bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical guidelines for the management of weight during pregnancy: a qualitative evidence synthesis of practice recommendations across NHS Trusts in England
Authors: Goddard Lucy , Astbury Nerys M. , McManus Richard J. , Tucker Katherine , MacLellan Jennifer 
Published: March 2023

AbstractBackgroundWomen who enter pregnancy with a Body Mass Index above 30 kg/m2face an increased risk of complications during pregnancy and birth. National and local practice recommendations in the UK exist to guide healthcare professionals in supporting women to manage their weight. Despite this, women report inconsistent and confusing advice and healthcare professionals report a lack of confidence and skill in providing evidence-based guidance. A qualitative evidence synthesis was conducted to examine how local clinical guidelines interpret national recommendations to deliver weight management care to people who are pregnant or in the postnatal period.MethodsA qualitative evidence synthesis of local NHS clinical practice guidelines in England was conducted. National Institute for Health and Care Excellence and Royal College of Obstetricians and Gynaecologists guidelines for weight management during pregnancy constructed the framework used for thematic synthesis. Data was interpreted within the embedded discourse of risk and the synthesis was informed by the Birth Territory Theory of Fahy and Parrat.ResultsA representative sample of twenty-eight NHS Trusts provided guidelines that included weight management care recommendations. Local recommendations were largely reflective of national guidance. Consistent recommendations included obtaining a weight at booking and informing women of the risks associated with being obese during pregnancy. There was variation in the adoption of routine weighing practices and referral pathways were ambiguous. Three interpretive themes were constructed, exposing a disconnect between the risk dominated discourse evident in the local guidelines and the individualised, partnership approach emphasised in national level maternity policy.ConclusionsLocal NHS weight management guidelines are rooted in a medical model rather than the model advocated in national maternity policy that promotes a partnership approach to care. This synthesis exposes the challenges faced by healthcare professionals and the experiences of pregnant women who are in receipt of weight management care. Future research should target the tools utilised by maternity care providers to achieve weight management care that harnesses a partnership approach empowering pregnant and postnatal people in their journey through motherhood.
Complication experience during pregnancy and place of delivery among pregnant women: a cross-sectional study
Authors: Worku Bekelu Teka , Abdulahi Misra , Tsega Merertu , Edilu Birtukan , Ali Rahma , Habte Mahilet Berhanu , Awel Samira , Getnet Masrie , Melaku Yabsira , Kidane Radiet , Taye Abonesh , Tamirat Meseret 
Published: March 2023

Abstract
Background
Unlike other causes such as abortion, obstetric complications like hemorrhage, and hypertensive disorders of pregnancy, which are difficult to resolve for women who give birth out of health facilities are persisted or increased to be the cause of maternal mortality in Ethiopia. Direct obstetric complications resulted in the crude direct obstetric case fatality rate in this country. This study aimed to assess the relationship between Complication Experience during Pregnancy and Place of Delivery among Pregnant Women.

Method
A community-based cross-sectional study was conducted to assess the baseline information as a part of a randomized control trial study. The sample size that was calculated for the cohort study with the assumptions to detect an increase in a minimum acceptable diet from 11 to 31%, with 95% CIs and 80% power, an intra-cluster correlation coefficient of 0·2 for a cluster size of 10 was used for this study. Statistical analysis was done using SPSS version 22.

Result
The prevalence of self-reported pregnancy-related complications and home delivery were 79(15.9%, CI; 12.7–19.1) and 46.90% (95%CI; 42.5–51.1) respectively. Women who did not face vaginal bleeding were five times AOR 5.28(95% CI: 1.79–15.56) more like to give birth at home than those who faced this problem. Women who did not face severe headache were nearly three AOR 2.45(95%CI:1.01–5.97) times more like to give birth at home.

Conclusion
This study concluded that home delivery was high among the study participants whereas pregnancy-related complications such as vaginal bleeding and severe headache were identified as protective factors for facility delivery. Hence, the researchers recommended the incorporation of “storytelling” into the existing health extension program packages to improve facility delivery which shall be applied after the approval of its effectiveness by further research.
The feasibility and acceptability of Project POWER: a mindfulness-infused, cognitive-behavioral group intervention to address mental and sexual health needs of young pregnant women in Liberia
Authors: Callands Tamora A. , Hylick Kandyce , Desrosiers Alethea , Gilliam Shantesica M. , Taylor Erica N. , Hunter Josalin J. , Hansen Nathan B. 
Published: March 2023

Abstract
Background
Following 14 years of civil war in Liberia, war exposure, gender-based violence, and extreme poverty have been identified as key challenges affecting the mental and sexual health of young pregnant women and the health of their unborn children. Despite ongoing efforts to rebuild the country’s healthcare infrastructure, empirical and culturally tailored interventions to address the consequences of war are severely limited. To address these concerns, we developed Project POWER (Progressing Our Well-being, Emotions, and Relationships), a mindfulness-infused, cognitive-behavioral intervention for young adult pregnant women. This study sought to 1) assess the feasibility and acceptability of POWER and 2) determine the preliminary efficacy of POWER for improving mental and sexual health outcomes among Liberian war-exposed young adult pregnant women.

Methods
Eighty-seven women aged 18–25 were recruited from three catchment areas in Monrovia, Liberia to participate in a two-condition, pre-post design quasi-experimental pilot trial. Participants were allocated to the intervention (POWER) or the control condition (a health education program) based on where they resided relative to the catchment areas. Each condition completed a ten-session program delivered over 5-weeks. Feasibility and acceptability of POWER were examined using program logs (e.g., the number of participants screened and enrolled, facilitator satisfaction, etc.) and data from an end-of-program exit interview. The preliminary efficacy of POWER on mental and sexual health outcomes was assessed using repeated measures ANOVA with time and condition as factors.

Results
Analyses provided preliminary support for the feasibility and acceptability of POWER. Participants attended an average of 8.99 sessions out of 10 and practiced material outside the sessions at least 2.77 times per week. Women in both conditions showed significant reductions in the level of prenatal distress (baseline, M = 16.84, 3-month assessment, M = 12.24), severity of post-traumatic stress disorder (PTSD) symptoms (baseline, M = 11.97, 3-month assessment, M = 9.79),), and the number of transactional sexual behaviors (baseline, M = 1.37, 3-month assessment, M = .94) over time. Participants who received POWER showed significant reductions in the frequency of depressive symptoms (baseline, M = 5.09, 3-month assessment, M = 2.63) over women in the control condition.

Conclusions
Findings suggest that POWER may be a feasible and acceptable intervention to promote mental and sexual health for young adult pregnant women in Liberia. However, fully powered clinical trials are still needed to determine the efficacy and effectiveness of POWER before recommending its use on a larger scale in Liberia.
Lessons from digital technology-enabled health interventions implemented during the coronavirus pandemic to improve maternal and birth outcomes: a global scoping review
Authors: Moise Imelda K. , Ivanova Nicole , Wilson Cyril , Wilson Sigmond , Halwindi Hikabasa , Spika Vera M. 
Published: March 2023

Abstract
Background
Timely access to essential obstetric and gynecologic healthcare is an effective method for improving maternal and neonatal outcomes; however, the COVID-19 pandemic impacted pregnancy care globally. In this global scoping review, we select and investigate peer-reviewed empirical studies related to mHealth and telehealth implemented during the pandemic to support pregnancy care and to improve birth outcomes.

Methods
We searched MEDLINE and PubMed, Scopus, CINAHL and Web of Science for this Review because they include peer-reviewed literature in the disciplines of behavioral sciences, medicine, clinical sciences, health-care systems, and psychology. Because our investigative searches reviewed that there is considerable ‘grey literature’ in this area; we did not restrict our review to any study design, methods, or place of publication. In this Review, peer-reviewed preprints were comparable to published peer-reviewed articles, with relevant articles screened accordingly.

Results
The search identified 1851 peer reviewed articles, and after removal of duplicates, using inclusion and exclusion criteria, only 22 studies were eligible for inclusion in the review published from January 2020 to May 2022. mHealth interventions accounted for 72.7% (16 of 22 studies) and only 27.3% (6 of 22 studies) were telehealth studies. There were only 3 example studies that integrated digital technologies into healthcare systems and only 3 studies that developed and evaluated the feasibility of mobile apps. Experimental studies accounted 68.8% of mHealth studies and only 33.3% studies of telehealth studies. Key functionalities of the pregnancy apps and telehealth platforms focused on mental and physical wellness, health promotion, patient tracking, health education, and parenting support. Implemented interventions ranged from breastfeeding and selfcare to behavioral health. Facilitators of uptake included perceived benefits, user satisfaction and convenience. Mobile apps and short messaging services were the primary technologies employed in the implemented mHealth interventions.

Conclusion
Although our Review emphasizes a lack of studies on mHealth interventions and data from pregnant women during the COVID-19 crisis, the review shows that implementation of digital health interventions during emergencies are inevitable given their potential for supporting pregnancy care. There is also a need for more randomized clinical trials and longitudinal studies to better understand the effectiveness and feasibility of implementing such interventions during disease outbreaks and emergencies.
Implementation of a women’s reproductive behavioral health telemedicine program: a qualitative study of barriers and facilitators in obstetric and pediatric clinics
Authors: Sterba Katherine R. , Johnson Emily E. , Douglas Edie , Aujla Rubin , Boyars Lisa , Kruis Ryan , Verdin Rebecca , Grater Rachel , King Kathryn , Ford Dee , Guille Constance 
Published: March 2023

Abstract
Background
Perinatal Mood and Anxiety Disorders and Substance Use Disorders are common and result in significant morbidities and mortality. Despite evidence-based treatment availability, multiple barriers exist to care delivery. Because telemedicine offers opportunities to overcome these barriers, the objective of this study was to characterize barriers and facilitators to implementing a mental health and substance use disorder telemedicine program in community obstetric and pediatric clinics.

Methods
Interviews and site surveys were completed with practices engaged in a Women’s Reproductive Behavioral Health Telemedicine program (N = 6 sites; 18 participants) at the Medical University of South Carolina and telemedicine providers involved in care delivery (N = 4). Using a structured interview guide based on implementation science principles, we assessed program implementation experiences and perceived barriers and facilitators to implementation. A template analysis approach was used to analyze qualitative data within and across groups.

Results
The primary program facilitator was service demand driven by the lack of available maternal mental health and substance use disorder services. Strong commitment to the importance of addressing these health concerns provided a foundation for successful program implementation yet practical challenges such as staffing, space, and technology support were notable barriers. Services were supported by establishing good teamwork within the clinic and with the telemedicine team.

Conclusion
Capitalizing on clinics’ commitment to care for women’s needs and a high demand for mental health and substance use disorder services while also addressing resource and technology needs will facilitate telemedicine program success. Study results may have implications for potential marketing, onboarding and monitoring implementation strategies to support clinics engaging in telemedicine programs.
Body perception in pregnant women: a qualitative study
Authors: Sohrabi Zahra , Kazemi Ashraf , Farajzadegan Ziba , Janighorban Mojgan 
Published: March 2023

Abstract
Background
Dramatic body changes in pregnancy cause severe concerns among pregnant women about their appearance. Therefore, this study aimed to explore body perception in pregnant women.

Materials and methods
The qualitative study, using the conventional content analysis approach, was conducted on Iranian pregnant women who were in their second or third trimester of pregnancy. Participants were selected through purposeful sampling method. In-depth and semi-structured interviews were held with 18 pregnant women aged 22 to 36 years, using open-ended questions. Sampling was performed until data saturation was reached.

Results
Three main categories were extracted from 18 interviews: (1) “symbols,” with two subcategories, including ‘motherhood’ and ‘vulnerability,’ (2) “feelings toward body changes,” with five subcategories, including ‘negative feelings toward skin changes,’ ‘feeling unfit,’ ‘attention-drawing body shape,’ ‘the ridiculous body shape’ and ‘obesity,’ and (3) “attraction and beauty,” with two subcategories, including ‘sexual attraction’ and ‘facial beauty.’

Conclusion
The results showed that pregnant women’s body perception could be described as maternal feelings and feminine attitudes toward changes during pregnancy compared to mental ideals of facial and body beauty. It is recommended that Iranian women’s body perception during pregnancy be evaluated using this study results and that counseling interventions be implemented for women with negative body perceptions.
Association of delivery mode and number of pregnancies with anorectal manometry data in patients with postpartum constipation
Authors: Yin Yan , Zhang Yumin , Qian Cheng 
Published: March 2023

Abstract
Objective
To explore the association of delivery mode and the number of pregnancies with anorectal manometry data in patients with postpartum constipation.

Methods
This retrospective study included women with postpartum constipation treated at the pelvic floor rehabilitation department of Huzhou Maternity & Child Health Care Hospital between January 2018 and December 2019.

Results
Among 127 patients included, 55 (43.3%) had one pregnancy, 72 (56.7%) had two pregnancies, 96 (75.6%) delivered spontaneously, 25 (16.7%) underwent Cesarean section, and six (4.7%) needed a Cesarean section despite spontaneous labor. The median duration of constipation was 12 months (range, 6–12). There were no differences between the two groups for any manometry parameters (all P > 0.05). The patients with a spontaneous delivery had a lower change in maximal contracting sphincter pressure compared with those with Cesarean section (14.3 (4.5–25.0) vs. 19.6 (13.4–40.0), P = 0.023). Only the delivery mode (Cesarean vs. spontaneous) independently affected the changes in contracting sphincter pressure (B = 10.32, 95%CI: 2.95–17.69, P = 0.006); age (P = 0.201), number of pregnancies (P = 0.190), and constipation duration (P = 0.161) were not associated.

Conclusion
The patients with a spontaneous delivery had a lower change in maximal contracting sphincter pressure compared with those with a Cesarean section, suggesting that patients with Cesarean may retain a better “push” function during defecation.
Closed-loop insulin delivery in pregnant women with type 1 diabetes (CRISTAL): a multicentre randomized controlled trial – study protocol
Authors: Beunen Kaat , Van Wilder Nancy , Ballaux Dominique , Vanhaverbeke Gerd , Taes Youri , Aers Xavier-Philippe , Nobels Frank , Marlier Joke , Lee Dahae , Cuypers Joke , Preumont Vanessa , Siegelaar Sarah E. , Painter Rebecca C. , Laenen Annouschka , Gillard Pieter , Mathieu Chantal , Benhalima Katrien 
Published: March 2023

AbstractBackgroundDespite increasing use of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII, insulin pumps) in type 1 diabetes (T1D) in pregnancy, achieving recommended pregnancy glycaemic targets (3.5–7.8 mmol/L or 63–140 mg/dL) remains challenging. Consequently, the risk of adverse pregnancy outcomes remains high. Outside pregnancy, hybrid closed-loop (HCL) insulin delivery systems have led to a paradigm shift in the management of T1D, with 12% higher time in glucose target range (TIR) compared to conventional CSII. However, most commercially available HCL systems are currently not approved for use in pregnancy. This study aims to evaluate the efficacy, safety and cost-effectiveness of the MiniMed™ 780G HCL system (Medtronic) in T1D in pregnancy.MethodsIn this international, open-label, randomized controlled trial (RCT), we will compare the MiniMed™ 780G HCL system to standard of care (SoC) in T1D in pregnancy. Women aged 18–45 years with T1D diagnosis of at least one year, HbA1c ≤ 86 mmol/mol (≤ 10%), and confirmed singleton pregnancy up to 11 weeks 6 days will be eligible. After providing written informed consent, all participants will wear a similar CGM system (Guardian™ 3 or Guardian™ 4 CGM) during a 10-day run-in phase. After the run-in phase, participants will be randomised 1:1 to 780G HCL (intervention) or SoC [control, continuation of current T1D treatment with multiple daily injections (MDI) or CSII and any type of CGM] stratified according to centre, baseline HbA1c (< 53 vs. ≥ 53 mmol/mol or < 7 vs. ≥ 7%), and method of insulin delivery (MDI or CSII). The primary outcome will be the time spent within the pregnancy glucose target range, as measured by the CGM at four time points in pregnancy: 14–17, 20–23, 26–29, and 33–36 weeks. Prespecified secondary outcomes will be overnight TIR, time below range (TBR: <3.5 mmol/L or < 63 mg/dL), and overnight TBR. Other outcomes will be exploratory. The planned sample size is 92 participants. The study will end after postpartum discharge from hospital. Analyses will be performed according to intention-to-treat as well as per protocol.DiscussionThis large RCT will evaluate a widely used commercially available HCL system in T1D in pregnancy. Recruitment began in January 2021 and was completed in October 2022. Study completion is expected in May 2023.Trial registrationClinicalTrials.gov: NCT04520971. Registration date: August 20, 2020.https://clinicaltrials.gov/ct2/show/NCT04520971
Foetal death due to extensive extra-abdominal umbilical vein Varix with umbilical vein thrombosis: a case report
Authors: Song Qing-Yun , Tang Ying 
Published: March 2023

Abstract
Background
Foetal anaemia and umbilical vein thrombosis are rare pregnancy complications that can increase the risk of perinatal adverse events, which, in severe cases, can lead to foetal death. During pregnancy, umbilical vein varix (UVV) commonly occurs in the intra-abdominal part of the umbilical vein and is associated with an increased risk of foetal anaemia and umbilical vein thrombosis. However, UVV occurring in the extra-abdominal part of the umbilical vein is rare, especially when accompanied by thrombosis. In this case report, we describe a rare case of an extensive extra-abdominal umbilical vein varix (EAUVV), which ultimately resulted in foetal death due to umbilical vein thrombosis.

Case presentation
In this report, we describe a rare case of an extensive EAUVV that was discovered at 25 weeks and 3 days of gestation. During the examination, there were no abnormalities in foetal haemodynamics. The estimated weight of the foetus was only 709 g. In addition to refusing to be hospitalized, the patient refused close monitoring of the foetus. As a result, we were limited to choosing an expectant therapy. The foetus died 2 weeks after diagnosis and was confirmed to have EAUVV with thrombosis after the induction of labour.

Conclusion
In the case of EAUVV, lesions are extremely rare, and it is very easy for thrombosis to form, which may result in the death of the child. When determining the next step in the treatment of the condition, the degree of UVV, possible complications, gestational age, foetal haemodynamics, and other relevant factors are strongly connected to the clinical therapy decision, and these factors should be considered comprehensively when making a clinical decision. We recommend close monitoring with hospital admission (to facilities capable of handling extremely preterm foetuses) after variability in delivery for worsening haemodynamic status.
Application of machine learning to identify risk factors of birth asphyxia
Authors: Darsareh Fatemeh , Ranjbar Amene , Farashah Mohammadsadegh Vahidi , Mehrnoush Vahid , Shekari Mitra , Jahromi Malihe Shirzadfard 
Published: March 2023

Abstract
Background
Developing a prediction model that incorporates several risk factors and accurately calculates the overall risk of birth asphyxia is necessary. The present study used a machine learning model to predict birth asphyxia.

Methods
Women who gave birth at a tertiary Hospital in Bandar Abbas, Iran, were retrospectively evaluated from January 2020 to January 2022. Data were extracted from the Iranian Maternal and Neonatal Network, a valid national system, by trained recorders using electronic medical records. Demographic factors, obstetric factors, and prenatal factors were obtained from patient records. Machine learning was used to identify the risk factors of birth asphyxia. Eight machine learning models were used in the study. To evaluate the diagnostic performance of each model, six metrics, including area under the receiver operating characteristic curve, accuracy, precision, sensitivity, specificity, and F1 score were measured in the test set.

Results
Of 8888 deliveries, we identified 380 women with a recorded birth asphyxia, giving a frequency of 4.3%. Random Forest Classification was found to be the best model to predict birth asphyxia with an accuracy of 0.99. The analysis of the importance of the variables showed that maternal chronic hypertension, maternal anemia, diabetes, drug addiction, gestational age, newborn weight, newborn sex, preeclampsia, placenta abruption, parity, intrauterine growth retardation, meconium amniotic fluid, mal-presentation, and delivery method were considered to be the weighted factors.

Conclusion
Birth asphyxia can be predicted using a machine learning model. Random Forest Classification was found to be an accurate algorithm to predict birth asphyxia. More research should be done to analyze appropriate variables and prepare big data to determine the best model.