Deficiency of folic acid increases the risk for neural tube defects among newborn children and megaloblastic anaemia in the mother. The aim of this study was to make a survey of how midwives working in maternity health care, family planning guidance, and specialist prenatal care in a Swedish county inform women of childbearing age about folic acid. The questionnaire study showed that 79% of the midwives informed the women about folic acid. Usually, the women received information first when they asked for it and midwifes were less prone to inform young women about folic acid. 87% of the midwives felt that they did not know enough about folic acid. CONCLUSIONS: Midwives play an important role in information about the need of folic acid intake for women in childbearing age. Changes in local routines, guidelines and further education of midwifes would subsequently provide information about the importance of folic acid to women in childbearing age.
A new agrarian policy in a number of countries caused the necessity to introduce additional measures aimed at preventing of agricultural workers' health. The epidemiological studies in the Ukraine revealed the prevalence of cardiovascular diseases (ischemic heart disease, arterial hypertension) particularly among operators of agricultural machines and workers being in contact with pesticides. The state of health of women working in greenhouses and those in sugar beet growing is assessed. The rate of spontaneous abortions and other pregnancy disorders as well as the retardation in physical development of newborns and infants are evaluated. The necessity to improve the ergonomy of agricultural machines, to increase their quality and reliability is emphasized. The search of physiological optimum of efforts to steering wheel and pedals is given as an example. This approach is of general significance and can be applied to road-building machines as well. The role of pesticide management in the Ukraine is also considered in this paper. The damage to human health and the environment is most often connected with violations of regulations, or persistent usage of highly toxic substances. The most urgent tasks are the revision of the registered and applied pesticides, development of new ecological and hygienic standards, improvement of biomonitoring methods and efficiency of the state sanitary supervision.
OBJECTIVE: To investigate whether acupuncture has a greater treatment effect than non-penetrating sham acupuncture in women with pelvic girdle pain (PGP) during pregnancy. DESIGN: Randomised double-blinded controlled trial. SETTING: East Hospital, Gothenburg, and 25 antenatal primary care units in the region of Västra Götaland, Sweden. POPULATION: A total of 115 pregnant women with a clinical diagnosis of PGP who scored > or =50 on a 100-mm visual analogue scale (VAS). METHOD: Women were randomly allocated to standard treatment plus acupuncture or to standard treatment plus non-penetrating sham acupuncture for 8 weeks. MAIN OUTCOME MEASURES: Main outcome measure was pain. Secondary outcomes were frequency of sick leave, functional status, discomfort of PGP, health-related quality of life and recovery of severity of PGP as assessed by the independent examiner. RESULTS: After treatment, median pain decreased from 66 to 36 in the acupuncture group and from 69 to 41 in the non-penetrating sham group (P = 0.493) as assessed on a VAS. Women in the acupuncture group were in regular work to a higher extent than women in the sham group (n = 28/57 versus 16/57, P = 0.041). The acupuncture group had superior ability to perform daily activities measured with the disability rating index (DRI) (44 versus 55, P = 0.001). There were no significant differences in quality of life, discomfort of PGP and recovery from severity of PGP between the groups. CONCLUSIONS: Acupuncture had no significant effect on pain or on the degree of sick leave compared with non-penetrating sham acupuncture. There was some improvement in performing daily activities according to DRI. The data imply that needle penetration contributes to a limited extent to the previously reported beneficial effects of acupuncture.
Alcohol consumption in pregnancy may result in serious adverse fetal outcome. Non- or low alcoholic wines and beers may be a risk-reduction strategy to help alcohol-dependent individuals to prevent or limit ethanol consumption. The objective of this study was to quantify ethanol concentrations in Canadian beverages claiming to contain no or low alcohol content.
Forty-five different beverages claiming to contain no or low alcohol content in the Canadian market were tested for ethanol concentration using gas chromatography.
Thirteen (29%) of the beverages contained ethanol levels higher than the declared concentration on their label. Six beverages claiming to contain no alcohol were found to contain greater than 1% ethanol.
Pregnant women seeking replacement to alcoholic beverages may be misled by these labels, unknowingly exposing themselves and their unborn babies to ethanol.
Russia provides an interesting case for comparative research of maternity care due to the rapid social change and steep fertility decline since the collapse of the Soviet Union. I analyze out-patient maternity care in public sector women's clinics in St. Petersburg on the basis of qualitative observation and interview data. Gynecologists' role in monitoring pregnancy is central, resulting in an emphasis on medical expertise and risk management. Ideally, gynecologists see themselves as medical experts and maternal caretakers, but the latter role seldom materializes in practice. Gynecologists' ideas of pregnancy planning demonstrate a wish for further medicalization of maternity care.
INTRODUCTION: The aim of this study was to determine where and from whom postpartum women recalled receiving information about urinary incontinence (UI) and pelvic floor exercises (PFEs), the helpfulness of this information, and their preferred sources of help with UI. METHODS: Women who had recently given birth in a Danish hospital (N = 439) were mailed a survey that elicited information about their experiences of receiving information about UI and PFEs. RESULTS: Surveys were returned from 266 women, representing a response rate of 61%. Although almost all participants recalled receiving information about PFEs (95%), only half (55%) recalled being provided with information about UI. Midwives were the health care professionals who most commonly provided women with information about UI (33%) and PFEs (55%). Women generally perceived the information as being helpful, with the information from physiotherapists obtaining the highest mean ratings for helpfulness. Postpartum women indicated that they would prefer to consult with continence nurses or general nurses if they experienced UI. Health care professionals did not consistently provide postpartum women with information on UI and PFEs. DISCUSSION: A coordinated multidisciplinary approach is needed to ensure that women are adequately informed about the risk of developing UI after childbirth and the ways in which this condition can be managed or resolved.
The aim of our study was to determine whether the use of iron supplements during pregnancy affects the risk for celiac disease in children.
We assessed data from the prospective Norwegian Mother and Child cohort study, in which individuals with celiac disease were identified by answers on questionnaires and linkage to the Norwegian Patient Register. Complete data were available for 78,846 children (mean age 5.9 years, range 2-12 years); 314 children were identified with celiac disease. Questionnaires were given to pregnant women to collect information on use of iron-containing supplements, diet, anemia, and levels of hemoglobin.
Celiac disease was diagnosed in 4.65 of 1000 children whose mothers took iron supplements while they were pregnant, compared with 3.15 of 1000 children whose mothers did not. After adjusting for children's age, sex, and age of gluten introduction, and the presence of celiac disease in mothers, iron supplementation during pregnancy remained significantly associated with celiac disease in children (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.05-1.68; P = .019). However, celiac disease was not associated with the mothers' intake of iron from foods (adjusted OR, 1.00; 95% CI, 0.97-1.03). Anemia before or during the early stages of pregnancy was not significantly associated with the risk of celiac disease in children (adjusted OR, 1.24; 95% CI, 0.84-2.00; P = .24). The use of iron supplements during pregnancy remained significantly associated with celiac disease in children after adjusting for children who were given iron supplements before 18 months of age, which itself was associated with celiac disease.
In a prospective Norwegian Mother and Child cohort study, we found an increased risk of celiac disease in children whose mothers used iron supplements during pregnancy; this association does not appear to arise from maternal anemia.