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Maternal mortality rates within the United States have reached an all-time high.  Annually, nearly seven hundred women die from pregnancy-related complications, a number of which were highly preventable.  When taking a closer look at these statistics, these deaths disproportionately affect Native American and African American women, making them two to three times more likely to suffer from poorer pregnancy outcomes.  This paper examines the variety of factors that contribute to such a disproportionate maternal mortality rate, including geographic differences, racial and economic inequalities, and the accessibility of healthcare.  Despite attempts to fix these issues, systemic and intrinsic issues persist, and individuals continue to suffer.  This paper highlights the need to address maternal mortality disparities that affect marginalized groups, improved accessibility to healthcare for all, and overall policy reform in order to solve this issue indefinitely.

Background: Antenatal care (ANC) plays a crucial role in reducing maternal fatalities and morbidities through early detection and management of pregnancy-related complications and ensures the proper referral in the level of care. Various variables facilitate a pregnant woman’s ability to schedule enough ANC visits. This research sought to identify factors contributing to Tanzanian pregnant women receiving adequate antenatal care. Methods: The study used data from the 2015-16 TDHS-MIS. We analysed a total of 6924 included in the analysis. The outcome variable was adequate ANC, and we assessed different predictors on how they influence good antenatal care attendance. Bivariate (chi-square) and multivariate logistic regression were conducted at the statistical significance of p < 0.05. Results: 3438 (49.7%) had inadequate ANC visits. Determinants for antenatal attendance included giving birth outside health facility (aOR = 0.77, 95%CI = 0.62–0.95, p-value = 0.02) are less likely to complete all the ANC, mothers who book early for ANC (aOR = 5.79, 95%CI = 4.56–7.35, p-value < 0.001) were more likely to achieve the recommended visits, parity of 2 to 4 (aOR = 0.63, 95%CI = 0.48–0.81, p-value < 0.001), and five and above (aOR = 0.48, 95%CI = 0.35–0.68, p-value < 0.001) showed a decreased odd to complete adequate ANC, the use of the Internet (aOR = 1.62, 95%CI = 1.08–2.42, p-value = 0.02) were two times more likely to attend the required visits, pregnant mothers who experienced sexual violence from partners (aOR = 0.70, 95%CI = 0.52–0.94, p-value = 0.02) were less likely to complete the adequate visit, and the use of the mobile telephone for health-related issues (aOR = 1.476, 95%CI = 1.02–2.14, p-value = 0.04) slightly increase the chance of attending adequate visits. Conclusion: This study identified determinants influencing ANC visits. ANC booking, using the Internet, and mobile phones enhance the likelihood of completing recommended ANC visits while higher parity and experiencing partner-related sexual violence decrease these chances. These findings show a need for addressing wealth inequality, geographical barriers, the impact of intimate partner violence, encouraging internet access for health information, and health promotion for early ANC booking to improve the uptake of ANC services. [ABSTRACT FROM AUTHOR]

Objective(s): Maternal health indicators, especially for pregnant mothers, are among the most important health indicators for any country. Given the implementation of the health transformation plan in the service delivery system in Iran, it was expected that there would be a significant improvement in the quality and quantity of services provided to mothers in recent years. Therefore, the aim of this research was to investigate the effect of implementing healthcare reform on maternal health indicators in East Azerbaijan province, Iran. Methods: This was a quasi-experimental study. The research population consisted of people living in villages in East Azerbaijan province - Tabriz district, Iran; with active health centers from 2007 to 2016, including a sample size of 200 mothers per year. Villages were randomly selected as clusters. Data collection tool was a questionnaire and all data were analyzed by SPSS version 22 statistical software. Results: The findings showed that the mean age of mothers during the study period ranged from 25 to 27 years. The number of pregnancies before the reform was 1.39 and after the reform, it was 1.20 which was statistically significant. Examination of the insurance status of pregnant mothers showed that before the reform, 6.4% of rural residents were uninsured, while after the reform, all of them were covered. In terms of laboratory services, 97.7% of mothers underwent routine tests in the first trimester, and 90.5% underwent routine tests in the second trimester. Additionally, over 99% of mothers had undergone at least one ultrasound, with an average of 2.56 ultrasound appointments. Conclusion: The implementation of the healthcare reform increased the insurance coverage of pregnant mothers and the utilization of services such as ultrasound. This initiative led to a reduction in maternal and neonatal mortality rates and a decrease in the rate of natural childbirth. [ABSTRACT FROM AUTHOR]

Objective(s): Maternal health indicators, especially for pregnant mothers, are among the most important health indicators for any country. Given the implementation of the health transformation plan in the service delivery system in Iran, it was expected that there would be a significant improvement in the quality and quantity of services provided to mothers in recent years. Therefore, the aim of this research was to investigate the effect of implementing healthcare reform on maternal health indicators in East Azerbaijan province, Iran. Methods: This was a quasi-experimental study. The research population consisted of people living in villages in East Azerbaijan province - Tabriz district, Iran; with active health centers from 2007 to 2016, including a sample size of 200 mothers per year. Villages were randomly selected as clusters. Data collection tool was a questionnaire and all data were analyzed by SPSS version 22 statistical software. Results: The findings showed that the mean age of mothers during the study period ranged from 25 to 27 years. The number of pregnancies before the reform was 1.39 and after the reform, it was 1.20 which was statistically significant. Examination of the insurance status of pregnant mothers showed that before the reform, 6.4% of rural residents were uninsured, while after the reform, all of them were covered. In terms of laboratory services, 97.7% of mothers underwent routine tests in the first trimester, and 90.5% underwent routine tests in the second trimester. Additionally, over 99% of mothers had undergone at least one ultrasound, with an average of 2.56 ultrasound appointments. Conclusion: The implementation of the healthcare reform increased the insurance coverage of pregnant mothers and the utilization of services such as ultrasound. This initiative led to a reduction in maternal and neonatal mortality rates and a decrease in the rate of natural childbirth.

Abstract Introduction Refugee HIV positive mothers experience significant obstacles in accessing, utilizing and adhering to antiretroviral therapy (ART). Identifying ART non-adherence can help in the development of interventions aimed at improving adherence and subsequently effectiveness of ART among the refugee mothers. We describe the use and the factors associated with non-adherence to ART among Refugee HIV positive pregnant mothers aged 18–49 years in Kyangwali Refugee Camp, Uganda. Methods We conducted a cross-sectional study among HIV positive pregnant mothers aged 18–49 years in Kyangwali refugee camp between May and June 2023. Using a structured questionnaire, we collected data on use, and factors associated with non-adherence to ART. We used modified Poisson regression analysis to determine factors associated with non-adherence to ART. Results Of the 380 participants enrolled, 192 (50.5%) were married, mean age 32.1 years. Overall, 98.7; 95% Confidence Interval (CI) [97.5–99.8%] were using ART and 27.4; 95% CI [22.9–31.9%] were non-adherent. Non-adherence was associated with: Initiating Prevention of Mother to Child Transmission (PMTCT) care in the third trimester of pregnancy (adjusted Prevalence ration(aPR): 2.06; 95% CI: 1.27–3.35), no need to get permission to seek PMTCT services aPR 1.61; 95% CI [1.07–2.42] and poor attitude of PMTCT providers aPR 1.90; 95% CI [1.20–3.01]. Conclusion and recommendations Non-adherence to ART was generally high; therefore limiting the effectiveness of the PMTCT program in this setting. Refugee context specific education interventional programs aimed at early initiation into HIV care, strong social and psychological support from families, communities and health care providers are vital to improve adherence in this setting.

Background: The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being, not just the absence of illness or disability, allowing individuals to lead socially and economically productive lives. A WHO expert panel has suggested that anaemia should be diagnosed when haemoglobin levels fall below 13g/dl in adult men, 12g/dl in non-pregnant adult women, and below 11g/dl in pregnant women. Anaemia during pregnancy is typically due to iron deficiency. WHO estimates that two billion people worldwide are affected by anaemia, with around 50% of cases caused by iron deficiency. Anaemia is linked to several maternal and foetal complications, including reducing a woman's ability to cope with blood loss during or after childbirth. It is also associated with low birth weight, premature delivery, intrauterine growth retardation, and higher perinatal mortality. Aim: To assess the association of various socioeconomic and demographic factors on anaemia and the degree of anaemia found in pregnant mothers at RHC. Objectives: 1. To assess the influence of social and economic status and factors influencing anaemia in pregnant mothers using B.G. Prasad classification. 2. To assess the influence of demographic factors like parity, education, occupation, etc. on anaemia in pregnant mothers. 3. To assess the utilization of various ANC services being provided at RHC especially the use of iron and folic acid tablets. Materials and Methods: This is a longitudinal prospective observational study conducted in a field practice area. The study was undertaken at a RHTC under Tertiary Care Teaching Hospital. All the pregnant women who were anaemic i.e. whose Hb levels were less than 11g/dl (according to WHO classification) and who had no other comorbidities who visited the RHTC for the first time were included in the study. All pregnant women whose Hb levels were below 11g/dl and who visited the RHTC for the first time for various antenatal services during the study period were included in the study. All anaemic pregnant women in any trimester of pregnancy were included in the study. Results: Table shows the level of anaemia among the 178 subjects included in the study divided according to the WHO classification of anaemia in pregnancy. It shows that 61 participants (34.26%) had mild anaemia, 98(55.05%) mothers had moderate anaemia whereas 19(10.6%) had severe type of anaemia. According to table 7 of the 178 pregnant anaemic mothers, 39(21.91%) were taking iron and folic acid tablets regularly, 66(37.07%) were taking iron and folic acid tablets irregularly whereas 73(41.01%) were not taking any iron and folic acid tablets. Of the 178 participating anaemic pregnant mothers, 123(69.10%) visited ANC units 1-2 times and 55(30.89%) visited ANC units 3 or more times. As seen in table 8, of the 123 pregnant mothers with anaemia who visited the ANC unit 1-2 times in the present pregnancy, 41(33.33%) had mild anaemia, 67(54.47%) had moderate anaemia and 15(12.19%) had severe anaemia. Of the 55 pregnant mothers with anaemia who visited the ANC unit 3 or more times in the present pregnancy, 20(36.36%) had mild anaemia, 31(56.36%) had moderate anaemia and 4(7.27%) had severe anaemia. Conclusion: Most of the anaemic pregnant women were in middle socioeconomic class i.e. class 3 with majority having completed primary education and were Hindu housewives with mixed diets living in a joint family. Even with the low levels of Hb most of the women were not taking any IFA tablets and the birth spacing was not 3 years in majority of the cases. [ABSTRACT FROM AUTHOR]

Introduction: Refugee HIV positive mothers experience significant obstacles in accessing, utilizing and adhering to antiretroviral therapy (ART). Identifying ART non-adherence can help in the development of interventions aimed at improving adherence and subsequently effectiveness of ART among the refugee mothers. We describe the use and the factors associated with non-adherence to ART among Refugee HIV positive pregnant mothers aged 18–49 years in Kyangwali Refugee Camp, Uganda. Methods: We conducted a cross-sectional study among HIV positive pregnant mothers aged 18–49 years in Kyangwali refugee camp between May and June 2023. Using a structured questionnaire, we collected data on use, and factors associated with non-adherence to ART. We used modified Poisson regression analysis to determine factors associated with non-adherence to ART. Results: Of the 380 participants enrolled, 192 (50.5%) were married, mean age 32.1 years. Overall, 98.7; 95% Confidence Interval (CI) [97.5–99.8%] were using ART and 27.4; 95% CI [22.9–31.9%] were non-adherent. Non-adherence was associated with: Initiating Prevention of Mother to Child Transmission (PMTCT) care in the third trimester of pregnancy (adjusted Prevalence ration(aPR): 2.06; 95% CI: 1.27–3.35), no need to get permission to seek PMTCT services aPR 1.61; 95% CI [1.07–2.42] and poor attitude of PMTCT providers aPR 1.90; 95% CI [1.20–3.01]. Conclusion and recommendations: Non-adherence to ART was generally high; therefore limiting the effectiveness of the PMTCT program in this setting. Refugee context specific education interventional programs aimed at early initiation into HIV care, strong social and psychological support from families, communities and health care providers are vital to improve adherence in this setting. [ABSTRACT FROM AUTHOR]

Background and Aim: Gestational diabetes is the most common complication of pregnancy that can lead to adverse consequence for the pregnant mother and the fetus. The purpose of this study was to investigate the relationship between blood groups and gestational diabetes. Materials and Methods: This case-control study included 211 pregnant women with gestational diabetes as cases and 211 pregnant women without gestational diabetes as controls. We used two-stage sampling method. In the first stage, 10 bases were randomly selected from 35 active bases in the urban areas of Sanandaj, and in the next stage, the cases were entered into the study using census method and the controls were selected based on convenience sampling. Using SPSS 16 software analysis, Data were analyzed by chi-square test and logistic regression. Results: The mean values of age for the pregnant women in the case and control groups were 34.29 ± 5.33 years and 30.05 ± 5.50 years, respectively. The most common blood group in both case and control groups was blood group O (more than 40%). In the univariate analysis of ABO and Rh blood groups, there was no significant relationship between the two groups (p>0.05) in regard to the history of abortion and family history of type 2 diabetes. In the, final regression model age, body mass index and parity showed a significant relationship with gestational diabetes (p

BACKGROUND: Effective family support is essential for promoting the well-being of pregnant women and reducing the risk of adverse pregnancy outcomes. This study examined family support patterns and influencing factors among pregnant women attending antenatal clinics in Ile-Ife, Nigeria. METHODS: This descriptive cross-sectional study involved 384 pregnant women in a Local Government Area in southwestern Nigeria. Three healthcare facilities with the highest antenatal attendance were selected through purposive sampling. Data were collected using a tested and structured questionnaire, which was developed following a review of similar studies. The results were analyzed using SPSS version 20.0, employing Pearson Chi-square tests with a significance level set at p < 0.05. RESULTS: More than half of the respondents reported inadequate family support in various aspects including tangible/instrumental support (52.9%), emotional support (51.4%), and financial support (54.4%). However, the majority reported significant financial supports from their spouses (60.7%). Religion, educational qualification, and partner's occupation were found to significantly influence the likelihood of women receiving higher levels of social support. CONCLUSION: Many respondents lacked adequate support from spouses and families. Encouraging family involvement in antenatal care can improve understanding and support, benefiting maternal and child health. Hence, healthcare professionals and policymakers should consider the factors influencing family support options when designing focused interventions to strengthen maternal support systems and address the varied needs of pregnant women. [ABSTRACT FROM AUTHOR]

BackgroundFear of childbirth is recognized as a growing problem in developing countries, including Ethiopia. The impact of this fear on women's reproductive choices and decisions is significant. Therefore, the systematic review and meta-analysis will help to consolidate the existing research on childbirth-related fear in Ethiopia. Synthesizing the findings and providing a pooled prevalence estimate, can contribute to a better understanding of the scale of the problem in the country.ObjectiveThis systematic review and meta-analysis assessed the pooled prevalence of childbirth-related fear and its associated factors among pregnant mothers in Ethiopia.MethodsPubMed, Google Scholar, and African Journals Online were searched for included articles. A weighted inverse-variance random-effects model was used to estimate the prevalence of childbirth-related fear. Variations in the pooled estimates of the prevalence were adjusted through subgroup analysis according to the specific region where the study was conducted. Funnel plot and Egger's regression test were used to check for publication bias. STATA version 14 statistical software was used for meta-analysis.ResultsA total of 2,015 pregnant mothers were included. The combined prevalence of fear of childbirth among pregnant mothers was found to be 21% (95% CI: 19–22; I2 = 0.00%, p value

Introduction: Infection by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been shown to affect multiple organs in the human body. Research shows that Coronavirus Disease (COVID-19)-positive pregnant women experience poorer perinatal outcomes related to placental infection, including higher risks of miscarriage, preeclampsia, preterm birth, and stillbirth. Aim: To evaluate the histopathological changes in the placentas of COVID-19-positive mothers and the associated foetal outcomes. Materials and Methods: This cohort study was conducted at Kalinga Institute of Medical Sciences (KIMS) Bhubaneswar, Odisha, India, over a period of one year and eight months, from November 2020 to July 2022. It included 23 COVID-19-positive pregnant females admitted for safe confinement during the first and second COVID-19 waves. Thirty COVID-19-negative pregnant women admitted for safe delivery during the same period served as controls. Placentas were collected, processed, and stained according to standard protocols. Descriptive data were interpreted as frequencies and percentages, and associations were tested using the Chi-square test. A p-value

Introduction: Infection by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been shown to affect multiple organs in the human body. Research shows that Coronavirus Disease (COVID-19)-positive pregnant women experience poorer perinatal outcomes related to placental infection, including higher risks of miscarriage, preeclampsia, preterm birth, and stillbirth. Aim: To evaluate the histopathological changes in the placentas of COVID-19-positive mothers and the associated foetal outcomes. Materials and Methods: This cohort study was conducted at Kalinga Institute of Medical Sciences (KIMS) Bhubaneswar, Odisha, India, over a period of one year and eight months, from November 2020 to July 2022. It included 23 COVID-19-positive pregnant females admitted for safe confinement during the first and second COVID-19 waves. Thirty COVID-19-negative pregnant women admitted for safe delivery during the same period served as controls. Placentas were collected, processed, and stained according to standard protocols. Descriptive data were interpreted as frequencies and percentages, and associations were tested using the Chi-square test. A p-value <0.05 was considered statistically significant. Results: The study included 23 cases (mean gestational age: 37 weeks and 5 days) and 30 controls (mean gestational age: 38 weeks and 6 days). The prevalence of Maternal Vascular Malperfusion (MVM) and Foetal Vascular Malperfusion (FVM) was found to be higher among cases than controls. Conclusion: Compared to controls, COVID-19-positive placentas showed a higher prevalence of both MVM and FVM. This might be attributable to the hypercoagulable state associated with COVID-19. Further research is needed to explore the potential effects of intrauterine inflammation on neonates exposed to COVID-19. [ABSTRACT FROM AUTHOR]

Background: Iron/foliate affects the lives of more than two billion people, accounting for over 30% of global population which is the highest in developing countries and about 18% of maternal mortality in low- and middle-income countries. Iron/foliate supplementation for pregnant mothers is the most cost-effective method of reducing iron deficiency, low birth weight, and neural tube defects among pregnant mothers and newborns in resource-limited countries like Ethiopia, so the purpose of this study has been to assess the iron/foliate utilization status of pregnant mothers and associated factors among pregnant mothers. Method: The study have used institution-based cross-sectional design with systematic random sampling, binary and multiple logistic regression to identify significantly associated variables, and a single population proportion formula to determine the sample size. Result: From the total of 318 participants only 32.1% of them utilized iron/foliate adequately. Marital status (AOR; 0.03 95%, CL (0.01–0.86), occupation (AOR; 11.12 95%, CL (1.95–69.05), gestation age when ANC visit started (AOR; 0.23 95%, CL (0.07–0.83), health education(AOR; 36.51 95%, CL (10.14–131.46), waiting time(AOR; 0.07 95%, CL (0.02–0.27) and knowledge (AOR; 0.17 95%, CL (0.05–0.57) were significantly associated variables with the outcome variable. Conclusion: According to this study, 32.1 % utilized iron/foliate adequately, whereas the remaining 67.9 % did not yet. Moreover, this study identified major associated variables with iron/foliate utilization status, including marital status, occupation, gestation age when ANC visit started, health education, average wait time, and knowledge of mothers on anemia/iron.

Abinet Arega Sadore,1 Yohannes Kebede,2 Zewdie Birhanu2 1School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia; 2Department of Health, Behaviour and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Abinet Arega Sadore, PO Box 667 Wachemo University, Hossana, Ethiopia, Email abinetarega24@gmail.comBackground: Poor pregnancy risk perception, ignorance of obstetric risk symptoms, and attitudes toward institutional delivery services are factors that prevent pregnant women from choosing to receive emergency obstetric treatment.Objective: To assess pregnancy risk perception, attitude towards skilled delivery service, and knowledge of obstetric danger signs and associated factors among pregnant mothers.Methods: A cross-sectional community-based study design was used. The 668 pregnant women who participated in this study were chosen using a multi-stage sampling methodology. Data were gathered using a pretested questionnaire that was presented by an interviewer. To find independent factors, logistic regression analysis was used. With a p-value of less than 0.05, which denotes statistical significance, a corresponding 95% confidence interval (CI) was calculated.Results: Pregnancy risk perception was shown to have a lower mean score (23) overall. Only 40.9% of the study participants had high pregnancy risk perception. Over 50% (337) of respondents had a positive attitude towards skilled delivery service utilization. In all categories of obstetric danger signs, only 153 respondents (or 22.9%) knew what the obstetric danger signs were. Maternal age (AOR = 1.966, CI: 1.185– 3.261), maternal education (AOR = 1.965, 1.002– 3.854), and parity (AOR = 0.534, CI: 0.305– 0.933) were factors affecting knowledge of obstetric danger signs. Pregnancy risk Perception (AOR = 14.7, CI: 9.849– 22.235) and parity (AOR = 2.27, CI: 1.381– 3.733) were significantly associated with attitudes on the use of skilled delivery services.Conclusion: This study found that pregnant women in rural locations had poor levels of knowledge of obstetric danger sign, attitude toward using skilled delivery services, and perception of pregnancy risk. The knowledge of obstetric danger indicators among pregnant women was considerably affected by the mother’s age, education, and parity. The perception of pregnancy risk and parity were found to be substantially associated with attitudes towards skilled delivery services.Keywords: pregnancy risk perception, pregnant mothers, Ethiopia

Tobacco use during and around pregnancy can significantly increase the risk of stillbirth, congenital disabilities, premature birth, and low-weight birth. To establish maternal tobacco prevention and cessation frameworks for primary care and dental providers and to facilitate cross-national learning, this scoping review aims: 1) to analyze the body of literature on maternal tobacco prevention and cessation frameworks, guidelines, recommendations, and strategies at the international and national level; 2) to identify common core elements; and 3) to identify gaps in the literature, and propose future initiatives and policy development directions. A systematic database search based on the JBI methodology and corresponding PRISMA-ScR guidelines will be conducted from January 2015 to August 2023. Searches in different databases will be combined with an expert survey among the members of the World Federation of Public Health Associations (WFPHA) – Oral Health, Tobacco Control, and the Women, Adolescent, and Children’s Working Groups to evaluate the search outcomes and add maternal tobacco prevention and cessation frameworks, guidelines, recommendations, or strategies. Using a systematic review tool to support the screening, two independent reviewers will screen the titles and abstracts of all articles, in order to include the relevant ones for full-text screening, and an independent third author will resolve conflicts, if there is any discrepancy between the two independent reviewers’ search. After a full-text review, data extraction will be conducted for analysis. Descriptive analyses include the publication year, country, legal quality, and target group addressed. A narrative synthesis will describe the scope and content of the frameworks, guidelines, recommendations, and strategies. The scoping review will serve as a stepping-stone to creating a WFPHA policy resolution on tobacco prevention and cessation framework for women of childbearing age led by the WFPHA Oral Health, Tobacco Control and the Women, Adolescent, and Children’s Working Group members. This WFPHA policy resolution ‘Maternal Tobacco Cessation and Prevention Recommendations for Primary Care Providers and Dental Providers’ will be forwarded to the WFPHA General Council and the General Assembly for approval and will be disseminated to the WFPHA public health association members. Ultimately, this recommendation will be used by each national public health association to consider integrating it into their maternal health strategy.

Abstract Problem Research so far has evaluated the effect of antenatal classes, but few studies have investigated its usefulness from the perspective of mothers after birth. Background Antenatal classes evolved from pain management to a mother-centred approach, including birth plans and parenting education. Evaluating the perception of the usefulness of these classes is important to meet mother’s needs. However, so far, research on the mothers’ perception of the usefulness of these classes is sparse, particularly when measured after childbirth. Given that antenatal classes are considered as adult education, it is necessary to carry out this evaluation after mothers have had an opportunity to apply some of the competences they acquired during the antenatal classes during their childbirth. Aim This study investigated mothers’ satisfaction and perceived usefulness of antenatal classes provided within a university hospital in Switzerland, as assessed in the postpartum period. Methods Primiparous mothers who gave birth at a Swiss university hospital from January 2018 to September 2020 were contacted. Those who had attended the hospital’s antenatal classes were invited to complete a questionnaire consisting of a quantitative and qualitative part about usefulness and satisfaction about antenatal classes. Quantitative data were analysed using both descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. Findings Among the 259 mothers who answered, 61% (n = 158) were globally satisfied with the antenatal classes and 56.2% (n = 145) found the sessions useful in general. However, looking at the utility score of each theme, none of them achieved a score of usefulness above 44%. The timing of some of these sessions was questioned. Some mothers regretted the lack of accurate information, especially on labour complications and postnatal care. Discussion Antenatal classes were valued for their peer support. However, in their salutogenic vision of empowerment, they did not address the complications of childbirth, even though this was what some mothers needed. Furthermore, these classes could also be more oriented towards the postpartum period, as requested by some mothers. Conclusion Revising antenatal classes to fit mothers’ needs could lead to greater satisfaction and thus a better impact on the well-being of mothers and their families.

Abstract Background Vaginal births after cesarean or elective repeat cesarean sections (CS) are the options for delivery after one cesarean scar. However, there is a lack of data regarding the preferred next mode of delivery in Ethiopia after a previous cesarean section. Thus, this study assessed the preferred mode of delivery and determinants after one previous CS in the antenatal clinic at the University of Gondar Comprehensive Specialized Hospital (UoGCSH). Methods An institutional-based cross-sectional study was conducted among pregnant mothers with one previous CS at UoGCSH from March to August 2022. Structured questionnaires were used to collect the data. The collected data were entered, cleaned, and edited using Epi-data 4.6 and exported to SPSS version 26 for analysis. A binary logistic regression was performed to assess the determinants of the preferred mode of delivery. A p-value of

Introduction: Diabetes mellitus in pregnancy can cause several complications for the mother and the neonate if left untreated. This study identifies the proportion of undiagnosed pre-existing diabetic pregnant women and the necessity of doing an HbA1C test in the first trimester for its diagnosis. Methodology: Pregnant women in the first trimester without a history of hypertensive disorders, Diabetes Mellitus in their previous pregnancies were recruited for the studies. Then blood samples were withdrawn from them to perform OGTT and the HbA1C test on booking visit (8-12 weeks of gestation). The results were used to diagnose and find the proportions of pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus. Results: The HbA1C test was done for 428 pregnant women and among them, 25 (5.8%) had levels above ≥ 48 mmol/mol (6.5%) and were diagnosed with pre-existing diabetes. Of the 428 pregnant women, only 267 attended the OGTT. Among the 267 pregnant women, 15 had HbA1C levels equal to or more than 6.5% and they were identified to have pre-existing diabetes. Pregnant women diagnosed with gestational diabetes were 34 and the HbA1C of these women was

Aim. This research aims to explore the integration of Traditional Knowledge and Traditional Practices during pregnancy and childbirth with Modem Health Knowledge and Practices in Cirebon, Indonesia. Methods. This research uses a qualitative method that includes participatory observation and interviews. Participants in this study consisted of pregnant mothers or patients giving birth in village health centres in Cirebon. Data was collected through participatory observations during visits to health centres and in-depth interviews with the participants. Results. The research results indicate that this integration occurs naturally in Cirebon. Respondents combine traditional and modem healthcare practices to meet their health needs during pregnancy and childbirth, taking into consideration cultural factors, religion, family support, healthcare accessibility, and past experiences. Conclusion. This study demonstrates that the integration of Traditional Knowledge and Traditional Practices during pregnancy and childbirth with Modem Health Knowledge and Practices is crucial in maternal healthcare practices in Cirebon, Indonesia. Cognitive value. The findings of this study can assist healthcare practitioners in improving the quality of maternal healthcare services in Indonesia and can serve as a reference for future research. [ABSTRACT FROM AUTHOR]

Tobacco use during and around pregnancy can significantly increase the risk of stillbirth, congenital disabilities, premature birth, and low-weight birth. To establish maternal tobacco prevention and cessation frameworks for primary care and dental providers and to facilitate cross-national learning, this scoping review aims: 1) to analyze the body of literature on maternal tobacco prevention and cessation frameworks, guidelines, recommendations, and strategies at the international and national level; 2) to identify common core elements; and 3) to identify gaps in the literature, and propose future initiatives and policy development directions. A systematic database search based on the JBI methodology and corresponding PRISMA-ScR guidelines will be conducted from January 2015 to August 2023. Searches in different databases will be combined with an expert survey among the members of the World Federation of Public Health Associations (WFPHA) -- Oral Health, Tobacco Control, and the Women, Adolescent, and Children's Working Groups to evaluate the search outcomes and add maternal tobacco prevention and cessation frameworks, guidelines, recommendations, or strategies. Using a systematic review tool to support the screening, two independent reviewers will screen the titles and abstracts of all articles, in order to include the relevant ones for full-text screening, and an independent third author will resolve conflicts, if there is any discrepancy between the two independent reviewers' search. After a full-text review, data extraction will be conducted for analysis. Descriptive analyses include the publication year, country, legal quality, and target group addressed. A narrative synthesis will describe the scope and content of the frameworks, guidelines, recommendations, and strategies. The scoping review will serve as a stepping-stone to creating a WFPHA policy resolution on tobacco prevention and cessation framework for women of childbearing age led by the WFPHA Oral Health, Tobacco Control and the Women, Adolescent, and Children's Working Group members. This WFPHA policy resolution 'Maternal Tobacco Cessation and Prevention Recommendations for Primary Care Providers and Dental Providers' will be forwarded to the WFPHA General Council and the General Assembly for approval and will be disseminated to the WFPHA public health association members. Ultimately, this recommendation will be used by each national public health association to consider integrating it into their maternal health strategy. [ABSTRACT FROM AUTHOR]

Background Pregnancy-related coronavirus disease 2019 (COVID-19) transmission and infection rates have continued to be a top public health concern. Pregnant mothers also have a higher risk of developing serious illness, needing to be admitted to an intensive care unit, and needing mechanical ventilation. More than six million people died as a result of COVID-19 worldwide. The aim of this study was to assess the level of adherence to COVID-19 preventive practice among pregnant mothers in Jinka Town. Methods In Jinka, South Omo Zone, between January 1 and January 30, 2023, a cross-sectional study was conducted. Using a simple random sampling technique, 412 pregnant women were selected. Data were collected using a face-to-face interviewer-administered, pre-tested questionnaire. The data were entered using Epi-data version 3.1, and after being exported, were analyzed using SPSS version 25. Bivariate and multivariable logistic regression analysis was carried out to identify relevant components. An adjusted odds ratio and a 95% confidence interval were used to report the relationship between the covariates and the outcome variable. Results The percentage of participants who adhered to COVID-19 prevention measures was only 11.4% (95% CI: 8.5, 14.8). Mothers with at least a bachelor’s degree 3.71 (AOR=3.71, 95% CI=1.28, 10.73), a residency of 4.40 (AOR=4.40, 95% CI=1.96, 9.87), and a history of chronic illness of 4.30 (AOR=4.30, 95% CI=1.69, 10.93) were significantly associated with good adherence to COVID-19 prevention practices. Conclusions Only a very small percentage of pregnant women, according to this poll, adhere to COVID-19 preventative practices. In order to raise pregnant women’s awareness of COVID-19 preventive practices, it is crucial to use a variety of media for health education. Further, it is preferable to focus on urban living and give special attention to women without a formal education.

Introduction and purpose: The caesarean method is used in Iran more than the standard rate recommended by the World Health Organization. Reducing the number of caesarean births and promoting natural births at all levels of the country's health system is a concern of the country's health policymakers. Therefore, the present research aimed to identify the effective factors in selecting the type of delivery based on the Health Belief Model. Methods: This analytical cross-sectional study was conducted among 144 pregnant mothers in the comprehensive health centers of Saveh, Iran. A designed questionnaire based on the constructs of the Health Belief Model (Perceived susceptibility, Perceived severity, Perceived benefits, Perceived barriers, and Self-efficacy) and knowledge was used to determine the beliefs related to the type of the selected delivery. The collected data was analyzed in SPSS software (version 16). Results: Out of 144 individuals, who participated in the study, 52.08% of mothers selected the natural method, and 47.91% chose cesarean as the preferred method of delivery. The structure of perceived barriers, with a mean of 56.50 had the highest mean in the cesarean delivery group. Based on the logistic regression, all six constructs of the Health Belief Model had an impact on predicting the type of delivery, and overall, the model, by 71%, could predict the pregnant mothers’ preferred delivery type. Conclusion: Health professionals can reduce the number of unnecessary cesarean births by designing and implementing educational interventions aimed at raising the level of awareness of pregnant mothers and focusing on psychological structures that are effective in behavior, including strengthening self-efficacy in women and removing obstacles regarding natural childbirth.

Iron-deficiency anemia is defined as anemia, a condition in which there less than the normal hemoglobin (Hb) accompanied by an indication of iron deficiency. Nearly half of all pregnant women worldwide suffer from anemia, and iron deficiency accounts for about half the world’s anemia burden. Most of the studies conducted on iron-deficiency anemia during pregnancy were conducted at the institution level and associated factors are not well studied and documented. Hence, the aim of this study is to determine the prevalence of iron-deficiency anemia and associated factors among pregnant women in Bolosso Bomibe District, Southern Ethiopia, 2019. Community-based cross-sectional quantitative study was conducted from April to June 2019. Multistage sampling was used to include 270 study participants in 6 kebeles. The structured and pretested questionnaire, middle upper arm circumference (MUAC), Hb, serum ferritin, and C-reactive protein were used as a tool to collect data. The data was compiled and entered to EpiData version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 23.00 packages for analysis. Univariate, bivariate, and multivariable logistic regression with odds ratio along with the 95% confidence intervals (CI) was computed and interpreted. p value < 0.05 was declared as statistically significant. The prevalence of iron-deficiency anemia was 11.3% (95% CI: 8.9–15.7). Factors associated with iron-deficiency anemia were ANC follow-up for the recent pregnancy (adjusted odds ratio [AOR] = 3, 95% CI: 1.15−8.9, and years b/n successive pregnancy (AOR = 4,95% CI: 1.2–12.4). Prevalence of iron-deficiency anemia was low, which is a mild public health concern among pregnant women in Bolosso Bombe District. The factors associated with iron-deficiency anemia in this study population were MUAC, ANC follow-up, birth spacing among successive pregnancy, and duration of menstrual bleeding. Thus, there should be the integration of concerned stakeholders for implementation of different interventions to solve these problems.

Problem: Research so far has evaluated the effect of antenatal classes, but few studies have investigated its usefulness from the perspective of mothers after birth. Background: Antenatal classes evolved from pain management to a mother-centred approach, including birth plans and parenting education. Evaluating the perception of the usefulness of these classes is important to meet mother's needs. However, so far, research on the mothers' perception of the usefulness of these classes is sparse, particularly when measured after childbirth. Given that antenatal classes are considered as adult education, it is necessary to carry out this evaluation after mothers have had an opportunity to apply some of the competences they acquired during the antenatal classes during their childbirth. Aim: This study investigated mothers' satisfaction and perceived usefulness of antenatal classes provided within a university hospital in Switzerland, as assessed in the postpartum period. Methods: Primiparous mothers who gave birth at a Swiss university hospital from January 2018 to September 2020 were contacted. Those who had attended the hospital's antenatal classes were invited to complete a questionnaire consisting of a quantitative and qualitative part about usefulness and satisfaction about antenatal classes. Quantitative data were analysed using both descriptive and inferential statistics. Qualitative data were analysed using thematic analysis. Findings: Among the 259 mothers who answered, 61% (n = 158) were globally satisfied with the antenatal classes and 56.2% (n = 145) found the sessions useful in general. However, looking at the utility score of each theme, none of them achieved a score of usefulness above 44%. The timing of some of these sessions was questioned. Some mothers regretted the lack of accurate information, especially on labour complications and postnatal care. Discussion: Antenatal classes were valued for their peer support. However, in their salutogenic vision of empowerment, they did not address the complications of childbirth, even though this was what some mothers needed. Furthermore, these classes could also be more oriented towards the postpartum period, as requested by some mothers. Conclusion: Revising antenatal classes to fit mothers' needs could lead to greater satisfaction and thus a better impact on the well-being of mothers and their families. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Supporting the psychological well-being of pregnant mothers is critical. The purpose of this study was to map the intervention to improve the psychological well-being of pregnant mothers. MATERIALS AND METHODS: This research method uses a scoping review with five stages, i.e., problem identification, identification of relevant studies, study selection, data mapping, compiling, summarizing, and reporting results. A systematic search strategy was applied to check for relevant papers dated 2011 until 2021, based on Pubmed, Scopus, Web of Science, Cochrane, Science Direct, Google Scholar, and Grey Literature. PRISMA flowchart was used to select and summarize the studies, and the PCC framework was used for the search strategy. Criteria for inclusion were studies with pure experimental or quasi-experimental designs, focusing on improving women's psychological well-being or mental health, utilizing psychological well-being measures, and written in English with full-text availability. RESULTS: From 32 articles, 56.24% used randomized control trials (RCT), 28.12% used quasi-experimental, 9.38% used experimental, and 3.13% used a clustered randomized trial and case study methods. 50% of the articles used developed countries, while the remaining 50% used developing countries. 12.50% of the articles used online or web-based for intervention, physical activities, and antenatal education, 9.38% used Cognitive Behavior Therapy (CBT), 21.85% used psychoeducation, 6.25% used mindfulness, Interpersonal Therapy (IPT), training-based, and 3.13% used psychodrama, relaxation, counseling, and happiness therapy. Intervention facilitators were engaged in 25% of the articles, no information regarding facilitators in another 25% of the articles, 21.85% engaged midwives, 12.50% engaged psychologists and physiotherapists, 6.25% engaged health workers, the researchers did 15.63%, and community workers and lectures did the remaining 3.13%. CONCLUSIONS: Further empirical research to improve the psychological well-being of pregnant mothers needs to be done with a psychoeducational approach considering such communications, the role of the facilitator in intervention, and the research media used. [ABSTRACT FROM AUTHOR]

Background: Vaginal births after cesarean or elective repeat cesarean sections (CS) are the options for delivery after one cesarean scar. However, there is a lack of data regarding the preferred next mode of delivery in Ethiopia after a previous cesarean section. Thus, this study assessed the preferred mode of delivery and determinants after one previous CS in the antenatal clinic at the University of Gondar Comprehensive Specialized Hospital (UoGCSH). Methods: An institutional-based cross-sectional study was conducted among pregnant mothers with one previous CS at UoGCSH from March to August 2022. Structured questionnaires were used to collect the data. The collected data were entered, cleaned, and edited using Epi-data 4.6 and exported to SPSS version 26 for analysis. A binary logistic regression was performed to assess the determinants of the preferred mode of delivery. A p-value of < 0.05 at the 95% confidence level (CI) was considered statistically significant. Results: The majority, 71.5% (95% CI: 64.7, 77.1), of participants preferred the trial of labor after cesarean (TOLAC) as their mode of delivery. Mothers who were married (AOR = 4.47, 95% CI: 1.19–16.85), had a diploma educational level (AOR = 3.77, 95% CI: 1.84–12.36), had previous post-cesarean complications (AOR = 3.25, 95% CI: 1.08–9.74), and knew about the success of the trial of labor after cesarean (AOR = 13.56, 95% CI: 4.52–37.19) were found to prefer the trial of labor compared with their counterparts. Conclusion: This study concluded that most pregnant mothers preferred labor trials after one CS, which is a bit lower but comparable with recommended practice guidelines. Providing adequate information and counseling mothers to make informed decisions about their preferred mode of delivery could be substantial. [ABSTRACT FROM AUTHOR]

Abstract Background Antenatal care is critical for women’s and unborn children’s health. In Ethiopia there is still a delay in getting antenatal care visit in the first trimester as recommended by the World Health Organization. Therefore, the purpose of this study was to assess the prevalence of delayed antenatal care visits and associated factors among pregnant women who attend antenatal care at a public health facility in Gondar town, Northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted between August 20 to September 15/2021. A simple random sampling technique was used to select 392 women. Data were collected using a pre-tested structured questionnaire through a face-to-face interview. Epi Info version 7 and SSPS 26.0 were used for data entry and further analysis. Descriptive statistics and multivariable logistic regression analyses were performed. An adjusted odds ratio with 95% confidence interval at p-value

Background/Aims: Antenatal care aims to identify and treat pregnancy-related problems that can harm either the mother or fetus. The objective of this study was to evaluate delays to the first antenatal care visit, and factors associated with a delay, among pregnant women in Addis Ababa, Ethiopia. Methods: An institutional cross-sectional study design was used, with a sample of 403 pregnant women. Data were gathered using a pretested, structured interview questionnaire that asked for participants' sociodemographic and obstetric characteristics, their access to information and support, and their attendance at antenatal care. Descriptive and logistic regression analysis was done to assess association with delays to attendance at antenatal care. Results: The majority of participants attended their first antenatal care visit later than is recommended (61.5%). Factors significantly associated with delayed attendance included being aged 25–49 years (adjusted odds ratio=2.17, P<0.01), being unmarried (adjusted odds ratio=1.78, P=0.03), having a husband who was unable to read and write (adjusted odds ratio=2.12, P=0.006), being a housewife (adjusted odds ratio=3.36, P=0.04), having a parity higher than 5 (adjusted odds ratio=3.47, P=0.03), having had an unplanned pregnancy (adjusted odds ratio=1.74, P=0.05), not having been counselled about early antenatal care (adjusted odds ratio=1.70, P=0.02) and having no financial support (adjusted odds ratio=1.99, P=0.01). Conclusions: Several factors were found to be associated with delays in attending antenatal care among women in Addis Ababa. The Addis Ababa Health Bureau and sub-city health departments should strengthen efforts to improve awareness of the importance of early attendance at antenatal care. [ABSTRACT FROM AUTHOR]

Subjective social status is how a person perceives their social class relative to other people and has frequently been associated with people's health and well-being. A frequently used measure of subjective social status is the MacArthur Scale of Subjective Social Status that depicts social status as a 10 rung ladder, asking individuals to rank themselves on this ladder relative to other people, either in their local neighbourhood or wider society. The Born in Bradford's Better Start birth cohort study aims to understand the lives, relationships, wellbeing, and social and economic circumstances of pregnant women and their children in three inner city areas of Bradford, UK. Pregnant mothers were asked to report their subjective social status, using the MacArthur subjective social status scales, comparing themselves to other people in their local neighbourhood and in England as a whole. This paper explores the characteristics of the women who gave responses, examines associations between the MacArthur subjective social status measures and other subjective and objective measures and looks specifically at the characteristics of women who reported either very low or very high subjective social status. On average, women reported that they had a higher social status compared to others within their local neighbourhood (mean ladder rung = 6) and, although participants were from areas of Bradford with very high levels of deprivation, 23% placed themselves on the top three rungs, 8–10. Respondents reported that they had an average social status when comparing themselves to people in all of England (mean ladder rung = 5) and 13% placed themselves on the top rungs 8–10. These findings raise important questions about the interpretation of the MacArthur scale of subjective social status.

Purpose of the study: The purpose of the study was to assess the factors associated with adherence to Anti-Retroviral Therapy among pregnant mothers attending the ART clinic at China Uganda Friendship Hospital, Naguru To assess the knowledge, demographic factors, and socio-economic factors associated with the adherence to Anti-retroviral therapy among pregnant mothers attending the ART clinic at China-Uganda Friendship Hospital, Naguru. Method: The descriptive cross-sectional study was carried out from November 2022 to January 2023 where study data was collected at once and there were no follow-up of respondents after the study. The participants in the study were selected using a purposive sampling method. Open and close-ended questionnaires were used in data collection. Results: Many (55.9%) of the well-adherent mothers were 30 years and above. The majority (97%) of the well-adherent mothers were urban dwellers. The majority (60%) of the respondents earned less than Ush500,000 per month while the minority (7%) earned above Ush300,000 per month. Mothers with a relatively high monthly income were found to adhere better than those with a low monthly income. A majority (96.8%) of the well-adherent respondents had good social support. Conclusion: Knowledge about ART adherence and PMTCT is associated with the level of adherence to ART among pregnant mothers attending the ART clinic at China-Uganda Friendship Hospital, Naguru. Demographic factors such as the respondent’s age, place of residence, and level of education were found to be associated with ART adherence. The mother’s financial status, social support, and HIV-associated stigma were some of the socioeconomic factors found to be associated with the adherence to ART. Recommendations: Consistent attendance of routine health education and counseling, prescription of drugs for quite a long duration, male partner involvement, and starting up of small scale income generating projects should be advocated for to improve medication adherence.

الملخص: أهداف البحث: يستخدم عدد كبير من السيدات الأدوية دون وصفة طبية، خاصة أثناء الحمل. لهذا، تهدف هذه الدراسة للتحقيق في إدراك المخاطر لاستخدام الأدوية بين الأمهات السعوديات الحوامل. طرق البحث: تم اعتماد التصميم المقطعي وأخذ العينات الهادفة لهذه الدراسة، تم استخدام ال ٢٨ عنصرا لمقياس المعتقدات الصحية لتعاطي الأدوية لجمع العينات من الأمهات السعوديات الحوامل (العدد=۳٦٦) من مستشفى متخصص من الدرجة الثالثة. تم تحليل البيانات باستخدام الإحصاء الوصفي والاستنتاجي. بعد الاختبارات الطبيعية، تم استخدام النسب المئوية، متوسط الدرجات، والانحراف المعياري لفحص البيانات الديموغرافية. تم استخدام اختبار انوفا الاتجاه الواحد لتحديد الاختلافات في المخاطر المتصورة على مقياس المعتقدات الصحية بما يخص متغيرات الملف الاجتماعي الديموغرافي. تم استخدام الاختبارات اللاحقة لتحديد الاختلافات بين المجموعات في المتغيرات المستقلة. النتائج: عبر المجالات الخمسة لمقياس المعتقدات الصحية، حصل مجال الحساسية المدرك على أعلى مرتبة (٠٫۳٦). كان هناك اختلاف كبير بين متوسط درجات إدراك الأمهات السعوديات الحوامل للقابلية للإصابة وفوائد استخدام الأدوية دون وصفة طبية، إدراك القابلية، والفوائد عند استخدام الأدوية دون وصفة طبية. ولكن، لم يكن هناك فرق كبير في درجة الشدة، والعوائق، والكفاءة الذاتية للأمهات عند استخدام الأدوية التي تصرف دون وصفة طبية. الاستنتاجات: هناك اختلافات ملحوظة لإدراك السيدات الحوامل لمخاطر استخدام الأدوية دون وصفة طبية. نوصي بزيادة الوعي بمخاطر الأدوية دون وصفة طبية أثناء الحمل لضمان سلامة الأم وطفلها. ونحث على إجراء المزيد من الأبحاث حول مبادرات تدريس مخاطر استخدام الأدوية دون وصفة طبية أثناء الحمل. Abstract: Objectives: Many women use over-the-counter (OTC) medicines, particularly during pregnancy. Therefore, this study investigated the perceived risks of using OTC medicines among pregnant Saudi mothers. Methods: With a cross-sectional design and purposive sampling, the 28-item Drug Use Health Belief Scale was used to collect data from pregnant Saudi mothers (n = 366) in a general tertiary hospital. The data were analyzed with descriptive and inferential statistics. After normality testing, the percentages, mean scores, and standard deviations were used to examine the demographic data. One-way ANOVA was used to identify the relationships between perceived risks on the Health Belief Scale and the participants’ sociodemographic profile variables. Post-hoc tests were used to identify differences in the independent variables among groups. The statistical significance threshold was set at p ≤ 0.05. Results: Across the five domains of the Health Belief Scale, the perceived susceptibility domain had the highest rank (0.36). Significant differences were observed between the mean scores of pregnant Saudi mothers’ perceptions of susceptibility and the benefits of using OTC medications (p = 0.05), perceptions of susceptibility (p 0.05). Conclusion: Notable differences were found in pregnant women's perceptions of the risks of using OTC medications. Greater awareness of the risks of OTC medication use during pregnancy is required. To ensure mothers' safety, a collaboration between prenatal multidisciplinary team of professionals (e.g., doctors, nurses, midwives) in community and hospital settings should be prioritized.

Background: Syphilis infection is a major public health problem in developing countries including Ethiopia. Thus, this study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending Antenatal Care (ANC) in Public health facilities in Shashemene town, southern Ethiopia. Method: An institutional-based cross-sectional study design was conducted among 230 pregnant women from the 27th of August to the 30th of September 2018. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Info 7 and analyzed with SPSS Version 21. A multivariate logistic regression model was used to investigate factors associated with syphilis infection. A p-value of

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Objective: This study assessed the antibiotic susceptibility and characterized antibiotic resistance genes of group B Streptococcus (GBS) isolates from selected tertiary care hospitals in Western Province, Sri Lanka. Methods: A descriptive cross-sectional study was carried out to determine antibiotic sensitivity of GBS among 175 pregnant women of >35 weeks of gestation attending antenatal clinics in four teaching hospitals. Low vaginal and rectal swabs were collected separately, and GBS was identified by standard microbiological methods. Antibiotic sensitivity and minimum inhibitory concentration (MIC) were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. DNA was extracted from culture isolates, and antibiotic-resistant genes were identified by polymerase chain reaction using ermB, ermTR, mefA, and linB genes. Results: GBS colonization in the study sample was 25.7% (45/175) with detection rate of 22.9% (40/175) and 2.9% (5/175) in vaginal and rectal samples, respectively. All isolates were susceptible to penicillin with an MIC range of 0.03–0.12 μg/mL. Six isolates (13.3%) were intermediate, and 11 isolates (24.4%) were resistant to erythromycin. There were 5 intermediately resistant isolates (11.1%) and 10 resistant isolates (22.2%) for clindamycin. Of them, seven had inducible clindamycin resistance (iMLSB). MIC range of erythromycin was 0.03–0.32 μg/mL and that of clindamycin was 0.06–0.32 μg/mL. ermB gene was detected in 7 (15.5%). ermTR gene was found in 16 (35.6%) and was significantly associated with iMLSB phenotype (p = 0.005). mefA gene was detected in two (4.4%) isolates, while linB gene was not detected in tested isolates. Conclusion: All isolates were sensitive to penicillin, and the most prevalent resistance genotype was ermTR in the study population. [ABSTRACT FROM AUTHOR]

Bisphenols are mainly used as protective coatings for plastics and resin-based materials in various consumer products. Industrial producers have a high demand for bisphenol A (BPA) among all bisphenol substitutes for various consumer products. However, according to reports, prolonged exposure to BPA can cause multiple health issues, including neurodevelopmental disorders in young children. BPA exposure during pregnancy has been considered as the primary cause of increasing the risk of neurological disorders in children as their neural systems are designed to respond to any environmental changes during prenatal life. Recently, there has been an increased focus on the effects of prenatal exposure to BPA, as it has been found to alter gene expression related to epigenetic mechanisms like DNA methylation, histone modification, and microRNA expression. Based on the evidence, frequent interactions can lead to inherited changes in an individual's neural profile. In this review, we delve into the current knowledge regarding the toxicity mechanism of BPA for expecting mothers. Next, we will discuss the possible action of BPA on the epigenetic mechanism during brain development. This is especially important to portray an overview on the role of epigenetic modification caused by prenatal BPA exposure and next, give future directions for improving human health risk assessment caused by BPA exposure. • The leaching of BPA from plastic and resin-based products increases human exposure in daily life. • BPA exposure during pregnancy is a particular concern as fetus brain programming is susceptible to any environmental insults. • Early life exposure to BPA was demonstrated to cause impairment in cognitive function when reaching adulthood. • BPA-induced disruption of the epigenetic mechanism may be a key factor causing a persistent impact on cognitive function. [ABSTRACT FROM AUTHOR]

BackgroundHepatitis B infection is one of the world's most serious public health problems, causing significant morbidity and mortality. More than 2 billion individuals around the world have been infected with the hepatitis B virus (HBV), and approximately 400 million people are chronically infected with the virus, with more than a million dying each year from hepatitis B virus-related liver disease. A newborn infant whose mother is positive for both HBsAg and HBeAg has a 90% chance of developing chronic infection by the age of 6. Its infectivity is a 100 times that of the human immunodeficiency virus, but it receives little attention in public health. Therefore, this study was conducted to assess the prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals in west Hararghe, eastern Ethiopia 2020.MethodThis institution-based cross-sectional study was conducted on 300 pregnant mothers selected by systematic random sampling from September to December 2020. Data were collected by face-to-face interview using a pretested structured questionnaire. A blood sample was collected and tested for hepatitis B surface antigen using the enzyme-linked immunosorbent assay test method. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value

Background: Prenatal iron and folic acid supplementation is an economical strategy for reducing iron and folic acid deficiency anemia among expectant mothers in resource-limited countries like Uganda. This study aimed to assess the level of compliance with iron and folic acid supplementation (IFAS) and identify associated factors among mothers receiving prenatal services in Lira district, Uganda. Methods: A cross-sectional study was conducted at the antenatal clinic of Lira Regional Referral Hospital, involving 252 pregnant mothers. Adherence levels to IFAS were evaluated using a visual analogue scale, and associated factors were collected through an interviewer-administered questionnaire. The data were analyzed using SPSS software, and the results were presented in tables. Results: Only 46% of the mothers attending the antenatal clinic adhered to IFAS during the 30 days preceding the study. Participants who had good knowledge of IFAS before recruitment (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.12-1.97), utilized reminder techniques (OR 1.05, 95% CI 1.02-1.09), and received support from their partners or relatives (OR 1.56, 95% CI 1.07-2.29) were more likely to have good adherence. The main reasons for missing IFAS were forgetfulness and fear of taking too many tablets. Conclusions: There was a low adherence rate to IFAS among mothers attending antenatal clinics in Lira district. Further investigations are recommended to identify barriers to adherence, and comprehensive health education programs should be provided to pregnant mothers. [ABSTRACT FROM AUTHOR]

Background: Food aversion is one of the reasons for maternal undernutrition. Early screening for maternal undernutrition risk factors would improve the ability to recognize this problem and intervene early. Hence, this study was intended to identify the association of food aversion with maternal nutritional status., Objectives: To assess food aversion and its association with pregnant women's nutritional status in Teticha Woreda, Sidama region, Ethiopia, March, 2022., Methods: In Teticha Woreda, a mixed community-based comparative cross-sectional study was carried out from 1 March to 15 April 2022. Data were collected using an unstructured interview guide for qualitative data and a structured questionnaire for quantitative data. Epi-Data version 3.1 was used to enter quantitative data. Quantitative data were exported and cleaned and analyzed in SPSS version 20. For the quantitative data, descriptive statistics were calculated. To identify predictors of low nutritional status and control for confounders, multivariable logistic regression was utilized. Using Pearson's Chi-square test, the association between food aversion and the anthropometric status of pregnant women was examined., Results: Maternal undernutrition was found in 109 (48.9%; 95% CI: 42.4%-55.4%) of pregnant women with food aversion and 69 (30.9%; 95% CI: 25.1%-37.2%) women without food aversion (mid-upper arm circumference 23 cm). A significant proportion of mothers 95 (42.6%) stated that food aversion stemmed from the taste or smell of the food. Some mothers avoided "Enset," while others avoided foods like cereal, milk, and coffee. In the Chi-square test, pregnant women who had food aversion had a higher likelihood of maternal undernutrition as compared to women who did not have food aversion ( p -value of 0.000)., Conclusion: This study found higher magnitude of undernutrition among pregnant women who had food aversion as compared to their counterparts. Nutritional interventions, especially nutritional counseling focusing on food aversion, are essential to tackle maternal undernutrition., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: A study was carried out to identify the factors contributing to low uptake of 1st ANC services among pregnant mothers during the first trimester at Kamira Health Centre III, Luweero District. The study design was descriptive and cross-sectional and it employed both quantitative and qualitative data collection methods. A sample of 60 respondents was selected using a purposive sampling procedure and an interview guide was used to collect data. Results: Socio-economic factors contributing to low uptake of 1st ANC services among pregnant mothers during the first trimester as 36 (60%) reported 4 – 6 months as the age at which they were supposed to start attending ANC services, 40 (66.7%) started attending ANC between 4 – 6 months and the major reasons were lack of awareness/knowledge 24 (40%) and lack of support 16 (26.7%). 40 (66.7%) reported that the income was not enough to enable access to ANC services as 24 (40%) resided 4 – 5 km away and 24 (40%) spent between 5,000 – 10,000shs on transport to the health facility. Health facility factors contributed to low uptake of 1st ANC services among pregnant mothers during the first trimester as 40 (67%) reported that Kamira Health Centre III was understaffed, and 20 (50%) had the inadequate infrastructure to handle large numbers of mothers. 40 (67%) reported that health workers had negative attitudes during the provision of ANC services to mothers 24 (40%) mentioned that they were rude and unwelcoming and 16 (26.7%) mentioned that health workers had poor customer care skills. Conclusion: Respondents faced various socio-economic, cultural, and health facility factors which contributed to low uptake of 1st ANC services among pregnant mothers during the first trimester. Recommendations: Including improving efficiency and reducing waiting time, improving customer care, more support, and health education about ANC among others.

Background: Pregnancy itself is a hypercoagulable state. COVID-19 infection makes it more deleterious. As a consequence of exaggerated inflammatory response in COVID 19 infected mothers, there is alterations of coagulation system occurs, causing thrombi (micro and macro) in various organs reducing blood flow in capillaries, followed by emboli formation mainly in lung, heart, brain and kidney, resulting in multiple organ failure even death The present study aims to observe retrospectively the clinical outcome of parturients with COVID-19 infection undergoing caesarean sections. Methods: This observational study was done in the COVID dedicated operation theatre of Department of Anaesthesia, Pain, Palliative and Intensive Care, Dhaka Medical College Hospital, Bangladesh, between May 2020 and December 2021. A total 640 obstetric patients undergoing caesarean section (both COVID positive and suspected) were observed. The demographic and outcome data of mothers (transferred from post-operative ward to parent ward/ICU) were collected. Informations of ultimate fate (alive/death) of operated mothers were also noted. Demographic (sex) data and outcome data of newborn baby (alive/dead) were also included. The statistical analysis was carried out by using the Statistical Package for Social Sciences version 22.0 for Windows. Results: In this study, the age of the most (n=532, 83.13%) of the pregnant mothers belongs to 18-30 years of age group, remaining 16.86% patients are within the age group of 31-45 years (n=108). Although 18.75% study subjects were illiterate below class VIII(31.25), SSC(17.97%), HSC(16.40%), Graduate(12.5%), masters(3.13%)], miscellaneous type of occupational status [home-maker(70%), service holder(19.85%), entrepreneurship(1.56%) & others(8.59%. and came from different category of social classl most of the patients belong to lower(54.68%) and lower middle class (27.81 %) sodoeconomic status]. Among total study sample (n=640), 55.63% (n=356) patients were infected with COVID 19 virus confirmed by RT-PCR and 44.38% (n-284) mothers were clinically COVID infected or suspected cases. The majority of the pregnant mothers (n=565. 88.28%) experienced sub-arachnoid block or spinal anaesthesia whereas only 6.09% (n=39) patients got experience of general anaesthesia. Apparently, 93.44% (n=598) of mothers come back to the parent ward after observing in post-operative ward. Of them, (n=640), 2.19% of mothers were not survived in operation theatre or post-operative ward and 4.34% (n=21 )ofpatients had to go to Covid dedicated Intensive Care Unit. Survivors mothers (n=619, 96. 72%) were greater than that of non-survivors (n=21, 3.28%). Among the delivered new born babies, the number of female babies (n=330, 51.56%) were slightly higher than that of male (n=310, 48.44%). In a total 640 babies, 560 babies (87.50%) were survived but 12.50% (n-=80 ) of babies were not survived. Conclusions: This observational study represents that among 640 number of COVID positive or suspected pregnant mothers who were undergoing caesarean section, 93.44% of mothers come back to the parent ward, 2.19% of mothers were expired in operation theatre or post operative ward because of complications. Unfortunanely, 4.34% of mothers had experience to go to Intensive Care Unit. Survivors mothers were greater than that of non-survivors. New born babies of confirmed and suspected COVID mothers were slightly female predominant. Total of them, 8 7.50% of babies were survived. [ABSTRACT FROM AUTHOR]

Background. Physical activity during pregnancy provides many health benefits not only to pregnant mothers but also to the fetuses. This study assessed the attitude of pregnant women towards PA in pregnancy among pregnant women attending ANC in Lira Regional Referral Hospital. Methods. The cross-sectional study of 152 pregnant women attending antenatal clinic visits in Lira Regional referral Hospital, northern Uganda. Data were obtained on socio-demographic characteristics of mothers’ attitudes towards PA in pregnancy. Results. We found that 80% of pregnant mothers had a positive attitude toward physical activity during pregnancy. The attitude was associated with marital status (p=0.049), the number of children they had to care for, a busy schedule, fear of PA, and lack of information were the principal reasons not to do Physical Activity. Conclusion. The majority of women (80%) had a positive attitude toward PA during pregnancy Recommendations. Based on the findings that some small percentages had a negative attitude towards PA in pregnancy, health educators should be encouraged to avail the information to the community members, this will enable the community to develop good feelings towards antenatal exercises. Pregnant women should be encouraged to form exercise groups in their communities so they provide moral support for each other. Based on findings from other studies that there is a low practice of PA in pregnancy, further studies should be done in Uganda to come up with the prevalence of PA during pregnancy in Uganda.

Background. Physical activity during pregnancy provides many health benefits not only to pregnant mothers but also to the fetuses. Adequate knowledge among pregnant mothers is vital to enhance positive attitudes. This study assessed knowledge of pregnant women on PA in pregnancy among pregnant women attending ANC in Lira Regional Referral Hospital. Methods. The cross-sectional study of 152 pregnant women attending antenatal clinic visits in Lira Regional referral Hospital, northern Uganda. Data were obtained on socio-demographic characteristics of mothers, knowledge, and attitude towards PA in pregnancy. Results. Decreasing the risk of swelling of extremities (65%), back pain (73%), and high blood pressure (80%), and promoting a better ability to cope with labor and delivery (72%) were the most commonly known benefits of PA in pregnancy and vaginal bleeding (80%), chest pain (70%), difficulty in breathing (77%), abdominal pain (72%), premature labor (73%), muscle weakness and migraine headache (73%) were perceived contraindications of physical activity during pregnancy. 46% had adequate overall knowledge of PA during pregnancy. The knowledge of women was influenced by gestational age (p=0.007) and level of education (p=0.014). Conclusion. The majority of women demonstrated inadequate knowledge of physical activity during pregnancy. Mothers had a fair knowledge of the benefit, but the majority had minimal information about the contraindication and when to start and stop physical activity when they get pregnant. Recommendation Based on the findings, women in this study didn’t have comprehensive knowledge about PA during pregnancy, health care providers should be empowered to counsel healthy and fit pregnant women with comprehensive, evidence-based prenatal exercise guidelines on the safety of involvement in PA during pregnancy.

Introduction: Social support by family and community reduces maternal stress during pregnancy and enhances the process of delivery and thus improves maternal health. This study aimed to analyze the concept of social support for pregnant mothers.Methods: This study was a qualitative phenomenological one. The data were collected through in-depth semi-structured in-person interviews with 40 pregnant mothers and health care providers. A total of 40 individual interviews were conducted. The participants were selected using purposive sampling, and the interviews continued until new and rich concepts did not emerge. Conceptual analysis in this study was performed using the Dikelman method.Results: In the initial data analysis, 1017 codes were first extracted. After comparing the data, the number of codes was reduced to 105, and finally, three categories were extracted. The concept of social support for pregnant mothers from the participants’ perspective was classified into three categories of “information support”, “need satisfaction”, and “spiritual support”.Conclusion: Policymaking and service delivery for pregnant women considering the dimensions of social support through increasing information, meeting needs, and providing spiritual support for mothers can be an effective step in improving the health of pregnant mothers.

Background: SARS-CoV-2 has affected millions of people around the world. There is a need for data on the effects of this infection on neonates admitted to neonatal intensive care (NICU) units born to infected mothers. Here, we decided to analyze neonates born to mothers who tested positive for SARS-CoV-2 and admitted to NICU compared with neonates who remained with their mothers. Methods: All pregnant mothers who tested positive for SARS-CoV-2 during pregnancy between 1 June 2020 and 30 June 2021, along with all neonates born to infected pregnant women, were included in this study. We then compared the neonates admitted to NICU with the neonates who remained with their mothers. Results: Eighty-eight neonates were born to eighty-eight SARS-CoV-2-positive mothers. Fifteen of these neonates were admitted to the NICU. The mothers of the neonates admitted to the NICU were more likely to have received prenatal care outside of the USA. In addition, the neonates admitted to the NICU were more likely to have needed significant resuscitation at birth. Respiratory distress was the most common reason for NICU admission. None of the NICU-admitted neonates were SARS-CoV-2-positive. There were no differences between the values of the complete blood counts, morbidities at discharge, lengths of hospitalization, or rates of readmission to hospital in the first month of life observed between the two groups. Conclusions: The vertical transmission of the SARS-CoV-2 infection remains rare; there was no difference in the hospital outcomes in the neonates of infected mothers. Unlike other studies, which show an increased tendency toward preterm birth in SARS-CoV-2-positive mothers, our study indicates no such association. [ABSTRACT FROM AUTHOR]