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Ayari F, Sdiri Y, Cherifi E, Khemiri S, Chourou H, Cheour M, Belhajammar W, Karoui A, Channoufi MB, Kacem S, Achour R. [Knowledge of breastfeeding among mothers before maternity discharge]. Gynecol Obstet Fertil Senol 2022; 50:164-172. [PMID: 34626850 DOI: 10.1016/j.gofs.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The aim of our study was to assess the knowledge of parturients about breastfeeding and to analyze the factors influencing this level of knowledge. METHODS It was a prospective, descriptive and analytical, cross-sectional study carried out over a period of six months including 500 parturients who gave birth at the maternity unit of the National Center for Maternity and Neonatalogy of Tunis during the period from July to December 2020. Sociodemographic, obstetrical and breastfeeding related data were collected through individual interviews carried out before leaving the postpartum service using a questionnaire written in Tunisian dialectal Arabic. RESULTS The average age of the mothers was 31.5 years. Housewives accounted for 73.3 % of cases. Forty-four percent of the women surveyed were first-time mothers. The main source of information was relatives (74.8 %). The prevalence of breastfeeding was 93.8 %. Knowledge about breasfeeding was insufficient in 76.4 % of cases. The level of knowledge was insufficient in particular regarding signs of effective breastfeeding, signs of awakening of the newborn, lactogenesis, and diet of breastfeeding women. Unemployment of the parturient age over 30 and primiparity negatively influenced the knowledge of parturients. CONCLUSION The level of knowledge of parturients was heterogeneous but generally insufficient. Health education programs on MA targeting subjects most at risk of insufficient knowledge should be put in place in order to improve the knowledge base and hopefully improve the breastfeeding rates.
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Affiliation(s)
- F Ayari
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie.
| | - Y Sdiri
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - E Cherifi
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - S Khemiri
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - H Chourou
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - M Cheour
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - W Belhajammar
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - A Karoui
- Service de gynécologie et d'obstétrique 'C' du centre de maternité et de néonatologie de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - M B Channoufi
- Service de gynécologie et d'obstétrique 'C' du centre de maternité et de néonatologie de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - S Kacem
- Service de médecine et de réanimation néonatale du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
| | - R Achour
- Service des urgences de gynécologie et d'obstétrique du centre de maternité de Tunis, Beb Saadoun, 1007 Tunis, Tunisie
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Grangé G, Berlin I, Bretelle F, Bertholdt C, Berveiller P, Blanc J, DiGuisto C, Dochez V, Garabedian C, Guerby P, Koch A, Le Lous M, Perdriolle-Galet E, Peyronnet V, Rault E, Torchin H, Legendre G. [CNGOF-SFT Expert Report and Guidelines for Smoking Management during Pregnancy-Short Text]. Gynecol Obstet Fertil Senol 2020; 48:539-545. [PMID: 32289497 DOI: 10.1016/j.gofs.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy. METHODS Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest). RESULTS "Counseling", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child's development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression. CONCLUSIONS Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.
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Affiliation(s)
- G Grangé
- Maternité Port-Royal, université de Paris, AP-HP, 75014 Paris, France.
| | - I Berlin
- Département de pharmacologie, AP-HP, 75000 Paris, France; Centre universitaire de médecine générale et de santé publique, 1000 Lausanne, Suisse
| | - F Bretelle
- Department of obstetrics and gynecology, conception hospital, Aix Marseille université, prenatal diagnosis Timone Conception, IHU, IRD, Assistance publique des Hôpitaux de Marseille (AP-HM), 13005 Marseille, France
| | - C Bertholdt
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France; IADI, Inserm U1254, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain-en-Laye, 78300 Poissy, France
| | - J Blanc
- Service de gynécologie obstétrique, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France; EA3279, CEReSS, health service research and quality of life center, université Aix-Marseille, 13284 Marseille, France
| | - C DiGuisto
- Université de Paris, epidemiology and statistics research center/CRESS, Inserm (U1153 - Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé)), INRA, hôpital Tenon, bâtiment Recherche, rue de la Chine, 75020 Paris, France; Maternité Olympe de Gouges, centre hospitalier régional universitaire Tours, Tours, France; Université François-Rabelais, 37000 Tours, France
| | - V Dochez
- Service de gynécologie-obstétrique, CHU de Nantes, 44093 Nantes, France
| | - C Garabedian
- EA 4489 - Perinatal Environment and Health, université de Lille, hôpital Jeanne-de-Flandre, clinique d'obstétrique, CHU de Lille, 59000 Lille, France
| | - P Guerby
- Service de gynécologie obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse, France
| | - A Koch
- Service de gynécologie-obstétrique, CHU de Strasbourg, 67000 Strasbourg, France
| | - M Le Lous
- Département de gynécologie obstétrique et médecine de la reproduction, CHU de Rennes, Rennes, France; LTSI-Inserm, université de Rennes 1, UMR 1099, 35000 Rennes, France
| | - E Perdriolle-Galet
- Pôle de la femme, maternité régionale du CHRU de Nancy, 10, rue Dr-Heydenreich, 54000 Nancy, France
| | - V Peyronnet
- Service de gynécologie obstétrique, hôpital L.-Mourier, AP-HP, 92700 Colombes, France
| | - E Rault
- Hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - H Torchin
- Service de médecine et réanimation néonatales de Port-Royal, AP-HP, 75014 Paris, France; Université de Paris, epidemiology and statistics research center/CRESS, Inserm, INRA, 75004 Paris, France
| | - G Legendre
- CESP-Inserm, U1018, Team 7, Genre, Sexual and Reproductive Health, Paris-Sud University, Paris-Saclay University, UVSQ, Inserm, 94800 Villejuif, France; Department of obstetrics and gynecology, Angers university hospital, 49000 Angers, France
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Jégu M, Some Der A, Morcel K, Abadie C, Fritel X, Levêque J. [Breast and ovarian cancer due to BRCA1&2 hereditary cancer predisposition syndrome and reproduction: literature review]. J Gynecol Obstet Hum Reprod 2015; 44:10-17. [PMID: 25455630 DOI: 10.1016/j.jgyn.2014.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 10/03/2014] [Accepted: 10/10/2014] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Germline mutations BRCA1&2 are responsible in women for breast and ovarian cancers that commonly occur at a young age: as such, there are strong interactions between the oncological risks and the events of reproductive life, pregnancy, breastfeeding, and management of infertility. MATERIALS AND METHODS A review of the international literature from the PubMed database was conducted, and recommendations of French health agencies were exposed. Published studies are case-control and cohort studies in the majority, with a low level of evidence. RESULTS Pregnancy and lactation have no effect on breast and ovaries or even decreases the risk. The sex ratio among patients carrying the mutation is in favor of girls. It is not observed more infertility in patients carrying a mutation despite a strong suspicion of premature ovarian failure, and infertility treatments do not increase breast and ovarian risk. There are ethical debates concerning the place of pre-natal diagnosis: both experts and concerned patients recommend a case-by-case analysis of the requests.
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Affiliation(s)
- M Jégu
- Service de gynécologie obstétrique, CHU La Milétrie, 86000 Poitiers, France
| | - A Some Der
- Service de gynécologie, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90 347, 35203 Rennes cedex 2, France
| | - K Morcel
- Service de gynécologie, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90 347, 35203 Rennes cedex 2, France
| | - C Abadie
- Service de génétique, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90 347, 35203 Rennes cedex 2, France
| | - X Fritel
- Service de gynécologie obstétrique, CHU La Milétrie, 86000 Poitiers, France
| | - J Levêque
- Service de gynécologie, CHU Anne-de-Bretagne, 16, boulevard de Bulgarie, BP 90 347, 35203 Rennes cedex 2, France.
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Adarmouch L, Abourrahouat A, Sebbani M, Amine M, Sbihi M. [Weaning before the age of 6 months in Marrakech: associated factors and prevalence]. Rev Epidemiol Sante Publique 2013; 61:429-35. [PMID: 23993045 DOI: 10.1016/j.respe.2013.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 05/06/2013] [Accepted: 05/28/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In Morocco breastfeeding has become a declining practice. The objectives of this study were to estimate the prevalence of weaning before the age of 6 months and to identify associated factors. METHODS A cross-sectional survey was conducted among 400 mothers of infants aged 0 to 24 months. Participants were recruited from patients attending 40 randomly selected general practices in Marrakech. A trained interviewer administered a questionnaire to collect data on breastfeeding practice and factors associated with it. Early weaning was defined as a cessation of breastfeeding before the age of 6 months and was studied in mother-child couples whose infants were aged 6 months and older. Three binary logistic regression models were used to model the probability that an infant aged 6 months or more is weaned early. RESULTS Breastfeeding was initiated by the majority of respondents (97.5%). Early weaning was observed in 75 infants (28% of registered weaning). Factors associated with early weaning were: mother having an occupational activity (Odds Ratio [OR]=2.09; 95% confidence interval [CI]: [1.07-4.06]), caesarean delivery (OR=4.15; 95% CI: [1.74-9.88]) and the fact that the pregnancy was desired (OR=0.19; 95% CI: [0.05-0.68]). CONCLUSION Weaning before 6 months of age is a common practice in our context. Identifying factors associated with early weaning is critical to promote breastfeeding.
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Affiliation(s)
- L Adarmouch
- Service d'épidémiologie, laboratoire PCIM, faculté de médecine et de pharmacie, université Cadi Ayyad, CHU Mohammed VI, Marrakech, Maroc.
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