Frontiers in global women's health最新文献

Introduction: Cleft lip and/or palate (CL/P), the most prevalent congenital anomaly, has been associated with higher rates of child maltreatment. In particular, the presence of cleft lip has more of an impact on external appearance and may increase the risks of negative health outcomes such as parental postpartum depression; however, this concept remains controversial. Item #10 of the Edinburgh Postpartum Depression Scale is the assessment of parental self-harm ideation, and its presence in postpartum mothers merits risk assessments as an emergent issue that may affect the health of both mothers and infants. This study focused on the impact of CL/P on maternal self-harm ideation.

Methods: Of 100,300 live births from a nationwide birth cohort in Japan, 238 mothers of infants with CL/P [186 children born with cleft lip (CL ± P) and 52 born with isolated cleft palate (CP)] were included in the analyses. The prospective association of children with CL/P and maternal self-harm ideation, which were acquired using item #10 in the Edinburgh Postpartum Depression Scale at 1 and 6 months postpartum, was examined using binomial logistic regression analyses after multiple imputations and with adjustments for several maternal (age at delivery, smoking habit, and alcohol intake) and child-related (sex and prevalence of other congenital diseases) variables.

Results: The prevalence of self-harm ideation in 238 mothers of infants with CL/P at 1 and 6 months were 14.7% (35/238) and 18.8% (45/238) [8.2% (8,185/100,062) and 12.9% (12,875/100,062) in the control group], respectively. The odds ratio (95% confidence interval) for maternal self-harm ideation increased with CL/P prevalence [1.80 (1.22-2.65) and 1.47 (0.98-2.18)] at 1 and 6 months of age, respectively. After stratified by the prevalence of cleft lip, we found significant differences in the CL ± P group but not in the CP group. Furthermore, persistent self-harming ideation was associated with a higher risk in the CL ± P group [2.36 (1.43-3.89)].

Conclusion: CL/P, particularly cleft lip, which is more noticeable externally, was associated with an increased prevalence of maternal self-harm ideation. The findings in this study indicate some potential benefits of increasing support for mothers who have infants with CL/P.

Background: There is a general concurrence on the health benefits that breastfeeding confers to children, including offering maximal protection against obesity across their life course. However, the scientific evidence on similar benefits for women who breastfeed their children remains inconclusive. This study contributes to the discourse by examining the association of breastfeeding duration with overweight and obesity among women in Ghana.

Methods: Data on 8,516 women of reproductive age were pooled from the last five (5) Ghana Demographic and Health Surveys, and analysed using descriptive proportions and logistic regression models.

Results: The prevalence of overweight and obesity was about 8% lower for women who breastfed their children beyond 18 months (overweight = 13%, obesity = 5%) compared with women who did not breastfeed (overweight = 21%, obesity = 13%) their children at all. With reference to women who did not breastfeed their children, a significant lower odds of obesity was observed for those who breastfed their children for 13-18 months (OR = 0.46, 95% CI = 0.268, 0.864) and >18 months (OR = 0.41, 95% CI = 0.216, 0.764), after adjusting for possible confounding factors.

Discussion: Women who breastfeed their children for a minimum of 12 months have lower risk of developing obesity. Promoting prolonged breastfeeding among mothers could be an effective pathway to preventing obesity among women in Ghana.

Objective: This study investigated the relationship between years of employment and cognitive health among older non-Latinx Black, Latinx, and non-Latinx White women. We hypothesized that women who had never been formally employed (i.e., zero years of formal work experience) would exhibit a pronounced cognitive decline.

Methods: Our study included 5,664 older adult women from the Health and Retirement Study (2010-2016) aged 65-101 (M = 75.41). Out of 5,664 participants, 850 identified as non-Latinx Black, 475 identified as Latinx, and 4,339 identified as non-Latinx White. Furthermore, 5,292 women indicated having a professional employment history of at least one year, whereas 372 women reported no formal work experience. The Telephone Interview for Cognitive Status-27 (TICS-27) was used to assess cognitive performance. Linear mixed effects models were conducted to assess whether employment history was associated with the rate of cognitive decline.

Results: In all three racial and ethnic groups, lower age, higher education, greater number of years worked, fewer chronic conditions, and greater household income were associated with better cognitive performance at baseline (p < .05). Additionally, women who had not worked in any formal capacity had a lower baseline cognitive performance (p < .001) and a more extreme decline in cognitive performance over time (p = .04).

Conclusion: In conclusion, we found that women without any formal work experience performed lower at baseline and experienced a steeper cognitive decline over time. These findings underscore the need to further explore the complex interrelationships between employment duration and cognitive trajectories, especially among older women and those from different racial and ethnic backgrounds.

Background: Maternal undernutrition during lactation is a worldwide public health problem. It causes impaired cognitive ability, poor productivity, irreversible loss, and intergenerational malnutrition, which has harmful effects on the next generation. Overall, there is little information on undernutrition and risk factors among lactating mothers, especially in resource-poor settings, including Ethiopia. This study assessed undernutrition and associated factors among lactating mothers in rural Chiro district, eastern Ethiopia.

Method: A community-based cross-sectional study was conducted among 629 lactating mothers in the Chiro district from July 2-30, 2019. Data were collected from participants using pretested, structured questionnaires and anthropometric measurements. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27. Multivariable logistic regression analyses were used to identify factors associated with undernutrition.

Results: Undernutrition among lactating mothers was 26.9% (95% CI: 23.2%, 30.2%). Female-headed household (AOR = 0.34, 95% CI:0.13, 0.94), medium (AOR = 0.58, 95% CI: 0.38, 0.95) and rich (AOR = 0.30, 95% CI: 0.18, 0.51) wealth quintiles, lack of dietary advice (AOR = 1.62, 95% CI: 1.10, 2.39), chewing khat (AOR = 1.82, 95% CI: 1.23, 2.70), low dietary diversity (AOR = 3.10, 95% CI: 1.82, 5.29), and household food insecurity (AOR = 3.67, 95% CI:1.47, 9.20) were factors significantly associated with undernutrition.

Conclusions: Around one in every four lactating mothers in rural eastern Ethiopia had undernutrition. Poor wealth, lack of dietary feeding advice, substance use disorder, low minimum dietary diversity, and household food insecurity were factors significantly associated with the undernutrition of lactating mothers. Thus, focusing on implementing existing strategies/programs for effective nutritional interventions and poverty alleviation that enhance food security status would be essential to improving the nutritional status of lactating mothers and children.

Background: Stillbirth always resulted in a multi-dimensional impact from the individual level to the country level at large. It causes psychological depression, social stigmatization, and decreased quality of life for women. Despite several studies conducted in Ethiopia, no national pooled estimates were done. Therefore, this systematic review and meta-analysis sought to assess intrapartum stillbirth and associated factors among women who had childbirth in Ethiopia using the available published evidence.

Methods: The current review included studies conducted in Ethiopia. The databases used primarily were Medline/PubMed, Google Scholar, Scopus, Web of Science, Ethiopian University Repository Online, CINAHL, African Journals Online and Cochrane Library. All cross-sectional studies conducted in English and met eligibility criteria were included in the final review. A random-effects meta-analysis was performed. Data extraction and analysis were also performed using Microsoft Excel and STATA version 14 software respectively.

Results: In the current review, eleven studies were included, and their quality was assessed before being chosen for the final review. The pooled prevalence of intrapartum stillbirth among women who had childbirth in Ethiopia was 9.21% [95% CI (7.03%, 11.39%); I ² = 90.2, P = 0.000]. Women with a previous history of stillbirth [OR = 5.14, 95% CI (3.53-6.75), I ² = 60.0%, p = 0.04] and had no use of antenatal care {[OR = 0.43, 95% CI (0.18-0.68) I ² = 85.3%, p = 0.001]} were significantly associated with intrapartum stillbirth among women who gave childbirth.

Conclusions: Nearly one-tenth of women who had childbirth in Ethiopia had an intrapartum SB. Revitalizing the existing health extension package particularly family health services with emphasis on focused antenatal care and counselling as well as with prompt referral system would reduce intrapartum SB. This review calls for the need to assess the quality of ANC provision and tailor targeted interventions to best improve the service quality.

Introduction: Ethiopia has one of the highest maternal death rates in the world, with 412 deaths for every 100,000 live births. A qualified healthcare professional's care during pregnancy, delivery, and the postnatal period is crucial to saving the lives of the mother and her child. The continuum of maternity health services in Ethiopia is still shallow, despite efforts to increase the use of these services. This study's goal was to evaluate the magnitude and factors influencing the entire continuum of care for maternal health services in Chiro City in 2024.

Methods: A community-based cross-sectional study was conducted from 15 January to 15 February 2024, among mothers who gave birth in the last year preceding the data collection period in Chiro City, Eastern Ethiopia. Data were collected through face-to-face interviews using a structured questionnaire. Multivariable logistic regression analysis was done to identify determinants of the complete continuum of care. A P-value of <0.05 was considered statistically significant in this study.

Result: The prevalence of a complete continuum of care among mothers who gave birth in the last year in Chiro District was 37.0%. Accordingly, women who received ANC were 5.24 times more likely to complete the maternal health services continuum of care compared with their counterparts (AOR: 5.24, 95% CI: 1.94, 14.15). Compared with their counterparts, women who received health education were 4.36 times more likely to complete the continuum of care (AOR: 4.36, 95% CI: 2.0, 9.51). Similarly, women who had planned pregnancies were 4.32 times more likely to complete the maternal health services continuum of care than those who had unplanned pregnancies (AOR: 4.32, 95% CI: 2.38, 7.85).

Conclusion and recommendation: The continuum of care was favorably correlated with ANC usage, health education, and planned pregnancies. To increase the coverage of the entire continuum of maternal care, it is desirable to develop programs that encourage women to initiate ANC contacts, provide health education, and promote planned pregnancies.

Introduction: This study aimed to identify the determinants that influence the use of DMPA-SC/Sayana Press among women who use modern contraceptive methods in Burkina Faso.

Methods: This study used secondary data obtained from the 2021 Burkina Faso Demographic and Health Survey (EDSBF). The dependent variable is the use of DMPA-SC among women aged 15-49 who employ modern contraceptive methods. The descriptive analysis used percentages to describe the study variables. The Pearson chi-square test was used to assess the associations between the explanatory variables and the study variable of interest. Bivariate logistic regression was used to examine the crude odds ratios of each explanatory variable with respect to the dependent variable. The multivariate model was used to determine the net effect of each independent variable on the dependent variable. The significance levels were defined at p < 0.05, with corresponding confidence intervals.

Results: The study revealed significant differences in the use of DMPA-SC according to age, marital status, region of residence, level of education, number of children, and involvement in contraceptive decision-making within the couple. Younger women (aged 15-29 aOR = 2.12, p < 0.001)) and women aged 30-39 (aOR = 1.51, p = 0.02) are also more likely to use DMPA-SC compared to those aged 40-49. Married women or those living with a partner [aOR = 1.93 (1.22, 3.05)] are more likely to use DMPA-SC. Women with 1-3 children are twice as likely to use DMPA-SC as those without children (aOR = 1.97, p = 0.02). Region and Wealth Index were significantly associated with DMPA-SC use. The Boucle du Mouhoun region showed a significantly higher likelihood of DMPA-SC use (aOR = 8.10) and women in the highest wealth group are significantly less likely to use DMPA-SC (aOR = 0.59, p = 0.001).

Conclusion: These results demonstrated the importance of adapting interventions to account for socio-demographic, regional, and cultural differences. This will enable the provision of services to the entire female population in a fair and equitable manner, while also addressing the limitations and enhancing the understanding of the underlying factors influencing the use of DMPA-SC.

Background: One of the most important health interventions for reducing maternal morbidity and death is the use of maternal healthcare services. In Ethiopia, maternal healthcare services are not well utilized, particularly in rural pastoralist communities, despite their significance. Therefore, the purpose of this study was to evaluate the use of maternal healthcare services and the characteristics that are related to it in the East Borena zone. Techniques: In September 2020, a community-based cross-sectional survey was carried out in Liben with 416 randomly selected mothers. Mothers who had given birth within the 12 months before the study comprised the respondents. Questionnaires given by interviewers were used to gather the data. The data were transferred to SPSS version 20 for analysis after being entered into Epi-Info version 4.1 for coding. The Kolmogorov-Smirnov, Hosmer, and Lemeshow goodness of fit tests were employed, along with descriptive statistics. Additionally, multivariate and binary logistic regression analyses were carried out. 95% CI and the odd ratio were used to examine the relationship between the outcome and predictive variables.

Results: At least one prenatal visit was received by 60% of moms. Only 21.2% and 17.5% of women had given birth in a medical facility and made use of early postnatal care services. The use of antenatal care was strongly correlated with maternal education [AOR = 2.43 (95% CI: 1.22-4.89)], decision-making capability [AOR = 2.40 (95% CI: 1.3-23.3)], felt compassionate and respectful treatment [AOR = 0.30 (95% CI: 0.18-0.50)], and intended current pregnancy [AOR = 0.22 (95% CI: 0.12-0.37)]. Moms b/n ages 15-19 had a 3.7-fold higher probability of giving birth in a hospitals than moms b/n ages 35 and 49 [AOR = 1.74 (95% CI: 1.02-3.08)]. Mothers who lived far away were 1.02 times less likely to give birth at a hospital than those who could reach one within an hour (AOR = 1.74;95% CI: 1.02, 3.08). While recent use of antenatal care [AOR = 5.34 (95% CI: 1.96-8.65)], planned current pregnancy, and knowledge of using postnatal care were shown to be strongly correlated with danger indicators [AOR = 2.93 (95% CI: 1.59-5.41)], knowledge of danger signs [AOR = 3.77 (95% CI: 2.16-6.57)] and perceived compassionate and respectful care were significantly associated with institutional delivery.

Conclusion: Overall the prevalence of maternal healthcare services utilization was far below the national and regional targets in the study area. Thus, promoting institutional services, raising community knowledge, empowering women to make decisions, and enhancing the infrastructure of the health sector.

Background: Worldwide, nearly 830 women die from complications of pregnancy and childbirth daily. Ninety-nine per cent of these maternal deaths take place in low and middle-income countries. Basic Emergency Obstetric Care (BEmONC) is one method of reducing maternal mortality related to pregnancy and childbirth complications. However, the status of its implementation fidelity has not been investigated. Therefore, this study sought to evaluate the implementation fidelity of BEmONC services in Beyeda District, Northwest Ethiopia.

Evaluation methods: A single case study design with mixed method was employed from June 01 to July 30, 2022. 415 client exit interviews, 14 key informants' interviews and 423 retrospective document reviews were conducted. Adherence, participant responsiveness and quality of delivery dimensions from Carroll's conceptual framework, with a total of 21 indicators were used in this evaluation. The overall implementation fidelity status of BEmONC service was judged based on the pre-seated judgmental criteria as; low, medium, and high fidelity.

Results: The overall degree of implementation fidelity of the BEmONC services was 74.5%. Moreover, the implementation fidelity status of adherence, quality of delivery, and participant responsiveness dimensions were 74.7%, 77.2%, and 71.5% respectively. Uterotonic drugs were not administered as per the recommended protocol. Participants' engagement towards the neonatal resuscitation service delivery was inadequate. Likewise, healthcare providers' respect for the clients was not sufficient. Furthermore, women aged >30 years, being government employed and ANC visits four and above were variables positively associated with the quality of delivery of BEmONC services.

Conclusion: The overall implementation fidelity of the BEmONC services was judged as implemented in medium fidelity. Moreover, the adherence, participant responsiveness and quality of delivery dimensions were found to be implemented in medium fidelity. Therefore, public health sectors at all levels should strive to enhance the implementation fidelity of BEmONC services. Moreover, healthcare providers should adhere to the BEmONC implementation protocol guideline during service delivery. Healthcare managers should facilitate a continuous awareness creation for mothers regarding the merit of neonatal resuscitation for neonatal complications. Furthermore, healthcare providers should give due respect to mothers while delivering the services.