Low compliance with recommendations on folic acid use in relation to pregnancy: is there a need for fortification?

2004 ◽  
Vol 7 (7) ◽  
pp. 843-850 ◽  
Author(s):  
Vibeke K Knudsen ◽  
Ivanka Orozova-Bekkevold ◽  
Lone B Rasmussen ◽  
Tina B Mikkelsen ◽  
Kim F Michaelsen ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
First Trimester ◽  
Vulnerable Groups ◽  
Information Campaign ◽  
Effective Strategies ◽  
Unplanned Pregnancies ◽  
Low Education ◽  
Periconceptional Period ◽  
First Trimester Of Pregnancy

AbstractObjective:As a means to prevent neural tube defects (NTDs), women planning pregnancy in Denmark are recommended to take a dietary supplement of 400 μg folic acid daily during the periconceptional period. We examined compliance with this recommendation in a national survey.Design:Cohort study on pregnant women in Denmark.Setting:The Danish National Birth Cohort (DNBC).Subjects:From November 2000 to February 2002, 22 000 pregnant women were recruited for DNBC. Use of dietary supplements was recorded at enrolment. Compliance with the recommendation was related to an information campaign that took place during the second half of 2001, and to lifestyle factors provided in a telephone interview by the end of the first trimester of pregnancy.Results:An increase was seen in the proportion of women complying with the recommendation in the study period and this coincided with the information campaign events. However, even at the end of the period, only 22.3% of the women who had planned their pregnancy fully complied with the recommendation. No increase at all was seen in periconceptional folic acid use among women with unplanned pregnancies. Young age, low education and smoking were identified as factors that determined non-compliance.Conclusions:Alternative and more effective strategies are needed if the Danish population is to benefit fully from the knowledge that folic acid prevents NTDs. Future strategies should not only target vulnerable groups, such as the less educated and the young, but also women who get pregnant without planning this. The only possible way to reach the last group may be through fortification of foods with folic acid.

scholarly journals Folic acid usage and awareness in pregnant women in Istanbul, Turkey

2012 ◽  
Vol 1 (1) ◽  
pp. 9 ◽  
Author(s):  
Nilgün Tekkeşin ◽  
Figen Taser
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Unplanned Pregnancy ◽  
Folic Acid Supplementation ◽  
Study Group ◽  
Turkish Women ◽  
Educational Strategies ◽  
Unplanned Pregnancies ◽  
Periconceptional Period ◽  
The Difference

Intake of folic in the periconceptional period reduces the risk of neural tube defects (NTDs). The aim of this study was to assess the level of awareness regarding the use of folic acid in pregnacy. We assessed the consumption of folic acid during pregnancy among Turkish women presented to the hospital and analyzed the difference of folic acid supplementation between planned and unplanned pregnancies. Of the 1076 women, 677 (62.9%) reported current use of a prenatal folic acid at the time of the department visit, while 399 pregnant women (37.0%) identified themselves as non-users (p = 0.006). In the unplanned pregnancy group, 302 (65.22%) women reported taking folic acid during pregnancy, but 161 (34.77%) women began three months prior to conception as recommended by their gynecologists (p<0.0001). Although, the study group was a significant user with a high awareness of folic acid, our findings may not be generalizable to other areas of the country. Because, parcitipants were likely to be one of the most educated group with a medium or high socio-economical status. Besides these hopeful results, we believe the necessity to re-evaluate our educational strategies and consider reduction of unplanned pregnancies as part of our goals. 

scholarly journals Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan
Keyword(s):  
Pregnant Women ◽  
Ambulatory Care ◽  
National Level ◽  
Mainland China ◽  
Antibiotic Use ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fetal Safety ◽  
First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

scholarly journals Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 795
Author(s):  
Mary M. Murphy ◽  
Kelly A. Higgins ◽  
Xiaoyu Bi ◽  
Leila M. Barraj
Keyword(s):  
Pregnant Women ◽  
Protein Intake ◽  
First Trimester ◽  
The United States ◽  
Limited Information ◽  
Health And Nutrition ◽  
Animal Source ◽  
Usual Intake ◽  
First Trimester Of Pregnancy ◽  
Using Data

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.

AYURVEDIC MANAGEMENT OF GARBHINI CHARDI (Emesis Gravidarum) WITH CHATURJATA CHOORNA (CHATURJATA POWDER) - A PILOT STUDY

2020 ◽  
Vol 8 (9) ◽  
pp. 4317-4323
Author(s):  
Priyanka 1 ◽  
Shreyes. S ◽  
Yogitha Bali M.R
Keyword(s):  
Pilot Study ◽  
Pregnant Women ◽  
First Trimester ◽  
Nausea And Vomiting ◽  
Morning Sickness ◽  
Excessive Salivation ◽  
First Trimester Of Pregnancy ◽  
Rice Water ◽  
Single Blind

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.

scholarly journals Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Brazilian Amazon ◽  
First Trimester ◽  
Inflammatory Factors ◽  
Anthropometric Measures ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

scholarly journals Erratum – Association between Dietary Glycemic Index and Excess Weight in Pregnant Women in the First Trimester of Pregnancy

2019 ◽  
Vol 41 (03) ◽  
pp. 209-210
Author(s):  
Thais de Pontes Ellery ◽  
Helena de Carvalho Sampaio ◽  
Antônio Carioca ◽  
Bruna da Costa Silva ◽  
Júlio Alves ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Glycemic Index ◽  
First Trimester ◽  
Excess Weight ◽  
First Trimester Of Pregnancy ◽  
Dietary Glycemic Index

scholarly journals Relationships among Constitution, Stress, and Discomfort in the First Trimester

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Hsiao-Ling Wang ◽  
Tzu-Chi Lee ◽  
Shih-Hsien Kuo ◽  
Fan-Hao Chou ◽  
Li-Li Chen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Professionals ◽  
Neutral Type ◽  
First Trimester ◽  
Constitutional Change ◽  
Correlational Research ◽  
Individualized Care ◽  
First Trimester Of Pregnancy ◽  
Southern Taiwan ◽  
Constitutional Changes

The purpose of this study was to explore correlations among constitution, stress, and discomfort symptoms during the first trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1) stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2) Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for “running nose”; (3) Tan-Shi-Yu-Zhi constitution and stress were two indicators for “fatigue”; Tan-Shi-Yu-Zhi was the indicator for “nausea”; Yang-Xu and Yin-Xu were indicators for “frequent urination.” Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.

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