Pregnancy is a critical period in every woman's life. The health of both the mother and her unborn child is at stake, with poor access to needed prenatal care services. Obtaining prenatal care is affected by the pregnancy literacy of the expectant mother. However, the assessment tool for health literacy among Filipino pregnant women is limited. This paper aimed to examine existing maternal health literacy instruments. Hopefully, an adopted tool can be found for assessing prenatal health literacy. After examining existing maternal health literacy tools, 18 questions were suggested that can be further modified before they are used for Filipino pregnant women to assess their prenatal health literacy.
Human ; Female ; Prenatal Care ; Pregnant Women

Objective: Exploring the mediating effect of perceived social support between the maternal personality traits and pregnancy-related anxiety. Methods: Singleton pregnant women who underwent antenatal checkups in the obstetrics department of general hospital affiliated to Ningxia Medical University from July to December 2021 were enrolled in this study to investigate perceived social support, pregnancy-related anxiety and conscious personality traits. Pearson correlation analysis was used to analyze the association between the maternal personality traits, perceived social support, and pregnancy-related anxiety, and the mediating effect of perceived social support was analyzed using Bootstrap method. Results: A total of 1 259 subjects were included in the study, of which 170 (13.50%) pregnant women felt introverted. The total score of perceived social support was (46.37±8.38), and 31.45% of pregnant women had high perceived social support. The total score of pregnancy-related anxiety was (21.48±5.53). The score of worry about fetal health was (10.09±3.24), and 368 (29.23%) of pregnant women had pregnancy-related anxiety. Maternal personality traits and pregnancy-related anxiety were negatively correlated (r=-0.076, P<0.05) and positively correlated with perceived social support during pregnancy (r= 0.127, P<0.05). Perceived social support during pregnancy and pregnancy-related anxiety were negatively correlated (r=-0.236, P<0.05). Perceived social support partially mediated the relationship between the maternal personality traits and pregnancy-related anxiety, with a relative effect value of 37.50%. Conclusion: The maternal personality traits, level of perceived social support and pregnancy-related anxiety are all related. Perceived social support could mediate the relationship between the maternal personality traits and pregnancy-related anxiety.
Female ; Pregnancy ; Humans ; Anxiety ; Pregnant Women ; Personality ; Social Support ; Prenatal Care

Pregnancy ; Female ; Humans ; Mosaicism ; Prenatal Diagnosis ; Prenatal Care ; Aneuploidy

After the promulgation of the first edition of expert consensus on the application of chromosomal microarray analysis (CMA) technology in prenatal diagnosis in 2014, after 8 years of clinical and technical development, CMA technology has become a first-line diagnosis technology for fetal chromosome copy number deletion or duplication abnormalities, and is widely used in the field of prenatal diagnosis in China. However, with the development of the industry and the accumulation of experience in case diagnosis, the application of CMA technology in many important aspects of prenatal diagnosis, such as clinical diagnosis testimony, data analysis and genetic counseling before and after testing, needs to be further standardized and improved, so as to make the application of CMA technology more in line with clinical needs. The revision of the guideline was led by the National Prenatal Diagnostic Technical Expert Group, and several prenatal diagnostic institutions such as Peking Union Medical College Hospital were commissioned to write, discuss and revise the first draft, which was discussed and reviewed by all the experts of the National Prenatal Diagnostic Technical Expert Group, and was finally formed after extensive review and revision. This guideline is aimed at the important aspects of the application of CMA technology in prenatal diagnosis and clinical diagnosis, from the clinical application of evidence, test quality control, data analysis and interpretation, diagnosis report writing, genetic counseling before and after testing and other work specifications are elaborated and introduced in detail. It fully reflects the integrated experience, professional thinking and guidance of the current Chinese expert team on the prenatal diagnosis application of CMA technology. The compilation of the guideline for the application of CMA technology in prenatal diagnosis will strive to promote the standardization and advancement of prenatal diagnosis of fetal chromosome diseases in China.
Female ; Humans ; Pregnancy ; Asian People ; Chromosome Aberrations ; Chromosome Deletion ; Chromosome Duplication/genetics* ; DNA Copy Number Variations/genetics* ; Fetal Diseases/genetics* ; Genetic Counseling ; Microarray Analysis ; Prenatal Care ; Prenatal Diagnosis ; Practice Guidelines as Topic

Objective: To explore the key points for preventing and reducing severe pre-eclampsia (SPE) and its severe complications in the tertiary medical referral system of a second-tier city by analyzing the clinical characteristics of SPE. Methods: The clinical data of 341 patients with SPE who terminated pregnancy in Women and Children's Hospital, School of Medicine, Xiamen University, from January 1, 2020 to December 31, 2022 were retrospectively analyzed, and the pre-eclampsia (PE) risk factors, clinical characteristics and severe complications of SPE between the patients referred from primary hospitals (referral group) and the patients received regular prenatal care in the tertiary referral center (central group) were compared, as well as the influence of the referral timing on the maternal and perinatal outcomes. Results: Among the 341 cases of SPE, 92 cases were in the referral group and 249 cases were in the central group. (1) Analysis of PE risk factors: there was no statistical difference in the proportion of risk factors of PE between these two groups [75.0% (69/92) vs 71.9% (179/249); χ²=0.328, P=0.567]. (2) Analysis of clinical features: the gestational ages at the PE early warning factors onset, at the PE first symptom onset and at SPE diagnosed, pregnancy terminated and onset of SPE severe complications in the referral group were significantly earlier than those in the central group (all P<0.05), the proportions of terminating pregnancy before 32 weeks of gestation, between 32 and 34 weeks of gestation, intensive care unit (ICU), neonatal ICU hospitalization and fetal growth restriction in single pregnancies were higher than those in the central group, while the live birth rate was lower than that in the central group (all P<0.05). (3) Analysis of SPE severe complications: the rates of SPE severe complications in the referral group was higher than that in the central group [28.3% (26/92) vs 13.7% (34/249); χ²=9.885, P=0.002]. Among them, the rates of placental abruption [7.6% (7/92) vs 2.8% (7/249); χ²=3.927, P=0.048] and still birth [6.5% (6/92) vs 0.4% (1/249); χ²=9.656, P=0.002] in the referral group were significantly higher than those in the central group. (4) Analysis of referral timings: the timings included referral after onset of SPE severe complications (9.8%, 9/92), referral after SPE diagnosed (63.0%, 58/92), referral after detection of SPE early warning signs (20.7%, 19/92) and referral after detection of PE risk factors (6.5%, 6/92). The gestational ages at SPE diagnosed and pregnancy terminated in group of referral after onset of SPE severe complications and group of referral after SPE diagnosed were significantly earlier than those in group of referral after detection of PE early warning signs and group of referral after detection of PE risk factors (P<0.05). The earlier the referral, the higher the live birth rates (P<0.05). Conclusions: The tertiary referral center of the second-tier city plays an important role in reducing the maternal and perinatal damage of PE. The timing of referral in primary medical institutions is the key point of reducing the occurrence of SPE severe complications and maternal, perinatal damage of PE. It is necessary for medical institutions of all levels in all regions to improve the ability of early identification and early intervention for PE, to enhance the awareness of SPE and its severe complications prevention and control. Primary medical institutions should especially pay attention to raise the consciousness of PE risk factors and early warning signs, and to improve the ability of PE risk factors and early warning signs screening.
Infant, Newborn ; Child ; Pregnancy ; Female ; Humans ; Pre-Eclampsia/epidemiology* ; Retrospective Studies ; Tertiary Care Centers ; Placenta ; Prenatal Care ; Gestational Age ; Pregnancy Outcome/epidemiology*

Background: While COVID‑19 spreads rapidly around the world, innovative means to provide continuing prenatal care are being developed to monitor maternal and fetal health while minimizing disease transmission. Telemedicine is one platform by which patients are provided the necessary prenatal and postpartum care safely as the pandemic rages Aims and Objectives: To evaluate the acceptability of telemedicine in the delivery of prenatal and postnatal care in the setting of the COVID‑19 pandemic Materials and Methods: A cross‑sectional study was conducted in a tertiary hospital in Manila. A structured Likert scale‑based survey consisting of a model measuring telemedicine perception was utilized. This was a predeveloped model by Lin in 2017.[1] Descriptive statistical analysis and Chi‑square tests were done to evaluate the data Results: A total of 193 pregnant and postpartum patients participated in the study. Majority of the respondents were between 25 and 34 years old, living within Metro Manila, and normal obstetric patients who were previously seen at the outpatient department. Most of the participants considered telemedicine to be cost‑effective, reliable, easy to use, and useful Conclusion We conclude that telemedicine is an acceptable means of providing prenatal and postnatal care among pregnant patients because it allowed the necessary interaction between patient and doctor and these “users” kept on using the system. There was no association between telemedicine perceptions and patient age, place of residence, type of patient encounter, disease, and treatment. In the setting of the COVID‑19 pandemic, telemedicine is an acceptable means of providing prenatal and postnatal care regardless of patient characteristics
COVID‑19 ; Pandemics ; Postnatal Care ; Prenatal Care ; Telemedicine

BACKGROUND: The fetal growth charts in widest use in China were published by Hadlock >35 years ago and were established on data from several hundred of American pregnant women. After that, >100 fetal growth charts were published around the world. We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age (SGA). METHODS: For this retrospective observational study, we reviewed all pregnant women ( n  = 106,455) who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019. A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL). The differences between Shenzhen charts and published charts were quantified by calculating the Z -score. The impact of applying these published charts was quantified by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts. The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA (birthweight <10th centile) were assessed. RESULTS: Following selection, 169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed. When using Hadlock references (<3rd centile), the proportions of small heads and short femurs were as high as 8.9% and 6.6% in late gestation, respectively. The INTERGROWTH-21st standards matched those of our observed curves better than other charts, in particular for fat-free biometry (HC and FL). When using AC<10th centile, all of these references were poor at predicting neonatal SGA. CONCLUSIONS Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA. INTERGROWTH-21st standard appears to be a safe option in China. For fat-based biometry, AC, a reference based on the Chinese population is needed. In addition, when applying published charts, particular care should be taken due to the discrepancy of measurement methods.
Infant, Newborn ; Child ; Female ; Pregnancy ; Humans ; Growth Charts ; Prenatal Care ; Ultrasonography, Prenatal/methods* ; Fetal Development ; Fetal Growth Retardation ; Gestational Age ; Fetus ; China ; Infant, Newborn, Diseases ; Observational Studies as Topic

Background: Antenatal Care (ANC) is an essential mandatory preventive care service freely given to pregnant women by the Philippine government. Despite the available ANC services in the country, not all pregnant women still avail of the service. Objective: The study determined the socio-demographic profile of mothers, their ANC services utilization, and the different problems encountered during their antenatal care. Methods: A descriptive research design was used. Purposive sampling was employed to identify the population of the study: women of reproductive age, 18-45 years old, and who had a live birth for the last three years regardless of utilization, partial utilization, or non-utilization of ANC services. Mothers who were currently pregnant and had a history of abortion or stillbirth delivery were excluded from participation. Proportionate sampling was computed to get the sample size: 334 mothers from Iriga City and 392 from Tabaco City. The survey questionnaire was based on the ANC guidelines of the DOH. The statistical treatment used was frequency counting, percentage, and ranking in data analysis. Results: The mothers in Iriga City and Tabaco City were ages 23-27 years old who had 1-3 children, were single but living with partners, and in a nuclear type of family with 4-6 members, were unemployed/housewives, and belonged to a low-income family with >P7,890 family income. In Iriga City, the majority were high school graduates, while in Tabaco City, most were graduates of vocational courses; and elementary and high school undergraduates. There were excellent assessments for history-taking, physical examination, and care provisions in both cities, except for oral health care examination, tests for syphilis, stool examination, acetic acid wash, safe sex education, and oral health checkups and prophylaxis. The identified problems were financial constraints, lack of support system, busy taking care of the kids, sickness, forgetfulness, unwanted pregnancy, drunkard husband, difficult first trimester, bad attitude of midwives, nurses, doctors, and unequal treatment of poor patients. Conclusions Mothers in both cities were young adults with a low education level who lived with their partners in a poor small nuclear family. Not all ANC services were excellently utilized. Among these were the poor utilization of the tests for syphilis, stool, acetic acid wash; oral health care examination; safe sex education; and oral health checkups and prophylaxis. There were various problems that mothers encountered when seeking ANC services, the most common of which were financial and personal issues.
Prenatal Care

Female ; Humans ; Mosaicism ; Pregnancy ; Prenatal Care ; Prenatal Diagnosis ; Trisomy/genetics*

BACKGROUND: In ensuring access to maternal health services, various strategies toward safer health practices and improved health service delivery are important ingredients to eliminate avoidable maternal deaths. A recent household survey showed that access to antenatal care (ANC) (89%) and facility-based delivery (FBD) (82.4%) in the Eastern Visayas region is significantly high, despite the extensive damage to over 500 health facilities caused by Typhoon Haiyan in November 2013. Postpartum care (PPC), however, was relatively low (37.4%). As these findings needed further elaboration, a qualitative study using focus groups was conducted. METHOD: The focus groups method was utilized to elicit responses from the mothers, BHWs, and midwives to explain what contributed to the high ANC visits, high FBD, and low PPC. Sixteen focus groups were conducted in the local dialect (Waray and Cebuano), and all discussions were audio recorded. Focus groups data were transcribed and subsequently translated to English text, then reviewed and validated by socio-linguistic academics from the region. Other data sources included debriefing session reports and expanded field notes. Nvivo 10 software was used in the coding process and data management. The data analysis referred to the principles of thematic analysis. RESULTS: The findings showed that incentives in the form of free maternal services and cash grants drive mothers to go to the health facility for antenatal care and facility-based deliveries. The free services were provided by PhilHealth (the country's social health insurance), while cash grants were awarded through the government's conditional cash transfer program and other community partners. Mothers were provided with some financial risk protection through these financial incentives. The disincentives came in the form of local ordinances, which prohibited home births. Penalties included fines for both mother and birth attendant when the mother was found to deliver outside the health facility. The unintended stigma, shame, and fear that developed in response to these ordinances also deterred home births. The significantly low use of PPC services in the health facility was attributed to the lack of advices given to mothers regarding the need for follow up care after delivery. It is also noted that there are no incentives for PPC, which may contribute to its low rates. The role of the community health workers and midwives were to inform and educate the mothers on these incentives and disincentives. However, these incentives and disincentives are extrinsic motivators and are deemed insufficient to provide long-term impact. CONCLUSION AND RECOMMENDATIONS. The implementation of the incentives and disincentives in Eastern Visayas has increased rates of ANC and FBD. The presence of these in the current environment has initially facilitated behavior change, shifting home births to facility births. However, we argue that financial incentives, with a lack of intrinsic motivation, may be insufficient to sustain long-term impact. Disincentives, in the form of local ordinances, forced mothers instead to seek care in facilities. Such an approach may eventually become less effective over time. Incentives and disincentives are both demand-side factors, and to sustain change, concurrent improvements in the supply end need to be implemented. The capacity of facilities to absorb the increased demand should be in place to provide positive experiences for mothers in the health facilities.
Pregnancy ; Female ; Prenatal Care ; Postnatal Care ; Postpartum Period