International Journal of Reproductive Medicine最新文献

Background: Postpartum family planning is an effective strategy for reducing maternal and childhood morbidity and mortality by preventing unintended pregnancy and short interpregnancy intervals. Despite the paramount advantages of long-acting reversible contraceptives (LARC), their uptake remains low in Ethiopia. Therefore, the aim of this study was to assess the uptake of immediate postpartum LARC methods and its associated factors among women who gave birth in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Southern Ethiopia.

Methods: An institution-based cross-sectional study was conducted among 418 eligible mothers who were in the immediate postpartum period. Data were collected using a pretested structured questionnaire before their discharge from the hospital and analyzed by using SPSS version 20. The statistical significance was declared at P value less than 0.05.

Results: The uptake LARCs among immediate postpartum mothers was 25.4%. The most commonly reported reasons for not using LARC were preference to start contraception after six weeks of delivery (43.3%) and the need to use other methods of contraception (26%). Having unplanned birth (AOR: 1.97; 95% CI: 1.04-3.71) and receiving family planning counselling on LARCs during the postpartum period (AOR: 21.1; 95% CI: 6.49-68.66) were factors significantly associated with immediate postpartum LARC use.

Conclusion: Low utilization of immediate postpartum LARC uptake was found in the current study setting. There was increased utilization of immediate postpartum LARC among mothers who received family planning counselling during the postpartum period. Therefore, strengthening family planning counselling during the immediate postpartum period is crucial to enhance postpartum LARC use.

Background: Adolescence is a time of opportunity, vulnerability, and risk, particularly in relation to health, unsafe sexual activity, and reproductive health. Neglecting their reproductive health issues leads to a great risk of agonizing transition to parenthood, lifetime effects, and early pregnancy, which can compromise educational achievements and economic potentials. Meeting the reproductive health needs of adolescents mostly rests on the parents' shoulders. Thus, this study explored parental knowledge, willingness, and attitude towards contraceptive use among their unmarried adolescents.

Methods: This was an analytical cross-sectional study design. The multistage sampling technique was used to recruit 360 parents from Ekpoma community, Edo State, Nigeria. A structured questionnaire was used to generate data for this study. Data processing and analysis were done using SPSS version 24. In order to determine association with outcome variables, chi-square (χ ²) and Fisher's exact test statistics were used while statistical significance was set at p < 0.05.

Results: The proportion of parental knowledge on contraceptive methods was at 96.9%, parental willingness for their adolescents' contraceptive uptake at 31.7%, and positive attitude at 24.2%. Associated factors for parental knowledge of contraceptives include gender (χ ²⁼8.655, p = 0.003), age († = 13.377, p = 0.001), marital status († = 133.730, p < 0.001), educational level († = 103.689, p < 0.001), religion († = 164.592, p < 0.001), ethnicity († = 25.273, p < 0.001), and duration of marriage († = 11.365, p = 0.008). Factors such as educational level († = 21.220, p < 0.001), marital status († = 9.001, p = 0.022), and religion († = 6.058, p = 0.046) were associated with parental attitude towards contraceptives for their unmarried adolescents. Education level († = 19.905, p < 0.001) was associated with parental willingness for their unmarried adolescents' use of contraceptives.

Conclusion: Although parents have good knowledge of contraception, this knowledge has not been passed on to their adolescents. However, few parents would encourage their adolescents to use contraceptives and advise the use of condoms if they are sexually active. Parents should be advised about contraceptive matters further to influence their adolescents' attitudes towards its usage. Establishing youth-friendly health centers will also encourage health information use and exposure.

Background: Letrozole, an aromatase inhibitor, is suggested as a first-line drug for ovulation induction in women with polycystic ovary syndrome (PCOS) especially in obese women. Letrozole has also been used in women with unexplained infertility with similar rates of success to clomiphene. However, literature on letrozole and gonadotropins in obese and nonobese women is sparse. Hence, this study was done to assess the success of ovulation induction (OI) with letrozole plus follicle stimulating hormone (FSH) in obese (BMI ≥ 30 kg/m²) and nonobese women (BMI < 30 kg/m²).

Methods: A retrospective descriptive cohort study was conducted involving 135 women who underwent OI with letrozole plus follicle stimulating hormone therapy and either timed intercourse or intrauterine insemination. The data was collected from the hospital information system, including the age, body mass index, the type of infertility, number of induction cycles with letrozole, number of gonadotropin injections, and the pregnancy occurrence following treatment. SPSS was used to analyze the data.

Results: There were 135 women who used FSH injections along with letrozole. Of this, 28.5% obese women got pregnant compared to 29.2% nonobese women, but this did not attain statistical significance (P = 0.75). About 70% of obese women and 57% on nonobese women had polycystic ovarian syndrome. The median number of FSH injections was six, and the interquartile range was 3 to 11.

Conclusion: Of the 135 women undergoing letrozole and FSH, there was almost an equal probability of pregnancy in the obese group (BMI ≥ 30 kg/m²) and nonobese women.

Background: The World Health Organization Report noted that unintended pregnancy is the most common cause of maternal mortality in developing countries. Most unintended pregnancies occur where access to maternal care is limited, and because of this, many mothers lose their life. Therefore, this study was an attempt to assess the proportion of unintended pregnancy and associated factors among women who live in Ilu Gelan District, Western Ethiopia, 2021.

Method: A community-based cross-sectional study was conducted in the rural and urban kebeles of Ilu Gelan Woreda West Shoa Zone, Ethiopia, from March 1 to 30, 2021. The study population consists of 540 pregnant women who were living in Ilu Gelan Woreda for at least the last six months during the data collection period. Simple random sampling by lottery method was used to recruit the study subject. Data were checked, coded, entered to EpiData version 3, and then exported to SPSS version 25 for analysis. Both descriptive and analytical statistical procedures were utilized. Both bivariable and multivariable logistic regressions was implemented.

Result: In this study, the proportion of unintended pregnancy was found to be 55%, at 95% CI: 50.7-59.3. Multivariable logistic regression results showed that married women (AOR = 0.117, CI: 0.04-0.38), monthly income less than 1000 Ethiopian Birr (AOR = 4.93, CI: 1.72-14.09), gravidity greater than or equal to five (AOR = 6.07, CI: 2.4-15.28), birth interval less than 2 years (AOR = 3.35 (1.44-7.8)), lack of awareness about contraceptive (AOR = 2.06 (1.03-4.15)), and husband decision-making on health care (AOR = 11.1 (2.07-59.51)) were significantly associated with unintended pregnancy. Conclusion and Recommendation. This study indicated that more than half of pregnant women reported that their current pregnancy was found to be unintended pregnancy. Married women, family monthly income less than 1000 Ethiopian Birr, gravidity greater than or equal to five, birth space less than two years, lack of contraceptive awareness, and health care decisions by husband only showed a significant association with unintended pregnancy. To decrease the current level of unintended pregnancy, all concerned stakeholders should emphatically consider those identified factors for intervention; specifically, Ilu Gelan District Health Bureau and health providers should empower women with health education about family planning and decision-making related to their health issues in the study area.

Background: The World Health Organization recommends the use of effective contraception for the prevention of unintended pregnancy and unsafe abortion. The main aim of postabortion contraceptive services is to prevent recurrent pregnancy and ultimately mitigate the associated maternal mortality.

Objective: To assess postabortion contraceptive utilization (PACU) and postabortion contraceptive preferences (PACP) and the associated factors among women receiving abortion care services in Ambo town, Oromia Region, Western Ethiopia.

Methods: A cross-sectional study was conducted at the health facilities in Ambo town from 22 July to 24 September 2021. The data was collected using a structured questionnaire. Bivariate and multivariable logistic regression was done to determine the factors associated with postabortion contraceptive utilization and preferences.

Results: Out of 388 participants who were included in the final analysis, 262 (67.5%) had utilized postabortion contraceptives of which 173 (66%) received contraceptive methods of their primary preference. The multivariate logistic regression showed that cohabiting couples showed lower utilization (AOR = 0.15; 95% CI: 0.06-0.21; p value = 0.004) than married ones and planning to have an additional child within 1-3 years (AOR = 7.41; 95% CI: 2.18-11.41; p value = 0.005) or after 3-5 years (AOR = 6.67: 95% CI: 5.12-10.18; p value = 0.033) was identified to be significantly associated with postabortion contraceptive utilization. Having a secondary education level (AOR = 3.06; 95% CI: 1.54-6.07; p value = 0.001) and having experience of domestic violence (AOR = 2.19; 95% CI: 1.27-3.81; p value = 0.005) were significantly associated with unsatisfied postabortion contraceptive preference. Conclusions and Recommendations. About two-thirds of the women who were given abortion services received postabortion contraceptives whereas almost two-thirds of them received a contraceptive method of their primary preference. Marital status, duration before additional child planned, and being counseled on contraceptive determined postabortion contraceptive utilization. Having a secondary education level and having experienced domestic violence were significantly associated with unsatisfied PACP.

Background: Sexual violence is a serious public health problem affecting millions of young girls and women across the world. Recently, the issue of sexual violence against schoolgirls has garnered global and national attention with implications for health and education outcomes. Sexual violence is driven by a multitude of risk factors that occur at different levels. Understanding the magnitude, risk factors, and conceptuality of sexual violence is crucial for setting priorities and elimination efforts at different levels. Therefore, the objective of this study was to determine the lifetime prevalence of sexual violence and associated factors among high school female students in Jarso district, Oromia region, eastern Ethiopia.

Methods: A school-based cross-sectional study was conducted in public high schools of Jarso district, eastern Ethiopia, from 1^st March to 5^th April 2019. A multistage sampling technique was used to select 559 eligible study participants. Data were collected by a structured self-administered questionnaire. The outcome measure of interest was lifetime sexual violence. Bivariate and multivariable logistic regression analyses were done. Statistically significant association of variables had been declared based on the adjusted odds ratio (AOR) with its 95% CI and p value < 0.05.

Results: The overall magnitude of sexual violence among female students was 28.6% (95% CI: 25%-32.2%) in the study area. Forty (7.2%) participants have experienced coercive sex against their consent. Participant's level of education ((AOR = 1.5, 95% CI (1.03-2.30)), being unmarried ((AOR = 2.80, 95% CI (1.40-5.81)), consumption of alcohol ((AOR = 3.41, 95% CI (1.11-10.40)), using substances (hashish and/or shisha) ((AOR = 2.6, 95% CI (1.02-6.50)), and ever initiated sexual intercourse ((AOR = 5.9, 95% CI (3.3-10.7)) were positively and statistically associated with sexual violence at p value < 0.05.

Conclusion: The overall magnitude of sexual violence was relatively high (28.6%). Thus, any intervention aimed to address sexual violence should consider the identified associated risk factors in the study area.

Background: Viral hepatitis is an emerging global health problem. A pregnant mother infected with the hepatitis B virus has a high rate of vertical transmission, causing adverse fetal and neonatal outcomes. Understanding the magnitude of the problem and associated factors has paramount importance to avert such adverse fetal and neonatal outcomes. Therefore, the main aim of this study was to assess the seroprevalence of hepatitis B virus and associated factors among pregnant women attending antenatal care clinics at public health facilities in Nekemte town.

Methods: An institutional-based cross-sectional study was conducted among 277 pregnant women attending antenatal care at public health facilities in Nekemte town from June 1 to July 30, 2020. All public health institutions in Nekemte town (two hospitals and one health center) were recruited, and study participants were selected by using a systematic sampling method. The data were collected using pretested and structured questionnaires using a face-to-face interview, and a blood sample was collected to test for hepatitis B surface antigen. Logistic regression analysis was employed to identify factors significantly associated with hepatitis B virus infection. Variables with a p value < 0.05 were considered statistically significant predictors of the outcome variable.

Result: The overall seroprevalence of hepatitis B virus infection was 16 (5.8%) [95% CI: 3.2-8.7], which indicates intermediate endemicity. History of abortion (AOR =6.155; 95% CI: 1.780, 21.291), history of contact with hepatitis patient (AOR =7.178; 95% CI: 1.702, 30.279), and having multiple sexual partners (AOR =6.788; 95% CI: 1.701, 27.086) had a statistically significant association with hepatitis B surface antigen seropositivity.

Conclusion: Hepatitis B virus seroprevalence among pregnant women in this study shows intermediate endemicity. Therefore, health professionals should provide health information on the risk of having multiple sexual partners, risk factors of unprotected contact with hepatitis patients, and abortion for pregnant women during their antenatal care visits.