The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health an...The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health and well-being as well as that of their families.This article outlines the forms and risk factors associated with trauma,examines the connection between trauma-informed care(TIC)principles and trauma,and reviews the implementation methods and application outcomes of TIC in perinatal care.The aim is to provide a reference for healthcare professionals to advance research related to TIC in perinatal women.展开更多
Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less...Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.展开更多
Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perin...Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.展开更多
Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-y...Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.展开更多
Objective: to investigate the influence of postpartum personalized rehabilitation nursing on postpartum lactation and uterine rejuvenation. Methods: the first mothers were divided into 40 study group and control group...Objective: to investigate the influence of postpartum personalized rehabilitation nursing on postpartum lactation and uterine rejuvenation. Methods: the first mothers were divided into 40 study group and control group, with routine perinatal nursing, personalized perinatal rehabilitation nursing, and maternal lactation, uterine rejuvenation and perinatal complications were evaluated. Results: the time of first lactation in the observation group was significantly shorter than the normal group, and the excellent rate of milk was higher than the control group, the incidence of 4, the endometrial thickness within 10 mm, and the incidence of perinatal complications was lower (P < 0.05). Conclusion: personalized perinatal rehabilitation care can improve the rejuvenation of postpartum lactation and uterus, and reduce the occurrence of perinatal complications.展开更多
BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model ...BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.展开更多
Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identif...Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.展开更多
This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of d...This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.展开更多
<strong>Background:</strong> When family members and/or patients behave in a problematic way, this hinders the provision of safe and secure medical care. During the perinatal period, a family’s relationsh...<strong>Background:</strong> When family members and/or patients behave in a problematic way, this hinders the provision of safe and secure medical care. During the perinatal period, a family’s relationships and functions change significantly, and each family member is prone to experiencing stress. As such, conflict arises easily between family members and medical staff. <strong>Aims: </strong>Therefore, we conducted this study to shed light on the following phenomena: 1) family members’ problematic behaviors;2) the concerns of a perinatal ward nurse manager (hereafter referred to as the manager) and ward nurses;and 3) countermeasures carried out by the manager, together with the ward nurses, based on the manager’s experiences. <strong>Methods: </strong>We conducted an 80-minute, semi-structured interview with the manager, following which we analyzed the content of her narrated accounts. <strong>Results:</strong> According to the findings, 1) family members’ problematic actions include verbal abuse;arrogance, unreasonableness, and selfish behaviors;and violent conduct;2) the manager’s and ward nurses’ fears and worries about family members’ problematic behaviors;responses to gradually becoming involved with family members;and resistance to staying involved with family members following patient discharge. In addition, we examined 3) countermeasures carried out by the manager together with the ward nurses: resolute and consistent responses to family members’ problematic behaviors;attempted enforcement measures taken to deal with family members who exhibit problematic behaviors;engagement while trying to avoid conflict with family members;preparation that anticipates the occurrence of problematic conduct;cooperation with the medical team;cooperation with the hospital organization;cooperation with social resources outside the hospital;and patient protection.<strong> Conclusions:</strong> With awareness of cooperation with the medical team toward family members who engage in problematic actions, the medical staff members try to unify their response and share their feelings of hardship with each other.展开更多
Background:Mental health has recently been receiving a growing amount of attention in China's Mainland,with mental disorders increasingly being recognized as a major public health concern.However,the treatment gap...Background:Mental health has recently been receiving a growing amount of attention in China's Mainland,with mental disorders increasingly being recognized as a major public health concern.However,the treatment gap for mental health care is markedly high in China.Previous research and clinical practice have focused on high-risk physical disorders but overlooked psychosocial factors,especially during the perinatal period.Aims:To explore Chinese professionals'perception and attributions of perinatal mental health in China.Method:The study was conducted in Shanghai,China,in 2018,drawing on interviews with 15 key informants including health professionals,government officials,and policymakers recruited through snowball sampling.Content analysis of the semi-structured interviews was performed.Results:The study yielded insights into the perceptions of perinatal mental health among health professionals in Shanghai.Three themes emerged from the informants'reports:(1)mental health influenced by tradition—describing traditions affecting the perception of mental health at both the societal and individual level;(2)societal changed contributing perinatal mental health problems—referring to a rapidly changing cultural and economic backdrop as a source of stress leading to mental health problems;and(3)existing and required resources—demonstrating a lack of professional training,staff shortages,and inadequacy of resources to provide the required mental health care.Conclusion:Our results provide new insights into key health professionals'perceptions of mental health problems in Shanghai.Hesitation to seek care owing to a lack of knowledge,and resource shortages in health care systems are obstacles to improve mental health among women in urban China.展开更多
Objective: the whole process of pregnant women from pregnancy to delivery is a special period. Because of the influence of pregnancy, many changes will take place in pregnant women's bodies. Although the changes a...Objective: the whole process of pregnant women from pregnancy to delivery is a special period. Because of the influence of pregnancy, many changes will take place in pregnant women's bodies. Although the changes are mainly physiological changes, these changes will gradually become obvious with the pregnant women's pregnancy, and it is easy for pregnant women to have certain psychological pressure. Many hospitals mainly pay attention to the daily health care and the handling of unexpected events during the clinical nursing of pregnant and lying-in women, but pay little attention to health education. Especially the opening of the second-child policy in China, due to the increase of the number of pregnant women, the obstetrics and gynecology department is facing great work pressure. Among these pregnant women, high-collar women and high-risk women occupy a certain number. If we can't give scientific health education to pregnant women, the pregnant women's self-health cognitive ability is insufficient, which will even affect the delivery outcome. In addition, the emotional and psychological changes of pregnant women have obvious changes during pregnancy. It's easy to get too excited because of some small things. If you can't get a good dredge, you may have anxiety, depression and other performances. The existence of these negative factors will have a certain degree of impact on the health care of pregnant women during pregnancy. Therefore, this paper will explore the perinatal health education. Methods: China is a populous country. With the implementation of relevant policies, the number of new pregnant women in China is increasing every year. In order to improve the comfort and safety of pregnant women's care, this time, some pregnant women were selected from the department as the research object, and 76 pregnant women who met the requirements were selected. They were randomly divided into groups by computer and given clinical care according to their conditions. This time, it was determined as routine perinatal care and perinatal health education intervention. Patients in the control group were given the first type of nursing program, while other patients were given health education. After nursing, a comprehensive investigation was made on the patients' knowledge and cognition, living conditions, and whether they had bad psychological conditions. Results: some parturients are multiparas, who have a certain knowledge base about pregnancy and childbirth, and can keep a good psychological state during pregnancy. But for primiparas, because they are the first "mothers", they don't know a lot of health knowledge, and because they don't understand, they are prone to all kinds of unpredictable events during pregnancy. Therefore, this time, nursing intervention was carried out in this respect. The data showed that after intervention, the pregnant women in the observation group knew more about related knowledge, and their cognitive level was obviously improved. The nursing behavior of the department has a great influence on the parturient. If proper nursing can be given, the self-care ability of the parturient can be improved and the quality of life can be guaranteed. This evaluation shows that the living conditions of some parturient women in the control group are not in line with expectations. Pregnant women will have all kinds of discomfort due to pregnancy, such as morning sickness and grumpy temper. If they can't get the understanding of their families, they are more likely to have psychological problems. In order to promote the pregnant women to self-regulate their emotions and keep the sunshine's psychology and emotions, this intervention is made in this respect. Most pregnant women in the observation group have little emotional fluctuation and good psychological state, and the difference of data results is statistically significant (P<0.05). Conclusion: clinical practice shows that the implementation of health education in the perinatal period of pregnant women can make them have a comprehensive grasp and understanding of health knowledge, improve the level of knowledge cognition of pregnant women, and have a positive impact on the mental and psychological aspects of pregnant women through this measure.展开更多
Objective: to carry out perinatal comprehensive nursing intervention for parturients in natural labor and observe the effect of this kind of nursing. Methods: the parturients from February 2020 to February 2021 were t...Objective: to carry out perinatal comprehensive nursing intervention for parturients in natural labor and observe the effect of this kind of nursing. Methods: the parturients from February 2020 to February 2021 were taken as observation objects and divided into the first group (using basic nursing intervention) and the second group (using perinatal comprehensive nursing intervention). Results: In the comparison of natural childbirth rate and nursing satisfaction degree between the first group and the second group, the first group was 79.66% and 86.44% respectively, and the second group was 94.91% and 96.61% respectively (χ2 = 8.966, P = 0.000). There was a difference between the two groups. Conclusion: the effect of perinatal comprehensive nursing intervention for parturients in natural labor is good, and this method can be popularized.展开更多
Objective: To explore the perinatal nursing experience of full-term pregnant women. Methods: 100 full-term pregnant women in our hospital were selected and divided into groups. The control group received routine nursi...Objective: To explore the perinatal nursing experience of full-term pregnant women. Methods: 100 full-term pregnant women in our hospital were selected and divided into groups. The control group received routine nursing and the observation group received nursing intervention. The nursing quality of the two groups was counted. Results: the nursing quality of the observation group was better than that of the control group (P < 0.05).Conclusion: pregnant women's nursing is a special clinical nursing. Because it bears the important hope of the family during delivery, it has high requirements for nursing staff. During the near modern nursing period, full-term pregnant women should be given all-round nursing under the condition of ensuring their safety, so as to avoid unnecessary doctor-patient friction. Integrating nursing intervention on the basis of routine nursing can not only have good clinical effect on pregnant women, but also ensure the health of newborns. After the delivery of newborns, it can ensure their normal body development in the early stage, and then help the pregnant women recover the relevant normal indexes of the body. After the pregnant women receive high-quality nursing services, they can also recover their psychological state and avoid the occurrence of adverse diseases such as postpartum depression after delivery, which has high clinical practice popularization.展开更多
Global prevalence of hyperglycaemia in pregnancy in women of 20 - 49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of a...Global prevalence of hyperglycaemia in pregnancy in women of 20 - 49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of anti-diabetic therapy is diet, physical activity and medications. The study utilized a qualitative descriptive design using key informant interviews from August 2016 to November 2016 to explore challenges of adherence to anti-diabetic therapy in pregnant women with diabetes at a central hospital in Harare, Zimbabwe. Permission to conduct the study was obtained from the respective local and national ethical review boards. All participants gave verbal and written informed consent. A sample of eight key informants directly involved in the care of pregnant women with diabetes was purposively selected for key informant interviews. Key informants should have worked with diabetic pregnant women for at least one year. Sample size was determined by data saturation. Interviews followed a semi structured questionnaire that had sections on the burden of diabetes in pregnancy, challenges of adherence, challenges in management and possible solutions to challenges faced. All interviews were conducted in a private room. Detailed notes were taken during the interviews which were also being audiotaped. Trustworthiness was achieved by observing credibility, dependability, transferability and confirmability. Thematic analysis was done. Thematic analysis was done manually. The stages of data analysis followed were data organization, familiarization, transcription, coding, developing a thematic framework, indexing, displaying and reporting. Major themes identified were barriers and facilitators of adherence to anti-diabetic therapy. Categories under barriers were financial barriers, lack of health education, lack of trained personnel, shortage of staff and lack of collaboration among practitioners. Categories under facilitators of adherence were subsidization of care, formal training of professionals, promoting collaboration and establishment of a unit dedicated to the care of pregnant women with diabetes. Barriers and solutions identified should be utilized to develop frameworks to promote adherence to anti-diabetic therapy incidence of adverse perinatal outcomes.展开更多
There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesar...There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesarean section rates. This article explores known information about the obstetrical experiences of refugee and displaced women. Pregnancy care varies depending on the location of the displaced women. Obstetrical care in refugee centers in Greece is examined as an example of the overall challenges facing European countries as they juggle the influx of refugees. Challenges to obstetrical care include physician shortage and the ongoing economic crisis in Greece. Refugees are some of the world’s most vulnerable populations and overall their obstetrical outcomes are worse than women of the host communities. Providers in refugee centers must be supported and educated in best obstetrical practices including labor management and a judicious use of caesarean deliveries. Increased outreach and training of maternal health worker can improve reproductive healthcare for refugees in non-camp environments.展开更多
基金2024 Zhejiang Provincial Education Science Planning Project“A Study of the Mediating Effect of Spiritual Health on the Sense of Meaning in Life and Death Coping Skills Among Undergraduate Nursing Students”(Project No.2024SCG410)。
文摘The perinatal period,defined as 28 weeks of gestation to one week postpartum,is a time when women are particularly vulnerable to re-traumatization or the formation of new trauma,significantly impacting their health and well-being as well as that of their families.This article outlines the forms and risk factors associated with trauma,examines the connection between trauma-informed care(TIC)principles and trauma,and reviews the implementation methods and application outcomes of TIC in perinatal care.The aim is to provide a reference for healthcare professionals to advance research related to TIC in perinatal women.
文摘Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.
文摘Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.
文摘Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.
文摘Objective: to investigate the influence of postpartum personalized rehabilitation nursing on postpartum lactation and uterine rejuvenation. Methods: the first mothers were divided into 40 study group and control group, with routine perinatal nursing, personalized perinatal rehabilitation nursing, and maternal lactation, uterine rejuvenation and perinatal complications were evaluated. Results: the time of first lactation in the observation group was significantly shorter than the normal group, and the excellent rate of milk was higher than the control group, the incidence of 4, the endometrial thickness within 10 mm, and the incidence of perinatal complications was lower (P < 0.05). Conclusion: personalized perinatal rehabilitation care can improve the rejuvenation of postpartum lactation and uterus, and reduce the occurrence of perinatal complications.
文摘BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.
文摘Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.
文摘This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.
文摘<strong>Background:</strong> When family members and/or patients behave in a problematic way, this hinders the provision of safe and secure medical care. During the perinatal period, a family’s relationships and functions change significantly, and each family member is prone to experiencing stress. As such, conflict arises easily between family members and medical staff. <strong>Aims: </strong>Therefore, we conducted this study to shed light on the following phenomena: 1) family members’ problematic behaviors;2) the concerns of a perinatal ward nurse manager (hereafter referred to as the manager) and ward nurses;and 3) countermeasures carried out by the manager, together with the ward nurses, based on the manager’s experiences. <strong>Methods: </strong>We conducted an 80-minute, semi-structured interview with the manager, following which we analyzed the content of her narrated accounts. <strong>Results:</strong> According to the findings, 1) family members’ problematic actions include verbal abuse;arrogance, unreasonableness, and selfish behaviors;and violent conduct;2) the manager’s and ward nurses’ fears and worries about family members’ problematic behaviors;responses to gradually becoming involved with family members;and resistance to staying involved with family members following patient discharge. In addition, we examined 3) countermeasures carried out by the manager together with the ward nurses: resolute and consistent responses to family members’ problematic behaviors;attempted enforcement measures taken to deal with family members who exhibit problematic behaviors;engagement while trying to avoid conflict with family members;preparation that anticipates the occurrence of problematic conduct;cooperation with the medical team;cooperation with the hospital organization;cooperation with social resources outside the hospital;and patient protection.<strong> Conclusions:</strong> With awareness of cooperation with the medical team toward family members who engage in problematic actions, the medical staff members try to unify their response and share their feelings of hardship with each other.
基金funded by the Swedish Foundation for International Cooperation in Research and Higher Education(IB2016-6905).
文摘Background:Mental health has recently been receiving a growing amount of attention in China's Mainland,with mental disorders increasingly being recognized as a major public health concern.However,the treatment gap for mental health care is markedly high in China.Previous research and clinical practice have focused on high-risk physical disorders but overlooked psychosocial factors,especially during the perinatal period.Aims:To explore Chinese professionals'perception and attributions of perinatal mental health in China.Method:The study was conducted in Shanghai,China,in 2018,drawing on interviews with 15 key informants including health professionals,government officials,and policymakers recruited through snowball sampling.Content analysis of the semi-structured interviews was performed.Results:The study yielded insights into the perceptions of perinatal mental health among health professionals in Shanghai.Three themes emerged from the informants'reports:(1)mental health influenced by tradition—describing traditions affecting the perception of mental health at both the societal and individual level;(2)societal changed contributing perinatal mental health problems—referring to a rapidly changing cultural and economic backdrop as a source of stress leading to mental health problems;and(3)existing and required resources—demonstrating a lack of professional training,staff shortages,and inadequacy of resources to provide the required mental health care.Conclusion:Our results provide new insights into key health professionals'perceptions of mental health problems in Shanghai.Hesitation to seek care owing to a lack of knowledge,and resource shortages in health care systems are obstacles to improve mental health among women in urban China.
文摘Objective: the whole process of pregnant women from pregnancy to delivery is a special period. Because of the influence of pregnancy, many changes will take place in pregnant women's bodies. Although the changes are mainly physiological changes, these changes will gradually become obvious with the pregnant women's pregnancy, and it is easy for pregnant women to have certain psychological pressure. Many hospitals mainly pay attention to the daily health care and the handling of unexpected events during the clinical nursing of pregnant and lying-in women, but pay little attention to health education. Especially the opening of the second-child policy in China, due to the increase of the number of pregnant women, the obstetrics and gynecology department is facing great work pressure. Among these pregnant women, high-collar women and high-risk women occupy a certain number. If we can't give scientific health education to pregnant women, the pregnant women's self-health cognitive ability is insufficient, which will even affect the delivery outcome. In addition, the emotional and psychological changes of pregnant women have obvious changes during pregnancy. It's easy to get too excited because of some small things. If you can't get a good dredge, you may have anxiety, depression and other performances. The existence of these negative factors will have a certain degree of impact on the health care of pregnant women during pregnancy. Therefore, this paper will explore the perinatal health education. Methods: China is a populous country. With the implementation of relevant policies, the number of new pregnant women in China is increasing every year. In order to improve the comfort and safety of pregnant women's care, this time, some pregnant women were selected from the department as the research object, and 76 pregnant women who met the requirements were selected. They were randomly divided into groups by computer and given clinical care according to their conditions. This time, it was determined as routine perinatal care and perinatal health education intervention. Patients in the control group were given the first type of nursing program, while other patients were given health education. After nursing, a comprehensive investigation was made on the patients' knowledge and cognition, living conditions, and whether they had bad psychological conditions. Results: some parturients are multiparas, who have a certain knowledge base about pregnancy and childbirth, and can keep a good psychological state during pregnancy. But for primiparas, because they are the first "mothers", they don't know a lot of health knowledge, and because they don't understand, they are prone to all kinds of unpredictable events during pregnancy. Therefore, this time, nursing intervention was carried out in this respect. The data showed that after intervention, the pregnant women in the observation group knew more about related knowledge, and their cognitive level was obviously improved. The nursing behavior of the department has a great influence on the parturient. If proper nursing can be given, the self-care ability of the parturient can be improved and the quality of life can be guaranteed. This evaluation shows that the living conditions of some parturient women in the control group are not in line with expectations. Pregnant women will have all kinds of discomfort due to pregnancy, such as morning sickness and grumpy temper. If they can't get the understanding of their families, they are more likely to have psychological problems. In order to promote the pregnant women to self-regulate their emotions and keep the sunshine's psychology and emotions, this intervention is made in this respect. Most pregnant women in the observation group have little emotional fluctuation and good psychological state, and the difference of data results is statistically significant (P<0.05). Conclusion: clinical practice shows that the implementation of health education in the perinatal period of pregnant women can make them have a comprehensive grasp and understanding of health knowledge, improve the level of knowledge cognition of pregnant women, and have a positive impact on the mental and psychological aspects of pregnant women through this measure.
文摘Objective: to carry out perinatal comprehensive nursing intervention for parturients in natural labor and observe the effect of this kind of nursing. Methods: the parturients from February 2020 to February 2021 were taken as observation objects and divided into the first group (using basic nursing intervention) and the second group (using perinatal comprehensive nursing intervention). Results: In the comparison of natural childbirth rate and nursing satisfaction degree between the first group and the second group, the first group was 79.66% and 86.44% respectively, and the second group was 94.91% and 96.61% respectively (χ2 = 8.966, P = 0.000). There was a difference between the two groups. Conclusion: the effect of perinatal comprehensive nursing intervention for parturients in natural labor is good, and this method can be popularized.
文摘Objective: To explore the perinatal nursing experience of full-term pregnant women. Methods: 100 full-term pregnant women in our hospital were selected and divided into groups. The control group received routine nursing and the observation group received nursing intervention. The nursing quality of the two groups was counted. Results: the nursing quality of the observation group was better than that of the control group (P < 0.05).Conclusion: pregnant women's nursing is a special clinical nursing. Because it bears the important hope of the family during delivery, it has high requirements for nursing staff. During the near modern nursing period, full-term pregnant women should be given all-round nursing under the condition of ensuring their safety, so as to avoid unnecessary doctor-patient friction. Integrating nursing intervention on the basis of routine nursing can not only have good clinical effect on pregnant women, but also ensure the health of newborns. After the delivery of newborns, it can ensure their normal body development in the early stage, and then help the pregnant women recover the relevant normal indexes of the body. After the pregnant women receive high-quality nursing services, they can also recover their psychological state and avoid the occurrence of adverse diseases such as postpartum depression after delivery, which has high clinical practice popularization.
文摘Global prevalence of hyperglycaemia in pregnancy in women of 20 - 49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of anti-diabetic therapy is diet, physical activity and medications. The study utilized a qualitative descriptive design using key informant interviews from August 2016 to November 2016 to explore challenges of adherence to anti-diabetic therapy in pregnant women with diabetes at a central hospital in Harare, Zimbabwe. Permission to conduct the study was obtained from the respective local and national ethical review boards. All participants gave verbal and written informed consent. A sample of eight key informants directly involved in the care of pregnant women with diabetes was purposively selected for key informant interviews. Key informants should have worked with diabetic pregnant women for at least one year. Sample size was determined by data saturation. Interviews followed a semi structured questionnaire that had sections on the burden of diabetes in pregnancy, challenges of adherence, challenges in management and possible solutions to challenges faced. All interviews were conducted in a private room. Detailed notes were taken during the interviews which were also being audiotaped. Trustworthiness was achieved by observing credibility, dependability, transferability and confirmability. Thematic analysis was done. Thematic analysis was done manually. The stages of data analysis followed were data organization, familiarization, transcription, coding, developing a thematic framework, indexing, displaying and reporting. Major themes identified were barriers and facilitators of adherence to anti-diabetic therapy. Categories under barriers were financial barriers, lack of health education, lack of trained personnel, shortage of staff and lack of collaboration among practitioners. Categories under facilitators of adherence were subsidization of care, formal training of professionals, promoting collaboration and establishment of a unit dedicated to the care of pregnant women with diabetes. Barriers and solutions identified should be utilized to develop frameworks to promote adherence to anti-diabetic therapy incidence of adverse perinatal outcomes.
文摘There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesarean section rates. This article explores known information about the obstetrical experiences of refugee and displaced women. Pregnancy care varies depending on the location of the displaced women. Obstetrical care in refugee centers in Greece is examined as an example of the overall challenges facing European countries as they juggle the influx of refugees. Challenges to obstetrical care include physician shortage and the ongoing economic crisis in Greece. Refugees are some of the world’s most vulnerable populations and overall their obstetrical outcomes are worse than women of the host communities. Providers in refugee centers must be supported and educated in best obstetrical practices including labor management and a judicious use of caesarean deliveries. Increased outreach and training of maternal health worker can improve reproductive healthcare for refugees in non-camp environments.
