scholarly journals Effect of complete adherence to antenatal care guideline during first visit on maternal and neonatal complications during the intrapartum and postpartum periods: a prospective cohort study in Northwest Ethiopia

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049271
Author(s):  
Tewodros Seyoum ◽  
Mekuriaw Alemayehu ◽  
Kyllike Christensson ◽  
Helena Lindgren
Keyword(s):  
Cohort Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Northwest Ethiopia ◽  
Exposed Group ◽  
Neonatal Outcomes ◽  
Negative Binomial Regression Model ◽  
Neonatal Complications

ObjectivesTo examine the relationship between complete of providers’ adherence to antenatal care (ANC) guideline during first visit and maternal and neonatal complications during intrapartum and postpartum periods.DesignProspective cohort study.SettingGondar town public health facilities in Northwest, Ethiopia.ParticipantsA total of 832 pregnant women with gestational age <28 weeks who came for first ANC visit were enrolled and followed up to the first 6 hours of the postpartum periods.ExposureProviders’ adherence to ANC guideline during first visit was the exposure variable. An 18-point checklist was used to record the level of providers’ adherence. Clients who received care from providers who adhered completely to the guideline constituted the ‘exposed group’, and those who did not receive such care constituted the ‘unexposed group’.Main outcomesMaternal and neonatal complications occurred during the intrapartum and postpartum periods.Data analysisNegative binomial regression model was used to analyse the data. The adjusted incidence risk ratio (AIRR) with 95% CI was reported in the final model.ResultsA total of 782 pregnant women were followed up and included in the final analysis (254 in the exposed group and 528 non-exposed). Complete adherence to the guidelines during first visit reduced the risk of neonatal complications (AIRR 0.56; 95% CI 0.39 to 0.79). However, complete adherence to the guidelines was not found to have a statistically significant effect on maternal complications (AIRR 0.84; 95% CI 0.67 to 1.05) during the intrapartum and the postpartum periods.ConclusionsThe group that received care from providers who completely adhered to the ANC guidelines during the first antenatal visit showed significantly improved neonatal outcomes. However, it did not show a significant improvement in maternal outcomes. Hence, focusing on safe motherhood programmes like training that gears provider’s conformity to ANC guideline is quite crucial to improve neonatal outcomes.

scholarly journals Incidence and Predictors of Pre-Eclampsia Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, North West Ethiopia: Prospective Cohort Study

2020 ◽  
Vol Volume 12 ◽  
pp. 1013-1021
Author(s):  
Molla Yigzaw Birhanu ◽  
Habtamu Temesgen ◽  
Gebreselassie Demeke ◽  
Moges Agazhe Assemie ◽  
Alehegn Aderaw Alamneh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Referral Hospital ◽  
North West ◽  
North West Ethiopia ◽  
Debre Markos

scholarly journals Serum hepcidin and iron status parameters in pregnant women and the association with adverse maternal and fetal outcomes: a study protocol for a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032280
Author(s):  
Gabriela Amstad Bencaiova ◽  
Deborah Ruth Vogt ◽  
Irene Hoesli
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Gestational Hypertension ◽  
Smoking Status ◽  
Iron Status ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Serum Hepcidin

IntroductionHepcidin production is normally upregulated by iron stores, and in obesity has been shown to be overexpressed and correlated with low iron status. The increased hepcidin may restrain the iron release from the cells by affecting the expression of ferroportin, which probably associates with the development of diabetes complication. First, we investigate the difference of serum hepcidin and iron parameters between obese and non-obese pregnant women; second, we examine the correlation between serum hepcidin and adverse maternal and neonatal outcomes in pregnant women.Methods and analysisThis is a mono-centre, prospective cohort study with a study (obese) and a control group (non-obese women). In the first trimester, 188 singleton pregnancies will be recruited. Thereof, we expect 75 with a body mass index (BMI) ≥30 kg/m2and 113 with a BMI 18.5–30 kg/m2. Serum hepcidin, iron and haematological parameters will be measured at 11–14, 24–28, 32–36 weeks of gestation and at time of delivery. Blood pressure, weight, BMI and smoking status will be examined at all visits. We will assess the composite endpoints adverse maternal outcomes (including pre-eclampsia, gestational hypertension, gestational diabetes mellitus, haemorrhage, placenta abruption) and adverse neonatal outcomes (preterm birth, intrauterine growth restriction, preterm premature rupture of membranes, Apgar score <7 at 5 min, stillbirth, neonatal death).Recruitment has started in April 2019.Ethics and disseminationThis study received ethical approval from the ethics committee in Basel. The results of the study will be published in a peer-reviewed journal, and presented at national scientific conferences.Trial registration numberNCT03792464.

scholarly journals High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244072
Author(s):  
Sushma Rajbanshi ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Risk Stratification ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Maternal Morbidity ◽  
Low Risk ◽  
Severe Maternal Morbidity

Background The early identification of pregnant women at risk of developing complications at birth is fundamental to antenatal care and an important strategy in preventing maternal death. This study aimed to determine the prevalence of high-risk pregnancies and explore the association between risk stratification and severe maternal morbidity. Methods This hospital-based prospective cohort study included 346 pregnant women between 28–32 gestational weeks who were followed up after childbirth at Koshi Hospital in Nepal. The Malaysian antenatal risk stratification approach, which applies four color codes, was used: red and yellow denote high-risk women, while green and white indicate low-risk women based on maternal past and present medical and obstetric risk factors. The World Health Organization criteria were used to identify women with severe maternal morbidity. Multivariate confirmatory logistic regression analysis was performed to adjust for possible confounders (age and mode of birth) and explore the association between risk stratification and severe maternal morbidity. Results The prevalence of high-risk pregnancies was 14.4%. Based on the color-coded risk stratification, 7.5% of the women were categorized red, 6.9% yellow, 72.0% green, and 13.6% white. The women with high-risk pregnancies were 4.2 times more likely to develop severe maternal morbidity conditions during childbirth. Conclusions Although smaller in percentage, the chances of severe maternal morbidity among high-risk pregnancies were higher than those of low-risk pregnancies. This risk scoring approach shows the potential to predict severe maternal morbidity if routine screening is implemented at antenatal care services. Notwithstanding, unpredictable severe maternal morbidity events also occur among low-risk pregnant women, thus all pregnant women require vigilance and quality obstetrics care but high-risk pregnant women require specialized care and referral.

scholarly journals Complete adherence to antenatal care guideline during the first visit and antepartum complications in public health facilities: a prospective cohort study in Northwest Ethiopia

2021 ◽  
Author(s):  
Tewodros Seyoum ◽  
Mekuriaw Alemayehu ◽  
Kyllike Christensson ◽  
Helena Lindgren
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Health Facilities ◽  
Maternal Complications ◽  
Public Health Facilities ◽  
The Relationship

Abstract Background Adherence to a minimum level of recommended content during the first Antenatal care (ANC) is low in Ethiopia but less is known about if there is an association between the level of adherence to focused ANC guideline and pregnancy outcomes. Therefore, the goal of this study was to examine the relationship between the level of adherence to Ethiopian ANC guidelines during the first visit and maternal complications that occur during the antepartum period. Methods A prospective cohort study was conducted in Gondar town public health facilities from May, 2019, to January, 2020. A total of 832 pregnant women with gestational age < 28 weeks who came for their first ANC visit were enrolled and followed until their last visit or before the commencement of labor. An 18-point checklist was used to record the level of providers’ adherence. Clients who received all the components in the ANC guideline during the first visit adhered to by the provider were considered as an exposed group. A Log-binomial model was used to examine the relationship between the level of adherence to the guideline and the risk of antenatal complications. The adjusted Relative Risk (ARR) with a 95% Confidence Interval (CI) was reported in the final model. Result A total of 808 pregnant women were included in the final analysis. Complete providers’ adherence was associated with a lower risk of anemia (ARR = 0.54; 95% CI: 0.31, 0.94), but with a higher risk for Pregnancy-induced hypertension (ARR = 1.71; 95% CI: 1.04, 2.81). Conclusions Complete providers’ adherence to the first ANC guideline influences maternal complications during antepartum period. Therefore, improving the level of adherence by the provider to the ANC guideline during the first visit is very important.

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