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1.
Sahar Ghale Askari Masomeh Khatbasreh Mohammad Hassan Ehrampoush Mohammad Hassan Sheikhha Hadi Eslami Mahmoud Taghavi Samira Shahrokhi Sodeh Andishmand 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e204-e209
Problem
The process of industrialization and lifestyle changes have gradually exposed human ?societies to a larger number of environmental risk factors, which may cause hormonal ?abnormalities and congenital anomalies.Background
The current study aimed to investigate the relationship ?between environmental factors and hormonal abnormalities among pregnant women in Yazd, ?Iran.Methods
A hundred participants were randomly selected from among a group of pregnant women. According to the screening tests (AFP, free β-?HCG, uE3, PAPP-A, and inhibin-A) performed at the genome clinic in Yazd in 2016, the risk of Down Syndrome (DS) was sufficiently high in this group of pregnant women from which the participants were selected. A ?questionnaire was used to collect data on the degree of the participants’ exposure to pesticides ?at home, use of canned and fast foods, and consumption of greenhouse fruits. The collected data were ?analyzed by One-way ANOVA and Kruskal–Wallis Test.Findings
The mean of Multiple of Median (MoM) for inhibin-A was significantly higher among pregnant ?women who often or always used pesticides at home (p = 0.047). The mean MoM ?for free β-HCG was significantly higher among pregnant women who often or always used canned ?foods (p = 0.024). Finally, the mean MoM for uE3 (1.85 ± 1.30) was significantly higher among ?pregnant women who never consumed greenhouse fruits (p = 0.003).Conclusion
It can be concluded that it is possible to reduce environmental exposures affecting hormonal abnormalities among pregnant women by improving nutritional patterns, minimizing the use of pesticides at home, and reducing the intake of canned foods and greenhouse fruits. 相似文献2.
Amelia Lee Michelle Newton Jessica Radcliffe Regina Belski 《Women and birth : journal of the Australian College of Midwives》2018,31(4):269-277
Background
Dietary intake of pregnant women do not appear to meet the dietary recommendations. Nutrition knowledge and practices of pregnant women and their antenatal care clinicians are factors that may be influential on dietary intakes of pregnant women.Aim
To assess and compare pregnancy nutrition recommendation knowledge and to explore how nutrition knowledge impacts on food choices in pregnant women and nutrition education practices of antenatal care providers.Methods
An explanatory sequential research mixed methods study design was applied. All participants were recruited from a metropolitan maternity hospital in Melbourne, Australia. The first phase assessed pregnancy nutrition knowledge and sources of nutrition information using a questionnaire (n = 202) then followed semi-structured interviews with women and clinicians (n = 31).Findings
The clinicians obtained significantly higher nutrition scores than compared to women, however, nutrition knowledge gaps were highlighted for both women and clinicians. Women reported receiving limited nutrition advice, a reflection of the clinicians reporting they provided limited nutrition advice.Conclusion
A key challenge for women adhering to dietary recommendations was having inadequate knowledge of the dietary recommendations and receiving limited information from their care providers. Similarly, as well as time constraints, limited nutrition knowledge and a lack of nutrition training impacted on the capacity of clinicians to provide adequate nutrition education. 相似文献3.
Paula Olsen Moira Williamson Victoria Traynor Chris Georgiou 《Women and birth : journal of the Australian College of Midwives》2018,31(1):31-37
Objective
To perform a pilot project to determine if this research design was appropriate to explore potential causal relationships between oral probiotic use and vaginal Group B Streptococcal (GBS) colonisation rates in pregnant women.Method
Thirty-four GBS-positive women at 36 weeks pregnant were recruited. The participants were randomly allocated to the control group, who received standard antenatal care, or to the intervention group, who received standard antenatal care and a daily oral dose of probiotics for three weeks or until they gave birth. A vaginal GBS swab was collected three weeks post consent or during labour.Findings
No significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n = 16), also showed no significant difference in vaginal GBS when compared to the control. The findings did show significantly more vaginal commensals in the probiotics group (p = 0.048).Discussion
Five possible reasons for the lack of significant results are: the length of the intervention was too short; the dosage of the probiotics was too low; the wrong strains of probiotics were used; the sample size was inadequate; or oral probiotics are ineffective in impacting vaginal GBS.Implications
The finding of a significant increase of vaginal commensals in women who completed 14 days or more of probiotics supports the potential of probiotics to impact vaginal GBS in pregnancy. 相似文献4.
Marjon De Roose Dimitri Beeckman Katrijn Eggermont Elke Vanhouche Ann Van Hecke Sofie Verhaeghe 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e197-e203
Problem
To date, it is unclear which factors are associated with parenting stress.Background
There are no studies investigating the association between parenting stress and coping strategies such as coparenting and social support, while simultaneously considering demographic and obstetric factors, in mothers of singletons and twins.Aim
To investigate if parenting stress is associated with personal, and obstetric characteristics, the level of coparenting, and the availability of and satisfaction with social support in mothers of singletons and twins until one year postpartum.Methods
A cross-sectional study was conducted. A total of 151 singleton mothers and 101 twin mothers were included.Results
Both singleton and twin mothers experiencing lower parenting stress levels indicated a better coparenting relationship quality (β = ?0.253, p < 0.01; β = ?0.341, p = 0.001). Elevated parenting stress levels positively influenced the level of satisfaction with social support in only mothers of twins (β = 0.273, p < 0.01). The availability of social support, personal, and obstetric characteristics were not associated with the level of parenting stress in neither singleton nor twin mothers.Conclusion
Coparenting seems to be a significant coping strategy reducing the level of parenting stress in singleton and twin mothers, irrespective of their personal and obstetric characteristics. Large-scale longitudinal research is needed to identify predictors of parenting stress, which may help to develop parenting stress reducing interventions. The acknowledgement and support of an adequate coparenting relationship quality by health care professionals might be an important factor to include in such interventions. 相似文献5.
Karen Matvienko-Sikar Samantha Dockray 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e111-e118
Problem
Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being.Background
Mindfulness and gratitude based interventions consistently demonstrate benefits in diverse populations. Interventions integrating these constructs have potential to improve psychological and physiological health during pregnancy.Aim
The aim of this pilot study is to examine the effect of a novel gratitude and mindfulness based intervention on prenatal stress, cortisol levels, and well-being.Methods
A pilot randomised controlled trial was conducted with 46 pregnant women. Participants used an online mindfulness and gratitude intervention 4 times a week for 3 weeks. Measures of prenatal stress, salivary cortisol, gratitude, mindfulness, and satisfaction with life were completed at baseline, 1.5 weeks later, and 3 weeks later.Findings
Intervention participants demonstrated significant reductions in prenatal stress in comparison to the control condition (p = .04). Within subjects reductions in waking (p = .004) and evening cortisol (p > .001) measures were observed for intervention participants. Significant effects were not observed for other well-being outcomes.Discussion
Reducing self-report and physiological stress in pregnancy can improve maternal and infant outcomes. The findings of this pilot study indicate potential direct effects of the intervention on self-reported stress in comparison to a treatment-as-usual control. Effects on a biomarker of stress, cortisol, were also observed within the intervention group.Conclusion
A brief mindfulness and gratitude based intervention has the potential to reduce stress in pregnancy. Future research is needed to further explore mechanisms and potential benefits of such interventions. 相似文献6.
7.
Shahnaz Torkzahrani Fatemeh Mahmoudikohani Kiarash Saatchi Reyhaneh Sefidkar Mojdeh Banaei 《Women and birth : journal of the Australian College of Midwives》2017,30(1):46-50
Background
Induction of labor is a common obstetric procedure. Acupressure is a natural method that is used for inducing uterine contractions. Nevertheless, few studies have examined the impact of acupressure on the induction of labor.Aim
The aim of this study was to evaluate the effect of acupressure on the initiation of labor.Material and methods
In this randomized clinical trial, 162 nulliparous pregnant women were admitted to the hospital. They were categorized into 3 groups; acupressure, sham acupressure and control. Acupressure points SP6, BL 60 and BL 32 were pressured bilaterally. The intervention was done by the researcher every other day between 9 am and 11 am. The intervention was carried out on women in the afternoon and the following day. Subjects were examined to determine the initiation of labor symptoms48 and 96 h after the start of intervention and at the time of hospitalization. Data were analyzed using the ANOVA, Kruskal–Wallis and Chi-square tests (p < 0.05).Results
There was no significant difference among the groups for spontaneous initiation of labor within 48 h (P = 0.464), and 49–96 h after beginning the intervention (P = 0.111) and 97 h after beginning the intervention to the time of hospitalization for the spontaneous initiation of labor (P = 0.897). There were no significant differences in the secondary outcomes between the groups.Conclusion
According to the finding of this study, it seems that acupressure treatment was not effective in initiating labor as compared with the sham acupressure and the routine care groups. 相似文献8.
Iva Sklempe Kokic Marina Ivanisevic Gianni Biolo Bostjan Simunic Tomislav Kokic Rado Pisot 《Women and birth : journal of the Australian College of Midwives》2018,31(4):e232-e238
Problem
Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child.Aim
To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus.Methods
Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30 min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50–55 min.Findings
The experimental group had lower postprandial glucose levels at the end of pregnancy (P < 0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P = 0.035).Conclusion
The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy. 相似文献9.
Adriana Amorim Francisco Sonia Maria Junqueira Vasconcellos De Oliveira Mary Steen Moacyr Roberto Cuce Nobre Eder Viana De Souza 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e334-e340
Background
Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy.Aims
To evaluate if a 10 min ice-pack application relieved postpartum perineal pain and if the analgesic effect was maintained for up to 2 h.Methods
A randomised controlled trial conducted from December 2012 to February 2013 with 69 primiparous women ≥18 years old, 6–24 h postpartum, with perineal pain ≥3, who had not received anti-inflammatory medication or analgesics after childbirth, who were randomised to a single ice-pack application on the perineum for 10 min or standard care. The primary and secondary outcomes were a reduction ≥30% in perineal pain intensity, immediately after the application and the maintenance of the analgesic effect for up to 2 h, respectively.Findings
Immediately post-intervention, the proportion of women whose perineal pain decreased ≥30% was significantly higher in the experimental group. Within 2 h, there was no significant difference in the pain levels in both groups. Within 2 h, for 61.9% and 89.3% of women in the experimental and control group, respectively, the perineal pain levels remained unchanged. For the remaining participants, perineal pain was increasing after an average time of 1 h 45 min and 1 h 56 min for the experimental and control groups, respectively.Conclusion
By applying an ice-pack for 10 min to the perineum, effective pain relief is achieved, that is maintained for between 1 h 45 min and 2 h. 相似文献10.
Ying Zhao Michelle L. Munro-Kramer Shenxun Shi Jing Wang Xinli Zhu 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e395-e402
Background
Information is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need.Aim
The goal of this study was to examine whether women’s perinatal depression scores change across the perinatal period and evaluate risk factors associated with postnatal depression at 6-weeks after delivery.Methods
A sample of 167 Chinese pregnant women with medically defined complications and an Edinburgh Postnatal Depression Scale ≥ 9 and/or a Postpartum Depression Screening Scale ≥ 60 were followed throughout early pregnancy (<28 weeks), late pregnancy (>28 weeks), 3-days and 6-weeks after delivery.Findings
Repeated measures analysis of variance showed that there were significant differences on the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale scores at each time point between high-risk depressed and low-risk depressed groups. Binary logistic regression indicated a significant association between postnatal depression at 6-weeks after delivery and depression in late pregnancy and 3-days after delivery, postnatal stress events, postnatal complications, and concerns about the fetus.Conclusions
Postnatal depression is a common condition with limited research among Chinese pregnant women with medically defined complications. Additional research is warranted to develop strategies to identify high-risk depressed pregnant women as well as effective treatment options during the perinatal period. 相似文献11.
12.
Kathleen M. Baird Amornrat S. Saito Jennifer Eustace Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(4):285-291
Background
Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills.Aim
To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period.Method
A pre-post intervention design was used. Midwives and nurses (n = 154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants’ perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016.Findings
Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5–25.6 (Z = ?9.56, p < 0.001) and level of preparedness increased from 40.8 to 53.2 (Z = ?10.12, p < 0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV.Conclusions
Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training. 相似文献13.
Robin S. Cronin Minglan Li Kate Culliney Robyn Maude Katherine Nelson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):422-429
Background
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.Aim
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.Methods
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.Findings
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.Conclusions
Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education. 相似文献14.
15.
Roianne West Somer Wrigley Kyly Mills Kate Taylor Dale Rowland Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2017,30(3):236-244
Background
Midwives have a central role in closing the gap in health inequalities between Australias’ First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) identifies five core cultural capabilities (respect, communication, safety and quality, reflection and advocacy) to foster culturally safe health care.Aim
To use a decolonising, First Peoples-led approach to develop and validate a tool to measure the development students’ cultural capabilities.Method
A pre- post intervention design was used. Development of the Cultural Capability Measurement Tool followed a staged process which centred on First Peoples’ knowledges. This process included: item generation, expert review; a pilot, test-retest; and psychometric testing (reliability, factor analysis and construct validity). All third year midwifery students (n = 49) enrolled in a discrete First Peoples health course were invited to complete the survey pre and post course.Findings
A response rate of 77.5% (n = 38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated good internal reliability (Cronbach alpha = .89–.91). Principal component analysis with varimax rotation produced a five-factor solution. A paired samples t-test revealed a significant increase from pre-course (mean 93.13, SD 11.84) to post-course scores (mean = 100.53, SD 7.54) (t (14) = ?2.79, p = .014).Conclusion
A First Peoples approach was critical to tool development and conceptual validity. The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities of The Framework. The draft tool appears suitable for use with midwifery students. 相似文献16.
Joyce C.S. Camargo Vitor Varela Fernanda M. Ferreira Lucila Pougy Angela M. Ochiai Maria Elisabete Santos Maria Catarina L.R. Grande 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e325-e333
Introduction
The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital.Methods
A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data.Background
The Apgar score (at 1 min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning.Results
The mean water immersion time was 1 h and 46 min and had an influence on the duration of labour (mean 5 h and 37 min), with a statistically significant difference (P = 0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9).Conclusion
These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women. 相似文献17.
18.
Arndt Büssing Undine Waßermann Niels Christian Hvidt Alfred Längler Michael Thiel 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e89-e98
Background
Spirituality is part of the basic needs of all humans, yet often undervalued by health professionals. Less is known about the spiritual needs of mothers of preterm or sick new born children.Aim
Identify unmet psychosocial and spiritual needs of these mothers, and to relate these needs to their perceived stress and impairments of life concerns.Methods
Anonymous cross-sectional survey with standardized instruments (e.g., Spiritual Needs Questionnaire) among 125 mothers of two paediatric departments in Germany.Findings
Mothers felt supported by their partner and hospital staff, and hospital staff assured 82% of them that they must not worry about their child’s prognosis. They nevertheless did have specific unmet spiritual needs. Religious Needs and Existentialistic Needs scored lowest, while Giving/Generativity Needs were of moderate and Inner Peace Needs of strongest relevance. With respect to the expected diagnosis and prognosis of their child, there were no significant differences for their secular spiritual needs scores, but significant differences for Religious Needs which scored highest in mothers with children having an unclear prognosis (F = 8.6; p = .004). Particularly Inner Peace Needs correlated with their stress perception (r = .34), impairments of life concerns (r = .25) and grief (r = .23).Discussion
Mothers of sick born/premature children felt supported by the hospital team and their partner, but nevertheless experienced stress and daily life impairments, and particularly have unmet Inner Peace Needs.Conclusions
Addressing mothers’ specific needs may help support them in their struggle with their difficult situation avoiding fears and insecurity and thus facilitating positive bonding to their child. 相似文献19.
Jennifer Fenwick Mary Sidebotham Jenny Gamble Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(1):38-43
Background
Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.Aim
To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.Method
Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n = 862) was divided into two groups; midwives working in continuity (n = 214) and those not working in continuity (n = 648). Mann Whitney U tests were used to compare the groups.Results
The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p = .002; CBI Work p < .001; CBI Client p < .001) and Anxiety (p = .007) and Depression (p = .004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p < .001) and the Skills and Resources subscale (p = .002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.Conclusion
Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward. 相似文献20.
Ronit Gilad Hagit Hochner Bella Savitsky Shay Porat Drorith Hochner-Celnikier 《Women and birth : journal of the Australian College of Midwives》2018,31(1):e26-e31