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International Urogynecology Journal Nov 2015Several studies have described the evidence of prenatal physiotherapy for one symptom, but none has made an overview. We provided a systematic review on the... (Review)
Review
Several studies have described the evidence of prenatal physiotherapy for one symptom, but none has made an overview. We provided a systematic review on the effectiveness of prenatal physiotherapy. A full search was conducted in three electronic databases (Embase, PubMed/MEDLINE and PEDro), selecting randomized controlled trials concerning prenatal physiotherapy. Methodological quality was assessed using the PEDro scale. We identified 1,249 studies and after exclusions 54 studies were included concerning the evidence of prenatal physiotherapy. The majority of studies indicated a preventative effect for low back pain/pelvic girdle pain, weight gain, incontinence, and perineal massage. For leg edema, fear, and prenatal depression, the efficacy was only based on one study per symptom. No preventative effect was found for gestational diabetes, while literature concerning gestational hypertensive disorders was inconclusive. Regarding the treatment of low back pain/pelvic girdle pain and weight gain, most therapies reduced pain and weight respectively. Evidence regarding exercises for diabetes was contradictory and only minimally researched for incontinence. Foot massage and stockings reduced leg edema and leg symptoms respectively. Concerning gestational hypertensive disorders, perineal pain, fear, and prenatal depression no treatment studies were performed. The majority of studies indicated that prenatal physiotherapy played a preventative role for low back pain/pelvic girdle pain, weight gain, incontinence, and pelvic pain. Evidence for the remaining symptoms was inclusive or only minimally investigated. Regarding treatment, most studies indicated a reduction of low back pain/pelvic girdle pain, weight gain, incontinence, and the symptoms of leg edema.
Topics: Female; Humans; Low Back Pain; Pelvic Floor Disorders; Pelvic Girdle Pain; Physical Therapy Modalities; Pregnancy; Pregnancy Complications; Prenatal Care
PubMed: 25822028
DOI: 10.1007/s00192-015-2684-y -
Curationis Apr 2016Herbal and homeopathic remedies have been used to assist with child bearing and pregnancy for centuries. Allopathic ('Western') medicine is traditionally avoided during... (Review)
Review
BACKGROUND
Herbal and homeopathic remedies have been used to assist with child bearing and pregnancy for centuries. Allopathic ('Western') medicine is traditionally avoided during pregnancy because of limited drug trials and the suspected teratogenic effects of these medications. This has led to an increase in the use of herbal and homeopathic remedies, asthey are viewed to have no teratogenic effect on the developing foetus. Health providers are faced with questions from their clients regarding the safety of these remedies, but much of the evidence about these herbal and homeopathic remedies is anecdotal and few remedies havebeen tested scientifically.
OBJECTIVES
By conducting a systematic review, the primary objective was to evaluate maternal and neonatal outcomes of ingested herbal and homeopathic remedies during pregnancy.
METHOD
A systematic review was conducted to synthesise all the evidence with the purpose of evaluating the safety of herbal and homeopathic remedies based on adverse maternal and neonatal outcomes. Only randomised and quasi-randomised controlled trials that met allinclusion criteria were included in the review.
RESULTS
The ingestion of ginger for nausea and vomiting during pregnancy was shown to have no harmful maternal or neonatal effects. Ingestion of castor oil for induction of labour showed a tendency towards an increase in the incidence of caesarean section and meconiumstained liquor, warranting further research into its safety issues.
CONCLUSION
Larger randomised controlled trials need to be conducted, especially in South Africa, to establish the safety and efficacy of commonly-used remedies.
Topics: Female; Homeopathy; Humans; Patient Safety; Phytotherapy; Plant Preparations; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prenatal Care
PubMed: 27246791
DOI: 10.4102/curationis.v39i1.1514 -
Neurourology and Urodynamics Jan 2024To evaluate the effectiveness of aerobic and/or resistance group exercise programs associated with pelvic floor muscle training (PFMT) during prenatal care for the... (Meta-Analysis)
Meta-Analysis Review
Effectiveness of group aerobic and/or resistance exercise programs associated with pelvic floor muscle training during prenatal care for the prevention and treatment of urinary incontinence: A systematic review.
AIM
To evaluate the effectiveness of aerobic and/or resistance group exercise programs associated with pelvic floor muscle training (PFMT) during prenatal care for the prevention and treatment of urinary incontinence (UI) using the best level of evidence.
METHODS
A search was carried out in the MEDLINE/PubMed, LILACS, PEDro, CENTRAL, and SCOPUS databases, without restrictions. The terms "urinary incontinence" and "pregnant woman" were used. Randomized and quasi-randomized clinical trials were included using aerobic and/or resistance exercise programs plus PFMT as an intervention compared to usual care. The Cochrane tool (RoB 2.0) and GRADE were used to assess risk of bias and certainty of evidence, respectively. Quantitative analysis was assessed by meta-analyses.
RESULTS
Five publications were included. There was a reduction in the reports of UI postintervention at 16 weeks (RR: 0.83; 95% CI: 0.74-0.93, one study, 762 women, random effects: p = 0.002) and after 3 months (RR: 0.76; 95% CI: 0.60-0.95, one study, 722 women, random effects: p = 0.02), based on moderate certainty of evidence and improvement in UI-specific quality of life (MD: -2.42; 95% CI: -3.32 to -1.52, one study, 151 women, random effects: p < 0.00001), based on low quality of evidence. Other results showed no difference between the postintervention groups, with low and very low evidence.
CONCLUSION
There is moderate evidence that the aerobic and/or resistance exercise program associated with PFMT compared to usual care can reduce postintervention UI, as well as 3 months postintervention, and that it can improve UI-specific quality of life, but with low-evidence certainty.
Topics: Female; Humans; Pregnancy; Exercise Therapy; Pelvic Floor; Prenatal Care; Quality of Life; Resistance Training; Urinary Incontinence
PubMed: 37942825
DOI: 10.1002/nau.25309 -
MCN. the American Journal of Maternal... 2015The purpose of this systematic review of the literature is to highlight published studies of perinatal substance use disorder that address relational aspects of various... (Review)
Review
OBJECTIVE
The purpose of this systematic review of the literature is to highlight published studies of perinatal substance use disorder that address relational aspects of various care delivery models to identify opportunities for future studies in this area.
METHOD
Quantitative, qualitative, and mixed-methods studies that included relational variables, such as healthcare provider engagement with pregnant women and facilitation of maternal-infant bonding, were identified using PubMed, Scopus, and EBSCO databases. Key words included neonatal abstinence syndrome, drug, opioid, substance, dependence, and pregnancy.
RESULTS
Six studies included in this review identified statistically and/or clinically significant positive maternal and neonatal outcomes thought to be linked to engagement in antenatal care and development of caring relationships with healthcare providers.
IMPLICATIONS/CONCLUSION
Comprehensive, integrated multidisciplinary services for pregnant women with substance use disorder aimed at harm reduction are showing positive results. Evidence exists that pregnant women's engagement with comprehensive services facilitated by caring relationships with healthcare providers may improve perinatal outcomes. Gaps in the literature remain; studies have yet to identify the relative contribution of multiple risk factors to adverse outcomes as well as program components most likely to improve outcomes.
Topics: Female; Humans; Infant, Newborn; Maternal-Child Health Services; Pregnancy; Pregnancy Complications; Prenatal Care; Substance-Related Disorders
PubMed: 26295509
DOI: 10.1097/NMC.0000000000000160 -
Reproductive Health Aug 2022In developing countries, including Ethiopia the risk of neonatal death can be easily prevented and avoided by implementing essential newborn care with simple, low cost,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In developing countries, including Ethiopia the risk of neonatal death can be easily prevented and avoided by implementing essential newborn care with simple, low cost, and a short period time immediately after delivery. However, the problem is still persisting due to lack of adequate maternal and newborn care practice. Hence, this review aimed to estimate the pooled prevalence of women's knowledge and practice of essential newborn care and its associated factors in Ethiopia using systematic review and meta-analysis.
METHOD
An intensive literature search was performed from PubMed, Google Scholar, EMBASE, HINARI, Scopus, and Web of Sciences from April 1-30, 2021. Data were extracted by using a pre-tested and standardized data extraction format. The data were analyzed by using STATA 14 statistical software. I tests assessed heterogeneity across the included studies. A random-effect model was used to estimate the pooled prevalence of knowledge and practice of essential newborn care.
RESULTS
From 1275 identified studies, 25 articles were included. The national pooled prevalence of essential newborn care knowledge and practice among women was 55.05% and 41.49% respectively. Secondary education (AOR = 2.75, 95% CI 1.62, 4.66), multiparity (AOR = 2.14, 95% CI 1.41, 3.26), antenatal care (AOR = 2.94; 95% CI 2.03, 4.26), and postnatal follow-up (AOR = 1.64, 95% CI 1.20, 2.23) were significantly associated with knowledge level whereas; primary education (AOR = 7.08, 95% CI 4.79, 10.47), urban residency (AOR = 2.22, 95% CI 1.65, 3.00), attending monthly meetings (AOR = 2.07, 95% CI 1.64, 2.62), antenatal care (AOR = 2.89, 95% CI 1.97, 4.26), advised during delivery (AOR = 2.54, 95% CI 1.80, 3.59), postnatal follow-up (AOR = 7.08, 95% CI 4.79, 10.47) and knowledge (AOR = 2.93; 95% CI 1.81, 4.75) were statistically significant with essential newborn practice.
CONCLUSIONS
The current systematic review and meta-analysis findings reported that the level of knowledge and practice of essential newborn care among Ethiopian women was low. Therefore, improvement of essential newborn through the provision of community-based awareness creation forum, improving antenatal and postnatal care follow up, education on essential newborn care to all pregnant and postnatal women are very important. Trial registration Prospero registration: CRD 42021251521.
Topics: Educational Status; Ethiopia; Female; Humans; Infant, Newborn; Pregnancy; Prenatal Care; Prevalence
PubMed: 35927762
DOI: 10.1186/s12978-022-01480-0 -
The Cochrane Database of Systematic... Dec 2015Prenatal care is recommended during pregnancy as a method to improve neonatal and maternal outcomes. Improving the use of prenatal care is important, particularly for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prenatal care is recommended during pregnancy as a method to improve neonatal and maternal outcomes. Improving the use of prenatal care is important, particularly for women at moderate to high risk of adverse outcomes. Incentives are sometimes utilized to encourage women to attend prenatal care visits.
OBJECTIVES
To determine whether incentives are an effective tool to increase utilization of timely prenatal care among women.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015) and the reference lists of all retrieved studies.
SELECTION CRITERIA
Randomized controlled trials (RCTs), quasi-RCTs, and cluster-RCTs that utilized direct incentives to pregnant women explicitly linked to initiation and frequency of prenatal care were included. Incentives could include cash, vouchers, coupons or products not generally offered to women as a standard of prenatal care. Comparisons were to no incentives and to incentives not linked directly to utilization of care. We also planned to compare different types of interventions, i.e. monetary versus products or services.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for inclusion and methodological quality. Two review authors independently extracted data. Data were checked for accuracy.
MAIN RESULTS
We identified 11 studies (19 reports), six of which we excluded. Five studies, involving 11,935 pregnancies were included, but only 1893 pregnancies contributed data regarding our specified outcomes. Incentives in the studies included cash, gift card, baby carrier, baby blanket or taxicab voucher and were compared with no incentives. Meta-analysis was performed for only one outcome 'Return for postpartum care' and this outcome was not pre-specified in our protocol. Other analyses were restricted to data from single studies.Trials were at a moderate risk of bias overall. Randomization and allocation were adequate and risk of selection bias was low in three studies and unclear in two studies. None of the studies were blinded to the participants. Blinding of outcome assessors was adequate in one study, but was limited or not described in the remaining four studies. Risk of attrition was deemed to be low in all studies that contributed data to the review. Two of the studies reported or analyzed data in a manner that was not consistent with the predetermined protocol and thus were deemed to be at high risk. The other three studies were low risk for reporting bias. The largest two of the five studies comprising the majority of participants took place in rural, low-income, homogenously Hispanic communities in Central America. This setting introduces a number of confounding factors that may affect generalizability of these findings to ethnically and economically diverse urban communities in developed countries.The five included studies of incentive programs did not report any of this review's primary outcomes: preterm birth, small-for-gestational age, or perinatal death.In terms of this review's secondary outcomes, pregnant women receiving incentives were no more likely to initiate prenatal care (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.78 to 1.38, one study, 104 pregnancies). Pregnant women receiving incentives were more likely to attend prenatal visits on a frequent basis (RR 1.18, 95% CI 1.01 to 1.38, one study, 606 pregnancies) and obtain adequate prenatal care defined by number of "procedures" such as testing blood sugar or blood pressure, vaccinations and counseling about breastfeeding and birth control (mean difference (MD) 5.84, 95% CI 1.88 to 9.80, one study, 892 pregnancies). In contrast, women who received incentives were more likely to deliver by cesarean section (RR 1.97, 95% CI 1.18 to 3.30, one study, 979 pregnancies) compared to those women who did not receive incentives.Women who received incentives were no more likely to return for postpartum care based on results of meta-analysis (average RR 0.75, 95% CI 0.21 to 2.64, two studies, 833 pregnancies, Tau² = 0.81, I² = 98%). However, there was substantial heterogeneity in this analysis so a subgroup analysis was performed and this identified a clear difference between subgroups based on the type of incentive being offered. In one study, women receiving non-cash incentives were more likely to return for postpartum care (RR 1.26, 95% CI 1.09 to 1.47, 240 pregnancies) than women who did not receive non-cash incentives. In another study, women receiving cash incentives were less likely to return for postpartum care (RR 0.43, 95% CI 0.30 to 0.62, 593 pregnancies) than women who did not receive cash incentives.No data were identified for the following secondary outcomes: frequency of prenatal care; pre-eclampsia; satisfaction with birth experience; maternal mortality; low birthweight (less than 2500 g); infant macrosomia (birthweight greater than 4000 g); or five-minute Apgar less than seven.
AUTHORS' CONCLUSIONS
The included studies did not report on this review's main outcomes: preterm birth, small-for-gestational age, or perinatal death. There is limited evidence that incentives may increase utilization and quality of prenatal care, but may also increase cesarean rate. Overall, there is insufficient evidence to fully evaluate the impact of incentives on prenatal care initiation. There are conflicting data as to the impact of incentives on return for postpartum care. Two of the five studies which accounted for the majority of women in this review were conducted in rural, low-income, overwhelmingly Hispanic communities in Central America, thus limiting the external validity of these results.There is a need for high-quality RCTs to determine whether incentive program increase prenatal care use and improve maternal and neonatal outcomes. Incentive programs, in particular cash-based programs, as suggested in this review and in several observational studies may improve the frequency and ensure adequate quality of prenatal care. No peer-reviewed data have been made publicly available for one of the largest incentive-based prenatal programs - the statewide Medicaid-based programs within the United States. These observational data represent an important starting point for future research with significant implications for policy development and allocation of healthcare resources. The disparate findings related to attending postpartum care should also be further explored as the findings were limited by the number of studies. Future large RCTs are needed to focus on the outcomes of preterm birth, small-for-gestational age and perinatal outcomes.
Topics: Adult; Cesarean Section; Female; Humans; Infant, Newborn; Motivation; Postnatal Care; Pregnancy; Pregnancy Outcome; Prenatal Care; Quality of Health Care; Randomized Controlled Trials as Topic
PubMed: 26671418
DOI: 10.1002/14651858.CD009916.pub2 -
PloS One 2019Mother-to-infant bonding is defined as the emotional tie experienced by a mother towards her child, which is considered to be important for the socio-emotional...
BACKGROUND
Mother-to-infant bonding is defined as the emotional tie experienced by a mother towards her child, which is considered to be important for the socio-emotional development of the child. Numerous studies on the correlates of both prenatal and postnatal mother-to-infant bonding quality have been published over the last decades. An up-to-date systematic review of these correlates is lacking, however.
OBJECTIVE
To systematically review correlates of prenatal and postnatal mother-to-infant bonding quality in the general population, in order to enable targeted interventions.
METHODS
MEDLINE, Embase, CINAHL, and PsychINFO were searched through May 2018. Reference checks were performed. Case-control, cross-sectional or longitudinal cohort studies written in English, German, Swedish, Spanish, Norwegian, French or Dutch defining mother-to-infant bonding quality as stipulated in the protocol (PROSPERO CRD42016040183) were included. Two investigators independently reviewed abstracts, full-text articles and extracted data. Methodological quality was assessed using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional studies and was rated accordingly as poor, fair or good. Clinical and methodological heterogeneity were examined.
MAIN RESULTS
131 studies were included. Quality was fair for 20 studies, and poor for 111 studies. Among 123 correlates identified, 3 were consistently associated with mother-to-infant bonding quality: 1) duration of gestation at assessment was positively associated with prenatal bonding quality, 2) depressive symptoms were negatively associated with postnatal mother-to-infant bonding quality, and 3) mother-to-infant bonding quality earlier in pregnancy or postpartum was positively associated with mother-to-infant bonding quality later in time.
CONCLUSION
Our review suggests that professionals involved in maternal health care should consider monitoring mother-to-infant bonding already during pregnancy. Future research should evaluate whether interventions aimed at depressive symptoms help to promote mother-to-infant bonding quality. More high-quality research on correlates for which inconsistent results were found is needed.
Topics: Child Development; Depression, Postpartum; Female; Humans; Infant; Mother-Child Relations; Mothers; Postpartum Period; Pregnancy; Prenatal Care
PubMed: 31550274
DOI: 10.1371/journal.pone.0222998 -
Midwifery Jun 2023Maternal obesity has been related to adverse maternal and infant outcomes. It is a persistent challenge of midwifery care worldwide and can present clinical challenges... (Review)
Review
OBJECTIVE
Maternal obesity has been related to adverse maternal and infant outcomes. It is a persistent challenge of midwifery care worldwide and can present clinical challenges and complications. This review sought to identify evidence on the practice patterns of midwives related to prenatal care of women with obesity.
METHODS
The databases Academic Search Premier, APA PsycInfo, CINAHL PLUS with Full Text, Health Source: Nursing/Academic Edition, and MEDLINE were searched November 2021. Search terms included weight, obesity, practices, and midwives. Inclusion criteria included quantitative, qualitative, and mixed method studies that addressed practice patterns of midwives related to prenatal care of women with obesity published in peer-reviewed journals, written in English. The recommended Joanna Briggs Institute approach to mixed methods systematic reviews was followed e.g. study selection, critical appraisal, data extraction, and a convergent segregated method of data synthesis and integration.
RESULTS
Seventeen articles from 16 studies were included. The quantitative evidence showed a lack of knowledge, confidence, and support for midwives that would facilitate adequate management of pregnant women with obesity while the qualitative evidence revealed that midwives desire a sensitive approach to discussing obesity and the risks associated with maternal obesity.
DISCUSSION
Quantitative and qualitative literature report consistent individual and system-level barriers to implementing evidence-based practices. Implicit bias training, midwifery curriculum updates, and the use of patient centered care models may help overcome these challenges.
Topics: Female; Humans; Pregnancy; Midwifery; Obesity; Obesity, Maternal; Prenatal Care; Qualitative Research
PubMed: 36907010
DOI: 10.1016/j.midw.2023.103653 -
BMC Pregnancy and Childbirth Jan 2019Research and different organizations have proposed indicators to monitor the quality of maternal and child healthcare, such indicators are used for different purposes.
BACKGROUND
Research and different organizations have proposed indicators to monitor the quality of maternal and child healthcare, such indicators are used for different purposes.
OBJECTIVE
To perform a systematic review of indicators for the central phases of the maternal and child healthcare continuum of care (pregnancy, childbirth, newborn care and postpartum).
METHOD
A search conducted using international repositories, national and international indicator sets, scientific articles published between 2012 and 2016, and grey literature. The eligibility criteria was documents in Spanish or English with indicators to monitor aspects of the continuum of care phases of interest. The identified indicators were characterized as follows: formula, justification, evidence level, pilot study, indicator type, phase of the continuum, intended organizational level of application, level of care, and income level of the countries. Selection was based on the characteristics associated with scientific soundness (formula, evidence level, and reliability).
RESULTS
We identified 1791 indicators. Three hundred forty-six were duplicated, which resulted in 1445 indicators for analysis. Only 6.7% indicators exhibited all requirements for scientific soundness. The distribution by the classifying variables is clearly uneven, with a predominance of indicators for childbirth, hospital care and facility level.
CONCLUSIONS
There is a broad choice of indicators for maternal and child healthcare. However, most indicators lack demonstrated scientific soundness and refer to particular continuum phases and levels within the healthcare system. Additional efforts are needed to identify good indicators for a comprehensive maternal and child healthcare monitoring system.
Topics: Continuity of Patient Care; Evidence-Based Medicine; Female; Humans; Infant Health; Infant, Newborn; Maternal Health; Maternal Health Services; Parturition; Perinatal Care; Postnatal Care; Pregnancy; Prenatal Care; Quality Indicators, Health Care; Quality of Health Care
PubMed: 30634946
DOI: 10.1186/s12884-019-2173-2 -
Revista de Saude Publica 2015To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. (Review)
Review
OBJECTIVE
To review the frequency of and factors associated with fetal death in the Brazilian scientific literature.
METHODS
A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners.
RESULTS
The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history.
CONCLUSIONS
Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary.
Topics: Brazil; Cause of Death; Death Certificates; Female; Fetal Death; Fetal Mortality; Health Information Systems; Humans; Infant; Male; Pregnancy; Prenatal Care; Risk Factors; Socioeconomic Factors
PubMed: 25902565
DOI: 10.1590/s0034-8910.2015049005568