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PloS One 2023A number of studies have looked at neonatal structural birth defects. However, there is no study with a comprehensive review of structural anomalies. Therefor we aimed... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A number of studies have looked at neonatal structural birth defects. However, there is no study with a comprehensive review of structural anomalies. Therefor we aimed to verify the best available articles to pool possible risk factors of structural congenital anomalies in resource limited settings.
SETTING
Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google database search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis.
PARTICIPANTS
This review analyzed data from 95,755 women who have birthed from as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. Articles which have no full information important for the analysis and case reports were excluded from the study.
RESULTS
The overall pooled effect estimate of structural congenital anomalies was 5.50 [4.88-6.12]. In this systematic review and meta-analysis maternal illness effect estimate (EI) with odds ratio (OR) = 4.93 (95%CI 1.02-8.85), unidentified drug use OR = 2.83 (95%CI 1.19-4.46), birth weight OR = 4.20 (95%CI 2.12-6.28), chewing chat OR = 3.73 (95%CI 1.20-6.30), chemical exposure OR = 4.27 (95%CI 1.19-8.44) and taking folic acid tablet during pregnancy OR = 6.01 (95%CI 2.87-14.89) were statistically significant in this meta-regression.
CONCLUSIONS
The overall pooled effect estimate of structural congenital anomalies in a resource limited setting was high compared to better resource countries. On the Meta-regression maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure and never using folic acid were found to be statistically significant variables Preconception care and adequate intake of folic acid before and during early pregnancy should be advised.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Birth Weight; Resource-Limited Settings; Folic Acid; Preconception Care
PubMed: 37831686
DOI: 10.1371/journal.pone.0291875 -
Health Science Reports Aug 2023Approximately half of Iranian marring couples have poor sexual knowledge and attitudes. This article delves into the main concerns and queries regarding sexual and...
BACKGROUND AND AIMS
Approximately half of Iranian marring couples have poor sexual knowledge and attitudes. This article delves into the main concerns and queries regarding sexual and reproductive health among Iranian newly married couples.
METHODS
We conducted a content analysis of the sexual and reproductive health questions and concerns that were anonymously submitted by newly married couples to the researcher via social media in 2021-2022.
RESULTS
A total of 141 questions and concerns that were related to sexual and reproductive health were considered for content analysis. Findings illustrated two main categories: (1) the need to create a reproductive life plan, and (2) the need for sexual knowledge and counseling. The first category consisted of three subcategories: "Poor contraceptive knowledge," "Need for support in case of a missed period or unplanned pregnancy," and "Need for preconception care." The second category included three subcategories: "Concern regarding virginity," "Sexual problems on the honeymoon," and "Sexual problems in newlyweds."
CONCLUSION
Iranian newly married couples need long-term specialized services addressing their reproductive life planning and sexual knowledge needs. Integrating reproductive life planning and comprehensive sex education into the primary care services for newly married couples can help to reduce delayed childbearing, unintended pregnancy, unsafe and illegal abortion, and subsequent infertility.
PubMed: 37564396
DOI: 10.1002/hsr2.1479 -
Cureus Dec 2023This comprehensive review delves into the intricate relationship between asthma and pregnancy, specifically focusing on the challenges encountered in the first trimester... (Review)
Review
This comprehensive review delves into the intricate relationship between asthma and pregnancy, specifically focusing on the challenges encountered in the first trimester and the ensuing impact on maternal and fetal health. Examining physiological changes during pregnancy reveals the dynamic interplay influencing respiratory function and immune responses. Key findings underscore the vulnerability to asthma exacerbations in the critical first trimester, emphasizing the potential risks to both maternal and fetal well-being. Maternal and fetal outcomes are discussed, emphasizing the associations between poorly controlled asthma and adverse perinatal outcomes. Implications for clinical practice highlight the importance of preconception care, continuous monitoring, and collaborative efforts between obstetricians and pulmonologists. Patient education emerges as a fundamental aspect to empower pregnant women in managing their condition. The conclusion emphasizes the imperative for comprehensive care, advocating for individualized treatment plans, multidisciplinary collaboration, and public health initiatives. By adopting this holistic approach, healthcare providers can navigate the complexities of asthma during pregnancy, ultimately ensuring the optimal health of both the expectant mother and her developing fetus.
PubMed: 38169705
DOI: 10.7759/cureus.49849 -
Healthcare (Basel, Switzerland) Sep 2023Preconception care (PCC) is the provision of biomedical, behavioural, and social health interventions to women and couples before they fall pregnant. The World Health...
UNLABELLED
Preconception care (PCC) is the provision of biomedical, behavioural, and social health interventions to women and couples before they fall pregnant. The World Health Organization (WHO) developed PCC recommendations in 2013, which were included in the South African maternity care guidelines in 2016. The purpose of PCC is to lessen behaviours and environmental factors leading to maternal ill-health, thus reducing maternal and perinatal mortality rates.
OBJECTIVE
To determine the implementation of PCC recommendations at health facilities in the selected districts of Limpopo Province and the associated factors.
METHODS
A qualitative exploratory design was used. Nonprobability, purposive sampling was used to sample 29 professional nurses (PNs), and 51 women of childbearing age (WCBA) (19-35 years) from clinics and community health centres (CHCs). Data were collected through in-depth interviews with the professional nurses and focus group discussions with the WCBA. Data analysis was performed through open coding. Measures of trustworthiness were adhered to. Permission to conduct the study was obtained from relevant stakeholders, participation was voluntary and participants signed a consent form prior to data collection.
RESULTS
The findings of the study revealed that there was partial implementation of the PCC recommendations in the selected districts of Limpopo Province, PCC provision was dependent on clients' initiation, a knowledge gap regarding PCC recommendations was identified from the professional nurses, and a lack of awareness regarding PCC from the WCBA.
CONCLUSION
The preconception period is an important determinant of the pregnancy outcome; therefore, focus should be redirected to the pre-pregnancy period and not only to when the woman is already pregnant. However, to achieve this, professional nurses and WCBA should be empowered regarding PCC and its benefits.
PubMed: 37761782
DOI: 10.3390/healthcare11182586 -
Ciencia & Saude Coletiva Nov 2023This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age....
This article aims to evaluate the performance of preconception health indicators according to sociodemographic characteristics among Brazilian women of reproductive age. We conducted a descriptive epidemiological study using data from 21,645 and 25,228 women, respectively, who responded the 2013 and 2019 national health surveys, and data for the period 2010 to 2020 derived from the national health system's Department of Informatics (DATASUS). We calculated the prevalence of indicators according to sociodemographic characteristics and statistical significance of differences was measured using Pearson's chi-squared test. Syphilis and HIV incidence rates were also calculated. There was an increase in the prevalence of access to health service indicators (medical and dental consultations and recent Pap smear). However, there was an increase in the prevalence of hypertension, alcohol use, and obesity. The prevalence of use of contraceptive methods and fertility treatment remained stable. Syphilis incidence increased sevenfold between 2010 and 2020. Black/brown women with a low level of education, higher parity, and living in the North or Northeast performed worse for preconception health indicators. Despite the increase in access to health services, performance on preconception health indicators declined and health inequities continued.
Topics: Pregnancy; Humans; Female; Preconception Care; Syphilis; Prevalence; Brazil; Contraception
PubMed: 37971017
DOI: 10.1590/1413-812320232811.16282022 -
Health Education & Behavior : the... Apr 2024Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing...
Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women's autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness.
Topics: Pregnancy; Female; Humans; Preconception Care; Postpartum Period; Pregnancy, Unplanned; Contraception; Qualitative Research; Ill-Housed Persons
PubMed: 37846846
DOI: 10.1177/10901981231204583 -
BMC Pregnancy and Childbirth Oct 2023Preconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and...
BACKGROUND
Preconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and childhood. This study assessed maternal health status prior to conception in Trinidad by means of a screening tool, physical measurements, and laboratory samples.
METHODS
A cross-sectional study was conducted among women aged 18-45 years at a primary care centre in Arima, Trinidad. A de novo PCC screening tool was used to assess 13 domains of high-risk pregnancy in participants. These domains included dietary details, gynaecological and obstetric histories, and genetic and vaccination histories, among others. Blood pressure, weight, height, and waist circumference were recorded, and a capillary blood sample was used to determine random blood glucose and HbA1c levels. All data were coded and entered into SPSS ver. 21.
RESULTS
A total of 400 nongravid participants were recruited, of whom 366 were included in the final analysis. Most (96.7%) had one or more risk factors for adverse pregnancy outcomes. These included overweight (27%), obesity (35%), central obesity (69.4%), and impaired glucose tolerance/diabetes mellitus (IGT/DM) (26.2%). Additionally, a sedentary lifestyle and diet high in processed food/fats were self-reported by 74.9% and 88.8% of participants, respectively. Only 13.1% had planned to conceive, and of those who had no immediate plans to conceive, 76.4% were currently sexually active, and many (60.7%) did not use birth control techniques. More than half (57.1%) had never had a pap smear. On the other hand, 86.3% knew their HIV status. Self-reported percentages for vaccination were as follows: MMR (100%), tetanus (17.5%), hepatitis B (11.5%) and influenza (2.7%). The majority (82.8%) of participants had not visited the dentist in the past year, with 35.9% of these individuals reporting symptoms of periodontitis. Segments of the population had multiple risk factors; for example, 23.7% of participants were overweight or obese and had an elevated HbA1c level.
CONCLUSIONS
Unexpectedly, most participants had a risk factor for an adverse pregnancy outcome, and many had multiple risk factors. There is a strong case for enhanced preconception care for women in Trinidad.
Topics: Adult; Middle Aged; Young Adult; Cross-Sectional Studies; Glycated Hemoglobin; Obesity; Overweight; Preconception Care; Trinidad and Tobago; Humans; Female
PubMed: 37817065
DOI: 10.1186/s12884-023-06017-2 -
BMJ Open Jul 2023To explore the reasons for unintended pregnancy and effective prevention measures from the perspectives of women and healthcare providers in Addis Ababa, Ethiopia.
OBJECTIVES
To explore the reasons for unintended pregnancy and effective prevention measures from the perspectives of women and healthcare providers in Addis Ababa, Ethiopia.
DESIGN
Phenomenological qualitative study.
SETTING AND PARTICIPANTS
This study was conducted at three public health facilities found in Addis Ababa, Ethiopia. Women with unintended pregnancies and healthcare providers currently working in maternal health services were purposively recruited for in-depth interviews. Twenty in-depth interviews were conducted until data saturation was achieved. Data were analysed using thematic analysis.
RESULTS
Seven themes emerged from the transcribed interview data. These include: Personal characteristics (negligence; lower pregnancy expectation), family influence (fear of family), sociocultural and economic influence (stigma and discrimination), healthcare provider influence (disrespectful and abusive approach; disregard for women's contraceptive choice), preconception thoughts and behaviours (unprotected early sexual practice; myths and misunderstanding), lack of access to quality family planning services (lack of trained contraceptive counsellor, inappropriate contraceptive use), and preventive strategies for unintended pregnancy (comprehensive sexual education; sexual and reproductive health and rights service integration) CONCLUSIONS: This study identified multilevel reasons for unintended pregnancy from the perspective of the participants. Participants shared their views on preventive measures for unintended pregnancy, including comprehensive sexual education, service integration and male-inclusive contraceptive counselling. This study highlights the need to improve sexual and reproductive health services by shedding light on the viewpoints and experiences of women and healthcare providers.
Topics: Pregnancy; Humans; Male; Female; Pregnancy, Unplanned; Ethiopia; Family Planning Services; Qualitative Research; Contraceptive Agents
PubMed: 37491099
DOI: 10.1136/bmjopen-2023-072008 -
Ecotoxicology and Environmental Safety Oct 2023Parabens are common preservatives in personal care products, cosmetics, and medical goods. In the past few years, animal studies showed the male reproductive toxicity...
BACKGROUND
Parabens are common preservatives in personal care products, cosmetics, and medical goods. In the past few years, animal studies showed the male reproductive toxicity associated with some parabens. Yet, epidemiological studies have generated inconsistent findings and research rarely has focused on the mixture effects of the parabens. We aimed to explore the associations between individual paraben exposure as well as the mixture and semen quality parameters.
METHODS
A total of 795 male partners from preconception couples were included in the study. Their urine samples were analyzed for the concentrations of six parabens, namely methyl paraben (MeP), ethyl paraben (EtP), propyl paraben (PrP), butyl paraben (BuP), benzyl paraben (BzP) and heptyl paraben (HeP). Multiple linear regression models and weighted quantile sum regression (WQS) models were utilized to assess the relationships between individual paraben exposure and paraben mixture with semen quality parameters, respectively.
RESULTS
After adjusting for covariates, exposure to a paraben mixture was significantly associated with declining sperm concentration, total sperm count, and progressive motility, among which BuP was identified as the main contributor to sperm concentration and total sperm count while MeP to progressive motility. Results from multiple linear regression models were generally in line with the WQS analysis.
CONCLUSIONS
Our results suggest negative associations between paraben mixture and sperm concentration, total sperm count, and sperm motility among reproductive-aged men.
Topics: Animals; Male; Humans; Adult; Semen Analysis; Parabens; Sperm Motility; Semen
PubMed: 37688867
DOI: 10.1016/j.ecoenv.2023.115453 -
BMC Medicine Jan 2024Higher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains...
BACKGROUND
Higher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains unclear.
METHODS
We explored the relation of maternal pre-/early-pregnancy BMI with 20 pregnancy and perinatal outcomes by integrating evidence from three different approaches (i.e. multivariable regression, Mendelian randomisation, and paternal negative control analyses), including data from over 400,000 women.
RESULTS
All three analytical approaches supported associations of higher maternal BMI with lower odds of maternal anaemia, delivering a small-for-gestational-age baby and initiating breastfeeding, but higher odds of hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, gestational diabetes, pre-labour membrane rupture, induction of labour, caesarean section, large-for-gestational age, high birthweight, low Apgar score at 1 min, and neonatal intensive care unit admission. For example, higher maternal BMI was associated with higher risk of gestational hypertension in multivariable regression (OR = 1.67; 95% CI = 1.63, 1.70 per standard unit in BMI) and Mendelian randomisation (OR = 1.59; 95% CI = 1.38, 1.83), which was not seen for paternal BMI (OR = 1.01; 95% CI = 0.98, 1.04). Findings did not support a relation between maternal BMI and perinatal depression. For other outcomes, evidence was inconclusive due to inconsistencies across the applied approaches or substantial imprecision in effect estimates from Mendelian randomisation.
CONCLUSIONS
Our findings support a causal role for maternal pre-/early-pregnancy BMI on 14 out of 20 adverse pregnancy and perinatal outcomes. Pre-conception interventions to support women maintaining a healthy BMI may reduce the burden of obstetric and neonatal complications.
FUNDING
Medical Research Council, British Heart Foundation, European Research Council, National Institutes of Health, National Institute for Health Research, Research Council of Norway, Wellcome Trust.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Body Mass Index; Cesarean Section; Diabetes, Gestational; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Mendelian Randomization Analysis
PubMed: 38281920
DOI: 10.1186/s12916-023-03167-0