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Smoking during pregnancy may negatively impact newborn birth weight. This study investigates the relationship between maternal active smoking during pregnancy and low birth weight in the Americas through systematic review and meta-analysis. A literature search was conducted through indexed databases and the grey literature. Case-control and cohort studies published between 1984 and 2016 conducted within the Americas were included without restriction regarding publication language. The article selection process and data extraction were performed by two independent investigators. A meta-analysis of random effects was conducted, and possible causes of between-study heterogeneity were evaluated by meta-regressions and subgroup analyses. Publication bias was assessed by visual inspection of Begg's funnel plot and by Egger's regression test. The literature search yielded 848 articles from which 34 studies were selected for systematic review and 30 for meta-analysis. Active maternal smoking was associated with low birth weight, OR = 2.00 (95% CI: 1.77-2.26; I2 = 66.3%). The funnel plot and Egger's test (p = .14) indicated no publication bias. Meta-regression revealed that sample size, study quality, and the number of confounders in the original studies did not account for the between-study heterogeneity. Subgroup analysis indicated no significant differences when studies were compared by design, sample size, and regions of the Americas. Low birth weight is associated with maternal active smoking during pregnancy regardless of the region in the Americas or the studies' methodological aspects. A previous search of the major electronic databases revealed that no studies appear to have been conducted to summarize the association between maternal active smoking during pregnancy and low birth weight within the Americas. Therefore, this systematic review may help to fill the information gap. The region of the Americas contains some of the most populous countries in the world; therefore, this study may provide useful data from this massive segment of the world's population.

Objectives We examined the utilisation, equity and determinants of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods We analysed a sample of 190,898 women from India’s National Family Health Survey 4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable logistic regression model was used to examine the factors associated with full ANC utilisation. Results In India, 21% of pregnant women utilised full ANC, ranging from 2.3–65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Full ANC utilisation was inequitable across place of residence, caste and maternal education. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Conclusions Full ANC utilisation in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program.

Pregnant women were one of the most exposed and vulnerable groups during the COVID-19 pandemic. While much is known about the general effects of the pandemic on pregnant women's well-being, little research has focused on the experiences of women who gave birth while infected with SARS-CoV-2. The aim of this study was to gain a deeper understanding of the lived experiences of women who gave birth while being ill with COVID-19. This is a qualitative study utilising a phenomenological reflective lifeworld approach to explore the lived experiences of Swedish women (n = 10) who gave birth while ill with COVID-19 between April 2020 and May 2021. The essence of the women's experiences was described as 'Reclaiming motherhood through shame, distance, and gratitude,' supported by four constituents: \"feeling intense shame and guilt for getting infected\",\" striving to overcome distance in the birth setting\", \"experiencing gratitude for receiving compassionate care\" and \"trying to comprehend motherhood and fighting to be reunited\". A nuanced understanding of the experience at the intersection between childbirth, illness and the societal context is imperative for healthcare professionals and society to provide optimal care for one of the most vulnerable groups during pandemics, pregnant women and their newborns.

Background Maternal hemoglobin (Hgb) is considered an essential, modifiable risk factor for adverse pregnancy outcomes (APOs). Evidence for the effect of nutrition education on the Hgb levels of pregnant women in low-income countries, including Ethiopia, is inconclusive. This study aimed to assess the effect of nutrition education on the Hgb levels of pregnant women in urban settings in the Bale Zone, Southeast Ethiopia. Methods A community-based two-arm parallel cluster randomized controlled trial was carried out among 447 randomly selected pregnant women attending antenatal care (224 intervention and 223 control groups) at health facilities from February to December 2021. A multistage cluster sampling technique followed by systematic sampling was used to select the pregnant women. Pregnant women who took part in the intervention arm received six nutrition education sessions, whereas pregnant women in the control group received routine standard care. We used a pretested, interviewer-administered, structured questionnaire to collect the data. The Hgb level of pregnant women was measured by collecting a finger-prick blood sample using a HemoCue Hb 301. A generalized estimating equation (GEE) model was used to isolate the net effect of the intervention on Hgb, accounting for the clustering. Beta coefficients (β) along with a 95% confidence interval (CI) were used for interpretations. Results The mean difference in Hgb levels between the intervention and control groups was 0.12 ± 0.04 (P value < 0.002). The multivariable GEE linear model revealed that nutrition education significantly improved the Hgb levels of pregnant women [β = 0.36, 95% CI: (0.30, 0.43)]. An increase in the consumption of a cup of coffee or tea decreased Hgb levels by 0.14 g/dL [β = -0.14, 95% CI: (-0.23, -0.06)]. Conclusion The findings showed that a comprehensive nutrition education intervention using the health belief model (HBM) and theory of planned behaviour (TPB) designed to improve dietary diversity substantially improved hemoglobin (Hgb) levels among pregnant women. While we found no single dietary factor to be significant, in this group of pregnant women in Ethiopia, an increase in the daily consumption of a cup of coffee or tea decreased Hgb levels. As a consequence, pregnant women should be advised to limit their coffee or tea consumption. The study was registered on Clinicaltrials.gov retrospectively with the registration number PACTR202201731802989 on 24/01/2022.

Background Pregnant women often exhibit comorbidities of depression and anxiety, adversely affecting maternal and foetal health. Cognitive fusion is a cognitive process in which individuals excessively identify with ideas, and it is closely related to depression and anxiety; however, their symptom-level associations are still unclear. Network analysis provides a robust method to reveal important associations between symptoms. This study employed network analysis to explore the characteristics of depression and anxiety symptoms in pregnant women and their relationship with cognitive fusion. Methods This cross-sectional study was conducted from June 2021 to August 2023 at two Asian hospital obstetric outpatient clinics in Guangzhou and Zhongshan, Guangdong Province, China, and included a total of 1691 pregnant women. Depression, anxiety symptoms and cognitive fusion were measured with the Edinburgh Postpartum Depression Scale (EPDS), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the Cognitive Fusion Questionnaire-Fusion (CFQ-F), respectively. Central and bridge symptoms were identified via centrality indices and bridge centrality indices. Network stability and accuracy were estimated. Results The prevalence of depression (EPDS score ≥ 9) was 43.00% (95% confidence interval [CI]: 40.60–45.40%), the prevalence of anxiety (GAD-7 score ≥ 7) was 31.70% (95% CI: 29.50–33.90%), and the prevalence of comorbid depression and anxiety (EPDS score ≥ 9 and GAD-7 score ≥ 7) was 25.00% (95% CI: 22.90–27.10%). “Sad or miserable”, “trouble relaxing” and “scared or panicked” were the central symptoms in the whole depression‒anxiety network. “Feeling afraid”, “scared or panicked” and “trouble relaxing” were the key bridge symptoms linking depression and anxiety. Three symptoms (“excessive worry”, “nervousness” and “sleep difficulties”) were the strongest edges connected to cognitive fusion. Conclusions This study identified the central and bridging symptoms of depression and anxiety in pregnant women using network analysis, as well as their relationships with cognitive fusion. The results highlight the clinical relevance of these symptoms in perinatal mental health management. Close monitoring of these symptoms may be crucial for reducing depression and anxiety in pregnant women. Further research is needed to verify whether these symptoms are actionable treatment priorities. Clinical trial number Not applicable.

Background According to the World Health Organization report, immigrants are at increased risk of malnutrition. Nutritional deficiencies in pregnancy are a public health concern and around 20 to 30 percent of pregnant women suffer from it worldwide. There has not been any investigation about the effect of any intervention on improving nutritional intake in pregnant Afghan immigrant women. Therefore, the present study was conducted to determine the effect of nutrition education based on the Health Belief Model (HBM) on food intake in pregnant Afghan immigrant women. Methods A semi-experimental study study was conducted on 116 Afghan immigrant pregnant women who have the inclusion criteria, were referred to health center No. 2 in Mashhad, Iran in June 2022 until February 2023, and were randomly assigned to the intervention (56) and control (56) groups. The demographic, HBM questionnaire and the standard 24-h food reminder questionnaire were the research tools. The intervention consisted of four sessions of 45–60 min of nutrition education based on the Health Belief Model in groups of 8–10 people. The questionnaires were completed before, immediately, and one month after the intervention by the research units. Data were analyzed with SPSS version 21 software. Results The intake of energy, protein, carbohydrates, and micronutrients such as iron, calcium, zinc, and vitamin D increased in the intervention group immediately and one month after the intervention significantly compared to before the intervention ( P  < 0.05). Although all these nutrients intake had a significant decrease in control group women ( P  < 0.05). Conclusions Nutrition education based on the health belief model is effective in the nutritional intake of Afghan immigrant pregnant women. According to the importance of getting enough nutrients in pregnancy and its effects on the mother and fetus’s health, nutrition education based on the Health Belief Model model is suggested for these mothers. Trial registration It is registered in the Iranian clinical trials database under the code: IRCT20220629055312N1, Date of first registration: 25/07/2022.

This was a randomised controlled study to investigate the effect of web-based breastfeeding education given to primiparous pregnant women on postpartum breastfeeding. The study included a total of 120 primiparous pregnant women, including control group (n:60) and experimental group (n:60). The study was conducted in a district in northern Turkey. Only the pregnant women in the experimental group received web-based breastfeeding education. Descriptive statistics and independent two-sample t-test analysis were used to analyse the data and to compare the demographic characteristics and scale scores according to the groups. ‘IOWA Infant Feeding Scale’, “Edinburgh Depression Scale”, “IMDAT”, “Breastfeeding Self-Efficacy Scale”, “Perception of Insufficient Milk Scale” and “Breastfeeding Motivation Scale” were administered to the experimental and control groups on the 7th day, 3rd month and 6th month after birth. Several factors, including breastfeeding motivation, breastfeeding self-efficacy, and the perception of milk sufficiency for the baby, were significantly different between the groups (p<0.001). A significant difference was found between the two groups in terms of mothers breastfeeding their babies within the first half hour after birth. All of the mothers in the experimental group breastfed their babies within the first half hour. Breastfeeding self-efficacy and motivation levels in the experimental group showed a statistically significant increase when compared to both pre-training levels and the control group. (Clinical Trials Number: NCT06443801).

Background Childbirth is considered as the happiest action that occurs in any parent's life. Although childbirth is a natural process, the choice of delivery mode is one of the concerns of pregnant women. Consequently, the objective of this study to assess the effect of antenatal education on pregnant women`s knowledge, attitude, and preferences of delivery mode. Methods A quasi-experimental research design was utilized to achieve the study utilizing 140 purposive sample of pregnant women selected from antenatal outpatient clinics at the New Obstetrics and Gynecology Hospital in Mansoura, Egypt. Results The study findings reported that there was a significant improvement in total scores of the intervention group`s knowledge and attitude toward the modes of delivery, with a highly statistically significant difference ( p  < 0.001) at post-intervention compared to the control group. Conclusion Prenatal education sessions were linked to a significantly improved maternal outcome in terms of knowledge, attitude, and preferences for delivery mode ( p  < 0.001). Trial registration ClinicalTrials.gov, NCT06561984, registered on August 19, 2024, retrospectively registered.

Background Pregnancy-related anxiety affects a significant number of women and has adverse consequences for both mothers and children. Virtual reality has emerged as an innovative strategy in the field of mental health to address anxiety disorders. However, in the field of obstetric healthcare, it has mostly been used as a distraction tool. The aim of this research was to determine the effectiveness of an immersive virtual reality intervention in reducing pregnancy-related anxiety during the third trimester of pregnancy. Methods A single-group pre-post quasiexperimental study was conducted with 73 pregnant women who participated in a prenatal education program at a health center in Madrid. The intervention consisted of an interactive and immersive simulation with virtual reality, which was carried out during the last trimester of pregnancy. Anxiety was measured before and after the intervention via the Pregnancy Related Anxiety Questionnaire (PRAQ-20). The data were analyzed using descriptive and inferential statistical tests, including logistic regression. Results The median age of the participants was 34 years. Most were university educated and had no previous children. The results revealed a statistically significant decrease ( p  < 0.001) in the pregnancy-related anxiety score following the intervention. According to the logistic regression model, the intervention significantly increased the probability of reducing anxiety ( p  < 0.047), adjusting for other variables. Conclusions Compared with other interventions that have demonstrated efficacy in decreasing pregnancy-related anxiety, such as cognitive behavioral therapy, mindfulness, and others, immersive VR intervention offers the advantage of being a brief and unique intervention. In conclusion, it could be an effective tool for reducing pregnancy-related anxiety.

During pregnancy, various factors influence sexual life, and religious attitudes play a significant role. However, studies on sexual satisfaction and religious attitudes in pregnant Muslim women are limited. This cross-sectional study, conducted in Türkiye's Mediterranean region with 230 pregnant volunteers (October 2023–March 2024), found that sexual satisfaction is significantly associated with educational status, frequency of intercourse, perceptions of safety, and feelings of shame or guilt. Despite no restrictions on sexual activity in healthy pregnancies, religious beliefs can negatively impact sexual life. The study highlights the lack of discussion on female sexuality during pregnancy in clinical settings and emphasizes the need for integrating this topic into pregnancy education. While contributing to the limited literature, findings are specific to one region and based on self-reported data, which may introduce bias Pendant la grossesse, divers facteurs influencent la vie sexuelle, et les attitudes religieuses jouent un rôle important. Cependant, les études sur la satisfaction sexuelle et les attitudes religieuses chez les femmes musulmanes enceintes restent limitées. Cette étude transversale, menée dans la région méditerranéenne de la Turquie auprès de 230 volontaires enceintes (octobre 2023 – mars 2024), a montré que la satisfaction sexuelle est significativement associée au niveau d'éducation, à la fréquence des rapports sexuels, à la perception de la sécurité ainsi qu'aux sentiments de honte ou de culpabilité. Bien qu'aucune restriction n'existe pour l'activité sexuelle lors de grossesses sans complication, les croyances religieuses peuvent avoir un impact négatif sur la vie sexuelle. L'étude met en évidence l'absence de discussions sur la sexualité féminine pendant la grossesse dans les contextes cliniques et souligne la nécessité d'intégrer ce sujet dans l'éducation prénatale. Tout en contribuant à la littérature limitée, les résultats restent spécifiques à une région donnée et reposent sur des données autodéclarées, ce qui peut introduire un biais