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1.
Artigo em Inglês | MEDLINE | ID: mdl-35682475

RESUMO

Over recent years, the concept of Sensory Integration has become more popular. Knowledge about Sensory Processing Disorder (SPD) also has grown, and it is often discussed in scientific research. Sensory disturbances can cause problems in learning and behaviour of children in whom no medical diagnosis has been made. These are healthy children regarding the environment, but their behaviour is often described as strange in the meaning not appropriate/not adequate to the situation. The aim of the study was to analyse if there is a correlation between occurrence of SPD and the time or the way of delivery. Participants were 75 children, ages 5-9 years old. Children born prematurely (n = 25), and children delivered by caesarean section (C-section) (n = 25) were compared to the ones born on time by natural means (n = 25). Research was based on a questionnaire filled by children's parents. Descriptive results and percentage calculations were compared. SPD were detected among 84% of pre-borns and among 80% of children delivered by C-section and it is statistically significant. Both groups are at higher risk of Sensory Processing Disorder than those delivered on time by vaginal birth. Due to the results, the time and the way of the delivery are the factors that affect Sensory Processing Disorder.


Assuntos
Cesárea , Parto , Criança , Pré-Escolar , Feminino , Humanos , Percepção , Projetos Piloto , Gravidez , Sensação
2.
Enferm Clin (Engl Ed) ; 32 Suppl 1: S14-S22, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35688562

RESUMO

AIM: To explore and describe the experiences of women giving birth in a tertiary public hospital, with special focus on experiences related to humanized care and women's participation in decision making. METHOD: This is a qualitative phenomenological study through semi-structured interviews to postpartum women giving birth in a tertiary hospital between January and May 2017. Data were analysed through content analysis. RESULTS: The two overarching themes emerged were the professional-information dyad and privacy. Subthemes of the first main theme were the therapeutic relationship, decision-making, feeding the baby, procedures, and the time factor. Subthemes of the second topic were the feelings generated by the hospital environment, the delivery room, and the maternity ward. CONCLUSIONS: If the therapeutic relationship is good, technology is not seen as dehumanising but rather as necessary to ensure continuing safety. "Humanising" material resources are not a priority for women in the birth process and are little used. Privacy was experienced as being a particularly intense need, which women called for throughout the healthcare process.


Assuntos
Hospitais , Parto , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Espanha , Fatores de Tempo
3.
BMC Pregnancy Childbirth ; 22(1): 451, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641939

RESUMO

BACKGROUND: Evidence shows that women in Ghana experience disrespectful care (slapping, pinching, being shouted at, etc.) from midwives during childbirth. Hence, evidence-based research is needed to advance the adoption of respectful maternity care (RMC) by midwives. We therefore sought to explore and document midwives' perspectives concerning challenges faced and prospects available for promoting RMC in a tertiary health facility. METHODS: We employed an exploratory descriptive qualitative study design. In total, we conducted 12 interviews with midwives educated on RMC. All audio data were transcribed verbatim and exported to NVivo-12 for data management and analyses. We relied on the Consolidated Criteria for Reporting Qualitative Research guideline in reporting this study. RESULTS: The findings were broadly categorised into three themes: emotional support, dignified care and respectful communication which is consistent with the WHO's quality of care framework. For each theme, the current actions that were undertaken to promote RMC, the challenges and recommendations to improve RMC promotion were captured. Overall, the current actions that promoted RMC included provision of sacral massages and reassurance, ensuring confidentiality and consented care, and referring clients who cannot pay to the social welfare unit. The challenges to providing RMC were logistical constraints for ensuring privacy, free movement of clients, and alternative birthing positions. Poor attitudes from some midwives, workload and language barrier were other challenges that emerged. The midwives recommended the appointment of more midwives, as well as the provision of logistics to support alternative birthing positions and privacy. Also, they recommended the implementation of continuous training and capacity building. CONCLUSION: We conclude that in order for midwives to deliver RMC services that include emotional support, dignified care, and respectful communication, the government and hospital administration must make the required adjustments to resolve existing challenges while improving the current supporting activities.


Assuntos
Serviços de Saúde Materna , Tocologia , Feminino , Gana , Instalações de Saúde , Humanos , Parto/psicologia , Gravidez
4.
BMC Pregnancy Childbirth ; 22(1): 452, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641954

RESUMO

BACKGROUND: The reduction of maternal mortality in developing countries such as the Democratic Republic of Congo (DRC) still raises many questions. Indeed, this large country in the heart of Africa ranks 4th among the eight countries that alone account for more than 50% of maternal deaths in the world, behind India, Nigeria and Pakistan. However, there is no up-to-date data on maternal mortality in eastern DRC. This study measures the mortality rate rate in health facilities in eastern DRC and identifies the associated risk factors. METHODS: This analytical epidemiological study was based on retrospective data materna deaths recorded in 59 health facilities, in three health zones in the southern part of Maniema province in east DRC. The study was conducted from July 1, 2015 to June 30, 2020. Descriptive, bi and multivariate analyses were used. RESULTS: The maternal mortality rate was estimated at 620 deaths per 100,000 live births, of which 46% of maternal deaths were related to a parturients' delayed decision in seeking healthcare in time (first delay). Maternal deaths were significantly associated with extreme ages (≤ 19 years and ≥ 40 years: p = < 0.001), patient parity (in primigravidas and in large multiparas: p = 0.001), complications such as hemorrhagic, (p = < 0.001), uterine ruptures:(p = < 0.001), infections, (p = < 0.001), and dystocia (p = < 0.001). CONCLUSION: Despite the efforts made by the DRC and its partners in the fight against maternal mortality, women continue to lose their lives when they decide to give birth. The results imply that it is imperative to strengthen both women and health professionals' knowledge about pregnancy and maternal health and their power to reduce instances of first delay by supporting women in formulating their birth plans.


Assuntos
Morte Materna , Mortalidade Materna , Adulto , República Democrática do Congo/epidemiologia , Feminino , Humanos , Morte Materna/etiologia , Parto , Gravidez , Estudos Retrospectivos , Adulto Jovem
5.
Rev Bras Enferm ; 75(6): e20210534, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35674579

RESUMO

OBJECTIVES: to assess the association between breastfeeding and diseases prevalent in the first two years of a child's life. METHODS: a retrospective cross-sectional study that analyzed electronic medical records of 401 children. Data on birth, growth, breastfeeding and medical care in the first two years of life were collected. In the analysis, Poisson regression with robust variance was used. RESULTS: 27.9% of children were exclusively breastfed until six months, and, at 24 months, 93.3% had already had some prevalent childhood disease. In the crude analysis, 5-minute Apgar association, length, weight at 12 months, exclusive and non-exclusive breastfeeding time had association. In the adjusted analysis, only the variable breastfeeding at six months maintained the association with prevalent childhood diseases. CONCLUSIONS: children who were not breastfed, exclusively or not, up to six months of age, had a higher prevalence of diseases compared to breastfed children.


Assuntos
Aleitamento Materno , Parto , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Gravidez , Prevalência , Estudos Retrospectivos
6.
BMC Pregnancy Childbirth ; 22(1): 471, 2022 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-35672663

RESUMO

BACKGROUND: The use of caesarean section has steadily increased, with Latin America being the region with the highest rates. Multiple factors account for that increase and the Robson classification is appropriate to compare determinants at the clinical level for caesarean section rates over time. The purpose of this study is to describe the evolution of caesarean section rates by Robson groups in Uruguay from 2008 to 2018 using a country level database. METHODS: We included the records of all women giving birth in Uruguay (pregnancies ≥22 weeks and weights ≥500 g) with valid data in the mode of childbirth recorded in the Perinatal Information System database between 2008 and 2018. Caesarean section rates were calculated by Robson groups for each of the years included, disaggregated by care sector (public/private) and by geographical area (Capital City/Non-Capital), with time trends and their significance analyzed using linear regression models. RESULTS: Of the total 485,263 births included in this research, the overall caesarean section rate was 43,1%. In 2018, among the groups at lower risk of caesarean section (1 to 4), the highest rates were seen in women in group 2B (98,8%), followed by those in group 4B (97,9%). A significant increase in the number of caesarean sections was seen in groups 2B (97,9 to 98,8%), 3 (8,36 to 11,1%) and 4 (A (22,7 to 26,9%) and B (95,4 to 97,9%) Significant growth was also observed in groups 5 (74,3 to 78,1%), 8 (90,6 to 95,5%), and 10 (39,1 to 46,7%). The private sector had higher rates of caesarean section for all groups throughout the period, except for women in group 9. The private sector in Montevideo presented the highest rates in the groups with the lowest risk of caesarean section (1, 2A, 3 and 4A), followed by the private sector outside of the capital. CONCLUSION: Uruguay is no exception to the increasing caesarean section trend, even in groups of women who have lower risk of requiring caesarean section. The implementation of interventions aimed at reducing caesarean section in the groups with lower obstetric risk in Uruguay is warranted.


Assuntos
Cesárea , Parto Obstétrico , Bases de Dados Factuais , Feminino , Humanos , Parto , Gravidez , Uruguai/epidemiologia
7.
BMJ Open ; 12(6): e058003, 2022 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-35728904

RESUMO

OBJECTIVES: Invasive meningococcal disease (IMD) is an urgent notifiable disease and its early notification is essential to prevent cases. The objective of the study was to assess the sensitivity of two independent surveillance systems and to estimate the incidence of IMD. DESIGN: We used capture-recapture model based on two independent surveillance systems, the statutory disease reporting (SDR) system and the microbiological reporting system (MRS) of the Public Health Agency of Catalonia, between 2011 and 2015. The capture-recapture analysis and 95% CIs were calculated using the Chapman formula. Multivariate vector generalised linear model was performed for adjusted estimation. MEASURES: The variables collected were age, sex, year of report, size of municipality (<10 000 and ≥10 000), clinical form, death, serogroup, country of birth and type of reporting centre (private and public). RESULTS: The sensitivity of the two combined surveillance systems was 88.5% (85.0-92.0). SDR had greater sensitivity than the MRS (67.9%; 62.7-73.1 vs 64.7%; 59.4-70.0). In 2014-2015, the sensitivity of both systems was higher (80.6%; 73.2-87.9 vs 73.4%; 65.2-81.6) than in 2011-2013 (59.3%; 52.6-66.0 vs 58.3%; 51.6-65.1). In private centres, the sensitivity was higher for SDR than for MRS (100%; 100-100 vs 4.8%; -4.4-13.9). The adjusted estimate of IMD cases was lower than that obtained using the Chapman formula (279; 266-296 vs 313; 295-330). The estimated adjusted incidence of IMD was 0.7/100 000 persons-year. CONCLUSIONS: The sensitivity of enhanced surveillance through the combination of two complementary sources was higher than for the sources individually. Factors associated with under-reporting in different systems should be analysed to improve IMD surveillance.


Assuntos
Infecções Meningocócicas , Neisseria meningitidis , Feminino , Humanos , Incidência , Infecções Meningocócicas/microbiologia , Parto , Gravidez , Sorogrupo , Espanha/epidemiologia
8.
Cien Saude Colet ; 27(7): 2741-2752, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35730843

RESUMO

Collaborative models (CM) focused on intrapartum care shared between both midwives and obstetricians have been proposed as a strategy to reduce these rates. Our aim was to compare use of evidence-based practices, obstetric interventions and c-section rates in two settings: a maternity hospital that applies a CM of care (MRJ) and data from a pool of maternity hospitals included in the Birth in Brazil Survey (NB) that do not adopt a CM. Data was abstracted from medical and administrative records in MRJ and from medical records and face-to-face interviews in NB. Differences were compared using chi-square test, with significance level set at p<0.05. MRJ showed a higher frequency of labour companionship, labour care provided by nurse midwives, non-pharmacological pain relief methods, food intake during labour, and less use of oxytocin, analgesia and amniotomy. More women also had second stage assisted by a nurse midwife and in a vertical position, as well as lower use of episiotomies and vacuum-extractor/forceps. The c-section rate was lower at MRJ. Shared care between midwives and obstetricians can be an effective strategy to improve quality of intrapartum care.


Assuntos
Trabalho de Parto , Tocologia , Enfermeiras Obstétricas , Parto Obstétrico/métodos , Feminino , Maternidades , Humanos , Parto , Gravidez
9.
Sante Publique ; 33(5): 645-654, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35724098

RESUMO

INTRODUCTION: Recent quantitative research in public health indicates that women across the globe report suboptimal treatment during institutional deliveries. The most common approaches used to comprehend this abuse, violence, or mistreatment have not fully achieved a balance between theoretical perspectives and empirical assessment. To contribute to a more accurate account of the cultural driving forces, institutional conditions, direct expressions, and individual perceptions that undermine or preserve what we define as “integrity at birth”, we develop a new theoretical approach and a multi-level model. PURPOSE OF RESEARCH: We ground the terminology for integrity at birth upon theoretical foundations, referring to two theoretical discourses: medicalization and risk theory on the one hand, and embodiment and intersectionality theory on the other. We then contextualize this in a multi-level model in order to operationalize its potential for public health research. RESULTS: The concept and model of “integrity at birth” recognize that women in labor suffer from a number of gender-specific violations, which can be expressed at all levels (macro to micro) as implicit, inherent, normalized and invisible, or explicit, intentional, visible and socially accepted. In distinguishing six separate domains, we propose a theoretical contribution for obstetric care practices. CONCLUSION: Integrity at birth, as a multi-level and theoretically grounded approach, constitutes an important step towards raising awareness about this issue beyond the dimensions that have been studied to date in quantitative health research. Beyond available evidence of disrespectful and abusive practices constituting violations to integrity at birth, this study takes a step towards understanding gender-based violence and inequalities of health at childbirth.


Assuntos
Trabalho de Parto , Serviços de Saúde Materna , Atitude do Pessoal de Saúde , Parto Obstétrico , Feminino , Humanos , Recém-Nascido , Medicalização , Parto , Gravidez , Saúde Pública
10.
Sante Publique ; 33(5): 685-694, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35724102

RESUMO

The category of obstetric violence has existed for several years in the legal and public arenas in Mexico. Among the practices in this field, the increase in the use of caesarean section has fueled a reflection on the kind of considerations that push to favor a surgical intervention over a vaginal delivery; this situation increasingly raises discussions in several public arenas. The article analyses several articles written by specialists in two Mexican journals Salud Pública de México and Género y Salud en Cifras. The goal is to observe, after an analysis of some articles, the evolution of conceptions of caesarean sections over the past decades and to understand the questions surrounding the increase of the C-Sections and the reasons (medical and non-medical) which underpin this decision, to identify a potential profile of women and the progressive emergence of the discourse of risk of having a C-Section. We could observe that the research on the increase in the number of caesarean sections has indeed gained in importance, also the research on the non-medical criteria. We also noticed that the two reviews analyzed, rarely link their reflections to the category of obstetric violence. Among other things, we were able to remark the gradual amplification of the discourse of risk, as well as the establishment of an approach consisting in including among the risk factors for the childbirth the fact of being a candidate for a C-Section without specific medical justifications.


Assuntos
Cesárea , Parto Obstétrico , Feminino , Humanos , México , Parto , Gravidez , Violência
11.
Sante Publique ; 33(5): 695-704, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35724103

RESUMO

INTRODUCTION: Violence against women during institutional childbirth is recognized as a major barrier to the quality of care. In recent years, several countries have implemented interventions aimed at improving the childbirth experience of women through humanized care. However, the literature on the effectiveness of these interventions remains weak. PURPOSE OF RESEARCH: The aim of this study is therefore to analyze the experience of care of women regarding the intervention of humanized childbirth in Senegal. Qualitative research based on a multiple case study was done. Three collection methods were used: observation, individual interview, and document analysis. Individual interview were carried out with 20 women. RESULTS: In general, women who gave birth following the intervention appreciated their experience due to changes such as the opportunity to eat and drink, to be accompanied by a trusted person and to choose their position during childbirth. However, it was the way in which women were received at the health facility and the attitude of health professionals that were decisive in their level of satisfaction with care. Few women benefited from all the components of the intervention. The difficulties encountered in the implementation such as non-functional delivery rooms, the lack of qualified human resources and the lack of awareness of the intervention explain this. CONCLUSIONS: Our results therefore suggest that improving the quality of care at birth, for a “humanized” (or natural, respectful) birth, is only possible when certain materials and medical conditions are met and prepared in advance, during the prenatal period.


Assuntos
Parto Obstétrico , Parto , Feminino , Instalações de Saúde , Humanos , Recém-Nascido , Gravidez , Pesquisa Qualitativa , Senegal
12.
Sante Publique ; 33(5): 741-751, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35724108

RESUMO

INTRODUCTION: Co-administration of the bilié de Calmette et Guérin (BCG) and birth doses of oral polio (OPV zero) and hepatitis B (HepB BD) vaccines is strongly recommended. The objective was to determine the factors associated with this co-administration in the health district of Podor (Senegal). METHODS: This cross-sectional study was conducted among 726 children aged 12 to 23 months. This was a two-stage cluster sampling. The data was collected in June 2020. An electronic questionnaire was developed using the Open Data Kit Collect application. Co-administration was modeled as one dose, two doses and three doses. Ordinal logistic regression was used to search for factors likely to influence co-administration. RESULTS: Of the 726 children, 115 (16%), 234 (32%) and 377 (52%) received a single dose, two and three doses, respectively. Factors associated with co-administration were recognition by mothers or caregivers that several vaccines can be administered simultaneously (adjusted OR = 1.46, p-value = 0.017), availability of a health record kept at home (adjusted OR = 6.88, p-value = 0.006), hospitalization of the newborn after birth (adjusted OR = 1.74, p-value = 0.002) and receipt of advice during postnatal care (adjusted OR = 1.72, p-value = 0.01). CONCLUSION: Co-administration of birth doses is an infrequent practice in Podor. Awareness and availability and proper maintenance of health information management tools would be necessary.


Assuntos
Hepatite B , Vacinas , Criança , Estudos Transversais , Feminino , Hepatite B/prevenção & controle , Humanos , Programas de Imunização , Lactente , Recém-Nascido , Parto , Gravidez , Vacinação
13.
BMC Public Health ; 22(1): 1224, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725421

RESUMO

BACKGROUND: Maternal knowledge that motivates improvements in critical perinatal health behaviors has the potential to significantly reduce maternal and neonatal mortality. However, evidence-based health information often fails to reach mothers and their partners. mHealth video micro-messages, which disseminate evidence-based perinatal health messages, have the potential to address this gap. METHODS: The study will make use of a mixed method design, using both qualitative and quantitative methods. The study consists of two phases. During Phase 1, qualitative in-depth interviews will be used as part of a human-centered design approach to co-create 10 videos on priority perinatal behaviors. During Phase 2, quantitative methods (a randomized control trial) will be used to test the effectiveness of the videos in improving maternal knowledge and intended behavioral change. DISCUSSION: We hypothesize that by engaging mothers and their partners through emotive, resonant narratives and visuals, we can facilitate the delivery of evidence-based health messages at the foundation of perinatal health, thereby motivating life-saving improvements in health behaviors during the perinatal period. TRIAL REGISTRATION: This trial has been prospectively registered on the Pan African Clinical Trials Registry (PACTR), with the registration number PACTR202203673222680 . Registration date: 14 March 2022.  TRIAL REGISTRATION WHO DATA SET: Registry - Pan African Clinical Trials Registry (PACTR). Date: 14 March 2022. Secondary identification number - grant number: GCCSOAFMNH1. Source of support: Science for Africa Foundation. Primary sponsor - Clinton Health Access Initiative South Africa. Secondary sponsor - Stanford University School of Medicine and Heidelberg University. Contact for public & scientific queries: amandlamamasa@clintonhealthaccess.org ; +27 123,426,911; 1166 Francis Baard St, Hatfield, Pretoria, 0028. Public title - Amandla Mama. Scientific title - Optimizing knowledge and behavioral intention of women and their partners in the perinatal period in South Africa. Countries of recruitment - South Africa. Health conditions - antenatal care. Intervention - Amandla Mama mHealth videos, short 2D animated health promotional videos that promote healthy behavior in expectant mothers. Inclusion and exclusion criteria - Expectant mothers and their partners must be 18 years and older. Study type - randomized control trial. Date of first enrollment - 14 March 2021. Sample size - plan to enrol 450 participants, participants enrolled 29 participants. Recruitment Status - suspended. Primary outcome - improving knowledge. Secondary outcome - intended behavioral change. Ethics review - Approved on 24 January 2022 by Pharma-Ethics, contact Mrs. Marzelle Haskins, marzelle@pharma-ethics.co.za . Completion date - N/A. Summary results - N/A. IPD sharing statement - yes, through the publication of results in a journal article.


Assuntos
Intenção , Parto , Ensaios Clínicos Fase II como Assunto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Recém-Nascido , Mães , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , África do Sul
14.
Reprod Health ; 19(1): 141, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725476

RESUMO

BACKGROUND: Respectful maternity care (RMC) has been elevated in the global discourse, however, instances of disrespect and abuse remain prevalent. While several studies have highlighted promising approaches to promote RMC, this body of literature is still limited and few approaches have been scaled outside the initial study sites. Building on formative research conducted through a behavioral science lens, we sought to develop and test evidence-based, low-cost solutions to promote RMC which would be well-positioned for scale-up. Our study highlights the effectiveness of the solution package on provider provision of respectful care and client satisfaction, as well as intermediary outcomes and behavioral mechanisms. METHODS: A quasi-experimental evaluation, informed by the behavioral design approach, was completed to test the effectiveness of a 5-component solution package in Chipata, Zambia. Quantitative surveys were collected from health facility providers and postpartum clients at baseline and endline in intervention and comparison facilities. Additional qualitative interviews were conducted with health facility providers and postpartum clients at endline. We also conducted interviews with health facility in-charges and observed labor and delivery practices at intervention facilities over the course of implementation. RESULTS: Evidence suggested that at endline, clients at implementation facilities were less likely to experience disrespect and abuse compared to clients at comparison facilities (ß = - 0.15 p = 0.01). Clients at intervention facilities were more likely to request pain management compared to clients at comparison facilities (ß = 0.33, p = 0.003). The solutions were simple for providers to implement and were easily integrated into existing services by providers during labor and delivery. Providers at intervention facilities also described the pain management toolkit as helpful in expanding the types of pain management techniques used during labor. CONCLUSIONS: The results of this small-scale study act as a proof of concept, demonstrating that the behavioral design approach can lead to solutions that show potential for impact. In other settings where providers face similar barriers to providing RMC, an adaptation of this solution package might lead to similarly positive results. Given the global scale of disrespectful care, these low-cost solutions hold promise for improving the quality of care women receive during labor and delivery.


Instances of disrespect and abuse during childbirth are prevalent around the world, particularly in low-resource settings. Few interventions have been designed and evaluated in these settings and even fewer in Southern Africa. This study aimed to understand the effects of a behaviorally informed intervention on the provision of respectful maternity care. We performed an evaluation of a health facility-based intervention, in Chipata District, Zambia. The study included quantitative and qualitative surveys with health care providers and women who recently delivered, as well as health facility observations and qualitative interviews with health facility supervisors. Our results show that clients who delivered at a facility where our intervention took place had a decreased likelihood of experiencing disrespect and abuse and an increased provision of pain management support. Our findings suggest that facility-based approaches informed by behavioral science have the potential to increase provision of respectful care and decrease the prevalence of mistreatment in low-resource settings. A large-scale evaluation of these interventions across settings could contribute valuable evidence around low-cost solutions to promote respectful maternity care.


Assuntos
Serviços de Saúde Materna , Atitude do Pessoal de Saúde , Parto Obstétrico , Feminino , Humanos , Masculino , Parto , Gravidez , Relações Profissional-Paciente , Qualidade da Assistência à Saúde , Zâmbia
15.
Anim Sci J ; 93(1): e13752, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35726538

RESUMO

The present study aimed to investigate the quantitative relationship between the number of cross-fostering (CF) piglets and subsequent productivity of sows. Data were obtained from seven commercial farms including 41,086 farrowing records. Sows were divided into those that fostered out three or more piglets (CF ≥ 3-), fostered out one or two piglets (CF1-2-), did not do CF (NCF), fostered in one or two piglets (CF1-2+), and fostered in three or more piglets (CF ≥ 3+). CF ≥ 3- sows had the lowest number of piglets weaned and the highest preweaning mortality rate, whereas CF ≥ 3+ sows had the second-lowest number of piglets weaned and the second-highest preweaning mortality rate (p < .05). The number of piglets weaned and preweaning mortality rate did not differ among CF1-2-, NCF, and CF1-2+ sows. CF ≥ 3+ sows had the lowest farrowing rate (p < .05). The number of piglets born alive at the subsequent parity was highest for CF ≥ 3- sows (p < .05), followed in order by CF1-2-, NCF, CF1-2+, and CF ≥ 3+ sows (p < .05). In summary, CF1-2- and CF1-2+ sows showed no decreases in productivity compared with NCF sows, whereas CF ≥ 3- and CF ≥ 3+ sows had reduced productivity.


Assuntos
Parto , Animais , Fazendas , Feminino , Paridade , Gravidez , Suínos , Desmame
17.
BMC Pregnancy Childbirth ; 22(1): 479, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698051

RESUMO

BACKGROUND: Women who smoke during pregnancy make less use of prenatal care; the relation of smoking behavior with the use of other forms of maternal healthcare is unknown. The objective of this study is to investigate the association between women's smoking behavior and their use of healthcare during pregnancy, birth and six weeks postpartum. METHODS: We analyzed data from the Dutch Midwifery Case Registration System (VeCaS), period 2012-2019. We included women with a known smoking status, singleton pregnancies, and who had their first appointment before 24 weeks of gestation with the primary care midwife. We compared three groups: non-smokers, early stoppers (stopped smoking in the first trimester), and late- or non-stoppers (stopped smoking after the first trimester or continued smoking). Descriptive statistics were used to report maternal healthcare utilization (during pregnancy, birth and six weeks postpartum), statistical differences between the groups were calculated with Kruskal-Wallis tests. Multivariable logistic regression was conducted to assess the association between smoking behavior and referrals to primary, secondary or tertiary care. RESULTS: We included 41 088 pregnant women. The groups differed significantly on maternal healthcare utilization. The late- or non-stoppers initiated prenatal care later and had less face-to-face consultations with primary care midwives during pregnancy. Compared to the non-smokers, the early- and late- or non-stoppers were statistically signficiantly more likely to be referred to the obstetrician during pregnancy and birth. Postpartum, the early- and late- or non-stoppers were statistically signficantly less likely to be referred to the obstetrician compared to the non-smokers. CONCLUSIONS: Although the early- and late- or non-stoppers initiated prenatal care later than the non-smokers, they did receive adequate prenatal care (according to the recommendations). The results suggest that not smoking during pregnancy may decrease the likelihood of referral to secondary or tertiary care. The large population of smokers being referred during pregnancy underlines the important role of the collaboration between healthcare professionals in primary and secondary or tertiary care. They need to be more aware of the importance of smoking as a medical and as a non-medical risk factor.


Assuntos
Parto , Cuidado Pré-Natal , Estudos de Coortes , Feminino , Humanos , Gravidez , Encaminhamento e Consulta , Fumar/epidemiologia
18.
Lipids Health Dis ; 21(1): 53, 2022 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-35698189

RESUMO

BACKGROUND: An excessive rise in maternal lipids during pregnancy may have detrimental impacts on maternal and fetal health leading to adverse pregnancy outcomes. However, knowledge gaps exist with respect to the association between lipid biomarkers and birth outcomes. METHODS: We conducted a secondary data analysis of healthy pregnant women (N = 25) with mid-pregnancy fasting serum samples collected at 22-28 weeks of gestation and birth outcome data. Serum was analyzed for conventional lipid profile (total-C, HDL-C, LDL-C, and triglycerides) and lipoprotein subclass distribution, including particle number (nM) and size (nm), for very low-density lipoprotein (VLDL)/chylomicron (CM), low density lipoprotein (LDL), and high-density lipoprotein (HDL), by nuclear magnetic resonance spectroscopy. Associations between maternal lipids and birth outcomes, including birth weight (g) and gestational age (weeks), were assessed using multivariable linear regression, adjusted for pre-pregnancy BMI. RESULTS: Although conventional lipids were not associated (p > 0.05) with birth outcomes, every 1-unit increment in large VLDL/CM particles (nM) and VLDL/CM size (nm) was associated with an increase in birth weight (confounder-adjusted ß-coefficient, 45.80 g [5.30, 86.20, p = 0.003] and 24.90 g [8.80, 40.90, p = 0.002], respectively). Among the HDL subclass parameters, a 1-unit (nM) increase in the concentration of total HDL-particles was associated with a reduced birth weight (confounder adjusted ß-coefficient, -19.40 g [95% confidence interval, -36.70, -2.20]; p = 0.03) after adjustment for maternal pre-pregnancy BMI. CONCLUSION: The preliminary results of this pilot study suggest that total particle concentrations of VLDL/CM and HDL in mid-pregnancy have divergent associations with birth weight, potentially reflecting the specific roles of these lipoprotein particles with respect to placental function and fetal growth.


Assuntos
Lipoproteínas , Placenta , Peso ao Nascer , Quilomícrons , Feminino , Humanos , Lipoproteínas HDL , Lipoproteínas VLDL , Tamanho da Partícula , Parto , Projetos Piloto , Gravidez , Triglicerídeos
19.
BMJ Open ; 12(6): e062294, 2022 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-35688597

RESUMO

INTRODUCTION: The COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates. METHODS AND ANALYSIS: We will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and (3) determine the role of social contextual factors on racial/ethnic disparities in pregnancy-related morbidities using machine learning algorithms. We will leverage an existing South Carolina COVID-19 Cohort by creating a pregnancy cohort that links COVID-19 testing data, electronic health records (EHRs), vital records data, healthcare utilisation data and billing data for all births in South Carolina (SC) between 2018 and 2021 (>200 000 births). We will also conduct similar analyses using EHR data from the National COVID-19 Cohort Collaborative including >270 000 women who had a childbirth between 2018 and 2021 in the USA. We will use a convergent parallel design which includes a quantitative analysis of data from the 2018-2021 SC Pregnancy Risk Assessment and Monitoring System (unweighted n>2000) and in-depth interviews of 40 postpartum women and 10 maternal care providers to identify distinct mediating pathways. ETHICS AND DISSEMINATION: The study was approved by institutional review boards at the University of SC (Pro00115169) and the SC Department of Health and Environmental Control (DHEC IRB.21-030). Informed consent will be provided by the participants in the in-depth interviews. Study findings will be disseminated with key stakeholders including patients, presented at academic conferences and published in peer-reviewed journals.


Assuntos
COVID-19 , Serviços de Saúde Materna , COVID-19/epidemiologia , Teste para COVID-19 , Feminino , Humanos , Morbidade , Pandemias , Parto , Gravidez , SARS-CoV-2 , Estados Unidos/epidemiologia
20.
Stud Health Technol Inform ; 290: 178-181, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35672995

RESUMO

Electronic Integrated Antenatal Care is a web-based application for antenatal care (ANC) data and information management for independent practice midwives. This study aimed to assess the end-user needs for e-iANC development. Their needs for data and information were represented by a use case diagram. Five key stakeholders were identified related to the development of an e-iANC. Interviewing representatives of each informant provided the functions, and information content and flows for each function. The Extended e-iANC needs and promoted insight among all of the actors' perspectives. The use-case scenario for extended e-iANC includes all of the elements of midwifery care include antenatal care, childbirth, puerperium, immunization, and family planning. The deployment of integrated information of extended e-iANC with the primary healthcare applications and the district health department is necessary for comprehensive information on maternal and child care innovation.


Assuntos
Tocologia , Cuidado Pré-Natal , Eletrônica , Feminino , Humanos , Determinação de Necessidades de Cuidados de Saúde , Parto , Gravidez
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