Family Support to Women During Pregnancy and Its Impact on Maternal and Fetal Outcomes.

BACKGROUND: Family support is one of the determinants of lifestyle habits and relevant health behavior for pregnancy outcomes. In India, the joint family system is still practiced. Due to education, urbanization, and industrialization, the family institution continues to play a central role in people's lives. Pregnancy is a crucial period in women's lives. Good care during pregnancy is important for the health of the mother and the newborn baby. During this period, hormonal changes are complex and involve multiple hormones working together to support the developing fetus and prepare the mother's body for labor, delivery, and breastfeeding. To avoid maternal and fetal complications, she needs support from her family throughout pregnancy and the postnatal period. AIM AND OBJECTIVES: This study aims to evaluate the influence of the level and quality of family support during pregnancy on maternal and fetal outcomes and to identify any association between the sociodemographic variables and the impact of the level and quality of family support during the first trimester. MATERIAL AND METHODS: This study used a quantitative approach with a survey research design. Data were collected from four Primary Health Centers at Karad, Maharashtra, India, i.e., Rethare, Vadgaon, Kale, and Supane. A consecutive sampling technique was used to select the 344 subjects from the Rethare, Vadgaon, Kale, and Supane areas of Karad Taluka. Data were collected before the completion of the first three months of pregnancy, then during the second trimester and after delivery. Upon evaluation, the tool was validated by experts representing a range of specialties, including community health nursing, mental health nursing, obstetric gynecology, and pediatric care. A pilot study was conducted on 30 samples. The data collected were analyzed by using descriptive and inferential statistics. RESULT: The findings of the study show a significant association between the psychosocial support received in the first trimester and the total gestational weeks completed at the time of delivery (p < 0.05). The study suggests the need for psychosocial support during the first trimester for better maternal and fetal outcomes. CONCLUSION: Psychosocial family support is needed by pregnant women during the first trimester to achieve maternal and fetal outcomes.

Effectiveness of back massage on pain relief during first stage of labor in primi mothers admitted at a Tertiary care center.

BACKGROUND: Labor pain is one of the most severe pains a woman experiences in her life, causing an increase in the anxiety and stress levels. Massage therapy has proven beneficial for relaxation purposes. AIM: To evaluate the effectiveness of back massage in relieving pain during the first stage of labor in primi mothers. METHODOLOGY: The study included 40 primipara mothers belonging to the age group 22-25 years, equally divided into 2 groups: Experimental (massage therapy) and control (routine care). The socio-demographic data, labor assessment parameters (cervical dilation, status of fetal membranes, frequency and duration of uterine contractions during the latent and active phase of labor, and the total duration of the first stage of labor), and the level of labor pain (numerical rating pain scale) were recorded. Data analysis was performed by one-way ANOVA and two independent samples t-test (P ≤ 0.05 as significant). RESULTS: During the latent and active phase of labor, majority of the mothers experienced 4-5 contractions in a span of 10 min. During the latent phase of labor, uterine contractions for 20-40 s were exhibited by 90% and 75% mothers in the experimental and control group, respectively; and during active phase, contractions of >40 s were exhibited by 85% mothers in both groups. A significant difference in the post-test pain scores was noted between the 2 groups (P < 0.0001). CONCLUSION: Our study proved that back massage was effective in reducing pain during the first stage of labor in primipara mothers in comparison to those who were subjected to routine care.

Development of Risk Scoring Scale Tool for Prediction of Preterm Birth.

BACKGROUND: Prediction of preterm births in the early stage during pregnancy may reduce prevalence of preterm births by appropriate interventions. AIMS/OBJECTIVE: The aim of the study is to develop an antenatal risk scoring system/scale for prediction of preterm births. SUBJECTS AND METHODS: From a cohort of 1876 and subset of 380 pregnant women attending Krishna Hospital Karad, Maharashtra, routine antenatal and in-depth information on diet, occupation, and the rest were collected and analyzed using SPSS version 16. A scoring system was developed by multivariate analysis based on the relative risk (RR) and tested on separate set of 251 mothers. STATISTICAL ANALYSIS USED: Bivariate analysis by Chi-square test, backward multivariate regression model, receiver operating characteristic curve (ROC) curve analysis, and calculation of RR for identified risk factors. Sensitivity and specificity of newly developed risk scoring scale. RESULTS: Out of six risk factors from whole cohort (n = 1876) and three risk factors from subsample (n = 380) identified by bivariate analysis. Further four and three risk factors were retained after multivariate analysis from whole and part of cohort, respectively, and risk scores of "7" and "9" were assigned based on RR cutoff levels of three and five were identified separately for whole and part data by ROC curve analyses together making it "8" with 75.5% sensitivity and 85.5% specificity when tested on 251 independent patients. Based on the prevalence of preterm births, low-, moderate-, and high-risk grading was done by identifying as second cutoff value. CONCLUSIONS: Identification of low-, moderate-, and high-risk of preterm births was possible at <8, 8, and 9 and equal to ≥10 with high sensitivity at lower cutoff and high specificity at upper cutoff.

Antenatal Risk Scoring Scale for Predication of Low Birth Weight and Its Validity.

BACKGROUND: Prediction of low birth weight (LBW) early during pregnancy may prevent LBW by appropriate interventions. AIMS/OBJECTIVE: The aim of the study is to develop an antenatal risk scoring scale for prediction of LBW. SUBJECT AND METHODS: Routine and in-depth information on diet, occupation, and rest was collected from November 1, 2013, to November 13, 2015. A cohort of 1876 and subset of 380 pregnant women attending Krishna Hospital Karad, Maharashtra, India. STATISTICAL ANALYSIS: Multivariate analysis and relative risks (RRs) were found out by SPSS version 16 and tested on a separate set of 251 mothers. RESULTS: The frequency of meals of <4, hard work <6 h of sleep and illiteracy, antenatal morbidity, <10 kg weight gain, <40 kg maternal weight, and anemia during the first trimester were the risk factors identified from subset and cohort, respectively. Based on their RRs, a new scoring system with a total score of 24 and cutoff "12" was identified by using receiver operating characteristics (ROC) curve analysis with 98.6% sensitivity and 41.1% specificity as tested on 251-independent individuals. The second cutoff of "15" score was identified based on the prevalence of LBW in babies of these 251 mothers. CONCLUSIONS: The identification of low-, moderate-, and high-risk of LBW was possible at <12, between 12 and 15, and >15 scores, respectively, with good sensitivity and specificity.