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Demissie DB, Molla G, Tiruneh Tiyare F, Badacho AS, Tadele A. Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis. SAGE Open Med 2024; 12:20503121241248275. [PMID: 38737837 PMCID: PMC11085007 DOI: 10.1177/20503121241248275] [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: 12/12/2023] [Accepted: 03/27/2024] [Indexed: 05/14/2024] Open
Abstract
Background Antenatal care is directed toward ensuring healthy pregnancy outcomes. Quality antenatal care increases the likelihood of receiving an effective intervention to maintain maternal, fetal, and neonatal well-being, while poor quality is linked to poor pregnancy outcomes. However, owing to the complex nature of quality, researchers have followed several approaches to systematically measure it. The evidence from these variable approaches appears inconsistence and poses challenges to programmers and policymakers. Hence, it is imperative to obtain a pooled estimate of the quality of antenatal care. Therefore, considering the scarcity of evidence on the quality of antenatal care, this study aimed to review, synthesize, and bring pooled estimates of accessible evidence. Objective This study aimed to estimate the pooled magnitude and predictors of quality of antenatal care services and compare regional disparity. Method We conducted a comprehensive systematic three-step approach search of published and unpublished sources from 2002 to 2022. The methodological quality of eligible studies was checked using Joanna Briggs Institute critical appraisal tool for cross-sectional studies. Meta-analysis was carried out using STATA version 16. Statistical heterogeneity was assessed using Cochran's Q test. In the presence of moderate heterogeneity (I2 more than 50%), sensitivity and subgroup analyses were conducted and presented in a forest plot. Effect size was reported using standardized mean difference and its 95% confidence interval. Funnel plots and Egger's regression test were used to measure publication bias at the 5% significance level. A trim-and-fill analysis was conducted to adjust for publication bias. Pooled estimates were computed using random-effects models and weighted using the inverse variance method in the presence of high heterogeneity among studies. A 95% CI and 5% significance level were considered to declare significance variables. Results The global pooled poor-quality antenatal care was 64.28% (95% CI: 59.58%-68.98%) (I2 = 99.97%, p = 0.001). The identified pooled predictors of good-quality antenatal care service were: number of antenatal care visits (fourth and above antenatal care visit) (Adjusted odds ratio (AOR) = 2.6, 95% CI: 1.37-3.84), family wealth index (AOR = 2.72, 95% CI: 1.89-3.55), maternal education attainment (AOR = 3.03, 95% CI: 2.24-3.82), residence (urban dwellers) (AOR = 4.06, 95% CI: 0.95-7.17), and confidentiality antenatal care (AOR = 2.23, 95% CI: -0.36 to -4.82). Conclusions The study found regional and country-level disparities in the quality of antenatal care services for pregnant women, where poor-quality antenatal care services were provided for more than two-thirds to three-fourths of antenatal care attendants. Therefore, policymakers and health planners should put a great deal of emphasis on addressing the quality of antenatal care services.
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Affiliation(s)
- Dereje Bayissa Demissie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Gebeyaw Molla
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Firew Tiruneh Tiyare
- Faculty of Public Health, Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Ashenif Tadele
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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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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Mekonnen Y, Wolde E, Bekele A, Mehari Z, Abebe S, Hagos T, Tadesse Y, Taye T, Asire G, Nigatu T, Kumar S, Girma S, Salasibew M. Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial. BMC Pregnancy Childbirth 2023; 23:620. [PMID: 37644454 PMCID: PMC10466862 DOI: 10.1186/s12884-023-05912-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention was implemented in Ethiopia to improve newborn birth weight (BW) by strengthening the contents and quality of antenatal care (ANC), especially point-of-care testing for maternal infections. This study examined the effect of the ENAT intervention on birth weight. METHODS We conducted a cluster randomized controlled trial of 22 clusters (health centers), randomized equally between 11 intervention and 11 control clusters. This study enrolled and followed pregnant women from ANC booking to the end of pregnancy or loss to follow-up. The primary outcome was mean BW, and the incidence of low birth weight (LBW) was the secondary outcome. We presented univariate comparisons of outcomes between the intervention and control arms for mean BW and LBW. Multilevel analyses using random effects models were performed to adjust for clustering and individual-level covariates. RESULTS We enrolled and followed up 4,868 and 4,821 pregnant women in the intervention and control arms, respectively, from March 2021-July 2022. During follow-up, 3445 pregnant women in the intervention and 3192 in the control delivered in the health centers, and BW measurements of their babies were recorded within 48 h. The mean BW was 3,152 g (standard deviation (SD) = 339.8 g) in the intervention and 3,044 g (SD = 353.8 g) in the control arms (mean difference, 108 g; 95% confidence interval (CI): 91.3-124.6; P = 0.000). Adjusting for clustering and several covariates, the mean BW remained significantly higher in the intervention arm than in the control arm (adjusted ß coef., 114.3; p = 0.011). The incidence of LBW was 4.7% and 7.3% in the intervention and control arms, respectively. The adjusted risk of LBW was significantly lower by 36% in the intervention arm than in the control arm (adjusted relative risk, 0.645; p = 0.027). CONCLUSION This study provided sufficient evidence of the effectiveness of the ENAT intervention in improving birth weight in the study population. The intervention demonstrated that an increase in birth weight can be attained by availing point-of-care testing, strengthening infection prevention, and maternal nutrition within the ANC platform of public health facilities in a low-income setting. TRIAL REGISTRATION Registered at Pan African Clinical Trial Registry (PACTR) database dated 09/05/2023, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25493 . The unique identification number for the registry is PACTR202305694761480.
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Affiliation(s)
- Y Mekonnen
- Mela Research, P.O. Box 34422, Addis Ababa, Ethiopia
| | - E Wolde
- Mela Research, P.O. Box 34422, Addis Ababa, Ethiopia
| | - A Bekele
- Children’s Investment Fund Foundation (CIFF), Addis Ababa, UK
| | - Z Mehari
- Children’s Investment Fund Foundation (CIFF), Addis Ababa, UK
| | - S Abebe
- Jhpiego Ethiopia, Addis Ababa, Ethiopia
| | - T Hagos
- Mela Research, P.O. Box 34422, Addis Ababa, Ethiopia
| | - Y Tadesse
- Jhpiego Ethiopia, Addis Ababa, Ethiopia
| | - T Taye
- Children’s Investment Fund Foundation (CIFF), Addis Ababa, UK
| | - G Asire
- Jhpiego Ethiopia, Addis Ababa, Ethiopia
| | - T Nigatu
- John Snow Inc., Addis Ababa, Ethiopia
| | - S Kumar
- Jhpiego Ethiopia, Addis Ababa, Ethiopia
| | - S Girma
- Jhpiego Ethiopia, Addis Ababa, Ethiopia
| | - M Salasibew
- Children’s Investment Fund Foundation (CIFF), Addis Ababa, UK
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Izuka EO, Obiora-Izuka CE, Asimadu EE, Enebe JT, Onyeabochukwu AD, Nwagha UI. Effect of late antenatal booking on maternal anemia and fetus birth weight on parturients in Enugu, Nigeria: An analytical cross-sectional study. Niger J Clin Pract 2023; 26:558-565. [PMID: 37357470 DOI: 10.4103/njcp.njcp_117_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background The benefits of antenatal care are maximized when women book early for care. However, despite these resounding benefits, women still book late, while others do not book at all, resulting in dire feto-maternal consequences. Aim Determine the effect of late prenatal booking on maternal anemia and birth weight in babies of women who delivered in public health facilities in Enugu and deduce the reasons for booking late. Patients and Methods A cross-sectional study of two groups of women (235 participants in each group) who delivered in 4 randomly selected hospitals in Enugu. Descriptive statistics were obtained for continuous variables, and frequency and percentages were used for categorical variables. Degree of associations was determined using the Chi-square, the student's t-test, and 2 x 2 table. Results The prevalence of anemia among women that booked late and early were (69.7%; n = 147) and (50.7%; n = 107) respectively. Women who booked late were two times more likely to have anemia than those who booked early (OR = odds ratio, p = p-value, CI = confidence interval,). Those who booked late were six times more likely to deliver low birth weight babies than those who booked early (OR = 5.934, 95% CI = 1.299-27.119, P = 0.022). Conclusions Late prenatal booking is associated with a high prevalence of maternal anemia in labor, low mean maternal hemoglobin, and low birth weight compared to those of women who booked early and the reasons for booking late are multifactorial.
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Affiliation(s)
- E O Izuka
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
| | - C E Obiora-Izuka
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - E E Asimadu
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
| | - J T Enebe
- Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology, ESUTH-Parklane, Enugu, Nigeria
| | - A D Onyeabochukwu
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - U I Nwagha
- Department of Obstetrics and Gyanecology, College of Medicine, University of Nigeria, Ituku-Ozalla, Campus, Nigeria
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Caira-Chuquineyra B, Fernandez-Guzman D, Giraldez-Salazar H, Urrunaga-Pastor D, Bendezu-Quispe G. Association between inadequate prenatal care and low birth weight of newborns in Peru: Evidence from a peruvian demographic and health survey. Heliyon 2023; 9:e14667. [PMID: 37064470 PMCID: PMC10102233 DOI: 10.1016/j.heliyon.2023.e14667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
Objective To assess the association between inadequate prenatal care (IPNC) and Low birth weight (LBW) in newborns of singleton gestation mothers in Peru. Methods We performed a secondary analysis of data from the 2019 Demographic and Health Survey. We included a total of 10,186 women of reproductive age (15 - 49 years) who had given birth to a singleton child in the last 5 years. The dependent variable was LBW (< 2500 g). The independent variables were IPNC (inadequate: when at least one of the IPNC components was absent [number of PNC visits ≥ 6, first PNC visit during the first trimester, compliance with PNC visit contents, and PNC visits provided by trained health personnel]) and each of its components. We evaluated the association using logistic regression models to estimate crude odds ratios and adjusted odds ratios (aOR) and their respective 95% confidence intervals (95% CI). Results We found that approximately six out of 100 live births had LBW and that seven out of 10 women had received IPNC. We observed that receiving IPNC (aOR: 1.39; 95% CI: 1.09 - 1.77) and having less than six prenatal control visits (aOR: 3.20; 95% CI: 2.48 - 4.13) were associated with higher odds of LBW regardless of the mother's age, educational level, occupation, wealth, region, rural origin, ethnicity, sex of the newborns, and place of delivery. While, regarding to the other PNC components, first prenatal control in the first trimester (aOR: 0.99; 95% CI: 0.76 - 1.28) and compliance with prenatal control contents (aOR: 1.07; 95% CI: 0.86 - 1.34), they were associated with lower and higher odds of LBW, respectively, regardless of the same adjustment variables, but it was not statistically significant. Conclusions IPNC and having less than six PNC visits were associated with higher odds of LBW. Therefore, it is very important to implement strategies that ensure access to quality prenatal care is necessary to reduce the consequences of LBW.
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Ghimire PR, Buck G, Jackson J, Woolley E, Bowman R, Fox L, Gallagher S, Sorrell M, Dubois L. Impact of Antenatal Care on Perinatal Outcomes in New South Wales, Australia: A Decade-Long Regional Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:977. [PMID: 36673735 PMCID: PMC9859161 DOI: 10.3390/ijerph20020977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Low birth weight (LBW) and preterm birth are adverse perinatal outcomes that pose a significant risk to a child's healthy beginning. While antenatal care (ANC) is an established intervention for pregnancy care, little is understood about how the number and timing of ANC visits can impact these adverse health outcomes. This study aimed to examine the impact of the number and timing of ANC visits on LBW and preterm birth in a regional setting. A decade-long perinatal dataset related to singleton live births that took place in the Southern New South Wales Local Health District (SNSWLHD) was utilized. The outcomes of interest were LBW and preterm birth, and the exposure variables were based on the Australian pregnancy guidelines on the number and timing of ANC visits. A multivariable logistic regression was performed to measure the association between outcome and exposure while adjusting for potential confounders. A greater level of protection against LBW and preterm birth was observed among mothers who had an adequate number of visits, with early entry (first trimester) into ANC. The protective effect of an adequate number of ANC visits against LBW and preterm birth among mothers with late entry into ANC (third trimester) was found to be statistically non-significant.
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Affiliation(s)
- Pramesh Raj Ghimire
- Priority Populations, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Gretchen Buck
- Priority Populations, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Jackie Jackson
- Aboriginal Health, Southern New South Wales Local Health District, Batemans Bay, NSW 2536, Australia
| | - Emma Woolley
- Priority Populations, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Rebekah Bowman
- Nursing and Midwifery, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Louise Fox
- Integrated Care and Allied Health, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
| | - Shirlena Gallagher
- People and Wellbeing, Southern New South Wales Local Health District, Batemans Bay, NSW 2536, Australia
| | | | - Lorraine Dubois
- Priority Populations, Southern New South Wales Local Health District, Queanbeyan, NSW 2620, Australia
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Arsyi M, Besral B, Herdayati M, Phalkey R. Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries. J Prev Med Public Health 2022; 55:559-567. [PMID: 36475321 DOI: 10.3961/jpmph.22.316] [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: 07/20/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN). METHODS Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017. RESULTS The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers' demographic/socioeconomic factors, health behaviors, and other factors. CONCLUSIONS In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.
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Affiliation(s)
- Miftahul Arsyi
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Besral Besral
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Milla Herdayati
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Revati Phalkey
- Heidelberg Institute for Global Health, University of Heidelberg, Heidelberg, Germany.,Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
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Maharaj R, Mohammadnezhad M. Perception of pregnant women towards early antenatal visit in Fiji: a qualitative study. BMC Pregnancy Childbirth 2022; 22:111. [PMID: 35144576 PMCID: PMC8832671 DOI: 10.1186/s12884-022-04455-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 01/31/2022] [Indexed: 02/08/2023] Open
Abstract
Background Antenatal Care (ANC) is an opportunity to provide care to prevent potential maternal and new born mortality and morbidity and reduce new born mortality and morbidity. There has been an increase in the number of women receiving early ANC over the last two decades, however, in many developing regions such as Fiji, women are still delaying initiation of ANC. Therefore, the aim of this study is primarily to explore reasons for delayed initiation of ANC appointments and to explore knowledge and perception of pregnant mothers towards early antenatal appointments in Fiji. Methods The study uses a qualitative approach. Data was collected among pregnant women more than 18 years of age after 12 weeks of gestation attending their first ANC clinic at the Ba Mission Hospital (BMH) from February 28 to April 2, 2020. Heterogenous purposeful sampling method was used to select 25 pregnant women for the study. A semi-structured open-ended questionnaire was used for face to face in-depth interviews. Data was analyzed manually using thematic content analysis after verbatim transcription of the interviews. Results The mean age of the participants was 25.8 ± 5.9 years (age range of 19–40 years). The average gestational age of those making a booking for a consultation was 5.4 ± 1.4 months with a range of 4 to 8 months. The majority of women were multigravida (64%) and multiparous (40%). The main themes that emerged from the study were: i) perception of early ANC booking; ii) perceived barriers of early ANC booking and; iii) enabling factors of early ANC booking. Even though pregnant women have a good knowledge of when to initiate ANC, the practice of early booking was influenced by many other factors. Conclusions The results of this study highlight the need to change the current booking system. Efforts are needed to attract the hard-to-reach women through outreach visits and increased communication between health care workers and the community with the use of community resources such as community health workers and traditional birth attendants. The media should be used to create awareness on timing and importance of early ANC visits at a community level.
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Affiliation(s)
| | - Masoud Mohammadnezhad
- Associate Professor in Public Health, School of Public Health and Primary Care, Fiji National University, Suva, Fiji.
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Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9974636. [PMID: 35126962 PMCID: PMC8813240 DOI: 10.1155/2022/9974636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Abstract
Globally, 30 million low birth weight (LBW) babies are born every year and 95% of them are from developing countries. LBW neonates are at a high risk of mortality, morbidity, and long-term disability. The objective of this study is to investigate outcomes and disease spectrum among low birth weight neonates. This is a prospective, observational study conducted on 540 neonates admitted in the Mother and Child Hospital, Akure, Ondo State, Nigeria, from 2017 to 2018. Questionnaire, interview, clinical, and diagnostic procedures were used as research tools. There were 137 low birth weight (LBW) neonates, with the mean mothers’ age of 31.92 ± 6.60. Of the 540 neonates, 69 (50.4%) and 68 (49.6%) were term and preterm, respectively. There were 64 female neonates (46.7%) and 73 male neonates (53.3%). The mean weight of the neonates was 1.82 ± 0.44 kg, and mean number of days on admission was 6.42 ± 6.75 days. Neonatal sepsis (NNS) was the highest morbidity 51 (37.2%) among the LBW neonates, followed by prematurity 47 (34.4%) and neonatal jaundice (NNJ) 18 (13.1%). Sex (χ2 = 3.584,
), mode of delivery (χ2 = 4.669,
), and gestational age (χ2 = 3.904,
) were not a significant determinant of outcome among LBW neonates. Men were 2.36 times more likely to be preterm (OR = 2.36, 95% CL = 1.01–5.54,
) among LBW neonates. Outcomes of LBW neonates who were delivered by SVD were not significant compared to preterm delivered by CS (OR = 0.46, 95% CL = 0.13–1.65,
). Sixty percent (60%) of the mothers had Prolonged Rupture of Membranes (PROM). Morbidities such as hypothermia (72.2%), apnoea (63.6%), haemorrhagic disease of the newborn (HDN) (66.7%), and respiratory distress syndrome (RDS) (66.7%) were more observed with preterm LBW neonates. Importance of qualitative antenatal care (ANC) should be emphasized; anticipation and prevention of LBW births can help mitigate some of the problems they are prone to.
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Ranjbar F, Allahqoli L, Ahmadi S, Mousavi R, Gharacheh M, Eshraghi N, Alkatout I. Changes in pregnancy outcomes during the COVID-19 lockdown in Iran. BMC Pregnancy Childbirth 2021; 21:577. [PMID: 34420514 PMCID: PMC8380188 DOI: 10.1186/s12884-021-04050-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022] Open
Abstract
Background The Covid-19 pandemic response is influencing maternal and neonatal health care services especially in developing countries. However, the indirect effects of Covid-19 on pregnancy outcomes remain unknown. The aim of the present study was to compare pregnancy outcomes before and after the beginning of the Covid-19 pandemic in Iran. Methods We performed a retrospective analysis of the medical records of 2,503 pregnant women with singleton pregnancies, admitted to the maternity department of a women’s hospital in Tehran, Iran, during the pre-Covid-19 pandemic (February 19 to April 19, 2019) and the intra-Covid- 19 pandemic (February 19 to April 19, 2020) period. Results We included 2,503 women admitted to the hospital; 1,287 (51.4 %) were admitted before the Covid-19 lockdown and 1,216 (48.6 %) during the Covid-19 lockdown. There were no significant differences in stillbirth rates (p = 0.584) or pregnancy complications (including preeclampsia, pregnancy-induced hypertension and gestational diabetes) (p = 0.115) between pregnant women in the pre- and intra-pandemic periods. However, decreases in preterm births (p = 0.001), and low birth weight (p = 0.005) were observed in the pandemic period compared to the pre-pandemic period. No significant difference in the mode of delivery, and no maternal deaths were observed during the two time periods. Conclusions In our study we observed a decrease in preterm births and low birth weight, no change in stillbirths, and a rise in the admission rates of mothers to the ICU during the initial Covid-19 lockdown period compared to pre-Covid-19 lockdown period. Further research will be needed to devise plan for immediate post-pandemic care and future health care crises.
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Affiliation(s)
- Fahimeh Ranjbar
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran
| | - Leila Allahqoli
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran
| | - Soheila Ahmadi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Robab Mousavi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Gharacheh
- Reproductive Health, Nursing Care Research Centre, Iran University of Medical Sciences, P.O. Box 19395-4798, Rashid Yasemi St., Valiasr Ave., Tehran, Iran.
| | - Nooshin Eshraghi
- Department of Perinatology, Shahid Akbarabadi hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy. Campus Kiel, University Hospitals Schleswig-Holstein, Kiel, Germany
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An Association between Maternal Occupations and Low Birth Weight Infants in Japan from 1995 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158040. [PMID: 34360335 PMCID: PMC8345668 DOI: 10.3390/ijerph18158040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
Differences in low birth weight rate depending on maternal socioeconomic characteristics have not yet been demonstrated using the Vital Statistics in Japan; therefore, this study aimed to investigate these differences according to maternal occupations. “Report of Vital Statistics: Occupational and Industrial Aspects” and the Vital Statistics in Japan were used every five years from 1995 to 2015. Nine types of occupations were compared. The low birth weight rate was calculated according to maternal occupations and year. Also, the standardized low birth weight ratio was obtained by dividing the number of low-birth-weight infants for each maternal occupation by an expected number of low birth weight infants. The standardized low birth weight ratio for manual workers was the highest among all occupations from 2000 to 2015, and it was significantly higher than one throughout the years. The ratio for clerical workers was also significantly higher than one from 1995 to 2010. Whereas, the ratio for farmers was significantly lower than one in most of the years. It was suggested that health guidance and prenatal care are particularly needed for manual workers, and a study investigating the differences in prenatal characteristics among maternal occupations is necessary for finding a reason for disparity.
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Tello-Torres C, Hernández-Vásquez A, Dongo KF, Vargas-Fernández R, Bendezu-Quispe G. Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:442-451. [PMID: 34318469 PMCID: PMC10411206 DOI: 10.1055/s-0041-1732463] [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: 10/25/2020] [Accepted: 05/27/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. METHODS An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. RESULTS A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. CONCLUSION Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.
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Affiliation(s)
| | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Karla F. Dongo
- Facultad de Medicina Humana, Universidad Científica del Sur, Lima, Peru
| | | | - Guido Bendezu-Quispe
- Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
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Baldewsingh GK, Jubitana BC, van Eer ED, Shankar A, Hindori-Mohangoo AD, Covert HH, Shi L, Lichtveld MY, Zijlmans CWR. Adequate antenatal care and ethnicity affect preterm birth in pregnant women living in the tropical rainforest of Suriname. BMC Pregnancy Childbirth 2020; 20:683. [PMID: 33176728 PMCID: PMC7656737 DOI: 10.1186/s12884-020-03364-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
Background Adequate antenatal care (ANC) services are key for early identification of pregnancy related risk factors and maintaining women’s health during pregnancy. This study aimed to assess the influence of ANC provided by the Medical Mission Primary Health Care Suriname (MMPHCS) and of ethnicity on adverse birth outcomes in Tribal and Indigenous women living in Suriname’s remote tropical rainforest interior. Method From April 2017 to December 2018 eligible Tribal and Indigenous women with a singleton pregnancy that received ANC from MMPHCS were included in the study. Data on low birth weight (LBW < 2500 g), preterm birth (PTB < 37 weeks), low Apgar score (< 7 at 5 min), parity (≤1 vs. > 1) and antenatal visits utilization (≥8 vs. < 8) in 15 interior communities were retrospectively analyzed using descriptive statistics, crosstabs and Fisher’s exact tests. Results A total of 204 women were included, 100 (49%) were Tribal, mean age was 26 ± 7.2 years and 126 women (62%) had 8 or more ANC visits. One participant had a miscarriage; 22% had adverse birth outcomes: 16 (7.9%) LBW and 30 (14.8%) PTB; 7 women had a child with both PTB and LBW; 5 women had stillbirths. None of the newborns had low Apgar scores. Maternal age, ethnicity, ANC and parity were associated with PTB (χ2 = 8,75, p = 0.003, χ2 = 4,97, p = 0.025, χ2 = 17,45, p < 0.001, χ2 = 11,93, p < 0.001 respectively). Conclusion Despite an almost 100% study adherence over one fifth of women that received ANC in the interior of Suriname had adverse birth outcomes, in particular PTB and LBW. Younger nulliparous Indigenous women with less than the recommended 8 ANC visits had a higher risk for PTB. The rate of adverse birth outcomes highlights the need for further research to better assess factors influencing perinatal outcomes and to put strategies in place to improve perinatal outcomes. Exposure assessment of this sub-cohort and neurodevelopment testing of their children is ongoing and will further inform on potential adverse health effects associated with environmental exposures including heavy metals such as mercury and lead.
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Affiliation(s)
- G K Baldewsingh
- Medical Mission Primary Health Care Suriname, Paramaribo, Suriname. .,Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
| | - B C Jubitana
- Medical Mission Primary Health Care Suriname, Paramaribo, Suriname
| | - E D van Eer
- Medical Mission Primary Health Care Suriname, Paramaribo, Suriname
| | - A Shankar
- Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - A D Hindori-Mohangoo
- Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.,Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - H H Covert
- Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - L Shi
- Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - M Y Lichtveld
- Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.,Scientific Research Center Suriname / Academic Hospital Paramaribo, Paramaribo, Suriname
| | - C W R Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.,Tulane University School of Public Health and Tropical Medicine, New Orleans, USA.,Scientific Research Center Suriname / Academic Hospital Paramaribo, Paramaribo, Suriname
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Pereyra I, Bustos P. Trend and factors associated with adverse birth weight in Uruguayan children between 2009 and 2015. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000300009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to identify trendand factors associated with adverse birth weight. Methods: cross-sectional design. The analysis uses the 2009-2015 Uruguay Perinatal Computer Systemdata on 303,625 newborns. Results: the prevalence of macrosomia (> 3,999g) has increased from 7.0% to 8.4%. The prevalence of low birth weight (LBW) (< 2,500g) decreased, standing at 6.6% in the last year. The factors that determines more possibilities of LBW were preeclampsia (OR = 4.80; CI95%= 4.57-5.05), inadequate controls (OR = 2.29; CI95%= 2.20-2.39), shorter duration of pregnancy (OR = 2.52; CI95%= 2.50-2.55), previous hypertension (OR = 2.11; CI95%= 1.96-2.27), hypertensive disease of pregnancy (OR = 1.82; CI95%= 1.74-1.90), low prematernal maternal weight (OR = 1.65; CI95%= 1.58-1.74). Macrosomia was associated with type 1 diabetes (OR = 2.21; CI95%= 1.86-2.61), Type 2 or Gestational (OR = 1.78; CI95%= 1.70-1.87), obesity maternal (OR = 2.33; CI95%= 2.24-2.43) and longer gestation duration (OR = 2.62; CI95%= 2.53-2.72). Conclusions: the LBW decreases while the macrosomia increases. The health and nutritional status of women at the beginning of pregnancy, pathologies of the last trimester, smoking, shorter duration of pregnancy and inadequate controls are associated with BPN. Overweight, obesity and metabolic diseases determine macrosomia.
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15
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Bater J, Lauer JM, Ghosh S, Webb P, Agaba E, Bashaasha B, Turyashemererwa FM, Shrestha R, Duggan CP. Predictors of low birth weight and preterm birth in rural Uganda: Findings from a birth cohort study. PLoS One 2020; 15:e0235626. [PMID: 32658895 PMCID: PMC7357758 DOI: 10.1371/journal.pone.0235626] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Approximately 20.5 million infants were born weighing <2500 g (defined as low birthweight or LBW) in 2015, primarily in low- and middle-income countries (LMICs). Infants born LBW, including those born preterm (<37 weeks gestation), are at increased risk for numerous consequences, including neonatal mortality and morbidity as well as suboptimal health and nutritional status later in life. The objective of this study was to identify predictors of LBW and preterm birth among infants in rural Uganda. METHODS Data were derived from a prospective birth cohort study conducted from 2014-2016 in 12 districts across northern and southwestern Uganda. Birth weights were measured in triplicate to the nearest 0.1 kg by trained enumerators within 72 hours of delivery. Gestational age was calculated from the first day of last menstrual period (LMP). Associations between household, maternal, and infant characteristics and birth outcomes (LBW and preterm birth) were assessed using bivariate and multivariable logistic regression with stepwise, backward selection analyses. RESULTS Among infants in the study, 4.3% were born LBW (143/3,337), and 19.4% were born preterm (744/3,841). In multivariable analysis, mothers who were taller (>150 cm) (adjusted Odds Ratio (aOR) = 0.42 (95% CI = 0.24, 0.72)), multigravida (aOR = 0.62 (95% CI = 0.39, 0.97)), or with adequate birth spacing (>24 months) (aOR = 0.60 (95% CI = 0.39, 0.92)) had lower odds of delivering a LBW infant Mothers with severe household food insecurity (aOR = 1.84 (95% CI = 1.22, 2.79)) or who tested positive for malaria during pregnancy (aOR = 2.06 (95% CI = 1.10, 3.85)) had higher odds of delivering a LBW infant. In addition, in multivariable analysis, mothers who resided in the Southwest (aOR = 0.64 (95% CI = 0.54, 0.76)), were ≥20 years old (aOR = 0.76 (95% CI = 0.61, 0.94)), with adequate birth spacing (aOR = 0.76 (95% CI = 0.63, 0.93)), or attended ≥4 antenatal care (ANC) visits (aOR = 0.56 (95% CI = 0.47, 0.67)) had lower odds of delivering a preterm infant; mothers who were neither married nor cohabitating (aOR = 1.42 (95% CI = 1.00, 2.00)) or delivered at home (aOR = 1.25 (95% CI = 1.04, 1.51)) had higher odds. CONCLUSIONS In rural Uganda, severe household food insecurity, adolescent pregnancy, inadequate birth spacing, malaria infection, suboptimal ANC attendance, and home delivery represent modifiable risk factors associated with higher rates of LBW and/or preterm birth. Future studies on interventions to address these risk factors may be warranted.
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Affiliation(s)
- Jorick Bater
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jacqueline M. Lauer
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Shibani Ghosh
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, United States of America
| | - Patrick Webb
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, United States of America
| | - Edgar Agaba
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Bernard Bashaasha
- Department of Agribusiness and Natural Resource Economics, Makerere University, Kampala, Uganda
| | | | - Robin Shrestha
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Christopher P. Duggan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Xi C, Luo M, Wang T, Wang Y, Wang S, Guo L, Lu C. Association between maternal lifestyle factors and low birth weight in preterm and term births: a case-control study. Reprod Health 2020; 17:93. [PMID: 32527333 PMCID: PMC7291563 DOI: 10.1186/s12978-020-00932-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/24/2020] [Indexed: 12/16/2022] Open
Abstract
Background It has been reported that lifestyle factors may affect birth weight; however, few studies have explored the association between lifestyle factors and low birth weight in preterm and term births in China. The objective of this study was to explore the effect of lifestyle on low birth weight in preterm and term births. Methods This case-control study was conducted in fourteen hospitals in Jiangmen, Guangdong Province. Data were collected from August 2015 to May 2016 using a standard questionnaire. Data were analysed using logistic regression. Results Women who delivered preterm and were physically active (1–3 times per week and ≥ 4 times per week) had reduced odds of having low birth weight babies (aOR = 0.584, 95%CI = 0.394–0.867 and, aOR = 0.516, 95%CI = 0.355–0.752, respectively). Pregnant women who had insufficient gestational weight gain had increased odds of having low birth weight babies (aOR = 2.272, 95%CI = 1.626–3.176). Women exposed to passive smoking had an increased risk of delivering low birth weight infants (aOR = 1.404, 95%CI = 1.057–1.864). Insufficient gestational weight gain and excessive gestational weight gain were both significantly associated with low birth weight (aOR = 1.484, 95%CI = 1.103–1.998 and aOR = 0.369, 95%CI = 0.236–0.577, respectively) for term deliveries. In addition, parity, history of low birth weight, antenatal care and gestational hypertension were significantly associated with the likelihood of low birth weight. Conclusion Pregnant women without exercise contraindications should remain physically active. Pregnant women should be aware of the negative effects of smoke and be aware of strategies to protect themselves from passive smoke exposure. Hospitals should inform pregnant women of the importance appropriate gestational weight gain. These recommendations should be put into practice to decrease the prevalence of low birth weight infants.
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Affiliation(s)
- Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yingxiang Wang
- Maternity and Child Health Care Hospital of Guangdong, Jiangmen, China
| | - Songbai Wang
- Maternity and Child Health Care Hospital of Guangdong, Jiangmen, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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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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Esposti CDD, Santos-Neto ETD, Oliveira AE, Travassos C, Pinheiro RS. Social and geographical inequalities in the performance of prenatal care in a metropolitan area of Brazil. CIENCIA & SAUDE COLETIVA 2020; 25:1735-1750. [PMID: 32402040 DOI: 10.1590/1413-81232020255.32852019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/07/2019] [Indexed: 11/22/2022] Open
Abstract
This study analyzed the social and geographical inequalities in the performance of prenatal medical care in the Unified Health System (SUS) in the Metropolitan Region of Grande Vitória, Espírito Santo, Brazil. A cross-sectional study was carried out with 1,209 puerperae living in this region, admitted for childbirth from 2010 to 2011. Data about prenatal care and contextual, enabling, and social characteristics were collected, following the Andersen's Behavioral Model. The performance of prenatal care was classified into five levels, including information on the number of prenatal visits, initial and repetitive examinations, tetanus vaccination, gestational risk management, and participation in educational activities. The likelihood of different levels of prenatal care performance was analyzed using a multivariate multinomial model, according to maternal social variables. High prenatal coverage (98%) and 4.4% care adequacy were identified. The likelihood of access to prenatal care was increased by enabling, contextual, and social factors. The relationship between prenatal care quality and pregnant women's social and geographical conditions must be considered in the organization of services to achieve equity and reduce maternal and perinatal morbimortality.
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Affiliation(s)
| | | | - Adauto Emmerich Oliveira
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, ES, Brazil,
| | - Claudia Travassos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Rejane Sobrino Pinheiro
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Morón-Duarte LS, Ramirez Varela A, Segura O, Freitas da Silveira M. Quality assessment indicators in antenatal care worldwide: a systematic review. Int J Qual Health Care 2020; 31:497-505. [PMID: 30295805 DOI: 10.1093/intqhc/mzy206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 08/15/2018] [Accepted: 09/14/2018] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To describe indicators used for the assessment of antenatal care (ANC) quality worldwide under the World Health Organization (WHO) framework and based on a systematic review of the literature. DATA SOURCES Searches were performed in MEDLINE, SciELO, BIREME and Web of Science for eligible studies published between January 2002 and September 2016. STUDY SELECTION Original articles describing women who had received ANC, any ANC model and, any ANC quality indicators were included. DATA EXTRACTION Publication date, study design and ANC process indicators were extracted. RESULTS OF DATA SYNTHESIS Of the total studies included, 69 evaluated at least one type of ANC process indicator. According to WHO ANC guidelines, 8.7% of the articles reported healthy eating counseling and 52.2% iron and folic acid supplementation. The evaluation indicators on maternal and fetal interventions were: syphilis testing (55.1%), HIV testing (47.8%), gestational diabetes mellitus screening (40.6%) and ultrasound (27.5%). Essential ANC activities assessment ranged from 26.1% report of fetal heart sound, 50.7% of maternal weight and 63.8% of blood pressure. Regarding preventive measures recommended by WHO, tetanus vaccine was reported in 60.9% of the articles. Interventions performed by health services to improve use and quality of ANC care, promotion of maternal and fetal health, and the number of visits to the ANC were evaluated in 65.2% of the studies. CONCLUSION Numerous ANC content indicators are being used to assess ANC quality. However, there is a need to use standardized indicators across countries and efforts to improve quality evaluation.
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Affiliation(s)
- Lina Sofia Morón-Duarte
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Andrea Ramirez Varela
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Omar Segura
- SMC-AS Research Unit - Segura, Moron & Castañeda Health Consultants Ltd., Bogotá, D.C., Colombia
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Das Gupta R, Swasey K, Burrowes V, Hashan MR, Al Kibria GM. Factors associated with low birth weight in Afghanistan: a cross-sectional analysis of the demographic and health survey 2015. BMJ Open 2019; 9:e025715. [PMID: 31092648 PMCID: PMC6530387 DOI: 10.1136/bmjopen-2018-025715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/28/2019] [Accepted: 03/19/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the factors associated with low birth weight (LBW) in Afghanistan. DESIGN Cross-sectional study. SETTING This study used data collected from the Afghanistan Demographic and Health Survey 2015. PARTICIPANTS Facility-based data from 2773 weighted live-born children enrolled by a two-stage sampling strategy were included in our analysis. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was LBW, defined as birth weight <2.5kg. RESULTS Out of 2773 newborns, 15.5% (n=431) had LBW. Most of these newborns were females (58.3%, n=251), had a mother with no formal schooling (70.5%, n=304), lived in urban areas (63.4%, n=274) or lived in the Central region of Afghanistan (59.7%, n=257). In multivariable analysis, residence in Central (adjusted OR (AOR): 3.4; 95% CI 1.7 to 6.7), Central Western (AOR: 3.0; 95% CI 1.5 to 5.8) and Southern Western (AOR: 4.0; 95% CI 1.7 to 9.1) regions had positive association with LBW. On the other hand, male children (AOR: 0.5; 95% CI 0.4 to 0.8), newborns with primary maternal education (AOR: 0.5; 95% CI 0.3 to 0.8), birth interval ≥48 months (AOR: 0.4; 95% CI 0.1 to 0.8), belonging to the richest wealth quintile (AOR: 0.2; 95% CI 0.1 to 0.6) and rural residence (AOR: 0.3; 95% CI 0.2 to 0.6) had decreased odds of LBW. CONCLUSIONS Multiple factors had association with LBW in Afghanistan. Maternal, Neonatal and Child Health programmes should focus on enhancing maternal education and promoting birth spacing to prevent LBW. To reduce the overall burden of LBW, women of the poorest wealth quintiles, and residents of Central, Central Western and South Western regions should also be prioritised. Further exploration is needed to understand why urban areas are associated with higher likelihood of LBW. In addition, research using nationally representative samples are required.
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Affiliation(s)
- Rajat Das Gupta
- Centre for Science of Implementation and Scale-Up, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Krystal Swasey
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD-21201, United States of America
| | - Vanessa Burrowes
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD-21205, United States of America
| | | | - Gulam Muhammed Al Kibria
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD-21201, United States of America
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Quality antenatal care protects against low birth weight in 42 poor counties of Western China. PLoS One 2019; 14:e0210393. [PMID: 30650127 PMCID: PMC6335019 DOI: 10.1371/journal.pone.0210393] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/21/2018] [Indexed: 11/03/2022] Open
Abstract
Limited data exist related to low birth weight (LBW) incidence and risk factors in Western China. This paper aims to assess LBW and its relationship with antenatal care (ANC) in the poor counties of Western China. A community-based study in rural Western China was conducted in 2011. A kernel distribution was used to estimate the adjusted LBW incidence, and associations between LBW and socio-demographic or maternal factors were examined using multilevel logistic regression. Among 8,964 participants, 65.7% were weighed at birth. Crude LBW incidence was 6.6% and the adjusted rate was 9.3%. The study revealed that risk factors of LBW are being female, raised within a minority group, and with a family income below the national poverty line. For maternal risk factors, LBW was positively associated with not attending at least five or eight ANC visits, not receiving any ANC during the first trimester, and not having access to assess certain ANC content (weight, blood pressure, blood test, urine test, B-scan ultrasound, and folic acid supplement). There is urgent need to promote quality ANC in poor and rural areas of Western China and to prioritize vulnerable women and children who will benefit from quality ANC.
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Chhea C, Ir P, Sopheab H. Low birth weight of institutional births in Cambodia: Analysis of the Demographic and Health Surveys 2010-2014. PLoS One 2018; 13:e0207021. [PMID: 30408102 PMCID: PMC6224106 DOI: 10.1371/journal.pone.0207021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/22/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Low birth weight (LBW), an important risk factor for early childhood mortality and morbidity, is a major public health concern in developing countries including Cambodia. This study examined the prevalence of LBW across provinces in Cambodia and changes over time, and identified the factors associated with such condition. METHODS We used children datasets from Cambodia Demographic and Health Survey (CDHS) 2010 and 2014. There were 3,522 children and 4,991 children in both surveys. Maps illustrating provincial variation in LBW prevalence were constructed. Then, multivariate analyses were conducted to assess factors independently associated with LBW in CDHS 2014. RESULTS LBW prevalence remained stable between 2010 and 2014, at around 7.0% 95% CI: 5.8-8.1). all institutional births, but within significant variation across provinces. Factors independently associated with LBW included mother's no education compared with those whose mothers had secondary or higher education (AOR = 1.6, 95% CI: 1.0-2.6), babies born to mothers with < 4 antenatal care (ANC) visits during the pregnancy compared with those whose mothers had at least 4 ANC visits (AOR = 2.0, 95% CI: 1.5-2.8). Also, first-born babies were at greater risk of LBW compared with second-born babies (AOR = 1.4, 95% CI: 1.0-2.0). CONCLUSION The study points to key sub-populations at greater risk and regions where LBW is particularly prevalent. Programs should target provinces where LBW prevalence remains high. Illiterate women, especially those pregnant for the first time should be the program priority. The current national program policy, which recommends that pregnant women have ≥ 4 ANC visits during pregnancy should be further reinforced and implemented. Program design should consider ways to communicate the importance of making the recommended number of ANC visits among women with no formal education.
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Affiliation(s)
- Chhorvann Chhea
- School of Public Health at the National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
| | - Por Ir
- School of Public Health at the National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
| | - Heng Sopheab
- School of Public Health at the National Institute of Public Health, Tuol Kork District, Phnom Penh, Cambodia
- * E-mail:
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Chimatiro CS, Hajison P, Chipeta E, Muula AS. Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi. Reprod Health 2018; 15:158. [PMID: 30241542 PMCID: PMC6151039 DOI: 10.1186/s12978-018-0605-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background Exploring barriers contributing to low utilization of Antenatal Care (ANC) during the first trimester of pregnancy is of national programmatic importance. We conducted an exploratory study in 2013 at Bilira Health Centre in Ntcheu district-Malawi with an aim of understanding barriers that prevent pregnant women from attending antenatal clinics in the first trimester of pregnancy. Method This was cross sectional exploratory study using qualitative approach. Data were collected from ANC clients, key informants, health services professionals and women of child bearing age (15–49 years) using an in-depth interviews and Focus Group Discussions (FGDs). Data were analysed manually by reading the transcriptions and memos several times inorder to be familiar with the themes emerged. The emerged themes were coded. Results Most of the women reported that they have a feeling of starting ANC in the early days of their pregnancies, however, they also reported several barriers ranging from cultural beliefs, social economic to service delivery barriers. On cultural barriers many women wait for marriage counselors from husband’s side to give them advice before starting ANC in the process called “Kuthimba”. Some women hide the pregnancy in early months to avoid being bewitched. On social-economic barriers, some of the women mentioned that they don’t start ANC early waiting for new clothes. Poor attitude of health workers also has an effect on ANC attendants. Most women pointed out that they started ANC late because some health workers were rude and do not observe confidentiality. Men’s refusal to accompany their spouses to antenatal clinic in fear of HIV test and some by-laws which restrict women who had pregnancy outside marriage to seek an authorisation letter first from Traditional Leaders for them to start ANC at the health facility were also mentioned as contributing barriers. Conclusion Women should be oriented on the national guidelines on Focused ANC (FANC) which advocates for at least 4 visits. There should also be Information, Education and Communication (IEC) on ANC and interventions to deal with social-cultural issues while at the same time improving service delivery at the health facility so that ANC services can be accessible and responsive enough.
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Affiliation(s)
- Chancy S Chimatiro
- Department of Health Systems and Policy, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi. .,Africa Center of Excellence in Public Health and Herbal Medicine(ACEPHEM), University of Malawi, College of Medicine, Blantyre, Malawi.
| | - Precious Hajison
- PreLuHa consult, Namiwawa Street, Newroard location, PO BOX 703, Zomba, Malawi
| | - Effie Chipeta
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.,Centre for Reproductive Health (CRH), University of Malawi, College of Medicine, Blantyre, Malawi
| | - Adamson S Muula
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.,Centre for Reproductive Health (CRH), University of Malawi, College of Medicine, Blantyre, Malawi.,Africa Center of Excellence in Public Health and Herbal Medicine(ACEPHEM), University of Malawi, College of Medicine, Blantyre, Malawi
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González-Jiménez J, Rocha-Buelvas A. Risk factors associated with low birth weight in the Americas: literature review. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n2.61577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. El bajo peso al nacer (BPN) es uno de los principales factores de riesgo que afecta la morbimortalidad infantil en todo el mundo; cerca de 1/3 de las muertes neonatales son atribuibles a este.Objetivo. Revisar los artículos más relevantes sobre BPN en las Américas en el periodo de 2010-2016.Materiales y métodos. Revisión narrativa de literatura. La información se obtuvo de las bases de datos PubMed, SciELO, LILACS, Portal Regional da BVS, con el uso de los descriptores DeCS y MeSH.Resultados. La mayoría de los estudios fueron publicados entre el 2012 y el 2015. De los 27 artículos publicados, 11 (40.7%) fueron atribuidos a factores sociodemográficos, 9 (33.3%) a riesgos ambientales, 3 (11.1%) a factores conductuales, 2 (7.4%) a controles prenatales o por cobertura y 2 (7.4%) se interrelacionaban con otros factores de riesgo.Conclusión. La mayoría de los estudios coinciden en la asociación de factores sociodemográficos, biológicos y conductuales. Los estudios que refieren la asociación de BPN con factores de riesgo ambientales están tomando fuerza.
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Janssen M, Fonseca SC, Alexandre GC. Avaliação da dimensão estrutura no atendimento ao pré-natal na Estratégia Saúde da Família: potencialidades do PMAQ-AB. SAÚDE EM DEBATE 2016. [DOI: 10.1590/0103-1104201611111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Esta pesquisa analisou a dimensão estrutura das unidades para a atenção pré-natal em Niterói, realizada pela Estratégia Saúde da Família (ESF). O banco de dados foi o da avaliação externa do 1º ciclo do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB) do Ministério da Saúde. Foram entrevistados 69 profissionais, em 27 unidades de saúde. Com base nos resultados, propõe-se melhorar as condições de acessibilidade, qualificar os profissionais, estimular a permanência e o vínculo, ampliar a capacitação das equipes quanto ao gerenciamento do território e dos protocolos de risco. O PMAQ-AB foi corroborado como uma ferramenta para avaliações em saúde.
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Estrada-Restrepo A, Restrepo-Mesa SL, Feria NDCC, Santander FM. [Maternal factors associated with birth weight in term infants, Colombia, 2002-2011]. CAD SAUDE PUBLICA 2016; 32:e00133215. [PMID: 27982289 DOI: 10.1590/0102-311x00133215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 02/12/2016] [Indexed: 11/22/2022] Open
Abstract
The study aimed to identify maternal factors associated with birth weight in Colombia from 2002 to 2011. This was a descriptive study based on data from the Live Birth Registry of Colombia, Administrative Department of Vital Statistics. Birth weight was classified as low birth weight < 2,500g, insufficient birth weight 2,500-2,999g, normal birth weight 3,000-3,999g, and high birth weight ≥ 4,000g. Data analysis used Mann-Whitney U test, Kruskal-Wallis test, and multinomial logistic regression. Women with increased likelihood of low birth weight newborns were 35 years or older (OR = 1.4; 95%CI: 1.39-1.4), had little schooling (OR = 1.1; 95%CI: 1.1-1.1), were single (OR = 1.1; 95%CI: 1.1-1.2), without prenatal care (OR = 1.9; 95%CI: 1.9-2.0), and lived in rural areas (OR = 1.2; 95%CI: 1.1-1.2). Women with higher prevalence of high birth weight newborns were 35 years or older (OR = 1.1; 95%CI: 1.1-1.1) and had four or more children (OR = 2.1; 95%CI 2.0-2.1). Insufficient birth weight showed a similar pattern to low birth weight. In conclusion, social, demographic, and maternal factors influence the birth weight of newborns in Colombia.
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Fochi MML, Baring S, Spegiorin LCJF, Vaz-Oliani DCM, Galão EA, Oliani AH, de Mattos LC, de Mattos CCB. Prematurity and Low Birth Weight did not Correlate with Anti-Toxoplasma gondii Maternal Serum Profiles--a Brazilian Report. PLoS One 2015; 10:e0132719. [PMID: 26192182 PMCID: PMC4508015 DOI: 10.1371/journal.pone.0132719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/17/2015] [Indexed: 01/27/2023] Open
Abstract
Gestational Toxoplasma gondii infection is considered a major risk factor for miscarriage, prematurity and low birth weight in animals. However, studies focusing on this topic in humans are scarce. The objective of this study is to determine whether anti-Toxoplasma gondii maternal serum profiles correlate prematurity and low birth weight in humans. The study examined 213 pregnant women seen at the High-Risk Pregnancy Hospital de Base, São José do Rio Preto, São Paulo, Brazil. All serological profiles (IgM-/IgG+; IgM-/IgG-; IgM+/IgG+) were determined by ELISA commercial kits. Maternal age, gestational age and weight of the newborn at birth were collected and recorded in the Statement of Live Birth. Prematurity was defined as gestational age <37 weeks and low birth weight ≤ 2499 grams. The t-test was used to compare values (p < 0.05). The mean maternal age was 27.6±6.6 years. Overall, 56.3% (120/213) of the women studied were IgM-/IgG+, 36.2% (77/213) were IgM-/IgG- and 7.5% (16/213) were IgM+/IgG+. The average age of the women with serological profile IgM+/IgG+ (22.3±3.9 years) was different from women with the profile IgM-/IgG+ (27.9±6.7 years, p = 0.0011) and IgM-/IgG- (27.9±6.4 years, p = 0.0012). There was no statistically significant difference between the different serological profiles in relation to prematurity (p = 0.6742) and low birth weight (p = 0.7186). The results showed that prematurity and low birth weight did not correlate with anti-Toxoplasma gondii maternal serum profiles.
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Affiliation(s)
- Mariana Machado Lemos Fochi
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- FAMERP Toxoplasma Research Group, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
| | - Sabrina Baring
- Obstetrics and Gynecology Service, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto–HB-FUNFARME, São José do Rio Preto, São Paulo, Brazil
| | - Lígia Cosentino Junqueira Franco Spegiorin
- Obstetrics and Gynecology Service, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto–HB-FUNFARME, São José do Rio Preto, São Paulo, Brazil
- Department of Gynecology and Obstetrics, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade de São José do Rio Preto–HCM, São José do Rio Preto, São Paulo, Brazil
- FAMERP Toxoplasma Research Group, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
| | - Denise Cristina Mós Vaz-Oliani
- Obstetrics and Gynecology Service, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto–HB-FUNFARME, São José do Rio Preto, São Paulo, Brazil
- Department of Gynecology and Obstetrics, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade de São José do Rio Preto–HCM, São José do Rio Preto, São Paulo, Brazil
| | - Eloisa Aparecida Galão
- Obstetrics and Gynecology Service, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto–HB-FUNFARME, São José do Rio Preto, São Paulo, Brazil
- Department of Gynecology and Obstetrics, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade de São José do Rio Preto–HCM, São José do Rio Preto, São Paulo, Brazil
| | - Antonio Hélio Oliani
- Department of Gynecology and Obstetrics, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- Hospital da Criança e Maternidade de São José do Rio Preto–HCM, São José do Rio Preto, São Paulo, Brazil
| | - Luiz Carlos de Mattos
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- FAMERP Toxoplasma Research Group, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
| | - Cinara Cássia Brandão de Mattos
- Immunogenetics Laboratory, Department of Molecular Biology, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
- FAMERP Toxoplasma Research Group, Faculdade de Medicina de São José do Rio Preto–FAMERP, São José do Rio Preto, São Paulo, Brazil
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Gheibizadeh M, Abedi HA, Mohammadi E, Abedi P. Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study. Nurs Ethics 2015; 23:465-77. [PMID: 25802210 DOI: 10.1177/0969733015573653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. OBJECTIVE This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. RESEARCH DESIGN In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. PARTICIPANTS AND RESEARCH CONTEXT A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. ETHICAL CONSIDERATIONS The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. FINDINGS Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. CONCLUSION The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women.
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Affiliation(s)
| | | | | | - Parvin Abedi
- Ahvaz Jundishapur University of Medical Sciences, Iran
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