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Ekéus, Cecilia. "Teenage parenthood : paternal characteristics and child health outcomes /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-033-8/.
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Hertfelt, Wahn Elisabeth. "Teenage childbearing in Sweden : support from social network and midwife /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-289-7/.
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Simmons, Bonnie J. "Understanding Teen Pregnancy through the Younger Sister's Voice: A Focused Ethnography." unrestricted, 2006. http://etd.gsu.edu/theses/available/etd-07272006-212237/.
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Thesis (Ph. D.)--Georgia State University, 2006.Title from title screen. Sherry Gaines, committee chair; Kathleen Wilson, Wendy Simonds, committee members. Electronic text (144 p.) : digital, PDF file. Description based on contents viewed May 16, 2007. Includes bibliographical references (p. 141-144).
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Rapeta, Seshoka Joseph. "Managerial imperatives of teen motherhood in public secondary schools." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/40448.
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This study aims at investigating the managerial imperatives of teen motherhood in
public secondary schools in the Mamaila circuit, Limpopo province. The focus is on the
managerial imperatives of teen mothers that principal must fulfil; the experiences of
principals that have teen mothers in their school; the ability of the principals to fulfil
these managerial imperatives; and the kinds of support principals give teen mothers.
The study was informed by the legal framework entrenched in Chapter 2 (Bill of Rights)
of the Constitution of South Africa, especially such concepts as equality, human dignity, security, the interest of the child, the right to basic education and the safety of learners.
In South Africa it is illegal to expel pregnant girls in terms of the Constitution of the
Republic of South Africa (hereafter Constitution) (RSA, 1996a). Schoolgirls who become
pregnant are allowed to return to school after giving birth (Kaufman, De Wet and
Stadler, 2001:147). The learner pregnancy policy (DoBE, 2007) puts obligations to
principals to deal with each case confidentially (i.e. to respect the human dignity of the
learner); to support the learner by encouraging her to continue with education prior to
and after the delivery of the baby; to put in place appropriate mechanisms to deal with
unfair discrimination, hate speech or harassment that may arise.
The findings have revealed that most of the principals are not aware of the departmental
policy on learner pregnancy, but they acknowledge that it is unconstitutional to expel a
pregnant learner. Principals find it difficult to liaise with learners who are on maternity
leave in terms of giving them school tasks as advocated by the learner pregnant policy
(DoBE, 2007). Learners who are entitled to receive a child-support grant disrupt school
on the social grant payday by queuing for permission to go to local pay points.
Principals also experience late-coming and absenteeism from teen mothers due to a
lack of reliable people to care for their babies during the school day. The performance of
teen mothers deteriorates due to the household chores of taking care of the baby and
having no time to attend extralessons or afternoon study sessions at school.
The study has also revealed that principals engage the local clinics officials to present
pregnancy awareness with the learners as a way of educating them.Dissertation (MEd)--University of Pretoria, 2013.
gm2014
Education Management and Policy Studies
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Beesham, Nirupa. "The life-world of the schoolgirl-mother." Thesis, University of Zululand, 2000. http://hdl.handle.net/10530/1156.
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Submitted in fulfillment of the requirements of the degree Master of Education in the Department of Educational Psychology in the Faculty of Education at the University of Zululand, South Africa, 2000.The aim of this study was to investigate the life-world of the schoolgirl-mother. The study commenced with an orientation framework in which the problem of the high incidence of teenage pregnancies was analyzed. The orientation to this study is followed by a chapter concerning the design of the research, substantiating the choice of format, methods of data collection and analysis. A qualitative research method was chosen on account of its explorative, descriptive and contextual nature. Data was collected by means of interviews with schoolgirl-mothers. The data was analyzed by using a phenomenological approach in which emerging themes were identified. This was followed by a literature review to compare and complement the qualitative data analysis. The results from the qualitative research showed that adolescent girls are not adequately informed about the meaning of the onset of menarche and this lack of authentic knowledge may result in teenage pregnancy while still in school. Most girls fell pregnant between the ages of 15 and 17 years. Schoolgirl-mothers also indicated their lack of knowledge concerning the availability and use of contraceptives. The study revealed a relation between socio-economic status and teenage pregnancy and a recurrence of adolescent parents with each new generation. Teenage pregnancy is associated with interruption in schooling and school dropout. In the literature review the life-world of the schoolgirl-mother was discussed. She can only form a meaningful life-world by forming meaningful relationships with the self, other people, things and ideas and religion. Being a teenage mother causes these relationships to become impaired because the girl is not mature enough or emotionally ready for the responsibilities of motherhood. The study concludes with findings from the research and the following recommendations were made: Accountable sexuality education must be available to all teenagers. Clinics must be easily accessible with adequately equipped personnel to assist teenagers on all aspects of sexuality.
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Kubheka, Zenzele Leonard. "The relationship between child support grant and teenage pregnancy." Thesis, University of Zululand, 2013. http://hdl.handle.net/10530/1337.
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A dissertation submitted in the Faculty of Education in partial fulfilment of the requirements for a Masters degree in Educational Psychology at the University of Zululand, South Africa, 2013.This study examined the relationship between the Child Support Grant (CSG) and teenage pregnancy. The first objective of the study was to establish the relationship, if any, between teenage pregnancy and the Child Support Grant. The second objective was to determine whether or not the variable of educational level, religious affiliation, and location play a role in teenage pregnancy and the support grant. In order to achieve the aims of the study, the researcher constructed his own scale. The study used a quantitative methodology to establish the relationship between Child Support Grant and teenage pregnancy. Questionnaires were used to collect data. The questionnaires were distributed to fifty participants representing the total sample of the study. These questionnaires were correctly completed and were analysed using SPSS. The chi-square measure of association was used to test for the relationship between CSG and teenage pregnancy. The findings of the study indicated that teenagers differ in terms of whether there is a relationship between CSG and teenage pregnancy. Forty eight per cent of the participants were found to have a negative view on the notion that there is a relationship between CSG and teenage pregnancy, and fifty two per cent were favourably disposed. However, the difference was not statistically significant. In answering the second research question, this study revealed that variables such as educational level, location and religious affiliation did not have any influence on child support grant. This was confirmed by statistical tests performed. The limitations of the study were identified and suggestions for further research were documented.
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Hinz, Jessica G. "Prediction of child abuse potential of pregnant teens : social support, conflict, attachment /." free to MU campus, to others for purchase, 1997. http://wwwlib.umi.com/cr/mo/fullcit?p9841149.
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Ramirez, Starr Downey, and Debbie Vega. "Child sexual abuse as a factor in adolescent pregnancy." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1154.
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Kanyinda, Muya. "Reasons for pregnancy among women on prevention of mother-to-child transmission (PMTCT)program in Serowe-Botswana." Thesis, University of Limpopo (Medunsa Campus), 2009. http://hdl.handle.net/10386/245.
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Thesis (MPH)--University of Limpopo,2009.Background: Women living with HIV frequently report in the clinic with pregnancy despite their health status and knowledge of mother-to-child transmission HIV. This study assessed the level of knowledge of Prevention of Mother-to-Child Transmission (PMTCT) and the reasons for pregnancy among women on PMTCT in Serowe, Botswana. Objectives: The objectives of this study were to assess the level of knowledge of the PMTCT program and vertical transmission among HIV-positive women in Serowe; evaluate the reasons for pregnancy among HIV-positive pregnant women enrolled in the PMTCT program as well as describe the practices of family planning among these women in Serowe. Methodology: The study was a cross-sectional descriptive survey using qualitative method. Twenty six (26) participants attending PMTCT clinics at Serowe clinic, Nutrition clinic, and Kadimo clinic participated in the study between October and December 2008 after consenting to participate. Research assistants conducted in-depth interviews to collect socio-demographic data of the participants. Qualitative methods were used to collect data about the women’s level of understanding of the PMTCT program, reasons for falling pregnant, types and duration of their relationships with their partners and family planning practices. The interviews were conducted in the local language (Setswana) and then translated into English by the research assistant for transcribing. Their responses were audio taped. Results: The results indicated that most of pregnancies were unplanned. However, 26.9 % of participants said that they became pregnant because they desire to have another child. A number of participants ( 15.4%) indicated that they became pregnant because their partners wanted a child. Although all 26 participants had good knowledge and understanding of the family planning practices, but only 18 (69.2 %) had used the family planning methods before falling pregnant. The findings in this study revealed good social suport from the family members and the disclosure of HIV status was not a big issue to the participants. Majority of respondents (66.6%)) had good knowledge and understanding of the PMTCT program. One-third of the participants were single, ninety- six percentages of participants were unemployed, and about one-third of them live on less than 50 U$ dollars per month. Conclusion: As the desire to have children is usually perceived as a normal part of life for all women, including women living with HIV. Most women chose not to become pregnant after knowing their HIV status (HIV-positive) but the found themselves with unplanned pregnacy. The women with a procreative inclination were found to be more likely to choose to become pregnant which outweighed social support and personal health concerns. Additional factors included fear of transmitting HIV to their child, personal health-related concerns, unemploment and poverty. Participants had good knowledge of PMTCT program. The use of family planning by participants was poor despiste their good knowledge about it
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McCormick, Rachel L. "An investigation into domestic violence, violence in pregnancy and implications for mother-child relationships." Thesis, Bangor University, 2001. https://research.bangor.ac.uk/portal/en/theses/an-investigation-into-domestic-violence-violence-in-pregnancy-and-implications-for-motherchild-relationships(51953b26-aa3c-40a0-b971-78603e92d218).html.
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This study investigated the experiences of women subjected to domestic violence with a particular focus on violence during pregnancy and implications for the mother-child relationship. This is an area of increasing attention in health settings as the potential impact on women and children has been well established. Specific aims of the study were to investigate the impact of violence during pregnancy on women and their children and to assess whether the risk of child abuse is increased. In addition, the impact of violence on the mother-child relationship and the role of maternal mental health were investigated. Fifty-two women took part in the study, 28 of whom had experienced domestic violence; over half of these experienced violence during pregnancy. In addition to the questionnaire-based study, four women who had experienced domestic violence during pregnancy also took part in a semi-structured interview. The main findings highlighted an increased risk of child abuse in domestic violence cases but the risk was not increased in relation to violence in pregnancy. In addition, women who experienced domestic violence were more likely to perceive their child to be at risk from abuse. An increased prevalence of physical and mental health problems during pregnancy was found in women who experienced violence during the pregnancy. Domestic violence was associated with higher levels of maternal distress and child agency involvement. A mediation analysis of the mother-child relationship revealed that maternal distress was the stronger predictor of the quality of the relationship, although the experience of violence was also an important factor. Implications of the findings, limitations of the study and future research directions are discussed.
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Rust, Amy J. "Teenage pregnancy, depression, and high risk parenting attitudes in relation to child physical abuse the importance of school programs /." Online version, 1999. http://www.uwstout.edu/lib/thesis/1999/1999rustam.pdf.
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Pirkola, J. (Jatta). "Gestational diabetes:long-term, metabolic consequences for the mother and child." Doctoral thesis, University of Oulu, 2010. http://urn.fi/urn:isbn:9789514261701.
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Abstract
Gestational diabetes (GDM) indicates increased risk for diabetes and the metabolic syndrome in women. Research on prenatal exposure to GDM as a risk factor for metabolic diseases is conflicting. Overweight (body mass index ≥ 25 kg/m2) is a strong risk factor for GDM and metabolic diseases; however, there are few published previous studies distinguishing the separate effects of overweight and GDM on the later risk for metabolic diseases in women and their children.
The present study evaluated pre-pregnancy overweight and GDM as determinants of long-term risk for diabetes and hypertension in women, and the metabolic consequences of prenatal exposures to maternal pre-pregnancy overweight and different types of maternal diabetes in children. The results are based on prospective, clinical data from Oulu University Hospital (n = 63 mothers and their children), and the Northern Finland Birth Cohort 1986 (NFBC 1986, n = 9,362 mothers and their 9,479 children).
Compared to normal-weight mothers with normal glucose tolerance in pregnancy, the NFBC 1986 mothers with simultaneous pre-pregnancy overweight and GDM had strikingly high risks for developing diabetes (hazard ratio, HR 47.2; 95% confidence interval 25.5–87.4) and hypertension (HR 9.2 [6.1–13.9]) twenty years after delivery. The risks for these diseases were elevated in mothers with pre-pregnancy overweight even when they had normal glucose tolerance during pregnancy (HR diabetes 12.6 [7.4–21.6], HR hypertension 2.9 [2.1–3.9]). GDM per se indicated increased risk only for diabetes (HR 10.6 [4.2–27.0]).
In the cohort from Oulu University Hospital, increased fasting insulin concentration (P = 0.04), first phase insulin response (P = 0.03), and HOMA-B (P = 0.008) were already observed at pre-school age in the offspring of mothers with Type 1 diabetes compared with offspring of mothers with GDM.
In the NFBC 1986 offspring, the prevalence of metabolic syndrome was 2.4% at age 16 years, using the International Diabetes Federation pediatric definition. Abdominal obesity, a waist girth over half one’s length, defined approximately 85% of the adolescents with metabolic syndrome. The risks for overweight and abdominal obesity were high in those with prenatal exposure to both maternal pre-pregnancy overweight and GDM (odds ratio for overweight 4.1 [1.9–8.6], for abdominal obesity 3.8 [1.7–8.8]). In children of normal-weight women, prenatal exposure to GDM was not associated with increased risk of these outcomes.
Based on this study, preventing and reducing overweight in fertile age seems to be a key target for preventing metabolic diseases in women and their children.
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Päkkilä, F. (Fanni). "Thyroid function of mother and child and their impact on the child’s neuropsychological development." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526211268.
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Abstract Maternal gestational thyroid dysfunction has been associated with adverse neuropsychological development in children. This study investigated the effects of maternal thyroid dysfunction in early pregnancy and/or antibodies on the thyroid function and antibody status of children, as well as their association with the offspring’s ADHD symptoms, scholastic performance and sensory development. The study population consisted of the Northern Finland Birth Cohort of 1986. The mothers’ TSH, fT4 and TPO-Ab concentrations were evaluated in early pregnancy and in their offspring at 16 years of age. Data on the mothers and their families, their child’s health, development, behavior and scholastic performance were collected via parental questionnaires conducted in early pregnancy and when the children were 7-8 and 16 years old. Their teachers evaluated the children’s behavior and scholastic performance at 8 years of age, and at 16 years old the adolescents evaluated themselves. Maternal gestational thyroid dysfunction associated with adolescents’ increased odds of having the same thyroid dysfunction type. Adolescents of TPO-Ab-positive mothers had increased odds of being TPO-Ab-positive themselves. TPO-Ab-positive children had increased odds of having thyroid dysfunction. Increasing maternal TSH concentrations increased a child’s odds of having ADHD symptoms (OR 1.4 [95% CI 1.1-1.8]). Children of hypothyroxinemic mothers had increased odds of repeating a class at school (OR 3.5 [1.1-11.5]), and those of hyperthyroid mothers had increased odds of Finnish language learning difficulties (1.6 [1.03-2.4]). Furthermore, thyroid dysfunction in adolescents increased their odds of learning difficulties. No association was observed between maternal thyroid dysfunction and a child’s diagnosed intellectual deficiency and sensory development. Maternal thyroid dysfunction during pregnancy associated with thyroid dysfunction in the offspring. Maternal thyroid dysfunction may have a mild impact on her offspring’s neuropsychological development, but it had no effect on a child’s risk of diagnosed intellectual deficiency or sensory development. Children have compensatory mechanisms for overcoming early developmental thyroid hormone insufficiencies. Randomized trials for screening and treating maternal thyroid dysfunction during pregnancy are needed to evaluate the benefits to offspringTiivistelmä Äidin raskauden aikaiset kilpirauhasen toimintahäiriöt on yhdistetty lapsen neuropsykologisen kehityksen ongelmiin, mutta aiempi tutkimustieto aiheesta on ristiriitaista. Tämän vuoksi tutkimme äidin raskauden ajan kilpirauhasen toimintahäiriöiden ja/tai vasta-aineiden vaikutusta nuoren kilpirauhastoimintaan ja vasta-ainestatukseen, ja näiden molempien vaikutusta lapsen ADHD-oireisiin, koulumenestykseen ja aistien kehitykseen. Tämän väitöskirjatyön aineistona oli väestöpohjainen Pohjois-Suomen syntymäkohortti 1986, johon kuuluu yli 99 % alueen raskaana olevista naisista. Äitien TSH, T4-V ja TPO-Ab – mittaukset tehtiin alkuraskaudessa ja kohortin lasten mittaukset 16-vuotiaana. Molempien kohdalla käytettiin väestöpohjaisia viitevälejä toimintahäiriön määrittämiseksi. Tietoja raskaudesta, äidin ja muun perheen sairastavuudesta, elintavoista ja sosioekonomisista tekijöistä ja lapsen terveydestä, kehityksestä, koulumenestyksestä ja käyttäytymisestä kerättiin kyselylomakkeilla raskauden aikana, 7-8-vuotiaana ja 16-vuotiaana. Myös luokanopettajat arvioivat lapsen koulumenestystä ja käyttäytymistä, ja nuoret itse arvioivat koulumenestystään 16-vuotiaina. Äidin raskauden aikainen kilpirauhasen toimintahäiriö nosti nuoren riskiä saada sama kilpirauhasen toimintahäiriö kuin äidillään. Äidin TPO-vasta-aine-positiivisuus nosti nuoren riskiä vasta-ainepositiivisuuteen. Nuoren positiiviset vasta-ainepitoisuudet nostivat riskiä poikkeaville kilpirauhasarvoille. Äidin nouseva TSH-pitoisuus yhdistyi lapsen suurempaan riskiin saada ADHD oireita 8-vuotiaana, mutta selkeää raja-arvoa sille ei löytynyt. Äidin hypo- tai hypertyreoosi eivät nostaneet lapsen ADHD-oireiden riskiä. Äidin kilpirauhastoimintahäiriöt nostivat hieman nuoren riskiä oppimisvaikeuksille ja luokan kertaamiselle. Myös nuoren oma kilpirauhastoiminta vaikutti vähäisessä määrin oppimiseen ja keskittymiseen. Äidin kilpirauhastoiminnalla ei ollut vaikutusta lapsen matalaan älykkyysosamäärään tai aistien kehitykseen Äidin raskaudenaikainen kilpirauhasen toimintahäiriö vaikutti lapsen neuropsykologiseen kehitykseen lievästi, mutta löydösten kliininen merkitys on vähäinen. Lasten keskushermoston korjaavat mekanismit todennäköisesti kompensoivat varhaiskehityksen kilpirauhashormonien vajetta. Randomoidulla tutkimuksella voitaisiin selvittää, hyötyisivätkö lapset äidin kilpirauhassairauden seulomisesta ja hoitamisesta alkuraskaudessa
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Singh, Vikesh. "Implementation of the dual therapy prevention of mother-to-child transmission protocol." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1374.
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Antiretroviral drugs taken during pregnancy, reduce the rates of mother-to-child transmission from 35 percent to as low as 1 to 2 percent (UNAIDS, 2009). In 2002, the Prevention of Mother-to-Child Transmission (PMTCT) programme was implemented in South Africa. Studies on the implementation of the PMTCT programme have shown that understaffed and under-developed health care facilities were key barriers to the provision of PMTCT services (Health Systems Trust, 2002: 6; Skinner et al., 2003). The aim of this study was to assess the challenges experienced by health care workers working in public sector facilities in the Nelson Mandela Metropole after implementation of the dual therapy PMTCT programme. Four areas were investigated: Infrastructure; Drug Supply Management; Clinic Procedures and Staffing. A quantitative descriptive study was conducted in August 2009 at nine public health care facilities in the Nelson Mandela Metropole, South Africa. Questionnaires were issued to 81 nurses and 41 pharmacy personnel (pharmacists and pharmacist assistants). Checklist audit forms were issued to the Facility Manager of each facility and completed with the researcher. The key findings for Infrastructure were lack of space at patient waiting rooms (9; 100 percent n=9), counselling area (5; 55.5 percent; n=9), nurse consultation rooms (6; 66.6 percent; n=9), storage areas (5; 55.5 percent; n=9) and filing areas (7; 77.7 percent; n=9). The key findings for Drug Supply Management were none of the dispensaries (0 percent; n=10) were fully compliant with Good Pharmacy Practice, pharmacy personnel indicated that there were no stock cards for medication (13; 31.7 percent; n=41); there was less than two weeks supply of buffer stock kept for zidovudine and nevirapine (13; 35.1percent; n=37) and medication orders were placed without any reference to minimum and maximum levels of medication (15; 36.5 percent; n=41) . The key findings for Clinic Procedures were only two facilities followed up on patients that had missed appointments (22.2 percent; n=9) and four facilities (44.4 percent; n=9) had a tracking system for patients that had defaulted. Of the nine facilities only three (33.3 percent; n=9) updated patient demographic details regularly. The key findings for Staffing were a shortage of doctors, nurses, counsellors and pharmacists at the facilities. One of the major challenges identified was the lack of training offered on new PMTCT protocols with 56.2 percent (45; n=80) of the nurses stating that no training was provided on the dual PMTCT protocol. Only 54.3 percent (44; n=81) of nurses stated that they knew the criteria to start the mother on dual PMTCT therapy. In conclusion there is an urgent need for barriers such as lack of staff, lack of space, lack of training on PMTCT and standard procedures for follow up of patients to be addressed in order to ensure the successful scaling up of PMTCT.
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Martins, Letícia Wilke Franco. "Aspectos transgeracionais e desenvolvimentais nos modelos de mãe em gestantes adolescentes." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/141309.
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Este estudo investigou os aspectos transgeracionais e desenvolvimentais presentes nos modelos de mãe em adolescentes grávidas, ao comparar tais modelos entre as adolescentes com histórico materno de gravidez na adolescência e as que não possuíam tal histórico. Participaram do estudo 54 adolescentes com idades entre 13 e 18 anos que estavam no terceiro trimestre de gravidez. Foi utilizado um delineamento de grupos contrastantes, sendo o primeiro grupo constituído por 26 adolescentes que possuíam histórico materno de gravidez na adolescência e o segundo, por 28 que não o possuíam. As adolescentes responderam individualmente a uma entrevista semi-estruturada sobre a gravidez adolescente. A Análise de conteúdo qualitativa das entrevistas revelou que não houve diferenças acerca dos aspectos transgeracionais e desenvolvimentais presentes nos modelos de mãe de gestantes adolescentes nos dois grupos. Os resultados mostraram um predomínio dos aspectos desenvolvimentais aos transgeracionais na forma como as adolescentes relataram se imaginar enquanto mães, assim como quando relataram não possuírem modelos de mãe a seguir e a evitar. Pode-se pensar que seguir o modelo da própria mãe está mais relacionado com aspectos transgeracionais presentes em qualquer gravidez do que por uma repetição da história de gravidez na adolescência entre as gerações. Atenta-se, assim, para a importância de serem considerados os aspectos desenvolvimentais e transgeracionais presentes na história de adolescentes grávidas, a fim de que seja garantida uma assistência global no período pré-natal e após o nascimento do bebê.This study investigated the transgenerational and developmental aspects present in maternal models in pregnant adolescents, to compare such models among adolescents with a maternal history of teenage pregnancy and those who does not have such history. The study included 54 adolescents aged between 13 and 18 in their third trimester of pregnancy. A contrasting groups design was used. The first group consisted of 26 adolescents who had maternal history of teenage pregnancy and the second by 28 who hadn’t. Adolescents responded individually to a semi-structured interview about teenage pregnancy. Qualitative content analysis revealed no differences on the transgenerational and developmental aspects present in maternal models of pregnant teenagers in the two groups. The results showed a prevalence of the transgenerational then developmental aspects in how adolescents reported imagining themselves as mothers, as well as when they reported not having maternal models to follow or to avoid. The maternal model might be thought as commonly following the own´s mother's and is more related to transgenerational aspects present in any pregnancy than by a repetition of the story of teenage pregnancy between generations. Therefore, careful attention should be used to consider the importance of transgenerational and developmental aspects present in the history of every pregnant adolescent, in order that a comprehensive prenatal care and after birth the baby is guaranteed.
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Warrier, Nisha. "Lack of Knowledge of Mother-to-Child Transmission in Kenya Among Women Ages 15-49." VCU Scholars Compass, 2006. http://scholarscompass.vcu.edu/etd/723.
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Purpose: The epidemic of mother-to-child transmission (MTCT) of HIV/AIDS in resource-poor countries is dramatic; it is responsible for nearly 90% of childhood infections. The primary purpose of analysis was to understand the distribution of factors and their association with lack of knowledge of MTCT in Kenya. In parallel, another aim was to identify the relationship between media, particularly frequency of radio exposure, and lack of knowledge.Methods: This study used the 2003 Kenya Demographic and Health Survey (DHS) collected for 8,195 women, ages 15-49. Descriptive analysis, univariate analysis, and logistic regression were completed on SPSS 14 software.Results: In the sample, 1151 women (14.0%) lacked the knowledge of transmission. Univariate analysis suggested significant crude association for region (except Nairobi and Eastern), residence, education, religion, ethnicity, literacy, parity, prenatal care from someone, current work status, SES, and frequency of listening to the radio. In the logistic regression model after adjusting for the confounding variables, not listening to the radio at all had a significant association with lack of knowledge of MTCT (adjusted POR 2.38; 95% CI 2.00-2.82), while listening to radio less than once a week yielded no significant association.Conclusions: The results elucidate why Kenyan women do not know about MTCT and particularly the role of radio use as means of acquiring this information. MTCT prevention programs can use this information to accordingly tailor the programs to the needs in the community.
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Olagunju, Adeniyi. "Pharmacogenetics of antiretroviral drugs used for prevention of mother-to-child transmission of HIV during pregnancy and lactation." Thesis, University of Liverpool, 2015. http://livrepository.liverpool.ac.uk/2035139/.
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The use of antiretroviral therapy (ART) during pregnancy and lactation has significantly reduced the rate of mother-to-child transmission (MTCT) of HIV. However, pregnancy is known to affect the pharmacokinetics of many drugs, including key antiretroviral (ARV) drugs. In addition, ARV use during lactation raises questions about unintended exposure of breastfed infants to maternal drugs through breast milk. For drugs with significant genetic contribution to observed pharmacokinetic variability, we hypothesised that polymorphisms in drug disposition genes may accentuate or attenuate pregnancy-induced changes and/or breastfed infants’ exposure. HIV positive pregnant women and nursing mothers taking efavirenz (EFV)- or nevirapine (NVP)-based ART were recruited from three hospitals in Benue State, Nigeria. A novel strategy involving a preliminary pharmacogenetic association study was used to investigate the magnitude of pregnancy-induced changes in EFV and NVP pharmacokinetics in women stratified by single nucleotide polymorphisms (SNPs) in disposition genes. EFV apparent clearance (CL/F) was higher and AUC0-24, Cmax and Cmin were significantly lower in pregnant compared with postpartum women. When stratified based on the SNP with the highest predictive power, pregnant women with CYP2B6 516GG genotype were especially at risk. In the NVP cohort, exposure was also significantly lower in pregnant compared with postpartum women. When stratified based on composite CYP2B6 516G > T and 983T > C genotypes, Cmin was below target in most patients with combined CYP2B6 516GG and 983TT during pregnancy and postpartum. Cmin was below target in at least 50% of pregnant women with one or two variant alleles, compared with 0% in postpartum women. The intensive pharmacokinetics of EFV and NVP in breast milk and pharmacogenetic predictors were described for the first time. Breast milk pharmacokinetic parameters of EFV in breast milk differed significantly between patient groups stratified by CYP2B6 516G > T. The median time averaged milk-to-plasma concentration (M/P) ratio was 1.10 (range: 0.57-1.71) and the paediatric dose weight-adjusted exposure index was 4.05% (1.08-13.8). The resulting infant plasma concentration was influenced by CYP2B6 516G > T, highest up to 8 days of age at 1590 ng/mL (190-4631) and decreased by about 90% in the age stratum 9 days to 3 months. NVP AUC0-12, Cmax and Cmin in breast milk were significantly lower in patients with composite CYP2B6 516GG/983TT than those with at least one variant allele. The M/P ratio was 0.88 (0.74-1.2) and paediatric dose weight-adjusted exposure index was 3.64% (1.99-9.88). Infant plasma concentration differed significantly based on CYP2B6 516G > T/983T > C and CYP3A4 20230G > A (*1G), highest in those exposed through both breast milk and post-exposure prophylaxis compared with either alone. A breastfeeding physiologically-based pharmacokinetic (PBPK) model to predict infant exposure to maternal drugs through breast milk was developed and validated, with over 90% of all individual observed data points within the predictive interval. This thesis presents details about five different studies where these findings were observed. Their clinical implications in the context of current knowledge and practice were also explored.
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Cândido, Elaine Cristina 1976. "Transmissão vertical de hepatite em gestantes no CAISM Campinas = HBV mother to child transmission at CAISM UNICAMP." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312690.
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Orientador: Helaine Maria Besteti Pires Mayer MilanezDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivos: avaliar a transmissão vertical (TV) em gestantes portadoras de hepatite B crônica, em um serviço universitário. Sujeitos e Método: foram analisadas as sorologias para hepatite B de todas as gestantes atendidas no serviço entre 2000 e 2005, identificando-se as HbsAg +; nessas foi realizado levantamento de prontuários, avaliando a presença do marcador de replicação viral (HbeAg positivo), imunoprofilaxia neonatal e taxa de TV. Análise de dados: foi avaliada a proporção de casos com HbsAg+ e nessas a presença do HbeAg. Para as portadoras de hepatite B, analisaram-se características clínicas e epidemiológicas através de frequências simples e a presença de TV. Resultados: entre 2000 e 2005 foram rastreadas para hepatite B no CAISM 5638 mulheres; dessas 28 (0,5%) apresentavam HbsAg+, definindo-se como portadoras crônicas. Não se encontrou nenhuma com replicação viral (HbeAg+). A idade média foi de 25 anos, com escolaridade média de sete anos, sendo 57% de brancas. O número de gestações médio foi de dois, sendo 52% de nulíparas. A categoria de exposição foi ignorada em 20; em quatro a via foi a sexual, em duas por TV e em duas por uso de drogas. A média de Idade gestacional ao parto foi de 38 semanas, com uma taxa de cesárea de 42%. O peso médio ao nascimento foi de 3094g e todos os recém-nascidos apresentaram boas condições de vitalidade e receberam imunoprofilaxia neonatal (vacina e imunoglobulina específica) nas primeiras horas de vida. Não houve TV. Conclusões: Nas gestantes atendidas no período, a prevalência de hepatite B crônica foi de 0,5%. Todas as crianças receberam imunoprofilaxia neonatal nas primeiras horas de vida e não ocorreu nenhum caso de TV, reforçando que para as gestantes sem replicação viral, as medidas de imunoprofilaxia neonatal protegeram a totalidade de seus recém-nascidos
Abstract: The purpose of this paper is to evaluate mother-to-child transmission of chronic hepatitis B in a university hospital. Subjects and methods: Hepatitis B serologic studies were pooled from all pregnant women referred to this prenatal service from 2000 to 2005. HBsAg positive patients were selected and, for those, clinical, laboratory and epidemiologic data were analyzed, including presence of HBeAg marker, immunoprophylactic procedures for the newborn and mother-to-child transmission rates. Data analysis: HBsAg carriers were characterized for clinical and epidemiologic factors associated with mother-to-child transmission. Results: Between 2000 and 2005, 5638 pregnant women were referred to high-risk prenatal care at our facility; of these, 28 women (0,5%) were HbsAg+ ¿ defined as chronic Hepatitis B virus (HBV) carriers. None of these were seropositive for HBeAg. Mean age was 25 years with a mean of 7 years of formal education and 57% were white; 52% were nulliparous. Exposure to hepatitis B virus was ignored in 20 women, sexual in 4, from mother-to-child transmission in 2 and associated with drug use in 2. Mean gestational age at delivery was 38 weeks with cesarean delivery in 42% of women. Mean weight at birth was 3094g and all newborns presented with good vitality and received immunoprophylactic procedures. There were no cases of mother-to-child transmission. Conclusion: Among all pregnant women seen at this tertiary high risk prenatal care facility between 2000 and 2005, chronic HBV infection was detected in 0,5% of patients. All newborns received immunoprophylaxis during the first hours after delivery and no case of mother-to-child transmission was detected. Our findings support that, among pregnant chronic HBV carriers without serologic evidence of active viral replication, immunoprophylactic measures are effective in preventing mother-to-child transmission in all instances
Mestrado
Saúde Materna e Perinatal
Mestra em Ciências da Saúde
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Abelius, Martina. "Immunological interactions between mother and child during pregnancy in relation to the development of allergic diseases in the offspring." Doctoral thesis, Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-106220.
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Background: Pregnancy and allergic disease have both been postulated as T-helper 2 (Th2) phenomena. Thus, the increased propensity of allergic mothers to mount Th2-responses might generate favourable effects on the maintenance of pregnancy, but might also be unfavorable, as fetal exposure to a strong Th2 environment could influence the immune development in the offspring to a Th2-like phenotype, favouring IgE production and possibly allergy development later in life. The influence of the intrauterine environment on the immunity and allergy development in the offspring needs to be further investigated. Aim: The aim of this thesis was to explore the Th1/Th2 balance in allergic and non-allergic women during pregnancy and its influence on the shaping of the Th1/Th2 profile in the neonate and the development of allergic diseases in the offspring. Material and methods: The study group included 20 women with and 36 women without allergic symptoms followed during pregnancy (gestational week 10-12, 15-16, 25, 35, 39) and 2 and 12 months postpartum, and their children followed from birth to 6 years of age. The circulating Th1-like chemokines CXCL9, CXCL10, CXCL11, Th2-like chemokines CCL17, CCL18 and CCL22, and the allergen-induced secretion of interleukin-4 (IL-4), IL-5, IL-10, IL-13, Interferon-γ (IFN-γ), CXCL10 and CCL17 were measured by Luminex and ELISA. The allergen-specific and total IgE levels were quantified using ImmunoCAP Technology. mRNA expression of Th1-, Th2-, Treg- and Th17-associated genes were measured by PCR arrays and real-time PCR. Results: We found that sensitised women with allergic symptoms had increased total IgE levels and birch- and cat-induced IL-5, IL-13 and CCL17 responses during pregnancy as compared with postpartum. The non-sensitised women without allergic symptoms had elevated cat-induced IL-5 and IL-13 responses and lower birch- and cat-induced IFN-γ during pregnancy, but similar IgE levels as compared with postpartum. Maternal total IgE levels during and after pregnancy correlated with cord blood (CB) IgE and CCL22 levels (regardless of maternal allergy status). Circulating CXCL11, CCL18 and CCL22 levels during pregnancy and postpartum correlated with the corresponding chemokine levels in the offspring at various time points during childhood. Maternal IL-5 expression in peripheral blood mononuclear cells (PBMC) was associated with neonatal Galectin-1, and placental p35 expression was negatively associated with neonatal Tbx21 expression. Increased mRNA expression of CCL22 in cord blood mononuclear cells (CBMC), and increased CCL17 and CCL22 levels in CB were observed in children later developing allergic symptoms and sensitisation as compared with children who did not. Development of allergic symptoms and sensitisation were associated with increased total IgE, CCL17, CCL18 and CCL22 levels during childhood. Conclusions: Maternal allergy was associated with a pronounced Th2 deviation during pregnancy, shown as increased total IgE levels and birch- and cat-induced IL-5, IL-13 and CCL17 responses during pregnancy, possibly exposing their fetuses to a particular strong Th2 environment during gestation. Correlations were shown between the maternal immunity during pregnancy and the offspring’s immunity at birth and later during childhood, indicating an interplay between the maternal and fetal immunity. Allergy development during the first 6 years of life was associated with a marked Th2 deviation at birth and a delayed down-regulation of this Th2-skewed immunity during childhood.
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Silva, Cristiano Josà da. "Um novo olhar no cuidado com a gestaÃÃo: fortalecendo vÃnculos em grupos de gestantes." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=18522.
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A atenÃÃo integral proposta pela EstratÃgia SaÃde da FamÃlia contempla uma reorientaÃÃo do modelo assistencial, superando o antigo mÃtodo centrado na doenÃa. Por essa abordagem peculiar, os trabalhadores da saÃde podem ter uma visÃo inovadora, tanto centrada na pessoa, como focada no contexto amplo da famÃlia, com novos modos de cuidar. Este estudo teve como objetivo desenvolver uma tecnologia leve aplicada a gestantes vulnerÃveis à rejeiÃÃo da gravidez e concepto, buscando fortalecer o vÃnculo mÃe-filho-mundo. Tratou-se de uma abordagem norteada pela pesquisa-cuidado, cujo propÃsito foi beneficiar as participantes pelas diferentes formas de cuidar. A coleta de dados ocorreu pela aplicaÃÃo de formulÃrios, recursos de filmagem e gravaÃÃo de cinco sessÃes grupais, captando a essÃncia do fenÃmeno da rejeiÃÃo, tanto nas falas, como na linguagem corporal das participantes. Alguns resultados quantitativos foram apresentados em grÃficos e tabelas construÃdos a partir dos programas Excel e World versÃo 2010. A anÃlise desses dados delineou o perfil sociodemogrÃfico que vulnerabilizava o contexto da maternagem entre as participantes. Os dados qualitativos foram avaliados e confrontados pela abordagem fenomenolÃgica de Moustakas, a qual se adequou a esta pesquisa por ser mais focada na descriÃÃo das experiÃncias das participantes. A anÃlise revelou que um ambiente, no qual predominam a violÃncia intrafamiliar, a ausÃncia do parceiro, a dependÃncia econÃmica materna, carÃncias de uma mÃe suficientemente boa, memÃrias punitivas dessa mÃe e o nÃo planejamento da gravidez, percebida como sem sentido, influencia diretamente na negaÃÃo da maternidade, constituindo-se um entrave na relaÃÃo harmÃnica mÃe-filho-mundo. Tais fatores podem ser reproduzidos em um mecanismo de rejeiÃÃo, transmitido a cada geraÃÃo familiar. Subjetivamente, foram relatados sentimentos de medo, inseguranÃa, impotÃncia, mÃgoa, vergonha e negaÃÃo na construÃÃo da descriÃÃo estrutural deste estudo. Durante a aplicaÃÃo da pesquisa-cuidado, verificou-se a relevÃncia do cuidado na abordagem de grupo, como proposta de desconstruir o fenÃmeno da rejeiÃÃo. Propiciou-se, assim, um resgate aos princÃpios da maternagem, transcrito nas falas e observado nas imagens por meio de sete unidades de significado, inicialmente caracterizadas pela mÃgoa, desprezo, rejeiÃÃo, aborto e ambivalÃncia de sentimentos, reestruturadas pela resiliÃncia e finalizadas pela aceitaÃÃo. Por fim, à extremamente relevante se promover uma assistÃncia eficaz Ãs gestantes mais vulnerÃveis à rejeiÃÃo e instituir grupos como suporte nos eixos da saÃde mental e cuidado.
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Links, Nomvuyiseko. "Postnatal women's experiences of the prevention of mother-to-child transmittion of HIV programme." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/545.
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This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.
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Korsman, Stephen Nicolaas Jacques. "Molecular epidemiology of mother-to-child transmission of HIV-1 in children at Tygerberg Hospital." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/1074.
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Ishola, Adeyinka Ganiyat. "Acceptance and commitment therapy in the prevention of mother to child transmission of HIV program among pregnant women living with HIV in South Western States of Nigeria." University of the Western Cape, 2017. http://hdl.handle.net/11394/5775.
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Philosophiae Doctor - PhDThe objective of this study was to determine if introducing acceptance and commitment therapy in the prevention of mother to child HIV transmission (PMTCT) program using weekly mobile phone messages would result in improved mental health status of HIV-positive, pregnant women in Nigeria. The study used a quantitative approach using a Solomon four-group (two intervention and two control groups) randomised design to evaluate the impact of an acceptance and commitment therapy program. The study population was 132 randomly selected (33 per site), HIV-positive pregnant women attending four randomly selected PMTCT centres in Nigeria. Two were Intervention and two were Control sites which functioned as Intervention and Control groups. The intervention groups were exposed to one session of acceptance and commitment therapy with weekly value-based health messages sent by mobile phone for three months during pregnancy. The control groups received only post-HIV test counselling.
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Kasenga, Fyson. "Making it happen prevention of mother to child transmission of HIV in rural Malawi /." Doctoral thesis, Umeå : Umeå university, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-26223.
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Samuelsson, Jonna. "“Because their feet also used to be swollen... For those people their feet don’t use to fit in the shoes, so they used to tease them.” : - A qualitative study on the experience of being a pregnant teenager and young mother in Rundu, Namibia." Thesis, Högskolan Väst, Avd för socialpedagogik och sociologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-4704.
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Namibia, as most countries on the African continent, is facing a high rate of teenage pregnancies. It is one of the biggest social issues challenging contemporary society, contributing to social problems such as illegal abortions, baby dumping and suicide attempts. The aim of this bachelor thesis is to focus on young women and their experiences of being pregnant teenagers and young mothers. During this research process young mothers have elaborated on their own life situation discussing ideas that could have helped them during the pregnancy. They also give ideas on what could be helpful for them today. The research also pays attention to the attitudes that the young mothers face in their communities. The town were this research was carried out, Rundu, is situated in the Kavango region, which has the far highest rate of teenage pregnancies in the country. This is a qualitative research and data was collected through daily observations, conversations and semi-structured interviews. In the understanding of my results, I have used gender theory, social exclusion, social construction, stigmatisation and an intersectional perspective. According to the results six of my seven respondents were struggling during pregnancy and still do today. They struggle/struggled mainly due to lack of resources and money as well as not having enough people helping them taking care of the baby. Most of the young women left school at an early stage of the pregnancy. This either because school policies would not let them proceed or because school uniforms and shoes were getting too small. Attitudes present and the discourse on pregnant teenagers among young and old people in Rundu prevented some of the pregnant girls from taking part of a social life. They got blamed for falling pregnant. Some of them were feeling very ashamed over their condition and started living more isolated lives, not going in to town anymore and thereby missing health controls at the hospital.Namibia har, som de flesta afrikanska länderna, en hög grad av tonårsgraviditeter. Tonårsgraviditeter är ett av landets största sociala bekymmer, eftersom det leder till andra sociala problem så som illegala aborter, ”baby dumping” och självmordsförsök. Syftet med denna kandidatuppsats är att lägga fokus på de unga mödrarna och deras upplevelser av att vara gravida tonåringar och unga mammor. I uppsatsen får de unga mammorna möjlighet att resonera kring sina egna livssituationer och kring vad som hade kunnat hjälpa dem under tiden då de var gravida. De berättar också om vilken sorts stöd de behöver idag. Uppsatsen lägger vidare fokus på attityder som de unga mammorna möter i de olika sammanhang där de befinner sig. Staden Rundu, som är platsen där empirin har samlats in, är belägen i Kavangoregionen, som har den absolut högsta siffran tonårsgraviditeter i hela landet. Detta är en kvalitativ studie och empiri har samlats in genom dagliga observationer, samtal och semi-strukturerade intervjuer. I analysen av resultaten har teorier kring genus, social exklusion, social konstruktion, stigmatisering samt ett intersektionellt perspektiv använts. Resultaten visar att sex av de sju informanterna hade det svårt under sin graviditet och fortfarande har det svårt idag. De har det kämpigt främst på grund av att de saknar ekonomiska tillgångar och människor omkring dem som kan hjälpa dem att ta hand om barnet. De flesta av informanterna lämnade skolan vid ett tidigt stadium av graviditeten. Det berodde antingen på att policies på de olika skolorna inte lät dem fortsätta eftersom de var gravida eller för att deras skoluniformer och skor blev för små. Attityder mot tjejerna och diskursen kring tonårsgraviditeter i Rundu hindrade en del av informanterna från att ta del av ett socialt liv. De fick skulden för att ha blivit gravida och vissa av dem skämdes väldigt mycket över sin situation. Detta ledde till att de började leva mer isolerat och inte gärna vistades inne i centrum. Vissa av tjejerna missade därmed kontroller på mödravården.
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Jumare, Fadila. "Prevention of mother to child transmission (PMTCT) of HIV/AIDS: a review of using PMTCT services in South Africa." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1011508.
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Despite good intentions and commitment from health providers, it is difficult for HIV positive pregnant women to access Prevention of Mother to Child Transmission of HIV (PMTCT) services (Skinner et al 2005:115). The aim of this research was to find out the extent to which socio-economic and cultural factors influence access to and utilization of PMTCT services. It appeared that despite having a legal plan and framework to ensure that PMTCT services are available and free, the realities confronting HIV positive women in South Africa as suggested by the literature contradicted this objective. Inevitably, these contradictions were identified as some of the main factors contributing to lack of access and inadequate utilization of PMTCT services. These factors were identified through a review of fifteen studies selected based on their relevance to the research aim. The findings were presented according to the following themes: Functioning of clinics, adherence to ART, uptake of VCT and infant feeding practices. According to research evidence, the major socio-cultural factors influencing access and utilization of PMTCT services include fear of stigma and discrimination which are related to cultural norms and practices. The socio-economic factors include transport costs, lack of food, medicines and formula milk which are all related to poverty and unemployment. The research also found that health system constraints such as long waiting times in clinics, stock-outs of formula milk, medicines and test kits influenced the utilization of PMTCT services by HIV positive women.
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Makwindi, Chrispen Christopher. "Retention in care amongst women initiated on antiretroviral therapy during pregnancy at King Sobhuza II Public Health Unit, Swaziland." University of the Western Cape, 2016. http://hdl.handle.net/11394/4973.
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Magister Public Health - MPHBackground: The advent of antiretroviral therapy (ART) has significantly redefined the course of the HIV pandemic making HIV, a chronic illness rather than a death sentence. To maximize the efficacy of ART in improving survival rates of HIV/AIDS patients, lowering the incidence of opportunistic infections, reducing HIV transmission and minimizing the possibilities of developing drug resistance, long-term retention in care is critical. In South Africa, poor retention in care of 32% has been noted in women who were initiated on ART during pregnancy as compared to 13% in non-pregnant women initiated on ART. However, little is known in Swaziland about the retention in care in women who were initiated on ART during pregnancy and the factors that influence retention in care among this category of women. Aim: To determine the factors associated with poor retention in care among women initiated on ART during pregnancy at King Sobhuza II Public Health Unit (PHU) in Swaziland. Methodology: A quantitative, retrospective cohort review of 316 medical records of women who were initiated on ART during pregnancy from January 2012 to December 2013 was conducted. A data extraction sheet was used to collect data from the files of patients who were initiated on ART during pregnancy. The dataset was imported into IBM SPSS Statistic 20 Software for analysis. Bi-variate analysis was done to determine risk factors associated with retention in ART care at ART initiation and on the last ART refill visit. Kaplan-Meier analysis was used to determine retention in care at 6, 12, 24 and 36 months. Cox proportional hazards models were then used to determine factors associated with poor retention. Results: The overall retention rate of women who were initiated on ART during pregnancy at the PHU after a median duration on ART of 25.80 months [interquartile range (IQR): 16.70 – 30.98] of follow up was 74.1% (n=316). Most women initiated on ART during pregnancy (52.4%) became lost to follow up after giving birth as compared to 47.6% who became lost to follow up before giving birth. After 6 months on ART, the lost to follow up rate was 16.5% (n=316); but increased to 20.9% (n=316), 23.5% (n=243) and 26.9% (n=52) after 12, 24 and 36 months respectively. On the ART initiation visit, the factors associated with retention in care for pregnant women included being married, having the partner on ART, disclosing one’s HIV status to the partner, not drinking alcohol, being a non-smoker and reporting no financial challenges. In addition, on the last ART refill visit, the risk factors for retention in care for women initiated on ART during pregnancy were having the ART regimen changed, having regular CD4 cell count done, rise in CD4 cell count, good adherence on ART and use of contraceptive other than the condom for family planning after delivery. Conclusion: The retention in care for women who were initiated on ART during pregnancy was found to be lower than in the general adult population. However, the study findings on retention in care are similar to what has been found in other settings. The factors influencing poor retention also mirror those found in the other parts of sub-Saharan Africa. Whilst decentralisation of ART services improves ART coverage it should be coupled with strategies aimed at improving patient retention.
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Osman, Yusuf Ismail. "The cost effectiveness of a mother-to-child-transmission prevention programme in the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/49791.
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Thesis (MBA)--Stellenbosch University, 2003.Some digitised pages may appear illegible due to the condition of the original hard copy
ENGLISH ABSTRACT: After sexual transmission of HIV, mother-to-child (MTCT) transmission is the most common cause of HIV infection in South Africa. The Western Cape government, through the Premier, has committed itself to providing access for all HIV positive women in the province attending antenatal clinics to MTCT prevention programmes by the end of 2003. The MTCT prevention programme is aimed at intervening transmission during pregnancy, during the birth of the baby and post delivery during breast-feeding of the newborn baby. The HIV virus attacks and destroys the cells of the immune system by being incorporated into the reproductive cycle of the cell. Antiretroviral drugs in the fight against HIV target two aspects of this replication cycle of the virus and as such do not halt the infection but slow it down by preventing the replication of the virus. MTCT internationally has been reduced dramatically by the use of antiretroviral drugs (AZT) antenatally, during birth and post-natally for mother and baby. However this regimen was found to be not suitable for resource-poor countries due to the complexity in administration, compliance and costs. Poor countries have developed alternative MTCT prevention programmes based on shorter course regimens and on alternative antiretroviral drugs. MTCT prevention In South Africa initially did not have the support of the national government. However, the -Western Cape Administration had developed a regional programme phasing in MTCT prevention at all state clinics within the province. The cost drivers associated with the MTCT prevention programme include costs associated with the HIV tests, costs for pre- and post-test counselling, costs for the antiretroviral drugs and costs for substitute feeding to replace breast-feeding to prevent viral transmission during breast-feeding. Depending on the option exercised, costs can be calculated per HIV positive baby averted. As regards substitute feeding, which is a substantial cost driver and a major disadvantage to the newborn baby as regards protection from common childhood diseases such as diarrhea, research from Tanzania showed that ARV therapy during childbirth could suppress HIV transmission through breast-feeding during the first few weeks after childbirth, thus enabling an optimal combination of breast-feeding in the first few crucial weeks of the newborn's life for the protective benefits of breast-milk and formula feeding thereafter to ensure protection for the infant from HIV transmission through breastfeeding. The data were subjected to a sensitivity or a "what-if' analysis usmg an Excel spreadsheet. Costs per HIV averted were calculated for each assumed parameter in the model that was developed. As regards prevalence, the MTCT prevention programme is most cost effective at the lower levels of the seroprevalence of HIV in the population served. If the seroprevalence is above the "cross-over" or "optimal" point for the regimen an alternative regimen should be assessed. As regards levels of identification and number accepting intervention the principle of an economy of scale applies and therefore, a level of 100 percent in both cases should be targeted. This will be dependent on wide scale advertisements and support for the programme with active efforts to destigmatise the infection. Innovative programmes such as the mothers-to-mothers-to-be (M2M2B) programme must be encouraged.
AFRIKAANSE OPSOMMING: Na seksuele oordraging van HIV is moeder tot kind (MTK) oordraging die algemeenste rede van HIV infeksie in Suid Afrika. Die Wes-Kaapse regering, deur die Premier, het hulself verbind om toegang vir alle HIV positiewe vroue in die provinsie, wat voorgeboorte klinieke bywoon, tot MTK voorkomingsprogramme voor die einde van 2003 moontlik te maak. Die MTK voorkomingsprogram is gerig op die tussenkoms van transmissie gedurende swangerskap, gedurende die geboorte en die nasorg tydens die borsvoeding periode van die pasgebore baba. Die HIV virus val die selle van die immuun sisteem aan en' vernietig dit. Die virus word geïnkorporeer tot die reproduksie siklus van die sel. Antiretrovirale wat teen die virus gerig is, is gerig teen twee aspekte van die replikasie siklus van die virus en sodoende sal die medikasie die infeksie nie staak nie, maar eerder vertraag as gevolg van die voorkoming van die replikasie. Moeder-tot-kind infeksie is internasionaal drasties verminder deur die gebruik van antiretrovirale (AZT) gedurende die tydperk voor geboorte, gedurende die geboorte en gedurende nasorg van die moeder en baba. Hierdie regimen is egter nie altyd moontlik in arm lande nie vanweë die kompleksiteit van die administratiewe toepassing en kostes. Arm lande het alternatiewe MTK voorkomingsprogramme ontwikkel, gebaseer op korter kursusse en alternatiewe antiretrovirale. Die voorkoming van MTK infeksie in Suid-Afrika het eers nie die ondersteuning van die nasionale regering geniet nie. Die Wes-Kaapse Adminstrasie het onafhanklik van die nasionale regering, streeksprogramme ontwikkel vir die infasering van MTK voorkoming in alle klinieke in die Provinsie. Die kostedrywers wat met MTK voorkomingsprogramme geassosieer word, sluit in die koste van HIV toetse, koste van voor-en-na toets berading, koste van die antiretrovirale en alternatiewe voeding om virale transmissie te voorkom gedurende die tydperk van borsvoeding. Afhangende van die opsies wat gebruik is, kan die koste van elke baba wat nie HIV opdoen nie, bereken word. Sover dit alternatiewe voeding aangaan, wat 'n belangrike kostedrywer is en 'n nadeel vir elke baba is sover dit teen beskerming van algemene kindersiekte soos diarrhea gaan het navorsing in Tanzanië bewys dat ARV terapie gedurende geboorte ook HIV transmissie deur borsvoeding gedurende die eerste paar weke na geboorte onderdruk wat 'n optimale kombinasie van borsvoeding in die eerste paar kritiese weke van die nuutgebore baba se lewe vir die beskermende voordele van moedersmelk en formulêre voeding daarna te versterk met beskerming van die baba teen HIV transmissie deur borsvoeding. Deur die gebruik van 'n Excel werkblad en 'n "wat as" metode van analiese koste van HIV opdoen in bereken word vir elke aanvaarding. Sover dit voorkoms betref is die MTK voorkomingsprogramme die mees effektief hoe laer die "seroprevalence" van HIV in die populasie gedien word. As die "seroprevalence" hoër as die optimale punt is, moet 'n ander metode bereken word. Sover dit die mate van identifisering en hoeveelheid die tussenkoms aanvaar in 'n mate van 100 persent moet in beide gevalle die mikpunt wees. Dit sal afhang van grootskaalse advertensies en ondersteuning van die programme met bedrywige pogings om die' infeksie te destigmatiseer. Nuwe programme soos die moeder tot nuwe moeder (M2M2B) program moet aangemoedig word.
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Broström, Ann-Catrin, and Eeva Huttu. "Oj ska du behålla det? : En kvalitativ studie om Tonårsmammor i ett Brukssamhälle." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-15382.
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Enligt statistik föreligger det en högre frekvens av tonårsfödslar i detta specifika brukssamhälle i jämförelse med en närliggande mellanstorstad. Det existerar ofta en speciell bruksanda i brukssamhällen där arbete många gånger föredras framför utbildning. Uppmuntrar denna mentalitet till att skaffa barn i ung ålder och vilken betydelse och påverkan har mödrarnas ålder vid barnafödande? Skapar tonårsmammorna sin identitet genom att reproducera mödrarnas livsstil? För att ta reda på detta har fem tonårsmammor blivit intervjuade och fått lämna sin livsberättelse. Intervjufrågorna var uppdelade i tematisk ordning för att få en följsam berättelse. En professionell person som är anställd i en stödgrupp på orten har blivit intervjuad för att få en nyanserad bild av tonårsmammornas situation. Analysen av intervjuerna är genomförd med hjälp av teorier av Skeggs, Angelöw & Jonsson och Giddens om respektabilitet, roller och identitet. I forskningsprocessen upptäcktes vissa tydliga mönster gällande barnafödande och utbildningsnivå. De flesta tonårsmammorna hade mödrar som skaffat barn när de var i tonåren. De flest unga mammorna och deras föräldrar saknade eftergymnasial utbildning. Kulturen och den norm som råder i brukssamhället uppmuntrar ungdomar att skaffa barn tidigt.According to statistics, there is a higher rate of teenage births in this specific industrial community in comparison with the big city. There is often a special spirit of the mining communities where work is preferred more often than education. Does this mentality encourages having children at a young age and which meaning and influence do their mother’s age at childbirth. Creates teenage mothers their identity by reproducing maternal lifestyle. To find this out, five teenage mothers had been surveyed and they left theirs life story. The interview questions were divided into thematic order to get a smooth narrative. A professional person who is employed in a support group in the community has been interviewed to get a balanced picture of teenage mothers' situation. The analysis of the interviews implemented with using theories of Skeggs, Angelöw & Jonsson, and Giddens on respectability, roles and identity. The research discovered some clear patterns concerning child bearing and education. Most teenage mothers were mothers who had children when they were in their teens. The most of the young mothers and their parents had no post-secondary education. In the industrial community, the culture and the norms encourages young people to have children earlier.
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Mubangizi, Lilian. "Examining the association between future pregnancy intentions, contraceptive use and repeat pregnancies among women living with HIV in Cape Town, South Africa." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32825.
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Background: Given the rapid expansion of antiretroviral therapy (ART) services in South Africa, there is growing recognition of the importance of fertility intentions, contraceptive use and childbearing among women living with HIV (WLHIV). With the integration of family planning services in the prevention of mother-to-child transmission of HIV (PMTCT) services, understanding fertility intentions and contraceptive use is crucial in evaluating such programs. We investigated the relationship between future fertility intentions, contraceptive use and repeat pregnancies among WLHIV in Cape Town, South Africa. Methodology: We analyzed data from the MCH-ART study conducted at the Gugulethu Midwife Obstetric Unit (MOU) in Cape Town, South Africa, which followed women initiating ART during pregnancy through 36-60 months postpartum. Self-report data were collected using standardized questionnaires at repeated study visits. Data on repeat pregnancies were abstracted from the Western Cape Provincial Data Centre. Associations between maternal characteristics and repeat pregnancies were examined using Cox proportional hazards models. Results: Overall, 109 incident repeat pregnancies were recorded among the 471 women included in this analysis. The median time at risk per individual was 4.27 years. The rate of repeat pregnancies was 5.72 per 100 person-years (PY). This rate was significantly lower among women aged 35-45 years (2.11/100PY) compared to women aged 18-24 years [7.56/100 PY; adjusted hazard ratio (aHR), 0.26: 95% confidence interval [CI], 0.09, 0.81). A total of 333 women contributed data on future fertility intentions and contraceptive use at 12 months postpartum, with 9% reporting that they wanted another child in the future, and 82% reporting current contraceptive use; 16% (n=54) reported not wanting another child but no contraceptive use. The rate of repeat pregnancies was 3 folds higher among women who reported wanting a child in the future (12.59/100 PY) compared to women who did not want 5 a child in the future (4.31/100 PY; aHR, 3.46: 95% CI, 1.83, 6.50). Contraceptive use at 12 months postpartum was not associated with repeat pregnancies. Women who did not want a child and used contraceptives had a 45% decreased hazard of repeat pregnancies compared to women who did not want a child and did not use contraceptives (aHR 0.55: 95% CI [0.32, 0.94]. Conclusion: Among women initiating ART during pregnancy, a repeat pregnancy incidence rate of 5.72/100 PY was observed through 36-60 months postpartum, with the incidence lower among older women. At 12 months postpartum, a notable proportion of women reported not wanting another child but no contraceptive use. Wanting a child in the future was associated with a higher rate of repeat pregnancy, but contraceptive use at 12 months postpartum was not associated with repeat pregnancies. These results highlight the importance of understanding factors associated with the dissonance between fertility intentions and contraceptive use and childbearing to ensure delivery of quality integrated reproductive health services in the PMTCT framework.
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Bucagu, Maurice. "HIV-1 mother-to-child transmission: incidence & socio-economic, clinical and biological risk factors in Muhima health centre (Kigali/Rwanda)." Doctoral thesis, Universite Libre de Bruxelles, 2014. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209293.
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Abstract:Background. This dissertation focuses on HIV-1 mother-to-child transmission (MTCT) as a major global public health issue. It consists of three papers that were published in international peer review journals. We initiated the study to answer the following research question: what was the impact of socioeconomic, clinical and biological risk factors on HIV-1 mother-to-child transmission incidence at Muhima health centre, in the specific context of Rwanda health sector reforms?
Methods. A prospective cohort study in Muhima health centre (Rwanda) was used to address the study objectives, with a follow up of 700 mother-infants pairs (2007-2010).
Results. The observed overall transmission rate was 3.2% (CI 1.9% – 4.5%) at age 6 weeks of life and 3.7% (CI 2.3% – 5.1%) at 6 months of age. Among the 679 exposed and followed-up infants, a higher risk of HIV-1 MTCT was significantly associated with the following factors: non-disclosure of HIV status to partner; high viral load (HIV-1 RNA); infant mixed feeding before 6 months of age; low mother’s CD4 count and low hemoglobin level during pregnancy.
Conclusions. The health sector reforms were found to have led to a conducive environment that was favorable to scaling up of maternal health services in Rwanda (2000-2010).
The observed overall MTCT rate of 3.2% (CI 1.9% – 4.5%) at age 6 – weeks postnatal in the Muhima cohort is a significant reduction of MTCT incidence towards achieving the elimination target of < 5% for breastfeeding populations in developing setting.
The most relevant factors independently associated with increased risk of mother – to – child transmission of HIV-1 included non-disclosure of HIV status to partner and high HIV-1 RNA. Members of this cohort also showed socioeconomic inequalities, with unmarried status carrying higher risk of undisclosed HIV status.
Integrated service delivery for PMTCT/MCH interventions, including community-based approach, task shifting and subsidized membership fees for people living with HIV, were the key national policies implemented to support optimal access to and delivery of evidence – based interventions for prevention of mother – to – child transmission of HIV in Muhima.
Résumé:
Contexte
Cette thèse porte sur la transmission mère-enfant du VIH-1 comme un problème majeur de santé publique au niveau mondial. Il est composé de 3 publications dans des revues internationales à comité de lecture. Nous avons initié l’étude pour pouvoir répondre à la question de recherche suivante :quel a été l’impact des facteurs de risque socio-économiques, cliniques et biologiques sur l’incidence de la transmission du VIH-1de la mère à l’enfant au centre de santé de Muhima, dans le contexte spécifique des réformes du secteur de la santé au Rwanda.
Cadre méthodologique
Une étude cohorte prospective a été menée au centre de santé de Muhima pour pouvoir répondre aux objectifs de l’étude, avec un suivi de 700 couples mères-enfants éligibles (2007-2010).
Résultats
L’incidence cumulée de transmission mère-enfant du VIH-1 a été de 3,2% (IC 1,9% – 4,5%) à 6 semaines et 3,7% (IC 2,3% – 5,1%) à 6 mois de vie. Parmi les 679 nourrissons exposés et suivis, un risque plus élevé de transmission mère-enfant du VIH-1 était significativement associé aux facteurs suivants :non divulgation du statut séropositif au VIH-1 entre partenaires ;charge virale élevée (ARN-VIH-1) ;allaitement mixte de l’enfant avant 6 mois d’âge ;CD4 bas et taux d’hémoglobine bas pendant la grossesse.
Conclusions
Les réformes du secteur ont pu créer un environnement favorable à l’extension des services de santé maternelle (2007-2010).
Le taux global 3,2% (IC 1,9 – 4,5) à 6 semaines de vie représente une réduction significative de l’incidence de transmission mère-enfant du VIH-1 pour atteindre le niveau de <5% comme indicateur relatif au plan d’élimination des nouvelles infections VIH chez l’enfant au sein des populations avec allaitement maternel comme pratique universelle.
Les facteurs les plus pertinents indépendamment associés à un risque élevé de transmission mère-enfant du VIH-1sont représentés par la non-divulgation du statut séropositif au VIH-1 entre partenaires et la charge virale élevée (ARN-VIH-1). Au sein de cette cohorte, l’on a également pu identifier l’existence d’inégalités socio-économiques, avec le statut de femme seule associé au risque plus élevé de non-divulgation du statut séropositif au VIH-1 entre partenaires.
Le service intégré de PTME / interventions de santé de la mère et de l’enfant, y compris l'approche communautaire, l’approche de délégation des tâches et la subvention des frais d'adhésion à la mutuelle de santé pour les personnes vivant avec le VIH, ont été les principales politiques nationales mises en œuvre pour favoriser l'accès optimal et la prestation des interventions basées sur les preuves pour la prévention de la transmission du VIH-1 de la mère à l’enfant au centre de santé de Muhima.
Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished
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Kolář, Vojtěch. "Porodnice." Master's thesis, Vysoké učení technické v Brně. Fakulta architektury, 2017. http://www.nusl.cz/ntk/nusl-316353.
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A new concept of maternity hospital creates a place, where future mother is not stressed and where she feels free. A place, where birth is perceived as a common part of everyday life. It searches a compromise between birth at classical hospital environment on one side and birth at home on the other. Both aforementioned possibilities bring certain risks that are intended to be minimized using this concept. The idea is based on practice from birth facilities from Germany and creates new concept of so called „birth houses“ that is consistent with law in the Czech Republic. Design of maternity hospital should not be based solely on meeting technical requirements of a bulding, but first of all comfort of mothers should be taken into account to make them feel home.
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Chandiwana, Precious. "Exploration of factors influencing contraceptive use among HIV-positive women participating in a Prevention of Mother-to-Child Transmission program in an urban setting in Harare, Zimbabwe." University of the Western Cape, 2016. http://hdl.handle.net/11394/5500.
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Magister Public Health - MPHDual protection is protection against unwanted pregnancy, HIV and other sexually transmitted infections and a means of achieving safer sex and birth control (WHO, 2012). It is one of the essential tools promoted by the WHO for preventing unintended pregnancies and sexual transmitted infections among HIV-positive women to reduce dual risk of unintended pregnancies, re-infections and transmission of HIV in the cases of sero-discordant couples. However, the use of dual method use among HIV-positive women in Zimbabwe is poorly described. Hence to fill in the existing research gap, this study aims to explore the factors influencing dual protection use by HIV- positive women participating in a prevention of mother-to-child transmission (PMTCT) program in an urban setting in Zimbabwe. Methodology: A qualitative exploratory study design with a combination of qualitative research methods including interviews and focus group discussions was conducted. A total of five focus group discussions (FGDs) each consisting of 8-12 participants was conducted with a total of 51 women. Five in-depth interviews were conducted with key informants. All interviews and FGDs were audio recorded using a digital voice recorder. The interviews were conducted in Shona and translated into English. Data analysis was done manually using thematic coding. Codes emerged from the data using an inductive approach. Ethical principles of research and rigour were observed throughout the study. Results: Dual protection use was low among the HIV-positive women. Absolutely non-use of contraceptive was reported by some women. The main methods of contraceptives were the pill, depo provera and condoms. Inconsistent condom use was mentioned among the few women who reported using condoms. Many barriers to contraceptives use among HIV-positive women in Zimbabwe were identified. However there were a few facilitating factors too. Health system factors associated with health care workers (HCWs) related factors and service delivery processes were reported as major barriers to contraceptive use. Women expressed negative attitude towards condom use associating them with unfaithfulness. Facilitators of contraceptive use identified were couples' HIV testing and counselling, women's increase in CD4 count result, fear of vertical transmission and HIV sero-discordance between couples. Conclusion and Recommendations: In conclusion, dual protection use among HIV-positive women in this community was low. Health system factors were the main barriers to contraceptives use whilst health related factors were the main facilitators. HIV-positive women still face challenges in accessing and utilisation of contraceptives. Hence the barriers to contraceptive use needs to be addressed at the same time promoting the facilitators.
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Ogwu, Anthony Chibuzor. "Adherence to antiretroviral therapy amongst women commenced on treatment during pregnancy at research clinics in Botswana." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4809_1308307951.
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The study aimed to assess the level of adherence and to identify the barriers to adherence and the motivations for good adherence to antiretroviral therapy, amongst women who commenced treatment while pregnant at research clinics in Molepolole, Mochudi, Lobatse and Gaborone.
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Laudade, Lígia Gonzaga Ramos. "Maternidade na adolescência: o apoio social da família para o cuidado materno e autocuidado na perspectiva das adolescentes." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-14012014-141155/.
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A gravidez na adolescência é uma importante temática em saúde pública por relacionar-se à saúde sexual e reprodutiva das adolescentes, exigindo que a jovem mãe adquira responsabilidade e habilidades para o cuidado materno e o autocuidado. Apresenta-se como um momento difícil, pois requer reestruturação pessoal e social, sendo o apoio familiar fundamental para a superação das adversidades, permitindo que a mãe adolescente possa ser a protagonista de sua história. O presente estudo tem como objetivo analisar o apoio social no contexto da família, considerando o perfil estrutural e funcional da família de puérperas adolescentes frente à maternidade, especificamente no cuidado materno e no autocuidado no puerpério. Utiliza-se a abordagem quantitativa para análise da rede social, segundo o Modelo de Escolta Social. Para compreender o significado das vivências da maternidade pelas adolescentes e o apoio social recebido para o cuidado materno e autocuidado, utiliza-se a abordagem qualitativa. Foram realizadas entrevistas com puérperas adolescentes, analisadas por meio da técnica de análise e interpretação de sentidos, sobre a perspectiva teórica do apoio social. A maioria das adolescentes era primípara, cursara até o nível fundamental, não exercia atividade laboral e residia com o parceiro. A gestação foi indesejada, com a realização do pré-natal tardio. O parto cesariano foi predominante. Na Análise da Escolta Social, a rede de apoio social das adolescentes é constituída por pessoas próximas com predomínio de mulheres. Na análise das entrevistas, depreendem-se três categorias temáticas centrais: o significado da gravidez e da maternidade para a adolescente, a gravidez precoce no contexto da família e o apoio social, e o cuidado com o bebê e a prática do autocuidado no pós-parto. A gravidez precoce demarca um rompimento com os sonhos e planos pessoais e requer adaptação à nova situação, enquanto para outras se apresenta como um sonho realizado. A vivência da maternidade é percebida como oportunidade para o amadurecimento. Na família, a gravidez é um elemento surpresa, na qual, diante da sexualidade das filhas e a aceitação, a família presta ajuda de forma processual e gradativa. O apoio social é através de pessoas que contribuem financeiramente, com experiências, ajudando nas atividades domésticas, no cuidado materno e no autocuidado. A família possibilitou à mãe adolescente ser a protagonista do cuidado materno. Identifica-se a ausência do profissional de saúde como parte da rede de apoio social, tanto como referência de cuidado à saúde quanto como mediador deste cuidado a ser ofertado pela família. Considera-se que as políticas de saúde devem ser intensificadas na prevenção e promoção da saúde dos adolescentes, atuando na conscientização sobre a maternidade e paternidade. Importante desenvolver pesquisas de intervenção para subsidiar estratégias de atuação dos profissionais de saúde para uma apreensão ampliada das necessidades das adolescentes frente à maternidade precoceTeenage pregnancy is an important theme in the field of public health, it refers to sexual and reproductive teenager health, claiming from the young mother to be prepared with responsibility and skills to handle all situations, including maternal health care and her own care. It presents as a crisis which demands personal and social restructuration, familiar support is of primary importance helping to overcome adversities, so the teenager mother may be the protagonist of her own history. This study has as goal to analyze social support in the familiar context, considering the structural and functional profile of the puerperal teenager´s family facing motherhood, specifying maternal health care and postpartum care. We utilized quantitative approach to analyze the social network according to the Social Escort model. To understand the meaning of the motherhood experiences lived by the teenagers and the social support received to maternal care and theirs own care, we utilized qualitative approach. Postpartum teenagers were interviewed; technical analysis and interpretation of senses on the theoretical perspective of social support were used to analyze them. Most of them were primiparous teenagers; they just had studied until the elementary school, they did not have a labor activity and used to live with their partners. As well, the gestation was not desired, the prenatal monitoring had a late follow-up. The C-section was the prevalent one. In the analysis of social escort, the support of teenager is made by relatives and friends, most of these are women. Analyzing the interviews we had three categories of main themes: meaning of pregnancy and motherhood to the teenage, early motherhood in the familiar context and the social support, baby care and postpartum care. Early pregnancy demands a rupture with dreams and personal plans, it demands an adjustment to the new situation, while to others it represents a dream that was brought in. The experience of motherhood is noticed as an opportunity to have an adult condition. To the family motherhood is a surprise, having to face the sexuality of the daughters and the acceptance, their family helps on a procedural and gradual way. Social support is made by donation from known people, experiences, helping with the house activities, mother and baby care. The family helped the teenager mother to be the protagonist of the maternal care. We noticed the default from public health professional assistance as part of social support network, as well as reference of health care and support to the family. We consider that the policy of public health must be intensified to prevent and to promote teenage health, acting to create awareness about motherhood and fatherhood. It´s important to build up intervention researches to subsidize strategies to help health professionals, so they will be more prepared to handle all situations facing the needs of teenagers\' early motherhood
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Fleury, Camila 1975. "Desenvolvimento da relação mãe-filho em unidade de cuidados intermediários neonatais após gravidez de alto-risco = estudo clínico qualitativo = Development of mother-child relationship in intermediate care unit after righ-risk pregnancy: clinical-qualitative study." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312907.
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Orientadores: María Yolanda Makuch, Mary Angela ParpinelliTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivo: Estudar o desenvolvimento da relação mãe-bebê de mulheres diagnosticadas com gravidez de alto risco, cujos bebês foram internados em unidade de cuidados intermediários neonatais (UCIN) e as perspectivas e ações dos profissionais de saúde, que cuidam destes bebês, sobre o desenvolvimento dessa relação. Método: Como marco conceitual utilizou-se os conceitos psicanaliticos de preocupação materna primária e holding desenvolvidos por Winnicott. Foi realizado um estudo clínico-qualitativo com amostragem proposital, onde o número de participantes foi determinado pelo critério de saturação de informação. A amostra foi composta de dois grupos de participantes. Um grupo foi formado por mulheres puérperas diagnosticadas com síndrome hipertensiva ou diabetes gestacional, cujos bebês necessitaram internação na UCIN. O outro grupo foi formado por profissionais de saúde que cuidaram destes recém-nascidos na UCIN. Foram realizadas entrevistas semi-dirigidas utilizando-se roteiro temático. Todas as entrevistas foram gravadas e transcritas na íntegra. Os dados foram analisados por meio da técnica de análise de conteúdo temática. As categorias de análise foram organizadas de acordo com os conceitos do referencial teórico e temas emergentes. Resultados: Participaram do estudo 20 mulheres e 20 profissionais de saúde da UCIN - médicos assistentes, médicos residentes do terceiro ano, enfermeiras assistentes e técnicos de enfermagem. Todas as mulheres mostraram sinais do desenvolvimento da preocupação materna primária. As mães se referiram a uma aproximação crescente com seu bebê já nos relatos sobre a gestação. Apesar do receio inicial elas expressaram desejo de assumir os cuidados prestados ao filho, desenvolvendo habilidades para compreendê-lo, atendendo suas necessidades de forma sensível e amorosa. As mães sentiram restrições de contato com o bebê e expressaram a necessidade de maior liberdade para atender às suas necessidades. O contato mais próximo com o bebê foi descrito pelas mães e profissionais como importante para que as mulheres se sentissem desempenhando o papel materno. A atitude de holding às mães foi realizada de modo diferente entre médicos e profissionais de enfermagem. Os médicos auxiliavam as mães fornecendo informações clínicas, com atitude cuidadosa, mantendo-se à disposição para elucidar dúvidas. A equipe de enfermagem incentivava o contato mãe-bebê, apresentando e favorecendo diferentes formas de aproximação e cuidados. De acordo com as mães, o cuidado e carinho dos profissionais de saúde com as próprias mães e com os bebês incentivou sua aproximação com o bebê e contribuiu para deixá-las mais tranquilas e seguras para cuidar dele. Conclusão: Mulheres diagnosticadas com gravidez de alto risco, cujos bebês necessitaram internação em UCIN logo após o nascimento, embora tenham sentido limitações para o relacionamento com o filho, conseguiram desenvolver a preocupação materna primária e um bom relacionamento inicial com ele. O ambiente de holding proporcionado pelos profissionais de saúde foi importante para auxiliar estas mães a desenvolverem sua relação com o bebê no ambiente de internação
Abstract: Objective: Study the development of the mother-child relationship of the women diagnosed with high risk pregnancy whose newborn were hospitalized in an intermediate neonatal intensive care unit (NICU), and the perspectives and actions of the healthcare professionals, who take care of these babies, regarding this relationship development. Methods: Winnicott theoretical concepts regarding the primary maternal preoccupation and holding were used as a conceptual framework. A clinical-qualitative study was performed with purposeful sampling, whose number of participants was determined following the information saturation criteria. The sample was composed of two participants groups. One group was formed by postpartum women diagnosed with postpartum hypertension syndrome or gestational diabetes, whose newborns needed to be hospitalized in NICU. The other group was formed by health professionals who took care of these babies in the NICU. Semi-structured interviews were performed using a thematic guide. All interviews were recorded and verbatim transcribed. The data were analyzed through the thematic content analysis technique. The analysis categories were organized according to the theoretical concepts and emerging themes. Results: A total of 20 women and 20 health professionals of NICU participated in the study (physicians, medical residents, nurses and nursing technicians). All the women showed primary maternal preoccupation development signs. The mothers referred to a growing closeness with your baby in their pregnancy reports. Despite initial fears the mothers expressed a desire to take over the care provided to their child, developing skills to understand them, meeting their needs in a sensitive and loving way. Mothers felt restrictions of contact with the baby and expressed the need for a greater freedom to meet your needs. The closest contact with the baby was described by mothers and professionals as important for women to feel playing the maternal role. The holding attitude with the mothers was conducted differently among doctors and nurses. Doctors assisted mothers providing clinical information, with careful attitude, making them available to clarify doubts. The nurses encouraged the mother-infant contact, presenting and promoting different ways to approach and care. According to the mothers, the care and affection of health professionals with their own and the babies, encouraged their approach with the baby, making them more more calm and safe to care about him. Conclusion: Women diagnosed with high-risk pregnancy, whose babies required hospitalization in NICU after birth, although they felt limitations to relate with his child, developed the primary maternal preoccupation and a good initial relationship with her baby. The holding environment provided by the health professionals was important to help these mothers to develop their relationship with the baby in the hospitalization environment
Doutorado
Saúde Materna e Perinatal
Doutora em Ciências da Saúde
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Fernandes, Ravini dos Santos. "A maternagem em unidade de abrigamento: a relação entre mães adolescentes e seus filhos." Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=3611.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorPesquisa qualitativa que tem por objeto a relação entre mãe adolescente abrigada e seu filho. Objetiva descrever o significado do filho para a mãe adolescente abrigada; compreender os fatores que influenciam no estabelecimento da relação mãe adolescente abrigada e seu filho; e analisar a relação mãe-filho nos espaços do abrigamento partir dos cuidados realizados pela mãe adolescente abrigada. A pesquisa foi realizada em uma instituição de abrigamento no município do Rio de Janeiro, localizada no bairro de Vila Isabel. Os sujeitos foram seis mães adolescentes que se encontravam abrigadas em companhia de seus filhos. As entrevistas foram feitas através de um roteiro contendo questões de identificação das depoentes e perguntas abertas. A análise dos resultados foi realizada com base em Bardin (análise de conteúdo), emergindo duas categorias, a saber: 1) o significado do filho para a mãe adolescente; e 2) vivências maternas no cuidado do filho no interior da unidade de abrigamento. Ademais, evidencia-se que as mães adolescentes percebem seus filhos em sua vida como um aumento da responsabilidade e como fator de amadurecimento. O filho atua como estimulador deste processo, na medida em que ao depender da mãe adolescente para sobreviver, acaba induzindo transformações pessoais e sociais. Este novo ser representa para estas mães afeto, amor, carinho e sua própria família. O sentimento de amor que sente pelo filho e a forma como desempenha a maternagem solidificam a relação deste binômio, impulsionando a busca por uma mudança social em sua vida e o desejo de não mais voltar às ruas. A maternagem desenvolvida pelas jovens mães ocorreu de forma suficientemente boa, conseguindo atender as necessidades básicas de seu filho e estabelecendo a relação afetiva entre este binômio, mesmo mencionando a interferência dos profissionais de abrigo com relação ao cuidado que desenvolvem ao seu filho. É necessário oferecer bases para que essa mãe adolescente sinta-se fortalecida nas atividades maternas e que estas possam também continuar a desenvolver o cuidado do filho de maneira que atendam as necessidades do bebê, mantendo uma boa relação entre este binômio, para que o filho tenha um desenvolvimento emocional sadio e seja um adulto seguro para se lançar no mundo sem medos dos obstáculos e limitações provenientes de uma vida cheia de exclusões.
Qualitative research, whose object is the relationship between the sheltered teenage mothers and their children. It aims as describing the meaning of children for the sheltered teenage mothers; understanding the factors that influence the establishment of the sheltered teenage mother and her child; analyzing the relationship mother/child in the sheltered spaces from the caretaking performed by the sheltered teenage mother. The research was carried out in a sheltering institute in the city of Rio de Janeiro, located in Vila Isabel. The subjects were six teenage mothers who were sheltered with their children. The interviews were performed through a script containing interviewees identification questions and open questions. The analysis of the results was made based on Bardins technique (content analysis), giving rise to the following categories: the meaning of the child for the teenage mother and the maternal experiences gone through in taking care of the child in the sheltering unit. Teenage mothers perceive their children in their lives as an increased responsibility and as a factor for growth, being the child a stimulus for this process, as there is now somebody who depends on her to survive; therefore, the child stimulates personal and social transformations, as a being who represents affection, love, tenderness and her own family. The feeling of love for her child and how maternity is performed crystallizes the relationship within this binomial, boosting the search for a social change in her life and the desire to stay away from the streets. The maternity developed by the young mothers occurred satisfactorily, meeting the basic needs of their children and establishing the affective relationship within this binomial, even mentioning the interference of the shelter professionals as regards the care they develop for their children. It is necessary to provide them with a basis so that this teenage mother feels strong enough for motherhood activities, and they may also keep on developing the satisfactory care for their children by meeting the babies needs, keeping a good relationship within this binomial, so the child experiences a healthy emotional development and becomes a secure adult to fearlessly face the world`s obstacles and constraints arising from a lifetime of exclusions.
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Soomro, Munawar Hussain. "Health effects of endocrine disruptors during pregnancy and childhood Exposure to heavy metals during pregnancy related to gestational diabetes mellitus in diabetes-free mothers Prenatal exposure to phthalates and the development of eczema phenotypes in male children: Results from the EDEN mother-child Cohort study." Thesis, Sorbonne université, 2019. https://accesdistant.sorbonne-universite.fr/login?url=http://theses-intra.upmc.fr/modules/resources/download/theses/2019SORUS243.pdf.
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Les perturbateurs endocriniens (PE) sont des composés synthétiques capables de se lier aux récepteurs cellulaires et d'imiter ou de bloquer le fonctionnement des hormones naturelles, pouvant ainsi entraîner des effets néfastes sur la santé. Ces dernières années, des hypothèses ont été émises selon lesquelles les PE pourraient également contribuer au développement de maladies allergiques et respiratoires. En outre, il est probable que les PE pourraient déjà agir pendant la grossesse en provoquant un diabète gestationnel (DG) et une hypertension induite par la grossesse, pouvant également provoquer une hypertension et un diabète plus tard dans la vie. Ce travail de thèse a permis de mettre en évidence que l'exposition maternelle aux phtalates et aux métaux lourds (plomb, cadmium et manganèse) pendant la grossesse pourrait être associée au diabète gestationnel, à l'hypertension induite par la grossesse et à l'eczéma/dermatite atopique chez l'enfant. Nous avons utilisé les données de la cohorte Française de naissance mère-enfant, EDEN (Étude des déterminants pré et post-natals du développement de la santé de l’enfant) pour examiner les hypothèses de ce travail de thèse. Nos résultats apportent de nouvelles preuves potentielles sur la relation entre les perturbateurs endocriniens (phtalates et métaux lourds étudiés) et la santé de la mère et de l’enfant, selon lesquelles l’exposition prénatale à certains phtalates et métaux toxiques lourds pourrait jouer un rôle dans le développement du diabète gestationnel et de l’hypertension induite par la grossesse pendant la grossesse et, ultérieurement, un eczéma pendant la petite enfanceAll humans are exposed to chemicals in everyday life, from food, indoor environment, cosmetics and other products that surround us at home and at work. Endocrine disruptors (EDCs) are man-made compounds that can bind to cell receptors and mimic or block the functions of natural hormones potentially resulting in adverse health effects. In recent years, hypotheses have been put forward that EDCs may contribute also to the development of allergic and respiratory diseases. In addition, it is likely that EDCs could act already during pregnancy by causing gestational diabetes mellitus and pregnancy induced hypertension, which may also trigger to develop hypertension and diabetes mellitus later in life. This dissertation provides evidence that maternal exposure to phthalates and heavy metals (Lead, Cadmium and Manganese) during pregnancy may be associated with gestational diabetes mellitus, pregnancy induced hypertension and later eczema/atopic dermatitis in children. We used ongoing French EDEN-mother child cohort data for our three studies. Our results add new suggestive evidence on the relationship between EDCs (phthalates and heavy metals we studied) and maternal and children health, that prenatal exposure to certain phthalates and heavy toxic metals may play a role in the development of gestational diabetes mellitus and pregnancy induced hypertension during pregnancy and later eczema in early childhood. Future research focusing on larger populations and addressing multiple exposures assessed prenatally and postnatally are required to provide more evidence on possible contributions of emerging pollutants to study the role of phthalates and heavy metals
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Svrckova, Tatiana. "Nexus." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1341527229.
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Santos, Jaqueline Silva. "Promoção da saúde na infância e o direito à saúde: experiências de mães adolescentes no cuidado cotidiano de crianças." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-08052015-145309/.
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No seu processo de crescimento e desenvolvimento, a criança precisa de cuidados adequados desempenhados por pessoas comprometidas com a sua saúde e bem-estar. A maternidade na adolescência apresenta-se como uma situação delicada e complexa, em que a mãe adolescente necessita contar com uma rede de apoio para desempenhar um cuidado protetor que promova a saúde infantil. O objetivo do presente estudo foi analisar as experiências de mães adolescentes no cuidado de crianças com idade entre seis meses e menores de dois anos na perspectiva da promoção e defesa do direito à saúde da criança. Trata-se de um estudo exploratório com análise qualitativa temática indutiva dos dados. As informações foram coletadas em entrevistas semiestruturadas gravadas com 20 mães adolescentes com filhos acompanhados por equipes de Saúde da Família do município de Passos, Minas Gerais, Brasil. Os resultados foram organizados de acordo com os seguintes temas: A maternidade na adolescência; O cuidado cotidiano da criança; A saúde da criança e a defesa de seus direitos. Nas experiências narradas pelas mães adolescentes emergiram aspectos referentes à construção do papel materno e as perspectivas para o futuro, ao cuidado da criança, envolvendo a complexidade e a construção de conhecimentos e habilidades para um cuidado protetor, bem como à tradução de preocupações, lacunas e ações ora favoráveis, ora limitantes, para uma atenção ampliada e em defesa da criança. Desde a descoberta da gravidez até o cotidiano de cuidado, a adolescente depara-se com diversos sentimentos e emoções, sendo singular a presença de uma rede de apoio para a interação com a criança, o amparo nos momentos de dificuldades e o desempenho dos cuidados, auxiliando a adolescente a dar prosseguimento aos projetos de vida. As práticas de saúde e as ações profissionais vistas pelas mães adolescentes mostram-se favoráveis, de certo modo, ao exercício da defesa da saúde da criança, de acordo com as necessidades e vulnerabilidades por elas apreendidas. Os relatos maternos também apontaram lacunas que ocorrem no pré-natal e no acompanhamento do crescimento e desenvolvimento da criança, mostrando certas fragilidades para a garantia do direito à saúde na infância. Assim, os resultados sugerem que as potencialidades da mãe adolescente são mais evidentes quando ela é apoiada, permitindo demonstrar capacidade de enfrentamento e superação de dificuldades e estabelecer vínculos afetivos com a criança. O estudo traz contribuições para a atuação das equipes de saúde da família em busca de ampliar o empoderamento das mães adolescentes, fortalecer as práticas de defesa da saúde infantil e do cuidado integral à saúde de crianças e famíliasIn their growth and development process, the children need proper care provided by people committed to their health and well-being. Motherhood in adolescence appears as a delicate and complex situation, in which the teenage mother needs to count on a support network to play a protective care that promotes children health. The aim of this study was to analyze teenage mothers\" experience in providing care to children aged from six months to two years old, with a view to promoting and defending the right of the child to health. This is an exploratory study with qualitative analysis and inductive thematic data. Data were collected via semi-structured interviews, conducted with 20 teenage mothers with children, accompanied by Family Health teams at the city of Passos, Minas Gerais, Brazil. The results were organized according to the following topics: Motherhood in adolescence; The daily care of the child; The health of children and the defense of their rights. From the experiences narrated by adolescent mothers, aspects related to the construction of the maternal role and prospects for the future, to child care, involving the complexity and the construction of knowledge and skills to a protective care emerged, as well as others regarding concerns, gaps and actions sometimes favorable, sometimes limiting, for an attitude of more focused and child-centered attention. Since the discovery of pregnancy to the care provision in daily life, the teenager is faced with many feelings and emotions, and the presence of a support network is unique for interaction with the child, for protection in times of difficulties and for providing care, helping the adolescent to give continuity to the life projects. Health practice and professional actions seen by teenage mothers favor, in a way, the exercise of children\'s health protection, according to the needs and vulnerabilities perceived by them. Mothers\" reports also showed gaps in the prenatal and in the growth and development of children, showing certain weaknesses in ensuring the right to health in childhood. Thus, the results suggest that the teen mother\'s capabilities are more evident when she has support, allowing her to demonstrate some ability to cope and overcome difficulties and establish emotional bonds with the child. The study brings contributions to the work of Family Health teams seeking to extend the empowerment of adolescent mothers and strengthen defense practices of child health and comprehensive health care of children and families
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Yako, Elizabeth Matseliso. "Adherence to pre-selected infant feeding practices among mothers on the prevention of mother-to-child transmission (PMTCT) of HIV/AIDS programme in the Amathole region, Eastern Cape." Thesis, University of Fort Hare, 2011. http://hdl.handle.net/10353/d1001091.
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Infant feeding in the context of HIV/AIDS poses a challenge among mothers. The implementation of UNICEF guidelines on infant feeding, which state that “when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended” (WHO, 2003:12) are not easy to meet. In more developed countries, where these criteria are met, almost all HIV-infected mothers have ceased to breast feed. Consequently, infants of mothers in these countries are less likely to be infected with HIV postnatally. In South Africa, more specifically in the Eastern Cape, infant feeding is a challenge as a number of UNICEF criteria cannot be met. The Eastern Cape is one of the poorest Provinces in South Africa, with a number of rural communities. Earlier studies have shown that, if mothers select either exclusive breast feeding or exclusive formula feeding, this reduces mother-to-child transmission of HIV. A limited number of studies on adherence to the method of infant feeding selected before delivery were found in the literature, hence the need for the current study. The purpose of the study was to explore adherence to exclusive breast feeding and exclusive formula feeding among mothers with HIV infection and to determine the problems that mothers may be facing in implementing their pre-selected methods.
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Mäki, P. (Pirjo). "Parental separation at birth and maternal depressed mood in pregnancy: associations with schizophrenia and criminality in the offspring." Doctoral thesis, Oulun yliopisto, 2003. http://urn.fi/urn:isbn:9514270800.
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Abstract Early risk factors of the antenatal period and infancy have been increasingly linked to psychiatric disorders. The aim of this thesis was to study the associations between very early parental separation and maternal depressed mood in pregnancy on the other hand, and schizophrenia and criminality in the offspring in adolescence and adulthood, on the other, in two data sets. In the Christmas Seal Home Children Study the index cohort consisted of 3 020 subjects born in Finland in 1945–65 who were temporarily isolated from their family immediately after birth to nursing homes, the Christmas Seal Homes, due to tuberculosis in the family. The average separation time was seven months. For every index subject, two reference subjects were matched for sex, year of birth and place of birth. Data were obtained on schizophrenia from the Finnish Hospital Discharge Register (FHDR) in 1971–98 and on criminal offences from Statistics Finland in 1977–98. The 28-year cumulative incidence of schizophrenia was 1.6% both in the index cohort and in the reference cohort (RR 1.0; 95% CI 0.8–1.4). Both male and female index subjects had committed crimes more commonly than the reference subjects (in men RR 1.3; 95% CI 1.2–1.4; in women RR 1.5; 1.2–2.0). Of the male index subjects 12.1% as compared with only 7.1% of the reference cohort had committed violent offences (RR 1.7; 1.4–2.1). In the Northern Finland 1966 Birth Cohort mothers of 12 058 babies were asked at mid-gestation at the antenatal clinic if they felt depressed. This general population birth cohort of the children was followed up for 31 years being record-linked with the FHDR covering the years 1982–97 and with the criminal register of the Ministry of Justice up to 1998. We divided the schizophrenia patients into those having a psychotic first-degree relative (schizophrenia patients with familial risk for psychosis FR) and those without one. The cumulative incidence of hospital-treated schizophrenia was 1.3% among the offspring of depressed mothers and 0.9% among the descendants of non-depressed mothers (RR 1.5; 95% CI 0.9–2.4). The prevalence of antenatal depression was 35% in mothers of schizophrenia patients with FR. The respective prevalence was 14% both in the mothers of schizophrenia patients without FR and in the mothers of other cohort members. Both male and female offspring of antenatally depressed mothers were more commonly criminal offenders than offspring of non-depressed mothers (in men adjusted OR 1.5; 95% CI 1.2–1.9; in women OR 1.5; 0.8–3.0). In males, 6.5% with depressed mothers and 3.2% with non-depressed mothers had committed violent offences (adjusted OR 1.6; 1.1–2.4). Very early separation and mothers' depressed mood in pregnancy are per se unlikely to increase the risk for schizophrenia in the offspring, but seem to be connected to criminal behaviour, especially violent criminality in menTiivistelmä Raskaus- ja imeväisajan varhaiset tekijät on lisääntyvästi yhdistetty lapsen tuleviin mielenterveyshäiriöihin. Tarkoituksena oli tutkia hyvin varhaisen eron (separaation) ja äidin raskaudenaikaisen masentuneen mielialan yhteyttä lasten skitsofreniaan ja rikollisuuteen nuoruudessa ja aikuisuudessa kahdessa eri aineistossa. Joulumerkkikoti-lasten tutkimuksessa indeksikohortti koostui 1945–65 syntyneistä 3 020 tutkittavasta, jotka erotettiin väliaikaisesti perheistään heti syntymän jälkeen hoitokoteihin, Joulumerkkikoteihin, perheen tuberkuloosin takia. Ero vanhemmista kesti keskimäärin seitsemän kuukautta. Jokaiselle indeksitutkittavalle valittiin kaksi sukupuolen, syntymävuoden ja -paikan mukaan kaltaistettua verrokkitutkittavaa. Tieto skitsofreniaan sairastumisesta hankittiin sairaaloiden poistoilmoitusrekisteristä vv. 1971–98 ja rikoksista Tilastokeskuksesta 1977–98. 28 vuoden kumulatiivinen sairastuvuus skitsofreniaan oli 1,6 % sekä indeksi- että verrokkikohortilla (riskisuhde RR 1.0; 95 %:n luottamusväli CI 0,8–1,4). Sekä miehistä että naisista indeksitutkittavat olivat tehneet useammin rikoksia kuin vertailuryhmä (miehillä RR 1,3; 1,2–1,4; naisilla RR 1,5; 1,2–2,0). Miehistä 12,1 % indeksitutkittavista ja vain 7,1 % vertailuryhmästä oli tehnyt väkivaltarikoksen (RR 1,7; 1,4–2,1). Pohjois-Suomen 1966 syntymäkohortin 12 058 lapsen äideiltä kysyttiin keskiraskauden aikana äitiysneuvolassa, kokivatko he mielialansa masentuneeksi. Tämän väestötason syntymäkohortin (siis lasten) tietoja hankittiin 31-vuotisseurannassa sairaaloiden poistoilmoitusrekisteristä vuosilta 1982–97 ja oikeusministeriön rikosrekisteristä vuoteen 1998. Skitsofreniaan sairastuneet jaettiin niihin, joiden 1. asteen sukulainen oli ollut / ei ollut ollut psykoottinen. Sairaalahoitoa vaatineen skitsofrenian kumulatiivinen sairastuvuus oli 1,3 % masentuneiden ja 0,9 % masentumattomien äitien lapsilla (RR 1,5; 0,9–2,4). Raskaudenaikaisen masentuneen mielialan esiintyvyys oli 35 % niiden skitsofreniapotilaiden äideillä, joilla oli ollut lähisuvussa psykoosia. Vastaavasti masentunutta mielialaa esiintyi 14 %:lla sekä niiden skitsofrenia-potilaiden äideistä, joilla ei ollut sukurasitusta, että muiden kohorttitutkittavien äideistä. Sekä masentuneiden äitien pojista että tyttäristä useampi oli tehnyt rikoksen kuin masentumattomien äitien lapset (miehillä vakioitu vedonlyöntisuhde OR 1,5; 1,2–1,9; naisilla OR 1,5; 0,8–3,0). Masentuneiden äitien pojista 6,5 % ja masentumattomien äitien pojista 3,2 % oli tehnyt väkivaltarikoksen (vakioitu OR 1,6; 1,1–2,4). Hyvin varhainen ero ja äidin masentunut mieliala raskauden aikana eivät todennäköisesti sinänsä lisää skitsofrenian vaaraa lapsilla, mutta näyttävät olevan yhteydessä lasten rikolliseen käyttäytymiseen, erityisesti väkivaltarikoksiin miehillä
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Gil, Iolanda Maria Cortez Lopes Campos. "Nascimento antecipado: Associação entre a sintomatologia somática, representações maternas, a interacção mãe-filho e o nível de desenvolvimento do bebé, numa amostra de bebés pré-termo de muito baixo peso aos 4 meses de idade corrigida." Master's thesis, Instituto Superior de Psicologia Aplicada, 2005. http://hdl.handle.net/10400.12/554.
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Ferreira, Maria Leonor de Brito. "Atraso de crescimento intra-uterino e depressividade materna." Master's thesis, Instituto Superior de Psicologia Aplicada, 2004. http://hdl.handle.net/10400.12/519.
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Dissertação de Mestrado em PsicossomáticaO atraso de crescimento intra-uterino é uma situação clínica importante e que poderá pôr as crianças em risco de adquirir perturbações no desenvolvimento. Alguns autores referem a influência do estado emocional da grávida na vida fetal, considerando algumas patologias fetais e neonatais como capazes de serem condicionadas em parte pela vivência da gravidez pela mãe e pelo pai. Foi feito um estudo de caso de atraso de crescimento intra-uterino, tendo como objectivo explorar as representações e a depressividade maternas. Neste caso, não se constatou depressividade materna, todavia verificou-se um impasse afectivo e relacional, por parte quer da mãe quer do pai, que poderá ter tido um impacto na vida emocional fetal e condicionado o seu equilíbrio psicossomático. Estes progenitores terão investido deficitariamente no seu bebé-feto. A patologia psicossomática do feto terá sido o espelho das dificuldades de gestão dos afectos pelos pais, tendo-os colocado em risco de um adoecer somático. A presente investigação permitiu reflectir sobre a influência exercida pelo relacional, ligado aos processos de identificação/construção da identidade, à família uni ou biparental e ao adoecer psicossomático, numa patologia fetal pouco frequente mas considerada de risco. A análise deste caso poderá conduzir a um estudo científico, baseado em técnicas quantitativas, sobre a personalidade dos pais de bebés com atraso de crescimento intra-uterino assimétrico e a avaliação psicológica destes bebés.
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Santos, Kate Delfini. "Um estudo psicanalítico sobre a maternidade na adolescência: histórias de abandono, violência e esperança na trajetória de três jovens mães." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-20072011-150734/.
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A relação mãe-filho é um dos elementos fundadores do psiquismo humano e é por meio desta que a criança apreende o mundo a sua volta. São muitas as variáveis que interferem nessa relação como, por exemplo, a experiência pessoal, os legados inter e transgeracionais, as condições históricas, sociais, e econômicas. Tendo em vista a fragilidade dos laços afetivos nos dias atuais e a dificuldade no estabelecimento de vínculos que propiciem o sentimento de confiança, segurança e estabilidade, este trabalho tem como objetivo verificar como três jovens mães, que vivenciaram diversos tipos de violências em suas trajetórias, desempenham a função materna. As participantes encontravam-se em um abrigo para jovens mães no município de São Paulo. Foram realizados cinco encontros com cada dupla (mãe e filho) com cerca de uma hora de duração, onde foram explorados conteúdos a respeito da relação da adolescente com sua mãe e a família, a experiência com a gestação e a maternidade, a experiência com as diversas formas de violência e o vínculo com o filho. Foi empregado o método de pesquisa psicanalítico e, portanto, além da comunicação verbal foram analisados aspectos transferenciais e contratransferenciais. Os conteúdos encontrados articulam-se com as idéias de Winnicott. Por meio desse estudo concluiu-se que o sentimento de abandono e vazio causado pela a ausência de uma relação genuína de afeto é transmitido entre as gerações na relação mãe-filho, tendo muitas vezes como consequência a violência. Esta, por sua vez, interrompe o processo de amadurecimento emocional e a conquista de um sentimento de preocupação real com outro. A possibilidade de restaurar laços e dar continuidade ao processo de integração depende em grande parte da sustentação e do apoio (holding) oferecido a essas jovens mães. Nos três casos analisados, observamos que ainda há esperança, segundo a conceituação de Winnicott, de reencontrar uma experiência de afeto significativa, por meio da qual se constitua um sentimento autêntico de preocupação e comprometimento com o próximoThe mother-son relationship is one of the founding elements of the human psyche and it is through this that the child perceives the world around him/her. There are many variables that affect this relationship, for example, personal experience, the inter-and transgenerational legacy and the historical, social, and economic conditions. Given the fragility of the affective bonds today and the difficulty in establishing links that give the feeling of trust, security and stability, this study aims to determine how three young mothers, who experienced several types of violence in their lives, play the maternal role. The participants were in a shelter for young mothers in São Paulo city. Five meetings were conducted with each pair (mother and son) for about one hour, when the relationship between the teenager with her mother and family, her experience with pregnancy and motherhood, her experience with various forms of violence and the bond with her child, were exploited. The psychoanalytic research method was employed and transference and countertransference aspects, which go beyond the verbal communication, were therefore analyzed. The content found can be linked with the Winnicotts ideas. In this study we concluded that the feeling of abandonment and emptiness caused by the absence of a genuine affection is transmitted between generations in the mother-child relationship and frequently has the violence as consequence. The violence stops the process of emotional maturation and the achievement of a sense of real concern to another person. The possibility of restoring ties and continuing the integration process depends largely on the support and assistance (holding) offered to these young mothers. In these three cases, we observed that there is still hope, according to Winnicott\'s concept, to find a meaningful experience of affection, through which it constitutes a genuine feeling of concern and commitment to the other person
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Silveira, Anne Lise Sandoval Scappaticci [UNIFESP]. "Contextos de vida e as vivências da maternidade de adolescentes em situação de rua. Aspectos sociais e psicológicos." Universidade Federal de São Paulo (UNIFESP), 2006. http://repositorio.unifesp.br/handle/11600/9259.
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Previous issue date: 2006-01-01Nas últimas décadas, muito tem sido pesquisado acerca da gravidez na adolescência e a respeito de populações de rua; entretanto, pouco foi publicado no referente à jovem mãe em situação de rua. Este estudo possui o intuito de preencher esta lacuna. Com a finalidade de investigar os contextos de vida e as vivências de maternidade em adolescentes em situação de rua, foram entrevistadas vinte e uma adolescentes residentes em oito domicílios transitórios na cidade de São Paulo. Utilizando uma abordagem qualitativa, especificamente a Grounded Theory, realizou-se uma análise descritiva dos principais conteúdos das entrevistas enquanto num segundo momento, foi feita uma leitura psicanalítica. Os principais temas se desenvolveram em torno dos seguintes eixos: trajetória, vida familiar, vida de rua, sexualidade, gravidez, presença do parceiro, maternidade, maternidade no abrigo, vivências da maternidade. Os dados levantados por este estudo trazem à tona algumas hipóteses. A maior parte das adolescentes cresceu em contextos de pobreza chefiados pela mãe. A vida familiar foi marcada por instabilidade; muitas mudanças casuais de domicílio, geralmente regidas por conflitos nos relacionamentos, abandono, não ter onde/com quem ficar e, ainda, por um estilo de vida familiar nômade. Apesar de retratado com rejeição e conflito, o relacionamento com a mãe foi, em geral, referência enquanto a relação com o pai foi hostil ou ausente. A rua foi retratada como um lugar onde ‘tudo’ é possível, drogas e sexo são utilizados sem muito cuidado, mas que, com a aproximação do nascimento do bebê, vai se tornando inviável. Grande parte dos relacionamentos com o parceiro foram ocasionais e por pouco tempo. A maior parte das jovens recebeu a notícia da gravidez com surpresa e rejeição. O abrigo, apesar de visto com ambivalência, vai se constituindo como um lugar que as acolhe, tornando possível a vivência da maternidade. A hipótese da maternidade na adolescente em situação de rua como um fato positivo e paulatinamente construído com a função de dar sentido a uma existência cujos vínculos significativos foram pobremente investidos. O investimento necessário para que seja possível a construção de um vínculo com a própria adolescente e da mesma com o bebê é fundamental e necessita de tempo.
In recent decades there has been a great deal of research regarding adolescent pregnancy and the homeless population, however, little has been published concerning young homeless mothers. This study is intended to close this gap. In order to investigate the living context and experience of motherhood in homeless adolescents, 21 teens residing in eight shelters in the city of São Paulo were interviewed. Using a qualitative approach based on Grounded Theory, a descriptive analysis of the main interview contents was carried out, followed by a psychoanalytic reading of this same material. The main themes came out on the following axes: direction, family life, life on the street, sexuality, pregnancy, presence of a partner, maternity, maternity in the shelter, experiences with maternity. The information brought out by this study yields some hypotheses. Most of the teens grew up in home contexts of poverty headed by their mother. Family life was marked by instability; many offhand changes in residence, generally sparked by relational conflicts; neglect; having nowhere to stay and no one to stay with; and by a nomadic family lifestyle. Although marked by rejection and conflict, the maternal relationship is generally referential while the paternal relationship is either hostile or absent. The street is described as a place where anything goes, marked by careless use of drugs and sex, but this becomes unworkable with the approach of the birth of the baby. Most partner relationships are casual and short-term. Teens characteristically receive news of their pregnancy with surprise and rejection. Despite being seen with ambivalence, the shelter becomes a place of refuge that makes the experience of motherhood possible. Homeless teen maternity can be viewed as a positive fact gradually evolving in order to give meaning to an existence where significant bonds are poorly developed. As a result, creating bonds with the adolescent herself and giving her time to construct a relationship with her baby are fundamental.
TEDE
BV UNIFESP: Teses e dissertações
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Granato, Tania Mara Marques. "Encontros terapêuticos com gestantes à luz da preocupação materna primária." Universidade de São Paulo, 2000. http://www.teses.usp.br/teses/disponiveis/47/47133/tde-10112005-162658/.
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Considerando que a construção do conhecimento em Psicologia Clínica exige, desde o início, a integração de uma postura investigativa com a possibilidade de se fazer presente no encontro com o outro, fiz uso do conceito winnicottiano de Preocupação Materna Primária como farol que orienta o psicólogo em sua aproximação das vivências emocionais da mulher durante a gestação e o pós-parto. No fazer do pesquisador presentificou-se o fazer terapêutico, a partir dos dados surgiram as hipóteses e as diversas modalidades de trabalho: entrevistas, cartas, telefonemas e visitas. O campo da maternidade mostrou-se fertilíssimo exigindo, porém, algumas ferramentas básicas para que fosse fecundado, tais como: flexibilidade no atendimento às demandas, acolhimento de toda sorte de angústias, humildade diante da própria ignorância, preocupação autêntica pela paciente e respeito por sua forma de ser.Considering that the construction of knowledge in Clinical Psychology requires from the beginning the integration of an investigative posture with the possibility of being present before the other, I made use of the winnicottian concept of Primary Maternal Preoccupation like a lighthouse that guides the psychologist in her approach to the womans emotional experiences during pregnancy and postpartum. During the researcher task I encountered therapeutic alternatives. Hypothesis and working modalities came out from the data: interviews, letters, phone calls and home visits. The field of maternity presented itself extremely fertile, requiring though some basic tools in order to be fecundated, such as: flexibility to meet needs, holding all sorts of agonies, humility before of our own ignorance, true preoccupation with the patient and respect for her being.
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Pontes, Maria Jurema Bandeira. "Condições de nascimento das crianças do município de São José do Norte/RS." reponame:Repositório Institucional da FURG, 2004. http://repositorio.furg.br/handle/1/3643.
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Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2004.Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-10-29T18:13:42Z No. of bitstreams: 1 mariapontes.pdf: 605486 bytes, checksum: ad03f897cd7a81777a3d4addb7117e2a (MD5)
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Este estudo buscou identificar os fatores que influenciam as condições de nascimento das crianças do município de São José do Norte/RS, com a finalidade de subsidiar o planejamento e a implementação das ações de saúde voltadas para o binômio materno-infantil. Foi realizado um estudo transversal de base populacional com recém-nascidos deste município, no período de janeiro a setembro de 2004. As informações sobre os nascimentos foram obtidas junto ao livro de registros de nascimentos e foram aplicados questionários às puérperas no pós-parto imediato, de modo a obter informações quanto às condições socioeconômicas, demográficas, da história reprodutiva prévia, dos hábitos maternos e da situação ocupacional familiar. Foram 101 entrevistadas 188 mães (98,4%) internadas no Hospital e Maternidade São Francisco de São José do Norte/RS, ou transferidas para o Hospital Universitário Dr. Miguel Riet Correa Jr., no município do Rio Grande/RS, considerado referência para transferências de gestantes de risco da região. Entre os principais dados socioeconômicos destacam-se: a elevada porcentagem de famílias com baixa renda (28,2% vivem com menos de um salário mínimo); o percentual elevado de baixa escolaridade materna e, sobretudo, paterna; o índice elevado de gestantes adolescentes (31,4%); e a falta de saneamento básico em um quarto das residências. Quanto à situação ocupacional, houve predomínio de atividade familiar na pesca e na agricultura, com percentuais elevados de exposição a agrotóxicos. Com relação às patologias mais prevalentes da gestação, foram relatadas anemia (79,4%), infecção urinária (49,1%) e hipertensão arterial(11,4%). Quanto à assistência pré-natal, destaca-se o fato de que 92% das mães realizaram, no mínimo, uma consulta. No entanto, somente 53,2% iniciaram-na no primeiro trimestre da gestação e 64,9% realizaram cinco ou mais consultas. O índice de cesarianas foi de 30,3% e, em 39,3% dos partos, houve indução com ocitócitos. Quanto às condições de nascimento, 9,6% (<2500g) dos recém-nascidos apresentaram baixo peso ao nascer e 27,1% peso insuficiente(2500g-2999g). Esses resultados mostram a necessidade de que o poder público municipal volte a sua atenção para o binômio materno-infantil, melhorando as condições socioeconômicas da população, sobretudo a renda e a escolaridade dos pais. Faz-se necessária uma ação junto às adolescentes para reduzir o índice de gestação nessa faixa etária. Da mesma forma, é preciso melhorar a periodicidade e a precocidade do acompanhamento pré-natal e a assistência ao parto, reduzindo a porcentagem de induções.
Este estudio busca identificar los factores que influencian las condiciones de nacimiento de los niños en el municipio de São José do Norte/RS, con la finalidad de subsidiar el planeamiento y la ejecución de las acciones de salud materno-infantil. Fue realizado un estudio transversal de base popular con recién nacidos de ese municipio, en el periodo de enero a septiembre de 2004. Las informaciones sobre los nacimientos fueron obtenidas en el libro de registro de nacimientos, y fueron aplicados cuestionarios a las parturientas en el puerperal inmediato, de manera a obtener informaciones cuanto a las condiciones socioeconómicas,demográficas, de la historia reproductiva previa, de los costumbres maternos y de la situación ocupacional familiar. Fueron entrevistadas 188 madres (98,4%) internadas en el Hospital y Maternidad São Francisco, de São José do Norte/RS, o transferidas para el Hospital Universitario Dr. Miguel Riet Correa Jr., en el municipio del Rio Grande/RS, considerado referencia para transferencias de gestantes de riesgo de la región. Entre los principales datos socioeconómicos se destacan: la elevada porcentaje de familias con baja renta (28,2% viven con menos de un sueldo mínimo); el porcentual elevado de baja escolaridad materna y, sobretodo, paterna; el índice= elevado de gestantes adolescentes (31,4%), y la falta de saneamiento básico en un cuarto de las viviendas. Cuanto a la situación ocupacional, hubo predominio de actividad familiar en la pesca y en la agricultura, con porcentuales elevados de exposición a agrotóxicos. Con relación a las patologías más prevalecientes de la gestación, fueron relatadas anemia (79,4%), infección urinaria (49,1%) e hipertensión arterial (11,4%). Cuanto a la asistencia prenatal, se destaca el hecho de que 92% de las madres realizaron por lo menos una consulta. Pero solamente 53,2% la empezaron en el primero trimestre de la gestación, y 64,9% realizaron cinco o más 102 consultas. El índice de cesarianas fue de 30,3%, y, en 39,3% de los partos, hubo inducción con ocitócitos. Cuanto a las condiciones de nacimiento, 9,6% (<2500g) de los recién nacidos presentaron bajo peso al nacer, y 27,1% peso insuficiente (2500g – 2999g). Eses resultados muestran la necesidad de que el poder público municipal vuelva su atención para el binómio materno-infantil, mejorando las condiciones socioeconómicas de la población, sobretodo la renta y la escolaridad de los padres. Es necesaria una acción junto a las adolescentes para reducir el índice de gestación en esa edad. De la misma manera, es preciso mejorar la periodicidad y la precocidad del acompañamiento prenatal y la asistencia al parto, reduciendo el porcentaje de inducciones.
This study aims at identifying factors influencing the condition of childbirth in São José do Norte/RS, in order to contribute to planning and conducting measures for mothers and children. A crosssectional study on a popular basis was conducted among newborn babies in this district, from January to September 2004. Data about birth were caught from registrar books, and the mothers were interviewed soon after parturition, about their social-economical, demographic condition an about their previous reproductive history, their habits and their familiar condition concerning employment. The interviewed were responded by 188 inpatient mothers (98,4%) from the São Francisco Hospital-Maternity Ward, in São José do Norte/RS, or transferred to Dr. Miguel Riet Correa Jr. University Hospital, in the district of Rio Grande/RS. This one is considered a preferential hospital for transferences of high-risk pregnancies in this region. Among the principal socioeconomical data, a high percentage of low income families (28,2% earn less than a minimum salary); a high percentage of low instruction both of mothers and fathers, mainly fathers; a high rate of teenager pregnancies (31,4%), and a lack of basic sanitation for one quarter of houses were found. Concerning work and employment condition, most families depend on small-scale fishing and on agriculture, with high percentages of exposition to agro-chemicals. Concerning patologies related to pregnancy, anemia (79,4%), urinary infection (49,1%) and arterial hypertension (11,4%) were prevalent. Concerning prenatal care, 92% had at least one visit, but only 53,2% began prenatal care within the first quarter of pregnancy period, and 64,9% had made five or more visits. The rate of Caesarian parturition was 30,3%, and in 39,3% of cases, delivery was induced with ocitocites. Concerning birth condition, 9,6% (<2500g) of newborn babies had low weight, and 27,1% had unsufficient (2500g – 2999g) weight. These results evidence the need of more care by the public administration in the district towards mothers and children, improving social-economical condition of inhabitants, mainly the income and education of fathers. Measures towards teenager pregnancies are required for reducing their rate in this age. Also it is necessary to improve the prenatal care in periodicity and precocity, as well as the care on parturition, in order to decrease the rate of induction procedures.
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Van, Wyk Elisna. "The effect of pasteurisation on the composition of expressed human milk from HIV positive mothers, and its adequacy in relation to the growth of their very low birth weight premature infants." Thesis, Link to the online version, 2008. http://hdl.handle.net/10019/1507.
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Bazire, Anaelle. "Toxicomanie et materneité : qualité du processus de maternalité chez la femme toxicomane." Thesis, Normandie, 2017. http://www.theses.fr/2017NORMC029/document.
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La maternité des femmes dépendantes aux substances psychoactives est aujourd'hui une question de santé publique. Notre recherche porte sur la prédictivité potentielle des remaniements psychiques observés pendant la grossesse de femmes toxicomanes sur la qualité du processus de maternalité et l'investissement de l'enfant. Elle correspond ainsi à une étude clinique et projective psychodynamique de l’évolution du fonctionnement psychique et des représentations liées à l’enfant de la femme toxicomane et/ou substituée devenant mère. Pour ce faire, nous nous appuyons sur l’analyse d’entretiens semi-directifs et de tests projectifs de femmes consommatrices d’opiacés et/ou sous traitement de substitution aux opiacés et de femmes non toxicomanes, entre le dernier trimestre de grossesse et les un an de l’enfant. Un second versant de cette étude propose un état des lieux des modalités d’accompagnement des femmes enceintes et mères consommatrices de drogues illicites sur le territoire Ouest-Normand ainsi qu’un projet d’accompagnement spécifique et pluridisciplinaire de cette population, élaboré au sein d’un CSAPA (Centre de Soins, d’Accompagnement et de Prévention en Addictologie)Motherhood among women addicted to psychoactive substances is a public health concern. Our research concerns the predictive potential of the psychic reorganizations observed during pregnancy on the quality of motherhood process and of investment of the child. It is thus a psychodynamic clinical and projective study of the evolution of the psychic functioning and the representations bound to the child of drug addict woman and/or woman receiving opiate substitution treatments becoming a mother. In order to do this, we rely on the analysis of semi-directive interviews and projective tests of women opiate users and\or women receiving opiate substitution treatments and of non-addicted women, between the last quarter of pregnancy and on one year old of the child. A second part of this study proposes a state of play of welfare measures for pregnant addicted women and addicted mothers on West-Norman territory. It also proposes a project of specific and multidisciplinary accompaniment of this population which is developed within a CSAPA (Center of addiction care, support and prevention)