scholarly journals Folic Acid and Birth Defects: A Case Study (Iran)

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammad Bager Hosseini ◽  
Zhila Khamnian ◽  
Saeed Dastgiri ◽  
Bahram Samadi Raad ◽  
Yalda Ravanshad
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Diagnostic Tests ◽  
Odds Ratio ◽  
Prenatal Screening ◽  
Termination Of Pregnancy ◽  
Medical Diagnostic ◽  
Northwest Region ◽  
The Impact

The aim of this study was to evaluate the impact of folic acid use in pregnancy for the reduction of neural tube defects (NTDs) in the northwest region of Iran. We studied 243 women with pregnancies complicated by some forms of birth defect(s). These patients were identified by medical diagnostic tests as having a fetus with some types of congenital anomalies. The prevalence of NTDs among pregnant women who were referred for therapeutic termination of pregnancy was 24.7 percent. Consumption of folic acid prevented NTDs by 79 percent (Odds Ratio = 0.21, CI 95%: 0.12–0.40) and 94 percent (Odds Ratio = 0.06, CI 95%: 0.03–0.15) compared to pregnancies complicated by other anomalies and normal pregnancies, respectively. Hydrops fetalis, hydrocephaly, Down syndrome, and limb anomalies did not have any significant association with the folic acid use. Along with the advice for the consumption of folic acid for pregnant women, they should be offered prenatal screening or diagnostic tests to identify fetal abnormalities for possible termination of pregnancy.

Concerns of Pregnant Women in “Prenatal Screening/Diagnosis” Practice and Termination of Pregnancy

2020 ◽  
Vol 224 (03) ◽  
pp. 136-142
Author(s):  
Berna Tari Kasnakoglu ◽  
Mehmet Cakar ◽  
Zeynep Guldem Okem ◽  
Atakan Tanacan ◽  
Erdem Fadiloglu ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Service Providers ◽  
Diagnostic Testing ◽  
Religious Faith ◽  
Termination Of Pregnancy ◽  
University Hospital ◽  
Prenatal Diagnostic ◽  
Decision Making Factors

Abstract Objective To investigate the reasons for decision-making and concerns of patients in the field of prenatal screening, invasive prenatal diagnostic testing (IPDT), and termination of pregnancy (TOP). Study Design This questionnaire-based study consisted of 107 pregnant women who were referred for prenatal screening to the Hacettepe University Hospital. The questionnaire given to patients was prepared from scratch since there is no standard set of questions measuring patients’ feelings and concerns regarding prenatal screening/diagnosis, IPDT, and TOP. Results Our questionnaire results showed that it is possible to classify decision-making factors into 6 groups: psychological, social, fear, religious/faith, support, and trust. The majority of patients were undecided (48.6%) about IPDT if prenatal screening test results were risky. Only 23.4% of patients were willing to accept IPDT. On the other hand, 55.1% of patients were not willing to undergo TOP if the fetal karyotyping results were abnormal. Religious factors seem to be important in refusing IPDT and TOP. Conclusion Physicians should re-evaluate their practice in the field of prenatal screening and diagnosis in light of the high refusal rates of IPDT and TOP. Understanding factors influencing womenʼs decision-making processes provides insight for service providers to help women at high risk of having foetal anomalies to make better-informed choices.

scholarly journals Web-Based Training for Nurses on Shared Decision Making and Prenatal Screening for Down Syndrome: Protocol for a Randomized Controlled Trial

10.2196/17878 ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. e17878
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Melissa Cote ◽  
Codjo Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

Background Pregnant women often find it difficult to choose from among the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses provide maternity care and thus can train as decision coaches for prenatal screening. However, there is a knowledge gap about the effectiveness of SDM interventions in maternity care in nursing practice. Objective This study aims to assess the impact of an SDM training program on nurses’ intentions to use a decision aid for prenatal screening and on their knowledge and to assess their overall impressions of the training. Methods This is a 2-arm parallel randomized trial. French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were randomly allocated (1:1 ratio) to either an experimental group, which completed a web-based SDM training program that included prenatal screening, or a control group, which completed a web-based training program focusing on prenatal screening alone. The experimental intervention consisted of a 3-hour web-based training hosted on the Université Laval platform with 4 modules: (1) SDM; (2) Down syndrome prenatal screening; (3) decision aids; and (4) communication between health care professionals and the patient. For the control group, the topic of SDM in Module 1 was replaced with “Context and history of prenatal screening,” and the topic of decision aids in Module 3 was replaced with “Consent in prenatal screening.” Participants completed a self-administered sociodemographic questionnaire with close-ended questions. We also assessed the participants' (1) intention to use a decision aid in prenatal screening clinical practice, (2) knowledge, (3) satisfaction with the training, (4) acceptability, and (5) perceived usefulness of the training. The randomization was done using a predetermined sequence and included 40 nurses. Participants and researchers were blinded. Intention to use a decision aid will be assessed by a t test. Bivariate and multivariate analysis will be performed to assess knowledge and overall impressions of the training. Results This study was funded in 2017 and approved by Genome Canada. Data were collected from September 2019 to late January 2020. This paper was initially submitted before data analysis began. Results are expected to be published in winter 2020. Conclusions Study results will inform us on the impact of an SDM training program on nurses’ intention to use and knowledge of decision aids for prenatal screening and their overall impressions of the training. Participant feedback will also inform an upgrade of the program, if needed. Trial Registration ClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288 International Registered Report Identifier (IRRID) DERR1-10.2196/17878

scholarly journals Web-Based Training for Nurses on Shared Decision Making and Prenatal Screening for Down Syndrome: Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadje ◽  
Melissa Cote ◽  
Codjo Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

BACKGROUND Pregnant women often find it difficult to choose from among the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses provide maternity care and thus can train as decision coaches for prenatal screening. However, there is a knowledge gap about the effectiveness of SDM interventions in maternity care in nursing practice. OBJECTIVE This study aims to assess the impact of an SDM training program on nurses’ intentions to use a decision aid for prenatal screening and on their knowledge and to assess their overall impressions of the training. METHODS This is a 2-arm parallel randomized trial. French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were randomly allocated (1:1 ratio) to either an experimental group, which completed a web-based SDM training program that included prenatal screening, or a control group, which completed a web-based training program focusing on prenatal screening alone. The experimental intervention consisted of a 3-hour web-based training hosted on the Université Laval platform with 4 modules: (1) SDM; (2) Down syndrome prenatal screening; (3) decision aids; and (4) communication between health care professionals and the patient. For the control group, the topic of SDM in Module 1 was replaced with “Context and history of prenatal screening,” and the topic of decision aids in Module 3 was replaced with “Consent in prenatal screening.” Participants completed a self-administered sociodemographic questionnaire with close-ended questions. We also assessed the participants' (1) intention to use a decision aid in prenatal screening clinical practice, (2) knowledge, (3) satisfaction with the training, (4) acceptability, and (5) perceived usefulness of the training. The randomization was done using a predetermined sequence and included 40 nurses. Participants and researchers were blinded. Intention to use a decision aid will be assessed by a t test. Bivariate and multivariate analysis will be performed to assess knowledge and overall impressions of the training. RESULTS This study was funded in 2017 and approved by Genome Canada. Data were collected from September 2019 to late January 2020. This paper was initially submitted before data analysis began. Results are expected to be published in winter 2020. CONCLUSIONS Study results will inform us on the impact of an SDM training program on nurses’ intention to use and knowledge of decision aids for prenatal screening and their overall impressions of the training. Participant feedback will also inform an upgrade of the program, if needed. CLINICALTRIAL ClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17878

scholarly journals Multivariate regression analysis in the probability of deaths in COVID-19 cases: a case study in the State of Pará, Amazon region, Brazil

2020 ◽  
Vol 9 (11) ◽  
pp. e71291110299
Author(s):  
Cássio Pinho dos Reis ◽  
Herson Oliveira da Rocha ◽  
Nayara de Araújo Muzili Reis ◽  
Sávio Pinho dos Reis ◽  
Gustavo Nogueira Dias ◽  
...  
Keyword(s):  
Probabilistic Model ◽  
Odds Ratio ◽  
Multivariate Regression Analysis ◽  
The State ◽  
Metropolitan Region ◽  
Great Effort ◽  
Infected People ◽  
And Gender ◽  
The Impact

Since the first detected cases of COVID-19 in Brazil, researchers have made a great effort to try to understand the disease. Understanding the impact of the disease on people can be instrumental in identifying which groups can be considered at risk. Therefore, this study researches a probabilistic model based on a statistical model of non-linear regression analyzing the following variables: age, if you are a health professional, if you are resident in the Metropolitan Region of Belém (RMB), State of Pará and gender with the objective of identifying those people who have a greater impact on the number of people infected and killed by COVID-19, that is, people who are more likely to die. To carry out the research, we used the data of all infected people by COVID-19 in the State of Pará until July 2020. It can be verified according to the proposal of the probabilistic model that elderly people, with a odds ratio of 1.69 (95% CI 1.52-1.88), residents of Metropolitan Region of Belém, with an odds ratio of 2.14 (95% CI 2.02 - 2.27) and men, with an odds ratio of 1.83 (95% CI 1.73 - 1.95) are groups of people with a higher risk of dying from diseases, while health professionals, with a 0.36 chance ratio (CI9 5% 0.29 - 0.45), are less likely to die.

scholarly journals The Impact of Multiple Micronutrient Supplementation on Hemoglobin Concentration in Pregnant and Neonatal Birth Wight

2021 ◽  
Vol 9 (F) ◽  
pp. 366-369
Author(s):  
Abdul Faris ◽  
Muhammad Tahir Abdullah ◽  
Veni Hadju
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Public Health Problem ◽  
Hemoglobin Concentration ◽  
Acid Group ◽  
Adverse Outcomes ◽  
Micronutrient Supplementation ◽  
Infant Birth ◽  
The Impact

Background: Anemia during pregnancy is a public health problem especially in developing countries and it is associated with maternal and perinatal adverse outcomes.  Global data shows that 56% of pregnant women in low- and middle-income countries have anemia. Every year more than 20 million infants are born with low birth weigh t(LBW) worldwide. Objective: To analyze the impact of Multi Micronutrients (MM) supplementation on hemoglobin (Hb) levels of pregnant women and infant birth weight. Method: The databases used to obtain the literature were PubMed, ScienceDirect, MEDLINE, and PubMed Central. The keywords used were Multiple Micronutrien Supplementation, Hemoglobin, Pregnant and Neonatal Birth Weght in studies published from 2010 to 2020. A total of 14 articles were used in this review. Results: Seven articles obtained about the effects of multiple micronutrients on hemoglobin levels in pregnant women. Six studies support that MM supplementation increases hemoglobin levels or prevents pregnant women from anemia. One study showed a significant increase in serum ferritin One study reported ferritin levels in the MM group as well as the fe-folic acid group did not experience a significant decrease. There is only one study that shows the opposite results, which the mean maternal hemoglobin level significantly decreased during study, being the lowest in second trimester. Ferritin and serum iron levels were decreased at trimester one and two, also the zinc and vitamin D level declined. Seven articles show the effect of MM supplementation on pregnancy outcomes is better than Fe-folic acid supplementation. This can be seen in the results reported from various studies that have been carried out, which are reduce the incidence of LBW, small for gestational age, preterm labor. stillbirths, and NTD anomaly. Conclusion: Various empirical evidence that has been described in this paper confirms the plausibility that the provision of micronutrient supplementation in the periconceptional period is more important than only given during advanced pregnancy. Multi micronutrient administration increases hemoglobin levels in pregnant women and improves pregnancy outcomes

scholarly journals Does folic acid reduce congenital anomalies and adverse pregnancy outcomes in women received long-term low dose Methotrexate?

2019 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Ahmed M. Farag ◽  
Safaa A. Ibrahim
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Congenital Anomalies ◽  
Low Dose ◽  
Group 4 ◽  
Dose Methotrexate ◽  
Group 3 ◽  
The Impact ◽  
Group 1

Background: Methotrexate (MTX) which is folic acid antagonist is used to treat many diseases, including rheumatic, inflammatory, autoimmune disorders or malignancies; it is also used for the medical treatment of ectopic pregnancy and termination of pregnancy. The objective of this study was to assess the impact of folic acid in preventing congenital anomalies (CAs) in the fetus of pregnant that take long-term low dose methotrexate.Methods: The study included 1569 with history of low dose methotrexate therapy <25 mg/week that stopped one month before pregnancy, they were divided into 3 groups; Group 1 comprised 272 pregnant women, Group 2 comprised 367 pregnant women both groups take folic acid 4-5 weeks preconception and for the first 12-13 weeks gestation, the dose in the 1st group was 0.4 mg/day while in 2nd Group 4 mg/day, Group 3 comprised of 930 pregnant disease-matched with no folic acid. Group 4 comprised of 1015 pregnant no underlying autoimmune and no folic acid intake.Results: The overall rate of CAs and cardiovascular CAs were higher in fetuses of Group 3 (OR: 1.7; 95% CI: 1.1-2.7) and (OR: 2.7; 95% CI: 1.4-5.2) respectively compared to the overall rate of CAs and cardiovascular CAs in other groups. Other adverse outcomes as abortion, preterm delivery, preeclampsia, placenta abruption, PROM, low birth weight, admission to NICU, IUGR and IUFD were higher in Group 3 and 4 than in Group 1 and 2. There were no significant differences in umbilical arterial PH. The Apgar scores <7 at 1, 5 min and gestational age at delivery were higher in Group 1 and 2 than Group 3 and 4.Conclusions: There was a certain reduction in methotrexate teratogenic effect on the fetuses with folic acid intake during pregnancy, these pregnancies might benefit from taking of folic acid in high doses before conception and during the first trimester of pregnancy and improvement in fetal and maternal outcomes but the explanation of this effect requires further study.

scholarly journals How COVID-19 pandemic is changing the practice of prenatal screening and diagnosis?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hakan Golbasi ◽  
Ibrahim Omeroglu ◽  
Burak Bayraktar ◽  
Ceren Golbasi ◽  
Duygu Adıyaman ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Prenatal Screening ◽  
Screening Tests ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Outpatient Visits ◽  
Prenatal Diagnostic ◽  
The Impact ◽  
Fetal Screening ◽  
Screening And Diagnosis

Abstract Objectives To evaluate the impact of the COVID-19 pandemic on prenatal screening and diagnostic tests. Methods We conducted a retrospective study with pregnant women attending to the perinatology department of a tertiary referral center. The pre-COVID-19 period between 11 March 2019 and 10 March 2020 and COVID-19 period between 11 March 2020 and 10 March 2021 were evaluated. Both periods were compared in terms of outpatient visits, ultrasound examinations, prenatal screening and diagnostic tests. The correlation of deaths related to COVID-19 pandemic on these parameters was also assessed. Results A total of 38,918 patients were examined and 28,452 ultrasound examinations, 26,672 prenatal screening tests and 1,471 prenatal diagnostic tests were performed over two years. During COVID-19 pandemic, number of outpatient visits decreased by 25.2%, ultrasound examinations decreased by 44.2%, prenatal screening tests decreased by 36.2% and prenatal diagnostic tests decreased by 30.7%. Statistically significant correlation was not observed between deaths related to COVID-19 and outpatient visits (p=0.210), ultrasound examinations (p=0.265), prenatal screening (p=0.781) and diagnostic tests (p=0.158). Among indications of prenatal diagnostic tests, maternal anxiety was significantly higher in COVID-19 period (p=0.023). There was significant decrease in the detection of fetuses with trisomy 21 (p=0.047) and a significant increase in the detection of fetuses with Turner syndrome (p=0.017) during COVID-19 period. Conclusions The COVID-19 pandemic has severely impacted antenatal care. Prenatal fetal screening and diagnosis was adversely affected by the pandemic in terms of detecting genetic and structural anomalies.

Genetic Literacy of pregnant women and their use of prenatal screening and diagnostic tests in Turkey

2019 ◽  
Vol 28 (3) ◽  
pp. 578-586 ◽  
Author(s):  
Memnun Seven ◽  
Şeyma İnciser Paşalak ◽  
Eda Sahin ◽  
Aygul Akyuz
Keyword(s):  
Pregnant Women ◽  
Diagnostic Tests ◽  
Prenatal Screening ◽  
Genetic Literacy

Evaluating a Web-Based Training Program for Nurses on Shared Decision-Making and Screening for Down Syndrome: Protocol for a Randomized Control Trial (Preprint)

2020 ◽  
Author(s):  
Alex Poulin Herron ◽  
Titilayo Tatiana Agbadjé ◽  
Mélissa Côté ◽  
Codjo-Djignefa Djade ◽  
Geneviève Roch ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Training Program ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Control Group ◽  
Intention To Use ◽  
Shared Decision ◽  
Web Based ◽  
The Impact

BACKGROUND Pregnant women have difficulty choosing from amongst the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid (DA) and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses have responsibilities regarding maternity care and thus the potential to do decision coaching on prenatal screening. However, there is a gap of knowledge concerning the effectiveness of SDM interventions in this area of nursing practice. OBJECTIVE This study aims to assess the impact of an SDM training program on nurses’ intention to use a decision aid for prenatal screening as well as their knowledge and overall appreciation of the training. METHODS This is a two-arm parallel randomized trial. Nurses working with pregnant women from the province of Quebec, and speaking in French, will be recruited online by a private survey firm. They will be randomly allocated (1:1 ratio) to either an experimental group, which will complete a web-based SDM training program for prenatal screening, or to a control group, which will complete a web-based training program focusing on prenatal screening alone. The experimental intervention consists of a three hour web-based and fully automated training activity hosted on the University Laval platform and has four modules: 1) SDM; 2) Down syndrome prenatal screening; 3) DA; and 4) Communication between healthcare professionals and the patient. For the control group, the topic of SDM in Module 1 has been replaced with “Context and history of prenatal screening” and the topic of DA in Module 3 has been replaced with “Consent in prenatal screening.” In addition to sociodemographic questions using a self-administered questionnaire with closed ended questions, we will assess 1) intention to use a DA in prenatal screening clinical practice; 2) knowledge; 3) satisfaction with the training; 4) acceptability; and 5) perceived usefulness. The randomization will be done by a predetermined sequence and include 36 nurses. Participants and researchers will be blinded. Intention to use DA will be assessed by a Student t test and bivariate and multivariate analysis will be performed to assess knowledge and overall appreciation of the training. RESULTS This study is ongoing and results will be available at the end of 2020 CONCLUSIONS This study results will inform on the impact of an SDM training program on nurses’ intention to use a decision aid for prenatal screening as well as their knowledge and overall appreciation of the training. It will also provide feedback on ways to upgrade the SDM training program, if needed. CLINICALTRIAL ClinicalTrials.gov ID NCT04162288

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