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High levels of stress during pregnancy can have lasting effects on maternal and offspring health, which disproportionately impacts families facing financial strain, systemic racism, and other forms of social oppression. Developing ways to monitor daily life stress during pregnancy is important for reducing stress-related health disparities. We evaluated the feasibility and acceptability of using mobile health (mHealth) technology (i.e., wearable biosensors, smartphone-based ecological momentary assessment) to measure prenatal stress in daily life. Fifty pregnant women (67% receiving public assistance; 70% Black, 6% Multiracial, 24% White) completed 10 days of ambulatory assessment, in which they answered smartphone-based surveys six times a day and wore a chest-band device (movisens EcgMove4) to monitor their heart rate, heart rate variability, and activity level. Feasibility and acceptability were evaluated using behavioral meta-data and participant feedback. Findings supported the feasibility and acceptability of mHealth methods: Participants answered approximately 75% of the surveys per day and wore the device for approximately 10 hours per day. Perceived burden was low. Notably, participants with higher reported stressors and financial strain reported lower burden associated with the protocol than participants with fewer life stressors, highlighting the feasibility of mHealth technology for monitoring prenatal stress among pregnant populations living with higher levels of contextual stressors. Findings support the use of mHealth technology to measure prenatal stress in real-world, daily life settings, which shows promise for informing scalable, technology-assisted interventions that may help to reduce health disparities by enabling more accessible and comprehensive care during pregnancy. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed condition in pregnancy, associated with various maternal and fetal complications. This review synthesizes the current evidence on the epidemiology, pathophysiology, and neurological consequences of OSA in pregnancy, along with the potential management strategies. Articles were sourced from the PubMed, EMBASE, and Cochrane databases until 2023. Our comprehensive review highlights that the incidence of OSA increases during pregnancy due to physiological changes such as weight gain and hormonal fluctuations. OSA in pregnancy is linked with gestational hypertension, pre-eclampsia, gestational diabetes, and potential adverse fetal outcomes such as intrauterine growth restriction and preterm birth. Continuous positive airway pressure (CPAP) therapy remains the most effective management strategy for pregnant women with OSA. However, adherence to CPAP therapy is often suboptimal. This comprehensive review underscores the importance of the early recognition, timely diagnosis, and effective management of OSA in pregnancy to improve both maternal and fetal outcomes. Future research should focus on enhancing screening strategies and improving adherence to CPAP therapy in this population. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effect of cumulative prenatal risk factors (RFs) on the presence of Developmental Coordination Disorder (DCD) in young children. Methods: Participants (N = 589, 338 boys, Mage = 4.5 ± 0.5 years) were from a larger cohort study, the Coordination and Activity Tracking in Children (CATCH). Motor coordination was assessed using the Movement Assessment Battery for Children- 2nd Edition. Children were classified as at risk for DCD (DCDr) based on European Academy of Childhood Disability guidelines. RFs were obtained through a parent-completed survey. A multiple logistic regression was conducted to examine the effect of the RFs on DCD. Results: Results showed that the odds of a child having DCDr are significantly higher with a greater total number of prenatal RFs, after adjustment for mother's age at child's birth, child's sex, child's age, marital status and total annual household income (OR = 1.48, p < 0.01). Conclusions: These findings warrant further investigation into the cumulative impact of multiple prenatal RFs and whether specific combinations of RFs might be more strongly linked to DCD than others. These results provide additional insight into possible causes and prevention of DCD. Significance: The literature has shown a negative impact of prenatal risk factors on general motor and cognition skills in children. The results of this study reveal that mothers of children with DCDr reported a greater number of RFs than mothers of typically developing children. Furthermore, the odds of developing DCD are significantly greater as exposure to RFs increases. This study provides additional insight on prenatal care for women and knowledge surrounding perinatal RFs. [ABSTRACT FROM AUTHOR]

Background: Guidelines call for pregnant people to be screened for depression and anxiety. Screening may be particularly important for pregnant Black individuals who are reported to be more likely than non-Hispanic White pregnant people to experience prenatal stress, anxiety, and depressive symptoms. The purpose of this study was to determine if depression, anxiety, and stress co-occur in pregnant Black people and to identify which demographic factors are related to these mental health concerns. Methods: A subset analysis of an ongoing randomized controlled trial examined the risk of coexisting mental health conditions in pregnant Black people who screened eligible to participate (that is, they had high levels of depression, anxiety, and/or stress) in two urban clinics using a descriptive correlational design. Results: Of the 452 pregnant Black people who were screened for eligibility, 194 (42.9%) had elevated scores on depression, anxiety, and/or stress measures and were enrolled in the larger study. The average scores of the 194 enrolled participants were anxiety, mean (M) = 9.16 (standard deviation [SD] = 4.30); depression, M = 12.80 (SD = 4.27); and stress, M = 21.79 (SD = 4.76). More than one-third (n = 70, 36.1%) experienced two symptoms and 64 (33.0%) reported all three symptoms. Conclusion: Pregnant Black individuals experience high levels of comorbid mental health distress including depression, anxiety, and stress. The findings indicate that treatment for mental health concerns needs to be broad-based and effective for all three conditions. Prenatal interventions should aim to address mental health distress through screening and treatment of depression, anxiety, and stress, especially for pregnant Black individuals. This study furthers understanding of the prevalence of prenatal mental health conditions in pregnant Black people. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to explore Somali refugee women's experiences and perceptions of Western health care in the United States. This study took place in the Midwestern region of the United States. Methodology: This qualitative descriptive study collected data from 15 participants through in-depth interviews. Results: Six themes emerged: (a) communication and resource provision, (b) participatory decision-making, (c) provider attitudes toward cultural practices, (d) understanding the U.S. health care system, (e) resistance to Western health care and, (f) religious beliefs. Discussion and Conclusion: Accounts of the women in this study ran the gamut from positive views to those that were more critical and replete with complaints about Western health care providers and the system. Somali refugee women need culturally competent health care providers who provide sensitive care, offer resources, and involve the women in decision-making about their care. [ABSTRACT FROM AUTHOR]

Research on the effects of adversity has led to mounting interest in examining the differential impact of adversity as a function of its timing and type. The current study examines whether the effects of different types (i.e., physical, sexual, and emotional abuse) and timing (i.e., early, middle childhood, adolescence, or adulthood) of adversity on maternal mental and physical health outcomes in pregnancy, are best accounted for by a cumulative model or independent effects model. Women from a prospective pregnancy cohort (N =3,362) reported retrospectively on their experiences of adversity (i.e., physical, sexual, and emotional abuse) in early childhood (0–5 years], middle childhood (6–12 years], adolescence (13–18 years], and adulthood (19+ years]. Measures of overall health, stress, anxiety, and depression were gathered in pregnancy. Results showed that a cumulative formative latent model was selected as more parsimonious than a direct effects model. Results also supported a model where the strength of the effect of adversity did not vary across abuse timing or type. Thus, cumulative adversity resulted in greater physical and mental health difficulties. In conclusion, cumulative adversity is a more parsimonious predictor of maternal physical and mental health outcomes than adversity at any one specific adversity timing or subtype. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to explore the cultural beliefs and practices of resettled Somali refugee women around pregnancy and childbirth. This study took place in the Midwestern region of the United States. Methodology: Leininger's theory of Culture Care Diversity and Universality served as the theoretical framework for the design of this qualitative descriptive study. Data were collected from 15 Somali refugee women through in-depth interviews. Results: Three major themes emerged from this study. This article focuses on one of the themes: It's what women believe and do. This theme is reflective and indicative of the Somali refugee women cultural beliefs and practices during pregnancy, and during and after childbirth. Discussion and Conclusion: Somali refugee women approached, managed, and conceptualized pregnancy and childbirth in their cultural context. Western health care providers should strive to understand cultural beliefs and conceptualizations that may influence the utilization of prenatal health care. [ABSTRACT FROM AUTHOR]

Introduction Prenatal health programs provide health education, reproductive care and related services to women. Programs may be administered individually or collaboratively by agencies including public health units, hospitals, health clinics, community and non-governmental organizations. Prenatal health disparities among populations at-risk may be reduced through the provision of accessible health education, services and resources to help women mitigate modifiable risks to pregnancy. Although standardized guidelines inform clinical screening, testing and maternity care, gaps exist regarding the design, implementation and evaluation for comprehensive prenatal health programs. Methods Using a multijurisdictional approach, prenatal health guidance documents released by clinical associations and regional governments across Canada, Australia, the United States, the United Kingdom and Ireland were systematically evaluated to identify standards and practices regarding the design, implementation and evaluation of prenatal health programs. Results Evidence-based, surveillance/monitoring, and expert/stakeholder collaborations were principles affirmed by guidance documents across all jurisdictions. Each jurisdiction described tailored strategies to optimize prenatal health in their respective communities. Divergence between jurisdictions was noted for patient care models and promotion of providers and companions of choice. Discussion A best practices model is proposed describing recommendations as follows: prenatal health programs should be grounded in a theoretical approach, fundamentally woman-centered and designed to address interacting prenatal health determinants across the lifespan. Accessible and inclusive prenatal health care can be achieved through provider training and community stakeholder collaborations. Identification of best practices for prenatal health program design, implementation and evaluation ensures that service standards are harmonized across communities, thereby optimizing maternal and child health. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To date, most investigations of mental health in pregnant women have focused on depression or substance use. This study aimed to (a) delineate the relationships between symptoms of attention‐deficit/hyperactivity disorder (ADHD) and prenatal health behaviors and (b) explore whether the symptom clusters of ADHD differentially predict prenatal health behaviors (e.g., physical strain, healthy eating, prenatal vitamin use). Method: A total of 198 pregnant women (mean age = 27.94 years) completed measures of ADHD symptoms, prenatal health behaviors, and depression. Results: Inattention, hyperactivity, and impulsivity/emotional lability all evidenced significant relationships with the prenatal health behaviors, each differentially predicting different prenatal health behaviors. Conclusion: As decreased engagement in adequate prenatal health behaviors puts both the mother and fetus at risk for negative birth outcomes, future research should work to develop a brief ADHD screen to be used in obstetric clinics and should investigate these relationships within a sample of women with a diagnosis of ADHD. [ABSTRACT FROM AUTHOR]

Recent research in environmental epidemiology has attempted to estimate the effects of exposure to nature, often operationalized as vegetation, on health. Although many analyses have focused on vegetation or greenness with regard to physical activity and weight status, an incipient area of interest concerns maternal health and birth outcomes. This paper reviews 14 studies that examined the association between greenness and maternal or infant health. Most studies were cross-sectional and conducted in birth cohorts. Several studies found evidence for positive associations between greenness and birth weight and maternal peripartum depression. Few studies found evidence for an association between greenness and gestational age or other birth outcomes, or between greenness and preeclampsia or gestational diabetes. Several assessed effect modification by individual or area-level socioeconomic status and found that effects were stronger among those of lower socioeconomic status. Few studies conducted mediation analyses of any kind. Future research should include more diverse birth outcomes and focus on maternal health (especially mental health) and capitalize on richer exposure information during pregnancy rather than cross-sectional assessment at birth. [ABSTRACT FROM AUTHOR]

Objectives Domains of psychosocial health have been separately connected to pregnancy outcomes. This study explores the relationship between five domains of psychosocial health and their joint association with prenatal health and pregnancy outcomes. Methods Women from a prospective cohort study in Durham, North Carolina were clustered based on measures of paternal support, perceived stress, social support, depression, and self-efficacy. Clusters were constructed using the K-means algorithm. We examined associations between psychosocial health and maternal health correlates, pregnancy intention, and pregnancy outcomes using Chi square tests and multivariable models. Results Three psychosocial health profiles were identified, with the first (Resilient; n = 509) characterized by low depression and perceived stress and high interpersonal support, paternal support, and self-efficacy. The second profile (Vulnerable; n = 278) was marked by high depression and perceived stress, and low interpersonal support, paternal support, and self-efficacy. The third profile (Moderate, n = 526) fell between the other profiles on all domains. Health correlates, pregnancy intention, and pregnancy outcomes varied significantly across profiles. Women with the vulnerable profile were more likely to have risky health correlates, have an unintended pregnancy, and deliver preterm. Women with the resilient profile had better birth outcomes and fewer deleterious health correlates, preconception and prenatally. Conclusions We posit that vulnerable psychosocial health, deleterious health correlates, and the stress which often accompanies pregnancy may interact to magnify risk during pregnancy. Identifying and intervening with women experiencing vulnerable psychosocial health may improve outcomes for women and their children. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance In West Africa, women utilize wild plant species to maintain and enhance their health throughout the duration of pregnancy. These plants are a culturally resilient and financially accessible form of nourishment for pregnant women in the region, many of whom are malnourished, yet studies that identify both the nutritional and medicinal properties of these plants are limited. Aim of the study The objective of this study was to analyze women’s knowledge of plants consumed in pregnancy in the southern regions of Ghana and Benin from a food-medicine continuum perspective. Materials and methods We gathered data in two fieldwork periods in West Africa (Ghana 2010 and Benin 2011) through herbal market surveys and 56 questionnaires with women and then conducted a literature review on known properties of the plants. Results Ghanaian women reported consuming wild greens such as iron-rich Nephrolepis biserrata and tree barks such as protein-rich Ricinodendron heudelotii in a soup based on the African oil palm fruit ( Elaeis guineensis ), a source of fatty acids. In Benin, participants frequently reported ingesting plants during pregnancy in the form of herbal teas. Commonly cited species included Securidaca longipedunculata, Dichapetalum madagascariense, and Schwenckia americana. Several of the plants demonstrated antioxidant, anti-malarial and anti-inflammatory activity in pharmacological studies, yet the majority has incomplete nutritional and pharmacological profiles. In total, informants cited 105 species that were consumed during pregnancy. Although Ghanaian and Beninese women mentioned different species and different forms of consumption, in both countries women cited “strengthening” as the most common motivation to consume wild plants during pregnancy. Strengthening is a concept that resonates within the food-medicine continuum, bridging the local diet and herbal pharmacopoeia of women’s plant use during pregnancy. Conclusions Ethnobotanical studies of this nature highlight the multidimensional use of plants and can improve health and nutritional programs in the region. [ABSTRACT FROM AUTHOR]

Introduction. 'Parto fortuito' is a term used in Mexico to describe the births that happen outside the obstetric areas of hospitals. It involves a great number of conditions, some which have a high index of morbidity and mortality both maternal and perinatal. Objectives. To determine this phenomena frequency worldwide and to identify its determining factors and the maternal and perinatal consequences. Method and materials. A narrative revision of the medical literature, both in English and Spanish, published from January 1994 to April 2004. Results. The accidental out-of-hospital delivery is a worldwide condition with frequency variations in terms of human development in a country or micro-region. However, there are characteristics that are repeated in the different published studies: women with low economic status and low academic level, without prenatal control, multiparous, with a long distance between their homes and hospitals, or with difficulties to access a transport medium; as well as deficiencies in the pre-hospital ambulatory system attention. Conclusions. Maternal health and its deviations, such as the accidental out-of-hospital delivery, are sensitive signs of the health system's comprehensive functioning in which medical, economic and socio-cultural factors participate, which makes it into an excellent sentinel event to evaluate the access and quality of the obstetric attention in the health services. [ABSTRACT FROM AUTHOR]

Background: Coordination between the autonomous professional groups in midwifery and obstetrics is a key debate in the Netherlands. At the same time, it remains unclear what the current coordination challenges are. Methods: To examine coordination challenges that might present a barrier to delivering optimal care, we conducted a qualitative field study focusing on midwifery and obstetric professional's perception of coordination and on their routines. We undertook 40 interviews with 13 community midwives, 8 hospital-based midwives and 19 obstetricians (including two resident obstetricians), and conducted non-participatory observations at the worksite of these professional groups. Results: We identified challenges in terms of fragmented organizational structures, different perspectives on antenatal health and inadequate interprofessional communication. These challenges limited professionals' coordinating capacity and thereby decreased their ability to provide optimal care. We also found that pregnant women needed to compensate for suboptimal coordination between community midwives and secondary caregivers by taking on an active role in facilitating communication between these professionals. Conclusions: The communicative role that pregnant women play within coordination processes underlines the urgency to improve coordination. We recommend increasing multidisciplinary meetings and training, revising the financial reimbursement system, implementing a shared maternity notes system and decreasing the expertise gap between providers and clients. In the literature, communication by clients in support of coordination has been largely ignored. We suggest that studies include client communication as part of the coordination process. [ABSTRACT FROM AUTHOR]

In this article, we study the effects of prenatal health on educational attainment and on the reproduction of family background inequalities in education. Using Finnish birth cohort data, we analyze several maternal and fetal health variables, many of which have not been featured in the literature on long-term socioeconomic effects of health despite the effects of these variables on birth and short-term health outcomes. We find strong negative effects of mother's prenatal smoking on educational attainment, which are stronger if the mother smoked heavily but are not significant if she quit during the first trimester. Anemia during pregnancy is also associated with lower levels of attained education. Other indicators of prenatal health (pre-pregnancy obesity, mother's antenatal depressed mood, hypertension and preeclampsia, early prenatal care visits, premature birth, and small size for gestational age) do not predict educational attainment. Our measures explain little of the educational inequalities by parents' class or education. However, smoking explains 12%-and all health variables together, 19%-of the lower educational attainment of children born to unmarried mothers. Our findings point to the usefulness of proximate health measures in addition to general ones. They also point to the potentially important role played by early health in intergenerational processes. [ABSTRACT FROM AUTHOR]

Our objective was to evaluate in an exploratory framework the effects of prenatal use of folic acid and other dietary supplements on child development at around 3 years of life. Data from the 1988 National Maternal Infant Health Survey and the 1991 follow-up supplement is used. Performance indicators are formed based on 16 developmental assessment items completed by the mother to measure overall as well as domain specific (language, personal-social, gross-motor and fine-motor) development. Pooled as well as separate analyses by child race are performed. Multinomial and binary outcome logistic regression is used and several maternal and household characteristics are included as covariates. Folic acid use was associated with improved gross-motor development with a more pronounced effect among African-American children, but there was marginally significant poorer performance for the personal-social domain. Zinc and calcium use were associated with increased risks on the overall development scale and two other developmental domains. The negative effects of Zinc on overall development were only observed among white children. On the contrary, vitamin A was associated with decreased risks on the overall development scale only among white children. Study results suggest that while prenatal folic acid supplementation may improve development at 3 years of age, further research is needed in this regard. The results also emphasize the importance of further research into the use of prenatal calcium and zinc supplementation in a US population. [ABSTRACT FROM AUTHOR]