Publications by authors named "Barbara Baranowska"

12 Publications

  • Page 1 of 1

Fetal Growth Diagnosis and Management among Perinatal Medical Professionals: A Survey of Practice and Literature Review.

Fetal Diagn Ther 2021 Apr 6:1-11. Epub 2021 Apr 6.

Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland.

Introduction: This paper aimed to assess the knowledge of healthcare professionals (obstetric and gynecology residents, specialists, and midwives) in the field of perinatal medicine regarding fetal growth diagnosis and management.

Methods: A questionnaire was created consisting of a set of questions regarding demographic data, methods of growth assessment, and management. It was a handout survey. The results were analyzed with the use of descriptive statistics and χ2 analysis using the program Statistica.

Results: 190 medical professionals have participated in the questionnaire. 86.3% of respondents agreed that pregnancy dating should be modified based on first-trimester ultrasound. 90.9% agreed that III trimester ultrasound has a ±15% margin of error. When asked which growth charts are best fit for assessing growth in a studied population, 10.7% marked standard, 37.4% reference, 26.2% customized, and 26.2% did not know the difference between the three choices. 60.3% stated that they use a growth chart to assess growth and qualify fetuses for monitoring. 70.2% used the 10th centile as a cutoff, 20.1% 5th centile, and 9.7% 3rd centile. Only 40.9% would diagnose fetal growth restriction based on fetal weight only. 28.7% using the 10th centile cutoff, 16.1% 5th centile, and 54.0% 3rd centile. Only a quarter of the respondents were able to name the growth chart or tool that they use for assessment. The most common responses were Yudkin, Hadlock, and online calculators of Fetal Medicina Barcelona and the Fetal Medicine Foundation.

Discussion: A lot of confusion is observed primarily in the aspect of cutoff values for identification, subsequent monitoring, and management of fetal growth restriction. There is a need for extensive training and education in this field and uniform national recommendations.
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http://dx.doi.org/10.1159/000514504DOI Listing
April 2021

Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child.

Nutrients 2021 Jan 19;13(1). Epub 2021 Jan 19.

University of Pennsylvania School of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Breastfeeding is a gold standard of feeding of newborns and infants. Tandem breastfeeding (TBF) is feeding two children of different ages at the same time. The knowledge about the composition of human milk in prolonged lactation is still scarce. Milk from tandem breastfeeding women and after weaning was examined. Milk samples were collected from 13 TBF mothers. A 24-h milk collection was done. Analyses of fat, protein, carbohydrate and energy content were performed using MIRIS. Sociodemographic characteristics of TBF mothers was done. Higher fat content, energy value and total protein concentration was found in TBFM milk during tandem breastfeeding, than in milk after weaning the older child. The carbohydrate content remained stable. The composition of breastmilk, in terms of macronutrients, changes after weaning, taking into account the nutritional requirements of the younger child. The milk of nursing mothers in tandem did not show diurnal variability in individual components. These findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children. The results may support the promotion of long breastfeeding, including tandem breastfeeding.
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http://dx.doi.org/10.3390/nu13010277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835967PMC
January 2021

What are the Critical Elements of Satisfaction and Experience in Labor and Childbirth-A Cross-Sectional Study.

Int J Environ Res Public Health 2020 12 12;17(24). Epub 2020 Dec 12.

Educational Research Institute (IBE), 01-180 Warsaw, Poland.

The labor experience and satisfaction with childbirth are affected by the care provided (external factors) and individual variables (internal factors). In this paper, we present a descriptive analysis that aims to indicate the strongest correlates of birth experience among a wide range of indicators. The study is a prospective, cross-sectional, self-report survey. It includes the experiences of women giving birth in public and private hospitals in Poland. The two main variables were birth experience and satisfaction with care. The analysis consists of three parts: data pre-processing and initial analysis, explorative investigation, and regression analysis. Among the 15 variables with the highest predictive value regarding birth experience were being informed by the medical personnel, communication, and birth environment. The most significant variables among 15 variables, with the highest predictive value regarding care, were those concerning support, information, and respectful care. The strongest predictor for both, birth experience and satisfaction with care, is the sense of information, with logit coefficients of 0.745 and 1.143, respectively, for birth experience and satisfaction (0.367 and 0.346 for standardized OLS coefficient). The findings demonstrate that by using explanatory variables, one can predict a woman's description of her satisfaction with perinatal care received in the hospital. On the other hand, they do not have such a significant and robust influence on the birth experience examined by the variables. For both the birth experience and satisfaction with care, the sense of being informed is the highest predictor.
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http://dx.doi.org/10.3390/ijerph17249295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764244PMC
December 2020

Polish maternity services in times of crisis: in search of quality care for pregnant women and their babies.

Health Care Women Int 2020 Nov-Dec;41(11-12):1335-1348. Epub 2020 Oct 13.

Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.

The current COVID-19 pandemic put a burden on healthcare services around the globe and impacted many areas of care delivery, including maternity services. Prioritizing ringfenced community care to keep women away from hospitals may be the best strategic response to ensure pregnant and laboring women receive optimal care. By analyzing the structure of maternity services in Poland and their response to the current crisis, we show that while the available model allows to provide large share of prenatal services outside hospital settings, it allows no alternative to hospital births. In addition, medicalization, inequalities in access and fragmentation of care hinder services' ability to respond in a way it ensures best possible care.
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http://dx.doi.org/10.1080/07399332.2020.1830096DOI Listing
March 2021

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: A web-based cross-sectional survey.

Medicine (Baltimore) 2020 Jul;99(30):e21279

Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR.

Introduction: The article presents a protocol of a cross-sectional study of mental health of pregnant women in relation to the coronavirus disease 19 (COVID-19) pandemic. The primary aim is to compare differences in anxiety and depression scores of pregnant women between countries affected by the COVID-19 pandemic. The secondary aim is to assess demographic, economic, and social aspects affecting maternal anxiety and depression scores among pregnant women worldwide in the time of the COVID-19 pandemic. Finally, we will be able to compare differences in perception of the different aspects of the COVID-19 pandemic (social distancing, restrictions related to delivery) between countries and according to the epidemic status (number of infected patients, number of reported deaths). The comparisons will also be done according to the COVID-19 status of the participants.

Methods And Analysis: It is a web-based anonymous survey of pregnant women living in countries affected by the COVID-19 pandemic. The survey is comprised of 3 sections:Web-based recruitment for health research has proven to be cost-effective and efficient. At current times with the COVID-19 pandemic, limited resources and social distancing restrictions, performing a mental health study involving pregnant women on a large international scale cannot be safely conducted without involving social-media.The fears of pregnant women fall into 3 categories: the medical condition, the economic status and the organization of daily activity.The study has received approval of the medical ethics committee and has been registered on Clinicaltrials.gov. Results will be published in peer-reviewed journals and made public through all available media.
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http://dx.doi.org/10.1097/MD.0000000000021279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387043PMC
July 2020

Freestanding Midwife-Led Units: A Narrative Review.

Iran J Nurs Midwifery Res 2020 May-Jun;25(3):181-188. Epub 2020 Apr 18.

Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.

Background: Strengthening of midwives' position and support for freestanding birth centers, frequently referred to as Freestanding Midwife-led Units (FMUs), raise hopes for a return to humanized labor. Our study aimed to review published evidence regarding FMUs to systematize the knowledge of their functioning and to identify potential gaps in this matter.

Materials And Methods: A structured integrative review of theoretical papers and empirical studies was conducted. The literature search included MEDLINE, Cochrane, Scopus, and Embase databases. The analysis included papers published in 1977-2017. Relevant documents were identified using various combinations of search terms and standard Boolean operators. The search included titles, abstracts, and keywords. Additional records were found through a manual search of reference lists from extracted papers.

Results: Overall, 56 out of 107 originally found articles were identified as eligible for the review. Based on the critical analysis of published data, six groups of research problems were identified and discussed, namely, 1) specifics of FMUs, 2) costs of perinatal care at FMUs, 3) FMUs as a place for midwife education, 4) FMUs from midwives' perspective, 5) perinatal, maternal, and neonatal outcomes, and 6) FMUs from the perspective of a pregnant woman.

Conclusions: FMUs offers a home-like environment and complex midwifery support for women with uncomplicated pregnancies. Although emergency equipment is available as needed, FMU birth is considered a natural spontaneous process. Midwives' supervision over low-risk labors may provide many benefits, primarily related to lower medicalization and fewer medical interventions than in a hospital setting.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_209_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299417PMC
April 2020

How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries.

PLoS One 2020 28;15(7):e0227941. Epub 2020 Jul 28.

Swedish University of Agriculture, Skara, Sweden.

Objective: To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours.

Design: Observational study.

Setting: Twelve countries, eleven European and South Africa.

Sample: National, regional or institutional-level regimens on oxytocin for induction and augmentation labour.

Methods: Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67μg for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused.

Results: Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference.

Conclusion: Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution's mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227941PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386656PMC
September 2020

Spirituality and childbirth: An international virtual co-operative inquiry.

Women Birth 2021 Mar 14;34(2):e135-e145. Epub 2020 Feb 14.

Faculty of Health and Social Science, Bournemouth University, Dorset, England, UK.

Problem: Medicalised maternity systems do not address spirituality as an aspect of childbirth and its practices of care. Neglecting the spiritual nature of childbirth may negatively affect psychological, emotional and physical wellbeing.

Background: While there is growing interest in the spiritual side of childbirth there is a paucity of literature on the topic, and hence a lack of understanding generally about how to attend to women's needs for emotional and spiritual support in childbirth.

Aim: To collaboratively and through consensus explore ways that spirituality could be honoured in 2 Century maternity care.

Methods: An online co-operative inquiry. Starting with a scoping exercise (N=17) nine co-inquirers continued to Phase One using online discussion boards and seven co-inquirers continued to Phase Two and Three. Co-inquirers were involved in international group work and individual reflective and transformational processes throughout.

Findings: Four reflective themes emerged: 'meaning and sense-making'; 'birth culture'; 'embodied relationships and intuition'; and 'space/place/time'. 'Spiritual midwifing' was an overarching theme. There were eight areas of individual transformation and actions concerning spirituality and birth: 1) disseminating inquiry findings; 2) motivating conversations and new ways of thinking; 3) remembering interconnectedness across time and spaces; 4) transforming relationships; 5) transforming practice; 6) generating reflexivity; 7) inspiring self and others to change, and 8) inspiring creativity.

Conclusion: Spiritual awareness around birth experience emerges through relationships and is affected by the spatial environment. Spiritual midwifing is a relational approach to birth care that recognises and honours the existential significance and meaningfulness of childbirth.
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http://dx.doi.org/10.1016/j.wombi.2020.02.004DOI Listing
March 2021

Is there respectful maternity care in Poland? Women's views about care during labor and birth.

BMC Pregnancy Childbirth 2019 Dec 23;19(1):520. Epub 2019 Dec 23.

School of Nursing and Midwifery, RGU University, Garthdee Road, Aberdeen, Scotland, AB10 7AQ.

Background: Abuse against women in labor starts with subtle forms of discrimination that can turn into overt violence. Therefore it is crucial to work towards prevention and elimination of disrespect and ill-treatment in medical facility perinatal care in which staff allows such abuse. The aim of the study was to analyze the experiences of women related to perinatal care. Special emphasis was put on experiences that had traits indicating disrespectful and offensive care during childbirth in medical facilities providing perinatal care.

Methods: This was a cross-sectional survey. A questionnaire was prepared for respondents who gave birth in medical facilities. Information about the study was posted on the website of a non-governmental foundation dealing with projects aimed at improving perinatal care. The respondents gave online consent for processing the submitted data. 8378 questionnaires were submitted. The study was carried out between February 06 and March 20, 2018. The results were analyzed using the Chi-square independence test. The analysis was carried out at the significance level of 0.05 in Excel, R and SPSS.

Results: During their hospital stay, 81% of women in the study experienced violence or abuse from medical staff on at least one occasion. The most common abuse was having medical procedures without prior consent. Inappropriate comments made by staff related to their own or a woman's situation were reported in 25% of situations, whilst 20% of women experienced nonchalant treatment. In the study 19.3% of women reported that the staff did not properly care for their intimacy and 1.7% of the respondents said that the worst treatment was related to feeling anonymous in the hospital.

Conclusions: The study shows that during Polish perinatal care women experience disrespectful and abusive care. Most abuse and disrespect involved violation of the right to privacy, the right to information, the right to equal treatment, and the right to freedom from violence. The low awareness of abuses and complaints reported in the study may result from women's ignorance about relevant laws related to human rights.
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http://dx.doi.org/10.1186/s12884-019-2675-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929297PMC
December 2019

The quality of childbirth in the light of research the new guidelines of the World Health Organization and Polish Perinatal Care Standards.

Dev Period Med 2019 ;23(1):54-59

Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland.

The quality of birth is assessed by means of a comprehensive approach to the process of coming into the world, taking into account the perspective of the mother and the child and the influence of labour on their future health and life. According to the recommendations of the World Health Organization, the delivery of every child should be consistent with the mother's personal and socio-cultural beliefs and should meet her expectations as to the care provided.
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August 2019

Extended Breastfeeding in Poland: Knowledge of Health Care Providers and Attitudes on Breastfeeding Beyond Infancy.

J Hum Lact 2019 May 20;35(2):371-380. Epub 2018 Dec 20.

4 Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland.

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals' levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition.

Research Aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy.

Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample ( N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher's exact test, post-hoc testing, and two-part tables using SPSS.

Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation ( F = 105.847; p = < .01) between levels of knowledge and respondents' attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed.

Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.
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http://dx.doi.org/10.1177/0890334418819448DOI Listing
May 2019

CD9 protein appears on growing mouse oocytes at the time when they develop the ability to fuse with spermatozoa.

Zygote 2006 May;14(2):119-23

Department of Embryology, Institute of Zoology, Warsaw University, Warsaw, Poland.

CD9 is a member of the tetraspanin superfamily proteins and is the only protein on the mouse oocyte which is known to be indispensable in sperm-egg fusion. Here, using indirect immunofluorescence we show that CD9 appears on the oolemma during the early stages of the growth of the oocyte, when it measures 13-22 microm in diameter. When the oocyte reaches a diameter of 17-22 microm, the density of CD9 in its oolemma is similar to the density of this protein in the cell membrane of the fully grown secondary oocyte. The appearance of CD9 in growing oocytes correlates with the previously reported time of the acquisition of fusibility between the spermatozoon and the egg. Accordingly we propose that during oogenesis the development of the ability of the oolemma to fuse with sperm may be regulated by synthesis of CD9 by the oocyte.
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http://dx.doi.org/10.1017/S0967199405003497DOI Listing
May 2006