Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys

Adverse birth outcome among women who gave birth at the University of Gondar comprehensive specialized hospital, Northwest Ethiopia

BACKGROUND

In Ethiopia, various maternal and child health interventions, including comprehensive and basic obstetric cares were conducted to curb high neonatal and infant morbidity and mortality. As such, adverse birth outcome has been a public health concern in the country. Thus, this study aimed to assess the burden and associated factors with adverse birth outcomes among women who gave birth at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

A health facility-based cross-sectional study was employed from 30 March to 01 May 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 455 women were interviewed using a structured questionnaire. A binary logistic regression model was fitted Adjusted Odds Ratio (AOR) with 95%CI and p-value < 0.05 were used to declare factors significantly associated with adverse birth outcomes.

RESULTS

In this study, 28% of women had adverse birth outcomes (8.4% stillbirths, 22.9% preterm births, and 10.11% low birth weights). Women aged 20-34) (AOR: 0.32, 95%CI: 0.14, 0.76), rural dwellers (AOR: 2.7, 95%CI: 1.06, 6.32), lack of ANC visits (AOR: 4.10, 95%CI: 1.55, 10.85), APH (AOR: 3.0, 95%CI: 1.27, 7.10) and fever (AOR: 7.80, 95%CI: 3.57, 17.02) were associated to stillbirths. Multiple pregnancy (AOR:7.30, 95%CI:1.75, 20.47), rural dwellers (AOR:4.60, 95%CI:1.36, 15.52), preterm births (AOR: 8.60, 95% CI: 3.88, 19.23), previous perinatal death (AOR:2.90, 95%CI:1.35, 6.24), fever (AOR:2.7,95%CI:1.17 ,6.23) and premature rupture of membrane (AOR:2.60, 95% CI:1.02, 6.57) were affecting low birth weights. In addition, previous antepartum hemorrhage (AOR: 2.40, 95%CI: 1.37, 4.10) and fever (AOR: 3.8, 95%CI: 2.13, 6.89) were also factors contributing to preterm births.

CONCLUSION

Adverse birth outcomes continue to pose a significant public health concern. Such high rates of adverse birth outcomes, such as preterm birth, low birth weight, and birth defects, can have serious and long-lasting effects on the health and well-being of both infants and their families, and the community at large. As such, public health efforts are crucial in addressing and mitigating the risk factors associated with adverse birth outcomes. This may involve implementing interventions and policies to improve maternal health, access to prenatal care and nutritional support, and reducing exposure to environmental risks.

Adverse fetal birth outcomes and its associated factors among mothers with premature rupture of membrane in Amhara region, Ethiopia

BACKGROUND

Adverse birth outcomes are the leading cause of neonatal mortality worldwide. Ethiopia is one of the countries struggling to reduce neonatal mortality through different strategies, but neonatal mortality remains high for many reasons. Despite adverse birth outcomes being a public health problem in Ethiopia, the contribution of Premature rupture of the membrane to the adverse fetal birth outcome is neglected and not well explained in our country. This study aims to assess fetal birth outcomes and associated factors among mothers with all types of PROM at Specialized Hospitals in Amhara Region, Ethiopia.

METHODS

A facility-based cross-sectional study design was applied among 538 mothers with premature rapture of the membrane at Amhara region specialized hospitals. A simple random sampling technique was employed to select the medical charts diagnosed with all types of PROM and giving birth in the hospital within the period from July 8, 2019, to July 7, 2021. The data was collected using a checklist, entered into EPI Data version 3.1, and analyzed using SPSS version 23. A binary logistic regression model was used to see the association between independent and dependent variables. A P-value <0.05 was used to declare the statistical significance. The AOR with 95% CI was used to measure the strength of the association.

RESULT

Adverse birth outcome among all types of Premature rupture of membrane mothers was 33.1% [95% CI 29.2-37.2]. Rural residents [AOR = 2.94, 95% CI:1.73-4.97], have a history of urinary tract infection [AOR = 6.87, 95% CI: 2.77-17.01], anemia [AOR = 7.51, 95% CI: 2.88-19.62], previous history of adverse birth outcome [AOR = 3.54, 95% CI: 1.32-9.47] and less than two years interpregnancy interval [AOR = 6.07, 95% CI: 2.49-14.77] were positively associated with adverse birth outcome compared to their counterparts.

CONCLUSION

The adverse birth outcome was high in the Amhara region as compared to the World Health Organization's estimated figure and target; the target is less than 15%. History of the previous adverse birth outcome, residence, urinary tract infection, Anemia, and interpregnancy interval had an association with adverse birth outcomes. Therefore, strengthening close follow-up for mothers who had previous adverse birth outcomes, screening and treatment of urinary tract infection, anemia prevention, and maximizing birth interval are recommended for reducing adverse birth outcomes.

Utilization of preconception care and associated factors among pregnant mothers in Fiche Town, Central Ethiopia: a community-based cross-sectional study 2021

Introduction

Preconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021.

Method

A community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p-value less than 0.05.

Results

388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization.

Conclusions

Overall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care.

Utilization of preconception care and associated factors among pregnant women attending ANC in private MCH Hospitals in Addis Ababa, Ethiopia

BACKGROUND

Despite its benefit in promoting maternal health and the health of her developing fetus, little is known about preconception care practice and its associated factors in Ethiopia. Moreover, preconception care utilization in private hospitals is not known. The purpose of this study, therefore, is to determine the utilization of preconception health care services and its associated factors among pregnant women following antenatal care in the private Maternal and Child Health hospitals in Addis Ababa.

METHODS

A Hospital based cross-sectional study was conducted from April 1 to April 30,2022 among 385 women attending ANC in private MCH hospitals. Bestegah and Hemen MCH hospitals were selected by convenience method. Data were collected by a pretested self-administered semi-structured questionnaire. To identify the factors associated with the utilization of preconception care, bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratios with 95% confidence interval were estimated to assess the strength of associations, and statistical significance was declared at a p-value < 0.05.

RESULTS

The utilization of preconception care among the pregnant mothers according to our study was 40%. Professional/technical/managerial occupation (AOR = 4.3, 95%CI = 1.13, 16.33, P < 0.032), having good knowledge on preconception care (AOR = 3.5, 95%CI = 1.92, 6.53, P < 0.000), having unintended pregnancy (AOR = 0.1, 95%CI = 0.03, 0.42, P < 0.001), history of family planning use before conception (AOR = 3.9, 95%CI = 1.20, 12.60, P < 0.023), having pre-existing medical disease(s) (AOR = 8.4, 95%CI = 2.83, 24.74, P < 0.002), and having adverse pregnancy outcome(s) in previous pregnancies (AOR = 3.2, 95%CI = 1.55, 6.50, P < 0.000) were significantly associated with preconception care utilization.

CONCLUSIONS

This study found out that the utilization of preconception care in the private MCH hospitals is still low i.e., only 40%. Occupation, level of knowledge, having unintended pregnancy, history of family planning use before conception, having adverse pregnancy outcome(s) in previous pregnancy and having pre-existing medical disease(s) were independently associated with preconception care utilization. Lack of awareness about the availability of the services and having an unintended pregnancy were the main reasons for not utilizing preconception care.

“We Are Having a Huge Problem with Compliance”: Exploring Preconception Care Utilization in South Africa

Background: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in most African countries, its provision and utilization are not widely documented. Hence, this study aimed to explore the factors influencing preconception care utilization among high-risk women in South Africa. Methods: A descriptive qualitative study of 29 purposively selected women and healthcare workers was conducted through individual in-depth interviews using a semi-structured interview guide. The interviews were transcribed verbatim, and the analyses were performed using Nvivo version 12. The Social-Ecological Model (SEM) guided the data analysis. Four levels of factors (the individual, the interpersonal, the community and social, and the policy and institutional) were used to assess what can influence PCC utilization. Findings: The availability of PCC services, the intrahospital referral of women, the referral practices of other healthcare workers, the underutilization of the PCC facility, and resources emerged at the institutional levels, while compliance with PCC appointments, socioeconomic factors, pregnancy planning, assumptions, and knowledge was at the individual levels. Conclusion: The utilization of the preconception care services was inadequate. The primary influencer of preconception care utilization was at the individual, policy, and institutional levels. The availability of preconception care services and the intrahospital referral of women at high risk of adverse pregnancy outcomes positively influenced the women’s PCC utilization, while poor pregnancy planning, and unavailability of PCC policies and guidelines negatively influenced preconception care utilization. Therefore, interventions to improve PCC utilization should focus on the four SEM levels for effectiveness. There is a need to raise PCC awareness and develop policy and guidelines to ensure consistent, standardized practice among healthcare workers.

Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia

Introduction

There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman’s may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town.

Methods

A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05.

Result

This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization.

Conclusions

The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women’s/couples knowledge & strengthening counseling services is pivotal.

A longitudinal study on the effects of previous stillbirth or abortion on subsequent pregnancies and infants

BACKGROUND

This study was conducted to assess the effects of stillbirth and abortion on the health of the subsequent newborns.

METHODS

A prospective cohort study was implemented. The data were collected from January 2015 to August 2019. The study participants were selected using the simple random sampling technique. The data were collected using interviewing the pregnant mothers, reviewing medical charts, analyzing the blood samples from the newborn and scheduled medical checkups. The general linear model was used to assess the effects of stillbirth and abortion on the health of the newborn, Poisson regression was used to identify predictors of childhood infectious disease episodes and Kaplan-Meier survival curves were used to estimate time to childhood pneumonia and diarrhea.

RESULTS

Two thousand, eight hundred and seventy-two infants were included giving a response rate of 88.97%. Neonates born from mothers with a previous history of stillbirth or abortion had low birth-weight, low serum iron and zinc levels. High infection episodes of diarrhea and pneumonia were observed among infants born from a previous history of stillbirth and abortion mothers. The infection episodes during the childhood period were determined by serum zinc level [incident rate ratio (IRR): 0.71; 95% confidence interval (CI): 0.61-0.83], birth-weight (IRR: 0.86; 95% CI: 0.81-0.91) and breastfeeding frequency (IRR: 0.9; 95% CI: 0.87-0.93).

CONCLUSION

The birth-weight, serum iron and zinc levels of neonates born from the previous history of stillbirth and abortion were lower. The infection episodes of newborns born from mothers with a previous history of stillbirth or abortion were higher.

Mothers' utilization and associated factors of preconception care in Africa, a systematic review and meta-analysis

BACKGROUND

As the studies show, in every minute in the world, 380 women become pregnant and 190 face unplanned or unwanted pregnancies; 110 experience pregnancy-related complications, and one woman dies from a pregnancy-related cause. Preconception care is one of the proven strategies for the reduction in mortality and decreases the risk of adverse health effects for the woman, fetus, and neonate by optimizing maternal health services and improves woman's health. Therefore, this study aimed to estimate the pooled prevalence of utilization of preconception of care and associated factors in Africa.

METHODS

Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL, and manually on Google Scholar. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed by the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software.

RESULT

From 249,301 obtained studies, 28 studies from 3 African regions involving 13067 women included in this Meta-analysis. The overall pooled prevalence of utilization of preconception care among pregnant women in Africa was found to be 18.72% (95% CI: 14.44, 23.00). Knowledge of preconception care (P = <0.001), preexisting medical condition (P = 0.045), and pregnancy intention (P = 0.016) were significantly associated with the utilization of preconception care.

CONCLUSION

The results of this meta-analysis indicated, as one of best approaches to improve birth outcomes, the utilization of preconception care is significantly low among mothers in Africa. Therefore, health care organizations should work on strategies to improve preconception care utilization.

Knowledge and utilisation of preconception care and associated factors among women in Ethiopia: systematic review and meta-analysis

BACKGROUND

Preconception care is the provision of biomedical, behavioural, and social health interventions provided to women and couples before conception. However, in Ethiopia, little is known and practised to support preconception care. Therefore, this study aimed to assess women's knowledge and utilisation of preconception care and its associated factors in Ethiopia using systematic review and meta-analysis.

METHOD

In the current meta-analysis, variables were searched from different electronic database systems, which included PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were analysed by using STATA 14 statistical software. I² tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled knowledge and utilisation of preconception care.

RESULTS

Thirteen full-text studies were included. The pooled prevalence of knowledge and utilisation of preconception care among women in Ethiopia was 30.95% and 16.27% respectivelly. Secondary education (OR = 2.78, 95% CI,2.01-3.85), college and above (OR = 5.05, 95% CI,2.70-9.44), and antenatal care (OR = 3.89, 95% CI, 1.69-8.98) were significantly associated with knowledge level whereas; age (OR = 2.43, 95% CI, 1.30-4.53) and knowledge on preconception care (OR = 3.95, 95% CI,2.35-6.62) were positively associated with utilisation of preconception.

CONCLUSIONS

Women's level of knowledge and utilisation of preconception care was significantly low. Educational status and antenatal care follow-up were factors shown to affect knowledge of preconception care. Age and having a sound knowledge of preconception care indicated a significant association towards utilisation of preconception care. Thus, integrating preconception care strategies and policies that can address all the components of preconception care services with other maternal and child health services will be essential when designing effective implementation strategies to improve preconception care uptake. Besides this, advocating for better education for women, awareness creation, and increasing antenatal care services are essential. Prospero registration: CRD42020218062.

Protocol for the development and validation of a risk prediction model for stillbirths from 35 weeks gestation in Australia

BACKGROUND

Despite advances in the care of women and their babies in the past century, an estimated 1.7 million babies are born still each year throughout the world. A robust method to estimate a pregnant woman's individualized risk of late-pregnancy stillbirth is needed to inform decision-making around the timing of birth to reduce the risk of stillbirth from 35 weeks of gestation in Australia, a high-resource setting.

METHODS

This is a protocol for a cross-sectional study of all late-pregnancy births in Australia (2005-2015) from 35 weeks of gestation including 5188 stillbirths among 3.1 million births at an estimated rate of 1.7 stillbirths per 1000 births. A multivariable logistic regression model will be developed in line with current Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) guidelines to estimate the gestation-specific probability of stillbirth with prediction intervals. Candidate predictors were identified from systematic reviews and clinical consultation and will be described through univariable regression analysis. To generate a final model, elimination by backward stepwise multivariable logistic regression will be performed. The model will be internally validated using bootstrapping with 1000 repetitions and externally validated using a temporally unique dataset. Overall model performance will be assessed with R², calibration, and discrimination. Calibration will be reported using a calibration plot with 95% confidence intervals (α = 0.05). Discrimination will be measured by the C-statistic and area underneath the receiver-operator curves. Clinical usefulness will be reported as positive and negative predictive values, and a decision curve analysis will be considered.

DISCUSSION

A robust method to predict a pregnant woman's individualized risk of late-pregnancy stillbirth is needed to inform timely, appropriate care to reduce stillbirth. Among existing prediction models designed for obstetric use, few have been subject to internal and external validation and many fail to meet recommended reporting standards. In developing a risk prediction model for late-gestation stillbirth with both providers and pregnant women in mind, we endeavor to develop a validated model for clinical use in Australia that meets current reporting standards.

Maternal Depressive Symptoms and Developmental Delay at Age 2: A Diverse Population-Based Longitudinal Study

OBJECTIVES

Children raised by depressed mothers perform lower on measures of cognitive, emotional, and behavioral skills, compared to children of non-depressed mothers. It is unclear how maternal depressive symptoms (MDS), which persist and accrue over time, impact child development. The purpose of this study was to determine whether cumulative MDS from pre-pregnancy to postpartum influences child development in children by age 2.5.

METHODS

Using a longitudinal population-based study design, 2679 racially and ethnically diverse mothers completed the 2014 Los Angeles Mommy and Baby (LAMB) and 2016 Follow-Up surveys. A total MDS score was created based on responses to standardized questions, including the Patient Health Questionnaire-2 (PHQ-2). Data was collected for before pregnancy, during pregnancy, and 4 months postpartum in the 2014 survey, and at 2.5 years postpartum in the 2016 survey. Child development was measured using the CDC's Learn the Signs. Act Early Milestones Checklist. Bivariate and multivariate logistic regressions were conducted.

RESULTS

The prevalence of any cumulative MDS was 45.2%. Language, cognitive/adaptive, motor, and social-emotional delays for surveyed toddlers were 7.7%, 4.0%, 1.2%, and 14.2%. After adjusting for covariates, mothers reporting depressive symptoms at all four time points were significantly more likely to report a social-emotional delay in their child (aOR = 4.39, 95% CI - 1.72 to 11.18).

CONCLUSIONS FOR PRACTICE

Mothers with cumulative depressive symptoms are at-risk of reporting social-emotional delays by age 2.5. Understanding these effects may help direct resources to target interventions that support mothers with depressive symptoms early-on and promote positive developmental outcomes among their children.

Why do women not prepare for pregnancy? Exploring women's and health care providers' views on barriers to uptake of preconception care in Mana District, Southwest Ethiopia: a qualitative study

Background

Preconception care has the potential to reduce maternal and child morbidities and mortalities. It is a window of opportunity to timely alter or eliminate risk factors for adverse pregnancy outcomes. However, despite strong evidence on the effectiveness of preconception care in safeguarding maternal and child health, its uptake remains low. Therefore, this study aimed to explore barriers to the uptake of preconception care.

Methods

A descriptive qualitative study was conducted in Mana district, Jimma Zone, Oromia region, Southwest Ethiopia from March 02 to April 10, 2019. A purposive sampling approach was used, and 13 key informant interviews (6 in rural and 7 in urban areas) were held with women of different age groups, health extension workers, and health care providers of different professions. In addition, 4 focused group discussions with women of reproductive age groups (two with rural women only and two with urban women only) were conducted. The data were collected by trained experts using semi-structured guides. An inductive process of thematic analysis was employed and the data were coded, categorized, and thematized using Atlas ti version 7.0.71 software.

Results

Four women of reproductive age groups, 1 older woman (grandmother), 2 health extension workers, and 6 health care providers of different professions were interviewed. In addition, a total of 38 women of reproductive age groups participated in the 4 focused group discussions: 20 in the two rural-focused group discussions and 18 in the two urban-focused group discussions. The findings indicated the presence of many barriers affecting the uptake of preconception care and organized into five themes: women-related barriers, husband-related barriers, community-related barriers, health-service-related barriers, and media-related barriers.

Conclusions

This study found a diverse array of potentially modifiable barriers to the uptake of preconception care. The findings imply the importance of scaling up health education and counseling, establishing preconception care strategies and functional units that can address all the components at all levels of health care facilities. Therefore, we recommend all stakeholders, such as program planners and managers, non-governmental organizations, media personnel, and health care providers to work in collaboration to increase the uptake of preconception care.

Husband Support Rises Women’s Awareness of Preconception Care in Northern Ethiopia

Background. Preconception care (PCC) aims to improve pregnancy and health outcomes of mothers and their offspring. However, there is no adequate evidence of awareness on preconception care in Ethiopia. Therefore, the present study was performed to assess the level of awareness and associated factors of preconception care among currently delivered mothers. Method. A community-based cross-sectional study was conducted among 561 mothers in Northern Ethiopia. Data were collected using a pretested, structured questionnaire. Odds ratio presented with 95% confidence interval, and a p value <0.25 at bivariable and p value <0.01 at multivariable logistic regression were used to declare statistical significance. Results. 39.0% of mothers were aware of preconception care. Awareness of preconception care was lower among mothers who did not have joint plan discussion with their partner (AOR = 0.15; 95% CI (0.08, 0.28)); did not have a history of adverse pregnancy outcome (AOR = 0.45; 95% CI (0.25, 0.83)), and did not receive husband support (AOR = 0.10; 95% CI (0.05, 0.19)). Conclusion. Women’s awareness of preconception care remains low. Joint plan discussion with the partner, previous history of adverse pregnancy outcome, and husband support were statistically significant predictors of awareness of preconception care. Thus, informing and sensitizing women and advocating husband support on preconception care are needed.

Mothers' utilization and associated factors in preconception care in northern Ethiopia: a community based cross sectional study

BACKGROUND

Adverse pregnancy outcomes remain a prevalent health problem in Ethiopia. Mothers' use of preconception care service has the potential to avert many of the adverse outcomes. However, the use of this service and its determinants is not well investigated. Therefore, this study was conducted to assess the utilization and determinants of preconception care among recently delivered mothers.

METHODS

A community based cross-sectional design was conducted among 564 recently delivered mothers in Mekelle City, Northern Ethiopia. A multi stage cluster sampling technique was employed. Data was collected using a pre-tested, structured interviewer questionnaire and was entered in to Epi-Info™ Version 7 and analyzed using SPSS™ Version 20.0. Descriptive, bivariable and multivariable logistic regression was used to identify the association.

RESULTS

This study revealed that, 102(18.2%) of the mothers had utilized preconception care. Mothers' knowledge on preconception care (AOR: 2.21; 95% CI: 1.03, 4.73), prior experience of adverse birth outcomes (AOR: 5.10; 95% CI: 2.31, 11.24), history of chronic health problems (AOR: 5.69; 95% CI: 2.06, 15.72), husband's support (AOR: 13.84; 95% CI: 6.02, 31.79), and challenges in accessing a health facility (AOR: 0.24; 95% CI: 0.16, 0.48) were significantly associated with preconception care service utilization.

CONCLUSION

Mothers' utilization of preconception care is low. Mothers knowledge on preconception care, experience of adverse birth outcome, having chronic health problems and husband support increases utilization of preconception care. However, mothers who experienced challenges in visiting a health facility showed decrease preconception care utilization. Therefore, increased efforts are need in terms of advocating for involvement of husband's and awareness creation respecting preconception care services for all women.

MEDICAL GENETIC COUNSELING OF WOMEN WITH CONGENITAL HEART DISEASES OF FETUS

Aim of the work. Determine the effectiveness of prenatal diagnosis of congenital heart defects in the fetus and the informativeness of different markers used in the medical-genetic counseling of pregnant women.. Materials and methods. The analysis of the results of medical genetic counseling of pregnant women with fetal heart diseases was carried out. The effectiveness of using different methods of prenatal diagnosis in 67 pregnant women is estimated. The data of somatic, genealogical and reproductive anamnesis, biochemical markers of chromosomal pathology of the 1st and 2nd trimester of pregnancy, and the spectrum of the detected fetal heart disease were studied. Results of the research. It was found that 46 (68.7 %) women had somatic diseases: pathology of the cardiovascular system (11.9 %); endocrine system - at 8 (11,9 %); respiratory disease – 3 (4.5 %) and urinary system – 2 (3.0 %). 13 (19.4 %) out of 67 women had acute respiratory viral infections in the first trimester of pregnancy. In 4 (6 %) cases - bad habits. The first time pregnant were 31 (46.3 %) women, 21 (31.3 %) – the second time, 10 (14.9 %) in the third, and 5 (7.5 %) in the fourth or more times. In history, 58 (86.6 %) women did not have reproductive function disorders, 8 (11.9 %) had unauthorized miscarriages and frozen pregnancy. The burden of gynecological anamnesis was observed in 12 (17.9 %) women, and hereditary - in 6 (9.0 %) women. In the structure of congenital defects of the heart, false anatomical anomalies were found more often: hypoplasia of the left heart organs – 14 (20.9 %), tetralogy of Fallot - 9 (13.3 %). Biochemical markers of chromosomal pathology in the first trimester in 11 (16.4 %) women recorded indicators that are characteristic of the risk of chromosomal pathology, and in the second trimester – in 9 (13.4 %). Two pregnant women used a NIPT (non-invasive prenatal test) test that did not detect chromosomal abnormalities in the fetus. In 8 cases, invasive prenatal diagnosis of the fetus was recommended, which was carried out by three women, and five refused. Conclusions. The peculiarities of somatic (in 46–68.7 % of women), reproductive (in 8-11.9 % of women) gynecological anamnesis (in 12–17.9 % of women), which can be the risk factors of congenital fetal heart disease, are revealed. In the structure of congenital defects of the heart of the fetus more often revealed hypoplasia of the left heart organs – 14 (20.9 %), tetralogy of Fallot – 9 (13.3 %). In 11 (16.4 %) women recorded indicators of biochemical markers, characteristic for the risk of chromosomal pathology, in the first trimester, and – in 9 (13.4 %) pregnant women – in the second trimester. Comparative data on prenatal diagnosis of congenital heart defects in the fetus of chromosomal, monogenic and multifactorial etiology are given. On the basis of the obtained results an algorithm of medical-genetic counseling of this contingent of patients was offered.

Prevalence of adverse birth outcome and associated factors among women who delivered in Hawassa town governmental health institutions, south Ethiopia, in 2017

Background

Most pregnancies are unplanned in Ethiopia. This is due to ignorance of the types and efficacy of each method of contraception they are associated with vast and unpredictable complications. Most of the time, these complications result in adverse birth outcomes. Information about prevalence of adverse birth outcome and it’s factors are relevant for designing, and initiating and intervening programs to decrease these undesirable out comes.

Objective

To assess prevalence of adverse birth outcome and associated factors among women who delivered in Hawassa town governmental health institutions, south Ethiopia, in 2017.

Method

We conducted institutional based cross sectional study among 580 pregnant women from december1–30/2017, by multistage systematic random sampling method in governmental health institution in Hawassa town. Data were collected through structured pre-tested, close ended and interview administered questionnaire in their post-partum period. Collected data was entered in Epi-info version 7 and analyzed using SPSS. Odds ratio with 95% confidence interval on multivariable logistic regression was computed and P-value< 0.05 considered as significance.

Result

From a total of 580 respondents 106(18.3%) respondent’s had child related adverse birth outcome. Previous History of child related adverse pregnancy outcome 4.2 (95%,CI = 2.5–6.9), Attend at list one antenatal care visit 2.3 (95%CI = 1.1–4.3), Own cat in the house 2.2 (95%,CI = 1.3–3.7), Had any chronic disease/s 2.1(95%,CI = 1.1–4.8), Age of the mother (from 35 to 45 Years) 2.3(95%,CI = 1.1–4.8), Poor participants’ Knowledge on preconception care 3 (95%CI = 1.4–1.6) were significant predictor of adverse birth outcome in this study .

Conclusion and recommendation

Prevalence of adverse birth outcome was found to be significant in the current study. Presence of Previous History of adverse pregnancy outcome, on ante-natal attendance, presence of cat in the house, presence of chronic disease/s, younger mother and Poor Knowledge of preconception care were significant predictor of adverse pregnancy outcome. Therefore it is better to give more attention on expanding preconception and antenatal care. Creating awareness about family planning methods type and efficacy for women of reproductive health is mandatory. Services, increasing health education on personal hygiene vaccination of cats. Moreover, early detecting and treatment of chronic disease.