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Factors Associated with the Unplanned Pregnancy at Suhul General Hospital, Northern Ethiopia, 2018. 2018年,埃塞俄比亚北部苏胡尔综合医院意外怀孕相关因素。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-06-27 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2926097
Yohannes Moges, Solomon Adanew Worku, Abrhaley Niguse, Bayew Kelkay

Background: Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing.

Objective: This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia.

Methods: A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable.

Result: The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. Conclusion and Recommendation. The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.

背景:意外怀孕是一个基本概念,用于认识人口生育和未满足的避孕和计划生育需求。意外妊娠的发生主要是由于未采取避孕措施或不一致或不正确使用有效方法所致。减少计划外怀孕的次数主要是通过减少妇女面临怀孕和生育风险的次数来促进生殖健康。目的:本研究旨在评估在埃塞俄比亚北部Suhul总医院接受产前护理的孕妇中计划外妊娠的程度及其相关因素。方法:对2018年2月至4月在苏胡尔综合医院、Shire和埃塞俄比亚北部进行产前保健随访的孕妇进行了基于设施的横断面研究设计。本研究采用系统抽样法选取研究对象,通过面对面访谈的方式,采用预测的结构化问卷收集数据。进行了双变量和多变量逻辑回归分析,以确定每个自变量与因变量的关联。结果:379例孕妇意外妊娠发生率为20.6%。未婚妇女[AOR: 4.73, 95% CI:(1.56, 14.33)],年龄在40岁以上[AOR: 4.17, 95% CI:(1.18, 14.6)],无计划外妊娠史[AOR: 3.26, 95% CI:(1.65, 6.44)],无业[AOR: 6.79;95% CI:(2.05, 22.46)]是与意外妊娠程度显著相关的变量。结论和建议。本研究结果表明,意外妊娠的发生率较高,年龄、婚姻状况、职业、意外妊娠史与意外妊娠有统计学关系。似乎有必要规划夫妻或个人之间关于生殖特别是生育力的交流战略,并促进计划生育方法。
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引用次数: 15
The Effect of Pregnancy in the Hemoglobin Concentration of Pregnant Women: A Longitudinal Study. 妊娠对孕妇血红蛋白浓度的影响:一项纵向研究。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-06-03 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2789536
Berhanu Elfu Feleke, Teferi Elfu Feleke

Background: The objective of this study was to estimate and identify the determinants of hemoglobin concentration before pregnancy, during pregnancy, and after labor and delivery.

Methods: A prospective cohort study design was implemented. Data were collected from May 2015 to September 2018. A simple random sampling technique was used to select the participants. An interview technique was used to collect the data. Blood samples were collected before pregnancy, during each trimester, during labor and delivery, after third stage of labor, and at the 6-week postpartum period. Descriptive statistics were used to describe the profile of study participants. Generalized estimating equations were used to identify the determinants of hemoglobin concentration during each phase of pregnancy.

Results: The mean hemoglobin concentrations of primigravida and multigravida before pregnancy were 12.41 g/dl and 10.78 g/dl, respectively. The hemoglobin concentration decreases with consecutive trimester reaching the lowest level at 42 days after delivery. The hemoglobin concentrations of pregnant women were decreased by hookworm 0.24 g/dl [95% CI:0.18-0.29], multiple pregnancy 0.16 g/dl [95% CI: 0.07-0.24], episiotomy 0.05 g/dl [95% CI: 0.01-0.09], gravidity 0.15 g/dl [95% CI: 0.09-0.21], age 0.03 g/dl [95% CI: 0.03-0.04], and gestational age 0.1 g/dl [95% CI: 0.09-0.11]. The hemoglobin concentration increased by iron supplementation 1.02 g/dl [95% CI: 0.97-1.07] and birth weight 0.14 g/dl [95% CI: 0.02-0.11].

Conclusion: Pregnancy significantly decreases the hemoglobin concentration of pregnant women reaching the lowest point during labor and delivery. Recommendation. Regular anemia screening intervention should be implemented after delivery.

背景:本研究的目的是评估和确定怀孕前、怀孕期间、分娩后血红蛋白浓度的决定因素。方法:采用前瞻性队列研究设计。数据收集时间为2015年5月至2018年9月。采用简单的随机抽样技术来选择参与者。采用访谈法收集数据。在怀孕前、每个孕期、分娩和分娩期间、分娩第三期后和产后6周采集血样。描述性统计用于描述研究参与者的概况。使用广义估计方程来确定妊娠各阶段血红蛋白浓度的决定因素。结果:初产妇和多胎产妇孕前平均血红蛋白浓度分别为12.41 g/dl和10.78 g/dl。血红蛋白浓度随妊娠期的延长而降低,在分娩后42天达到最低水平。钩虫使孕妇血红蛋白浓度降低0.24 g/dl [95% CI:0.18-0.29],多胎妊娠0.16 g/dl [95% CI: 0.07-0.24],会阴切开术0.05 g/dl [95% CI: 0.01-0.09],妊娠0.15 g/dl [95% CI: 0.09-0.21],年龄0.03 g/dl [95% CI: 0.03-0.04],胎龄0.1 g/dl [95% CI: 0.09-0.11]。血红蛋白浓度增加1.02 g/dl [95% CI: 0.97-1.07],出生体重增加0.14 g/dl [95% CI: 0.02-0.11]。结论:妊娠可显著降低孕妇血红蛋白浓度,在产程及分娩时达到最低点。建议。产后应定期进行贫血筛查干预。
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引用次数: 8
Women's Choice to Deliver at Home: Understanding the Psychosocial and Cultural Factors Influencing Birthing Choices for Unskilled Home Delivery among Women in Southwestern Uganda. 妇女选择在家分娩:了解影响乌干达西南部妇女不熟练在家分娩选择的社会心理和文化因素。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-06-03 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6596394
Esther C Atukunda, Godfrey R Mugyenyi, Celestino Obua, Angella Musiimenta, Edgar Agaba, Josephine N Najjuma, Norma C Ware, Lynn T Matthews

Background: Utilization of perinatal services in Uganda remains low, with correspondingly high rates of unskilled home deliveries, which can be life-threatening. We explored psychosocial and cultural factors influencing birthing choices for unskilled home delivery among postpartum women in rural southwestern Uganda.

Methods: We conducted in-depth qualitative face-to-face interviews with 30 purposively selected women between December 2018 and March 2019 to include adult women who delivered from their homes and health facility within the past three months. Women were recruited from 10 villages within 20 km from a referral hospital. Using the constructs of the Health Utilization Model (HUM), interview topics were developed. Interviews were conducted and digitally recorded in a private setting by a native speaker to elicit choices and experiences during pregnancy and childbirth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive categories using inductive content analytic approach.

Results: Eighteen women (60%) preferred to deliver from home. Women's referent birth location was largely intentional. Overall, the data suggest women choose home delivery (1) because of their financial dependency and expectation for a "natural" and normal childbirth, affecting their ability and need to seek skilled facility delivery; (2) as a means of controlling their own birth processes; (3) out of dissatisfaction with facility-based care; (4) out of strong belief in fate regarding birth outcomes; (5) because they have access to alternative sources of birthing help within their communities, perceived as "affordable," "supportive," and "convenient"; and (6) as a result of existing gender and traditional norms that limit their ability and freedom to make family or health decisions as women.

Conclusion: Women's psychosocial and cultural understandings of pregnancy and child birth, their established traditions, birth expectations, and perceptions of control, need, and quality of maternity care at a particular birthing location influenced their past and future decisions to pursue home delivery. Interventions to address barriers to healthcare utilization through a multipronged approach could help to debunk misconceptions, increase perceived need, and motivate women to seek facility delivery.

背景:乌干达围产期服务的利用率仍然很低,相应地,不熟练的家庭分娩率很高,这可能危及生命。我们探讨了影响乌干达西南部农村不熟练的产后妇女在家分娩选择的社会心理和文化因素。方法:我们在2018年12月至2019年3月期间对30名有意选择的妇女进行了深入的定性面对面访谈,其中包括过去三个月内从家中和医疗机构分娩的成年妇女。妇女是从距离转诊医院20公里以内的10个村庄招募的。采用健康利用模型(HUM)构建访谈主题。访谈由一名以英语为母语的人进行,并在私人环境中进行数字记录,以引出怀孕和分娩期间的选择和经历。翻译的文本被生成并编码。使用归纳内容分析方法对编码数据进行迭代审查和排序,以派生类别。结果:18名妇女(60%)倾向于在家分娩。女性所指的出生地点在很大程度上是有意为之。总体而言,数据表明妇女选择在家分娩(1)是因为她们的经济依赖和对“自然”和正常分娩的期望,影响了她们寻求熟练设施分娩的能力和需求;(二)作为控制自身生育过程的手段;(3)出于对设施型护理的不满;(4)对生育结果有强烈的命运信念;(5)因为她们可以在社区内获得被认为是“负担得起的”、“支持的”和“方便的”其他生育帮助来源;(6)由于现有的性别和传统规范限制了她们作为妇女作出家庭或健康决定的能力和自由。结论:妇女对怀孕和分娩的社会心理和文化理解、她们的既定传统、分娩期望以及对特定分娩地点的控制、需求和产科护理质量的看法影响了她们过去和将来选择在家分娩的决定。通过多管齐下的方法解决医疗保健利用障碍的干预措施有助于消除误解,增加感知到的需求,并激励妇女寻求机构分娩。
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引用次数: 11
Optimal Profile Limits for Maternal Mortality Rates (MMR) Influenced by Haemorrhage and Unsafe Abortion in South Sudan. 南苏丹受出血和不安全堕胎影响的产妇死亡率(MMR)的最佳剖面限制
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2793960
Gabriel Makuei, Mali Abdollahian, Kaye Marion

Maternal mortality rate (MMR) is one of the main worldwide public health challenges. Presently, the high levels of MMR are a common problem in the world public health and especially, in developing countries. Half of these maternal deaths occur in Sub-Saharan Africa where little or nothing progress has been made. South Sudan is one of the developing countries which has the highest MMR. Thus, this paper deploys statistical analysis to identify the significant physiological causes of MMR in South Sudan. Prediction models based on Poisson Regression are then developed to predict MMR in terms of the significant physiological causes. Coefficients of determination and variance inflation factor are deployed to assess the influence of the individual causes on MMR. Efficacy of the models is assessed by analyzing their prediction errors. The paper for the first time has used optimization procedures to develop yearly lower and upper profile limits for MMR. Hemorrhaging and unsafe abortion are used to achieve UN 2030 lower and upper MMR targets. The statistical analysis indicates that reducing haemorrhaging by 1.91% per year would reduce MMR by 1.91% (95% CI (42.85-52.53)), reducing unsafe abortion by 0.49% per year would reduce MMR by 0.49% (95% CI (11.06-13.56)). The results indicate that the most influential predictors of MMR are; hemorrhaging (38%), sepsis (11.5%), obstructed labour (11.5%), unsafe abortion (10%), and indirect causes such as anaemia, malaria, and HIV/AIDs virus (29%). The results also show that to obtain the UN recommended MMR levels of minimum 21 and maximum 42 by 2030, the Government and other stakeholders should simultaneously, reduce haemorrhaging from the current value of 62 to 33.38 and 16.69, reduce unsafe abortion from the current value of 16 to 8.62 and 4.31. Thirty years of data is used to develop the optimal reduced Poisson Model based on hemorrhaging and unsafe abortion. The model with R 2 of 92.68% can predict MMR with mean error of -0.42329 and SE-mean of 0.02268. The yearly optimal level of hemorrhage, unsafe abortion, and MMR can aid the government and other stakeholders on resources allocation to reduce the risk of maternal death.

产妇死亡率(MMR)是世界范围内主要的公共卫生挑战之一。目前,高水平的MMR是世界公共卫生的一个共同问题,特别是在发展中国家。这些产妇死亡中有一半发生在撒哈拉以南非洲,那里几乎没有取得任何进展。南苏丹是孕产妇死亡率最高的发展中国家之一。因此,本文采用统计分析来确定南苏丹MMR的重要生理原因。然后,基于泊松回归的预测模型被开发用于根据显著生理原因预测MMR。采用决定系数和方差膨胀系数来评估个体原因对MMR的影响。通过分析模型的预测误差来评价模型的有效性。本文首次采用优化程序制定了MMR的年上剖面下限。出血流产和不安全流产用于实现联合国2030年孕产妇死亡率低和高目标。统计分析表明,每年减少出血1.91%可使产妇死亡率降低1.91% (95% CI(42.85 ~ 52.53)),每年减少不安全流产0.49%可使产妇死亡率降低0.49% (95% CI(11.06 ~ 13.56))。结果表明,对MMR影响最大的预测因子有;出血(38%)、败血症(11.5%)、难产(11.5%)、不安全流产(10%)以及间接原因,如贫血、疟疾和艾滋病毒/艾滋病(29%)。结果还表明,为了到2030年达到联合国建议的最低21和最高42的产妇死亡率水平,政府和其他利益攸关方应同时将大出血从目前的62减少到33.38和16.69,将不安全堕胎从目前的16减少到8.62和4.31。利用30年的数据,建立了基于出血和不安全流产的最优简化泊松模型。r2为92.68%的模型预测MMR的平均误差为-0.42329,SE-mean为0.02268。每年出血、不安全堕胎和产妇死亡率的最佳水平可以帮助政府和其他利益攸关方分配资源,以降低孕产妇死亡风险。
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引用次数: 7
Striae Gravidarum, Acne, Facial Spots, and Hair Disorders: Risk Factors in a Study with 1284 Puerperal Patients. 妊娠纹、痤疮、面部斑点和毛发疾病:1284例产褥期患者的危险因素研究
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8036109
Isadora da Rosa Hoefel, Magda Blessmann Weber, Ana Paula Dornelles Manzoni, Bárbara Hartung Lovato, Renan Rangel Bonamigo

Objective: To determine the prevalence of skin changes during pregnancy and to relate their occurrence to specific factors in a population of south Brazil.

Methods: A cross-sectional analytical study was carried out with 1284 puerperal patients. A questionnaire about skin changes during pregnancy was developed and applied by the authors to all puerperal women admitted in a tertiary hospital in south Brazil.

Results: The appearance of striae during pregnancy was reported by 633 women (49.5%) and had a statistically significant association with primiparity, presence of stretch marks before pregnancy, and gestational weight gain above 21 kg. Facial blemishes were reported by 33.9% (n = 434) and were associated with a positive family history, multiparity, and the use of facial sunscreen (p < 0.0001). The onset or worsening of acne was identified in 35.7% (n = 456) and was statistically associated with primiparity and Fitzpatrick phototypes IV and V. Hair alterations were reported by 44.5% (n = 569) and were associated with primiparity (p = 0.029).

Conclusion: Although most of the skin changes during pregnancy are considered "physiologic," they can cause significant discomfort. Thus, it is important to know them and to understand which risk factors may be associated with such changes.

目的:确定怀孕期间皮肤变化的患病率,并将其发生与巴西南部人群中的特定因素联系起来。方法:对1284例产褥期患者进行横断面分析研究。作者编制了一份关于怀孕期间皮肤变化的问卷,并将其应用于巴西南部一家三级医院收治的所有产褥期妇女。结果:633名妇女(49.5%)报告了妊娠期间出现条纹,与初产、孕前妊娠纹的存在和妊娠体重增加超过21 kg有统计学意义。33.9% (n = 434)的患者报告有面部瑕疵,并与阳性家族史、多胎和使用面部防晒霜有关(p < 0.0001)。35.7% (n = 456)的患者有痤疮的发生或恶化,与初产和Fitzpatrick IV型和v型有统计学关联。头发改变的患者有44.5% (n = 569),与初产有关(p = 0.029)。结论:虽然大多数怀孕期间的皮肤变化被认为是“生理性的”,但它们会引起明显的不适。因此,了解它们并了解哪些风险因素可能与这些变化有关是很重要的。
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引用次数: 1
The Influence of Antenatal Oral Iron and Folic Acid Side Effects on Supplementation Duration in Low-Resource Rural Kenya: A Cross-Sectional Study. 在资源匮乏的肯尼亚农村,产前口服铁和叶酸副作用对补充时间的影响:一项横断面研究。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-11 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9621831
Shadrack Oiye, Margaret Juma, Silvenus Konyole, Fatuma Adan
Background Undesirable effects of a daily regimen of iron and folic acid ingested jointly (iron-folate) are potential disincentives to optimal antenatal supplementation. We intended to profile antenatal iron-folate side effects and elucidate their influence on supplementation duration in low-resource rural Kenya. Methods This was a cross-sectional descriptive study of randomly selected postnatal mothers of under-five-year-old children. Using a modified WHO Safe Motherhood Assessment standard questionnaire, they recalled the total number of days of antenatal iron-folate intake and the attendant supplement-attributed undesirable experiences. The analyses considered only participants who ingested the supplements in their immediate last pregnancies (n = 277). Results About half of the study participants reported at least a side effect and a mean of 2.4 (SD 1.5) effects per person in the entire pregnancy period. Most common reported effects were chest pains (31.8%), constipation (28.5%), severe stomach pains (11.6%), and diarrhoea (11.6%). Mothers who reported at least a side effect ingested the supplements for ten days less compared to those who did not experience any effect (p = 0.03); and a greater proportion of the former were primigravida (p = 0.02) and used combined form of iron and folic acid (p = 0.003). In a multivariate analysis, significant correlations with supplementation compliance (ingestion for 90+ days) were found only for nausea and severe stomach pain experiences (r = −0.1, p = 0.04; r = 0.2, p = 0.01, resp.). Conclusions The commonness of undesirable experiences attributed to daily ingestion of 60 mg iron and 0.4 mg folic acid and their deterrence to longer supplementation durations suggest the need for considering a weekly intermittent regimen for some antenatal women in such set-ups. Our study demonstrated that potentially, more counselling on nausea as a side effect might be critical in advancing iron-folate supplementation compliance.
背景:铁和叶酸联合摄入(叶酸铁)的每日方案的不良影响是潜在的抑制最佳产前补充。我们打算分析产前叶酸铁的副作用,并阐明其对资源匮乏的肯尼亚农村补充时间的影响。方法:这是一项横断面描述性研究,随机选择五岁以下儿童的产后母亲。他们使用经修改的世卫组织安全孕产评估标准问卷,回顾了产前叶酸铁摄入量的总天数以及随之而来的因补充而导致的不良经历。分析只考虑了在最近一次怀孕时服用补充剂的参与者(n = 277)。结果:大约一半的研究参与者报告至少有一个副作用,平均每人在整个怀孕期间有2.4 (SD 1.5)个副作用。最常见的不良反应是胸痛(31.8%)、便秘(28.5%)、严重胃痛(11.6%)和腹泻(11.6%)。报告至少有副作用的母亲服用补充剂的时间比没有任何副作用的母亲少十天(p = 0.03);前者的比例较大(p = 0.02),使用铁和叶酸的组合形式(p = 0.003)。在多变量分析中,仅在恶心和严重胃痛经历中发现了与补充依从性(摄入90天以上)的显著相关性(r = -0.1, p = 0.04;R = 0.2, p = 0.01)。结论:每日摄入60毫克铁和0.4毫克叶酸所导致的不良经历的普遍性及其对较长补充时间的威慑表明,有必要考虑对一些产前妇女在这种情况下每周间歇性治疗。我们的研究表明,潜在地,更多关于恶心作为副作用的咨询可能对提高叶酸铁补充剂的依从性至关重要。
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引用次数: 2
Risk of Severe Adverse Maternal and Neonatal Outcomes in Deliveries with Repeated and Primary Cesarean Deliveries versus Vaginal Deliveries: A Cross-Sectional Study. 重复和初次剖宫产分娩与阴道分娩的严重不良孕产妇和新生儿结局风险:一项横断面研究
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-04 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9207431
Kiattisak Kongwattanakul, Rungroj Thamprayoch, Chumnan Kietpeerakool, Pisake Lumbiganon

Objective: To determine risks of severe adverse maternal and neonatal outcomes in women with repeated cesarean delivery (CD) and primary CD compared with those with vaginal delivery (VD).

Methods: Data of this cross-sectional study were extracted from 2,262 pregnant women who gave birth between August 2014 and December 2016, at Srinagarind Hospital, Khon Kaen University. Severe maternal outcomes were categorized based on the World Health Organization criteria. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated to indicate the risk of severe adverse maternal and neonatal outcomes among women underwent CD compared with those who underwent VD.

Results: There were no cases of maternal death in this study. CD significantly increased risk of severe adverse maternal outcomes (SMO) (aOR 10.59; 95% CI, 1.19-94.54 for primary CD and aOR 17.21; 95% CI, 1.97-150.51 for repeated CD) compared with women who delivered vaginally. When compared with vaginal delivery, the risks of neonatal near miss (NNM) and severe adverse neonatal outcomes (SNO) were significantly higher in primary CD group (aOR 1.71; 95% CI 1.17-2.51 and aOR 1.66; 95% CI 1.14-2.43), respectively. For repeated CD, the risks were borderline significant (aOR, 1.58; 95% CI, 0.98-2.56 for NNM and aOR, 1.61; 95% CI, 0.99-2.60 for SNO).

Conclusion: Primary and repeated CD significantly increased the risk of SMO compared with VD. Risks of NNM and SNO were also significantly increased in women with primary CD. The risks of NNM and SNO for repeated CD trended toward a significant increase.

目的:确定反复剖宫产(CD)和原发性CD妇女与阴道分娩(VD)妇女发生严重不良孕产妇和新生儿结局的风险。方法:本横断面研究的数据提取自2014年8月至2016年12月在孔庆大学斯利那加林德医院分娩的2262名孕妇。根据世界卫生组织的标准对严重产妇结局进行分类。计算校正优势比(aOR)和95%置信区间(CI),以表明接受CD的妇女与接受VD的妇女相比发生严重不良孕产妇和新生儿结局的风险。结果:本研究无产妇死亡病例。乳糜泄显著增加严重不良产妇结局(SMO)的风险(aOR 10.59;原发性CD的95% CI为1.19-94.54,aOR为17.21;95% CI, 1.97-150.51(重复CD)与阴道分娩的妇女相比。与阴道分娩相比,原发性CD组新生儿近流产(NNM)和新生儿严重不良结局(SNO)的风险显著高于阴道分娩组(aOR 1.71;95% CI 1.17-2.51, aOR 1.66;95% CI分别为1.14-2.43)。对于重复CD,风险具有临界显著性(aOR, 1.58;NNM的95% CI为0.98-2.56,aOR为1.61;SNO的95% CI为0.99-2.60)。结论:与VD相比,原发性和重复性CD显著增加SMO的风险。原发性CD患者NNM和SNO的风险也显著增加。重复CD患者NNM和SNO的风险有显著增加的趋势。
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引用次数: 7
Maternal Serum Concentrations of Selenium, Copper, and Zinc during Pregnancy Are Associated with Risk of Spontaneous Preterm Birth: A Case-Control Study from Malawi. 孕妇血清硒、铜和锌浓度与自发性早产风险相关:马拉维的一项病例对照研究
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-30 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9435972
Grace Chiudzu, Augustine T Choko, Alfred Maluwa, Sandra Huber, Jon Odland

Preterm birth is delivery before 37 completed weeks. A study was conducted to evaluate the association of maternal serum concentrations of selenium, copper, and zinc and preterm birth. There were 181 women in this nested case-control study, 90/181 (49.7%) term and 91/181 (50.3%) preterm pregnant women. The overall mean serum concentration of selenium was 77.0, SD 19.4 μg/L; of copper was 2.50, SD 0.52 mg/L; and of zinc was 0.77, SD 0.20 mg/L with reference values of 47-142 μg/L, 0.76-1.59 mg/L, and 0.59-1.11 mg/L, respectively. For preterm birth, mean serum concentration for selenium was 79.7, SD 21.6 μg/L; for copper was 2.61, SD 0.57 mg/L; and for zinc was 0.81, SD 0.20 mg/L compared to that for term births: selenium (74.2; SD 16.5 μg/L; p = 0.058), copper (2.39; SD 0.43 mg/L; p = 0.004), and zinc (0.73; SD 0.19 mg/L; p = 0.006), respectively. In an adjusted analysis, every unit increase in maternal selenium concentrations gave increased odds of being a case OR 1.01 (95% CI: 0.99; 1.03), p = 0.234; copper OR 1.62 (95% CI: 0.80; 3.32), p = 0.184; zinc OR 6.88 (95% CI: 1.25; 43.67), p = 0.032. Results show that there was no deficiency of selenium and zinc and there were high serum concentrations of copper in pregnancy. Preterm birth was associated with higher maternal serum concentrations of copper and zinc.

早产是指在37周之前分娩。一项研究是为了评估母亲血清中硒、铜和锌的浓度与早产的关系。本研究共纳入181例孕妇,足月孕妇占90/181(49.7%),早产儿占91/181(50.3%)。血清中硒的总体平均浓度为77.0,SD为19.4 μg/L;铜为2.50,SD为0.52 mg/L;锌、SD含量分别为0.77、0.20 mg/L,参考值分别为47 ~ 142、0.76 ~ 1.59、0.59 ~ 1.11 mg/L。早产儿血清硒平均浓度为79.7,SD为21.6 μg/L;铜为2.61,SD为0.57 mg/L;锌为0.81,SD为0.20 mg/L与足月分娩相比:硒(74.2;SD 16.5 μg/L;P = 0.058),铜(2.39;SD 0.43 mg/L;P = 0.004),锌(0.73;SD 0.19 mg/L;P = 0.006)。在一项校正分析中,母亲硒浓度每增加一个单位,患病几率就增加1.01 (95% CI: 0.99;1.03), p = 0.234;铜OR 1.62 (95% CI: 0.80;3.32), p = 0.184;锌OR 6.88 (95% CI: 1.25;43.67), p = 0.032。结果表明,妊娠期孕妇硒、锌不缺乏,铜含量较高。早产与较高的母亲血清铜和锌浓度有关。
{"title":"Maternal Serum Concentrations of Selenium, Copper, and Zinc during Pregnancy Are Associated with Risk of Spontaneous Preterm Birth: A Case-Control Study from Malawi.","authors":"Grace Chiudzu,&nbsp;Augustine T Choko,&nbsp;Alfred Maluwa,&nbsp;Sandra Huber,&nbsp;Jon Odland","doi":"10.1155/2020/9435972","DOIUrl":"https://doi.org/10.1155/2020/9435972","url":null,"abstract":"<p><p>Preterm birth is delivery before 37 completed weeks. A study was conducted to evaluate the association of maternal serum concentrations of selenium, copper, and zinc and preterm birth. There were 181 women in this nested case-control study, 90/181 (49.7%) term and 91/181 (50.3%) preterm pregnant women. The overall mean serum concentration of selenium was 77.0, SD 19.4 <i>μ</i>g/L; of copper was 2.50, SD 0.52 mg/L; and of zinc was 0.77, SD 0.20 mg/L with reference values of 47-142 <i>μ</i>g/L, 0.76-1.59 mg/L, and 0.59-1.11 mg/L, respectively. For preterm birth, mean serum concentration for selenium was 79.7, SD 21.6 <i>μ</i>g/L; for copper was 2.61, SD 0.57 mg/L; and for zinc was 0.81, SD 0.20 mg/L compared to that for term births: selenium (74.2; SD 16.5 <i>μ</i>g/L; <i>p</i> = 0.058), copper (2.39; SD 0.43 mg/L; <i>p</i> = 0.004), and zinc (0.73; SD 0.19 mg/L; <i>p</i> = 0.006), respectively. In an adjusted analysis, every unit increase in maternal selenium concentrations gave increased odds of being a case OR 1.01 (95% CI: 0.99; 1.03), <i>p</i> = 0.234; copper OR 1.62 (95% CI: 0.80; 3.32), <i>p</i> = 0.184; zinc OR 6.88 (95% CI: 1.25; 43.67), <i>p</i> = 0.032. Results show that there was no deficiency of selenium and zinc and there were high serum concentrations of copper in pregnancy. Preterm birth was associated with higher maternal serum concentrations of copper and zinc.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"9435972"},"PeriodicalIF":3.2,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9435972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37938061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 16
Partograph Utilization and Associated Factors among Obstetric Care Providers at Public Health Facilities in Hadiya Zone, Southern Ethiopia. 埃塞俄比亚南部哈迪亚区公共卫生设施产科护理提供者的产褥利用率及其相关因素
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-30 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3943498
Yosef Haile, Fikru Tafese, Tesfaye Dagne Weldemarium, Mulugeta Hailu Rad

Background: A partograph is a graphic representation of labor which is used by health professionals for monitoring labor progress and fetal and maternal wellbeing. However, its utilization and associated factors have not been studied yet in Hadiya Zone, Southern Ethiopia. Hence, the aim of this study was to determine partograph utilization and associated factors among obstetric care providers at public health facilities in Hadiya Zone, Southern Ethiopia.

Methods: A facility-based cross-sectional study was conducted on 436 health professionals. The study was conducted from March 04 to April 07, 2019. A simple random sampling method was carried out to select 19 health facilities and study participants from selected facilities. Data was collected using a pretested structured questionnaire, entered into EPI-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics and binary and multivariable logistic regression analyses were done. P values less than 0.05 were used to declare significant association between dependent and independent variables.

Results: The overall magnitude of partograph utilization was found to be 54.4%, and finding from data abstraction from a document revealed that out of 18 parameters, only 10 parameters were recorded completely. Type of health facility (hospital as compared to HC) (AOR = 2.96; CI = 1.71, 5.12), received on-the-job training on partograph (AOR = 7.06; CI = 4.3, 11.37), knowledgeable about partograph (AOR = 2.12; CI = 1.3, 3.9), and favorable attitude toward partograph use (AOR = 1.8; CI = 1.12 - 2.97) were significantly associated with partograph use.

Conclusion: Overall partograph utilization was low, and incomplete recording of required parameters on partograph was observed in this study. Participants who received on-the-job training on partograph, who are working in a hospital, who are knowledgeable about partograph, and who have favorable attitude toward partograph use were factors affecting partograph use positively.

背景:产程图是一种劳动的图形表示,被卫生专业人员用于监测劳动进展和胎儿和母亲的健康。然而,在埃塞俄比亚南部的哈迪亚地区,尚未对其利用和相关因素进行研究。因此,本研究的目的是确定埃塞俄比亚南部哈迪亚区公共卫生机构产科护理提供者的产褥利用率及其相关因素。方法:对436名卫生专业人员进行了以医院为基础的横断面调查。该研究于2019年3月4日至4月7日进行。采用简单随机抽样的方法,从选定的卫生机构中选择19个卫生机构和研究对象。使用预测试的结构化问卷收集数据,输入EPI-data版本3.1,并导出到社会科学统计软件包(SPSS)版本20。描述性统计和二元及多变量logistic回归分析。使用P值小于0.05表示因变量和自变量之间存在显著相关。结果:整体参数利用率为54.4%,从某文献的数据提取中发现,18个参数中只有10个参数被完整记录。卫生设施类型(与卫生保健中心相比的医院)(AOR = 2.96;CI = 1.71, 5.12),接受过在职培训(AOR = 7.06;CI = 4.3, 11.37),对剖面图了解(AOR = 2.12;CI = 1.3, 3.9),对剖宫图使用持良好态度(AOR = 1.8;CI = 1.12 - 2.97)与剖宫产使用显著相关。结论:本研究剖宫产总体利用率较低,剖宫产所需参数记录不完整。接受过产程培训、在医院工作、了解产程知识和对产程使用持积极态度的被试是产程使用的积极影响因素。
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引用次数: 9
Maternal Satisfaction with Intrapartum Nursing Care and Its Associated Factors among Mothers Who Gave Birth in Public Hospitals of North Wollo Zone, Northeast Ethiopia: Institution-Based Cross-Sectional Study. 埃塞俄比亚东北部北沃罗区公立医院产妇产时护理满意度及其影响因素:基于机构的横断面研究
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-27 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8279372
Asmamaw Demis, Ribka Nigatu, Derebe Assefa, Getnet Gedefaw

Background: Now a day, satisfaction had been identified as the major index to assess the quality of health-care provision in the world including Ethiopia. Mothers judge the quality of intrapartum care received based on their satisfaction with the services provided, thus influencing their utilization of the available health facilities. Therefore, this study aimed to assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in North Wollo Zone, Northeastern Ethiopia, 2019.

Methods: Institutional-based cross-sectional quantitative study was conducted in public hospitals of North Wollo Zone, and a total of 398 study participants were selected by using a systematic random sampling method. Data was collected using a standardized questionnaire by direct interviewing of study participants, and data was analyzed using SPSS 24 versions to determine the frequency of variables. Logistic regression was carried out to identify factors associated with maternal satisfaction.

Results: From the total of 398 study participants, about 51% of women were satisfied with the hospital-based intrapartum nursing care. Being rural in residency (AOR: 2.03; 95% CI: 1.05-3.93), time to be seen by health-care providers (AOR: 2.82; 95% CI: 1.46-5.46), having history of ANC follow-up (AOR: 3.73; 95% CI: 1.12-12.57), and getting adequate meal (AOR: 3.96; 95% CI: 1.13-13.83) had showed statistical significant association with maternal satisfaction.

Conclusion: In this study, the overall maternal satisfaction with intrapartum nursing care was low. Therefore, improving ANC follow-up, early examined by health-care providers, and getting adequate meal while in labour and delivery might enhance women satisfaction with intrapartum nursing care services.

背景:如今,满意度已被确定为评估包括埃塞俄比亚在内的全世界保健服务质量的主要指标。母亲根据对所提供服务的满意程度来判断分娩时护理的质量,从而影响到她们对现有保健设施的利用。因此,本研究旨在评估2019年在埃塞俄比亚东北部北沃罗区公立医院分娩的母亲对分娩时护理的满意度及其相关因素。方法:采用系统随机抽样的方法,在北沃罗地区公立医院进行基于机构的横断面定量研究,共抽取398名研究对象。通过对研究参与者的直接访谈,采用标准化问卷收集数据,并使用SPSS 24版本对数据进行分析,确定变量的频率。进行Logistic回归以确定与产妇满意度相关的因素。结果:在398名研究参与者中,约51%的女性对医院分娩护理感到满意。居住在农村(AOR: 2.03;95% CI: 1.05-3.93)、就诊时间(AOR: 2.82;95% CI: 1.46-5.46),有ANC随访史(AOR: 3.73;95% CI: 1.12-12.57),膳食充足(AOR: 3.96;95% CI: 1.13-13.83)与产妇满意度有统计学意义。结论:本研究中产妇对产时护理的总体满意度较低。因此,改善产前护理随访,由保健提供者早期检查,以及在分娩和分娩期间获得足够的膳食,可能会提高妇女对分娩期间护理服务的满意度。
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引用次数: 5
期刊
Journal of Pregnancy
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