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Abuduxike G, Cali S, Vaizoğlu SA, Aşut Ö, Çavuş M, Olgu M, Çavuş SN, Arkut M, Idehen BO, Almezghwi HAS, Asswayeh HMA, Abawu JJ, Hossain MJ, Almawali NA. An Analysis of the Mode of Delivery, Risk Factors, and Subgroups with High Caesarean Birth Rates Using Robson Classification System. Matern Child Health J 2024; 28:667-678. [PMID: 37840109 DOI: 10.1007/s10995-023-03783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We aimed to understand the utilization of the mode of delivery and related risk factors. Further aimed to apply the Robson classification system to evaluate the data quality and analyze the CS rates in subgroups. METHODS We conducted a retrospective descriptive study by reviewing the medical records of all women who delivered at the State Hospital in 2019. A proforma was developed for extracting data from patient records. All women with six obstetric parameters were categorized into Robson groups to determine the absolute and relative contributions of each group to the overall CS rate. RESULTS Of 797 deliveries, 401 (50.2%) were CSs. Being older, being Turkish Cypriot, having preterm births, previous CS, multiple fetuses, and having breech or transverse fetal presentations were related to having higher risks of CS. The most common medical indication for CSs (52.3%) was a history of previous CSs. Robson Group 5 contributed the most (50.7%) to the overall CS rate, with the highest absolute contribution of 21.8%. Group 10 and Group 8 were the second and third highest contributors to the overall CS rate, with relative contributions of 25.3% and 9.0%, respectively. CONCLUSIONS Findings revealed the substandard quality of obstetric data and a noticeably high overall CS rate. The top priority should be given to improving the quality of medical records. It underscored the necessity of implementing the Robson classification system as a standard clinical practice to enhance data quality, which helps to effectively evaluate and monitor the CS rates in obstetric populations.
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Affiliation(s)
- Gulifeiya Abuduxike
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus.
| | - Sanda Cali
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Songül Acar Vaizoğlu
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Özen Aşut
- Department of Public Health, Faculty of Medicine, Near East University, Near East Boulevard, 99138, Nicosia, Northern Cyprus
| | - Mahmut Çavuş
- Dr. Burhan Nalbantoğlu State Hospital Obstetrics and Gynaecology Department, Nicosia, Northern Cyprus
| | - Musa Olgu
- Dr. Burhan Nalbantoğlu State Hospital Obstetrics and Gynaecology Department, Nicosia, Northern Cyprus
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2
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Baradwan S, Khadawardi K, Alayed NM, Akkour KM, Mahmoud MS, Abdelhakim AM, Sunoqrot M, Abdel Hamid AS. The effect of Pilates exercise during pregnancy on delivery outcomes: a systematic review and meta-analysis. Women Health 2024; 64:131-141. [PMID: 38221667 DOI: 10.1080/03630242.2024.2304893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
A systematic review and meta-analysis were conducted to investigate the effectiveness of the Pilates exercise program during pregnancy on different delivery outcomes. Various databases were searched from inception until November 2022. The included studies compared Pilates exercise to routine antenatal care in pregnant women. The primary outcomes assessed were vaginal and cesarean delivery rates, as well as labor duration. Secondary outcomes included episiotomy incidence, Apgar scores, and epidural analgesia. Seven studies met the inclusion criteria, involving a total of 1,003 patients. Results indicated a significant increase in the vaginal delivery rate among the Pilates exercise group compared to the control group (p < .001). Moreover, the Pilates exercise group exhibited significantly reduced rates of cesarean delivery and shorter labor duration. Pilates exercise was associated with a significant decline in the incidence of episiotomy and the number of women requiring epidural analgesia during delivery (p < .001 & p = .008). In addition, Apgar scores at one and five minutes were significantly higher in the Pilates exercise group compared to the control group (p < .001). In conclusion, Pilates exercise during pregnancy has a positive effect on maternal outcomes and Apgar scores. However, more trials are needed to confirm these findings.
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Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nada M Alayed
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid M Akkour
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Ahmed Sherif Abdel Hamid
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Wilczyńska D, Walczak-Kozłowska T, Santos-Rocha R, Laskowski R, Szumilewicz A. Stress is not so bad-cortisol level and psychological functioning after 8-week HIIT program during pregnancy: a randomized controlled trial. Front Public Health 2024; 11:1307998. [PMID: 38259751 PMCID: PMC10800893 DOI: 10.3389/fpubh.2023.1307998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Background Amid extensive pregnancy exercise research, the impact of High Intensity Interval Training (HIIT) on pregnant women's mental health is underexplored. Despite exercise benefits, it can trigger stress responses like elevated cortisol. This study fills the gap by investigating correlations between hair cortisol levels, mental health, and HIIT effects in pregnant women. Methods We conducted a randomized control trial among 38 Caucasian women in uncomplicated, singleton pregnancy (age 31.11 ± 4.03 years, 21.82 ± 4.30 week of gestation; mean ± SD). The experimental group comprised 22 women engaged in an 8-week high-intensity interval training program (HIIT). The comparative group consisted of 16 pregnant women undergoing an 8-week educational program (EDU). Before and after the interventions, all women were evaluated using the following tools: Hair cortisol level measurements, Beck Depression Inventory - II for depressive symptoms assessment, Childbirth Attitudes Questionnaire for childbirth fear measurement, 12-item Short Form Health Survey to gage health-related quality of life, International Physical Activity Questionnaire for physical activity level estimation, and a Progressive maximal exercise test to evaluate maternal exercise capacity. Results The key finding of our study reveals that women engaged in the HIIT intervention exhibited a distinct cortisol production pattern in contrast to the EDU group practicing standard moderate intensity physical activity. In the HIIT group, there was an increase in hair cortisol levels, while the EDU group showed a notable decrease. Remarkably, HIIT stimulated cortisol production without adversely impacting fear of childbirth and psychophysical condition during pregnancy. In fact, only the HIIT group showed a significant enhancement in mental health. Conclusion No links were discovered between hair cortisol levels and the severity of depressive symptoms, psychophysical well-being, or fear of childbirth. Hence, based on our research, employing cortisol levels during pregnancy as an indicator of negative stress or depression risk appears unwarranted.
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Affiliation(s)
- Dominika Wilczyńska
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | | | - Rita Santos-Rocha
- ESDRM Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, Santarém, Portugal
- CIPER Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, Lisbon, Portugal
| | - Radosław Laskowski
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Anna Szumilewicz
- Department of Physical Culture, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
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Swift B, Taneri B, Cagnan I, Becker CM, Zondervan KT, Quigley MA, Rahmioglu N. Predictors and trends of Caesarean section and breastfeeding in the Eastern Mediterranean region: Data from the cross-sectional Cyprus Women's Health Research (COHERE) Initiative. PLoS One 2023; 18:e0287469. [PMID: 37418433 PMCID: PMC10328327 DOI: 10.1371/journal.pone.0287469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/22/2023] [Indexed: 07/09/2023] Open
Abstract
INTRODUCTION Caesarean section (C-section) is a life-saving procedure when medically indicated but unmet need and overuse can add to avoidable morbidity and mortality. It is not clear whether C-section has a negative impact on breastfeeding and there is limited data available on rates of C-section or breastfeeding from Northern Cyprus, an emerging region in Europe. This study aimed to investigate prevalence, trends and associations of C-section and breastfeeding in this population. METHODS Using self-reported data from the representative Cyprus Women's Health Research (COHERE) Initiative, we used 2,836 first pregnancies to describe trends in C-section and breastfeeding between 1981 and 2017. Using modified Poisson regression, we examined the relationship between year of pregnancy and C-section and breastfeeding, as well as the association between C-section and breastfeeding prevalence and duration. RESULTS C-section prevalence in first pregnancies increased from 11.1% in 1981 to 72.5% in 2017 with a relative risk of 2.60 (95%CI; 2.14-2.15) of babies being delivered by C-section after 2005 compared to before 1995, after full adjustment for demographic and maternal medical and pregnancy related factors. Prevalence of ever breastfeeding remained steady throughout the years at 88.7% and there was no significant association between breastfeeding initiation and the year of pregnancy, or demographic and maternal medical and pregnancy related variables. After full adjustment, women who gave birth after 2005 were 1.24 (95%CI; 1.06-1.45) times more likely to breastfeed for >12 weeks compared to women who gave birth before 1995. There was no association between C-section and breastfeeding prevalence or length. CONCLUSION Prevalence of C-section in this population is much higher than WHO recommendations. Public awareness campaigns surrounding choice during pregnancy and change in legal framework to allow for midwife-led continuity models of birthing care should be implemented. Further research is required to understand the reasons and drivers behind this high rate.
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Affiliation(s)
- Bethan Swift
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Bahar Taneri
- Faculty of Arts and Sciences, Department of Biological Sciences, Eastern Mediterranean University, Famagusta, Northern Cyprus
- Cyprus Women’s Health Research Society (CoHERS), Nicosia, Northern Cyprus
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, The Netherlands
| | - Ilgin Cagnan
- Faculty of Arts and Sciences, Department of Biological Sciences, Eastern Mediterranean University, Famagusta, Northern Cyprus
- Cyprus Women’s Health Research Society (CoHERS), Nicosia, Northern Cyprus
| | - Christian M. Becker
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Krina T. Zondervan
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Maria A. Quigley
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Nilufer Rahmioglu
- Oxford Endometriosis CaRe Centre, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Cyprus Women’s Health Research Society (CoHERS), Nicosia, Northern Cyprus
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Zaman AY. Obstetric, maternal, and neonatal outcomes after Pilates exercise during pregnancy: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33688. [PMID: 37233445 PMCID: PMC10219711 DOI: 10.1097/md.0000000000033688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 04/13/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND One of the major exercises to improve the psychological and physical functions of pregnant women is Pilate's exercises. The aim of this study is to collect evidence about Pilates exercise effects on many consequences in pregnant women, such as maternal and neonatal outcomes and obstetric outcomes. METHODS PubMed, Clinical Key, Cochrane Library, Scopus, Embase, and Web of Science were scoured from their inception. Research comparing Pilates during pregnancy to other methods, or to the control was included. For randomized controlled trials (RCTs), The researcher utilized the Cochrane risk of bias tool; for non-RCTs, risk of bias tool to assess non-randomized studies of interventions, was used for cohort studies, and the national heart, lung, and blood institute tool. Meta-analysis was done using the Review manager 5.4. For continuous data, calculated the mean difference and 95% confidence interval (CI), and the risk ratio (RR) and 95% CI for dichotomous data. RESULTS Finally, 13 studies included with a total number of 719 pregnant women. The analysis showed that the Pilates group was significantly more likely to deliver vaginally than the control group (RR = 1.21, 95% CI [1.05 to 1.41], P value = .009). Women in the Pilates group were significantly lower than the control group to have Cesarean delivery (RR = 0.67, 95% CI [0.48-0.94], P value = .02). Moreover, Pilates-treated women were less likely to gain weight during pregnancy than control (mean difference = -3.48, 95% CI [-6.17 to -0.79], P value = .01). CONCLUSION Pilates exercise improved the outcomes of pregnant women. It decreases the rate of Cesarean delivery and the time of delivery. Moreover, Pilates has a role in decreasing weight gain in pregnant women. As a result, that may improve the pregnancy experience for women. However, more RCTs needed with larger sample sizes to assess the Pilates effect on neonatal outcomes.
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Affiliation(s)
- Amal Yaseen Zaman
- Taibah University College of Medicine, Department of Obstetrics and Gynecology, AL Madinah Munawara, Saudi Arabia
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Mazzarino M, Kerr D, Morris ME. Feasibility of pilates for pregnant women: A randomised trial. J Bodyw Mov Ther 2022; 32:207-212. [DOI: 10.1016/j.jbmt.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/28/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
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Determining the childbirth stories of women doing prenatal pilates and their views on the advantages of pilates. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.934172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Background Between 5% and 14% of women suffer from fear of childbirth (FOC) which is associated with difficulties during birth and in postnatal psychological adjustment. Therefore, effective interventions are needed to improve outcomes for women. A systematic review and meta-analysis was used to identify effective interventions for treating women with FOC. Methods Literature searches were undertaken on online databases. Hand searches of reference lists were also carried out. Studies were included in the review if they recruited women with FOC and aimed to reduce FOC and/or improve birth outcomes. Data were synthesised qualitatively and quantitatively using meta-analysis. The literature searches provided a total of 4474 citations. Results After removing duplicates and screening through abstracts, titles and full texts, 66 papers from 48 studies were identified for inclusion in the review. Methodological quality was mixed with 30 out of 48 studies having a medium risk of bias. Interventions were categorised into six broad groups: cognitive behavioural therapy, other talking therapies, antenatal education, enhanced midwifery care, alternative interventions and interventions during labour. Results from the meta-analysis showed that most interventions reduced FOC, regardless of the approach (mean effect size = −1.27; z = −4.53, p < 0.0001) and that other talking therapies may reduce caesarean section rates (OR 0.48, 95% CI 0.48–0.90). Conclusions Poor methodological quality of studies limits conclusions that can be drawn; however, evidence suggests that most interventions investigated reduce FOC. Future high-quality randomised controlled trials are needed so that clear conclusions can be made.
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Necipoğlu D, Bebiş H, Seviğ Ü. The effect of nursing interventions on immigrant women living in Northern Cyprus on their breastfeeding self-efficacy and success: a randomized controlled trial. Health Care Women Int 2021; 42:235-247. [PMID: 33667155 DOI: 10.1080/07399332.2021.1883023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was conducted as a randomized controlled study to determine the effect of nursing interventions, which were based on Dennis's Breastfeeding Self-Efficacy Theory and Pender's Health Promotion Model during home visits, on the breastfeeding self-efficacy and success of immigrant women living in Northern Cyprus. The sample consisted of N = 60 primipar immigrant women (experimental group n = 30, control group n = 30) who attended a primary healthcare center in Northern Cyprus between April 2019 and January 2020. The data were collected from the participants using a Socio-Demographic Questionnaire, the Breastfeeding Self-Efficacy Scale and the LATCH Breastfeeding Assessment Tool. Before the study, no statistically significant difference was found between two groups in terms of breastfeeding self-efficacy and the LATCH assessment (p > 0.05). After the intervention, the mean score for the Breastfeeding Self-Efficacy Scale increased by 9.73 in the experimental group and 3.16 in the control group compared to before the study, and the effect size was found to be 6.57. The score for the LATCH assessment increased by 3.2 in the experimental group and 1.44 in the control group, and the effect size was found to be 1.76 (p < 0.05).
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Affiliation(s)
| | - Hatice Bebiş
- Faculty of Nursing, Near East University, Nicosia, Cyprus
| | - Ümit Seviğ
- Faculty of Nursing, Near East University, Nicosia, Cyprus
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Mazzarino M, Morris ME, Kerr D. Pilates for low risk pregnant women: Study protocol for a randomized controlled trial. J Bodyw Mov Ther 2020; 25:240-247. [PMID: 33714503 DOI: 10.1016/j.jbmt.2020.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 10/25/2020] [Accepted: 12/11/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pilates has growing appeal to pregnant women, as a form of exercise and relaxation. It is purported to benefit lumbo-pelvic stability, as well as motor control, strength and endurance. Some suggest that modified Pilates exercises may assist low risk pregnant women to enjoy a healthier pregnancy and prepare for the physical demands of labour and birth. The feasibility and safety of Pilates during pregnancy is poorly understood. We describe the protocol for a feasibility study designed to compare a midwife-led 6-week community-based Pilates intervention with standard antenatal care. METHODS A convenience sample of 30 low-risk pregnant women will be recruited from private obstetric clinics in Melbourne, Australia. Participants shall be randomly allocated to a six-week, 1-h weekly Pilates exercises group session or to usual care. The Pilates exercise class will have a warm-up phase, Pilates exercises, breathing exercises, and a cool down phase. Exercises have been designed to prepare for active birth. The primary outcome will be feasibility of implementation, determined by recruitment, retention, adherence and safety. Secondary outcomes include women's health (quality of life, pain, mobility for daily activities, lower extremity performance, abdominal separation, continence) and labour and birth outcomes (duration of first stage and second stage labour, analgesia used, mode of birth). Validated questionnaires will include the Quality of life 12-item short form survey; Pregnancy Mobility Index, and International Consultation on Incontinence Questionnaire. Lower extremity performance and abdominal separation will also be measured. DISCUSSION This trial will provide preliminary data regarding the feasibility and safety of Pilates exercise in healthy pregnant women. It will also provide preliminary outcome data used to inform the design of a future large scale, multi-centre RCT. TRIAL REGISTRATION This clinical trial has been registered with the Australian and New Zealand Clinical Trials Registry 2016 (ACTRN12616000809437).
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Affiliation(s)
- Melissa Mazzarino
- La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Kingsbury Drive, Bundoora, VIC, 3086, Australia.
| | - Meg E Morris
- Healthscope ARCH, Victorian Rehabilitation Centre, Glen Waverly, VIC, 3150, Australia.
| | - Debra Kerr
- Deakin University, School of Nursing and Midwifery, Geelong, VIC, 3220, Australia.
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