Petersen's Hernia in a Pregnant Woman Following Roux-en-Y Gastric Bypass Surgery: The Importance of Emergency Surgical Treatment.

Roux-en-Y gastric bypass (RYGB) patients are at risk of creating potential spaces for possible internal hernias during the procedure. During pregnancy, the pregnant uterus elevates the bowel, increasing intra-abdominal pressure. Cases reported to date have described mild abdominal pain and no evidence of peritoneal irritation, with inconclusive ultrasound and MRI findings for diagnosis of Petersen's hernia. We present the case of a 42-year-old female patient with a history of RYGB eight years earlier without complications, with a pregnancy of 34 weeks of gestation. Symptomatology began with colicky abdominal pain in the epigastric, with irradiation to the right upper quadrant. On physical examination, revealed a painful abdomen on the median and deep palpation in the epigastric and right upper quadrant, the rest of the studies were inconclusive. As there was no improvement of the symptoms in 12 hours, an emergency diagnostic laparoscopy was performed, finding a strangulated Petersen's hernia requiring resection, with the closure of the gastric pouch, intestinal anastomosis, and Stamm gastrostomy with closure of the mesenteric gap. Therefore, a pregnant patient presenting with upper quadrant abdominal pain with a history of RYGB, even one with normal labs and imaging, should be assumed to have an internal hernia until proven otherwise. The emergency surgical approach is associated with early resolution and prevents its progression with catastrophic results.

Network analysis of posttraumatic stress and posttraumatic growth symptoms among women in subsequent pregnancies following pregnancy loss.

BACKGROUND: Pregnant women who have undergone pregnancy loss often display both posttraumatic stress (PTS) and posttraumatic growth (PTG). However, the precise relationship and structure of symptomatic levels of PTS and PTG have not been well understood. This study aimed to assess the associations between PTS and PTG symptoms in women during subsequent pregnancies following a previous pregnancy loss. METHODS: A total of 406 pregnant women with a history of pregnancy loss were included in this study. The Impact of Events Scale-6 (IES-6) and the Posttraumatic Growth Inventory Short Form (PTGI-SF) were used to assess symptoms of PTS and PTG, respectively. The Graphical Gaussian Model was employed to estimate the network model. Central symptoms and bridge symptoms were identified based on "expected influence" and "bridge expected influence" indices, respectively. The stability and accuracy of the network were examined using the case-dropping procedure and nonparametric bootstrapped procedure. RESULTS: The network analysis identified PTG3 ("Ability to do better things") as the most central symptom, followed by PTS3 ("Avoidance of thoughts") and PTG6 ("New path for life") in the sample. Additionally, PTS3 ("Avoidance of thoughts") and PTG9 ("Perception of greater personal strength") were bridge symptoms linking PTS and PTG clusters. The network structure was robust in stability and accuracy tests. CONCLUSIONS: Interventions targeting the central symptoms identified, along with key bridge symptoms, have the potential to alleviate the severity of PTS experienced by women with a history of pregnancy loss and promote their personal growth.

Exploring the relationships between pre-pregnancy BMI, gestational weight gain, and nutritional intake: a real-world investigation in Shandong, China.

This study investigated the associations between gestational weight gain (GWG), pre-pregnancy body mass index (BMI), and prenatal diet quality in pregnant women from Shandong, China. We analyzed a sample of 532 early-stage pregnant women registered at an outpatient clinic. Diet quality was evaluated using the Chinese Healthy Dietary Index for Pregnancy (CHDI-P), encompassing three dimensions: diversity, adequacy, and limitation, with an overall score out of 100. Dietary intake was documented via 24-h dietary recalls spanning three consecutive days and subsequently translated to a CHDI-P score. At the time of enrollment, BMI was measured on-site and classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Pregnant women were also categorized into inadequate, adequate, and excessive weight gain groups based on their GWG. We employed a Tukey-adjusted generalized linear model to compare the CHDI-P scores between the pre-pregnancy BMI groups and GWG groups. The results revealed that the underweight group had significantly higher total scores and limitation total scores on the CHDI-P (p < 0.001). Conversely, the overweight and obese groups were more susceptible to suboptimal dietary quality. Notably, the inadequate weight gain group displayed significantly elevated food adequacy scores compared to the other two groups (p < 0.05). This indicates that greater GWGs do not necessarily align with principles of adequate nutrition.

Associação do comportamento alimentar com o estado nutricional de gestantes de alto risco internadas em um centro de referência no nordeste / Association of eating behavior with the nutritional status of high-riskpregnant women admitted to a reference center in the Northeast

Introduction: Pregnancy is a period of physical and physiological changes that progresses without complications when free from factors that can compromise maternal and fetal health. Diabetes mellitus, high blood pressure, obesity and inadequate weight gain are the most common causes of gestational risk, and these can be strongly associated with the nutritional status, eating habits and behavior of the pregnant woman. Objective: To describe and associate eating behavior with the nutritional status of high-risk pregnant women admitted to a reference center in the Northeast. Materials and methods: This is a cross-sectional study carried out with patients admitted to high-risk wards at the Instituto de Medicina Integral Prof. Fernando Figueira – IMIP (Recife-PE), anthropometric data and data related to eating behavior were collected (TEMS instrument). Results: Around 56,4% of pregnant women had a prepregnancy BMI classified as overweight or obese, with only 16% classified as underweight. The evaluation of the evolution of weight gain demonstrated that 66.4% had insufficient weight gain, while 12,8% had high gestational weight gain. Discussion: When analyzing eating behavior through the TEMS instrument, the relationship of giving a good image when eating had a significant value (p < 0,05) as well as considerations of choosing healthy foods and related to obtaining energy are directly associated with the current BMI, therefore, note- It is clear that emotional, social, physiological and economic factors influence the choice of food. Conclusion: The high prevalence of overweight and obesity found in this population demonstrates the influence of eating behavior on nutritional status. Reinforcing the importance of preventive measures to identify risk factors and obtain adequate nutritional monitoring during pregnancy with the aim of reducing damage to health and promoting autonomy to make more appropriate and healthy food choices.(AU)

Introdução: A gestação é um período de mudanças físi-cas e fisiológicas que evolui sem complicações quando isentade fatores que podem acarretar no comprometimento dasaúde materna e fetal. O diabetes mellitus, hipertensão arte-rial, obesidade, ganho de peso inadequado são as mais fre-quentes causadoras do risco gestacional, podendo estas serfortemente associadas com o estado nutricional, hábito ecomportamento alimentar da gestante. Objetivo: Descrever e associar o comportamento alimen-tar com o estado nutricional de gestantes de alto risco inter-nadas em um centro de referência no Nordeste. Materiais e métodos: Trata-se de um estudo do tipotransversal realizado com pacientes internadas nas enferma-rias de alto risco do Instituto de Medicina Integral Prof.Fernando Figueira – IMIP (Recife- PE), foram coletados dadosantropométricos, dados relacionados ao comportamento ali-mentar (instrumento TEMS). Resultados: Cerca de 56,4% das gestantes tinham IMCpré-gestacional classificados em sobrepeso ou obesidade sendo apenas 16% classificadas como baixo peso. A avalia-ção da evolução do ganho ponderal demonstrou que 66,4%apresentaram um ganho de peso insuficiente, enquanto12,8% tiveram um ganho de peso gestacional elevado. Discussão: Ao analisar o comportamento alimentar atravésdo instrumento TEMS, a relação de passar uma boa imagemao se alimentar teve valor significativo (p < 0,05) bem comoconsiderações de escolher alimentos saudáveis e relacionadosa obter energia estão diretamente associados com o IMCatual, assim sendo, nota-se que fatores emocionais, sociais, fi-siológicos, econômicos influenciam na escolha dos alimentos. Conclusão: A elevada prevalência do excesso de peso eobesidade encontrada nessa população demonstra a influência do comportamento alimentar no estado nutricional.Reforçando a importância de medidas preventivas para identificar fatores de risco e obter um acompanhamento nutricio-nal adequado durante a gestação com...(AU)

Associations of COVID-19 lockdown with birth weight in China.

Background: During the special period of the global spread of COVID-19, pregnant women are sensitive groups to the impacts of COVID-19 epidemic. However, the effects of lockdown measures implemented in response to the COVID-19 on fetal birthweight remain unclear. Objectives: This study investigated the associations of COVID-19 lockdown with birth weight in Chinese population. Methods: We collected 730,153 data of participants from hospitals of five cities in the south of China, we defined the time period of level I response (1/23-2/24/2020) as level I lockdown, and women who were pregnant during level I lockdown as the exposure group. Women who were pregnant during the same calendar month from 2015 to 2019 were defined as the unexposed group. We quantitatively estimate the individual cumulative exposure dose by giving different weights to days with different emergency response levels. Generalized linear regression models were used to estimate the association between COVID-19 lockdown exposure with birth weight and risk of low birth weight (<2,500 g) and macrosomia (>4,000 g). Results: The birth weight of the exposed group is heavier than the unexposed group (3,238.52 vs. 3,224.11 g: adjusted ß = 24.39 g [95% CI: 21.88, 26.91 g]). The exposed group had a higher risk of macrosomia (2.8% vs. 2.6%; adjusted OR = 1.17 [95% CI: 1.12, 1.22]). More obvious associations were found between COVID-19 lockdown and macrosomia in women who experienced the lockdown in their early pregnancy. Women who experienced the lockdown at their 4-7 weeks of pregnancy showed statistically significant heavier birth weight than unexposed group (after adjustment): ß = 1.28 (95% CI: 1.11, 1.46) g. We also observed a positive association between cumulative exposure dose of COVID-19 lockdown in all pregnant women and birth weight, after divided into four groups, Q1: ß = 32.95 (95% CI: 28.16, 37.75) g; Q2: ß = 18.88 (95% CI: 14.12, 23.64) g; Q3: ß = 19.50 (95% CI: 14.73, 24.28) g; Q4: ß = 21.82 (95% CI: 17.08, 26.56) g. However, there was no statistically significant difference in the risk of low birth weight between exposed and unexposed groups. Conclusions: The COVID-19 lockdown measures were associated with a heavier birth weight and a higher risk of macrosomia. Early pregnancy periods may be a more susceptible exposure window for a heavier birth weight and a higher risk of macrosomia. We also observed a positive association between cumulative exposure dose of COVID-19 lockdown and birth weight. The government and health institutions should pay attention to the long-term health of the infants born during the COVID-19 lockdown period, and follow up these mothers and infants is necessary.

Influence of the COVID-19 Outbreak in Vulnerable Patients (Pediatric Patients, Pregnant Women, and Elderly Patients) on an Emergency Medical Service System: A Pre- and Post-COVID-19 Pandemic Comparative Study Using the Population-Based ORION Registry.

Background and Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread all over the world. To assess the influence of the COVID-19 pandemic on emergency medical services (EMS) for vulnerable patients transported by ambulance. Materials and Methods: This study was a retrospective, descriptive study with a study period from 1 January 2019 to 31 December 2021 using the Osaka Emergency Information Research Intelligent Operation Network (ORION) system. We included all pediatric patients, pregnant women, and elderly patients ≥ 65 years of age transported by ambulance in Osaka Prefecture. The main outcome of this study was difficult-to-transport cases. We calculated the rate of difficult-to-transport cases under several conditions. Results: For the two year-long periods of 1 January 2019 to 31 December 2019 and 1 January 2021 to 31 December 2021, a total of 887,647 patients were transported to hospital by ambulance in Osaka Prefecture. The total number of vulnerable patients was 579,815 (304,882 in 2019 and 274,933 in 2021). Multivariate logistic regression analysis showed that difficult-to-transport cases were significantly more frequent in 2021 than in 2019. Difficult-to-transport cases were significantly less frequent in the vulnerable population than in the non-vulnerable population (adjusted odds ratio 0.81, 95% confidence interval 0.80-0.83; p < 0.001). Conclusion: During the pandemic (2021), difficult-to-transport cases were more frequent compared to before the pandemic (2019); however, vulnerable patients were not the cause of difficulties in obtaining hospital acceptance for transport.

Evaluation of cesarean delivery rates and factors associated with cesarean delivery among women enrolled in a pregnancy cohort study at two tertiary hospitals in Thailand.

BACKGROUND: Cesarean delivery rates have increased globally resulting in a public health concern. We estimate rates of cesarean deliveries among Thai women using the World Health Organization (WHO) Robson Classification system and compare rates by Robson group to the Robson guideline for acceptable rates to identify groups that might benefit most from interventions for rate reduction. METHODS: In 2017 and 2018, we established cohorts of pregnant women aged ≥ 18 years seeking prenatal care at two tertiary Thai hospitals and followed them until 6-8 weeks postpartum. Three in-person interviews (enrollment, end of pregnancy, and postpartum) were conducted using structured questionnaires to obtain demographic characteristics, health history, and delivery information. Cesarean delivery indication was classified based on core obstetric variables (parity, previous cesarean delivery, number of fetuses, fetal presentation, gestational week, and onset of labor) assigned to 10 groups according to the Robson Classification. Logistic regression was used to identify factors associated with cesarean delivery among nulliparous women with singleton, cephalic, term pregnancies. RESULTS: Of 2,137 participants, 970 (45%) had cesarean deliveries. The median maternal age at delivery was 29 years (interquartile range, 25-35); 271 (13%) participants had existing medical conditions; and 446 (21%) had pregnancy complications. The cesarean delivery rate varied by Robson group. Multiparous women with > 1 previous uterine scar, with a single cephalic pregnancy, ≥ 37 weeks gestation (group 5) contributed the most (14%) to the overall cesarean rate, whereas those with a single pregnancy with a transverse or oblique lie, including women with previous uterine scars (group 9) contributed the least (< 1%). Factors independently associated with cesarean delivery included age ≥ 25 years, pre-pregnancy obesity, new/worsen medical condition during pregnancy, fetal distress, abnormal labor, infant size for gestational age ≥ 50th percentiles, and self-pay for delivery fees. Women with existing blood conditions were less likely to have cesarean delivery. CONCLUSIONS: Almost one in two pregnancies among women in our cohorts resulted in cesarean deliveries. Compared to WHO guidelines, cesarean delivery rates were elevated in selected Robson groups indicating that tailored interventions to minimize non-clinically indicated cesarean delivery for specific groups of pregnancies may be warranted.

[Knowledge, attitudes and practices in oral health of breastfeeding women]. / Connaissances, attitudes et pratiques en santé orale des femmes allaitantes.

The benefits of breastfeeding on the health of infants and mothers are no longer in doubt. On the other hand, the advantages in terms of maxillofacial development and the risks of prolonged breastfeeding on oral health are much less discussed. An exploratory qualitative study, carried out within the pediatric dentistry functional unit of the dental care service of the Lille University Hospital Center in 2022, aimed to analyze the knowledge, attitudes and practices in oral health of breastfeeding women. This article will discuss the gaps in prevention as well as the obstacles and levers to improving care.

Low vitamin D during pregnancy is associated with infantile eczema by up-regulation of PI3K/AKT/mTOR signaling pathway and affecting FOXP3 expression: A bidirectional cohort study.

Vitamin D has received increasing attention because of its association with atopic disease development. Limited studies that have been done on the impact of maternal vitamin D levels during pregnancy on infantile eczema are still debatable. We wanted to discover the effect of maternal vitamin D on infantile eczema and explore whether regulatory T cells (Treg) play a role in this process. 219 pairs of mothers and children were enrolled. Maternal fasting venous blood was collected in pregnancy's second and third trimesters to determine vitamin D levels. Cord blood and placenta samples were collected during childbirth for detecting levels of genes, proteins and cytokines. Pediatricians followed up the prevalence of eczema in infants within 1 year. The reported rate of vitamin D deficiency and insufficiency was 35.6% and 28.3%. Lower maternal 25(OH)D3 levels were related to a higher risk of infantile eczema. Foxp3 gene expression is lower in cord blood of infants with eczema compared to infants without eczema. There was a positive correlation between maternal 25(OH)D3 levels and the expression of FOXP3 gene in cord blood. Compared to vitamin D sufficiency women, vitamin D deficiency women's placental FOXP3 protein expression was decreased and PI3K/AKT/mTOR protein was up-regulated. Our study demonstrates that low prenatal maternal vitamin D levels increased the risk of infantile eczema aged 0-1 year, which might be related to the downregulating of the FOXP3 gene expression in cord blood and decreased placental FOXP3 protein expression. Low placental FOXP3 protein was related with activating PI3K/AKT/mTOR signaling pathway.

Consumption of Acetaminophen During Pregnancy: A Survey on Knowledge, Attitudes and Practices of Lebanese Women.

OBJECTIVES: Use of acetamoniphen (paracetamol or N-acetyl-para-aminophenol [APAP]) during pregnancy is considered safe; however certain practices have been related to the risk of developing neurodevelopmental disorders in offspring. Therefore, the present study aimed to assess women's knowledge, attitudes and practices (KAP) towards the use APAP during pregnancy and its associated factors. METHODS: This cross-sectional study was conducted between May 15 and August 31, 2020, among pregnant Lebanese women and those who had given birth in the last 12 months. Online self-administered questionnaire was used for data collection. KAP were described and a knowledge score was generated. Multivariable linear models were used to test the association of participants' sociodemographic characteristics with their knowledge and practices related to the use of APAP. RESULTS: Out of 305 participants, 72.8% had moderate knowledge about the use of APAP during pregnancy. Actually, more than 50% of them were unable to differentiate between APAP and other pain medications, determine the maximum recommended daily dose, specify the minimum time to wait between doses and identify potential effects of APAP on both mother and unborn child. A higher level of education was associated with a higher knowledge score (ß = 2.32, 95%CI=[0.91; 3.73]; p = 0.001). Moreover, women had positive attitudes towards APAP use, perceiving a low risk of toxicity. Indeed, 70.5% of women used APAP at least once during their pregnancy, with 63.7% using it safely. Women with higher knowledge, experiencing at least five somatic symptoms and having a low socioeconomic level tended to be more APAP users (p < 0.05). CONCLUSIONS FOR PRACTICE: Health professionals have the responsibility to give adequate and personalized advice to women regarding their medicines.

Successful perinatal management of a woman with congenital factor XIII deficiency using recombinant factor XIII: A case report and literature review.

Factor XIII deficiency is an extremely rare autosomal recessive genetic disorder, occurring in 1 of 3-5 million people, and is associated with perinatal complications, such as habitual abortion and prolonged bleeding. Although plasma-derived factor XIII (Fibrogamin®) carries a risk of infection and contains very low concentrated forms of factor XIII (FXIII) used for a pregnant woman with congenital coagulation factor XIII deficiency, recombinant factor XIII (rFXIII, Novo Thirteen®; Tretten®, Novo Nordisk, Bagsvaerd, Denmark), which has no risk of infection and is highly concentrated, has emerged as a novel formulation. Herein, we report the first case of a Japanese pregnant woman with congenital coagulation factor XIII deficiency successfully managed by rFXIII. She had a good perinatal course without pregnancy-related complications and transfusion through the perinatal period.

Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta-analysis.

BACKGROUND: Lumbopelvic pain is considered the most frequent complication during pregnancy. OBJECTIVE: To compare whether the combination of exercise with education is more effective for the treatment of low back and/or pelvic pain (PP) than each of these interventions separately in pregnant women. SEARCH STRATEGY: A systematic review was performed in WOS, PEDro, PubMed, Cochrane, and ClinicalTrials.gov. The terms used were low back pain, PP, pregnancy, pregnant woman, exercise, exercise therapy, health education, and prenatal education. SELECTION CRITERIA: The PICO question was then chosen as follows: P-population: pregnant women with nonspecific low back pain or PP; I-intervention: exercise therapy plus health education; C-control: only exercise therapy or only health education; O-outcome: characteristics of pain, disability, and kinesophobia; S-study designs: randomized controlled trial. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened articles for eligibility. The following inclusion criteria were applied for the selection of studies: (i) published in the past 10 years; (ii) exercise plus health education was administered compared with a group receiving either exercise or education alone; and (iii) the sample consisted of pregnant women with nonspecific low back pain or PP. This review excluded: (i) nonrandomized controlled trials; and (ii) articles whose full text was not available. The meta-analysis was performed using the random-effects model, due to the observed heterogeneity. MAIN RESULTS: A total of 13 articles were selected. There is a significant decrease in pain in the combination of exercise and education compared with education alone (standardized mean difference, -0.29 [95% confidence interval, -0.47 to -0.11]). With respect to disability, there is a significant decrease in the exercise and education group compared with the group that only addressed education (standardized mean difference, -0.37 [95% CI, -0.60 to -0.14]). One article analyzed kinesophobia, reporting no significant changes. CONCLUSION: The combination of exercise and education seems to be more effective in reducing pain and disability in pregnant women with low back and/or PP than the use of education alone. In kinesophobia, the results found are not significant.

Connaissances, attitudes et perceptions de la césarienne chez les gestantes suivies en CPN dans 6 maternités de Kinshasa / NA

Objectifs: Evaluer le niveau de connaissances, décrire les attitudes ainsi que les perceptions des gestantes sur la césarienne. MéthodesIl s'agissait d'une étude descriptive transversale qui s'est déroulée durant la période allant du 01 Février au 30Avril 2023 (soit 3mois) dans les services des consultations prénatales (CPN) des 6 6 structures de la Ville Province de Kinshasa ; les Cliniques Universitaires de Kinshasa (CUK), le Centre Hospitalier Roi Baudoin 1, l'Hôpital Saint Joseph(HSJ), les Maternités de Kintambo, de Binza et de Kingasani. Un total de 481 gestantes était interrogé dans l'ensemble des formations sanitaires sélectionnées. Les données sociodémographiques et celles relatives à la connaissance, attitude et perception sur la césarienne ont été récoltées par interview et analysées à l'aide des statistiques descriptives. L'évaluation de connaissances était faite selon la cotation suivante; moins de 50% de bonnes réponses (MAUVAISES) ;entre 50% et 70% de bonnes réponses (MOYENNES) et plus de 70% de bonnes réponses ( BONNES ). L'échelle de Likert a servi à l'évaluation des attitudes et perceptions sur la césarienne. Résultats Sur les 481 gestantes interviewées, seulement 16,1% avaient un antécédent personnel de Césarienne, l'âge de moyen de gestantes était de 29 ans, mariées pour la plupart (87,9%), employée (56,4%) avec un niveau d'étude secondaire (49,3%) et un niveau socio-économique moyen (53,8%). La source d'information sur cette intervention était diversifiée chez 39,8% de gestantes et les CPN n'ont contribué que dans 22,4%. Le niveau de connaissance était satisfaisant chez 73, 3% de gestantes. L'attitude des gestantes était négative chez 70,1% la perception par contre était positive à 64,4 %. Conclusion: La majorité de gestantes avait un niveau suffisant de connaissances sur la césarienne et une perception positive alors qu'elle garde une attitude négative face à cette intervention.

Objectives: Evaluate the level of knowledge, describe the attitudes and perceptions of pregnant women about cesarean section. Methods This was a cross-sectional descriptive study which took place during the period from February 1 to April 30, 2023 (i.e. 3 months) in the prenatal consultation services (PCS) of the 6 health structures in the City Province of Kinshasa; the University Clinics of Kinshasa (UCK), Roi Baudoin 1 Hospital Center, Saint Joseph Hospital (SJH), Kintambo, Binza and Kingasani maternity wards. A total of 481 pregnant women were interviewed in all the selected health facilities.ResultsAmong the 481 pregnant women interviewed, only 16.1% had a personal history of Caesarean section, the average age of pregnant women was 29 years, most of them married (87.9%), employed (56.4%) with a secondary education level (49.3%) and a socio-economic level. average economic (53.8%). The source of information on this intervention was diversified among 39.8% of pregnant women and antenatal cares only contributed to 22.4%. The level of knowledge was satisfactory in 73.3% of pregnant women. The attitude of the pregnant women was negative at 70.1%, the perception on the other hand was positive at 64.4%.Conclusion:The majority of pregnant women had a sufficient level of knowledge about caesarean section and a positive perception while they maintain a negative attitude towards this intervention

Differences in Changes in Game Usage Time and Game Use-Related Factors Depending on Parity in a Prospective Study of Pregnant Women in Japan.

Game usage has recently been increasing, but the actual situation of game usage and issues among pregnant women are not clarified. The purpose of this prospective longitudinal study was to examine changes in game usage, lifestyle, and thoughts about game usage during pregnancy depending on parity and to clarify the characteristics of pregnant women who continue to use games. We conducted three web surveys in early, mid- and late pregnancy in 238 pregnant women. For primiparous women who continued to use games, there was a significant increase in game usage time from early to late pregnancy (p = 0.022), and 25.0% of those women had anxiety that they might have a game addiction. For primiparous women in mid-pregnancy and multiparous women in early and late pregnancy, the proportions of women who thought that they could not use gaming sufficiently due to pregnancy and child-rearing were significantly higher in women who continued to use games. In both primiparous women and multiparous women, the proportion of partners who used games was significantly higher in women who continued to use games. It is necessary for midwives to discuss with pregnant women and their partners about game usage and to provide advice about control of game usage in daily life.

A Study on the Psychological Experience and Influential Factors of Pregnant Women Who Decided Elective Caesarean Section After Public Health Emergencies - A Cross-Sectional Survey.

Background: The COVID-19 pandemic used to be a major public health emergency which affected people worldwide, and it affected individuals' body, mood, work and lifestyle to some extent. The pregnant woman affected by the unstable hormone will be more sensitive than normal ones. Long-term depression and anxiety could feedback on their body and lead to a host of pregnancy complications. Because pregnant women who choose cesarean section are awake during the perioperative period, to ensure safety, the degree of cooperation about psychology and behavior is relatively high, so we should know the psychological state of such a group of people. Objective: This study aims to explore psychological experience and influential factors of pregnant women who decided elective caesarean section after the COVID-19 pandemic. Methods: This is a cross-sectional study carried out in a hospital in Shanghai, according to the inclusion and exclusion criteria, we selected pregnant women who selected elective cesarean section as the study objects, all participants provided informed consent and completed questionnaires, including sociodemographic questionnaire, Generalized Anxiety Disorder scale (GAD-7) and General Well-Being Schedule (GWBS). Software SPSS 23.0 was used to analyze and explore the influencing factors. Results: Eligible 595 questionnaires were included in the study, the mean score of GAD-7 was 4.855 ± 3.254 and 90.699 ± 13.807 of GWBS. Generalized linear regression analysis revealed several factors that were statistically significant with the two scales, including birthplace, average monthly income, number of abortion and pregnancy complication (p < 0.01). Conclusion: The COVID-19 infection status and symptoms around infection have no statistical difference in anxiety level and general well-being after they experience the COVID-19 pandemic. However, through this study, we found some influencing factors that worth further exploration. In the future, we will expand the sample size to explore the different situation of multi-center, and we hope provide psychological nursing interventions based on existing results to offer a better delivery experience.

Latent profile analysis and influencing factors of quality of life in pregnant women with gestational diabetes mellitus.

PURPOSE: Gestational diabetes mellitus (GDM) negatively affects the quality of life of pregnant women and is influenced by several factors. Research to date treats pregnant women with gestational diabetes as a homogeneous group based on their quality of life. We attempted to identify subgroups based on self-reported quality of life and explored variables associated with subgroups. METHODS: From September 1, 2020 to November 29, 2020, pregnant women with GDM from two hospitals in Guangdong Province were selected as subjects by convenience sampling method. Medical records provided sociodemographic data, duration of GDM, pregnancy status, and family history of diabetes. Participants completed validated questionnaires for quality of life, anxiety and depression. Latent profile analysis was used to identify profiles of quality of life in pregnant women with GDM, and then a mixed regression method was used to analyze the influencing factors of different profiles. RESULTS: A total of 279 valid questionnaires were collected. The results of the latent profile analysis showed that the quality of life of pregnant women with GDM could be divided into two profiles: C1 "high worry-high support" group (75.6%) and C2 "low worry-low support" group (24.4%). Daily exercise duration and depression degree are negative influencing factors, making it easier to enter the C1 group (p < 0.05). Disease duration and family history of diabetes are positive influencing factors, making it easier to enter the C2 group (p < 0.05). CONCLUSION: The quality of life of pregnant women with GDM had obvious classification characteristics. Pregnant women with exercise habits and depression are more likely to enter the "high worry-high support" group, and health care providers should guide their exercise according to exercise guidelines during pregnancy and strengthen psychological intervention. Pregnant women with a family history of diabetes and a longer duration of the disease are more likely to fall into the "low worry-low support" group. Healthcare providers can strengthen health education for them and improve their disease self-management abilities.

Field study on pregnant women's thermal preference in different trimesters in winter.

This study investigated the differences in the thermal preferences of pregnant women during various trimesters and the factors influencing these preferences. The survey was conducted in a hospital waiting room, encompassing the testing of thermal environmental parameters, and the distribution of questionnaires to pregnant women. These questionnaires encompassed various aspects, including basic information, thermal responses, pregnancy diseases, and more. In total, 1388 questionnaires were collected, distributed across the first trimester (225 participants), second trimester (498 participants), and third trimester (665 participants). The findings revealed a notable shift in the thermal preferences of pregnant women as their pregnancies progressed, transitioning from a preference for warmer conditions to a preference for cooler environments. Specifically, the mean thermal preference scores for the first, second, and third trimesters were 0.82, -0.27, and -1.76, respectively. These shifting preferences were associated with various factors, including pregnancy diseases, pre-pregnancy body mass index (PBMI), and exercise habits. Notably, hyperthyroidism, a higher PBMI, and regular exercise were correlated with a preference for cooler conditions, whereas hypothyroidism, anemia, a lower PBMI, and rare exercise were associated with a preference for warmer environments. Furthermore, it was observed that the actual neutral temperatures for pregnant women in the first, second, and third trimesters were 20.3 °C, 19.5 °C, and 19 °C, respectively. By contrast, the predicted neutral temperatures were 23.5 °C for the first and third trimesters and 23.4 °C for the second trimester. This indicated that the Predicted Mean Vote (PMV) model tended to underestimate the acceptability that pregnant women experienced in colder environments. Given the unique thermal preferences of pregnant women, further research is essential to refine thermal comfort parameters and the PMV model tailored specifically to this demographic.

Non-small cell lung cancer with bone metastasis and pneumocystis pneumonia in a pregnant woman: a case report and literature review.

BACKGROUND: Cancer case during pregnancy is rare, but it is the second leading cause of maternal mortality. CASE PRESENTATION: A-32-year old pregnant woman with a gestational age of 37 weeks was admitted to the hospital due to repeated coughing for 5 months. She received Veno-Venous Extracorporeal Membrane Oxygenation (V-V ECMO) treatment for severe hypoxemia after delivery. She was diagnosed with non-small cell lung cancer (NSCLC) with bone metastasis and pneumocystis pneumonia (PCP). She subsequently received anti-tumor therapy and anti-infective therapy. After treatment, her condition improved and she was weaned from ECMO. Two weeks after weaning ECMO, her condition worsened again. Her family chose palliative treatment, and she ultimately died. CONCLUSIONS: NSCLC is rare during pregnancy. At present, there is still a lack of standardized methods to manage these cases. For theses cases, the clinician should be wary of opportunistic infections, such as pneumocystis jirovecii (P. jirovecii) and Elizabethkingia spp. Specialized medical teams with abundant experience and multidisciplinary discussions from the perspectives of the patient's clinical characteristics as well as preferences are crucial for developing individualized and the best approach.

Relationship between maternal antenatal attachment and traumatic childbirth perception among pregnant women.

OBJECTIVE: To examine the relationship between the perception of traumatic birth and maternal attachment in pregnant women. METHODS: This descriptive and correlational study recruited 370 pregnant women who applied for an antenatal visit to outpatient clinics of a state hospital. The data were collected using a Personal Information Form, Maternal Antenatal Attachment Scale (MAAS), and Traumatic Birth Perception Scale (TBPS). Data were collected using the face-to-face method. The study was reported according to the STROBE. RESULTS: The mean total score of MAAS was 75.71 ± 7.72 and the mean TBPS score was 73.21 ± 28.34. Normal birth pain was perceived as "severe" by 38.3% of pregnant women and as "very severe" by 46.1%. It was determined that 29.2% of pregnant women had a "high" level of traumatic birth perception and 14.5% had a "very high" level. A negative correlation was found between the mean scores of MAAS and TBPS of pregnant women. The trimester of pregnancy, listening to the birth story, planned pregnancy, and traumatic birth perception, was a significant predictor of maternal antenatal attachment. CONCLUSION: As the maternal antenatal attachment levels of pregnant women increased, their perceptions of traumatic birth decreased.

Effects of Varied Omega-3 Fatty Acid Supplementation on Postpartum Mental Health and the Association between Prenatal Erythrocyte Omega-3 Fatty Acid Levels and Postpartum Mental Health.

We investigated the postpartum mental health of women who had consumed perilla oil or fish oil containing various omega-3 fatty acids for 12 weeks starting in mid-pregnancy. The association between fatty acids in maternal erythrocytes and mental health risk factors was also examined. Healthy Japanese primiparas in mid-pregnancy (gestational weeks 18-25) were randomly divided into two groups and consumed approximately 2.0 g/day of omega-3 fatty acids in either perilla oil (the ALA dose was 2.4 g/day) or fish oil (the EPA + DHA dose was 1.7 g/day) for 12 weeks. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS) as the primary measure and the Mother-to-Infant Bonding Scale (MIBS) as the secondary measure. Data from an observational study were used as a historical control. Maternal blood, cord blood, and colostrum samples were collected for fatty acid composition analysis. In addition, completers of the observational studies were enrolled in a case-control study, wherein logistic regression analysis was performed to examine the association between maternal fatty acids and EPDS score. The proportion of participants with a high EPDS score (≥9) was significantly lower in the perilla oil group (12.0%, p = 0.044) but not in the fish oil group (22.3%, p = 0.882) compared with the historical control (21.6%), while the proportions between the former groups also tended to be lower (p = 0.059). No marked effect of omega-3 fatty acid intake was observed from the MIBS results. In the case-control study of the historical control, high levels of α-linolenic acid in maternal erythrocytes were associated with an EPDS score of <9 (odds ratio of 0.23, 95% confidence interval: 0.06, 0.84, p = 0.018 for trend). The results of this study suggest that consumption of α-linolenic acid during pregnancy may stabilize postpartum mental health.