INTRODUCTION:

"The health of children is one of the most important measures of the health of a society, and that starts during pregnancy and at the very beginning of life."⁴

Healthy children need healthy mother. The health of the mother vastly impact on the health and success of our future generation. Yearly 8 million babies die before or during delivery or in first week of life. The report says that majority of the disease in early neonatal period is related to poor maternal health and nutrition as well as quality of care at pregnancy.³

In the last two decades, about 295 000 women died during and following pregnancy and childbirth in 2017. This number is unacceptably high. The most common direct causes of maternal injury and death are excessive blood loss, infection, high blood pressure, unsafe abortion, and obstructed labour, as well as indirect causes such as anemia, malaria, and heart disease.¹

Ninety-nine percent of these maternal deaths and disabilities occur in developing countries—countries where poverty, lack of education, infectious diseases, poorly equipped health care facilities, and the lack of trained medical personnel conspire against the health and survival of women...and their children.²

Maternal deaths are preventable with timely management by a skilled health professional working in a supportive environment. Ending preventable maternal death must remain at the top of the global agenda. At the same time, simply surviving pregnancy and childbirth can never be the marker of successful maternal health care. It is critical to expand efforts reducing maternal injury and disability to promote health and well-being. Every pregnancy and birth is unique. Addressing inequalities that affect health outcomes, especially sexual and reproductive health and rights and gender, is fundamental to ensuring all women have access to respectful and high-quality maternity care.¹

STATEMENT

A study to assess the maternal health among primipara mothers in selected hospital at Mysuru

OBJECTIVES:

1. To assess the maternal health.

2. To find the association between maternal health with obstetrical history of mothers.

NEED FOR THE STUDY

Globally. Some 350,000 women die in pregnancy or childbirth. More than 8 million children die before their fifth birthday; About 40% of those die in the first month of life (neonate mortality): An estimated 6 million deaths could be prevented through better access and integration of health interventions; These needed interventions are known and affordable. and 0.75 million neonates die due to poor neonatal outcome. In that, 99% of these occur in developing countries. Most common causes for the neonatal mortality which influence the poor neonatal outcome includes prematurity & low birth weight (44%); neonatal infection (15%), birth asphyxia & birth trauma (19%); congenital anomalies (8%), other conditions (7%); pneumonia (45%), tetanus (2%); diarrheal diseases (1%) and injuries (1%) (WHO, World Bank & UNICEF, 2015).⁵

HYPOTHESIS

All the hypotheses tested at 0.05 level of significance.

H₁:-There will be statistical significant association between maternal health with obstetrical history of mothers.

MATERIAL AND METHOD

Research Approach and Design

A descriptive design was selected for the study.

Variables of Study

Study Variables: Maternal health.

Obstetrical history variables: Age in years, initiation of antenatal care, vaccination (tetanus Toxoid), supplementary iron and folic acid intake during pregnancy, supplementary calcium tablet intake during pregnancy, total weight gain of the mother during pregnancy in kg, height of the mother in cm, type of delivery, condition of the baby at birth, conception of pregnancy, week of gestation at birth.

Setting of the study

In this study the setting was selected Hospital among primipara mothers, Mysuru.

Population

A population is the entire aggregation of cases in which a researcher is interested. In the present study, population comprises of all primipara mothers in the selected Hospitals, Mysuru.

Sample size and sampling technique

The sample of the study comprises of 100 primipara mothers in JSS hospital at Mysuru.

Non probability convenient sampling technique was used in present study.

RESULTS:

1. Findings related to obstetrical history of mothers.

The findings revealed that majority 56% of the mothers age ranges in between 24-29 years. Majority 90 % of mothers were initiated antenatal visit before 12 weeks of gestation. All the mothers have taken both dose of TT vaccine, regular dose of iron and folic acid tablet during pregnancy and calcium tablet during pregnancy. Most of them52% mothers have gained10-14 kg of weight during their pregnancy. Most of them 62% of mothers height ranges from 160-167. Majority 55% mothers had undergone for cesarean section. Majority 80% of the baby had healthy condition. Major part of 96% mothers conceived spontaneously. Majority 80% mothers week of gestation ranges between 37-40 weeks. Similar studies were supported by other reviews^3,6,7,8,9.

2. Findings related to maternal health.

The following findings related to maternal health include; selected minor disorders during pregnancy, high risk condition in pregnancy and existing condition complicating pregnancy in Table 1.

Table-1 Frequency and percentage distribution to describe the maternal health. n=100

Sample No.	Sample characteristics	1^st trimester		2^nd trimester		3^rd trimester
	Selected Minor Disorders During Pregnancy	Frequency (F)	(%)	Frequency (F)	(%)	Frequency (F)	(%)
1	Vomiting	93	93	50	50	06	06
2	No vomiting	07	07	50	50	94	94
3	Backache	15	15	21	21	43	43
4	No backache	85	85	79	79	57	57
5	Muscle cramps	10	10	17	17	41	41
6	No muscle cramps	90	90	83	83	59	59
7	Constipation	01	01	01	01	02	02
8	No constipation	99	99	99	99	98	98
9	Leukorrhea	9	9	9	9	16	16
10	No leukorrhea	91	91	91	91	84	84
	High Risk Condition in Pregnancy
11	Hyperemesis gravidarum	7	7	5	5	0	0
12	No hyperemesis gravidarum	93	93	95	95	100	100
13	Vaginal bleeding	2	2	2	2	1	1
14	No vaginal bleeding	98	98	98	98	99	99
15	Reproductive tract infection	2	2	3	3	3	3
16	No reproductive tract infection	98	98	98	98	99	99
17	Anaemia
	a) Normal (12-16gram % of hemoglobin)	85	85	85	85	82	82
	b) Mild (9-10gram % of hemoglobin)	14	14	11	11	15	15
	c) Moderate (7-9gram % of hemoglobin)	1	1	4	4	3	3
	d) Severe (<7gram % of hemoglobin)	0	0	0	0	0	0
18	Pregnancy Induced Hypertension
	a) Controlled (Blood pressure <140/90 mmhg without proteinuria	95	95	95	95	95	95
	b) Unontrolled (Blood pressure >140/90 mmhg with proteinuria	5	5	5	5	5	5
19	Eclampsia
	a) Controlled	97	97	98	98	98	98
	b) Uncontrolled	3	3	2	2	2	2
20	Gestational Diabetes Mellitus (GDM)
	a) Controlled (Fasting plasma glucose<90 mg and postprandial <120 mg)	96	96	95	95	96	96
	b) Uncontrolled (Fasting plasma glucose>90 mg and postprandial >120 mg)	4	4	5	5	4	4
21	Interpretation of USG
	a) Oligohydramnious	2	2	2	2	3	3
	b) Polyhydramnious	3	3	5	5	5	5
	c) Placenta praevia	0	0	0	0	0	0
	d) Abruptio placenta	0	0	0	0	0	0
	e) Cord around the neck	1	1	2	2	4	4
	f) Abnormal position and prsentation	3	3	8	8	10	10
	g) IUGR	2	2	2	2	2	2
	h) Malformatio of the fetus	0	0	0	0	0	0
	Existing Condition Complicating Pregnancy
22	Hypertension
	a) Controlled	99	99	100	100	100	100
	b) Uncontrolled	1	1	0	0	0	0
23	Diabetes mallitus
	a) Controlled	100	100	100	100	100	100
	b) Uncontrolled	0	0	0	0	0	0
24	Thyroid dysfunction
	a) Controlled	91	91	91	91	91	91
	b) Uncontrolled	9	9	9	9	9	9
25	Cardiac disease	0	0	0	0	0	0
26	Abdominal surgeries	0	0	0	0	0	0

3. Findings related to association between maternal health with their obstetrical history.

There was no statistically significant association found between maternal health of mothers with initiation of antenatal care, total weight gain of mother in kg, height of the mother in cm, conception of pregnancy and week of gestation at birth except with type of delivery and condition of baby at birth and the computed chi square value of type of delivery 14.91 and condition of baby at birth 4.84 was found to be significant at 0.05 level of significance. Hence, the null hypothesis H₀₄was partially accepted and inferred that with type of delivery and condition of baby at birth was associated with maternal health of mother. The above findings were supported by study conducted by Manisha Nair, Manoj K Choudhury, et al. that assessed the relationship between maternal anemia and adverse maternal and infant outcome.

RECOMMENDATIONS:

1. A study can be conducted with multiple variables which will influence the maternal health and neonatal outcome.

2. A study can be conducted using variables of maternal health.

CONCLUSION:

The findings of present study concluded Healthy mothers and healthy baby outcomes are the future homemakers. Therefore special attention should be given to the health promotion of primipara mothers by early detection of high risk condition and preventing existing conditions complicating pregnancy.

ACKNOWLEDGEMENT:

This a project conducted by Mrs. Chanda Jha 2^nd year M.Sc. Nursing student of JSS College of nursing, Mysuru.

REFERENCES:

1. https://www.who.int/health-topics/maternal-health#tab=tab_1

2. https://resourcecentre.savethechildren.net/node/3280/pdf/3280.pdf

3. Marie Blomberg & Rasmus Birch Tyrberg. (2014). Impact of Maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish medical birth register study. British Medical Journal (BMJ Open) 4(11): e005840. Retrieved from http://datadryad.org/ with the DOI:10.5061/ dryad.nc576.

4. Jacob, A. (2015). A Comprehensive textbook of Midwifery & Gynecological Nursing. (4th Ed). New Delhi: Jaypee Brothers Medical Publication Pvt Ltd.

5. Naoko Kozuki. Et al (2013). The associations of parity and maternal age with small for gestational age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 13 (suppl 3): S2, DOI: 10.1186/1471-2458-13-S3-S2.

6. Michele Drehmer& Bruce Bartholow Duncan. (2013). Association of Second and Third Trimester Weight gain in Pregnancy with Maternal and Neonatal Outcomes. Retrieved from http://dx.doi.org/10.1371/journal pone.0054704.

7. Lumbanraja S, Lutan D & Usman I. (2013). Maternal Weight gain and Correlation with Birth weight of Infants. Retrieved from 13th International Educational Technology Conference Report.

8. The Tamilnadu Dr. M.G.R. Medical University Chennai-600032. Assessment Of The Relationship Between Maternal Health And Neonatal Outcome Among Postnatal Mothers At Selected Hospitals In Chennai..Dr.M.G.R.Medical University Chennai-600 032: Prof. Dr. R. Sudha, R.N., R.M., M.Sc (N), Ph.D, Principal and Professor in Nursing M.A.Chidambaram College of Nursing , Adyar,; OCTOBER-2017.

9. Maheswari K, Narendra Behera. (2014). Maternal risk factors and outcome of low birth weight babies admitted to a Tertiary care Teaching Hospital. Retrieved from www.Current Pediatrics.com. 18(2): 69-7.

Received on 25.06.2023 Modified on 05.07.2023

Asian J. Nursing Education and Research. 2023; 13(3):213-216.

DOI: 10.52711/2349-2996.2023.00045