Journal of Pregnancy最新文献

{"title":"Partograph Utilization and Associated Factors among Obstetric Care Providers Working in Public Health Facilities of Wolaita Zone, 2017.","authors":"Mesfin Markos, Aseb Arba, Kebreab Paulos","doi":"10.1155/2020/3631808","DOIUrl":"10.1155/2020/3631808","url":null,"abstract":"<p><strong>Background: </strong>Obstructed or prolonged labor is a major cause of maternal deaths. Prolonged and obstructed labor contributed to 13% of global maternal deaths which can be reduced by proper utilization of a partograph during labor. Obstetric caregivers' use of the partograph during labor has paramount importance in identifying any deviation during labor. Even though partograph use is influenced by different factors as obtained from the literatures, the magnitude of partograph utilization and the factors associated with its use are not well determined in the health facilities of Wolaita Zone.</p><p><strong>Objective: </strong>To assess the magnitude of partograph utilization and factors that affect its utilization among obstetric caregivers in public health facilities of Wolaita Zone, Ethiopia, 2017.</p><p><strong>Methods: </strong>An institution-based cross-sectional study was conducted on obstetric caregivers. A pretested and structured questionnaire was used to collect data. Data was entered to EpiData version 3.01 and exported to SPSS version 23.0 for further analysis. Logistic regression analyses were used to see the association of different variables.</p><p><strong>Result: </strong>A total of 269 obstetric caregivers participated in the study. Among those who were utilizing the partograph, 193 (71.7%) routinely used it for all laboring mothers and 76 (28.3%) of participants reported that they do not routinely utilize it. Greater number of service years (AOR = 4.93, 95% CI: 1.53-15.88), on-the-job training (AOR = 0.16, 95% CI: 0.06-0.43), good knowledge (AOR = 3.35, 95% CI: 1.61-6.97), and favorable attitude towards partograph utilization (AOR = 2.99, 95% CI: 1.28-7.03) were significantly associated with partograph utilization. <i>Conclusion and Recommendation</i>. Partograph utilization among obstetric caregivers in the public health facilities was good. Greater years of work experience, in-service training, having good knowledge, and favorable attitude towards partograph utilization among obstetric caregivers independently determined partograph utilization. Provision of on-the-job training to make obstetric caregivers improve knowledge and skill on partograph utilization, maintaining caregivers' retention to decrease turnover by providing different incentives to more experienced obstetric care providers, and establishing favorable attitude could improve the proper use of the tool.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"3631808"},"PeriodicalIF":3.2,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3631808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers.","authors":"M Patabendige, S R Athulathmudali, S K Chandrasinghe","doi":"10.1155/2020/4926702","DOIUrl":"10.1155/2020/4926702","url":null,"abstract":"<p><strong>Background: </strong>Mental illness related to pregnancy can have long-lasting consequences. Healthcare providers are often the most frequent medical contact with the potential for early detection of these. Objectives were to study the awareness regarding mental health problems during pregnancy and the postpartum period among healthcare providers.</p><p><strong>Methods: </strong>A cross-sectional study was carried out with healthcare providers including the nursing staff, midwifery staff, and medical officers working at obstetric wards in three tertiary care hospitals in Sri Lanka. A self-administered questionnaire assessed staff experience with mothers having mental problems, knowledge on mental health problems related to pregnancy, and knowledge about risk factors, common symptoms, and possible consequences on a five-point Likert scale from \"Strongly Agree\" to \"Strongly Disagree.\"</p><p><strong>Results: </strong>A total of 300 staff were approached and invited to participate. Only 152 responded to the questionnaire (response rate of 50.1%). Mean (SD) age was 35.8 (9.7) years and mean (SD) years of experience was 10.1 (9.1) years. Age more than 35 years of healthcare providers is associated with statistically significant (<i>p</i> = 0.02) average knowledge scores on the consequences of maternal mental health problems. The symptom of \"excessively worrying about baby's health\" had the lowest score across all three categories with an average of 34.2%. Only 42.8% have ever heard of EPDS. Overall awareness and knowledge about risk factors, symptoms, and consequences regarding pregnancy-related maternal mental health problems are generally good among the healthcare providers studied. However, some of the few aspects are not satisfactory. Health education of pregnant women, promoting regular in-service training sessions, improvement of infrastructure, and involvement of family members from the antenatal period were discussed by the majority.</p><p><strong>Conclusion: </strong>Despite good overall awareness and knowledge, application into practice with the utilization of validated assessments is poor. This may probably explain why Sri Lanka has a high prevalence of postpartum depression suggesting urgent attention.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"4926702"},"PeriodicalIF":3.2,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38177479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with the Unplanned Pregnancy at Suhul General Hospital, Northern Ethiopia, 2018.","authors":"Yohannes Moges,&nbsp;Solomon Adanew Worku,&nbsp;Abrhaley Niguse,&nbsp;Bayew Kelkay","doi":"10.1155/2020/2926097","DOIUrl":"https://doi.org/10.1155/2020/2926097","url":null,"abstract":"<p><strong>Background: </strong>Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing.</p><p><strong>Objective: </strong>This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable.</p><p><strong>Result: </strong>The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. <i>Conclusion and Recommendation.</i> The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"2926097"},"PeriodicalIF":3.2,"publicationDate":"2020-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2926097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38177478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Pregnancy in the Hemoglobin Concentration of Pregnant Women: A Longitudinal Study.","authors":"Berhanu Elfu Feleke,&nbsp;Teferi Elfu Feleke","doi":"10.1155/2020/2789536","DOIUrl":"https://doi.org/10.1155/2020/2789536","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to estimate and identify the determinants of hemoglobin concentration before pregnancy, during pregnancy, and after labor and delivery.</p><p><strong>Methods: </strong>A prospective cohort study design was implemented. Data were collected from May 2015 to September 2018. A simple random sampling technique was used to select the participants. An interview technique was used to collect the data. Blood samples were collected before pregnancy, during each trimester, during labor and delivery, after third stage of labor, and at the 6-week postpartum period. Descriptive statistics were used to describe the profile of study participants. Generalized estimating equations were used to identify the determinants of hemoglobin concentration during each phase of pregnancy.</p><p><strong>Results: </strong>The mean hemoglobin concentrations of primigravida and multigravida before pregnancy were 12.41 g/dl and 10.78 g/dl, respectively. The hemoglobin concentration decreases with consecutive trimester reaching the lowest level at 42 days after delivery. The hemoglobin concentrations of pregnant women were decreased by hookworm 0.24 g/dl [95% CI:0.18-0.29], multiple pregnancy 0.16 g/dl [95% CI: 0.07-0.24], episiotomy 0.05 g/dl [95% CI: 0.01-0.09], gravidity 0.15 g/dl [95% CI: 0.09-0.21], age 0.03 g/dl [95% CI: 0.03-0.04], and gestational age 0.1 g/dl [95% CI: 0.09-0.11]. The hemoglobin concentration increased by iron supplementation 1.02 g/dl [95% CI: 0.97-1.07] and birth weight 0.14 g/dl [95% CI: 0.02-0.11].</p><p><strong>Conclusion: </strong>Pregnancy significantly decreases the hemoglobin concentration of pregnant women reaching the lowest point during labor and delivery. <i>Recommendation</i>. Regular anemia screening intervention should be implemented after delivery.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"2789536"},"PeriodicalIF":3.2,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2789536","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38070344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Choice to Deliver at Home: Understanding the Psychosocial and Cultural Factors Influencing Birthing Choices for Unskilled Home Delivery among Women in Southwestern Uganda.","authors":"Esther C Atukunda, Godfrey R Mugyenyi, Celestino Obua, Angella Musiimenta, Edgar Agaba, Josephine N Najjuma, Norma C Ware, Lynn T Matthews","doi":"10.1155/2020/6596394","DOIUrl":"10.1155/2020/6596394","url":null,"abstract":"<p><strong>Background: </strong>Utilization of perinatal services in Uganda remains low, with correspondingly high rates of unskilled home deliveries, which can be life-threatening. We explored psychosocial and cultural factors influencing birthing choices for unskilled home delivery among postpartum women in rural southwestern Uganda.</p><p><strong>Methods: </strong>We conducted in-depth qualitative face-to-face interviews with 30 purposively selected women between December 2018 and March 2019 to include adult women who delivered from their homes and health facility within the past three months. Women were recruited from 10 villages within 20 km from a referral hospital. Using the constructs of the Health Utilization Model (HUM), interview topics were developed. Interviews were conducted and digitally recorded in a private setting by a native speaker to elicit choices and experiences during pregnancy and childbirth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive categories using inductive content analytic approach.</p><p><strong>Results: </strong>Eighteen women (60%) preferred to deliver from home. Women's referent birth location was largely intentional. Overall, the data suggest women choose home delivery (1) because of their financial dependency and expectation for a \"<i>natural</i>\" and normal childbirth, affecting their ability and need to seek skilled facility delivery; (2) as a means of controlling their own birth processes; (3) out of dissatisfaction with facility-based care; (4) out of strong belief in fate regarding birth outcomes; (5) because they have access to alternative sources of birthing help within their communities, perceived as \"<i>affordable</i>,\" \"<i>supportive</i>,\" and \"<i>convenient</i>\"; and (6) as a result of existing gender and traditional norms that limit their ability and freedom to make family or health decisions as women.</p><p><strong>Conclusion: </strong>Women's psychosocial and cultural understandings of pregnancy and child birth, their established traditions, birth expectations, and perceptions of control, need, and quality of maternity care at a particular birthing location influenced their past and future decisions to pursue home delivery. Interventions to address barriers to healthcare utilization through a multipronged approach could help to debunk misconceptions, increase perceived need, and motivate women to seek facility delivery.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"6596394"},"PeriodicalIF":3.2,"publicationDate":"2020-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6596394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38070347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Profile Limits for Maternal Mortality Rates (MMR) Influenced by Haemorrhage and Unsafe Abortion in South Sudan.","authors":"Gabriel Makuei,&nbsp;Mali Abdollahian,&nbsp;Kaye Marion","doi":"10.1155/2020/2793960","DOIUrl":"https://doi.org/10.1155/2020/2793960","url":null,"abstract":"<p><p>Maternal mortality rate (MMR) is one of the main worldwide public health challenges. Presently, the high levels of MMR are a common problem in the world public health and especially, in developing countries. Half of these maternal deaths occur in Sub-Saharan Africa where little or nothing progress has been made. South Sudan is one of the developing countries which has the highest MMR. Thus, this paper deploys statistical analysis to identify the significant physiological causes of MMR in South Sudan. Prediction models based on Poisson Regression are then developed to predict MMR in terms of the significant physiological causes. Coefficients of determination and variance inflation factor are deployed to assess the influence of the individual causes on MMR. Efficacy of the models is assessed by analyzing their prediction errors. The paper for the first time has used optimization procedures to develop yearly lower and upper profile limits for MMR. Hemorrhaging and unsafe abortion are used to achieve UN 2030 lower and upper MMR targets. The statistical analysis indicates that reducing haemorrhaging by 1.91% per year would reduce MMR by 1.91% (95% CI (42.85-52.53)), reducing unsafe abortion by 0.49% per year would reduce MMR by 0.49% (95% CI (11.06-13.56)). The results indicate that the most influential predictors of MMR are; hemorrhaging (38%), sepsis (11.5%), obstructed labour (11.5%), unsafe abortion (10%), and indirect causes such as anaemia, malaria, and HIV/AIDs virus (29%). The results also show that to obtain the UN recommended MMR levels of minimum 21 and maximum 42 by 2030, the Government and other stakeholders should simultaneously, reduce haemorrhaging from the current value of 62 to 33.38 and 16.69, reduce unsafe abortion from the current value of 16 to 8.62 and 4.31. Thirty years of data is used to develop the optimal reduced Poisson Model based on hemorrhaging and unsafe abortion. The model with <i>R</i> ² of 92.68% can predict MMR with mean error of -0.42329 and SE-mean of 0.02268. The yearly optimal level of hemorrhage, unsafe abortion, and MMR can aid the government and other stakeholders on resources allocation to reduce the risk of maternal death.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"2793960"},"PeriodicalIF":3.2,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2793960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38070345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Striae Gravidarum, Acne, Facial Spots, and Hair Disorders: Risk Factors in a Study with 1284 Puerperal Patients.","authors":"Isadora da Rosa Hoefel,&nbsp;Magda Blessmann Weber,&nbsp;Ana Paula Dornelles Manzoni,&nbsp;Bárbara Hartung Lovato,&nbsp;Renan Rangel Bonamigo","doi":"10.1155/2020/8036109","DOIUrl":"https://doi.org/10.1155/2020/8036109","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of skin changes during pregnancy and to relate their occurrence to specific factors in a population of south Brazil.</p><p><strong>Methods: </strong>A cross-sectional analytical study was carried out with 1284 puerperal patients. A questionnaire about skin changes during pregnancy was developed and applied by the authors to all puerperal women admitted in a tertiary hospital in south Brazil.</p><p><strong>Results: </strong>The appearance of striae during pregnancy was reported by 633 women (49.5%) and had a statistically significant association with primiparity, presence of stretch marks before pregnancy, and gestational weight gain above 21 kg. Facial blemishes were reported by 33.9% (<i>n</i> = 434) and were associated with a positive family history, multiparity, and the use of facial sunscreen (<i>p</i> < 0.0001). The onset or worsening of acne was identified in 35.7% (<i>n</i> = 456) and was statistically associated with primiparity and Fitzpatrick phototypes IV and V. Hair alterations were reported by 44.5% (<i>n</i> = 569) and were associated with primiparity (<i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>Although most of the skin changes during pregnancy are considered \"physiologic,\" they can cause significant discomfort. Thus, it is important to know them and to understand which risk factors may be associated with such changes.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"8036109"},"PeriodicalIF":3.2,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8036109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38019527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Antenatal Oral Iron and Folic Acid Side Effects on Supplementation Duration in Low-Resource Rural Kenya: A Cross-Sectional Study.","authors":"Shadrack Oiye,&nbsp;Margaret Juma,&nbsp;Silvenus Konyole,&nbsp;Fatuma Adan","doi":"10.1155/2020/9621831","DOIUrl":"https://doi.org/10.1155/2020/9621831","url":null,"abstract":"Background Undesirable effects of a daily regimen of iron and folic acid ingested jointly (iron-folate) are potential disincentives to optimal antenatal supplementation. We intended to profile antenatal iron-folate side effects and elucidate their influence on supplementation duration in low-resource rural Kenya. Methods This was a cross-sectional descriptive study of randomly selected postnatal mothers of under-five-year-old children. Using a modified WHO Safe Motherhood Assessment standard questionnaire, they recalled the total number of days of antenatal iron-folate intake and the attendant supplement-attributed undesirable experiences. The analyses considered only participants who ingested the supplements in their immediate last pregnancies (n = 277). Results About half of the study participants reported at least a side effect and a mean of 2.4 (SD 1.5) effects per person in the entire pregnancy period. Most common reported effects were chest pains (31.8%), constipation (28.5%), severe stomach pains (11.6%), and diarrhoea (11.6%). Mothers who reported at least a side effect ingested the supplements for ten days less compared to those who did not experience any effect (p = 0.03); and a greater proportion of the former were primigravida (p = 0.02) and used combined form of iron and folic acid (p = 0.003). In a multivariate analysis, significant correlations with supplementation compliance (ingestion for 90+ days) were found only for nausea and severe stomach pain experiences (r = −0.1, p = 0.04; r = 0.2, p = 0.01, resp.). Conclusions The commonness of undesirable experiences attributed to daily ingestion of 60 mg iron and 0.4 mg folic acid and their deterrence to longer supplementation durations suggest the need for considering a weekly intermittent regimen for some antenatal women in such set-ups. Our study demonstrated that potentially, more counselling on nausea as a side effect might be critical in advancing iron-folate supplementation compliance.","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"9621831"},"PeriodicalIF":3.2,"publicationDate":"2020-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9621831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37977173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Severe Adverse Maternal and Neonatal Outcomes in Deliveries with Repeated and Primary Cesarean Deliveries versus Vaginal Deliveries: A Cross-Sectional Study.","authors":"Kiattisak Kongwattanakul,&nbsp;Rungroj Thamprayoch,&nbsp;Chumnan Kietpeerakool,&nbsp;Pisake Lumbiganon","doi":"10.1155/2020/9207431","DOIUrl":"https://doi.org/10.1155/2020/9207431","url":null,"abstract":"<p><strong>Objective: </strong>To determine risks of severe adverse maternal and neonatal outcomes in women with repeated cesarean delivery (CD) and primary CD compared with those with vaginal delivery (VD).</p><p><strong>Methods: </strong>Data of this cross-sectional study were extracted from 2,262 pregnant women who gave birth between August 2014 and December 2016, at Srinagarind Hospital, Khon Kaen University. Severe maternal outcomes were categorized based on the World Health Organization criteria. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated to indicate the risk of severe adverse maternal and neonatal outcomes among women underwent CD compared with those who underwent VD.</p><p><strong>Results: </strong>There were no cases of maternal death in this study. CD significantly increased risk of severe adverse maternal outcomes (SMO) (aOR 10.59; 95% CI, 1.19-94.54 for primary CD and aOR 17.21; 95% CI, 1.97-150.51 for repeated CD) compared with women who delivered vaginally. When compared with vaginal delivery, the risks of neonatal near miss (NNM) and severe adverse neonatal outcomes (SNO) were significantly higher in primary CD group (aOR 1.71; 95% CI 1.17-2.51 and aOR 1.66; 95% CI 1.14-2.43), respectively. For repeated CD, the risks were borderline significant (aOR, 1.58; 95% CI, 0.98-2.56 for NNM and aOR, 1.61; 95% CI, 0.99-2.60 for SNO).</p><p><strong>Conclusion: </strong>Primary and repeated CD significantly increased the risk of SMO compared with VD. Risks of NNM and SNO were also significantly increased in women with primary CD. The risks of NNM and SNO for repeated CD trended toward a significant increase.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"9207431"},"PeriodicalIF":3.2,"publicationDate":"2020-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9207431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37952400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Serum Concentrations of Selenium, Copper, and Zinc during Pregnancy Are Associated with Risk of Spontaneous Preterm Birth: A Case-Control Study from Malawi.","authors":"Grace Chiudzu,&nbsp;Augustine T Choko,&nbsp;Alfred Maluwa,&nbsp;Sandra Huber,&nbsp;Jon Odland","doi":"10.1155/2020/9435972","DOIUrl":"https://doi.org/10.1155/2020/9435972","url":null,"abstract":"<p><p>Preterm birth is delivery before 37 completed weeks. A study was conducted to evaluate the association of maternal serum concentrations of selenium, copper, and zinc and preterm birth. There were 181 women in this nested case-control study, 90/181 (49.7%) term and 91/181 (50.3%) preterm pregnant women. The overall mean serum concentration of selenium was 77.0, SD 19.4 <i>μ</i>g/L; of copper was 2.50, SD 0.52 mg/L; and of zinc was 0.77, SD 0.20 mg/L with reference values of 47-142 <i>μ</i>g/L, 0.76-1.59 mg/L, and 0.59-1.11 mg/L, respectively. For preterm birth, mean serum concentration for selenium was 79.7, SD 21.6 <i>μ</i>g/L; for copper was 2.61, SD 0.57 mg/L; and for zinc was 0.81, SD 0.20 mg/L compared to that for term births: selenium (74.2; SD 16.5 <i>μ</i>g/L; <i>p</i> = 0.058), copper (2.39; SD 0.43 mg/L; <i>p</i> = 0.004), and zinc (0.73; SD 0.19 mg/L; <i>p</i> = 0.006), respectively. In an adjusted analysis, every unit increase in maternal selenium concentrations gave increased odds of being a case OR 1.01 (95% CI: 0.99; 1.03), <i>p</i> = 0.234; copper OR 1.62 (95% CI: 0.80; 3.32), <i>p</i> = 0.184; zinc OR 6.88 (95% CI: 1.25; 43.67), <i>p</i> = 0.032. Results show that there was no deficiency of selenium and zinc and there were high serum concentrations of copper in pregnancy. Preterm birth was associated with higher maternal serum concentrations of copper and zinc.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2020 ","pages":"9435972"},"PeriodicalIF":3.2,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9435972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37938061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}