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Liu Y, Che CC, Hamdan M, Chong MC. Psychometric validation of the Chinese version of the empowerment scale for pregnant women. Res Nurs Health 2024. [PMID: 39177122 DOI: 10.1002/nur.22419] [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: 12/05/2023] [Revised: 07/11/2024] [Accepted: 08/11/2024] [Indexed: 08/24/2024]
Abstract
Empowering pregnant women is a crucial process that healthcare providers should evaluate, as empowerment is a meaningful indicator that can reflect the impact of health promotion and education in antenatal care. The Empowerment Scale for Pregnant Women (ESPW) is a reliable and valid instrument for measuring empowerment. The cross-sectional study was conducted to translate and validate the psychometric properties of the ESPW among 526 pregnant women in China. The forward-backward method was used to translate the English version of the ESPW into the Chinese version. Reliability was examined with the internal consistency and test-retest coefficients. Validity was analyzed with structural, dimensionality, convergent, discriminant, and concurrent validity. The Cronbach's α value of 0.97 and the intraclass correlation coefficient of 0.98 (95% confidence interval [CI], [0.96, 0.99]) demonstrated excellent internal consistency and test-retest reliability. Exploratory factor analysis revealed that five factors with eigenvalues > 1 explained 68.41% of the total variance. Confirmatory factor analysis verified an acceptable model that fit the data exceptionally. The Chinese-translated version of the ESPW (CV-ESPW) had acceptable convergent and discriminant validity. Concurrent validity was supported by the correlation between the total scores of the CV-ESPW and the Chinese version of the Patient Perceptions of the Empowerment Scale (r = 0.64, p < 0.001). The CV-ESPW is a valid and reliable assessment tool for measuring pregnant women's empowerment in China and can potentially contribute to evaluating the effectiveness of programs that empower pregnant women.
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Affiliation(s)
- Yanjia Liu
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mukhri Hamdan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Hassan AA, Omar SM, Osman OS, AlHabardi N, Al-Wutayd O, Adam I. High rate of inadequate antenatal contacts among mothers in eastern Sudan: a cross-sectional study. Women Health 2024; 64:595-603. [PMID: 39135218 DOI: 10.1080/03630242.2024.2389523] [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: 07/24/2023] [Revised: 07/01/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
This study assesses the prevalence and determinants of inadequate (less than eight contacts) and late antenatal care (ANC) initiation (starting after 12 weeks) among mothers delivered at Gadarif Maternity Hospital in eastern Sudan. A hospital-based cross-sectional study was conducted at Gadarif Maternity Hospital. A questionnaire was used to collect sociodemographic, clinical, and obstetric data through face-to-face interviews. Seven hundred mothers were enrolled with the median (interquartile range) of mothers' age, and parity was 28(24-32) years and 3(2-5), respectively. Of these 700 mothers, 79.3 percent and 10.3 percent had inadequate and late ANC, respectively. In multivariable logistic regression analysis, being a housewife (adjusted odds ratio [AOR] 1.93, 95 percent CI 1.09, 3.43) was associated with inadequate ANC. High parity (AOR 1.27, 95 percent CI 1.07-1.52) was positively associated with late ANC initiation. There was no association between age, residence, education, preexisting medical disorder, and history of miscarriage) with inadequate or late ANC initiation In eastern Sudan, four out of five mothers did not comply with the World Health Organization's recommendation of a minimum of eight ANC contacts for positive pregnancy outcomes. This study is crucial for policy-makers to take further strategic actions to ensure adequate and early ANC initiation for all mothers in Sudan.
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Affiliation(s)
| | - Saeed M Omar
- Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Osama S Osman
- Faculty of Medicine, Gadarif University, Gadarif, Sudan
| | - Nadiah AlHabardi
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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Fajarina M, Terathongkum S, Lininger J. Factors influencing late antenatal care of Muslim pregnant women: A predictive correlational study in Aceh, Indonesia. BELITUNG NURSING JOURNAL 2024; 10:360-367. [PMID: 38947307 PMCID: PMC11211745 DOI: 10.33546/bnj.3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/22/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background Late antenatal care (ANC) has significant implications for maternal and infant morbidity and mortality among Muslim pregnant women in Indonesia. Existing literature has primarily focused on gestational weeks at the first ANC contact, with limited attention to the total number of ANC visits. Objective This study aimed to explore the factors predicting late antenatal care contact among Muslim pregnant women, including the gestational weeks of the first ANC contact and the total number of ANC visits in Aceh, Indonesia. Methods A predictive correlational study design was utilized. Eighty postpartum women who received late ANC were purposively sampled and included in the study. Data were collected in May 2023 using ANC knowledge, beliefs, and social support questionnaires. Statistical analyses included descriptive statistics, Spearman's rank correlation, Chi-Square tests, and binary logistic regression with the enter method. Results Pregnant women residing farther from home to ANC services were more likely to have their first ANC contact after 20 weeks than those with a shorter distance (AOR = 1.06; 95% CI: 1.02-1.10; p = 0.007). Additionally, women with a history of multiple abortions were more inclined to have four or more ANC visits compared to those with fewer abortions (AOR = 6.78; 95% CI: 1.64-28.09; p = 0.008). Conclusion Distance from home to healthcare services emerged as a significant barrier to ANC contact, while a history of abortion appeared to motivate pregnant women to seek ANC more frequently. To address these issues effectively, nurses should consider implementing telemedicine services for ANC provision, integrating information on pregnancy complications to better support pregnant women in their care journey.
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Affiliation(s)
- Mira Fajarina
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sangthong Terathongkum
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Jiraporn Lininger
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
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Lateef MA, Kuupiel D, Mchunu GG, Pillay JD. Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:440. [PMID: 38673351 PMCID: PMC11050659 DOI: 10.3390/ijerph21040440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Daily, the number of women who die around the world reaches an average of 800; these deaths are a result of obstetric complications in pregnancy and childbirth, and 99% of these deaths occur in low- and middle-income countries. This review probes the use of antenatal care (ANC) and skilled birth delivery (SBD) services in sub-Saharan Africa (SSA) and highlights research gaps using Arksey and O'Malley's methodological approach. The screening of abstracts and full text was carried out by two independent authors who ensured the eligibility of data extraction from the included articles. An exploration of the data was undertaken with descriptive analyses. In total, 350 potentially eligible articles were screened, and 137 studies were included for data extraction and analysis. From the 137 included studies, the majority were from Ethiopia (n = 40, 29.2%), followed by Nigeria (n = 30, 21.9%). Most of the studies were published between 2019 and 2023 (n = 84, 61%). Significant trends and challenges with ANC and SBD services emerged from the studies. It is revealed that there are wide gaps in the utilization of ANC and SBD services. Policy attention, intervention strategies to improve access, resources, rural-urban disparity, and women's literacy are recommended to improve the utilization of ANC and SBD services in SSA countries.
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Affiliation(s)
- Monsurat A. Lateef
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Desmond Kuupiel
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Gugu G. Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Julian D. Pillay
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
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Alamgir F, Hossain MF, Ullah MS, Hossain MS, Hasan M. Socio-economic status and pregnancy complications and their impact on antenatal care services provided at home and Upazila health complex. Heliyon 2024; 10:e27716. [PMID: 38533022 PMCID: PMC10963214 DOI: 10.1016/j.heliyon.2024.e27716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
The stage of pregnancy is crucial for women of reproductive age and their families. However, in low- and middle-income countries like Bangladesh, antenatal and postnatal care are not widely practiced due to various socio-economic factors, such as low education levels, income, age, pregnancy knowledge, and limited healthcare facilities. The objective of this study was to examine the factors associated with antenatal care in two locations in Bangladesh based on the data collected from the Bangladesh Demographic and Health Survey (BDHS) 2017-2018. We explored different variables as explanatory variables related to ANC service. The results showed that most of the respondents were from rural areas, with 77.02% receiving antenatal care at home. Women with secondary education were more likely to receive care at home than those without education. The Chi-square test indicated a positive correlation between antenatal care at home with several variables, whereas, in the case of Upazila health complexes, only three variables showed a positive association. Logistic regression analysis further showed some specific variables such as geographical division, religion, iron intake during pregnancy, and reporting pregnancy complications had a significant impact on ANC at home. In contrast, covariates such as residence, division, and wealth index were significant for antenatal care at Upazila health complexes. The division was a significant covariate in both cases. Interestingly, we observed that mothers who had been informed about the signs of pregnancy complications were 92% more likely to receive antenatal care at home than those who had not experienced pregnancy complications. Conversely, the results revealed that mothers who were unaware of pregnancy complications were 32% more likely to receive antenatal care at home than those who had been informed about complications. This suggests that when women are educated about pregnancy complications, they are more likely to receive more antenatal care. However, Bangladesh's situation is quite different due to a lack of proper education and knowledge of antenatal care services.
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Affiliation(s)
- Fariha Alamgir
- Department of Statistics, Comilla University, Cumilla, 3506, Bangladesh
| | | | | | | | - Mahmud Hasan
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, 1212, Bangladesh
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Abdullahi AS, Suliman A, Khan MAB, Khair H, Ghazal-Aswad S, Elbarazi I, Al-Maskari F, Loney T, Al-Rifai RH, Ahmed LA. Temporal trends of hemoglobin among pregnant women: The Mutaba'ah study. PLoS One 2023; 18:e0295549. [PMID: 38064469 PMCID: PMC10707684 DOI: 10.1371/journal.pone.0295549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Low hemoglobin (Hb) level is a leading cause of many adverse pregnancy outcomes. Patterns of changes in Hb levels during pregnancy are not well understood. AIM This study estimated Hb levels, described its changing patterns across gestational trimesters, and identified factors associated with these changes among pregnant women. MATERIALS AND METHODS Data from the ongoing maternal and child health cohort study-The Mutaba'ah Study, was used (N = 1,120). KML machine learning algorithm was applied to identify three distinct cluster trajectories of Hb levels between the first and the third trimesters. Descriptive statistics were used to profile the study participants. Multinomial multivariable logistic regression was employed to identify factors associated with change patterns in Hb levels. RESULTS The three identified clusters-A, B and C-had, respectively, median Hb levels (g/L) of 123, 118, and 104 in the first trimester and 119, 100, and 108 in the third trimester. Cluster 'A' maintained average normal Hb levels in both trimesters. Cluster 'B', on average, experienced a decrease in Hb levels below the normal range during the third trimester. Cluster 'C' showed increased Hb levels in the third trimester but remained, on average, below the normal range in both trimesters. Pregnant women with higher gravida, diabetes mellitus (type 1 or 2), nulliparity or lower level of education were more likely to be in cluster 'B' than the normal cluster 'A'. Pregnant women who reported using iron supplements before pregnancy or those with low levels of education. were more likely to be in cluster 'C' than the normal cluster 'A'. CONCLUSION The majority of pregnant women experienced low Hb levels during pregnancy. Changes in Hb levels during pregnancy were associated with parity, gravida, use of iron before pregnancy, and the presence of diabetes mellitus (type 1 or 2).
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Affiliation(s)
- Aminu S. Abdullahi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abubaker Suliman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Moien AB Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Howaida Khair
- Department of Obstetrics & Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Saad Ghazal-Aswad
- Obstetrics and Gynecology Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Abdo R, Demelash M, Seid AM, Mussema A. First trimester antenatal care contact in Africa: a systematic review and meta-analysis of prevalence and contributing factors. BMC Pregnancy Childbirth 2023; 23:742. [PMID: 37858033 PMCID: PMC10585910 DOI: 10.1186/s12884-023-06034-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Early detection, prevention, and management of diseases associated with pregnancy and pregnancy-related conditions depend on the beginning of antenatal care contact in the first trimester. Across Africa, regional and national differences are observed in the proportion of first-trimester ANC contact and the factors contributing to it. To create a suitable intervention plan, it is crucial to overcome these differences through single standard and uniform guidelines. This can be achieved through meta-analysis and systematic reviews. Therefore, this systematic review aimed to assess the pooled prevalence of first trimester ANC contact and the factors contributing to it in Africa. METHODS Observational studies conducted in Africa were retrieved from PubMed, Google Scholar, EMASE, CINHAL, Cochrane Library, Hinari databases and Mednar using combinations of search terms with Boolean operators. The JBI 2020 Critical Appraisal Checklist was used to assess the methodological quality of the studies. To assess publication bias, a funnel plot and Egger's test were used to and I-squared was used to check the heterogeneity of the included studies. Data were extracted using Microsoft Excel and exported to Stata 16 software for analysis. RESULTS A total of 86 articles with 224,317 study participants from 19 African countries were included. The overall pooled prevalence of first-trimester ANC contact was 37.15% (95% CI: 33.3-41.0; I2 = 99.8%). The following factors were found to be significantly associated with first-trimester ANC contact: urban residence (OR = 2.2; 95% CI: 1.5-3.1; I2 = 98.5%); women under the age of 25 (OR = 1.5; 95% CI: 1.2-1.9; I2 = 94.1%);, educational status (OR = 1.8; 95% CI: 1.4-2.2; I2 = 96.1%), primiparity (OR: 1.7; 95% CI: 1.2-2.4: I2 = 97.4%), having planned pregnancies (OR: 2.1; 95% CI: 1.5-2.7; I2 = 95.5%) and employed women (OR = 1.7; 95% CI: 1.7-2.1; I2 = 94.4%). CONCLUSION Because so few women in Africa initiate first-trimester ANC contact, it is clear that increasing maternal healthcare service uptake is still a challenge and will require significant effort to scale up the services. When working to improve maternal health in Africa, each nation's government and nongovernmental organizations should prioritize raising women's educational levels and providing pertinent information to rural women, focusing on reducing unintended pregnancies, women who live far from health facilities, women with low socioeconomic statuses, multiparous women and older women. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic reviews (ID: CRD42023401711).
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Affiliation(s)
- Ritbano Abdo
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
| | - Minychil Demelash
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Abdulrezak Mohammed Seid
- Department of Medical Laboratory, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Abdulhakim Mussema
- Department of Medical Laboratory, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
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Fente BM, Asaye MM, Tesema GA, Gudayu TW. Development and validation of a prognosis risk score model for preterm birth among pregnant women who had antenatal care visit, Northwest, Ethiopia, retrospective follow-up study. BMC Pregnancy Childbirth 2023; 23:732. [PMID: 37848836 PMCID: PMC10583360 DOI: 10.1186/s12884-023-06018-1] [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: 06/03/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Prematurity is the leading cause of neonatal morbidity and mortality, specifically in low-resource settings. The majority of prematurity can be prevented if early interventions are implemented for high-risk pregnancies. Developing a prognosis risk score for preterm birth based on easily available predictors could support health professionals as a simple clinical tool in their decision-making. Therefore, the study aims to develop and validate a prognosis risk score model for preterm birth among pregnant women who had antenatal care visit at Debre Markos Comprehensive and Specialized Hospital, Ethiopia. METHODS A retrospective follow-up study was conducted among a total of 1,132 pregnant women. Client charts were selected using a simple random sampling technique. Data were extracted using structured checklist prepared in the Kobo Toolbox application and exported to STATA version 14 and R version 4.2.2 for data management and analysis. Stepwise backward multivariable analysis was done. A simplified risk prediction model was developed based on a binary logistic model, and the model's performance was assessed by discrimination power and calibration. The internal validity of the model was evaluated by bootstrapping. Decision Curve Analysis was used to determine the clinical impact of the model. RESULT The incidence of preterm birth was 10.9%. The developed risk score model comprised of six predictors that remained in the reduced multivariable logistic regression, including age < 20, late initiation of antenatal care, unplanned pregnancy, recent pregnancy complications, hemoglobin < 11 mg/dl, and multiparty, for a total score of 17. The discriminatory power of the model was 0.931, and the calibration test was p > 0.05. The optimal cut-off for classifying risks as low or high was 4. At this cut point, the sensitivity, specificity and accuracy is 91.0%, 82.1%, and 83.1%, respectively. It was internally validated and has an optimism of 0.003. The model was found to have clinical benefit. CONCLUSION The developed risk-score has excellent discrimination performance and clinical benefit. It can be used in the clinical settings by healthcare providers for early detection, timely decision making, and improving care quality.
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Affiliation(s)
- Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine & Health sciences, University of Gondar, Gondar, Ethiopia
| | - Mengstu Melkamu Asaye
- Department of Women’s and Family Health, School of midwifery, College of Medicine & Health sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Temesgen Worku Gudayu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine & Health sciences, University of Gondar, Gondar, Ethiopia
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Bukhari AA, Alhibshi DN, Alsayyad HM, Altaifi RI, Althakafi KA. Assessing the Quality of Antenatal Care in King Abdulaziz University Hospital: A Retrospective Study. Cureus 2023; 15:e37150. [PMID: 37153298 PMCID: PMC10161147 DOI: 10.7759/cureus.37150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Antenatal care is vital for pregnant women and fetuses. However, the coronavirus disease 2019 (COVID-19) pandemic has hindered access to care worldwide, resulting in missed appointments. Therefore, assessing the quality of antenatal care during the pandemic is crucial. This study evaluated the care provided at King Abdulaziz University Hospital in Saudi Arabia and suggested areas for improvement. METHODS This retrospective medical records review involved 400 pregnant patients who received antenatal care at King Abdulaziz University Hospital in the past two years. A checklist was used to collect patient data, including demographics, antenatal care visits, ultrasounds, gestational age at first visit and ultrasound, prior cesarean section and preterm delivery, and virtual clinic attendance during the COVID-19 pandemic. Statistical analyses were performed using SPSS version 25 (Armonk, NY: IBM Corp.). RESULTS The sample had a mean age of 30±6 years, and most participants (87.8%) were Saudi women. Over half of the participants did not attend any antenatal follow-up visits, and the majority had only one ultrasound. Only a small proportion of mothers attended virtual clinics during the pandemic. Having a prior cesarean section and a parity of 1-3 were positively associated with ultrasound attendance, while prior preterm delivery was positively associated with antenatal visits and virtual clinic attendance. CONCLUSION This study highlighted the importance of improving antenatal care quality at King Abdulaziz University Hospital, especially during COVID-19. To achieve this, strategies such as increasing visits, ultrasound attendance, and virtual clinic access should be considered. By implementing these recommendations, the hospital can enhance care and promote maternal and fetal health.
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Determinants of Maternal Mortality in Southern Africa: A Macro-Level Analysis. WOMEN 2023. [DOI: 10.3390/women3010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
This study sought to investigate the macro determinants of maternal mortality in Southern African Development Community (SADC) states. The study drew on the fact that maternal mortality remains a major public health issue in developing countries. The Millennium Development Goals (MDGs) were adopted by UN member states in 2000, and one of them was to reduce maternal deaths by three-quarters by 2015. While the Millennium Development Goals increased efforts, the goal was not met in the countries with the highest death rates. The World Health Organisation (WHO) estimates that every single day about 810 women die from pregnancy or childbirth-related complications around the world. This is despite several international initiatives being adopted to reduce maternal mortality. The study was quantitative, and it used secondary data to achieve its objective. A panel data estimation (Generalized Method of Moments) covering the period from 2005–2019 was used to examine how various factors affect maternal mortality. The analysis included the following variables: education, fertility, GDP per capita, institutional quality, health expenditure and HIV infection. The econometric analysis reveals a significant positive impact of fertility, GDP per capita and HIV on maternal mortality. This implies that when fertility, GDP per capita and HIV are increasing, maternal mortality also increases. The analysis also showed that education has a negative relationship with maternal mortality. This implies that when literacy levels (education) increase, maternal mortality decreases. Based on the results, this study emphasizes that, in order to improve maternal health and consequently reduce maternal mortality, access to family planning (to reduce fertility), access to early prenatal care and promoting women’s access to education should be a priority in government policies.
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Spatial distribution and predictive factors of antenatal care in Burundi: A spatial and multilevel baseline analysis for the third burundian demographic and health survey. PLoS One 2023; 18:e0272897. [PMID: 36649240 PMCID: PMC9844929 DOI: 10.1371/journal.pone.0272897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION The use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during childbirth. To avoid these complications, the World Health Organization (WHO) recommends at least four antenatal visits. Therefore, this study was conducted to identify predictive factors of antenatal care (ANC) among women aged 15 to 49 years and its spatial distribution in Burundi. METHODS We used data from the Second Burundi Demographic and Health Survey (DHS). A Spatial analysis of ANC prevalence and Mulitlevel logistic regressions of determinants factors of ANC with a medical doctor were done. The ANC prevalence was mapped by region and by province. In unsampled data points, a cluster based interpolation of ANC prevalence was done using the kernel method with an adaptive window. Predictive factors of ANC were assessed using Mulitlevel logistic regressions. The dependent variable was antenatal care with a medical doctor and the explanatory variables were place of residence, age, education level, religion, marital status of the woman, household wealth index and delivery place of the woman. Data processing and data analysis were done using using Quantum Geographic Information System (QGIS) and R software, version 3. 5. 0. RESULTS The ANC prevalence varied from 0. 0 to 16. 2% with a median of 0. 5%. A highest predicted ANC prevalence was observed at Muyinga and Kirundo provinces' junction. Low prevalence was observed in several locations in all regions and provinces. The woman's education level and delivery place were significantly associated with antenatal care with a medical doctor. CONCLUSION Globally, the ANC prevalence is low in Burundi. It varies across the country. There is an intra-regional or intra-provincial heterogeneity in term of ANC prevalence. Woman's education level and delivery place are significantly associated antenatal care. There is a need to consider these ANC disparities and factors in the design and strengthening of existing interventions aimed at increasing ANC visits.
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Fear of childbirth among pregnant women in Eastern Ethiopia: A community-based study. Midwifery 2023; 116:103515. [PMID: 36283296 DOI: 10.1016/j.midw.2022.103515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/24/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Fear of childbirth refers to feelings of uncertainty and anxiety before, during, or after childbirth by thinking about future labor and birth or experience of others. Evidence on burden of fear of childbirth and its associated factors is limited in Ethiopia. In this study, we assessed magnitude of fear of childbirth and its associated factors among pregnant women in Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women recruited from Kersa Health and Demographic Surveillance System-an open cohort consisting of continuous registry of health and demographic conditions in eastern Ethiopia. Women were interviewed and fear of childbirth was assessed using the Wijma Delivery Expectancy Questionnaire. Data were entered using EpiData 3.1 and analyzed using SPSS 20. Factors associated with fear of childbirth were identified using binary and multiple logistic regression and described using adjusted odds ratio (aOR) along with 95% confidence interval (CI). Finally, statistical significance was set at p < 0.05 in the multiple logistic regression. RESULTS Of a total of 476 pregnant women included in the study, 111(23.3%; 95% CI 19.3-26.9) had fear of childbirth. Fear of childbirth was more likely among women who had no antenatal care (aOR = 2.6; 95% CI:1.22-5.50), no husband support (aOR = 5.7; 95% CI: 2.32-13.10), unplanned pregnancy (aOR = 7.8; 95% CI: 3.92-15.42), and had history of complication in labor and pregnancy (aOR = 10.4; 95% CI: 5.20-20.81). CONCLUSION A quarter of pregnant women in eastern Ethiopia had fear of childbirth. Helping women to have positive pregnancy experience requires strengthening antenatal care, partner support, and prevention of unwanted pregnancy.
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Dickson KS, Okyere J, Ahinkorah BO, Seidu AA, Salihu T, Bediako V, Owusu BA, Budu E, Agbemavi W, Edjah JO, Darteh EKM. Skilled antenatal care services utilisation in sub-Saharan Africa: a pooled analysis of demographic and health surveys from 32 countries. BMC Pregnancy Childbirth 2022; 22:831. [DOI: 10.1186/s12884-022-05137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/19/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Each day, an estimated 800 women die from preventable pregnancy and childbirth related complications, where 99% of these avoidable deaths happen in low-and middle-income countries. Skilled attendance during antenatal care (ANC) plays a role in reducing maternal and child mortality. However, the factors that predict the utilisation of skilled ANC services in sub-Saharan Africa (SSA) remains sparsely investigated. Therefore, we examined women’s utilisation of skilled ANC services in SSA.
Methods
The research used pooled data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA between January 1, 2010, and December 31, 2019. Binary logistic regression was used to examine the predictors of skilled ANC services utilisation. The results are presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI).
Results
The prevalence of skilled ANC services utilisation in SSA was 76.0%, with the highest and lowest prevalence in Gambia (99.2%) and Burundi (8.4%), respectively. Lower odds of ANC from skilled providers was found among women aged 45–49 compared to those aged 20–24 (aOR = 0.86, CI = 0.79–0.94); widowed women compared to married women (aOR = 0.84, CI = 0.72–0.99); women who consider getting permission to visit the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.74, CI = 0.71–0.77); women who consider getting money needed for treatment as not a big problem compared to those who consider that as a big problem (aOR = 0.84, CI = 0.72–0.99); and women who consider distance to the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.75, CI = 0.72–0.77).
Conclusion
SSA has relatively high prevalence of skilled ANC services utilisation, however, there are substantial country-level disparities that need to be prioritised. Increasing maternal reproductive age being widowed and far distance to health facility were factors that predicted lower likelihood of skilled ANC services utilisation. There is, therefore, the need to intensify female formal education, invest in community-based healthcare facilities in rural areas and leverage on the media in advocating for skilled ANC services utilisation.
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Purohit N. Utilization of antenatal care services in a remote, tribal and hilly district of Himachal Pradesh: Challenges to access. J Family Med Prim Care 2021; 10:3374-3380. [PMID: 34760760 PMCID: PMC8565120 DOI: 10.4103/jfmpc.jfmpc_426_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A traditional African phrase, 'A pregnant woman has one foot in the grave' expresses the immense health risks associated with pregnancy and childbirth. Antenatal care (ANC) is considered an important determinant to alleviate mortalities and morbidities associated with maternal health. OBJECTIVES The study aimed to identify the utilization pattern of ANC services by pregnant women in a remote, tribal, and hilly district of Himachal Pradesh and to understand their healthcare needs during antenatal period. METHODS A community based descriptive, cross-sectional study was carried out in 41 far-flung villages of Lahaul and Spiti district in Himachal Pradesh, India, using a mixed-method approach of data collection. Purposive sampling was done to select 103 females who had experienced delivery in the past 2 years and were residents of Lahaul for minimum of 3 years. The participants were interviewed using a semi-structured questionnaire and the data were analysed by SPSS-20. RESULTS The study revealed high utilization of ANC services by indigenous women, but it was accompanied by physical, psychological, and financial hardships. The triple challenge of inadequacy of quality antenatal services, transport facilities, and unfavourable weather conditions compelled women to leave their communities in Lahaul and relocate to adjoining districts during the maternity period. CONCLUSION Pregnancy is still a stressful event that disrupts the link between families and communities in such underserved areas. The study recommends the establishment of programs that promote availability of quality ANC services within the rural and remote communities.
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Affiliation(s)
- Neha Purohit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Hashim M, Coussa A, Al Dhaheri AS, Al Marzouqi A, Cheaib S, Salame A, Abu Jamous DO, Naja F, Hasan H, Stojanovska L, Mohamad MN, Bataineh MF, Faris ME, Al Daour R, Obaid RS, Saleh ST, Osaili TM, Cheikh Ismail L. Impact of coronavirus 2019 on mental health and lifestyle adaptations of pregnant women in the United Arab Emirates: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:515. [PMID: 34281501 PMCID: PMC8287543 DOI: 10.1186/s12884-021-03941-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/31/2021] [Indexed: 01/14/2023] Open
Abstract
Background In light of the pandemic, pregnant women are particularly vulnerable to increased psychological distress and in need of imperative preventive measures. This study aimed to investigate the impact of the pandemic on mental health, lifestyle adaptations, and their determinants among pregnant women in the United Arab Emirates. Methods A survey was conducted electronically between June and August 2020. Pregnant women were recruited from prenatal clinics in the UAE and invited to participate in an online survey developed on Google Forms. The questionnaire included socio-demographic characteristics, the Impact of Event Scale- Revised, the Perceived Support Scale and lifestyle-related factors. Results A total of 384 pregnant women completed the questionnaire of whom 20.6% were in their 1st trimester, 46.1% in their 2nd and 33.3% in their 3rd trimester. The mean IES-R score for the respondents was 26.15 ± 13.55, corresponding to a mild stressful impact, which did not differ significantly among trimesters of pregnancy. Pregnant women expressed increased stress from staying home (64%), work (40%), feeling frightened (66%) and apprehensive (59%). Women reported increased support and sharing their feelings with family members (59%), mainly in the 1st and 3rd trimester of pregnancy (P < 0.05). There was a greater attention to mental health (48%), resting time (55.3%), and relaxing time (57.3%); while a decreased amount of time was spent engaging in physical activities (53.6%), which differed significantly between trimesters (P = 0.02). Conclusions The COVID-19 pandemic was associated with a mild stressful impact among pregnant women in the UAE, braced by strong family support and self-care mental health behaviors.
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Affiliation(s)
- Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Nutrition and Dietetics Program, School of Health Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Ayla Coussa
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Ayesha S Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, United Arab Emirates
| | - Amina Al Marzouqi
- Department of Health Services Administration, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Samer Cheaib
- Fakih IVF Clinics, Fetal Medicine Department, Jumeirah 1, Dubai, 72960, United Arab Emirates
| | - Anastasia Salame
- Fakih IVF Clinics, Obstetrics and Gynecology Department, Ashraj 13, Al Ain, 31453, Abu Dhabi, United Arab Emirates
| | - Dima O Abu Jamous
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, United Arab Emirates.,Victoria University, Institute for Health and Sport, Melbourne, 14428, Australia
| | - Maysm N Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, 15551, United Arab Emirates
| | - Mo'ath F Bataineh
- Department of Sport Rehabilitation, Faculty of Physical Education and Sport Sciences, The Hashemite University, Zarqa, Jordan
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Rameez Al Daour
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Reyad S Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Sheima T Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Tareq M Osaili
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.,Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates. .,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates. .,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, OX1 2JD, UK.
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Ali N, Aldhaheri AS, Alneyadi HH, Alazeezi MH, Al Dhaheri SS, Loney T, Ahmed LA. Effect of Gestational Diabetes Mellitus History on Future Pregnancy Behaviors: The Mutaba'ah Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E58. [PMID: 33374764 PMCID: PMC7796159 DOI: 10.3390/ijerph18010058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 12/26/2022]
Abstract
Gestational diabetes mellitus (GDM) increases the risk of adverse pregnancy outcomes in any pregnancy and recurrence rates are high in future pregnancies. This study aims to investigate the effect of self-reported history of previous GDM on behaviors in a future pregnancy. This is an interim cross-sectional analysis of the pregnant women who participated in the Mutaba'ah Study between May 2017 and March 2020 in the United Arab Emirates. Participants completed a baseline self-administered questionnaire on sociodemographic and pregnancy-related information about the current pregnancy and previous pregnancies. Regression models assessed the relationships between self-reported history of GDM and pre-pregnancy and pregnancy behaviors in the current pregnancy. Out of 5738 pregnant parous women included in this analysis, nearly 30% (n = 1684) reported a history of GDM in a previous pregnancy. Women with a history of previous GDM were less likely to plan their current pregnancies (adjusted odds ratio (aOR): 0.84, 95% confidence interval (CI) 0.74-0.96) and more likely to be worried about childbirth (aOR: 1.18, 95% CI 1.03-1.36). They had shorter interpregnancy intervals between their previous child and current pregnancy (aOR: 0.88, 95% CI 0.82-0.94, per SD increase). There were no significant differences between women with and without a history of GDM in supplement use, sedentary behavior, or physical activity before and during this current pregnancy. Nearly a third of parous pregnant women in this population had a history of GDM in a previous pregnancy. Pregnant women with a previous history of GDM were similar to their counterparts with no history of GDM in the adopted pre-pregnancy and prenatal health behaviors. More intensive and long-term lifestyle counseling, possibly supported by e-health and social media materials, might be required to empower pregnant women with a history of GDM. This may assist in adopting and maintaining healthy prenatal behaviors early during the pregnancy or the preconception phase to minimize the risk of GDM recurrence and the consequential adverse maternal and infant health outcomes.
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Affiliation(s)
- Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
| | - Aysha S. Aldhaheri
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
| | - Hessa H. Alneyadi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
| | - Maha H. Alazeezi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
| | - Sara S. Al Dhaheri
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, P.O. Box 505055, Dubai, UAE;
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE; (N.A.); (A.S.A.); (H.H.A.); (M.H.A.); (S.S.A.D.)
- Zayed Centre for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, UAE
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Al-Rifai RH, Elbarazi I, Ali N, Loney T, Oulhaj A, Ahmed LA. Knowledge and Preference Towards Mode of Delivery among Pregnant Women in the United Arab Emirates: The Mutaba'ah Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E36. [PMID: 33374611 PMCID: PMC7793149 DOI: 10.3390/ijerph18010036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The rate of cesarean section (CS) is growing in the United Arab Emirates (UAE). Pregnant women's knowledge on the mode of delivery, factors associated with lack of adequate knowledge, and preference towards CS delivery were investigated. METHODS Baseline cross-sectional data from 1617 pregnant women who participated in the Mutaba'ah Study between September 2018 and March 2020 were analyzed. A self-administered questionnaire inquiring about demographic and maternal characteristics, ten knowledge-based statements about mode of delivery, and one question about preference towards mode of delivery was used. Knowledge on the mode of delivery was categorized into "adequate (total score 6-10)" or "lack of adequate (total score 0-5)" knowledge. Crude and multivariable models were used to identify factors associated with "lack of adequate" knowledge on the mode of delivery and factors associated with CS preference. RESULTS A total of 1303 (80.6%) pregnant women (mean age 30.6 ± 5.8 years) completed the questionnaire. The majority (57.1%) were ≥30 years old, in their third trimester (54.5%), and had at least one child (76.6%). In total, 20.8% underwent CS delivery in the previous pregnancy, and 9.4% preferred CS delivery for the current pregnancy. A total of 78.4% of pregnant women lacked adequate knowledge on the mode of delivery. The level of those who lacked adequate knowledge was similar across women in different pregnancy trimesters. Young women (18-24 years) (adjusted odds ratios (aOR), 3.07, 95% confidence interval (CI), 1.07-8.86) and women who had CS delivery in the previous pregnancy (aOR, 1.90, 95% CI, 1.06-3.40) were more likely to be classified with a lack of adequate knowledge. Age (aOR, 1.08, 95% CI, 1.02-1.14), employment (aOR, 1.96, 95% CI, 1.13-3.40), or previous CS delivery (aOR, 31.10, 95% CI, 17.71-55.73) were associated with a preference towards CS delivery. CONCLUSION This study showed that pregnant women may not fully appreciate the health risks associated with different modes of delivery. Therefore, antenatal care appointments should include a balanced discussion on the potential benefits and harms associated with different delivery modes.
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Affiliation(s)
- Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE; (I.E.); (N.A.); (A.O.); (L.A.A.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE; (I.E.); (N.A.); (A.O.); (L.A.A.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE; (I.E.); (N.A.); (A.O.); (L.A.A.)
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, UAE;
| | - Abderrahim Oulhaj
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE; (I.E.); (N.A.); (A.O.); (L.A.A.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE; (I.E.); (N.A.); (A.O.); (L.A.A.)
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, UAE
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Ali N, Elbarazi I, Ghazal-Aswad S, Al-Maskari F, H Al-Rifai R, Oulhaj A, Loney T, A Ahmed L. Impact of Recurrent Miscarriage on Maternal Outcomes in Subsequent Pregnancy: The Mutaba'ah Study. Int J Womens Health 2020; 12:1171-1179. [PMID: 33324118 PMCID: PMC7733378 DOI: 10.2147/ijwh.s264229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/12/2020] [Indexed: 01/28/2023] Open
Abstract
Purpose To estimate the prevalence of recurrent miscarriage (RM) and investigate the association between RM and adverse maternal outcomes in subsequent pregnancies. Participants and Methods This is an interim analysis of a prospective study of 1737 pregnant women with gravidity of two or more prior to the current pregnancy. These women joined the Mutaba’ah Study between May 2017 and April 2019 and were followed up until they delivered. Hospital medical records were used to extract data on past pregnancy history and the progress and outcomes of the current pregnancy, such as gestational diabetes, preeclampsia, mode of delivery, preterm delivery, and complications at birth. Results Amongst pregnant women with at least two previous pregnancies (n=1737), there were 234 (13.5%) women with a history of two or more consecutive miscarriages. Women with RM were slightly older, more parous, and more likely to have had previous infertility treatment (all p-values <0.05). Women with a history of RM had independently significant increased odds of cesarean section (adjusted odds ratio (aOR) 1.81, 95% CI 1.24–2.65) and preterm (<37 weeks, aOR: 2.52, 95% CI 1.56–4.08) or very preterm delivery (<32 weeks, aOR: 7.02 95% CI 2.41–20.46) in subsequent pregnancies than women who did not have a history of RM. Conclusion Women with a history of RM were twice as likely to undergo cesarean section and seven times more likely to deliver prior to 32 weeks of gestation than women without a history of RM. The study findings support the need for early pregnancy monitoring or assessment units to ensure better follow-up and customized care for at-risk pregnant women with a history of RM.
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Affiliation(s)
- Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Saad Ghazal-Aswad
- Obstetrics and Gynecology Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abderrahim Oulhaj
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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