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Fulltext Antenatal care (ANC) services utilization in maternal and child health (MCH) clinics of Kinabatangan (rural) and Sandakan (urban) of Sabah, Malaysia

Win SS, Aung S, Tha TO, Myint T, Awang Besar J, Yayaha Z

Malaysian Journal of Public Health Medicine, 2017;17(2):42-51.

This paper investigates the antenatal care (ANC) services utilization in currently pregnant women during their visits to maternal and child health (MCH) clinics of rural (Kinabatangan) and urban (Sandakan), Sabah. A community clinic based, cross-sectional descriptive study was performed. In total, 800 currently pregnant women attending two MCH clinics, from April to September 2012, were participated using tested set questionnaires. Descriptive analysis was used for background characteristics and chi-square analysis was applied to identify the rural-urban differences among the variables.In both study areas, previous births delivered by skilled birth personnel were same. In pregnant women from rural, less income, more grand-multiparity, earlier antenatal care booking, more frequent post-natal care, more use of contraception compared to those in urban. In comparison, urban pregnant women had more anti-tetanus toxoid injection in their previous pregnancies, past history of antenatal care for at least four times, increase in household members. As this study found the differences in ANC services utilization at Rural and Urban, further study is needed to explore concrete reasons for above findings. By delivering services according to the needs of all clients, irrespective of their place of residence, it will improve ANC services utilization in both areas of Sabah and hence will improve more on existing health status of the Nation.
Study site: Klinik Kesihatan, Kinabatangan and Sandakan, Sabah, Malaysia

Matched MeSH terms: Prenatal Care
Fulltext Patient perception of pre-pregnancy care and family planning among reproductive-age female diabetes mellitus patients in a primary care clinic in Penang, Malaysia

Leow SN, Tang WS, Pararajasingam RP, Ee WS

Malays Fam Physician, 2020;15(3):35-42.
PMID: 33329861

Introduction: Pre-pregnancy care (PPC) is an important part of diabetic care among females in the reproductive age group, as it improves feto-maternal outcomes.

Objective: We aimed to assess female diabetic patients' perception of PPC and family planning prior to PPC care.

Methods: This was an observational, cross-sectional survey performed from June 2019 to September 2019, using universal sampling of registered female diabetic patients who fit the inclusion criteria prior to integrated PPC care. A self-administered questionnaire was used to assess patients' perception of PPC.

Results: A total of 67 patients were recruited for the study. Only 39.4% (n=26) of the patients had heard of PPC. In our study, Code 1 contraception included those methods with a Pearl index of ≤9. Code 2 & 3 contraception included those methods with a Pearl index of >9. Only one-third of patients, 29.9% (n=20), were using Code 1 contraception, although the majority, 79.1% (n=53), felt that they had completed their family. 45 patients (68.2%) felt that they were at risk of developing complications if they were to become pregnant, and 46 patients (69.7%) felt that their health condition was not suitable for another pregnancy. However, only 31.1% (n=14) and 34.8% (n=16) of these patients were using Code 1 contraception, respectively. There were 30 patients (65.2%) who perceived that their health was not suitable for another pregnancy but were only using Code 2 or 3 contraception.

Conclusion: The patients' perception of PPC was poor. Patients had an inadequate knowledge of the effectiveness of their current contraceptive practice in relation to their intentions for further pregnancy and their self-perceived risk in case of future conception. We suggest that integration of PPC into routine follow-ups for other high-risk medical diseases, such as hypertension, heart disease, and epilepsy, be considered in future practice.

Matched MeSH terms: Prenatal Care
Fulltext Maternal obesity and its determinants: A neglected issue?

Nurul-Farehah S, Rohana AJ

Malays Fam Physician, 2020;15(2):34-42.
PMID: 32843943

Maternal obesity is a global public health concern that affects every aspect of maternity care. It affects the short-term and long-term health of the mother and her offspring. Obese pregnant mothers are at an increased risk of developing complications during antenatal, intrapartum, and postnatal periods. Maternal complications include gestational diabetes mellitus, hypertensive disorder in pregnancy, pre-eclampsia and eclampsia, increased rate of cesarean delivery, pulmonary embolism, and maternal mortality; fetal complications include congenital malformation, stillbirth, and macrosomia. Moreover, both mother and infant are at an increased risk of developing subsequent non-communicable diseases and cardiovascular problems later in life. Several factors are associated with the likelihood of maternal obesity, including sociodemographic characteristics, obstetric characteristics, knowledge, and perception of health-promoting behavior. Gaining a sound understanding of these factors is vital to reaching the targets of Sustainable Developmental Goal 3-to reduce global maternal mortality and end preventable deaths of children under 5 years of age-by 2030. It is essential to identify pregnant women who are at risk of maternal obesity in order to plan and implement effective and timely interventions for optimal pregnancy outcomes. Importantly, maternal obesity as a significant pregnancy risk factor is largely modifiable.

Matched MeSH terms: Prenatal Care
Fulltext Exploring the determinant of pre-pregnancy care services usage among reproductive ages women in Kedah, Malaysia

Rozaimah Abu Talib, Idayu Badilla Idris, Rosnah Sutan, Norizan Ahmad, Norehan Abu Bakar, Sharifah Hildah Shahab

Int J Public Health Res, 2016;6(2):719-726.
MyJurnal

Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.

Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.

Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.

Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
workshops.

Matched MeSH terms: Prenatal Care
Fulltext Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Sushma R, Norhayati MN, Nik Hazlina NH

BMC Pregnancy Childbirth, 2021 Jun 09;21(1):422.
PMID: 34107909 DOI: 10.1186/s12884-021-03894-3

BACKGROUND: The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors.
METHODS: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.
RESULTS: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07-9.84) and no formal education (aOR 2.16; 95% CI 1.12-4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32-0.86) and caesarean section (aOR 0.44; 95% CI 0.19-0.99) had negative associations with NNM.
CONCLUSIONS: Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.

Matched MeSH terms: Prenatal Care
Transitional society, health status and international migration of Muslim villagers in the lower part of southern Thailand

Chongsuvivatwong V, Mo-Suwan L, Mahahing P

Southeast Asian J Trop Med Public Health, 1990 Sep;21(3):442-6.
PMID: 2075485

A survey was carried out in a Malay-speaking Muslim community in southern Thailand to obtain baseline data for planning of long term multidisciplinary research and development. By using a 30-cluster sampling technique, 210 households of 1,308 subjects were studied in the post-Ramadan period. It was found that the community was in a social transition. The crude birth rate was 4% and 37.6% of the households had at least one migrant. About half of these migrants had been to Malaysia and mainly worked in rubber plantations. Ninety-five per cent of the households had electricity whereas only 23.8% had a latrine. Boiled or rain water was regularly drunk in only 13.3 per cent of the households. Home-grown agricultural products were not sufficient to provide adequate food. Twenty-six per cent of the adults were unemployed and 24.6% were illiterate. Of the pregnancies 26.7% had no antenatal care and complete tetanus toxoid was given to only 27.8%. Traditional birth attendants conducted 81.1% of the deliveries and only 28.9 and 24.4% of the umbilical cords were correctly cut and correctly dressed, respectively. Breast feeding was still a common (87.8%) practice. However, complete immunization was given to only 10.8%, and 37.8% of the infants had at least one diarrheal episode in the previous month. It was concluded that high birth rate, high migration, low education, low income and bad health of infants are major problems. These problems were interlinked and needed a special multidisciplinary approach. In addition to common obstacles for routine health delivery, migration may create international complications, particularly related to maternal and child care.

Matched MeSH terms: Prenatal Care
Fetal surgery and stem cell therapy for meningomyelocele

Hii LY, Sung CA, Shaw SW

Curr Opin Obstet Gynecol, 2020 04;32(2):147-151.
PMID: 32004173 DOI: 10.1097/GCO.0000000000000614

PURPOSE OF REVIEW: To review the advance of maternal--fetal surgery, the research of stem cell transplantation and tissue engineering in prenatal management of fetal meningomyelocele (fMMC).
RECENT FINDINGS: Advance in the imaging study provides more accurate assessment of fMMC in utero. Prenatal maternal--fetal surgery in fMMC demonstrates favourable postnatal outcome. Minimally invasive fetal surgery minimizes uterine wall disruption. Endoscopic fetal surgery is performed via laparotomy-assisted or entirely percutaneous approach. The postnatal outcome for open and endoscopic fetal surgery shares no difference. Single layer closure during repair of fMMC is preferred to reduce postnatal surgical intervention. All maternal--fetal surgeries impose anesthetic and obstetric risk to pregnant woman. Ruptured of membrane and preterm delivery are common complications. Trans-amniotic stem cell therapy (TRASCET) showed potential tissue regeneration in animal models. Fetal tissue engineering with growth factors and dura substitutes with biosynthetic materials promote spinal cord regeneration. This will overcome the challenge of closure in large fMMC. Planning of the maternal--fetal surgery should adhere to ethical framework to minimize morbidity to both fetus and mother.
SUMMARY: Combination of endoscopic fetal surgery with TRASCET or tissue engineering will be a new vision to achieve to improve the outcome of prenatal intervention in fMMC.

Matched MeSH terms: Prenatal Care
Fulltext Patterns of pre-pregnancy care usage among reproductive age women in Kedah, Malaysia

Abu Talib R, Idris IB, Sutan R, Ahmad N, Abu Bakar N

Iran J Public Health, 2018 Nov;47(11):1694-1702.
PMID: 30581786

Background: This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia.

Methods: Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed.

Results: The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.001), high education level (P<0.001), non-working mothers (P<0.001), multipara (P=0.001), awareness on the existence of pre-pregnancy care services in government health facilities (P<0.001), intention to use the services (P=0.0030), having medical illness (P=0.005), having social support (P=0.001), high knowledge (P<0.001), and positive perception (P<0.001).

Conclusion: Low usage of pre-pregnancy care services can be improved through health screening on reproductive-aged women with positive determinant factors at the triage level in integrated clinics. Information and knowledge on pre-pregnancy services should be disseminated among community members through various means including roadshows and pre-wedding workshops.

Matched MeSH terms: Prenatal Care
Analysis of birth weight data from the Malaysian Family Life Survey II

Awang Mahmud AB, Sallam AA

Asia Pac J Public Health, 1999;11(2):71-6.
PMID: 11195161 DOI: 10.1177/101053959901100204

An analysis of birth weight was undertaken on secondary data derived from the Malaysian Family Life Survey II. A total of 1629 last singleton live birth infants was analysed with the aim of identifying from the variables available potential risk factors for low birth weight. Univariate and subsequently multivariate analyses were carried out for this purpose. The incidence of low birth weight was 11.8 percent. Race, parity and prematurity were found to be significantly associated with low birth weight after controlling of the other variables. The findings indicate that more work needs to be done to establish the underlying reasons for low birth weight in Malaysia.
Study name: Malaysian Family Life Survey (MFLS-2)

Matched MeSH terms: Prenatal Care
Fulltext Management of Severe Traumatic Brain Injury in Pregnancy: A Body with Two Lives

Kho GS, Abdullah JM

Malays J Med Sci, 2018 Sep;25(5):151-157.
PMID: 30914871 MyJurnal DOI: 10.21315/mjms2018.25.5.14

Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. The treatment of severe traumatic brain injury in pregnancy requires a multidisciplinary team approach. The management of a pregnant trauma patient warrants consideration of several issues specific to pregnancy, such as the alterations in the maternal physiology and anatomy. In the case of maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival is linked with the timing of caesarean section after maternal cardiac arrest. Moreover, the decision for perimortem caesarean section is clear after maternal cardiac arrest. The foetal survival rate is 67% if the operation is done before 15 min of cardiopulmonary compromise has occurred, and it drops to 40% at the duration range of 16-25 min. Whether minor or severe, traumatic brain injury during pregnancy is associated with unfavourable maternal outcomes. Injuries considered minor for the general population are not minor for pregnant women. Therefore, these patients should be intensively monitored, and multidisciplinary approaches should always be involved.

Matched MeSH terms: Prenatal Care
Knowledge of Pre-Pregnancy Care Among Men Attending the Outpatient Clinics of Hospital Universiti Sains Malaysia

Ishak SH, Yaacob LH, Ishak A

Malays J Med Sci, 2021 Apr;28(2):119-127.
PMID: 33958966 DOI: 10.21315/mjms2021.28.2.11

Background: Men's involvement in pre-pregnancy care is important to ensure a positive pregnancy outcome. The objective of this study is to determine the level of knowledge of pre-pregnancy care among men and the factors associated with poor knowledge.
Methods: This work is a cross-sectional study conducted at the outpatient clinics of Hospital Universiti Sains Malaysia involving 235 married men. A self-administered questionnaire was used and it consisted of four sections: socio-demographic data, reproductive characteristics of couples, clinical characteristics and knowledge of pre-pregnancy care.
Results: More than half of the men (51.9%) had poor knowledge of pre-pregnancy care, mostly on high-risk pregnancy, consequences of poor birth spacing and effect of maternal anaemia on a baby. The mean (SD) knowledge was 11.86 (3.85). Poor knowledge of pre-pregnancy care was significantly associated with age (adjusted odds ratio [AOR] = 0.96; 95% CI: 0.94, 0.99, P = 0.002) and education level (AOR = 2.61; 95% CI: 1.49, 4.57; P = 0.001).
Conclusion: The men in our study had poor knowledge of pre-pregnancy care. Further health promotion and education are needed to be focused on men to increase their knowledge and share the responsibilities in maternal health.

Matched MeSH terms: Prenatal Care
Fulltext Pheochromocytoma and pregnancy: a difficult and dangerous ordeal

Mohamed Ismail NA, Abd Rahman R, Abd Wahab N, Muhammad R, Nor Azmi K

Malays J Med Sci, 2012 Jan;19(1):65-8.
PMID: 22977377 MyJurnal

Pheochromocytoma during pregnancy is potentially disastrous to the mother and fetus. Its ambiguous presentation is often mistaken for pre-eclampsia, although it may imitate other problems during pregnancy. Early diagnosis and timely, appropriate management reduces possible maternal and fetal complications. We identified a case of pheochromocytoma during pregnancy; the condition was initially diagnosed as pre-eclampsia complicated with gestational diabetes. Surgical intervention via left adrenalectomy was successfully performed in the second trimester. After surgery, all of the patient's medical problems nearly subsided and she did not require further treatment. However, her fetus displayed restricted intrauterine growth, and the patient eventually had premature delivery via a caesarean section. A multidisciplinary team to identify and treat pheochromocytoma is mandatory to ensure optimal conditions for tumour removal and to anticipate any possible catastrophic events.

Matched MeSH terms: Prenatal Care
Fulltext A strategy for reducing maternal mortality

Suleiman AB, Mathews A, Jegasothy R, Ali R, Kandiah N

Bull World Health Organ, 1999;77(2):190-3.
PMID: 10083722

A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.
PIP: This is a report on the methods, findings, resulting recommendations and actions of a study on maternal mortality in Malaysia during the period 1991-94. Maternal death was defined as the death of a woman while pregnant or within 42 days following termination of pregnancy from any cause related to the pregnancy or its management but not from accidental causes. Between 1991 and 1994 there were 1066 reported maternal deaths, and the maternal mortality ratios for the successive years were respectively 44, 48, 46 and 39 per 100,000 live births. The primary causes of maternal death were postpartum hemorrhage (24%), hypertensive disorders of pregnancy (16%), obstetric pulmonary embolism (13%), and associated medical conditions (7%). Analysis of the 375 deaths from 1992 - 1993 showed that the maternal mortality ratio was 53/100,000 live births for deliveries performed at home, 36/100,000 in government hospitals, and 21/100,000 in private institutions. Shortcomings among health personnel were detected in several cases; these involved failure to diagnose, failure to appreciate the severity of a patient's condition, inadequate therapy, and inappropriate, delayed or failed adherence to protocols. The high proportion of maternal mortality associated with substandard care demonstrates that it is important to make the standard of care more widely available. Reports have been circulated to institutions and organizations providing maternal care and to medical schools. Articles and case histories have been published, and many new protocols and procedures have been developed. Furthermore, seminars have been organized and training modules have been distributed to all involved in the provision of maternity care.

Matched MeSH terms: Prenatal Care
eRegistries: indicators for the WHO Essential Interventions for reproductive, maternal, newborn and child health

Flenady V, Wojcieszek AM, Fjeldheim I, Friberg IK, Nankabirwa V, Jani JV, et al.

BMC Pregnancy Childbirth, 2016 Sep 30;16(1):293.
PMID: 27716088

BACKGROUND: Electronic health registries - eRegistries - can systematically collect relevant information at the point of care for reproductive, maternal, newborn and child health (RMNCH). However, a suite of process and outcome indicators is needed for RMNCH to monitor care and to ensure comparability between settings. Here we report on the assessment of current global indicators and the development of a suite of indicators for the WHO Essential Interventions for use at various levels of health care systems nationally and globally.
METHODS: Currently available indicators from both household and facility surveys were collated through publicly available global databases and respective survey instruments. We then developed a suite of potential indicators and associated data points for the 45 WHO Essential Interventions spanning preconception to newborn care. Four types of performance indicators were identified (where applicable): process (i.e. coverage) and outcome (i.e. impact) indicators for both screening and treatment/prevention. Indicators were evaluated by an international expert panel against the eRegistries indicator evaluation criteria and further refined based on feedback by the eRegistries technical team.
RESULTS: Of the 45 WHO Essential Interventions, only 16 were addressed in any of the household survey data available. A set of 216 potential indicators was developed. These indicators were generally evaluated favourably by the panel, but difficulties in data ascertainment, including for outcome measures of cause-specific morbidity and mortality, were frequently reported as barriers to the feasibility of indicators. Indicators were refined based on feedback, culminating in the final list of 193 total unique indicators: 93 for preconception and antenatal care; 53 for childbirth and postpartum care; and 47 for newborn and small and ill baby care.
CONCLUSIONS: Large gaps exist in the availability of information currently collected to support the implementation of the WHO Essential Interventions. The development of this suite of indicators can be used to support the implementation of eRegistries and other data platforms, to ensure that data are utilised to support evidence-based practice, facilitate measurement and accountability, and improve maternal and child health outcomes.

Matched MeSH terms: Prenatal Care/statistics & numerical data
Tetanus neonatorum in West Malaysia

Chen ST

J Trop Med Hyg, 1974 Sep;77(9):204-7.
PMID: 4416077
Matched MeSH terms: Prenatal Care
Fulltext Factors influencing pregnancy planning of multi-ethnic Asian women with diabetes: A qualitative study

Z I I, C J N, P Y L, N H

PLoS One, 2020;15(12):e0242690.
PMID: 33270663 DOI: 10.1371/journal.pone.0242690

INTRODUCTION: Pregnancy planning varies among women with diabetes. Observing that the literature examining the factors affecting diabetic women's pregnancy intentions in multi-ethnic Asian populations is limited, we sought to explore these factors to give a better perspective on these women's pregnancy planning.
METHODS: This qualitative study used individual in-depth interviews to capture the views and experiences of non-pregnant diabetic women of reproductive age in four public health clinics in a southwestern state of peninsular Malaysia from May 2016 to February 2017. The participants were purposively sampled according to ethnicity and were interviewed using a semi-structured topic guide. Interviews were audio-recorded, and transcripts were analysed using thematic analysis.
RESULTS: From the 33 interviews that were analysed, four important factors influencing participants' decisions regarding pregnancy planning were identified. Participants' perception of poor pregnancy outcomes due to advanced age and medical condition was found to have an impact. However, despite these fears and negative relationships with doctors, personal, family and cultural influences supported by religious 'up to God' beliefs took centre stage in the pregnancy intention of some participants. Participants demonstrated a variety of understandings of pregnancy planning. They outlined some activities for pregnancy preparation, although many also reported limited engagement with pre-pregnancy care.
CONCLUSIONS: This study emphasised the known dilemma experienced by diabetic women considering their desire for an ideal family structure against their perceived pregnancy risks, heterogeneous religious beliefs and the impact of cultural demands on pregnancy intention. This study urges healthcare providers to increase their engagement with the women in pregnancy planning in a more personalised approach.

Matched MeSH terms: Prenatal Care
Sero-prevalence of toxoplasmosis among pregnant women attending an ante-natal clinic at a teaching hospital in Al Kharj, Saudi Arabia

Qamer S, Rizvi SSR, Raoof S, Kamal SM, Khan S

Trop Biomed, 2020 Mar 01;37(1):186-193.
PMID: 33612729

Toxoplasma gondii (T. gondii) is a zoonotic infection that may be transmitted to human beings either by consumption of raw or uncooked meat or by ingesting oocysts. Toxoplasma organisms can cross blood placenta barrier and may result in congenital toxoplasmosis. About 80% of immunocompetent individuals do not show any clinical manifestations and are silent carriers of this disease. Pregnant women especially in highly prevalent areas are recommended to be screened for this disease in order to prevent the potential vertical transmission. To our knowledge no such study has been conducted in this region of Saudi Arabia. This study attempted to carry out two objectives: first, to find out the seroprevalence of T. gondii infection in pregnant women attending prenatal care services in our hospital; second, to find out risk factors associated with T. gondii seroprevalence in our patients. It was carried out in Teaching Hospital in Al-Kharj over a period of one year. All 306 pregnant women attending antenatal clinic were involved in the study. A pretested selfexplanatory questionnaire was filled out by the patients and their sera were collected to be tested for IgG and/or IgM against T. gondii. The results were then statistically analyzed using SPSS software and p-value was calculated using Pearson Chi Square test. Out of the 306 blood samples tested, 99 (32.4%) were seropositive for specific anti T. gondii IgG antibodies and 3(1%) were seropositive for IgM. This show that seroprevalence of T. gondii antibodies was high among pregnant women and the prevalence showed a significant association with age. The study recommends conducting educational programs to raise awareness among women about risk factors and precautions to be taken.

Matched MeSH terms: Prenatal Care
Fulltext Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia

Rashid A, Mohd R

Reprod Health, 2017 Nov 02;14(1):144.
PMID: 29096646 DOI: 10.1186/s12978-017-0404-4

BACKGROUND: Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support.
METHODS: This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support.
RESULTS: The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%).
CONCLUSIONS: Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.
Study site: Antenatal clinics (klinik kesihatan), Pulau Pinang, Malaysia

Matched MeSH terms: Prenatal Care
Fulltext Antenatal HIV screening--knowledge, attitudes and practices of obstetricians in KKH

Tan TY, Teo KP, Tan KH

Singapore Med J, 1999 Dec;40(12):733-7.
PMID: 10709422

To determine the knowledge, attitudes and practices of obstetricians with regards to HIV screening in pregnant women.

Matched MeSH terms: Prenatal Care
Fulltext Rate of gestational weight gain trajectory is associated with adverse pregnancy outcomes

Yong HY, Mohd Shariff Z, Appannah G, Rejali Z, Mohd Yusof BN, Bindels J, et al.

Public Health Nutr, 2020 Dec;23(18):3304-3314.
PMID: 32814606 DOI: 10.1017/S1368980020002372

OBJECTIVE: To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.
DESIGN: GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.
SETTING: Negeri Sembilan, Malaysia.
PARTICIPANTS: Two thousand one hundred ninety-three pregnant women.
RESULTS: Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0·58 kg/week' and 'Group 3 - maintaining rate of GWG at 0·38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.
CONCLUSIONS: Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

Matched MeSH terms: Prenatal Care

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