Pregnancy outcome among high-risk pregnant women in the rural area of Belagavi.

Background: India has around 25% high-risk pregnant mothers, which leads to about 75% perinatal morbidities.(1) The early prediction of a high-risk pregnancy and planning interventions can help in preventing complications and result in good pregnancy outcomes. Aims: To study the pregnancy outcome among the high-risk pregnant women of a rural area and to associate pregnancy outcomes of high-risk pregnant women with modified Coopland's criteria. Material and Methods: Study design: 1-year Longitudinal study from 2016 to 2017, Study population: The high-risk pregnant women attending PMSMA camp, Study area: Kinaye, Primary Health Centre, Belagavi. Sample size: 147, Data collection was done using a pretested predesigned questionnaire after obtaining patient consent and ethical clearance. Chi-square test was used to study the association of variables and categorical data presented as percentages. Results: Among the participants, 40.4% of the pregnant women had low-risk scores; 45.9% had high-risk scores, and 13.7% had severe-risk scores according to Coopland's high-risk pregnancy scoring. Nearly 29.5% high-risk pregnancies resulted in bad fetal outcomes. As Coopland's score in the high-risk group increased, the chance of having good fetal outcomes decreased, and this association was found to be statistically significant. Conclusions: 70.5% of the high-risk mothers had good pregnancy outcomes. The scoring system can be used by health workers for the prediction of high-risk pregnancy and plan treatment and preventive measures.

Prevalence of intimate partner violence among pregnant women attending a public sector hospital in Bengaluru, southern India.

Background Intimate partner violence (IPV) is recognized as an important public health problem globally as well as in India. It may result in adverse physical and mental health consequences for the victim or unfavourable pregnancy outcomes if it happens during pregnancy. The possible risk factors for IPV can be explained by four levels of ecological factors: individual, partner, household and community. We estimated the prevalence of IPV and its association with selected ecological risk factors among pregnant women availing of antenatal care at a public sector hospital in Bengaluru, southern India. Methods We included 350 women above the age of 18 years with a confirmed pregnancy of less than 24 weeks and having no obstetric complication. We used the Conflict Tactics Scale to determine the presence of IPV. The risk factors measured were-individual level: respondent's age, education, occupation, gravidity, planned or unplanned pregnancy, substance abuse, presence of depression and anxiety; partner-related: spouse's education, occupation and marital discord; household/community-related: socioeconomic status, social support, religion and consanguinity. Results The prevalence of IPV was 3.7%. Factors that were significantly associated on multivariate analysis were higher age (above 20 years) (adjusted odds ratio [AOR] 1.82 [1.12-2.97], p=0.016) and presence of depression (AOR 6.84 [1.76-26.61], p=0.005). Conclusion The prevalence of IPV was less in our study population compared to figures reported from other Indian study settings.

Prevalence of hypertension in pregnancy and its associated factors among women attending antenatal clinics in Bengaluru.

BACKGROUND: Hypertension in pregnancy is a major challenge in antenatal practice due to its impact on obstetric and foetal outcomes. OBJECTIVE: To assess the prevalence of hypertension during pregnancy and its associated risk factors among pregnant women availing of antenatal care at public sector hospitals in Bengaluru, Southern India. METHODS: The sample frame included pregnant women who were attending the antenatal clinic at three public sector hospitals. The data were analyzed for 783 pregnant women who had completed their baseline visit over a period of 18 months (September 2017 to March 2019). The blood pressure was categorized based on the American College of Cardiology/American Heart Association 2017 guidelines. RESULTS: Out of the 783 respondents who were examined, 13.9% were found to be hypertensive. The adjusted Odd's ratio was significantly higher for those who were employed outside the house and obese respondents. Other factors such as higher maternal age, lower socioeconomic status, pregnancy-related anxiety, prenatal depression, nulliparity appeared to increase the risk. CONCLUSION: Hypertension during pregnancy continues to be a matter of concern. Risk factor profiling of pregnant women is of utmost importance to identify those who may be likely to develop hypertensive disorders during pregnancy.

Prevalence of cognitive impairment in elderly population residing in an urban area of Belagavi.

CONTEXT: Cognitive impairment (CI) is emerging as an important health problem of the elderly population in India. As the impact of this illness at various levels is not well understood, so situation analysis is the need of the hour. AIMS: (1) To know the prevalence of CI in elderly population residing in an urban area. (2) To assess the burden of health care among the care givers. SETTINGS AND DESIGN: A cross-sectional study was carried out among 770 elderly aged ≥60 years residing in two Urban Health Centres of Belagavi District. METHODS AND MATERIAL: Socio-demographic profile of the participant was collected using a predesigned and pretested questionnaire by personal interview at the participants' residence. To assess the CI and burden of healthcare, Mini Mental State Examination and Zarit Caregiver Burden Scale were used, respectively. STATISTICAL ANALYSIS USED: IBM SPSS version 22 was used. Chi square test and Fisher's Exact test were applied. RESULTS: The overall prevalence of CI was 8.4% in our study. The risk factors noted for CI were advancing age, female sex, unmarried or widow/widower, illiterate, not working presently, staying alone, and poverty. Out of 65 caregivers, 67.7% of them had mild or moderate burden of caring for the cognitively impaired elderly. CONCLUSIONS: It is important to assess older people for any CI, when planning geriatric health care. Priority must be given to the older age group and female, as they are more vulnerable to CI.

The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India.

Background: A pregnant woman undergoes physiological as well as psychological changes during this phase of life during which anxiety is a commonly faced mental condition. There is sufficient evidence on the association of pregnancy specific anxiety with adverse pregnancy outcomes. Studies on anxiety during pregnancy from low and middle income countries are limited. Methods: This study included 380 pregnant women, having a confirmed pregnancy of less than 24 weeks without any obstetric complication, who were availing of antenatal care at a public sector hospital in Bangalore city. Pregnancy-related thoughts (PRT) scale was used to screen for anxiety. Details pertaining to sociodemographic data, obstetric history, psychosocial factors including social support, marital discord, domestic violence, consanguinity, history of catastrophic events, history of mental illness, current presence of depression and anxiety was obtained by means of electronic data capture using an Android-based App. Results: Out of 380 pregnant women, 195 (55.7%) were found to have pregnancy-related anxiety. Lower socioeconomic status, low social support and depression emerged as significant determinants of anxiety. Conclusion: The prevalence of anxiety was fairly high in the study population and isp therefore an important public health concern. Pregnancy-related anxiety must be identified early during routine antenatal care to prevent any untoward pregnancy outcomes.

Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study.

Background: Depression is the commonest psychological problem that affects a woman during her perinatal period worldwide. The risk of prenatal depression increases as the pregnancy progresses and clinically significant depressive symptoms are common in the mid and late trimester. There is a paucity of research on depression during the prenatal period in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. Methods: The study was nested within an on-going cohort study. The study participants included 280 pregnant women who were attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected by using a structured questionnaire which included. Edinburgh Postnatal Depression Scale (EPDS) to screen for prenatal depression. Results: The proportion of respondents who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety and a recent history of catastrophic events were also found to be a positive predictors of prenatal depression. Conclusion: The high prevalence of prenatal depression in the present study is suggestive of its significance as a public health problem. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided.

Prevalence and risk factors of anemia among pregnant women attending a public-sector hospital in Bangalore, South India.

BACKGROUND: Anemia affects almost two-thirds of pregnant women in developing countries and contributes to maternal mortality and low birthweight. According to the National Family Health Survey-4 reports, maternal anemia continues to be a public health problem. OBJECTIVE: To study the prevalence of anemia and its risk factors among pregnant women attending a public-sector hospital. MATERIALS AND METHODS: This study was nested within an ongoing cohort study "ÇASCADE" which is exploring the effect of prenatal exposure to maternal cortisol and psychological distress on infant development in Bangalore. The respondents were enrolled from the antenatal clinic at Jayanagar General Hospital, which is a sub-district hospital. A total of 280 women who fulfilled the eligibility criteria were enrolled. RESULTS: The prevalence of anemia was observed to be 33.9%; proportion of mild and moderate anemia was almost similar (48.4 and 49.5%). The mean hemoglobin level of all the participants was 11.33 ± 1.460 g/dl. The mean hemoglobin level concentration was high during early gestation with a slight decrease by 21-24 weeks. Prenatal depression but not anxiety appeared to be a strong predictor of anemia on bivariate as well as multivariate analysis. No association was observed with socio-demographic and obstetric variables. CONCLUSION: The burden of maternal anemia was considerably high in the study population. Although iron-folic acid supplementation is available under the national health program to address this issue, it is important to consider and address other risk factors when designing and implementing target interventions for anemia control in selected populations.

Prediction of low birth weight using modified Indian council of medical research antenatal scoring method.

OBJECTIVE: To study the prediction of low birth weight (LBW) using modified Indian Council of Medical Research (ICMR) antenatal scoring method. METHOD: The present longitudinal study was carried out amongst 1138 pregnant women residing in area covered by Kinaye primary health centre (PHC) in rural Karnataka, India. RESULTS: Modified ICMR risk scoring revealed that 597 (52.5%) women had a risk score 6-10 (mild risk), 142 (12.5%) women had risk score 11-15 (moderate risk) and 29 (2.5%) had risk score ≥16 (severe risk), whereas, remaining 370 (32.5%) had a score of 0-5 considered as "no risk group". The incidence of LBW had direct relationship with the risk score. The sensitivity was high (80.6%), whereas, specificity was slightly low (70.4%), positive predictive value was low (43.8%) and negative predictive value high (92.7%) for LBW when the risk score cut-off point was >7. CONCLUSION: The modified ICMR antenatal scoring method can be used at all levels of health care and is an ideal instrument for prediction of LBW at the community level. It can be easily applied by even a health worker, not time consuming and at the same time does not lose its predictability.

Factors affecting birth weight of a newborn--a community based study in rural Karnataka, India.

BACKGROUND: Low birth weight (LBW) is a major public health problem in many developing countries, especially so in India. Although we do not know all the causes of LBW, maternal and environmental factors appear to be significant risk factors in its occurrence. OBJECTIVES: To know the factors affecting the birth weight of a newborn and to estimate the prevalence of LBW. METHODS: The present study was carried out amongst 1138 pregnant women and their newborns residing in area covered by Kinaye Primary Health Centre in rural Karnataka, India. The study was conducted from 1(st) June 2008 to 31(st) December 2009. RESULTS: The mean birth weight of newborns was 2.6 kg with a range of 1.2 to 3.8 kg. The prevalence of LBW was 22.9%. Among the studied risk factors, 25 of them were significantly associated with the birth weight of a newborn on univariate logistic regression analysis. Maternal education [Odds Ratio (OR) 3.2], exposure to passive smoking [OR 2.3], age at first pregnancy ≥25 years [OR 3.6], birth interval <2 years [OR 2.4], previous history of LBW baby [OR 3.3], weight gain ≤4 kg during pregnancy [OR 7.0], maternal weight at last week of gestation ≤45 kg [OR 2.3], pregnancy induced hypertension [OR 3.3], high risk pregnancy [OR 3.6] and late antenatal registration [OR 3.6] emerged as significant risk factors on multivariate analysis. CONCLUSION: The problem of LBW is multidimensional, and hence, we need an integrated approach incorporating medical, social, economical and educational measures to address this issue.

Nutritional status of under-fives in rural area of South India.

BACKGROUND: Malnutrition is widely recognized as a major health problem in developing countries. It is wide spread in rural, tribal and urban slum areas. Growing children are most vulnerable to its consequences. Anthropometry is a simple field technique for evaluating physical growth and nutritional status of the children. OBJECTIVE: To assess the nutritional status of under-fives'. MATERIALS AND METHODS: This cross sectional study was conducted in Kakati-A sub-centre, under Primary Health Centre Vantamuri of Belgaum district. The sample size was 290. Data collection was done using pre-designed and pre-tested questionnaire. STATISTICAL ANALYSIS: Distribution of variables was assessed and comparison was done using chi square test and P value. RESULTS: The prevalence of underweight, stunting and wasting was observed to be 26.55%, 31.38% and 7.59%, while severe degree of underweight, stunting and wasting was observed in 5.86%, 27.24% and 6.51% respectively according to World Health Organization (WHO) 2006 classification. According to the Indian Academy of Pediatrics (IAP) classification the prevalence of Grade I malnutrition was 121 (47.10%), Grade II was 29 (10.00%) and Grade III and IV were 4 (1.40%). CONCLUSION: Majority of the children's diet was not adequate for calories and proteins as per Indian Council for Medical Research (ICMR) guidelines. Less than half of children were underweight, nearly one third were stunted and one fifth of children were wasted. No child was found to be overweight or obese.