Assessment of the level of knowledge about health behaviors and puerperium of various social groups in the Świętokrzyskie Voivodeship during the Covid-19 pandemic

Introduction The puerperium is a period in a woman's life after childbirth, during which systemic changes occur. The woman's body returns to its pre-pregnancy condition. It lasts about 6 weeks. Having a baby and placenta causes changes in the concentration of pregnancy hormones, fluctuations that can negatively affect the behavior of women. In addition, the Covid-19 pandemic may interfere with the clinical condition of the pregnant woman, causing her mental health to deteriorate. Aim of the study: The aim of the study was the assessment of the level of knowledge about health behaviors and puerperium of various social groups in the Świętokrzyskie Voivodeship during the Covid-19 pandemic. Material and methods             The survey covered 603 respondents from the Świętokrzyskie Voivodeship from February to April 2021. 18 subjects were excluded from the study due to incomplete completion of the questionnaire. Ultimately, the analysis was conducted on the data of 584 respondents. The analyzes included women and men aged 19-45, who were divided into four groups. The first group included 130 obstetricians, the second 86 midwives, the third 50 teachers, and the fourth 318 students of the JKU. The Bioethics Committee of the JKU approved the study. Statistical analysis was performer. Results The respondents' knowledge about puerperium was 78.6%. Midwives had the most information, while obstetricians had the least. Participants in all 4 groups have a satisfactory level of knowledge about the duration of the puerperium, the principles of prophylaxis and hygiene in puerperium and feeding the newborn. The respondents obtain their knowledge from books and magazines.  Wstęp Połóg to okres w życiu kobiety, kiedy po porodzie dochodzi do zmian ogólnoustrojowych, które wystąpiły w ciąży tj: inwolucja macicy, gojenie rany krocza, rozpoczęcie laktacji, podjęcie czynności hormonalnych przez jajniki. Trwa on 6 tygodni i dzielimy go na połóg bezpośredni do 24 godzin po porodzie, wczesny 1 tydzień  i późny do 6 tygodni. Urodzenie dziecka i łożyska powoduje obniżenie stężenia hormonów ciążowych tj: laktogen łożyskowy, gonadotropina kosmówkowa.  Stężenie prolaktyny i estrogenów zaczyna wracać do wartości sprzed ciąży. Pierwsza owulacja czyli powrót płodności może wystąpić po 6-8 tyg po porodzie, a u kobiet karmiących piersią nawet po roku ze względu na wysokie stężenie PRL związane z karmieniem piersią. Pandemia mogła negatywnie wpłynąć na przebieg ciąży i połogu, ingerować w stan kliniczny kobiety ciężarnej w konsekwencji kształtując obraz przyszłych pokoleń. W tym czasie u kobiet mogły pojawić się dodatkowe obciążenia psychiczne, które pogarszały stan psychiczny, w wyniku którego mogło dojść do  tzw. zjawiska Baby Blues. Cel pracy Celem badania była ocena poziomu wiedzy na temat zachowań zdrowotnych i połogu różnych grup społecznych województwa świętokrzyskiego w czasie pandemii Covid-19. Materiał i metody                 Badaniem zostało objętych 603 respondentów województwa świętokrzyskiego od lutego do kwietnia 2021 roku. Z badania wykluczono 18 respondentów ze względu na niekompletne wypełnienie  ankiety. Ostatecznie analizę przeprowadzono o dane 584 ankietowanych. Do analiz włączono kobiety i mężczyzn w przedziale wiekowym 19-45 lat, których podzielono na cztery grupy. Do pierwszej grupy zakwalifikowano 130 położnic, drugiej 86 położnych, trzeciej 50 nauczycieli, czwartej 318 studentów UJK. Ankiety od położnic zostały zebrane w Klinice Ginekologii i Położnictwa Wojewódzkiego Szpitala Zespolonego w Kielcach, materiał w pozostałych grupach został zebrany przy pomocy formularza online. Wśród nauczycieli przeważali mieszkańcy małych miast do 50 tys. - 68%, natomiast wśród położnic dotyczyło to środowiska wiejskiego (48,46%). Średni wiek ankietowanych mieścił się w przedziale wiekowym 20-30 lat /65,2%/, między 30 -40 rokiem życia w badaniu wzięło udział 18,2%, powyżej 40 rż- 9,6%,  Osób poniżej 20 r.ż. było 7,1%. W badaniach zastosowano autorski kwestionariusz ankiety za pomocą którego zebrano informacje dotyczące miejsca zamieszkania, wieku, wykształcenia, stanu cywilnego oraz liczby posiadanych dzieci i pytań dotyczących wiedzy na temat połogu. Komisja Bioetyczna Uniwersytetu Jana Kochanowskiego zatwierdziła badanie wiedzy na temat połogu. Informacje niezbędne do przeprowadzenia badania zostały pozyskane w zgodzie z polityką ochrony danych osobowych.                                                              Analiza statystyczna                                                                                                                  Analiza statystyczna przeprowadzona została za pomocą programu komputerowego Statistica 13. Uzyskane wyniki zostały poddane testowi zgodności Chi² zwanemu także testem zgodności Pearsona. Obliczono także współczynniki V Cramera oraz korelacji rangowej Spearmana.                                                                              Wyniki Średnia ocena poziomu wiedzy respondentów wynosi 78,6%. Największy zakres wiedzy posiadały położne, najniższy przedstawiały położnice. Respondenci wszystkich grup mają zadowalający poziom wiedzy na temat czasu trwania połogu, zasad profilaktyki i higieny w tym okresie oraz karmienia noworodka. Swoją wiedzę respondenci pozyskują z książek i czasopism

Parents' knowledge of neonatal transitory conditions and their expectations of the midwife

Introduction The neonatal period is the period of the child's adaptation to life outside the mother's body. The child has to adapt to the changes taking place in its body. After delivery, the new-born baby is assessed according to the Apgar scale. Objective of the study The objective of the study was to assess the parents' knowledge of the transitory conditions of neonates and to identify their expectations towards medical personnel. Material and methods 248 women participated in the study. Inhabitants of large cities accounted for 64.5% of the respondents and 16.2% of the respondents were inhabitants of rural areas. Women aged over 35 accounted for 46.8% of patients, 19.3% were patients between the ages of 26 and 30. Patients between the ages of 30 and 35 also accounted for 19.3%. Patients under 25 years of age accounted for 14.6%. The Bioethics Committee approved the project. Statistical analysis was performed with the use of the Statistica computer program. Results 81% of women displayed knowledge about the duration of the neonatal period. 62% of the respondents knew the effect of vitamin K in preventing the occurrence of haemorrhagic disease in the neonate. Half of the women prefer to feed on demand. A big problem among women in childbed is the lack of access to a psychologist. Conclusions Parents cannot recognize transitory conditions in a neonate. Antenatal education of future mothers influences their pro-health behaviour. Parents source their knowledge from their family, friends, guides and books.Introduction The neonatal period is the period of the child's adaptation to life outside the mother's body. The child has to adapt to the changes taking place in its body. After delivery, the new-born baby is assessed according to the Apgar scale. Objective of the study The objective of the study was to assess the parents' knowledge of the transitory conditions of neonates and to identify their expectations towards medical personnel. Material and methods 248 women participated in the study. Inhabitants of large cities accounted for 64.5% of the respondents and 16.2% of the respondents were inhabitants of rural areas. Women aged over 35 accounted for 46.8% of patients, 19.3% were patients between the ages of 26 and 30. Patients between the ages of 30 and 35 also accounted for 19.3%. Patients under 25 years of age  accounted for 14.6%.          The Bioethics Committee approved the project.      Statistical analysis was performed with the use of the Statistica computer program. Results 81% of women displayed knowledge about the duration of the neonatal period. 62% of the respondents knew the effect of vitamin K in preventing the occurrence of haemorrhagic disease in the neonate. Half of the women prefer to feed on demand. A big problem among women in childbed is the lack of access to a psychologist. Conclusions Parents cannot recognize transitory conditions in a neonate. Antenatal education of future mothers influences their pro-health behaviour. Parents source their knowledge from their family, friends, guides and books

Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice

Objectives: Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells. Material and methods: The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed. Results: In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (–1.4 g/L vs –0.9 g/L, p = 000), and haematocrit (–4.05% vs –2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement. Conclusion: Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients

Navigating Uncertain Waters: First-Trimester Screening’s Role in Identifying Neonatal Complications

Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal Intensive Care Unit (NICU), would be beneficial for appropriately stratifying pregnant women into a high-risk category. Our study evaluated whether biochemical and ultrasonographical markers universally used in first-trimester screenings for non-heritable chromosomal aberrations could serve this purpose. Methods: This study encompassed 1164 patients who underwent first-trimester screening, including patient history, ultrasound examinations, and biochemical tests for pregnancy-associated plasma protein-A (PAPP-A) and the free beta-HCG subunit (fbHCG), from January 2019 to December 2021. The research concentrated on the correlation between these prenatal test results and neonatal outcomes, particularly Apgar scores, umbilical blood pH levels, and the necessity for NICU admission. Results: In our cohort, neonates scoring lower than 8 on the Apgar scale at birth exhibited lower concentrations of PAPP-A in the first trimester, both in raw and normalized values (PAPP-A MoM 0.93 vs. 1.027, p = 0.032). We also observed a higher pulsatility index in the venous duct in the first trimester in full-term neonates born with p = 0.04). We also noted that neonates requiring NICU hospitalization post-delivery had lower first-trimester bHCG concentrations (0.93 MoM vs. 1.11 MoM, p = 0.03). However, none of the correlations in our study translated into a robust prognostic ability for predicting dichotomous outcomes. All areas under the curve achieved a value Conclusions: Low concentrations of PAPP-A and free bHCG subunit in the first trimester may be associated with poorer clinical and biochemical conditions in neonates post-delivery. However, the relationship is weak and has limited predictive capability. Further research evaluating these relationships is necessary for the appropriate stratification of pregnant women into high-risk categories for neonatological complications