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Primary Health Care Research &... Feb 2023Appropriate prenatal care (PNC) is essential for improving maternal and infant health; nevertheless, millions of women in low- and middle-income countries (LMICs) do not... (Review)
Review
BACKGROUND
Appropriate prenatal care (PNC) is essential for improving maternal and infant health; nevertheless, millions of women in low- and middle-income countries (LMICs) do not receive it properly. The objective of this review is to identify and summarize the qualitative studies that report on health system-related barriers in PNC management in LMICs.
METHODS
This systematic review was conducted in 2022. A range of electronic databases including PubMed, Web of Knowledge, CINHAL, SCOPUS, Embase, and Science Direct were searched for qualitative studies conducted in LMICs. The reference lists of eligible studies also were hand searched. The studies that reported health system-related barrier of PNC management from the perspectives of PNC stakeholders were considered for inclusion. Study quality assessment was performed applying the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed.
RESULTS
Of the 32 included studies, 25 (78%) were published either in or after 2013. The total population sample included 1677 participants including 629 pregnant women, 122 mothers, 240 healthcare providers, 54 key informed, 164 women of childbearing age, 380 community members, and 88 participants from other groups (such as male partners and relatives). Of 32 studies meeting inclusion criteria, four major themes emerged: (1) healthcare provider-related issues; (2) service delivery issues; (3) inaccessible PNC; and (4) poor PNC infrastructure.
CONCLUSION
This systematic review provided essential findings regarding PNC barriers in LMICs to help inform the development of effective PNC strategies and public policy programs.
Topics: Infant; Female; Pregnancy; Male; Humans; Prenatal Care; Developing Countries; Pregnant Women; Qualitative Research
PubMed: 36843095
DOI: 10.1017/S1463423622000706 -
Midwifery Mar 2021Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and... (Review)
Review
OBJECTIVE
Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and children. However, childbirth is a life event that parents may experience differently. First-time fathers' experiences have been barely studied and may differ from those of fathers who have already had a child. In order to adapt support and care during childbirth to the needs of first-time fathers, a deeper insight must be gained into their experiences and needs during childbirth.
DESIGN
A systematic review of qualitative studies was conducted using PubMed, Embase and CINAHL as well as the snowball method. Quality appraisal was performed and evaluated using the Critical Appraisal Skills Programme. A thematic best evidence synthesis was performed.
FINDINGS
Of 821 articles, eight qualitative studies and the qualitative data of one mixed methods study were included. amongst other feelings, fathers experience a lack of knowledge and a need to be better prepared. First-time fathers want to be more involved and need guidance, information and honest answers to help them fulfil a supportive role. Fathers disregard their own needs to focus on the needs of the mother. Meeting the baby for the first time changes the focus from the mother to the child, and fathers need time and privacy for this special moment.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
To adapt support and care during childbirth to the needs of first-time fathers, professionals must be aware of their needs. Professionals must realise the significant influence of their professional behaviour on first-time fathers' experiences. Care for first-time fathers should be formalised. Follow-up research must be conducted on integrating the preparation of first-time fathers into prenatal care. Education and training of professionals must be improved.
Topics: Child; Delivery, Obstetric; Fathers; Female; Humans; Male; Mothers; Parturition; Pregnancy; Prenatal Care; Qualitative Research
PubMed: 33444743
DOI: 10.1016/j.midw.2020.102921 -
Journal of Immigrant and Minority Health Feb 2015Female migration represents a major public health challenge faced today because its heterogeneity and gender issues placing immigrant women among the most vulnerable and...
Female migration represents a major public health challenge faced today because its heterogeneity and gender issues placing immigrant women among the most vulnerable and at-risk group. To identify and analyze studies dealing with immigrant women's perspectives with prenatal and postpartum health care. A systematic literature review was conducted to assess studies published between 2000 and 2010 using Cumulative Index to Nursing and Allied Health Literature, EMBASE, PubMed and Cochrane Database of Systematic Reviews. The studies explored the relation between socio-demographic characteristics of immigrant women participants and its impact on the main factors identified as influencing prenatal and postpartum care, characterizing the manifested knowledge and behaviors expressed and describing the women's experience with health care services and the incidence of postpartum depression symptoms. The less favorable socio-economic status of migrant women participants seems to have been influential in the quality of health service in prenatal and postpartum periods. The language barrier was the main negative factor interfering with communication between women and health professionals, followed by health care professionals' lack of cultural sensitivity, leading to women's reluctance in using health services.
Topics: Emigrants and Immigrants; Female; Humans; Postnatal Care; Pregnancy; Prenatal Care; Women
PubMed: 24052479
DOI: 10.1007/s10903-013-9915-4 -
International Journal of Nursing Studies Aug 2021The World Health Organization has emphasized the critical role of prenatal care in achieving the Millennium Development Goals to reduce child and maternal mortality. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The World Health Organization has emphasized the critical role of prenatal care in achieving the Millennium Development Goals to reduce child and maternal mortality. The CenteringPregnancy program is a widely recognized model of prenatal care. Several countries have attempted to implement the program in prenatal care practice; however, its effectiveness on maternal and birth outcomes has not been systematically evaluated and analyzed.
OBJECTIVES
To determine the effect of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depression.
DESIGN
This study evaluated and analyzed randomized controlled trials by comparing the CenteringPregnancy program with o0bstetric led prenatal care. Maternal and birth outcomes of interest included low birthweight, preterm birth, and postpartum depressive symptoms.
DATA SOURCES
Embase, PubMed, CINAHL, Web of Science, and The Cochrane Library were utilized in this systematic review. Additionally, a supplemental Google Scholar search was performed to capture all relevant articles.
METHODS
All data were extracted independently by two trained researchers, who evaluated the quality of the study by examining the risk of bias. The biases of selection, allocation, measurement, reporting, and loss of follow-up were assessed using the Cochrane risk of bias for these included randomized controlled trials. A meta-analysis of eligible randomized controlled trials was conducted using Review Manager. Heterogeneity of studies was assessed using the I statistic.
RESULTS
Out of 591 articles reviewed, seven randomized controlled trials were included in this study. Findings showed that the CenteringPregnancy program was not associated with lower rates of preterm birth (0.88 [0.71-1.07], p = 0.20, I = 0%), low birth weight (0.87 [0.68-1.12], p =0.29, I = 0%), or 12-month postpartum depressive symptoms (0.07 [-0.12-0.26], p =0.46, I = 69%). However, the CenteringPregnancy program was associated with reduced rates of 6-month postpartum depressive symptoms (0.49 [0.40-0.59], p < 0.01, I = 40%).
CONCLUSIONS
Existing evidence suggests that the CenteringPregnancy program and obstetric led care have similar effects on reducing the rates of preterm birth and low birth weight but different effects on postpartum depressive symptoms. More studies are needed to examine the effect of the CenteringPregnancy program on the improvement of postpartum depressive symptoms. PROSPERO Registration number: CRD42020171831. Tweetable abstract: We conducted a systematic review and meta-analysis of randomized controlled trials to determine the effects of the CenteringPregnancy program on improving maternal and birth outcomes, including low birth weight, preterm birth, and postpartum depressive symptoms. Seven randomized controlled trials were included in this study. The findings suggested that the CenteringPregnancy program and obstetric led care had similar effects in reducing the rates of preterm birth and low birth weight. More studies are needed to examine the effect of the CenteringPregnancy program on the improvement of postpartum depressive symptoms.
Topics: Child; Female; Humans; Infant, Newborn; Parturition; Postpartum Period; Pregnancy; Premature Birth; Prenatal Care; Randomized Controlled Trials as Topic
PubMed: 34098451
DOI: 10.1016/j.ijnurstu.2021.103981 -
American Journal of Preventive Medicine Aug 2016The role of paternal alcohol consumption on fetal and infant health outcomes, and on social facilitation of maternal alcohol consumption during pregnancy, has not been... (Review)
Review
CONTEXT
The role of paternal alcohol consumption on fetal and infant health outcomes, and on social facilitation of maternal alcohol consumption during pregnancy, has not been well established. This review identifies the range of impacts of paternal preconception alcohol consumption and alcohol consumption during partner's pregnancy, on maternal consumption, and fetal and infant health outcomes.
EVIDENCE ACQUISITION
The review accessed articles from the following databases: Scopus, Science Direct, Wiley Online, MEDLINE, ProQuest Central, PsycINFO, and Web of Science. The review included medium- and large-scale studies that provided separate paternal alcohol results, had a non-respondent rate ≤20%, an attrition rate ≤10% per year of data collection up to 30%, and were published between 1990 and 2014. The review included both randomly and non-randomly selected studies, and both case-control and non-case-control studies with notation on risk of bias.
EVIDENCE SYNTHESIS
Independent extraction and assessment of articles by two authors was conducted using predefined data fields, including study quality indicators, during 2015. Studies included in the review (11 studies, N=41,062) provide evidence that paternal alcohol consumption during preconception or during pregnancy has an impact on maternal health and alcohol consumption during pregnancy, fetal outcomes, and infant health outcomes.
CONCLUSIONS
Attention to paternal preconception health care related to alcohol consumption is an important future focus in policies dealing with reproductive, prenatal, fetal, and infant health.
Topics: Alcohol Drinking; Fathers; Female; Fetal Alcohol Spectrum Disorders; Humans; Maternal Health; Pregnancy; Pregnancy Outcome; Prenatal Care
PubMed: 27017419
DOI: 10.1016/j.amepre.2016.02.009 -
Effect of antenatal care on low birth weight: a systematic review and meta-analysis in Africa, 2022.Frontiers in Public Health 2023Risk identification, as well as the prevention and management of diseases associated with pregnancy or other conditions that may occur concurrently, is the essential... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Risk identification, as well as the prevention and management of diseases associated with pregnancy or other conditions that may occur concurrently, is the essential component of ANC.
METHOD
The observational follow-up and cross-sectional studies on the effect of antenatal care on low birth weight in Africa were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five computerized bibliographic databases: Google Scholar, PubMed, Scopus, Cochrane Library, and Hinari Direct were searched for published studies written in English till May 2022. The risk of bias assessment tools developed by the Joanna Briggs Institute for cross-sectional and observational follow-up research was used, and the caliber of each included study was assessed. Seven papers were included, with a total of 66,690 children participating in the study.
RESULTS
Seven studies met the selection criteria. Prenatal care and low birth weight were linked in four of the seven studies included in the review. The pooled odd ratio for low birth weight in the random-effects model was 0.46 (95% CI: 0.39, 0.53). The pooled odds ratio for low birth weight was 0.21 (95% CI: 0.19, 0.22) and 0.21 (95% CI: 0.19, 0.22), respectively, among pregnant women who had no antenatal care follow-up and those who had antenatal care follow up.
CONCLUSION
Women who attended at least one antenatal care appointment were more likely than their counterparts to have a baby of normal weight. Interventions to reduce low birth weight in Africa should focus on providing adequate antenatal care and quality healthcare services to women with low socioeconomic status.
Topics: Infant, Newborn; Infant; Child; Pregnancy; Female; Humans; Prenatal Care; Cross-Sectional Studies; Infant, Low Birth Weight; Pregnant Women; Africa
PubMed: 37441651
DOI: 10.3389/fpubh.2023.1158809 -
Midwifery Jan 2022Positive prenatal attachment facilitates parental role adaptation and psychological adjustment during pregnancy, which is a significant predictor of postpartum... (Review)
Review
OBJECTIVE
Positive prenatal attachment facilitates parental role adaptation and psychological adjustment during pregnancy, which is a significant predictor of postpartum attachment. The objective of this systematic review was to examine the effect of psychoeducation interventions on prenatal attachment of pregnant women and their partners.
DESIGN
Systematic literature searches of randomized controlled trials (RCTs) were conducted from January 2000 to January 2021, using databases: CINAHL, Embase, Medline, PsycInfo, PubMed, Web of Science and Cochrane Central Register of Controlled Trial and through hand-searching. Studies were independently selected by two reviewers, who also assessed the methodological quality of the included studies using the Cochrane Risk of Bias Tool. Narrative synthesis was conducted due to the significant clinical and methodological heterogeneity.
SETTING/PARTICIPANTS
Fifteen studies met the eligibility criteria for this review, among which 11 studies focused on pregnant women and four studies on their partners.
FINDINGS
The psychoeducation interventions in the included studies showed consistent favorable effects on prenatal attachment. Nine out of the 11 included studies showed statistical significant effects on maternal fetal attachment. Three out of the four studies reported significant effects favoring paternal fetal attachment.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The preliminary evidence suggests that psychoeducation interventions have potential favorable effects on maternal fetal attachment and can enhance paternal fetal attachment. However, more studies are needed for investigating the effects of psychoeducation on paternal fetal attachment and for enhancing the validity of the evidence. Our review recommends that healthcare professionals to include psychoeducation as a part of their prenatal care for promoting prenatal attachment. Common characteristics of the interventions could act as references when designing psychoeducation programs for enhancing prenatal attachment.
Topics: Female; Humans; Parents; Pregnancy; Pregnant Women; Prenatal Care
PubMed: 34753018
DOI: 10.1016/j.midw.2021.103184 -
Midwifery Aug 2022The birth plan was introduced in the 1980s to facilitate communication between maternity care providers and women and increase agency for childbearing women in the face... (Review)
Review
BACKGROUND
The birth plan was introduced in the 1980s to facilitate communication between maternity care providers and women and increase agency for childbearing women in the face of medicalised birth. Forty years on, the birth plan is a heterogeneous document with uncertainty surrounding its purpose, process, and impact. The aim of this review was to synthesise the evidence and improve understanding of the purpose, process and impact of the birth plan on childbearing women's experiences and outcomes.
METHODS
This systematic review followed the PRISMA guidelines. A comprehensive search strategy was designed and applied to electronic databases CINAHL, MEDLINE, PsychINFO, Cochrane Library, Scopus, and ClinicalTrials.gov. Articles were appraised using the Crowe Critical Appraisal Tool and a five-step integrative approach to analysis followed.
FINDINGS
Eleven articles were identified, all quantitative in nature. It is clear that the general purpose of birth plans is communication, with decision making a key factor. Even though the processes of birth planning were varied, having a birth plan was associated with generally positive birth outcomes.
CONCLUSIONS
Despite the heterogeneity of birth plans, birth plans were associated with positive outcomes for childbearing women when developed in collaboration with care providers. The act of collaboratively creating a birth plan may improve obstetric outcomes, aid realistic expectations, and improve satisfaction and the sense of control.
Topics: Female; Humans; Maternal Health Services; Parturition; Pregnancy; Prenatal Care
PubMed: 35640358
DOI: 10.1016/j.midw.2022.103388 -
PloS One 2022In Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
In Ethiopia limited information is available regarding the prevalence and predictors of anemia in pregnancy. This systematic review and meta-analysis estimated the pooled prevalence of anemia among pregnant women in Ethiopia and also identified its predictors.
MATERIALS AND METHODS
The published primary studies were searched in the following electronic databases; PubMed/Medline, Google scholars, AJOL, and EMBASE. All primary studies published from 01/01/2010 to 30/05/2020 and written in English language were included without restriction on study setting and design. Critical appraisal of all available articles was done and extracted data was analyzed using STATA software version 14. The pooled prevalence of anemia was presented using a forest plot. The I2 statistical test for heterogeneity, and the Egger's and Begg's tests for publication bias were used. The relative risk was used to assess the association of predictor variables with anemia.
RESULT
After screening 274 articles, sixty studies were included in the analysis. The pooled prevalence of anemia among pregnant women was 26.4(95% CI: 23.1, 29.6). Sub-group analysis showed higher pooled prevalence from community-based studies than institutional-based studies. Factors that were protective against maternal anemia included urban residence, formal education and smaller family size. Short birth interval and not having antenatal care (ANC) are associated with a higher risk of maternal anemia. Women with low dietary diversity [RR: 2.61(95% CI, 1.85, 3.68)], mid-upper arm circumference (MUAC) less than 23 cm [RR: 2.35(95% CI, 1.53, 3.68)] and those not taking iron-folic acid [RR: 1.53(95% CI: 1.30, 1.81)] also had a higher risk of anemia.
CONCLUSION
Almost one in four pregnant women in Ethiopia had anemia. Being literate, living in urban areas with small family size and adequate birth spacing, as well as good dietary diversity are associated with a lower risk of anemia in pregnancy.
REGISTRATION NUMBER
(ID: CRD42020211054).
Topics: Anemia; Ethiopia; Female; Humans; Pregnancy; Pregnant Women; Prenatal Care; Prevalence
PubMed: 35895619
DOI: 10.1371/journal.pone.0267005 -
Asia-Pacific Journal of Public Health Jul 2017The rapid influx of married immigrant women from low-income Asian countries is a concern in South Korea, Japan, and Taiwan. In South Korea, 1 in 10 couples includes a... (Meta-Analysis)
Meta-Analysis Review
The rapid influx of married immigrant women from low-income Asian countries is a concern in South Korea, Japan, and Taiwan. In South Korea, 1 in 10 couples includes a Korean man and a migrant woman, increasing the need for prenatal and postnatal care interventions. Studies published in English or Korean after 2000 were retrieved from 8 databases and reviewed via a systematic review and meta-analysis of the effectiveness of prenatal and postnatal psychosocial and educational interventions in Korea. Of 3583 records, 10 studies (1 randomized controlled trial [RCT] and 9 non-RCTs) involving 408 married immigrant women fulfilled the inclusion criteria. A meta-analysis of the non-RCTs showed that prenatal and postnatal care interventions were effective in improving family support, knowledge regarding self-care management and infant rearing, and self-efficacy regarding self-care management and infant rearing. Subgroup analysis showed that interventions involving husbands and individualized care were most effective. This study illustrated the extent to which strategies are needed for developing prenatal and postnatal care interventions for married immigrant women. Further studies should explore other factors and identify the most important factor for improving the effectiveness of such interventions. Robust study designs published in peer-reviewed journals are required for examining the effectiveness of these interventions.
Topics: Emigrants and Immigrants; Female; Health Promotion; Humans; Infant, Newborn; Marital Status; Postnatal Care; Pregnancy; Prenatal Care; Program Evaluation; Randomized Controlled Trials as Topic; Republic of Korea
PubMed: 28719791
DOI: 10.1177/1010539517717364