المؤلفون: Fernandez Turienzo, Cristina¹ (AUTHOR) cristina.fernandez_turienzo@kcl.ac.uk, Silverio, Sergio A.¹ (AUTHOR), Coxon, Kirstie² (AUTHOR), Brigante, Lia³ (AUTHOR), Seed, Paul T.¹ (AUTHOR), Shennan, Andrew H.¹ (AUTHOR), Sandall, Jane¹ (AUTHOR)

المصدر: PLoS ONE. 4/21/2021, Vol. 16 Issue 4, p1-21. 21p.

مصطلحات موضوعية: *MATERNAL health services, *PREMATURE labor, *CHILDBIRTH, *CONTINUUM of care, *MIDWIFERY, *SENSORY perception, *PRENATAL care

مصطلحات جغرافية: UNITED Kingdom

مستخلص: Background: Midwifery continuity of care models for women at low and mixed risk of complications have been shown to improve women's experiences of care. However, there is limited research on care experiences among women at increased risk of preterm birth. We aimed to explore the experiences of care among women with risk factors for preterm birth participating in a pilot trial (POPPIE) of a midwifery continuity of care model which included a specialist obstetric clinic. Methods: A total of 334 pregnant women identified at increased risk of preterm birth were randomly allocated to either midwifery continuity of care (POPPIE group) or standard maternity care. Women in both groups were followed up at six-to-eight weeks postpartum and were invited to complete a postnatal survey either online or by post. An equal status exploratory sequential mixed method design was chosen to collect and analyse the quantitative postnatal survey data and qualitative interviews data. The postnatal survey included measures of social support, trust, perceptions of safety, quality of care, control during childbirth, bonding and quality of life. Categorical data were analysed with chi-squared tests and continuous data were analysed with t-tests and/or Mann-Whitney U test to measure differences in measures scores among groups. The qualitative interview data were subjected to a thematic framework analysis. Data triangulation brought quantitative and qualitative data together at the interpretation stage. Findings: A total of 166 women completed the survey and 30 women were interviewed (90 and 16 in POPPIE group; 76 and 14 in standard group). We found survey respondents in the POPPIE group, compared to respondents in the standard group, were significantly more likely to report greater trust in midwives (Mann-Whitney U, p<0.0001), greater perceptions of safety during the antenatal care (t-test, p = 0.0138), have a particular midwife to contact when they needed during their pregnancy (t-test, p<0.0001) and the postnatal period (chi-squared, p<0.0001). They reported increased involvement in decisions regarding antenatal, intrapartum and postnatal care (t-test, p = 0.002; p = 0.008; p = 0.006 respectively); and greater postnatal support and advice about: feeding the baby (chi-squared, p<0.0001), handling, settling and looking after the baby (chi-squared, p<0.0001), baby's health and progress (chi-squared, p = 0.039), their own health and recovery (chi-squared, p = 0.006) and who to contact about any emotional changes (chi-squared, p = 0.005). There were no significant differences between groups in the reporting of perceptions of safety during birth and the postnatal period, concerns raised during labour and birth taken seriously, being left alone during childbirth at a time of worries, control during labour, bonding, social support, and physical and mental health related quality of life after birth. Results from qualitative interviews provided insight and depth into many of these findings, with women in the POPPIE group reporting more positive experiences of bonding towards their babies and more positive physical health postnatally. Conclusions: Compared with standard maternity care, women at increased risk of PTB who received midwifery continuity of care were more likely to report increased perceptions of trust, safety and quality of care. Trial registration: ISRCTN (Number: 37733900); UK CRN (ID: 31951). [ABSTRACT FROM AUTHOR]

المؤلفون: Woday, Abay¹ (AUTHOR), Muluneh, Muluken Dessalegn^2,3 (AUTHOR) destamule@gmail.com, Sherif, Samiha⁴ (AUTHOR)

المصدر: PLoS ONE. 11/11/2019, Vol. 14 Issue 11, p1-12. 12p.

مصطلحات موضوعية: *PREMATURE labor, *MOTHERS, *PRENATAL care, *PUBLIC hospitals, *CHILDBIRTH, *CHILDBIRTH at home

مصطلحات جغرافية: ETHIOPIA

مستخلص: Background: Preterm birth (PTB) is a public health issue worldwide. In developing nations, like Ethiopia, PTB is under reported and underestimated. However, it is the leading cause of neonatal and under-five mortality in Ethiopia. Besides, limited and non-comparative research studies to date has been conducted in the country to address the prevalence of PTB. Therefore, this study aims to determine predictors of PTB. Methods: Hospital-based unmatched case control study was employed on a sample of 139 cases and 278 controls from October 2017 to December 2017 in the Amhara region, Ethiopia. The cases and controls were proportionally allocated in each hospital based on the last one-year case flows. As soon as a case was identified, the respective two controls were enrolled until the required sample size was satisfied. The outcome variable was measured by using either last menstrual period (LMP), early ultrasound result, or Ballard maturity examination. Face-to-face interviews were conducted using a standardized, structured, and pre-tested questionnaire to collect data. The collected data was entered into Epi-data and exported into SPSS for analysis. Independent variables with p-values < 0.25 in the bivariate analysis were entered into multivariable logistic regression models with forward logistic regressions method to control the influence of covariates. Ethical clearance was ensured. Results: A total of 134 cases and 268 controls participated with a response rate of 96.4%. After adjusting for covariates, the following variables were associated with PTB: residing in rural areas [AOR = 2.99: 95% CI 1.19, 7.48], low maternal age [AOR = 3.47: 95% CI 1.11, 10.83], being illiterate [AOR = 4.56: 95% CI 1.11,8.62], short birth spacing [AOR = 2.48: 95% CI 1.07, 5.75], no antenatal care visits for this index pregnancy [AOR = 10.78: 95% CI 4.43, 26.25], having a history of previous adverse birth outcomes [AOR = 3.47: 95% CI 1.51, 8.02], and exposure to medical problems during pregnancy [AOR = 13.94: 95% CI 4.39, 24.27]. Conclusion: The study revealed maternal sociodemographic factors, short birth space, lack of antenatal care, exposure to previous adverse birth outcomes and facing medical illnesses during pregnancy were the predictors of PTB. Therefore, inclusive preventive and control interventions should be developed at regional, zonal and district levels to reduce the burden of PTB among women resided in rural areas such as integrating antenatal care services into the existing health extension packages. Study results suggest increasing the awareness of PTB, contraceptive utilization and counseling to enhance birth spacing, antenatal care visits, and accessibility to services among women in Ethiopia should be given due attention. Health care providers should focus on mothers with previous adverse birth outcomes and those exposed to medical problems during pregnancy. Additional community based longitudinal studies supplemented with qualitative methods are recommended. [ABSTRACT FROM AUTHOR]

المصدر: Women's Health Weekly; 2024, p965-965, 1p

مصطلحات موضوعية: LOW birth weight, PRENATAL care, RESEARCH personnel, CHILDBIRTH, LIFE sciences, PREMATURE labor

مستخلص: A recent study conducted by researchers from the University of Indonesia examined the association between antenatal care (ANC) utilization and low birth weight (LBW) children among women with high-risk births. The study utilized data from the 2017 Indonesia Demographic and Health Survey and found that adequate ANC utilization was significantly associated with LBW among women with more than two children. Preterm birth was also found to be more likely to result in LBW. The researchers concluded that there is a need for increased monitoring of pregnant women with high-risk births and for improved implementation of qualified ANC standards. [Extracted from the article]

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المؤلفون: Klerman, Lorraine V.¹, Cliver, Suzanne P.², Goldenberg, Robert L.²

المصدر: American Journal of Public Health. Aug1998, Vol. 88 Issue 8, p1182-1185. 4p. 4 Charts.

مصطلحات موضوعية: PREGNANCY, PREMATURE labor, PRENATAL care, CHILDBIRTH, OBSTETRICS, AFRICAN Americans

مستخلص: Objectives. The objective of this study was to determine whether the length of the interval between pregnancies was associated with either preterm birth or intrauterine growth retardation in a low-income, largely Black population. Methods. The study population consisted of 4400 women who had received prenatal care in county clinics and had two consecutive singleton births between 1980 and 1990. Results. Interpregnancy intervals were positively associated with age and negatively associated with the trimester in which care was initiated in the second pregnancy. Whites had shorter intervals than non-Whites. The percentage of preterm births increased as the length of the interpregnancy interval decreased, but only for women who had not had a previous preterm birth. The association between interval and preterm birth was maintained when other factors associated with preterm birth were controlled. There was no significant relationship between intrauterine growth retardation and interpregnancy interval. Conclusions. Women, particularly those who are poor and young, should be advised of the potential harm to their infants of short interpregnancy intervals. [ABSTRACT FROM AUTHOR]

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المؤلفون: Hailemichael, Helen Tsehaye, Debelew, Gurmesa Tura, Alema, Haileselasie Berhane, Weldu, Meresa Gebremedhin, Misgina, Kebede Haile

المصدر: BMC Pediatrics; 1/8/2020, Vol. 20 Issue 1, p1-9, 9p, 3 Charts

مصطلحات موضوعية: LABOR (Obstetrics), CHILDBIRTH, PRENATAL care, NUTRITION counseling, PREMATURE labor, ASPHYXIA neonatorum

مصطلحات جغرافية: ETHIOPIA

مستخلص: Background: Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia.Methods: Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05.Result: The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15-13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92-36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35-17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89-13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83-14.01] were significantly associated with adverse birth outcomes.Conclusion and Recommendation: The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes. [ABSTRACT FROM AUTHOR]

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المؤلفون: Baer, Rebecca J., Altman, Molly R., Oltman, Scott P., Ryckman, Kelli K., Chambers, Christina D., Rand, Larry, Jelliffe-Pawlowski, Laura L.

المصدر: Journal of Maternal-Fetal & Neonatal Medicine; Oct2019, Vol. 32 Issue 20, p3336-3342, 7p

مصطلحات موضوعية: BIRTH certificates, PRENATAL care, INFANT health, MATERNAL age, CHILDBIRTH, ETHNICITY, PREMATURE labor

مصطلحات جغرافية: CALIFORNIA

مستخلص: Objective: Examine factors influencing late (> sixth month of gestation) entry into prenatal care by race/ethnicity and insurance payer. Methods: The study population was drawn from singleton live births in California from 2007 to 2012 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes linked birth certificate and mother and infant hospital discharge records. The sample was restricted to infants delivered between 20 and 44 weeks gestation. Logistic regression was used to calculate relative risks (RR) and 95% confidence intervals (CI) for factors influencing late entry into prenatal care. Maternal age, education, smoking, drug or alcohol abuse/dependence, mental illness, participation in the Women, Infants and Children's program and rural residence were evaluated for women entering prenatal care > sixth month of gestation compared with women entering < fourth month. Backwards stepwise logistic regression was used to create final multivariable models of risk and protective factors for late prenatal care entry for each race or ethnicity and insurance payer. Results: The sample included 2,963,888 women. The percent of women with late entry into prenatal care was consistently higher among women with public versus private insurance. Less than 1% of white non-Hispanic and Asian women with private insurance entered prenatal care late versus more than 4% of white non-Hispanic and black women with public insurance. After stratifying by race or ethnicity and insurance status, women less than 18 years of age were more likely to enter prenatal care late, with young Asian women with private insurance at the highest risk (15.6%; adjusted RR 7.4, 95%CI 5.3-10.5). Among all women with private insurance, > 12-year education or age >34 years at term reduced the likelihood of late prenatal care entry (adjusted RRs 0.5-0.7). Drugs and alcohol abuse/dependence and residing in a rural county were associated with increased risk of late prenatal care across all subgroups (adjusted RRs 1.3-3.8). Participation in the Women, Infants, and Children's program was associated with decreased risk of late prenatal care for women with public insurance (adjusted RRs 0.6-0.7), but increased risk for women with private insurance (adjusted RRs 1.4-2.1). Conclusions: The percent of women with late entry into prenatal care was consistently higher among women with public insurance. Younger women, women with <12-year education, those who used drugs or alcohol or resided in rural counties were more likely to enter prenatal care late, with Asian women <18 years at especially high risk. Participation in the Women, Infants, and Children's program and maternal age >34 years at delivery increased the likelihood of late prenatal care for some subgroups of women and decreased the likelihood for others. These findings can inform institutional factors influencing late prenatal care, especially among lower income women, and may assist efforts aimed at encouraging earlier entry into prenatal care. Rationale: Optimal prenatal care includes initiation before the 14th week of gestation. Beginning care in the first trimester provides an opportunity for sonographic pregnancy dating or confirmation with best accuracy, which can later prove critical for management of preterm labor, maternal or fetal complications, or prolonged pregnancy. In order to improve maternal and infant health by increasing the number of women seeking prenatal care in the first trimester, it is important to examine the drivers for late entry. Here, we examine factors influencing late (> sixth month of gestation) entry into prenatal care by race/ethnicity and insurance payer. We found the percent of women with late entry into prenatal care was consistently higher among women with public insurance. Younger women, women with <12-year education, those who used drugs or alcohol or resided in rural counties were more likely to enter prenatal care late, with Asian women <18 years at especially high risk. These findings can inform institutional factors influencing late prenatal care, especially among lower income women, and may assist efforts aimed at encouraging earlier entry into prenatal care. [ABSTRACT FROM AUTHOR]

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المؤلفون: Um‐Bergström, Miranda, Papadogiannakis, Nikos, Westgren, Magnus, Vinnars, Marie‐Therese

المصدر: Acta Obstetricia et Gynecologica Scandinavica; Jan2018, Vol. 97 Issue 1, p74-81, 8p

مصطلحات موضوعية: CORTICOSTEROIDS, STEROID receptors, CHILDBIRTH, PREMATURE infants, PREGNANCY complications, PRENATAL care, PREMATURE labor, CHORIONIC villi, GESTATIONAL age, GLUCOCORTICOIDS, PLACENTA, RISK assessment, PLACENTA diseases, STATISTICS, RETROSPECTIVE studies, PREVENTION, DIAGNOSIS

مصطلحات جغرافية: SWEDEN

مستخلص: Introduction: Mothers at risk of preterm birth are treated with antenatal corticosteroids, which have advantageous effects for prematurely born infants. Accelerated villous maturation in the placenta is also associated with improved perinatal outcome. The primary aim of this study was to examine the association between antenatal corticosteroids and accelerated villous maturation. The secondary aim was to study associations with other placental pathologies.Material and Methods: A retrospective cohort study including 105 women who had (n = 75) or had not (n = 30) been treated with antenatal corticosteroids. The women gave birth between 22+0 and 26+6  weeks of gestation in Stockholm County between 1 April 2004 and 31 March 2007. A pathologist blinded to all clinical data except gestational age examined the placental slides to identify pathology parameters. The outcomes were correlated with antenatal corticosteroid treatment, and confounding factors were adjusted using logistic regression.Results: Accelerated villous maturation was significantly higher in the group treated with corticosteroids (odds ratio 16, 95% CI 2.4-690, p = 0.0005). After adjustment for gestational age and preeclampsia, the difference remained significant (odds ratio 8.9, 95% CI 1.2-389, p = 0.021). No significant associations were found regarding the secondary outcome variables, after adjusting for possible confounders.Conclusions: Antenatal corticosteroid treatment before preterm birth is associated with accelerated villous maturation. This could be one of the pathways by which corticosteroids are beneficial for preterm infants. [ABSTRACT FROM AUTHOR]

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المؤلفون: de Heus, Roel¹ R.deHeus-2@umcutrecht.nl, Mol, Ben Willem^2,3, Erwich, Jan-Jaap H.M.⁴, van Geijn, Herman P.⁵, Gyselaers, Wilfried J.⁶, Hanssens, Myriam⁷, Härmark, Linda⁸, van Holsbeke, Caroline D.⁶, Duvekot, Johannes J.⁹, Schobben, Fred F.A.M.¹⁰, Wolf, Hans³, Visser, Gerard H.A.¹

المصدر: BMJ: British Medical Journal (Overseas & Retired Doctors Edition). 3/28/2009, Vol. 338 Issue 7697, p758-760. 3p. 1 Chart.

مصطلحات موضوعية: *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *PREMATURE labor, *PREGNANCY complications, *DRUG side effects, *PRENATAL care, *HEALTH outcome assessment, *NIFEDIPINE, *COMORBIDITY, *MANAGEMENT, *PHYSIOLOGY, *THERAPEUTICS

مستخلص: Objective To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations. Design Prospective cohort study. Setting 28 hospitals in the Netherlands and Belgium. Participants 1920 consecutive women treated with tocolytics for threatened preterm labour. Main outcome measures Maternal adverse events (those suspected of being causally related to treatment were considered adverse drug reactions) leading to cessation of treatment. Results An independent panel evaluated the recorded adverse events, without knowledge of the type of tocolytic used. Of the 1920 women treated with tocolytics, 1327 received a single course of treatment (69.1%), 282 sequential courses (14.7%), and 311 combined courses (16.2%). Adverse drug reactions were categorised as serious or mild in 14 cases each. The overall incidence of serious adverse drug reaction was 0.7%. Compared with atosiban, the relative risk of an adverse drug reaction for single treatment with a ß adrenoceptor agonist was 22.0 (95% confidence interval 3.6 to 138.0) and for single treatment with a calcium antagonist was 12 (1.9 to 69). Multiple drugtocolysis led to five serious adverse drug reactions (1.6%). Multiple gestation, preterm rupture of membranes, and comorbidity were not independent risk factors for adverse drug reactions. Conclusions The use of ß adrenoceptor agonists or multiple tocolytics for preventing preterm birth is associated with a high incidence of serious adverse drug reactions. Indometacin and atosiban were the only drugs not associated with serious adverse drug reactions. A direct comparison of the effectiveness of nifedipine and atosiban in postponing preterm delivery is needed. [ABSTRACT FROM AUTHOR]

المؤلفون: Rempis, Eva M., Schnack, Alexandra, Decker, Sarah, Braun, Vera, Rubaihayo, John, Tumwesigye, Nazarius Mbona, Busingye, Priscilla, Harms, Gundel, Theuring, Stefanie

المصدر: BMC Pregnancy & Childbirth; 3/7/2017, Vol. 17, p1-12, 12p

مصطلحات موضوعية: PREGNANT women, HIV prevention, CHILDBIRTH, STILLBIRTH, PREMATURE labor, PUBLIC health, HIV infection transmission, VERTICAL transmission (Communicable diseases), ANTI-HIV agents, BIRTH size, COMMUNICABLE diseases, HIV infections, PREMATURE infants, PERINATAL death, PREGNANCY complications, PRENATAL care, CROSS-sectional method, PREVENTION

مصطلحات جغرافية: UGANDA

مستخلص: Background: While most Sub-Saharan African countries are now implementing the WHO-recommended Option B+ protocol for prevention of vertical HIV transmission, there is a lack of knowledge regarding the influence of Option B+ exposure on adverse birth outcomes (ABOs). Against this background, we assessed ABOs among delivering women in Western Uganda.Methods: A cross-sectional, observational study was performed within a cohort of 412 mother-newborn-pairs in Virika Hospital, Fort Portal in 2013. The occurrence of stillbirth, pre-term delivery, and small size for gestational age (SGA) was analysed, looking for influencing factors related to HIV-status, antiretroviral drug exposure and duration, and other sociodemographic and clinical parameters.Results: Among 302 HIV-negative and 110 HIV-positive women, ABOs occurred in 40.5%, with stillbirth in 6.3%, pre-term delivery in 28.6%, and SGA in 12.2% of deliveries. For Option B+ intake (n = 59), no significant association was found with stillbirth (OR 0.48, p = 0.55), pre-term delivery (OR 0.97, p = 0.92) and SGA (OR 1.5, p = 0.3) compared to seronegative women. Women enrolled on antiretroviral therapy (ART) before conception (n = 38) had no different risk for ABOs than women on Option B+ or HIV-negative women. Identified risk factors for stillbirth included lack of formal education, poor socio-economic status, long travel distance, hypertension and anaemia. Pre-term delivery risk was increased with poor socio-economic status, primiparity, Malaria and anaemia. The occurrence of SGA was influenced by older age and Malaria.Conclusion: In our study, women on Option B+ showed no difference in ABOs compared to HIV-negative women and to women on ART. We identified several non-HIV/ART-related influencing factors, suggesting an urgent need for improving early risk assessment mechanisms in antenatal care through better screening and triage systems. Our results are encouraging with regard to continued universal scale-up of Option B+ and ART programmes. [ABSTRACT FROM AUTHOR]

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المؤلفون: McGauley, Justine, Norton, Jessica, Woolfolk, Candice, Raghuraman, Nandini, Stout, Molly J., Carter, Ebony B.

المصدر: American Journal of Obstetrics & Gynecology; 2020 Supplement, Vol. 222 Issue 1, pS422-S423, 2p

مصطلحات موضوعية: PRENATAL care, CHILDBIRTH, MATERNAL age, POSTPARTUM contraception, PREMATURE labor