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Revista Brasileira de Ginecologia E... Aug 2018Evaluate the influence of prenatal care on the occurrence of gestational hypertension.
OBJECTIVE
Evaluate the influence of prenatal care on the occurrence of gestational hypertension.
METHODS
The Web of Science, Scopus, Pubmed, Cochrane and ClinicalTrials electronic databases were searched for articles published between January 1, 2012 and December 31, 2016. No language restrictions were imposed. The following keywords were used: prenatal care, medical assistance, prenatal education, pregnancy-induced hypertension. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist was employed. Two hundred and forty articles were identified during the initial search, but only seven met the inclusion criteria. This systematic review is registered with the international prospective register of systematic reviews (PROSPERO; #CRD42017064103).
RESULTS
The seven studies had a low risk of bias, with methodological quality scores ranging from six to eight points. Five studies found a positive relationship between prenatal care and pregnancy-induced hypertension, whereas two studies found no significant association between the two variables. The divergence among the studies may have been due to the type of healthcare service at which the study was conducted and the sample size.
CONCLUSION
Although the studies analyzed differed with regard to methodological aspects, the findings demonstrate the importance of prenatal care during the gestational period as a prevention and health promotion measure.
Topics: Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Female; Humans; Hypertension, Pregnancy-Induced; Pregnancy; Prenatal Care; Syndrome
PubMed: 29925111
DOI: 10.1055/s-0038-1660526 -
International Journal of Environmental... Dec 2023International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with... (Review)
Review
BACKGROUND
International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with prepregnancy obesity and excessive gestational weight gain. Clinicians often lack evidence-based eating, nutrition, and activity strategies to share with patients.
METHODS
This systematic review aimed to find eating patterns and behaviors that could be used safely during pregnancy to limit excessive gestational weight gain. PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews performed in the United States or Canada and published in English from 2013 to 2023. Keyword search terms included weight, manage, behavior, strategy, strategies, gestational weight gain, and nutrition. Excluded research used pediatric or adolescent populations, restrictive diets, such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry or profit-earning programs using food brands, or specific diet programs.
RESULTS
A total of 844 abstracts were retrieved, with 103 full-text studies reviewed. Behaviors had to be useful for maintaining a healthy gestational weight gain and had to be safe for use during pregnancy. Behaviors useful during pregnancy included meal planning, home meal preparation, portion control, using diets such as the Mediterranean diet, the low-glycemic index diet, and the Dietary Approaches to Stop Hypertension diet (DASH), regular physical activity, sleeping 6-7 h a night, mindful eating, intuitive eating, and regular seif-weighing.
CONCLUSION
The evidence-based strategies outlined in this review are safe for use during pregnancy and can assist patients in avoiding excessive gestational weight gain while maintaining the nutrition needed for healthy fetal growth.
Topics: Pregnancy; Female; Adolescent; Humans; Child; Gestational Weight Gain; Exercise; Pregnancy Complications; Weight Gain; Diet; Diet, Mediterranean
PubMed: 38276803
DOI: 10.3390/ijerph21010015 -
Human Vaccines & Immunotherapeutics Dec 2023Immunization is one of the most cost-effective measures to prevent morbidity and mortality in children. Therefore, the purpose of this systematic review and... (Meta-Analysis)
Meta-Analysis
Immunization is one of the most cost-effective measures to prevent morbidity and mortality in children. Therefore, the purpose of this systematic review and meta-analysis was to determine the pooled prevalence of incomplete immunization among children in Africa as well as its determinants. PubMed, Google Scholar, Scopus, Science Direct, and online institutional repository homes were searched. Studies published within English language, with full text available for searching, and studies conducted in Africa were included in this meta-analysis. A pooled prevalence, Sub-group analysis, sensitivity analysis and meta-regression were conducted. Out of 1305 studies assessed, 26 met our criteria and were included in this study. The pooled prevalence of incomplete immunization was 35.5% (95% CI: 24.4, 42.7), I = 92.1%). Home birth (AOR=2.7; 95% CI: 1.5-4.9), rural residence (AOR = 4.6; 95% CI: 1.1-20.1), lack of antenatal care visit (AOR = 2.6; 95% CI: 1.4-5.1), lack of knowledge of immunizations (AOR=2.4; 95% CI: 1.3-4.6), and maternal illiteracy (AOR = 1.7: 95%CI: 1.3-2.0) were associated with incomplete immunization. In Africa, the prevalence of incomplete immunization is high. It is important to promote urban residency, knowledge of immunization and antenatal follow up care.
Topics: Humans; Pregnancy; Female; Child; Vaccination; Africa; Immunization; Prenatal Care; Prevalence
PubMed: 37144686
DOI: 10.1080/21645515.2023.2202125 -
International Journal of Environmental... Nov 2022: Child marriage is a serious public health issue with dire implications at the individual and societal level. Almost half of all child marriages globally originate from... (Meta-Analysis)
Meta-Analysis Review
: Child marriage is a serious public health issue with dire implications at the individual and societal level. Almost half of all child marriages globally originate from South Asia. The aim of this study is to identify consistent factors associated with and resulting from child marriage in South Asia through a review of available evidence. This systematic review adhered to the 2015 Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, namely PsycINFO, CINAHL, EMBASE, Ovid Medline, PUBMED, and Scopus were searched. Retrieved studies were exported to EndNote and screened for eligibility using pre-determined criteria. The quality of the included studies was rated using 14 quality appraisal criteria derived from the National Institutes of Health (NIH) Tool. A total of 520 articles were retrieved from six databases. Of these, 13 articles met the eligibility criteria and were included in this study. Factors consistently associated with child marriage in South Asia were rural residence, low level of education, poor economic background, low exposure to mass media and religion (Hindu and Muslim in particular countries). Maternal health care factors resulting from child marriage included: low utilization of antenatal care services, low institutional delivery, and low delivery assistance by a skilled birth attendant. Child marriage results from an interplay of economic and social forces. Therefore, to address the complex nature of child marriage, efforts targeting improvement in education, employment, exposure to health information via mass media, and gender egalitarianism are required. This systematic review was registered with PROSPERO [CRD42020190410].
Topics: United States; Child; Humans; Female; Pregnancy; Marriage; Maternal Health Services; Educational Status; Prenatal Care; Asia
PubMed: 36429857
DOI: 10.3390/ijerph192215138 -
American Journal of Obstetrics &... Nov 2021Our objective was to conduct a systematic review of the published literature on housing instability during pregnancy and adverse pregnancy outcomes and perinatal... (Review)
Review
OBJECTIVE
Our objective was to conduct a systematic review of the published literature on housing instability during pregnancy and adverse pregnancy outcomes and perinatal healthcare utilization.
DATA SOURCES
We performed a systematic search in November 2020 using Embase, MEDLINE, Cochrane Library, and Scopus using terms related to housing instability during pregnancy, adverse pregnancy outcomes, and perinatal healthcare utilization. The search was limited to the United States.
STUDY ELIGIBILITY CRITERIA
Studies examining housing instability (including homelessness) during pregnancy and adverse pregnancy outcomes (including preterm birth, low birthweight neonates, and maternal morbidity) and perinatal healthcare utilization were included.
METHODS
Two authors screened abstracts and full-length articles for inclusion. The final cohort consisted of 14 studies. Two authors independently extracted data from each article and assessed the study quality using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Risk of bias was assessed using the National Institutes of Health Study Quality Assessment Tools.
RESULTS
All included studies were observational, including retrospective cohort (n=10, 71.4%), cross-sectional observational (n=3, 21.4%), or prospective cohort studies (n=1, 7.1%). There was significant heterogeneity in the definitions of housing instability and homelessness. Most of the studies only examined homelessness (n=9, 64.3%) and not lesser degrees of housing instability. Housing instability and homelessness during pregnancy were significantly associated with preterm birth, low birthweight neonates, neonatal intensive care unit admission, and delivery complications. Among studies examining perinatal healthcare utilization, housing instability was associated with inadequate prenatal care and increased hospital utilization. All studies exhibited moderate, low, or very low study quality and fair or poor internal validity.
CONCLUSION
Although data on housing instability during pregnancy are limited by the lack of a standardized definition, a consistent relationship between housing instability and adverse pregnancy outcomes has been suggested by this systematic review. The evaluation and development of a standardized definition and measurement of housing instability among pregnant individuals is warranted to address future interventions targeted to housing instability during pregnancy.
Topics: Cross-Sectional Studies; Female; Housing; Humans; Infant, Newborn; Pregnancy; Premature Birth; Prospective Studies; Retrospective Studies; United States
PubMed: 34481998
DOI: 10.1016/j.ajogmf.2021.100477 -
BMC Pregnancy and Childbirth Sep 2017Group prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes. Our objective was to review and... (Review)
Review
BACKGROUND
Group prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes. Our objective was to review and summarize outcomes for women in GPC for women with specific high-risk conditions.
METHODS
A systematic literature review of Ovid, PubMed, and Google Scholar was performed to identify studies reporting the effects of group prenatal care in high-risk populations. Studies were included if they reported on pregnancy outcome results for women using GPC. We also contacted providers known to be utilizing GPC for specific high-risk women. Descriptive results were compiled and summarized by high-risk population.
RESULTS
We identified 37 reports for inclusion (8 randomized trials, 23 nonrandomized studies, 6 reports of group outcomes without controls). Preterm birth was found to be decreased among low-income and African American women. Attendance at prenatal visits was shown to increase among women in GPC in the following groups: Opioid Addiction, Adolescents, and Low-Income. Improved weight trajectories and compliance with the IOM's weight recommendations were found in adolescents. Increased rates of breastfeeding were found in adolescents and African Americans. Increased satisfaction with care was found in adolescents and African Americans. Pregnancy knowledge was increased among adolescents, as was uptake of LARC. Improved psychological outcomes were found among adolescents and low-income women. Studies in women with diabetes demonstrated that fewer women required treatment with medication when exposed to GPC, and for those requiring treatment with insulin, GPC individuals required less than half the dose. Among women with tobacco use, those who had continued to smoke after finding out they were pregnant were 5 times more likely to quit later in pregnancy if they were engaged in GPC.
CONCLUSIONS
Several groups of high-risk pregnant women may have benefits from engaging in group prenatal care. Because there is a paucity of high-quality, well-controlled studies, more trials in high-risk women are needed to determine whether it improves outcomes and costs of pregnancy-related care.
Topics: Adolescent; Adult; Female; Health Knowledge, Attitudes, Practice; Humans; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Premature Birth; Prenatal Care; Psychotherapy, Group; Young Adult
PubMed: 28962601
DOI: 10.1186/s12884-017-1522-2 -
Substance Abuse : Research and Treatment 2016The nature, impact, and treatment of substance use during pregnancy are well described for women living in urban settings. Less is known about pregnant substance-using... (Review)
Review
The nature, impact, and treatment of substance use during pregnancy are well described for women living in urban settings. Less is known about pregnant substance-using women living in rural communities. The objective of this review is to describe the existing evidence for the management of substance use in pregnant women living in rural areas. A systematic review of the literature was conducted using PubMed, Embase, and the Cochrane Database of Systematic Reviews, and the quality of the evidence was assessed using the GRADE system. Twenty-two articles that met the inclusion criteria were identified. Descriptive studies document high rates of smoking, marijuana, and polysubstance use among rural, substance-using pregnant women compared to their urban counterparts. Management of substance use disorders is limited by access to and acceptability of treatment modalities. Several innovative, integrated addiction and prenatal care programs have been developed, which may serve as models for management of substance use during pregnancy in rural settings.
PubMed: 27375357
DOI: 10.4137/SART.S34547 -
BMJ Open Apr 2016To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the effects of use of cannabis during pregnancy on maternal and fetal outcomes.
DATA SOURCES
7 electronic databases were searched from inception to 1 April 2014. Studies that investigated the effects of use of cannabis during pregnancy on maternal and fetal outcomes were included.
STUDY SELECTION
Case-control studies, cross-sectional and cohort studies were included.
DATA EXTRACTION AND SYNTHESIS
Data synthesis was undertaken via systematic review and meta-analysis of available evidence. All review stages were conducted independently by 2 reviewers.
MAIN OUTCOMES AND MEASURES
Maternal, fetal and neonatal outcomes up to 6 weeks postpartum after exposure to cannabis. Meta-analyses were conducted on variables that had 3 or more studies that measured an outcome in a consistent manner. Outcomes for which meta-analyses were conducted included: anaemia, birth weight, low birth weight, neonatal length, placement in the neonatal intensive care unit, gestational age, head circumference and preterm birth.
RESULTS
24 studies were included in the review. Results of the meta-analysis demonstrated that women who used cannabis during pregnancy had an increase in the odds of anaemia (pooled OR (pOR)=1.36: 95% CI 1.10 to 1.69) compared with women who did not use cannabis during pregnancy. Infants exposed to cannabis in utero had a decrease in birth weight (low birth weight pOR=1.77: 95% CI 1.04 to 3.01; pooled mean difference (pMD) for birth weight=109.42 g: 38.72 to 180.12) compared with infants whose mothers did not use cannabis during pregnancy. Infants exposed to cannabis in utero were also more likely to need placement in the neonatal intensive care unit compared with infants whose mothers did not use cannabis during pregnancy (pOR=2.02: 1.27 to 3.21).
CONCLUSIONS AND RELEVANCE
Use of cannabis during pregnancy may increase adverse outcomes for women and their neonates. As use of cannabis gains social acceptance, pregnant women and their medical providers could benefit from health education on potential adverse effects of use of cannabis during pregnancy.
Topics: Anemia; Birth Weight; Cannabis; Child Health; Female; Gestational Age; Humans; Infant, Low Birth Weight; Infant, Newborn; Intensive Care Units, Neonatal; Marijuana Smoking; Pregnancy; Premature Birth; Prenatal Exposure Delayed Effects
PubMed: 27048634
DOI: 10.1136/bmjopen-2015-009986 -
Journal of Midwifery & Women's Health Nov 2016This article presents an integrative review of the literature examining the relationship between racial discrimination and adverse birth outcomes. (Review)
Review
INTRODUCTION
This article presents an integrative review of the literature examining the relationship between racial discrimination and adverse birth outcomes.
METHODS
Searches for research studies published from 2009 to 2015 were conducted using PubMed, CINAHL, Scopus, PsycINFO, Web of Science, and Embase. Articles were assessed for potential inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2009 framework.
RESULTS
Fifteen studies met criteria for review. The majority of the studies found a significant relationship between racial discrimination and low birth weight, preterm birth, and small for gestational age. Each of the studies that examined more proximal variables related to birth outcomes such as entry into prenatal care, employment opportunities, neighborhood characteristics, or inflammatory markers found significant associations between the specific variables examined and racial discrimination. Participants in qualitative studies discussed experiences of institutional racism with regard to several components of prenatal care including access and quality of care.
DISCUSSION
Racial discrimination is a significant risk factor for adverse birth outcomes. To best understand the mechanisms by which racial discrimination impacts birth outcomes, and to inform the development of effective interventions that eliminate its harmful effects on health, longitudinal research that incorporates comprehensive measures of racial discrimination is needed. Health care providers must fully acknowledge and address the psychosocial factors that impact health outcomes in minority racial/ethnic women.
Topics: Birth Weight; Female; Health Services Accessibility; Healthcare Disparities; Humans; Infant, Low Birth Weight; Infant, Premature; Pregnancy; Pregnancy Outcome; Premature Birth; Prenatal Care; Racism
PubMed: 27737504
DOI: 10.1111/jmwh.12490 -
BMC Infectious Diseases Nov 2014Tuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care,... (Review)
Review
BACKGROUND
Tuberculosis (TB) during pregnancy may lead to severe consequences affecting both mother and child. Prenatal care could be a very good opportunity for TB care, especially for women who have limited access to health services. The aim of this review was to gather and evaluate studies on TB care for pregnant women.
METHODS
We used a combination of the terms "tuberculosis" and "pregnancy", limited to human, to search for published articles. Studies reflecting original data and focusing on TB care for pregnant women were included. All references retrieved were collected using the Reference Manager software (Version 11).
RESULTS
Thirty five studies were selected for review and their data showed that diagnosis was often delayed because TB symptoms during pregnancy were not typical. TB prophylaxis and anti-TB therapy appeared to be safe and effective for pregnant women and their babies when suitable follow up and early initiation were present, but the compliance rate to TB prophylaxis is still low due to lack of follow up and referral services. TB care practices in the reviewed studies were in line in principle with the WHO International Standards for Tuberculosis Care (ISTC).
CONCLUSIONS
Integration of TB care within prenatal care would improve TB diagnosis and treatment for pregnant women. To improve the quality of TB care, it is necessary to develop national level guidelines based on the ISTC with detailed guidelines for pregnant women.
Topics: Antitubercular Agents; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Prenatal Care; Prenatal Diagnosis; Tuberculosis
PubMed: 25407883
DOI: 10.1186/s12879-014-0617-x