International Journal of Reproductive Medicine最新文献

Background: Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care.

Objective: To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019.

Methods: A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants' medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20.

Result: The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI = 11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR = 399; 95%CI = 1.65, 9.65), seven or more days of hospital stay (AOR = 5.43; 95%CI = 2.49, 11.83), vaginal bleeding (AOR = 2.75, 95%CI = 1.17, 6.47), and pregnancy-induced hypertension (AOR = 5.13; 95%CI = 2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.

This cross-sectional, observational, and descriptive study was conducted to evaluate the association between age at menarche in the adolescent population and the age at sexual initiation, age at first pregnancy, and experience of sexual violence in the adolescent population visiting a primary health unit in Brazil. We recruited 201 female adolescents who visited the gynecology outpatient clinic of a Basic Health Unit in the Federal District of Brazil. These adolescents answered a questionnaire with regard to sexual and reproductive health during doctor's appointments. To calculate the association, we recorded data for age at menarche, age at first sexual intercourse, age at first pregnancy, and experience of sexual violence. Pearson and Mann-Whitney correlation coefficient statistical tests were performed to evaluate the association between these variables. Mean age at menarche was lower among adolescents who became pregnant (p = 0.0004) and those who experienced sexual violence (p = 0.0008). Further, there was a strong association between age at menarche and age at first sexual intercourse (p < 0.0001). This study also demonstrated that the earlier the age at menarche, the earlier was the age at sexual initiation and age at first unintended pregnancy and the greater was the risk of experiencing sexual violence. Early menarche may be considered a vulnerability factor during adolescence.

Background: Violence against women perpetrated by an intimate partner is an important public health issue. In recent years, attention has focused also on intimate partner violence (IPV) during pregnancy due to its prevalence, adverse health consequences, and intervention potentials.

Aim: To determine the knowledge, experiences, and factors influencing IPV, including the controlling behaviors of male partners of pregnant women attending an antenatal clinic (ANC) of a tertiary health facility in Sokoto. Materials and method. A descriptive cross-sectional study was conducted among 260 pregnant women attending ANC in a tertiary health facility in the Sokoto metropolis. They were selected using a systematic sampling technique, and a set of pretested questionnaire items was used for data collection. Data were analysed using IBM SPSS version 20.

Results: The respondents' ages ranged from 19 to 40 years with a mean of 29.09 ± 4.99 years, and up to 83.5% of them were in a monogamous setting. Three-quarters of them were Muslims mostly from urban areas (72.1%), and 36.4% had a university or HND degree. Majority of them responded correctly to questions on IPV; overall, up to 99.2% of them had good knowledge of IPV. About 33% of the respondents have experienced IPV while pregnant and up to 61.7% of them said they did nothing because of fear. Some of the controlling behaviors of male partners included always asking for permission before seeing friends and family members and also controlling their finances. Factors associated with IPV include tribe, place of residence, and partner consuming alcohol.

Conclusion: Majority of the respondents had good knowledge of IPV with about one-third of them ever experiencing it. Respondent's partners were mostly jealous and exhibited some form of controlling behaviors. Physical violence was the most prevalent form, and most of the victims did nothing about it. Government and women's right groups should push for the implementation of tougher punitive measures against perpetrators of IPV.

Background: Long-acting contraceptive methods, subdermal implants, and intrauterine devices are reliable, safe, and cost-effective family planning methods. However, these methods are not widely used in Ethiopia despite government effort to increase access. The study is aimed at assessing the rate of utilization of long-acting contraceptive methods among married women and associated factors.

Method: We analyzed the 2016 Ethiopian Demographic and Health Survey dataset. A total of 2045 married women of reproductive age group, who were using any modern contraceptive method at the time of the survey, were included in the study. Descriptive statistics were computed to characterize the study participants. Bivariate and multivariable logistic regression analyses were performed to identify associated factors, reporting odds ratios (ORs) and 95% confidence intervals (95% CIs).

Result: The multivariable analyses showed that women educational status, parity, religion, previous history of abortion, desire for more child, and region where the respondents reside were significantly the factors that determine the utilization of long-acting contraceptive. There is a significant regional disparity in long-acting contraceptive utilization. Compared to women residing in Tigray region, those who live in other regions (Afar-Somali, Oromia, Amhara, Benishangul Gumz-Gambela, and Southern Nations Nationalities and People) have low likelihood of using long-acting contraceptive methods.

Conclusion: Utilization of long-acting family planning method is low in Ethiopia. There is a significant regional disparity in utilizing these methods. Policy makers should promote culture-sensitive and tailored interventions to improve the utilization of long-acting family planning methods.

Background: Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures.

Methods: A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2.

Results: Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR = 0.5, 95% CI: 0.22-0.69, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71, p = 0.038) and gestational age of 37 weeks or more (aOR = 0.3, 95% CI: 0.14-0.71.

Conclusions: Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.

Compared to other Mexican states, Chiapas possessed the lowest rate of contraception use among women 15-49 years old (44.6%) in 2018. This convergent mixed-methods study assessed family planning use, perceptions, and decision-making processes among women and men in rural communities where Compañeros En Salud (CES) works in Chiapas, Mexico. We conducted surveys of reproductive-aged women and semi-structured interviews with reproductive-aged women, men, and physicians completing their social-service year in CES communities from 2016 to 2017. Of the 625 survey respondents, 368 (58.9%) reported using contraception. The most common methods were female sterilization (27.7%), bimonthly injection (10.9%), and the implant (10.9%). Interviews were completed with 27 women, 24 men, and 5 physicians and analyzed through an inductive approach. Common reasons for contraception use were preventing pregnancy, lack of resources for additional children, and birth spacing. Adverse effects, influence of male partners, and perceived lack of need emerged as reasons for non-use. Male partners often made the final decision about contraceptive use, while women often chose what method. Physicians reported adverse effects, misconceptions about methods, and lack of women's autonomy as barriers to contraception use. Given misconceptions about contraception methods and the dominant role of men in contraception decision-making, our study illustrates the importance of effective counseling and equitable gender dynamics for family planning programming in rural Chiapas.

Background: Good quality family planning counseling particularly in the postpartum period is paramount to contraception adoption and continuation; it is also paramount in the reduction of maternal as well as infant morbidity and mortality.

Objective: Assess the level of family planning counseling provided for women in their immediate postpartum period in the labor ward at Saint Paul's Hospital in 2019.

Method: An institution-based cross-sectional study was conducted from February to March of 2019 among women in the labor ward. A face-to-face exit interview was conducted with 209 randomly selected women. A structured pretested questionnaire was used to assess the level of family planning counseling provided. Bivariate logistic regression was used to test for statistical association.

Results: Only 28.2% of the counseling sessions were adequate. Most (58.9%) of the counseling sessions did not maintain the privacy of the client. In 67.9% of the sessions, the counselor did not ask the concern of the client regarding the use of modern family planning methods and 74.2% of the clients were not told about the possible side effects of a method. Clients with no formal education (OR = 2.52, 95%CI = 1.1-3.3) and those with only primary level education (OR = 1.22, 95%CI = 1.04-3.02) were more likely to have had inadequate counseling.

Conclusion: The level of family planning counseling was inadequate. The study indicated the need to provide training for service providers on family planning counseling with the existing standard frameworks but also in consideration of the sociodemographic background of the client, particularly their educational status.

Objective: Hormones play a vital role in initiating and maintaining male reproductive function. The present study explores the influence and predictive ability of two reproductive hormones on semen quality among men who were partners in an infertile couple.

Design: During our cross sectional study, men were recruited from private and public hospital and laboratories for clinical evaluation of fertility status.

Methods: Fresh semen samples were assessed for quality (concentration, motility and morphology) according to the 2010 World Health Organization manual and the serum levels of hormones, including follicle-stimulating hormone (FSH), Inhibin B was measured (ELISA).

Results: We found a significant difference in the two groups regarding sperm concentration (p < 0.0001), total sperm count (p < 0.0001), total sperm count (p < 0.0001), total sperm count (p < 0.0001), total sperm count (p < 0.0001), total sperm count (.

Conclusion: Consistent with other studies, our results show strong association between semen quality and FSH and Inhibin B.

Introduction. Neonatal mortality contributes a higher percentage of infant mortality, especially in developing countries including Ethiopia where the rate of institutional delivery is low. In Ethiopia, scientific evidences on the level of community-based essential newborn care practice were scanty and inconclusive.

Objectives: The aim of the study was to assess community-based essential newborn care practices and associated factors among women who have infant < 12 months.

Methods: A community-based cross-sectional study was employed among 634 randomly selected women who have infant < 12 months from June 23, 2017, to August 29, 2017, at Enderta district. Data was collected by a face-to-face interview through structured questionnaires, and it was coded, entered, and cleaned using EpiData version 3.1. Then, the data was exported to SPSS version 21 for analysis. Odds ratios and p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at.

Result: The overall community-based essential newborn care practice was found 40.7%. Educational status (AOR = 6.6, 95% CI, 2.49-11.97), previous ANC follow-up (AOR = 1.7, 95% CI, 1.2-3.80), weight of the child during birth (AOR = 1.3, 95% CI, 1.12-2.98), and place of delivery (AOR = 2.1, 95% CI, 1.50-4.63) were found to be significantly associated with community-based essential newborn care. Even though overall newborn practice was found to be good, the cord care practices were found to be poor that indicated there is a need to rise community awareness.

Background: Postpartum contraceptive use is defined as the avoidance of short spaced pregnancies and unintended pregnancy through the first 12 months after delivery. In Ethiopia, different studies have been conducted to assess the prevalence of postpartum contraceptive use and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of postpartum contraceptive use and determinants in Ethiopia using the accessible studies.

Methods: The articles were identified through electronic search of reputable databases (MEDLINE through PubMed, EMBASE, HINARI, Science Direct, and Cochrane Library) and the hand search of reference listed in previous prevalence studies to retrieve more. 18 articles are included based on a comprehensive list of inclusion and exclusion criteria. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 14 statistical software was used to analyze the data. The Cochrane Q and I ² test were used to assess the heterogeneity between the studies. A random effects model was calculated to estimate the pooled prevalence of postpartum contraceptive use. Moreover, the determinants for family planning use were reviewed.

Results: The pooled prevalence of family planning use among mothers during the postpartum period in Ethiopia was 48.11% (95% CI: 36.96, 59.27). Besides, subgroup analysis revealed that the highest family planning use prevalence among postpartum mothers was observed in Addis Ababa, 65.41 (95% CI: 48.71, 82.11). Resumed sexual activity: 7.91 (95% CI: 4.62, 13.55), antenatal care: 4.98 (95% CI: 2.34, 10.21), secondary school and above level of maternal education: 3.53 (95% CI: 1.67, 7.45), postnatal care: 3.16 (95% CI: 1.7, 5.88), menses resumption: 3.12 (95% CI: 1.52, 6.39), and ≥6 months of postpartum period: 2.78 (95% CI: 1.97, 3.93) have shown a positive association with the use of family planning among mothers in the postpartum epoch.

Conclusions: In this study, family planning use among mothers of the postpartum period in Ethiopia was significantly low compared to the existing global commendation on postpartum contraceptive use. Resumed sexual activity, antenatal care, secondary and above level of maternal education, postnatal care, menses resumption, and postpartum period ≥ 6 months were found to be significantly associated with postpartum contraceptive use.