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Introduction: Anaemia in pregnant women is a major public health problem and is associated with adverse outcomes both in pregnant mothers and new-borns. According to NFHS-5, 45.7% of women in urban India were affected by anaemia during their pregnancy. The objectives of this study were to estimate the proportion of pregnant women who were anaemic and its effect on maternal and birth outcomes, and additionally, to assess the various socio-economic factors contributing to anaemia during pregnancy. Methodology: Data was collected by reviewing records between December 2018 and December 2021 of 302 pregnant women who had received antenatal care at a secondary level health facility in Krishnagiri, Tamil Nadu. The data included details of socio-economic parameters, parity, haemoglobin levels, mode of delivery, pregnancy related complications during the antenatal period and during delivery, including need for blood transfusions in mothers. Birth-related outcomes like miscarriages, intra-uterine death, low birth weight (LBW), need for NICU admission and congenital defects were also analysed. Variables in the study are described as frequencies and proportions. Appropriate tests were used to check for association and a P- value of less than 0.05 was considered as statistically significant. Results: The mean age of the women was 24 ± 3.72 years and the mean Haemoglobin level during the first trimester was 10.5 ± 1.12 gm/dl. The proportion of women with anaemia in the first trimester was 174 (57.6%). Among the anaemics, 15 (8.6%) required treatment in the form of injectable iron and 29 (16.7%) required blood transfusion. Gestational diabetes mellitus (GDM) (31.6%) (P < 0.05), preeclampsia (38.9%) (P < 0.02) less among anaemic. Hyperemesis (66.7%) (P = 0.58), risk of miscarriage (57.8%) (P = 0.94), postpartum haemorrhage (PPH) (80.0%) (P = 0.15) was higher in the anaemic group. Adverse Neonatal-related outcomes such as low birth weight babies (52.0%) (P = 0.54), meconium aspiration (72.7%) (P = 0.25) and need for NICU admission (75.0%) (P = 0.25) was higher in babies born to anaemic pregnant women. Conclusions: The proportion of anaemic women was 57.6%. There was no significant difference in maternal demographic characteristics or obstetric factors between anaemic and non-anaemic pregnant women. GDM, pre-eclampsia was less prevalent among anaemic women. Hyperemesis, risk of abortion, postpartum haemorrhage and low birth weight (LBW) infants was higher in anaemic pregnancies. The need for providing education regarding iron supplementation and early detection of anaemia during pregnancy should be emphasised to avoid complications.
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Purpose To assess the effectiveness of a community-health-worker (CHW)-driven intervention in improving the quality of life (QOL) of caregivers of children with disability in rural Karnataka, India. Methodology A community-based quasi-experimental study with cluster randomization on the village level was done. CHWs provided structured health education and training for the intervention arm. Pre- and post-intervention, the QOL and Zarit burden scores were compared between and within the two arms. Results From baseline, the physical domain score improved from 49.66 to 53.88 (p < 0.001). The Zarit burden scores decreased from 33.27 to 28.89 (p < 0.001). On comparing the post-test QOL scores between the two arms, the physical domain scores increased from 51.68 to 56.08 (p = 0.025). The Zarit burden scores also significantly decreased from 31.50 to 26.28. Conclusion The intervention by the CHWs on the caregivers has significant improvements in the physical domain of QOL and a reduction in caregiver burden.
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BACKGROUND: Cardiovascular disease (CVD) is one of the leading causes of death among Indian women but not a focus of current strategies to improve women's health. OBJECTIVES: To assess 10-year CVD risk and estimate the prevalence of CVD risk factors among underprivileged women. METHODS: A cross-sectional study among women aged 40-79 years in an urban underprivileged area of Bangalore city, using nonlaboratory-based World Health Organization and the International Society of Hypertension risk prediction chart and INTERHEART list of CVD risk factors. Blood pressure, random blood sugar, height, weight, and waist circumference were measured. The Chi-square test was done for the association between CVD risk status and risk factors. Multiple logistic regression performed to calculate adjusted odds ratios (ORs). RESULTS: Of 1027 women, 11% women had high risk of CVD (≥20% risk of fatal/nonfatal cardiovascular event within next 10 years). The prevalence of CVD risk factors was high with 20.2% diabetes, 53.7% hypertension, 77% overweight/obesity, and 92% central obesity. Majority were physically inactive with unhealthy diet, lacking daily fruits and vegetables, excess consumption of salty food, junk food, red meat, and excess oil. Significantly higher CVD risk found among women who were sedentary during leisure time (P = 0.028), single/separated/widowed women (OR = 1.84 [1.26-4.29] P = 0.002), and women who did not walk or cycle as a regular means of transport (OR = 1.47 [1.98-2.19] P = 0.041). CONCLUSION: High risk of CVD among underprivileged women reveals an urgent need for community-based interventions for prevention of CVD. Screening and management of diabetes and hypertension must include weight reduction and health education strategies. Policy-makers need to initiate efforts toward improving affordability of healthy diets for the urban underprivileged.
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INTRODUCTION: The primary caregiver of a child with disability has to undergo a lot of difficulties in taking care of the child. OBJECTIVE: To assess the quality of life and burden of caregiving of primary caregivers of children with disability registered in a CBR services in rural Karnataka. METHODOLOGY: A cross-sectional study was done among 100 children with disability and their primary caregivers. Interview schedule including socio-demography, WHOQOL-BREF, ZBI and WHODAS was used. RESULTS: Mean age of caregivers was 36.38 of which 97% were women and 82% were mothers of children with disability. Mean age of children was 11.43 years, 56% males and most common diagnosis was multiple disabilities (38%). Mean caregiver burden according to Zarit scale was 33.27 and mean burden scores were significantly different between the disability domains of the children. Mean quality of life (QOL) scores for each domain was 49.6 in physical, 60.47 in psychological, 45.67 in social and 58.44 in environmental domains. Marital status of the caregivers was significantly associated with both physical and the social domain of the QOL. Occupation of the caregiver was significantly associated with the environmental domain and the type of disability in the children significantly affected the physical domain of the QOL of the caregivers. CONCLUSION: Caregiver QOL is overall poor but it was the lowest in the physical domain and higher in psychological domain. Caregiver burden scores were high and depends on the type of disability. Importance should be given to the care of the caregivers.
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INTRODUCTION: Sleep changes are more common in pregnancy and lack of sleep in antenatal women can lead to hypertension, postpartum depression, abortions, and preterm babies. OBJECTIVES: 1. To assess sleep quality and daytime sleepiness among pregnant women attending government health care facilities in Urban Bangalore. 2 To measure the association between sleep quality, daytime sleepiness with restless leg syndrome (RLS) in the same study population. METHODOLOGY: A cross-sectional study was conducted in March and April 2018 among all antenatal women attending the Government District Hospital, Anekal Taluk and Primary Health Centre, Sarjapur, in Urban Bangalore. The calculated sample size was 255 and we interviewed 260 women using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale and RLS rating scale along with details on socio-demography. RESULTS: According to PSQI, 83.1% had good sleep quality, 14.2% had daytime sleepiness and 21.9% had RLS. The RLS was significantly associated (P < 0.05) with trimester, sleep onset position, sleep quality, and daytime sleepiness. On logistic regression, there are 3.6 times the chances of having RLS when the sleep quality is bad and 5.3 times more chances of having RLS when there is daytime sleepiness. CONCLUSION: RLS is significantly associated with daytime sleepiness and sleep quality in antenatal women. Health education on the importance of sleep and about RLS should be included during antenatal visits.
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Objective: To develop a comprehensive antenatal risk assessment tool to predict adverse maternal and early perinatal outcomes in a rural setting. Materials and methods: Cross-sectional study among women admitted for delivery in a rural maternity hospital, south India. Risk factors from Rotterdam Reproductive Risk Reduction (R4U) scorecard and social factors relevant to Indian rural context were included in questionnaire. Maternal and perinatal outcomes were obtained from in-patient records. Logistic regression of risk factors associated with adverse outcomes and weighted scores assigned using beta-coefficients. Cut-off score to predict adverse outcome was derived using Receiver Operator Characteristic Curve (ROC Curve) and Likelihood ratios. Results: Adjusted odds for adverse outcome highest for small for gestational age by ultrasound scan [OR=7.4 (1.4-36.5)], tobacco chewing [OR=5.6 (1.8-28.5)] and hypertensive disorders of pregnancy [OR=3.5 (1.9-9.6)]. After assigning weighted scores, the 74-item antenatal risk assessment tool had a maximum possible score of 86. Risk score was calculated for all subjects. Cut-off score to predict adverse outcome was 4, using ROC curve, with a sensitivity of 98%, a specificity of 21% and positive likelihood ratio of 1.23 (1.10-1.37). Conclusion: This comprehensive antenatal risk assessment tool is easy to administer, specific to rural areas and can help community-level workers to screen, monitor, and refer high risk pregnancies for further management to prevent adverse maternal and perinatal outcomes. This may be considered a prototype towards developing more robust antenatal risk screening and outcome prediction in rural settings.
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BACKGROUND: Various factors such as age, sex, nutrition, hygiene, and morbidity impact the scholastic performance of schoolchildren. OBJECTIVES: (1) The objective of the study is to assess the hygiene level, nutritional status, morbidity profile, and scholastic performance of children attending government schools in two select subcenter areas of Karnataka and (2) to study the association of hygiene level, nutritional status, and morbidity profile with scholastic performance. METHODOLOGY: A cross-sectional study was done from July to August 2017 among children studying in the government schools of Mugalur and Kuthganahalli subcenters under Sarjapur PHC, Anekal Taluk, Bengaluru urban district. After obtaining permissions, general checkup of the students was done for morbidity pattern, and their anthropometric measurements were documented. Hygiene levels of the students were observed with a checklist to obtain scores that were grouped into good and poor. Attendance and grades were obtained from the class teacher to assess the scholastic performance. RESULTS: Of a total 403 students studied, the mean age was 10.2 years (standard deviation: 2.87) with 51.1% girls. Nutrition status was good in 236 (58.6%) students and 262 (65%) had good hygiene. At the time of examination, 211 (53%) had at least one morbidity, with most common being dental caries (16.3%). Logistic regression showed that odds of girls having better grades is 2.4 times more when compared to boys and 2.1 times more likely in students with good hygiene. Students with good hygiene are 2.1 times more likely to have good attendance. CONCLUSION: Hygiene status impacts the attendance and grades of the students. Girl students had significantly better grades than the boys.
