Awareness of danger signs and symptoms of pregnancy complication among women in Jordan

Spatial variation and associated factors of inadequate counselling regarding pregnancy danger signs during antenatal care visits among pregnant women in Ethiopia: a Geographically Weighted Regression Model

INTRODUCTION

Inadequate counselling of pregnant women regarding pregnancy danger signs contributes to a delay in deciding to seek care, which causes up to 77% of all maternal deaths in developing countries. However, its spatial variation and region-specific predictors have not been studied in Ethiopia. Hence, the current study aimed to model its predictors using geographically weighted regression analysis.

METHODS

The 2019 Ethiopian Mini Demographic and Health Survey data were used. A total weighted sample of 2922 women from 283 clusters was included in the final analysis. The analysis was performed using ArcGIS Pro, STATA V.14.2 and SaTScan V.10.1 software. The spatial variation of inadequate counselling was examined using hotspot analysis. Ordinary least squares regression was used to identify factors for geographical variations. Geographically weighted regression was used to explore the spatial heterogeneity of selected variables to predict inadequate counselling.

RESULTS

Significant hotspots of inadequate counselling regarding pregnancy danger signs were found in Gambella region, the border between Amhara and Afar regions, Somali region and parts of Oromia region. Antenatal care provided by health extension workers, late first antenatal care initiation and antenatal care follow-up at health centres were spatially varying predictors. The geographically weighted regression model explained about 66% of the variation in the model.

CONCLUSION

Inadequate counselling service regarding pregnancy danger signs in Ethiopia varies across regions and there exists within country inequality in the service provision and utilisation. Prioritisation and extra efforts should be made by concerned actors for those underprivileged areas and communities (as shown in the maps), and health extension workers, as they are found in the study.

Pregnancy Risk Perception, Knowledge of Obstetric Danger Signs and Attitude Towards Skilled Delivery Service Utilization Among Pregnant Mothers in a Rural Setting in South Ethiopia: A Community-Based Cross-Sectional Study

Background

Poor pregnancy risk perception, ignorance of obstetric risk symptoms, and attitudes toward institutional delivery services are factors that prevent pregnant women from choosing to receive emergency obstetric treatment.

Objective

To assess pregnancy risk perception, attitude towards skilled delivery service, and knowledge of obstetric danger signs and associated factors among pregnant mothers.

Methods

A cross-sectional community-based study design was used. The 668 pregnant women who participated in this study were chosen using a multi-stage sampling methodology. Data were gathered using a pretested questionnaire that was presented by an interviewer. To find independent factors, logistic regression analysis was used. With a p-value of less than 0.05, which denotes statistical significance, a corresponding 95% confidence interval (CI) was calculated.

Results

Pregnancy risk perception was shown to have a lower mean score (23) overall. Only 40.9% of the study participants had high pregnancy risk perception. Over 50% (337) of respondents had a positive attitude towards skilled delivery service utilization. In all categories of obstetric danger signs, only 153 respondents (or 22.9%) knew what the obstetric danger signs were. Maternal age (AOR = 1.966, CI: 1.185-3.261), maternal education (AOR = 1.965, 1.002-3.854), and parity (AOR = 0.534, CI: 0.305-0.933) were factors affecting knowledge of obstetric danger signs. Pregnancy risk Perception (AOR = 14.7, CI: 9.849-22.235) and parity (AOR = 2.27, CI: 1.381-3.733) were significantly associated with attitudes on the use of skilled delivery services.

Conclusion

This study found that pregnant women in rural locations had poor levels of knowledge of obstetric danger sign, attitude toward using skilled delivery services, and perception of pregnancy risk. The knowledge of obstetric danger indicators among pregnant women was considerably affected by the mother's age, education, and parity. The perception of pregnancy risk and parity were found to be substantially associated with attitudes towards skilled delivery services.

Knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care services at Thai community hospital

BACKGROUND

To decrease preventable maternal mortality, providing health education to all parties is mandatory. Good knowledge, including awareness of pregnant women regarding obstetric danger signs (ODS), leads to appropriate practices and services. The knowledge of ODS varies among countries and regions. Since the data in rural regions of Thailand remains unavailable, this study aimed to identify the prevalence of good ODS knowledge and associated factors among pregnant women attending antenatal services at a Thai community hospital.

METHODS

We performed a cross-sectional, analytical study in 415 singleton pregnant women who visited the antenatal clinic at Wang Saphung Hospital, Loei, Thailand. A well-trained research assistant interviewed all participants using the data record form containing twenty items on the demographic and obstetric data and sixteen items on ODS knowledge. An ODS score of at least 75% (12 points) was considered a good level of knowledge.

RESULTS

A total of 275 participants (66.27%) had good knowledge of ODS. The most recognized ODS was vaginal bleeding whereas the least recognized ODS during pregnancy was convulsion; the least recognized ODS during labor and delivery was retained placenta. Multivariate regression analysis showed that the predictive factors of good OBS knowledge included a higher education level, maternal age of at least 20 years, and having medical personnel as a source of knowledge.

CONCLUSIONS

In a rural setting of Thailand, two-thirds of pregnant women had good ODS knowledge. Identifying those at risk for fair and poor ODS knowledge and prompt management for the vulnerable subgroups might help decrease maternal mortality.

The Awareness and Knowledge of Normal and Abnormal Signs and Symptoms of Pregnancy Among Women of Childbearing Age in Saudi Arabia

BACKGROUND

Pregnancy is a natural physiological process that leads to the outstanding outcome of giving birth. It involves normal and abnormal signs and symptoms that women need to be aware of during this period.

OBJECTIVES

This study aims to assess the awareness and knowledge about normal and abnormal signs and symptoms of pregnancy among women of childbearing age in Saudi Arabia.

METHODS

This is an online questionnaire-based cross-sectional study done in 2023 among women in Saudi Arabia, aged 18 to 45. The estimated sample size was 385 after applying inclusion and exclusion criteria. However, 981 responses were collected and included.

RESULTS

A total of 981 participants were included in our study. The study findings noted that the majority of women demonstrated a good level of knowledge about the normal signs and symptoms of pregnancy. About 82% of the women reported that they knew mood swings were normal symptoms during pregnancy, 80.1% were aware of nausea, 75.9% knew about fatigue, and 68.9% knew about fainting or dizziness. The findings noted that less than half of the participants were fully aware of the abnormal obstetric signs. For the abnormal signs and symptoms during the first trimester, only 45.2% were fully aware of the symptoms. In the second trimester, 39.0% were fully aware of the symptoms. Only 30.5% of the participants were fully aware of the abnormal signs and symptoms in the third trimester. The study established a statistically significant relationship between age and knowledge of abnormal symptoms during the first, second, and third trimesters (P=0.027, 0.041, and 0.006) (r=0.139, 0.105, and 0.146). Furthermore, a statistically significant relationship was found between the level of education of the participants and the level of awareness of abnormal symptoms during the first trimester (P=0.043). However, there was no significant relationship between education level and the level of knowledge regarding abnormal symptoms during the second and third trimesters (r=0.22, 0.061, P=0.578, 0.603).

CONCLUSION

The study found that the majority of women had a good level of awareness and knowledge about normal signs and symptoms of pregnancy, while less than half of the women were fully aware of the abnormal signs and symptoms at different stages of pregnancy. The older respondents and people with higher levels of education demonstrated more knowledge. The two variables, age and education level, had a statistically significant relationship with knowledge of abnormal signs and symptoms of pregnancy with education level being only significant during the first trimester period. Our study concluded that women had different symptoms during pregnancy, both normal and abnormal. Their knowledge about these signs and symptoms was considerably moderate, but further awareness about the normality of these signs is needed. The study recommends more research to measure women's awareness about normal and abnormal symptoms of pregnancy, and more awareness programs should be carried out in the region as a way of enhancing a better understanding of normal and abnormal pregnancy symptoms. This will go a long way in helping women through their pregnancy and make them more comfortable.

Knowledge of Obstetric Danger Signs among Pregnant Women in the Eastern Democratic Republic of the Congo

A lack of awareness regarding obstetric danger signs (ODS) is one of the factors that delay a pregnant woman's decision to seek emergency obstetric care. In developing countries, this delay can lead to high morbidity and mortality among pregnant women. In eastern Democratic Republic of Congo (DRC), very few studies have been conducted to assess the level of knowledge of pregnant women about ODS. Therefore, this study aimed to assess the knowledge of pregnant women about ODS in health facilities in eastern DRC. This quantitative cross-sectional, descriptive, and analytical study was conducted in 19 health facilities in the Kasongo health zone in the south Maniema Province of eastern DRC. A total of 624 pregnant women aged 12-49 years were interviewed in this study. Of these, 60.6% were secondary school graduates, >99% were married, 85.5% were cultivators, and 67.9% were Muslims. The knowledge of ODS among pregnant women was low (21.9%). The most cited danger signs during pregnancy, labor/delivery, and postpartum included severe abdominal pain and severe vaginal bleeding. Additionally, pregnant women aged 30-39 years (p = 0.015) and those who had given birth once (p = 0.049), twice (p = 0.003), 3-5 times (p = 0.004), and >5 times (p = 0.009) were more likely to be aware of ODS than others. Our findings indicated that pregnant women have little knowledge of ODS, which makes it difficult for them to take prompt decisions to seek emergency obstetric care. Thus, strategies to increase the knowledge of pregnant women about obstetrical danger signs by healthcare providers during prenatal consultations (antenatal care) must be developed to improve their rapid decision-making skills during pregnancy, labor, and postpartum.

Individual, socio-cultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia: A mixed method study

Introduction:

Traditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.

Objectives:

The aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.

Methods:

A community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men’s involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software.

Results:

Out of 800 men, only 36.5% (95% confidence interval: 33.3%–39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men’s involvement in facility-based childbirth of this, being in the age group of 40–49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49–10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53–5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25–7.46) associated with men’s involvement in facility-based childbirth.

Conclusion:

Relevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men’s involvement in the study area.

Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

BACKGROUND

The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women's understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies.

METHODS

This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan's largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as 'good' (≥80%), 'satisfactory' (60-79%) and 'poor' (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson's correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good' versus 'satisfactory' and 'poor' combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant.

RESULTS

Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had 'good' knowledge, 245 (58.1%) had 'satisfactory' knowledge and 157 (37.2%) had 'poor' knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having 'good' level of knowledge.

CONCLUSIONS

Most pregnant women had 'satisfactory' knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

The Pattern and Level of Knowledge on Obstetric and Newborn Danger Signs and Birth Preparedness among Pregnant Women in Dodoma Municipal: a Cross Sectional Study

Background:

Unacceptable high maternal mortality rates remain a major challenge in many low-income countries. Early detection and management of antenatal risk factors and good preparation for birth and emergencies are critical for improved maternal and infant outcomes. The aim of this study was to understand the pattern and level of knowledge on obstetric and newborn danger signs, Individual Birth Preparedness and Complication Readiness (IBPACR) among pregnant women in Dodoma Municipal.

Methods:

A quantitative cross sectional study was carried out between February and June 2018. A random selection of participants was employed to achieve a sample size of 450 pregnant women. A standard semi-structure questionnaire was used to collect data and descriptive analysis was carried out by using SPSS software to see the pattern and level of knowledge on obstetric danger signs and individual birth preparedness.

Results:

The mean age of participants was 25.6 years ranging from 16 to 48 years and majority 326 (72.4%) had 2 to 4 pregnancies. Only 203(45.1%) of the pregnant women were able to tell 8 and above danger signs with at least 1 from each of the 4 phases, with the most known obstetric danger signs being vagina bleeding during pregnancy 287(63.8), labour and delivery 234(52.0%), after delivery 278 (61.8) . 164 (36.4%) of the participants reported fever and difficult in feeding 182 (40.4%) as danger signs in newborn. Furthermore, only 75(16.7%) of the participants reported to be prepared for birth and complications. The most known component of birth preparedness was preparing important supply which are needed during birth 283 (62.9%).

Conclusion:

Results of this study showed a low level of knowledge on obstetric and newborn danger signs as well as poor individual birth preparedness and complication readiness. Important predictors of knowledge level and birth preparedness were found to be age, education level, gestation age at first visit and husband involvement in Antenatal visit and care.

Knowledge about child birth and postpartum obstetric danger signs and associated factors among mothers in Dale district, Southern Ethiopia

BACKGROUND

Globally, every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. The majority of these deaths occur after childbirth (post-partum period) mostly within 24 h. Raising awareness of women on obstetric danger sign of childbirth and postpartum, are crucial for safe motherhood initiative and to reduce maternal mortality.

METHODS

A community based cross sectional study was conducted from December 15, 2017 up to February 10, 2018 on randomly selected sample of 782 women who had at least one delivery in the last 12 months. Multi stage sampling technique was used to select the study participants. Pre tested structured questionnaire was used to collect quantitative data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20.0 software.

RESULTS

Total 732 women who had at least one birth prior to this survey were interviewed and making a response rate of 93.6%.The most common spontaneously mentioned danger signs during childbirth was Severe vaginal bleeding by 281 (68.4%). Women who could mention at least two danger signs during child birth and post-partum period were 333 (45.5%), 213(29.1%) respectively. Being urban (AOR = 3.54, 95% of CI: [2.20-5.69] and delivered previous birth at health institution (AOR = 3.35, 95% of CI: [2.38-4.72]) were factors found to be significantly associated with knowledge of danger signs during postpartum. Being Attended secondary level and above (AOR = 2.41, 95% of CI: [1.02-7.76]) and use of ANC during last pregnancy (AOR = 3.63, 95% of CI: [2.51-5.25]), were factors found to be significantly associated with knowledge of danger signs during childbirth.

CONCLUSIONS

The level of knowledge about danger signs of child birth and postpartum were low. This indicates that many mothers are more likely to delay in deciding to seek health care. Also, knowledge about danger signs of childbirth and postpartum were affected by place of residence, formal education, use of ANC and place of delivery. Therefore, the identified gap in awareness should be addressed through effective maternal health services by strengthening and designing appropriate strategies including provision of targeted health information, education and communication.

Knowledge of obstetric danger signs and associated factors: a study among mothers in Shashamane town, Oromia region, Ethiopia

Background

Child birth which is a special moment for parents, families and communities is also a time of intense vulnerability. In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden. Raising awareness of women about the danger signs of pregnancy and childbirth is the first essential step in appropriate and timely obstetric care.

Objective

To assess the knowledge of obstetric danger signs among mothers and associated factors in Shashamane town, oromia region, Ethiopia.

Methods

A community based cross sectional study design was employed. All kebeles were included in study; the number of households was determined using proportionate-to-population size then systematic random sampling technique to select 422 women who gave birth in Shashamane town between April and May 2018. A structured questionnaire was used to collect data. Data was checked and entered into Epi data version 3.1 then exported to Statistical Package for Social Science version 23 for analysis. Univariate, bivariate and multivariable analysis with 95% CI was carried out. Women who spontaneously mentioned at least two danger signs of pregnancy from eight items were considered to have good knowledge of the obstetric danger signs.

Result

A total of 422 mothers were involved in the study. The mean age of the respondent was 25 with a standard deviation of 4.3 year. 59.5% of the respondents were found to have poor knowledge of obstetric danger signs. Majority of respondents mentioned vaginal bleeding (64.7%) as a danger sign of pregnancy. According to the result of the multivariable analysis, antenatal care was significantly associated with the knowledge of obstetric danger sign. Respondents who attended antenatal care were 1.26 times more likely to have good knowledge of obstetric danger signs than those who had no antenatal care [AOR = 1.26, 95%CI (1.08–1.85)]. Respondents who gave birth at health center were 3.57 time more likely to have good knowledge of obstetric danger signs than those who gave birth at home [AOR = 3.57, 95%CI (1.23–10.39)].

Conclusion

According to this study, the knowledge of obstetric danger signs was poor. Some of the factors associated with this knowledge were antenatal care attendance and place of delivery; therefore, it is recommended that mothers should have at least four antenatal visits; this may create good relationship with the providers and enhance their knowledge. In addition to this providing compassionate and respectful maternity care in health facility is also crucial steps to attract more women to health facilities, and to reduce home deliveries.

Awareness of obstetric warning signs in Ecuador: a cross-sectional study

OBJECTIVE

In Ecuador, the reported maternal death rate was 45.71 per 100,000 live births in 2013. This may be partly due to a lack of maternal knowledge of obstetric warning signs during pregnancy, delivery and the post-partum period. This study sought to evaluate awareness of obstetric warning signs among pregnant women in relation to individual demographic and area-level socio-economic indicators.

STUDY DESIGN

We conducted a cross-sectional analysis of data collected by Ecuador's Ministry of Health at the conclusion of a national maternal health campaign (2014-2015). A nationally representative sample of 3435 pregnant women from the nine administrative zones completed surveys regarding basic demographics and their awareness of obstetric warning signs.

METHODS

We defined eight obstetrical warning signs according to the literature and Ecuadorian practice that could occur during pregnancy, delivery and the post-partum period (severe headache, strong abdominal ache, bleeding or presence of malodorous secretion, rupture of the amniotic sac, high fever, abnormal presentation of the baby, decrease in baby's movements and delayed labour). A woman was considered 'aware' if she recognised at least four of the eight warning signs and stated she would seek immediate healthcare at their presentation. For each administrative zone, four socio-economic indicators (poverty, illiteracy, unemployment and subemployment) were obtained from the National Institute of Statistics and Census. Correlates of awareness of the obstetric warning signs were evaluated using hierarchical logistic models clustered by the administrative zone.

RESULTS

Nationally, 86.9% of women were 'aware' of obstetric warning signs. After adjustment for age, socio-economic indicators and clustering, indigenous participants were 59% less likely to be aware of obstetric warning signs than mestizos (odds ratio [OR] = 0.41, 95% confidence interval [CI] = 0.28-0.59). For every 1% increase in area poverty, participants had a 5% decreased likelihood of being aware of obstetric warning signs (OR = 0.95, 95% CI = 0.93-0.96), adjusting for age, ethnicity and other socio-economic indicators. The most effective source of campaign information about obstetric warning signs was personal communication with a healthcare professional, as opposed to mass media advertisements (OR = 1.90, 95% CI = 1.34-2.71).

CONCLUSIONS

A majority of Ecuadorian pregnant and post-partum women are aware of obstetric warning signs. Indigenous ethnicity and area-level poverty are associated with a lack of awareness. Personal communication with a healthcare professional was the most effective source of information. These findings have implications for improvement of maternal awareness of warning signs.

Knowledge of Pregnancy and Its Danger Signs Not Improved by Maternal and Child Health Handbook

Background

High numbers of maternal mortality rate and child mortality rate continue to be the pressing issues in Indonesia. To tackle this problem, multiple approaches have been undertaken, particularly through distributing a Maternal and Child Health (MCH) handbook to every pregnant woman. However, despite the widespread usage of such handbook, its true efficacy in supporting safe motherhood by improving maternal knowledge on various stages of pregnancy and the associated obstetric danger signs is relatively unknown and remains to be established.

Methods

This is a primary cross-sectional study conducted at Majalengka General District Hospital on recently delivering postpartum women between August and September 2017. A total of 127 women were recruited and later divided into two separate groups according to their self-admission on the degree they had read the MCH handbook (≥ 50% and < 50%) and administered a pre-validated questionnaire to assess their knowledge around pregnancy and its danger signs.

Results

We discovered that our population had high knowledge around pregnancy and its danger signs, and the MCH handbook did not hold a significant role in effecting this finding (p value 0.295). Furthermore, various sociodemographic factors (age, educational backgrounds, welfare status, distance from healthcare center, parity and number of ANC visits) also did not exert a statistically significant influence on the level of knowledge in our population (p values 0.579, 0.521, 0.617, 0.908, 0.342, 0.618 and 0.939 respectively).

Conclusion

To conclude, the MCH handbook did not exert a significant influence in improving maternal knowledge levels around pregnancy and the associated obstetric danger signs.

WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis

BACKGROUND

According to the 2015 World Health Organization report, globally, an estimated 10.7 million mothers died from 1990 to 2015 due to obstetric complications. This report showed that almost all global maternal deaths (99%) occurred in developing countries and two thirds of these deaths took place in sub-Saharan Africa where the majority of women lack knowledge about obstetric danger signs. In Ethiopia, in several research reports, it has been indicated that women have poor knowledge about obstetric danger signs. Although several studies have been conducted to assess women's knowledge of obstetric danger signs, to date, no systematic review has been conducted in Ethiopia. Therefore, this review is aimed at synthesising the existing literature about women's knowledge of obstetric danger signs.

METHODS

We systematically searched for articles from MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, Scopus, Google Scholar and Maternity and Infant Care databases. A combination of search terms including 'knowledge' or 'awareness' or 'information' and 'pregnancy danger signs' or 'obstetric danger signs' or 'obstetric warning signs' and 'Ethiopia' was used to locate appropriate articles. Two reviewers conducted article screening and data abstraction independently. Observational studies published in English and conducted in Ethiopia to date were assessed for quality using the adapted Newcastle Ottawa Scale for cross-sectional studies. The PRISMA checklist was used to present the findings of this systematic review.

RESULTS

From the 215 articles initially screened by abstracts and titles, 12 studies fulfilled the inclusion criteria. All the studies reported women's knowledge of obstetric danger signs during pregnancy, ten articles reported on the level of knowledge during delivery and eight studies reported on the level of knowledge of danger signs during the postpartum period. The pooled random effect meta-analysis level of women's knowledge about obstetric danger signs during pregnancy, delivery and postpartum was 48%, 43% and 32%, respectively. Maternal age, education, income, health service use, distance from facility and women's autonomy were reported in several studies as determinants of women's knowledge of obstetric danger signs.

CONCLUSIONS

Women's knowledge about obstetric danger signs in Ethiopia was very poor, which could hamper access to obstetric care when women encounter obstetric complications. Counselling services during antenatal care and community-based health information dissemination about obstetric danger signs should be strengthened.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017077000.

Assessment of knowledge of obstetric danger signs among pregnant women attending a teaching hospital

Introduction

Knowledge of obstetric danger signs among pregnant women is of paramount importance in improving maternal, and fetal health outcomes. This study aims to determine the knowledge of danger signs among pregnant women seeking antenatal care in a teaching hospital.

Materials and Methods

A cross-sectional study was carried out for two months among pregnant women who visited the antenatal clinic of a teaching hospital. A pre-tested and pre-designed proforma was used. Mean knowledge scores were computed and knowledge was classified into adequate and inadequate.

Results

A total of 170 pregnant women fulfilling the inclusion criteria were included. Mean age of the study participants was found to be 26.40 ± 4.14 years. Nearly 67.10% were aware of bleeding per vagina being a danger sign, 50.0% stated excessive vomiting as a danger sign, 23.50% knew that blurring of vision was a danger, while a mere 20.0% reported that convulsions were a danger sign. Overall, adequate knowledge (total knowledge score of 5 and above) was observed in 54.70% of the participants.

Conclusion

Majority of the study participants had adequate knowledge of danger signs in pregnancy. However, when knowledge about specific individual danger signs were further assessed, a high proportion had very poor knowledge. The mean knowledge scores were found to be low.

Knowledge of danger signs during pregnancy and subsequent healthcare seeking actions among women in Urban Tanzania: a cross-sectional study

BACKGROUND

Tanzania is among the countries with a high maternal mortality ratio. However, it remains unclear how information and education on danger signs of pregnancy translate into appropriate actions when a woman recognizes danger signs. This study aimed to determine women's knowledge of obstetric danger signs during pregnancy and their subsequent healthcare seeking actions.

METHODS

The study design was a health facility-based cross-sectional study. Quantitative data were collected through interviewer-administered questionnaires. Descriptive and inferential statistics were used to analyze the data. The study enrolled 384 women from two health centers in Kinondoni Municipality, Dar es Salaam, Tanzania. A woman who had not mentioned any danger sign was categorized as having no knowledge, mentioned one to three danger signs as having low knowledge, and mentioned four or more danger signs as having sufficient knowledge.

RESULTS

Among the 384 participants, 67 (17.4%) had experienced danger signs during their pregnancy and reported their healthcare seeking actions after recognizing the danger signs. Among those who recognized danger signs, 61 (91%) visited a healthcare facility. Among the 384 participants, five (1.3%) had no education, 175 (45.6%) had primary education, 172 (44.8%) had secondary education, and 32 (8.3%) had post-secondary education as their highest educational levels. When asked to spontaneously mention the danger signs, more than half of the participants (n = 222, 57.8%) were able to mention only one to three danger signs. Only 104 (31%) had correct knowledge of at least four danger signs and nine (2.7%) were not able to mention any item. The most commonly known pregnancy danger signs were vaginal bleeding (81%); swelling of the fingers, face, and legs (46%); and severe headache (44%). Older women were 1.6 times more likely to have knowledge of danger signs than young women (OR 1.61; 95% CI 1.05-2.46)".

CONCLUSION

Women took appropriate healthcare seeking action after recognizing danger signs during pregnancy. However, the majority had low knowledge of pregnancy danger signs. Additional studies are warranted to address the knowledge gap and to plan interventions for improving health education under limited resource settings.

Knowledge of obstetric danger signs among recently-delivered women in Chamwino district, Tanzania: a cross-sectional study

Background

Low knowledge of danger signs has been shown to delay seeking obstetric care which leads to high maternal mortality and morbidity worldwide. In Tanzania about half of pregnant women are informed about obstetric danger signs during antenatal care, but the proportion of those who have full knowledge of these obstetric danger signs is not known. This study assessed the knowledge of obstetric danger signs and its associated factors among recently-delivered women in Chamwino District, Tanzania.

Methods

A community-based cross-sectional study was conducted in January 2014 in Chamwino District, Tanzania. A woman was considered knowledgeable if she spontaneously mentioned at least five danger signs in any of the three phases of childbirth (pregnancy, childbirth and postpartum) with at least one in each phase. Multistage cluster sampling was used to recruit study participants. Descriptive and bivariate analyses were conducted. Multivariable logistic regression analyses were performed to control for confounding and other important covariates.

Results

A total of 428 women were interviewed. The median age (IQR) was 26.5 (22–33) years. Only 25.2% of respondents were knowledgeable about obstetric danger signs during pregnancy, childbirth/labour and postpartum. Significant explanatory variables of being knowledgeable about obstetric danger signs were found to be maternal education (AOR = 1.96; 95% CI: 1.01, 3.82), maternal occupation (AOR = 2.23; 95% CI; 1.10, 4.52), spouse occupation (AOR = 2.10; 95% CI: 1.02, 4.32) and counseling on danger signs (AOR = 3.42; 95% CI: 1.36, 8.62) after controlling for the clustering effect, confounding and important covariates.

Conclusion

A low proportion of women was found to be knowledgeable about obstetric danger signs in Chamwino district. Therefore, we recommend the Ministry of Health to design and distribute the maternal health booklets that highlight the obstetric danger signs, and encourage antenatal care providers and community health workers to provide frequent health education about these danger signs for every pregnant woman in order to increase their level of knowledge about obstetric danger signs.

Effect of socio-cultural factors on spontaneous abortion in Burdur, Turkey: A population based case-control study

Objective:

To determine the sociocultural factors that have effect on spontaneous abortion in Burdur, Turkey.

Methods:

Study was designed as case-control study. The case group consist of 257 women whose pregnancies ended with spontaneous abortion. The control group consisted of 514 women whose pregnancy continued since 22 weeks and more during the study. Chi-square, and backward LR logistic regression were utilized in analyses.

Results:

In multifactorial-analyses it was determined that four factors (educational status of women, employment status of women, exposure to physical violence and non-receipt of ANC) created independent risk on spontaneous abortions.

Conclusions:

Pregnant women with these risk factors should be followed up more frequently and in a more qualified way in primary and secondary and tertiary health institutions.

Pregnant women: What do they need to know during pregnancy? A descriptive study

BACKGROUND

Antenatal education programs provide women with essential knowledge and skills in various aspects of maternal and fetal health. Antenatal education is based on improving women's health, reducing the risks of complications and enhancing couples' positive experience during childbirth. There is a lack of formal antenatal educational programs based on women's needs in Jordan.

AIM

This study sought to identify and prioritize the learning needs for women during pregnancy.

METHODS

A descriptive cross-sectional design was employed. The study sample was recruited from three maternal and child health centers. Data were collected from a convenient sample of 150 pregnant women during their antenatal visits. One hundred and twenty three participants (response rate=82%) completed the self-reported antenatal learning needs questionnaire.

FINDINGS

Women identified their most important learning needs were related to managing major complications of pregnancy (mean=3.49, SD=0.78), investigations and physician follow-up visit during pregnancy (mean=3.42, SD=0.71), appropriate diet (mean=3.36, SD=0.84) and information about medication and supplements (mean=3.22, SD=0.97). Spearman correlation showed negative association between participants' age and physical (r=-0.536, p=0.015) and emotional concerns (r=-0.490, p=0.001). Women who had a diploma or higher degree reported greater concern regarding physical (median=4.00, IQR=3.00-4.00, p=0.047) and emotional changes (median=3.33, IQR=3.00-4.00, p=0.004). Finally, migrant participants showed greater significant concern regarding emotional changes and coping with minor complications.

CONCLUSION

A large proportion of pregnant women in this study reported a high degree of importance of specific learning topics that were closely relevant to their current period of pregnancy. The lack of focusing on issues related to maternal emotional status and possible complications suggests a need for a national strategy to provide antenatal education based on women's perceptions of their needs.

Knowledge about Danger Signs of Obstetric Complications and Associated Factors among Postnatal Mothers of Mechekel District Health Centers, East Gojjam Zone, Northwest Ethiopia, 2014

Background. Developing countries like Ethiopia contributed highest level of maternal mortality due to obstetric complications. Women awareness of obstetric danger sign to recognize complications to seek medical care early is the first intervention in an effort to decrease maternal death. Objective. To assess knowledge about danger signs of obstetric complications and associated factors among postnatal mothers at Mechekel district health centers, East Gojjam zone, Northwest Ethiopia, 2014. Methods. An institution based cross-sectional study was conducted from August to October, 2014, in Mechekel district health centers. Systematic random sampling was used to select four hundred eleven study participants. A pretested structured questionnaire was used to collect data. Data were entered to Epi Info version 3.5.3 and exported to SPSS 20.0 for further analysis. Descriptive and summary statistics were done. Logistic regression analyses were used to see the association of different variables. Odds ratios and 95% confidence interval were computed to determine the presence and strength of association. Results. According to this study, 55.1% participants were knowledgeable about danger signs of obstetric complications. Maternal and husband educational level ((AOR = 1.977, 95% CI: 1.052, 3.716) and (AOR = 3.163, 95% CI: 1.860, 5.3770), resp.), family monthly income ≥ 1500 (AOR = 2.954, 95% CI: 1.289, 6.770), being multipara (AOR = 7.463, 95% CI: 1.301, 12.800), ANC follow-up during last pregnancy (AOR = 2.184, 95% CI: 1.137, 4.196), and place of last delivery (AOR = 1.955, 95% CI: 1.214, 3.150) were variables found to be significantly associated with women's knowledge on danger signs of obstetric complications. Conclusion. Significant proportion of respondents were not knowledgeable about obstetric danger signs and factors like educational status, place of last delivery, and antenatal follow-up were found to be associated.

The role of obstetric knowledge in utilization of delivery service in Nepal

Birth Preparedness and Complication Readiness (BP/CR) program has been promoted in Nepal to equip pregnant women with obstetric knowledge so as to motivate them to seek professional care. Using a prospective design of 701 pregnant women of more than 5 months gestation in a central hills district of Nepal, we evaluated if having obstetric knowledge could make a difference in maternal delivery behaviour. The results suggested that BP/CR program was effective in raising women's obstetric knowledge, which was significantly associated with facility delivery according to logistic regression analysis. In particular, women who acknowledged that unexpected problems could occur during pregnancy and childbirth were more likely (odds ratio [OR] 5.83, 95% confidence interval [CI] 2.95-11.52) to deliver at a health facility than others unaware of the possible consequences. Similarly, women who knew any antepartum danger sign (OR 2.16, 95% CI: 1.17-3.98), any intrapartum danger sign (OR 3.80, 95% CI: 2.07-6.96) and any postpartum danger sign (OR 3.47 95% CI: 1.93-6.25), tended to deliver at a health facility. Convincing and counselling the pregnant women of the health consequences of pregnancy and childbirth would increase their utilization of delivery service.

Knowledge about obstetric danger signs and associated factors among mothers in Tsegedie district, Tigray region, Ethiopia 2013: community based cross-sectional study

Background

In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden and thus progress towards the fifth Millennium Development Goal (MDG) remains slow. Raising awareness of women about the danger signs of pregnancy and childbirth is the first essential step in accepting appropriate and timely referral to obstetric care. However, in Ethiopia little is known about the knowledge level of mothers about obstetric danger signs. The objective of this study was to assess the status of knowledge of danger signs of pregnancy and childbirth among mothers who gave birth in the past two years prior to the survey in Tsegedie district, Tigray regional state, Ethiopia.

Methods

A Community based cross-sectional study was conducted from November 20, 2012 to June 30, 2013 on a randomly selected sample of 485 women who had at least one delivery in the past two years. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire was used to collect quantitative data. Focus group discussion and in-depth interviews were utilized to supplement the Quantitative data. Bivariate and multivariate data analysis was performed using SPSS version 17.0 software.

Result

Four hundred eighty five mothers participated in the study making a response rate of 100%. Vaginal bleeding was the most commonly mentioned danger signs of pregnancy (49.1%) and childbirth (52.8%). Two hundred eighty five (58.8%) and 299 (61.6%) of respondents mentioned at least two danger signs of pregnancy and childbirth respectively. One hundred seventy (35.1%) and 154 (31.8%) of respondents didn't know any danger signs of pregnancy and childbirth respectively. Educational status of the mother, place of delivery and having functional radio were found to be independent predictors of knowledge of women about the danger signs of pregnancy and childbirth.

Conclusion

Educational status of the mother, place of delivery and having functional radio were independently associated with knowledge of women about obstetric danger signs. Thus, provision of information, education and communication targeting women, family and the general community on danger signs of pregnancy and childbirth and associated factors was recommended.