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Bombana M, Wensing M, Wittenborn L, Ullrich C. Health Education about Lifestyle-Related Risk Factors in Gynecological and Obstetric Care: A Qualitative Study of Healthcare Providers' Views in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11674. [PMID: 36141943 PMCID: PMC9517227 DOI: 10.3390/ijerph191811674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Lifestyle-related risk factors (LRRFs) during pregnancy and lactation are associated with a range of health problems. However, previous studies have shown a large knowledge gap among pregnant women regarding the effects of LRRFs. This study aimed to investigate the role of health education about LRRFs during pregnancy and lactation in gynecological and obstetric care from healthcare providers' (HCPs) point of view. METHODS To explore the views of healthcare providers, a qualitative study was performed. In 2019, 22 in-depth interviews were conducted with a purposive sample of 9 gynecologists and 13 midwives. Participants came from different inpatient and outpatient care settings and from rural, urban, and socially deprived areas in southern Germany. All the interviews were tape-recorded and transcribed verbatim. A combined inductive and deductive approach was applied for data analysis. RESULTS Interviews with HCPs showed that they were aware of the possible impacts of LRRFs during pregnancy and lactation. They noted the importance of action, specifically among women with low socioeconomic status (SES), migrants, and women with a concerning medical history or other specific needs. However, the interviews showed that, at present, there is no standardized practice of educating patients on LRRFs in routine care. This was attributed to a lack of guidelines and time, unfavorable regulations, and undefined responsibilities. The priority of health education is lower in inpatient healthcare settings as compared to outpatient healthcare settings. HCPs apply a demand-driven healthcare approach, focusing on a woman's medical history, needs, and personal circumstances. HCPs voiced the importance of implementing pre-conception education across different healthcare settings, garnering support from other health organizations, and setting out clearly defined responsibilities among HCPs. CONCLUSIONS This qualitative study explored HCPs' perspectives on health education about LRRFs during pregnancy and lactation. The results from this study emphasize the need for a central strategy for health education about LRRFs during pregnancy and lactation in gynecological and obstetric care.
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Affiliation(s)
- Manuela Bombana
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
- Department of Prevention, AOK Baden-Württemberg, Presselstrasse 19, 70191 Stuttgart, Germany
| | - Michel Wensing
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Lisa Wittenborn
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Medicine and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
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Preventive Counseling in Routine Prenatal Care-A Qualitative Study of Pregnant Women's Perspectives on a Lifestyle Intervention, Contrasted with the Experiences of Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106122. [PMID: 35627659 PMCID: PMC9140722 DOI: 10.3390/ijerph19106122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022]
Abstract
Maternal lifestyle during pregnancy and excessive gestational weight gain can influence maternal and infant short and long-term health. As part of the GeMuKi intervention, gynecologists and midwives provide lifestyle counseling to pregnant women during routine check-up visits. This study aims to understand the needs and experiences of participating pregnant women and to what extent their perspectives correspond to the experiences of healthcare providers. Semi-structured interviews were conducted with 12 pregnant women and 13 multi-professional healthcare providers, and were analyzed using qualitative content analysis. All interviewees rated routine check-up visits as a good setting in which to focus on lifestyle topics. Women in their first pregnancies had a great need to talk about lifestyle topics. None of the participants were aware of the link between gestational weight gain and maternal and infant health. The healthcare providers interviewed attributed varying relevance regarding the issue of weight gain and, accordingly, provided inconsistent counseling. The pregnant women expressed dissatisfaction regarding the multi-professional collaboration. The results demonstrate a need for strategies to improve multi-professional collaboration. In addition, health care providers should be trained to use sensitive techniques to inform pregnant women about the link between gestational weight gain and maternal and infant health.
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Menzel P, Vogel M, Austin S, Sprenger N, Grafe N, Hilbert C, Jurkutat A, Kiess W, Binia A. Concentrations of oligosaccharides in human milk and child growth. BMC Pediatr 2021; 21:481. [PMID: 34717578 PMCID: PMC8556924 DOI: 10.1186/s12887-021-02953-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/14/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The relationship between human milk oligosaccharides (HMO) and child growth has been investigated only insufficiently with ambiguous results. Therefore, this study examines potential influencing factors of HMO concentrations and how HMO are associated with child growth parameters. METHODS Milk samples from the German LIFE Child cohort of healthy children were analyzed for 9 HMO. Putative associations with maternal and child cofactors and child height, head circumference and BMI between 3 months and 7 years of age were examined. Secretor status, defined as the presence of 2'-fucosyllactose, was investigated for associations with infant outcomes. RESULTS Our population consisted of 21 (14.7%) non-secretor and 122 (85.3%) secretor mothers. Maternal age was significantly associated with higher 3'SL concentrations; gestational age was associated with LNT, 6'SL and LNFP-I. Pre-pregnancy BMI was negatively associated with LNnT only in non-secretors. The growth velocity of non-secretors' children was inversely associated with LNnT at 3 months to 1 year (R = 0.95 [0.90, 0.99], p = 0.014), 1 to 2 years (R = 0.80 [0.72, 0.88], p < 0.001) and 5 to 6 years (R = 0.71 [0.57, 0.87], p = 0.002). 2'FL was negatively associated with BMI consistently, reaching statistical significance at 3 months and 4 and 5 years. Children of non-secretors showed higher BMI at 3 months, 6 months, and 3, 6, and 7 years of age. CONCLUSION We found that some associations between HMO and infant growth may extend beyond the infancy and breastfeeding periods. They highlight the importance of both maternal and infant parameters in the understanding of the underlying associations. TRIAL REGISTRATION The study is registered with ClinicalTrial.gov: NCT02550236 .
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Affiliation(s)
- Philipp Menzel
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
| | - Mandy Vogel
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany.
- Center for Pediatric Research, Leipzig University, Department of Women and Child Health, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany.
| | - Sean Austin
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000, Lausanne, Switzerland
| | - Norbert Sprenger
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000, Lausanne, Switzerland
| | - Nico Grafe
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Department of Women and Child Health, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Cornelia Hilbert
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Department of Women and Child Health, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Anne Jurkutat
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Department of Women and Child Health, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- Leipzig University, Leipzig University Hospital for Children and Adolescents, LIFE Child, Ph.-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Center for Pediatric Research, Leipzig University, Department of Women and Child Health, Leipzig University, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Aristea Binia
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000, Lausanne, Switzerland
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