scholarly journals Joint Modeling of Hypertension Measurements and Time-to-Onset of Preeclampsia Among Pregnant Women Attending Antenatal Care Service at Arerti Primary Hospital, North Shoa, Ethiopia

Author(s):  
Dawit Baye Haile ◽  
Aragaw Eshetie Aguade ◽  
Moges Zerihun Fetene

Abstract Background: Preeclampsia is a hypertensive disorder of pregnancy that affects 2-8% of pregnant women. It is the major cause of maternal and perinatal morbidity and mortality worldwide. The purpose of this study was to identify factors associated with hypertension measurements and time-to-onset of preeclampsia among pregnant women attending antenatal care service at Arerti Primary Hospital. Methodology: A retrospective longitudinal study design was employed on a total of 201 pregnant women attending the antenatal clinic of Arerti Primary Hospital between September 2018 and June 2019. A closed-form sample size formula for estimating the effect of the longitudinal data on time-to-event was used. To analyze our data we employed descriptive method, linear mixed effect model, Cox-PH model and joint models for longitudinal and survival outcomes.Relevantdemographicandclinicalcovariateswereincludedinsubmodels. Results: This study revealed that baseline age, visiting times, weight, diabetes, history of PE and parity had significantly associated with mean change in the BP measurements. From the Cox model result, age, weight, history of PE and marital status were associated with a significant hazard of developing preeclampsia. The univariate joint models reveal that the each longitudinal BP measurements are significantly associated with hazard of developing preeclampsia. Form the bi-ariate joint model; only DBP is significantly associated with risk of developing PE. Conclusion: As the result obtained in this study, we summarized that, age, weight, history of PE and marital status had a significant effect on time to developing preeclampsia. Furthermore, due to significance of association between the longitudinal BP measurements and time to onset of preeclampsia, joint model analysis was suggested as it incorporates all information simultaneously and provides valid and efficient inferences over separate models analysis.

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Yonas Tesfaye ◽  
Liyew Agenagnew

Background. Antenatal depression has immense public health importance, as it can adversely affect both the mother and child health. The problem contributes to the disease burden in both developed and developing countries. Despite this, it is less investigated and not getting the necessary attention in the study setting. Objective. The aim of the study was to assess the prevalence of antenatal depression and associated factors among women attending antenatal care (ANC) service in Kochi Health Center, Jimma town, southwest Ethiopia, 2019. Method. Institutional based cross-sectional survey was conducted on 314 pregnant women attending Kochi Health Center from February 15 to April 15, 2019. A systematic random sampling technique was used to include the study participants. Antenatal depression was assessed using the Patient Health Questionnaire (PHQ-9) tool. Data was collected through face-to-face interviews using a pretested and structured questionnaire. Descriptive statistics was done to summarize the dependent and independent variables. Moreover, the chi-square test analysis was done to determine the association between the outcome and explanatory variables. Results. A total of 314 pregnant women participated in the study, making a response rate of 96.7%. The study has revealed a total of 52 (16.6%) of the respondent had antenatal depression. A chi-square test of independence analysis showed a significant association between antenatal depression and marital status, family history of depression, pregnancy planning, history of abortion, social support, and intimate partner violence ( P < 0.00001 ). Conclusion. The study has shown that the prevalence of antenatal depression was high and associated with multiple psychosocial, clinical, and obstetric factors. Therefore, screening pregnant women for depression and the provision of necessary mental health services is recommended to mitigate the adverse health outcome of the problem.


2020 ◽  
Vol 8 ◽  
pp. 205031212097348
Author(s):  
Simon Birhanu ◽  
Melake Demena ◽  
Yohannes Baye ◽  
Assefa Desalew ◽  
Bedru Dawud ◽  
...  

Background: Antenatal care coverage is very low in low-and middle-income countries, including Ethiopia. Self-reported pregnant women’s satisfaction may be important in identifying the demographic, provider-, and facility-related factors that can be improved to increase antenatal care satisfaction. However, there is a paucity of data on pregnant women’s satisfaction in Ethiopia, particularly in the study setting. Therefore, this study aimed to assess antenatal care service satisfaction and associated factors among pregnant women at public health facilities in the Harari region of eastern Ethiopia. Methods: A health institution–based cross-sectional study was conducted among women who were attending antenatal care clinics in February 2017. All 531 pregnant women were selected using a systematic random sampling method. Data were collected using an interviewer-administered questionnaire, entered into EpiData version 3.1, and analyzed using SPSS version 22.0 software. A logistic regression model was applied to control for confounders. The level of significance was determined at a p-value of less than 0.05. Results: The magnitude of pregnant women’s satisfaction with antenatal care services was 70.3% (95% confidence interval (CI) = 66.4%–74.3%). Receiving antenatal care services from the hospital (adjusted odds ratio (AOR) = 2.44, 95% CI = 1.50–3.98), did not attend formal education (AOR = 2.53, 95% CI = 1.52–4.20) and attended primary education (AOR = 2.17, 95% CI = 1.17–4.04), having a repeated visit to antenatal care (AOR = 4.62, 95% CI = 2.98–7.17), initiating antenatal care services within the first trimester (AOR = 1.74, 95% CI = 1.12–2.71), having no history of stillbirth (AOR = 2.52, 95% CI = 1.37–4.65), and waiting for no more than 30 min in the health facility to get service (AOR = 2.31, 95% CI = 1.28–4.16) were factors associated with pregnant women’s satisfaction with antenatal care services. Conclusion: More than two-thirds of pregnant women were satisfied with the antenatal care service. The type of health facility, education status, number and initiation time of antenatal visit, history of stillbirth, and waiting time to get service were factors associated with pregnant women’s satisfaction with antenatal care services.


2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).


2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.


2021 ◽  
pp. IJCBIRTH-D-20-00033
Author(s):  
Aynalem Yetwale ◽  
Teklemariam Gultie ◽  
Dessalegn Ajema ◽  
Bezawit Afework ◽  
Semahegn Tilahun

BACKGROUNDAntenatal depression is the most common psychiatric disorder during pregnancy with serious consequences for the mother and the fetus. However, there are few studies about this health issue in developing countries. This study aimed to determine the prevalence of antenatal depression and its associated risk factors among pregnant mothers attending antenatal care service at Jinka public health facilities, south Omo zone, Southern Ethiopia.METHODSInstitutional-based cross-sectional study design was conducted on 446 pregnant women at Jinka public health facilities, from June 1 to June 30, 2018. Beck Depression Inventory was used to assess women's level of depression. Statistical package for social science version 20.0 was used for analysis. Logistic regression was used to find out the association between explanatory and depression. The strength of association was evaluated using odds ratio at 95% confidence interval (CI).RESULTThe magnitude of antenatal depression in this study was 24.4% (20.2–28.5 at 95% CI) and it had statistically significant association with unmarried marital status a djusted o dds r atio (AOR) = 13.39 [(95% CI); (3.11–57.7)], chronic medical illness AOR = 3.97 [(95% CI); (1.07–14.7)], unplanned pregnancy AOR = 6.76 [(95% CI); (2.13–21.4)], history of abortion AOR = 2.8 [(95% CI); (1.14–7.02)], history of previous pregnancy complication AOR = 4.8 [(95% CI); (2.12–17.35)], and fear of pregnancy-related complications AOR = 5.4 [(95% CI); (2.32–12.4)].CONCLUSIONSNearly one pregnant woman develops antenatal depression in every four pregnant women. Variables like unmarried marital status, chronic medical illness and unplanned pregnancy, history of previous pregnancy complications, and fear of pregnancy-related complications were associated with antenatal depression. Therefore, it is recommended that these risks factors should be evaluated during antenatal care with a view to improving maternal health.


2020 ◽  
Vol 4 (1) ◽  

Background: Antenatal care (ANC) is an important health care service which is intended to potentially reduce maternal morbidity and mortality particularly in areas where the general health status of women is presumed poor, choice of facilities is limited and the service delivery compromised by geography (terrain, transport), socio-demographic factors, financial capability and awareness. Though improving the quality of health care is one of the targeted strategies in the Health Sector Development Program IV (HSDP IV) of Ethiopia, little is known about the quality of antenatal care service and client satisfaction at the different hospitals in Addis Ababa, the capital city of Ethiopia. Objective: To determine satisfaction of ANC services among pregnant women at the public teaching and private hospitals in Addis Ababa, Ethiopia. Methods: Health institution-based comparative cross-sectional study was conducted from February to June, 2019 in public and private hospitals, in Addis Ababa, using sample size determination for comparisons of proportion between the two populations. All participants who fulfilled the inclusion criteria were enrolled based on the flow of pregnant women to the ANC clinics at the selected hospitals. Data were entered and cleaned using EPI-info version 3.5.1 and analysis was performed by SPSS version 21. Association of independent variables with the client satisfaction was done using binary and multivariate logistic regression. Significant association of variables with outcome was determined using adjusted odds ratio (AOR) together with 95 % confidence interval. Level of significance was set at P-value of ≤ 0.05. Results: Five hundred seventy one pregnant women attending Antenatal Care at private (281) and public (290) hospitals were included with response rates of 94.1 and 91.2% for public and private hospitals, respectively. The age distribution of the participants was between 17 and 43 years with a mean age of 27.3±5.1 years. Most of the clients, 249 (88.7%) at private and 276 (95.2%) at public hospitals were between the ages of 20 and 34 years. One hundred fourteen (39.3%) of the clients at public and 113 (40.2%) at private hospitals were nulliparous. The clients overall satisfaction with antenatal care was mostly positive both at the private and public hospitals and two hundred twenty eight (81.1%) of the private and 174 (60%) of the public hospitals were satisfied with the services provided. Having ANC follow up at the private hospitals had statistically significant difference in client satisfaction compared to those in public hospitals with P value of 0.019, (AOR 2.97, 95% CI:1.19 -7.74). Clients’ satisfaction with the cleanliness of the environment was 11.1 times more likely to be satisfied with the general ANC service, P<0.05, (AOR 12.18 95% CI: 7.45-19.91). Having more than 4 ANC visits was positively associated with client overall satisfaction, P= 0.021, (AOR 2.41, 95% CI: 1.12-5.24,) while long waiting time is negatively associated with client satisfaction. Conclusions: The study showed significant difference in client satisfaction rate between the selected private and public facilities. Private facilities outperformed public facilities with regards to structural features (privacy, waiting time, space, and neatness). We recommend concerted effort to improve ANC visits and pay due attention to the privacy, waiting time, and the neatness of the facilities in public hospitals.


2020 ◽  
Vol 11 (2) ◽  
pp. 86
Author(s):  
Evi Diliana Rospia ◽  
Andari Wuri Astuti ◽  
Retno Mawarti

Preeclampsia and eclampsia are the second direct cause of maternal death worldwide, estimated to complicate 2-8% of all pregnancies, the global prevalence of preeclampsia is around 4.6%. The purpose of this scoping review is to provide an overview of studies related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy. The authors identify studies that explain preeclampsia in pregnancy from several databases namely PubMed, ProQuest, EBSCO and Springer Link. Searches are limited to studies published in English and present data for the 2009-2019 period. The identified study was reviewed using PRISMA Flowchart. Studies with qualitative and quantitative designs that explore the experiences of pregnant women regarding antenatal support, access and services were selected for review, while studies that were not experience related to antenatal support, access and services to mothers with a history of preeclampsia in pregnancy were excluded. A total of twelve articles were reviewed which obtained three sub-themes of support, namely the support of husband, family and health workers, from the theme of access obtained three sub-themes namely information search, modification programs and the availability of health workers. From the theme of antenatal care, four sub-themes are found, namely unsustainable care, lack of information, screening and feeling empowered. Pregnant women with preeclampsia need support from a partner or family and health workers. Information and screening need to be improved in antenatal care.


2020 ◽  
Author(s):  
Desta Samuel Umuro ◽  
Yared Lasebew Asres ◽  
Gezahegn Mamo Muluneh

Abstract Background This study aimed to assess magnitude and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods Institution based cross sectional study design was conducted from December 1–30, 2018 on 405 pregnant women attending antenatal clinic. All pregnant women visiting the Antenatal care clinic during the study period and who fulfilled the eligibility criteria were included in the study. Secondary data was collected from clients register and personal files on hemoglobin, HIV, stool, and other variables. Descriptive statistics was used to analysis some variables by using SPSS. Logistic regression was carried out to identify factors associated with anemia in pregnancy. Adjusted odds ratio with their 95% of confidence interval and p < 0.05 are consider to have significant association. Results The magnitude of Anemia in pregnant women in this study was 19.8%, (95% CI 16.00-23.70). HIV infection (AOR = 6.12(95% CI 2.19, 17.08) parasitic infestation (AOR = 11.88 (95% CI 5.60, 25.20) and history of not taking fruit after meal during pregnancy (AOR = 3.12(95% CI 1.72, 5.67) were the major determinants of anemia. Conclusion This study showed that the magnitude of anemia among pregnant women was high especially at third trimester. Living with HIV /AIDS, parasitic infestation and no history of taking fruits after meal were the main factors.


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