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1.
Sci Rep ; 14(1): 5070, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429426

RESUMO

When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.


Assuntos
Ganho de Peso na Gestação , Estado Nutricional , Gravidez , Feminino , Adolescente , Humanos , Etiópia , Gestantes , Aconselhamento
2.
Sci Rep ; 14(1): 5128, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429388

RESUMO

To identify pregnant women's attitudes towards, and acceptance and rejection of, COVID-19 vaccination. This prospective, descriptive, implementation study was conducted in the Antenatal clinic of Siriraj Hospital, Bangkok, Thailand. In Phase I, 40 pregnant women were interviewed. Phase II consisted of questionnaire development and data validation. In Phase III, the questionnaire was administered to 400 participants. Pregnant women's attitudes towards and acceptance and rejection of COVID-19 vaccination. Most pregnant women were uncertain about the potential harm of vaccination to themselves or their unborn child, including risks such as miscarriage or premature birth (59-66/101 [58.4%-65.3%]; OR 2.53-8.33; 95% CI 1.23-3.60, 5.17-19.30; P < 0.001) compared to those who disagreed with vaccination. Their vaccination decisions were significantly influenced by social media information regarding vaccination complications in pregnant women (74/101 [73.3%]; OR 15.95; 95% CI 2.15-118.55; P = 0.001) compared to those who disagreed with vaccination. Most pregnant women opined that they should not receive a COVID-19 vaccination during pregnancy (adjusted odds ratio [AOR] 6.57; 95% CI 2.44-17.70; P = 0.001). Most also rejected vaccination despite being aware of its benefits (AOR 17.14; 95% CI 6.89-42.62; P < 0.001). Social media messages and obligatory vaccination certifications influence maternal vaccination decisions. Pregnant women believe vaccination helps prevent COVID-19 infection and reduces its severity. Nevertheless, the primary reason for their refusal was concern about potential harm to their unborn child or themselves during pregnancy.The Thai clinical trials registry: TCTR20211126006.


Assuntos
Aborto Espontâneo , COVID-19 , Feminino , Gravidez , Humanos , Gestantes , Tailândia , Vacinas contra COVID-19/efeitos adversos , Estudos Prospectivos , Aceitação pelo Paciente de Cuidados de Saúde , Conhecimentos, Atitudes e Prática em Saúde , COVID-19/prevenção & controle , Inquéritos e Questionários , Vacinação
3.
Clin Lab ; 70(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38469790

RESUMO

BACKGROUND: This case involves a 28-year-old pregnant woman (39w+2) who was admitted to obstetrics due to abdominal tightness and bacteremia with Gardnerella vaginalis which developed after caesarean section and vaginal myomectomy. METHODS: A blood culture was performed, and the bacteria were identified through mass spectrometry. RESULTS: Mass spectrometry data indicated that the infection bacteria were Gardnerella vaginalis. The patient's temperature returned to normal after oral ampicillin in combination with clindamycin. CONCLUSIONS: Gardnerella vaginalis bacteremia is very rare in clinical practice, and the combination of ampicillin and clindamycin has a good therapeutic effect. This study may provide a reference for the diagnosis and treatment of Gardnerella vaginalis bacteremia.


Assuntos
Bacteriemia , Miomectomia Uterina , Vaginose Bacteriana , Feminino , Gravidez , Humanos , Adulto , Gardnerella vaginalis , Gestantes , Clindamicina/uso terapêutico , Cesárea/efeitos adversos , Ampicilina/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Vaginose Bacteriana/tratamento farmacológico , Vagina
4.
BMJ Case Rep ; 17(3)2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38442979

RESUMO

Polypectomy during pregnancy is known to be a risk for spontaneous late miscarriage or preterm delivery. We managed a pregnant woman in her 30s with a large cervical polyp without polypectomy, and we administered probiotics including Clostridium butyricum and 17-alpha-hydroxyprogesterone caproate. As a result, she delivered a healthy baby at 38 weeks.


Assuntos
Adenoma , Neoplasias do Colo do Útero , Adulto , Feminino , Humanos , Gravidez , Genitália , Hemorragia , Primeiro Trimestre da Gravidez , Gestantes , Recém-Nascido
5.
BMC Womens Health ; 24(1): 175, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481249

RESUMO

BACKGROUND: Male partners' involvement in birth preparedness and complication readiness plans is a key strategy to improve maternal and child health. It assists an expectant mother to make timely decisions in receiving care where service is inaccessible. Despite its significance, information is scarce about male partner involvement in birth preparedness and complication readiness plan in the study setting. OBJECTIVE: To assess prevalence and factors associated with male partners' involvement in birth preparedness and complication readiness plan in Dale district Sidama, Ethiopia in 2021. METHODS: A community-based survey was done from November to December, in 2021. Data were collected using a structured, pre-tested and interview administered questionnaire. A multi-stage cluster sampling was applied to recruit 634 samples. Logistic regression analysis was performed to identify factors associated with male partner involvement in birth preparedness and complication readiness plan. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) of associated factors were estimated by stepwise backward likelihood ratio method. RESULTS: 622 out of the 634 study participants completed the interview, yielding a 98.1% response rate. Prevalence of male partners' involvement in birth preparedness and complication readiness plan was 47.6% (95%CI: 44.9%, 48.9%). After adjusting the cofounding variables, factors like accompanying wives with their partners during their antenatal care visits (AOR = 2.3, 95%CI 1.5, 3.5), male partners whose wives had a history of caesarean birth (AOR = 2.1, 95%CI 1.1, 3.8), knowledge of male partners on birth preparedness and complication readiness plan (AOR = 3.5, 95%CI:3.1,6.6), presence of obstetric complications(AOR = 5.1,95%CI:4.3,11.2),primi-gravida (AOR = 2.7,95%CI:1.6,4.7), and male partners' knowledge of obstetrics complications (AOR = 3.5,95%CI,2.2,5.7) were significantly associated with male partners' involvement in birth preparedness and complication readiness plan. CONCLUSION: This study indicates that prevalence of male partners' involvement in birth preparedness and complication readiness was low. Therefore, awareness creation should be strengthened on male involvement on birth preparedness and complication readiness plan.


Assuntos
Gestantes , Cuidado Pré-Natal , Criança , Gravidez , Feminino , Masculino , Humanos , Etiópia/epidemiologia , Parto Obstétrico , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais
6.
BMC Pregnancy Childbirth ; 24(1): 189, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38468217

RESUMO

BACKGROUND: Drug use during pregnancy can cause unfavorable fetal and maternal outcomes. Information sharing is essential for pharmacists' role within intricate, modern healthcare systems. Community pharmacists (CPs) have demonstrated unsatisfactory knowledge across various pharmacological domains in most developing countries. This study aimed to explore the knowledge and practices of CPs regarding medications and herb safety during pregnancy. METHODS: A cross-sectional study was conducted in a developing country using a self-administered questionnaire. A sample of CPs working in the northern governorates of the West Bank was selected by convenience sampling. The questionnaire included questions on sociodemographic characteristics, practices and knowledge. Descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences (SPSS) to analyze the data. RESULTS: A total of 207 questionnaires were completed. Most respondents had only a bachelor's degree (89.9%) but did not participate in continuous professional development (CPD) (71.0%). Almost one-third of the CP workload involved dispensing drugs to pregnant women. The majority of the participants reported that they inquire about pregnancy status (59.9%), refer to scientific sources (82.6%), and contact a prescribing physician (51.2%) in cases of uncertainty. A higher knowledge score was associated with receiving a master's degree and CPD programs. Most CPs identified folic acid, paracetamol and amoxicillin as safe, while tetracycline, isotretinoin, enalapril, pseudoephedrine and ibuprofen were among the drugs mostly reported as unsafe. Castor oil, Senna, St. John's wort and ginseng were the most frequently reported herbs as unsafe. CONCLUSIONS: Despite the gaps in knowledge about herb pharmacology, CPs demonstrated acceptable knowledge and practice regarding drug safety during pregnancy. CPD is recommended for addressing gaps in knowledge and practice. Future research evaluating knowledge and practice may benefit from developing a specific, accurate, validated instrument.


Assuntos
Países em Desenvolvimento , Farmacêuticos , Humanos , Feminino , Gravidez , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Gestantes , Inquéritos e Questionários
7.
Nutrients ; 16(5)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38474846

RESUMO

This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14-16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14-16th and 34-37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.


Assuntos
Dieta Mediterrânea , Qualidade de Vida , Animais , Humanos , Feminino , Gravidez , Adulto , Estudos Transversais , Gestantes/psicologia , Verduras , Dor
8.
Am J Reprod Immunol ; 91(3): e13832, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38462543

RESUMO

PROBLEM: Excisional surgery for cervical intraepithelial neoplasia is a risk factor for preterm birth in subsequent pregnancies. However, the underlying mechanisms of this association remain unclear. We previously showed that cervical MUC5B, a mucin protein, may be a barrier to ascending pathogens during pregnancy. We thus hypothesized that hyposecretion of cervical MUC5B is associated with preterm birth after cervical excisional surgery. METHOD OF STUDY: This prospective nested case-control study (Study 1) included pregnant women who had previously undergone cervical excisional surgery across 11 hospitals. We used proteomics to compare cervicovaginal fluid at 18-22 weeks of gestation between the preterm and term birth groups. In another case-control analysis (Study 2), we compared MUC5B expression in nonpregnant uterine tissues between 15 women with a history of cervical excisional surgery and 26 women without a history of cervical surgery. RESULTS: The abundance of MUC5B in cervicovaginal fluid was significantly decreased in the preterm birth group (fold change = 0.41, p = .035). Among the 480 quantified proteins, MUC5B had the second highest positive correlation with gestational age at delivery in the combined preterm and term groups. The cervicovaginal microbiome composition was not significantly different between the two groups. Cervical length was not correlated with gestational age at delivery (r = 0.18, p = .079). Histologically, the MUC5B-positive area in the nonpregnant cervix was significantly decreased in women with a history of cervical excisional surgery (0.85-fold, p = .048). The distribution of MUC5B-positive areas in the cervical tissues of 26 women without a history of cervical excisional surgery differed across individuals. CONCLUSIONS: This study suggests that the primary mechanism by which cervical excisional surgery causes preterm birth is the hyposecretion of MUC5B due to loss of the cervical glands.


Assuntos
Colo do Útero , Nascimento Prematuro , Feminino , Gravidez , Recém-Nascido , Humanos , Colo do Útero/cirurgia , Gestantes , Estudos de Casos e Controles , Estudos Prospectivos , Estudos Retrospectivos , Mucina-5B
9.
Int J Public Health ; 69: 1606289, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38440081

RESUMO

Objectives: To compare the utilization of prenatal services between immigrant and Italian women during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted at 3 maternity care centers in Italy. Results: We included 1,312 women, 1,198 (91.3%) were Italian and 114 (8.7%) were immigrants. A significantly higher proportion of Italians underwent 8 or more prenatal care visits (64.4% vs. 54.4%, p = 0.03) and more immigrants than Italians attended their appointments at hospital settings (45% vs. 18%, p < 0.001). Regarding prenatal course, Italians were more likely than immigrants to attend a non-hospital setting or an online class (49.6% and 30.2% vs. 34.9% and 11.6%, p = 0.008). A higher influenza vaccine uptake among immigrants compared with Italians was observed (39.5% vs. 19.8%, p < 0.001). Among women not receiving certain prenatal services, immigrants were more likely to state COVID-19 pandemic was the main reason for non-compliance. Conclusion: Immigrant pregnant women were more likely to receive prenatal services at a hospital setting than their Italian counterparts. Among women who did not comply with prenatal services, immigrants were more likely to cite the pandemic as their main reason.


Assuntos
COVID-19 , Emigrantes e Imigrantes , População Europeia , Serviços de Saúde Materna , Gravidez , Humanos , Feminino , COVID-19/epidemiologia , Cuidado Pré-Natal , Estudos Transversais , Pandemias , Gestantes , Itália/epidemiologia
10.
Afr J Prim Health Care Fam Med ; 16(1): e1-e8, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38426780

RESUMO

BACKGROUND: Maternal health information handouts are used by midwives to facilitate health education of pregnant women during their antenatal care (ANC) period. South Africa's Saving Mothers Report 2014 showed that delay in accessing medical help, as a patient-related avoidable factor, accounted for 27% of maternal and neonatal mortality. AIM: To ascertain the perceptions of pregnant women attending ANC in the Msunduzi sub-district in uMgungundlovu District, towards the maternal health information handouts. SETTING: The study was conducted at three primary health care (PHC) clinics (two PHC and one CHC [Community Health Care]) that provided ANC in the Msunduzi sub-district KwaZulu-Natal, in 2019. METHODS: Using a qualitative approach, focus group discussions (FGDs) were conducted with 10 participants from each clinic. Data were transcribed and analysed using thematic analysis. RESULTS: The themes explored included: availability and access of handouts, usefulness, review of handouts, alternative methods available, and family involvement. CONCLUSION: The authors concluded that although the maternal information handouts were given to the mothers during their maternal health visits, few of them were aware of these handouts. New strategies should be employed to deliver this vital information, as suggested by mothers.Contribution: The awareness of pregnant mothers about the information handouts contributes to the positive perinatal outcomes at clinic levels.


Assuntos
Saúde Materna , Gestantes , Recém-Nascido , Feminino , Gravidez , Humanos , África do Sul , Cuidado Pré-Natal/métodos , Mães
11.
BMC Pregnancy Childbirth ; 24(1): 185, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454336

RESUMO

BACKGROUND: Pre-eclampsia (PE) is a major contributor to morbidity and mortality in mothers worldwide. Adequate understanding of this condition improves treatment, control, and prevention. This study evaluated preeclampsia awareness among pregnant women in Syria, and the characteristics related to awareness adequacy. METHODS: This national cross-sectional study was conducted in Syria between 25 October and November 19, 2022. We included pregnant females of all age groups from all Syrian governorates. The questionnaire consisted of sociodemographic characteristics and knowledge of pre-eclampsia and its associated factors, symptoms, and complications. RESULTS: Overall, 706 participants were involved in this research, with a mean age of 38.22. Only 52.1% of them reported that they had heard of preeclampsia. Among the participants, 56.5% stated that they would not terminate a pregnancy if they were determined to be likely to develop preeclampsia, while nearly 55.2% agreed to continue the pregnancy rather than deliver prematurely even if their where a potential risk on their health risks. Participants who reported a family history of PE or had already experienced PE were more likely to have appropriate preeclampsia knowledge than those who did not (OR = 2.27, OR = 3.18, respectively). Respondents aged 25 to 35 years had the highest knowledge scores, and participants living in cities scored higher knowledge than rural residents. CONCLUSION: According to our findings, pregnant women in Syria have a awareness gaps regarding the PE topic. This highlights the need to enhance women's preeclampsia understanding for better pregnancy outcomes. Education through organizations, the media, and national programs is a significant aspect that promotes an adequate understanding of preeclampsia.


Assuntos
Pré-Eclâmpsia , Feminino , Gravidez , Humanos , Adulto , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/prevenção & controle , Gestantes , Estudos Transversais , Síria , Mães
12.
J Med Case Rep ; 18(1): 143, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454441

RESUMO

BACKGROUND: Every year 2% of pregnant women undergo nonobstetric surgical interventions worldwide. According to the American College of Obstetricians and Gynecologists Committee on Obstetric Practice, pregnant women should never be denied the most appropriate surgical treatment, regardless of the trimester of pregnancy. However, additional attention should be paid during the first trimester since it has the highest risk of inducing teratogenic mutations; additionally, during the third trimester, due to the possibility of preterm birth and low birth weight of the newborn, great care should be paid. CASE PRESENTATION: We present the case of a Caucasian 36-year-old woman during her 21st week of pregnancy, with a normal-sized fetus, according to the gestational age on ultrasound exam, and with no additional risk factors. The patient referred to an increasing nasal obstruction associated with rhinorrhea of the left nasal cavity. She also reported episodes of sleep apnea and hyposmia. The patient received a detailed otolaryngological examination, which allowed for identification of a mass within the left nasal cavity. The subsequent nasal endoscopy confirmed a grayish polypoid mass lesion with a multinodular surface occupying the entire left nasal fossa. The lesion totally obliterated the left maxillary sinus, resulting in obstruction of the anterior osteomeatal unit and ethmoidal sinusitis. She was referred for a functional endoscopic sinus surgery using analgosedation with remifentanil target-controlled infusion. DISCUSSION AND CONCLUSION: To the very best of our knowledge, this is the first case described in English literature about the use of analgosedation with remifentanil target-controlled infusion for otolaryngology surgery, specifically in functional endoscopic sinus surgery. It could be an interesting option to avoid the use of inhaled anesthetics that could induce fetal damage, especially during the first months of pregnancy. Furthermore, patient intubation is not necessary, which avoids cases of difficult intubation or any trauma to the airways. An adequate informed consent and appropriate compliance are elements of paramount importance in tailoring the anesthetic strategy for pregnant women who need nonobstetric surgical management.


Assuntos
Gestantes , Nascimento Prematuro , Recém-Nascido , Gravidez , Humanos , Feminino , Adulto , Remifentanil , Sedação Consciente , Endoscopia
13.
BMC Pregnancy Childbirth ; 24(1): 187, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38459499

RESUMO

In sub-Saharan Africa, malaria, which remains a major public health burden, has a prevalence of 9 to 28% and malaria in pregnancy is associated with severe adverse outcomes for the mother and her baby. Here, we sought to determine the predictors of birth weight in a cohort of 140 women with malaria in pregnancy, who were recruited at the Webuye County hospital in Western Kenya. All study participants underwent malaria diagnosis through microscopic examination of blood smear samples and were grouped into the malaria-positive and malaria-negative groups. Both groups were followed up beginning at the first antenatal visit (March 2022) until delivery (December 2022) and various data, including demographic, parity, gravidity, socioeconomic, maternal and fetal outcomes were collected. Data analyses were done using SPSS version 27. Chi-square and Fisher's Exact tests were used for bivariate and relative risk analyses at a p-value of ≤0.05 (95%) confidence level. Most of the participants were aged 18-25 years, were primigravidas and married, had secondary school-level education, earned 20-30 thousand Kenya shillings, resided in rural areas, and were in the second trimester. There were 6 (4.6%) cases of low birth weight, 3 (4.5%) in the malaria-negative group and 3 (4.7%) in the malaria-positive group. During pregnancy, 41 (31.5%) were anaemic, 5 (3.8%) were HIV-positive, 5 (3.8%) had preeclampsia, and 2 (1.5%) had gestational diabetes. Our analyses show that confounding factors like anaemia, HIV, pre-eclampsia and gestational diabetes did not influence birthweight (p ≥ 0.923). The malaria-positive and malaria-negative groups did not differ significantly with regard to the low birth weight (relative risk: 0.999, 95% confidence interval: 0.926-1.077). Marital status, gestational age, and area of residence were associated with malaria p ≤ 0.001, ≤ 0.001 and 0.028 respectively. In both groups, 124 of the 140 deliveries had normal birth weights and of these 63 (95.4%, n = 70) were in the malaria-negative group, whereas 61 (95.3%, n = 70) belonged to the malaria-positive group.


Assuntos
Anemia , Diabetes Gestacional , Malária , Feminino , Gravidez , Humanos , Adolescente , Adulto Jovem , Adulto , Peso ao Nascer , Gestantes , Quênia/epidemiologia , Estudos Prospectivos , Malária/epidemiologia , Anemia/epidemiologia
14.
BMC Pregnancy Childbirth ; 24(1): 203, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491430

RESUMO

BACKGROUND: Multiple gestations present numerous physical, psychological, social, and economic challenges for women. Understanding the problem-solving experiences of pregnant women carrying multiple can be invaluable. This study aimed to explore the experiences of Iranian women with multiple gestations. METHODS: This descriptive phenomenological study utilized purposive sampling and continued until data saturation. Data collection involved in-depth semi-structured interviews, with analysis performed using Colaizzi's 7-step method. MAXQDA software was employed for data management. RESULTS: This study involved 12 women with multiple gestations. The average age of the participants was 33.76 ± 6.22 years, and 9 were pregnant with triplets. The data were categorized into four primary themes: the paradox of emotions, the pregnancy prison, immersion in fear, and the crystallization of maternal love, encompassing 17 sub-themes. CONCLUSION: Pregnant women with multiple gestations undergo various changes and experience conflicting emotions. Enhancing their ability to adapt to and accept numerous pregnancies can be achieved through supportive, personalized, and family-centered care, along with improvements and revisions in care policies for multiple gestations.


Assuntos
Gravidez Múltipla , Gestantes , Feminino , Humanos , Gravidez , Adulto , Irã (Geográfico) , Gestantes/psicologia , Emoções , Família , Pesquisa Qualitativa
15.
Eur Rev Med Pharmacol Sci ; 28(5): 1904-1912, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38497873

RESUMO

OBJECTIVE: Hepatitis E virus (HEV) infection may occur in pregnant women who had chronic hepatitis B virus (HBV) infection. This study aimed to evaluate whether HEV-HBV co-infection increases the risk of obstetric complications and perinatal adverse outcomes in pregnant women. PATIENTS AND METHODS: We investigated the clinical data of 3,251 pregnant women with chronic HBV infection. The obstetric complications and perinatal adverse outcomes were compared between patients with HEV-HBV co-infection and patients who had pure chronic HBV infection. RESULTS: Of the 3,251 pregnant women with chronic HBV infection, 98 patients (3%) had HEV-HBV co-infection. Compared with healthy controls, there is an increased risk of obstetric complications in pregnant women with pure HEV infection [odds ratio (OR)= 3.99, p < 0.001], pure chronic HBV infection (OR = 2.76, p < 0.001), and HEV-HBV co-infection (OR = 5.41,p < 0.001). The rate of obstetric complications and perinatal adverse outcomes is significantly higher in pregnant women with HEV-HBV co-infection compared with those with pure chronic HBV infection or those with pure HEV infection (all p< 0.05). The HEV-HBV co-infection is the most significant risk factor for perinatal adverse outcomes (OR = 15.47, p < 0.001), followed by pure HEV infection (OR = 10.22, p < 0.001), and pure HBV infection (OR = 5.82, p < 0.001). CONCLUSIONS: HEV infection increases the risk of obstetric complications and perinatal adverse outcomes in pregnant women with chronic HBV infection.


Assuntos
Coinfecção , Hepatite B Crônica , Hepatite B , Vírus da Hepatite E , Hepatite E , Gravidez , Humanos , Feminino , Hepatite B Crônica/complicações , Gestantes , Hepatite E/complicações , Hepatite E/epidemiologia , Vírus da Hepatite B
16.
Sci Rep ; 14(1): 6292, 2024 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491024

RESUMO

Recently, many phenotyping algorithms for high-throughput cohort identification have been developed. Prospective genome cohort studies are critical resources for precision medicine, but there are many hurdles in the precise cohort identification. Consequently, it is important to develop phenotyping algorithms for cohort data collection. Hypertensive disorders of pregnancy (HDP) is a leading cause of maternal morbidity and mortality. In this study, we developed, applied, and validated rule-based phenotyping algorithms of HDP. Two phenotyping algorithms, algorithms 1 and 2, were developed according to American and Japanese guidelines, and applied into 22,452 pregnant women in the Birth and Three-Generation Cohort Study of the Tohoku Medical Megabank project. To precise cohort identification, we analyzed both structured data (e.g., laboratory and physiological tests) and unstructured clinical notes. The identified subtypes of HDP were validated against reference standards. Algorithms 1 and 2 identified 7.93% and 8.08% of the subjects as having HDP, respectively, along with their HDP subtypes. Our algorithms were high performing with high positive predictive values (0.96 and 0.90 for algorithms 1 and 2, respectively). Overcoming the hurdle of precise cohort identification from large-scale cohort data collection, we achieved both developed and implemented phenotyping algorithms, and precisely identified HDP patients and their subtypes from large-scale cohort data collection.


Assuntos
Hipertensão Induzida pela Gravidez , Pré-Eclâmpsia , Gravidez , Feminino , Humanos , Hipertensão Induzida pela Gravidez/diagnóstico , Gestantes , Estudos de Coortes , Estudos Prospectivos
17.
Int J Qual Stud Health Well-being ; 19(1): 2326109, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38498815

RESUMO

PURPOSE: Pregnant women with smoking family members are at risk of exposure to second-hand smoke, which leads to adverse pregnancy outcomes. Second-hand smoke prevention is thus important but remains less understood based on pregnant women's perceptions. This study aimed to describe the perceptions of pregnant women on second-hand smoke prevention. METHODS: This study employed a qualitative descriptive approach. Data collection was performed between July and August 2023 through in-depth interviews with 17 pregnant women purposively selected from a province in central Thailand. The verbatim transcribed data were analysed using thematic analysis. RESULTS: Five themes emerged: unclear understanding of second-hand smoke; influences shaping perceptions related to second-hand smoke; attempt to prevent second-hand smoke exposure; barriers to prevention of second-hand smoke exposure; and needs related to prevention of second-hand smoke exposure. CONCLUSION: The findings provide insights into second-hand smoke prevention from the perception of pregnant women with smoking family members. Healthcare professionals need to design interventions tailored to pregnant women's needs and involve smoking family members. It is necessary to develop and incorporate clinical guidelines into standard prenatal care to support healthcare personnel in identifying, assessing, educating, and mitigating the issue of second-hand smoking exposure.


Assuntos
Gestantes , Poluição por Fumaça de Tabaco , Feminino , Humanos , Gravidez , Poluição por Fumaça de Tabaco/prevenção & controle , Poluição por Fumaça de Tabaco/análise , Tailândia , Família , Fumar
18.
J Infect Dev Ctries ; 18(2): 258-265, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38484352

RESUMO

INTRODUCTION: Mycoplasma hominis and Ureaplasma parvum have been recently linked to sexually transmitted diseases and other conditions. There are a limited number of studies conducted on South African pregnant women that have assessed the prevalence and risk factors for genital mycoplasmas. METHODOLOGY: This study included 264 HIV infected pregnant women attending the King Edward VIII antenatal clinic in eThekwini, South Africa. DNA was extracted using the PureLink Microbiome kit and pathogens were detected using the TaqMan Real-time PCR assays. The statistical data analysis was conducted in a freely available Statistical Computing Environment, R software, version 3.6.3 using the RStudio platform. RESULTS: The prevalence of M. hominis and U. parvum, was 215/264 (81.4%), and 203/264 (76.9%), respectively. In the M. hominis positive group, a significantly (p = 0.004) higher proportion, 80.5% tested positive for U. parvum infection when compared to 61.2% among the M. hominis negative. Of the U. parvum positive women, a significantly (p = 0.004) higher proportion of women (85.2%) tested positive for M. hominis when compared to 68.9% among the U. parvum negative. In the unadjusted and adjusted analysis, being M. hominis positive increased the risk for U. parvum by approximately 3 times more (p = 0.014) and 4-fold (p = 0.008), respectively. CONCLUSIONS: This study showed a significant link between M. hominis and U. parvum infection. To date, there are a limited number of studies that have investigated M. hominisbeing a risk factor for U. parvum infection. Therefore, the data presented in the current study now fills in this gap in the literature.


Assuntos
Infecções por Mycoplasma , Infecções por Ureaplasma , Humanos , Feminino , Gravidez , Mycoplasma hominis , Gestantes , HIV , Infecções por Mycoplasma/epidemiologia , Ureaplasma/genética , Infecções por Ureaplasma/epidemiologia , Ureaplasma urealyticum/genética
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