Pub Date : 2024-05-13DOI: 10.29011/jpch-124.100024
{"title":"Calling for Better Maternal Care Requires a Call for More Training","authors":"","doi":"10.29011/jpch-124.100024","DOIUrl":"https://doi.org/10.29011/jpch-124.100024","url":null,"abstract":"","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141128602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29DOI: 10.29011/jpch-122.100022
{"title":"Cardio-Renal & Neurologic Complications of Preeclampsia: Current Concepts & Clinical Implications","authors":"","doi":"10.29011/jpch-122.100022","DOIUrl":"https://doi.org/10.29011/jpch-122.100022","url":null,"abstract":"","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-29DOI: 10.29011/jpch-121.100021
Rebecca Ssengonzi, Yuye Wang, Nobuyo Maeda-Smithies, Feng Li
Preeclampsia (PE) is a common pregnancy-related hypertensive disorder and is a leading cause of maternal and perinatal morbidity and mortality. The incidence of PE and its associated health care costs have been increasing in the United States over the past three decades. Pregnancies complicated by PE put both the mother and child at increased risk for chronic illnesses such as cardiovascular disease, cerebrovascular disease, and cognitive impairment later in life. To date, there is no effective treatment for PE and the etiology of PE is largely unknown. While human epidemiological studies have established an association between various genetic factors and PE, a causative link between genes associated with PE and PE development has been difficult to establish. Human studies have shown that variants in eNOS (endothelial nitric oxide synthase, also known as NOS3) gene are associated with PE, and animal experimental studies have provided evidence to show the potential functional connection between the eNOS gene and PE. Here we review several studies that investigated the role of eNOS in PE, as well as studies that described how manipulating the eNOS/NO pathway could aid in disease intervention.
子痫前期（PE）是一种常见的与妊娠有关的高血压疾病，是导致孕产妇和围产期发病和死亡的主要原因。在美国，子痫前期的发病率及其相关的医疗费用在过去三十年中不断上升。妊娠合并 PE 会增加母婴罹患心血管疾病、脑血管疾病和认知障碍等慢性疾病的风险。迄今为止，还没有治疗 PE 的有效方法，而 PE 的病因在很大程度上也是未知的。虽然人类流行病学研究已经确定了各种遗传因素与 PE 之间的关联，但与 PE 相关的基因与 PE 的发病之间的因果关系却难以确定。人类研究表明，eNOS（内皮一氧化氮合酶，又称 NOS3）基因变异与 PE 相关，动物实验研究也提供了证据，表明 eNOS 基因与 PE 之间存在潜在的功能性联系。在此，我们回顾了几项调查 eNOS 在 PE 中作用的研究，以及描述操纵 eNOS/NO 通路如何有助于疾病干预的研究。
{"title":"Endothelial Nitric Oxide synthase (eNOS) in Preeclampsia: An Update.","authors":"Rebecca Ssengonzi, Yuye Wang, Nobuyo Maeda-Smithies, Feng Li","doi":"10.29011/jpch-121.100021","DOIUrl":"10.29011/jpch-121.100021","url":null,"abstract":"<p><p>Preeclampsia (PE) is a common pregnancy-related hypertensive disorder and is a leading cause of maternal and perinatal morbidity and mortality. The incidence of PE and its associated health care costs have been increasing in the United States over the past three decades. Pregnancies complicated by PE put both the mother and child at increased risk for chronic illnesses such as cardiovascular disease, cerebrovascular disease, and cognitive impairment later in life. To date, there is no effective treatment for PE and the etiology of PE is largely unknown. While human epidemiological studies have established an association between various genetic factors and PE, a causative link between genes associated with PE and PE development has been difficult to establish. Human studies have shown that variants in eNOS (endothelial nitric oxide synthase, also known as NOS3) gene are associated with PE, and animal experimental studies have provided evidence to show the potential functional connection between the eNOS gene and PE. Here we review several studies that investigated the role of eNOS in PE, as well as studies that described how manipulating the eNOS/NO pathway could aid in disease intervention.</p>","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10929736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112421","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}
Pub Date : 2022-01-14DOI: 10.29011/jpch-119.100019
Deogratias Katabalo, Debora N Robert, Stanley Mwita, Winfrida, V. Minja, Shadya Abbas, K. Marwa
Background: Self-medication with conventional and/or herbal medicines is an important public health concern, especially to a delicate group of pregnant women due to its harmful and potential risks to mother and foetus. Awareness to its detrimental effects is influenced by social demographic factors and is highly related to its practice. This study determined the general knowledge, practice and common factors for self-medication among pregnant women attending antenatal clinic at Sengerema designated district hospital. Method: A hospital based descriptive cross-sectional study was conducted using a semi structured questionnaire in which a sample of 381 pregnant women on their first trimester of pregnancy was enrolled through convenient sampling. Data were analysed using STATA version 13 (TX: StataCorp LLC). Continuous variables were presented as frequencies, percentages and proportions while categorical variables were presented in charts, graphs and figures. Logistic regression analysis was performed to determine the factors associated with self medications. Results: The overall proportion of self-medication practice was found to be 289(75.9%) whereby 146(38.3%) and 143(37.5%) did self-medication with conventional and herbal medicines respectively. Prior experience with the medicine and better knowledge on disease and treatment were common reasons for self medication reported by 178(61.6%) and 152(52.6%) pregnant women respectively. On the other hand, Malaria, headache and morning sickness (nausea and vomiting) were the leading ailments treated by self-medication as reported by 93(32.2%), 72(24.9%) and 68(23.5%) proportions of women respectively. Marital status, occupation, Level of education, parity was significantly associated with self-medication with conventional medicines (p-value < 0.01) while residence, occupation and level of education were associated with self-medication with herbal medicines Journal of Pregnancy and Child Health Katabalo DM, et al. J Preg Child Health 5: 119. www.doi.org/10.29011/JPCH-119.100019 www.gavinpublishers.com Citation: Katabalo DM, Robert DN, Mwita S, Minja WV, Abbas S, et al. (2022) Self-Medication during First Trimester Among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania. J Preg Child Health 5: 119. DOI: 10.29011/JPCH-119.100019 2 Volume 05; Issue 01 (p-value <0.01). Furthermore this study found that participants had no adequate knowledge on the medication they were using as well as harmful effects of self-medication during first trimester of pregnancy. Conclusion: The practice of self-medication during first trimester was highly common among women attending district hospital. Majority of them had no adequate knowledge on the detrimental effects of this practice posing a potential risk to them and to the foetus they are carrying.
{"title":"Self-Medication During First Trimester among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania","authors":"Deogratias Katabalo, Debora N Robert, Stanley Mwita, Winfrida, V. Minja, Shadya Abbas, K. Marwa","doi":"10.29011/jpch-119.100019","DOIUrl":"https://doi.org/10.29011/jpch-119.100019","url":null,"abstract":"Background: Self-medication with conventional and/or herbal medicines is an important public health concern, especially to a delicate group of pregnant women due to its harmful and potential risks to mother and foetus. Awareness to its detrimental effects is influenced by social demographic factors and is highly related to its practice. This study determined the general knowledge, practice and common factors for self-medication among pregnant women attending antenatal clinic at Sengerema designated district hospital. Method: A hospital based descriptive cross-sectional study was conducted using a semi structured questionnaire in which a sample of 381 pregnant women on their first trimester of pregnancy was enrolled through convenient sampling. Data were analysed using STATA version 13 (TX: StataCorp LLC). Continuous variables were presented as frequencies, percentages and proportions while categorical variables were presented in charts, graphs and figures. Logistic regression analysis was performed to determine the factors associated with self medications. Results: The overall proportion of self-medication practice was found to be 289(75.9%) whereby 146(38.3%) and 143(37.5%) did self-medication with conventional and herbal medicines respectively. Prior experience with the medicine and better knowledge on disease and treatment were common reasons for self medication reported by 178(61.6%) and 152(52.6%) pregnant women respectively. On the other hand, Malaria, headache and morning sickness (nausea and vomiting) were the leading ailments treated by self-medication as reported by 93(32.2%), 72(24.9%) and 68(23.5%) proportions of women respectively. Marital status, occupation, Level of education, parity was significantly associated with self-medication with conventional medicines (p-value < 0.01) while residence, occupation and level of education were associated with self-medication with herbal medicines Journal of Pregnancy and Child Health Katabalo DM, et al. J Preg Child Health 5: 119. www.doi.org/10.29011/JPCH-119.100019 www.gavinpublishers.com Citation: Katabalo DM, Robert DN, Mwita S, Minja WV, Abbas S, et al. (2022) Self-Medication during First Trimester Among Pregnant Women Attending Antenatal Care Clinic at a District Hospital in Mwanza, North-western Tanzania. J Preg Child Health 5: 119. DOI: 10.29011/JPCH-119.100019 2 Volume 05; Issue 01 (p-value <0.01). Furthermore this study found that participants had no adequate knowledge on the medication they were using as well as harmful effects of self-medication during first trimester of pregnancy. Conclusion: The practice of self-medication during first trimester was highly common among women attending district hospital. Majority of them had no adequate knowledge on the detrimental effects of this practice posing a potential risk to them and to the foetus they are carrying.","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42025542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/jpch-117.100017
Piffer Silvano, R. Rizzello, Orrasch Massimo, Zambotti Francesca
Introduction: Pre-Pregnancy Diabetes (PPD) affects 03-05/100 and Gestational Diabetes (GDM) affects 7/100 pregnancies. The prevalence estimates show, for both conditions, a wide range of variability in relation to the characteristics of the populations and the diagnostic criteria used. In recent years there has been a significant increase in pregnancies in women with both type 1 and type 2 PPD. Similar increases are also reported for the GDM. The study reports the trend of the prevalence of PPD and GDM in pregnant women assisted at the maternity units of the province of Trento (North East Italy) from 2012 to 2019. Material and Methods: The criteria for monitoring blood glucose during pregnancy are based on the recommendations by the International Association of Diabetes and Pregnancy Study Groups. The glycemic monitoring data are recorded in the province of Trento, on the personal obstetric guide of each pregnant woman, which is updated on the occasion of periodic checks and therefore in all pregnant women on the occasion of registration of data in the Birth Attendance Certificate (BAC) on a specific computer support operating at each maternity unit. The cases recorded in the BAC were compared with those collected by the provincial register of type 1 diabetes mellitus and with the hospital discharge archive. Based on the integrated data, the birth cohorts 2012-2019 were retrospectively analyzed. The temporal trend of the prevalence of PPD and GDM was calculated, considering the citizenship, the age group and the educational qualification of the pregnant women. Prevalence estimates are provided by 95% confidence intervals Results: Between 01.01.2012 and 12.31.2019, 33,577 pregnant women received care at hospital maternity units of the province of Trento. 158 cases of PPD (20 cases per year) and 1,950 cases of GDM (244 cases per year) were recorded. 1 case of GDM and one case of PDD had escaped the BAC. The mean period prevalence for PPD in all pregnant women is 0.44/100 (95% CI 0.37-0.50), in Italian women is 0.39/100 (95% CI 0, 31-0.46) while in foreign women it is 0.57/100 (95% CI 0.42-0.72). The average period prevalence of GDM for all pregnant women is 5.5/100 (95% CI 5.27-7.73), in Italian women is 4.3/100 (95% CI 4.064.54), while in foreign women it is 8.8/100 (95% CI 8.23-9.37). The prevalence of PPD overall shows a slight increase over time, this appears substantially stable in the Italians and increasing in the foreigners. In the case of the GDM, there is an increase over time in both population groups, greater in foreigners than in Italians. The prevalence of PPD and GDM in foreign women is higher than in Italian women. Women coming from African and Asian countries show the highest values. The prevalence of PPD and GDM grows linearly with age and with the reduction in the level of education of women. Discussion: The information flow of the BAC, as organized in the province of Trento, can be considered a reliable source in the recovery an
妊娠前糖尿病(PPD)影响3-05/100，妊娠期糖尿病(GDM)影响7/100。流行率估计表明，对于这两种情况，在人口特征和所使用的诊断标准方面存在很大差异。近年来，患有1型和2型PPD的妇女怀孕的人数显著增加。据报道，GDM也有类似的增长。该研究报告了2012年至2019年在特伦托省(意大利东北部)产科单位协助的孕妇中PPD和GDM的流行趋势。材料和方法:监测妊娠期间血糖的标准是基于国际糖尿病和妊娠研究小组协会的建议。在特伦托省，血糖监测数据记录在每个孕妇的个人产科指南上，在定期检查时更新，因此，在所有孕妇在每个产科单位运行的特定计算机支持的接生证书(BAC)中登记数据时更新。将BAC记录的病例与省1型糖尿病登记处收集的病例和医院出院档案进行比较。基于综合数据，回顾性分析2012-2019年出生队列。考虑孕妇的国籍、年龄、学历等因素，计算PPD和GDM患病率的时间趋势。结果:在2012年1月1日至2019年12月31日期间，33,577名孕妇在特伦托省的医院产科接受了护理，记录了158例PPD(每年20例)和1,950例GDM(每年244例)。1例GDM和1例PDD逃过BAC。所有孕妇PPD的平均期患病率为0.44/100 (95% CI 0.37-0.50)，意大利妇女为0.39/100 (95% CI 0.31 -0.46)，而外国妇女为0.57/100 (95% CI 0.42-0.72)。所有孕妇妊娠期GDM的平均患病率为5.5/100 (95% CI 5.27-7.73)，意大利妇女为4.3/100 (95% CI 4.064.54)，而外国妇女为8.8/100 (95% CI 8.23-9.37)。总的来说，随着时间的推移，PPD的患病率略有上升，意大利人的患病率基本稳定，而外国人的患病率则有所上升。在GDM的情况下，随着时间的推移，这两个人口群体都有增长，外国人比意大利人更大。国外女性患PPD和GDM的比例高于意大利女性。来自非洲和亚洲国家的女性表现出最高的价值。PPD和GDM的患病率随着年龄和女性受教育程度的降低呈线性增长。讨论:在Trento省组织的BAC信息流可以被认为是PPD和GDM频率恢复和登记的可靠来源。在本研究中报道的PPD和GDM的患病率估计在随后的出生队列中增加，与国际文献报道的一致。总的来说，对于这两种形式的糖尿病，我们在研究期间报告的患病率约为6/100。从出生队列来看，患病率的增加在外国人中尤为明显。外国妇女，特别是来自亚洲和非洲的妇女以及生育年龄超过35岁的妇女，教育程度低，在产后抑郁症和GDM病例中占很大比例，因此在公共卫生行动中被视为优先考虑的风险较大的亚人群中也占很大比例。引用本文:Piffer S, Rizzello R, Massimo O, Francesca Z(2021)意大利特伦托-北省孕前和妊娠期糖尿病患病率:趋势2012 - 2019。[J]孕妇与儿童健康杂志04:117。DOI: 10.29011/JPCH-117.100017 2 Volume 04;问题1
{"title":"Prevalence of Pre-Pregnancy and Gestational Diabetes in the Province of Trento-North Italy: Trend 2012-2019","authors":"Piffer Silvano, R. Rizzello, Orrasch Massimo, Zambotti Francesca","doi":"10.29011/jpch-117.100017","DOIUrl":"https://doi.org/10.29011/jpch-117.100017","url":null,"abstract":"Introduction: Pre-Pregnancy Diabetes (PPD) affects 03-05/100 and Gestational Diabetes (GDM) affects 7/100 pregnancies. The prevalence estimates show, for both conditions, a wide range of variability in relation to the characteristics of the populations and the diagnostic criteria used. In recent years there has been a significant increase in pregnancies in women with both type 1 and type 2 PPD. Similar increases are also reported for the GDM. The study reports the trend of the prevalence of PPD and GDM in pregnant women assisted at the maternity units of the province of Trento (North East Italy) from 2012 to 2019. Material and Methods: The criteria for monitoring blood glucose during pregnancy are based on the recommendations by the International Association of Diabetes and Pregnancy Study Groups. The glycemic monitoring data are recorded in the province of Trento, on the personal obstetric guide of each pregnant woman, which is updated on the occasion of periodic checks and therefore in all pregnant women on the occasion of registration of data in the Birth Attendance Certificate (BAC) on a specific computer support operating at each maternity unit. The cases recorded in the BAC were compared with those collected by the provincial register of type 1 diabetes mellitus and with the hospital discharge archive. Based on the integrated data, the birth cohorts 2012-2019 were retrospectively analyzed. The temporal trend of the prevalence of PPD and GDM was calculated, considering the citizenship, the age group and the educational qualification of the pregnant women. Prevalence estimates are provided by 95% confidence intervals Results: Between 01.01.2012 and 12.31.2019, 33,577 pregnant women received care at hospital maternity units of the province of Trento. 158 cases of PPD (20 cases per year) and 1,950 cases of GDM (244 cases per year) were recorded. 1 case of GDM and one case of PDD had escaped the BAC. The mean period prevalence for PPD in all pregnant women is 0.44/100 (95% CI 0.37-0.50), in Italian women is 0.39/100 (95% CI 0, 31-0.46) while in foreign women it is 0.57/100 (95% CI 0.42-0.72). The average period prevalence of GDM for all pregnant women is 5.5/100 (95% CI 5.27-7.73), in Italian women is 4.3/100 (95% CI 4.064.54), while in foreign women it is 8.8/100 (95% CI 8.23-9.37). The prevalence of PPD overall shows a slight increase over time, this appears substantially stable in the Italians and increasing in the foreigners. In the case of the GDM, there is an increase over time in both population groups, greater in foreigners than in Italians. The prevalence of PPD and GDM in foreign women is higher than in Italian women. Women coming from African and Asian countries show the highest values. The prevalence of PPD and GDM grows linearly with age and with the reduction in the level of education of women. Discussion: The information flow of the BAC, as organized in the province of Trento, can be considered a reliable source in the recovery an","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69488413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/jpch-118.100018
Sunanda Bharatnur, C. Rani, S. Hebbar
Objective: To evaluate the effect of abnormal Umbilical artery Doppler and Cerebro-placental ratio on perinatal outcome in pregnant women between 28-40 weeks of gestation. Methods: It’s a prospective observational study of 139 pregnant women with abnormal umbilical artery Doppler and cerebroplacental ratio from 28-40wks excluding all medical diseases. Doppler was considered abnormal when pulsatality Index (PI) > 95th percentile for gestational age and when Cerebro-placental Ratio is less than 1.08. Results: Abnormal Doppler results are grouped into 3 groups, AEDF (absent end diastolic factor), REDF (reverse end diastolic factor), CPR (cerebro-placental ratio) <1. In AEDF, REDF, CPR groups, respiratory distress syndrome (RDS) was noted in73%, 95%, 37%. Low Apgar (score less than 7), was 4.5%, 35%, 3.1%.FGR was noted in 37%, 81%, 15%. Birth weight < 2.5kg as seen in 32%, 45% whereas in REDF group 95% of babies were <2kg.Sepsis were noted more in REDF 70% whereas none in CPR group. Meconium stained amniotic fluid seen in 13%, 10% and none in CPR group. All babies required NICU stay more than 7 days in REDFcompared to other groups. Perinatal mortality was highest in the REDF (15 %) compared to AEDF (2.29 %) and CPR <1.08 (Zero) [p <0.001]. Conclusion: Abnormal umbilical artery Doppler along with CPR <1 is associated with substantial risk of adverse perinatal outcomes. Abnormal CPR and AEDF are not the indications for immediate delivery. Using Dopplers of other vessels like ductus venosus with UAAEDF could help in deciding the time of delivery and reduce the adverse perinatal outcome.
{"title":"Study of Cerebro-Placental Ratio in Pregnancies with Abnormal Umbilical Artery Doppler in Predicting Adverse Perinatal Outcome: Are we here yet?","authors":"Sunanda Bharatnur, C. Rani, S. Hebbar","doi":"10.29011/jpch-118.100018","DOIUrl":"https://doi.org/10.29011/jpch-118.100018","url":null,"abstract":"Objective: To evaluate the effect of abnormal Umbilical artery Doppler and Cerebro-placental ratio on perinatal outcome in pregnant women between 28-40 weeks of gestation. Methods: It’s a prospective observational study of 139 pregnant women with abnormal umbilical artery Doppler and cerebroplacental ratio from 28-40wks excluding all medical diseases. Doppler was considered abnormal when pulsatality Index (PI) > 95th percentile for gestational age and when Cerebro-placental Ratio is less than 1.08. Results: Abnormal Doppler results are grouped into 3 groups, AEDF (absent end diastolic factor), REDF (reverse end diastolic factor), CPR (cerebro-placental ratio) <1. In AEDF, REDF, CPR groups, respiratory distress syndrome (RDS) was noted in73%, 95%, 37%. Low Apgar (score less than 7), was 4.5%, 35%, 3.1%.FGR was noted in 37%, 81%, 15%. Birth weight < 2.5kg as seen in 32%, 45% whereas in REDF group 95% of babies were <2kg.Sepsis were noted more in REDF 70% whereas none in CPR group. Meconium stained amniotic fluid seen in 13%, 10% and none in CPR group. All babies required NICU stay more than 7 days in REDFcompared to other groups. Perinatal mortality was highest in the REDF (15 %) compared to AEDF (2.29 %) and CPR <1.08 (Zero) [p <0.001]. Conclusion: Abnormal umbilical artery Doppler along with CPR <1 is associated with substantial risk of adverse perinatal outcomes. Abnormal CPR and AEDF are not the indications for immediate delivery. Using Dopplers of other vessels like ductus venosus with UAAEDF could help in deciding the time of delivery and reduce the adverse perinatal outcome.","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69488950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/jpch-116.100016
Gloria L Mrosso, Fridolin Mujuni, Namanya Basinda, Joshua Ngimbwa
Background: Unintended pregnancy is a potential hazard for every sexually active woman as it poses a serious threat to the health and well-being of families globally. Information on Tanzanian women who conceive unintentionally is rarely documented. Understanding the extent of unintended pregnancy and the factors associated is crucial to devise evidence-based interventions. This study aimed to determine prevalence of and factors associated with unintended pregnancy Methods: This was a hospital-based cross-sectional study. A total of 300 pregnant women were recruited through random sampling and questionnaires were pre-tested and administered. Multiple logistic regression analysis was performed using SPSS version 20 software to identify the factors associated with an unintended pregnancy. Results: The overall prevalence of unintended pregnancy was found to be 73 (24.3%) and those who wanted it at a later time and not at all accounted for 143 (47.7%) and 227 (75.7%) respectively. The prevalence of unintended pregnancies decreased with the use of emergency contraceptives and being married. However, it increases in lower age 15 to 20 years 67.3% (99/147) at first pregnancy, those who have high parity 54.5% (12/22), divorced 57.1% (4/7) and not married 62.7% (37/59). The prevalence was independent of the use of modern contraceptives, the number of sexual partners, and the level of education of the mother. Conclusion: Unintended pregnancy is one of the major reproductive health problems since approximately over a quarter (24.3%) of the pregnant women attending ANC had unintended pregnancy experience. There is a need to inaugurate a community-based program through increasing knowledge of family planning by designing strategic policy programs aimed at creating more sensitization on reducing the unintended pregnancy reflecting those with young age, high parity, and not married.
背景:意外怀孕是每个性活跃妇女的潜在危险，因为它对全球家庭的健康和福祉构成严重威胁。关于坦桑尼亚无意怀孕妇女的信息很少有记录。了解意外怀孕的程度及其相关因素对于制定基于证据的干预措施至关重要。本研究旨在确定意外妊娠的患病率及相关因素。方法:这是一项基于医院的横断面研究。通过随机抽样，共招募了300名孕妇，并对问卷进行了预测试和管理。采用SPSS version 20软件进行多元logistic回归分析，确定与意外妊娠相关的因素。结果:总意外妊娠发生率为73例(24.3%)，有晚点妊娠和不妊娠的分别为143例(47.7%)和227例(75.7%)。意外怀孕的发生率随着使用紧急避孕药具和结婚而下降。15 ~ 20岁初孕者增加67.3%(99/147)，高胎次者增加54.5%(12/22)，离婚者增加57.1%(4/7)，未婚者增加62.7%(37/59)。这种流行与现代避孕药具的使用、性伴侣的数量和母亲的教育水平无关。结论:意外怀孕是主要的生殖健康问题之一，因为大约四分之一以上(24.3%)参加非国大的孕妇有意外怀孕的经历。有必要启动一个以社区为基础的方案，通过设计战略政策方案，提高人们对减少年轻、高胎次和未婚妇女意外怀孕的认识，提高人们对计划生育的认识。
{"title":"Prevalence and Factors Associated with Unintended Pregnancy among Women Attending Antenatal Clinic in General Hospital in Dodoma","authors":"Gloria L Mrosso, Fridolin Mujuni, Namanya Basinda, Joshua Ngimbwa","doi":"10.29011/jpch-116.100016","DOIUrl":"https://doi.org/10.29011/jpch-116.100016","url":null,"abstract":"Background: Unintended pregnancy is a potential hazard for every sexually active woman as it poses a serious threat to the health and well-being of families globally. Information on Tanzanian women who conceive unintentionally is rarely documented. Understanding the extent of unintended pregnancy and the factors associated is crucial to devise evidence-based interventions. This study aimed to determine prevalence of and factors associated with unintended pregnancy Methods: This was a hospital-based cross-sectional study. A total of 300 pregnant women were recruited through random sampling and questionnaires were pre-tested and administered. Multiple logistic regression analysis was performed using SPSS version 20 software to identify the factors associated with an unintended pregnancy. Results: The overall prevalence of unintended pregnancy was found to be 73 (24.3%) and those who wanted it at a later time and not at all accounted for 143 (47.7%) and 227 (75.7%) respectively. The prevalence of unintended pregnancies decreased with the use of emergency contraceptives and being married. However, it increases in lower age 15 to 20 years 67.3% (99/147) at first pregnancy, those who have high parity 54.5% (12/22), divorced 57.1% (4/7) and not married 62.7% (37/59). The prevalence was independent of the use of modern contraceptives, the number of sexual partners, and the level of education of the mother. Conclusion: Unintended pregnancy is one of the major reproductive health problems since approximately over a quarter (24.3%) of the pregnant women attending ANC had unintended pregnancy experience. There is a need to inaugurate a community-based program through increasing knowledge of family planning by designing strategic policy programs aimed at creating more sensitization on reducing the unintended pregnancy reflecting those with young age, high parity, and not married.","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69488169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/jpch-108.100008
David Mulenga, Tambulani Nyirenda, H. T. Nyirenda, D. Mobegi, Brenda Mubita, Ronald Kapesha, V. Sakanga, R. Zulu, Emmanuel Chongwe, Inambao Mubiana
Background: Prenatal care is one of the recommended interventions globally to improve maternal and neonatal outcomes. In most Sub-Saharan African countries, high rates of poor pregnancy outcomes coexist with high Antenatal (ANC) coverage rates. Therefore, in order to understand this inconsistency, this study was designed to explore the association between adequacy of prenatal care received and low birth weight in Ndola and Kitwe, Zambia. Method: A cross sectional study on 384 women and their babies was conducted in Ndola and Kitwe based health facilities. Adequacy of prenatal care was evaluated according to the seven parameters defined by the Zambian Ministry of Health in the Program for Maternal and Child Health: 1. Obstetric history 2. Intermitted Presumptive Treatment of Malaria 3. Nutritional supplements (folic acid/iron) 4. Tetanus toxoid vaccination 5. Deworming 6. Health Education and 7. Screening tests. Data was analysed using Stata version 13.1; low birth weight and adequacy of prenatal care were described. Associations between adequacy of prenatal care and low birth weight were calculated and statistical significance was set at 5%. Results: A low birth weight of 13.5% was found in the study population. The most received screening test was abdominal pelvic scan (84.9%) and the least was the blood group (19.5%) and Rhesus factor (18.0%). On average, women received 60.9% of the ANC screening tests. Based on our classification, only 2.9% of the participants received adequate content of prenatal care. Only slightly above a quarter (25.8%) of women started their ANC visit in the first trimester. The study demonstrated a statistically significant association (p value 0.001) between basic screening tests and timing of prenatal care initiation. Similarly, a statistically significant association (p value 0.001) between essential screening tests and timing of prenatal care initiation was observed. Receiving essential screening tests was statistically significantly associated (p value 0.025) with low birth weight and no association observed between prenatal care and low birth weight. Conclusion: Evaluating the adequacy of prenatal care received by mothers using appropriate classification tools is an efficient means of identifying deficiencies in the provision of preventive services to women during pregnancy. The findings in Kitwe and Ndola, Zambia indicate that mothers who initiated prenatal care in the first trimester were more likely to receive all the screening tests compared to those that started in subsequent trimesters. Therefore, interventions to improve quality of prenatal care should target timing of ANC initiation and factors related to the availability and accessibility to screening tests during pregnancy. Citation: Mulenga D, Nyirenda T, Nyirenda HT, Mobegi D, Mubita B, et al. (2020) Adequacy of Prenatal Care and its Association with Low Birth Weight in Ndola and Kitwe, Zambia. J Preg Child Health 03: 108. DOI: 10.29011/JPCH-108.100008
{"title":"Adequacy of Prenatal Care and its Association with Low Birth Weight in Ndola and Kitwe, Zambia","authors":"David Mulenga, Tambulani Nyirenda, H. T. Nyirenda, D. Mobegi, Brenda Mubita, Ronald Kapesha, V. Sakanga, R. Zulu, Emmanuel Chongwe, Inambao Mubiana","doi":"10.29011/jpch-108.100008","DOIUrl":"https://doi.org/10.29011/jpch-108.100008","url":null,"abstract":"Background: Prenatal care is one of the recommended interventions globally to improve maternal and neonatal outcomes. In most Sub-Saharan African countries, high rates of poor pregnancy outcomes coexist with high Antenatal (ANC) coverage rates. Therefore, in order to understand this inconsistency, this study was designed to explore the association between adequacy of prenatal care received and low birth weight in Ndola and Kitwe, Zambia. Method: A cross sectional study on 384 women and their babies was conducted in Ndola and Kitwe based health facilities. Adequacy of prenatal care was evaluated according to the seven parameters defined by the Zambian Ministry of Health in the Program for Maternal and Child Health: 1. Obstetric history 2. Intermitted Presumptive Treatment of Malaria 3. Nutritional supplements (folic acid/iron) 4. Tetanus toxoid vaccination 5. Deworming 6. Health Education and 7. Screening tests. Data was analysed using Stata version 13.1; low birth weight and adequacy of prenatal care were described. Associations between adequacy of prenatal care and low birth weight were calculated and statistical significance was set at 5%. Results: A low birth weight of 13.5% was found in the study population. The most received screening test was abdominal pelvic scan (84.9%) and the least was the blood group (19.5%) and Rhesus factor (18.0%). On average, women received 60.9% of the ANC screening tests. Based on our classification, only 2.9% of the participants received adequate content of prenatal care. Only slightly above a quarter (25.8%) of women started their ANC visit in the first trimester. The study demonstrated a statistically significant association (p value 0.001) between basic screening tests and timing of prenatal care initiation. Similarly, a statistically significant association (p value 0.001) between essential screening tests and timing of prenatal care initiation was observed. Receiving essential screening tests was statistically significantly associated (p value 0.025) with low birth weight and no association observed between prenatal care and low birth weight. Conclusion: Evaluating the adequacy of prenatal care received by mothers using appropriate classification tools is an efficient means of identifying deficiencies in the provision of preventive services to women during pregnancy. The findings in Kitwe and Ndola, Zambia indicate that mothers who initiated prenatal care in the first trimester were more likely to receive all the screening tests compared to those that started in subsequent trimesters. Therefore, interventions to improve quality of prenatal care should target timing of ANC initiation and factors related to the availability and accessibility to screening tests during pregnancy. Citation: Mulenga D, Nyirenda T, Nyirenda HT, Mobegi D, Mubita B, et al. (2020) Adequacy of Prenatal Care and its Association with Low Birth Weight in Ndola and Kitwe, Zambia. J Preg Child Health 03: 108. DOI: 10.29011/JPCH-108.100008 ","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69485097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/jpch-112.100012
Pouran Malekzadeh, C. Witt, Irtiqa F. Fazili, Rebecca E. Fleenor, Kirsten Young, D. Dibaba, C. Chiu, C. Shephard
Introduction: The ARRIVE study found that induction of labor decreased the rates for cesarean section and was not associated with adverse neonatal outcomes. However, it is unclear if their study results are generalizable. Here, we aimed to analyze the perinatal and maternal outcomes of women undergoing elective induction of labor versus expectant management at a single center tertiary hospital. Methods: We retrospectively investigated outcomes in 188 low risk nulliparous women who either underwent labor induction (n=66) or had spontaneous labor (n=122). Results: There were no statistically significant outcomes between the two groups as it relates to the mother and neonate. The rate of cesarean delivery was 20% in the induction group versus 16% in the active labor group (p = 0.713). The woman who underwent induction had a relatively higher risk for morbidity including third degree laceration (p = 0.329), hypertensive disorders of pregnancy (p = 0.246), chorioamnionitis (p = 0.828), hemorrhage (p = 0.586) and infection (p = 0.586). Women in the induction group also spent more time in the labor (p < 0.001). Neonates in the induction group did have a relatively higher risk for meconium aspiration syndrome (p = 0.246), requiring respiratory support within 72 hours (p = 0.398), hyperbilirubinemia requiring phototherapy (p = 1.00), and shoulder dystocia (p = 0.732). Conclusions: We provide evidence of higher rate of maternal and neonatal morbidity in women undergoing inductions, although not statistically significant. Thus, providers should have an informed discussion when deciding timing of delivery.
{"title":"Evaluating Outcomes in Low-Risk Nulliparous Women who Underwent Labor Induction versus Expectant Management: Single Institution Experience","authors":"Pouran Malekzadeh, C. Witt, Irtiqa F. Fazili, Rebecca E. Fleenor, Kirsten Young, D. Dibaba, C. Chiu, C. Shephard","doi":"10.29011/jpch-112.100012","DOIUrl":"https://doi.org/10.29011/jpch-112.100012","url":null,"abstract":"Introduction: The ARRIVE study found that induction of labor decreased the rates for cesarean section and was not associated with adverse neonatal outcomes. However, it is unclear if their study results are generalizable. Here, we aimed to analyze the perinatal and maternal outcomes of women undergoing elective induction of labor versus expectant management at a single center tertiary hospital. Methods: We retrospectively investigated outcomes in 188 low risk nulliparous women who either underwent labor induction (n=66) or had spontaneous labor (n=122). Results: There were no statistically significant outcomes between the two groups as it relates to the mother and neonate. The rate of cesarean delivery was 20% in the induction group versus 16% in the active labor group (p = 0.713). The woman who underwent induction had a relatively higher risk for morbidity including third degree laceration (p = 0.329), hypertensive disorders of pregnancy (p = 0.246), chorioamnionitis (p = 0.828), hemorrhage (p = 0.586) and infection (p = 0.586). Women in the induction group also spent more time in the labor (p < 0.001). Neonates in the induction group did have a relatively higher risk for meconium aspiration syndrome (p = 0.246), requiring respiratory support within 72 hours (p = 0.398), hyperbilirubinemia requiring phototherapy (p = 1.00), and shoulder dystocia (p = 0.732). Conclusions: We provide evidence of higher rate of maternal and neonatal morbidity in women undergoing inductions, although not statistically significant. Thus, providers should have an informed discussion when deciding timing of delivery.","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69485335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.29011/jpch-109.100009
H. T. Nyirenda, Brenda Mubita, Nancy Choka, David Mulenga, Ronald Kapesha, Bright Mukanga, P. Agina, D. Mobegi, Emmanuel Chongwe, V. Sakanga, R. Zulu, Inambao Mubiana
Introduction: Evidence suggests that health care providers habitually fail to provide respectful maternity care during facilitybased delivery. This study explored the relationship between disrespect and abuse experienced by women during child birth and postpartum depression. Methods: This was a cross-sectional study targeting women attending postnatal services within 28 days of delivery preceding the survey. A random sample of 306 women from 20 health facilities were selected and interviewed. Self-reported disrespect and abuse included physical abuse, non-consented care, non-confidential care, verbal abuse, and discrimination based on specific attributes. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depression. Results: Findings reveal that 13% and 12% of the women had mild and severe symptoms of emotional distress respectively. One third (33%) experienced at least one form of disrespect and abuse. Further, the risk of having severe emotional distress symptoms was; (RRR=2.52, 95%CI: 1.256 5.057); (RRR=1.90, 90%CI: 0.905 3.985); (RRR=2.23, 90%CI: 0.874 5.669); (RRR=2.32, 95%CI: 1.146 4.692) and (RRR=4.41, 99%CI: 1.769 10.980) times higher for women who experienced; Physical abuse; Non-confidential care; Non-dignified care; Abandonment or denial of care; and Detention in facilities respectively. Similarly, the risk of having mild emotional distress was (RRR=2.44, 95%CI: 1.201 4.939) and (RRR=2.34, 95%CI: 1.176 4.672) times higher for women who experienced; Non-confidential care and Abandonment or denial of care respectively. Conclusion: Disrespect and abuse during Labour and delivery have potential of crafting adverse health outcomes such as postpartum depression hence negative child birth experiences defile the fundamentals for healthy motherhood. Recommendation: There is need to address the various forms of disrespect and abuse in order to ensure respectful maternity care and elude the potential adverse outcomes of postpartum depression. Postnatal services should incorporate critical assessment of signs of mental illness among women for early intervention. Citation: Nyirenda HT, Mubita B, Choka N, Mulenga D, Kapesha R, et al. (2020) Postpartum Depression among Postnatal Women as a Result of Disrespect and Abuse During Labour and Delivery. J Preg Child Health 03: 109. DOI: 10.29011/JPCH-109.100009 2 Volume 03; Issue 0
{"title":"Postpartum Depression among Postnatal Women as a Result of Disrespect and Abuse during Labour and Delivery","authors":"H. T. Nyirenda, Brenda Mubita, Nancy Choka, David Mulenga, Ronald Kapesha, Bright Mukanga, P. Agina, D. Mobegi, Emmanuel Chongwe, V. Sakanga, R. Zulu, Inambao Mubiana","doi":"10.29011/jpch-109.100009","DOIUrl":"https://doi.org/10.29011/jpch-109.100009","url":null,"abstract":"Introduction: Evidence suggests that health care providers habitually fail to provide respectful maternity care during facilitybased delivery. This study explored the relationship between disrespect and abuse experienced by women during child birth and postpartum depression. Methods: This was a cross-sectional study targeting women attending postnatal services within 28 days of delivery preceding the survey. A random sample of 306 women from 20 health facilities were selected and interviewed. Self-reported disrespect and abuse included physical abuse, non-consented care, non-confidential care, verbal abuse, and discrimination based on specific attributes. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depression. Results: Findings reveal that 13% and 12% of the women had mild and severe symptoms of emotional distress respectively. One third (33%) experienced at least one form of disrespect and abuse. Further, the risk of having severe emotional distress symptoms was; (RRR=2.52, 95%CI: 1.256 5.057); (RRR=1.90, 90%CI: 0.905 3.985); (RRR=2.23, 90%CI: 0.874 5.669); (RRR=2.32, 95%CI: 1.146 4.692) and (RRR=4.41, 99%CI: 1.769 10.980) times higher for women who experienced; Physical abuse; Non-confidential care; Non-dignified care; Abandonment or denial of care; and Detention in facilities respectively. Similarly, the risk of having mild emotional distress was (RRR=2.44, 95%CI: 1.201 4.939) and (RRR=2.34, 95%CI: 1.176 4.672) times higher for women who experienced; Non-confidential care and Abandonment or denial of care respectively. Conclusion: Disrespect and abuse during Labour and delivery have potential of crafting adverse health outcomes such as postpartum depression hence negative child birth experiences defile the fundamentals for healthy motherhood. Recommendation: There is need to address the various forms of disrespect and abuse in order to ensure respectful maternity care and elude the potential adverse outcomes of postpartum depression. Postnatal services should incorporate critical assessment of signs of mental illness among women for early intervention. Citation: Nyirenda HT, Mubita B, Choka N, Mulenga D, Kapesha R, et al. (2020) Postpartum Depression among Postnatal Women as a Result of Disrespect and Abuse During Labour and Delivery. J Preg Child Health 03: 109. DOI: 10.29011/JPCH-109.100009 2 Volume 03; Issue 0","PeriodicalId":87313,"journal":{"name":"Journal of pregnancy and child health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69485175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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