<i>Background</i>. Global prevalence of chronic hepatitis B virus (HBV) infection was estimated between 257 and 291 million since 2020, posing a great public health challenge. In Africa, an estimated 60 million cases of HBV were reported in the same year. Pregnant women might be susceptible to HBV infection dependent on their level of awareness and knowledge about the causes, transmission, and prevention of HBV. The aim of the study was to assess the awareness and prevalence of HBV infection and prolonged bleeding risk among pregnant women at the Suhum Municipality of Ghana. <i>Methods</i>. The study was a cross-sectional design involving pregnant women who were sampled following their visit to the antenatal unit at the Suhum Government Hospital. Sociodemographics including history of HBV screening and vaccinations were obtained from consented individuals using pretested questionnaires. Also, venous blood samples were obtained for platelet count, whereas bleeding time assay was performed to assess functional platelet disorders. <i>Results</i>. Hepatitis B prevalence was 4.4%, with 14.1% prevalence of mild thrombocytopenia and 1.5% prevalence of prolonged bleeding time. Pregnant women who had tertiary education and previous screening were about 8 times (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M1" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><path id="g190-80" d="M381 665C170 665 44 498 44 318C44 125 188 -15 369 -15C552 -15 703 117 703 333C703 534 550 665 381 665ZM359 629C491 629 601 517 601 306C601 114 502 21 390 21C249 21 146 158 146 346S248 629 359 629Z"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><path id="g190-83" d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"></span><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g><g transform="matrix(.013,0,0,-0.013,47.522,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,50.486,0)"><use xlink:href="#g113-56"/></g><g transform="matrix(.013,0,0,-0.013,56.728,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g></svg>,</span></span> 95% CI: 1.50-40.50) and 14 times (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M2" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"></span><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.157pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 28.157 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.013,0,0,-0.013,53.76,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g><g transform="matrix(.013,0,0,-0.013,62.964,0)"><use xlink:href="#g113-55"/></g></svg>,</span></span> 95% CI: 1.72-108.75) more likely to have knowledge of hepatitis B than those without tertiary education and previous screening, respectively. <i>Conclusion</i>. The prevalence of HBV was 4.4%. Education status and previous screening were associated with demonstration of knowledge about HBV; therefore, intensification of education and screening are recommended.

Joseph Boachie

Doreen Pidah

Henrietta Eshun

Emmanuel Jingbeja

Praise Fosu Adjei

Patrick Adu

Prevalence of Hepatitis B Viral Infection in Pregnant Women at the Suhum Municipality, Ghana

<i>Background</i>. Exposure to maternal near-misses has a massive effect on adverse perinatal outcomes. Hence, investigating the effect of maternal near-misses on perinatal outcomes can aid in the reduction of perinatal morbidity and mortality. The study is aimed at assessing the incidence of adverse perinatal outcomes among women exposed to maternal near-misses at Arsi Zone public hospitals in Ethiopia in 2022. <i>Method</i>. The study included a prospective cohort of 335 women at Arsi Zone public hospitals from December 2021 to June 2022. Women who were admitted for management of pregnancy were followed. The exposed group was women with maternal near-misses screened based on disease-validated criteria. The nonexposed group was made up of women who delivered without complications. Trained data collectors used pretested, structured questionnaires to collect data from women. Pertinent data was also extracted from the clients’ logbooks. Data was transferred from EpiData version 3.1 to SPSS version 25 for analysis, logistic regression was computed, and 95% confidence intervals were declared at a <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> value of 5% significance level. <i>Result</i>. The incidence of adverse perinatal outcomes was higher in the exposed women than in the nonexposed women (56% versus 16%). Contrasted with the nonexposed, women exposed to maternal near-misses had a higher incidence of stillbirth (22% vs. 0.5%), low birth weight (13% vs. 3%), and preterm birth (12% vs. 2%). After adjusting for confounders, exposed women had a twofold increased risk of adverse perinatal outcomes compared to nonexposed women. Delivery mode, delay in seeking care, transport mode, and delay in receiving treatment were the risk factors for negative pregnancy outcomes. <i>Conclusion</i>. In exposed women, a higher incidence of adverse perinatal outcomes was linked to aforementioned risk factors. Evidence-based practice intended to decrease delays in providing maternal care services does indeed improve perinatal outcomes.

Wogene Morka

Getu Megersa

Elias Bekele

Abdi Deksisa

Incidence of Adverse Perinatal Outcomes among Women Exposed to Maternal Near-Misses in Arsi Zone in Ethiopia: Prospective Cohort Study in 2022

Qiuping Zhao

Rongmei Liu

Hui Chen

Xiaomo Yang

Jiajia Dong

Minfu Bai

MingYang Yu

Zeying Feng

Dingyuan Zeng

Higher Circulating Lymphocytes and the Incidence of Pre-eclampsia and Eclampsia

<i>Objective</i>. To validate a model for predicting magnesium concentration in magnesium sulfate treatment in preeclampsia. <i>Design</i>. Retrospective cohort study. <i>Setting</i>. Three secondary care hospitals, one accepting neonates from gestational week <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="23.017pt" style="vertical-align:-0.3499298pt" id="M1" height="8.69875pt" version="1.1" viewBox="-0.0498162 -8.34882 23.017 8.69875"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.013,0,0,-0.013,6.24,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,15.386,0)"><path id="g117-36" d="M535 230V280H323V490H265V280H52V230H265V-3H323V230H535Z"/></g></svg><span class="ibiop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="6.438pt" style="vertical-align:-0.3499298pt" height="8.69875pt" version="1.1" viewBox="25.872183800000002 -8.34882 6.438 8.69875"><g transform="matrix(.013,0,0,-0.013,25.922,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g></svg>.</span></span> <i>Population</i>. Women with preeclampsia undergoing magnesium sulfate treatment. Subjects initially received Zuspan treatment (4 g bolus and 1 g/h maintenance dose), commonly increased by individual titration. <i>Main Outcome Measures</i>. Difference in mean between measured and predicted magnesium concentration. Proportion of women reaching target concentration (>2 mM) in 25 h. <i>Results</i>. 56 women were included, with 356 magnesium measurements available. Mean magnesium concentration was 1.82 mM. The prediction model overestimated magnesium concentration by 0.10 mM (CI 0.04–0.16) but exhibited no bias for weight, creatinine, or treatment duration. Weighted mean infusion rate was 1.22 g/h during 30 hours. Overall success rate in reaching target concentration was 54%, decreasing to 40% in <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="49.913pt" style="vertical-align:-0.6370001pt" id="M2" height="8.98582pt" version="1.1" viewBox="-0.0498162 -8.34882 49.913 8.98582"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-120" d="M696 437H516V411C580 402 587 397 574 345C555 271 527 183 505 114H503C461 222 420 328 383 432H357C315 316 278 214 241 118H239C214 195 189 274 165 350C151 396 156 402 216 411V437H9V411C57 405 65 398 83 346C125 226 162 108 199 -11H227C267 100 308 199 346 300C387 195 428 97 468 -11H497C542 124 587 257 617 337C637 392 646 404 696 411V437Z"/></g><g transform="matrix(.013,0,0,-0.013,8.801,0)"><path id="g190-112" d="M257 449C165 449 37 374 37 209C37 98 119 -12 256 -12C355 -12 473 65 473 226C473 349 381 449 257 449ZM244 416C333 416 380 320 380 204C380 67 329 21 267 21C184 21 130 115 130 241C130 354 184 416 244 416Z"/></g><g transform="matrix(.013,0,0,-0.013,15.274,0)"><path id="g190-110" d="M797 0V26C739 32 732 36 732 103V296C732 394 682 449 605 449C576 449 550 437 529 423C504 407 475 389 446 366C425 418 382 449 334 449C303 449 279 437 253 421C222 403 201 385 180 371V452C135 432 85 419 41 411V388C99 379 102 374 102 310V103C102 38 93 32 27 26V0H238V26C189 32 180 38 180 103V338C210 363 250 390 289 390C351 390 377 348 377 275V103C377 37 368 32 306 26V0H520V26C465 32 456 38 456 101V296C456 314 455 326 453 338C491 369 529 390 565 390C628 390 653 345 653 274V107C653 36 642 32 583 26V0H797Z"/></g><g transform="matrix(.013,0,0,-0.013,25.869,0)"><path id="g190-102" d="M380 106C343 72 306 56 265 56C195 56 116 112 115 248C235 252 361 262 377 265C396 269 400 277 400 297C400 374 333 449 250 449H249C198 449 144 421 103 376S37 269 37 201C37 88 109 -12 232 -12C263 -12 332 6 395 84L380 106ZM225 412C281 412 315 364 314 312C314 297 308 292 290 292C232 290 176 289 120 289C135 370 180 412 225 412Z"/></g><g transform="matrix(.013,0,0,-0.013,31.394,0)"><path id="g190-111" d="M524 0V26C466 32 460 36 460 104V297C460 393 411 449 331 449C302 449 276 437 248 419C223 402 201 387 181 372V451C137 432 90 420 42 411V388C96 378 102 374 102 310V104C102 38 97 33 29 26V0H246V26C187 32 181 36 181 104V339C211 365 250 390 290 390C357 390 381 345 381 276V109C381 40 374 32 315 26V0H524Z"/></g><g transform="matrix(.013,0,0,-0.013,42.282,0)"><path id="g117-92" d="M512 230V281L75 514V456L453 256V254L75 55V-3L512 230Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="12.655pt" style="vertical-align:-0.6370001pt" height="8.98582pt" version="1.1" viewBox="53.4951838 -8.34882 12.655 8.98582"><g transform="matrix(.013,0,0,-0.013,53.545,0)"><path id="g113-58" d="M244 635C114 635 38 519 38 422C38 317 111 240 217 240C236 240 255 244 277 256L345 292C311 140 203 39 59 15L64 -15C89 -15 150 -5 204 17C339 72 440 202 440 386C440 521 368 635 244 635ZM228 602C326 602 352 479 352 390C352 370 351 347 348 324C327 308 293 296 258 296C174 296 124 369 124 458C124 517 152 602 228 602Z"/></g><g transform="matrix(.013,0,0,-0.013,59.786,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg></span> kg. Overall success rate at 8 hours was 11%. No toxic concentrations were found. <i>Conclusions</i>. Zuspan regimen is very safe, but slow to reach therapeutic concentrations—despite efforts of individual titration. Success rate is lower in heavy women, which is of particular importance considering their predisposition to develop preeclampsia. The validated pharmacokinetic model performs well and may be used to individually tailor treatment from the outset.

Erik Holmström Thalme

Magnus Frödin-Bolling

Validation of a Model for Predicting Magnesium Concentration in Women with Preeclampsia: A Retrospective Cohort Study

<i>Background</i>. Childbirth self-efficacy is a pregnant women’s perception of their ability to cope with labor stress. Low childbirth self-efficacy is linked to pain intolerance and poor labor progression, which increase the possibility of operative delivery. However, Ethiopia has limited data. So, the aim of this study was to assess childbirth self-efficacy and its factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. <i>Objective</i>. To assess childbirth self-efficacy and associated factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. <i>Methods</i>. An institution-based cross-sectional study was carried out among 416 women from January 1 to January 30, 2023. A systematic random sampling technique was employed. Data were collected by KoboToolbox through face-to-face interviews using a structured and pretested questionnaire. Modified short-form childbirth self-efficacy inventory was used to score self-efficacy. The Statistical Package for Social Sciences, version 27, was used for data management and analysis. Descriptive statistics were calculated for each variable, and a logistic model was used. Statistical significance was determined at a <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-3.42943pt" id="M1" height="10.2124pt" version="1.1" viewBox="-0.0498162 -6.78297 7.83752 10.2124" width="7.83752pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-113" d="M570 304C570 398 525 448 414 448C385 448 343 445 312 434L329 511L321 518C297 504 262 482 244 460L233 411C195 397 159 381 128 358L135 332C160 347 189 360 224 373L111 -147C97 -210 84 -218 17 -231L13 -257L254 -247L259 -218L233 -216C183 -212 177 -202 189 -142L218 -1C238 -10 266 -12 283 -12C351 3 429 48 483 105C543 168 570 242 570 304ZM482 289C482 161 380 33 304 33C278 33 248 51 233 69L303 396C326 400 352 403 369 403C428 403 482 380 482 289Z"/></g></svg> value of less than 0.05 and 95% confidence level. <i>Results</i>. A total of 416 pregnant women participated in the study. Two hundred twenty-eight (54.8%) of the pregnant women had low childbirth self-efficacy. Age group in ≤24 years (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M2" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-66" d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><path id="g190-80" d="M381 665C170 665 44 498 44 318C44 125 188 -15 369 -15C552 -15 703 117 703 333C703 534 550 665 381 665ZM359 629C491 629 601 517 601 306C601 114 502 21 390 21C249 21 146 158 146 346S248 629 359 629Z"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><path id="g190-83" d="M631 18C609 24 585 35 559 65C534 91 514 117 478 169C448 214 406 281 389 313C462 346 516 399 516 485C516 545 490 590 449 616C412 641 363 650 290 650H42V622C120 615 128 612 128 527V125C128 40 120 34 38 28V0H300V28C221 34 212 40 212 125V284H244C295 284 312 272 329 244C359 195 395 133 430 84C475 19 516 -3 592 -7C603 -8 615 -8 627 -8L631 18ZM212 316V563C212 591 215 602 223 607C231 613 248 617 277 617C352 617 423 577 423 469C423 415 407 375 368 345C343 324 310 316 260 316H212Z"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-52" d="M285 378C315 398 338 416 353 432C373 451 384 474 384 503C384 579 325 635 236 635H235C182 635 136 610 108 579L65 516L85 496C110 533 150 575 205 575C258 575 300 543 300 481C300 407 232 369 141 339L147 310C163 315 188 321 211 321C268 321 338 284 338 192C338 94 288 40 217 40C160 40 119 68 93 91C85 98 77 97 69 91C60 84 47 71 46 58C44 46 48 35 62 22C75 10 116 -12 162 -12C234 -12 424 62 424 224C424 297 373 359 285 376V378Z"/></g><g transform="matrix(.013,0,0,-0.013,47.52,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.013,0,0,-0.013,50.484,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g></svg>,</span></span> 95% CI: 1.82-8), primigravida (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M3" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-50" d="M384 0V27C293 34 287 42 287 114V635C232 613 172 594 109 583V559L157 557C201 555 205 550 205 499V114C205 42 199 34 109 27V0H384Z"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-50"/></g></svg>,</span></span> 95% CI: 1.10-2.86), unplanned pregnancy (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M4" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><path id="g113-55" d="M137 343C167 482 260 545 321 574C357 591 397 603 429 609L423 641C382 634 335 622 295 608C189 570 37 457 37 238C37 84 125 -12 242 -12C362 -12 447 89 447 209C447 311 374 393 267 393C247 393 226 386 204 376L137 343ZM227 337C318 337 361 256 361 173C361 105 336 22 258 22C176 22 126 120 126 240C126 266 127 291 132 310C155 323 189 337 227 337Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><path id="g113-56" d="M447 623H65C61 580 56 530 47 475H76C100 541 106 550 172 550H388C308 376 196 170 91 -1L98 -12L172 -2C268 204 360 408 455 611L447 623Z"/></g></svg>,</span></span> 95% CI: 1.02-2.70), poor social support (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M5" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><path id="g113-51" d="M412 140C382 77 369 73 315 73H129L270 222C362 320 402 379 402 466C402 571 322 635 234 635C177 635 130 609 99 576L42 495L64 475C90 514 133 568 201 568C274 568 318 519 318 435C318 349 255 267 193 193C144 135 87 78 32 23V0H405C417 45 427 89 440 131L412 140Z"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,56.723,0)"><use xlink:href="#g113-56"/></g></svg>,</span></span> 95% CI: 1.09-4.30), having anxiety (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M6" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-50"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-52"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-49"/></g></svg>,</span></span> 95% CI: 1.10-3.64), having poor knowledge of childbirth (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M7" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,47.519,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.483,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,56.723,0)"><use xlink:href="#g113-50"/></g></svg>,</span></span> 95% CI: 2.09-5.39), and severe fear of childbirth (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="37.647pt" style="vertical-align:-0.2324905pt" id="M8" height="8.98583pt" version="1.1" viewBox="-0.0498162 -8.75334 37.647 8.98583"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g190-66"/></g><g transform="matrix(.013,0,0,-0.013,8.618,0)"><use xlink:href="#g190-80"/></g><g transform="matrix(.013,0,0,-0.013,18.211,0)"><use xlink:href="#g190-83"/></g><g transform="matrix(.013,0,0,-0.013,30.016,0)"><use xlink:href="#g117-34"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="21.894pt" style="vertical-align:-0.2324905pt" height="8.98583pt" version="1.1" viewBox="41.2291838 -8.75334 21.894 8.98583"><g transform="matrix(.013,0,0,-0.013,41.279,0)"><use xlink:href="#g113-55"/></g><g transform="matrix(.013,0,0,-0.013,47.52,0)"><use xlink:href="#g113-47"/></g><g transform="matrix(.013,0,0,-0.013,50.484,0)"><path id="g113-53" d="M456 178V225H360V632H320C217 496 115 347 20 206V178H280V106C280 40 276 34 189 27V0H445V27C364 34 360 39 360 106V178H456ZM280 225H82C149 335 214 431 278 520H280V225Z"/></g><g transform="matrix(.013,0,0,-0.013,56.724,0)"><use xlink:href="#g113-49"/></g></svg>,</span></span> 95% CI: 2.60-9.80) were statistically significant with low childbirth self-efficacy. <i>Conclusions</i>. The magnitude of low childbirth self-efficacy was high in the study area. Being primigravida, unplanned pregnancy, <span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="28.474pt" style="vertical-align:-3.40338pt" id="M9" height="11.7522pt" version="1.1" viewBox="-0.0498162 -8.34882 28.474 11.7522"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g190-98" d="M433 39L423 65C413 59 399 54 387 54C370 54 352 69 352 114V299C352 352 342 392 307 422C285 440 255 449 225 449C168 437 102 399 75 379C56 365 44 353 44 339C44 315 69 296 87 296C101 296 111 303 116 319C124 349 133 371 145 385C156 397 171 404 190 404C241 404 275 364 275 291V274C253 256 180 229 120 209C65 190 39 159 39 110C39 47 88 -12 159 -12C189 -12 237 25 277 52C282 35 288 21 301 8C312 -3 333 -12 348 -12L433 39ZM275 84C256 65 221 48 195 48C164 48 124 73 124 124C124 161 146 180 185 198C206 208 254 229 275 240V84Z"/></g><g transform="matrix(.013,0,0,-0.013,5.642,0)"><path id="g190-104" d="M463 437C426 431 375 425 327 422C297 440 264 449 231 449H230C153 449 51 396 51 283C51 215 94 168 139 149C123 129 91 103 51 88C50 78 53 60 62 46C75 25 100 2 136 -9C112 -28 73 -59 53 -79C38 -94 29 -113 29 -135C30 -192 91 -257 203 -257C336 -257 452 -160 452 -59C452 39 371 59 309 59C275 59 240 58 203 58C158 58 140 77 140 96C140 110 157 129 170 138C186 135 205 133 221 133C306 133 396 185 396 293C396 328 384 360 366 381L423 378C439 387 459 413 468 429L463 437ZM219 418C277 418 314 362 314 284C314 205 275 166 231 165C176 165 137 221 137 299C137 376 177 418 219 418ZM241 -11C285 -11 314 -14 339 -24C367 -36 384 -61 384 -95C384 -157 335 -206 240 -206C166 -206 108 -165 108 -110C108 -82 128 -54 154 -32C172 -17 195 -11 241 -11Z"/></g><g transform="matrix(.013,0,0,-0.013,11.621,0)"><path id="g190-102" d="M380 106C343 72 306 56 265 56C195 56 116 112 115 248C235 252 361 262 377 265C396 269 400 277 400 297C400 374 333 449 250 449H249C198 449 144 421 103 376S37 269 37 201C37 88 109 -12 232 -12C263 -12 332 6 395 84L380 106ZM225 412C281 412 315 364 314 312C314 297 308 292 290 292C232 290 176 289 120 289C135 370 180 412 225 412Z"/></g><g transform="matrix(.013,0,0,-0.013,20.843,0)"><path id="g117-93" d="M531 71V127L115 310L531 494V550L57 335V285L531 71ZM531 -40V10H57V-40H531Z"/></g></svg><span class="irelop"/><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="12.655pt" style="vertical-align:-3.40338pt" height="11.7522pt" version="1.1" viewBox="32.0561838 -8.34882 12.655 11.7522"><g transform="matrix(.013,0,0,-0.013,32.106,0)"><use xlink:href="#g113-51"/></g><g transform="matrix(.013,0,0,-0.013,38.346,0)"><use xlink:href="#g113-53"/></g></svg></span> years, severe fear of childbirth, anxiety, poor social support, and poor knowledge were significantly associated with low childbirth self-efficacy. Therefore, giving special attention to these factors during antenatal care would be important.

Tesfahun Simon

Kassahun Fikadu

Bezawit Afework

Habtamu Alemu

Begetayinoral Kussia

Childbirth Self-Efficacy and Its Associated Factors among Pregnant Women in Arba Minch Town, Southern Ethiopia, 2023: A Cross-Sectional Study

<i>Background</i>. Elective single-embryo transfers are being increasingly used to curb the increase in multiple gestation rates. However, it has been documented that single-embryo transfers could still result in twins and on rarer occasions in triplet pregnancies. <i>Main Body</i>. A literature review was done to highlight the possible mechanisms leading to embryonic splitting. In this review, the incidence of zygotic splitting was addressed and the notion of chorionicity was explained. Risk factors for zygotic splitting and suggested mechanisms for both twin and higher order pregnancies were suggested and discussed. <i>Conclusion</i>. The hypotheses that we have so far remain unproven due to the rarity of zygotic splitting as well as the ethicolegal considerations of human embryo research. The presence of such incidents necessitates extensive counselling of the couple.

Mokhamad Zhaffal

Rania Al Jafari

Anastasia Salame

Multiple Gestation after Elective Single-Embryo Transfer: A State-of-the-Art Review of Literature and Suggested Mechanisms

<i>Purpose</i>. Studies focusing on safety outcomes typically require large populations to comprehensively characterise the patient groups exposed to the medicines under investigation. However, there is often less information for subpopulations, such as pregnant or breastfeeding women, particularly when new medicines are considered. It is important to understand what information can be obtained from drug utilization studies (DUS) involving pregnant women in the early years postmarketing to provide supportive information for safety studies. The aims of this literature review are to (1) identify and review DUS for new medicines in pregnancy and breastfeeding and (2) list and summarise key information items to be reported in a DUS for new medicines in pregnancy. <i>Methods</i>. To identify postmarketing DUS of new prescription medicines or enantiomers in pregnancy, a systematic literature review was undertaken in PubMed and Embase between January 2015 and June 2022. In addition, the complete database of the ENCePP EU PAS Register was systematically searched to June 2022. <i>Results</i>. We identified 11 published DUS on new medicines in pregnancy from the ENCePP EU PAS Register and none from other sources. No studies on breastfeeding were identified. The 11 identified publications reported the medicine’s use for the first 3 to 5 years after marketing approval. No reports assessed utilization in the first 3 years of approval. It was usual to issue interim reports annually (7 studies). All studies concerned conditions managed in ambulatory care (primary care and outpatient facilities) and included some primary care prescribing. Most (<span class="inline_break"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="17.789pt" style="vertical-align:-0.2063904pt" id="M1" height="8.55521pt" version="1.1" viewBox="-0.0498162 -8.34882 17.789 8.55521"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g113-111" d="M495 86L479 114C446 82 419 66 409 66C401 66 401 72 406 97C420 166 436 231 453 297C489 435 454 448 428 448C406 448 384 439 354 422C305 394 222 327 161 247H159L183 345C200 415 194 448 173 448C143 448 82 410 23 351L38 325C64 349 95 371 105 371C111 371 116 365 109 336L25 -4L31 -12C50 -4 77 3 107 9C119 69 132 122 145 168C197 254 321 381 370 381C387 381 393 374 378 305L329 95C309 17 320 -12 345 -12C372 -12 430 19 495 86Z"/></g><g transform="matrix(.013,0,0,-0.013,10.158,0)"><path id="g117-34" d="M535 323V373H52V323H535ZM535 138V188H52V138H535Z"/></g></svg><span class="irelop"/><span class="nowrap"><svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" width="6.416pt" style="vertical-align:-0.2063904pt" height="8.55521pt" version="1.1" viewBox="21.3711838 -8.34882 6.416 8.55521"><g transform="matrix(.013,0,0,-0.013,21.421,0)"><path id="g113-57" d="M249 635C141 635 70 555 70 471C70 401 114 353 179 316C143 294 106 267 90 252C68 231 45 202 45 157C45 50 130 -12 237 -12C322 -12 435 52 435 169C435 256 372 304 303 343C349 374 375 398 383 407C401 429 411 458 411 487C411 569 344 635 249 635ZM238 603C285 603 337 567 337 482C337 422 310 385 276 358C205 393 145 426 145 500C145 552 179 603 238 603ZM248 20C183 20 125 70 125 163C125 218 158 268 206 300C284 261 355 217 355 143C355 66 308 20 248 20Z"/></g></svg>)</span></span> only had prescribing/dispensing data available at individual level for ambulatory care; outpatient prescribing was included in three of these studies Three studies held a limited amount of in-hospital prescribing data. A DUS can confirm at an early stage whether there are sufficient exposed pregnancies in available data sources to ensure a safety study is powered to detect a difference in the prevalence of adverse pregnancy or infant outcomes or if additional data from other databases are needed. A DUS may also help address methodological considerations such as selection of comparators. DUS can be performed embedded in a DUS in the general population, in a cohort of women of childbearing age, or in a cohort of pregnant women. <i>Conclusion</i>. This review summarises key aspects of a DUS for new medicines in pregnancy. DUS for new medicines in pregnancy should be planned before marketing, scheduled for the first 3 to 5 years after release, with annual interim/progress reports, and reported in peer-reviewed journals. By offering detailed information on data sources, exposure timing, prevalence and location, coprescribing, comorbidities, coexposures, and demographics, a DUS will offer a firm foundation for safety studies and will help to contextualize spontaneous reporting of serious adverse events.

Sandra Lopez-Leon

Anja Geldhof

Julie Scotto

Keele Wurst

Meritxell Sabidó

Jingping Mo

Ditte Molgaard-Nielsen

Jorieke E. H. Bergman

Xuan Anh Phi

Sue Jordan

Drug Utilization Studies in Pregnant Women for Newly Licensed Medicinal Products: A Contribution from IMI ConcePTION

About this journal

<p><em>Journal of Pregnancy</em> 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.</p>


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<p>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.</p>


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Journal of Pregnancy - Table of contents 2024

title

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.

Journal of Pregnancy