http://localhost:8080/xmlui/handle/123456789/10711 2026-04-11T21:08:24Z http://localhost:8080/xmlui/handle/123456789/10733 Title: Trends in perinatal outcomes of women with chronic medical conditions: A 10-year population-based study in the Netherlands Authors: Rosman, Ageeth N.; Vliet - Torij, Hanneke W. Harmsen van der; Hilberink, Sander R. Abstract: Objective: To gain insight into perinatal outcomes in women with chronic medical conditions, in order to contribute to the optimization of personalized perinatal care. We hypothesize that women with a chronic medical condition have poorer perinatal outcomes than women without a known chronic medical condition. Design: Population-based study using data of the Netherlands Perinatal Registry between 2010-2019. Setting: Nationwide study in the Netherlands. Participants: Pregnancies of women who were diagnosed with chronic medical conditions by a medical specialist before pregnancy (n=36,835), divided into seven sub-groups and a reference group of pregnancies of women without known chronic medical conditions (n=1,084,623). Measurements and findings: The primary outcome measure was mode of birth. Secondary outcomes measures were onset of labour, preterm birth, asphyxia, Neonatal Intensive Care Unit (NICU) admission, and perinatal mortality. Spontaneous birth ranged from 45.0% (orthopaedic conditions) to 71.3% (neurological conditions) to 82.6% in the reference group. Assisted vaginal birth, planned caesarean birth, and emergency caesarean birth occurred significantly more in all groups compared to the reference group (p<0.001). Preterm birth was significantly more likely in the studied groups as well as perinatal asphyxia and NICU admission (all p<0.001). Adjusting for mode of birth, parity, age and ethnicity did not change the outcomes for the group of women with chronic medical conditions. Perinatal mortality was seen in all groups but in none of the separate groups significantly more than in the reference group. Descriptive statistics, univariate and multivariable logistic regression analyses were applied. Key conclusions: Women with chronic medical conditions are more likely to experience preterm birth, caesarean births and NICU admission of the new-born. Implications for practice: Knowledge about perinatal outcomes of women with chronic medical conditions is a first step for obstetrics care providers in order to optimize personalized care. 2023-12-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10732 Title: Taking up the challenge of trans and non-binary inclusion in midwifery education: Reflections from educators in Aotearoa and Ontario Canada Authors: Parker, George; Kelly, Lou; Miller, Suzanne; Wagner, Vicki Van; Handa, Manavi; Baddoc, Sally; Griffiths, Christine; Kelsey, Fleur Abstract: Perinatal services are being challenged to acknowledge that not all pregnant and birthing people are women and to ensure the design and delivery of services that are inclusive of, and deliver equitable outcomes for, trans, non-binary, and other gender diverse people. This is posing unique challenges for midwifery with its women-centred philosophy and professional frameworks. This paper presents the critical reflections of midwifery educators located in two midwifery programmes in Aotearoa1 and Ontario Canada, who are engaged in taking up the challenge of trans and non-binary inclusion in their local contexts. The need to progress trans and non-binary inclusion in midwifery education to secure the human rights of gender diverse people to safe midwifery care and equitable perinatal outcomes is affirmed. We respond to an existing lack of research or guidance on how to progress trans and non-binary inclusion in midwifery education. We offer our insights and reflections organised as four themes located within the frameworks of cultural humility and safety. These themes address midwifery leadership for inclusion, inclusive language, a broader holistic approach, and the importance of positioning this work intersectionally. We conclude by affirming the critical role of midwifery education/educators in taking up the challenge of trans and non-binary inclusion to ensure a future midwifery workforce skilled and supported in the provision of care to the growing gender diverse population 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10725 Title: Social support and mental health in maternity: Effects of the COVID-19 pandemic Authors: Tania, Alonso Titos; Natalia, Arias-Ramos; Verónica, Valle-Barrio; Pilar, Marqués-Sánchez; Rubén, García-Fernández; Cristin, Liébana-Presa Abstract: Background: Motherhood involves a process of adaptation and the perception of social support influences mental health, breastfeeding or newborn care among others. The COVID-19 pandemic has generated a distancing from family, friends and health professionals. Methods: Quantitative, descriptive, cross-sectional study. The present study aims to describe and analyze the social support and mental health of mothers during this period. Methods: The sample were 179 women with children older than 6 months. The questionnaires used were the DUKE-UNC-11 and GHQ-12. Data analysis was carried out with Spearman’s Rho and Mann Whitney U test. Results: 75.8% of the sample perceived normal social support during the pandemic. Within the dimensions of social support, women reported perceiving satisfactory confidential support, while affective support was perceived as low. Correlational analysis reported a significant relationship between mental health, confidential support and affective support. Group comparison noted greater confidential support in primiparous. Conclusions: The sample is sensitive to changes originated by COVID-19 constraints influencing perceived social support and mental health. Affective and confidential support as well as the involvement of health professionals and the environment are fundamental for mental health during the first year of maternity. Relevance to clinical practice: Mothers’ mental health is sensitive and vulnerable to social changes, in this case, those that occurred as a consequence of the COVID-19 outbreak. 2023-12-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10720 Title: Personal protective equipment: Analysis of supply among midwives during the COVID-19 pandemic in Peru Authors: Valverde-Espinoza, Natalia; Barja-Ore, John; Rojas, Mirian Solis; Pérez-Silva, Margarita; Herrera-Málaga, Rocío; Angulo, Lizardo Huamán; López, Brenda Rodríguez Abstract: Objective: To report the details of provision of personal protective equipment to midwives during the COVID-19 pandemic in Peru Methods: This is a non-experimental, descriptive, cross-sectional study. An online survey of 679 midwives working at public healthcare centres was conducted via questionnaires. The following aspects were outlined: method of supply and frequency of delivery of personal protective equipment, type of personal protective equipment provided by the institution, and self-purchase. Furthermore, features of the midwives’ workplace were described. For statistical analysis, absolute frequencies and relative proportions were used for categorical variables, and mean and standard deviation were used for numerical variables. Measurements and findings: The most important finding of this study is that a large proportion of midwives (66.6%) did not receive new personal protective equipment for each shift; 41.9% of midwives who received personal protective equipment during each shift exclusively provided services in the COVID-19 ward, whereas 27.6% did not. The least received supplies were of N95 respirator masks (41.7%) and disposable isolation suit gown (50.5%). Only a certain proportion of midwives (38.6%) were trained by their own institutions on the use of personal protective equipment. Key conclusions: The provision of personal protective equipment to midwives and training on personal protective equipment were insufficient at all workplaces. Therefore, measures must be taken to increase the supply of this material to midwives who are essential workers in reproductive health 2023-12-01T00:00:00Z