BMC Pregnancy and Childbirth最新文献

Background: Nursing is a high-stress profession frequently marked by demanding workplace conditions. Pregnant nurses, in particular, face heightened pressure to balance work and family responsibilities while maintaining their professional obligations throughout pregnancy. Adjusting to the physical, emotional, and occupational challenges of pregnancy is a complex process with important implications for both maternal well-being and fetal development. This study aims to explore the factors that influence how pregnant nurses adjust to continuing to deliver nursing care during this critical period.

Methods: This study utilized the qualitative content analysis method proposed by Graneheim and Lundman. Eighteen participants were selected between May 2023 and August 2024 from healthcare centers affiliated with Semnan University of Medical Sciences, Iran, including fourteen pregnant nurses and four nursing managers (two head nurses and two supervisors). Based on the study's central research question, data collection tools included in-depth semi-structured interviews, field observations, and field notes. To ensure rich and comprehensive data, the study aimed to achieve maximum variation in age, educational level, work departments, and different stages of pregnancy. Data management was conducted using MAXQDA software, version 2020.

Results: Data analysis yielded three themes, including "Health Concerns," "Thoughts and Past Experiences," and "Workplace Tensions in the Nursing Profession," comprising seven categories and twenty-two subcategories.

Conclusion: Pregnant nurses' adjustment is influenced not only by pregnancy-related factors such as workplace conditions, fetal health, and the physical and mental well-being of the mother, but also by past personal experiences. Identifying and understanding the factors affecting pregnant nurses' adjustment and designing a mandatory training for all managers on Iranian pregnancy labor laws enables nursing managers to reduce occupational stressors. These programs could be directed toward creating a system of non-reciprocal behaviors, voluntary shift swaps for pregnant staff, and the reassignment of high-risk nurses with physical and psychological problems. Such initiatives may improve nurses' adjustment during pregnancy, the quality of patient care, and the health of both mother and fetus.

Background: Pelvic floor disorders, often resulting from muscle damage during pregnancy and childbirth, are a global health concern. Even though pelvic floor muscle exercises are recommended to alleviate discomfort, there is a significant lack of knowledge and practice among pregnant women in Ethiopia.

Objective: To assess knowledge and practice of antenatal pelvic floor muscle exercise and its associated factors among pregnant women attending antenatal care at Jimma zone public hospitals, southwest Ethiopia, 2024.

Method: An institution-based, cross-sectional study was conducted at public hospitals in the Jimma Zone from January 1 to March 1, 2024. Trained data collectors employed systematic random sampling for the selection of 422 participants involved in the study. The study used bivariate and multivariable logistic regression to assess associations between dependent and independent variables, considering P-values less than 0.05 as statistically significant.

Result: Out of the total study participants, 32.0% (95%CI: 27.5-36.5) had good knowledge of pelvic floor muscle exercises, and 9.5% (95%CI: 6.6-12.6) had good practice of these exercises. Knowledge of pelvic floor muscle exercises was statistically associated several factors: age (AOR = 2.61; 95% CI: 1.05, 6.48), educational status (AOR = 4.83; 95% CI: 1.72, 13.53), residence (AOR = 2.56; 95% CI: 4.76, 26.52), gravidity (AOR = 4.78; 95% CI: 2.25, 10.16), and previous cesarean section (AOR = 6.15; 95% CI: 2.46, 15.36). Similarly, the practice of pelvic floor muscle exercises was found to be statistically associated with educational status (AOR = 4.37; 95%CI: 1.53, 12.49), residence (AOR 3.76; 95%CI: 1.69, 8.36)), gravidity (AOR 2.6; 95% CI: 1.1, 6.39), and previous cesarean section (AOR 2.86; 95%CI: 1.34, 6.1).

Conclusion and recommendations: A small proportion of pregnant women had good knowledge and practice of pelvic floor muscle exercises. Knowledge of these exercises was significantly associated with age, educational level, residence, gravidity, and previous history of cesarean section. Similarly, the practice of these exercises was significantly associated with educational level, residence, gravidity, and previous history of cesarean section. Therefore, future studies should consider using qualitative or mixed methods research designs to explore antenatal exercise from various perspectives.

Background: Our study aims to compare the differences in gut fungal community structure between pregnant women with gestational diabetes mellitus (GDM) and healthy pregnant women at 24-28 weeks of gestation, and to explore the correlation between differential fungi, clinical indicators and adverse pregnancy outcomes.

Methods: We selected 96 pregnant women with GDM and 92 healthy pregnant women, all of whom had established prenatal care records at Hangzhou Women's Hospital, and assigned them to the case group and the control group respectively. Fecal samples were collected from all participants at 24-28 weeks of gestation and sequenced using ITS rRNA gene sequencing. We then compared the fungal community characteristics between the two groups, screened for differential fungi between the groups, analyzed their association with clinical indicators, and further explored influencing factors for adverse pregnancy outcomes.

Results: There were significant differences in gut fungal characteristics and clinical indicators between pregnant women with GDM and the healthy group. Compared with the healthy group, the α-diversity (including the Shannon, Simpson index, etc.) of gut fungi in pregnant women with GDM was decreased (P < 0.01). There were differential changes in the community structure. At the genus level, Candida contributed to the clustering analysis of pregnant women with GDM and was positively correlated with glucose metabolism indicators, whereas eight genera including Saccharomycopsis, Aspergillus, Penicillium and Pichia were more enriched in the gut of healthy pregnant women. To accurately identify the key fungi in the two groups, a random forest algorithm was used in the study for ranking. In addition, Spearman's correlation analysis revealed a significant correlation between the differential fungi and clinical indicators. Additionally, logistic multivariate regression analysis revealed that intestinal Saccharomyces acted as an independent protective factor against adverse pregnancy outcomes in pregnant women with GDM (OR = 0.206, 95CI%: 0.046-0.916, P = 0.038).

Conclusions: Pregnant women with GDM in the second trimester of pregnancy exhibit intestinal fungal dysbiosis. This dysbiotic state is associated with abnormal pregnancy-related clinical indicators and is also closely correlated with a significant increase in the risk of adverse pregnancy outcomes.

Background and objectives: In India, like most countries, the COVID-19 pandemic in successive waves severely hampered the emergency medical services (EMS) and the government made prompt interventions, including substantial investments in both EMS and maternal health care immediately after the first wave. The study assessed variations in EMS efficiency and critical perinatal outcomes between the pre-pandemic era and the post pandemic-resilient phase in 2023 and 2024.

Data and methods: The study analysed the key EMS metrics based on the calls related to pregnancy, including call volume, response and transfer time, hospital handoff time and ambulance travel distance, and important maternal-newborn health outcomes such as maternal and neonatal mortalities, home deliveries, institutional childbirths, C-section deliveries, miscarriages and complicated vaginal births. The data relied upon encompasses the period from January 2017 to December 2024, including eight pandemic phases in 2020-22 and the resilient period of 2023 and 2024, obtained from the Tamil Nadu 108 Ambulance Control Room. A time series analysis method evaluated the EMS metrics in various pandemic phases; a statistical comparison was made with the pre-pandemic period for maternal-newborn outcomes. The appropriate effect size metric quantified the change in both analyses.

Results: In the pandemic phases, despite an increase in pregnancy related call volume, the EMS metrics such as response times, transfer times and hospital handoff times witnessed notable improvement. The maternal and childbirth outcomes, especially in the post-pandemic and resilient phases during 2023-24, were markedly superior when compared with the corresponding period in the pre-pandemic era. In particular, the maternal mortality rate reduced by 19%, with 37 deaths per 100,000 live births. This is far lower than the national average of 97 deaths per 100,000 live births. Also, the rates of infant death, neonatal death, miscarriage, difficult vaginal births, and home births went down by 19.35%, 17.03%, 28.02%, 19.23%, and 36.05%, respectively.

Conclusions: Government investments during the pandemic, along with the sustained focus on maternal health programmes, appear to have provided substantial support to pregnant women and newborns. The reproductive health of women in Tamil Nadu does not seem to have been undermined by the pandemic.