• Women's Health Nursing
• /
• v.27 no.3
• /
• pp.180-195
• /
• 2021

Purpose: This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor. Methods: The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality. Results: Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges' g=-0.67; 95% confidence interval [CI], -0.91 to -0.44), gestational diabetes (Hedges' g=-0.38; 95% CI, -0.54 to -0.12), and preterm labor (Hedges' g=-0.73; 95% CI, -1.00 to -0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias. Conclusion: Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

• Women's Health Nursing
• /
• v.27 no.2
• /
• pp.104-112
• /
• 2021

Purpose: This study investigated the mediating effect of family support in the relationships of anxiety and depression with maternal-fetal attachment among pregnant women admitted to the maternal-fetal intensive care unit (MFICU) in Korea. Methods: The participants were high-risk pregnant women with a gestational age of at least 20 weeks who were admitted to MFICUs in Busan and Yangsan. The Korean versions of four measurement tools were used for the self-report questionnaire: Spielberger's State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, Cobb's family support measurement, and Cranley's maternal-fetal attachment scale. Data were collected from June 22 to September 20, 2020. Out of 124 participants, data from 123 respondents were analyzed. Descriptive statistics and regression analysis were done. Results: The average age of participants was 34.1 years. Their anxiety level was moderate (43.57±11.65 points out of 80) and 53.6% were identified as having moderate depression (average 10.13±5.48 points out of 30). Family support was somewhat high (average 43.30±5.03 points out of 55). The average score of maternal-fetal attachment was also somewhat high (73.37±12.14 points out of 96). Family support had a partial mediating effect in the relationships of anxiety and depression with maternal-fetal attachment among high-risk pregnant women admitted to the MFICU. Conclusion: Maintaining family support is challenging due to the nature of the MFICU. Considering the mediating effect of family support, establishing an intervention plan to strengthen family support can be helpful as a way to improve maternal-fetal attachment for high-risk pregnant women admitted to the MFICU.

• Biomedical Science Letters
• /
• v.14 no.4
• /
• pp.233-238
• /
• 2008

Gestational diabetes mellitus (GDM) is a common complication during pregnancy and one of the main causes of adverse fetal-maternal outcomes. However, the pathogenesis of GDM has not been clearly stated. Adiponectin, an adipose tissue-derived plasma protein, is involved in regulation of insulin resistance and glucose hemostasis, and thus is a key modulator of insulin action and glucose metabolism. In this study, we investigated to compare serum adiponectin levels in pregnant women with diabetes, pregnant women who are without diabetes, and non-pregnant women, and to evaluate relationship between serum adiponectin. levels and metabolic parameters. Forty-one pregnant women with diabetes, fifty-nine pregnant women without diabetes and forty non-pregnancy women were recruited. Adiponectin levels were significantly lower in pregnant women with diabetes when compared to non-pregnant women and pregnant women without diabetes. Pregnant women without diabetes at second trimester had lower adiponectin levels compared to non-pregnant women. Adiponectin was negatively correlated with BMI, fasting insulin, HOMA-IR, total cholesterol, and triglyceride. In conclusion, this study confirmed that the decreased level of adiponectin precedes the onset of abnormal glucose level during pregnancy and also normal pregnant women had lower adiponectin levels compared to non-pregnant women. This knowledge may help to identify strategies for lowering the occurrence of GDM in women who are at high risk of developing the disorder.

• Parasites, Hosts and Diseases
• /
• v.53 no.5
• /
• pp.605-610
• /
• 2015

Toxoplasmosis is considered as an important risk factor for bad obstetric history (BOH) and one of the major causes of congenitally acquired infections. The present study aimed to estimate the seropositivity of T. gondii infection and associated risk factors among the attendees of high risk pregnancy and low risk antenatal care clinic of Minia Maternity and Pediatric University Hospital, Minia, Egypt. The study was carried out from April 2013 to April 2014 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. A total of 120 high risk pregnant and 120 normal pregnant females were submitted to clinical examinations, serological screening for anti-Toxoplasma IgM and IgG antibodies by ELISA, and an interview questionnaire. Seropositive cases were subjected to spiramycin course treatment. The results showed that the seroprevalence of toxoplasmosis in high-risk pregnancy group was 50.8%, which was significantly different from that of normal pregnancy group (P<0.05). Analysis of seropositive women in relation to BOH showed that abortion was the commonest form of the pregnancy wastage (56.5%). The high prevalence of T. gondii seropositive cases was observed in the age group of 21-30 years. Post-delivery adverse outcome was observed in 80.3% of high-risk pregnancy group compared to 20% of normal pregnancy group. There was a statistically significant relationship between seropositivity and living in rural area, low socioeconomic level, and undercooked meat consumption (P<0.05). Serological screening for anti-Toxoplasma antibodies should be routine tests especially among high-risk pregnant women.

• Korean Journal of Community Nutrition
• /
• v.6 no.5
• /
• pp.734-743
• /
• 2001

Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.

• Women's Health Nursing
• /
• v.24 no.3
• /
• pp.297-309
• /
• 2018

Purpose: To develop Pregnancy Risk symptom Perception Scale (PRPS) and evaluate its validity and reliability. Methods: A preliminary 30-item version of PRPS was developed through literature review, in-depth interview, and Content Validity. Each item was scored on a four-point Likert scale. The preliminary scale was developed based on 301 pregnant women who visited a hospital. Date were analyzed using item analysis, factor analysis, confirmatory factor analysis, Pearson's correlation coefficients, and Cronbach's ${\alpha}$ (0.90 for total item, 0.80 to 0.88 for factors). Results: The PRPS consisted of 27 items. Three factors (physical, environmental, and emotional factors) explained 55% of the total variance. Cronbach's Criterion validity was supported by comparison with the Perception of Pregnancy Risk Questionnaire (r=0.34). In reliability test, the reliability coefficient of pregnancy risk symptom perception was high at 0.90. Conclusion: These results suggest that the pregnancy risk symptom perception scale developed in this study comprises items that can assess the level of pregnant women's pregnancy risk symptom perception in Korea. Its validity and reliability were proven. PRPS can be utilized to measure pregnant women's risk symptom perception during pregnancy. PRPS will contribute to the development of systematic prenatal care and effective risk management.

• Journal of Korean Academy of Nursing
• /
• v.42 no.4
• /
• pp.477-485
• /
• 2012

Purpose: This study was done to evaluate the effects of antenatal depression on birth outcomes. Methods: The participants were 255 pregnant women who were followed in a prospective study. Of these, 197 cases were examined included birth weight, Apgar scores at 5 minute, premature contraction, complication of labor, delivery types and laboratory data. Descriptive statistics, ANOVA, Chi square test of linear by linear association, Kruskal Wallis test, Relative Risk, univariate and adjusted multiple logistic regression were used for data analysis with SPSS/Win. Results: Level of antenatal depression was associated with low birth weight ($x^2$=7.69, p=.010). High risk pregnancy was a predictor of low birth weight (OR=6.98 [1.21-40.30]) and baby's weight (OR=2.12, [1.05-4.28]). Prepregnancy body mass index (BMI) was a predictor of complications in labor (OR=3.59, [1.03-12.48]). But there were no significant effects of antenatal depression on other birth outcomes. Conclusion: The results of this study indicate that women with antenatal depression, high risk pregnancy, prepregnancy $BMI{\geq}23kg/M^2$ should be monitored and managed to ensure favorable birth outcomes.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.8
• /
• pp.4163-4167
• /
• 2016

Background: Cervical cancer is the second most common in Thailand, but the mortality rate may be rising yearly. It is a cancer that can be prevented by early screening for precancerous lesions, several methods being available. Objective: To identify the prevalence of abnormal Papanicolaou (Pap) smears and lesions with visual inspection with acetic acid (VIA) in pregnant women and assess risk factors for this group. Materials and Methods: This prospective study was performed at Prapokklao Hospital, Thailand during April-July 2016. All pregnant women of gestational age between 12-36 weeks who attended an antenatal clinic were recruited. All participants were screened for cervical cancer by Pap smear and VIA. If results of one or both were abnormal, colposcopic examination was evaluated by gynecologic oncologist. Results: A total of 414 pregnant women were recruited. Prevalence of abnormal Pap smear and VIA were 6.0 and 6.7 percent, respectively. The most common abnormal Pap smear was low grade intraepithelial lesion (LSIL, 44%). Factors associated with abnormal Pap smear in pregnant women were low BMI, multiple partners and being a government officer. In pregnancy, Pap smear had higher sensitivity and specificity than VIA for detection of precancerous cervical lesion. Patients with young coitarche or more than 25 years of active sexual activity were high risk groups. Conclusions: Prevalence of abnormal Pap smear and VIA in pregnant women was 6.0 and 6.7 percent, respectively. Factors associated with abnormal Pap smear were coitarche, years of sexual activity, low BMI, multiple partners and being a government officer.

• Nutrition Research and Practice
• /
• v.12 no.1
• /
• pp.78-84
• /
• 2018

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to reduce the risk of neural tube defects. The purposes of this study were to investigate the awareness, knowledge, and use of folic acid supplements along with their associated factors among non-pregnant Korean women of childbearing age. SUBJECTS/METHODS: From August 2012 to March 2013, 704 women aged 19-45 years completed a self-administered questionnaire regarding their awareness, knowledge, and use of folic acid as well as questions to identify risk of inadequate folate intake. RESULTS: Approximately 67% of women reported that they had heard of folic acid, and 23.7% had knowledge of both the role of folic acid in preventing birth defects and appropriate time for taking folic acid supplements to prevent birth defects. However, only 9.4% of women took folic acid supplements at the time of the survey. Women aged 19-24 years, unmarried women, and women who had never been pregnant were less likely to be aware and knowledgeable of folic acid or take folic acid supplements. In addition, women at high risk of inadequate folate intake were less likely to take folic acid supplements. In a multivariate analysis, women aged 19-24 years, women with a high school diploma or lower education level, and unmarried women were less likely to be aware and have knowledge of folic acid. The percentage of women taking folic acid supplements was significantly higher among knowledgeable women than among unknowledgeable women. CONCLUSIONS: These results support our hypothesis that women with knowledge of folic acid are more likely to take folic acid supplements. Therefore, educational programs or campaigns to improve knowledge regarding the importance of folic acid and to promote consumption of folic acid supplements as well as folate-rich foods are needed to target young, less educated, and unmarried women.

• Women's Health Nursing
• /
• v.17 no.3
• /
• pp.256-264
• /
• 2011

Purpose: This study was conducted to identify the association of dietary intake levels with ante-natal depression among pregnant women. Methods: Secondary data analysis was done using Can Pro software (version 3.0) to evaluate the diet intake levels with 24 hour recall diary method with 130 pregnant women visiting a general hospital. Statistical analysis included descriptive statistics, t-test, Mann-Whitney U test and adjusted logistic regression using the SPSS/WIN program. Results: Whole dietary intake levels of pregnant women were insufficient according to Recommended Nutrient Intake (RI) with the except of phosphorus intake. There were significant differences in RI by gestation period and high risk pregnancies. Non-depressed women showed more intake in niacin (z=1.33, p=.018) and zinc (t=3.99, p=.048) than depressed women did. Niacin was a significant determinant of ante-natal depression (Exp (B)=5.88, p=.47, 95% CI [1.02~23.83]). Conclusion: Dietary intake assessment would be necessary during pregnancies for the screening of ante-natal depression. For ante-natal depression care, a tailored dietary intervention should be applied for women with insufficient nutrient intake.