Machine learning-based analysis on factors influencing blood heavy metal concentrations in the Korean CHildren's ENvironmental health Study (Ko-CHENS)

Heavy metal concentration in pregnant women affects neurocognitive and behavioral development of their infants and children. The majority of existing research focusing on pregnant women's heavy metal concentration has considered individual environmental factor. In this study, we aim to comprehensively consider lifestyle, food, and environmental factors to determine the most influential factor affecting heavy metal concentration in pregnant women. The Ko-CHENS (Korean CHildren health and ENvironmental Study) is a nationwide prospective birth cohort study in South Korea enrolling pregnant women from 2015 to 2020. A total of 5458 eligible pregnant women were included in this study, and 897 variables were included in questionnaire comprising: maternal general information, indoor and living environment, dietary habits, health behavior, exposure to chemicals. Lead, cadmium and mercury concentration on blood were measured in early, late pregnancy and in cord blood at birth. Variables that might be related to heavy metal concentrations were included in machine learning models. Random forest and XGBoost machine learning models were conducted for predictions. Both models had similar but better performance than multiple linear regression. Kimchi (β = 1.55), seaweed (β = 0.40), fatty fish (β = 1.55), intakes respectively affected lead, cadmium, and mercury exposure through early, late pregnancy and cord blood.

Pregnant women's lifestyles and exposure to endocrine-disrupting chemicals: A machine learning approach

Women have ubiquitous exposure to various endocrine disrupting chemicals (EDCs) present in personal care products, food packaging, and processing. Pregnancy is a phase of increased vulnerability to environmental stressors. Therefore, we aimed to identify questionnaire based variables of pregnant women's lifestyle factors affecting the prenatal concentrations of EDCs: bis-phenol A (BPA), triclosan (TCS), parabens, and phthalates. We also aimed to explore the association between these lifestyle factors and EDC exposure in pregnant women in South Korea. This study is a part of Korean CHildren's ENvironmental health Study (Ko-CHENS). The following lifestyle factors: usage of personal care products, eating habits, cooking practices, food storage practices, and chemical exposure were evaluated through questionnaire. We examined prenatal EDCs: phenols (BPA), TCS, parabens (MEP, ETP, and PRP), and phthalates (MEHHP, MEOHP, MECPP, MBZP, MCOP, MCPP, MCNP, and MNBP). The random forest and least absolute shrinkage and selection operator regression machine learning models were used to predict the important lifestyle factors affecting the prenatal EDC concentrations in pregnant women. Next, we calculated the lifestyle score and evaluated its association with prenatal EDCs, respectively. Our results show that pregnant women who used makeup [β: 1.01, 95% C.I.: 0.01,2.00] >6 times/week had a significant increase in early-pregnancy (EP) ΣParaben exposure. Using perfume up to 3 times/month was significantly associated with EP TCS exposure (β: 0.05, 95% C.I.: 0.01,0.23). While, using perfume >6 times/week was significantly associated to late-pregnancy (LP) ΣParaben exposure, and consuming cup noodles significantly increased LP ΣDEHP exposure. Linear model analysis showed that the lifestyle score significantly increased the EP (β: 0.24, 95% C.I.: 0.07,0.40) and LP (β:0.10, 95% C.I.: 0.01,0.20) ΣParaben exposure. Therefore, pregnant women's lifestyle factors, such as using makeup and perfume and eating habits (e.g., cup noodle consumption), were associated with prenatal EDC exposure.

The Impact of the COVID-19 Pandemic on Health Behaviours of Pregnant Women in Poland: A Cross-Sectional Study

Health behaviours of pregnant women should promote an optimal course of pregnancy and maternal health. The purpose of this study was to assess the impact of COVID-19 pandemic on pregnant women's health behaviours (proper eating habits with a particular focus on the type of food consumed; preventive behaviours in terms of compliance with health recommendations and obtaining information on health and disease; healthy practices-daily habits in terms of sleep, rest and physical activity; as well as positive mental attitudes-avoiding strong emotions, stress, and depressing situations, determined by the frequency of each behaviour reported by the respondents). The study included women at different stages of pregnancy and women who were pregnant during the COVID-19 pandemic. A total of 355 women participated in the study. The study used a proprietary questionnaire and the Health Behaviour Inventory (HBI). The overall health behaviour score during the pandemic was higher (85.87) than the pre-pandemic score (82.16). There was a statistically significant difference between the total pre-pandemic and during-pandemic HBI scores. Additionally, there was an increase in the total score in each of the health behaviour domains during the pandemic period compared to the pre-pandemic results. During the COVID-19 pandemic, pregnant women presented a statistically significantly higher rate of health behaviours, as measured with the HBI, indicating that respondents were more likely to engage in health-promoting behaviours. The study has shown a positive change in pregnant women's eating habits, which can potentially affect the health of the population in the future.

Risks of motor vehicle crash before and during pregnancy: A population-based controlled study in Taiwan

BACKGROUND

Changes in risk of motor vehicle crashes (MVCs) during pregnancy are less known, and very few studies have assessed this issue by using unselected population-based datasets and adopting a before-and-during design. The study aimed to address the risk of MVC events in association with pregnancy using a national pregnant women cohort in Taiwan.

METHODS

We conducted a self-matched design in which each woman served as a driver before and during pregnancy. A total of 1,372,664 pregnant women with live birth(s) at 18-50 years of age between 2008 and 2017 were identified from the Birth Notification dataset. MVC events as a driver were ascertained from the Police-reported Traffic Accident Registry dataset. We calculated the rate ratio (RR) with a 95 % confidence interval (CI) using the conditional Poisson regression model to compare the MVC event rates between pre-pregnancy and pregnancy periods.

RESULTS

The overall rate of MVC events was significantly reduced during pregnancy (RR = 0.69, 95 % confidence interval (CI) = 0.68-0.71). Mothers with alcoholism during pregnancy were associated with an increased RR at 2.00 but with a very wide CI. Reduction in RR was primarily attributed to the reduced MVC event rate involving scooter crashes (0.60, 95 % CI = 0.58-0.62).

CONCLUSION

Although MVC event rates decreased during women became pregnant, many women drivers were still involved in MVCs during pregnancy. Their potential maternal and perinatal conditions along with their offspring's health outcomes need further investigations.

Prenatal harmful substances: Thai pregnant women's experiences

Background

The exposure of unborn babies to harmful substances during prenatal stages can lead to fetal anomalies, emphasizing the significance of pregnant women's practices in ensuring optimal fetal outcomes. However, there is a lack of understanding regarding this issue from the perspective of pregnant women.

Objective

This study aimed to describe the experiences of pregnant women in avoiding harmful substances to their unborn babies.

Methods

This study used a qualitative descriptive approach. Data were collected between September 2020 and April 2021 through in-depth interviews with 17 pregnant women purposively selected from two hospitals in southern Thailand. Data were transcribed verbatim and analyzed using thematic analysis.

Results

Four themes emerged from the participants' experiences: 1) understanding of harms, which included substance characteristics, exposure characteristics, body's protective mechanism, personal experiences, and obtained information; 2) practices for safety, which consisted of food safety, work safety, ambient air safety, and safety in personal/household products; 3) challenges in avoiding harmful substances, which were unrecognition, unavailability of safe substances, discomfort and inconvenience, inevitability, and family traditions; and 4) overcoming the challenges through personal changes, obtaining support, and ensuring a peaceful mind.

Conclusion

The findings provide valuable insights into prenatal exposure to harmful substances, which can serve as a basis for developing comprehensive guidelines for best practices. It is crucial for nurses to receive training that enables them to educate pregnant women, enhancing their awareness of important harmful substances and promoting effective methods for maintaining safety in their daily activities. Additionally, nurses can develop interventions to empower pregnant women to overcome challenges by involving significant individuals, particularly family members, in providing support and creating an optimal prenatal environment.

Corona disease anxiety and health related behaviors: What happened to primgravida women post COVID-19?

Background

The COVID-19 pandemic has sparked psychological and behavioural changes among pregnant women across the globe and thereby might have a devastating impact on the fetal and neonatal outcomes. The dearth of information related to this significant topic can contribute to surge feelings of uneasiness and perinatal anxiety of primigravida women. Therefore, assessing and investigating the relationship between corona disease anxiety and health related behaviors among primigravida women post COVID-19, would provide an auxiliary template to the Ministry of health in the Middle East and North Africa (MENA) region to integrate this into their sustainable health agenda.

Methods

A descriptive correlational research design was used in this study in which a convenient sample of 200 primigravida women completed a Corona disease anxiety scale (CDAS) and pregnant women's health- related behavior changes post COVID-19.

Results

More than four fifth of the study subjects reported mild anxiety level (82%) and nearly three fifth of the studied primigravidas' reported fair level of health-related behaviors (59%). Also, a statistical significant correlation was found between the studied primigravidas' anxiety level and their health-related behavior including; healthy diet regimen, follow up visits, and protective personal measures (r = 0.273, P<0.001, r = 0.188, P<0.008, r = 0.242, P<0.001, r = 0.189, P<0.007, r = 0.407, P<0.001 and r = 0.309, P<0.001, respectively).

Conclusion

Corona disease anxiety was proved to be the independent predictor of health- related behavior. Mental health screening of primigravida women at the outset of any public health emergency should be prompted.

The Impact of a Communication Training on the Birth Experience: Qualitative Interviews with Mothers after Giving Birth at Obstetric University Departments in Germany

(1) Background: Patient safety is a pressing issue in healthcare. Besides economical and organizational issues, human factors play a crucial role in providing safe care. Safe and clear communication on both the healthcare workers' and patients' sides contribute to the avoidance of medical errors and increase patients' and healthcare workers' satisfaction. Globally, the incidence of experiencing at least one adverse event in obstetrics is about 10%, of which half are classified as preventable. According to international research, improving communication skills may decrease preventable adverse events. The research question was to what extent communication training for pregnant women impacts the quality of communication and mutual understanding during birth. (2) Methods: Communication interventions with pregnant women were conducted in two German university obstetric departments in a mixed methods research design, based on the Health Action Process Approach. The online classes covered the awareness of personal wishes, the understanding and usage of communication strategies, self-efficacy and empathy. This study presents the qualitative results. Out of 142 mothers who answered two questionnaires before the communication training and after the birth, 24 in-depth semistructured interviews were conducted to explore the subjective impact of the communication training. The results were analyzed with qualitative content analysis. (3) Results: The majority of participants felt incentivized to be aware of their personal wishes for birth and to express them. Perceived positive experiences with sufficient competency in communication, empathy and mutual understanding outweighed negative treatments and experiences in the hospital, some of which could be attributed to structural problems. (4) Discussion: The reported positive effects of the communication training underline the need but also the potential for communication lessons to reflect and improve communication skills in obstetrics. However, negative experiences due to structural problems in the healthcare system may be buffered by communication skills but not solved.