妊娠と小児の健康に関するジャーナル

抽象的な

Health Assessment of a Rural Obstetrical Population in a Midwestern State

Lisette T Jacobson*, Jennifer Duong, David Grainger, Tracie Collins, Darren Farley, Michael Wolfe, Frank Dong and Benjamin Anderson

A critical access hospital in a Midwestern state experiences an alarming number of high-risk pregnancies including pregnancies complicated by gestational diabetes mellitus. A health collaborative among local healthcare providers, a regional health system, a medical school, and the state health department was established to improve pregnancy and birth outcomes. The purpose of this study was to learn about the characteristics and health behaviours of rural pregnant women. A survey was administered to women who received care at two critical access hospitals and one federally qualified health centre between January and March 2015. Survey questions focused on pregnancy risk factors and ascertained health status, anthropometrics, prenatal education, dietary habits, physical activity, health behaviours, family medical history, and demographic characteristics. Descriptive analyses were conducted. Sample size included 177 rural women. Most respondents were Hispanic (50.3%), 18-25 years old (48.6%), completed some high school (20.5%) or high school graduate (30.7%), WIC enrolled (51.7%), and an income of < $25,000/year (54.2%). The majority were overweight (34.4%) or obese (41.6%) during pregnancy and 54% engaged in 30 minutes of moderate physical activity per day for ≤ 2 days per week. Education regarding fetal movement counts was minimal. Nearly one-third (30.5%) had an immediate family member with diabetes and 24.3% had an immediate family member with heart or circulation problems. Findings indicate that this rural population is at risk for pregnancy complications including gestational diabetes leading to an increased risk for developing type 2 diabetes and cardiovascular disease later in life. This study is an initial step toward understanding rural pregnant women in the catchment area. Follow-up studies that could further guide the design for intervention programming that aims to reduce the risk for cardiovascular disease are needed. Additional studies into annual screening for pregestational diabetes and early serial screening for gestational diabetes are also warranted.