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Allouch F, Burwick R, Gupta M, Bartal MF, Bicocca MJ, Chauhan SP, Wagner S. The association between maternal insurance status on maternal and neonatal outcomes in women with hypertensive disorders of pregnancy. J Hum Hypertens 2024; 38:75-80. [PMID: 36774406 DOI: 10.1038/s41371-023-00809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/13/2023]
Abstract
The objective of this study was to examine the association between maternal insurance status and maternal and neonatal adverse outcomes in women who had hypertensive disorders in pregnancy. A population-based retrospective cohort study was undertaken using the US Vital Statistics dataset on Period Linked Birth-Infant Data from 2016-2020. The study population was restricted to non-anomalous births from women whose pregnancies were complicated by hypertensive disorders. Insurance status was categorized as private, Medicaid, self-pay and other. The primary outcome was a composite of maternal adverse outcomes, which included admission to the intensive care unit, unplanned hysterectomy, maternal blood transfusion or uterine rupture. We examined the role of prenatal care in these relationships using a mediation analysis with Kotelchuck's Adequacy of Prenatal Care Utilization Index. Multivariable logistic regression models were used to estimate the association between maternal insurance status and adverse outcomes (using adjusted odds ratios [aOR] and 99% confidence interval [CI]). Of the 18,999,865 live births in the five-year study, 1,642,654 (8.6%) met the inclusion criteria. The frequency of the composite maternal adverse outcome was 1.3%. The maternal composite occurred more frequently in women with Medicaid (aOR = 1.11, 99% CI: 1.06, 1.16) or self-pay (aOR = 1.40, 99% CI: 1.25, 1.55) when compared to private insurance. Adjusting for prenatal care slightly attenuated this association, but remained significant. Among women with hypertensive disorders in pregnancy, women with Medicaid insurance or self-pay were more likely to experience maternal and neonatal adverse outcomes than women with private insurance.
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Affiliation(s)
- Farah Allouch
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Megha Gupta
- Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA
| | - Michal Fishel Bartal
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Matthew J Bicocca
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Stephen Wagner
- Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI, USA.
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Desai M, Zhou B, Nalawade V, Murphy J, Veeravalli N, Henk H, Gyamfi-Bannerman C, Whitcomb B, Su HI. Maternal comorbidity and adverse perinatal outcomes in survivors of adolescent and young adult cancer: A cohort study. BJOG 2023; 130:779-789. [PMID: 36655360 PMCID: PMC10401611 DOI: 10.1111/1471-0528.17380] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/04/2022] [Accepted: 10/19/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate risks of preterm birth (PTB) and severe maternal morbidity (SMM) in female survivors of adolescent and young adult cancer and assess maternal comorbidity as a potential mechanism. To determine whether associations differ by use of assisted reproductive technology (ART). DESIGN Retrospective cohort. SETTING Commercially insured females in the USA. SAMPLE Females with live births from 2000-2019 within a de-identified US administrative health claims data set. METHODS Log-binomial regression models estimated relative risks of PTB and SMM by cancer status and tested for effect modification. Causal mediation analysis evaluated the proportions explained by maternal comorbidity. MAIN OUTCOME MEASURES PTB and SMM. RESULTS Among 46 064 cancer survivors, 2440 singleton births, 214 multiple births and 2590 linked newborns occurred after cancer diagnosis. In singleton births, the incidence of PTB was 14.8% in cancer survivors versus 12.4% in females without cancer (aRR 1.19, 95% CI 1.06-1.34); the incidence of SMM was 3.9% in cancer survivors versus 2.4% in females without cancer (aRR 1.44, 95% CI 1.13-1.83). Cancer survivors had more maternal comorbidities before and during pregnancy; 26% of the association between cancer and PTB and 30% of the association between cancer and SMM was mediated by maternal comorbidities. Tests for effect modification of cancer status on perinatal outcomes by ART were non-significant. CONCLUSIONS Preterm birth and SMM risks were modestly increased after cancer. Significant proportions of elevated risks may result from increased comorbidities. ART did not significantly modify the association between adolescent and young adult cancer and adverse perinatal outcomes. The prevention and treatment of comorbidities provides an opportunity to improve perinatal outcomes among cancer survivors.
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Affiliation(s)
- Milli Desai
- Department of Obstetrics, Gynecology, and Reproductive Sciences; University of California, San Diego, 3855 Health Sciences Drive, Dept 0901, La Jolla, CA 92093-0901, USA
| | - Beth Zhou
- Department of Obstetrics, Gynecology, and Reproductive Sciences; University of California, San Diego, 3855 Health Sciences Drive, Dept 0901, La Jolla, CA 92093-0901, USA
| | - Vinit Nalawade
- Department of Radiation Medicine and Applied Sciences; University of California, San Diego, La Jolla CA
| | - James Murphy
- Department of Radiation Medicine and Applied Sciences; University of California, San Diego, La Jolla CA
| | | | | | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics, Gynecology, and Reproductive Sciences; University of California, San Diego, 3855 Health Sciences Drive, Dept 0901, La Jolla, CA 92093-0901, USA
| | - Brian Whitcomb
- Department of Biostatistics and Epidemiology; University of Massachusetts, 433 Arnold House, 715 N Pleasant St, Amherst, MA 01003, USA
| | - H. Irene Su
- Department of Obstetrics, Gynecology, and Reproductive Sciences; University of California, San Diego, 3855 Health Sciences Drive, Dept 0901, La Jolla, CA 92093-0901, USA
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Channon S, Coulman E, Cannings-John R, Henley J, Lau M, Lugg-Widger F, Strange H, Davies F, Sanders J, Scherf C, Couzens Z, Morantz L. Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study. Health Technol Assess 2023; 27:1-224. [PMID: 36688498 PMCID: PMC9885302 DOI: 10.3310/nkix8285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Women with overweight (a body mass index of ≥ 25 kg/m2) or obesity (a body mass index of ≥ 30 kg/m2) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e. coils or implants) are one of the few groups of people who contact services as part of their preparation for conception, creating an opportunity to offer a weight loss intervention. OBJECTIVES The objectives were to understand if routine NHS data captured the pathway from long-acting reversible contraception removal to pregnancy and included body mass index; to identify the suitable components of a preconception weight loss intervention; and to engage with key stakeholders to determine the acceptability and feasibility of asking women with overweight/obesity to delay the removal of their long-acting reversible contraception in order to take part in a preconception weight loss intervention. DESIGN This was a preparatory mixed-methods study, assessing the acceptability and feasibility of a potential intervention, using routine NHS data and purposefully collected qualitative data. PARTICIPANTS The NHS routine data included all women with a long-acting reversible contraception code. There were three groups of participants in the surveys and interviews: health-care practitioners who remove long-acting reversible contraception; weight management consultants; and women of reproductive age with experience of overweight/obesity and of using long-acting reversible contraception. SETTING UK-based health-care practitioners recruited at professional meetings; and weight management consultants and contraceptive users recruited via social media. DATA SOURCES Anonymised routine data from UK sexual health clinics and the Clinical Practice Research Datalink, including the Pregnancy Register; and online surveys and qualitative interviews with stakeholders. RESULTS The records of 2,632,871 women aged 16-48 years showed that 318,040 had at least one long-acting reversible contraception event, with 62% of records including a body mass index. Given the identified limitations of the routine NHS data sets, it would not be feasible to reliably identify women with overweight/obesity who request a long-acting reversible contraception removal with an intention to become pregnant. Online surveys were completed by 100 health-care practitioners, four weight management consultants and 243 contraceptive users. Ten health-care practitioners and 20 long-acting reversible contraception users completed qualitative interviews. A realist-informed approach generated a hypothesised programme theory. The combination of weight discussions and the delay of long-acting reversible contraception removal was unacceptable as an intervention to contraceptive users for ethical and practical reasons. However, a preconception health intervention incorporating weight loss could be acceptable, and one potential programme is outlined. LIMITATIONS There was very limited engagement with weight management consultants, and the sample of participating stakeholders may not be representative. CONCLUSIONS An intervention that asks women to delay long-acting reversible contraception removal to participate in a preconception weight loss intervention would be neither feasible nor acceptable. A preconception health programme, including weight management, would be welcomed but requires risk communication training of health-care practitioners. FUTURE WORK Work to improve routine data sets, increase awareness of the importance of preconception health and overcome health-care practitioner barriers to discussing weight as part of preconception care is a priority. TRIAL REGISTRATION This trial is registered as ISRCTN14733020. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 1.
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Affiliation(s)
- Susan Channon
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Josie Henley
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Mandy Lau
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Freya Davies
- The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Caroline Scherf
- Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
| | - Zoë Couzens
- Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
| | - Leah Morantz
- 1Centre for Trials Research, Cardiff University, Cardiff, UK
- 2The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
- 3School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- 4Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
- 5Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
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Walker RE, Quong S, Olivier P, Wu L, Xie J, Boyle J. Understanding Preconception Women’s Needs and Preferences for Digital Health Resources: Qualitative Study. JMIR Form Res 2022; 6:e39280. [PMID: 35930344 PMCID: PMC9391970 DOI: 10.2196/39280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background Improving preconception health can benefit all women, their children, and their families regardless of their individual pregnancy intentions. Rapidly increasing access to information technology and online engagement have created opportunities to use digital health resources to engage with preconception women regarding lifestyle behaviors. Objective This study explores how preconception women engage with digital health resources and online platforms to inform the design and development of a digital health resource to support women to make positive behavior change for their preconception health. Methods This codesign research followed the Double Diamond process, which focuses on contextualization and explorative processes in phase 1 and ideation and development processes in phase 2. Phase 1 is reported on in this study and was undertaken via a series of 1-on-1 in-depth interviews with female participants (N=12) aged 18-45 years over 3 months. Interviews were designed to explore participants’ lived experiences in relation to their health and desired supports for healthy lifestyle behaviors. The first interview focused on participants’ perceptions of health and health behaviors, the second interview focused on social connections for health, and the third interview focused on digital health information and supports. Conversations from the first interview informed the development of the second interview, and conversations from the second interview informed the development of the third interview. Community advisors (N=8) met to provide feedback and advice to the researchers throughout the interview process. Qualitative analyses of transcripts from interviews were undertaken by 2 researchers before a deductive process identified themes mapped to the capability, opportunity, motivation, and behavior (COM-B) framework. Results In total, 9 themes and 8 subthemes were identified from 124 codes. In relation to digital health resources, specifically, participants were already engaging with a range of digital health resources and had high expectations of these. Digital health resources needed to be easy to access, make women’s busy lives easier, be evidence based, and be reputable. Social connectedness was also highly important to our participants, with information and advice from peers with similar experiences being preferred over yet more online health information. Online communities facilitated these social interactions. Participants were open to the idea of chatbots and virtual assistants but acknowledged that they would not replace authentic social interactions. Conclusions Codesigned digital health resources should be evidence based, reputable, and easy to access. Social connections were considered highly important to women, and designers of digital health resources should consider how they can increase opportunities for women to connect and learn from each other to promote health behaviors.
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Affiliation(s)
- Ruth Elizabeth Walker
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Sara Quong
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | | | - Ling Wu
- Action Lab, Monash University, Clayton, Australia
| | - Jue Xie
- Action Lab, Monash University, Clayton, Australia
| | - Jacqueline Boyle
- Eastern Health Clinical School, Monash University, Box Hill, Australia
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Schlegel EC, Smith LH. Improving Research, Policy, and Practice to Address Women's Sexual and Reproductive Health Care Needs During Emerging Adulthood. Nurs Womens Health 2021; 25:10-20. [PMID: 33453156 PMCID: PMC8549865 DOI: 10.1016/j.nwh.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/11/2020] [Accepted: 10/01/2020] [Indexed: 11/24/2022]
Abstract
Women in the period of emerging adulthood (18-25 years of age) have the greatest rates of unintended pregnancy and sexually transmitted infections. Despite this disproportionate risk, women's sexual and reproductive health needs during emerging adulthood are poorly understood. As a result, few age-specific policies or person-centered practice guidelines are available to reduce sexual risk. In this commentary we explore the unique characteristics of emerging adulthood that contribute to greater sexual and reproductive health risks for women. Current evidence on sexual and reproductive health outcomes of women during emerging adulthood and limited practice guidelines are discussed. Recommendations for health care providers, especially nurses, for guiding personalized care for women in emerging adulthood are discussed.
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Hürter H, Vontelin van Breda S, Vokalova L, Brandl M, Baumann M, Hösli I, Huhn EA, De Geyter C, Rossi SW, Lapaire O. Prevention of pre-eclampsia after infertility treatment: Preconceptional minimalisation of risk factors. Best Pract Res Clin Endocrinol Metab 2019; 33:127-132. [PMID: 31130446 DOI: 10.1016/j.beem.2019.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although an increased risk of pre-eclampsia in pregnancies conceived after infertility treatment has been reported, it remains unknown whether preconceptional minimalisation of known risk factors would help in preventing pre-eclamsia. Obesity and preconceptional blood pressure are discussed as major risks for the development of pre-eclampsia and low doses of aspirins, folic acid, statins and metformin are discussed as potential preventive treatments to decrease the risk of pre-eclampsia. In the present review we discuss whether present-day reproductive medicine could progress towards complication-free pregnancy.
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Affiliation(s)
- Hanna Hürter
- Department of Obstetrics, University Women's Hospital, University of Basel, Basel, Switzerland
| | | | - Lenka Vokalova
- Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland
| | - Marlene Brandl
- Department of Obstetrics, University Women's Hospital, University of Basel, Basel, Switzerland
| | - Marc Baumann
- Department of Obstetrics and Gynaecology, University Hospital Bern, Bern, Switzerland
| | - Irene Hösli
- Department of Obstetrics, University Women's Hospital, University of Basel, Basel, Switzerland; Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland
| | - Evelin Annegret Huhn
- Department of Obstetrics, University Women's Hospital, University of Basel, Basel, Switzerland; Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland
| | - Christian De Geyter
- Reproductive Medicine and Gynecological Endocrinology (RME), University Hospital, University of Basel, Vogesenstrasse 124, 4031, Basel, Switzerland; Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland
| | - Simona W Rossi
- Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland
| | - Olav Lapaire
- Department of Obstetrics, University Women's Hospital, University of Basel, Basel, Switzerland; Department of Biomedicine (DBM), University Hospital, University of Basel, Basel, Switzerland.
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Assibey-Mensah V, Fabio A, Mendez DD, Lee PC, Roberts JM, Catov JM. Neighbourhood assets and early pregnancy cardiometabolic risk factors. Paediatr Perinat Epidemiol 2019; 33:79-87. [PMID: 30632180 PMCID: PMC6353674 DOI: 10.1111/ppe.12531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prepregnancy cardiometabolic risk factors are associated with increased risks of adverse pregnancy outcomes. Neighbourhood features may reflect prepregnancy exposures that contribute to poor cardiometabolic health before pregnancy and may contribute to racial disparities in pregnancy outcomes. METHODS Early pregnancy measurements from 1504 women enrolled in the Prenatal Exposures and Preeclampsia Prevention study were linked to a 2000 Census-based measure of neighbourhood socio-economic status and commercial data (food, alcohol, and retail density) during 1997-2001. Multilevel random-intercept linear regression was used to separately estimate the association between levels of neighbourhood assets (low, mid-low, mid-high, high) and C-reactive protein (CRP), systolic blood pressure (SBP), and body mass index (BMI) in cross-sectional analyses. Low neighbourhood assets have high-poverty/low-retail, whereas high neighbourhood assets have low-poverty/high-retail. Models were adjusted for individual-level factors (age and race), and we assessed effect modification by race. RESULTS Low compared with high neighbourhood assets were associated with higher BMI (β 1.95 kg/m2 , 95% CI 0.89, 3.00), after adjusting for individual-level covariates. After adjusting for BMI and other covariates, low compared with high assets were associated with higher CRP concentrations (β 0.20 ng/mL, 95% CI 0.01, 0.39). Neighbourhood assets were not associated with SBP. Race did not modify the association between neighbourhood assets and cardiometabolic risk factors. CONCLUSIONS Early pregnancy adiposity is related to neighbourhood features independent of individual factors. Further, inflammation beyond accounting for adiposity is related to neighbourhood features. Strategies that address neighbourhood assets during preconception and interconception may be promising approaches to improve prepregnancy health.
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Affiliation(s)
- Vanessa Assibey-Mensah
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA,Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA
| | - Anthony Fabio
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
| | - Dara D. Mendez
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA,University of Pittsburgh, Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, PA USA
| | - Pei-Chen Lee
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA,Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - James M. Roberts
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA,Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA USA
| | - Janet M. Catov
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA USA,Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA USA,Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health Pittsburgh, PA USA
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Henriques A, Azevedo A. A biopsychosocial approach to the interrelation between motherhood and women's excessive weight. Porto Biomed J 2016; 1:59-64. [PMID: 32258551 DOI: 10.1016/j.pbj.2016.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/16/2016] [Indexed: 12/26/2022] Open
Abstract
Portugal is characterized by a high prevalence of overweight and obesity among women, whose weight increases most rapidly in early adulthood. Individual genetic features and behaviours, along with social, cultural and environmental factors interact in complex relationships with body weight and with its variation throughout time. Motherhood may trigger an increase in weight, potentially influencing the associations between excessive weight and several other health determinants. Taking into account the quality of prenatal care within Portugal's health care system, regarding coverage and success in improved outcomes, we theoretically demonstrate why pregnancy and motherhood should be seen as opportunities for prevention and why a deeper knowledge about the interplay of biological, social and psychological determinants of weight at this stage of life can be useful to design more effective weight control interventions towards this population.
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Affiliation(s)
- Ana Henriques
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana Azevedo
- Epidemiology Research Unit (EPIUnit) - Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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Nekuei N, Kazemi A, Hasanzadeh A. Preconception interventions in infertile couples. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2014; 3:101. [PMID: 25250367 PMCID: PMC4165121 DOI: 10.4103/2277-9531.139683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Preconception interventions in infertile couples can increase the chance of pregnancy and lower its complications. The success in infertility treatment and achieving a successful pregnancy is of great importance among infertile couples compared to others. This study has tried to investigate necessary preconception interventions before beginning of infertility treatment cycle among infertile couples. MATERIALS AND METHODS This is a cross-sectional study of 268 individuals presenting to fertility clinics (Moshtagh and Shahid beheshty) across the city of Isfahan, Iran. Simple sampling method was used. Questionnaire and patients' medical records were used to collect data. Descriptive and analytic statistical methods and SPSS software were used for analysis. RESULTS The results showed that the interventions related to diseases treatment and prescription of folic acid before the beginning of infertility treatment were complete for most of the subject (47.06% and 79.9% respectively), but referral for genetics counseling had not been conducted in most of the cases (98.9%). Specific interventions in relation with the infertility treatment before beginning the treatment cycle had been conducted in 50% of the subjects. CONCLUSION The results of this study showed a weakness concerning necessary preconception interventions before beginning of infertility treatment cycle in most of the studied subjects. With regard to the effect of preconception interventions on outcome of infertility treatment, and with consideration of high importance of pregnancy success in infertile couples, paying more attention to conduct this manner is necessary.
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Affiliation(s)
- Nafisehsadat Nekuei
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan, Iran
| | - Akbar Hasanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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