Retrospective study of factors related to preterm labor in Yasuj, Iran

The Effect of Prenatal Self-Care Based on Orem's Theory on Preterm Birth Occurrence in Women at Risk for Preterm Birth

BACKGROUND

Preterm birth is increasing as a major cause of perinatal complications and mortality in Iran. The present study aimed to investigate the effect of prenatal self-care based on Orem's theory on preterm birth occurrence in women at risk for preterm birth.

MATERIALS AND METHODS

The present clinical trial was conducted on 176 pregnant women at 24-26 weeks at risk for preterm birth in Mashhad, Iran, from December 2015 to October 2016. A multistage sampling method was used in this study. The intervention group (88 pregnant women) received individual self-care education but the control group (88 pregnant women) received only common prenatal care.

RESULTS

There was a statistically significant difference between intervention and control groups in terms of preterm birth occurrence (6.80% vs 20.50%) (χ2 = 6.90, df = 1,p = 0.008). The incidence of preterm birth in the intervention group was approximately three times higher than that in the control group.

CONCLUSIONS

Given that educational interventions could reduce the incidence of preterm birth, it is suggested that the women at risk for preterm birth are trained for prenatal self-care.

Obstetric determinants of preterm delivery in a regional hospital, Accra, Ghana 2016

BACKGROUND

Globally, prematurity is a major determinant of morbidity and mortality contributing 30-40% of neonatal mortality. The consequences of preterm deliveries are enormous with developmental and childhood complications as well as high economic and psycho-social burden on the parents (family) and society. Some risk factors include ever having preterm delivery, multiple births and some medical conditions like sexually transmitted infection and urinary tract infections but these have not been ascertained in our study area. Much research into these risk factors is needed in Ghana. We assessed the obstetric determinants of preterm delivery.

METHODS

We conducted a 1:2 unmatched case-control study in Greater Accra Regional Hospital (GARH) -Ridge, a secondary referral facility in Accra, Ghana (from October, 2015 -May, 2016). A case was a mother who delivered between 28 and 36 weeks of gestation (preterm) and a control was a mother who delivered after 37 to 42 completed weeks (term). We used structured questionnaire to collect data, reviewed maternal and foetal records using a checklist. Categorical variables were analysed and expressed as frequencies and proportions. We determined the association between obstetric factors and preterm delivery with multiple logistic regression. Significance level of the strength of association was determined at 95% CI and p-value < 0.05.

RESULTS

We recruited 390 mothers, 130 had preterm deliveries (cases) and 260 had term deliveries (controls). Experiencing premature rupture of membrane (aOR: 2.3; 95% CI:1.0-5.5), pre-eclampsia/eclampsia (aOR: 3.4; 95% CI: 1.0-11.9) were found to be associated with preterm delivery. However, four or more ANC visit was protective factor for preterm delivery (aOR: 0.2; 95% CI: 0.1-0.4).

CONCLUSION

Premature rupture of membrane, hypertensive complications and antepartum haemorrhage were found to be risk factors associated with preterm delivery in Ridge Hospital. Health workforce providing ANC services need to identify risk factors and refer these mothers to the doctor for early management and improved outcome decreasing preterm delivery.

Construct and Psychometric Properties of a New Version Quality of Life Scale Based on Choice Theory

BACKGROUND

Choice theory, as a psychopathological model, postulated five basics, genetically and universally, needs. Accordingly, the rate of everybody happiness and quality of life is depended on the number of his needs fulfilling. Although some scales have been constructed to assess basic needs, they have proposed unity of needs for all human.

AIM

The present study was designed to construct a new scale, considering individualisation needs for each person; quality of life scale based on choice theory (QOLSCT).

METHODS

Using cluster sampling, six hundred (49% female and 51% male) postgraduate students were selected. One hundred fifty participants also filled SF-36 and GHQ, and 80 participants refilled QOLSCT with four weeks' interval again.

RESULTS

Cronbach's alpha, split-half and test re-test (one month) reliability scores were 0.78, 0.75, and 0.92 successively. The correlation between items and total scores range from 0.36 to 0.72, all with P values ≥ 0.0001. Confirmatory factor analysis showed satisfactory values of goodness-of-fit indices, RMSEA, CFI, NFI and GFI were, 0.05, 0.99, 0.99 and 0.99 respectively. Convergent and divergent validity also showed significant correlations.

CONCLUSION

The result of the present study showed that the new version of quality of life scale based on choice theory could be confirmed. The good level of reliability, fairly goodness of fit indexes, and very good convergent validity support this idea.

Emotional Processing In Patients with Ischemic Heart Diseases

BACKGROUND:

Cardiovascular disease is the most prevalent public health problem on a worldwide scale, and ischemic heart disease accounts for approximately one-half of these events in high-income countries. One of the most important risk factors for this disease is mental and psychological especially stressful experiences.

AIM:

This research was established to compare emotional processing, as a key factor in stress appraisal, between IHD patients and people with no cardiovascular disease.

METHODS:

Using simple sampling, fifty patients were selected from people who diagnosed as IHD in the hospital and referred for treatment after discharging care and treatment. Control group participants were selected as control group peoples, using neighbourhood controls selection. The Emotional Processing Scale was filled by all members of the two groups.

RESULTS:

There were significant differences between the two groups on the EPS-25 total scores, as well as on emotional processing dimensions of signs of unprocessed emotion, unregulated emotion; avoidance and impoverished. Also, there was no significant difference between the two groups in the dimension of Suppression. The final step of regression revealed a β of 10.15 and 1.05 for AVO and IEE subscales respectively.

CONCLUSION:

The result showed that patients with IHD are using more negative emotional processing styles.

Prevalence of preterm labor in Iran: A systematic review and meta-analysis

BACKGROUND

Preterm labor, which defines as live-birth delivery before 37 weeks of gestation is a main determinant of neonatal morbidity and mortality around the world.

OBJECTIVE

The aim of this study was to determine the prevalence of preterm labor in Iran by a meta-analysis study, to be as a final measure for policy makers in this field.

MATERIALS AND METHODS

In this meta-analysis, the databases of Thomson database (Web of Knowledge), PubMed/Medline, Science Direct, Scopus, Google Scholar, Iranmedex, Scientific Information Database (SID), Magiran, and Medlib were searched for articles in English and Persian language published between 1995 and 2014. Among the studies with regard to the inclusion and exclusion criteria, 14 studies (out of 1370 publications) were selected. Data were analyzed by using Stata software version 11. The heterogeneity of reported prevalence among studies was evaluated by the Chi-square based Q test and I2 statistics.

RESULTS

The results of Chi-square based on Q test and I2 statistics revealed severe heterogeneity (Q=2505.12, p-value < 0.001 and I2= 99.5%) and consequently, the random effect model was used for the meta-analysis. Based on the random effect model, the overall estimated prevalence of preterm in Iran was 9.2% (95% CI: 7.6 - 10.7).

CONCLUSION

Present study summarized the results of previous studies and provided a comprehensive view about the preterm delivery in Iran. In order to achieve a more desirable level and its reduction in the coming years, identifying affecting factor and interventional and preventive actions seem necessary.

Risk factor of preterm labor in the west of iran: a case-control study

BACKGROUND

Prematurity is the most common cause of neonatal death. Risk factors of premature birth can be related with ethnicity and genetic. There is no comprehensive high sample size study in Kurdish ethnicity to determine risk factors related to prematurity. This study evaluated risk factors of preterm labor in Kurdish ethnicity.

METHODS

This case-control study was conducted in 200 preterm infants (case group) and 400 term infants (control group), in Besat Hospital, Sanandaj, Iran, in the year 2012. Data was analyzed using SPSS software and analysis was performed by Chi-square, Mann-Whitney and logistic regression tests.

RESULTS

In univariate analysis, mother's own prematurity, history of previous preterm labor, prematurity in the first-degree family members, history of dead children, premature rupture of membranes, multiple pregnancies, overt diabetes, chronic hypertension, preeclampsia and eclampsia, infertility and cervical incompetence had significant relation-ship with preterm labor. However, multivariate analysis results showed that abnormal amniotic fluid, premature rupture of membranes, double and multiple pregnancies, chronic hypertension, family history of premature birth, mothers age over 35 years, and cervical incompetence (P<0.05) had significant relationship with the premature birth.

CONCLUSION

Screening of newborns at risk of preterm labor could be achieved by these risk factors: family history of prematurity, mother's own history of prematurity and previous preterm labor, history of previous neonatal death, decreased amniotic fluid, multiple pregnancies, overt diabetes, hypertension, preeclampsia, infertility and cervical incompetence, however some of these factors are not the direct cause of prematurity. Our study suggests genetic' s role in preterm labor.

Prevalence and risk factors associated with preterm birth in Ardabil, Iran

BACKGROUND

Preterm birth is a leading cause of perinatal mortality and long-term morbidity as well as the long-term health consequences and cognitive outcomes.

OBJECTIVE

Present study was conducted to determine prevalence and risk factors associated with preterm birth in Ardabil, Iran.

MATERIALS AND METHODS

A case control study was conducted between Nov 2010 and July 2011 in all three maternal hospitals in Ardabil. All the live newborns during the study period were investigated. Of 6705 live births during the study period 346 births occurred in <37 weeks were taken as a case and 589 term neonates were taken as a control group. Data were obtained through review of prenatal and hospital delivery records. Univariate and multivariate logistic regression analysis were applied to obtain magnitude of association between independent variables and preterm birth.

RESULTS

The prevalence rate of preterm birth was 5.1%. History of previous preterm birth (OR=12.7,CI: 3.9-40.4, p<0.001), hypertension (OR=7.3, CI:2.1-25.4, p=0.002), Oligohydramnios (OR=3.9, CI:1.6-9.5, p=0.002), spouse abuse (OR=3.7, CI:1.1-11.8, p=0.024), preeclampsia (OR=3.6, CI:1.3-10.3, p=0.014), premature rupture of membrane (OR=3.1, CI:1.9-4.9, p=0.000), bleeding or spotting during pregnancy (OR=2.0, CI:1.0-3.8, p=0.037), Hyperemesis Gravid arum (OR=2.0, CI: 1.1-3.8, p=0.015), urinary tract infection in 26-30 weeks , (OR=1. 8 CI:1.0-3.2, p=0.04), diastolic blood pressure ≤60 mmg (OR=1.5, CI: 0.99-2.2, p=0.049) were determined as significant risk factors for preterm birth.

CONCLUSION

Early detection and treatment of diseases or disorders among pregnant women especially hypertension, Oligohydramnios, preeclampsia, bleeding or spotting, Hyperemesis Gravid arum, urinary tract infection, and low diastolic blood pressure as well as the improving health care quality delivered to pregnant women may reduce preterm prevalence rate.