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Chavin M, Latour G, Guyard-Boileau B, Durand MA. Evaluation of the Tuto’Tour pregnancy intervention among pregnant smokers in vulnerable situations. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2024; 36:45-72. [PMID: 38580466 DOI: 10.3917/spub.241.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
INTRODUCTION In France, pregnant women generally receive written information about their pregnancy. The efficacy of these materials is limited for socially disadvantaged women, who are more likely to have lower levels of health literacy. As an alternative tool, awareness-raising videos have become popular, and the “Tuto’Tour de la grossesse” health promotion intervention has been created, which includes videos about smoking. The study objective was to evaluate the acceptability, usability, and accessibility of two videos about smoking among pregnant smokers in vulnerable situations. METHODS We conducted semi-structured interviews with these women, using a participatory approach. We then carried out a hybrid qualitative analysis, combining an analysis based on a conceptual framework and an inductive analysis. RESULTS Out of twenty participants, nine were separated from their child’s father and nine were unemployed. Twelve participants had less than a baccalaureate level of education and seven had a mother tongue other than French. Participants found the videos acceptable, usable, and accessible. We received positive feedback about the efficacy of the videos in terms of participants’ ability, opportunity, and motivation to change their behavior. Suggestions for improving the videos were made. CONCLUSIONS Other studies have looked at health promotion with similar interventions, but acceptability, usability, and accessibility have not been tested with socially disadvantaged women. These videos, which are acceptable, usable, and accessible to socially disadvantaged people, seem to have an influence on two out of three factors leading to behavior change. They could now be tested on a larger scale in a randomized controlled study.
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Affiliation(s)
- Maëva Chavin
- UMR 1295 CERPOP, Inserm, université Toulouse-III-Paul-Sabatier, EQUITY, Toulouse, France
- CHU de Toulouse, Toulouse, France
| | - Gillien Latour
- UMR 5502 IMFT, Institut de mécanique des fluides de Toulouse, Toulouse, France
| | | | - Marie-Anne Durand
- UMR 5502 IMFT, Institut de mécanique des fluides de Toulouse, Toulouse, France
- The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Lebanon, NH, États-Unis
- Unisanté, centre universitaire de médecine générale et santé publique, Lausanne, Suisse
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Vila-Farinas A, Pérez-Rios M, Montes-Martinez A, Ruano-Ravina A, Forray A, Rey-Brandariz J, Candal-Pedreira C, Fernández E, Casal-Acción B, Varela-Lema L. Effectiveness of smoking cessation interventions among pregnant women: An updated systematic review and meta-analysis. Addict Behav 2024; 148:107854. [PMID: 37683574 DOI: 10.1016/j.addbeh.2023.107854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/08/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To carry out a systematic review of systematic reviews with an update of the existing evidence relating to a broad range of smoking cessation interventions, including psycho-social, digital and pharmacologic interventions, for pregnant women. DATA-SOURCES Search was conducted in March 2022 in PubMed, EMBASE, and Cochrane in two stages: 1) a search of systematic reviews and meta-analyses, published from January 2012 through January 2022; 2) an update of those that fulfilled eligibility criteria reproducing the primary search strategy. STUDY ELIGIBILITY CRITERIA We selected randomized clinical trials (RCTs) that evaluated the effectiveness of pharmacological, digital, and psychosocial interventions in aged 18 years and over who were daily smokers, and compared these with routine care, less intense interventions or placebo. STUDY APPRAISAL AND SYNTHESIS METHODS Data from eligible studies were manually extracted by two authors and reviewed by a third. The quality of the reviews was evaluated using the AMSTAR scale, and risk of bias was measured with the Rob-2 tool and GRADE level of evidence. RESULTS The meta-analysis included 63 RCTs (n = 19849 women). The interventions found to be effective were: financial incentives (RR:1.77; 95%CI:1.21-2.58), counseling (RR:1.27; 95%CI:1.13-1.43) and long-term nicotine replacement therapy (NRT) (RR:1.53; 95%CI:1.16-2.01). Short-term NRT, bupropion, digital interventions, feedback, social support, and exercise showed no effectiveness. The GRADE level of evidence was moderate-to-high for all interventions, with the exception of long-term NRT. CONCLUSIONS Non-pharmacological interventions for smoking cessation are the most effective for pregnant women. The moderator analysis suggests that pregnant women of low socioeconomic status might benefit less from smoking cessation interventions than women of a high socioeconomic status. These women are usually heavier smokers that live in pro-smoking environments and could require more intensive and targeted interventions.
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Affiliation(s)
- A Vila-Farinas
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Pérez-Rios
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain.
| | - A Montes-Martinez
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - A Ruano-Ravina
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J Rey-Brandariz
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - C Candal-Pedreira
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - E Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - B Casal-Acción
- Galician Agency for Health Knowledge Management (avalia-t; ACIS), Santiago de Compsotela, Spain
| | - L Varela-Lema
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
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Gervoise-Boyer MJ, Fauque P, De Mouzon J, Devaux A, Epelboin S, Levy R, Valentin M, Viot G, Bonomini J, Bergère M, Jonveaux P, Pessione F. Risk factors associated with preterm birth in singletons born after IVF: a national cohort study. Reprod Biomed Online 2023; 46:750-759. [PMID: 36868885 DOI: 10.1016/j.rbmo.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
RESEARCH QUESTION What are the risk factors for prematurity other than intrauterine growth restriction in singletons after IVF? DESIGN Data were collected from a national registry, based on an observational prospective cohort of 30,737 live births after assisted reproductive technology (fresh embryo transfers: n = 20,932 and frozen embryo transfer [FET] n = 9805) between 2014 and 2015. A population of not-small for gestational age singletons conceived after fresh embryo transfers and FET, and their parents, was selected. Data on a number of variables were collected, including type of infertility, number of oocytes retrieved and vanishing twins. RESULTS Preterm birth occurred in 7.7% (n = 1607) of fresh embryo transfers and 6.2% (n = 611) of frozen-thawed embryo transfers (P < 0.0001; adjusted odds ratio [aOR] = 1.34 [1.21-1.49]). Endometriosis and vanishing twin increased the risk of preterm birth after fresh embryo transfer (P < 0.001; aOR 1.32 and 1.78, respectively). Polycystic ovaries or more than 20 oocytes retrieved also increased preterm birth risk (aOR 1.31 and 1.30; P = 0.003 and P = 0.02, respectively); large oocyte cohort (>20) was no longer associated with the risk of prematurity in FET. CONCLUSION Endometriosis remains a risk for prematurity even in the absence of intrauterine growth retardation, which suggests a dysimmune effect. Large oocyte cohorts obtained by stimulation, without clinical polycystic ovary syndrome diagnosed before attempts, do not affect FET outcomes, reinforcing the idea of a phenotypic difference in the clinical presentation of polycystic ovary syndrome.
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Affiliation(s)
| | - Patricia Fauque
- University of Bourgogne Franche-Comté - INSERM UMR1231, 2 Rue Angélique Ducoudray, F-21000 Dijon, France
| | | | - Aviva Devaux
- Centre for Medically Assisted Reproduction, Reproductive Biology, CHU Amiens-Picardie, France
| | - Sylvie Epelboin
- Centre for Medically Assisted Reproduction, Obstetrics and Gynaecology, Reproductive Medicine, Université Paris 7 Diderot, Bichat Claude-Bernard Hospital Group, AP-HP, Paris, France
| | - Rachel Levy
- Inserm, Genetic and acquired lipodystrophies team, Reproductive Biology Department-CECOS, Saint-Antoine Research center, Sorbonne university, hôpital Tenon, AP-HP, 75020 Paris, France
| | - Morgane Valentin
- Antenatal diagnosis, obstetrics and gynaecology, Paris 7 Diderot university, Bichat Claude-Bernard Hospital group, AP-HP, Paris, France
| | - Géraldine Viot
- Clinical Genetics Unit of La Muette 50 rue Nicolo 75116 Paris, France
| | - Justine Bonomini
- Clinical Research Department, Hôpital Saint-Joseph, Marseille 8, France
| | - Marianne Bergère
- Agence de la biomédecine, 1 avenue du stade de France, 93212 La Plaine Saint Denis, France
| | - Philippe Jonveaux
- Agence de la biomédecine, 1 avenue du stade de France, 93212 La Plaine Saint Denis, France
| | - Fabienne Pessione
- Agence de la biomédecine, 1 avenue du stade de France, 93212 La Plaine Saint Denis, France
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Weiss S. Protecting Infants from Sudden Unexpected Infant Death: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S83-S92. [PMID: 36480671 DOI: 10.1111/jmwh.13430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
With 300-400 annual deaths in France, sudden unexpected infant death (SUID) is the leading cause of mortality in France among infants from the end of their first through their 12th month of life. These clinical practice guidelines aim to identify strategies for (future) parents to prevent avoidable SUIDs. They are based on a narrative literature review and an analysis of the existing reports and guidelines available on the topic in 2019-2020. In summary, it is recommended that parents ensure that their infants sleep on their back on a firm, empty surface in a sufficiently ventilated environment, share the parental bedroom, and be breastfed and vaccinated. All of these actions create protective factors against SUID. Conversely, parents should know that several factors increase the risk of SUID: unsafe sleep, maternal smoking, passive smoking after birth, exposure to alcohol or other psychoactive substances, and excessive heat. Precis: Sudden Unexpected Infant Death prevention includes infants being breastfed and vaccinated, sleeping on their back, on a firm, empty surface, near parents, and that they are not overheated.
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Affiliation(s)
- Stephanie Weiss
- Savoie Metropolitan Area Hospital Center, Place Lucien Biset, Chambéry
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Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. [CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy-Short Text]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:539-545. [PMID: 32289497 DOI: 10.1016/j.gofs.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. METHODS Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest). RESULTS "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. CONCLUSIONS Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
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Affiliation(s)
- G Grangé
- Maternité Port-Royal, université de Paris, AP-HP, 75014 Paris, France.
| | - I Berlin
- Département de pharmacologie, AP-HP, 75000 Paris, France; Centre universitaire de médecine générale et de santé publique, 1000 Lausanne, Suisse
| | - F Bretelle
- Department of obstetrics and gynecology, conception hospital, Aix Marseille université, prenatal diagnosis Timone Conception, IHU, IRD, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - C Bertholdt
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France; IADI, Inserm U1254, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain-en-Laye, 78300 Poissy, France
| | - J Blanc
- Service de gynécologie obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA3279, CEReSS, health service research and quality of life center, université Aix-Marseille, 13284 Marseille, France
| | - C DiGuisto
- Université de Paris, epidemiology and statistics research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, hôpital Tenon, bâtiment Recherche, rue de la Chine, 75020 Paris, France; Maternité Olympe de Gouges, centre hospitalier régional universitaire Tours, Tours, France; Université François-Rabelais, 37000 Tours, France
| | - V Dochez
- Service de gynécologie-obstétrique, CHU de Nantes, 44093 Nantes, France
| | - C Garabedian
- EA 4489 - Perinatal Environment and Health, université de Lille, hôpital Jeanne-de-Flandre, clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - P Guerby
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Koch
- Service de gynécologie-obstétrique, CHU de Strasbourg, 67000 Strasbourg, France
| | - M Le Lous
- Département de gynécologie obstétrique et médecine de la reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, université de Rennes 1, UMR 1099, 35000 Rennes, France
| | - E Perdriolle-Galet
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de gynécologie obstétrique, hôpital L.-Mourier, AP-HP, 92700 Colombes, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - H Torchin
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, epidemiology and statistics research center/CRESS, Inserm, INRA, 75004 Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800 Villejuif, France; Department of obstetrics and gynecology, Angers university hospital, 49000 Angers, France
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