Obesity Cut-Off Points Using Prepregnancy Body Mass Index according to Cardiometabolic Conditions in PregnancyRead the full article
Journal of Pregnancy publishes original research articles, review articles, and clinical studies related to all aspects of pregnancy and childbirth. Topics include biomedical aspects of pregnancy labour, maternal health and breastfeeding.
Chief Editor, Dr. Ozgu-Erdinc, has been an active practitioner for over 30 years. Her research is focused on gestational diabetes mellitus screening, diagnosis and management including being actively involved in clinical research for new and novel ways to improve outcomes for mothers and babies.
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Assessment of Place of Delivery and Associated Factors among Pastoralists in Ethiopia: A Systematic Review and Meta-Analysis Evaluation
Background. Pastoralist communities rely on their livestock for at least 50% of their food supply and source of income. Home births raise the risk of maternal morbidity and death, whereas institutional births lessen the likelihood of difficulties during labor. Around 70% of labors in pastoralist regions of Ethiopia were assisted by traditional birth attendants. Methods. Studies done from January 2004 to January 2023, accessed in PubMed, EMBASE, Medline, and other search engines, were included. PRISMA guidelines and JBI critical appraisal checklist were used to assure the quality of the review. Ten articles were included in this review. Data were extracted with Excel and exported to STATA 16 for analysis. Heterogeneity of literatures was evaluated using statistics and publication bias using the Egger regression asymmetry test and the Duval and Tweedie trim-fill analysis. Statistical significance was declared at value less than 0.05. Result. The pooled estimate of institutional delivery among the pastoralist community in Ethiopia is 21.2% (95% CI: 16.2-26.1). Husbands who were involved to decide place of delivery (; 95% CI: 1.61, 7.50), women with good knowledge of MCH services (; 95% CI: 1.51, 3.44), women who had a positive attitude towards MCH services (; 95% CI: 0.79, 3.6), availability of health institutions (; 95% CI: 0.95, 7.20), and women who had an ANC follow-up (; 95% CI: 2.07, 3.73) were higher institutional delivery prevalence among pastoralist women. Moreover, institutional delivery among women who were educated above the college level was more than two times (; 95% CI: 1.985, 3.304) higher than among women who were not educated. Conclusion. Pastoralist women in Ethiopia were found to be a disadvantaged group for institutional delivery at national level. Husband involvement, educational level, ANC visit, knowledge and attitude for MCH service, and health facility distance were identified to have significant association with institutional delivery.
Missed Opportunity of Antenatal Care Services Utilization and Associated Factors among Reproductive Age Women in Eastern Hararghe Zone, Eastern Ethiopia: Mixed Methods Study
Background. Despite the enormous advantages of early pregnancy-related problem diagnosis and therapy during prenatal care visits, not all pregnant women begin antenatal care at the proper time. Thus, this study aims to identify factors associated with missed opportunities for antenatal care service utilization among reproductive-age women in Eastern Ethiopia. Methods. A mixed methods study design (quantitative and qualitative) was conducted in Grawa, Meta, and Haramaya woredas from September 5 to December 5, 2019. The quantitative data were analyzed using SPSS version 25. A multivariable logistic regression analysis model was used to identify the predictors. Statistical software programs based on ATLAS.ti version 8.2 was were used to conduct the thematic analysis of the qualitative data. Results. Overall, missed opportunities for antenatal care were 15.4% of 95% (12.1, 19.1%). Factors such as maternal age being 15–24 (, 95% CI: 2.89–8.81); having a college education (, 95% CI: 0.001, 0.42), elementary (, 95% CI: 0.002, 0.98), and secondary education (, 95% CI: 0.001, 0.88); having five and more parity (, 95% CI: 0.01, 0.75); three visits (, 95% CI: 0.02, 0.71); those in the first trimester (, 95% CI: 0.001, 0.35) and the second trimester (, 95% CI: 0.001, 0.26); and get information from a health facility (AOR =0.09, 95% CI: 0.01, 0.67) and traditional birth attendance (, 95% CI: 0.001, 0.74) were factors statistically associated with outcome variables. Conclusions. According to this report, relatively high proportions of pregnant women experienced missed opportunities in antenatal care follow-up. Factors such as maternal age, education, parity, frequency, timing, and media access were statistically significantly correlated with missed antenatal care follow-up. Therefore, all stakeholders should emphasize advocating for and enhancing the benefits of antenatal care; this in turn plays a crucial role in increasing the follow-up of clients for these crucial services. Moreover, health policy implementers need to coordinate their tracking of pregnant women who missed their antenatal care session.
Disparities in Antenatal Care Visits between Urban and Rural Ethiopian Women
Background. Utilizing antenatal care is one of the best ways to identify issues that are already present or could arise throughout pregnancy. Despite increased efforts to expand health services and antenatal care utilization, less is known regarding antenatal care disparities across different population segments. Therefore, the purpose of this study was to assess the degree of discrepancies between urban and rural Ethiopian pregnant women’s use of antenatal care. Methods. A total sample of 3927 women who gave birth to living children between 2014 and 2019 was included in the study from the 2019 Ethiopia Mini Demographic and Health Survey. Negative binomial Poisson’s regression was adopted to analyze the data. Results. The majority of pregnant women (73.8%) attend at least one antenatal care. Pregnant women in rural areas visited fewer number of antenatal care (68.36%) than those in urban areas (90.1%). Women with age range of 30-40 (IRR: 4.56, 95% CI: 1.07-19.34), women with attending incomplete primary education (IRR: 0.05, 95% CI: 0.02-0.12), women with attending complete primary education (IRR: 0.17, 95% CI: 0.07-0.42), women from middle-income households (IRR: 0.12, 95% CI: 0.06-0.24), women from richer household (IRR: 0.26, 95% CI: 0.14,0.5), women from the richest household (IRR: 0.45, 95% CI: 0.24-0.86), and pregnant women from rural areas (IRR: 0.615, 95%: 0.56-0.67) were observed to be linked with the frequency of antenatal care visits. Conclusion. In Ethiopia, three-fourths of pregnant women attend at least one antenatal care. Place of residence, educational attainment, age in five years’ group, and wealth index for urban/rural were related to the frequency of antenatal care visits.
Prevalence, Awareness, and Control of Hypertensive Disorders amongst Pregnant Women Seeking Healthcare in Ghana
Hypertensive disorders in pregnancy (HDPs) are no longer seen as “transitory diseases cured by delivery.” It accounts for up to 50% of maternal deaths. Information concerning HDPs is less in developing countries like Ghana. This study was conducted to find out the prevalence, awareness, risk factors, control, and the birth outcomes of HDPs. This was a retrospective cohort study conducted among pregnant women seeking care in selected health facilities in the Ashanti Region. Data on demographics, HDPs, and its associated birth outcomes were collected. Logistic regression models were used to examine the association of the independent variables with HDPs. The burden of HDPs was 37.2% among the 500 mothers enrolled with chronic hypertension superimposed with preeclampsia accounting for 17.6%, chronic hypertension, 10.2%, and preeclampsia 6.8% whilst gestational hypertension was 2.6%. It was observed that 44% (220) of the mothers had excellent knowledge on HDPs. Oral nifedipine and methyldopa were frequently used for HDP management, and it resulted in a significant reduction in HDP burden from 37.2% to 26.6%. Factors that influenced the increased risk of HDPs were grand multigravida (; –14.42), family history of hypertension (; –6.90), and the consumption of herbal preparations (; –7.41) and alcohol (; -12.62) during pregnancy. HDPs increased the risk of preterm delivery (; –5.89), stillbirth (; –57.24), and undergoing caesarean section (; –2.61) amongst mothers during delivery. The burden of HDPs is high amongst pregnant mothers seeking care in selected facilities. There is the need for intensified campaign on HDPs in the Ashanti Region of Ghana.
High Seropositivity of Brucella melitensis Antibodies among Pregnant Women Attending Health Care Facilities in Mwanza, Tanzania: A Cross-Sectional Study
Background. Brucellosis is one of the most prevalent zoonotic neglected tropical diseases across the globe. Brucella melitensis (B. melitensis), the most pathogenic species is responsible for several pregnancy adverse outcomes in both humans and animals. Here, we present the data on the magnitude of B. melitensis antibodies among pregnant women in Mwanza, Tanzania, the information that might be useful in understanding the epidemiology of the disease and devising appropriate control interventions in this region. Methodology. A hospital-based cross-sectional study involving pregnant women was conducted at two antenatal clinics in Mwanza between May and July 2019. The pretested structured questionnaire was used for data collection. Blood samples were collected aseptically from all consenting women followed by the detection of B. melitensis antibodies using slide agglutination test. Descriptive data analysis was done using STATA version 17. Results. A total of 635 pregnant women were enrolled with the median age of 25 (interquartile range (IQR): 16-48) years and median gestation age of 21 (IQR: 3-39) weeks. Seropositivity of B. melitensis antibodies was 103 (16.2 (95% CI:13.3-19.1)). On the multivariate logistic regression analysis, as the gestation age increases, the odds of being seropositive decreases (aOR:0.972 (95% CI: 0.945-0.999), ). Furthermore, being a housewife (aOR:3.902 (95% CI:1.589-9.577), ), being employed (aOR:3.405 (95% CI:1.412-8.208), ), and having history of miscarriage (aOR:1.940 (95% CI:1.043-3.606), ) independently predicted B. melitensis seropositivity among pregnant women in Mwanza. Conclusion. High seropositivity of B. melitensis was observed among employed and housewife pregnant women in Mwanza. This calls for the need of more studies in endemic areas that might lead to evidence-based control interventions.
Parental Satisfaction towards Care Given at Neonatal Intensive Care Unit and Associated Factors in Comprehensive and Referral Hospitals of Southern Ethiopia
Background. Patient satisfaction is an important aspect of the quality of care in the inpatient setting. In neonatal intensive care units, parents’ satisfaction and their experiences are fundamental to assessing clinical practice and improving the quality of care delivered to infants. Hence then, it reduces infant mortality rates globally. In Ethiopia, few studies address the level of parental satisfaction towards care given at neonatal intensive care unit and no single study was done in the study area. Therefore, this study is aimed at assessing parental satisfaction towards care given at neonatal intensive care unit and associated factors in comprehensive and referral hospitals of southern Ethiopia. Methods. An institutional-based cross-sectional study was conducted among 401 parents who visited neonatal intensive care from March 28 to April 28, 2022. The data were assorted via a structured interviewer-administered questionnaire using ODK collect version and exported to SPSS window version 25 for further cleaning and analysis. Bivariate and multivariate logistic regressions were used to identify factors associated with parental satisfaction with care given at the neonatal intensive care unit. The adjusted odds ratio with 95% CI was used to show the strength of the association, and a value < 0.05 was used to declare the cutoff point to determine the level of significance. Results. In this study, 63% (95% CI: 58%, 68%) of the parents were satisfied with the care given at the neonatal intensive care unit. Factors associated with parental satisfaction towards care given at neonatal intensive care unit were parents with no formal education (AOR: 0.15; 95% CI: 0.07-0.31), availability of necessary information using direction indicator (AOR: 3.14; 95% CI: 1.85-5.31), and availability of enough chairs in waiting area (AOR: 3.26; 95% CI: 1.81-5.87). Conclusion. Nearly two-thirds of the parents were satisfied with the care given at the neonatal intensive care unit. The availability of enough chairs in the waiting area and the creation of direction indicators are key issues to improve parental satisfaction towards their neonatal care.