scholarly journals Exploratory Efficacy of Calcium-Vitamin D Milk Fortification and Periodontal Therapy on Maternal Oral Health and Metabolic and Inflammatory Profile

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 783
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Danilo Dias Santana ◽  
Pedro Paulo Teixeira dos Santos ◽  
Paula Guedes Cocate ◽  
Camila Benaim ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Large Scale ◽  
Health Centre ◽  
Randomised Trial ◽  
Periodontal Therapy ◽  
Feasibility Trial ◽  
Periodontal Health ◽  
Powdered Milk ◽  
Public Health Centre

In this 2 × 2 factorial, outcome-assessor blinded, feasibility randomised trial we explored the effect of a non-pharmaceutical multi-component intervention on periodontal health and metabolic and inflammatory profiles among pregnant women with periodontitis receiving prenatal care in a Brazilian public health centre. 69 pregnant women (gestational age ≤20 weeks, T0) were randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus periodontal therapy during pregnancy (early PT) (n = 17); (2) placebo sachet and powdered milk plus early PT (n = 15); (3) fortified sachet and powdered milk plus late PT (after delivery) (n = 19); (4) placebo sachet and powdered milk plus late PT (n = 18). Third trimester (T1) and 6–8 weeks postpartum (T2) exploratory outcomes included periodontal health (% sites with bleeding on probing (BOP)), glucose, insulin, C-Reactive Protein, serum calcium and vitamin D. The mean BOP was significantly reduced in the early PT groups, while BOP worsened in the late PT groups. No significant effect of fortification on BOP was observed. Changes in glucose levels and variation on birthweight did not differ among groups This feasibility trial provides preliminary evidence for estimating the minimum clinically important differences for selected maternal outcomes. A large-scale trial to evaluate the interventions’ clinical benefits and cost-effectiveness is warranted.

scholarly journals Calcium and vitamin D supplementation and/or periodontal therapy in the treatment of periodontitis among Brazilian pregnant women: protocol of a feasibility randomised controlled trial (the IMPROVE trial)

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Paula Guedes Cocate ◽  
Gilberto Kac ◽  
Berit L. Heitmann ◽  
Paulo Nadanovsky ◽  
Maria Cláudia da Veiga Soares Carvalho ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomised Controlled Trial ◽  
Pregnant Women ◽  
Low Income ◽  
Controlled Trial ◽  
Periodontal Therapy ◽  
Periodontal Health ◽  
Powdered Milk ◽  
Feasibility Randomised Controlled Trial ◽  
Randomised Controlled

Abstract Background Periodontitis is a common oral inflammation, which is a risk factor for adverse pregnancy outcomes. Intakes of vitamin D and calcium are inversely associated with occurrence and progression of periodontitis. This study aims to assess the feasibility of a multi-component intervention, including provision of milk powder supplemented with calcium and vitamin D and periodontal therapy (PT), for improving maternal periodontal health and metabolic and inflammatory profiles of low-income Brazilian pregnant women with periodontitis. Methods The IMPROVE trial is a feasibility randomised controlled trial (RCT) with a 2 × 2 factorial design with a parallel process evaluation. Pregnant women with periodontitis, aged 18–40 years and with < 20 gestational weeks (n = 120) were recruited and randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus PT during pregnancy, (2) placebo sachet and powdered milk plus PT during pregnancy, (3) fortified sachet (vitamin D and calcium) and powdered milk plus PT after delivery and (4) placebo sachet and powdered milk plus PT after delivery. Dentists and participants are blinded to fortification. Acceptability of study design, recruitment strategy, random allocation, data collection procedures, recruitment rate, adherence and attrition rate will be evaluated. Data on serum levels of vitamin D, calcium and inflammatory biomarkers; clinical periodontal measurements; anthropometric measurements; and socio-demographic questionnaires are collected at baseline, third trimester and 6–8 weeks postpartum. Qualitative data are collected using focus group, for analysis of favourable factors and barriers related to study adherence. Discussion Oral health and mineral/vitamin supplementation are much overlooked in the public prenatal assistance in Brazil and of scarcity of clinical trials addressing these issues in low and middle-income countries,. To fill this gap the present study was designed to assess the feasibility of a RCT on acceptability of a multi-component intervention combining conventional periodontal treatment and consumption of milk fortified with calcium-vitamin D for improving periodontal conditions and maternal metabolic and inflammation status, among Brazilian low-income pregnant women with periodontitis. Thus, we hope that this relatively low-cost and safe multicomponent intervention can help reduce inflammation, improve maternal periodontal health and metabolic profile and consequently prevent negative gestational outcomes. Trial registration NCT, NCT03148483. Registered on May 11, 2017.

scholarly journals Acceptability, Adherence and Retention of a Feasibility Randomised Trial on Periodontal Treatment and Vitamin D/ Calcium Milk Fortification among Pregnant Women: A Mixed-Methods Evaluation

2020 ◽  
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Danilo Dias Santana ◽  
Paula Guedes Cocate ◽  
Camila Benaim ◽  
Pedro Paulo Teixeira dos Santos ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mixed Methods ◽  
Pregnant Women ◽  
Low Income ◽  
Retention Rate ◽  
Randomised Trial ◽  
Feasibility Trial ◽  
Random Allocation ◽  
Treatment Groups ◽  
Mixed Methods Evaluation

This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca+VitD) and periodontal therapy (PT) among low income Brazilian pregnant women with periodontitis (IMPROVE trial). This 2x2 factorial feasibility trial used a mixed-methods evaluation. 69 pregnant women were randomly allocated to four groups: 1.fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2.placebo and milk plus early PT; 3.fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4.placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.

scholarly journals Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial

2020 ◽  
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Paula G Cocate ◽  
Camila Benaim ◽  
Maria Claudia da Veiga Carvalho ◽  
Michael M Schlüssel ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
Low Income ◽  
Quantitative Data ◽  
Health Centre ◽  
Feasibility Trial ◽  
Random Allocation ◽  
Eligibility Criteria ◽  
Related Factors ◽  
Phone Calls

Abstract Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aim of this study is to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy (PT) and describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study. Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2x2 factorial feasibility clinical trial were used. 18 women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions and data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (>20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, unresponsive to phone calls, and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthy and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation cost) could hinder participation in the study. Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related socio-demographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.

scholarly journals Evaluation of HIV screening at antenatal care settings in Denpasar City

2017 ◽  
Vol 5 (1) ◽  
pp. 33
Author(s):  
Putu Cintya Denny Yuliyatni ◽  
Wayan Pujana ◽  
Citra Indriani
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Health Centre ◽  
Secondary Data ◽  
Performance Outcomes ◽  
Hiv Screening ◽  
Public Health Centre ◽  
Key Informants ◽  
Hiv Test

Background and purpose: National strategy to increase the coverage of prevention of mother to child transmission (PMTCT) program in Indonesia is integrating the service into public health centres (puskesmas). In Bali, the integration has been started since 2014. After one year of program implementation, an evaluation was conducted in order to provide input and feedback for program improvement.Methods: Secondary data analysis and indepth interview with 13 key informants in Denpasar City were conducted to assess input, process and output of the integration implementation. Results: Of the 11,719 pregnant women targeted within the program, 43% were offered to undergo HIV testing and 98% of these agreed to have HIV test with 17 were found HIV positive. Interviews with key informants found that there were adequate resources both in terms of manpower, funds and equipment. Obstacles found in the implementation include different site of ANC and HIV testing facility. The other barrier was high number of pregnant mother who conducted ANC at private obstetrician which not yet included in the program.Conclusions: Integration of PMTCT into ANC services at public health centre (PHC) is an effective way to improve the uptake of HIV screening among pregnant women. However, there is a need of effective of referral systems from private midwives and PHC satellite services. The expansion of networks into private midwives and obstetrician will be instrumental in improving performance outcomes.

scholarly journals Barriers and opportunities for implementing prevention of mother to child transmission (PMTCT) in Bangli District

2017 ◽  
Vol 5 (1) ◽  
pp. 67
Author(s):  
Ketut Espana Giri ◽  
Ni Made Sri Nopiyani ◽  
Ketut Tuti Parwati Merati
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Health Centre ◽  
Community Leaders ◽  
Pmtct Program ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Public Health Centre ◽  
Mother To Child ◽  
Village Health

Background and purpose: HIV testing among pregnant women can reduce the risk of mother to child HIV transmission. The implementation of prevention of mother to child transmission (PMTCT) program in Bangli District is suboptimal. This study aims to explore challenges and opportunities for implementing PMTCT program from both user and provider perspectives.Methods: A qualitative approach was conducted in Bangli District between April and May 2016. Data were collected using in-depth interviews with 18 informants. All informants were purposively selected and covered of 10 pregnant women, two counsellors, two laboratory analysts, two head of community health centres, one disease control officer from Bangli District Health Office and one officer from Bangli District AIDS Commission. Data were analysed using thematic method.Results: Pregnant women chose to have ANC service at private midwife and obstetrician instead of  public health centre. From health providers’ perspectives barrier of PMTCT implementation included lack of health human resources and a high level of stigma and discrimination related to HIV/AIDS in the community. This study revealed that there was an opportunity for PMTCT implementation in Bangli District due to positive attitudes and supports from husband and health provider toward HIV testing. Another opportunity is to involve village health cadres and community leaders in promoting HIV testing among pregnant women.Conclusions: Implementation of PMTCT program in health centre should include network of private practitioner and enhance village health cadres’ and community leaders’ participation.

scholarly journals Faktor-faktor yang berhubungan dengan hipertensi pada ibu hamil

2021 ◽  
Vol 14 (4) ◽  
pp. 642-650
Author(s):  
Syamraini Silda ◽  
Ana Mariza ◽  
Sunarsih Sunarsih
Keyword(s):  
Pregnant Women ◽  
Health Centre ◽  
Previous History ◽  
Cross Sectional ◽  
Public Health Centre ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Risk Parity ◽  
History Of ◽  
In Pregnancy

Factors for hypertensive disorders of pregnancy among mothers in Lampung, IndonesiaBackground: Hypertension in pregnancy when blood pressure reaching 140/90 mmHg or more, which occurs during pregnancy. Hypertension in pregnancy can cause mortality and the number of prevalent still too high.Purpose: To know the factors associated with hypertension among pregnant women Inpatient public health centre, South Lampung.Method: A quantitative study with a cross-sectional with a prospective approach. The sampling was all pregnant women who follow up at the health center of 80 respondent on May 20 - July 24, 2019 taken by accidental sampling and data collected using observational sheets and interviews. Data analysis using chi-square test to find correlation among variables.Results: Shows that of 80 respondents who suffering of hypertension of 45%, age its risky category of  57.5%, parity its risky category, has obesity of 42.5% and having a history of hypertension in those without a previous history of hypertension of 35%. Statistical test results show that age its risk with p = 0.029, parity its risk (p = 0,000), obesity (p = 0.000) and a history of hypertension (p = 0.000). conclusion that there was a relationship between age its risk, parity its risk, obesity, and hypertension history with the incidence of hypertensionKeywords: Hypertensive disorders; Pregnancy; An age of risk; A parity of risk; Obesity; History of hypertensionPendahuluan:Hipertensi dalam kehamilan adalah tekanan darah mencapai 140/90  mmHg atau lebih yang terjadi saat kehamilan. Hipertensi pada kehamilan dapat menyebabkan mortalitas pada ibu hamil dan angkanya masih cukup relatif tinggi.Tujuan: Diketahui faktor-faktor yang berhubungan dengan hipertensi pada ibu hamil di wilayah kerja UPT Puskesmas Rawat Inap Katibung Lampung Selatan.Metode : Penelitian kuantitatif dengan pendekatan desain cross sectional study pendekatan prospektif. Teknik pengambilan sampel yang dilakukan adalah Accidental sampling. Sampel dalam penelitian ini adalah seluruh ibu hamil yang datang ke Puskesmas selama penelitian berlangsung yaitu sebanyak 80 ibu hamil pada tanggal 20 Mei – 24 Juli 2019 . Pengumpulan data diperoleh menggunakan lembar observasional dan wawancara. Analisis hubungan menggunakan uji chi-square.Hasil: Menunjukkan bahwa dari 80 ibu hamil yang mengalami hipertensi sebanyak 36 orang (%) sedangkan yang tidak hipertensi sebanyak 44 orang (%).Umur terbanyak pada yang beresiko 46 orang (57,5%) , Paritas pada yang tidak beresiko sebanyak 43 orang (53,75%) , Obesitas yang terbanyak pada yang tidak obesitas 46 orang (57,5%) dan Riwayat hipertensi sebelumnya terbanyak pada yang tidak ada riwayat hipertensi sebelumnya sebanyak 52 orang (65%).Hasil uji statistik bivariate menunjukkan bahwa umur (p=0,029) , paritas (p=0,000) , obesitas (p=0.000) dan  riwayat hipertensi (p=0.000) sehingga disimpulkan umur, paritas, obesitas dan riwayat hipertensi berhubungan dengan kejadian hipertensi pada ibu hamil.

scholarly journals Vitamin D and Calcium Milk Fortification in Pregnant Women with Periodontitis: A Feasibility Trial

2020 ◽  
Vol 17 (21) ◽  
pp. 8023
Author(s):  
Amanda Rodrigues Amorim Adegboye ◽  
Danilo Dias Santana ◽  
Paula Guedes Cocate ◽  
Camila Benaim ◽  
Pedro Paulo Teixeira dos Santos ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Low Income ◽  
Retention Rate ◽  
Recruitment Rate ◽  
Feasibility Trial ◽  
Random Allocation ◽  
Treatment Groups ◽  
Late Treatment ◽  
Participant Flow

This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca + VitD) and periodontal therapy (PT) among low income Brazilian pregnant women with periodontitis (IMPROVE trial). This 2 × 2 factorial feasibility trial used a mixed-methods evaluation. In total, 69 pregnant women were randomly allocated to four groups: 1. fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2. placebo and milk plus early PT; 3. fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4. placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation, and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.

Evaluation of HIV screening at antenatal care settings in Denpasar City

2017 ◽  
pp. 41
Author(s):  
P. Cintya Denny Yuliyatni ◽  
W. Pujana ◽  
C. Indriani
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Health Centre ◽  
Secondary Data ◽  
Performance Outcomes ◽  
Hiv Screening ◽  
Public Health Centre ◽  
Key Informants ◽  
Hiv Test

Background and purpose: National strategy to increase the coverage of prevention of mother to child transmission (PMTCT) program in Indonesia is integrating the service into public health centres (puskesmas). In Bali, the integration has been started since 2014. After one year of program implementation, an evaluation was conducted in order to provide input and feedback for program improvement.Methods: Secondary data analysis and in depth interview with 13 key informants in Denpasar City were conducted to assess input, process and output of integration implementation.Results: Of the 11,719 pregnant women targeted within the program, 43% were offered to undergo HIV testing and 98% of these agreed to have HIV test with 17 were found HIV positive. Interviews with key informants found that there were adequate resources both in terms of manpower, funds and equipment. Obstacles found in the implementation includes different site of ANC and HIV testing facility. The other barrier was high number of pregnant mother who conducted ANC at private obstetrician which not yet included in the program.Conclusions: Integration of PMTCT into ANC services at public health centre (PHC) is an effective way to improve the uptake of HIV screening among pregnant women. However, there is a need for effective of referral systems from private midwives and PHC satellite services. The expansion of networks into private midwives and obstetrician will be instrumental in improving performance outcomes.

scholarly journals Perilaku gizi dan hidrasi selama kehamilan berhubungan dengan konstipasi

2020 ◽  
Vol 9 (1) ◽  
pp. 27-32
Author(s):  
Khairizka Citra Palupi ◽  
Mertien Sa’pang ◽  
Erry Yudhya Mulyani ◽  
Aditya Fatkhi Laili
Keyword(s):  
Pregnant Women ◽  
Health Centre ◽  
P Value ◽  
Differential Analysis ◽  
Public Health Centre ◽  
Attitudes And Practices ◽  
Hydration Behaviour ◽  
Arm Circumference ◽  
Determining Factors ◽  
The Difference

Background: Prevalence of constipation in pregnant women is estimated at 11-38%. Impact of constipation in pregnant women are haemorrhoids and decreased quality of life. Meanwhile, determinants known to influence constipation during pregnancy are hormonal changes, poor diet, low physical activity and lack of fluid consumption. Objectives: Identify the determining factors that can affect occurrence of constipation and investigated the difference based on constipation status among pregnant women in Public Health Centre in Jakarta, Indonesia;Methods: This research was a cross sectional design conducted in July 2019 to October 2019. The subject was pregnant women. We used accidental sampling method to recruit subjects in Public Health Centre, Kebun Jeruk, West Jakarta. We measured the determining factors of constipation among pregnant women. Characteristic of pregnant women, knowledge, attitudes and practices were measured by questionnaires. Anthropometrics data for weight, height, and mid arm circumference were measured. Haemoglobin level was also measured. Bivariate analysis using Pearson or Spearman was used to investigate which factors associated significantly with constipation among pregnant women. We also assessed the difference of characteristic of pregnant women, knowledge, attitudes and practices using differential analysis (Mann-Whitney U-test). Results: The results showed that prevalence of constipation was 30%. Differential analysis showed that mothers who experienced constipation had a younger age and low nutritional and hydration behaviour scores. Other variables such as gestational age, weight before pregnancy, upper arm circumference, height, haemoglobin, knowledge score and nutritional attitude and hydration did not show significant differences based on constipation status. Correlation analysis showed an inverse relationship between maternal age and incidence of constipation, with r = 0.242 and a p-value = 0.015. Maternal age, nutritional behaviour and hydration also showed significant inverse relationship with incidence of constipation (r = -0.206 and p-value 0.039);Conclusion: Nutritional and hydration behaviour during pregnancy was related to the occurrence of constipation. Mothers are advised to have good nutrition and hydration behaviour to prevent constipation.

scholarly journals Consuming Mung Beans (Phaseolus radiatus L.) Increase Hemoglobin Levels among Pregnant Women with Anemia in The Second Trimester at Klenang Public Health Centre, Probolinggo District

2021 ◽  
Vol 14 (3) ◽  
pp. 250-256
Author(s):  
Tutik Hidayati ◽  
Roviatun Holila
Keyword(s):  
Pregnant Women ◽  
Health Centre ◽  
Intervention Group ◽  
Control Group ◽  
Second Trimester ◽  
Control Group Design ◽  
Public Health Centre ◽  
Measuring Device ◽  
Significant Difference ◽  
Quasi Experimental

Anemia in pregnancy is a pregnant mother with hemoglobin levels below 11g/dL in the first and third trimesters or hemoglobin levels less than 10.5 g/dLin the second trimester. This paper investigates the effect of consuming mungbeans (Phaseolus radiatus L.) on hemoglobin levels in the Second trimester ofpregnant women with anemia. This research used a quasi-experimental designwith randomized pretest-Posttest with a control group design. The populationwas 37 pregnant women in the second trimester who experienced anemia atKlenang PHC. Meanwhile, the sample was 34 respondents by simple randomsampling. The independent variable was consuming mung beans, while thedependent variable was the hemoglobin levels. In the control group, theauthors observed the consumption of Fe tablets once a day for 20 days in 17respondents. While in the intervention group, we monitored the consumptionof Fe tablets once a day and were given mung bean juice every day for 20days in 17 respondents. The instrument used an observation sheet and a digitalhemoglobin measuring device. Then, data analysis utilized the paired samplet-test with a significance of 0.05. After consuming mung beans and Fesupplements, the average hemoglobin levels in the intervention group were12.1588g/dL. Meanwhile, in the intervention group, after Fe observation were10.6412d/dL. There was a significant difference between the control andintervention groups p=0.000 (p<0.05). In conclusion, consuming mung beansincreases hemoglobin levels among pregnant women with anemia in thesecond trimester.

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