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Tilahun C, Getie A, Tadesse H, Geta T, Ashiko A. Determinants of preterm delivery among mothers who gave birth in hospitals of Wolaita zone, southern Ethiopia, 2023: unmatched case-control study. BMC Pregnancy Childbirth 2024; 24:681. [PMID: 39425069 PMCID: PMC11490083 DOI: 10.1186/s12884-024-06891-4] [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: 10/23/2023] [Accepted: 10/09/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Preterm delivery refers to childbirth that occurs before 37 full weeks' gestation. Globally, around 13.4 million babies are born preterm annually, a million died due to its complications. Identifying its determinants is mandatory to decrease preterm birth and thereby neonatal deaths. Therefore, this study aimed to identify the determinants of preterm delivery among mothers who gave birth in hospitals in the Wolaita zone, southern Ethiopia. METHODS A hospital-based unmatched case-control study design was conducted from March 29 to May 20, 2023, in the Wolaita zone, southern Ethiopia. Cases were women who gave birth after 28 weeks and before 37 completed weeks, and controls were women who gave birth at and after 37 and before 42 weeks of gestation from the first day of the last normal menstrual period. A consecutive sampling method was used. Data were collected by a structured interviewer-administered questionnaire. Data were coded and entered into Epi data 3.1 and analyzed by using SPSS version 25. Variables that had a P-value < 0.25 in the bivariate logistic regression analysis were entered into a multivariable logistic regression model. Finally, p-value < 0.05 was used to claim statistical significance. RESULT From a total of 405 eligible participants, 399 respondents (133 cases and 266 controls) participated in this study with a response rate of 98.52%. The result of the multivariable analysis shows that mothers who resided in rural areas [AOR = 2.78:95% CI (1.51-5.12)], not receiving support from their partner [AOR = 2.37:95% CI (1.24-4.51)], less than four antenatal care visits [AOR = 4.52:95%CI (2.38-8.57)], developed pregnancy-induced hypertension [AOR = 5.25:95%CI (2.27-12.14)] and exposed for intimate partner violence [AOR = 2.95:95%CI (1.105-7.85)], had statistically significant association with experiencing preterm delivery. CONCLUSION AND RECOMMENDATION Most of the determinants for preterm delivery have been proven modifiable. Thus, designing new strategies, providing comprehensive mobile clinic services to address hard-to-reach areas and Health care providers should give due attention to mothers with pregnancy-induced hypertension and exposure to intimate partner violence and increase the awareness of antenatal care follow-up and benefit of support during pregnancy to reduce preterm delivery.
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Affiliation(s)
- Cherinet Tilahun
- School of Nursing and Midwifery, Collage of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia.
| | - Asmare Getie
- School of Nursing, Collage of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Hiwot Tadesse
- School of Nursing, Collage of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Geta
- School of Nursing and Midwifery, Collage of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Adisu Ashiko
- School of public health, Collage of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
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Zhou H, Yang Y, Chi P, Cheng H, Alifu X, Qiu Y, Huang Y, Zhang L, Ainiwan D, Zhuang Y, Liu H, Chen Z, Yu Y. The association of Chinese and American antenatal care utilization indices with birth outcomes. Front Public Health 2024; 12:1420943. [PMID: 39171300 PMCID: PMC11335484 DOI: 10.3389/fpubh.2024.1420943] [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: 04/21/2024] [Accepted: 07/15/2024] [Indexed: 08/23/2024] Open
Abstract
Objective Few comparisons have been implemented between different prenatal care utilization indices and their effects on adverse outcomes. This study investigated the appropriateness of Chinese antenatal care (ANC) regulations and compared Chinese and American adequacy of prenatal care utilization (APNCU) scores. Methods From 2010 to 2022, the medical records of 60,114 pregnant women were collected from the electronic medical record system (EMRS) in Zhoushan, China. ANC utilization was measured using the APNCU score and five times antenatal care (ANC5). Birth weight outcomes, including small for gestational age (SGA) and large for gestational age (LGA), low birth weight (LBW), macrosomia, birth weight, and preterm birth (PTB), were utilized as outcomes. Multinomial, linear, and logistic regression were used to analyze the association of ANC5 and APNCU with outcomes, respectively. Crossover analysis was implemented to compare the interaction between ANC5 and APNCU on the outcomes. Results Women who received inadequate prenatal care had increased odds for PTB (ANC5: odds ratio (OR) = 1.12, 95% confidence interval (95%CI) = 1.03-1.21; APNCU: OR = 1.18, 95%CI: 1.07-1.29), delivering SGA infants (ANC5: OR = 1.13, 95%CI = 1.07-1.21; APNCU: OR = 1.11, 95%CI = 1.03-1.20). Crossover analysis revealed that inadequate prenatal care in APNCU only was significantly associated with an increased risk of PTB (OR = 1.48, 95%CI: 1.26-1.73). Conclusion Women with inadequate prenatal care in ANC5 or APNCU were more likely to suffer from adverse birth outcomes, including PTB, birth weight loss, SGA, and LBW. It indicated that adequate prenatal care is necessary for pregnant women. However, there were interactions between ANC5 and APNCU on PTB, with inadequate prenatal care use by APNCU showing the highest risk of PTB. This indicates that APNCU would be a better tool for evaluating prenatal care use.
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Affiliation(s)
- Haibo Zhou
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Science and Education of the Fourth Affiliated Hospital, and Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Yang
- Department of Science and Education of the Fourth Affiliated Hospital, and Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Peihan Chi
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haoyue Cheng
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xialidan Alifu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yiwen Qiu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Huang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Libi Zhang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Diliyaer Ainiwan
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Zhuang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hui Liu
- Clinical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhi Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yunxian Yu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
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Aziz MA, Hidayat D, Irwantoro G, Nugrahani AD, Wijaya JJ, Alamsyah SNK, Almira NL, Sutjighassani T, Santoso DPJ, Krisnadi SR. Differential DHA and EPA Levels in Women with Preterm and Term Births: A Tertiary Hospital Study in Indonesia. Med Sci Monit 2024; 30:e943895. [PMID: 38733071 PMCID: PMC11095130 DOI: 10.12659/msm.943895] [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: 01/23/2024] [Accepted: 02/22/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Preterm birth is one of the main causes of neonatal death worldwide. One strategy focused on preventing preterm birth is the administration of long chain polyunsaturated fatty acids (LCPUFAs) during pregnancy. Omega-3 LCPUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential in metabolic and physiological processes during embryonic and fetal development. This study aimed to compare DHA and EPA levels in 44 women with preterm births and 44 women with term births at a tertiary hospital in West Java Province, Indonesia, between November 2022 and March 2023. MATERIAL AND METHODS A total of 88 patients in this study consisted of 44 patients with term births (≥37 gestational weeks) and 44 patients with preterm births (<37 gestational weeks) at a tertiary hospital in West Java Province, Indonesia. This observational, cross-sectional study was conducted from November 2022 to March 2023. Using the enzyme-linked immunosorbent assay test, maternal DHA and EPA levels were investigated. IBM SPSS 24.0 was used to statistically measure outcomes. RESULTS Average maternal DHA and EPA levels in patients with preterm births were significantly lower than those in term births. Preterm labor risk was further increased by DHA levels of ≤5.70 µg/mL (OR=441.00, P=0.000) and EPA levels ≤3971.54 µg/mL (OR=441.00, P=0.000). CONCLUSIONS Since the average maternal DHA and EPA levels were significantly lower in patients with preterm births, adequate intake of omega-3 LCPUFA in early pregnancy and consistency with existing nutritional guidelines was associated with a lower risk of preterm delivery for pregnant women.
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Affiliation(s)
- Muhammad Alamsyah Aziz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Dini Hidayat
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Giritama Irwantoro
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Annisa Dewi Nugrahani
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Jeffri Januar Wijaya
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Siti Nadya Khairunissa Alamsyah
- Clinical Clerkship, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Nadia Larastri Almira
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Tjut Sutjighassani
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Dhanny Primantara Johari Santoso
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
| | - Sofie Rifayani Krisnadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Padjadjaran – Dr. Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia
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Aboagye RG, Okyere J, Seidu AA, Ahinkorah BO, Budu E, Yaya S. Does women's empowerment and socio-economic status predict adequacy of antenatal care in sub-Saharan Africa? Int Health 2024; 16:165-173. [PMID: 36916325 PMCID: PMC10911537 DOI: 10.1093/inthealth/ihad016] [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: 10/23/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Quality and adequate antenatal care (ANC) are key strategies necessary to achieve Sustainable Development Goal 3.1. However, in sub-Saharan Africa (SSA), there is a paucity of evidence on the role women's empowerment and socio-economic status play in ANC attendance. This study aimed to examine whether women's empowerment and socio-economic status predict the adequacy of ANC in SSA. METHODS Data from the recent Demographic and Health Surveys (DHSs) of 10 countries in SSA were used for the study. We included countries with a survey dataset compiled between 2018 and 2020. We included 57 265 women with complete observations on variables of interest in the study. Frequencies and percentages were used to summarize the results of the coverage of adequate ANC services across the 10 countries. A multivariable binary multilevel regression analysis was employed to examine the association between women's empowerment and socio-economic status indicators and the adequacy of ANC. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were used to present the findings of the regression analysis. RESULTS The average prevalence of adequate ANC in SSA was 10.4%. This ranged from 0.2% in Rwanda to 24.5% in Liberia. Women with medium (aOR 1.24 [CI 1.10 to 1.40]) and high (aOR 1.24 [CI 1.07 to 1.43]) decision-making power had higher odds of adequate ANC compared to those with low decision-making power. Women with higher levels of education (aOR 1.63 [CI 1.36 to 1.95]) as well as partners with higher education levels (aOR 1.34 [CI 1.14 to 1.56]) had the highest odds of adequate ANC compared to those with no formal education. Additionally, those working (aOR 1.35 [95% CI 1.23 to 1.49]) and those in the richest wealth category (aOR 2.29 [CI 1.90 to 2.76]) had higher odds of adequate ANC compared to those who are not working and those in the poorest wealth category. Those with high justification of violence against women (aOR 0.84 [CI 0.73 to 0.97]) had lower odds of adequate ANC compared to those with low justification of violence against women. CONCLUSIONS Adequacy of ANC was low across all 10 countries we included in this study. It is evident from the study that women's empowerment and socio-economic status significantly predicted the adequacy of ANC. As such, promoting women's empowerment programs without intensive improvements in women's socio-economic status would yield ineffective results. However, when women's empowerment programs are combined with active improvements in socio-economic status, then women will be encouraged to seek adequate ANC.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Faculty of Built and Natural Environment, Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Eugene Budu
- Research Unit, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana
| | - Sanni Yaya
- University of Parakou, Faculty of Medicine, Parakou, Benin
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
- George Institute for Global Health, Imperial College London, London, UK
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Saaka M, Sulley I. Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes. Ann Med 2023; 55:2197294. [PMID: 37092735 PMCID: PMC10128459 DOI: 10.1080/07853890.2023.2197294] [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: 09/14/2022] [Accepted: 03/26/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Poor quality and inadequate of antenatal care (ANC) visits during pregnancy may increase the risk of preventable adverse pregnancy outcomes. We tested the hypothesis that the adequacy of ANC utilization combined with quality of ANC services will reduce the risk of low birth weight (LBW) and preterm delivery (P T D) in the Tamale metropolis of Ghana. MATERIALS AND METHODS A facility-based analytical cross-sectional study was conducted on a sample of 553 postpartum women who had delivered within the last 12 months prior to the study. The overall utilization of ANC services was measured in terms of ANC timing, contacts, and content (TCC) of essential ANC services. The sample was drawn using systematic random sampling procedure. Primary data was collected from mothers by administering a structuredquestionnaire while the secondary data was extracted from individual records. RESULTS After controlling for confounders, women who had adhered to all WHO recommendations in terms of ANC timing, frequency and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83). CONCLUSION Individually and jointly, inadequate ANC contacts and content associatedsignificantly with preterm delivery than LBW.Key messagesLimited evidence exists on the joint effect of ANC services timing, contacts and content on adverse pregnancy outcomes.Total adherence to recommended ANC initiation, attendance and receipt of essential services had greater protection against PTD and LBW, compared to any single element/component of ANCWomen who had adequate overall ANC services utilization in terms of timing, contacts and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83).
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Affiliation(s)
- Mahama Saaka
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Issahaku Sulley
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Mina MN, Nuruzzaman M, Habib MN, Rahman M, Chowdhury FM, Ahsan SN, Ahmed FF, Azizi S, Mubin N, Kibria AHMG, Shuchi FA. The Effectiveness of Adequate Antenatal Care in Reducing Adverse Perinatal Outcomes: Evidence From a Low- or Middle-Income Country. Cureus 2023; 15:e51254. [PMID: 38283425 PMCID: PMC10822035 DOI: 10.7759/cureus.51254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Background and aim Antenatal care (ANC) is universally acknowledged as an essential intervention for enhancing the well-being of both mothers and children. The World Health Organization advises a minimum of four ANC visits. The objective of this study is to assess the effectiveness of adequate ANC in mitigating adverse perinatal outcomes. Methods This cross-sectional study was done at the Department of Obstetrics and Gynecology, Delta Medical College & Hospital, Bangladesh, from March 2023 to August 2023. A total of 226 mothers who gave birth at the hospital during this period were enrolled in the study. Results More than 87% of the participants received adequate (≥4 visits) antenatal care from a registered physician. More than 84% of the mothers gave birth via cesarean section. Among the mothers who received inadequate ANC, the proportion of adverse perinatal outcomes was higher (69.0%) than that of those who received adequate ANC (32.0%). A significant association (p<0.05) was noted between inadequate antenatal care and adverse perinatal outcomes. Pregnant women receiving adequate antenatal checkups were 79% less likely to experience adverse perinatal outcomes compared to those receiving inadequate ANC. Conclusion Adequate ANC is a very efficient and economical strategy for mitigating adverse perinatal outcomes.
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Affiliation(s)
| | - Mostafa Nuruzzaman
- Anaesthesia, Analgesia and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | | | - Mahin Rahman
- Obstetrics and Gynaecology, Delta Medical College & Hospital, Dhaka, BGD
| | - Faiza Mehrab Chowdhury
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Syeda Nafisa Ahsan
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Fabliha Fyrose Ahmed
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Shajeda Azizi
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Nazirum Mubin
- Radiotherapy, Dhaka Medical College Hospital, Dhaka, BGD
| | - A H M Golam Kibria
- Epidemiology and Biostatistics, Centre for Medical Research & Development (CMRD), Dhaka, BGD
| | - Ferdous Ara Shuchi
- Obstetrics and Gynaecology, Delta Medical College & Hospital, Dhaka, BGD
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Das S, Sagar S, Chowdhury S, Akter K, Haq MZ, Hanifi SMA. The risk of miscarriage is associated with ambient temperature: evidence from coastal Bangladesh. Front Public Health 2023; 11:1238275. [PMID: 38026421 PMCID: PMC10656765 DOI: 10.3389/fpubh.2023.1238275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Exposure to high ambient temperature is reported to cause adverse pregnancy outcomes. However, considering myriad temperature and climatic conditions as well as different contextual factors, the paucity of studies from the developing regions impedes the development of a clear understanding of the heat-pregnancy outcome relationship. Materials and methods This study was conducted in Chakaria, a coastal region of Bangladesh, where International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) administers a health and demographic surveillance system (HDSS). The surveillance workers visit the households every three months as a part of the routine surveillance activity. Between 2012 and 2020, the surveillance workers documented histories of 23,482 pregnancies among 13,376 women and the women were followed up for their pregnancy outcomes. The temperature records were obtained from the Bangladesh Meteorological Department's weather station at Cox's Bazar. The dates of pregnancy outcome were linked with the daily average temperature on the day of pregnancy outcome. A logistic regression model was employed to examine the relationship between temperature and the incidence of miscarriage. Results Out of 23,482 pregnancy outcomes, 3.7% were induced abortions. Among the remaining 22,624 pregnancy outcomes, 86.2% were live births, 10.7% were miscarriages and 3.1% were stillbirths. Miscarriages peaked between 8-14 weeks of gestation and varied according to temperature. For women exposed to temperatures between 28°C and 32°C, the risk of miscarriage was 25% greater (adjusted OR 1.25, 95% CI 1.07-1.47) compared to those exposed to temperatures from 16°C to 21°C. Conclusion The study establishes a connection between miscarriage and high ambient temperatures in a coastal region of Bangladesh. Implementing timely and appropriate adaptation strategies to prevent miscarriages is of paramount importance for a densely populated country like Bangladesh.
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Affiliation(s)
- Susmita Das
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Israel E, Abayneh S, Utalo D, Geta T, Kassaw T, Shonde T, Gebre M. Determinants of fetomaternal complication of instrumental vaginal delivery among women who gave childbirth in Southern Ethiopia: a facility-based cross-sectional study. BMC Res Notes 2023; 16:308. [PMID: 37919825 PMCID: PMC10623779 DOI: 10.1186/s13104-023-06583-w] [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: 04/25/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND In Ethiopia, one in five instrumental deliveries among women giving birth resulted in an unfavourable outcome. This study aimed to assess the determinants of feto-maternal complications of instrumental delivery in selected public hospitals of Gamo and Gofa zones, Southern Ethiopia. METHODS An institution-based cross-sectional study was conducted among 399 women attending selected public hospitals in the Gamo and Gofa zones. Data were collected using data extraction tools using a systematic random sampling technique. The collected data was entered into Epi-data version 3.1 and then analyzed using SPSS version 25. Logistic regression analysis was conducted to determine an association. RESULTS One hundred eighty-three (45.9%, n = 183/399) instrumental deliveries were found to be complicated. Primigravida women (AOR: 95% CI: 2.21 (1.35, 3.63), infant birth weight (AOR: 95% CI: 2.56 (1.37, 4.77), post-term pregnancy (AOR: 95% CI: 12.77 (2.92, 55.78), and maternal age (AOR: 95% CI: 7.00 (2.16, 22.64) were associated with fetomaternal complications in instrumental delivery among women who gave birth. CONCLUSIONS AND RECOMMENDATION A high proportion of women developed fetomaternal complications when compared to local studies. Promotion of antenatal care services, increasing women's education and empowerment as well as working on capacity building of health care professionals through education and training is cost-effective to reduce the occurrence of fetomaternal complications.
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Affiliation(s)
- Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Samuel Abayneh
- Department of Maternal and Child Health, Gofa Zone Health Department, Sawula, Ethiopia
| | - Dawit Utalo
- Departement of Public Health, Consortium Project at Women Empowerment Action with Amref Health Africa, Wolaita Sodo, Ethiopia
| | - Temesgen Geta
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tamirat Kassaw
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tamirayehu Shonde
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Merihun Gebre
- Department of Maternal and Child Health, Southern Ethiopia Regional Health Beurea, Jinka, Ethiopia
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Espinosa CA, Khan W, Khanam R, Das S, Khalid J, Pervin J, Kasaro MP, Contrepois K, Chang AL, Phongpreecha T, Michael B, Ellenberger M, Mehmood U, Hotwani A, Nizar A, Kabir F, Wong RJ, Becker M, Berson E, Culos A, De Francesco D, Mataraso S, Ravindra N, Thuraiappah M, Xenochristou M, Stelzer IA, Marić I, Dutta A, Raqib R, Ahmed S, Rahman S, Hasan ASMT, Ali SM, Juma MH, Rahman M, Aktar S, Deb S, Price JT, Wise PH, Winn VD, Druzin ML, Gibbs RS, Darmstadt GL, Murray JC, Stringer JSA, Gaudilliere B, Snyder MP, Angst MS, Rahman A, Baqui AH, Jehan F, Nisar MI, Vwalika B, Sazawal S, Shaw GM, Stevenson DK, Aghaeepour N. Multiomic signals associated with maternal epidemiological factors contributing to preterm birth in low- and middle-income countries. SCIENCE ADVANCES 2023; 9:eade7692. [PMID: 37224249 PMCID: PMC10208584 DOI: 10.1126/sciadv.ade7692] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/20/2023] [Indexed: 05/26/2023]
Abstract
Preterm birth (PTB) is the leading cause of death in children under five, yet comprehensive studies are hindered by its multiple complex etiologies. Epidemiological associations between PTB and maternal characteristics have been previously described. This work used multiomic profiling and multivariate modeling to investigate the biological signatures of these characteristics. Maternal covariates were collected during pregnancy from 13,841 pregnant women across five sites. Plasma samples from 231 participants were analyzed to generate proteomic, metabolomic, and lipidomic datasets. Machine learning models showed robust performance for the prediction of PTB (AUROC = 0.70), time-to-delivery (r = 0.65), maternal age (r = 0.59), gravidity (r = 0.56), and BMI (r = 0.81). Time-to-delivery biological correlates included fetal-associated proteins (e.g., ALPP, AFP, and PGF) and immune proteins (e.g., PD-L1, CCL28, and LIFR). Maternal age negatively correlated with collagen COL9A1, gravidity with endothelial NOS and inflammatory chemokine CXCL13, and BMI with leptin and structural protein FABP4. These results provide an integrated view of epidemiological factors associated with PTB and identify biological signatures of clinical covariates affecting this disease.
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Affiliation(s)
- Camilo A. Espinosa
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Waqasuddin Khan
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Rasheda Khanam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sayan Das
- Centre for Public Health Kinetics, New Delhi, Delhi, India
| | - Javairia Khalid
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Jesmin Pervin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Margaret P. Kasaro
- University of North Carolina Global Projects Zambia, Lusaka, Zambia
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kévin Contrepois
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Alan L. Chang
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Thanaphong Phongpreecha
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Basil Michael
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Mathew Ellenberger
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Usma Mehmood
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Ambreen Nizar
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Ronald J. Wong
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Martin Becker
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Eloise Berson
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Anthony Culos
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
- Department of Computer Science, Columbia University, New York, NY, USA
| | - Davide De Francesco
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Samson Mataraso
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Neal Ravindra
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Melan Thuraiappah
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Maria Xenochristou
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Ina A. Stelzer
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Ivana Marić
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Arup Dutta
- Centre for Public Health Kinetics, New Delhi, Delhi, India
| | - Rubhana Raqib
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | - Said M. Ali
- Public Health Laboratory—Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | - Mohamed H. Juma
- Public Health Laboratory—Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | - Monjur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shaki Aktar
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Saikat Deb
- Centre for Public Health Kinetics, New Delhi, Delhi, India
- Public Health Laboratory—Ivo de Carneri, Pemba, Zanzibar, Tanzania
| | - Joan T. Price
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
| | - Paul H. Wise
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Virginia D. Winn
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Maurice L. Druzin
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ronald S. Gibbs
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Gary L. Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Jeffrey S. A. Stringer
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Brice Gaudilliere
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael P. Snyder
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | - Martin S. Angst
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Anisur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Abdullah H. Baqui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fyezah Jehan
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Faculty of Health Sciences, Medical College, The Aga Khan University, Karachi, Pakistan
| | - Bellington Vwalika
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
| | - Sunil Sazawal
- Centre for Public Health Kinetics, New Delhi, Delhi, India
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - David K. Stevenson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
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10
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Girma N, Abdo M, Kalu S, Alemayehu A, Mulatu T, Hassen TA, Roba KT. Late initiation of antenatal care among pregnant women in Addis Ababa city, Ethiopia: a facility based cross-sectional study. BMC Womens Health 2023; 23:13. [PMID: 36627620 PMCID: PMC9832813 DOI: 10.1186/s12905-022-02148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/26/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Antenatal care (ANC) is the care given to pregnant women to prevent poor feto-maternal outcomes during pregnancy. The World Health Organization recommends first ANC visit be started as early as possible within in 12 weeks of gestation. Although there is improvement in overall ANC coverage, a sizable proportion of pregnant women in Ethiopia delay the time to initiate their first ANC visit. Therefore, this study aimed to investigate factors associated with late ANC initiation among pregnant women attending public health centers in Addis Ababa, Ethiopia. METHODS A facility-based cross-sectional study was conducted among 407 randomly selected pregnant women who attended ANC at selected public health centers in Addis Ababa from December 2020 to January 2021. Data were collected using pretested and structured questionnaires through a face-to-face interview and reviewing medical records. Binary and multivariable logistic regressions were fitted sequentially to identify predictors for late ANC initiation. Adjusted odds ratios with 95% CI were computed to measure the strength of associations and statistical significance was declared at a p-value < 0.05. RESULT This study showed that 47% of pregnant women started their first ANC visit late.The age of 30 years and above, being married, unplanned pregnancy, having a wrong perception about the timing of the first ANC visit, and not having ANC for previous pregnancy was significantly associated with late ANC initiation. CONCLUSION Nearly half of the women initiated their first ANC visit late. Tailored interventions aimed at promoting early ANC initiation should target married women, women with an unplanned pregnancy, women who perceived the wrong timing of their first ANC, and those who have no ANC for their previous pregnancy.
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Affiliation(s)
- Niguse Girma
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Meyrema Abdo
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Sultan Kalu
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Afework Alemayehu
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical science, Haramaya University, Harar, Ethiopia
| | - Teshale Mulatu
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical science, Haramaya University, Harar, Ethiopia
| | - Tahir Ahmed Hassen
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical science, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical science, Haramaya University, Harar, Ethiopia
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11
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Tesfay N, Hailu G, Woldeyohannes F. Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Front Pediatr 2023; 11:1120979. [PMID: 36824654 PMCID: PMC9941639 DOI: 10.3389/fped.2023.1120979] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Receiving at least four antenatal care (ANC) visits have paramount importance on the health of mothers and perinates. In Ethiopia, several studies were conducted on ANC service utilization; however, limited studies quantified the effect of care on maternal and perinate health. In response to this gap, this study is conducted to quantify the effect of optimal ANC care (≥4 visits) on maternal and perinatal health among women who received optimal care in comparison to women who did not receive optimal care. METHODS The study utilized the Ethiopian perinatal death surveillance and response (PDSR) system dataset. A total of 3,814 reviewed perinatal deaths were included in the study. Considering the nature of the data, preferential within propensity score matching (PWPSM) was performed to determine the effect of optimal ANC care on maternal and perinatal health. The effect of optimal care was reported using average treatment effects of the treated [ATT]. RESULT The result revealed that optimal ANC care had a positive effect on reducing perinatal death, due to respiratory and cardiovascular disorders, [ATT = -0.015, 95%CI (-0.029 to -0.001)] and extending intrauterine life by one week [ATT = 1.277, 95%CI: (0.563-1.991)]. While it's effect on maternal health includes, avoiding the risk of having uterine rupture [ATT = -0.012, 95%CI: (-0.018 to -0.005)], improving the utilization of operative vaginal delivery (OVD) [ATT = 0.032, 95%CI: (0.001-0.062)] and avoiding delay to decide to seek care [ATT = -0.187, 95%CI: (-0.354 to -0.021)]. CONCLUSION Obtaining optimal ANC care has a positive effect on both maternal and perinatal health. Therefore, policies and interventions geared towards improving the coverage and quality of ANC services should be the top priority to maximize the benefit of the care.
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Affiliation(s)
- Neamin Tesfay
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Girmay Hailu
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fitsum Woldeyohannes
- Health Financing Department, Clinton Health Access Initiative, Addis Ababa, Ethiopia
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12
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Roro M, Deressa W, Lindtjørn B. Antenatal care utilization and compliance with national and WHO guidelines in rural Ethiopia: a cohort study. BMC Pregnancy Childbirth 2022; 22:849. [PMID: 36397014 PMCID: PMC9670428 DOI: 10.1186/s12884-022-05171-3] [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: 08/23/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Antenatal health care utilization has the potential to influence maternal and new-born health. In this study, we assessed compliance of antenatal care utilization with national and World Health Organization (WHO) guidelines. We also examined association of antenatal care utilization with adverse pregnancy outcomes as secondary outcome. METHODS This was a community-based cross sectional study conducted from July 2016 to November 2017 in rural south-central Ethiopia. We described antenatal care received by pregnant women, whom we followed at three prescheduled visits during pregnancy and collected birth data at time of delivery. Extent of antenatal care content received, timing of antenatal care, place of antenatal care and place and mode of delivery were obtained and computed in accordance with national and WHO guidelines. For adverse pregnancy outcomes, computed as sum of low birth weight, preterm birth, intrauterine foetal death, and stillbirth, the exposure variable used was antenatal care utilization. RESULTS Seven hundred and four (704) women participated in the study, and 536 (76.1%) had attended at least one antenatal care visit. Among women who attended antenatal care visit, majority, 421 (79.3%), had done so at health centres and hospitals, while 110 (20.7%) attended at health post. Average number of antenatal care visits was 2.5, which is less than that recommended in national and WHO guidelines. Only 18 (2.6%) women had attended antenatal care in their first trimester, which is low in contrast to the expected 100% specified in the guidelines. Less than half (47%) of the women delivered in a health facility. This is in contrast to the 100% expected health institution deliveries. Low birth weight was 7.9% (n = 48), and preterm birth was 4.9% (n = 31). There were 12 twin pregnancies, three stillbirths, 11 spontaneous abortions, and two intrauterine foetal deaths. We did not find significant association between adverse pregnancy outcomes and antenatal care utilization (COR = 1.07, 95% CI 0.62, 1.86). CONCLUSION This study showed that antenatal care service utilization in the study area was markedly low compared to that recommended in national and WHO guidelines. The obtained antenatal health care utilization was not associated with the registered adverse pregnancy outcomes.
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Affiliation(s)
- Meselech Roro
- Centre for International Health, University of Bergen, Bergen, Norway.
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bernt Lindtjørn
- Centre for International Health, University of Bergen, Bergen, Norway
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13
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Hossain MA, Al Mamun ASM, Aik S, Karim MR, Zeshan MHL, Sabiruzzaman M, Islam MS, Ahmed S, Hossain MG. Preterm delivery and its associated factors among mothers in Bangladesh: survey in Rajshahi district. BMJ Open 2022; 12:e061920. [PMID: 36216425 PMCID: PMC9557306 DOI: 10.1136/bmjopen-2022-061920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Preterm delivery (PD) is a worldwide health burden particularly in low-income and middle-income countries such as Bangladesh. It is a key indicator of neonatal mortality and a risk of morbidity in later life. This study aimed to determine the prevalence of PD and its associated factors among mothers in Northern region of Bangladesh. SETTING AND PARTICIPANTS Multistage sampling technique was used to select samples covering all the population from 9 Upazilas in Rajshahi district with 233 community clinics. A total of 540 mothers and their under-5 children were enrolled for the study. Descriptive statistics, χ2 test and logistic regression model were used to analyse the data. RESULTS Among all live births, the prevalence of PD was found to be 14.6%. Multiple binary logistic regression model suggested five factors of PD: (1) mothers who used contraceptive pill had lower chance of PD (p<0.05); (2) mothers with high fever during pregnancy period were more likely to have PD (p<0.05); (3) mothers who did not receive antenatal care service less than four times during pregnancy period had higher chance of PD (p<0.01); (4) mothers first married before 18 years who were more likely to have PD (p<0.01); (5) PD delivered mothers had more chance to get low birth weight children (p<0.05). In addition, unadjusted model demonstrated that mothers delivered first baby before their age<20 years were more risk to get PD (p<0.05). CONCLUSION Approximately one in seven infants was born preterm in our study area. Family planning method, number of antenatal care visit, mothers' age at marriage and high fever during pregnancy were the most important predictors of PD, these factors could be considered to reduce PD among Bangladeshi mothers. PD risk could be reduced by counselling and encouraging women to take antenatal care facilities from trained health providers.
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Affiliation(s)
- Md Aslam Hossain
- Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Abu Sayed M Al Mamun
- Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Saw Aik
- Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Md Reazul Karim
- Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | | | - Md Sabiruzzaman
- Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Shariful Islam
- Department of Public Health, First Capital University of the Bangladesh, Chuadanga 7200, Bangladesh
| | - Sharmin Ahmed
- Specialist, Quality Assurance, Communicable Diseases Program, BRAC, Mohakhali, Dhaka 1212, Bangladesh
| | - Md Golam Hossain
- Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh
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14
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Liu XC, Strodl E, Huang LH, Lu Q, Liang Y, Chen WQ. First Trimester of Pregnancy as the Sensitive Period for the Association between Prenatal Mosquito Coil Smoke Exposure and Preterm Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11771. [PMID: 36142044 PMCID: PMC9517152 DOI: 10.3390/ijerph191811771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Mosquito coils are efficient mosquito repellents and mosquito coil smoke (MCS) contributes to indoor air pollution. However, no prior population-based study has investigated whether prenatal MCS exposure is a risk factor for preterm birth (PTB) and whether exposure to MCS in different trimesters of pregnancy is associated with different levels of risk. The sample involved 66,503 mother-child dyads. Logistic regression models were used to examine the relationships between prenatal MCS exposure during different trimesters of pregnancy and PTB. We found that prenatal MCS exposure was associated with a greater likelihood of PTB (OR = 1.12, 95%CI: 1.05-1.20). The prenatal MCS exposure during the first trimester was associated with 1.17 (95%CI: 1.09-1.25) times the odds of being PTB, which was higher than exposure during the second trimester (OR = 1.11, 95%CI: 1.03-1.19) and during the third trimester (OR = 1.08, 95%CI: 1.01-1.16). In the stratified analysis, prenatal MCS exposure significantly increased PTB risk among girls but not among boys. Our results indicated that maternal MCS exposure during pregnancy was associated with PTB and that the first trimester might be the sensitive period. In light of these findings, public health interventions are needed to reduce prenatal exposure to MCS, particularly during the first trimester of pregnancy.
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Affiliation(s)
- Xin-Chen Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Li-Hua Huang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qing Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yang Liang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- School of Health, Xinhua College of Guangzhou, Guangzhou 510080, China
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15
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Hakim S, Chowdhury MAB, Ahmed Z, Uddin MJ. Are Bangladeshi healthcare facilities prepared to provide antenatal care services? Evidence from two nationally representative surveys. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000164. [PMID: 36962302 PMCID: PMC10021659 DOI: 10.1371/journal.pgph.0000164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/17/2022] [Indexed: 06/18/2023]
Abstract
Identifying high-risk pregnancies through antenatal care (ANC) is considered the cornerstone to eliminating child deaths and improving maternal health globally. Understanding the factors that influence a healthcare facility's (HCF) preparedness to provide ANC service is essential for assisting maternal and newborn health system progress. We aimed to evaluate the preparedness of HCFs to offer ANC services among childbearing women in Bangladesh and investigate the facility characteristics linked to the preparedness. The data for this study came from two waves of the Bangladesh Health Facilities Survey (BHFS), conducted in 2014 and 2017 using a stratified random sample of facilities. The study samples were 1,508 and 1,506 HCFs from the 2014 and 2017 BHFS, respectively. The outcome variable "ANC services preparedness" was calculated as an index score using a group of tracer indicators. Multinomial logistic regression models were used to identify the significant correlates of ANC service preparedness. We found that private hospitals had a lower chance of having high preparedness than district and upazila public facilities in 2014 (RRR = 0.04, 95% CI: 0.01-0.22, p-value = <0.001) and 2017 (RRR = 0.23, 95% CI: 0.07-0.74, p-value = 0.01), respectively. HCFs from the Khulna division had a 2.84 (RRR = 2.84, CI: 1.25-6.43, p-value = 0.01) and 3.51 (RRR = 3.51, CI: 1.49-8.27, p-value = <0.001) higher likelihood of having medium and high preparedness, respectively, for ANC service compared to the facilities in the Dhaka division in 2017. The facilities that had a medium infection prevention score were 3.10 times (RRR = 3.10, 95% CI: 1.65-5.82; p-value = <0.001) and 1.89 times (RRR = 1.89, 95% CI: 1.09-3.26, p-value = 0.02) more likely to have high preparedness compared to those facilities that had a low infection prevention score in 2014 and 2017 respectively. Facilities without visual aids for client education on pregnancy and ANC were less likely to have high (RRR = 0.29, 95% CI: 0.16-0.53, p-value = <0.001) and (RRR = 0.55, 95% CI: 0.30-0.99, p-value = 0.04) preparedness, respectively, than those with visual aids for client education on pregnancy and ANC in both the surveys. At all two survey time points, facilities that did not maintain individual client cards or records for ANC clients were less likely to have high (RRR = 0.53, 95% CI: 0.31-.92, p-value = 0.02) and (RRR = 0.41, 95% CI: 0.25-0.66, p-value = <0.001) preparedness, respectively, compared to their counterparts. We conclude that most facilities lack adequate indicators for ANC service preparedness. To improve the readiness of ANC services, government authorities could focus on union-level facilities, community clinics, private facilities, and administrative divisions. They could also make sure that infection control items are available, maintain individual client cards or records for ANC clients, and also ensure ANC clients have access to visual aids.
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Affiliation(s)
- Shariful Hakim
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Chander Hat Degree College, Nilphamari, Bangladesh
| | | | - Zobayer Ahmed
- Department of Economics, Selcuk University, Selçuklu, Turkey
- Department of Economics & Banking, International Islamic University Chittagong, Kumira, Bangladesh
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh
- Department of General Educational and Development, Daffodil International University, Dhaka, Bangladesh
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Okui T, Nakashima N. Analysis of differences in preterm birth rate depending on household occupation in Japan from 2007 to 2019. J Prev Med Public Health 2022; 55:371-378. [PMID: 35940192 PMCID: PMC9371782 DOI: 10.3961/jpmph.22.178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/03/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Díaz-Rodríguez A, Feliz-Matos L, Ruiz Matuk CB. Risk factors associated with preterm birth in the Dominican Republic: a case-control study. BMJ Open 2021; 11:e045399. [PMID: 34933854 PMCID: PMC8693088 DOI: 10.1136/bmjopen-2020-045399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 10/28/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic. DESIGN Case-control study. SETTINGS Seven National Reference Hospitals from different regions of the Dominican Republic. PARTICIPANTS A probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1 =0.5, P2 =0.6, and β=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports. PRIMARY OUTCOME MEASURES A protocol was created to obtain maternal and obstetric information. RESULTS The main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=-10.294, p<0.001). CONCLUSION Maternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.
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Pervin J, Venkateswaran M, Nu UT, Rahman M, O’Donnell BF, Friberg IK, Rahman A, Frøen JF. Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh. PLoS One 2021; 16:e0257782. [PMID: 34582490 PMCID: PMC8478219 DOI: 10.1371/journal.pone.0257782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. METHODS This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). RESULTS Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05-2.19); nulliparity (AOR: 1.30, 95% CI: 1.04-1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09-1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18-1.89). Facility deliveries were associated with woman's age; parity; education; the husband's education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. CONCLUSIONS The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. CLINICAL TRIAL REGISTRATION ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.
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Affiliation(s)
- Jesmin Pervin
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- University of Bergen, Bergen, Norway
| | - Mahima Venkateswaran
- University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - U. Tin Nu
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Monjur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Ingrid K. Friberg
- Norwegian Institute of Public Health, Oslo, Norway
- Tacoma-Pierce County Health Department, Tacoma, WA, United States of America
| | - Anisur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - J. Frederik Frøen
- University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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Yaya S, Odusina EK, Adjei NK, Uthman OA. Association between intimate partner violence during pregnancy and risk of preterm birth. BMC Public Health 2021; 21:1610. [PMID: 34479527 PMCID: PMC8414853 DOI: 10.1186/s12889-021-11625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background Preterm birth is a risk factor for child survival in both the short and long term. In Zimbabwe, the prevalence of preterm birth is rising, and there are growing concerns about the adverse consequences. This study explored the association between intimate partner violence (IPV) during pregnancy and preterm birth in Zimbabwe. Methods Using data from the 2015 Zimbabwe Demographic and Health Survey, we applied propensity score matching to estimate the effect of IPV during pregnancy on preterm birth among women of reproductive age (15–49 years). A total of 4833 pregnant women who gave birth during the five years preceding the survey were analysed. Results We successfully matched 79 women who were exposed to IPV during pregnancy to 372 unexposed during pregnancy. Using the matched sample, the probability of preterm delivery was significantly higher among women who were exposed to IPV during pregnancy than those who were not exposed. The findings showed that 7 out of 79 (8.9%) of women exposed to IPV during pregnancy experienced preterm delivery, and 11 out of 372 (3.0%) of those who were not exposed to IPV during pregnancy experienced preterm delivery. In the urban areas, those exposed to IPV during pregnancy were almost five times more likely to experience preterm delivery (OR = 4.8, 95% CI 2.0–11.6), but the association was not significantly different among women in rural areas. Conclusion The findings showed that women exposed to IPV during pregnancy were at increased risk of preterm birth. Some of the risk factors associated with IPV were urban residence, low economic status and unemployment. Effective policies and programmes are required to address the issue of IPV in Zimbabwe.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
| | | | - Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Olalekan A Uthman
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Schmidt CN, Butrick E, Musange S, Mulindahabi N, Walker D. Towards stronger antenatal care: Understanding predictors of late presentation to antenatal services and implications for obstetric risk management in Rwanda. PLoS One 2021; 16:e0256415. [PMID: 34432829 PMCID: PMC8386859 DOI: 10.1371/journal.pone.0256415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/03/2021] [Indexed: 12/03/2022] Open
Abstract
Background Early antenatal care (ANC) reduces maternal and neonatal morbidity and mortality through identification of pregnancy-related complications, yet 44% of Rwandan women present to ANC after 16 weeks gestational age (GA). The objective of this study was to identify factors associated with delayed initiation of ANC and describe differences in the obstetric risks identified at the first ANC visit (ANC-1) between women presenting early and late to care. Methods This secondary data analysis included 10,231 women presenting for ANC-1 across 18 health centers in Rwanda (May 2017-December 2018). Multivariable logistic regression models were constructed using backwards elimination to identify predictors of presentation to ANC at ≥16 and ≥24 weeks GA. Logistic regression was used to examine differences in obstetric risk factors identified at ANC-1 between women presenting before and after 16- and 24-weeks GA. Results Sixty-one percent of women presented to ANC at ≥16 weeks and 24.7% at ≥24 weeks GA, with a mean (SD) GA at presentation of 18.9 (6.9) weeks. Younger age (16 weeks: OR = 1.36, 95% CI: 1.06, 1.75; 24 weeks: OR = 1.33, 95% CI: 0.95, 1.85), higher parity (16 weeks: 1–4 births, OR = 1.55, 95% CI: 1.39, 1.72; five or more births, OR = 2.57, 95% CI: 2.17, 3.04; 24 weeks: 1–4 births, OR = 1.93, 95% CI: 1.78, 2.09; five or more births, OR = 3.20, 95% CI: 2.66, 3.85), lower educational attainment (16 weeks: primary, OR = 0.75, 95% CI: 0.65, 0.86; secondary, OR = 0.60, 95% CI: 0.47,0.76; university, OR = 0.48, 95% CI: 0.33, 0.70; 24 weeks: primary, OR = 0.64, 95% CI: 0.53, 0.77; secondary, OR = 0.43, 95% CI: 0.29, 0.63; university, OR = 0.12, 95% CI: 0.04, 0.32) and contributing to household income (16 weeks: OR = 1.78, 95% CI: 1.40, 2.25; 24 weeks: OR = 1.91, 95% CI: 1.42, 2.55) were associated with delayed ANC-1 (≥16 and ≥24 weeks GA). History of a spontaneous abortion (16 weeks: OR = 0.74, 95% CI: 0.66, 0.84; 24 weeks: OR = 0.70, 95% CI: 0.58, 0.84), pregnancy testing (16 weeks: OR = 0.48, 95% CI: 0.33, 0.71; 24 weeks: OR = 0.41, 95% CI: 0.27, 0.61; 24 weeks) and residing in the same district (16 weeks: OR = 1.55, 95% CI: 1.08, 2.22; 24 weeks: OR = 1.73, 95% CI: 1.04, 2.87) or catchment area (16 weeks: OR = 1.53, 95% CI: 1.05, 2.23; 24 weeks: OR = 1.84, 95% CI: 1.28, 2.66; 24 weeks) as the health facility were protective against delayed ANC-1. Women with a prior preterm (OR, 0.71, 95% CI, 0.53, 0.95) or low birthweight delivery (OR, 0.72, 95% CI, 0.55, 0.95) were less likely to initiate ANC after 16 weeks. Women with no obstetric history were more likely to present after 16 weeks GA (OR, 1.18, 95% CI, 1.06, 1.32). Conclusion This study identified multiple predictors of delayed ANC-1. Focusing existing Community Health Worker outreach efforts on the populations at greatest risk of delaying care and expanding access to home pregnancy testing may improve early care attendance. While women presenting late to care were less likely to present without an identified obstetric risk factor, lower than expected rates were identified in the study population overall. Health centers may benefit from provider training and standardized screening protocols to improve identification of obstetric risk factors at ANC-1.
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Affiliation(s)
- Christina N Schmidt
- School of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Elizabeth Butrick
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Sabine Musange
- School of Public Health, National University of Rwanda, Kigali, Rwanda
| | | | - Dilys Walker
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America.,Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
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Anik AI, Islam MR, Rahman MS. Do women's empowerment and socioeconomic status predict the adequacy of antenatal care? A cross-sectional study in five South Asian countries. BMJ Open 2021; 11:e043940. [PMID: 34083327 PMCID: PMC8183191 DOI: 10.1136/bmjopen-2020-043940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 05/19/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Relative to the attention given to improving the measurement of adequacy of antenatal care (ANC) in South Asian (SA) region, the influence of women's empowerment and socioeconomic status (WESES) on adequate ANC services has hardly received any attention. This study aimed to investigate the present scenario of adequacy of ANC in SA and how its adequacy was associated with WESES. SETTING AND PARTICIPANTS Using the Demographic and Health Survey data set of five SA countries, that is, Afghanistan, Bangladesh, India, Nepal and Pakistan, 48 107 women were selected in this study who received at least one ANC component and had at least one live birth in the 3 or 5 years preceding the survey. ANALYSIS Multilevel logistic regression models were used to investigate the relationship between adequacy of ANC and WESES. RESULTS Only 30% women received adequate ANC in SA, ranging from 8.4% (95% CI 7.1% to 9.9%) in Afghanistan to 39.8% (95% CI 37.4% to 42.2%) in Nepal. The poor utilisation of adequate ANC services was most prevalent among the women residing in rural areas and that of poor families as well as low empowerment status in SA countries. Different levels of WESES, that is, highly empowered but poor (adjusted OR (AOR): 1.33; 95% CI 1.18 to 1.49), lowly empowered but rich (AOR: 2.07; 95% CI 1.84 to 2.32) and highly empowered and rich women (AOR: 3.07; 95% CI 2.75 to 3.43), showed significant positive association with adequate ANC services than the poor and low empowered women, after adjusting the potential covariates. CONCLUSION As unsatisfactory level of adequate ANC services has been observed in SA region, this study suggests a nationwide comprehensive improvement of women's empowerment status as well as establishment of necessary healthcare centres in remote areas is essential to ensure long-term and sustainable adequacy of ANC services.
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Affiliation(s)
- Asibul Islam Anik
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Md Rashedul Islam
- Department of Global Health Policy, Faculty of Medicine, The University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Division of Prevention, Center for Public Health Science, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Md Shafiur Rahman
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan
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Lin L, Lu C, Chen W, Li C, Guo VY. Parity and the risks of adverse birth outcomes: a retrospective study among Chinese. BMC Pregnancy Childbirth 2021; 21:257. [PMID: 33771125 PMCID: PMC8004392 DOI: 10.1186/s12884-021-03718-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Nulliparity is considered to be a risk factor of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). With the new two-child policy launched in 2016, more Chinese women have delivered their 2nd baby. Yet few studies have assessed the impact of parity on adverse birth outcomes in China. This study aimed to examine the association between parity and risks of PTB, LBW and SGA in a Chinese population. The combined effects of maternal age and parity on adverse birth outcomes were also assessed. Methods This retrospective study included all non-malformed live births born during January 1, 2014 and December 31, 2018 in Chengdu, China. A total of 746,410 eligible live singletons with complete information were included in the analysis. Parity was classified into nulliparity (i.e. has never delivered a newborn before) and multiparity (i.e. has delivered at least one newborn before). Log-binomial regression analyses were applied to evaluate the association between parity and PTB, LBW and SGA. We further divided maternal age into different groups (< 25 years, 25–29 years, 30–34 years and ≥ 35 years) to assess the combined effects of maternal age and parity on adverse birth outcomes. Results Multiparity was associated with reduced risks of PTB (aRR = 0.91, 95% CI: 0.89–0.93), LBW (aRR = 0.74, 95% CI: 0.72–0.77) and SGA (aRR = 0.67, 95% CI: 0.66–0.69) compared with nulliparity. In each age group, we observed that multiparity was associated with lower risks of adverse birth outcomes. Compared to nulliparous women aged between 25 and 29 years, women aged ≥35 years had greater risks of PTB and LBW, regardless of their parity status. In contrast, multiparous women aged ≥35 years (aRR = 0.73, 95% CI: 0.70–0.77) and those aged < 25 years (aRR = 0.88, 95% CI: 0.84–0.93) were at lower risk of SGA compared with nulliparous women aged between 25 and 29 years. Conclusion Multiparity was associated with lower risks of all adverse birth outcomes. Special attention should be paid to nulliparous mothers and those with advanced age during antenatal care, in order to reduce the risks of adverse birth outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03718-4.
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Affiliation(s)
- Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Ciyong Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Chunrong Li
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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Udoh MME, Nkanga E, Agweye C, Etim B, Ochigbo S, Nkanga D, Udoh J, Asam-Utiin K. Retinopathy of prematurity in the University of Calabar Teaching Hospital, Calabar, Nigeria: An early report of a screening service. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2021; 11:6-12. [PMID: 36132975 PMCID: PMC9484501 DOI: 10.4103/jwas.jwas_62_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/07/2022] [Indexed: 11/04/2022]
Abstract
Background: Aims/Objectives: Design of Study: Settings: Materials and Methods: Results: Conclusion:
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