Search results for: adolescents pregnant women

Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

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Authors: Nor Hafizah Selamat, Intan Hashima Mohd Hashim, Noraida Endut, Shariffah Suraya Syed Jamaludin, Sharifah Zahhura Syed Abdullah, Suziana Mat Yasin, Nurul Jannah Ambak

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In Malaysia, report on discrimination against pregnant women at work does exist, and this issue should be taken seriously as large proportion of women in the workforce in Malaysia are of reproductive age. It has been well established that women tend to leave the workforce because of their responsibility in raising the family, to care for family members and, also due to lack of work-life balance. In this case, women find themselves disadvantaged in career and job advancements due to gender roles and expectations connected with maternity. This maternity discrimination have pushed women out of work although The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), to which Malaysia is a party, considers discrimination on the ground of maternity is a form of gender discrimination because it hinders women of their effective right to work and requires that special protection be provided for women during maternity to ensure their ability to enjoy the right to work (Article 11(2). What factors prevent women from returning to work and at the same time performing their gender roles expectations? Using semi-structured in-depth interviews this paper explores the experiences of maternity discrimination and their perspectives towards their work employment. 15 women employees who were pregnant or had given birth during her employment period in public and private organizations in Malaysia were participated in this study. While data were analyzed using narrative analysis, respondents were asked on issues related to managing pregnancy, maternity leave and returning to work. The findings revealed that several respondents from private companies stated that they were either dismissed or forced to take unpaid leave due to the company policies. In some cases, respondents also shared how they were treated poorly that they felt that they had to leave their jobs. However, in public organization, the maternity policy implemented showed the support that the employees received from their employer. Study shows that supportive family and employers will encourage employees to return to work. Reasonable adjustments in terms of maternity policies at workplace such as allowing sufficient time in postnatal appointments, offering clear explanation on maternity issues at workplace are something that employees expected from their employers.

Keywords: maternity discrimination, women and work, gender, maternity protection, Malaysia

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Authors: Mona Bakry Abdel Meguid Abdelaal

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Despite growing evidence that parental involvement in their adolescents’ lives affects the way they perceive the community around them, little effort has been made to address the importance of this relationship and how it affect the adolescents' interaction with their environment. Adolescents are influenced by their parents while they are growing up and this socialization process services to shape the adolescents sense of self, influencing not only how adolescents feel about themselves, but affecting how they interact with their surroundings. In order to effectively understand this issue, it is important to understand the adolescents’ understanding of healthy parental involvement in their lives, in addition to the obstacles that hinder their communication styles with their parents. Understanding parental involvement in their adolescents’ lives will provide further understanding of the role that social work can perform in this field. The rationale for undertaking this study grew out of the literature on adolescents’ studies in addition to the researchers’ interaction with freshmen female students, who are still in the adolescent stage, in the university. The primary purpose of this study was to understand female adolescents’ awareness of healthy parental involvement in their freshmen year in the university life, as well as obstacles that might hinder that healthy involvement. Using semi-structured interview with a purposive sample of the first year female students in the university, the study managed to determine if the type of parental involvement and parental emotional responsiveness between the adolescents and their parents affects the way they interact with their environment, in addition, to determine the obstacles that hamper the communication between adolescents and their parents.

Keywords: adolescents, parental involvement, interaction, university life

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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Authors: Archana Surendran, Kalpana C. A.

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Vitamin D insufficiency is highly prevalent in women. Vitamin D bioavailability could be reduced in obesity due to increased sequestration by white adipose tissue. Increased sun exposure due to more frequent outdoor physical activity as well as a diet rich in vitamin D could be the common cause of both higher levels of 25(OH)D and a more favorable lipid profile. The study was conducted with the aim to assess the obesity status among selected working women in Coimbatore, determine their lifestyle and physical activity pattern, study their dietary intake, estimate the vitamin D and lipid profile of selected women and associate the relationship between Vitamin D and obesity among the selected women. A total of 100 working women (non pregnant, non lactating) working in IT sector, hotels and teaching staff were selected for the study. Anthropometric measurements and dietary recall were conducted for all. The women were further categorized as obese and non-obese based on their BMI. Fifteen obese and 15 non-obese women were selected and their fasting blood glucose level, serum Vitamin D and lipid profile were measured. Association between serum vitamin D, lipid profile, anthropometric measurements, food intake and sun exposure was correlated. Fifty six percent of women in the age group between 25-39 years and 44 percent of women in the age group between 40-45 years were obese. Waist and hip circumference of women in the age group between 40-45 years (89.7 and 107.4 cm) were higher than that of obese women in the age group between 25-39 years (88.6 and 102.8 cm). There were no women with sufficient vitamin D levels. In the age group between 40-45 years (obese women), serum Vitamin D was inversely proportional to waist-hip ratio and LDL cholesterol. There was an inverse relationship between body fat percentage and Total cholesterol with serum vitamin D among the women of the age group between 25-39 years. Consumption of milk and milk products were low among women. Intake of calcium was deficit among the women in both the age groups and showed a negative correlation. Sun exposure was less for all the women. Findings from the study revealed that obese women with a higher consumption of fat and less intake of calcium-rich foods have low serum Vitamin D levels than the non-obese women. Thus, it can be concluded that there is an association between Vitamin D status and obesity among adult women.

Keywords: obesity, sun exposure, vitamin D, women

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Authors: Saeedeh Salimi, Farzaneh Farajian- Mashhadi, Ehsan Tabatabaei, Mahnaz Shahrakipoor, Minoo Yaghmaei, Mojgan Mokhtari

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Purpose: Estrogen receptor-α (ERα) plays an essential role in the adaptation of increased uterine blood flow during gestation. Therefore ERα gene could be a possible candidate for preeclampsia(PE) susceptibility. In the current study, we aimed to investigate the association of the ERα gene polymorphisms and PE in an Iranian population. Methods: One hundred ninety-two pregnant women with PE and 186 normotensive women were genotyped for ERα gene (PvuII and XbaI) polymorphisms by PCR-RFLP method. Results: The frequency of alleles and genotypes of ERα PvuII and XbaI polymorphisms were not different between PE and normotensive control women. However, higher frequency of GG genotype was observed in women with severe PE compared to mild PE (OR, 1.8 [95% CI, 1.1 to 3]; P = 0.02) and in severe PE compared to normotensive women [OR= 1.8(1.1-3), P=0.02] after adjusting for age, ethnicity and primiparity. Conclusions: The GG genotype of ERα XbaI polymorphism could be a genetic risk factor for PE predisposition.

Keywords: estrogen receptor-α, polymorphism, gene, preeclampsia

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Authors: Oluwayemisi D. Ishola, Lekan Ajijola

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Nigeria faces a demographic challenge characterized by a burgeoning youth population and an escalating fertility rate. A notable decline in the use of modern contraceptives among adolescent girls and young women compounds the challenge. The youthful demographic stands at a critical juncture in the nation's pursuit to fulfill its pledge of achieving a 27% modern contraceptive rate by 2030, embodying the potential to translate this ambitious commitment into a tangible reality. This research undertook a multi-dimensional examination to scrutinize contraceptive ideational disparities among adolescents and young women in Nigeria, with a particular emphasis on ideational factors. The data underpinning this study were drawn from a cross-sectional household survey carried out in the Nigerian states of Edo, Ogun, Plateau, and Niger between October 2019 and January 2020. The survey encompassed 2,857 sexually active women aged 15-24 years. Employing an ideational framework focusing on behavior that accentuates psychosocial factors, the study dissected nine unique ideational variables into three principal domains: social, cognitive, and emotional. Multivariate logistics regression analyses were used to assess associations between ideational elements and contraceptive use within the total sample and specific age brackets (adolescents of 15-19 years and youth of 20-24 years). For this study, a p-value less than 0.05 was considered indicative of statistical significance. The study's results revealed significant associations between the ideational variables and contraceptive use in total sample and among adolescent and youth, ranging from p < .05 to p < .001. The influence of each domain's predictors on Family Planning (FP) manifested variations when assessed separately and across the different age groups. Notably, cognitive and emotional domains were found to be the strongest predictor of contraceptive use when compared with social domains in the general sample and among youth. This study’s findings highlight the complex interplay of social, cognitive, and emotional factors in contraceptive use among young individuals. Understanding these dynamics is crucial in developing effective strategies to overcome barriers and improve access to contraceptive services among young women in Nigeria.

Keywords: adolescents, contraception, ideation, youth

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Authors: Isa Shu’aibu, A. A. Mu’inat, F. U. Maigari, M. A. Mani

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Candida albicans is the common cause of both oral and vaginal candidiasis in humans. This candidiasis leads to a wide range of physical, psychological and even physiological problems in humans particularly pregnant women. Samples of endocervical and high vaginal swab were collected from 200 women attending Gombe Specialist Hospital and inoculated on Saboraud Dextrose Agar (SDA) incorporated with chloramphenicol to get rid of the unwanted bacterial contaminants. Gram staining technique and germ tube test were employed for the identification, as Candida albicans is positive for both. Gram positive samples were 70% (n=140) and were further subjected to germ tube test. The remaining 30% (n=60) were found to be Gram negative. 90% (n=126) of the Gram positive ones isolated were also found to be positive for germ tube test; confirming the presence of Candida albicans. Antifungal susceptibility testing revealed that members of Imidazole (Ketoconazole, Miconazole) and those of Triazoles (Fluconazole and Itraconazole) were found to be more effective at concentrations of 20, 50 and 100 µg/disc compared to Griseofulvin (Fulcin) with only 26.00 mm zone of inhibition at 100 µg/disc concentration.

Keywords: Candida albicans, candidiasis, endocervical, vaginal swab, antifungal susceptibility, imidazole, triazoles

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Authors: Negar Mirzaie, Hedayet Allah Sharifi

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The present study was conducted with the aim of investigating the role of positive adolescent development on hope for the future in adolescents aged 14 to 18 with anxiety in the city of Ahvaz in the country of Iran in 2023. This research was descriptive and correlational. The statistical population of the present research was the adolescents aged 14 to 18 with anxiety of Ahvaz city in Iran in 2023. 150 people were selected by Purposeful sampling method and answered questionnaires of positive adolescent development and hope. The data were analyzed by Pearson correlation and multiple regression. The results showed that there is a significant relationship between the positive development of adolescence and hope for the future in anxious adolescents aged 14 to 18 in the city of Ahvaz in Iran in 2023 (p<0.05). Therefore, it is suggested to use the program of positive transformation of adolescents as hope in adolescents.

Keywords: positive adolescent development, hope, adolescents, anxiety

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Authors: B. Nageshwar Rao

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Urinary tract infection (UTI) represents the most commonly acquired bacterial infection worldwide, with substantial morbidity, mortality, and economic burden. The objective of the study is to characterize the microbial profiles of uropathogenic in the obstetric population by RTPCR. Study design: An observational cross-sectional study was performed at a single tertiary health care hospital among 50 pregnant women with UTIs, including asymptomatic and symptomatic patients attending the outpatient department and inpatient department of Obstetrics and Gynaecology.Methods: Serotyping and genes detection of various uropathogens were studied using RTPCR. Pulse filed gel electrophoresis methods were used to determine the various genetic profiles. Results: The present study shows that CsgD protein, involved in biofilm formation in Escherichia coli, VIM1, IMP1 genes for Klebsiella were identified by using the RTPCR method. Our results showed that the prevalence of VIM1 and IMP1 genes and CsgD protein in E.coli showed a significant relationship between strong biofilm formation, and this may be due to the prevalence of specific genes. Finally, the genetic identification of RTPCR results for both bacteria was correlated with each other and concluded that the above uropathogens were common isolates in producing Biofilm in the pregnant woman suffering from urinary tract infection in our hospital observational study.

Keywords: biofilms, Klebsiella, E.coli, urinary tract infection

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Authors: Sadandaula Rose Muheriwa Matemba, Alexander Glazier, Natalie M. LeBlanc

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In the United States, up to 10% of girls and 22 % of boys 10-14 years have had sex, 5% of them had their first sex before 11 years, and the age of first sexual encounter is reported to be 8 years. Over 4,000 adolescent girls, 10-14 years, become pregnant every year, and 2.6% of the abortions in 2019 were among adolescents below 15 years. Despite these negative outcomes, little research has been conducted to understand the sexual health education offered to young adolescents ages 10-14. Early sexual health education is one of the most effective strategies to help lower the rate of early pregnancies, HIV infections, and other sexually transmitted. Such knowledge is necessary to inform best practices for supporting the healthy sexual development of young adolescents and prevent adverse outcomes. This qualitative descriptive study was conducted to explore the community stakeholders’ experiences in sexual health education for young adolescents ages 10-14 and ascertain the young adolescents’ sexual health support needs. Maximum variation purposive sampling was used to recruit a total sample of 13 community stakeholders, including health education teachers, members of youth-based organizations, and Adolescent Clinic providers in Rochester, New York State, in the United States of America from April to June 2022. Data were collected through semi-structured individual in-depth interviews and were analyzed using MAXQDA following a conventional content analysis approach. Triangulation, team analysis, and respondent validation to enhance rigor were also employed to enhance study rigor. The participants were predominantly female (92.3%) and comprised of Caucasians (53.8%), Black/African Americans (38.5%), and Indian-American (7.7%), with ages ranging from 23-59. Four themes emerged: the perceived need for early sexual health education, preferred timing to initiate sexual health conversations, perceived age-appropriate content for young adolescents, and initiating sexual health conversations with young adolescents. The participants described encouraging and concerning experiences. Most participants were concerned that young adolescents are living in a sexually driven environment and are not given the sexual health education they need, even though they are open to learning sexual health materials. There was consensus on the need to initiate sexual health conversations early at 4 years or younger, standardize sexual health education in schools and make age-appropriate sexual health education progressive. These results show that early sexual health education is essential if young adolescents are to delay sexual debut, prevent early pregnancies, and if the goal of ending the HIV epidemic is to be achieved. However, research is needed on a larger scale to understand how best to implement sexual health education among young adolescents and to inform interventions for implementing contextually-relevant sexuality education for this population. These findings call for increased multidisciplinary efforts in promoting early sexual health education for young adolescents.

Keywords: community stakeholders’ perspectives, sexual development, sexual health education, young adolescents

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Authors: Jaeyoung Lee, Minji Je

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Objectives: The adolescents not attending school are named out-of-school adolescents. They are more vulnerable to health management and are likely to be exposed to a number of risk factors. This study was conducted to investigate the problem behavior of out-of-school adolescents and analyze the difference caused by gender. Methods: In this study, the problem behaviors of out-of-school adolescents, the vulnerable class, were defined in 8 types and based on this definition, the survey on run away from home, drop out, prostitution, violence, internet game addiction, theft, drug addiction, and smoking was conducted. The study was conducted in a total of 507 out-of-school adolescents, including 342 males, and 165 females. The type, frequency and start time of the 8 problem behaviors were identified. The collected data were analyzed with chi-square test and t-test using SPSS statistics 22. Results: Among the problem behaviors of the subjects, violence ( =17.41, p < .001), internet game addiction ( =16.14, p < .001), theft ( =22.48, p < .001), drug addiction ( =4.17, p=.041), and smoking ( =3.90, p=.048) were more significantly high in male out-of-school adolescents than female out-of-school adolescents. In addition, the frequency of the problem behavior was higher in male out-of-school adolescents with statistical significance than in female out-of-school adolescents (t=5.08, p= < .001). In terms of the start time of the problem behavior, only internet game addiction was higher in male out-of-school adolescents with the statistical significance than in female out-of-school adolescents ( =6.22, p=.032). No statistically significant difference was found in other problem behaviors (p > .05). Conclusions: In this study, it was found that gender difference in problem behaviors of out-of-school adolescents exists, and its frequency and difference of types were identified. When the social countermeasures were provided for those adolescents, a distinguished approach is required depending on the patterns of problem behavior and gender. When preparing policy alternatives and interventions for out-of-school adolescents, it is required to reflect the results of this study.

Keywords: addictive behavior, adolescent, gender, problem behavior

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge

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Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.

Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Bankole Do, Omodara T. R., Awyinka O. A.

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Probiotic supplementation has been known to be associated with a lower prevalence of hypertension. Against these backdrop, activities of the gut microbiota from hypertensive induced pregnant and non-pregnant rats as mediated by the soluble and indigestible fraction of carbohydrates derived from Otiliand fermentedIru were studied in this present work. Microbiota from hypertensive induced non- pregnant rats fed with Otili and Iruhad Proteus vulgaris + Staphylococcus aureus. However, hypertensive induced pregnant rats fed with Otilipredominantly contained Proteus vulgaris + Bacillus lichniformiswhile the group fed with Iruhad Staphylococcus aureus + Bacillus lichniformis. Thus, showingdysbiosis in hypertensive induced rats is influenced by pregnancy. Further In-vitro study showed Proteus vulgaris playing a key role in the fermentative process of the indigestible fraction of carbohydrates while Esherichia coli played the key role in the fermentative process of the soluble fraction of carbohydrates in all the bean samples. This dysbiosis of the gut microbiota, as seen in hypertension in rats in this present study, might be part of the strategies for the prevention and treatment of this Non-Communicable Disease.

Keywords: probiotic, microbiota, dysbiosis, hypertension

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Authors: Gaironeesa Hendricks, Shazly Savahl, Maria Florence

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The aim of the study is to determine whether peer pressure and leisure boredom influence substance use among adolescents in low-income communities in Cape Town. Non-probability sampling was used to select 296 adolescents between the ages of 16–18 from schools located in two low-income communities. The measurement tools included the Drug Use Disorders Identification Test, the Resistance to Peer Influence and Leisure Boredom Scales. Multiple regression revealed that the combined influence of peer pressure and leisure boredom predicted substance use, while peer pressure emerged as a stronger predictor than leisure boredom on substance use among adolescents.

Keywords: substance use, peer pressure, leisure boredom, adolescents, multiple regression

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Authors: Bedilu A. Ejigu, Eshetu Wencheko, Kiros Berhane

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Anaemia is a condition in which the haemoglobin concentration falls below an established cut-off value due to a decrease in the number and size of red blood cells. The current study aimed to assess the spatial pattern and identify predictors related to anaemia using the third Ethiopian demographic health survey which was conducted in 2010. To achieve this objective, this study took into account the clustered nature of the data. As a result, multilevel modeling has been used in the statistical analysis. For analysis purpose, only complete cases from 15,909 females, and 13,903 males were considered. Among all subjects who agreed for haemoglobin test, 5.49 %males, and 19.86% females were anaemic. In both binary and ordinal outcome modeling approaches, educational level, age, wealth index, BMI and HIV status were identified to be significant predictors for anaemia prevalence. Furthermore, it was noted that pregnant women were more anaemic than non-pregnant women. As revealed by Moran's I test, significant spatial autocorrelation was noted across clusters. The risk of anaemia was found to vary across different regions, and higher prevalence was observed in Somali and Affar region.

Keywords: anaemia, Moran's I test, multilevel models, spatial pattern

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Authors: Janet Tolulope Olaseni

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Emotional well-being in adolescents is an important psychological factor that can enhance positive living, but if it is not well groomed, it can have adverse impacts on their development. Therefore, the present study examined the efficacy of psycho-education on the emotional well-being of adolescents who are visually impaired in Nigeria. A total of twenty-eight (28) participants, which comprisednineteen (19) males and nine (9) females (M=15.82, SD=2.23) from a Nigerian School for the Blind, participated in the quasi-experimental study. Randomized clinical trial designwas used to assigned the participants into three (Complete Psycho-education, Incomplete Psycho-education, and No Psycho-education) groups. Standardized scales were used to gather data from the respondents. The formulated hypotheses were tested using Dependent T-Test and Analysis of Co-Variance. The results showed that there was a significant effect of Psycho-education on the emotional well-being of the Visually Impaired Adolescents. Those who received complete Psycho-educationhad the highest level of emotional well-being compared to those in the other groups. In order to enhance the emotional well-being of the Visually Impaired Adolescents, the study recommended that complete Psycho-education programme should be incorporated into the school activities of the Visually Impaired Adolescents.

Keywords: emotional well-being, psycho-education, visually impaired adolescents, Nigeria

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Authors: Jamilu Lawal Ajiya

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Background: Physical activity is essential for improving maternal health outcomes, particularly in low- and middle-income countries like Nigeria. Objective: The aim is to evaluate the effectiveness of physical activity interventions on maternal health outcomes among Nigerian pregnant women. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in Nigeria, published in English, and focusing on physical activity and maternal health outcomes. Results: Ten RCTs (N=1,200) were included. Physical activity interventions significantly reduced the risk of gestational diabetes, hypertension and preterm birth. Also, the study found that brisk walking and aerobic exercise were more effective than yoga. Conclusion: Physical activity interventions improve maternal health outcomes among Nigerian pregnant women. Policy changes and public health programs should prioritize physical activity promotion during pregnancy. This study informs healthcare providers, policymakers, and researchers on the effectiveness of physical activity interventions in improving maternal health outcomes in Nigeria.

Keywords: physical activity, maternal health, Nigeria, randomized controlled trials

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Authors: Nkiru Nnaemezie, J. O. Okafor

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The high mortality as a result of pregnancy related illnesses is a global public health problem and a source of concern to most countries including Nigeria. This study was therefore designed to determine the Demographic Variables associated with common pregnancy related illnesses among pregnant mothers in Awka South Local Government Area of Anambra State. The design of the study was an expost-facto research design. All the folders of the pregnant mothers that were studied from 2010-2014 formed the population of the study which included 10,250 folders. Based on the content of the folders, a researcher developed pro-forma (RDP) was used for data collection. Five research questions and five hypotheses were postulated for the study. Research questions postulated were answered using simple percentage. Hypotheses stated were analyzed at 0.05 level of significance using chi-square (X²) statistics. The result among others showed that pregnant mothers within 15-29 years had the most pregnancy related illnesses than mothers on other age brackets. Pregnant mothers with 0-1 parity level experienced the most pregnancy related illnesses than mothers on other parity levels. Public servants experienced the most pregnancy related illnesses than mothers in other occupations. Married pregnant mothers experienced the most pregnancy related illnesses than single mothers. Pregnant mothers with secondary education had the most pregnancy related illnesses than mothers in other education levels. There were significant differences in the common pregnancy related illnesses among the pregnant mothers of the study in relation to the demographic variables of the study which included age, parity, occupation, marital status and educational level. Based on the findings, conclusions were drawn, and the following recommendations among others were made: there is need for health education in terms of educating those pregnant mothers during antenatal clinics; single mothers should be advised to register for antenatal early enough.

Keywords: analysis, demographic variables, pregnancy related illnesses, pregnant mothers

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Authors: Moushira Zaki, Wafaa Ezzat, Yasser Elhosary, Omnia Saleh

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Nonalcoholic fatty liver disease (NAFLD) has increased in conjunction with obesity. The accuracy of risk factors for detecting NAFLD in obese adolescents has not undergone a formal evaluation. The aim of this study was to evaluate predictors of NAFLD among Egyptian female obese adolescents. The study included 162 obese female adolescents. All were subjected to anthropometry, biochemical analysis and abdominal ultrasongraphic assessment. Metabolic syndrome (MS) was diagnosed according to the IDF criteria. Significant association between presence of MS and NAFLD was observed. Obese adolescents with NAFLD had significantly higher levels of ALT, triglycerides, fasting glucose, insulin, blood pressure and HOMA-IR, whereas decreased HDL-C levels as compared with obese cases without NAFLD. Receiver–operating characteristic (ROC) curve analysis shows that ALT is a sensitive predictor for NAFLD, confirming that ALT can be used as a marker of NAFLD.

Keywords: obesity, NAFLD, predictors, adolescents, Egyptians, risk factors, prevalence

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Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

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Authors: Preeti Khanna, Bani T. Aeri

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Background: Recent studies have indicated challenges that hamper health and wellbeing of a vast majority of adolescents in developing countries. Many modifiable factors like behavior and temperament related to food intake among adolescents have not been adequately explored. The aim of the proposed research is to study the impact of behavior and temperament on food intake and diet quality of adolescents. Objectives: In the present study data on dietary behavior and anthropometry of adolescent boys & girls (aged 13-16 years) studying in public schools of Delhi will be gathered to ascertain the quality of diet among adolescent boys and girls and to study the effect of behavior and temperament on diet quality of adolescents. Methods: In total, 400 adolescents will participate in this cross-sectional study. Weight and height of adolescents will be measured and BMI will be calculated. Information will be obtained on their socio-demographic profile and various factors influencing their Food Choices and diet quality such as body image perception, Behavior, temperament, locus of control and parental influence. Expected results: Several direct effects of adolescent traits and behavior on food intake will be observed. Maturational patterns and gender differences in behavior traits will be assessed. By profiling of the behavior and temperament traits, we will have a better understanding of impact of these factors on weight and eating behaviors in overweight/obese or even underweight adolescents. Conclusions: The proposed study will highlight the association of behavioral factors with nutritional status of adolescents. It will also serve as a strategic approach for the obesity prevention and health management policies designed for adolescents.

Keywords: behaviour, temperament, food intake, adolescents

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Authors: Rasha Kumari Panda

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The crime against women in closed door is an important burning issue in day to day life. Domestic violence has become daily part of women’s life. It affects the millions of the women throughout the India as it violates their human rights. Crime against women behind closed door is a manifestation of historically unequal power relations between men and women, discrimination against women moreover, when the world is approaching towards modernization, worse the condition of women and girls in our society. This paper examines how the rights of women are being violated and suggests the remedial measures to empower women. Powerlessness of women is the root cause of violence has been specifically addressed.

Keywords: domestic violence, cruelty, dowry, statutes

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Authors: Rocio Murad, Juan Carlos Rivillas, Nury Alejandra Rodriguez, Daniela Roldán

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In Colombia, around 5 million women have suffered forced displacement and all forms of gender-based violence, mostly adolescents and young women, single mothers, or widows with children affected by the war. After the signing of the peace agreements, the department of Antioquia has been one of the most affected by the armed conflict, from a territorial and gender perspective in the period. The objective of the research was to analyze the situation of sexual and reproductive rights in the department of Antioquia from a territorial and gender perspective in the period after the signing of the Peace Agreement. A mixed methodology was developed. The quantitative component conducted a cross-sectional descriptive study of barriers to access to contraceptive methods, safe abortion and gender-based violence based on microdata from the 2015 National Demographic and Health Survey. In the qualitative component, a case study was developed in Dabeiba, a municipality of Antioquia prioritized in order to deepen the experiences before, during and after the armed conflict in sexual and reproductive rights; using three research techniques: Focused observation, Semi-structured interviews, and Documentary review. The results showed that there is a gradient of greater vulnerability to greater effects of the conflict and that the subregion of Urabá Antioqueño, to which Dabeiba belongs, has the highest levels of vulnerability in relation to departmental data. In this subregion, the percentage of women with an unmet need for contraceptive methods (9%), women with unintended pregnancies (31%), of women between 15 and 19 years of age who are already mothers or are pregnant with their first child (32%) and the percentage of women victims of physical violence (42%) and sexual violence (13%) by their partners are significantly higher. Women, particularly rural and indigenous women, were doubly affected due to the existence of violence that is specifically directed at them or that has a greater impact on their life projects. There was evidence of insufficient, fragmented and disjointed social and institutional action in relation to women's rights and the existence of androcentric and patriarchal social imaginaries through which women and the feminine are undervalued. These results provide evidence of violations of sexual and reproductive rights in contexts of armed conflict and make it possible to identify mechanisms to guarantee the re-establishment of the rights of the victims, particularly women and girls. Among the mechanisms evidenced are: working for the elimination of gender stereotypes; supporting the formation and strengthening of women's social organizations; working for the concerted definition and articulated implementation of actions necessary to respond to sexual and reproductive health needs; and working for the recognition of reproductive violence as specific and different from sexual violence in the context of armed conflict. Also, it was evidenced that it is necessary to implement prevention, attention and reparation actions.

Keywords: sexual and reproductive rights, Colombia, armed conflict, violence against women

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Authors: Simin Hosseinian, Roghieh Nooripour

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Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a major neuropsychiatric disorder diagnosis in children, adolescents. This study was aimed to investigate the quality of life of mothers of adolescents with ADHD based on Lazarus-Folkman's coping. Method: Due to this purpose, 120 mothers were selected with convenience sampling method that referred to counseling centers with their adolescents with ADHD for treatment of their adolescents and then they completed Iranian Quality of Life Questionnaire and The Ways of Coping Questionnaire (WCQ). Data were analyzed by the Pearson correlation and stepwise regression methods with SPSS-19. Results: The result showed that there was a positive significant relationship between quality of life and self-controlling and also a negative relationship between quality of life and accepting responsibility (p < 0.05). Conclusion: According to these findings, we can suggest suitable intervention for mothers who have adolescents with ADHD and enhance their quality of life.

Keywords: ADHD, mother, adolescent, quality of life, Lazarus-Folkman

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Authors: Anteneh Berhane Yeyi, Tefera Belachew

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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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Authors: Vidhya Venugopal, Rekha S.

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Introduction: Climate change and the growing frequency of higher average temperatures and heat waves have detrimental health effects, especially for certain vulnerable groups with limited socioeconomic status (SES) or physiological capacity to adapt to or endure high temperatures. Little research has been conducted on the effects of heat stress on pregnant women and fetuses in tropical regions such as India. Very high ambient temperatures may worsen Adverse Pregnancy Outcomes (APOs) and are a major worry in the scenario of climate change. The relationship between rising temperatures and APO must be better understood in order to design more effective interventions. Methodology: We conducted an observational cohort study involving 865 pregnant women in various districts of Tamil Nadu districts between 2014 and 2021. Physiological Heat Strain Indicators (HSI) such as morning and evening Core Body Temperature (CBT) and Urine Specific Gravity (USG) were monitored using an infrared thermometer and refractometer, respectively. A validated, modified version of the HOTHAPS questionnaire was utilised to collect self-reported health symptoms. A follow-up was undertaken with the mothers to collect information regarding birth outcomes and APOs, such as spontaneous abortions, stillbirths, Preterm Birth (PTB), birth abnormalities, and Low Birth Weight (LBW). Major findings of the study: According to the findings of our study, ambient temperatures (mean WBGT°C) were substantially higher (>28°C) for approximately 46% of women performing moderate daily life activities. 82% versus 43% of these women experienced dehydration and heat-related complaints. 34% of women had USG >1.020, which is symptomatic of dehydration. APOs, which include spontaneous abortions, were prevalent at 2.2%, stillbirth/preterm birth/birth abnormalities were prevalent at 2.2%, and low birth weight was prevalent at 16.3%. With exposures to WBGT>28°C, the incidence of miscarriage or unexpected abortion rose by approximately 2.7 times (95% CI: 1.1-6.9). In addition, higher WBGT exposures were associated with a 1.4-fold increased risk of unfavorable birth outcomes (95% Confidence Interval [CI]: 1.02-1.09). The risk of spontaneous abortions was 2.8 times higher among women who conceived during the hotter months (February – September) compared to those women who conceived in the cooler months (October – January) (95% CI: 1.04-7.4). Positive relationships between ambient heat and APOs found in this study necessitate further exploration into the underlying factors for extensive cohort studies to generate information to enable the formulation of policies that can effectively protect these women against excessive heat stress for enhanced maternal and fetal health.

Keywords: heat exposures, community, pregnant women, physiological strain, adverse outcome, interventions

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