Knowledge and Practice of Childbearing Women in Saudi Arabia towards Folic Acid Supplement—Evidence from a Cross-Sectional Study

Background and objectives: Neural tube defects are congenital anomalies which canlead to infant death and serious disability. They are initiated during embryogenesis, between the 23rd and 27th day of fetal life, and can be prevented by the administration of folic acid. Therefore, this study aims to evaluate the knowledge and practice of Saudi women at childbearing age regarding NTDs and FA supplementation. Methodology: This is a cross-sectional study on Saudi women of reproductive age who were asked to complete an online survey to examine their knowledge and practice regarding folic acid supplementation and neural tube defects. Descriptive and simple linear regression analyses were conducted using SPSS v.26 (SPSS Inc., Chicago, IL, USA). Results: A total of 613 women have completed the questionnaire, from which the majority (46.7%) were aged between 36 and 40 years. About 94% of women heard about folic acid and 80% indicated that its deficiency has some relation to neural tube defects. Approximately 37%, 25.3%, and 23.2% of women reported the proper time for folic acid intake to be during first trimester of pregnancy, before pregnancy, or throughout pregnancy, respectively. Linear regression analysis revealed that increase age and education were significantly correlated with a decrease in folic acid administration (p = 0.008) and (p = 0.001), respectively. However, there was no association between time of folic acid administration and income or number of parities. Conclusion: Despite the acceptable level of awareness about the relation of folic acid and neural tube defects, our results revealed that more education is required towards the proper time of supplementation among Saudi childbearing women.

Antenatal screening of depressive and manic symptoms in south Brazilian childbearing women: A transversal study in advance of the pandemic scenario

Background The diagnosis of mood disorders (MD) during pregnancy is challenging and may bring negative consequences to the maternal-fetal binomial. The long waitlist for specialized psychiatric evaluation in Brazil contributes to the treatment omission. Almost 20.0% of women treated with antidepressants have a positive screening for bipolar disorder. Therefore, it has been recommended the investigation of depressive and bipolar disorder during prenatal care. Unfortunately, the screening for mood disorders is not a reality in Brazil and many childbearing women remain undiagnosed. The objective of this study is to observe the frequency of MD and the effectiveness of screening scales for routine use by health professionals during prenatal care in high-risk pregnancies. Methodology/Principal findings This cross-sectional study included 61 childbearing women in their second trimester who were interviewed using the Edinburgh Postnatal Depression Scale (EPDS) and the Mood Disorder Questionnaire (MDQ). The cut-off point was EPDS ≥ 13 and MDQ ≥ 7 and the SCID-5 was the gold standard diagnosis. MD were diagnosed in 24.6% of the high-risk pregnancies. EDPS was positive in 19.7% and the frequency of major depression was 8.2%. 16.4% of the childbearing women were diagnosed with bipolar disorder, while MDQ was positive in 36.1%. 11.5% of the women had EPDS and MDQ positive. EPDS sensitivity was 80.0% and specificity 92.1%, whereas MDQ presented a sensitivity of 70.0% and specificity of 70.6%. Conclusion/Significance There is a high prevalence of MD in high-risk pregnancies. The routine use of EPDS simultaneously to MDQ during antenatal care is effective and plays an important role in early diagnosis, counselling, and promotion of perinatal mental health.

To Assess the Effectiveness of Planned Teaching on Knowledge Regarding Mid-Wife Led Continuity of Care Model (MLCC) on Final Year Nursing Students

Background: In many parts of the world, midwives are the primary providers of care for childbearing women. There are considerable variations in the organisation of midwifery services and in the education and role of midwives. Childbearing women are often faced with different opinions as to which option might be best for them. The midwife‐led continuity model of care is based on the premise that pregnancy and birth are normal life events. Pregnancy and birth are significant life events for women and their families and midwife supports a woman throughout pregnancy, birth, and the postnatal period. So, the demand for services that are family friendly, women focused, safe and accessible is increasing. Objectives: 1) To assess the existing knowledge regarding mid-wife led continuity of care model on final year nursing students. 2) To evaluate the effectiveness of planned teaching on knowledge regarding mid-wife led continuity of care model (MLCC) on final year nursing students. 3) To find out the association between knowledge regarding mid-wife led continuity of care model (MLCC) with selected demographic variables. Materials and Methods: In this study, evaluatory research approach and one group pre-test post-test research design was used. The study was conducted at a Selected Nursing College. The sample was collected from final year nursing students (120) by using non-probability convenient sampling technique. Results: In this study the study of the findings shows that 10.83% had good level of knowledge score in pre-test. While in post-test, out of 120 subjects the majority of the subjects and 92.50% had good level of knowledge score. This statistically shows that there is profound level of improvement on knowledge. Conclusion: Hence, this implies that the planned teaching was effective. Also, the study shows that the knowledge scores of final year nursing students is associated with the age in year and course of study. Hence, this means that greater the number of age in years and the course, greater level of knowledge scores. However, gender was not found to be associated.

Impact of Electronic Medical Records Within the Maternity Environment: An Ethnographic Exploration of Midwifery Practice

Integration of care through digitalisation of paper records is important for childbearing women who may see multiple clinicians both within the hospital and the community. It is important that in the implementation of an EMR, the established benefits of a paper and handheld records are transferred and not lost. Acceptance and positive use of digital records in maternity settings has occurred despite concerns regarding workload interrupting women centred care.

Threshold for Relationship between Vitamin D and Parathyroid Hormone in Chinese Women of Childbearing Age

Background: The aim of this study was to assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum intact parathyroid hormone (PTH) in Chinese childbearing women, and to estimate the optimum threshold of 25(OH)D that maximally inhibits the PTH, which is considered to be the optimal status for vitamin D sufficiency. Methods: Serum samples were selected from the biological samples’ bank of the Chinese Chronic Diseases and Nutrition Survey (CCDNS) 2015. The serum 25(OH)D concentration was determined by liquid chromatography tandem mass spectrometry and the serum PTH was determined by electronic chemiluminescence. Simple linear and partial correlation analysis, locally weighted regression smooth scatterplot (LOESS), nonlinear least squares estimation (NLS), and segmented regression (SR) were utilized to estimate the relationship of 25(OH)D and PTH, and to determine the threshold of 25(OH)D. Results: A total of 1568 serum samples of 25(OH)D concentration and PTH concentration were analyzed. A significant inverse relationship between 25(OH)D and PTH concentration was observed below 15.25 (14.22–16.28) ng/mL, and PTH decreased slowly with the increase of 25(OH)D above 16.75 (15.43–18.06) ng/mL after adjusting by age, latitude, city type, season, corrected calcium, and phosphorus. A very short plateau of PTH was found at 15.25 ng/mL and 16.75 ng/mL in terms of 25(OH)D according to LOESS, NLS, and SR. Conclusions: The serum 25(OH)D was negatively correlated with the serum PTH. The threshold of VitD sufficiency was found in the range of 14.22–18.06 ng/mL in terms of serum 25(OH)D concentration for Chinese childbearing women aged 18–44 years old.

Maternal Morbidity in a Context of Social Vulnerability: The Case of the Province of Essaouira, Morocco

Aims: The main aim of this study is to assess the prevalence of maternal morbidity among childbearing women and to determine the associated factors in a context of social vulnerability. Study Design: This is a quantitative analytical cross-sectional study. Place and Duration of Study: The study was conducted in 18 health centers in the province of Essaouira, Morocco from January 2020 to January 2021. Methodology: We conducted a structured interview survey. Simple: We included 1184 married women aged 18 to 49. Results: The prevalence of maternal morbidity was 64.8%. The main morbidities were sexually transmitted infections (50.1%) and anemia (45.8%). Multivariate analysis showed that frequency of postnatal visits, socioeconomic level, knowledge of pregnancy risks, and couple literacy, were statistically associated with maternal morbidity. Conclusion: The use of postnatal care, the improvement of the socio-economic level of households, health education programs, and the fight against illiteracy are factors that would reduce maternal morbidity.

Dietary Exposure of the Taiwan Population to Mercury Content in Various Seafood Assessed by a Total Diet Study

This paper examines the health risks of exposure to methylmercury (MeHg) through the consumption of mercury-contaminated seafood in Taiwan, based on the total diet study (TDS) method. Samples of seafood (n = 140) were purchased at fishing harbors or supermarkets and classified into seven categories (pelagic fish, inshore fish, farmed fish, shellfish, cephalopods, crustaceans, and algae). For each sample, we analyzed raw and cooked versions and compared the concentration difference. Total mercury (THg) was detected at the highest rate and in the highest concentrations in pelagic fish, followed by inshore fish and other farmed fish. The average concentration of THg was higher after cooking. In a 75th percentile scenario, the hazard indices for children aged 1 to 3 years and children aged 4 to 6 years were higher than 100% of the provisional tolerable weekly intake. Taking into consideration the risk assessment results, MeHg concentrations, and the nutritional composition of fish, we have provided weekly consumption advisories for children aged 1 to 3 years, children aged 4 to 6 years, and childbearing women aged 19 to 49 years. The weekly consumption advisories for childbearing women are 35 g/week of pelagic fish and 245 g/week of inshore fish based on the risk results from MeHg and the potential benefits from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake.

Experiences with Technology and Telehealth Among Women with Perinatal Depression

Background Perinatal depression (PD) affects 10-20% of childbearing women. Telehealth is increasingly utilized for mental health services to increase access to care and overcome COVID-19 pandemic barriers. Women’s perspectives on telehealth services for PD is unknown, however. This study's primary objective was to obtain the perspectives of women who participated in an 8-week group videoconference intervention for PD symptoms, including how technology impacted their experience. Methods We utilized theoretical sampling and included perinatal women who had completed the 8-week mindfulness-based cognitive-behavioral intervention group. Semi-structured focus groups with four to six women were conducted on a videoconference platform. Primary analysis used grounded theory and a secondary analysis used qualitative description and was conducted by two coding teams. The teams collaborated on the final themes across the analyses. Results Three groups, with a total of 17 participants were conducted. Composition consisted of seven postpartum and ten pregnant women from the 47 total participants. Identified core themes regarding their experiences of the videoconference intervention were: positive experiences, negative experiences, suggestions and ideas, and screening and communication. Conclusion This study provides growing evidence informed by perinatal women of positive experiences with engagement in a videoconference intervention for PD. Telehealth may be a reasonable and acceptable platform to increase access and retention for mental health services in childbearing women. Further, this pilot work showcases videoconferencing delivery for a wide range of effective and affordable mental health services in low-resource communities.

COVID-19 vaccination perceptions and intentions of maternity care consumers and providers in Australia

Introduction Vaccination against COVID-19 is a key global public health strategy. Health professionals including midwives and doctors support and influence vaccination uptake by childbearing women. There is currently no evidence regarding the COVID-19 vaccination perceptions and intentions of those who receive or provide maternity care in Australia. The aim of this study was to address this gap in knowledge and explore the perceptions and intentions regarding COVID-19 vaccination from consumers and providers of maternity care in Australia. Methods A national cross-sectional online study conducted in early 2021 in Australia, a country that has had a very low number of COVID-19 cases and deaths. Recruitment was undertaken through parenting and health professional social media sites and professional college distribution lists. A total of 853 completed responses, from women (n = 326), maternity care providers including doctors (n = 58), midwives (n = 391) and midwifery students (n = 78). Findings Personal intention to be vaccinated ranged from 48–89% with doctors most likely and women least likely. Doctors and midwifery students were significantly more likely to recommend the vaccine to pregnant women in their care than midwives (p<0.001). Fewer doctors (2%) felt that women should wait until breastfeeding had concluded before being vaccinated compared with 24% of midwives and 21% of midwifery students (p<0.001). More than half of the midwives (53%) had concerns about the COVID-19 vaccine for the women in their care compared with 35% of doctors and 46% of midwifery students. Despite national guidelines recommending vaccination of breastfeeding women, 54% of practitioners were unlikely to recommend vaccination for this group. Conclusion This is the first study to explore the perceptions and intentions regarding COVID-19 vaccination from the perspective of those who receive and provide maternity care in Australia. Findings have utility to support targeted public health messaging for these and other cohorts.

Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis

Background. Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia. Methods. Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I 2 test. Egger’s weighted regression test was used to assess publication bias. Results. We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I 2 = 98.4 % ). Antenatal care ( OR = 7.8 (95% CI: 3.2, 19.2), I 2 = 96.3 % ), media exposure ( OR = 8.3 (95% CI: 2.1, 33.3), I 2 = 98.1 % ), distance from the health facility ( OR = 2.64 (95% CI: 1.1, 6.6), I 2 = 94.1 % ), educational status of women ( OR = 4.7 (95% CI: 2.07, 9.56), I 2 = 94.2 % ), and educational status of husbands ( OR = 2.995 (95% CI: 1.194, 7.512), I 2 = 92.5 % ) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia. Conclusions. The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.