Safer sex negotiation and parity among women in sub-Saharan Africa

Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.

Prevalence of endometriosis in women undergoing laparoscopic surgery for various gynaecological indications at a Jordanian referral centre: gaining insight into the epidemiology of an important women's health problem

Background Endometriosis is a considerable health challenge for women of reproductive age. Information about its prevalence in the Jordanian population is sparse. The objective of this research was to evaluate the presence of endometriosis in gynaecological patients undergoing laparoscopic surgery for various indications and to correlate the finding of endometriosis with variables, including patient demographics, obstetric history, type, and indication of laparoscopic procedure. Methods A retrospective cohort study involving 460 women who underwent different laparoscopic procedures for a variety of indications was conducted in the Department of Obstetrics and Gynaecology in Jordan University Hospital, a tertiary referral hospital in Jordan, between January 2015 and September 2020. Results The prevalence of endometriosis in this patient group was higher than that of the general population (13.7% vs. 2.5%), and the mean age at diagnosis (31.9 years) was younger than the general population's age of peak incidence (35–45 years). It was significantly higher in women with lower numbers of pregnancies (p = 0.01) and a lower number of Caesarean sections (p = 0.05) and in those where the indication for surgery was related to decreased fertility or pelvic pain (p = 0.02). Women with high parity or where the surgery's indication suggested normal fertility, such as family planning, were less likely to have endometriosis. Conclusion To our knowledge, this is the first Jordanian study to assess the prevalence of endometriosis in women undergoing gynaecological laparoscopy. This study suggests that the epidemiology of endometriosis in this region follows similar trends to what has been previously documented in international literature, while emphasizing the need for further research into this important women's health issue in this part of the world.

Analisa faktor-faktor yang berhubungan dengan pemberian ASI eksklusif Di wilayah kerja Puskesmas Prabumulih Timur Kota Prabumulih Tahun 2021

Exclusive breastfeeding is given to infants aged 0-6 months, because the best nutrition for babies is only obtained through breast milk (WHO, 2020). According to data from the World Health Organization (WHO) worldwide exclusive breastfeeding coverage is only around 44 percent during the 2015-2020 period. Based on data from the 2019 Indonesian health profile, it is stated that the percentage of exclusive breastfeeding coverage in Indonesia for infants 0-6 months is 67.74 percent. Exclusive breastfeeding coverage in Prabumulih City in 2019 was 65.8 percent. The results of a preliminary study at the Prabumulih Timur Health Center covered only 43.1 percent of exclusive breastfeeding. The results showed that from 78 respondents. It was found that those who gave exclusive breastfeeding were 38 (48.7%) and those who did not gave exclusive breastfeeding were 40 (51.3%), low level of education 44 (56.4%) and higher education 34 (43.6%). working mothers 44 (56.4%) and mothers who did not work 34 (43.6%), low parity 30 (38.5%) and high parity 48 (61.5%), normal delivery 59 (75.6% ) and CS 19 delivery (24.4%). chi-square results 4 (four) significant variables with p-value <0.05, namely education level variable p-value = 0.013, OR = 0.280 (95% CI = 0.109-0.714), employment status p-value = 0.002 , OR = 0.193 (95% CI = 0.073-0.514), parity with p-value = 0.023, OR = 3.333 (95% CI = 1.279-8.688), delivery process with p-value = 0.012, OR = 5.100 (95% CI= 1,509-17,237). The conclusion in this study is that there is a relationship between parity and the process of giving birth simultaneously with exclusive breastfeeding in the working area of the Prabumulih Timur Health Center, Prabumulih City in 2021. It is recommended that the community give exclusive breastfeeding to their babies in order to prevent infant morbidity.

The Experience of Healthy Pregnancy in High Parity Women: A Phenomenological Study in North Jordan

Background and Objectives: High parity women are more likely to have poor quality of life during pregnancy than low parity women. Thus, the aim of this study was to explore the lived experience of healthy pregnancy among high parity women in North Jordan. Materials and Methods: A descriptive phenomenological design was employed in this study to complement previously published quantitative results. Fourteen pregnant women, who had four children or more, were recruited purposely according to inclusion criteria from Irbid city in North Jordan. Data were collected using face-to-face, semi-structured interviews. Colaizzi’s method was employed to analyze the verbatim data. Results: There were three main themes which emerged from participants significant statements: they had new discomforts, antenatal care and follow-up, and social issues. Each extracted theme was linked to some factors (subthemes), which had a positive or negative impact on the quality of life of high parity women during pregnancy. High parity women who experienced multiple stressors had a poor quality of life. Conclusions: Experiencing new discomforts, less or no antenatal care, and a lack of social support negatively affected the quality of life among high parity women. Antenatal interventions should be designed based on high parity women’s perceptions of their health and wellbeing in order to improve their quality of life and ultimately prevent maternal morbidity and mortality. Further quantitative studies are needed to explore the impact of previous mentioned factors on maternal quality of life and outcomes.

Frequency of True and False Umbilical Cord Knots and their Relation Maternal Age and Parity

Background: Umbilical Cord Knots both true and false are common abnormalities whichobstruct the blood flow and oxygen supply to the fetus and are frequently associated with advanced age and high parity of the mother. Aim: To find the frequency of true and falseumbilical cord knots in 100 samples of placentae (with attached umbilical cords ) and their relation to maternal age and parity. Study design: Descriptive cross sectional study. Place of study: Anatomy Department of (BMSI) Basic Medical Science Institute, JPMC Karachi. Methodology: 100 normal vaginally delivered full term placentae with attached umbilical cords were studied with direct Visual examination of the cords. The study included frequency, type and location of the knots and their relation with maternal age and parity. Data collected was analyzed by SPSS version 23 and presented in the form of tables and figures, cross tabulations of umbilical cord knots with age of mother and parity was done. Chi square test was used as test of significance asvariablesunder study are qualitative in nature. Results: This study showed that frequency of umbilical cord knots in 100 samples of placentae was 14% out of which 10(72%) were false knot and 4(28%) were true knot. Bothtrue and false knots were more frequent in male babies. There was statistically significant relation of knots with advanced maternal age (>30) and high parity (>5). Conclusion: Frequency of true umbilical cord knots is 4%. Most of knots are found in male babies and there is statistically significant relation of umbilical cord knots with advanced maternal age and high parity. Keywords: Umbilical cord, true knots, false knots, fetus.

Effects of Litter Size and Parity Number on Mammary Secretions Including, Insulin-Like Growth Factor-1, Immunoglobulin G and Vitamin A of Black Bengal, Saanen and Their Crossbred Goats in Thailand

The present study aims to investigate the composition including concentrations of IGF-1, IgG and Vit A in colostrum and their effects by litter size and goat parity in 3 groups of goats; Black Bengal (BB), Saanen (SA) and their crossbred (BBSA). Thirty-eight goats were used (23 BB, 7 BBSA and 8 SA). The composition (fat, protein, lactose and total solid; TS) in colostrum (Day 0; D0) and milk (Day 4; D4 and Day 7; D7) were measured. The IGF-1, IgG concentrations were analysed in some samples collected at D0, D4 and D7 while Vit A was analysed only in colostrum. The results showed that colostrum components were similar among experimental groups. However, the colostral IGF-1 concentration of BBSA (983.0 ± 163.6 ng/mL) was higher than that of BB (340.7 ± 85.5 ng/mL, p < 0.01) and SA (417.1 ± 93.9 ng/mL, p < 0.01). The colostral IgG concentration of BB (8.2 ± 0.9 mg/mL) was lower than that of BBSA (12.9 ± 1.7 mg/mL, p < 0.05) and SA (12.9 ± 1.0 mg/mL, p < 0.01). Colostral Vit A concentration in BBSA (787.2 ± 152.6 µg/100 gm) was higher than that in BB (388.9 ± 84.3 µg/100 gm, p < 0.05) but was not different from SA (522.8 ± 96.9 µg/100 gm). Colostrum from all groups contained higher protein and TS but was lower in lactose concentration than milk. The IGF-1 and IgG concentrations in colostrum were much higher than in milk both D4 and D7 (p < 0.001). Additionally, litter size had no effects on colostrum contents but colostrum from goats with a higher parity number had higher IgG concentration. It is concluded that colostrum from BBSA may be superior when fed to BB newborn goats in terms of higher IGF-1, IgG and Vit A contents. Moreover, colostrum from goats with a high parity number contained more IgG content.

THE RELATIONSHIP BETWEEN PREECLAMPSIA AND PARITY IN MATERNAL BIRTH IN RSUD MUHAMMAD SANI KARIMUN

Background : In Indonesia, eclampsia in addition to bleeding and infection is still the main cause of maternal mortality and a high cause of perinatal mortality. Therefore, early diagnosis of preeclampsia, which is a preliminary level of eclampsia, and its handling need to be implemented immediately to reduce maternal and child mortality (Prawiroharjo, 2012). Method : The research design used was case control. Population is the whole object of research. The population in this study were all women who gave birth at Muhammad Sani Karimun Hospital, namely 218 people with the number of preeclampsia incidents of 30 people. The number of cases to be used is 2 (two) times the number of cases, namely 60 people. The analysis used was the Ods Ratio (OR), which is a measure of the association of exposure (risk factors) with the incidence of disease in the risk group (exposed to risk factors) compared to the incidence of disease in the group that is not at risk (not exposed to risk factors). Result : The results of the study, the value of the Prevalence Odds Ratio (POR) = 6,875 with a value of 95% Confidence Interval (CI) = 3,318-12,410. Congclusions : The conclusion of this research is that respondents with high parity are 6.8 times more likely to experience preeclampsia than respondents with little parity.

High parity is associated with increased risk of cervical cancer: Systematic review and meta-analysis of case-control studies

Background: Cervical cancer is the fourth most common cancer among women. High parity has long been suspected with an increased risk of cervical cancer. Evidence from the existing epidemiological studies regarding the association between parity and cervical cancer is variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to synthesize the best available evidence on the epidemiological association between parity and cervical cancer. Methods: MEDLINE/PubMed, HINARI, Google scholar, Science direct, and Cochrane Libraries were systematically searched. Cochrane Q statistics and I2 tests were performed to assess heterogeneity among included studies. Begg's test and egger's regression analysis were performed to assess publication bias. A random-effect meta-analysis model was used to compute pooled odds ratio of the association between parity and cervical cancer. Results: A total of 6975 participants (1998 patients; 4977 controls) were incorporated in the 13 articles included in the final meta-analysis. The meta-analysis revealed that women with parity greater than or equal to three had 2.4 times higher odds of developing cervical cancer compared to women with parity less than three [pooled odds ratio (POR) = 2.4, 95% CI: 1.9-3.2]. Conclusion: High parity is associated with an increased risk of cervical cancer. Strong epidemiological studies are recommended to further explore the mechanisms and role of parity in the causation of cervical cancer.

Prevalence of Preconception Risk Factors Among Women From Tribal and Non-tribal Blocks in Nashik District, India: A Cross-Sectional Study

Background: Preconception phase in women though critical is comparatively ignored. The presence of risk factors affects well-being of the woman and her forthcoming progeny. The objectives of the study were to measure the prevalence of various risk factors among women and their comparison between blocks.Methods: This was a community based cross-sectional study in two tribal and two non-tribal blocks in Nasik district, Maharashtra, India. The study included women desiring conception within one year. Trained Accredited Social Health Activists collected information through house-to-house visits using a validated interview schedule. They recorded anthropometric measures of women in a standard manner. Results: The study enlisted 7,875 women desiring pregnancy soon. The mean age of women was 23.19 (+3.71) years and 16% of them were adolescents. Women's illiteracy was higher in tribal areas than non-tribal (p<0.001). About one-third of women did not have any risk factor and 41.21% of women had at least one risk factor. The commonest risk factor determined was no formal education (44.35%). Prevalence of selected risk factors was significantly higher among tribal women. The mean BMI of women was 19.73 (+3.51) and higher proportion (40.5%) of women from tribal areas were having BMI<18.5. Despite being high parity status (3+), about 7.7% of tribal and 3% of non-tribal women desired pregnancy. Tobacco and alcohol consumption were higher among tribal women. Majority of women consumed meals with family members or husband. Protein and calorie intake of about 1.4% women was less than 50% recommended consumption, however, most of them perceived to have abundant food.Conclusions: Health risks namely younger age, illiteracy, high parity, consumption of tobacco, low protein and calories intake were found to be prevalent and the risks were significantly more among tribal women. “Continuum of care” must include preconception care.

Associations of Fertility History and Cognitive Decline, Depression, Chronic Disease Comorbidity in West China: Results from WCHAT Study

ObjectivesThe purpose of the study was to investigate the association between fertility history and cognition function, depression and chronic comorbidity in west China.MethodsWe included 4,276 women aged 50 or older in our study, and we analyzed associations between parity history and cognitive decline, depression, chronic disease comorbidity in west China using univariate and multivariate models. Multivariate models were adjusted for age, ethnic groups, occupation, marriage status, educational level, life style factors, sleeping time and so on. ResultsOf 4,276 women in west China, 18.4% were either childless or had one child, 33.8% had two children, 23.7% had three children, and 24.1% had four or more children. Compared to low parity (0-1 children), having 4 or more children was significantly associated with depression (OR 1.379, 95%CI 1.046-1.819), chronic disease comorbidity (OR 1.714, 95%CI 1.252-2.346), mild cognitive decline (OR 2.179, 95%CI 1.503-3.159) and moderate/severe cognitive decline (OR 1.806, 95% CI 1.064-3.067). Conclusions This study indicated that high parity was significantly associated with poorer cognitive functioning, depression and chronic disease comorbidity. For a better mid-late life health, reproductive women should plan their number of desired children.