This prospective cohort study compared women participating in CenteringPregnancy® group prenatal care (N = 120) with those in standard individual care (N = 221) to determine if participation in Centering was associated with improvements in perceived social support and quality of life, with concomitant decreases in screens of postpartum depression and improvements in breastfeeding rates. Participants completed surveys at the onset of prenatal care, in the late third trimester and in the postpartum period. Centering participants had higher scores of perceived social support from friends after participating in group care (p < 0.05) with associated improvements in quality of life in the psychological and relational domains (p < 0.05) compared to standard care participants who showed higher scores of perceived support from family (p < 0.05) but did not show concomitant improvements in quality of life. This did not translate to any significant difference in scores on postpartum depression screens but was associated with improvements in breastfeeding continuation rates among Centering participants in the postpartum period. This study indicates that Centering care is associated with improved perceptions of peer social support with associated improvements in quality of life and higher rates of continued breastfeeding.
Background: Patient involvement is essential to maintain accurate and updated medication lists, provide quality care, and decrease potential errors. The purpose of this study was to determine the acceptance of medication lists maintained by patients and if their use affected perceptions of patient and physician responsibility and patients' knowledge of their medical care.Methods: A foldable, wallet-sized medication list card was distributed to a convenience sample of 104 patients >40 years of age at an outpatient residency site. They were also given a survey of demographic variables and the Patient Medication Scale, which measures their perceptions of patient responsibility, physician responsibility, and patients' knowledge of their medical care. They were contacted by phone 4 to 11 months later to ascertain if they were using the medication card and the Patient Medication Scale was readministered.Results: Forty-two of 66 patients contacted after the intervention consented to a full interview. Thirty-eight percent (25 of 66) reported using the card. The patients using the card showed increased scores in perceived patient knowledge and patient responsibility, with no change in their perceptions of physician responsibility. Among the 41 respondents not using the card, approximately half indicated interest in using the card in the future or were using a card of their own.Conclusions
Importance: There is great concern about the impact of COVID-19 in pregnancy due to the high morbidity and mortality associated with prior coronavirus infections.Objective: The objective of this review is to summarize the current literature on the impact of COVID-19 on pregnant women and their newborns.Evidence Acquisition: The search terms COVID-19 and pregnancy were used in Medline and Clinical Key databases. Only articles written in English with outcome data on both mothers and their newborns were incorporated.Results: Pregnant women generally experience COVID-19 as a mild-moderate illness. However, approximately 5% become critically ill. Women with underlying comorbidities seem more likely to experience severe morbidity. Newborns also generally have a favorable course.Vertical transmission in the intrauterine period is possible but rare. Infection control measures need to be taken to prevent transmission during the peripartum period. There is a paucity of data on infections in the first and second trimesters, but research from those infected in the third trimester indicates a possible link with preterm birth. There is a significant percentage of asymptomatic cases. Racial disparities are also being noted with disproportionate numbers of racial/ethnic minorities being affected.Conclusions: COVID-19 is generally experienced by pregnant women and their newborns as a mild to moderate illness, although a minority become critically ill and mortality does occur. This is more likely among those with underlying comorbidities, as in the general population. Asymptomatic cases heighten the need for increased testing and infection control measures. Racial disparities highlight underlying vulnerabilities and the need for increased research and policy changes.Target Audience: Obstetricians and gynecologist, family physicians Learning Objectives: After completing this activity, the reader should be better able to describe clinical presentations of pregnant women who contract COVID-19; explain the risks associated with maternal morbidity and mortality with COVID-19 infections; outline the risks of vertical transmission and neonatal outcomes of pregnant women with COVID-19 infections; and identify racial/ethnic disparities among pregnant women with COVID-19.Since the novel coronavirus (2019-nCov now known as SARS-CoV-2) came to light in December 2019 in Wuhan, China, it has spread throughout the world causing the COVID-19 pandemic. As of October 14, 2020, there were more than 38 million confirmed cases documented worldwide with approximately 8 million of those in the United States, and over 1 million deaths globally. Given the grave complications that other severe coronavirus infections (severe acute respiratory coronavirus [SARS-CoV] and Middle East respiratory syndrome coronavirus [MERS-CoV]) have caused in pregnant women, 1,2 there was heightened concern about how COVID-19 would significantly impact maternal child
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