Barriers to care and treatment experiences among individuals with postpartum psychosis
by Kobylski L.A. et al.Postpartum psychosis (PP) is a severe psychiatric disorder affecting 1-2 per 1,000 deliveries. Prompt access to healthcare and timely initiation of treatment are crucial to minimizing harm and improving outcomes. This analysis seeks to fill gaps in knowledge surrounding barriers to care and treatment experiences among this population. This report is the first of its kind to assess key public health domains among individuals with PP. Findings point to several directions for future research and clinical practice to improve treatment timeliness and quality, potentially improving long-term outcomes related to this serious illness.
Racial Disparity in Severe Maternal Morbidity Associated with Hypertensive Disorders in Washington State: A Retrospective Cohort Study
by Albright C.M. et al.The objective of the study was to evaluate the relationship between hypertensive (HTN) disorders and severe maternal morbidity (SMM). To understand whether there is differential prevalence of HTN disorders by race and whether the relationship between HTN disorders and SMM is modified by race and ethnicity. Findings suggest that in Washington, HTN disorders are associated with SMM in a dose-dependent fashion with the greatest impact among Black individuals.
Treating Mild Chronic Hypertension During Pregnancy: A Cost-Effectiveness Analysis
by Doshi U. et al.The objective of the study was to assess the cost effectiveness of targeting a blood pressure of less than 140/90 mm Hg compared with 160/105 mm Hg. A decision-analytic model was constructed to compare the treatment of chronic hypertension in pregnancy at mild-range blood pressures (140/90 mm Hg) with the treatment of chronic hypertension before 20 weeks of gestation at severe-range blood pressures (160/105 mm Hg) in a theoretical cohort of 180,000 patients with mild chronic hypertension. Treating chronic hypertension at a threshold of mild-range blood pressures is a dominant (lower costs, better outcomes) and cost-effective strategy that results in fewer neonatal and maternal deaths compared with the standard treatment of treating at severe range blood pressures.
Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan
by Assaf EA. et al.The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.
Association between tuberculosis and pregnancy outcomes: a retrospective cohort study of women in Cape Town, South Africa
by Meehan SA. et. al.This study aimed to determine risk factors for an adverse pregnancy outcome among pregnant women diagnosed with TB. Findings suggest that pregnancy outcomes among women with TB were poor, irrespective of HIV status. Pregnant women with TB are a complex population who need additional support prior to, during and after TB treatment to improve TB treatment and pregnancy outcomes. Pregnancy status should be considered for inclusion in TB registries.
The contribution of suicide to maternal mortality: A nationwide population-based cohort study
by Lommerse, K.M. et. al.The objective of this study was to identify the incidence and characteristics of maternal suicide. Findings suggest that although the overall maternal mortality ratio declined, maternal suicides did not and are now the leading cause of maternal mortality if late deaths up to 1 year postpartum are included. Data collection and analysis of suicides must improve.
The impact of vitamin D changes during pregnancy on the development of maternal adverse events: a random forest analysis
by Borumandnia N et. al.Maternal vitamin D deficiency during pregnancy has been associated with various maternal adverse events (MAE). However, the evidence regarding the effect of vitamin D supplementation on these outcomes is still inconclusive. This secondary analysis utilized a case-control design. This study provides evidence that maternal vitamin D changes during pregnancy have a significant impact on MAE. Findings suggest that monitoring and treatment of vitamin D deficiency during pregnancy may be a potential preventive strategy for reducing the risk of MAE. The presented RF model had a moderate to high performance for predicting MAE.
Hypertensive Disorders of Pregnancy (HDP) and the risk of Maternal Dementia: A Systematic Review and Meta-Analysis
by Carey C. et al.The objective was to review and synthesize the published literature on hypertensive disorders of pregnancy (HDP) and subsequent risk of maternal dementia or cognitive impairment. Findings suggest that women whose pregnancies were complicated by preeclampsia (PE) appear to be at a substantially increased future risk of vascular dementia. The longer-term risks for these women in regards to Alzheimer's disease and other forms of dementia are less clear.
This study aimed at assessing the level of timely and adequate ANC visits and their determinants in the 18 Sub-Saharan African countries with the most recent DHS report (2016-2021). The findings revealed a low coverage of timely and adequate ANC visits in SSA countries. Governments and healthcare managers in sub-Saharan African countries should leverage their efforts to prioritize and implement activities and interventions that increase women's autonomy, and economic capability, to improve their health-seeking behavior during pregnancy. More commitment is needed from governments to increase mobile phone distribution across countries, and then work on integrating mHealth into their health system. Finally, efforts should be made to increase the coverage of health insurance schemes enrolment for the citizens.
Effect of early vitamin D supplementation on the incidence of preeclampsia in primigravid women: a randomised clinical trial in Eastern Democratic Republic of the Congo
by Kabuyanga RK. et al.The objective of this study was to evaluate the effect of cholecalciferol supplementation on the incidence of preeclampsia in primigravid women and its related maternal and foetal outcomes. Findings suggest that a single monthly dose (60,000 IU) of vitamin D supplementation, started in earlypregnancy, significantly reduced the incidence of preeclampsia and its maternal and foetal complications.
Risk of stillbirth after a previous caesarean delivery: A Swedish nationwide cohort study
by Al Khalaf SY. et al.The objective of the study was to investigate the risk of stillbirth in relation to (1) a previous caesarean delivery (CD) compared with those following a vaginal birth (VB); and (2) vaginal birth after caesarean (VBAC) compared with a repeat CD. This study confirms that a CD is associated with an increased risk of subsequent stillbirth, with a greater risk among pre-labour CD. This association is not solely mediated by increases in intrapartum asphyxia, uterine rupture or attempted VBAC. Further research is needed to understand this association, but these findings might help healthcare providers to reach optimal decisions regarding mode of birth, particularly when CD is unnecessary.
Patient Acceptability of Telehealth Medication Abortion Care in the United States, 2021‒2022: A Cohort Study
by Koenig, LR. et al.The authors described care experiences of 1600 telehealth abortion patients in 2021 to 2022 and used logistic regression to explore differences by race or ethnicity and between synchronous (phone or video) and asynchronous (secure messaging) telehealth abortion care. Findings suggest that telehealth abortion care is highly acceptable, and benefits include privacy and expediency.
Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts' maternal death surveillance and response data
by Shafiq Y. et al.This paper presents the first comprehensive analysis of the burden of different causes of maternal deaths reported in the Maternal Death Surveillance and Response (MDSR) system at the district level from 2016 to 2019. The MDSR database provides an opportunity for shared learning and can be used to improve the quality of maternal health services. To improve the accuracy and availability of data, under-reporting must be addressed, and frontline community staff must be trained to accurately capture and report death events.
The effect of sexual education on the postpartum women's sexual self-confidence and self-efficacy: a theory-based intervention
by Musavi M. et al.This study aimed to determine the effect of sexual education on postpartum women's sexual self-efficacy and self-confidence. Considering the effect of training based on the sexual self-concept model on postpartum women, the researchers recommend using this model to improve their sexual self-efficacy and self-confidence after childbirth.
Effects of armed conflict on maternal and infant health: a mixed-methods study of Armenia and the 2020 Nagorno-Karabakh war
by Rostomian L. et al.The authors hypothesised that crises exposure would correspond to decreased healthcare utilisation rates and worse health outcomes for the maternal and infant population in Armenia, compounded during the pandemic. Maternal and infant health measures showed adverse trends during the 2020 Nagorno-Karabakh war, potentially amplified by the concurrent COVID-19 pandemic. To mitigate effects of future crises on population health in Armenia, informants recommended investments in healthcare system reform focused on primary care and health promotion.
Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana
by Lori JR. et al.This study aims to determine the effect of group antenatal care (G-ANC) on increasing maternal health literacy. Findings sugget that while health literacy scores improved for all women attending ANC, women randomized into G-ANC exhibited greater improvement in overall health literacy post-birth compared to those receiving routine individual care. Life-saving information provided during ANC must be presented in an understandable format to prevent women and newborns from dying of preventable causes.
GDF15 linked to maternal risk of nausea and vomiting during pregnancy
by Fejzo M. et al.GDF15, a hormone acting on the brainstem, has been implicated in the nausea and vomiting of pregnancy, including its most severe form, hyperemesis gravidarum (HG), but a full mechanistic understanding is lacking. Here the authors report that fetal production of GDF15 and maternal sensitivity to it both contribute substantially to the risk of HG.