جستجوی مقالات مرتبط با کلیدواژه « Maternal health » در نشریات گروه « پزشکی »

 Breastfeeding provides several positive health benefits for the newborn child, yet breastfeeding rates remain low in the United States (US). Theory-based approaches have the potential to improve breastfeeding promotion interventions. Hence, the study examined the correlates of intention to breastfeed among US pregnant women based on the multi-theory model (MTM) of health behavior change.

 Using a cross-sectional design, a 36-item online survey was administered to a nationally representative sample of 315 pregnant women in the US. The instrument was psychometrically validated for face, content, and construct validity by a panel of six experts over two rounds. Further, construct validation was done by confirmatory factor analysis (CFA). Hierarchical regression modeling was employed to explain the intention to start breastfeeding and sustain exclusive breastfeeding for up to six months and with complementary foods for up to 24 months.

 Internal consistency using Cronbach’s alpha was found to be acceptable. It was found that behavioral confidence and changes in the physical environment positively affected the initiation of breastfeeding (P<0.01; adjusted R2=0.478). All three constructs of MTM namely practice for change, emotional transformation, and changes in the social environment were significant predictors for the sustenance of breastfeeding at six months (P<0.01; adjusted R2=0.591) and at 24 months (P<0.01; adjusted R2=0.347).

 Based on the findings of this study it is essential for educators and healthcare providers to design MTM-based interventions to promote breastfeeding among pregnant women in the US.

 A maternal near-miss (MNM) case is defined as “a woman who nearly died but survived from life-threatening pregnancy or childbirth complication”. This study was conducted on health care providers and near-miss mothers (NMMs) with the aim of discovering the unmet needs of Iranian NMM.

 In this qualitative study 37 participants of key informants, health providers, NMMs and their husbands were selected using purposive sampling. Semi-structured in-depth interviews were conducted for data collection until data saturation was achieved. Data were analyzed using Graneheim and Lundman conventional content analysis.

 The analysis revealed the core category of “the need for comprehensive support”. Eight categories included “psychological”, “fertility”, “information”, “improvement the quality of care”, “sociocultural”, “financial”, “breastfeeding” and “nutritional” needs emerging from 18 sub-categories, were formed from 2112 codes.

 Many of the real needs of NMM have been ignored. Maternal health policymakers should provide standard guidelines based on the needs discovered in this study to support the NMMs’ unmet needs.

 The COVID-19 pandemic has profoundly affected healthcare systems worldwide, with significant collateral damage to vulnerable populations, including the perinatal population. This study sought to compare pregnancy-related complications before and during the COVID-19 pandemic in Iran.

 This retrospective data analysis was performed from February 20 to August 20, 2019 (prior to the onset of the COVID-19 pandemic) and from February 20 to August 20, 2020 (during the pandemic), encompassing the initial wave of the pandemic and the subsequent lockdown. To collect data, we utilized the medical records of 168,358 women obtained from the Iranian Maternal and Neonatal Network, which is a comprehensive electronic health record database management system specifically designed to store information pertaining to maternal and neonatal health.

 A total of 168,358 medical records were analyzed, with 87388 (51.9%) and 80970 (48.1%) before and during the pandemic, respectively. The occurrence of pregnancy complications was found to be significantly more frequent during the pandemic compared to the pre-pandemic period. Notably, there was a higher likelihood of experiencing preeclampsia (odds ratio [OR]=1.14, 95% confidence interval [CI]: 1.07‒1.22, P=0.0001) and gestational diabetes (OR=1.14, 95% CI: 1.09‒1.19, P=0.0001) during the pandemic. Furthermore, cesarean section (CS) became more prevalent during the pandemic in comparison to vaginal delivery (OR=1.19, 95% CI: 1.17‒-1.22, P=0.0001).

 Our findings demonstrated a significant association between the COVID-19 pandemic and an escalation in adverse pregnancy outcomes, notably preeclampsia, gestational diabetes, and CS deliveries. However, further research is warranted to gain a richer understanding of the intricate interplay between the COVID-19 pandemic and pregnancy complications. This is particularly crucial in light of the evolving landscape of new coronavirus variants.

Cesarean section (CS) could be life-saving with medically indicated, but without it, both women and children could be at risk. The maximum rate for CS is 15%, but it tends to exceed globally.

We aimed to analyze the education level's role in the delivery of CS in Indonesia.

We used the 2017 Indonesia Demographic and Health Survey data. The study sampled 15,357 women who delivered in five last years. Besides delivery mode and education level, the study also used nine control variables: residence, age, marital, employment, parity, wealth, insurance, antenatal care, and birth type. The study employed a binary logistics regression.

The results show women with secondary education (16.5% CS) are 2.174 times (AOR 2.174; 95% CI 1.095-4.316), and higher education (33% CS) are 3.241 (AOR 3.241; 95% CI 1.624-6.469) times more likely to deliver by CS than no-school education (4.4% CS). There was no significant difference between primary (9.1%) and no-education women. Apart from education, primiparous women, age 34-34 yr, attending antenatal care ≥4 times, non-poorest, having insurance, living in the city, and being unemployed also related to higher risk of CS.

Exceeded CS in Indonesia occurs mostly in higher education women. Higher education women were more likely to access more information and technology, therefore health promotion on healthy normal birth on social media or m-Health (mobile device-based health promotion) and involving health authorities at every level were suitable to reduce the overuse of the CS.

 Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes.

 This systematic review aimed to assess the relationship between ART and maternal outcomes.

 In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies.

 A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally.

 In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.

Although maternal health in India has generally improved over the past two decades, the current Maternal Mortality Rate (MMR) implies that India’s MMR is approximately 2.4 times higher than the set target in MDG-5. The study fills the gap by looking at women from the rural and urban areas with varying demographic and other socioeconomic attributes to find out their effect on Maternal and Child Health (MCH) service utilization in Maharashtra. Using data from the District Level Household Survey 2007-08, study attempt to investigate the rural-urban differences in maternal health care service utilization in Maharashtra, India. This study use data from District Level Household Survey –conducted in 2007-08. The analysis carried out among ever-married women aged 15-49 years were interview from each districts of Maharashtra. Bivariate method used to fulfill the above objective. The result presented in the study shows that there is a huge gap in the utilization of maternal health services in the urban and rural areas of Maharashtra. Women’s education through the media is more effective in the urban areas than in the rural areas, and wealth remains an issue particularly in the rural areas.  A sustained and focused Information Education and Communication campaign to improve the awareness amongst the community on MCH will help in improving the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas of Maharashtra, India

The investigation of Maternal Near‑Miss (MNM) risk factors is important for the global reduction of maternal mortality. This study aimed to identify the determinants of MNM among pregnant women in northeastern Iran.

A prospective case‑control study was conducted on 250 women referred to the maternity ward of Nohom‑e‑Dey hospital in Torbat‑e Heydarieh, Iran, from June 2018 to May 2020. Applying the criteria of the World Health Organization tool, near‑miss mothers were taken as cases, and mothers with normal obstetric outcomes were selected as controls with convenience sampling. Logistic regression models using Stata version 14.0 and odds ratios (95% confidence intervals) were reported.

A total of 123 MNM cases and 127 controls were included in the study. The multiple logistic regression represented that having had previous abortion, living in rural or urban areas, whether the mother went through C/S or vaginal delivery and level of prenatal education were associated with MNM. Besides, having experienced chronic medical diseases during pregnancy had the strongest association with MNM, and next were complications during childbirth and neonatal outcomes which were associated with MNM, although in terms of statistical association, only the first two mentioned factors were statistically significant.

Determinants of MNM could be experiencing chronic medical disorders during maternal complications. Health providers need to carefully manage past medical history and adverse perinatal outcomes, especially in pregnant women who live in rural areas. Encouraging mothers to attend pregnancy training classes is effective in reducing MNM.

The COVID-19 pandemic has wrought significant repercussions on lives worldwide. Pregnancy, a period marked by profound physiological changes, renders women susceptible to fluctuations in various biological parameters. The study aimed to fill this void by examining the levels of inflammatory markers, as well as liver and renal function tests, in pregnant women suffering from COVID-19.

This study was conducted to investigate inflammatory markers such as C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), white blood cell (WBC), as well as liver function tests (LFT) and renal function tests (RFT) in pregnant women afflicted with COVID-19. We enrolled 52 COVID-19-positive women (cases) alongside 48 COVID-negative women (controls) who underwent delivery at Dr. D. Y. Patil Hospital and Research Institute in Kolhapur, India. All participants underwent COVID-19 testing via reverse transcription polymerase chain reaction (RT-PCR) methodology.

The findings revealed that a majority of cases exhibited elevated WBC counts compared to controls (78.8% versus 27.1%), with D-dimer levels higher in 61.5% of cases versus 12.5% of controls. LFT and RFT abnormalities were observed in 51.9% of cases versus 20.8% of controls. Moreover, LDH and CRP levels were elevated in 71.2% and 90.4% of cases, respectively, in contrast to 16.7% and 10.4% of controls, respectively. Statistical analysis underscored a significant association between deranged laboratory parameters and COVID-19 positivity.

The study underscores the potential exacerbation of inflammatory responses to COVID-19 among pregnant women with preexisting chronic conditions, which may precipitate liver damage. Thus, prioritizing inflammation and liver health management in the treatment regimen for pregnant women with COVID-19, especially those with chronic comorbidities, emerges as imperative.

The Coronavirus disease-2019 (COVID-19) pandemic may profoundly impact on maternal and neonatal health worldwide. However, a few studies have investigated this topic.

This study aimed to investigate the impact of the COVID-19 pandemic on maternal and neonatal health.

This retrospective cohort study analyzed collected data from March to May 2020, and the same period in 2019, involving 5711 pregnant women referring to comprehensive healthcare centers in Isfahan province health facilities, Iran. Pregnant women and neonates were followed-up until 40 days after the delivery. Demographic characteristics, pre-pregnancy, antenatal care, and post-pregnancy variables were collected.

A total of 5711 pregnant women were studied, of whom 3477 (61%) were referred in 2019 (before the COVID-19 pandemic as nonexposed) and 2234 (39%) during the COVID-19 pandemic (as exposed group) in 2020. For those living in cities with a population of > 20,000, the number of antenatal care were lower about 2% compared to nonexposed group (p = 0.01). The number of mothers with a history of the underlying disease who referred to a comprehensive healthcare center during the COVID-19 pandemic (47%) was lower about 6% compared to nonexposed group (41%) (p < 0.001). During the COVID-19 pandemic, the prevalence of hypertension and gestational diabetes mellitus was 5% (n = 109) and 20% (n = 445), which were higher about 2% and 4%, respectively, compared to nonexposed group. The COVID-19 pandemic had no other significant effect on mothers' and neonates' other characteristics than nonexposed group.

The COVID-19 pandemic imposes no significant effect on mothers' and neonates' health compared to nonexposed group.

Due to the great importance of health literacy during pregnancy and its direct impact on the health of the mother and her child, this study aimed to evaluate the health literacy of pregnant women in a semi-urban area, Kuhdasht county, located in western Iran and to investigate its associated factors.

This is a cross-sectional study conducted on 300 pregnant mothers referred to a governmental prenatal care center in Kuhdasht county, Iran, in 2019. Data collection tools included a demographic form and the Persian version of the Maternal Health Literacy and Pregnancy Outcome Questionnaire (MHLAPQ). Collected data were then analyzed through SPSS software version 22 using the Pearson correlation test and Multiple linear regression analysis.

The mean score for the maternal health literacy dimension was 58.38±8.87 (out of 70), and it was 47.20±6.22 (out of 60) for the pregnancy outcome dimension. This indicates that the current pregnant women had adequate health literacy and pregnancy outcome. Further, there was a significant relationship between maternal health literacy and pregnancy outcome (r=0.58, P=0.001). Moreover, multiple linear regression results indicated that age, occupation, education, ferrous sulfate uptake, history of abortion, frequency of pregnancy, the trimester for prenatal care initiation, and birth weight of infants could not significantly predict health literacy in women (P>0.05).

The health literacy level of pregnant women in Kuhdasht county, Iran, is adequate but not high. Accordingly, it is necessary to further consider maternal health literacy in socio-economic and health planning due to its effect on the health of the child and mother.

This study aims to understand the factors that support occupational engagement of working mothers who are breast cancer survivors based on their experiences. These factors are vital for occupational therapists and other health professionals in the promotion of their health and well-being.

Using phenomenology, through in-depth interviews, this study explored experiences of mothers who survived breast cancer and have returned to work. Ten participants from ICanServe Foundation in Cebu, Philippines participated in one-on-one interviews.

Thematic analysis identified three themes: (1) Baggage and uncertainties of life with cancer, (2) Lessons on grit, and (3) Beating the odds through occupational adaptation. Findings suggest that mothers face obstacles both in the home and in the workplace.

Obstacles identified include mother-child role reversals, physical and cognitive changes, stigma and discrimination in the workplace, and fear of death and uncertainty, which indicate the need for support. Findings based on their experiences can help inform collaborative efforts from occupational therapists and professionals across disciplines to support breast cancer survivors such as maternal support groups, informing employment or workplace policies, and community opportunities.

Utilizing maternity waiting homes (MWHs) is a strategy to improve access to skilled obstetric care in rural Zambia. However, out-of-pocket (OOP) expenses remain a barrier for many women. We assessed deliveryrelated expenditure for women who used MWHs and those who did not who delivered at a rural health facility.

During the endline of an impact evaluation for an MWH intervention, household surveys (n = 826) were conducted with women who delivered a baby in the previous 13 months at a rural health facility and lived >10 km from a health facility in seven districts of rural Zambia. We captured the amount women reported spending on delivery. We compared OOP spending between women who used MWHs and those who did not. Amounts were converted from Zambian kwacha (ZMW) to US dollar (USD).

After controlling for confounders, there was no significant difference in delivery-related expenditure between women who used MWHs (US$40.01) and those who did not (US$36.66) (P = .06). Both groups reported baby clothes as the largest expenditure. MWH users reported spending slightly more on accommodation compared to those did not use MWHs, but this difference represents only a fraction of total costs associated with delivery.

Findings suggest that for women coming from far away, utilizing MWHs while awaiting delivery is not costlier overall than for women who deliver at a health facility but do not utilize a MWH.

Maternal knowledge is one of the indirect causes of maternal mortality in Indonesia. Maternal knowledge that mothers must possess includes knowledge about pregnancy, childbirth, and postpartum. Maternal knowledge should be provided during pregnancy. The aim of this study is to identify maternal knowledge in postpartum women who have a history of the frequency of pregnancy visits according to the minimum standard.

A descriptive quantitative design was performed by assessing maternal knowledge to postpartum mothers using an online questionnaire which conducted in 2020 at two public health centers of Surabaya, Indonesia. A sample of this research involved postpartum mothers who completed inclusion criteria, namely physiological postpartum mothers and had regular pregnancy at least 6 antenatal care (ANC) visits. In contrast, the exclusion criteria were postpartum mothers who were not included in the target areas of research. It uses random sampling techniques and performs an analysis using descriptive statistics.

Three research questions showed a large percentage of wrong answers, namely preparation to face complications (64%), contraceptive methods in breastfeeding mothers (50%) and the first time using contraception during childbirth (42%). Meanwhile, all the correct results (100%) are exclusive breastfeeding and supplementary feeding for babies.

Completing minimal standards of ANC visits cannot ensure adequate maternal knowledge, particularly crucial health information that influences maternal and neonatal health status.

Many pregnant women experience discomforts during their pregnancy that are not severe, but may reduce their well-being. These minor discomforts such as vomiting, heartburn, and leg cramps can be troublesome and may affect the women’s quality of life.

This research aims to determine the relationship between socio-demographic variables and minor discomforts in pregnancy.
  

This is an analytical cross-sectional study. Participants were 202 pregnant women in Birnin-Kebbi, Kebbi State, Nigeria. Systematic sampling was used for their recruitment. A self-report questionnaire was used for surveying socio-demographic characteristics and assessing the pattern and severity of minor discomforts. Chi-square test and ordinal logistic regression analysis were used for analyzing the collected data at 95% Confidence Interval (CI).

The age range of most women (42.1%) was 20-24 years. Most of them had their 2-4th pregnancy (37.6%) and a tertiary education (62.4%). There was a significant relationship between the variables of age, number of pregnancies and occupation and the occurrence of minor discomforts in pregnancy (P< 0.05). There was a significant relationship between the occupation and duration of minor discomforts (P < 0.05), and between educational levels and mode of treatment for minor discomforts (P=0.05). The Odds Ratios (OR) in ordinal logistic regression models indicated that with one unit change in age, number of pregnancies and occupation, the duration of minor discomforts was 1.05 (95% CI;  0.457-1.722, P=0.0001), 1.07 (95% CI; 0.316-2.021, P=0.0001) and 1.07 (95% CI; 0.662-2.063, P=0.0001) times more likely to change, respectively.

Healthcare professionals should consider the factors of age, number of pregnancies, and occupation when providing care to pregnant women. More research to address the minor discomforts in pregnancy is recommended using different methods.

Social determinants of health (SDoH) affect health during pregnancy. Previous studies have looked at the association between individual SDoH among pregnant women and neonatal outcome. In this study we looked at the correlation between a cumulative SDoH score and birth weight.

Information on the social determinants of health (SDoH) among pregnant women was collected by using the electronic questionnaire. By using the color-coded wheel, generated by the electronic record system, we developed a SDoH score, ranging from 0-20. A SDoH color of green indicated no concern, while red indicated severe concern. The corresponding birth weight for the maternal SDoH score was noted after delivery. The data was analyzed using the MS excel program.

A total of 130 women out of 159 (81%) completed the questionnaire during the study period of eight weeks. The mean SDoH score was 3.12 with standard deviation of 2.3 (range 0-13). The mean birth weight was 3048 grams with standard deviation of 563 grams (range 860-4215 grams). A weak negative correlation (r = - 0.14, R² = 0.0217) was noted between the birth weight and SDoH score.

Maternal social determinants of health affect fetal growth. Further studies are needed to validate our findings.

Pregnant women are at higher risk of severe COVID-19 than the general population. Furthermore, COVID-19 increases the preterm and cesarean rates due to maternal and fetal complications. Owing to the adverse effects of the COVID-19 on pregnant women, in-person prenatal visits face challenges. Thus, alternative solutions that reduce the number of visits while preserving maternal and fetal care quality should be considered. Digital health is one of the potential solutions. Obstetricians and gynecologists, and other clinical experts should cooperate to define digital tools’ requirements and standards for prenatal care. Moreover, governments and healthcare insurances should facilitate the coverage of provided services’ costs by digital health tools, especially in developing countries.