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Background: According to the Indonesia Ministry of Health in 2023, only 20% of pregnant women adhared to iron supplement intake. Poor adherence to iron supplementation also leads to increased prevalence of maternal anaemia and low birth weight. Objective. This review to analyze the adherence or compliance to iron supplement intake among pregnant women. Methods. The study employed a systematic review and meta-analysis based on the PRISMA 2020 guidelines. During the article selection, the study applied inclusion criteria, such as original research articles conducted in Indonesia, using Indonesian or English language, and published between 2019 and 2024. Additionally, the articles must discuss the effect of adherence to iron supplement intake on the incidence of maternal anemia and low birth weight. They were systematically searched in the following databases: PubMed, Science Direct, Springer, Google Scholar, and Proquest. To facilitate the systematic review analysis, the Odds ratio (OR) was analyzed using Review Manager 5.4. Results. A total of 16 studies (10 articles on maternal anemia and 6 articles on low birth weight) were included in this meta-analysis. The results revealed that maternal anemia had a significant relationship with adherence to iron supplement intake (OR: 0.10, 95%CI 0.06 - 0.14; p-value <0.001) and also low birth weight (OR: 0.42, 95%CI 0.21 - 0.86; p-value: 0.02). Conclusion. Based on this finding, poor adherence to iron supplement intake significantly increase risk of maternal anemia and low birth weight. Antecedentes: Según el Ministerio de Salud de Indonesia, solo el 20% de las embarazadas se adhirieron a la suplementación con hierro en 2023. La mala adherencia a la suplementación con hierro conlleva un aumento de la prevalencia de anemia materna y bajo peso al nacer. Objetivo: Esta revisión busca examinar la adherencia a la suplementación con hierro en embarazadas. Métodos: Este estudio utilizó la observación sistemática y un metanálisis basado en las directrices PRISMA de 2020. Los criterios de inclusión para la selección de artículos fueron artículos de investigación realizados en Indonesia, escritos en indonesio o inglés, y publicados entre 2019 y 2024. Además, los artículos debían abordar la relación entre la adherencia a la suplementación con hierro y la incidencia de anemia materna y bajo peso al nacer. Se realizó una búsqueda sistemática en las siguientes bases de datos: PubMed, Science Direct, Springer, Google Scholar y Proquest. En un análisis descriptivo sistemático, se analizaron las razones de probabilidades (OR) con Review Manager 5.4. Resultados: Se incluyeron en el metanálisis un total de 16 estudios (10 artículos sobre anemia materna y 6 artículos sobre bajo peso al nacer). Los resultados mostraron que la anemia materna se asoció significativamente con la suplementación con hierro (OR: 0,10; IC95%: 0,06-0,14; valor p <0,001) y el bajo peso al nacer (OR: 0,42; IC95%: 0,21-0,86; valor p: 0,02). Conclusión: Según estos hallazgos, la suplementación deficiente con hierro aumenta significativamente el riesgo de anemia materna y bajo peso al nacer.

Objetivo: Describir las interacciones que tienen las mujeres gestantes con sus familias y el programa de control prenatal para la construcción de significados sobre salud materna. Método: Estudio cualitativo, el método utilizado fue la teoría fundamentada. Se realizaron entrevistas a profundidad; el análisis de la información se hizo por medio del método comparativo constante. Los códigos sustantivos fueron consignados en un libro de Excel® (codificación abierta), posteriormente fueron ensamblados de manera explicativa aplicando el modelo paradigmático, estableciendo así las relaciones entre categorías y subcategorías (codificación axial). Finalmente, se hizo el refinamiento de las categorías y subcategorías encontradas, integrando los datos e identificando la categoría central (codificación selectiva). Resultados: Emergió una categoría central: cuidado de la salud materna caracterizado por relaciones jerárquicas entre la madre, la familia y los servicios de salud y tres categorías interpretativas aportantes a la categoría central. Conclusiones: Las interacciones con la atención prenatal y la construcción de significados de las gestantes y sus familias sobre la salud materna en el contexto de las relaciones surgidas en la prestación de los servicios de salud están definidas por el rol asumido por la gestante como receptora de información y cumplidora de ordenes emanadas por estos. Las gestantes y sus familias en su interacción con los prestadores del servicio de salud (control prenatal) no tienen la oportunidad de expresar sus opiniones acerca del cuidado de la salud durante el embarazo.

Introduction: SARS-CoV-2 infection in the perinatal period may be associated with an increased risk of morbidity and mortality in both the mother and the neonate. Objective: To describe the clinical characteristics and, laboratory and imaging findings in pregnant women with COVID-19 and their newborns. Materials and methods: We searched PubMed, Scopus, Web of Science, and Cochrane databases for systematic reviews published between February 1, 2020, and May 30, 2021, describing clinical characteristics and laboratory and imaging (chest) findings in pregnant women with COVID-19 and their newborns; there were no language restrictions. Data were reanalyzed by means of Bayesian meta-analysis using Markov Chain Monte Carlo methods. The study protocol is registered in PROSPERO under code CRD42020178329. Results: Six systematic reviews were retrieved (for a total of 617 primary studies). A narrative synthesis of the proportions of signs, symptoms, and imaging and laboratory findings of both mothers and neonates was performed. The Odds ratios (OR) between pregnant women with and without COVID-19 were as follows: fetal well-being involvement: 1.9 (95%CI:1.09-3.63); stillbirth: 1.73 (95%CI:1.01-2.94); preterm birth: 1.77 (95%CI:1.25-2.61); maternal admission to the intensive care unit (ICU): 6.75 (95%CI:1-31.19). Regarding symptomatology, the following OR was obtained for myalgia between pregnant women and non-pregnant women with COVID-19: 0.67 (95% CI:0.51-0.93). Conclusions: Cough, fever, dyspnea, and myalgia are the most common symptoms in pregnant women with COVID-19; in addition, there is a higher risk of admission to the ICU. Regarding complementary testing, the most frequent alterations are lymphopenia and the evidence of lesions in chest imaging studies. The presence of COVID-19 in pregnant women is associated with premature birth. It seems that SARS-CoV-2 infection in neonates is not serious and the risk of vertical transmission is low, since no data about congenital malformations attributable to the virus were found.

Introduction: The lack of discussions on nursing care for pregnant women with sickle cell disease in Brazil and the urgent need for intervention and improvements in the nursing care provided to these women sparked this study. In addition, validity is an essential attribute for instruments used in research and/or clinical practice. Objective: To develop and validate an instrument covering the care of pregnant women with sickle cell disease. Materials and methods: This is a methodological, content validation study conducted with specialist judges. The instrument was structured with 19 nursing diagnoses that addressed the biological, psychological, and social dimensions, as well as 126 nursing interventions. The Delphi technique was used with the participation of 18 judges. The results were analyzed using the content validity index and a level of agreement above 0.80. Results: Of the 145 items analyzed, 22 (15.17 %) scored a content validity index < 0.80, and the adjustments suggested by the judges were implemented. The instrument’s general content validity index was calculated at 0.87. The instrument reached acceptable content validity parameters, according to the criteria used. Conclusions: The instrument’s potential stands out, and it can be improved through its use as a resource for guiding nursing practices directed to pregnant women with sickle cell disease, both in primary health care and in hospital networks. Introdução: a escassez de debates sobre o cuidado de enfermagem às gestantes com doença falciforme no país e a urgente necessidade de intervenção e melhorias na assistência de enfermagem prestada às essas mulheres, motivaram este estudo. Além disso, em instrumentos para uso em pesquisa e/ou na prática clínica, a validade é um atributo essencial. Objetivo: desenvolver e validar um instrumento para cuidados às gestantes com doença falciforme. Materiais e método: estudo metodológico, de validação de conteúdo com juízas(es) especialistas. O instrumento foi estruturado com 19 diagnósticos de enfermagem que abordaram as dimensões biológica, psíquica e social, e 126 intervenções de enfermagem. Utilizou-se a técnica Delphi, com participação de 18 juízas(es). Os resultados foram analisados por meio do índice de validade de conteúdo e nível de concordância acima de 0,80. Resultados: dos 145 itens analisados, 22 (15,17 %) apresentaram índice de validade de conteúdo < 0,80, e os ajustes sugeridos pelas(os) juízas(es) foram implementados. O índice de validade de conteúdo geral do instrumento foi calculado em 0,87. O instrumento alcançou parâmetros aceitáveis de validade de conteúdo, segundo o critério utilizado. Conclusões: destaca-se o potencial do instrumento, que pode ser aprimorado a partir do seu uso, como recurso na orientação das práticas de enfermagem voltadas às mulheres grávidas com doença falciforme, nos âmbitos da atenção primária à saúde e da rede hospitalar. Introducción: la escasez de debates sobre la atención de enfermería a gestantes con anemia de células falciformes en el país y la urgente necesidad de intervención y mejora de los cuidados de enfermería prestados a esas mujeres motivaron la realización de este estudio. Además, la validez es un atributo esencial en los instrumentos para uso en investigación y/o práctica clínica. Objetivo: elaborar y validar un instrumento de atención a gestantes con anemia de células falciformes. Material y método: estudio metodológico, de validación de contenido con jueces/as expertos/as. El instrumento se estructuró con 19 diagnósticos de enfermería que abordaban las dimensiones biológica, psicológica y social, y 126 intervenciones de enfermería. Se utilizó la técnica Delphi, con la participación de 18 jueces/as. Los resultados se analizaron utilizando el índice de validez de contenido y un nivel de acuerdo superior a 0,80. Resultados: de los 145 ítems analizados, 22 (15,17 %) tenían un índice de validez de contenido < 0,80, y se aplicaron los ajustes sugeridos por los/las jueces/as. El índice global de validez de contenido del instrumento se calculó en 0,87. El instrumento alcanzó parámetros de validez de contenido aceptables, según los criterios utilizados. Conclusiones: se destaca el potencial del instrumento, que puede ser perfeccionado a través de su utilización como recurso para orientar las prácticas de enfermería dirigidas a gestantes con anemia de células falciformes, tanto en la atención primaria de salud como en la red hospitalaria.

Introduction: Gestation is a period in the life of the woman that exposes her to various physical and psychic changes. It is at this point in her life that a woman is more likely to develop mental disorders, which may be related to low level of schooling and/or socioeconomic status, being female, being single or separated, having no job, being a smoker, and have a family history of mental illness. Objective: to analyze the occurrence of mental illness in pregnant women and the associated factors. Method: cross-sectional study with quantitative approach. The study population consisted of pregnant women enrolled in Family Health Units. To collect the data, a questionnaire was used with identification data of the participants and the Self-Reporting Questionnaire (SRQ-20). Absolute and relative frequency were used to analyze the data, as well as the chi-square test without correction, chi-square test with Mantel-Haenzel extension and the chi-square test with yacht correction to analyze the association between mental illness and socio-demographic, gestational and health variables. Study approved by the Research Ethics Committee of the Federal University of Pernambuco (CAAE 64945317.1.0000.5208). Results: the proportion of suggestion of mental illness in pregnant women was 31.9% and was associated with being single, having studied until elementary school, not having planned pregnancy and having a chronic illness. Conclusions: therefore, the mental illness identified in pregnant women participating in the study may be associated with variables marital status, schooling, pregnancy planning, and chronic illness.

Objective. The aim of study is the effect of educational intervention on anxiety of pregnant women. Methods. This quasi-experimental study is done on the pregnant women referring to family physician’s offices in Gerash City, Iran. 62 women were selected and divided into 2 groups (control and intervention). In intervention group the anxiety reduction training classes were held as a group discussion in 4 weekly 90-minute sessions. Control group received routine care. The anxiety assessment completed by two groups before and after the educational intervention. The measurement instruments included a demographic information questionnaire and the short form of the Pregnancy Related Anxiety Questionnaire (PRAQ-17). Results. Comparison of the mean scores of different dimensions of pregnancy anxiety in the pre-intervention and post-intervention stages in the intervention group using paired t-test indicated a statistically significant difference in the dimensions Fear of childbirth, Fear of giving birth to a physically or mentally disabled child, Fear of mood swings and Fear of changes in marital relations (p < 0.05) in comparison with control group.  Conclusion. Holding pregnancy-training classes using group discussion method is a good strategy to reduce anxiety in pregnant women. Therefore, it is recommended that this educational  strategy classes be used with mothers from the second trimester of pregnancy in urban family physician centers or those referred to a nearby clinic.

Objective. This study investigated the effect of Extended Theory of Planned Behavior (ETPB) extended theory of planned behavior in comparison with the Theory Of Planned Behavior (TPB) in explaining the intention of Exclusive Breastfeeding Intention (EBF) in Pregnant nulliparous women of Kerman (Iran). Methods. In this descriptive study, 249 pregnant women in Kerman participated via simple random sampling. The research instruments included Questionnaire related to the structures of the theory of planned behavior, breastfeeding self-efficacy and social support questionnaire for breastfeeding. Results. The results of the correlation test showed a significant relationship between all constructs of the theory of extended planned behavior and the intention of EBF. The highest correlation belonged to the construct of subjective norms (r=0.49). Path regression coefficients in the second model showed that the Self-Efficacy mediator variable is fully capable of meaningful mediation between Social Support and Intention (p<0.001;  B=0.383). The conceptual diagram of Structural equation modeling showed a higher explained variance or R2 index for the intention variable for the developed model compared to that of the first model, i.e. (the first model: R2=0.37, the second model: R2=0.46). The goodness-of-fit index had a better status for the developed model. Conclusion. Extended TPB with social support and breastfeeding self-efficacy constructs can be appropriate model for predicting the intention and behavior of EBF

Objective: To map the diverse scientific evidence on nursing diagnoses and interventions in women with pregnancy hypertensive disorders under Primary Health Care. Materials and method: A scoping review was conducted through nine stages in seven databases and the thesis and dissertation catalog of the Coordinating Office for Improving Higher Education Personnel. The search was performed from January to March 2021. Results: A total of 2,505 articles were retrieved, of which five were included in the final review. Nine primary diagnoses from the 2009-2011 version of NANDA-I were identified. Each diagnosis was classified according to physical, psychological, behavioral, and environmental characteristics. The interventions were related to controlling pain, anxiety, hemodynamic dysfunctions, self-esteem level, fluid replacement, patient/environment hygiene, and sleep-rest ratio. Conclusions: The nursing diagnoses and interventions presented in this study corroborate the clinical practice and aid nursing professionals’ reasoning. Objetivo: mapear as evidências científicas sobre os diagnósticos e intervenções de enfermagem em mulheres com distúrbios hipertensivos da gravidez na atenção primária à saúde. Materiais e método: scoping review em nove etapas, em sete bases de dados e no catálogo de teses e dissertações da Coordenação de Aperfeiçoamento de Nível Superior. Realizou-se a busca de janeiro a março de 2021. Resultados: 2505 artigos foram recuperados, dos quais cinco foram incluídos na revisão final. Nove diagnósticos principais da versão 2009-2011 da NANDA-I. Classificou-se cada diagnóstico quanto às características físicas, psicológicas, comportamentais e ambientais. As intervenções foram relacionadas ao controle da dor, da ansiedade, das disfunções hemodinâmicas, do nível de autoestima, da reposição hídrica, da limpeza do paciente/ambiente e à relação sono-repouso. Conclusões: os diagnósticos e intervenções de enfermagem apresentados neste estudo corroboram a prática clínica e auxiliam no raciocínio do profissional de enfermagem. Objetivo: mapear las evidencias científicas acerca de los diagnósticos e intervenciones de enfermería en mujeres con hipertensión inducida en el embarazo en la atención primaria de salud. Materiales y método: scoping review en nueve etapas, en siete bases de datos y en el catálogo de tesis de la Coordinación de Perfeccionamiento de Nivel Superior de Brasil. Se realizó la búsqueda de enero a marzo de 2021. Resultados: se recopilaron 2505 artículos, de los cuales cinco se excluyeron en la revisión final. Nueve diagnósticos principales de la versión 2009-2011 de la NANDA-I. Se clasificó cada diagnóstico en cuanto a las características físicas, psicológicas, comportamentales y ambientales. Las intervenciones se relacionaron con el control del dolor, de la ansiedad, de las disfunciones hemodinámicas, del nivel de autoestima, de la reposición hídrica, de la higienización del paciente/ambiente y a la relación sueño-reposo. Conclusiones: los diagnósticos e intervenciones de enfermería presentados en el estudio corroboran la práctica clínica y auxilian en el razonamiento del profesional de enfermería.

Objective: To identify the practice of non-pharmacological methods implemented for the relief of the pain of childbirth in a university hospital, the reasons that led to using them and their degree of satisfaction.Material and method: cross-sectional study developed with 586 postpartum women in a university hospital in the south of Brazil. Data were collected from February to September 2016, from the registry of compendiums, from books of prenatal care, and a structured questionnaire applied 12 hours after childbirth. A descriptive analysis, using SPSS version 18, was carried out.Results: non-pharmacological methods best known by women were: the shower (83.1 %) and wandering (81.4 %). In the university hospital 55,5 % of the women received guidance/information on these methods. The most widely used was the shower (66.6 %). The most exposed reason was the decrease in the intensity of pain in childbirth/pain relief work (71.8 %), 89.4 % consider that the use of the method brought them benefits, and for 79,9 %, the level of satisfaction was greater than or equal to 7.Conclusion: the use of non-pharmacological methods is effective for pain relief. It is important to empower and inform pregnant women about the strategies available for the relief of pain during labour, so that they can at that time, in conjunction with health professionals, choose the best option.  Objetivo: identificar a prática de métodos não farmacológicos implementadas para o alívio da dor de parto em um hospital de ensino, os motivos que levaram a utilizá-los e o grau de satisfação.Materiais e métodos: estudo transversal, desenvolvido com 586 puérperas em um hospital de ensino do Brasil. A coleta de dados ocorreu entre fevereiro e setembro de 2016, tendo como fonte os registros dos prontuários, a carteira de pré-natal e um questionário estruturado aplicado 12 horas após o parto. Procedeu-se a uma análise descritiva por meio do SPSS, versão 18.Resultados: os métodos não farmacológicos mais conhecidos pelas mulheres foram banho (83,1 %) e deambulação (81,4 %). No hospital universitário, 55,5 % receberam orientação/informação sobre os métodos e o mais aceito foi o banho (66,6 %). O motivo mais relatado foi diminuição da intensidade/alívio da dor (71,8 %); 89,4 % consideram que a prática deste método lhes trouxe benefícios; para 79,9 %, o grau de satisfação foi maior ou igual a sete.Conclusão: o uso de métodos não farmacológicos é uma prática eficiente para o alívio da dor de parto. É importante empoderar e informar as parturientes quanto às estratégias disponíveis para o alívio da dor durante o trabalho de parto para que possam, nesse momento e em conjunto com os profissionais de saúde, escolher o melhor método. Objetivo: conocer el uso de métodos no farmacológicos implementados para el alivio del dolor durante el trabajo de parto en un hospital universitario, los motivos que llevaron a utilizarlos y el grado de satisfacción.Materiales y métodos: estudio transversal desarrollado con 586 puérperas en un hospital universitario del sur de Brasil. Se recolectaron datos desde febrero a septiembre de 2016, a partir del registro de prontuarios, de libretas de control prenatal y de un cuestionario estructurado aplicado 12 horas después del parto. Se realizó análisis descriptivo, con el empleo de SPSS, versión 18.Resultados: los métodos no farmacológicos más conocidos por las mujeres fueron: la ducha (83,1 %) y deambular (81,4 %). En el hospital universitario, 55,5 % de las mujeres recibió orientaciones/informaciones sobre estos métodos. El más utilizado fue la ducha (66,6 %). El motivo más expuesto fue la disminución de la intensidad del dolor en el trabajo de parto/alivio del dolor (71,8 %), el 89,4 % consideró que el uso del método le trajo beneficios y para el 79,9 % el grado de satisfacción fue mayor o igual a 7.Conclusión: el empleo de métodos no farmacológicos es eficaz para el alivio del dolor. Es importante empoderar e informar a las embarazadas sobre las estrategias disponibles para el alivio del dolor durante el trabajo de parto, para que en ese momento puedan, en conjunto con los profesionales de la salud, elegir la mejor opción.

Introduction: It is necessary to know the educational needs of pregnant women after the Covid-19 pandemic. Objectives: To know the educational needs of pregnant women and their preferred mans to receive that education. Method: Descriptive study through virtual survey with purposive sampling and snowball call towards pregnant women who had their deliveries during the pandemic, as well as healthcare workers dedicated to prenatal and delivery care. Educational needs, types of content and the preferred way to receive it were found out. Results: A total of 144 women participated, 34 (23.61%) pregnant and 110 (76.39%) mothers, between 17-34 years old. They stated that they needed education on prenatal/delivery care: 113 (78.47%), breastfeeding: 109 (75.69%), baby care: 108 (75.00%) maternity and Covid-19): 90 (62.50%), prevention of Covid-19 transmission to the baby, 85 (59.03%) and mental health: 79 (54.86%). They would prefer videos 114 (54.86%), by WhatsApp: 106 (73.61%) and email 82 (56.94%). Conclusions: Pregnant women, mothers need education on pregnancy care, but also on Covid-19 prevention. They suggest videos through social networks. Introducción: se requiere conocer las necesidades de educación para las gestantes en escenarios de post-pandemia por Covid-19. Objetivo: conocer las necesidades de educación para gestantes/maternas y los medios preferidos para recibirla. Método: estudio descriptivo mediante encuestas virtuales con muestreo intencional y convocatoria en bola de nieve, a gestantes/maternas cuyos partos ocurrieron en pandemia. Personal de atención prenatal y parto también fue entrevistado. Se averiguaron necesidades de educación, contenidos y formas preferidas para recibirla. Resultados: participaron 144 mujeres, 34 (23,6%) gestantes, 110 (76,4%) maternas, con edades entre 17-43 años. Manifestaron necesitar educación sobre cuidados del preparto/parto: 113 (78,5%), lactancia materna: 109 (75,7%), cuidados del bebé: 108 (75%), maternidad y Covid-19: 90 (62,5%), prevención de trasmisión al bebé: 85 (59%) y salud mental: 79 (54,9%). Preferirían videos 114(79,2%), por WhatsApp: 106 (73,6%) y correo electrónico: 82 (56,9%). Conclusiones: las maternas necesitan educación sobre cuidados de la gestación, pero también sobre prevención del Covid-19. Sugieren videos a través de redes sociales.