Obstetrics and Gynecology International最新文献

Coronavirus disease 2019 (COVID-19) has been increasing among pregnant women worldwide. Its impact on maternal, fetal, and neonatal health is still scarce in the published literature. As a routine COVID-19 prenatal screening has been established for all women requiring hospitalization, it is not clear whether symptomatic women carry worse pregnancy outcomes than those without symptoms. We aimed to analyze perinatal outcomes between symptomatic and asymptomatic women admitted to our center. Materials and Methods. A single-center retrospective cohort study was conducted for fourteen months. All pregnant women with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled, and their perinatal outcomes were analyzed in two groups based on whether they were symptomatic or not. The primary outcomes were composite adverse fetal, neonatal, and maternal outcomes and their comparison between study groups. Results. Out of 209 included COVID-19 positive pregnant women, 62 (30%) presented with one or more infection-related symptoms. Symptomatic women were older, multiparous, carried ≥1 comorbid condition, and attained infection at earlier gestational age (44% vs. 28%; 82% vs. 69%; 28% vs. 16%; and 34 vs. 36 weeks, respectively) (p < 0.05), when compared to asymptomatic women, respectively. Maternal composite adverse outcomes were higher in the symptomatic group and showed either one or more outcomes, positive chest radiological findings, requiring hospitalization with oxygen supplementation, or maternal death (8% vs. 0.7%) (p < 0.05). Composite fetal and neonatal adverse outcomes such as miscarriage, fetal or neonatal death, admission to neonatal intensive care unit, and neonatal COVID-19 infection were not statistically significant (p > 0.05) between symptomatic and asymptomatic women. Conclusion. COVID-19 infection among symptomatic pregnant women may carry a higher risk for adverse maternal outcomes. It may be associated with their advanced age and comorbid conditions. Maternal infection-associated symptoms per se likely do not pose an increased risk for adverse fetal or neonatal outcomes.

Background: One of the important goals of midwifery support and care is to control labor pain and increase the ability to cope with pain. The use of religious coping may be effective in counteracting the stressors of labor, especially labor pain, as well as increasing the self-efficacy of labor. This study was conducted to determine the relationship between religious coping, pain severity, and childbirth self-efficacy in Iranian primipara women.

Materials and methods: This cross-sectional study was performed on 200 Iranian primiparous women referred to eight health centers in the capital of Hormozgan Province who were intending to have a normal vaginal delivery (NVD) in the Persian Gulf and Sharifi Hospitals. The sampling was multistage. Data were collected by demographic and fertility questionnaires, the Iranian Religious Coping Scale, the Childbirth Self-Efficacy Inventory, and the Visual Analog Scale for pain measurement.

Results: Among the dimensions of religious coping, benevolent reappraisal had a significant direct relationship with pain severity, and negative religious coping had a significant inverse relationship with pain severity. In the case of childbirth self-efficacy subscales, the results showed dimensions of religious practices, benevolent reappraisal, and active religious coping had a significant direct relationship with outcome expectancy, and negative religious coping had a significant indirect relationship with outcome expectancy. Also, there was a significant direct relationship between religious practices and efficacy expectancy and a significant inverse relationship between negative and passive religious coping and efficacy expectancy.

Conclusion: With increasing some dimensions of positive religious coping, the severity of labor pain and childbirth self-efficacy increases, and with increasing dimensions of negative and passive religious coping, childbirth self-efficacy decreases. These correlations were weak in all the mentioned results.

Objective: To evaluate the maternal demographics, incidence, perinatal outcomes, and characteristics of babies born before arrival (BBAs) to hospitals.

Methods: A prospective, observational study was conducted at a large maternity unit in Durban, KwaZulu-Natal. A total of 200 mothers who attended the hospital within 24 hours of an out-of-hospital birth were recruited and interviewed, and 142 participants were eligible. A total of 128 mothers who delivered their babies in hospital (inborns) were used as the control group. Specific maternal and neonatal characteristics were analysed.

Results: The incidence of BBAs was 2.2%. The percentage of premature neonates in the BBA group was 54% vs 17.9% for inborns (p ≤ 0.001). A total of 33.8% of BBA mothers were unbooked vs 2.4% of inborns (p ≤ 0.001). The majority (59%) of inborns were primigravidas whereas the majority (73.9%) in the BBA group were multigravidas (p ≤ 0.001). Women in the BBA group were more prone to genital tears (p ≤ 0.001). There were no significant differences in respect of NICU admission and all-cause mortality; however, an increased risk for hypothermia and hypoglycaemia was found.

Conclusion: BBAs are at a significant risk of prematurity, low birth weight, hypothermia, and hypoglycaemia and are prone to longer hospital stays.

Background: Home delivery is childbirth in a nonclinical setting that takes place in a residence rather than in a health institution. Maternal morbidity and mortality are global health challenges, and developing countries contribute to most of the maternal deaths.

Objective: This study aimed to assess the extent and associated factors for home delivery in Serbo, Kersa Woreda, Jimma Zone, Southwest Ethiopia.

Method: A community-based cross-sectional study was employed among the 240 study participants. Data were collected by using systematic sampling technique from July 5 to 26, 2021, via a pretested semistructured questionnaire through face-to-face interview, and analyzed by a statistical package for the social sciences version 23.0. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with the extent of home delivery, and factors associated with the extent of home delivery were declared at a p value <0.05.

Result: In this study, the extent of home delivery was 28.7%. Identified factors statically associated with home delivery were low monthly income (AOR = 16.7, 95% CI: (2.028-13,83)), only the husband as the decision-maker (AOR = 5.0, 95% CI: (1.252-20.021)), never had a history of ANC follow-up (AOR = 5.7, 95% CI: (2.358-16.3)), poor knowledge toward delivery service (AOR = 3.0, 95% CI: (1.661-5.393)), negative attitude toward delivery service (AOR = 2.2, 95% CI: (1.054-4.409)), and large family size (AOR = 2.2, 95% CI: (1.187-4,119)).

Conclusion: When compared to the Ethiopian Demographic and Health Survey 2016, the prevalence of home delivery among women who gave birth in the last one year was low in this study. The study participants' identified factors that were significantly linked with home delivery were low monthly income, only husband as decision maker, no ANC follow-up, poor knowledge of delivery services, negative attitude toward delivery services, and large family size. Health professionals and health extension workers should raise awareness about institutional delivery and birth readiness so that women can give birth at a health facility even if labor begins unexpectedly.