Time to pregnancy—a model and its application

1990 ◽  
Vol 22 (2) ◽  
pp. 255-262 ◽  
Author(s):  
Jesper L. Boldsen ◽  
Inger Schaumburg
Keyword(s):  
Waiting Times ◽  
Time To Pregnancy ◽  
Number Of Children ◽  
Large Samples ◽  
Multiparous Women ◽  
Primiparous Women

SummaryBiological fertility is poorly measured by the number of children born in industrially advanced societies. The time elapsing from when a couple decides to have a child to clinically recognizable pregnancy is a useful alternative. Time to pregnancy can be collected in broad categories in large samples. A model for condensing important information from such data is presented, which fits several large samples of reported waiting times. It is shown that multiparous women conceive more quickly than primiparous women.

scholarly journals Women’s empowerment and elective cesarean section for a single pregnancy: a population-based and multivariate study in Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Myriam de Loenzien ◽  
Quoc Nhu Hung Mac ◽  
Alexandre Dumont
Keyword(s):  
Cesarean Section ◽  
Partner Violence ◽  
Negative Impact ◽  
Mode Of Delivery ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Elective Cesarean Section ◽  
Multiparous Women ◽  
Elective Cesarean ◽  
Primiparous Women

Abstract Background Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns. Methods We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. Results Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women. Conclusions These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.

scholarly journals Choice of postpartum contraception and its socio-demographic and cultural determinants

2020 ◽  
Vol 9 (7) ◽  
pp. 2866
Author(s):  
Vidyadhar B. Bangal ◽  
Sunil Thitame ◽  
K. V. Somasundaram
Keyword(s):  
Unwanted Pregnancy ◽  
Antenatal Visit ◽  
Third Trimester ◽  
Postpartum Contraception ◽  
Economic Class ◽  
Number Of Children ◽  
Cultural Determinants ◽  
Multiparous Women ◽  
Living Children ◽  
Barrier Contraception

Background: Postpartum contraception is essential for avoidance of unwanted pregnancy and for adequate spacing between two pregnancies. There are many socio demographic and cultural factors that influence the choice of contraception in rural community in India. Third trimester of pregnancy is ideal time for counselling the women regarding breast feeding and contraception. The objective of the present study was to find out the choice of postpartum contraception among antenatal women and the socio demographic and cultural determinants that influence this choice.Methods: Six hundred pregnant women were interviewed regarding their choice of postpartum contraception during their antenatal visit in third trimester of pregnancy, using a pre-validated and pre-tested brief questionnaire. The choices were compiled and analysed to draw conclusions.Results: Postpartum sterilization was choice of 30% of multiparous women. Primi-parous women either opted for barrier contraception like condom (10%), intrauterine contraception (9%) or oral steroidal pills (8%). The progesterone injectable contraceptives and centchroman each were chosen by 2% respondents. There was strong influence of education, parity, sex of the living children on the choice of contraception. It was observed that 40% of women did not want to use hormonal pills and intrauterine contraceptives due to strong age old misbelieves associated with them.Conclusions: Women in rural area prefer permanent method of contraception in the form of tubectomy operation after having desired number of children. There is insufficient spacing between pregnancies due to either non-use of contraception or inconsistent use of temporary method of contraception. More than 50% women are dependent on the husband regarding the choice and practice of contraception. The level of education of woman, age at marriage, socio economic class, desired sex combination of children are strong determinants of choice of contraception.

scholarly journals Parenthood and risk of hip fracture: a 10-year follow-up prospective study of middle-aged women and men in China

2019 ◽  
Vol 31 (4) ◽  
pp. 783-791
Author(s):  
K. Peng ◽  
P. Yao ◽  
L. Yang ◽  
C. Kartsonaki ◽  
D. Bennett ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Prospective Study ◽  
Cox Regression ◽  
Biological Effects ◽  
Men And Women ◽  
Cox Regression Analysis ◽  
Number Of Children ◽  
Nulliparous Women ◽  
Multiparous Women

Abstract Summary This prospective study of Chinese adults demonstrated an inverse J-shaped association of number of children with risk of hip fracture in both men and postmenopausal women aged 50 years or older. Women with 2 or 3 children and men with 4 children had the lowest risk of hip fracture. Introduction Women have higher absolute risks of fracture than men, which is believed to reflect differences in oestrogen exposure. The aim of this study was to compare the associations of number of children with risk of hip fracture between men and women aged over 50 years. Methods The China Kadoorie Biobank (CKB) recruited 133,399 women and 110,296 men, aged 50 years or older between 2004 and 2008. During 10-year follow-up, 2068 participants (1394 women and 674 men) suffered a hip fracture. Cox regression analysis was used to estimate sex-specific adjusted hazard ratios (HRs) and 95% CI for incident hip fracture. Results Over 98% of both subsets of men and women aged 50 or older reported having children. Women who had 2 or 3 children had the lowest risks of hip fracture compared with other groups. Compared with nulliparous women, the adjusted HR for hip fracture were 0.89 (95% CI; 0.72, 1.10) for 1 child, 0.79 (0.70, 0.90) for 2 children, 0.79 (0.72, 0.87) for 3 children, 0.81 (0.72, 0.91) for 4 children, and 0.95 (0.83, 1.10) for those with 5 or more children. The associations of number of children with hip fracture were broadly consistent in men of a similar age. Conclusions The concordant effects of the number of children with risk of hip fracture between men and women suggest that the lower risks in multiparous women are not due to differences in oestrogen exposure or other biological effects, but may reflect residual confounding by socioeconomic or lifestyle factors.

scholarly journals Childbearing after 40 Years: A Challenge of the Modern Obstetrics

2014 ◽  
Vol 8 (2) ◽  
pp. 144-148
Author(s):  
Florin Stamatian ◽  
Daniel Muresan ◽  
Ioana Rotar ◽  
Mariana Tanc ◽  
Paul Cotutiu ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Obstet Gynecol ◽  
Delivery Mode ◽  
Study Group ◽  
Maternal Complications ◽  
Continuous Growth ◽  
The Past ◽  
Obstetrical Interventions ◽  
Multiparous Women ◽  
Primiparous Women

ABSTRACT Aim Age at delivery has increased in the past decades, leading to a continuous growth of the number of women planning a pregnancy after the age of forty. Because delivering after this age is associated with an increased rate of maternal complications, the objective of this study was to analyze the delivery related issues in women ≥40 years of age. Materials and methods This was a retrospective study conducted in the 1st Clinic of Obstetrics and Gynecology, Cluj-Napoca in a 3-year period. One hundred and forty-two patients ≥40 years of age that delivered between 2010 and 2012 were included in the analysis. Results The frequency of deliveries after the age of 40 was 2.42% of all the deliveries. Eighty percent of nulliparous and 51.72% of multiparous women delivered by cesarean section. A significantly higher percentage of primiparous women delivered by cesarean section compared to secundiparous women (p = 0.0007). Fetal weight was significantly higher in multiparous than in primiparous women in the CS group (p = 0.01). No differences were observed between the Apgar scores according to the delivery mode or parity in the study group. Conclusion Delivery after 40 years of age is associated with an increased number of obstetrical interventions. Abbreviations CS: Cesarean section; 1p: Primiparous; 2p: Secundiparous; 3p: Tertiparous; >1p: Multiparous. How to cite this article Rotar I, Muresan D, Tanc M, Cotutiu P, Giurgiu C, Stamatian F. Childbearing after 40 Years: A Challenge of the Modern Obstetrics. Donald School J Ultrasound Obstet Gynecol 2014;8(2):144-148.

scholarly journals Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aazam Shakarami ◽  
Mojgan Mirghafourvand ◽  
Somyieh Abdolalipour ◽  
Mohammad Asghari Jafarabadi ◽  
Mina Iravani
Keyword(s):  
Trait Anxiety ◽  
Self Efficacy ◽  
Care Providers ◽  
Fear Of Childbirth ◽  
Confounding Variables ◽  
Significant Difference ◽  
Multiparous Women ◽  
The Mean ◽  
Efficacy Expectancies ◽  
Primiparous Women

Abstract Background The aim of this study was to compare fear of childbirth, state and trait anxiety, and childbirth self-efficacy among primiparous and multiparous women in Ahvaz, southwest of Iran. Methods This cross-sectional study was conducted with 200 pregnant women (100 primiparous and 100 multiparous women) who had been admitted to the maternity ward of hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The instruments used for data collection in this study included a demographic questionnaire, Delivery Fear Scale (DFS), Spielberger's State-Trait Anxiety Inventory (STAI), and Childbirth Self-Efficacy Inventory (CBSEI). The data were analyzed by chi-square test and independent t-test. Also, the univariate general linear model was used by adjusting for the socio-demographic and obstetric characteristics that were considered as possible confounding variables. Results The mean score of DFS in primiparous women was significantly higher than that of multiparous women. The mean of the overall score of childbirth self-efficacy of primiparous women was significantly lower than that of multiparous women. The mean score of the outcome expectancies and self-efficacy expectancies was significantly lower in primiparous women compared with multiparous women. There was no statistically significant difference between the two groups in terms of the mean score of STAI. After adjusting for possible confounding variables, the differences between the two groups in terms of fear of childbirth scores, overall childbirth self-efficacy score and self-efficacy expectancies remained significant. Conclusion Given the high fear of childbirth and low childbirth self-efficacy in primiparous women compared to the multiparous women, appropriate interventions should be adopted by health care providers in order to reduce fear and improve childbirth self-efficacy in primiparous women.

scholarly journals The Severity of Malarial-Anemia in Pregnant Women in Biyem-Assi, Yaounde

2021 ◽  
pp. 57-68
Author(s):  
Judith Lum Ndamukong-Nyanga ◽  
Ngo Batandi Helen Virginie ◽  
Tchanga Chanceline Flore ◽  
Fegue Celestine Nadege
Keyword(s):  
Pregnant Women ◽  
Demographic Factors ◽  
Sub Saharan Africa ◽  
Multiparous Women ◽  
Study Population ◽  
Health Institutions ◽  
Sub Saharan ◽  
Socio Demographic Factors ◽  
Primiparous Women ◽  
Prevalence Of Anemia

Malaria is a parasitic disease endemic in Sub-Saharan Africa especially in Cameroon. Pregnancy is associated with increased susceptibility to malaria. Closely associated to malaria is anaemia. It is generally accepted that pregnancy ends with childbirth. The outcome of the pregnancy is highly affected by the presence of malaria and anaemia. The aim of ths study was to determine the prevalence and severity of malaria and anemia among pregnant women and the influence of socio-demographic factors on malaria and anaemia prevalences in pregnant women in Biyam- Assi Yaounde. Information on socio-demographic factors was collected from 302 pregnant women attending prenatal clinics in health institutions within the Biyem-Assi Health District of Yaounde VI subdivision using a pretested questionnaire. Peripheral blood was collected and thick smears were prepared for screening Plasmodium parasites. The level of hemoglobin was measured using a haemoglobinometer URIT- 12. Analysis was done using SPSS version 20.0. Out of the 302 women, 146 (51.7%) had Plasmodium falciparum infected red cells. Among the 146 infected women, 36% had mild parasitaemia, 45% had moderate parasitaemia and 19% had severe parasitaemia. The prevalence of anemia in the study population was 53%. There was no significant association between the severity of malaria and the severity of anaemia (p > 0, 05). Parity had a significant influence on the severity of malaria. The level of school education significantly (p < 0, 05) influenced the severity of anaemia. Multiparous women were more affected by malaria than primiparous women. However, in relation to disease severity, primiparous women parasitized by Plasmodium presented a significantly higher risk of severe malaria compared to multiparous women. Malaria and anaemia prevalences in the study population were high (>50%), anaemia severity was directly associated to level of education. We recommend that more sensitization of women should be done to reduce ignorance, prevent malaria and in turn reduce anaemia and improve on the health of mother and baby.

scholarly journals Modeling Risk Factors Associated With Time to Pregnancy Termination in Ethiopia: Application of Frailty Models

2020 ◽  
Author(s):  
Aboma Temesgen Sebu
Keyword(s):  
Risk Factors ◽  
Pregnancy Termination ◽  
Survival Curve ◽  
Frailty Model ◽  
Survival Model ◽  
Frailty Models ◽  
Early Age ◽  
Time To Pregnancy ◽  
Factors Associated ◽  
Number Of Children

Abstract Background: Pregnancy termination commonly known as abortion is the preventable causes for the maternal mortality worldwide that largely forgotten. About 45 % of these pregnancy terminations are unsafe causing death of more than 22,000 women every year and remains major public health problems in developing countries including Ethiopia. This study was also aimed to model and investigate risk factors associated with time to pregnancy termination in Ethiopia by applying survival model considering the clustering effects.Methods: The study considered 15,683 reproductive age group women from 2016 Ethiopian Demographic and Health Survey data. Kaplan-Meier(KM) was employed to estimate the survival curve and this estimated KM survival curve estimated for different groups were tested based on log rank test. To come up with appropriate model for the time to pregnancy termination and the associated risk factors both semi-parametric and parametric survival model with no frailty effects as wells as with shared frailty effects which handles random effects were employed and compared based AIC and BIC of the fitted models.Results: The result of the study showed generalized gamma and lognormal survival models were appropriate models compared with semi-parametric and other candidate parametric models.Fitting these survival model with frailty showed the improvement of the models which was an indication for the presence of unobservable random effects in clusters. Regarding the frailty models comparison, log normal with gamma frailty model was considered as appropriate model for fitting time to pregnancy termination model in Ethiopia compared with other candidate frailty models. Furthermore, the selected frailty model result showed that age of women, ever trying to avoid pregnancy, contraceptive method use, age at first sex, total number of children ever born and place of residence were the identified risk factors for the time to pregnancy termination at 5% level of significance.Conclusions: Based on the finding of this study, starting sex at early age, residing urban areas, having lower number of children, being in married marital status group, chewing chat and do not using contraceptive methods were the risk factors that results pregnancy termination at early age that needs serious consideration to prevent the problem in Ethiopia.

Memories of Labor and Birth: Reliability of Post Partum Questionnaire Reports

1988 ◽  
Vol 67 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Rosemary Cogan ◽  
Susan Perkowski ◽  
Daniel A. Anderson
Keyword(s):  
Post Partum ◽  
Preparation Program ◽  
Multiparous Women ◽  
The Stability ◽  
Childbirth Preparation ◽  
Primiparous Women

The stability of reports of feelings during vaginal births was assessed in three studies. In Study I, post partum reports from 475 primiparous women who participated in a childbirth preparation program were compared to identify differences between reports completed from the day of the birth to more than six weeks after the birth. In Study II, the post partum reports of 46 primiparous and 95 multiparous women completed 1, 3, or 6 mo. after giving birth were compared. In Study III, test-retest reliabilities were calculated for post partum reports completed by 22 primiparous and 16 multiparous women during the 5th and 7th post partum weeks. In these studies, reports of pain during labor were stable.

scholarly journals Intrapartum interventions and outcomes for women and children following induction of labour at term in uncomplicated pregnancies: a 16-year population-based linked data study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047040
Author(s):  
Hannah G Dahlen ◽  
Charlene Thornton ◽  
Soo Downe ◽  
Ank de Jonge ◽  
Anna Seijmonsbergen-Schermers ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Linked Data ◽  
Child Outcomes ◽  
Population Based ◽  
Induction Of Labour ◽  
Vaginal Repair ◽  
Fourth Degree ◽  
Multiparous Women ◽  
Primiparous Women

ObjectivesWe compared intrapartum interventions and outcomes for mothers, neonates and children up to 16 years, for induction of labour (IOL) versus spontaneous labour onset in uncomplicated term pregnancies with live births.DesignWe used population linked data from New South Wales, Australia (2001–2016) for healthy women giving birth at 37+0 to 41+6 weeks. Descriptive statistics and logistic regression were performed for intrapartum interventions, postnatal maternal and neonatal outcomes, and long-term child outcomes adjusted for maternal age, country of birth, socioeconomic status, parity and gestational age.ResultsOf 474 652 included births, 69 397 (15%) had an IOL for non-medical reasons. Primiparous women with IOL versus spontaneous onset differed significantly for: spontaneous vaginal birth (42.7% vs 62.3%), instrumental birth (28.0% vs 23.9%%), intrapartum caesarean section (29.3% vs 13.8%), epidural (71.0% vs 41.3%), episiotomy (41.2% vs 30.5%) and postpartum haemorrhage (2.4% vs 1.5%). There was a similar trend in outcomes for multiparous women, except for caesarean section which was lower (5.3% vs 6.2%). For both groups, third and fourth degree perineal tears were lower overall in the IOL group: primiparous women (4.2% vs 4.9%), multiparous women (0.7% vs 1.2%), though overall vaginal repair was higher (89.3% vs 84.3%). Following induction, incidences of neonatal birth trauma, resuscitation and respiratory disorders were higher, as were admissions to hospital for infections (ear, nose, throat, respiratory and sepsis) up to 16 years. There was no difference in hospitalisation for asthma or eczema, or for neonatal death (0.06% vs 0.08%), or in total deaths up to 16 years.ConclusionIOL for non-medical reasons was associated with higher birth interventions, particularly in primiparous women, and more adverse maternal, neonatal and child outcomes for most variables assessed. The size of effect varied by parity and gestational age, making these important considerations when informing women about the risks and benefits of IOL.

scholarly journals A comparative study of perinatal outcome in primary caesarean in multiparous women to that in nulliparous women

2020 ◽  
Vol 9 (8) ◽  
pp. 3265
Author(s):  
Surabhi Kokate ◽  
Abhishek Kokate
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Tertiary Care Centre ◽  
Chi Square ◽  
Nulliparous Women ◽  
Significant Difference ◽  
Multiparous Women ◽  
Primiparous Women

Background: To compare indication, incidence, complication, fetal and maternal morbidity and mortality in primary caesarean section in multiparous women and nulliparous women. Objective of this study was to compare perinatal outcome of caesarean section in multiparous women to that in nulliparous women.Methods: It is a prospective observational study conducted in a tertiary care centre during April 2017 to April 2018. All patients who delivered vaginally and abdominally were noted during study period. All patients undergoing primary caesarean section were noted. Their indication, incidence and complication throughout stay were noted. Statistics were calculated separately for multiparous women and primiparous women. Statistical analysis was done using chi square test.Results: Total 150 primary caesarean section in primiparous women and 100 primary caesarean section in multiparous women were done.  Fetal distress and meconium stained amniotic fluid forms the most common indication in study. Birth weight of babies was more in multiparous women. Need of blood and blood products was more in multiparous women compared to nulliparous women. Complications like postpartum fever and wound gape was more in multiparous women.Conclusions: In the study population significant difference was seen between the indication and complication between multiparous and nulliparous women.

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