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Belay S, Astatkie A, Hinderaker SG. Birth weight was associated with maternal exposure to intimate partner violence during pregnancy in southern Ethiopia: A prospective cohort study. Front Public Health 2022; 10:960443. [PMID: 36407992 PMCID: PMC9667023 DOI: 10.3389/fpubh.2022.960443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Birth weight is defined as the first weight of the newborn, ideally measured soon after birth. A recent Ethiopian survey estimated that 48% of births took place in health facilities. Data for women exposed to intimate partner violence (IPV) may be lacking in official statistics because these women may prefer to deliver at home, where data from non-institutional births, including reporting of birth weights, are not routinely recorded. Objective The aim of this study was to investigate the association between maternal exposure to IPV during pregnancy and birth weight in a community in the Wondo Genet district of southern Ethiopia. Methods We carried out a community-based prospective cohort study from February to December 2017. We followed up with 505 pregnant women and their newborns until after delivery. An interview about partner violence was done during pregnancy at home when enrolled. Field assistants who visited the homes measured the birth weight of each baby in grams. Twins and late birth weight measurements were excluded. Factors associated with birth weight were assessed by multiple linear regression. Results Birth weight was assessed within 48 h for 477 (94.5%) newborns and between 48 and 72 h for an additional 28 (5.5%). There were 365 (72.3%) institutional deliveries. In an adjusted regression analysis (IPV adjusted for socio-economic status), birth weight was 203 g lower (B -203 95% CI -320 to -87) among newborns of women exposed to IPV than among the unexposed. Birth weight was also lower in girls than in boys, in newborns delivered at home rather than in a health facility, and in babies with a younger gestational age. Conclusion Maternal exposure to IPV during pregnancy was associated with lower baby birth weights. Antenatal clinics should consider routinely identifying IPV-exposed women, and identifying babies with lower birth weights at home is an important indicator.
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Affiliation(s)
- Sewhareg Belay
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia,Centre for International Health, University of Bergen, Bergen, Norway,*Correspondence: Sewhareg Belay
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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2
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Duong DTT, Binns C, Lee A, Zhao Y, Pham NM, Hoa DTP, Ha BTT. Intention to Exclusively Breastfeed Is Associated with Lower Rates of Cesarean Section for Nonmedical Reasons in a Cohort of Mothers in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020884. [PMID: 35055705 PMCID: PMC8776101 DOI: 10.3390/ijerph19020884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
Abstract
Background: Breastfeeding brings benefits to both mothers and children in the short term and long term. Unnecessary cesarean sections can bring risks to both parties. This study was undertaken to examine the relationship between exclusive breastfeeding intention and cesarean delivery. Methods: We analyzed data collected from 554 single mothers who delivered in Dong Anh General District Hospital or Hanoi Obstetrics and Gynecology Hospital, Vietnam, in 2020–2021. The relationship between exclusive breastfeeding intention and cesarean delivery for nonmedical reasons was adjusted for maternal education, maternal age, parity, history of fetal loss, having at least eight antenatal contacts, hospital of delivery, child sex, and birth weight. Results: Antenatally, 34.8% (184/529) of mothers intended to breastfeed exclusively until 6 months and 30.8% (84/274) underwent cesarean section for a nonmedical reason. After adjusting for other factors, mothers who intended to breastfeed exclusively until 6 months were less likely to undergo cesarean delivery for nonmedical reasons (OR = 0.55, 95% CI: 0.31–0.96, p = 0.034). Conclusions: This study adds to the growing evidence related to unnecessary cesarean sections and routine over-medicalization of normal birth in the urban areas of Vietnam. The association between breastfeeding intentions and a lower rate of cesarean section suggests that education on breastfeeding could be a useful intervention for reducing the rate of cesarean sections and improving maternal and child health.
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Affiliation(s)
- Doan Thi Thuy Duong
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Colin Binns
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Andy Lee
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Yun Zhao
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Ngoc Minh Pham
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam
| | - Dinh Thi Phuong Hoa
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Bui Thi Thu Ha
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
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3
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Takegata M, Ronsmans C, Nguyen HAT, Kitamura N, Iwasaki C, Toizumi M, Moriuchi H, Dang DA, Yoshida LM. Socio-demographic factors of cesarean births in Nha Trang city, Vietnam: a community-based survey. Trop Med Health 2020; 48:57. [PMID: 32669947 PMCID: PMC7350841 DOI: 10.1186/s41182-020-00239-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/11/2020] [Indexed: 11/10/2022] Open
Abstract
Background The cesarean section rate in Vietnam has been increasing especially in urban area. However, limited evidence identified regarding socio-demographic factors of the cesarean section birth. The objective of this study was to determine the current cesarean birth rate and the associated socio-demographic factors among mothers in Nha Trang city, south-central Vietnam. Methods A community-based cross-sectional study was conducted between October and November in 2016 as part of a Streptococcus pneumoniae carriage survey conducted in 27 communes of Nha Trang city. From each commune, 120 mothers and their children less than 2 years old were randomly selected. Mothers were asked to answer standardized questions regarding socio-demographic information and mode of birth. Multivariate logistic regression was adopted to examine associations between socio-demographic variables and mode of birth. Results Of 3148 participants, the number of cesarean births was 1396 (44.3 %). Older maternal age (≥ 30 years old), having another child going to school or kindergarten, monthly income more than 644 USD, gestational weeks at birth over 42 weeks, and low (< 2500 g) or high (≥ 3500 g) birth weight were associated with higher likelihood of cesarean births. Conclusion The CS rate obtained in this study was more than twice of what is recommended by the World Health Organization, which is consistent with the previous nation-wide study in Viet Nam. Further monitoring is suggested to examine the non-medical reason for the increased CS rate.
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Affiliation(s)
- Mizuki Takegata
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Carine Ronsmans
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT UK
| | - Hien Anh T Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, 100000 Vietnam
| | - Noriko Kitamura
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Chihiro Iwasaki
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Hospital, Nagasaki, 852-8523 Japan
| | - Duc Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, 100000 Vietnam
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
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4
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Nga HT, Quyen PN, Chaffee BW, Diep Anh NT, Ngu T, King JC. Effect of a nutrient-rich, food-based supplement given to rural Vietnamese mothers prior to and/or during pregnancy on birth outcomes: A randomized controlled trial. PLoS One 2020; 15:e0232197. [PMID: 32469870 PMCID: PMC7259625 DOI: 10.1371/journal.pone.0232197] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 04/08/2020] [Indexed: 12/31/2022] Open
Abstract
Obtaining a nutrient-rich diet during pregnancy is a challenge for pregnant women living in low-income countries. This randomized, controlled trial was designed to determine if a freshly prepared food supplement from local animal-source foods and dark-green leafy vegetables given prior to and/or during pregnancy improved birth outcomes in rural Vietnamese women. Primiparous women, 18 to 30 years of age, who participated in the study were assigned to one of three groups: PC-T women received the supplement from pre-conception to term, MG-T women received the supplement from mid-gestation to term, and the RPC women received routine prenatal care. Supplement intake was observed and quantified. Infant anthropometry was measured at birth and/or within seven days of delivery. The effect of the intervention on maternal and birth outcomes was determined using linear regression modeling. Of the 460 women enrolled in the study, 317 women completed the study. Those not completing the study had either moved from the area, did not conceive within 12 months of study enrollment, or miscarried. The food-based supplement increased protein, iron, zinc, folate, vitamin A and B12 intakes in the PC-T and the MG-T groups. However, it failed to alter infant anthropometric measurements at birth. In the entire cohort, maternal gestational weight gain was greater in women with a low pre-pregnancy BMI (<18.5) and in women with a higher educational attainment. Working as a farmer reduced gestational weight gain but it did not affect birth weight or length. In summary, a nutrient-rich, food-based supplement given to rural Vietnamese women from pre-conception to term or mid-gestation to term did not affect maternal or infant outcomes. The low weight gains, possibly due to demanding farm work done throughout the reproductive cycle, may have obviated any effects of the low energy, nutrient-rich food supplement on birth outcomes. Trial registration : Registered Clinical Trials.gov: NCT01235767.
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Affiliation(s)
| | | | - Benjamin W. Chaffee
- University of California San Francisco, San Francisco, CA, United States of America
| | | | - Tu Ngu
- National Institute of Nutrition, Hanoi, Vietnam
| | - Janet C. King
- Children’s Hospital Oakland Research Institute, Oakland, CA, United States of America
- * E-mail:
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5
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Silvestrin S, Hirakata VN, da Silva CH, Goldani MZ. Inequalities in birth weight and maternal education: a time-series study from 1996 to 2013 in Brazil. Sci Rep 2020; 10:8707. [PMID: 32457367 PMCID: PMC7251127 DOI: 10.1038/s41598-020-65445-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/30/2020] [Indexed: 11/20/2022] Open
Abstract
Maternal education represents one of the most important social determinants of inequality in birth weight (BW) in developing countries. The present study sought to investigate secular trends in health inequality considering the difference in mean BW between extremes of maternal educational attainment in Brazil. Using a time-series design, data from 6,452,551 live births which occurred in all Brazilian state capitals from 1996 to 2013 were obtained from the Information System on Live Births. Secular trends of the difference in mean birth weight between low (<8 years of schooling) and high (≥12 years of schooling) educational attainment were analyzed. The main finding was that differences in mean birth weight between the two extremes of maternal educational attainment decreased over time. There was a significant decrease in mean BW in neonates born to mothers with higher educational attainment, and a slight increase in those born to mothers with lower educational attainment. One of the key factors involved in decreasing inequality was an increase in the number of antenatal visits. In view of these results, we conclude, that despite a slight increase of mean birth weight among mothers with low education, the reduction of inequality in pregnancy outcomes over time in Brazil is attributable to a worsening scenario for mothers who are better off rather than to improvements for the most vulnerable group of mothers.
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Affiliation(s)
- Sonia Silvestrin
- Technical Area for Child and Adolescent Health, Porto Alegre Municipal Health Department, Porto Alegre, RS, 90040-971, Brazil
| | - Vânia Naomi Hirakata
- Research and Graduate Studies Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil
| | - Clécio Homrich da Silva
- Research and Graduate Studies Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil. .,Department of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, RS, 90035-003, Brazil.
| | - Marcelo Zubaran Goldani
- Research and Graduate Studies Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, 90035-007, Brazil.,Department of Pediatrics, Federal University of Rio Grande do Sul, Porto Alegre, RS, 90035-003, Brazil
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6
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Wells JCK, Stock JT. Life History Transitions at the Origins of Agriculture: A Model for Understanding How Niche Construction Impacts Human Growth, Demography and Health. Front Endocrinol (Lausanne) 2020; 11:325. [PMID: 32508752 PMCID: PMC7253633 DOI: 10.3389/fendo.2020.00325] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/27/2020] [Indexed: 12/18/2022] Open
Abstract
Over recent millennia, human populations have regularly reconstructed their subsistence niches, changing both how they obtain food and the conditions in which they live. For example, over the last 12,000 years the vast majority of human populations shifted from foraging to practicing different forms of agriculture. The shift to farming is widely understood to have impacted several aspects of human demography and biology, including mortality risk, population growth, adult body size, and physical markers of health. However, these trends have not been integrated within an over-arching conceptual framework, and there is poor understanding of why populations tended to increase in population size during periods when markers of health deteriorated. Here, we offer a novel conceptual approach based on evolutionary life history theory. This theory assumes that energy availability is finite and must be allocated in competition between the functions of maintenance, growth, reproduction, and defence. In any given environment, and at any given stage during the life-course, natural selection favours energy allocation strategies that maximise fitness. We argue that the origins of agriculture involved profound transformations in human life history strategies, impacting both the availability of energy and the way that it was allocated between life history functions in the body. Although overall energy supply increased, the diet composition changed, while sedentary populations were challenged by new infectious burdens. We propose that this composite new ecological niche favoured increased energy allocation to defence (immune function) and reproduction, thus reducing the allocation to growth and maintenance. We review evidence in support of this hypothesis and highlight how further work could address both heterogeneity and specific aspects of the origins of agriculture in more detail. Our approach can be applied to many other transformations of the human subsistence niche, and can shed new light on the way that health, height, life expectancy, and fertility patterns are changing in association with globalization and nutrition transition.
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Affiliation(s)
- Jonathan C. K. Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- *Correspondence: Jonathan C. K. Wells
| | - Jay T. Stock
- Department of Anthropology, University of Western Ontario, London, ON, Canada
- Department of Archaeology, Max Planck Institute for the Science of Human History, Jena, Germany
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Ngo TTD, Nguyen TD, Goyens P, Robert A. Misuse of antenatal care and its association with adverse outcomes of pregnancy in a Southern rural area of Vietnam. Health Care Women Int 2017; 39:472-492. [DOI: 10.1080/07399332.2017.1400035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thi-Thuy-Dung Ngo
- Epidemiology Department of Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
- Pôle Epide´miologie et Biostatistique, Institut de Recherche Expe´rimentale et Clinique, Faculte´ de Sante´ Publique, Universite´ catholique de Louvain, Brussels, Belgium
| | - The-Dung Nguyen
- Pôle Epidémiologie et Biostatistique, Institut de Recherche Expérimentale et Clinique, Faculté de Santé Publique, Universite´ catholique de Louvain
| | - Philippe Goyens
- Laboratory of Pediatrics, Queen Fabiola Children's Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Annie Robert
- Pôle Epide´miologie et Biostatistique, Institut de Recherche Expe´rimentale et Clinique, Faculte´ de Sante´ Publique, Universite´ catholique de Louvain, Brussels, Belgium
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8
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Duong DM, Nguyen AD, Nguyen CC, Le VT, Hoang SN, Bui HTT. A Secular Trend in Birth Weight and Delivery Practices in Periurban Vietnam During 2005-2012. Asia Pac J Public Health 2017; 29:18S-24S. [PMID: 28719774 DOI: 10.1177/1010539517718335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The remarkable increase in Vietnamese economic conditions can increase the birth weight in neonates and better delivery practices among women. The Chi Linh Health and Demographic Surveillance System started in 2004. An open cohort of data consisting of about 57 561 people from 17 993 households has been followed primarily with respect to demography, economy, and education. The aim of this research is to study secular trends in delivery practice and birth weight in the past decade (2005-2012) in Chi Linh. We found a significant change in delivery rates at hospitals and cesarean section rates, but the birth weights over a decade of drastic economic development were stable. Furthermore, the findings show significant associations of birth weight and delivery practices with the child's sex, mother's age, and household income. Our results might be considered as representative for other similar periurban settings in Vietnam. We suggest that appropriate policies should be developed given the reduction in the use of delivery services in commune health centers in urban areas.
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Affiliation(s)
- Duc Minh Duong
- 1 Hanoi University of Public Health, Ha Noi, Vietnam.,2 Uppsala University, Uppsala, Sweden
| | - Anh Duy Nguyen
- 3 Hanoi Obstetrics and Gynecology Hospital, Ha Noi, Vietnam
| | | | - Vui Thi Le
- 1 Hanoi University of Public Health, Ha Noi, Vietnam
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9
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Binh HD, Maasalu K, Dung VC, Ngoc CTB, Hung TT, Nam TV, Nhan LNT, Prans E, Reimann E, Zhytnik L, Kõks S, Märtson A. The clinical features of osteogenesis imperfecta in Vietnam. INTERNATIONAL ORTHOPAEDICS 2016; 41:21-29. [PMID: 27807717 DOI: 10.1007/s00264-016-3315-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Osteogenesis imperfecta (OI) has not been studied in a Vietnamese population before. The aim of this study was to systematically collect epidemiological information, investigate clinical features and create a clinical database of OI patients in Vietnam for future research and treatment strategy development. METHOD Participants underwent clinical and physical examinations; also medical records were reviewed. Genealogical information was collected and family members' phenotypical manifestations recorded. Cases were classified according to the Sillence classification. RESULTS In total, 146 OI patients from 120 families were studied: 46 with OI Type I, 46 with Type III and 54 with Type IV. Almost patients had skeletal deformations. One hundred and forty-two had a history of fractures, 117 blue sclera, 89 dentinogenesis imperfecta and 26 hearing loss. The total number of fractures was 1,932. Thirty-four patients had intra-uterine fractures and nine had perinatal fractures. Surgery was performed 163 times in 58 patients; 100 osteosyntheses and 63 osteotomies. Bisphosphonate treatment was used in 37 patients. The number of affected individuals and predominance of severe forms of OI indicate that the disease is under diagnosed in Vietnam, especially in cases without a family history or with mild form of OI. Deformities appeared in all patients with different severity and localisation, affecting mostly the lower limbs. OI medical and surgical treatment rates are low and in most cases surgery was performed due to fractures. CONCLUSIONS Compared to previous studies, our results indicate a lower OI prevalence and greater severity of symptoms in the Vietnamese population when compared with other areas. Further investigation, improved diagnosis and treatment are needed to increase the patients' quality of life.
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Affiliation(s)
- Ho Duy Binh
- Hue University of Medicine and Pharmacy, Hue University, 06 ngo Quyen, Hue, 530000, Vietnam. .,Clinic of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, 51014, Tartu, Estonia. .,Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Puusepa 8, 51014, Tartu, Estonia.
| | - Katre Maasalu
- Clinic of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, 51014, Tartu, Estonia.,Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Puusepa 8, 51014, Tartu, Estonia
| | - Vu Chi Dung
- National Hospital of Pediatrics, 18/879 La Thanh, Dong Da, 100000, Hanoi, Vietnam
| | - Can T Bich Ngoc
- National Hospital of Pediatrics, 18/879 La Thanh, Dong Da, 100000, Hanoi, Vietnam
| | - Ton That Hung
- OI Booming Diamond Center, 303/38 Ha Huy Giap, 12th District, 700000, Ho Chi Minh City, Vietnam
| | - Tran V Nam
- Traditional Medicine Institute, 273 Nguyen Van Troi, Phu Nhuan, 700000, Ho Chi Minh City, Vietnam
| | - Le N Thanh Nhan
- Hue University of Medicine and Pharmacy, Hue University, 06 ngo Quyen, Hue, 530000, Vietnam
| | - Ele Prans
- Pathophysiology Department, University of Tartu, Ravila 19, Tartu, 50411, Estonia
| | - Ene Reimann
- Pathophysiology Department, University of Tartu, Ravila 19, Tartu, 50411, Estonia
| | - Lidiia Zhytnik
- Clinic of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, 51014, Tartu, Estonia
| | - Sulev Kõks
- Pathophysiology Department, University of Tartu, Ravila 19, Tartu, 50411, Estonia
| | - Aare Märtson
- Clinic of Traumatology and Orthopaedics, University of Tartu, Puusepa 8, 51014, Tartu, Estonia.,Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Puusepa 8, 51014, Tartu, Estonia
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10
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Edvardsson K, Graner S, Thi LP, Åhman A, Small R, Lalos A, Mogren I. 'Women think pregnancy management means obstetric ultrasound': Vietnamese obstetricians' views on the use of ultrasound during pregnancy. Glob Health Action 2015; 8:28405. [PMID: 26519131 PMCID: PMC4627940 DOI: 10.3402/gha.v8.28405] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 09/06/2015] [Accepted: 09/26/2015] [Indexed: 11/14/2022] Open
Abstract
Objective To explore Vietnamese obstetricians’ experiences and views on the role of obstetric ultrasound in clinical management of complicated pregnancy and in situations where maternal and fetal health interests conflict. Design Seventeen obstetricians in northern Vietnam were interviewed as part of the CROss-Country Ultrasound Study (CROCUS) project in 2013. Data were analysed using qualitative content analysis. Results The participants described ultrasound as a central tool in prenatal care, although they called for increased training and resources to prevent inappropriate management. A prevailing overuse driven by women's request and increased commercialisation was described. Other clinical examinations were seen as being disregarded by women in favour of ultrasound, resulting in missed opportunities for identifying potential pregnancy complications. The use of ultrasound for sex selection purposes raised concern among participants. Visualisation of human features or heartbeat during ultrasound was commonly described as the point where the fetus became regarded as a ‘person’. Women were said to prioritise fetal health interests over their own health, particularly if a woman had difficulties becoming pregnant or had undergone assisted fertilisation. The woman's husband and his family were described as having an important role in decision-making in situations of maternal and fetal health conflicts. Conclusions This study provides insight into issues surrounding ultrasound use in contemporary Vietnam, some of which may be specific to this low-income context. It is clear that ultrasound has become a central tool in prenatal care in Vietnam and that it has also been embraced by women. However, there seems to be a need to balance women's demands for obstetric ultrasound with better recognition of the valuable contribution to be made by the full range of clinical examinations in pregnancy, along with a more strategic allocation of resources, that is, use of obstetric ultrasound based on clinical indications. Better regulation of private obstetric practice also appears to be needed. While the root causes of sex selection need to be addressed at societal level, efforts are also required more immediately to find ways to combat the inappropriate use of ultrasound for the purpose of sex selection.
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Affiliation(s)
- Kristina Edvardsson
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.,Judith Lumley Centre, La Trobe University, Melbourne, Australia;
| | - Sophie Graner
- Department of Women's and Childrens Health, Karolinska Institute, Stockholm, Sweden.,Department of Medicine, Centre for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
| | - Lan Pham Thi
- Department of Dermatology and Venereology, Hanoi Medical University, Hanoi, Vietnam
| | - Annika Åhman
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Rhonda Small
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Ann Lalos
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
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11
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Guo Y, Liu Y, He JR, Xia XY, Mo WJ, Wang P, Feng Q, Larson CP, Xia HM, Qiu X. Changes in birth weight between 2002 and 2012 in Guangzhou, China. PLoS One 2014; 9:e115703. [PMID: 25531295 PMCID: PMC4274089 DOI: 10.1371/journal.pone.0115703] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 11/26/2014] [Indexed: 11/18/2022] Open
Abstract
Background Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China. Methods We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28–41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA) and large (LGA) for gestational age and gestational length were explored in the overall population and gestational age subgroups. Results The mean birth weight decreased from 3162 g in 2002 to 3137 g in 2012 (crude mean difference, −25 g; 95% CI, −30 to −19). The adjusted change in mean birth weight appeared to be slight (−6 g from 2002 to 2012) after controlling for maternal age, gestational age, educational level, parity, newborn's gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28–31 weeks), while remained relatively stable among other gestational age subcategories. Conclusions Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age.
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Affiliation(s)
- Yong Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yu Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Xiao-Yan Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Guangzhou Women and Children's Health Information Center, Guangzhou, China
| | - Wei-Jian Mo
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ping Wang
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Qiong Feng
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Charles P. Larson
- Centre for International Child Health, BC Children's Hospital and University of British Columbia, Vancouver, Canada
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
- * E-mail:
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