significant association between the case and control regarding quality of sleep (p<0.05; 5.41 vs. 6.77). Conclusion: It is concluded that performing moderate-intensity pilates exercises for 12 weeks in the last months of pregnancy can increase sleep quality and life.

Estimating averted illnesses from influenza vaccination for children and pregnant women – El Salvador, Panama, and Peru, 2011–2018

BackgroundEstimating the burden of disease averted by vaccination can assist policymakers to implement, adjust, and communicate the value of vaccination programs. Demonstrating the use of a newly available modeling tool, we estimated the burden of influenza illnesses averted by seasonal influenza vaccination in El Salvador, Panama, and Peru during 2011–2018 among two influenza vaccine target populations: children aged 6–23 months and pregnant women. MethodsWe derived model inputs, including incidence, vaccine coverage, vaccine effectiveness, and multipliers from publicly available country-level influenza surveillance data and cohort studies. We also estimated changes in illnesses averted when countries’ vaccine coverage was achieved using four different vaccine deployment strategies. ResultsAmong children aged 6–23 months, influenza vaccination averted an estimated cumulative 2,161 hospitalizations, 81,907 medically-attended illnesses, and 126,987 overall illnesses during the study period, with a prevented fraction ranging from 0.3 % to 12.5 %. Among pregnant women, influenza vaccination averted an estimated cumulative 173 hospitalizations, 6,122 medically attended illnesses, and 16,412 overall illnesses, with a prevented fraction ranging from 0.2 % to 10.9 %. Compared to an influenza vaccine campaign with equal vaccine distribution during March—June, scenarios in which total cumulative coverage was achieved in March and April consistently resulted in the greatest increase in averted illness (23 %-3,129 % increase among young children and 22 %-3,260 % increase among pregnant women). DiscussionInfluenza vaccination campaigns in El Salvador, Panama, and Peru conducted between 2011 and 2018 prevented hundreds to thousands of influenza-associated hospitalizations and illnesses in young children and pregnant women. Existing vaccination programs could prevent additional illnesses, using the same number of vaccines, by achieving the highest possible coverage within the first two months of an influenza vaccine campaign.

Association of Various Factors and HIV Infection in Pregnancy: A Clinico- Epidemiological Review

HIV infection among pregnant women has been on the rise, demanding efforts to prevent vertical transmission. This study analyzed the epidemiological and clinical characteristics of HIV-positive pregnant women treated at the Hospital of Tropical Diseases of the Federal University of Tocantins between 2015 and 2019. Out of the 85 pregnant women analyzed, the majority were between 26 and 34 years old, with 37.64% completing high school. Most resided in Tocantins and had stable partners, with 44.11% unaware of their serological status. Women aged ≥25 years showed lower viral load detection. The majority already had HIV before prenatal care, but only 45.88% started follow-up in the first trimester. Treatment adherence was high, but 14.10% dropped out. The analysis highlighted the need for specific strategies for young pregnant women, emphasizing the importance of prenatal exams for early diagnosis and immediate treatment initiation, reducing vertical transmission. Adherence to antiretroviral therapy (ART) was crucial, although cases of dropout underscored the need for emotional support. The results reinforce the importance of health policies tailored to the needs of HIV-positive pregnant women, aiming to ensure a holistic and effective approach to this vulnerable population.

IJCM_65A: Prevalence and severity of anemia and its association with age and gender in patients attending rural health clinic in Aligarh, Uttar Pradesh: A retrospective study.

Background: Anemia is major public health concern and mainly affects young children, pregnant and postpartum women, and menstruating adolescent girls and women. As reported by WHO, 40% of all children aged 6–59 months, 37% of pregnant women and 30% of women 15–49 years of age are affected by anemia globally. The situation is even worse in India with the prevalence being 67%, 52.2% and 57% respectively, as reported by NFHS-V. Objective: To estimate prevalence of anemia and its severity stratified by age and gender in patients attending Rural Health Training Centre (RHTC), Jawan, Aligarh. Methodology: A retrospective observational study using routine clinical data of 402 patients attending general OPD of RHTC from January 1, 2022 to December 31, 2022 was performed. Pregnant females and patients who had more than one determination of hemoglobin during the study period were excluded from the study. Anemia was defined according to WHO criteria. Data was analyzed using SPSS version 20.0., descriptive statistics and Chi Square test were applied. P value Results: 40.5% of patients were males while 59.5% were females. The overall prevalence of anemia was found to be 93.3%. Anemia was most prevalent in children <5 years (95.7%). Females had significantly higher prevalence of anemia (97.4%) as compared to males (86.3%). (p<0.001) Conclusion: Prevalence of anemia was found to be very high in patients attending Rural Health Clinic. Targeted interventions like screening programmes, iron and folic acid supplementation and health education should be strengthened for decreasing prevalence of anemia especially in women and young children.

Synthesis and biological evaluation of hydantoin derivatives as potent antiplasmodial agents

Malaria, a devastating disease, has claimed numerous lives and caused considerable suffering, with young children and pregnant women being the most severely affected group. However, the emergence of multidrug-resistant strains of Plasmodium and the adverse side effects associated with existing antimalarial drugs underscore the urgent need for the development of novel, well-tolerated, and more efficient drugs to combat this global health threat. To address these challenges, six new hydantoins derivatives were synthesized and evaluated for their in vitro antiplasmodial activity. Notably, compound 2c exhibited excellent inhibitory activity against the tested Pf3D7 strain, with an IC50 value of 3.97 ± 0.01 nM, three-fold better than chloroquine. Following closely, compound 3b demonstrated an IC50 value of 27.52 ± 3.37 µM against the Pf3D7 strain in vitro. Additionally, all the hydantoins derivatives tested showed inactive against human MCR-5 cells, with an IC50 value exceeding 100 μM. In summary, the hydantoin derivative 2c emerges as a promising candidate for further exploration as an antiplasmodial compound.

Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium and risk factors among pregnant women in Brazil: Results from the national molecular diagnosis implementation project.

Sexually transmitted infections (STIs) are a public health problem. The aim of the present study was to assess the prevalence and risk factors associated with at least one STI (Chlamydia trachomatis [CT], Neisseria gonorrhoeae [NG], Trichomonas vaginalis [TV], and Mycoplasma genitalium [MG]) in Brazil. A cross-sectional study was conducted using secondary data from the pilot implementation of the National Service for molecular diagnosis of CT, NG, TV, and MG in pregnancy. We obtained Ministry of Health surveillance data from the implementation project. Data encompassing pregnant women aged 15-49 years from public antenatal clinics in Brazil in 2022 were included. A total of 2728 data of pregnant women were analyzed. The prevalence of at least one infection was 21.0% (573), with the highest prevalence in the Southeast region (23.3%) and the lowest in the Center-West region (15.4%). The prevalence of CT was 9.9% (270), NG 0.6% (16), TV 6.7% (184), and MG 7.8% (212). Factors associated with any infection were from 15 to 24 years (AOR = 1.93; 95% CI: 1.58-2.35); reported family income up to US$400 (AOR = 1.79; 95% CI: 1.03-3.34); declared not living maritally with their partners (AOR = 1.90, 95% CI: 1.52-2.37) and had more than one sexual partner in their lifetime (AOR = 2.09, 95% CI: 1.55-2.86). This study showed a high prevalence of at least one STI among pregnant women in Brazil, particularly among younger women. It also provides up-to-date national data on CT, NG, TV, and MG infections in this population. These findings underscore the importance of enhancing access to STI screening for young pregnant women within the Brazilian public health system.

Protective effects of Helicteres isora L. fruit extract on phenylhydrazine-induced hemolytic anemia in rats

BackgroundAnemia is a serious global public health problem that affects young children and pregnant women with an increased risk of maternal and child mortality. Helicteres isora L. (Family: Malvaceae) has significant antioxidant properties responsible for its medicinal properties. The present study was conducted to investigate the protective effects of aqueous fruit extract of Helicteres isora L. (AEHI) on phenylhydrazine-induced hemolytic anemia in rats. MethodsThe fruits of Helicteres isora L. (H. isora L.) were extracted with distilled water to obtain the AEHI. The AEHI was subjected to preliminary phytochemical analysis, iron estimation and in-vitro antioxidant assay. The HPTLC fingerprinting followed by HR-LCMS analysis of the isolated HPTLC fraction of AEHI was carried out to investigate the phytoconstitutents. Male Wistar albino rats were administered phenylhydrazine (40 mg/kg, i.p.) for two consecutive days to induce anemia. The effects of AEHI were investigated at three oral doses viz. 250, 500 and 750 mg/kg once daily for 13 days by estimating blood parameters and pathological changes in the liver, heart, spleen, kidney, lungs and bone marrow. ResultsThe phytochemical analysis showed the presence of alkaloids, tannins, phenolic compounds, carbohydrates and steroids in the AEHI. The iron content of AEHI was found to be 208 µg/ml. In-vitro antioxidant assays, the IC50 value of AEHI was found to be 90.01 µg/ml. Phenylhydrazine administration caused a significant decrease in red blood cells, hemoglobin, and hematocrit levels. These decreased levels were significantly improved by AEHI in a dose-dependent manner. Pathological changes in the liver, heart, spleen, kidney, lungs and bone marrow were prevented by AEHI treatment. ConclusionIt is concluded that the AEHI provides significant protection against phenylhydrazine-induced hemolytic anemia.

Factors Associated with Failed Completion of Four Antenatal Care Visits among Pregnant Women Delivering at Jinja Regional Referral Hospital, Eastern Uganda

ntenatal care (ANC) was a key strategy towards improving maternal and child health. A recent survey data from sub-Saharan Africa has however shown that most women only initiated ANC after the first trimester and did not achieve the recommended number of visits. This study aimed to determine the completion rate of four ANC visits and factors associated with failed completion of four ANC visits among women delivering at Jinja Regional Referral Hospital, eastern Uganda (JRRH). A cross-sectional study design was conducted from February 2021 to April 2021. A total of 355 pregnant women at term admitted at the maternity ward of JRRH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain data. Descriptive statistics followed by binary logistic regression were conducted. The variables in the final multivariate model were significant when p˂0.05. All data analyses were conducted using STATA 14.2. Of the 355 pregnant women recruited into the study, 98(27.6%) had completed a minimum of four ANC visits. Maternal age below 20 years (aOR=2.4, 95%CI: 1.61-5.21, p<0.0001*) and a distance of more than four kilometres were independently associated with failure to complete four antenatal care visits (aOR=4, 95%CI: 1.33-7.19; p=0.031*). A significant number of women do not complete the recommended minimum of four antenatal care visits in this setting. Young pregnant women and those without public health facilities within a distance of less than four kilometres are likely not to complete the recommended four antenatal care visits in this setting. Strategies aimed at enhancing the accessibility of healthcare services are very crucial. Health Information, Education, and Communication (IEC) messages targeting teenage mothers are key to increasing ANC completion rates. Keywords: Antenatal care, Women, Pregnancy, Maternal death, Teenage mothers

Global burden of maternal disorders attributable to malnutrition from 1990 to 2019 and predictions to 2035: worsening or improving?

Maternal malnutrition is a major global public health problem that can lead to serious maternal diseases. This study aimed to analyze and predict the spatio-temporal trends in the burden of maternal disorders attributable to malnutrition, and to provide a basis for scientific improvement of maternal malnutrition and targeted prevention of maternal disorders. Data on maternal disorders attributable to malnutrition, including number of deaths, disability-adjusted life years (DALYs), population attributable fractions (PAFs), age-standardized mortality rates (ASMRs), and age-standardized DALY rates (ASDRs) were obtained from the Global Burden of Disease Study 2019 to describe their epidemiological characteristics by age, region, year, and type of disease. A log-linear regression model was used to calculate the annual percentage change (AAPC) of ASMR or ASDR to reflect their temporal trends. Bayesian age-period-cohort model was used to predict the number of deaths and mortality rates to 2035. Global number of deaths and DALYs for maternal disorders attributable to malnutrition declined by 42.35 and 41.61% from 1990 to 2019, with an AAPC of -3.09 (95% CI: -3.31, -2.88) and -2.98 (95% CI: -3.20, -2.77) for ASMR and ASDR, respectively. The burden was higher among younger pregnant women (20-29 years) in low and low-middle socio-demographic index (SDI) regions, whereas it was higher among older pregnant women (30-39 years) in high SDI region. Both ASMR and ASDR showed a significant decreasing trend with increasing SDI. Maternal hemorrhage had the highest burden of all diseases. Global deaths are predicted to decline from 42,350 in 2019 to 38,461 in 2035, with the ASMR declining from 1.08 (95% UI: 0.38, 1.79) to 0.89 (95% UI: 0.47, 1.31). Maternal malnutrition is improving globally, but in the context of the global food crisis, attention needs to be paid to malnutrition in low SDI regions, especially among young pregnant women, and corresponding measures need to be taken to effectively reduce the burden of disease.

Evaluation of Mortality Risk Factors of COVID-19 in Jakarta Tertiary Hospital During Peak of Second Wave and Predictive Utility of Community RT-PCR Low CT Values

Background: The Delta variant of SARS-CoV-2 led to a surge in COVID-19 cases in Indonesia. This study aimed to assess the demographic profile and mortality rates of hospitalized COVID-19 patients in YARSI referral hospital, Jakarta, comparing pre-Delta and Delta wave periods. The study also investigated whether low CT values in RT-PCR tests indicated heightened viral transmission before the Delta wave surge. Method: A retrospective analysis was conducted on 1,457 COVID-19 patients hospitalized at YARSI (January-August 2021) and 25,279 RT-PCR test results from walk-in patients (April-August 17, 2021). Differences were evaluated using Chi-square or Fisher’s Exact Tests while binary logistic regression was used to assess mortality risk factors. Results: There were increased proportions of pregnant women, patients aged 20-29 and those with coronary artery disease during the Delta wave. This period also showed a significant increase in mortality rates, with the highest seen in patients >60 years old or those with multiple comorbidities. Notably, most of the deceased patients (131 of 139) were unvaccinated. Analysis of RT-PCR data showed rising percentages of positive results with low CT values (below 21 or 15) from April to June. Conclusion: The Delta wave saw a higher risk of hospitalization among young individuals and pregnant women, despite their low mortality risk. The unvaccinated and those with multiple comorbidities faced higher mortality risks. Increases in RT-PCR positivity with low CT values preceded the July COVID-19 case surge.

Perinatal characteristics and pregnancy outcomes of advanced maternal age women with gestational diabetes mellitus: A retrospective cohort study.

The prevalence of gestational diabetes mellitus (GDM) continues to increase, and the phenomenon of women giving birth at an older age is becoming more common worldwide. Less is known abouts the impact of GDM combined with advanced maternal age (AMA) on pregnancy outcomes. To explore the impact of AMA complicated with GDM on pregnancy outcomes. This study included 34,602 pregnancies between 2018 and 2020 in Hangzhou, China. The pregnant women were divided into four groups according to advanced age (≥35 years) and GDM as follows: AMA women without GDM (non-AGDM) group (n = 2614), young pregnant women with GDM (YGDM) group (n = 4016), AMA women with GDM (AGDM) group (n = 850), and young pregnant women without GDM (non-YGDM) group (n = 27,122). Univariate analysis was carried out by Mann-Whitney U test or Pearson's χ 2 test. Multivariate logistic regression analysis was used to investigate the effect of AMA and GDM on pregnancy outcomes. Multivariate logistic regression analysis showed that in the comparison against non-YGDM garoup, the ORs of fetal chromosome abnormality, parity, urgent cesarean section, gravidity, scheduled cesarean section, body mass index (BMI) ≥30 kg/m2, pre-eclampsia, thrombocytopenia, hyperlipidemia, BMI 25-29.9 kg/m2, blood urea nitrogen, fasting blood glucose, and creatinine in AGDM group were 16.044, 4.284, 3.530, 3.284, 3.257, 2.049, 1.935, 1.898, 1.690, 1.471, 1.304, 1.216, and 1.026 (all p < 0.05). The prevalence of pregnant women with AGDM was 2.46% in Hang Zhou, China. The increasing gravidity of AMA women was related to a greater risk of GDM. The AGDM group associated with a greater risks of chromosomal abnormality in offspring and cesarean section, especially urgent cesarean section.

Elevated serum uric acid to creatinine ratio is associated with adverse pregnancy outcomes: a prospective birth cohort study.

Purpose: This study evaluated the association between maternal serum uric acid-to-creatinine ratio (SUA/SCr) in the first trimester and adverse maternal and neonatal outcomes. Methods: A prospective birth cohort study was conducted between 2018 and 2021. Logistic regression models and restricted cubic splines were utilized to estimate the associations between the SUA/SCr ratio and feto-maternal pregnancy outcomes. Women were stratified according to maternal age and pre-pregnancy body mass index. Results: This study included 33,030 pregnant women with live singleton pregnancies. The overall prevalence of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), cesarean delivery, preterm birth, large-for-gestational age (LGA), small-for-gestational age, and low Apgar scores were 15.18%, 7.96%, 37.62%, 4.93%, 9.39%, 4.79% and 0.28%, respectively. The highest quartile of SUA/SCr was associated with the highest risk of GDM (odds ratio [OR] 2.14, 95% CI 1.93-2.36), PIH (OR 1.79, 95% CI 1.58-2.04), cesarean delivery (OR 1.24, 95% CI 1.16-1.33), and preterm birth (OR 1.30, 95% CI 1.12-1.51). The associations between SUA/SCr with adverse pregnancy outcomes showed linear relationships except for GDM (P < 0.001 for all, P < 0.001 for non-linearity). Subgroup analyses revealed that the associations between the SUA/SCr ratio and the risks of PIH and LGA were significantly stronger in younger pregnant women (P = 0.033 and 0.035, respectively). Conclusion: Maternal SUA/SCr levels were associated positively with the risk of adverse pregnancy outcomes. Timely monitoring of SUA and SCr levels during early pregnancy may help reduce the risk of adverse pregnancy outcomes and provide a basis for interventions.

Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study.

Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan. The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group. A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years. The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed. In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia. The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.

Non-invasive iron deficiency diagnosis: a saliva-based approach using capillary flow microfluidics.

Iron deficiency anemia (IDA) is a condition characterized by lower-than-average iron (Fe) levels in the body, affecting a substantial number of young children and pregnant women globally. Existing diagnostic methods for IDA rely on invasive analysis of stored Fe in ferritin from blood samples, posing challenges, especially for toddlers and young children. To address this issue, saliva has been proposed as a non-invasive sample matrix for IDA diagnosis. However, conventional Fe analysis techniques often necessitate complex and costly instrumentation. This study presents the first non-invasive, saliva-based preliminary screening test for IDA using a nitrocellulose lateral flow system. In this study, we introduce a novel approach using the ferroin reaction with bathophenanthroline (Bphen) and ferrous (Fe2+) ions to quantify Fe levels in saliva. Our methodology involves a capillary flow-driven microfluidic device integrated into a lateral flow system utilizing nitrocellulose membranes. Here, we present the first instance of saliva on a nitrocellulose substrate to detect salivary Fe levels. The optimized system yielded a linear response over the 1-200 ppm range in buffer solution, with a limit of detection (LoD) of 5.6 ppm. Furthermore, the system demonstrated a linear response in pooled saliva samples across the 1-1000 ppm range, with a LoD of 55.1 ppm. These results underscore the potential of our capillary flow-driven microfluidic device as a viable non-invasive diagnostic tool for IDA, particularly in remote and resource-limited settings.

In Vivo Genotoxicity and Cytotoxicity Kinetics of Trimethoprim Sulfamethoxazole in Well-nourished and Undernourished Young Rats.

Undernutrition is a serious health problem prevalent in poor countries, affecting millions of people worldwide, especially young children, pregnant women, and sick elderly individuals. This condition increases vulnerability to infections, leading to widespread use of antibiotic treatments in undernourished populations. The objective of the present study was to determine the in vivo genotoxic and cytotoxic effects of trimethoprim-sulfamethoxazole (TMP-SMX) treatment according to nutritional conditions. The effects of TMP-SMX treatment were measured by analyzing the kinetics of micronucleated reticulocytes (MN-RET) induced in the peripheral blood of young, well-nourished (WN) and undernourished (UN) rats. In the WN group, two distinct peaks of MN-RET were observed, while the UN group had a significantly higher basal frequency of MN-RET compared to the WN group and only a later peak. Reticulocyte (RET) frequency slightly decreased in WN, indicating a poor cytotoxic effect. In contrast, in the UN, the treatment caused a significant increase in RET frequency. The results indicate that SMX's aromaticity index decreases when formed with TMP, suggesting potentially fewer toxic effects. In vivo TMP-SMX produces two MN-RET induction peaks in WN animals, indicating two DNA damage induction mechanisms and consequent micronucleus production. The UN rats did not display the two peaks, indicating that the first MN induction mechanism did not occur in UN, possibly due to pharmacokinetic effects, decreased metabolism or effects on cell proliferation. TMP-SMX has a slight cytotoxic effect on WN. In contrast, in the UN, the antibiotic treatment seems to favor early erythropoiesis.

Ameliorative Effects of Coconut Water on Hematological and Lipid Profiles of Phenylhydrazine-treated Rats.

Anaemia is a widespread health issue affecting young children and pregnant women, characterized by reduced red blood cells or haemoglobin levels. Coconut water, rich in nutrients such as L-arginine, iron, vitamin C, vitamin B6, folic acid and fatty acids, is believed to aid in blood formation (hematopoesis). The study aimed to examine the impact of coconut water on hematological indices and lipid profiles in rats with phenylhydrazine-induced anemia. 30 rats were divided into 5 groups: a normal control, phenylhydrazine untreated, coconut water (0.5ml/kg), iron, and ferrous treated groups. Hemoglobin, hematocrit, and erythrocyte levels were measured using a Hematology Analyzer. Results showed a significant decrease in LDL and TG levels, and an increase in HDL levels in phenylhydrazine induced anemia compared to the control group. Coconut water administration at 0.5ml/kg reduced LDL, VLDL and TG levels, and increased HDL levels in rats with induced anemia. The study found that coconut water had a positive effect on hematological indices, as it increased hemoglobin and erythrocyte levels in rats with induced anemia. These findings suggest that coconut water may have potential therapeutic benefits for individuals with anemia, particularly in lowering lipid levels and improving blood formation. However, further research is needed to fully understand the mechanisms underlying these effects and to determine the most effective dosage and duration of treatment. Overall, the study highlights the importance of coconut water as a potentially beneficial alternative treatment for anemia.

Digital media and maternal healthcare among young women in Kenya: Use, patterns, and perspectives

This study aimed to examine the relationship between digital media use and maternal health care utilization among young pregnant mothers in Kenya. Using a mixed methods approach combining questionnaires and focus group discussions (FGDs), data were collected from pregnant women and new mothers aged 19–35 years in Nairobi. Using Microsoft Excel Data Analysis ToolPak Ver. 2016, primary data were statistically analyzed, while FGD data were subjected to thematic analysis and narrative interpretation. Findings revealed that 88% of participants preferred internet searches for information, 92% used different digital media during pregnancy, 56% used pregnancy apps, and 9% abstained from digital media for maternal health information. The study concludes that, in addition to the continued importance of traditional sources of information, digital media have a significant impact on the use of maternal health services. It recommends that health care providers actively usedigital media, especially apps, as educational tools to disseminate reliable information to young pregnant women and new mothers in Kenya. It also recommends that planners and policymakers incorporate digital media into maternal health interventions to increase their effectiveness.

Exploring Adolescent Pregnancy Expectations in Continuity of Midwifery Care: A Qualitative Study in Indonesia

Introduction: Adolescent pregnancy presents a significant challenge to global reproductive health, including in Indonesia. The unique obstacles that young pregnant women encounter when seeking appropriate and supportive healthcare services call for a deeper understanding to improve maternal care. Purpose: This study aims to explore the expectations of young pregnant women regarding continuous midwifery care in Indonesia. Method: This research employed an exploratory qualitative approach, conducting 13 face-to-face interviews between January and June 2022. Participants included midwives, young mothers, a coordinating midwife, and Mother and Child Health (MCH) program holders. Interviews, lasting 1-1.5 hours, were conducted, and the interview data were rigorously analyzed thematically by the research team, strengthening data reliability through triangulation. Results: Continuity management emphasizes friendly service, privacy, clear communication, and comprehensive health assessments. Informational continuity involves comprehensive information, direct communication, attractive aids, and health education evaluation. Relational continuity highlights comprehensive maternal care, family tradition approval, reminders, and efficient care. The study underscores the importance of tailored, holistic, and culturally sensitive midwifery care for young pregnant women's overall well-being. Conclusion: This study highlights adolescent pregnant women's unique needs, focusing on continuity management, informational continuity, and relational continuity. Proposed strategies include tailored health services, comprehensive maternal education, cultural sensitivity training for healthcare providers, policy integration, and diverse research. Successfully implementing these measures can significantly enhance maternal care outcomes for Indonesian adolescents.

Pregnancy in Women on Dialysis: Success Stories from a Tertiary Care Hospital in Dubai, United Arab Emirates

Background:: Pregnancy is rare in women with end-stage renal disease (ESRD). However, this scenario has changed in recent years with considerable improvement and successful outcomes in pregnant women with end-stage renal disease on dialysis. The understanding of the principles related to pregnant dialysis patients, combined with a multidisciplinary approach to case management, has resulted in many success stories, and today, pregnancy for young women with ESRD is more plausible and far safer than ever before. Case Presentation:: We present a series of three women who conceived while on dialysis and delivered successfully. These women were managed with increasing dialysis frequency and developing a clinical protocol early on, with a multidisciplinary approach and close collaboration with obstetricians. Our case series is unique as one of the women had three successful deliveries while on dialysis, and one of them had a positive outcome with twin pregnancies while on dialysis. Conclusion:: Successful outcomes in these high-risk pregnancies while on dialysis suggest that with meticulous care and a multidisciplinary approach, conception and successful deliveries are plausible in women who receive dialysis.