Maternal Sleep and Related Pregnancy Outcomes: A Multicenter Cross-sectional Study in 11 Provinces of Iran

Objective: Sleep disturbance during pregnancy is one of the most common maternal complaints. Not only does it play a crucial role in a mother’s life, but also it comes with a multitude number of complications. This study aimed at assessing the association between sleep disturbance in pregnancy and maternal and child outcomes. Materials and methods: This was a multicenter cross-sectional study, conducted on pregnant women across 11 provinces in Iran in 2018. Sleep disturbance as a composite variable was defined using the principal component analysis based on five questions. Abortion, anemia in the first and third trimester, gestational diabetes, gestational age, glucose tolerance test (GTT), fasting blood sugar (FBS), mode of delivery, low birth weight and stillbirth were defined as study outcomes. Results: Totally, 3675 pregnant women enrolled in the study. Most of the participants (84.5%) reported that their sleep duration is less than 8 hours per day. The prevalence of sleep disturbance was 20.7% (95% CI: 19.1, 22.3). After adjusting for maternal age, education, job, place of residency and physical violence, sleep disturbance would increase the odds of abortion (p=0.009), anemia in both first (p=0.001) and third (p=0.003) trimester, gestational age (p=0.049), abnormal FBS (p=0.015) and cesarean section (p<0.001). Conclusion: Regarding the effect of sleep quality on maternal outcomes, planning and implementing a suitable intervention in the context of primary health care is necessary. Increasing the awareness of mothers, health workers and medical personnel about the suitable quality and quantity of sleep during pregnancy is of great importance.

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Serum Concentrations of Selected Organochlorines in Pregnant Women and Associations with Pregnancy Outcomes. A Cross-Sectional Study from Two Rural Settings in Cambodia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207652 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7652

Author(s):

Margit Steinholt ◽

Shanshan Xu ◽

Sam Ol Ha ◽

Duong Trong Phi ◽

Maria Lisa Odland ◽

...

Keyword(s):

Polychlorinated Biphenyls ◽

Pregnant Women ◽

Gestational Age ◽

Low Income ◽

Cross Sectional Study ◽

Maternal Serum ◽

Sectional Study ◽

Serum Samples ◽

Cross Sectional ◽

Rural Settings

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.

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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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A cross-sectional study to determine the use of alternative medicines during pregnancy in the district hospitals in Manicaland, Zimbabwe

African Health Sciences ◽

10.4314/ahs.v20i1.11 ◽

2020 ◽

Vol 20 (1) ◽

pp. 64-72

Author(s):

Liphapang Dimene ◽

Mutseyekwa Fadzai ◽

Jephat Chifamba ◽

Gerald Nyakatawa ◽

Carol Mahachi ◽

...

Keyword(s):

Pregnant Women ◽

Traditional Medicine ◽

Family Income ◽

Mode Of Delivery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Traditional Medicines ◽

District Hospitals ◽

Medicines Use

Background: Traditional medicines are widely used in the rapidly growing health system and are of economic importance. The study aimed at determining the frequency, pattern of use and factors that influence traditional medicines use during pregnancy. Materials and methods: A cross-sectional study was carried out at four district hospitals in Manicaland, Zimbabwe, using questionnaire based convenience sampling. Results: Traditional medicines use was found to be high with 54% (n = 337) of pregnant women using traditional medicines during pregnancy. The major purpose of use of traditional medicine was found to be preparation for delivery; cervical dila- tion in particular. The following factors showed a significant statistical association for use of traditional medicines: previous mode of delivery (p = 0.006), level of education (p = 0.016), family income (p = 0.007), and residential settlement (p = 0.026). Some of the common traditional medicines used during pregnancy include Camellia sinensis, Aloe, Spirostachys Africana, Thumbergia lancifolia, Dalbergiella nyasae, Steganotaenia oraliacea, Stomatostemma monteiroae and Cussonia arborea. Conclusion: A number of pregnant women use traditional medicines as partus preparators (labour aids) throughout the entire pregnancy period. This calls for obstetricians, general practitioners and midwives to inquire about use of traditional medicine in history. Keywords: Traditional medicines; pregnancy; Zimbabwe.

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Prenatal distress level and its predictors according to the gestational age in pregnant women in the semi-urban region in Northwestern Turkey: A cross-sectional study

10.21203/rs.3.rs-90838/v1 ◽

2020 ◽

Author(s):

Yeliz Mercan ◽

Kevser TARI SELCUK ◽

Figen DIGIN ◽

Hasan SAYGIN

Keyword(s):

Social Support ◽

Pregnant Women ◽

Gestational Age ◽

Cross Sectional Study ◽

Education Level ◽

Urban Region ◽

Sectional Study ◽

Cross Sectional ◽

Northwestern Turkey ◽

Prenatal Distress

Abstract Background: The aim of the present study was to determine the level and predictors of prenatal distress in pregnant women according to gestational age.Methods: This a cross-sectional study was conducted in eight Family Health Centers (FHCs) in Kirklareli, in Turkey. The study included 179 pregnant women who presented to the FHCs, who were at ≥12th week of gestation. Results:The frequency of prenatal distress in the participants was 21.2% (between 12th-27th weeks:16.5%, between 28th-41st weeks: 26.8%). It was found that level of education, age of the spouse, current pregnancy being unplanned, and social support levels were associated with the level of prenatal distress in ≥12th week or between 12th-27th weeks or between 28th-41st weeks (p<0.05). And also, perceived income level, abortion, and the number of pregnancies were associated with the level of prenatal distress in ≥12th weeks; the age of women, perceived income levels, previous abortion experience, and the number of pregnancies were associated with the level of prenatal distress in between 12th-27th weeks; the age of women, education level of spouse', and previous birth experience prenatal distress levels were associated in between 28th-41st weeks (p<0.05).Conclusion: The level of prenatal distress according to the gestational age, the education level of the woman, the age of her spouse’, the unplanned pregnancy, and social support levels were predictors. In both periods, the age of women were determinants in prenatal stress levels in pregnant women. Pregnant women should be screened and evaluated for prenatal distress in their application to FHCs.

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Perceptions of pregnant woman on monetary and time sacrifice for satisfaction based on health workers roles in antenatal services to reduce the risk of maternal death at Gowa district

Health Science Journal of Indonesia ◽

10.22435/hsji.v10i2.2444 ◽

2019 ◽

Vol 10 (2) ◽

pp. 111-118

Author(s):

Serawati Dewi ◽

Yuni Romalita ◽

Yusriani Yusriani ◽

Muhammad Khidri Alwi

Keyword(s):

Maternal Health ◽

Antenatal Care ◽

Pregnant Women ◽

Study Design ◽

Health Workers ◽

Sampling Technique ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Latar belakang: Angka Kematian Ibu (AKI) merupakan salah satu indikator pembangunan kesehatan di Indonesia. Upaya percepatan penurunan AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu hamil yang berkualitas. Apabila antenatal care dimanfaatkan dengan baik maka kesehatan ibu dapat terpantau secara berkesinambungan dari masa kehamilan sampai dengan persalinan. Metode: Desain penelitian adalah kuantitatif dengan rancangan cross sectional study. Populasi pada penelitian ini adalah semua ibu yang memiliki bayi usia 0-11 bulan di Kabupaten Gowa sebanyak 122 orang. Sampel sebanyak 93 orang diambil dengan menggunakan teknik accidental sampling, besar sampel ditentukan dengan menggunakan rumus Slovin Hasil: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi. Ibu hamil yang memiliki persepsi pengorbanan moneter kecil dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90,0%. Ibu hamil yang memiliki persepsi pengorbanan moneter sangat kecil dan mengatakan peran petugas kesehatan kurang sebanyak 83.1%. Sedangkan persepsi pengorbanan waktu menunjukkan adanya korelasi dengan peran petugas kesehatan dalam pelayanan antenatal. Ibu hamil yang memiliki persepsi pengorbanan waktu besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 100%. Ibu hamil yang memiliki persepsi pengorbanan moneter besar dan mengatakan peran petugas kesehatan kurang dalam pelayanan antenatal sebanyak 90.2%. Kesimpulan: Persepsi ibu hamil terhadap peran petugas kesehatan dalam pelayanan antenatal berdasarkan pengorbanan moneter tidak menunjukkan korelasi sedangkan berdasarkan pengorbanan waktu menunjukkan ada korelasi. Perlu meningkatkan kecepatan proses pelayanan pemeriksaan kehamilan pada ibu hamil oleh tenaga kesehatan. Kata kunci: Pelayanan antenatal, Ibu Hamil, Pengorbanan, Waktu, Moneter Abstract Background: Maternal Mortality Rate (MMR) is one indicator of health development in Indonesia. Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services. If antenatal care is utilized properly, maternal health can be monitored continuously from pregnancy to delivery. Methods: The study design was quantitative with a cross sectional study design. The population in this study were all pregnant women who had a gestational age of 7 to 9 months in Gowa Regency as many as 122 people. A sample of 93 people was taken using accidental sampling technique, the sample size was determined using the Slovin formula. Results: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice did not show a correlation. Pregnant women who have a perception of small monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.0%. Pregnant women who have a perception of monetary sacrifice are very small and say the role of health workers is less as much as 83.1%. While the perception of sacrifice of time shows a correlation with the role of health workers in antenatal care. Pregnant women who have the perception of sacrifice of big time and say the role of health workers lacking in antenatal care as much as 100%. Pregnant women who have a perception of great monetary sacrifice and say the role of health workers is lacking in antenatal care are 90.2%. Conclusion: Perception of pregnant women towards the role of health workers in antenatal care based on monetary sacrifice does not show correlation while based on time sacrifice shows there is correlation. Need to increase the speed of the process of pregnancy examination services for pregnant women by health workers. Keywords: Antenatal care, Pregnant Women, Sacrifice, Time, Monetary

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Perinatal determinants of D-dimer levels in a cross-sectional study of low risk pregnant women

Obstetric Medicine ◽

10.1177/1753495x15625547 ◽

2016 ◽

Vol 9 (2) ◽

pp. 78-82

Author(s):

NM Murphy ◽

AS Khashan ◽

DI Broadhurst ◽

O Gilligan ◽

K O’Donoghue ◽

...

Keyword(s):

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Elective Caesarean Section ◽

Mode Of Delivery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

D Dimer ◽

In Pregnancy

Background To examine perinatal determinants of the antenatal levels of D-dimers. Methods Cross-sectional study of 760 low risk pregnant women recruited into five gestational groups. Variables examined in antenatal groups included maternal age, body mass index, parity, smoking, family history venous thromboembolism (VTE) and previous use of the oral contraceptive pill (OCP). Onset of labour and mode of delivery were also examined in the post-natal group. Results D-dimer levels in group 4 (38–40 + 6) were significantly lower in the women with a history of taking the OCP when compared to those that had not taken it in the past ( P = 0.027). In the day 2 post-natal group, the median level of D-dimer was significantly higher in primparous when compared to multiparous women ( P = 0.015). The median D-dimer levels were significantly lower in the elective Caesarean section group in comparison to spontaneous onset ( P = 0.003) and induction of labour ( P = 0.016). When the mode of delivery was examined, the median D-dimer levels were significantly lower in those that had an elective Caesarean section when compared to normal vaginal delivery ( P = 0.008) and instrumental vaginal delivery ( P = 0.007). Women post elective Caesarean section had a significantly lower D-dimer than those after emergency Caesarean section ( P = 0.008). Discussion There are some significant differences in D-dimer levels when certain perinatal determinants are examined. This work is potentially beneficial to the future diagnosis of VTE in pregnancy as it supports previously published recommended D-dimer levels for the diagnosis of VTE in pregnancy.

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Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional Study

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1608885 ◽

2017 ◽

Vol 40 (01) ◽

pp. 011-019 ◽

Cited By ~ 6

Author(s):

Sirlei Morais ◽

Simony Nascimento ◽

Ana Godoy-Miranda ◽

Karina Kasawara ◽

Fernanda Surita

Keyword(s):

Body Mass Index ◽

Cesarean Section ◽

Pregnant Women ◽

Gestational Age ◽

Perinatal Outcomes ◽

Cross Sectional Study ◽

Large For Gestational Age ◽

Sectional Study ◽

Cross Sectional ◽

Prenatal Visit

Objective To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. Methods A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared. Results An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97–2.28), fetal macrosomia (OR 4.13–12.54) and large for gestational age newborn (OR 2.88–9.83). Conclusion Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

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Length of stay in health facilities after childbirth and associated maternal and neonatal factors in Ethiopia: a cross-sectional study from a national survey

BMJ Open ◽

10.1136/bmjopen-2021-055327 ◽

2021 ◽

Vol 11 (12) ◽

pp. e055327

Author(s):

Yemisrach Belete Biru ◽

Getasew Assefa Lemelem ◽

Nahom Solomon

Keyword(s):

Length Of Stay ◽

Gestational Age ◽

Mode Of Delivery ◽

Cross Sectional Study ◽

Health Facilities ◽

Outcome Variable ◽

Sectional Study ◽

Cross Sectional ◽

Neonatal Deaths ◽

Average Size

ObjectiveThis study aimed to assess the length of stay in health facilities after childbirth and associated maternal and neonatal factors in Ethiopia.DesignA cross-sectional study.SettingEthiopia.Participants2260 mothers who participated in the 2016 Ethiopian Demographic and Health Survey were included in the study.OutcomeLength of stay in health facilities after childbirth was the outcome variable of the study.ResultIn Ethiopia, the mean duration of postpartum stay for mothers in health facilities was 21.96 (19.97–23.94) hours. Nine hundred and sixty-eight (34.80%) women remained in health institutions for ≥24 hours after delivery. Gestational age, birth weight and mode of delivery were significantly associated with length of stay. Gestational age was found to be inversely associated with length of stay. Mothers who had a vaginal delivery were 8.89% (adjusted HR (AHR) 8.89, 95% CI (4.28 to 18.46), p<0.001) more likely to discharge earlier from health facilities after delivery, compared with those who had a caesarian section. Women with larger size neonates during birth were 19% (AHR=0.81, 95% CI (0.67 to 0.96), p=0.019) more likely to stay longer in health facilities than women with average size neonates. Women with a smaller size neonate during birth were 16% (AHR=0.84, 95% CI (0.70 to 0.99), p=0.040) more likely to stay longer at a health facility, compared with those with an average size neonate.ConclusionA small percentage of Ethiopian mothers stayed in health facilities for 24 hours or more after delivery. Encouraging mothers to stay in health facilities for the recommended period after childbirth can play a significant role in reducing maternal and neonatal deaths.

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Dukungan Suami Meningkatkan Kunjungan Pemeriksaan K4 Ibu Hamil

Jurnal Kebidanan dan Kesehatan Tradisional ◽

10.37341/jkkt.v5i2.156 ◽

2020 ◽

Vol 5 (2) ◽

pp. 104-116

Author(s):

Eva Nurhidayati ◽

Emdat Suprayitno

Keyword(s):

Pregnant Women ◽

Health Workers ◽

Cross Sectional Study ◽

Sectional Study ◽

Third Trimester ◽

Chi Square ◽

Cross Sectional ◽

Study Approach ◽

Chi Square Test ◽

The Relationship

Background: K4 is the fourth prenatal check-up visit for health workers to obtain antenatal care according to standards and to detect complications as early as possible during pregnancy. The K4 coverage in Batang-Batang Daya village, the working area of the Batang-Batang Puskesmas is still below the target in 2018. The purpose of this study was to determine the relationship between husband's support and the decision of pregnant women in carrying out K4 examinations. Methods: The design of this study is analytic correlational with a cross-sectional study approach, the population of pregnant women in the third trimester of pregnancy in Batang-Batang Daya Village in 2019 was 27 respondents, using total sampling techniques, husband's support data was collected using a valid and reliable questionnaire. K4 examination data used a checklist in the KIA book, and the statistical test used was Chi-Square with an expected value of less than 5. Result: The results showed that most of the pregnant women received support from their husbands as many as 20 people (74.1). Most of the pregnant women underwent a K4 examination (4th pregnancy visit), as many as 20 people (74.1%). The analysis result from the Chi-Square test shows the value (ρ) = 0.000. Conclusion: It can be concluded that the husband's support is related to the decision by pregnant women to carry out K4 examinations. Husbands should always provide support to their wives to carry out routine checks so that pregnant women are motivated to carry out K4 examinations, and are more confident about carrying out their pregnancy.

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Psychological impact of COVID-19 amongst pregnant women in Conakry, Guinea. A cross-sectional study.

10.21203/rs.3.rs-122687/v1 ◽

2020 ◽

Author(s):

Almamy Touré ◽

Abdourahamane Diallo ◽

Aboubacar Magassouba ◽

Abdoulaye Doumbouya ◽

Ibrahima Conté ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Univariate Analysis ◽

Psychological Impact ◽

Cross Sectional Study ◽

Capital City ◽

Sectional Study ◽

Cross Sectional ◽

Event Scale ◽

State Worry

Abstract Introduction Pregnancy, apart from any external events, is subject to psychological changes. The COVID-19 pandemic in Guinea led to the implementation of restrictive measures followed by the mitigating ones, but few of them have targeted stress and anxiety management in pregnant women. This study aimed to assess the psychological impact and its associated factors in pregnant women. Methods We conducted a cross-sectional study in three health centres in Conakry capital city. Pregnant women were interviewed during antenatal care visits. We used two tools for stress and anxiety assessment: Impact of Event Scale-Revised (IES-R) and Penn State Worry Questionnaire (PSWQ), and followed three steps to seeking for factors associated with stress and anxiety: univariate analysis, regression tree (CART), and logistic regression. Results We surveyed a total of 649 pregnant women. Most of them presented a state of stress (97.7%) and anxiety (52.7%). Gestational age was the main factor associated with stress and anxiety. Pregnant women with a gestational age ≤ 34 weeks had an odd of 0.09 times lower of being stressed compared to those with a gestational age greater than 34 weeks. Pregnant women living in Ratoma and Kaloum with a gestational age was ≤ 9 weeks had an odds of 15.1 times [95% CI: 8.76, 27.4] higher of being worried compared to those from Matoto, Matam and Dixinn with a gestational age greater than 9 weeks. Similarly, pregnant women living in Matoto, Matam and Dixinn with a gestational age ≤ 9 weeks had an odds of 4.48 times [95% CI: 2.59, 8.12] higher of being worried compared to other women from the same localities. Conclusion Most of our participants were at a higher risk of stress and anxiety caused by COVID-19; women in their earlier stage of pregnancy tended to be more vulnerable to these psychological problems. Therefore, it is vital to implement an appropriate management plan which should prioritise those vulnerable pregnant women.

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