TX_1~ABS:AT/ADD:TX_2~ABS:AT 35 http://journals.cihanuniversity.edu.iq/index.php/cuesj CUESJ 2023, 7 (1): 35-38 ReseaRch aRticle Assessment of Minor Disorders among Pregnant Women Attending Malafandi Primary Health-Care Center/Erbil-City Ayad A. Rashid1, Samir M. Othman2, Dara A. Al-Banna3, Aram M. Bra1 1Department of Community Health, College of Health Technology, Cihan University-Erbil, Kurdistan Region, Iraq, 2Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq, 3Department of Nursing, Faculty of Nursing, Tishk International University. Erbil, Kurdistan region, Iraq ABSTRACT Minor disorders are the discomforts associated with the pregnancy such as nausea, vomiting, backache, heart burn constipation, varicose vein, hemorrhoids, frequency of urination, fatigue, and leg cramps. Many women experience some minor disorders during pregnancy; these discomforts should be adequate as they may occur due to hormonal changes and postural changes. The aim of this study was to assess minor disorder among pregnant women. A  descriptive study was conducted in Malafandi Primary Health-Care Center, from December 2020 to January 2021, 100 pregnant women were taken, and the data were collected by direct interview. The highest percentage of them with 25–34 years old graduated from high school with middle economic status. All of them had minor disorders nausea and vomiting, backache, heartburn, leg cramps, varicose veins, and hemorrhoids: Fatigue, frequency of urination, constipation, and loss of appetite. There is a statistically significant association between age group with nausea and vomiting, and hemorrhoids (P ≤ 0.001 and 0.002, respectively). The findings of this study indicated that the most common minor disorder in pregnancy came from fatigue, while the lowest came from constipation. Keywords: Hormonal change, minor discomforts, minor disorders, pregnancy, primary health-care center INTRODUCTION Minor disorders are the discomforts associated with the pregnancy such as nausea, vomiting, backache, heart burn, constipation, varicose vein, hemorrhoids, frequency of urination, fatigue, and leg cramps. Many women experience some minor disorder during pregnancy these discomforts should be adequate as they may occur due to hormonal changes and postural changes.[1] Nausea and vomiting during pregnancy known as “morning sickness” affects approximately 80% of pregnant women, nausea, and vomiting a common minor disorder in 1st trimester of pregnancy that the cause is unknown but sometimes due to an increase of human chorionic gonadotrophin and estrogens. Backache is cause by the relaxation of the pelvic joint and faulty posture. Constipation causes of growing uterus create pressure vertebrectomy. Veins are causes of action of progesterone on the blood vessels causing relaxation, making them more circular with sluggish blood flow. Fatigue is cause by the increase release of hormones and adds of the fetus. Heartburn caused by the regurgitation of acid gastric content into esophagus. Frequency of urination causing extra weight and pressure of baby pressing on the bladder and pelvic floor also causes incontinence. Hemorrhoids cause of pressure the gravid uterus, and a tendency to constipation.[2] Understanding the common disorder of pregnancy to advise the women on strategies that help to cope with the condition and minimize the effects she experiences. The severity and occurrence of minor discomfort differ from mother to mother and other factors, including maternal age and parity.[3] The National Institute for Care and Health Excellence report in 2008 shows that minor discomforts are very common and are reported by 50–80% of pregnant women. Nausea occurs in 80–85% of all pregnancies during the first-trimester. A Clinical gastroenterology report in 2007 shows that heartburn occurs from 30% to 50% of pregnancies, with prevalence approaching 80% in some populations.[4] This study is a benefit to benefit for pregnant women for their health protection and awareness of that disorder which has more effect on women and babies and it is important to find out the most common minor discomfort among pregnant women in Erbil city. The aim of the study Corresponding Author: Dara A. Al-Banna, Department of Nursing, Faculty of Nursing, Tishk International University, Erbil, Kurdistan region, Iraq. E-mail: dara.albanna@hmu.edu.krd Received: July 31, 2021 Accepted: February 22, 2023 Published: May 1, 2023 DOI: 10.24086/cuesj.v7n1y2023.pp35-38 Copyright © 2023 Ayad A. Rashid, Samir M. Othman, Dara A. Al-Banna, Aram M. Bra. This is an open-access article distributed under the Creative Commons Attribution License (CCBY-NC-ND 4.0). Cihan University-Erbil Scientific Journal (CUESJ) Rashid, et al.: Assessment of Minor Disorders Among Pregnant Women 36 http://journals.cihanuniversity.edu.iq/index.php/cuesj CUESJ 2023, 7 (1): 35-38 was to assess minor disorders among pregnant women in Malafandi Primary Health-Care Center/Erbil-City. MATERIALS AND METHODS A cross-sectional descriptive study was conducted in Malafandi Primary Health-Care Center in Erbil City from December 2020 to January 2021 among 100 pregnant women who recurred by non-probability (purposive) method and were attending for antenatal care unit or medical check-up during pregnancy in Malafandi Primary Health-Care Center. Data were collected using questionnaire by interview technique with pregnant women in the antenatal care unit. Pregnant women were excluded from this study that has a specific chronic diseases like cardiovascular disease, psychiatric disease and having gestational diabetes mellitus, urinary tract infection, hypertension induce pregnancy, placenta previa, sever anemia, oligohydramnios, and polyhydramnios. Before starting the interview, permission was taken from pregnant women and clarifying the purpose of this study. The data were analyzed by SPSS version 23 using descriptive statistical analysis of frequency, percentage, mean and standard deviation, and inferential statistical analysis using Chi-square and Fisher’s exact tests.[14] RESULTS Table 1 shows that the majority within each age group among pregnant women were 25–34 years old which represented 41%, while the lowest age group was 35–44 years old which represented 19%. The highest percentages of educational level were graduated from high school, which represented 29%, while the lowest percentages of educational level were Table 2: Reproductive variable data of the 100 pregnant women Age (years) of married F % Age (years) of married 1–7 65 65 8–15 23 23 16–23 12 12 Gravid of group 1 40 40 2–4 39 39 ≥5 21 21 Para of group Nullipara 46 46 Primiparous 20 20 Multiparous 28 28 Grand multipara 6 6 Abortion of group None 75 85 1–2 17 15 >2 8 8 Weight group 43–62 31 31 63–82 48 48 >83 21 21 Trimester First trimester 32 32 Second trimester 45 45 Third trimester 23 23 Type of pregnancy Planned 34 34 Unplanned 66 66 Chronic disease None chronic disease 92 92 Hypertension 6 6 Diabetes mellitus 2 2 Total 100 100 graduated from an institute which represented 9%. The most percentage among occupational was housewife which given 82%, while the lowest percentage among occupational were public-employee which given 7%. Then, the majority of economic statuses were middle which represented 86%. Table 2 indicated that the majority of the highest percentage within age groups of married 1–7 which represented 65%, while the lowest age of married were 16–23 which represented 12%. The majority of gravid women were 1 which represented 40%, while the lowest number of gravid women gravid was ≥5 which represented 21%. The majority of para were nullipara (a woman [or female animal] that has never given birth) which represented 46%, while the lowest Table 1: Sociodemographic characteristics of 100 the pregnant women Sociodemographical data F % Age group 15–24 40 40 25–34 41 41 35–44 19 19 Education Illiterate 22 22 Primary school 24 24 High school 29 29 Institute 9 9 University 16 16 Occupation Housewife 82 82 Self-employee 11 11 Public-employee 7 7 Economical status High 9 9 Middle 86 86 Low 5 5 Total 100 100 Rashid, et al.: Assessment of Minor Disorders Among Pregnant Women 37 http://journals.cihanuniversity.edu.iq/index.php/cuesj CUESJ 2023, 7 (1): 35-38 Table 4: Association between age group and some of minor disorder Minor pregnancy discomforts Age group/years of pregnant woman P-value 15–24 25–34 35–44 F % F % F % Nausea and vomiting Yes 28 58.3 18 37.5 2 4.2 <0.001 VHSNo 12 23.1 23 44.2 17 32.7 Backache Yes 33 39.8 36 43.4 14 16.9 0.397 NSNo 7 41.2 5 29.4 5 29.4 Heart burn Yes 9 27.3 15 45.5 9 27.3 0.135 NSNo 31 46.3 26 38.8 10 14.9 Leg cramps Yes 17 34 23 46 10 20 0.458 NSNo 23 46 18 36 9 18 Varicose vein Yes 7 25 12 42.9 9 32.1 0.056 NSNo 33 45.8 29 40.3 10 13.9 Hemorrhoids Yes 4 14.8 13 48.1 10 37 0.002 HSNo 36 49.3 28 38.4 9 12.3 Fatigue Yes 38 39.6 39 40.6 19 19.8 0.613 NSNo 2 50 2 50 0 0 Frequency of urination Yes 37 39.8 38 40.9 18 19.4 0.947 NSNo 3 42.9 3 42.9 1 14.3 Constipation Yes 6 27.3 11 50 5 22.7 0.386 NSNo 34 43.6 30 38.5 14 17.9 Anemia Yes 8 28.6 16 57.1 4 14.3 0.123 NSNo 32 44.4 25 34.7 15 20.8 Loss of appetite Yes 16 36.4 22 50 6 13.6 0.223 NSNo 24 42.9 19 33.9 13 23.2 of para were grand multiparous (a patient who has had ≥5 births (live or stillborn) at ≥20 weeks of gestation) which represented 6%. The majority of abortions were (none) which represented 75%, while the lowest of abortions were >2 which represented 8%. The majority of women’s weights were 63–82 which represented 48%, while the lowest of women weight <83 which represented 21%. About 45% of the women were second trimester, while 23% of the women were the third trimester. The majority type of pregnancies was unplanned which represented 66%, while 34% of the women were planned. About 92% of the women have non-chronic disease, while 2% of the women have diabetes mellitus. Table 3 demonstrate that all of the study sample had minor disorders as nausea and vomiting, backache, heart burn, leg cramps, varicose vein, hemorrhoid’s, fatigue, frequency of urination, constipation, and loss of appetite. The highest percentage (96%) had fatigue and the lowest percentage (22%) had constipation. Table 4 shows that was significant statistical association between age group and nausea and vomiting (P ≤ 0.001). There is a statistically significant association between age group hemorrhoids (P = 0.002). DISCUSSION The highest age groups of women were between 25 and 34 years old, this finding agrees with a descriptive study done by Nazik and Eryilmaz.[5] Agree with the of the development of a scale for pregnancy‐related discomforts done by Shinkawa et al., in 2012.[6] Agree with study of associations between nausea, vomiting, fatigue and health-related quality of life of women in theearly pregnancy: the generation R study Bai et al., 2016.[7] And agree with a study entitled: Associations Table 3: Assessment of the minor disorder during pregnancy Minor disorders Items Yes No F % F % 1. Do you have nausea and vomiting? 48 48 52 52 2. Do you have backache? 83 83 17 17 3. Do you have heart burn? 33 33 67 67 4. Do you have leg cramps? 50 50 50 50 5. Do you have varicose veins? 28 28 72 72 6. Do you have hemorrhoids? 27 27 73 73 7. Do you have fatigue? 96 96 4 4 8. Do you have a frequency of urination? 93 93 7 7 9. Do you have constipation? 22 22 78 78 10. Do you have anemia? 28 28 72 72 11. Do you have loss of appetite? 44 44 56 56 12. Are you take any medication? 49 49 51 51 13. Have you ever smoked during pregnancy? 7 7 93 93 14. Have you had previous experiences about minor disorder of pregnancy? 60 60 40 40 Total 100 100 100 100 between Nausea, Vomiting, Fatigue and Health-related Quality of Life of Women in Early Pregnancy: The Generation R study done by Bai et al. 2016 and along with other study done by Haider et al. under the title of Risk Factors of Urinary Tract Infection in Pregnancy[8,9] and also agree with the study done by Yikar and Nazik running with the title of the “Effects of prenatal education on complaints during pregnancy and on quality of life” in 2019.[10] Concerning educational level the heights percentages of educational level graduated from high school, while the lowest percentages of educational level were Rashid, et al.: Assessment of Minor Disorders Among Pregnant Women 38 http://journals.cihanuniversity.edu.iq/index.php/cuesj CUESJ 2023, 7 (1): 35-38 graduated from institute disagree with research associations between nausea, vomiting, fatigue, and health-related quality of life of women in the early pregnancy: the generation R study Bai et al., 2016 who showed the most representative was graduated from the institute and college[7] and in agreement with study done by Tshiama et al.[12] The majority of the most percentage among occupational was housewife, while the lowest percentage among occupational were public-employee. Then, the majority of economical statuses were middle which disagree with the research, which were associations between nausea, vomiting, fatigue, and health-related quality of life of women in the early pregnancy: the generation R study Bai et al., 2015[7] and agrees with the study of nausea, vomiting, fatigue, and health-related quality of life of women in early pregnancy the generation R study done by Bai et al., 2015. [8] The highest percentage within age groups of married were 1–7, while the lowest age of married were 16–23 this agree with study incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women, done by Nazik and Eryilmaz.[5] The majority of gravid was 1, while the lowest of gravid were ≥5, the majority of para were (nullipara), while the lowest para were (grand multiparaous). The majority of abortions were (none), while the lowest of abortions were >2. The majority of women’s weight was 63–82, while the lowest of women weight >83 these findings agree with the study incidence of pregnancy- related discomforts and management approaches to relieve them among pregnant women, done by Nazik and Eryilmaz. [5] The present study showed that less than half of the women were the second trimester, while others of the third trimester. The majority type of pregnancy was unplanned this agree with the study incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women, done by Nazik and Eryilmaz. The majority of the women do not have the chronic diseases.[5] The highest percentage had fatigue and the lowest percentage had constipation. This finding agrees with descriptive study done by Nazik and Eryilmaz[5] and agrees with the study of nausea, vomiting, fatigue, and health-related quality of life of women in early pregnancy: The generation R study done by Bai et al., 2015 and agree with the study of Development of a scale for pregnancy-related discomforts done by Shinkawa et al., 2012.[6] The findings of the current study agreed with the study under the title “Associations between nausea, vomiting, fatigue and health-related quality of life of women in early Pregnancy: The Generation R study” done by Bai et al. 2016[7] it is supported by the study done in 2020 entitled “Pregnant mother of trimester II and III pregnant to change physiological”[11] and a randomized clinical trial study done by Poskus et al, in 2022 under the title of “Preventing hemorrhoids during pregnancy: A multicenter, randomized clinical trial”[13] The finding of the study showed no significant association between the age group and (fatigue, frequency of urination, constipation, anemia, loss of appetite, backache, heartburn, leg cramps, and varicose veins). The present study showed a significant association between age group and nausea, vomiting, and hemorrhoid’s.[8] CONCLUSION This study concluded that the majority of the study sample indicated that the most common minor disorder in pregnancy came from fatigue while the lowest came from constipation and there is an association between age group and nausea and vomiting. There is a statistically significant association between age groups with nausea and vomiting and hemorrhoids pain. RECOMMENDATION This study recommended to encouraging the pregnant women to follow-up during pregnancy to prevent any complications any complication due to minor disorders to educate them about the minor disorders of pregnancy and their home self- management to help pregnant mothers to manage their minor disorders at home itself. REFERENCES 1. P. Delma. Minor disorder among pregnant women. Indian Journal of Scientific Research, vol. 5, no. 9, p. 1551, 2014. 2. P. Ian. Nursing Practice: Knowledge and Care. John Wiley and Sons Inc., UK. Malden, pp. 259-261, 2014. Available from: https:// www.books.google.iq/books?isban=8180613623 [Last accessed on 2016 Dec 01]. 3. P. Nitanjali. Assessment minor disorder of pregnancy and home remedies. Indian Journal of Scientific Research, vol. 4, no, 1, pp. 674, 2005. 4. S. H. Maqsood. Self-Management of Pregnant Women Regarding Minor Discomforts Primary Health Care Centers. Hawler Medical University/College of Nursing, Erbil, p. 2, 2015. 5. E. Nazik and G. Eryilmaz. Incidence of pregnancy‐related discomforts and management approaches to relieve them among pregnant women. Journal of Clinical Nursing, vol. 23, no. 11-12, p. 1736-1750, 2014. 6. H. Shinkawa, M. Shimada, K. Hirokane, M. Hayase and T. Inui. Development of a scale for pregnancy-related discomforts. Journal of Obstetrics and Gynecology Research, vol. 38, no. 1, p. 316-323, 2012. 7. G. Bai, I. Korfage, E. Hafkamp-de Groen, V. W. V. Jaddoe, E. Mautner and H. Raat. Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation R study. PLoS One, vol. 11, no. 11, p. e0166133, 2016. 8. G. Bai, E. H. Groen, H. A. Moll, V. W. Jaddoe, I. Korfage and H. Raat. Nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation R study. Quality of Life Research, vol. 24, p. 21, 2016. 9. G. Haider, N. Zehra, A. Munir and A. Haider. Risk factors of urinary tract infection in pregnancy. The Journal of the Pakistan Medical Association, vol. 60, no. 3, p. 213, 2010. 10. S. K. Yikar and E. Nazik. Effects of prenatal education on complaints during pregnancy and on quality of life. Patient Education and Counseling, vol. 102, no. 1, p. 119-125, 2019. 11. E. Mail. Pregnant mother of trimester II and III pregnant to change physiological. Journal Kebidanan, vol. 9, no. 2, p. 83-88, 2020. 12. C. Tshiama, G. Bongo, O. Nsutier and M. B. Babintu. The Lay knowledge regarding the prevention of complications related to childbirth: Perceptions of Congolese pregnant women. Qualitative Research in Medicine and Healthcare, vol. 6, no. 1, p. 8740, 2022. 13. T. Poskus, Z. Sabonyte-Balsaitiene, L. Jakubauskiene, M. Jakubauskas, I. Stundiene I, G. Barkauskaite, M. Smigelskaite, E. Jasiunas, D. Ramasauskaite, K. Strupas and G. Drasutiene. Preventing hemorrhoids during pregnancy: A multicenter, randomized clinical trial. BMC Pregnancy and Childbirth, vol. 23, no. 11-12, p. 374, 2022. 14. O. Polit and B. Hunger. Nursing Research, Principle and Methods. 6th ed. Lippincott, Philadelphia, PA, pp. 354-698, 1999.