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Orwa SA, Gudnadottir U, Boven A, Pauwels I, Versporten A, Vlieghe E, Brusselaers N. Global prevalence of antibiotic consumption during pregnancy: A systematic review and meta-analysis. J Infect 2024; 89:106189. [PMID: 38844084 DOI: 10.1016/j.jinf.2024.106189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Antibiotic use during pregnancy is widespread with notable variations across regions. METHODS This systematic review and meta-analysis (Prospero protocol CRD42023418979) examines the prevalence and variability of antibiotic use in pregnancy globally and regionally, considering different methodologies and maternal characteristics. We searched Embase, PubMed, and Web of Science for observational studies published in English from the year 2000 and onwards. Random-effect meta-analyses were used to pool the prevalence of antibiotic consumption during pregnancy, presented as percentages with 95% confidence intervals (CI). Joanna Briggs Institute Critical appraisal checklist for prevalence studies was used for bias assessment. FINDINGS Overall, 116 studies (14 from Africa, 24 from the Americas, six from Eastern Mediterranean, 57 from Europe, four from South-East Asia and 11 from Western Pacific) were included (33,821,194 pregnancies). The majority of studies (84.5%) were appraised with a low risk of bias. The prevalence of antibiotic consumption during pregnancy ranged between 0.04 to 90%, with a pooled estimate of 23.6% (95% CI: 20.1-27.5, I2 =100%). Low-income countries had the highest pooled prevalence (45.3%, 95% CI: 15.4-79.1, I2 =99.6%). Regionally, the Western Pacific had the highest pooled prevalence (34.4%, 95% CI: 13.4-64.1, I2 =100%). The prevalence of antibiotic consumption during pregnancy increased over time in the Americas and Western Pacific. The studies exhibited considerable heterogeneity (I2 >95%), and the trim-and-fill method estimated a potential 10% underestimation of the overall pooled prevalence, suggesting publication bias. INTERPRETATION This meta-analysis suggests that about 1/4 of women worldwide use antibiotics during pregnancy. This study suggests a high prevalence of antibiotic consumption during pregnancy with disparities according to region and level of country income, ethnicity and whether antibiotics were prescribed or self-medicated. There was a variability in reported findings across age categories, potential bias from small sample sizes, and language bias from including only studies published in English.
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Affiliation(s)
- Sheila A Orwa
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Unnur Gudnadottir
- Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Annelies Boven
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ines Pauwels
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ann Versporten
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Erika Vlieghe
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Antwerp, Belgium
| | - Nele Brusselaers
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
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Abiri OT, Lawal S, Coker J, Russell JBW, Kamara IF, Sesay NI, Kanu JS, Turay FU, Lahai M, Carter HEC, Bawoh M, Samai M. Assessment of self-medication practices and safety profile of medicines utilisation among pregnant women attending antenatal clinics in Freetown, Sierra Leone: a multicentre cross-sectional study. J Pharm Policy Pract 2024; 17:2380874. [PMID: 39055112 PMCID: PMC11271070 DOI: 10.1080/20523211.2024.2380874] [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: 04/23/2024] [Accepted: 07/04/2024] [Indexed: 07/27/2024] Open
Abstract
Background Despite the potential foetal and maternal risks of self-medication, studies on self-medication practice and the safety profile of medicines used during pregnancy are scarce in our setting. This study determined the self-medication practice and safety profile of medicines used among pregnant women. Methods This cross-sectional study was conducted in face-to-face interviews among 345 pregnant women at three hospitals in Sierra Leone. Data were analysed using descriptive statistics and binary logistic regression to determine the prevalence and associated factors of self-medication. Results A total of 345 pregnant women participated in the study. The prevalence of self-medication prevalence among pregnant women with conventional and/or herbal medicine was 132 (38.3%). Also, 93 (75%) of the conventional medicines (CMs) were categorised as probably safe, of which paracetamol 36 (29.0%) was commonly used, followed by amoxicillin 23 (18.5%) and antimalarials 22 (17.7%) for common illnesses such as headache 30 (25.4%), urinary tract infection 23 (19.4%) and malaria 22 (18.6%). The most common reason for self-medication was previous experience with the disease 24 (27.3%). Luffa acutangula 19 (30.2%) was the most used herbal medicine (HM), and Oedema 30 (47.6%) was the most reported ailment. Among the HM users, 34 (54.0%) believe they are more effective than CMs. Secondary school education (AOR = 2.128, 95%CI = 1.191-3.804, p = 0.011), tertiary education (AOR = 2.915, 95%CI = 1.104-7.693, p = 0.031), monthly income of greater than NLe 1,000 (AOR = 4.084, 95% CI = 1.269-13.144, p = 0.018), and perceived maternal illness (AOR = 0.367, CI = 0.213-0.632, p = <0.001) were predictors of self-medication. Conclusion Self-medication practice was highly prevalent and was associated with educational status, monthly income, and perceived maternal illness during pregnancy. Therefore, intervention programmes should be designed and implemented to minimise the practice and risk associated with self-medication among pregnant women.
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Affiliation(s)
- Onome Thomas Abiri
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Shakiratu Lawal
- Department of Clinical Pharmacy, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joshua Coker
- Department of Internal Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - James Baligeh Walter Russell
- Department of Internal Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ibrahim Franklyn Kamara
- Reproductive Maternal Newborn, Child and Adolescent Health, Universal Health Coverage/Life Course Cluster, World Health Organisation Country Office, Freetown, Sierra Leone
| | - N’falie Ibrahim Sesay
- Department of Obstetrics and Gynaecology, University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra Leone
| | - Joseph Sam Kanu
- Department of Community Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Foday Umaro Turay
- Department of Pharmaceutical Chemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Michael Lahai
- Department of Pharmaceutical Chemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Henry Edward Clarence Carter
- Department of Pharmaceutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Bawoh
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Gashaw A, Kebede D, Regasa T, Bekele H. Colostrum avoidance and associated factors among mothers of less than 6-month-old children in Dilla town, Southern Ethiopia. Front Pediatr 2024; 12:1399004. [PMID: 39055619 PMCID: PMC11269136 DOI: 10.3389/fped.2024.1399004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Background Colostrum, often referred to as "golden milk," is the initial milk produced after birth, crucial for preventing childhood malnutrition and boosting natural immunity. Neglecting colostrum intake heightens vulnerability to infections and mortality, particularly in developing regions of the world. Colostrum avoidance is prevalent in Ethiopia. This research aims to investigate the frequency and factors that contribute to colostrum avoidance in Dilla town, Southern Ethiopia. Method A community-based, cross-sectional study was carried out in late 2023. Data were gathered from 350 participants, selected through multistage sampling, using structured questionnaires and face-to-face interviews. Data entry was conducted using Epi Data version 4.2.0 and transferred to Stata version 18 for analysis. Bivariate and multivariable logistic regression analyses were employed to identify the factors associated with colostrum avoidance, with a significance level of p < 0.05. Result The rate of prevalence of colostrum avoidance was 28.3% [95% confidence interval (CI): 18.4%-38.2%]. Late initiation of breastfeeding [adjusted odds ratios (AOR) 4.15, 95% CI: 2.51-6.84] prelacteal feeding, non-use of postnatal care (PNC) (AOR 1.79, 95% CI: 1.05-3.04), and lack of information about colostrum (AOR 1.88, 95% CI: 1.14-3.08) were the factors significantly associated with colostrum avoidance. Conclusions and recommendations A high prevalence of colostrum avoidance was observed, with prelacteal feeding, delayed initiation of breastfeeding, lack of PNC, and inadequate maternal knowledge about colostrum identified as contributing factors. Consequently, interventions aimed at reducing colostrum avoidance should prioritize improving access to and promotion of PNC, promoting timely initiation of breastfeeding, and intensifying awareness campaigns highlighting the advantages of colostrum, while emphasizing the risks associated with prelacteal feeding.
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Affiliation(s)
- Anteneh Gashaw
- Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia
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Di Bello F, Califano G, Morra S, Ruvolo CC, Fraia A, Pezone G, Di Mauro E, Aprea S, Napolitano L, Saccone G, Creta M, Longo N. Urological Challenges during Pregnancy: Current Status and Future Perspective on Ureteric Stent Encrustation. J Clin Med 2024; 13:3905. [PMID: 38999471 PMCID: PMC11242795 DOI: 10.3390/jcm13133905] [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: 06/11/2024] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
The management of ureter hydronephrosis and urolithiasis during pregnancy has been changed by the adoption of ureteric stents. Despite their broad use for several other conditions, from emergency to elective settings, their complications cannot be ignored. Being most prevalent during pregnancy, urinary tract infections and stent encrustations are particularly common and can affect either fetal growth or maternal-fetal homeostasis, leading to obstetric complications. The main concern associated with ureteric stents is the indwelling time, which could represent the potential trigger of those complications. However, to ensure the optimal management of a ureteric stent during pregnancy, factors such as the grading of encrustations and the presence, size, and location of stones should be evaluated in pre-operative planning. As a consequence, a multimodal approach, including obstetrics, gynecologists, urologists, and nurses, is essential to ensure a complication-free procedure and successful ureteric stent removal. Finally, future research should focus on utilizing biodegradable and biocompatible materials to reduce and even eliminate the complications related to forgotten stents in order to reduce the financial burden associated with stent replacement and the management of stent-encrustation-related complications.
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Affiliation(s)
- Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Agostino Fraia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Gabriele Pezone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Ernesto Di Mauro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Salvatore Aprea
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Gabriele Saccone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
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Al Kadri HM, El-Metwally AA, Al Sudairy AA, Al-Dahash RA, Al Khateeb BF, Al Johani SM. Antimicrobial resistance among pregnant women with urinary tract infections is on rise: Findings from meta-analysis of observational studies. J Infect Public Health 2024; 17:102467. [PMID: 38850585 DOI: 10.1016/j.jiph.2024.05.055] [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: 12/24/2023] [Revised: 04/23/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024] Open
Abstract
Pregnant women have a higher risk of urinary tract infections (UTIs) compared to non-pregnant women, making antibiotics necessary for treatment. However, prescribing antibiotics without culture and sensitivity tests may contribute to antimicrobial resistance. A meta-analysis using R was conducted to determine the prevalence of antibiotic resistance patterns in UTIs among pregnant women. We identified observational studies published in the last 10 years and used a random effects model to calculate the pooled prevalence. The prevalence of Gram-negative organisms causing UTIs in pregnant women was 67 %, while Gram-positive organisms were 22 %. The burden of Gram-positive organisms exhibiting antimicrobial resistance was very high at 95 %, primarily to ampicillin. The most common Gram-negative organisms exhibiting antimicrobial resistance were E. coli, Klebsiella, and Pseudomonas aeruginosa, while the most common Gram-positive organisms resistant to antibiotics were Staphylococcus aureus and coagulase-negative Staphylococcus. Sensitivity and culture testing are recommended for effective treatment in pregnant women with UTIs.
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Affiliation(s)
- Hanan M Al Kadri
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Ashraf A El-Metwally
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Atika A Al Sudairy
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Raed A Al-Dahash
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Badr F Al Khateeb
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Sameera M Al Johani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
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Muhayimana A, Kearns I. Healthcare providers' perspectives on sustaining respectful maternity care appreciated by mothers in five hospitals of Rwanda. BMC Nurs 2024; 23:442. [PMID: 38943122 PMCID: PMC11212382 DOI: 10.1186/s12912-024-02017-5] [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: 12/30/2023] [Accepted: 05/15/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Childbirth reserves respect, as emphasized by the World Health Organization in 2018, and the focus towards the need for positive, dignified delivery experiences has become an integral aspect of Respectful Maternity Care (RMC). It is a known fact that RMC is pivotal for favourable birth outcomes and contributes to the satisfaction of maternity care. The absence of RMC negatively affects women's and newborns' rights. The study aimed to explore healthcare providers' perspectives on sustaining RMC actions that mothers previously reported. METHODOLOGY This study was conducted in five hospitals in the Eastern province of Rwanda, involving 5 Focus Group Discussions (FGDs) with midwives and nurses. For interviews, we purposively selected 5-unit managers and five physicians. Additionally, 40 midwives and nurses were recruited for the FGDs. The research utilized the Dream phase of Appreciative Inquiry (AI) for interviews and Focus Groups. Data collection aimed to gain insights into Healthcare Providers' perceptions of how RMC is provided and how to establish and sustain RMC in Rwandan health facilities. Nvivo 12 was employed for organizing codes and creating a codebook, and thematic analysis was applied. RESULTS Four themes with sub-themes emerged. Namely, 1) Women-centered care, with Compassionate care, Privacy and confidentiality maintenance, Information provision and Liberty in decision making, Effective communication, Family involvement, Cleanliness, and Equality care. 2) Professionalism compliance with Motivated staff, Teamwork, Continuous development, Quality work provision, and Community trust. 3) RMC encounters 4) RMC sustenance. CONCLUSION AND RECOMMENDATIONS The continuous pursuit of high RMC standards in Rwanda involves improving childbirth experiences through utilizing existing resources, ongoing improvement, and sustaining achievements. Key recommended actions in this study for sustaining RMC encompass promoting women-centred care, enhancing healthcare provider attitudes, ensuring professionalism, building community trust, maintaining conducive health facility environments, and involving leadership.
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Affiliation(s)
- Alice Muhayimana
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- School of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda
| | - Irene Kearns
- Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
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Kazemian SV, Farkhani EM, Jarahi L. Prevalence and determinants of suspected developmental delays among 12-month-old children in northeast of Iran: a large-scale population-based study. BMJ Paediatr Open 2024; 8:e002393. [PMID: 38925677 PMCID: PMC11202658 DOI: 10.1136/bmjpo-2023-002393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Early identification of suspected developmental delays (SDDs) is crucial for planning early interventions. This study aimed to determine the prevalence of SDDs and the associated determinants in children aged 12 months in the northeast of Iran, using the Age and Stage Questionnaire-3 (ASQ-3) as the evaluative tool. METHODS This study conducted an analytical cross-sectional design to investigate all children who had completed the ASQ-3 screening form at 12 months of age within the time frame of 2016-2023 in the northeast of Iran. The necessary data were extracted from the electronic health record database associated with Mashhad University of Medical Sciences. To examine the factors associated with SDDs within each domain of the ASQ-3, a multiple logistic regression model was employed, and the results were presented using ORs along with 95% CIs. RESULTS Over 7 years, 236 476 children (96.74%) underwent routine ASQ-3 screening at 12 months. After excluding certain cases, 226 076 children (95.60%) were included. Among them, 51 593 children (22.82%) had a score below -1 SD, indicating SDD prevalence in at least one domain. The social-personal domain had the highest prevalence with 22 980 children (10.16%), while the gross motor domain had the lowest with 5650 children (2.50%). Logistic regression analysis identified strong predictors of SDDs, including hospitalisation at birth (OR=1.85, 95% CI:1.69 to 2.02), prematurity (OR=1.56, 95% CI: 1.37 to 1.79), urbanisation (OR=1.51, 95% CI: 1.45 to 1.57), boys (OR=1.36, 95% CI: 1.31 to 1.40) and lack of exclusive breast feeding until 6 months (OR=1.30, 95% CI: 1.25 to 1.34). CONCLUSION The prevalence of SDDs highlights the urgency for prompt action, while considering contributing factors. Policymakers can address modifiable risk factors associated with SDDs, including urbanisation risks, support programmes for immigrant families and the importance of exclusive breast feeding until 6 months. Additionally, it is recommended establishing gender-specific local standard cut-off points for the ASQ.
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Affiliation(s)
- Seyedeh Vajiheh Kazemian
- Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran (the Islamic Republic of)
| | - Ehsan Mousa Farkhani
- Department of Epidemiology, Mashhad University of Medical Sciences, Mashhad, Iran (the Islamic Republic of)
| | - Lida Jarahi
- Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran (the Islamic Republic of)
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Gessesse AD, Belete MB, Tadesse F. Time, cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals, northwest Ethiopia: a prospective follow-up study. Front Pediatr 2024; 12:1335858. [PMID: 38919840 PMCID: PMC11196776 DOI: 10.3389/fped.2024.1335858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/15/2024] [Indexed: 06/27/2024] Open
Abstract
Background Globally, 75% of neonatal deaths occur during the first weeks of life and more than 43% of deaths are covered by sub-Saharan Africa. Health-related policymakers and decision-makers need to use evidence-based treatments to reduce the time to early neonatal death and associated predictors. However, there are limited studies on median survival time, cause, incidence, and predictors in the study area as well as the country. Therefore, the aim of the present study was to assess time, the cause of early neonatal death, and its predictors among neonates admitted to neonatal intensive care units at Bahir Dar City public hospitals in northwest Ethiopia. Methods An institution-based prospective follow-up study design was conducted among 387 early neonates selected by systematic sampling between 22 February and 22 April 2023. Statistical software, Epi Data version 4.6 and Stata version 14, was used for entry and analysis, respectively. Proportional hazard assumption and model fitness were checked by the Schoenfeld residual test and the Cox-Snell residual test, respectively. Descriptive statistics, the Kaplan-Meier curve, and the life table were used to describe variables. The Cox regression analysis model was fitted to identify the predictors of early neonatal death. Result During the follow-up time, 59 (15.25%) early neonates died, with an incidence of 31.79 per 1,000 early neonate days [95% confidence interval (CI): 0.024-0.041]. The leading causes of early neonatal death were prematurity complications, asphyxia, sepsis, meconium aspiration syndrome, and necrotizing enterocolitis. The mean survival time was 2.72 days. Being born from a multigravida mother [adjusted hazard ratio (AHR) 4.34; 95% CI: 1.63-11.55], a grand multigravida mother (AHR 3.50; 95% CI: 1.12-10.95), respiratory distress syndrome (AHR 2.60; 95% CI: 1.03-6.58), birth asphyxia (AHR 7.51; 95% CI: 2.30-24.51), a small gestational age (AHR 2.05; 95% CI: 1.08-4.92), and being unable to exclusively breastfeed (AHR 3.46; 95% CI: 1.52-7.88) were significantly associated predictors for time to early neonatal death. Conclusion and recommendations The incidence of early neonatal death was high, and the mean survival time was 2.72 days. Gravidity, respiratory distress syndrome, birth asphyxia, and being unable to exclusively breastfeed were identified as predictors of early neonatal death. Therefore, future research will consist of long-term prospective follow-up studies at a multicenter, nationwide level.
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Affiliation(s)
- Abraham Dessie Gessesse
- Department of Nursing, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Minyichil Birhanu Belete
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fikir Tadesse
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Liu X, Chen HX, Chen B. Impact of combined propranolol and oxytocin on the process and outcomes of labor: a meta-analysis of randomized controlled trials. Eur J Clin Pharmacol 2024; 80:901-910. [PMID: 38436704 DOI: 10.1007/s00228-024-03659-9] [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: 10/02/2023] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To systematically review the impact of propranolol combined with oxytocin on the process and outcomes of labor. METHODS A comprehensive literature search was performed across multiple databases, including China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biomedical Literature Database, PubMed, Embase, and the Cochrane Library. All publicly published randomized controlled trials (RCTs) of propranolol combined with oxytocin compared to the use of oxytocin alone in labor were collected. After screening the literature and extracting data, the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 recommended bias risk assessment tool was used to assess the quality of the included studies. A meta-analysis was conducted using RevMan 5.3 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the quality of evidence for outcome measures. RESULTS Meta-analysis results showed that the group receiving propranolol combined with oxytocin was more capable of reducing the cesarean section rate (eight studies, 815 women, RR = 0.67, 95% CI (0.53, 0.86), P = 0.001) and shortening the duration of the latent phase (two studies, 206 women, MD = - 1.20, 95% CI (- 1.97, - 0.43), P = 0.002) and the duration of the active phase on day 1 (two studies, 296 women, MD = - 0.69, 95% CI (- 0.83, - 0.54), P < 0.00001), compared to the oxytocin monotherapy group. No significant difference was found between the two groups in terms of the 5-min Apgar score (five studies, 609 women, MD = - 0.05, 95% CI (- 0.14, 0.04), P = 0.32) and the rate of admissions to the Neonatal Intensive Care Unit (NICU) (three studies, 359 women, RR = 0.82, 95% CI (0.38, 1.79), P = 0.62). CONCLUSION The combined use of propranolol and oxytocin can significantly reduce the cesarean section rate, shorten the duration of the latent phase and the duration of the active phase on day 1, and is safe. However, due to the limitations, the conclusions of this article still need to be verified by large-sample, multicenter, rigorously designed high-quality clinical RCTs. TRIAL REGISTRATION Registration number is INPLASY202390107.
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Affiliation(s)
- Xia Liu
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou, 646000, Sichuan, China
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, Sichuan, China
| | - Hai-Xu Chen
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, Sichuan, China
| | - Bo Chen
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou, 646000, Sichuan, China.
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Shibeshi KA, Lemu YK, Gebretsadik LA, Gebretsadik AM, Morankar S. Sex Disparities: Couple's Knowledge and Attitude Towards Obstetric Danger Signs and Maternal Health Care: in Rural Jimma Zone of Ethiopia. Int J Womens Health 2024; 16:987-1007. [PMID: 38831794 PMCID: PMC11146344 DOI: 10.2147/ijwh.s457357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/23/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose This study aimed to compare knowledge and attitudes towards obstetric danger signs and care between females receiving maternal care and their male partners. Methods and Materials A community-based comparative cross-sectional study was conducted in the rural setting of Jimma, Ethiopia. Female and their male partners were selected randomly. The number of participants included from each sex was 3235 totaling 6470. Face-to-face data collection was employed using open data kit (ODK) software. A pre-test was performed before the data collection. Descriptive and analytical statistical analysis was used to compare knowledge and attitudes regarding obstetric danger signs and care. Predictor variables were declared considering a 95% confidence interval, adjusted odds ratio (AOR) and P-value less than 0.05. Results On average, male and female participants identified at least two obstetric danger signs. More females could mention more antenatal, childbirth, and postnatal danger signs than their male partners. Both females and their male partners who listened to the radio at least once per week had a statistically significant positive attitude towards obstetric care. Nonetheless, both had an almost similar magnitude of attitude towards obstetric care irrespective of belonging to different occupational, educational, and other social strata. Males' knowledge of danger signs during pregnancy (95% CI = (1.07-1.62), AOR = 1.32, P < 0.008) and postnatal care (95% CI = (1.16-1.89), AOR = 1.48, P < 0.002) had a statistically significant association with the females utilization antenatal care (ANC) service, though not delivery care (DC) or postnatal (PNC). Conclusion There were inequalities in obstetric danger signs knowledge between females and their male partners. Male partners' knowledge of obstetric danger signs is not only significant during pregnancy and delivery but also has a lasting impact on post-natal service utilization, which underscores the importance of their involvement in maternal healthcare.
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Affiliation(s)
- Ketema Ayele Shibeshi
- Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia
- Department of Public Health, Dire Dawa University, Dire Dawa, Ethiopia
| | | | | | | | - Sudhakar Morankar
- Department of Health, Behavior and Society, Jimma University, Jimma, Ethiopia
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Finnbogadóttir HR, Henriksen L, Hegaard HK, Halldórsdóttir S, Paavilainen E, Lukasse M, Broberg L. The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253044. [PMID: 38805432 DOI: 10.1177/15248380241253044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.
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Affiliation(s)
| | | | - Hanne Kristine Hegaard
- Copenhagen University Hospital-Rigshospitalet, Denmark
- The University of Copenhagen, Denmark
| | | | | | | | - Lotte Broberg
- Bispebjerg and Frederiksberg Hospital, Denmark
- Slagelse Hospital, Denmark
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Ferede WY, Berihun Erega B, Yehuala ED, Yimer TS. An assessment of the provision of women-friendly care and its associated factors among mothers who gave birth at public health institutions in South Gondar Zone, Northwest Ethiopia. Front Glob Womens Health 2024; 5:1368388. [PMID: 38860180 PMCID: PMC11163033 DOI: 10.3389/fgwh.2024.1368388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction "Women-friendly care" is one of the categories of respectful maternal care and is a method of providing care that improves women's access to safe parenting and to reproductive health services by creating a friendly environment at all levels. Improving service use is crucial, particularly in situations where it is low. There is limited data on women-friendly care during childbirth in Ethiopia. Objective This study aimed to assess the provision of women-friendly care and its associated factors among mothers who gave birth at health institutions in the South Gondar zone, Northwest Ethiopia. Methods A multicenter institutional-based cross-sectional study design was conducted among mothers who gave birth at South Gondar Zone public health institutions, from February 01 to March 30/2021. Three hundred forty-eight study participants were selected by using systematic random sampling. A validated questionnaire was used for data collection. For analysis, the data were imported into Epi-Data version 4.6 and exported to SPSS version 25. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Results The study had 344 participants in total, with a response rate of 98.85%. The study revealed that a full 73% [95%; CI: 68.6, 77.3%] its participants received women-friendly care. Having antenatal care follow-up [AOR: 3.02, 95% CI: 2.16-11.68], being a primipara [AOR = 2.30 95% CI: 1.23-5.49], not experiencing complications during childbirth [AOR: 2.13, 95% CI: 1.17-12.4], stays at health care facilities, specifically between 13 and 24 h [AOR: 0.25, 95% CI: 0.09-0.67], place for delivery [AOR: 2.01, 95% CI: 1.29-6.09] and delivering during daytime hours [AOR = 2.17, 95% CI: 1.08-5.65] were significantly associated with the provision of women-friendly care. Conclusions Only two-thirds of the study participants received Women's-friendly care during childbirth. It was found to be low in our study area in contrast with the majority of the previous findings. Our own findings also suggest the importance of minimizing elective induction of labor during night, of providing comprehensive counseling on antenatal care follow-up, of ensuring mothers remain at health care facilities until the recommended duration, and of implementing early prevention and management of childbirth complications to ensure that mothers receive women-friendly care.
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Sohrabi M, Fathi J, Mohebi S, Hashemizadeh Z, Kholdi S, Hadadi M, Keshavarz K, Darvishvand Z. High prevalence of plasmid-mediated quinolone resistance in escherichia coli strains producing extended-spectrum beta-lactamases isolated from faeces and urine of pregnant women with acute cystitis. Mol Biol Rep 2024; 51:566. [PMID: 38656625 DOI: 10.1007/s11033-024-09491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Escherichia coli is the most common etiological agent of urinary tract infections (UTIs). Meanwhile, plasmid-mediated quinolone resistance (PMQR) is reported in E. coli isolates producing extended-spectrum β-lactamases (ESBLs). Furthermore, the reservoirs and mechanisms of acquisition of uropathogenic Escherichia coli (UPEC) strains are poorly understood. On the other hand, UTIs are common in pregnant women and the treatment challenge is alarming. METHODS AND RESULTS In the present study, 54 pregnant women with acute cystitis were included. A total of 108 E. coli isolates, 54 isolates from UTI and 54 isolates from faeces of pregnant women (same host) were collected. In the antimicrobial susceptibility test, the highest rate of antibiotic resistance was to nalidixic acid (77%, 83/108) and the lowest rate was to imipenem (9%, 10/108). Among the isolates, 44% (48/108) were ESBLs producers. A high frequency of PMQR genes was observed in the isolates. The frequency of PMQR genes qnrS, qnrB, aac(6')-Ib-cr, and qnrA was 58% (63/108), 21% (23/108), 9% (10/108), and 4% (4/108), respectively. Meanwhile, PMQR genes were not detected in 24% (20/85) of isolates resistant to nalidixic acid and/or fluoroquinolone, indicating that other mechanisms, i.e. chromosomal mutations, are involved in resistance to quinolones, which were not detected in the present study. In ESBL-producing isolates, the frequency of PMQR genes was higher than that of non-ESBL-producing isolates (81% vs. 53%). Meanwhile, UTI and faeces isolates mainly belonged to phylogenetic group B2 (36/54, 67% and 25/54, 46%, respectively) compared to other phylogenetic groups. In addition, virulence factors and multidrug-resistant (MDR) were mainly associated with phylogenetic group B2. However, predominant clones in faeces were not found in UTIs. Rep-PCR revealed the presence of 85 clones in patients. Among the clones, 40 clones were detected only in faeces (faeces-only), 35 clones only in UTI (UTI-only) and 10 clones in both faeces and UTI (faeces-UTI). We found that out of 10 faeces-UTI clones, 5 clones were present in the host's faeces flora. CONCLUSION This study revealed a high rate of resistance to the quinolone nalidixic acid and a widespread distribution of PMQR genes in MDR E. coli strains producing ESBLs. The strains represented virulence factors and phylogenetic group B2 are closely associated with abundance in UTI and faeces. However, the predominant clones in faeces were not found in UTIs and it is possible that rep-PCR is not sufficiently discriminating clones.
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Affiliation(s)
- Maryam Sohrabi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Fathi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Mohebi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hashemizadeh
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Soudeh Kholdi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Hadadi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kowsar Keshavarz
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Darvishvand
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Schafer KM, Mulligan E, Shapiro MO, Flynn H, Joiner T, Hajcak G. Antenatal anxiety symptoms outperform antenatal depression symptoms and suicidal ideation as a risk factor for postpartum suicidal ideation. ANXIETY, STRESS, AND COPING 2024:1-11. [PMID: 38523456 DOI: 10.1080/10615806.2024.2333377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/16/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND AND OBJECTIVES Suicidal ideation (SI) during the postpartum phase is linked with suicide, a leading cause of death during this period. Antenatal depression and anxiety symptoms have both been linked with increased risk for postpartum SI. However, research aimed at examining the relative contributions of antenatal anxiety and depression symptoms towards postpartum SI remains nascent. In this study, we investigated the relative contribution of antenatal anxiety symptoms, depression symptoms, and SI towards postpartum SI. DESIGN These data are from a longitudinal study in which American mothers were assessed during pregnancy and again at six- to eight weeks postpartum. METHODS Data were analyzed using correlations and logistic regression models. RESULTS Antenatal anxiety symptoms and antenatal depression symptoms were significantly correlated with postpartum SI. Results from a logistic regression model indicated that antenatal anxiety symptoms (T1; OR = 1.185 [1.125, 1.245], p = .004), but not antenatal depression symptoms (T1; OR = 1.018 [0.943, 1.093], p = .812) or antenatal SI (T1; OR = 1.58 [0.11, 22.29], p = 0.73), were significantly associated with postpartum SI. CONCLUSIONS Antenatal anxiety symptoms, depression symptoms, and SI were positively associated with postpartum SI. When examined simultaneously, anxiety symptoms during the antenatal phase (but not depression symptoms or SI) predicted SI in the postpartum phase.
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Affiliation(s)
- Katherine Musacchio Schafer
- Tennessee Valley Healthcare System, Geriatric Research and Education Clinical Center, Nashville, TN, USA
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
| | | | - Mary O Shapiro
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, LA, USA
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - Heather Flynn
- School of Medicine, Florida State University, Tallahassee, FL, USA
| | - Thomas Joiner
- Psychology, Florida State University, Tallahassee, FL, USA
| | - Greg Hajcak
- Psychology, Florida State University, Tallahassee, FL, USA
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Patjas A, Martelius A, Ollgren J, Kantele A. International travel increases risk of urinary tract infection caused by extended-spectrum beta-lactamase-producing Enterobacterales-three-arm case-control study. J Travel Med 2024; 31:taad155. [PMID: 38123504 DOI: 10.1093/jtm/taad155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) have worldwide become increasingly prevalent as pathogens causing urinary tract infections (UTIs), posing challenges in their treatment. Of particular concern are travellers to low- and middle-income countries (LMICs), a substantial proportion of whom become colonized by ESBL-PE, with UTIs as the most common clinical manifestation. Seeking tools for preventing ESBL-PE UTI, we explored factors associated with (i) any UTI (versus control), (ii) ESBL-PE UTI (versus control) and (iii) ESBL-PE versus non-ESBL-PE UTI. METHODS During 2015-20, we recruited patients with recent ESBL-PE or non-ESBL-PE UTIs, and controls with no UTI to fill in questionnaires covering potential (ESBL-PE-)UTI risk factors. RESULTS Of our 430 participants, 130 had ESBL-PE UTI and 187 non-ESBL-PE UTI; 113 were controls. Our three comparisons showed several risk factors as exemplified for any UTI versus controls by female sex, lower education, age, diabetes, antibiotic use, diarrhoea; for ESBL-PE UTI versus controls by travel to LMICs, antibiotic use, swimming; and ESBL-PE versus non-ESBL-PE UTI by male sex, higher education, LMIC travel (participant/household member), pets and antibiotic use. Weekly fish meals appeared protective against both UTI and ESBL-PE UTI. CONCLUSIONS Of the numerous factors predisposing to UTI and/or ESBL-PE UTI, our study highlights antibiotic use and LMIC travel. Household members' LMIC travel appears to pose a risk of ESBL-PE UTI, pointing to household transmission of travel-acquired uropathogens. As predisposing factors to multidrug-resistant UTI, international travel and antibiotic use constitute practical targets for prevention efforts.
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Affiliation(s)
- Anu Patjas
- Meilahti Vaccine Research Centre, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Antimicrobial Resistance Research, FIMAR, Helsinki, Finland
| | - Antti Martelius
- Meilahti Vaccine Research Centre, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland
| | - Jukka Ollgren
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anu Kantele
- Meilahti Vaccine Research Centre, MeVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Human Microbiome Research Unit, University of Helsinki, Helsinki, Finland
- Centre of Excellence in Antimicrobial Resistance Research, FIMAR, Helsinki, Finland
- Travel Clinic, Aava Medical Centre, Helsinki, Finland
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Mohamed FY, Dahie HA, Mohamoud JH, Adam MH, Dirie HM. Prevalence, antimicrobial susceptibility profile, and associated risk factors of uropathogenic Escherichia coli among pregnant women attending Dr. Sumait Hospital Mogadishu, Somalia. Front Public Health 2024; 11:1203913. [PMID: 38328535 PMCID: PMC10847321 DOI: 10.3389/fpubh.2023.1203913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/28/2023] [Indexed: 02/09/2024] Open
Abstract
Background Uropathogenic Escherichia coli (UPEC) is a strain of E. coli commonly associated with urinary tract infections. In addition, antibiotic resistance in UPEC is one of the most significant health problems. This study was conducted to determine the prevalence, antimicrobial resistance, and factors linked to uropathogenic Escherichia coli (UPEC) in pregnant women. Methods This cross-sectional study was conducted within a hospital setting between August 2022 and December 2022. Using consecutive convenient sampling, the research enrolled 220 pregnant women. The urine samples obtained from these women were cultured on MacConkey and blood agar and incubated at 37°C overnight, followed by sub-culturing on Mueller Hinton media. Bacterial identification involved Gram staining and biochemical characterization (TSI, indole, citrate, methyl red, urea agar, and motility tests). Conversely, susceptibility tests were performed using the Kirby-Bauer disk diffusion method. A binary logistic regression model and analysis of odds ratios (ORs) were employed to evaluate the risk factors associated with E. coli infection, and statistical significance was attributed to p-values of ≤0.05. Results Out of the 220 urine samples examined, 42 (19%) exhibited a positive culture, indicating an E. coli infection in pregnant women. Our analysis revealed that income, gestational age, and history of UTIs were identified as risk factors associated with E. coli infection. Most E. coli isolates demonstrated sensitivity to amikacin (100%), nitrofurantoin (85.7%), amoxicillin/clavulanic acid, and meropenem (83.3%). Conclusion The prevalence of E. coli was remarkable. It could be recommended that pregnant women in antenatal care have routine culture and antimicrobial susceptibility tests to prevent transmission of resistant pathogens and complications in both pregnant mothers and the unborn baby.
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Affiliation(s)
- Fartun Yasin Mohamed
- Departments Microbiology and Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | | | - Jamal Hassan Mohamoud
- Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Mohamed Hussein Adam
- Department of Public Health, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Hassan Mohamud Dirie
- Departments Microbiology and Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
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Bratosin F, Folescu R, Krupyshev P, Popa ZL, Citu C, Ratiu A, Rosca O, Ilie AC. Comparative Analysis of Microbial Species and Multidrug Resistance Patterns Associated with Lower Urinary Tract Infections in Preterm and Full-Term Births. Microorganisms 2024; 12:139. [PMID: 38257966 PMCID: PMC10821109 DOI: 10.3390/microorganisms12010139] [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: 12/25/2023] [Revised: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The rise of multidrug-resistant organisms has significantly complicated the clinical management of urinary tract infections (UTIs), particularly in the context of pregnancy. This study aimed to identify and analyze the significant differences in microbial species and multidrug resistance patterns associated with UTIs in preterm versus full-term births, determine the bacterial species significantly associated with preterm birth, and describe the antibiotic resistance patterns affecting pregnant women with UTIs. This case-control study was conducted in western Romania and focused on pregnant women with UTIs admitted from 2019 to 2023. Data were retrospectively collected from 308 patients with positive cultures. Statistical analyses, including the Chi-square test, Fisher's exact test, and logistic regression models, were employed to compare the proportions of microbial species and resistance patterns between preterm (n = 126) and full-term (n = 182) birth groups and identify factors independently associated with preterm birth. The study found no significant differences in demographic or lifestyle factors between the groups. However, significant differences were observed in several infection and inflammation markers. The median white blood cell count was higher in the preterm group (12.3 vs. 9.1, p = 0.032), and the median C-reactive protein level was significantly higher in the preterm group (18 vs. 7, p < 0.001). The preterm group exhibited a higher incidence of multidrug-resistant organisms, notably ESBL-producing organisms (19.8% vs. 4.4%, p < 0.001) and carbapenem-resistant Enterobacteriaceae (4.8% with p = 0.003). Notably, the resistance to amoxicillin was significantly higher in the preterm group (20.6% vs. 6.6%, p < 0.001). Significant bacterial associations with preterm births included Group B Streptococcus (OR 2.5, p = 0.001) and Enterobacter spp. (OR 1.8, p = 0.022). The study confirmed significant differences in microbial species and multidrug resistance patterns between UTIs associated with preterm and full-term births. The higher prevalence of certain bacteria and increased resistance to commonly used antibiotics in the preterm group underscore the need for tailored antimicrobial therapies and robust microbial identification in managing UTIs during pregnancy.
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Affiliation(s)
- Felix Bratosin
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.B.); (O.R.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Methodological and Infectious Diseases Research Center, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Folescu
- Department of Family Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Pavel Krupyshev
- Faculty of General Medicine, I.M. Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Ulitsa 2, 119435 Moscow, Russia;
| | - Zoran Laurentiu Popa
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.C.); (A.R.)
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.C.); (A.R.)
| | - Adrian Ratiu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (C.C.); (A.R.)
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (F.B.); (O.R.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Methodological and Infectious Diseases Research Center, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Adrian Cosmin Ilie
- Department III Functional Sciences, Division of Public Health and Management, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
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Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZAS, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. J Reprod Infant Psychol 2024; 42:5-21. [PMID: 35435061 DOI: 10.1080/02646838.2022.2059458] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.
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Affiliation(s)
- Azam Bakhteh
- Student Research Center, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, School of Health & Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mitra Kolivand
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Lau EYH, Li JB, Siu CTS. Postnatal depressive symptoms mediate the relation between prenatal role overload and responsiveness among first-time mothers. J Reprod Infant Psychol 2024; 42:95-109. [PMID: 35499554 DOI: 10.1080/02646838.2022.2070609] [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: 12/31/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study examined the association between prenatal role overload and maternal responsiveness, with postnatal depressive symptoms as a mediator. METHODS Participants were 127 first-time mothers in Hong Kong (M = 32.8, SD = 4.0). Participants completed data collection for self-report on prenatal role overload (Time 1) in the third trimester of pregnancy, postnatal depressive symptoms (Time 2) at 4-month postpartum and maternal responsiveness (Time 3) at 9-month postpartum. The hypothesised mediation model was tested with the Hayes PROCESS macro (model 4). RESULTS Time 1 prenatal role overload was not directly predictive of later responsiveness (B = -0.06, p = .270). However, the indirect effect of Time 2 postnatal depressive symptoms in the association between Time 1 prenatal role overload and Time 3 responsiveness was significant (unstandardised effect = -0.03, 95% Bootstrapping CI = [-0.081, -0.001]; standardised effect = -0.06, 95% Bootstrapping CI = [-0.152, -0.002]). CONCLUSION Findings highlighted that more attention is required to the support provided to first-time expectant mothers to prevent role overload, and that intervention for postnatal depressive symptoms may focus on role overload. The findings also highlighted that postnatal depressive symptoms could be a promising way to increase maternal responsiveness.
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Affiliation(s)
- Eva Yi Hung Lau
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
| | - Jian-Bin Li
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
| | - Carrey Tik-Sze Siu
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong
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20
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Radu VD, Vicoveanu P, Cărăuleanu A, Adam AM, Melinte-Popescu AS, Adam G, Onofrei P, Socolov D, Vasilache IA, Harabor A, Melinte-Popescu M, Scripcariu IS, Mihalceanu E, Stuparu-Cretu M, Harabor V. Pregnancy Outcomes in Patients with Urosepsis and Uncomplicated Urinary Tract Infections-A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2129. [PMID: 38138232 PMCID: PMC10744995 DOI: 10.3390/medicina59122129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/26/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Urinary tract infections (UTIs) are an important cause of perinatal and maternal morbidity and mortality. The aim of this study was to describe and compare the main pregnancy outcomes among pregnant patients with complicated and uncomplicated UTIs; Materials and Methods: This retrospective study included 183 pregnant patients who were evaluated for uncomplicated UTIs and urosepsis in the Urology Department of 'C.I. Parhon' University Hospital, and who were followed up at a tertiary maternity hospital-'Cuza-voda' from Romania between January 2014 and October 2023. The control group (183 patients) was randomly selected from the patient's cohort who gave birth in the same time frame at the maternity hospital without urinary pathology. Clinical and paraclinical data were examined. Descriptive statistics and a conditional logistic regression model were used to analyze our data. Results: Our results indicated that patients with urosepsis had increased risk of premature rupture of membranes (aOR: 5.59, 95%CI: 2.02-15.40, p < 0.001) and preterm birth (aOR: 2.47, 95%CI: 1.15-5.33, p = 0.02). We could not demonstrate a statistically significant association between intrauterine growth restriction and pre-eclampsia with the studied urological pathologies. Conclusions: Careful UTI screening during pregnancy is needed for preventing maternal-fetal complications.
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Affiliation(s)
- Viorel-Dragos Radu
- Urology Department, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania (P.O.)
| | - Petronela Vicoveanu
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - Alexandru Cărăuleanu
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - Ana-Maria Adam
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania; (A.-M.A.); (A.H.)
| | - Alina-Sinziana Melinte-Popescu
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania;
| | - Gigi Adam
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania; (G.A.); (M.S.-C.)
| | - Pavel Onofrei
- Urology Department, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania (P.O.)
| | - Demetra Socolov
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - Ingrid-Andrada Vasilache
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - AnaMaria Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania; (A.-M.A.); (A.H.)
| | - Marian Melinte-Popescu
- Department of Internal Medicine, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania
| | - Ioana Sadiye Scripcariu
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - Elena Mihalceanu
- Department of Mother and Child Care, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.S.); (I.S.S.); (E.M.)
| | - Mariana Stuparu-Cretu
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania; (G.A.); (M.S.-C.)
| | - Valeriu Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania; (A.-M.A.); (A.H.)
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Dereje I, Awol M, Getaye A, Tujara Z, Alemu A, Negash A, Alemu F, Zakir H, Dinka A, Edosa D, Shigign I, Tunta A, Mekonnen M, Tolesa F, Bekele K, Merkeb B, Oyato B, Tesfa M. Estimating gestational age using the anthropometric measurements of newborns in North Shewa Zone public hospitals, Oromia, Ethiopia. Front Pediatr 2023; 11:1265036. [PMID: 38125819 PMCID: PMC10731036 DOI: 10.3389/fped.2023.1265036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023] Open
Abstract
Background The accurate estimation of gestational age is crucial in identifying prematurity and other health problems in newborns and in providing appropriate perinatal care. Although there are numerous methods for measuring gestational age, they are not always applicable. During these situations, it becomes challenging to ascertain whether a baby has been born prematurely or not. Therefore, this study aims to estimate gestational age by utilizing newborn anthropometric parameters. Purpose The objective of this study is to estimate the gestational age of newborns in public hospitals located in the North Shewa Zone of the Oromia Region in Ethiopia, by using anthropometric parameters. Methods A cross-sectional study was conducted at a facility from February 2022 to April 2022, using an interview-based questionnaire and anthropometric measurements. The anthropometric parameters that were measured include foot length (FL), mid-upper arm circumference (MUAC), and chest and head circumference (CHC). The study's sample size had a total of 420 participants. The data were cleaned, edited, manually checked for completeness, and entered into Epi-data version 3.1. Subsequently, the data were transferred into SPSS for analysis. The data were analyzed using descriptive analysis, simple linear regression, and multiple linear regressions. Finally, the data were presented using statements and tables. Results There is a significant and positive correlation between anthropometric parameters, including head circumference (r: 0.483), MUAC (r: 0.481), foot length (r: 0.457), and chest circumference (r: 0.482) with gestational age. All anthropometric parameters demonstrated positive and significant estimates of gestational age. The combination of the four measurements yielded the strongest estimate of gestational age. Gestational age can be calculated by the formula: Gestational age (Weeks) = 9.78 + 0.209*CHC + 0.607*MUAC + 0.727*FL + 0.322*HC. Conclusion Gestational age can be measured using head circumference, mid-upper arm circumference, foot length, and chest circumference. Utilizing the four anthropometric parameters in combination exhibits greater efficacy in estimating gestational age than using them individually. Therefore, it is recommended to use these alternative approaches when standard methods are not applicable.
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Affiliation(s)
- Ifa Dereje
- Department of Medicine, College of Health Sciences, Salale University, Fitche, Oromia, Ethiopia
| | - Mukemil Awol
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Asfaw Getaye
- Department of Nursing, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Zenebe Tujara
- Department of Medicine, College of Health Sciences, Salale University, Fitche, Oromia, Ethiopia
| | - Adugna Alemu
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Abdi Negash
- Department of Medical Laboratory, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Fedasan Alemu
- Department of Medical Laboratory, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Husen Zakir
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Ararsa Dinka
- Department of Pharmacy, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Dejene Edosa
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Irean Shigign
- Department of Public Health, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Abayneh Tunta
- Department of Biomedical Science, College of Health Science, Woldia University, Woldia, Amhara, Ethiopia
| | - Mathewos Mekonnen
- Department of Nursing, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Fikadu Tolesa
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Kumera Bekele
- Department of Nursing, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Belay Merkeb
- Department of Medical Laboratory, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Befekadu Oyato
- Department of Midwifery, College of Health Science, Salale University, Fitche, Oromia, Ethiopia
| | - Mekonnin Tesfa
- Department of Medicine, College of Health Sciences, Salale University, Fitche, Oromia, Ethiopia
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Etil T, Opio B, Odur B, Lwanga C, Atuhaire L. Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital. BMC Pregnancy Childbirth 2023; 23:814. [PMID: 37996791 PMCID: PMC10666300 DOI: 10.1186/s12884-023-06120-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) defines Preterm Birth (PTB) as "a live birth taking place before the expected 37 weeks of gestation". Annually, approximately 15 million infants are born prematurely, constituting significantly to infant mortality during the initial four weeks of life, responsible for 40% of deaths among children under the age of five. Evidently, preterm deliveries have contributed to 46% of admissions to the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH) over the past three years. Paradoxically, while the prevalence of preterm births remains high, there is a lack of documented information regarding the underlying risk factors. Consequently, the primary objective of this study was to assess the potential risk factors associated with preterm birth at LRRH. METHODS An analytical cross-sectional research was undertaken at LRRH, employing a quantitative methodology. The study utilized secondary data obtained from a total of 590 comprehensive maternal medical records, of deliveries that occurred at the facility between April 2020 and July 2021. The collected data underwent analysis using STATA version 17 software. To identify predictors of preterm birth, a Logistic regression model was applied, yielding adjusted odds ratios (AOR) alongside 95% confidence intervals (CI). The significance level was set at p < 0.05 to establish statistical significance. Furthermore, assessments for multicollinearity and model fitness were conducted using the Variance Inflation Factor (VIF) and linktest, respectively. RESULTS The prevalence of preterm delivery among mothers who gave birth at LRRH stood at 35.8%. The outcomes of logistic regression analysis revealed that maternal employment status had a statistically significant association with preterm birth (AOR = 0.657, p = 0.037, 95%CI: 0.443-0.975); having a baby with low birth weight (AOR = 0.228, p < 0.001, 95% CI: 0.099-0.527) and experiencing preeclampsia (AOR = 0.142, p < 0.001, 95% CI: 0.088-0.229) were also identified as significant predictors of preterm birth in the study. CONCLUSIONS AND RECOMMENDATIONS The occurrence of preterm delivery is significantly higher (35.8%) among mothers who gave birth at LRRH when compared to the national average (13.6%). The prevalence of preterm birth among mothers was linked to factors such as employment status, delivery of low birth weight infants, and the presence of preeclampsia. Consequently, the research proposes a set of recommendations. Firstly, the Ministry of Health (MoH) should evaluate the present state of readiness within the healthcare system to effectively handle cases of preterm birth both within medical facilities and the community. Secondly, the Ministry of Gender, Labour, and Social Development should leverage Labor Officers to implement and uphold the regulations stipulated in the Employment Act and Labor Laws.
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Affiliation(s)
- Tom Etil
- School of Statistics and Planning, Makerere University, Kampala, Uganda.
| | - Bosco Opio
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | - Bernard Odur
- School of Statistics and Planning, Makerere University, Kampala, Uganda
| | | | - Leonard Atuhaire
- School of Statistics and Planning, Makerere University, Kampala, Uganda
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23
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Miller L, Schmidt CN, Wanduru P, Wanyoro A, Santos N, Butrick E, Lester F, Otieno P, Walker D. Adapting the preterm birth phenotyping framework to a low-resource, rural setting and applying it to births from Migori County in western Kenya. BMC Pregnancy Childbirth 2023; 23:729. [PMID: 37845611 PMCID: PMC10577962 DOI: 10.1186/s12884-023-06012-7] [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: 03/28/2022] [Accepted: 09/19/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Preterm birth is the leading cause of neonatal and under-five mortality worldwide. It is a complex syndrome characterized by numerous etiologic pathways shaped by both maternal and fetal factors. To better understand preterm birth trends, the Global Alliance to Prevent Prematurity and Stillbirth published the preterm birth phenotyping framework in 2012 followed by an application of the model to a global dataset in 2015 by Barros, et al. Our objective was to adapt the preterm birth phenotyping framework to retrospective data from a low-resource, rural setting and then apply the adapted framework to a cohort of women from Migori, Kenya. METHODS This was a single centre, observational, retrospective chart review of eligible births from November 2015 - March 2017 at Migori County Referral Hospital. Adaptations were made to accommodate limited diagnostic capabilities and data accuracy concerns. Prevalence of the phenotyping conditions were calculated as well as odds of adverse outcomes. RESULTS Three hundred eighty-seven eligible births were included in our study. The largest phenotype group was none (no phenotype could be identified; 41.1%), followed by extrauterine infection (25.1%), and antepartum stillbirth (16.7%). Extrauterine infections included HIV (75.3%), urinary tract infections (24.7%), malaria (4.1%), syphilis (3.1%), and general infection (3.1%). Severe maternal condition was ranked fourth (15.6%) and included anaemia (69.5%), chronic respiratory distress (22.0%), chronic hypertension prior to pregnancy (5.1%), diabetes (3.4%), epilepsy (3.4%), and sickle cell disease (1.7%). Fetal anaemia cases were the most likely to transfer to the newborn unit (OR 5.1, 95% CI 0.8, 30.9) and fetal anomaly cases were the most likely to result in a pre-discharge mortality (OR 3.9, 95% CI 0.8, 19.2). CONCLUSIONS Using routine data sources allowed for a retrospective analysis of an existing dataset, requiring less time and fewer resources than a prospective study and demonstrating a feasible approach to preterm phenotyping for use in low-resource settings to inform local prevention strategies.
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Affiliation(s)
- Lara Miller
- University of California San Francisco, Institute for Global Health Sciences, 550 16Th St, San Francisco, CA, 94158, USA.
| | - Christina N Schmidt
- University of California San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Phillip Wanduru
- School of Public Health, Makerere University, New Mulago Gate Rd, Kampala, Uganda
| | - Anthony Wanyoro
- Department of Obstetrics and Gynaecology, Kenyatta University, Main Campus, Kenya Drive, Nairobi, Kenya
| | - Nicole Santos
- University of California San Francisco, Institute for Global Health Sciences, 550 16Th St, San Francisco, CA, 94158, USA
| | - Elizabeth Butrick
- University of California San Francisco, Institute for Global Health Sciences, 550 16Th St, San Francisco, CA, 94158, USA
| | - Felicia Lester
- Department of Obstetrics, University of California San Francisco, Gynaecology & Reproductive Sciences, 1825 Fourth St Third Floor, San Francisco, CA, 94158, USA
| | - Phelgona Otieno
- Kenya Medical Research Institute, 00200 Off Raila Odinga Way, Nairobi, Kenya
| | - Dilys Walker
- University of California San Francisco, Institute for Global Health Sciences, 550 16Th St, San Francisco, CA, 94158, USA
- Department of Obstetrics, University of California San Francisco, Gynaecology & Reproductive Sciences, 1825 Fourth St Third Floor, San Francisco, CA, 94158, USA
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Khalid A, Haider KA, Ahmer H, Noorani S, Hoodbhoy Z. Why do women still give birth at home; perceptions of Pakistani women and decision-makers from marginalized communities. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002217. [PMID: 37831638 PMCID: PMC10575520 DOI: 10.1371/journal.pgph.0002217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/10/2023] [Indexed: 10/15/2023]
Abstract
In low- and middle-income countries (LMICs), maternal and newborn mortality is high due to the high prevalence of home births. Understanding the reasons behind this behavior is essential for improving maternal and newborn outcomes. Therefore, a qualitative exploratory study was conducted in a peri-urban community in Karachi, Pakistan to understand the perceptions of pregnant women who delivered at home despite receiving antenatal care and the perceptions of their decision-makers regarding this behavior. In-depth interviews were conducted with 15 randomly sampled women who chose to deliver at home after receiving antenatal care at a health facility, as well as 15 family members who were purposively identified as decision-makers by the women themselves. Thematic analysis was performed to explore the perceptions, myths, and cultural beliefs about homebirths as well as women's decision-making power related to childbirth. The three main themes identified showed that traditional beliefs and practices, poverty and gender inequality, and poor healthcare systems significantly influence the preference for childbirth. Traditional beliefs and practices, including religious and cultural beliefs, played a role in perceiving childbirth as a natural process best managed at home. The presence of traditional birth attendants who provide personalized care and emotional support further reinforced this preference. Gender inequalities, including limited access to mobile phones and women's caregiving roles, were identified as barriers to seeking formal healthcare at the time of delivery. Additionally, poor experiences with the formal healthcare system, such as the poor attitude of formal healthcare workers and fear of medical interventions, also contributed to the decision to deliver at home. The study highlighted the complex interplay between traditional/religious beliefs, gender inequalities, and healthcare experiences in shaping the decision to deliver at home despite receiving ANC services in marginalized settings. Addressing these factors is necessary for promoting facility-based delivery and improving maternal and neonatal outcomes in LMICs.
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Affiliation(s)
- Ayesha Khalid
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kaniz Amna Haider
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Hareem Ahmer
- Data and Digital Department, Vital Pakistan Trust, Karachi, Pakistan
| | - Sahir Noorani
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Zahra Hoodbhoy
- Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Sharifi-Heris Z, Amiri-Farahani L, Shahabadi Z, Sanaei M. Impact of social support and mindfulness in the associations between perceived risk of COVID-19 acquisition and pregnancy outcomes in Iranian population: a longitudinal cohort study. BMC Psychol 2023; 11:328. [PMID: 37821989 PMCID: PMC10566097 DOI: 10.1186/s40359-023-01371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND AIMS Various devastating infection outbreaks including COVID-19, threat both mother and fetus health. These life-threating outbreaks as potential harms are highly associated with relevant perceived risk. Social support and mindfulness are two factors that may moderate the associations between the perceived risk of COVID-19 and pregnancy outcomes. In this study we investigated the potential moderating impact of social support and mindfulness in the aforementioned association. METHODS This study is a longitudinal cohort study in which 483 Iranian pregnant women in Tehran have been studied. Perceived risk of COVID-19 questions, Mindful Attention Awareness Scale (MAAS), and Multidimensional Scale of Perceived Social Support (MSPSS) were used through an online platform to assess the independent variables during pregnancy. Neonatal and maternal outcomes including gestational diabetes, gestational hypertension, preeclampsia, abortion, birth weight, and gestational age at birth, was extracted from Electronic Health Record (EHR) after childbirth as the dependent variables. The aim of the study is to investigate whether social support and mindfulness can affect the associations between perceived risk of Covid-19 acquisition and pregnancy outcomes. RESULTS Perceived risk of COVID-19 was negatively associated with pregnancy outcomes including birth weight (-28, 95% CI [-53, -3.4], p < .05) and gestational age at birth (-0.9, 95% CI [-2,0.11], p < .05). However, social support could not moderate these associations. Mindfulness, on the other hand, moderated the association between perceived risk and stillbirth meaning that by increasing mindfulness, the association between the perceived risk and stillbirth may also be increased (OR = 0.03; p < .05). CONCLUSION The findings of this study showed that social support lacks the moderating impact on the association between perceived risk of COVID-19 and pregnancy outcomes. Mindfulness, on the other hand, indicate a positive moderating impact for the association between perceived risk of Covid-19 and stillbirth. More studies in different populations are suggested to investigate the impact of mindfulness and social support on the association between perceived risk and pregnancy outcomes.
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Affiliation(s)
- Zahra Sharifi-Heris
- Sue & Bill Gross School of Nursing, University of California at Irvine, Irvine, CA, USA
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Shahabadi
- Student Research Committee, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Sanaei
- Student Research Committee, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Ansaldi Y, Martinez de Tejada Weber B. Urinary tract infections in pregnancy. Clin Microbiol Infect 2023; 29:1249-1253. [PMID: 36031053 DOI: 10.1016/j.cmi.2022.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/05/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Urinary tract infections (UTIs) are the most common infection among pregnant women and have been associated with maternal and foetal complications. Antimicrobial exposure during pregnancy is not without risk. International guidelines recommend a single screen-and-treat approach to asymptomatic bacteriuria (ASB); however, this approach has been questioned by recent studies. OBJECTIVES The aim of this narrative review was to assess the pathophysiology, current risk factors and management of UTI during pregnancy, its impact on pregnancy outcomes, and to develop recommendations on the best use of antimicrobials. SOURCES PubMed, Cochrane database, and ClinicalTrials.gov. CONTENT Owing to the physiological changes related to pregnancy, pregnant women are at higher risk of UTI. All types of UTIs combined have been estimated to affect approximately 2% to 15% of women. ASB affects 2% to 7% of pregnant women. Recent studies do not provide good-quality evidence for an association between ASB and acute pyelonephritis if ASB is untreated. There is low-to-moderate-quality evidence that treatment of ASB results in a reduction in the incidence of low birth weight and preterm birth, which justifies screening practices for ASB with only a single urine culture in the first trimester. If the clinician opts for treatment, a short course of β-lactams, nitrofurantoin, or fosfomycin should be favoured. Studies on cystitis during pregnancy are limited. Acute pyelonephritis has been shown to be associated with increased maternal complications and in some studies has also been associated with preterm delivery and low birth weight. Preferred antimicrobials for the management of pyelonephritis are amoxicillin combined with an aminoglycoside, third-generation cephalosporins, or carbapenems. Studies on recurrent UTIs during pregnancy are limited, making it difficult to draw conclusions regarding prophylactic measures. IMPLICATIONS Further research is required to understand the true incidence of ASB-related complications and the benefit and modalities of screening for ASB and to further explore prophylactic measures.
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Affiliation(s)
- Yveline Ansaldi
- Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
| | - Begoña Martinez de Tejada Weber
- Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Beyene GM, Azale T, Gelaye KA, Ayele TA. Effect of antenatal depression on ANC service utilization in northwest Ethiopia. Sci Rep 2023; 13:14443. [PMID: 37660079 PMCID: PMC10475009 DOI: 10.1038/s41598-023-37382-9] [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: 11/23/2022] [Accepted: 06/21/2023] [Indexed: 09/04/2023] Open
Abstract
Maternal morbidity and mortality remain high among women who did not attend antenatal care (ANC). Antenatal care is one of the interventions given to pregnant women to detect existed problems or problems that can develop during pregnancy, which harm the health of pregnant women and fetuses. In Ethiopia, however, there is limited evidence that revealed the effect of antenatal depression on ANC service utilization. Hence, this study aimed to see the effect of antenatal depression on ANC visits among women in urban northwest Ethiopia. A population-based, prospective cohort study was done from June 2019 to March 2020. The Edinburgh postnatal depression scale was administered to 970 women in the second and third trimesters of pregnancy to screen for antenatal depression. Additional data were collected on ANC visits, the mother's socio-demographic, obstetric, clinical, psychosocial, and behavioral factors. A logistic regression model was used to adjust confounders and determine associations between antenatal depression and inadequate ANC visits. The cumulative incidence of inadequate ANC visits was 62.58% (95% CI: 59.43, 65.63). The cumulative incidence of inadequate ANC visits among depressed pregnant women was 75% as compared to 56% in non-depressed. The incidence of inadequate ANC visits in the exposed group due to antenatal depression was 25.33%. After multivariable analysis, antenatal depression at the second and third trimesters of pregnancy remained a potential predictor of inadequate ANC visits (AOR = 1.96: (95% CI 1.22, 3.16)). In addition, antenatal depression, long travel time for ANC visits (AOR = 1.83 (95% CI 1.166, 2.870)), and late initiation of ANC visits (AOR = 2.20 (95% CI 1.393, 3.471)) were the predictors of inadequate ANC visits as compared to their counterpart. This study suggested that antenatal depression affects ANC visits in Ethiopian urban settings. Therefore, early detecting and treating depression symptoms during the antenatal period reduced significantly the impacts of depression on the health of the mother and fetus.
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Affiliation(s)
- Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gunabalasingam S, De Almeida Lima Slizys D, Quotah O, Magee L, White SL, Rigutto-Farebrother J, Poston L, Dalrymple KV, Flynn AC. Micronutrient supplementation interventions in preconception and pregnant women at increased risk of developing pre-eclampsia: a systematic review and meta-analysis. Eur J Clin Nutr 2023; 77:710-730. [PMID: 36352102 PMCID: PMC10335932 DOI: 10.1038/s41430-022-01232-0] [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: 03/02/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pre-eclampsia can lead to maternal and neonatal complications and is a common cause of maternal mortality worldwide. This review has examined the effect of micronutrient supplementation interventions in women identified as having a greater risk of developing pre-eclampsia. METHODS A systematic review was performed using the PRISMA guidelines. The electronic databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials were searched for relevant literature and eligible studies identified according to a pre-specified criteria. A meta-analysis of randomised controlled trials (RCTs) was conducted to examine the effect of micronutrient supplementation on pre-eclampsia in high-risk women. RESULTS Twenty RCTs were identified and supplementation included vitamin C and E (n = 7), calcium (n = 5), vitamin D (n = 3), folic acid (n = 2), magnesium (n = 1) and multiple micronutrients (n = 2). Sample size and recruitment time point varied across studies and a variety of predictive factors were used to identify participants, with a previous history of pre-eclampsia being the most common. No studies utilised a validated prediction model. There was a reduction in pre-eclampsia with calcium (risk difference, -0.15 (-0.27, -0.03, I2 = 83.4%)), and vitamin D (risk difference, -0.09 (-0.17, -0.02, I2 = 0.0%)) supplementation. CONCLUSION Our findings show a lower rate of pre-eclampsia with calcium and vitamin D, however, conclusions were limited by small sample sizes, methodological variability and heterogeneity between studies. Further higher quality, large-scale RCTs of calcium and vitamin D are warranted. Exploration of interventions at different time points before and during pregnancy as well as those which utilise prediction modelling methodology, would provide greater insight into the efficacy of micronutrient supplementation intervention in the prevention of pre-eclampsia in high-risk women.
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Affiliation(s)
- Sowmiya Gunabalasingam
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Daniele De Almeida Lima Slizys
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Ola Quotah
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Laura Magee
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Sara L White
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | | | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Kathryn V Dalrymple
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, 4th floor Addison House, Guy's Campus, London, SE1 1UL, UK
| | - Angela C Flynn
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK.
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Negero MG, Sibbritt D, Dawson A. Women's utilisation of quality antenatal care, intrapartum care and postnatal care services in Ethiopia: a population-based study using the demographic and health survey data. BMC Public Health 2023; 23:1174. [PMID: 37337146 DOI: 10.1186/s12889-023-15938-8] [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: 05/06/2022] [Accepted: 05/19/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE This study sought to investigate the level and determinants of receiving quality antenatal care (ANC), intrapartum care, and postnatal care (PNC) services by women in Ethiopia. The quality of care a woman receives during ANC, intrapartum care, and PNC services affects the health of the woman and her child and her likelihood of seeking care in the future. METHODS Data from the nationally representative Ethiopia Mini Demographic and Health Survey 2019 were analysed for 5,527 mothers who gave birth within five years preceding the survey. We defined quality ANC as having: blood pressure measurement, urine and blood tests, informed of danger signs, iron supplementation, and nutritional counselling during ANC services; quality intrapartum care as having: a health facility birth, skilled birth assistance, and a newborn put to the breast within one hour of birth during intrapartum care services; and quality PNC as having: PNC within two days; cord examination; temperature measurement, and counselling on danger signs and breastfeeding of the newborn; and healthcare provider's observation of breastfeeding during PNC services. We used multilevel mixed-effects logistic regression analyses specifying three-level models: a woman/household, a cluster, and an administrative region to determine predictors of each care quality. The analyses employed sampling weights and were adjusted for sampling design. RESULTS Thirty-six percent (n = 1,048), 43% (n = 1,485), and 21% (n = 374) women received quality ANC, intrapartum care and PNC services, respectively. Private healthcare facilities provided higher-quality ANC and PNC but poor-quality intrapartum care, compared to public health facilities. Having four or more ANC visits, commencing ANC during the first trimester, and higher women's education levels and household wealth indices were positive predictors of quality ANC use. Government health posts were less likely to provide quality ANC. Wealthier, urban-residing women with education and four or more ANC contacts were more likely to receive quality intrapartum care. Women who received quality ANC and skilled birth assistance were more likely to receive quality PNC. Teenage mothers were more likely to receive quality intrapartum care, but were less likely to receive quality PNC than mothers aged 20-49. CONCLUSIONS We recommend standardizing the contents of ANC provided in all healthcare facilities; and promoting early and four or more ANC contacts, effectiveness, sensitivity and vigilance of care provided to teenage mothers, and women's education and economic empowerment.
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Affiliation(s)
- Melese Girmaye Negero
- School of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Angela Dawson
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Tesfahun TD, Awoke AM, Kefale MM, Balcha WF, Nega AT, Gezahegn TW, Alemayehu BA, Dabalo ML, Bogale TW, Azene Z, Nigatu S, Beyene A. Factors associated with successful vaginal birth after one lower uterine transverse cesarean section delivery. Sci Rep 2023; 13:8871. [PMID: 37258595 DOI: 10.1038/s41598-023-36027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 05/27/2023] [Indexed: 06/02/2023] Open
Abstract
A Trial of labor after cesarean section is an attempt to deliver vaginally by a woman who had a previous cesarean delivery and when achieved by a vaginal delivery it is called successful vaginal birth after cesarean section. Vaginal birth after a caesarian section is a preferred method to decrease complications associated with repeated caesarian section delivery for both mother and fetus. It has a higher success rate when the right women are selected for a trial of labor. This study aimed to assess factors associated with successful vaginal birth after one lower uterine transverse cesarean section and to validate the Flamm and Geiger score at the public hospitals of Bahir Dar City, Northwest, Ethiopia, 2021. A health facility-based retrospective cross-sectional study was conducted from March 1 to 15/2021. A medical record review of 408 women charts with a trial of labor after one lower uterine transverse cesarean section from January 1/2020 to December 31/2020 was done and 345 women charts with complete maternal and fetal information were included in the study with a response rate of 84.6%. The data were collected using a structured checklist, entered into Epi data 3.1, and analyzed using SPSS 25.0 version. Logistic regression analyses were done to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of less than 0.05 considered statistically significant. This study identified that the trial of labor after cesarean section rate was 69.5%, and the success rate of vaginal birth after one lower uterine transverse cesarean section was 35.07%. Of the failed trial of labor, fetal distress (38.9%) and failed progress of labor (32.1%) were the main indications for an emergency cesarean section. The maternal age group of 21-30 years, prior vaginal birth after or before cesarean section, non-recurring indication (fetal distress and malpresentation), ruptured membrane, cervical dilatation ≥ 4 cm, cervical effacement ≥ 50%, and low station (≥ 0) at admission were associated with successful vaginal birth after one lower uterine transverse cesarean section. For the Flamm and Geiger score at a cut point of 5, the sensitivity and specificity were 73.6% and 86.6% respectively. In this study area, the trial of labor after cesarean section rate is encouraging, however, the success rate of vaginal birth after one lower uterine transverse caesarian section was lower. The maternal socio-demographic and obstetric-related factors were significantly associated with successful vaginal birth after one lower transverse caesarian section delivery. This study indicated that when the Flamm and Geiger score increases, the chance of successful vaginal birth after one lower uterine transverse caesarian section also increases. We suggest emphasizing counselling and encouraging the women, as their chance of successful vaginal delivery will be high in the subsequent pregnancy, especially if the indications of primary caesarian section delivery were non-recurring.
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Affiliation(s)
- Tigist Derebe Tesfahun
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amlaku Mulat Awoke
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mezgebu Mihiret Kefale
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondu Feyisa Balcha
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Amanuel Tebabal Nega
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tigist Wubet Gezahegn
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bezawit Abeje Alemayehu
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Magarsa Lami Dabalo
- Department of Midwifery, College of Medicine and Health Sciences, Haramaya University, Haramaya, Ethiopia
| | - Tewodros Worku Bogale
- Department of Midwifery, School of Health Sciences, Injibara University, Injibara, Ethiopia
| | - Zigijit Azene
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamawit Nigatu
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Aberash Beyene
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Yeh PT, Kennedy CE, Rhee DK, Zera C, Tunçalp Ö, Lucido B, Gomez Ponce de Leon R, Narasimhan M. Self-monitoring of blood glucose levels among pregnant individuals with gestational diabetes: a systematic review and meta-analysis. Front Glob Womens Health 2023; 4:1006041. [PMID: 37293246 PMCID: PMC10244567 DOI: 10.3389/fgwh.2023.1006041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 04/25/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction The World Health Organization (WHO) recommends treatment and management of gestational diabetes (GD) through lifestyle changes, including diet and exercise, and self-monitoring blood glucose (SMBG) to inform timely treatment decisions. To expand the evidence base of WHO's guideline on self-care interventions, we conducted a systematic review of SMBG among pregnant individuals with GD. Setting Following PRISMA guidelines, we searched PubMed, CINAHL, LILACS, and EMBASE for publications through November 2020 comparing SMBG with clinic-based monitoring during antenatal care (ANC) globally. Primary and secondary outcome measures We extracted data using standardized forms and summarized maternal and newborn findings using random effects meta-analysis in GRADE evidence tables. We also reviewed studies on values, preferences, and costs of SMBG. Results We identified 6 studies examining SMBG compared to routine ANC care, 5 studies on values and preferences, and 1 study on costs. Nearly all were conducted in Europe and North America. Moderate-certainty evidence from 3 randomized controlled trials (RCTs) showed that SMBG as part of a package of interventions for GD treatment was associated with lower rates of preeclampsia, lower mean birthweight, fewer infants born large for gestational age, fewer infants with macrosomia, and lower rates of shoulder dystocia. There was no difference between groups in self-efficacy, preterm birth, C-section, mental health, stillbirth, or respiratory distress. No studies measured placenta previa, long-term complications, device-related issues, or social harms. Most end-users supported SMBG, motivated by health benefits, convenience, ease of use, and increased confidence. Health workers acknowledged SMBG's convenience but were wary of technical problems. One study found SMBG by pregnant individuals with insulin-dependent diabetes was associated with decreased costs for hospital admission and length of stay. Conclusion SMBG during pregnancy is feasible and acceptable, and when combined in a package of GD interventions, is generally associated with improved maternal and neonatal health outcomes. However, research from resource-limited settings is needed. Systematic Review Registration PROSPERO CRD42021233862.
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Affiliation(s)
- Ping Teresa Yeh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Caitlin Elizabeth Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Dong Keun Rhee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Chloe Zera
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research, World Health Organization, Includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction—HRP, Geneva, Switzerland
| | - Briana Lucido
- Department of Sexual and Reproductive Health and Research, World Health Organization, Includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction—HRP, Geneva, Switzerland
| | | | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, World Health Organization, Includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction—HRP, Geneva, Switzerland
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Abebe AH, Mmusi-Phetoe R. Quality of obstetric and newborn care in health centers of Addis Ababa City: using the WHO quality framework. BMC Health Serv Res 2023; 23:459. [PMID: 37161461 PMCID: PMC10169211 DOI: 10.1186/s12913-023-09414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 04/18/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVE The study aims to assess the quality of obstetric and newborn care using the WHO quality framework. DESIGN The study used explanatory sequential mixed methods design. SETTING This study was conducted in 50 health centers in Addis Ababa city administration from January 25 to December 31, 2021. METHODS A total of 50 health centers were surveyed using a structured questionnaire and 500 women in the postpartum period were interviewed using a structured questionnaire. Delivery records of the 500 women were reviewed using a structured checklist. A total of 338 midwives were interviewed using a structured questionnaire. The quantitative data was analyzed using Statistical Package for Social Sciences (SPSS). RESULTS The study revealed that only a third of the 50 health centers were providing good quality care (a quality score ≥ 75%). All the health centers had the physical resources (100%) to deliver obstetric and newborn care. The majority of the health centers had a system for actionable information (92%), functional referral (80%), and providing dignified care (80%). On the other hand, only a few of the health centers met the quality threshold for effective communication (24%), evidence-based practice of routine obstetric and newborn care (36%), and availability of mechanisms to support and motivate skilled birth attendants (24%). None of the health centers met the quality threshold for emotional support during labour and delivery. Obstetric caregivers' high workload and job dissatisfaction were barriers to quality care. CONCLUSION Ensuring quality obstetric and newborn care needs effective quality improvement interventions that aim to ensure women had effective communication, emotional support, and dignity during labour and delivery. Reducing the workload and increasing motivation of birth attendants play a critical role in improving the quality of care.
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Gamberini C, Donders S, Al-Nasiry S, Kamenshchikova A, Ambrosino E. Antibiotic Use in Pregnancy: A Global Survey on Antibiotic Prescription Practices in Antenatal Care. Antibiotics (Basel) 2023; 12:antibiotics12050831. [PMID: 37237734 DOI: 10.3390/antibiotics12050831] [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: 04/03/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Antibiotic prescription and use practices in the antenatal care setting varies across countries and populations and has the potential to significantly contribute to the global spread of antibiotic resistance. This study aims to explore how healthcare practitioners make decisions about antibiotic prescriptions for pregnant women and what factors play a role in this process. A cross-sectional exploratory survey consisting of 23 questions, including 4 free-text and 19 multiple-choice questions, was distributed online. Quantitative data were collected through multiple-choice questions and was used to identify the most common infections diagnosed and the type of antibiotics prescribed. Qualitative data were gathered through free-text answers to identify gaps, challenges, and suggestions, and the data were analyzed using thematic analysis. A total of 137 complete surveys mostly from gynecologists/obstetricians from 22 different countries were included in the analysis. Overall, national and international clinical guidelines and hospital guidelines/protocols were the most frequently used sources of information. This study highlights the crucial role of laboratory results and guidelines at different levels and emphasizes region-specific challenges and recommendations. These findings underscore the pressing need for tailored interventions to support antibiotic prescribers in their decision-making practice and to address emerging resistance.
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Affiliation(s)
- Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Sabine Donders
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Salwan Al-Nasiry
- Department of Obstetrics and Gynecology, Research School GROW for Oncology and Reproduction, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands
| | - Alena Kamenshchikova
- Department of Health, Ethics and Society, School of Public Health and Primary Care, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
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Ozcan S. Does the postpartum body image of primiparous women giving vaginal delivery affect their sexual functions and depression and fatigue levels? Health Care Women Int 2023; 45:495-511. [PMID: 36943288 DOI: 10.1080/07399332.2023.2190980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
The body image-related problems can negatively affect women's lives in many ways. The study was aimed at investigating the effects of postpartum body image on sexual functions, and fatigue and depression levels of primiparous women who gave birth vaginally. This cross-sectional study was conducted with 133 women who presented to the obstetrics and gynecology clinics of a state hospital in Turkey between June 2021 and December 2021. At the end of the study, a moderate relationship was determined between the women's body image and their depression (r = 0.500; p < 0.001) and fatigue (r = 0.666; p < 0.001) levels, and a weak relationship between their body image and sexual functions (r = -0.372; p < 0.001). According to the backward regression model used in the study, the women's fatigue and education levels accounted for their body image by 45.7%.
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Affiliation(s)
- Sadiye Ozcan
- Faculty of Health Sciences, Department of Obstetrics & Gynecological Nursing, Yalova University, Yalova, Turkey
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Küçük E, Yeşilçiçek Çalık K, Tayar N. The effect of perceived insufficient milk on transition to supplementary food and factors affecting it during the first six months postpartum in Turkey: A cross-sectional study. Health Care Women Int 2023; 44:295-313. [PMID: 34915824 DOI: 10.1080/07399332.2021.2007928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The researchers' aims were to determine the effect of perceived insufficient milk supply on the transition to supplementary food and the factors affecting it. This is a cross-sectional design study, we were conducted between April and August 2019 and included 335 mothers and their babies in a baby-friendly hospital in Turkey. It was shown that mothers with perceived insufficient milk switched to supplementary food 6.538 times more frequently (p < 0.05). It was shown that some maternal, lactational, and infant (baby's age) factors affected the perception of insufficient milk (p < 0.05). The perception of insufficient milk is an important factor contributing to the transition to supplementary food.
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Affiliation(s)
- Ebru Küçük
- Faculty of Health Science, Obstetrics and Gynaecology Nursing Department, Karadeniz Technical University, Trabzon, Turkey
| | - Kıymet Yeşilçiçek Çalık
- Faculty of Health Science, Obstetrics and Gynaecology Nursing Department, Karadeniz Technical University, Trabzon, Turkey
| | - Nazan Tayar
- Farabi Hospital International, Karadeniz Technical University, Trabzon, Turkey
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Watson D, Chatio S, Barker M, Boua PR, Compaoré A, Dalaba M, Erzse A, Godfrey K, Hofman K, Kehoe S, McGrath N, Mukoma G, Nonterah EA, Norris SA, Sorgho H, Ward KA, Hardy-Johnson P. Men’s motivations, barriers to and aspirations for their families’ health in the first 1000 days in sub-Saharan Africa: a secondary qualitative analysis. BMJ Nutr Prev Health 2023. [PMID: 37484540 PMCID: PMC10359544 DOI: 10.1136/bmjnph-2022-000423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
IntroductionThe first 1000 days of life are a critical period of growth and development that have lasting implications for health, cognitive, educational and economic outcomes. In sub-Saharan Africa, gender and social norms are such that many men have little engagement with maternal and child health and nutrition during pregnancy and early childhood. This study explores how men perceive their role in three sites in sub-Saharan Africa.MethodsSecondary qualitative analysis of 10 focus group discussions with 76 men in Burkina Faso, Ghana and South Africa. Data were thematically analysed to explore men’s perceptions of maternal and child health and nutrition.ResultsMen considered themselves ‘providers’ and 'advisors' within their families, particularly of finances, food and medicines. They also indicated that this advice was out of care and concern for their families’ health. There were similarities in how the men perceive their role. Differences between men living in rural and urban settings included health priorities, the advice and the manner in which it was provided. Across all settings, men wanted to be more involved with maternal and child health and nutrition. Challenges to doing so included stigma and proscribed social gender roles.ConclusionMen want a greater engagement in improving maternal and child health and nutrition but felt that their ability to do so was limited by culture-specified gender roles, which are more focused on providing for and advising their families. Involving both men and women in intervention development alongside policymakers, health professionals and researchers is needed to improve maternal and child health and nutrition.
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Diress M, Getnet M, Akalu Y, Dagnew B, Belsti Y, Gela YY, Chilot D, Belay DG, Bitew DA, Terefe B, Getahun AB. Myopia and its associated factors among pregnant women at health institutions in Gondar District, Northwest Ethiopia: A multi-center cross-sectional study. Front Glob Womens Health 2023; 3:1078557. [PMID: 36727043 PMCID: PMC9884705 DOI: 10.3389/fgwh.2022.1078557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background Myopia is the most common form of uncorrected refractive error with a growing burden worldwide. It is the principal complaint of most women during pregnancy. Although myopia has led to several consequences across the standard life of pregnant women, there is no previous study in Ethiopia regarding this topic. Thus, this study determined the prevalence of myopia and identifies its associated factors among pregnant women attending antenatal care units at governmental health institutions in Gondar City District, Northwest Ethiopia. Methods An institution-based cross-sectional study design was conducted from 08 February to 08 April 2021. From the selected health centres, study participants were recruited by systematic random sampling technique. A pre-tested, structured-interviewer-administered questionnaire consisting of socio-demographic variables, obstetric and clinical-related variables was used to collect the required data. Non-cycloplegic refraction was performed using trial lenses, trial frames, and retinoscopy in a semi-dark examination room. EpiData 3 and STATA 14 were used for data entry and statistical analysis respectively. Both bivariable and multivariable binary logistic regression analyses were executed to identify associated factors of myopia. Variables with a p-value ≤0.05 in the multivariable logistic regression analysis were declared as statistically significant with myopia. Model fitness was checked by Hosmer and Lemeshow goodness of test (at p > 0.05). Results A total of four-hundred and twenty-three pregnant women participated with a 100% response rate in this study. The overall prevalence of myopia among pregnant women was 26.48% (95% CI: 22.48-30.91). Eighty-Eight (20.81%) and Eighty-Four (19.85%) of the study participants had myopia in their right and left eyes respectively. The prevalence of myopia was significantly associated with age (AOR = 1.17; 95% CI: 1.09-1.28), the third trimester of gestation (AOR = 2.05, 95% CI: 1.08-3.90), multi & grand multipara (AOR = 3.15; 95% CI: 1.59-6.25), and history of contraceptive use (AOR = 3.30; 95% CI: 1. 50-7.28). Conclusion The finding of our study shows that there is a higher prevalence of myopia among pregnant women in our study area. Further prospective analytical studies regarding visual systems among pregnant women, particularly as a result of pregnancy, are strongly recommended.
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Affiliation(s)
- Mengistie Diress
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia,Correspondence: Mengistie Diress
| | - Mihret Getnet
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Yitayeh Belsti
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia,Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | | | - Dagmawi Chilot
- Department of Human Physiology, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia,Department of Human Anatomy, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, University of Gondar, Gondar, Ethiopia
| | - Amare Belete Getahun
- Department of Anesthesia, School of Medicine, University of Gondar, Gondar, Ethiopia
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Sisay G, Mulat T. Antenatal Care Dropout and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis. Health Serv Res Manag Epidemiol 2023; 10:23333928231165743. [PMID: 37021289 PMCID: PMC10068991 DOI: 10.1177/23333928231165743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background The prevalence and determinants of antenatal care (ANC) dropout in Ethiopia were studied. However, the results were inconsistent and showed considerable variation. Hence, this meta-analysis aimed at estimating the overall prevalence of ANC dropout and its predictors in Ethiopia. Methods A comprehensive search of published studies was done using different international databases such as such as PubMed, DOJA, Embase, Cochrane Library, Google Scholar, and the institutional repository of Ethiopian universities were used to search for relevant studies. Data were extracted using Microsoft Excel spreadsheet, and exported to STATA v17 for analysis. A random effect model was used to estimate the overall national prevalence of ANC dropout. Fixed effects model were used to compute the pooled adjusted odd ratios (AOR) with the corresponding 95% confidence intervals (CIs). I2 test was used to assess heterogeneity of the included studies. Egger's tests was used to check for the presence of publication bias. Results A total of 7 studies were included in this systematic review and meta-analysis with 11,839 study participants. The overall pooled prevalence of ANC in Ethiopia was found to be 41.37% (95% CI =35.04, 47.70). Distance from the health care facility (AOR = 2.93, 95% CI = 2.75, 3.11), pregnancy complication signs (AOR = 2.97, 95% CI = 2.77, 3.16), place of residence (AOR = 1.79, 95% CI = 1.31, 2.26), educational level (AOR = 1.79, 95%CI = 1.37, 2.21), and age group (30-49) (AOR = 0.61, 95% CI = 0.45, 0.78) were significantly associated with ANC dropout. Conclusion Based on this review and meta-analysis, 41% of Ethiopian women dropped out of ANC visits before the minimum recommended visit (4 times). Hence, to reduce the number of ANC dropouts, it is important to counsel and educate women during their first prenatal care. Issues of urban–rural disparities and noted hotspot areas for ANC dropout should be given further attention.
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Affiliation(s)
- Gizaw Sisay
- Department of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
- Gizaw Sisay Belay, Department of Public Health, College of Medicine and Health Science, Dilla University, Po. box 419, Dilla, Ethiopia.
| | - Tsion Mulat
- Department of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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Shahil Feroz A, Yasmin H, Saleem S, Bhutta Z, Seto E. Feasibility of implementing a mobile phone-based telemonitoring programme to support pregnant women at high-risk for pre-eclampsia in Karachi, Pakistan: protocol for a mixed-methods study. BMJ Open 2022; 12:e070535. [PMID: 36585144 PMCID: PMC9809301 DOI: 10.1136/bmjopen-2022-070535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION High maternal mortality from pre-eclampsia/eclampsia results from lack of early identification and management of pregnant women at high-risk for pre-eclampsia. A potential tool to support pregnant women at high-risk for pre-eclampsia is telemonitoring. There is limited evidence on the use and effectiveness of telemonitoring for pregnant women in low-income and middle-income countries (LMICs) which limits the understanding of the process and mechanisms through which the intervention works in LMICs. This study will explore the feasibility of implementing a mobile phone-based telemonitoring programme for pregnant women at high-risk for pre-eclampsia in Karachi, Pakistan. METHODS AND ANALYSIS A convergent mixed-methods study will be conducted at the Jinnah Postgraduate Medical Center (JPMC) in Karachi, Pakistan. This study will recruit 50 pregnant women at high-risk for pre-eclampsia to assess clinical feasibility across the five foci of Bowen's framework including acceptability, demand, implementation, practicality and limited-efficacy testing. Data sources will include semi-structured interviews with the enrolled women, caregivers and clinicians, as well as quantitative data from paper medical records, research logs and server data. The quantitative and qualitative data will be analysed separately and then integrated at the interpretation and reporting levels to advance our understanding of the telemonitoring programme's feasibility across the five areas of Bowen's framework. ETHICS AND DISSEMINATION Ethics approvals have been obtained from JPMC, the National Bioethics Committee of Pakistan, University Health Network, Aga Khan University and the University of Toronto. The study results will be disseminated to the scientific community through publications and conference presentations. Findings of the study will provide evidence on the feasibility of using a telemonitoring programme where pregnant women at high-risk for pre-eclampsia in Pakistan will take their own blood pressure readings at home. Lessons learnt in this feasibility trial will be used to determine the appropriateness of a future effectiveness trial. TRIAL REGISTRATION NUMBER NCT05662696.
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Affiliation(s)
- Anam Shahil Feroz
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Community Health Sciences Department, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Haleema Yasmin
- Obstetrics and Gynaecology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Sarah Saleem
- Community Health Sciences Department, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Zulfiqar Bhutta
- Division of Women and Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
- Global Child Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Dube R, Al-Zuheiri STS, Syed M, Harilal L, Zuhaira DAL, Kar SS. Prevalence, Clinico-Bacteriological Profile, and Antibiotic Resistance of Symptomatic Urinary Tract Infections in Pregnant Women. Antibiotics (Basel) 2022; 12:antibiotics12010033. [PMID: 36671233 PMCID: PMC9855124 DOI: 10.3390/antibiotics12010033] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Background: Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. Method: This is a prospective observational study conducted at the Abdullah Bin Omran Hospital, RAK, UAE, from March 2019 to February 2020. All pregnant women attending the antenatal clinic during this period were given a pre-validated questionnaire for the symptoms of UTI. In symptomatic patients, urine was sent for microscopy, culture, and sensitivity. Women were treated for UTI and were followed up for the rest of the pregnancy. Data analysis was performed by SPSS software version 24 using descriptive statistics and comparisons with significance at a p-value of <0.05. Results: The prevalence of symptomatic UTI was 17.9%. E.coli was the commonest isolate followed by Group B streptococcus. The commonest symptom reported was loin pain and the most common risk factor was diabetes. Women with risk factors are significantly more likely to have culture-positive UTIs. Most of the pathogens were sensitive to cefuroxime and benzyl penicillin. Risk of preterm labor was higher. Conclusions: Regular antenatal care and routine urine testing in all visits are recommended for early detection and treatment of UTI.
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Affiliation(s)
- Rajani Dube
- Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
- Correspondence: ; Tel.: +971-551383304
| | - Shatha Taher Salman Al-Zuheiri
- Department of Obstetrics and Gynecology, Abdullah Bin Omran Hospital for Obstetrics and Gynecology, Ras Al Khaimah 11172, United Arab Emirates
| | - Mariyam Syed
- Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
| | - Lekshmi Harilal
- Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
| | - Dean Allah Layth Zuhaira
- Department of Obstetrics and Gynecology, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
| | - Subhranshu Sekhar Kar
- Department of Pediatrics and Neonatology, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
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AlShamlan NA, AlOmar RS, Aldossary R, Alahmari M, Alghamdi A, AlGhamdi M, Alkanaan N, AlReedy AH, AlOtaibi AS, Alghamdi NS. The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia. Int J Womens Health 2022; 14:1749-1759. [PMID: 36561606 PMCID: PMC9766479 DOI: 10.2147/ijwh.s394936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia. Methods This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models. Results ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41-2.93 and OR= 1.50, 95% CI = 1.03-2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14-4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis. Conclusion With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.
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Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Correspondence: Nouf A AlShamlan, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 34224, Saudi Arabia, Tel +966504901406, Email
| | - Reem S AlOmar
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Roba Aldossary
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Maha Alahmari
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Asma Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mawaddah AlGhamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Najla Alkanaan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah H AlReedy
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amani S AlOtaibi
- Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nada S Alghamdi
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Kozica-Olenski SL, Soldatos G, Marlow L, Cooray SD, Boyle JA. Exploring the acceptability and experience of receiving diabetes and pregnancy care via telehealth during the COVID-19 pandemic: a qualitative study. BMC Pregnancy Childbirth 2022; 22:932. [PMID: 36514010 PMCID: PMC9745277 DOI: 10.1186/s12884-022-05175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted the delivery of diabetes in pregnancy care and general maternity care. This study aimed to explore the experiences and acceptability of telehealth use in diabetes in pregnancy care during the COVID-19 pandemic, from the perspectives of pregnant women and their clinicians. The secondary aim was to explore the experiences of pregnant women receiving general maternity care via telehealth during the COVID-19 pandemic. METHODS In-depth qualitative semi-structured interviews were undertaken and analysed via thematic inductive approaches. The Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies Framework (NASSS) was applied. RESULTS Eigthteen interviews were conducted with culturally and linguistically diverse pregnant women and 4 clinicians (endocrinologists and dietitians). All interviewees were satisfied with telehealth as a positive alternative to face-to-face consultations for diabetes care during the COVID-19 pandemic. Numerous benefits of delivering diabetes care via telehealth were discussed and themes centred around greater access to care, economic benefits and improved safety. Most barriers concerned the adopters (clinicians), yet, feasible and realistic suggestions to overcome barriers were voiced. The scope for technology adaptation and ongoing embedment into routine diabetes care was described. Overall, a hybrid flexible delivery model, predominantly consisting of telephone consultations, with some face-to-face consultations for initial diabetes appointments was recommended for future care. The use of telehealth in replacement of face-to-face appointments for general maternity care was perceived as reducing care quality. CONCLUSION In this study, telehealth was viewed as acceptable to women and clinicians for diabetes in pregnancy care, supporting the ongoing delivery of a hybrid service model of telehealth and face-to-face care. These findings provide valuable information to improve diabetes in pregnancy services to meet the needs of women during the COVID-19 pandemic and beyond.
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Affiliation(s)
- S. L. Kozica-Olenski
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia
| | - G. Soldatos
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia ,grid.419789.a0000 0000 9295 3933Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria Australia
| | - L. Marlow
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia
| | - S. D. Cooray
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia ,grid.419789.a0000 0000 9295 3933Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria Australia
| | - J. A. Boyle
- grid.419789.a0000 0000 9295 3933Department of Obstetrics and Gynaecology, Monash Health, Melbourne, Victoria Australia ,grid.1002.30000 0004 1936 7857Eastern Health Clinical School, Monash University, Box Hill, Melbourne, Australia
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Liang X, Wang R, Luo H, Liao Y, Chen X, Xiao X, Li L. The interplay between the gut microbiota and metabolism during the third trimester of pregnancy. Front Microbiol 2022; 13:1059227. [PMID: 36569048 PMCID: PMC9768424 DOI: 10.3389/fmicb.2022.1059227] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
The gut microbiota undergoes dynamic changes during pregnancy. The gut microbial and metabolic networks observed in pregnant women have not been systematically analyzed. The primary purpose of this study was to explore the alterations in the gut microbiota and metabolism during late pregnancy and investigate the associations between the gut microbiota and metabolism. A total of thirty healthy pregnant women were followed from 30 to 32 weeks of gestation to full term. Fecal samples were collected for microbiome analysis and untargeted metabolomic analysis. The characteristics of the gut microbiota were evaluated by 16S ribosomal RNA gene sequencing of the V3-V4 regions. The plasma samples were used for untargeted metabolomic analysis with liquid chromatography-tandem mass spectrometry. The interplay between the gut microbiota and metabolism was analyzed further by bioinformatics approaches. We found that the relative abundances of Sellimonas and Megamonas were higher at full term, whereas that of Proteobacteria was lower. The correlation network of the gut microbiota tended to exhibit weaker connections from 32 weeks of gestation to the antepartum timepoint. Changes in the gut microbiota during late pregnancy were correlated with the absorbance and metabolism of microbiota-associated metabolites, such as fatty acids and free amino acids, thereby generating a unique metabolic system for the growth of the fetus. Decreasing the concentration of specific metabolites in plasma and increasing the levels of palmitic acid and 20-hydroxyarachidonic acid may enhance the transformation of a proinflammatory immune state as pregnancy progresses.
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Affiliation(s)
- Xinyuan Liang
- Department of Obstetrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China,The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Rongning Wang
- Department of Obstetrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Huijuan Luo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yihong Liao
- Department of Obstetrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Xiaowen Chen
- Department of Obstetrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China
| | - Xiaomin Xiao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, China,*Correspondence: Xiaomin Xiao,
| | - Liping Li
- Department of Obstetrics, The Second Clinical Medical College, Jinan University (Shenzhen People’s Hospital), Shenzhen, China,Liping Li,
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Subedi S, Hazel EA, Mohan D, Zeger S, Mullany LC, Tielsch JM, Khatry SK, LeClerq SC, Black RE, Katz J. Prevalence and predictors of spontaneous preterm births in Nepal: findings from a prospective, population-based pregnancy cohort in rural Nepal-a secondary data analysis. BMJ Open 2022; 12:e066934. [PMID: 36456014 PMCID: PMC9716942 DOI: 10.1136/bmjopen-2022-066934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Preterm birth can have short-term and long-term complications for a child. Socioeconomic factors and pregnancy-related morbidities may be important to predict and prevent preterm births in low-resource settings. The objective of our study was to find prevalence and predictors of spontaneous preterm birth in rural Nepal. DESIGN This is a secondary observational analysis of trial data (registration number NCT01177111). SETTING Rural Sarlahi district, Nepal. PARTICIPANTS 40 119 pregnant women enrolled from 9 September 2010 to 16 January 2017. OUTCOME MEASURES The outcome variable is spontaneous preterm birth. Generalized Estimating Equations Poisson regression with robust variance was fitted to present effect estimates as risk ratios. RESULT The prevalence of spontaneous preterm birth was 14.5% (0.5% non-spontaneous). Characteristics not varying in pregnancy associated with increased risk of preterm birth were maternal age less than 18 years (adjusted risk ratio=1.13, 95% CI: 1.02 to 1.26); being Muslim (1.53, 1.16 to 2.01); first pregnancy (1.15, 1.04 to 1.28); multiple births (4.91, 4.20 to 5.75) and male child (1.10, 1.02 to 1.17). Those associated with decreased risk were maternal education >5 years (0.81, 0.73 to 0.90); maternal height ≥150 cm (0.89, 0.81 to 0.98) and being from wealthier families (0.83, 0.74 to 0.93). Pregnancy-related morbidities associated with increased risk of preterm birth were vaginal bleeding (1.53, 1.08 to 2.18); swelling (1.37, 1.17 to 1.60); high systolic blood pressure (BP) (1.47, 1.08 to 2.01) and high diastolic BP (1.41, 1.17 to 1.70) in the third trimester. Those associated with decreased risk were respiratory problem in the third trimester (0.86, 0.79 to 0.94); having poor appetite, nausea and vomiting in the second trimester (0.86, 0.80 to 0.92) and third trimester (0.86, 0.79 to 0.94); and higher weight gain from second to third trimester (0.89, 0.87 to 0.90). CONCLUSION The prevalence of preterm birth is high in rural Nepal. Interventions that increase maternal education may play a role. Monitoring morbidities during antenatal care to intervene to reduce them through an effective health system may help reduce preterm birth.
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Affiliation(s)
- Seema Subedi
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Nepal Nutrition Intervention Project Sarlahi, Kathmandu, Nepal
| | - Elizabeth A Hazel
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Diwakar Mohan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Scott Zeger
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luke C Mullany
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - James M Tielsch
- Department of Global Health, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
| | | | - Steven C LeClerq
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Nepal Nutrition Intervention Project Sarlahi, Kathmandu, Nepal
| | - Robert E Black
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanne Katz
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Lucha TA, Mengistu AK. Factors associated with early initiation of breastfeeding among children less than 24 months old: the 2019 Ethiopian mini demographic and health survey. Arch Public Health 2022; 80:164. [PMID: 35794649 PMCID: PMC9258214 DOI: 10.1186/s13690-022-00920-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The world Health Organization recommended that all mothers be supported to initiate breastfeeding as soon as possible after birth, within the first hour. This study examined the determinants of early initiation of breastfeeding in Ethiopia by using data from the 2019 Ethiopia Mini Demographic and Health Survey. Methods The data for this study was extracted from the 2019 Ethiopia Mini Demographic and Health Survey. A total of 1948 children aged less than 24 months at the time of the survey were included for analysis from the nine regional states and two city administrations. The analysis was carried out in STATA Version 14.2 software using survey commands to account for the complex sample design and apply sampling weights. A manual backward stepwise elimination approach was applied. Result The prevalence of early initiation of breastfeeding in Ethiopia was noted to be 75.2% [95% CI (71.9, 78.5%)]. In the multivariable analysis, mothers who had vaginal deliveries [AOR = 3.02 (95% CI: 1.55, 5.88)] had 3 times higher odds practicing early initiation of breastfeeding compared to mothers who had a cesarian section. Mothers aged between 35 and 49 years [AOR = 2.40, 95% CI: 1.20, 4.49] had 2.4 times higher odds of practicing early initiation of breastfeeding compared to mothers aged below 20 years. In addition, early initiation of breastfeeding was also associated with the region where mothers resided, in particular mothers in Amhara and Somali region, had lower odds of practicing early initiation of breastfeeding as compared with mothers residing in Tigray region. Conclusion Early initiation of breastfeeding in Ethiopia was found to be significantly associated with mode of delivery, mother’s age, and region. As a result, raising awareness about early initiation of breastfeeding is especially important for mothers who have had a cesarean section, which could be accomplished with the help of the health extension workforce.
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Mose A, Haile K, Timerga A. Prevalence of completion of maternity continuum of care and its associated factors in Ethiopia: a systematic review and meta-analysis. BMJ Open 2022; 12:e062461. [PMID: 36410822 PMCID: PMC9680161 DOI: 10.1136/bmjopen-2022-062461] [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: 03/01/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The present study aimed to estimate the pooled prevalence of completion of the maternity continuum of care (CoC) and its associated factors in Ethiopia. STUDY DESIGN Systematic review and meta-analysis. STUDY SETTING Ethiopia. STUDY PARTICIPANTS A total of 6245 reproductive-age women were included. PRIMARY OUTCOME The pooled prevalence of completion of the maternity CoC. SECONDARY OUTCOME Factors associated with completion of the maternity CoC. METHODS We systematically searched international databases such as PubMed, Scopus, African Journals Online, Google Scholar and Web of Sciences to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used for this study. Publication bias was assessed using the funnel plot and Egger's test. Evidence of heterogeneity was checked using Cochrane Q test and I2 statistics. Subgroup analysis was computed based on the study regions. Data were analysed using STATA V.14 statistical software. Weighted inverse variance random effect models were used to estimate the pooled prevalence of completion of the maternity CoC. RESULTS The pooled prevalence of completion of maternity continuum care in Ethiopia was 25.82% (95% CI: 16.69% to 34.94%). Urban residence(adjusted odds ratio (AOR)=2.77, 95% CI: 1.99 to 3.86), having secondary and above educational status (AOR=3.50, 95% CI: 2.50 to 50), prepregnancy contraceptive utilisation (AOR=3.25, 95% CI: 2.02 to 5.22), women's autonomy (AOR=3.81, 95% CI: 2.74 to 5.31), following mass media (AOR=2.51, 95% CI: 1.79 to 3.50), early initiation of antenatal care (ANC) (AOR=4.98, 95% CI: 3.28 to 7.57), planned pregnancy (AOR=2.93, 95% CI: 1.99 to 4.32), birth preparedness and complication readiness (AOR=1.80, 95% CI: 1.29 to 2.51) and distance from a health facility<30 min (AOR=3.29, 95% CI: 2.45 to 4.42) were factors associated with completion of maternity continuum care in Ethiopia. CONCLUSION The pooled prevalence of completion of maternity continuum care in Ethiopia was low. Therefore, policymakers and stakeholders should improve the completion of ANC, the rate of skilled birth attendants and postnatal follow-up. Enhancing the accessibility of health facilities, women's awareness and empowering women's decision-making are recommended. PROSPERO REGISTRATION NUMBER CRD42022312692.
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Affiliation(s)
- Ayenew Mose
- Midwifery, Wolkite University, Wolkite, Ethiopia
| | - Kassahun Haile
- Medical Laboratory Science, Wolkite University, Wolkite, Ethiopia
| | - Abebe Timerga
- Biomedical Science, Wolkite University, Wolkite, Ethiopia
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Bol KN, Negera E, Gedefa AG. Pregnancy among adolescent girls in humanitarian settings: a case in refugee camp of Gambella regional state, community-based cross-sectional study, Southwest Ethiopia, 2021. BMJ Open 2022; 12:e064732. [PMID: 36396321 PMCID: PMC9677029 DOI: 10.1136/bmjopen-2022-064732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of pregnancy and associated factors among adolescent girls in Nguenyyiel Refugee Camp. DESIGN Cross-sectional study was employed to conduct this study. SETTING A community-based cross-sectional study was done in Nguenyyiel Refugee Camp. PARTICIPANTS Four hundred and fourteen adolescent girls participated in this study. The systematic random sampling technique was used to select respondents. Data were collected using a well-structured and pretested questionnaire. Pregnancy test was done using the human chorionic gonadotropin test. Bivariate and multivariate logistic regression analysis was run to identify factors associated with adolescent pregnancy. RESULTS The prevalence of pregnancy among adolescent girls in the Nguenyyiel Refugee Camp was 21.7% (95% CI: 17.6% to 25.6%). Factors associated with adolescent pregnancy were age (17-19 years) (AOR): 2.79; 95% CI: 1.55 to 5.05; educational status: primary education (AOR: 7.69; 95% CI: 3.55 to 16.68) and no formal education (AOR: 3.42; 95% CI: 1.59 to 7.36); and household living arrangement: living with none of the biological parents (AOR: 2.14; 95% CI: 1.02 to 4.49) and living with either of the biological parent (AOR: 3.71; 95% CI: 1.76 to 7.81). CONCLUSIONS AND RECOMMENDATIONS This study showed that there is a high prevalence of pregnancy among adolescent girls in the study setting. Age (17-19 years), educational status and household living arrangement (living with none of the biological parents and living with either of the biological parents) were among the factors significantly associated with adolescent pregnancy. Hence, health workers and other stakeholders in the camps should focus on strengthening adolescent sexual health education giving special attention to late adolescents, uneducated and living without biological family.
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Affiliation(s)
- Koang Nyak Bol
- Universal Health Coverage, Communicable, and Non-communicable Diseases (UCN) Cluster, Neglected Tropical Diseases (NTDs) Program, WHO, Gambella, Ethiopia
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Tekalegn Y, Solomon D, Sahiledengle B, Beressa G, Desta F, Tolcha F, Rogers HL, Petrucka PP, Mwanri L. Level of physical activity and its associated factors among adults in southeast Ethiopia: a community-based cross-sectional study. BMJ Open 2022; 12:e063333. [PMID: 36385036 PMCID: PMC9670934 DOI: 10.1136/bmjopen-2022-063333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Insufficient levels of physical activity are a well-known modifiable risk factor for a number of chronic conditions including obesity, type 2 diabetes, cardiovascular diseases and certain malignancies. Little is known about the status of physical activity and its associated factors among adults in low-income countries, including Ethiopia. Therefore, this study aimed to assess the level of physical activity and its associated factors among adults in southeast Ethiopia. DESIGN Analytical cross-sectional study. SETTING Community setting in southeast Ethiopia. PARTICIPANTS 641 adults aged 18-64 years. PRIMARY OUTCOME Level of physical activity assessed via the Global Physical Activity Questionnaire (GPAQ). RESULTS The overall prevalence of insufficient physical activity in this study was 29.48% (95% CI: 25.78 to 33.18). Women were more likely to report insufficient physical activity compared with men (39.0% for women and 12.3% for men, p<0.001). Being: a women (adjusted OR (AOR)=3.99, 95% CI: 2.15 to 7.40)), overweight/obese (AOR=1.95, 95% CI: 1.23 to 3.09), ever-married (AOR=2.13, 95% CI: 1.01 to 4.47), a person with no formal education (AOR=1.94, 95% CI: 1.05 to 3.56), a housewife (AOR=3.04, 95% CI: 1.75 to 5.29) and unemployed (AOR=3.30, 95% CI: 1.55 to 7.02) were significantly associated with insufficient physical activity. CONCLUSION The study revealed that three in 10 adults did not achieve the recommended level of physical activity. For chronic disease prevention in Ethiopia, the Ethiopian Ministry of Health and other stakeholders should pay special attention to strategies to improve the population's physical activity especially among women, housewives, people with no formal education, and married, unemployed and overweight/obese adults.
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Affiliation(s)
| | - Damtew Solomon
- Biomedical Department, Madda Walabu University, Robe, Ethiopia
| | | | - Girma Beressa
- Public Health, Madda Walabu University, Addis Ababa, Oromia, Ethiopia
- Public Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Fikreab Desta
- Public Health, Madda Walabu University, Robe, Oromia Region, Ethiopia
| | | | - Heather L Rogers
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Ikerbasque, Bilbao, Bizkaia, Spain
| | - Pammla P Petrucka
- Nursing Education, University of Saskatchewan College of Nursing, Saskatoon, Saskatchewan, Canada
| | - Lillian Mwanri
- Torrens University Australia, Adelaide, South Australia, Australia
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Tenaw SG, Tsega D, Zewudie BT, Chekole B, Eniyew MA, Mesfin Y. Completion of the maternal continuum of care and its association with antenatal care attendance during previous pregnancy among women in rural areas of the Gurage Zone, Southwest Ethiopia: a community-based cross-sectional study. BMJ Open 2022; 12:e066536. [PMID: 36351709 PMCID: PMC9644349 DOI: 10.1136/bmjopen-2022-066536] [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] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The maternal continuum of care is a cost-effective intervention to prevent pregnancy and childbirth-related maternal and neonatal mortality and morbidity. This study aimed to investigate the prevalence of completion of the maternal continuum of care and its association with antenatal care (ANC) attendance during previous pregnancy among women in rural kebeles of Gurage Zone, Southwest Ethiopia. DESIGN A community-based cross-sectional study. SETTING The study took place in 12 rural kebeles of the Gurage Zone from 1 April 2022 to 12 May 2022. PARTICIPANTS Randomly selected 497 women who gave birth in the previous 12 months in rural kebeles of the Gurage Zone. OUTCOME The outcome of this study was the prevalence of completion of the maternal continuum of care. RESULTS Overall, the prevalence of completion of the maternal continuum of care was 15.5% (95% CI: 12.55% to 18.9%). After adjusting for potential confounders, having ANC attendance during a previous pregnancy (adjusted OR (AOR): 2.01; 95% CI: 1.07 to 3.76) was positively associated with the completion of the maternal continuum of care. In addition, having access to ambulance service as a means of transportation (AOR: 6.01; 95% CI: 3.16 to 11.39) and exposure to mass media (AOR: 2.43; 95% CI: 1.27 to 4.68) were positively associated with completion of the maternal continuum of care. CONCLUSION The prevalence of completion of the maternity continuum of care was unacceptably low in this study. This result indicates that the women did not receive the maximum possible health benefit from existing maternal healthcare services. The completion of the maternal continuum of care was affected by ANC attendance in a previous pregnancy. Therefore, interventions that can strengthen ANC are crucial in the maternal continuum of the care pathway.
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Affiliation(s)
| | - Daniel Tsega
- Midwifery, Wolkite University, Welkite, Ethiopia
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Kytö M, Markussen LT, Marttinen P, Jacucci G, Niinistö S, Virtanen SM, Korhonen TE, Sievänen H, Vähä-Ypyä H, Korhonen I, Heinonen S, Koivusalo SB. Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study). BMJ Open 2022; 12:e066292. [PMID: 36344008 PMCID: PMC9644362 DOI: 10.1136/bmjopen-2022-066292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Gestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes. METHODS AND ANALYSIS This randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24-28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35-37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child. ETHICS AND DISSEMINATION The study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER NCT04714762.
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Affiliation(s)
- Mikko Kytö
- Department of IT Management, Helsinki University Hospital, Helsinki, Finland
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - Lisa Torsdatter Markussen
- Department of IT Management, Helsinki University Hospital, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Pekka Marttinen
- Department of Computer Science, Aalto University, Aalto, Finland
| | - Giulio Jacucci
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - Sari Niinistö
- Department of Public Health, Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi M Virtanen
- Department of Public Health and Welfare, The National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, University of Tampere, Tampere, Finland
| | - Tuuli E Korhonen
- Department of Public Health, Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Harri Sievänen
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Ilkka Korhonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
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