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Association of Congenital Heart Defects (CHD) with Factors Related to maternal health and Pregnancy in Newborns in Puerto Rico

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Congenital Heart Disease 2024年第1期19卷 19-31页

作者： Yamixa Delgado Caliani Gaytan Naydi Perez Eric Miranda Bryan Colón Morales Mónica Santos Biochemistry&Pharmacology Department San Juan Bautista School of MedicineCaguas00726Puerto Rico Hispanic Alliance for Clinical and Translational Research University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico Department of Internal Medicine University of Puerto Rico Medical Sciences CampusSan Juan00936Puerto Rico

Background:Given the pervasive issues of obesity and diabetes both in Puerto Rico and the broader United States,there is a compelling need to investigate the intricate interplay among body mass index(BMI),pregesta-tional,and gestational maternal diabetes,and their potential impact on the occurrence of congenital heart defects(CHD)during neonatal development.Methods:Using the comprehensive System of Vigilance and Surveillance of Congenital Defects in Puerto Rico,we conducted a focused analysis on neonates diagnosed with CHD between 2016 and 2020.Our assessment encompassed a range of variables,including maternal age,gestational age,BMI,pregestational diabetes,gestational diabetes,hypertension,history of abortion,and presence of preeclampsia.Results:A cohort of 673 patients was included in our study.The average maternal age was 26 years,within a range of 22 to 32 years.The mean gestational age measured 39 weeks,with a median span of 38 to 39 weeks.Of the 673 patients,274(41%)mothers gave birth to neonates diagnosed with CHD.Within this group,22 cases were linked to pre-gestational diabetes,while 202 were not;20 instances were associated with gestational diabetes,compared to 200 without;and 148 cases exhibited an overweight or obese BMI,whereas 126 displayed a normal BMI.Conclusion:We identiﬁed a statistically signiﬁcant correlation between pre-gestational diabetes mellitus and the occurrence of CHD.However,our analysis did not show a statistically signiﬁcant association between maternal BMI and the likelihood of CHD.These results may aid in developing effective strategies to prevent and manage CHD in neonates.

关键词： Congenital heart defects(CHD) obesisty maternal health diabetes body mass index(BMI)

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maternal mental health and well-being during the COVID-19 pandemic in Beijing, China

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World Journal of Pediatrics 2021年第3期17卷 280-289页

作者： Zhuang Wei Ming-Yue Gao Mary Fewtrell Jonathan Wells Jin-Yue Yu Department of Child healthcare Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina Population Policy and Practice Research and Teaching DepartmentUCL Great Ormond Street Institute of Child Health30 Guilford StreetLondon WC1N 1EHUK

Background The aim of this study is to evaluate the impact of the coronavirus disease 2019(COVID-19)pandemic on breastfeeding women and to identify predictors of maternal mental health and coping.Methods Mothers aged≥18 years with a breast-fed infant≤18 months of age during the COVID-19 pandemic in Beijing,China,completed a questionnaire.Descriptive analysis of lockdown consequences was performed and predictors of these outcomes were examined using stepwise linear regression.Results Of 2233 participants,29.9%,20.0%and 34.7%felt down,lonely,and worried,respectively,during the lockdown;however,85.3%felt able to cope.Poorer maternal mental health was predicted by maternal(younger age,higher education)and infant(older age,lower gestation)characteristics,and social circumstances(husband unemployed or working from home,receiving advice from family,having enough space for the baby,living close to a park or green space).Conversely,better maternal mental health was predicted by higher income,employment requiring higher qualifications,more personal space at home,shopping or walking>once/week and lack of impact of COVID-19 on job or income.Mothers with higher education,more bedrooms,fair division of household chores and attending an online mother and baby group>once/week reported better coping.Conclusion The findings highlight maternal characteristics and circumstances that predict poorer mental health and reduced coping which could be used to target interventions in any future public health emergencies requiring social restrictions.

关键词： Coping Coronavirus disease 2019 maternal health Mental health Postpartum

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maternal health and its affecting factors in Nepal

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Family Medicine and Community health 2016年第3期4卷 30-34页

作者： Gehendra Mahara Jill Barr Janeeta Thomas Wei Wang Xiuhua Guo Department of Epidemiology and health Statistics School of Public HealthCapital Medical UniversityBeijingChina Beijing Municipal Key Laboratory of Clinical Epidemiology BeijingChina School of health and Well-Being University of WolverhamptonUK Ashwani Ayruvedic Hospital KeralaIndia School of Medical and health Sciences Edith Cowan UniversityPerthAustralia

maternal health is still a public health problem in developing countries,especially in low-resource settings rural and poor communities.The main aim of this article is to critically evaluate and explore the situation of maternal health in Nepal based on published or unpublished governmental or nongovernmental organization’s scientific reports regarding maternal health.We found that there were several direct or indirect causes and affecting factors of maternal death in Nepal,which are preventable.Women have been facing different consequences during pregnancy and delivery,attributed to lack of proper knowledge or less available and affordable health facilities in rural communities.Therefore,there is needed an essential maternal health knowledge to women and also establish health facilities with a quality health care service on affordable and accessible to prevent maternal death and minimize complications.

关键词： maternal health maternal mortality Nepal

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Pregnancy and fetal outcomes of chronic hepatitis C mothers with viremia in China

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World Journal of Gastroenterology 2022年第34期28卷 5023-5035页

作者： Calvin Q Pan Bao-Shen Zhu Jian-Ping Xu Jian-Xia Li Li-Juan Sun Hong-Xia Tian Xi-Hong Zhang Su-Wen Li Er-Hei Dai Center for Liver Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Division of Gastroenterology and Hepatology Department of MedicineNYU Langone HealthNYU School of MedicineFlushingNY 11355United States Department of Obstetrics and Gynecology The Fifth Hospital of ShijiazhuangHebei Medical UniversityShijiazhuang 050021Hebei ProvinceChina School of Public health North China University of Science and TechnologyTangshan 063210Hebei ProvinceChina Division of Liver Disease Department of MedicineThe Fifth Hospital of ShijiazhuangHebei Medical UniversityShijiazhuang 050021Hebei ProvinceChina

BACKGROUND Data that assess maternal and infant outcomes in hepatitis C virus(HCV)-infected mothers are limited.AIM To investigate the frequency of complications and the associated risk factors.METHODS We performed a cohort study to compare pregnancy and fetal outcomes of HCVviremic mothers with those of healthy mothers.Risk factors were analyzed with logistic regression.RESULTS Among 112 consecutive HCV antibody-positive mothers screened,we enrolled 79 viremic mothers.We randomly selected 115 healthy mothers from the birth registry as the control.Compared to healthy mothers,HCV mothers had a significantly higher frequency of anemia[2.6%(3/115)vs 19.0%(15/79),Pmaternal HCV infections may associate with pregnancy and obstetric complications.We demonstrated a previously unreported association between maternal HCV viremia and a smaller neonatal head circumference,suggesting fetal growth restriction.

关键词： Hepatitis C virus viremia Mother-to-child transmission Pregnancy complications maternal health Infant hepatitis C virus infection

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Assessment of reproductive health service utilization in urban slums: Evidence from Western Rajasthan

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Asian pacific Journal of Reproduction 2023年第2期12卷 52-57页

作者： Jyoti Sharma Nitin Kumar Joshi Yogesh Kumar Jain Kuldeep Singh Pankaj Bhardwaj School of Public health All India Institute of Medical SciencesJodhpurIndia Department of Community Medicine and Family Medicine and School of Public health All India Institute of Medical SciencesJodhpurIndia

Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;Phealth services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

关键词： Female Pregnancy maternal health maternal health services Prenatal care Postpartum period Facilities and services utilization health services accessibility

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Development, coinfection, and the syndemics of pregnancy in Sub-Saharan Africa

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Infectious Diseases of Poverty 2013年第1期2卷 213-222页

作者： Merrill Singer Department of Anthropology and Department of Community Medicine University of ConnecticutStorrsCT 06269USA

Notable among gaps in the achievement of the global health Millennium Development Goals(MDG)are shortcomings in addressing maternal health,an issue addressed in the fifth MDG.This shortfall is particularly acute in Sub-Saharan Africa(SSA),where over half of all maternal deaths occur each year.While there is not as yet a comprehensive understanding of the biological and social causes of maternal death in SSA,it is evident that poverty,gendered economic marginalization,social disruptions,hindered access to care,unevenness in the quality of care,illegal and clandestine abortions,and infections are all critical factors.Beyond these factors,this paper presents a review of the existing literature on maternal health in SSA to argue that syndemics constitute a significant additional source of maternal morbidity and mortality in the region.Increasing focus on the nature,prevention,and treatment of syndemics,as a result,should be part and parcel of improving maternal health in SSA.

关键词： Syndemics Coinfection maternal health Sub-Saharan Africa Millennium development goals

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Factors Influencing the Utilization of Postpartum Visits among Rural Women in China

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第6期34卷 869-874页

作者：项远兮熊巨洋田淼淼袁芳冯占春 School of Medicine and health Management Tongji Medical College Huazhong University of Science and Technology Center for Policy and health Management Chinese Academy of Medical Sciences

Postpartum visits （PPVs） are still underutilized in rural China, and identification of factors that influence PPV use is important in ensuring the utilization of maternal health services and for well- being of women. A cross-section study was undertaken to collect related data from 347 rural women in- terviewed six weeks or more after delivery, and an ANOVA was performed to find whether there were significant differences in the number of PPVs among different rural areas in China. According to An- dersen＇s socio-behavioral model of health service use, factors were divided into equitable and inequita- ble ＂ones. Chi-squared test, univariate and multiple analyses were used to determine the equity of PPV use by identifying factors that were most strongly associated with the use of a PPV. The results showed that 20.2% of the respondents （n=70） did not receive any PPVs, and 62.5% （n=173） of those who had PPVs （n=277） did not receive standard PPVs （referring to at least 3 visits）. There was no significant difference among different rural areas in terms of the number of PPVs （F=1.514, P=-0.211）. Multiple re- gression analyses revealed that enabling factors such as compensation for delivery expense [OR （95% CI）=2.825 （1.331, 5.995）], village type [OR （95% CI）=1.802 （1.021, 3.182）] and service quality [OR （95% CI）=1.847 （1.074, 3.176）] were strongly associated with PPV use. Both enabling factors such as home visits [OR （95% CI）=1.855 （1.085, 3.174）], service quality [OR （95% CI）=1.993 （1.155, 3.439）] and need factors such as low birth weight [OR （95% CI）=4.424 （1.482, 13.203）] were significantly as- sociated with standard PPV use. Our results suggested that the equitable access to PPVs has been con- siderably improved in rural areas in China. The associations between inequitable factors and PPV use warrant further exploration, and policies aimed at improving quality and patterns of service supply are needed in order to ensure a full equitable access to maternal health services.

关键词： postpartum visit utilization maternal health equitable access essential public health ser-vices

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Psychosocial Determinants of Postpartum Depression and maternal Well-Being among Postnatal Women

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Open Journal of Psychiatry 2021年第3期11卷 138-159页

作者： Anita Paddy Kenneth Asamoah-Gyimah Anthony Nkyi Department of Education and Psychology University of Cape Coast Cape Coast Ghana Department of Guidance and Counseling University of Cape Coast Cape Coast Ghana

Postpartum depression, a major depressive disorder, predisposes postnatal mothers to physical, social, and psychological malfunctioning. Purpose: The study aimed to identify the psychosocial determinants of postpartum depression and maternal well-being among mothers in the Accra metropolis. Materials and Method: A sample of 205 postnatal women between the ages of 15 - 39 years and are 4 - 12 weeks old postpartum was drawn from 37 Military Hospital, Accra. Employing a sequential explanatory approach, participants were administered the Depression, Anxiety and Stress Scale (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), Marital Adjustment Test (MAT), and the Edinburgh Postnatal Depression Scale (EPDS). Findings: The study revealed that 14.1% of postnatal women in the Accra metropolis are at risk of developing PPD. A significant model emerged, [R2 = 0.488, F (7, 197) = 26.86, ρ maternal well-being. Conclusion: It is concluded that PPD is patent among postnatal women and psychosocial variables contribute a significant role in their experience of mental health problems following childbirth. This, in effect, requires attention from health professionals for holistic healthcare. The implications of these outcomes are discussed concerning mental healthcare delivery, the general public, and stakeholders in the health sector.

关键词： Psychosocial Postpartum Depression maternal health Well-Being Ghana

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Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

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Family Medicine and Community health 2016年第4期4卷 30-43页

作者： Bronwyn Lapp David Zakus Department of Nursing Sunnybrook Health Sciences CentreTorontoONCanada Faculty of Community Services School of Occupational and Public HealthRyerson UniversityTorontoONCanada

Objective:To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia.Methods:Fifteen peer-reviewed,primary research articles published between 2011 and 2015 were selected for this scoping review.The articles included case-control,cross-sectional,and retro-spective follow-up studies conducted in Ethiopia.Results:Findings were categorized with use of content and factorial analysis.The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status,education,residence,autonomy in decision making,parity,and antenatal care attendance.Conclusion:Sociodemographic,accessibility,and obstetric factors are key determinants of skilled care utilization.Strategies and policy changes to address maternal health service use should aim to improve economic status,facilitate higher education,increase access to care,promote the empowerment of women,and enhance antenatal care initiatives.Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization,since few studies have examined these factors.

关键词： maternal health obstetrics midwifery Ethiopia

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The Contribution of Technological Approaches in Reducing maternal Mortality: An Integrative Review

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Open Journal of Nursing 2016年第3期6卷 133-147页

作者： Najma Naz Grace T.M. Dal Sasso Sabiha Khanum Maria de Lourdes de Souza Vera Radünz Saidu Group of Teaching Hospital Saidu Sharif Pakistan Post Graduate Program in Nursing (GIATE/UFSC) Federal University of Santa Catarina Florianópolis Brazil Post Graduate Program in Nursing (PEN/UFSC) Repensul Institute Federal University of Santa Catarina Florianópolis Brazil Post Graduate Program in Nursing (PEN/UFSC) Federal University of Santa Catarina Florianópolis Brazil

Aim: To analyze the role of available health technologies and techniques in reducing the number of women dying during pregnancy and childbirth. Background: health condition of women during pregnancy and childbirth is very sensitive. During this period, proper and timely care plays an important role in reducing maternal mortality. Design: Whitte more and Knal’s framework for integrative reviews was followed in the review. PUBMED/MEDLINE, CINHAL and COCHRANE were searched for published studies between 2008 and 2015. Studies included were systematic reviews, randomized control trials, prospective cohort study, literature review and descriptive studies. Methods: 28 articles were selected to be included in the review. An integrative review approach was followed to analyze data and draw conclusions. Screening of titles and abstracts along with data extraction was completed by two authors independently. Study quality is not reported because of the methodological difficulties. Data synthesis consists of writing descriptive summaries and thematic analysis of the key findings in the included articles. Results: The included studies were based on health technologies and techniques including different devices and tools, medication and drugs, massage techniques, immersion in water, intervention radiology, simulations and training for the health professional. Conclusion: There are numerous health technologies and techniques which are relatively simple to develop, effective to use and safe to apply with no adverse effects. These include simulations and training programs, educational and awareness programs, decision support tools and information systems. Besides these, there are technologies and techniques which show promising results with no or very little adverse effects. These include Active management of the third stage of labour, use of magnesium sulphate, uterine balloon tamponade, wearable cardiac defibrillator and non-pneumatic anti-shock garment. The government, hospitals and care providers should make policies to develo

关键词： health Technologies maternal Mortality Pregnancy Childbirth maternal health

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