Episiotomy and its relationship to various clinical variables that influence its performance

Objective: to understand the episiotomy rate and its relationship with various clinical variables. Method: a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results: the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions: episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure.

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Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031239 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1239

Author(s):

Moon-Sook Kim ◽

Hyun-Myung Jung ◽

Hyo-Yeon Lee ◽

Jinhyun Kim

Keyword(s):

Risk Factors ◽

Fall Prevention ◽

Medical Records ◽

Brain Injuries ◽

Tertiary Hospital ◽

Antiplatelet Drugs ◽

Cross Sectional ◽

Complete Survey ◽

Serious Injury ◽

Serious Injuries

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

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Objective assessment of alcohol consumption in early pregnancy using phosphatidylethanol: a cross‐sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03804-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leonieke J. Breunis ◽

Sophie Wassenaar ◽

Barbara J. Sibbles ◽

Ab A. Aaldriks ◽

Hilmar H. Bijma ◽

...

Keyword(s):

Alcohol Consumption ◽

Early Pregnancy ◽

Gestational Age ◽

Care Provider ◽

Objective Assessment ◽

Obstetric Care ◽

Tertiary Hospital ◽

Maternal Blood ◽

Added Value ◽

Cross Sectional

Abstract Background Alcohol consumption during pregnancy is associated with major birth defects and developmental disabilities. Questionnaires concerning alcohol consumption during pregnancy underestimate alcohol use while the use of a reliable and objective biomarker for alcohol consumption enables more accurate screening. Phosphatidylethanol can detect low levels of alcohol consumption in the previous two weeks. In this study we aimed to biochemically assess the prevalence of alcohol consumption during early pregnancy using phosphatidylethanol in blood and compare this with self-reported alcohol consumption. Methods To evaluate biochemically assessed prevalence of alcohol consumption during early pregnancy using phosphatidylethanol levels, we conducted a prospective, cross-sectional, single center study in the largest tertiary hospital of the Netherlands. All adult pregnant women who were under the care of the obstetric department of the Erasmus MC and who underwent routine blood testing at a gestational age of less than 15 weeks were eligible. No specified informed consent was needed. Results The study was conducted between September 2016 and October 2017. In total, we received 1,002 residual samples of 992 women. After applying in- and exclusion criteria we analyzed 684 samples. Mean gestational age of all included women was 10.3 weeks (SD 1.9). Of these women, 36 (5.3 %) tested positive for phosphatidylethanol, indicating alcohol consumption in the previous two weeks. Of women with a positive phosphatidylethanol test, 89 % (n = 32) did not express alcohol consumption to their obstetric care provider. Conclusions One in nineteen women consumed alcohol during early pregnancy with a high percentage not reporting this use to their obstetric care provider. Questioning alcohol consumption by an obstetric care provider did not successfully identify (hazardous) alcohol consumption. Routine screening with phosphatidylethanol in maternal blood can be of added value to identify women who consume alcohol during pregnancy.

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Gestational Age Specific Postnatal Growth Curves for Singleton Babies in Tertiary Hospital of Western Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.3105 ◽

2017 ◽

Vol 56 (207) ◽

pp. 325-330

Author(s):

Santosh Pathak ◽

Nagendra Chaudhary ◽

Prativa Dhakal ◽

Shyam Kumar Mahato ◽

Sandeep Shrestha ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Economic Status ◽

Tertiary Care ◽

Growth Curves ◽

Tertiary Hospital ◽

Care Hospital ◽

Cross Sectional ◽

Intrauterine Growth ◽

Geographical Regions

Introduction: Measurement of birth weight (BW), crown heel length (CHL), head circumference (HC) and chest circumference used to assess the intrauterine growth of a baby vary with altitude, race, gender, socio economic status, maternal size, and maternal diseases. The study aimed to construct centile charts for BW, CHL and HC for new born at different gestational ages in western Nepal. Methods: This was a descriptive cross sectional study done over a period of 15 months in a tertiary care hospital of western Nepal. BW, length, HC and CC were measured within 12-24 hours of birth. Gestational age was estimated from first day of last menstrual period, maternal ultrasonology and New Ballard’s scoring system. Microsoft 2007 Excel and SPSS-16 was used for data analysis. Cole’s Lambda Mu Sigma method was used for constructing centile curves. Results: Out of 2000 babies analysed, 1910 samples were used to construct smoothed intrauterine growth curve of BW, CHL, and HC from 33-42 weeks of gestation. 57.35% (1147) were male, mean gestational age was 38.13 ±2.44 weeks, where 21.5% were preterm and 1.7% post term. The means of BW, CHL, HC and CC were 2744.78 gm, 47.80 cm, 33.18 cm, and 30.20 cm with standard deviations of 528.29, 3.124, 1.78, and 2.35 respectively. These data vary as compared to the Kathmandu data, in case of birth weight for 10th and 90th centiles, and at 90th centile in case of length. Conclusions: This necessitates the update in the existing growth charts and develop in different geographical regions of a country.

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Maternal Prenatal Anthropometry, High Education and Cesarean Delivery as Risk Factors for Low Gestational Age in Iran

Open Medicine Journal ◽

10.2174/1874220301603010077 ◽

2019 ◽

Vol 6 (1) ◽

pp. 77-82

Author(s):

Sorayya Kheirouri ◽

Mohammad Alizadeh ◽

Parvin Sarbakhsh

Keyword(s):

Risk Factors ◽

High Education ◽

Preterm Birth ◽

Cesarean Delivery ◽

Gestational Age ◽

Economic Status ◽

Cross Sectional ◽

Data Set ◽

Pregnancy Weight ◽

High Bmi

Background: Preterm birth is an important contributor to the global burden of disease. Evidence indicating that maternal health, nutritional and socioeconomic status may contribute to preterm birth. Objective: This cross-sectional study was conducted to describe the contribution of prenatal maternal factors on low gestational age, and to assess newborns anthropometric measurements regarding gestational age. Methods: Data of mothers delivering a singleton live infant (n= 759) and their newborns (n= 755) during the two years up to August 2014 were collected. Data were collected from the data set of eight public health centers which were chosen from different administrative regions of Tabriz city and were analyzed. Differences between the groups were assessed by Student’s t-test or one- way analysis of variance (ANOVA). Multiple linear regression was used to estimate the association between gestational age and variables studied. Results: Incidence of preterm birth was 2.1%. Percentage of infants with low birth weight and Head Circumference (HC) under 34 cm was significantly higher in the preterm group. Mean gestational age was lower in mothers with cesarean delivery, high education, high economic status, high BMI, pre-pregnancy weight ≥ 65 kg and medical problem. Gestational age was inversely associated with maternal pre-pregnancy weight ≥ 65 kg (B= -0.20, p= 0.02), high BMI (B= -0.33, p= 0.01), high education (B= -0.47, p= 0.002) and cesarean delivery (B= -0.74, p< 0.001). Conclusion: The results indicate that maternal anthropometric characteristics, education and type of delivery are associated with gestational age. Explorating potentially modifiable risk factors for unfavorable gestational age and integrating them into intervention efforts may ameliorate adverse birth outcomes.

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CONSANGUINITY AND MATERNAL AGE;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.04.1458 ◽

2017 ◽

Vol 24 (04) ◽

pp. 511-515

Author(s):

Nayyab Zehra ◽

Ahmed Hassaan Malik ◽

Zahabia Khalid ◽

Misha Sabir ◽

Simra Tanvir ◽

...

Keyword(s):

Family History ◽

Gestational Age ◽

Maternal Age ◽

Sampling Technique ◽

Reproductive Age ◽

Military Hospital ◽

Age Group ◽

Spontaneous Abortions ◽

Cross Sectional ◽

History Of

Objectives: To determine the frequency of risk factors i.e. consanguinity andmaternal age associated with spontaneous abortions in Pakistan and to propose ways toreduce them. Study design: Cross sectional descriptive study. Place of study: Gynecologydepartment of Military Hospital and Combined Military Hospital, Rawalpindi. Duration ofstudy: 6 months (September 2015 to February 2016). Sampling technique: Non probabilityconvenient sampling. Methodology: 150 married female patients in reproductive age group(15-49 years), who were confirmed cases of pregnancy and presented with abortions, wereinterviewed and responses were filled in a structured questionnaire after written consent.The collected data was then entered and analyzed by SPSS 20.0. Results: The major bulkof spontaneous abortions occurred in the maternal age group of 25-35 years (55.3%). A totalof 53.3% of abortions occurred in the gestational age of less than 12 weeks. Around 54.7% offemales had family history of spontaneous abortions and 65.3% had consanguineous marriage.Conclusion: Spontaneous abortions occur more frequently in the females of 25-35 yearsage group and among the fetuses with gestational age less than 12 weeks (1st trimester ofpregnancy). Family history of spontaneous abortions and consanguinity are associated withspontaneous abortions.

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A study of low birth weight prevalence and risk factors among newborns in a public-hospital at Kilis, Turkey

African Health Sciences ◽

10.4314/ahs.v20i2.22 ◽

2020 ◽

Vol 20 (2) ◽

pp. 709-714

Author(s):

Hasan Hüseyin Çam ◽

Muazzez Harunoğulları ◽

Yadigar Polat

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Maternal Age ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Cross Sectional ◽

Important Indicator ◽

Maternal Risk ◽

Syrian Refugee

Background: Low birth weight (LBW) is an important indicator of reproductive health and general health status of population. Objectives: The present study was aimed to estimate the prevalence of low birth weight (LBW), and to investigate the associations between some risk factors and LBW in Syrian refugee and Turkish population in Kilis, Turkey. Methods: The population of this study constituted of a total of 4379 infants born in Kilis State Hospital in 2016 using a retrospective cross-sectional study design. The data were collected from birth records. The data were analyzed using SPSS version 16.0. Binary logistic regression analysis was performed to identify predictors of low birth weight. Factors with a p-value < 0.05 were deemed to be statistically significant. Results: The prevalence of LBW was 6.7% in all groups. Significant relationships were found between young maternal age, Syrian refugee mother, female infants, cesarean delivery and LBW. Conclusion: The prevalence of low birth weight in the study area was comparatively lower than that of countrywide figure. Maternal related variables like, maternal age, mother's nationality, and mode of birth (vaginal, cesarean) take after up as well as new-born related variables like gender of the neonate were significantly related with low birth weight. Keywords: Low birth weight; maternal; risk factors,; prevalence.

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Influence of Patient-Level Factors on Mode of Delivery among Operative Vaginal Delivery Candidates in Modern Practice

American Journal of Perinatology ◽

10.1055/s-0037-1601441 ◽

2017 ◽

Vol 34 (10) ◽

pp. 0974-0981 ◽

Cited By ~ 1

Author(s):

Christina Gonzalez ◽

Amanda Allshouse ◽

Erick Henry ◽

Sean Esplin ◽

Torri Metz

Keyword(s):

Vaginal Delivery ◽

Gestational Age ◽

Maternal Age ◽

Mode Of Delivery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Second Stage ◽

Patient Level ◽

Operative Vaginal Delivery

Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logistic modeling adjusting for clustering within physician and hospital. Results Total 3,771 (64%) women delivered with forceps, 1,474 (25%) vacuums, and 665 (11%) cesareans. Odds of forceps versus vacuum were higher with induction (OR = 2.16, 95% CI: 1.76–2.65), nulliparity (OR = 2.06, 95% CI: 1.59–2.66), epidural (OR = 2.05, 95% CI: 1.19–3.56), maternal indication (OR = 1.53, 95% CI 1.16–2.02), older maternal age (OR 1.18, 95% CI 1.06–1.31 per 5 years), and longer second stage (OR = 1.10, 95% CI: 1.01–1.20 per hour).Odds of cesarean versus operative vaginal delivery were higher with maternal indication (OR = 9.0, 95% CI: 7.23–11.20), a perinatologist (OR = 2.51, 95% CI: 1.09–5.78), longer second stage (OR = 1.79, 95% CI: 1.65–1.93 per hour), older gestational age (OR = 1.10, 95% CI: 1.01–1.20 per week), and longer labor (OR = 1.02, 95% CI: 1.01–1.04 per hour). Conclusion Patient-level factors influence the decision to proceed with an operative vaginal delivery and the choice of instrument, thereby emphasizing the importance of maintaining availability of both forceps and vacuums.

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Birthweight Discordance, Risk Factors and its Impact on Perinatal Mortality Among Japanese Twins: Data From a National Project During 2001–2005

Twin Research and Human Genetics ◽

10.1375/twin.13.5.490 ◽

2010 ◽

Vol 13 (5) ◽

pp. 490-494 ◽

Cited By ~ 10

Author(s):

Ruoyan Gai Tobe ◽

Rintaro Mori ◽

Norio Shinozuka ◽

Takahiko Kubo ◽

Kazuo Itabashi

Keyword(s):

Risk Factors ◽

Perinatal Mortality ◽

Gestational Age ◽

Maternal Age ◽

Delivery Mode ◽

Clinical Practices ◽

Sex Composition ◽

Assisted Reproduction Technologies ◽

Care Project ◽

Perinatal Health Care

Our aims were to assess the incidence of birthweight discordance of twins, to explore risk factors and its impact on perinatal mortality, and to quantify the risks at different severity of birthweight discordance in Japan, by using a nationwide obstetric database. There were 10,828 pairs of twins, born from 2001 to 2005 recorded in the database of the national Perinatal Health Care Project, fully enrolled. The overall incidence of birthweight discordance was 47.34%. The incidence of mild, severe and extremely severe discordance was 19.26%, 10.21% and 17.87%, respectively. The incidence of birthweight discordance in Japan is much higher than that in other countries, particularly at higher severity level. By linear regression model, our study added independent factors of primiparity (p < .001), sex composition (p < .001), chorionicity (p < .001), gestational age (p < .001), and delivery mode (p < .001) in determining birthweight discordance percentage. Maternal age and application of assisted reproduction technologies (ART) didn't significantly influence the birthweight discordance. The birthweight discordance is closely associated with gestational age and affected discharge mortality. From 25% of birthweight discordance, risk to discharge mortality tended to significantly increase, suggesting it should be added as a reference for clinical practices.

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RISK FACTORS FOR PREMATURE BIRTH IN INDONESIA

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v10i1.2021.61-67 ◽

2021 ◽

Vol 10 (1) ◽

pp. 61

Author(s):

Hafiza Ajeng Dianing Sukma ◽

Sagar Tiwari

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Child Health ◽

Maternal And Child Health ◽

Premature Birth ◽

Maternal Age ◽

Smoking Habits ◽

Cross Sectional ◽

Neonatal Deaths ◽

And Child Health

Indonesia is currently taking on the challenge of the relatively high number of neonatal deaths influencing maternal and child health. Premature birth is the most significant contributor to the number of neonatal deaths. The occurrence of premature birth is motivated by various risk factors. Knowing the magnitude of the relationship between several risks, namely maternal age, location, parity, and maternal smoking habits with preterm birth incidents was the aim of this study. The 2017 Indonesian Demographic and Health Survey (IDHS) was a source of data used. This study employed a cross-sectional approach and then processed the results with univariate and bivariate tests. The results showed a relationship between maternal age and residential area with the premature birth, where mothers under 20 years and over 35 years had a higher probability of giving birth prematurely. The area of residence, which was divided into rural and urban, also had a relationship with premature birth. The parity and smoking habits showed no association with preterm birth. Education, Antenatal Care (ANC), and other various efforts to emphasize maternal and child health care during pregnancy need to be continuously improved to reduce preterm birth rates in Indonesia.

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Prevalence and risk factors associated with low birth weight babies-a cross sectional study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212466 ◽

2021 ◽

Vol 8 (7) ◽

pp. 1168

Author(s):

Gurunathan Gopal

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Maternal Risk ◽

Factors Associated ◽

The World

Background: Babies with a birth weight of less than 2500 grams, irrespective of the period of their gestation are termed as low birth weight (LBW) babies. Despite consistent efforts to improve the quality of maternal and child health, more than twenty million LBW babies are born every year throughout the world. The present study was to explore the effects of various maternal risk factors associated with low birth-weight of institutionally delivered newborns. Across the world, neonatal mortality is 20 times more likely for LBW babies compared to normal birth weight (NBW) babies (>2.5 kg).Methods: A cross sectional study was conducted in neonatal intensive care unit (NICU) of ACS Medical College and Hospital, Chennai from December 2019 to October 2020. Altogether 350 babies were taken who were delivered at ACS hospital.Results: The number of times of ANC attendance was also significantly associated with LBW, odds ratio (OR)=1.296, and p=0.001. The number of meals was not associated with LBW OR=0.946, and p=0.831. The gestational age assessed as completed weeks of pregnancy was significantly associated with LBW OR=3.302; p=0.00001.Conclusions: This study suggests that there are several factors interplaying which lead to LBW babies. Socio-demographic factors (maternal age and gestational age) and antenatal care are more important.

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