Effects of personalized oral hygiene management on oral health status of pregnant women

BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women.AIM To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women.METHODS A total of 114 pregnant women who were examined at Dalian Women’s and Children’s Medical Center were divided into four groups:High-risk experimental group(n=29;CAT score≥2;received personalized oral hygiene management training),low-risk experimental group(n=29;CAT score≤1;received oral health education),high-risk control group(n=28;CAT score≥2),and low-risk control group(n=28;CAT score≤1).No hygiene intervention was provided to control groups.CAT scores at different times were compared using independent samples t-test and least significant difference t-test.RESULTS No significant difference in baseline CAT scores was observed between the experimental and control groups,either in the high-risk or low-risk groups.CAT scores were reduced significantly after 3(1.74±0.47 vs 2.50±0.38,P<0.0001)and 6 months(0.53±0.50 vs 2.45±0.42,P<0.0001)of personalized oral hygiene management intervention but not after oral health education alone(0.43±0.39 vs 0.46±0.33,P>0.05 and 0.45±0.36 vs 0.57±0.32,P>0.05,respectively).Within groups,the decrease in CAT scores was significant(2.43±0.44 vs 1.74±0.47 vs 0.53±0.50,P<0.0001)for only the high-risk experimental group.CONCLUSION Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.

COVID-19 Vaccine Acceptance and Hesitancy among Pregnant Women: A Knowledge, Attitude, and Perceived Risks Survey in Lusaka, Zambia

Introduction: The coronavirus disease 2019 (COVID-19) is an infectious disease of the respiratory tract caused by SARS-CoV-2. Since its emergence, there have been increased rates of transmission and spread, morbidity and mortality which led to the development of COVID-19 vaccines to address the pandemic. This study assessed acceptance, knowledge, attitude, and perceived risks regarding COVID-19 vaccines among pregnant women attending antenatal care at two First-Level Hospitals in Lusaka, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 241 pregnant women using a questionnaire from August 2023 to October 2023 in two First-Level Hospitals in Lusaka district, Zambia. The collected data were analyzed using IBM Statistical Package for Social Sciences (SPSS) version 22.0. Statistical analysis was performed using a Chi-square test. The statistical significance was set at a 95% confidence level. Results: Of the 241 participants, 107 (42.7%) were aged between 24 and 34 years. Overall, 64.3% accepted the COVID-19 vaccines, of which 122 (50.6%) were already vaccinated. Further, 203 (84.6%) of the pregnant women had good knowledge, and 199 (82.6%) had positive attitudes towards COVID-19 vaccines. However, 58.5% thought COVID-19 vaccines were not safe and could cause infertility. Alongside this, 70.1% thought that COVID-19 vaccines were harmful during pregnancy. Having good knowledge of COVID-19 vaccines was associated with age (p = 0.049), education status (p = 0.001), and employment status (p = 0.001). Having a positive attitude towards COVID-19 vaccines was associated with education status (p = 0.001) and employment status (p = 0.001). Conclusion: This study found that most pregnant women had good knowledge, and positive attitudes, and the majority accepted the COVID-19 vaccine. Encouragingly, most of the pregnant women who accepted the COVID-19 vaccines were already vaccinated. Most pregnant women thought that COVID-19 vaccines had side effects, were not safe, and could be harmful during pregnancy. Consequently, this could have contributed to the hesitancy to receive a vaccine among some participants. The findings of this study demonstrate the need to provide pregnant women with continuous educational programs on the benefits of vaccinations for themselves and their children.

Socio-Demographic and Economic Factors Associated with Uptake of COVID-19 Vaccine among Pregnant Women at Pumwani Maternity Hospital in Nairobi County, Kenya

Introduction: Pregnant women are a highly vulnerable population for COVID-19 with increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and mortality. Objective: This study determined the socio-demographic and economic factors associated with the uptake of COVID-19 vaccine among pregnant women utilizing antenatal care services in Pumwani Maternity Hospital, Nairobi County-Kenya. Methods: The study was carried out from 15 June to 23 July 2023. Systematic sampling was used to select 302 women from whom data was collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Data was analyzed using SPSS software in which bivariate and multivariate logistic regression analyses were done at a significance level of p Results: A total of 302 pregnant women participated in the study. Of these, 105 (34.8%) were aged between twenty-six (26) and thirty (30) years. The mean age of the women was 28.60 ± (SD = 5.297). The uptake of the COVID-19 vaccine was 41.1%. The common side effects reported to be associated with the vaccines were fever, headache, joint pain, vomiting and skin rash. Uptake of the COVID-19 vaccine was significantly associated with being married (AOR = 3.65, 95% CI: 0.62 - 1.80, p = 0.001), having a secondary level of education (AOR = 3.78, 95% CI: 0.99 - 2.88, p = 0.001) and being employed (COR = 2.66, 95% CI: 1.31 - 3.06, p = 0.001). Conclusion: COVID-19 vaccination uptake remains low among pregnant women in seeking ANC in Nairobi. The individual factors associated with the uptake of COVID-19 vaccine among pregnant Women at Pumwani maternity hospital in Nairobi County were being married, having secondary level of education and being employed. Integration of the COVID-19 vaccine with other routine vaccinations as per the national immunization program in Kenya and the enhancement of education regarding the safety and efficacy of the COVID-19 vaccine in pregnancy and breastfeeding and economic empowerment of women are recommended.

Effectiveness of Prophylactic Transvaginal Cervical Cerclage in Improving Clinical Outcomes among Pregnant Women with Cervical Insufficiency: Meta-Analysis

Background: Cervical insufficiency is one of the major causes of preterm birth among pregnant women that leads to severe mortality and morbidity issues among newborns. Prophylactic cervical cerclage is a surgical procedure performed between 11 and 14 weeks of gestation upon diagnosis of cervix insufficiency among pregnant women. Aims & Objectives: In this study, we aimed to evaluate the effectiveness of prophylactic cervical cerclage in comparison to other interventions to treat cervical insufficiency among pregnant women using a meta-analysis approach. Methods: We searched the three databases (Coachrane Library, PubMed, and MEDLINE) that were used for articles related to research aims by using MeSH keywords. The timeline of research was set from January 2015 to January 2024. The methodological quality assessment of included studies was performed by the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I). A recent meta-analysis was conducted by using Review Manager 5.4.0 software. Results: About 441 research articles were extracted from three electronic databases and only 125 articles were assessed for eligibility criteria. Finally, 8 studies were included in the analysis for a recent meta-analysis. Six out of eight included retrospective or pilot studies were graded as having a moderate risk of bias, and two studies had low risk on the basis of owning bias. About 1008 pregnant women with cervical insufficiency were analyzed in a recent meta-analysis. By pooled analysis, it was evaluated that significant difference found in prolongation of delivery weeks (Mean difference = 1.05;Cl: 0.81 to 1.29: p > 0.00001), number of deliveries > 37 weeks (OR = 0.59;Cl: 0.19 to 1.84: p > 0.006), and preterm birth (OR = 0.73;Cl: 0.42 to 1.28: p > 0.50) among pregnant women receiving prophylactic cervical cerclage as compared to other treatment strategies. Conclusion: Recent meta-analysis suggested the prophylactic cervical cerclage reduces the rates of preterm birth, abortion rates, number of deliveries > 37 weeks, and other complications as compared to the other cervical cerclage types and conservative treatments.

A causal model of eating behaviors among Thai pregnant women working in industrial factories

Objective:This study aimed to examine the causal model of eating behaviors among pregnant women working in industrial factories.Methods:This cross-sectional study was conducted on 210 participants,attending 4 healthcare centers,at a tertiary care hospital in Chonburi province,Thailand.Data were collected using 7 questionnaires:demographic form,eating behavior questionnaire,perceived benefits of the healthy eating questionnaire,perceived barriers to the healthy eating questionnaire,perceived self-efficacy questionnaire,social support questionnaire,and accessibility to healthy foods questionnaire.Descriptive statistics and path analysis were used for data analysis.Results:The participants had relatively high mean scores for eating behaviors.The final model fitted well with the dataχ^(2)=12.86,df=10,P=0.23;χ^(2)/df=1.29;comparative fit index(CFI)=0.98;goodness-of-fit index(GFI)=0.98;adjusted goodness-of-fit index(AGFI)=0.95;root mean square error of approximation(RMSEA)=0.04.Four factors-perceived benefits(β=0.13,P<0.05),perceived self-efficacy in healthy eating(β=0.22,P<0.001),pregnancy planning(β=0.28,P<0.001),and accessibility to healthy foods in the factory(β=0.12,P<0.05)-positively affected eating behavior,while only perceived barriers to healthy eating had a negative effect on eating behavior(β=−0.24,P<0.001).All the above factors explained 27.2%of the variance in eating behaviors.Conclusions:Nurses or healthcare providers can apply these findings to create an eating behavior modification program,focusing on pregnancy planning,behavior-specific variables,and interpersonal and situational influence,to promote the nutritional status of pregnant women working in industrial factories.

Analysis of Cardiac Functional Status and Factors Influencing Adverse Pregnancy Outcomes in Pregnant Women with Combined Heart Disease

Objective:To investigate the cardiac function of pregnant women with complicated heart disease during pregnancy and the factors influencing the adverse pregnancy outcome.Methods:A total of 162 cases of pregnant women with complicated heart disease admitted to the Beijing Anzhen Hospital from October 2021 to December 2023 were selected to compare the occurrence of adverse pregnancy outcomes in pregnant women with complicated heart disease at different levels of cardiac function and to analyze the single and multi factors leading to adverse pregnancy outcomes in pregnant women with complicated heart disease.Results:Among 162 pregnant women with combined heart disease in pregnancy,the highest percentage of heart disease type was congenital heart disease(80/49.38%),and the lowest percentage was other(9/5.56%);the overall incidence of adverse pregnancy outcomes in pregnant women with combined heart disease in pregnancy with cardiac function grades of 3–4 cardiac function(30/68.18%)was higher than that in pregnant women with combined heart disease in cardiac function grades of 1–2(40/33.90%)(P=0.000);age,marital status,hypertension,and past history of all pregnant women were not statistically significant(P>0.05);gestational age,type of heart disease,and cardiac function grading were statistically significant(P<0.05),and these factors were all independent risk factors for adverse pregnancy resolution in pregnant women with combined heart disease(P<0.05).Conclusion:The overall incidence of adverse pregnancy outcomes was higher in pregnant women with heart disease than in those with heart disease grades 1–2,and the number of pregnancies,the type of heart disease,and heart function grades were all independent risk factors for adverse pregnancy outcomes in pregnant women with heart disease.

Retrospective Cohort Study to Investigate Pregnancy Outcomes in a Population of Advanced Maternal Age Congolese Women of Kinshasa: A Study Protocol

Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The results of this study will enable us to update the frequency of AMA pregnancies in our environment. The socio-demographic and clinical profile of these pregnancies will be determined. The main maternal-fetal complications associated with AMA in our setting and the associated factors will be identified.

Antagonistic Potential against Pathogenic Microorganisms and Hydrogen Peroxide Production of Indigenous Lactobacilli Isolated from Vagina of Chinese Pregnant Women

Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women＇s vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.

Experience of Clinical Management for Pregnant Women and Newborns with Novel Coronavirus Pneumonia in Tongji Hospital,China

Based on the New Diagnosis and Treatment Scheme for Novel Coronavirus Infected Pneumonia(Trial Edition 5),combined with our current clinical treatment experience,we recently proposed a revision of the first edition of“Guidance for maternal and fctal management during pneumonia epidemics of novel coronavirus infection in the Wuhan Tongji Hospital".This article focused on the issues of greatest concern of pregnant women including severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection diagnostic criteria,inspection precautions,drug treatment options,indications and methods of termination of pregnancy,postpartum fever,breastfeeding considerations,mode of mother-to-child transmission,neonatal isolation and advice on nconatal nursing,to provide valuable experience for better management of SARS-CoV-2 infection in pregnant women and newborns.

Role of perceived family support in psychological distress for pregnant women during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has caused major public panic in China.Pregnant women may be more vulnerable to stress,which may cause them to have psychological problems.AIM To explore the effects of perceived family support on psychological distress in pregnant women during the COVID-19 pandemic.METHODS A total of 2232 subjects were recruited from three cities in China.Through the online surveys,information on demographic data and health status during pregnancy were collected.Insomnia severity index,generalized anxiety disorder 7-item scale,patient health questionnaire-9,somatization subscale of the symptom check list 90 scale,and posttraumatic stress disorder checklist were used to assess the psychological distress.RESULTS A total of 1015(45.4%)women reported having at least one psychological distress.The women who reported having inadequate family support were more likely to suffer from multiple psychological distress(≥2 psychological distress)than women who received adequate family support.Among the women who reported less family support,41.8%reported depression,31.1%reported anxiety,8.2%reported insomnia,13.3%reported somatization and 8.9%reported posttraumatic stress disorder(PTSD),which were significantly higher than those who received strong family support.Perceived family support level was negatively correlated with depressive symptoms(r=-0.118,P<0.001),anxiety symptoms(r=-0.111,P<0.001),and PTSD symptoms(r=-0.155,P<0.001).CONCLUSION Family support plays an important part on pregnant women’s mental health during the COVID-19 pandemic.Better family support can help improve the mental health of pregnant women.

Comparison of Thyroglobulin and Thyroid Function in Pregnant Women between Counties with a Median Urinary Iodine Concentration of 100-149 μg/L and 150-249 μg/L

Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.

Renal Function in Preeclamptics versus Normal Pregnant Women

Background: Pregnancy is implicated in notable physiological changes and the extraordinary kidney physiology during pregnancy is believed to have an effect on kidney functions. However, during pregnancy the glomerular filtration rate (GFR) increases its work rate up to 50%, on the contrary, in preeclampsia the GFR turns back to decline. Objectives: This study aims to measure and compare kidney function between preeclamptic and normal pregnant women. Materials and Methods: A cross-sectional hospital-based study was conducted in the period from March to May 2021 in Wad Medani Obstetrics and Gynecology Teaching Hospital. A total of 100 pregnant women, 50 apparently healthy pregnant women and 50 pregnant ladies proved to have preeclamptic toxemia, their ages ranged from 18 to 44 years old and at the third trimester of pregnancy. Blood samples were taken and serum was separated, then urea, creatinine, uric acid, sodium and potassium were determined. Data were analyzed using Statistical Package for Social Science (SPSS). Results: The results of this study revealed that 92% of preeclamptic pregnant women had the first time of the incidence and 8% were family inherited preeclampsia and injured multiple times. The preeclamptic pregnant women showed elevation in both systolic and diastolic blood pressure compared to the normal pregnant women. Although the creatinine values of all study subjects were in the normal range, the mean of its serum level was found to be higher in normal pregnant women than that in preeclamptic women. The study also showed urea level was elevated in the preeclampsia group in comparison to the normal one, while all values were in the normal range. In addition to the significant difference that observed in the uric acid mean between preeclamptic (higher) and normal pregnant groups, abnormal values were only noticed with many preeclamptic patients. The levels of electrolytes (sodium and potassium) were elevated in the preeclampsia women group, whereas all values were in the normal range. Conclusion: This study concluded that preeclamptics showed significant elevation in the urea, uric acid, sodium and potassium levels and a significant decrease in creatinine level compared to normal pregnant women, although all parameters values for both groups were in the reference values for non-pregnancy.

Asymptomatic Genital Infection of Human Papillomavirus in Pregnant Women and the Vertical Transmission Route

To further investigate the vertical transmission route of human papillomavirus (HPV) and the indication for the choice of mode of delivery, the infective status of 152 asymptomatic pregnant wemen and the maternal-fetal transmission were studied. By using general primers in polymerase chain reaction (GP-PCR) combined with restriction fragment length polymorphism analysis, HPV DNA positive rate in cervical secretions and venous blood in asymptomatic pregnant women was 36.21 % and 52.78 %, respectively, and the identified genotypes were mainly HPV_16 and _18. The maternal-fetal transmission rate of HPV via genital tract as well as blood was 40.91 % and 57.89 %, respectively. It was concluded that besides the transmission route of genital tract and amniotic fluid, there was also transplacental transmission of HPV in utero. Therefore,in our opinion, it is not an absolut indication to perform a cesarean delivery for the pregnant women with HPV asymtomatic genital infection.

Blood Lead Dynamics of Lead-Exposed Pregnant Women and Its Effects on Fetus Development

The dynamics of blood lead (Pb-B) and blood zinc protoporphyrin (ZPP-B) of women in early pregnancy and parturient women with lead exposure and the effects on fetus development were investigated. Pb-B of lead-exposed women was high: 0.984 μmol/L (20.38 μg/dl) and ZPP was 84.52μg/dl. Cord blood Pb-B was 0.896 μmol/L(18.56μg/dl)and cord blood ZPP was 69.24μg/dl. In the control group, Pb-B was 0.261μmol/L(5.41μg/dl), ZPP-B, 37.59 μg/dl, cord blood, Pb-B 0.34 μmol/L (7.93 μg/dl), and cord ZPP-B 49.0μg/dl. There was a significant correlation between blood lead and blood ZPP, maternal Pb-B and cord Pb-B, maternal Pb-B and cord ZPP-B. The significance of the consistency of high level Pb-B and the effects on fetus development is discussed.

Seroprevalence of hepatitis B surface antigen in pregnant women attending antenatal clinic in Honiara Solomon Islands,2015

AIMTo determine the seroprevalence of hepatitis B surface antigen (HBsAg) among pregnant women attending antenatal clinic in Honiara, Solomon Islands. METHODSThis descriptive cross-sectional study was carried out in seven area health centers in Honiara. From March to June 2015, identification of eligible pregnant women in each site was conducted using systematic random sampling technique. A total of 243 pregnant women who gave written informed consent were enrolled. Standardized tool was used to record demographics, obstetric history and serology results. HBsAg and hepatitis B e antigen (HBeAg) were tested using point-of-care rapid diagnostic test. All HBsAg positive samples were verified using enzyme-linked immunosorbent assay. RESULTSThe mean age of participants was 26 &plusmn; 6 years. The overall hepatitis HBsAg prevalence was 13.8% with higher rate (22%) reported in women between 30-34 years of age. Majority of HBsAg positive participants were Melanesians (29 out for 33). None of the pregnant women in the 15-19 years and &ge; 40 years tested positive for HBsAg. There was no statistically significant difference in HBsAg prevalence by age, ethnicity, education and residential location. The overall HBeAg seroprevalence was 36.7%. Women between 20-24 years of age had the highest rate of 54.5%. Low level of knowledge about hepatitis B vaccination was reputed. Overall, 54.6% of participants were not aware of their hepatitis B vaccination status and only 65.2% of mothers reported their child had been vaccinated. CONCLUSIONHepatitis B is a disease of public health importance in Solomon Islands and emphasize the need for integrated preventative interventions for its control.

Calculating the Number of Pregnant Women Receiving Standardized Services for PMTCT of HIV in Liangshan Prefecture,Based on the Equivalent Method

Objective To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission(PMTCT)services for HIV annually.Methods HIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects.The entire process,from when the subjects first received the PMTCT of HIV services to the end,was divided into four stages,which were further divided into 25 phases.The equivalent coefficient was used to indicate the weight of workload in each phase.Seven experts were invited to score the equivalent coefficient;the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated.Results A total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017.This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women,with 260 person-months(3.34%)spent on the first antenatal care,1,510 person-months(19.41%)during pregnancy,378 person-months(4.86%)on delivery,and 5,632 person-months(72.39%)on post-partum period.The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services.Conclusion The number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.

Influence of group B streptococcus and vaginal cleanliness on the vaginal microbiome of pregnant women

BACKGROUND The vaginal microbiome plays a critical role in the health of pregnant women and their newborns.Group B Streptococcus(GBS)and vaginal cleanliness significantly affect the vaginal microecosystem and are closely associated with vaginal diseases.AIM To explore the effects of GBS status and vaginal cleanliness on vaginal microecosystems.METHODS We collected 160 vaginal swabs from pregnant women and divided them into the following four groups based on GBS status and vaginal cleanliness:GBS-positive+vaginal cleanliness I–II degree,GBS-negative+vaginal cleanliness I–II degree,GBS-positive+vaginal cleanliness III–IV degree,and GBS-negative+vaginal cleanliness III–IV degree.Samples were subjected to 16S rRNA gene amplicon sequencing.RESULTS Alpha diversity analysis showed that the Shannon index did not significantly differ between the four groups.We identified significant variation in taxa abundance between the GBS-positive and GBS-negative groups and between the vaginal cleanliness I–II degree and III–IV degree groups.Principal coordinate analysis and non-metric multidimensional scaling analysis further confirmed the microbial diversity of the four groups.Moreover,the linear discriminant analysis demonstrated that Lactobacillus jensenii and Actinobacteria were strongly associated with GBS-positive status,and Lactobacillus iners,Lactobacillaceae,Lactobacillus,Lactobacillales,Bacilli and Firmicutes were closely correlated with GBS-negative status.CONCLUSION GBS status and vaginal cleanliness significantly affect vaginal microbiome differences in pregnant women.Our findings provide instructional information for clinical antibiotic treatment in pregnant women with different GBS statuses and vaginal cleanliness degrees.

Analysis of influencing factors and the construction of predictive models for postpartum depression in older pregnant women

BACKGROUND Changes in China's fertility policy have led to a significant increase in older pregnant women.At present,there is a lack of analysis of influencing factors and research on predictive models for postpartum depression(PPD)in older pregnant women.AIM To analysis the influencing factors and the construction of predictive models for PPD in older pregnant women.METHODS By adopting a cross-sectional survey research design,239 older pregnant women(≥35 years old)who underwent obstetric examinations and gave birth at Suzhou Ninth People's Hospital from February 2022 to July 2023 were selected as the research subjects.When postpartum women of advanced maternal age came to the hospital for follow-up 42 d after birth,the Edinburgh PPD Scale(EPDS)was used to assess the presence of PPD symptoms.The women were divided into a PPD group and a no-PPD group.Two sets of data were collected for analysis,and a prediction model was constructed.The performance of the predictive model was evaluated using receiver operating characteristic(ROC)analysis and the Hosmer-Lemeshow goodness-of-fit test.RESULTS On the 42nd day after delivery,51 of 239 older pregnant women were evaluated with the EPDS scale and found to have depressive symptoms.The incidence rate was 21.34%(51/239).There were statistically significant differences between the PPD group and the no-PPD group in terms of education level(P=0.004),family relationships(P=0.001),pregnancy complications(P=0.019),and mother–infant separation after birth(P=0.002).Multivariate logistic regression analysis showed that a high school education and below,poor family relationships,pregnancy complications,and the separation of the mother and baby after birth were influencing factors for PPD in older pregnant women(P<0.05).Based on the influencing factors,the following model equation was developed:Logit(P)=0.729×education level+0.942×family relationship+1.137×pregnancy complications+1.285×separation of the mother and infant after birth-6.671.The area under the ROC curve of this prediction model was 0.873(95%CI:0.821-0.924),the sensitivity was 0.871,and the specificity was 0.815.The deviation between the value predicted by the model and the actual value through the Hosmer-Lemeshow goodness-of-fit test was not statistically significant(χ^(2)=2.749,P=0.638),indicating that the model did not show an overfitting phenomenon.CONCLUSION The risk of PPD among older pregnant women is influenced by educational level,family relationships,pregnancy complications,and the separation of the mother and baby after birth.A prediction model based on these factors can effectively predict the risk of PPD in older pregnant women.

The Prevalence of Auto-Medication among Pregnant Women in a Conflict Affected, North West Region, Cameroon

Background: The excessive use of medicines and generally self-medication is considered as one of the major health and socio-economic problems in different countries. There is increasing evidence that self-medications among pregnant women are common in many developing countries. Despite the adverse impact on pregnancy, there are few programs available for their control. The Northwest region of Cameroon has been affected by socio-political crisis since 2016, which has slowed down economic activities and have grievous effects on the economy. It was therefore necessary to evaluate the prevalence of auto-medication amongst pregnant women. Aim: The aim of this study is to ascertain the knowledge, prevalence and practice of auto medication among pregnant women in Cameroon especially in the North West Region. Method: A community based cross-sectional study was conducted among 500 pregnant women, aged between 15 - 45 years in the Bamenda Health District between January to October 2019. A structured questionnaire based interview was used to collect data from each study subject. Then, data were categorized and analyzed using SPSS version 20 software. Results: The prevalence of auto-medication (allopathic and herbal medicines) in this study was 337 (67.4%) and was predominant during the first trimester 246 (72.86%) of pregnancy. 98 (29.09%) previous experience, 70 (20.77%) that they did not have money for consultation, 70 (20.77%) non-severity of ailments and 75 (22.25%) high cost of medication in hospital/pharmacy were the most common reason pregnant women auto medicate. 96 (28.48%) antiemetic, 72 (21.36%) analgesics and 58 (17.21%) antacids were the most frequent drugs used for auto-medication and the main symptoms for which pregnant women practice auto-medication were: 72 (21.36%) fever/headache, 63 (18.69%) constipation and 58 (17.21%) nausea/vomiting. 116 (34.42%) friends/family/neighbors were the main source of recommendation in auto medication. 96 (28.49%) of the self-medicating pregnant women, self-medicate with local herbs and 40 (41.66%) blood leaves (iron supplement) was the most used plant (herbs) in our study. Conclusion: We conclude that after 3 years of crisis in this region, the prevalence of auto-medication is increasing at a geometric rate and becoming a practical routine. Adequate counselling of reproductive age girls by healthcare professionals about the potential risks of self-medication with herbal medicine and allopathic drugs during pregnancy is strongly recommended.

Prevalence and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic in the Second and Third Trimesters at Pumwani Maternity Hospital, Kenya

Background: Anaemia is one of the most common nutritional deficiency diseases observed globally and affects more than a quarter of the world’s population. Globally, 41.8% pregnant women and close to one third of non-pregnant women (30.2%) are anaemic. Anaemia during pregnancy contributes to 20% of all maternal deaths and it increases the risks of foetal, neonatal and overall infant mortality. In Kenya, according to the Ministry of Health, the prevalence of anaemia among pregnant women is 55.1%. Objective: To determine the prevalence and associated factors of anaemia among pregnant women attending antenatal clinic (ANC) at Pumwani Maternity Hospital (PMH). Methodology: A hospital based cross-sectional study design was conducted from 8th June to 18th August, 2015. Systematic random sampling method was used to select 258 pregnant women. Mothers who attended ANC during the study period and who met the inclusion criteria were interviewed and a capillary blood sample was taken. Hemoglobin level was determined by using HemoCue photometer. Data were cleaned, coded and fed into SPSS Version 20.0 for analysis. Descriptive statistics such as frequency, percentage, mean and standard deviation were used to describe selected variables. Pearson’s chi-square test and odds ratio (OR) with corresponding 95% confidence intervals (CI) computed to find association between independent and dependent variables. Multivariate analysis was done to determine factors significantly and independently predicting anaemia during pregnancy. Results: The present study revealed that the prevalence of anaemia among the pregnant women was 57%. Advanced maternal age (>31 years) (AOR = 2.71;95% CI = 1.25 - 5.88;P = 0.012) more than 18 - 24 years, government/private employed women (AOR = 2.94;95% CI = 1.47 - 5.88;P = 0.002) and self-employed women (AOR = 1.91;95% CI = 1.03 - 3.53;P = 0.039) compared to housewives, not taking iron/folic acid supplementation (IFAS) (AOR = 2.04; 95% CI = 1.14 - 3.64;P = 0.016) and mid-upper arm circumference (MUAC) less than 23 cm (AOR = 2.52;95% CI = 1.36 - 4.67;P = 0.003) were found to be predictors of anaemia. Conclusion: Anaemia among pregnant women is found to be severe public health problem based on the World Health Organization classification of anaemia. Advanced age, employment, not taking IFAS during the current pregnancy and MUAC of less than 23 cm were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are employed and advanced in age. Moreover, they should be educated on the importance of taking iron and folic acid during pregnancy.