Objectives
To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by ...women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors.
Methods
A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals (n = 1100) followed by phase 2, a convenience sampling through women's self-reporting (n = 3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child.
Results
Of the 3205 participants (mean age = 33 years, SD = 0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals.
Conclusions
The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.
Alcohol consumption during pregnancy is a leading cause of fetal alcohol spectrum disorder (FASD). Maternal reporting in childbearing women or pregnant women is the standard for the early detection ...of alcohol consumption. The Green Page (GP) is a screening questionnaire of environmental health which includes the alcohol intake record during pregnancy and/or lactation period. The aim of this paper is to review the features of the different questionnaires for the detection of alcohol consumption during the gestation period and the GP, as well as to make a comparison between them. Review of the scientific literature published over the last 10 years of indexed articles in Medline. Combined searching strategy with MeSH descriptors: 'pregnancy, alcohol drinking, surveys and/or questionnaires. AUDIT, AUDIT-C and SURP-P are mainly self-administered and do not require training. SURP-P and 4P´s are validated in pregnant women. Others detect quantity and frequency of exposure, need specific training and are administered face to face: TLFB, RD, ACOG antepartum record and the GP. ACOG antepartum record and GP are specific for pregnant population. GP detects alcohol consumption at the beginning of pregnancy in both women and their partner on a holistic and global environmental health approach. A careful face-to-face recording of alcohol exposure with trained staff, with an integrative and global environmental health focus throughout pregnancy, may help improve prevention and screening of pregnancy at risk for FASD.
Abstract
Aims
In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol ...use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy.
Methods
A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data.
Results
About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women’s body mass index and European white race.
Conclusion
Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.
CDT showed the largest area under the ROC curve. The number of binge drinking episodes and mother’s BMI were the most significant predictors of a change in CDT values. CDT could be a good candidate for the screening of alcohol risk exposure at the beginning of pregnancy when used in combination with Green Page.
•Drug-dependency among expecting mothers is a product of sociocultural influences that are difficult to detect in clinical settings.•Structural violence and social network analysis are useful ...conceptual frameworks in examining the unique experiences and challenges this patient population face during pregnancy.•The “Hoja Verde” (green sheet) and similar perinatal screening methods can be valuable clinical tools in detecting risk factors during pregnancy and enhance the potential for better health outcomes among expecting mothers.
To contribute in closing the current gap in literature that holistically examines sociocultural influences on perinatal drug dependency. This article draws from social network theory and structural violence to qualitatively consider the contextual components of addiction and substance use during pregnancy, which purposefully moves away from situating this issue from solely being within the contexts of pathologized disorders or products of social inequalities.
Face-to-face semi-structured interviews with drug-dependent pregnant women identified during a reproductive environmental health consultation.
Interviews were conducted at a university hospital in southeastern Spain between October 2015 and June 2016.
10 pregnant women with confirmed perinatal substance use and/or drug dependency.
The sociocultural perspective offers a useful lens by which providers can understand the reasons for initial substance use and progress of multi-drug dependency as way of individually tailoring intervention strategies for expecting mothers. This perspective draws from the frameworks of social network analysis (SNA) and structural violence to dialectically examine drug dependency in this unique patient population not to be solely an individual occurrence, but rather a combination of macro and micro-level factors at play.
The sociocultural approach in examining maternal health allows for the holistic exploration of the already taboo and symbolically paradoxical phenomenon of drug dependency in pregnant women.
The “Hoja Verde” and similar perinatal screening methods that comprehensively assess for the potential of environmental risks can be a key instrument in the practice of preventing developmental issues of children as early as pregnancy and into adolescence.
Violence against women and gastroschisis: a case-control study Ortega-García, Juan Antonio; Soldin, Offie P; Sánchez-Sauco, Miguel Felipe ...
International journal of environmental research and public health,
10/2013, Letnik:
10, Številka:
10
Journal Article
Recenzirano
Odprti dostop
Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the ...likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20-24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, 'green sheet' questionnaire on environmental exposures.
Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional 'gender-related violence' (OR: 16.6, 95% CI 2.7 to 101.7) and younger maternal age (OR 1.1, 95% CI 1.0-1.3).
Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus.
Methylmercury (MeHg) is a bioaccumulable toxin in the trophic chain and a powerful neurotoxin during fetal and child development. Consumption of contaminated fish and shellfish is a principal ...environmental source of MeHg exposure. This study was designed to assess the Hg and estimated MeHg intake in vulnerable groups of the Murcia region, a Mediterranean part of Spain, compared with international regulations. A validated food frequency questionnaire was used to assess seafood consumptions in 320 children younger than 10 years, 301 women of childbearing age, and 537 pregnant women. Hg concentrations were measured in the most consumed fish products by cold vapor generation–atomic fluorescence spectrometry. The weekly intake of MeHg (μg/kg bw/week) was 2.60 (95% CI = 2.10–3.10) in children 1–5 years, 2.65 (95% CI = 2.26–3.03) in children 6–10 years, 0.98 (95% CI = 0.89–1.07) in women of childbearing age, and 0.88 (95% CI = 0.81–0.95) in pregnant women. The main exposure to MeHg, especially in young children, is related to intake of bluefin tuna and swordfish. Fifty-four percent of children aged 1–10 years, 10% of pregnant women, and 15% of women of childbearing age exceed the Joint Expert Committee on Food Additives provisional tolerable weekly intake of MeHg. In the Murcia region, where fish is a central component of the diet, the focus should be on educating vulnerable populations to reorient fish consumption in order to lower the amount of Hg incorporated with the diet as well as to reduce Hg emissions into the environment.
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