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BMC Pregnancy and Childbirth May 2023Mother's awareness of obstetric danger signs is the degree of a pregnant woman to fully utilize her knowledge of the signs and symptoms of complications of pregnancy,...
BACKGROUND
Mother's awareness of obstetric danger signs is the degree of a pregnant woman to fully utilize her knowledge of the signs and symptoms of complications of pregnancy, which helps the mother and family to seek medical help immediately. High maternal and infant mortality rates in developing countries are due to a combination of a lack of quality, resources and access to health services coupled with mother's lack of awareness. The purpose of this study was to collect current empirical studies to describe the pregnant women awareness about the obstetric danger sign in developing country.
METHOD
This review employed the Prisma-ScR checklist. The articles searched in four electronic databases (Scopus, CINAHL, Science Direct, Google Scholar). Variables that used to search the articles (pregnant woman, knowledge, awareness, danger signs pregnancy). The Framework used to review is PICOS.
RESULT
The results of the article found 20 studies which met inclusion criteria. The determinants were high educational status, more pregnancy experience, more ANC visit, and labour in the health facility.
CONCLUSION
The level of awareness is low to medium, only some have fair awareness, in which related to determinant. The recommended effective strategy is to improve the ANC program by assess the risk of obstetric danger sign promptly, assess the barrier of health seeking related to the family support, i.e. the husband and the elderly. Additionally, use MCH handbook or mobile application to record the ANC visit and communicate with the family.
Topics: Pregnancy; Female; Humans; Aged; Pregnant Women; Developing Countries; Cross-Sectional Studies; Mothers; Health Services; Health Knowledge, Attitudes, Practice; Prenatal Care
PubMed: 37194036
DOI: 10.1186/s12884-023-05674-7 -
Journal of Clinical and Translational... Jun 2023In the present study, the potential changes of oral microbes during pregnancy were investigated by examining the findings of the previous studies and comprehensively... (Review)
Review
BACKGROUND AND AIM
In the present study, the potential changes of oral microbes during pregnancy were investigated by examining the findings of the previous studies and comprehensively examining their results. The relationship between oral microorganisms and birth outcomes and adverse labor outcomes was investigated; to provide sufficient evidence. The purpose of the present study was to evaluate periodontal disease in oral microorganisms during pregnancy.
MATERIALS AND METHODS
All articles were published between January 2011 and January 2023 in international databases, including PubMed, Scopus, Science Direct, and Embase. To answer the research questions, the Google Scholar search engine employed the PECO strategy. STATA.V17 software was used to analyze the data.
RESULTS
Two hundred and eighteen studies were found in the initial search; 63 full texts were reviewed; and finally, 14 articles were included in the analysis. The mean differences in salivary S. mutans carriage before and after prenatal dental treatment were 0.92 (MD; 95 CI [0.57, 1.27], > 0.05). The odds ratio of association between perinatal mortality and periodontal treatment was -0.88 (OR; 95 CI [-2.53, 0.76], > 0.05) and the odds ratio of association between pre-term birth and periodontal treatment was -0.31 (OR; 95 CI [-0.70, 0.09], > 0.05). There was a statistically significant relationship between birth weight and periodontal treatment during pregnancy.
CONCLUSION
According to the present meta-analysis, periodontal treatment can reduce the odds ratio of perinatal mortality and pre-term birth by 88% and 31%, respectively. High association of microorganisms between pregnancy and postpartum requires further study.
RELEVANCE FOR PATIENTS
In the findings of the present study, it is observed that during pregnancy, there is a direct relationship between periodontal disease with low birth weight, perinatal mortality, and pre-term delivery; however, the high association of microorganisms between pregnancy and postpartum requires further study. Oral microforms are reported to be affected in pregnant women, and they should take extra care of their mouth and teeth. Sufficient and strong evidence can help to improve the health outcomes of mothers and children.
PubMed: 37181818
DOI: No ID Found -
Women and Birth : Journal of the... Sep 2023Stillbirth is one of the most devastating pregnancy outcomes that families can experience. Previous research has associated a wide range of risk factors with stillbirth,... (Review)
Review
BACKGROUND
Stillbirth is one of the most devastating pregnancy outcomes that families can experience. Previous research has associated a wide range of risk factors with stillbirth, including maternal behaviours such as substance use, sleep position and attendance and engagement with antenatal care. Hence, some preventive efforts have been focused on tackling the behavioural risk factors for stillbirth. This study aimed to identify the Behaviour Change Techniques (BCTs) used in behaviour change interventions tacking behavioural risk factors for stillbirth such as substance use, sleep position, unattendance to antenatal care and weight management.
STUDY DESIGN
A systematic review of the literature was conducted in June 2021 and updated in November 2022 in five databases: CINHAL, Psyhinfo, SociIndex, PubMed and Web of Science. Studies published in high-income countries describing interventions designed in the context of stillbirth prevention, reporting stillbirth rates and changes in behaviour were eligible for inclusion. BCTs were identified using the Behaviour Change Technique Taxonomy v1.
RESULTS
Nine interventions were included in this review identified in 16 different publications. Of these, 4 interventions focused on more than one behaviour (smoking, monitoring fetal movements, sleep position, care-seeking behaviours), one focused on smoking, three on monitoring fetal movements and one on sleep position. Twenty-seven BCTs were identified across all interventions. The most commonly used was "Information about health consequences" (n = 7/9) followed by "Adding objects to the environment" (n = 6/9). One of the interventions included in this review has not been assessed for efficacy yet, of the remaining eight, three showed results in the reduction of stillbirth rates. and four interventions produced behaviour change (smoking reductions, increased knowledge, reduced supine sleeping time).
CONCLUSIONS
Our findings suggest that interventions designed to date have limited effects on the rates of stillbirth and utilise a limited number of BCTs which are mostly focused on information provision. Further research is necessary to design evidence base behaviour change interventions with a greater focus to tackle all the other factors influencing behaviour change during pregnancy (e.g.: social influence, environmental barriers).
Topics: Humans; Pregnancy; Female; Stillbirth; Behavior Therapy; Prenatal Care
PubMed: 37179243
DOI: 10.1016/j.wombi.2023.05.002 -
Midwifery Aug 2023The widespread availability of reproductive technology and family planning services has led to an increase in the number of available pathways to parenthood for LGBTIQA+...
Experiences in the delivery of preconception and pregnancy care for LGBTIQA+ people: A systematic review and thematic synthesis of patient and healthcare provider perspectives.
BACKGROUND
The widespread availability of reproductive technology and family planning services has led to an increase in the number of available pathways to parenthood for LGBTIQA+ people. However, emerging research indicates that significant healthcare inequities have been documented among LGBTIQA+ people and attributed to the pervasiveness of structural and systemic discrimination that extends to preconception and pregnancy care.
AIM
The aim of this systematic review was to synthesise qualitative research that has explored the experiences of LGBTIQA+ people in navigating preconception and pregnancy care services to inform healthcare quality improvement.
METHOD
Six databases were searched for relevant research published between 2012 and 2023. The findings of all included studies underwent a secondary thematic synthesis, and methodological quality was assessed using the Joanna Briggs Institute Checklist for Qualitative Research.
FINDINGS
A total of 37 studies were eligible for inclusion. Four major themes were constructed through thematic synthesis: (1) unavailability of information, services, and support; (2) clinical competencies of healthcare staff; (3) hetero- and cis-sexist care experiences; and (4) discrimination and traumatisation.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
The findings of this review indicate that LGBTIQA+ people experience significant challenges during the journey towards parenthood, marked predominantly by the pervasiveness of inequity, and defined by discriminatory healthcare processes. This review has led to several recommendations for future healthcare quality improvement through an investment in policies, procedures, and interactions that are sensitive to the needs of LGBTIQA+ people. Importantly, future research must be co-designed and led by LGBTIQA+ community input.
Topics: Pregnancy; Female; Humans; Delivery of Health Care; Prenatal Care; Qualitative Research; Clinical Competence; Health Personnel
PubMed: 37178659
DOI: 10.1016/j.midw.2023.103712 -
The Cochrane Database of Systematic... May 2023Acceptable, effective and feasible support strategies (interventions) for parents experiencing complex post-traumatic stress disorder (CPTSD) symptoms or with a history... (Review)
Review
BACKGROUND
Acceptable, effective and feasible support strategies (interventions) for parents experiencing complex post-traumatic stress disorder (CPTSD) symptoms or with a history of childhood maltreatment may offer an opportunity to support parental recovery, reduce the risk of intergenerational transmission of trauma and improve life-course trajectories for children and future generations. However, evidence relating to the effect of interventions has not been synthesised to provide a comprehensive review of available support strategies. This evidence synthesis is critical to inform further research, practice and policy approaches in this emerging area.
OBJECTIVES
To assess the effects of interventions provided to support parents who were experiencing CPTSD symptoms or who had experienced childhood maltreatment (or both), on parenting capacity and parental psychological or socio-emotional wellbeing.
SEARCH METHODS
In October 2021 we searched CENTRAL, MEDLINE, Embase, six other databases and two trials registers, together with checking references and contacting experts to identify additional studies.
SELECTION CRITERIA
All variants of randomised controlled trials (RCTs) comparing any intervention delivered in the perinatal period designed to support parents experiencing CPTSD symptoms or with a history of childhood maltreatment (or both), to any active or inactive control. Primary outcomes were parental psychological or socio-emotional wellbeing and parenting capacity between pregnancy and up to two years postpartum.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the eligibility of trials for inclusion, extracted data using a pre-designed data extraction form, and assessed risk of bias and certainty of evidence. We contacted study authors for additional information as required. We analysed continuous data using mean difference (MD) for outcomes using a single measure, and standardised mean difference (SMD) for outcomes using multiple measures, and risk ratios (RR) for dichotomous data. All data are presented with 95% confidence intervals (CIs). We undertook meta-analyses using random-effects models.
MAIN RESULTS
We included evidence from 1925 participants in 15 RCTs that investigated the effect of 17 interventions. All included studies were published after 2005. Interventions included seven parenting interventions, eight psychological interventions and two service system approaches. The studies were funded by major research councils, government departments and philanthropic/charitable organisations. All evidence was of low or very low certainty. Parenting interventions Evidence was very uncertain from a study (33 participants) assessing the effects of a parenting intervention compared to attention control on trauma-related symptoms, and psychological wellbeing symptoms (postpartum depression), in mothers who had experienced childhood maltreatment and were experiencing current parenting risk factors. Evidence suggested that parenting interventions may improve parent-child relationships slightly compared to usual service provision (SMD 0.45, 95% CI -0.06 to 0.96; I = 60%; 2 studies, 153 participants; low-certainty evidence). There may be little or no difference between parenting interventions and usual perinatal service in parenting skills including nurturance, supportive presence and reciprocity (SMD 0.25, 95% CI -0.07 to 0.58; I = 0%; 4 studies, 149 participants; low-certainty evidence). No studies assessed the effects of parenting interventions on parents' substance use, relationship quality or self-harm. Psychological interventions Psychological interventions may result in little or no difference in trauma-related symptoms compared to usual care (SMD -0.05, 95% CI -0.40 to 0.31; I = 39%; 4 studies, 247 participants; low-certainty evidence). Psychological interventions may make little or no difference compared to usual care to depression symptom severity (8 studies, 507 participants, low-certainty evidence, SMD -0.34, 95% CI -0.66 to -0.03; I = 63%). An interpersonally focused cognitive behavioural analysis system of psychotherapy may slightly increase the number of pregnant women who quit smoking compared to usual smoking cessation therapy and prenatal care (189 participants, low-certainty evidence). A psychological intervention may slightly improve parents' relationship quality compared to usual care (1 study, 67 participants, low-certainty evidence). Benefits for parent-child relationships were very uncertain (26 participants, very low-certainty evidence), while there may be a slight improvement in parenting skills compared to usual care (66 participants, low-certainty evidence). No studies assessed the effects of psychological interventions on parents' self-harm. Service system approaches One service system approach assessed the effect of a financial empowerment education programme, with and without trauma-informed peer support, compared to usual care for parents with low incomes. The interventions increased depression slightly (52 participants, low-certainty evidence). No studies assessed the effects of service system interventions on parents' trauma-related symptoms, substance use, relationship quality, self-harm, parent-child relationships or parenting skills.
AUTHORS' CONCLUSIONS
There is currently a lack of high-quality evidence regarding the effectiveness of interventions to improve parenting capacity or parental psychological or socio-emotional wellbeing in parents experiencing CPTSD symptoms or who have experienced childhood maltreatment (or both). This lack of methodological rigour and high risk of bias made it difficult to interpret the findings of this review. Overall, results suggest that parenting interventions may slightly improve parent-child relationships but have a small, unimportant effect on parenting skills. Psychological interventions may help some women stop smoking in pregnancy, and may have small benefits on parents' relationships and parenting skills. A financial empowerment programme may slightly worsen depression symptoms. While potential beneficial effects were small, the importance of a positive effect in a small number of parents must be considered when making treatment and care decisions. There is a need for further high-quality research into effective strategies for this population.
Topics: Female; Pregnancy; Humans; Stress Disorders, Post-Traumatic; Parents; Psychotherapy; Mothers; Pregnant Women
PubMed: 37146219
DOI: 10.1002/14651858.CD014874.pub2 -
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 -
Alcohol, Clinical & Experimental... Jul 2023Early assessment and diagnosis of FASD are crucial in providing therapeutic interventions that aim to enhance meaningful participation and quality of life for... (Review)
Review
Early assessment and diagnosis of FASD are crucial in providing therapeutic interventions that aim to enhance meaningful participation and quality of life for individuals and their families, while reducing psychosocial difficulties that may arise during adolescence and adulthood. Individuals with lived experience of FASD have expertise based on their own lives and family needs. Their insights into the assessment and diagnostic process are valuable for improving service delivery and informing the provision of meaningful, person- and family-centered care. To date, reviews have focused broadly on the experiences of living with FASD. The aim of this systematic review is to synthesize qualitative evidence on the lived experiences of the diagnostic assessment process for FASD. Six electronic databases, including PubMed, the Cochrane Library, CINAH, EMBASE, PsycINFO, and Web of Science Core Collection were searched from inception until February 2021, and updated in December 2022. A manual search of reference lists of included studies identified additional studies for inclusion. The quality of included studies was assessed using the Critical Appraisal Skills Program Checklist for Qualitative Studies. Data from included studies were synthesized using a thematic analysis approach. GRADE-CERQual was used to assess confidence in the review findings. Ten studies met the selection criteria for inclusion in the review. Thematic analysis identified 10 first-level themes relating to four over-arching topics: (1) pre-assessment concerns and challenges, (2) the diagnostic assessment process, (3) receipt of the diagnosis, and (4) post-assessment adaptations and needs. GRADE-CERQual confidence ratings for each of the review themes were moderate to high. The findings from this review have implications for referral pathways, client-centered assessment processes, and post-diagnostic recommendations and support.
PubMed: 37132046
DOI: 10.1111/acer.15097 -
The Journal of Maternal-fetal &... Dec 2023Isolated coronary artery fistula (CAF) is a rare entity in which evidence for both prognosis and need for perinatal treatment is lacking. We aim to evaluate the...
BACKGROUND
Isolated coronary artery fistula (CAF) is a rare entity in which evidence for both prognosis and need for perinatal treatment is lacking. We aim to evaluate the characteristics, evolution and perinatal outcomes of reported cases, including one from our center.
MATERIAL AND METHODS
We performed a systematic review in Medline, Pubmed, and Embase databases for cohort studies or case series related to prenatally diagnosed isolated congenital CAF according to PRISMA guidelines. The search was restricted to articles published until January 2022, including a case report from our center. A descriptive analysis was performed, and perinatal characteristics were dichotomized by outcome (development of symptoms, as well as the need for surgery during the neonatal period). Strength of association between prenatal variables and outcome was evaluated through Odds Ratio.
RESULTS
Only 27 cases of prenatal diagnosis of isolated CAF have been published, including our patient. Most had their origin in the right coronary artery (63%) and drained in the right ventricle (55.6%). Most cases (72%) developed progressive intrauterine dilation of the fistulous tract, which was usually associated with symptoms of cardiac overload, such as cardiomegaly (57.7%). Up to two-thirds of prenatally diagnosed patients developed heart failure symptoms in the neonatal period, and 84% required postnatal intervention. Prenatal diagnosis of both cardiomegaly and diastolic steal is associated with an OR of 52 and 41 of developing postnatal symptoms.
CONCLUSION
Prenatal diagnosis of isolated CAF can be achieved with adequate tools and trained sonographers. The development of cardiomegaly and diastolic steal significantly increases the risk of developing postnatal symptoms.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Coronary Vessels; Prognosis; Prenatal Diagnosis; Heart Defects, Congenital; Fistula; Cardiomegaly; Vascular Diseases
PubMed: 37121905
DOI: 10.1080/14767058.2023.2206938 -
JPMA. the Journal of the Pakistan... Feb 2023To explain the factors related to the implementation of antenatal care in developing countries.
OBJECTIVES
To explain the factors related to the implementation of antenatal care in developing countries.
METHOD
The systematic review was conducted in June 2020 and comprised literature search on Scopus, Cumulated Index to Nursing and Allied Health Literature, PubMed and Garba Rujukan Digital databases for cross-sectional, survey-based, prospective, mixed-method, correlational, experimental, longitudinal, cohort and case-control studies published after 2015 in either English or Indonesian. The studies included involved pregnant women and discussed the factors of implementing antenatal care in developing countries, and explained the factors related to the implementation of antenatal care in accordance with the World Health Organisation recommendation. The Population, Intervention, Comparison, Outcomes and Study framework was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Data was analysed using descriptive statistics with a narrative approach.
RESULTS
Of the 9,733 studies initially found, 50(0.005%) were shortlisted for full-text review, and, of them, 15(30%) were reviewed and analysed. There were 3(20%) each from Pakistan and Ghana, 2(13.3%) each from Nepal and India, and 1(6.66%) each from Jordan, Egypt, Yemen, South Africa and Vietnam. Overall, 10(66.6%) were cross-sectional studies. There were five factors identified regarding antenatal care; behaviour intention, social support, accessibility of information, personal autonomy, and action situations, including economic status, availability of facility and transportation.
CONCLUSIONS
Antenatal care in pregnant women in developing countries is influenced by several factors, and economic status and the availability of facilities and infrastructure optimise the use of such services.
Topics: Female; Pregnancy; Humans; Prenatal Care; Health Services Accessibility; Developing Countries; Prospective Studies; Pregnant Women
PubMed: 37096726
DOI: 10.47391/JPMA.Ind-S2-37 -
BMC Pediatrics Apr 2023The developing nervous system in utero is exposed to various stimuli with effects that may be carried forward to the neonatal period. This study aims to investigate the...
BACKGROUND
The developing nervous system in utero is exposed to various stimuli with effects that may be carried forward to the neonatal period. This study aims to investigate the effects of sound stimulation (music and speech) on fetal memory and learning, which was assessed later in neonatal period.
METHODS
The MEDLINE (pubmed), Scopus, EMBASE, and Cochrane Library were searched. Two reviewers selected the studies and extracted the data independently. The quality of eligible studies was assessed using The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials (RCTs).
RESULTS
Overall 3930 articles were retrieved and eight studies met the inclusion criteria. All of the included studies had good general quality; however, high risk of selection and detection bias was detected in most of them. Fetal learning was examined through neonatal electrocardiography (ECG), electroencephalography (EEG), habituation tests, and behavioral responses. Seven studies showed that the infants had learned the fetal sound stimulus and one study indicated that the prenatally stimulated infants performed significantly better on a neonatal behavior test. There was considerable diversity among studies in terms of sound stimulation type, characteristics (intensity and frequency), and duration, as well as outcome assessment methods.
CONCLUSIONS
Prenatal sound stimulation including music and speech can form stimulus-specific memory traces during fetal period and effect neonatal neural system. Further studies with precisely designed methodologies that follow safety recommendations, are needed.
Topics: Pregnancy; Infant, Newborn; Infant; Female; Humans; Prenatal Care; Learning
PubMed: 37081418
DOI: 10.1186/s12887-023-03990-7