Acta Medica Philippina最新文献

{"title":"Knowledge and Practices of Nurses on the Prevention and Control of Healthcare-acquired Infections in a Private Tertiary Hospital in Baguio City.","authors":"Lyanne Kae C Campo, Aldren R Remon","doi":"10.47895/amp.vi0.9136","DOIUrl":"10.47895/amp.vi0.9136","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-acquired infections (HAIs) are adverse events brought about by non-compliance of the healthcare staff to set of infection prevention and control (IPC) standards. Consequently, additional medical costs, increased mortality and morbidity rates, and decreased quality of life among patients can happen. As valuable players in preventing and controlling HAIs, nurses must have good knowledge and strict compliance with infection control; however, recent evidence suggests that nurses may need more knowledge or better integration into practice. Nurses' degree of knowledge and practice in preventing and controlling HAIs and factors influencing them should be determined to provide solutions appropriately.</p><p><strong>Objectives: </strong>The study specifically sought answers to the following questions: (1) What is the level of knowledge of nurses in the prevention and control of HAIs? (2) What is the degree of practice of nurses in the prevention and control of HAIs? (3) Is there a significant relationship between nurses' knowledge level and degree of practice in the prevention and control of HAIs? (4) What are the facilitating and hindering factors that affect nurses' practice in the prevention and control of HAIs?</p><p><strong>Methods: </strong>The study utilized a quantitative descriptive correlational design. The study was conducted from May to June 2023 at a private tertiary hospital in Baguio City. The study included 128 nurses who fit the inclusion criteria. The respondents were asked to answer three questionnaires, and the data were statistically treated using mean, Spearman Rank correlation, frequency, percentage, and rank distribution.</p><p><strong>Results: </strong>The study found that nurses possess good knowledge and a suboptimal degree of practice in preventing and controlling HAIs. The results showed that no significant relationship existed between nurses' knowledge level and degree of practice in preventing and controlling HAIs. Perceived personal benefits and organizational encouragement were seen to primarily facilitate the prevention and control practices of nurses. The primary hindrance identified was work-load due to staff shortage, poor dissemination of guidelines, and personal discomfort associated with the use of PPE.</p><p><strong>Conclusions: </strong>A good level of knowledge is a derivative of learnings obtained through various educational modalities and these strategies are considered effective means of knowledge formulation. However, created knowledge without actual application into practice results in overuse of unhelpful interventions. To avoid the unnecessary effects of ineffective knowledge translation, a multifactorial consideration is necessary to identify other factors that may influence the practices of nurses on HAI prevention and control because knowledge does not solely improve or worsen actual practices. Identified facilitating factors should be supported, and hindering ","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 3","pages":"92-103"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727384","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":"Clinical, Biochemical, and Radiologic Profiles of Filipino Patients with 6-Pyruvoyl-Tetrahydrobiopterin Synthase (6-PTPS) Deficiency and their Neurodevelopmental Outcomes.","authors":"Leniza G de Castro-Hamoy, Ma Anna Lourdes A Moral, Loudella V Calotes-Castillo, Mary Ann R Abacan, Cynthia P Cordero, Maria Lourdes C Pagaspas, Ebner Bon G Maceda, Sylvia C Estrada, Mary Anne D Chiong","doi":"10.47895/amp.vi0.9439","DOIUrl":"10.47895/amp.vi0.9439","url":null,"abstract":"<p><strong>Background: </strong>Six-pyruvoyl-tetrahydrobiopterin synthase (6-PTPS) deficiency is an inherited metabolic disorder which results in tetrahydrobiopterin (BH4) deficiency causing hyperphenylalaninemia.</p><p><strong>Objective: </strong>This study aimed to describe the clinical, biochemical, and radiologic profiles, and neurologic and developmental outcomes of patients diagnosed with 6-pyruvoyl tetrahydrobiopterin (PTPS) deficiency through newborn screening and confirmed by BH4 loading test, pterin analysis, and gene sequencing who were following-up with the metabolic team.</p><p><strong>Methods: </strong>The research was a single-center descriptive case series study design that was done at the Philippine General Hospital, a tertiary government hospital. The clinical, biochemical, radiologic profiles and neurodevelopmental evaluation of each patient were described.</p><p><strong>Results: </strong>Nine patients from 1 year 2 months to 14 years 5 months of age were enrolled in the study. Clinical manifestations before treatment were hypotonia, poor suck, and seizure. The most common clinical manifestation even after treatment initiation was seizure. The mean phenylalanine level on newborn screening was 990.68 umol/L, but after treatment was started, mean levels ranged from 75.69 to 385.09 umol/L. Two of the patients had focal atrophy of the posterior lobe on brain imaging. Pathogenic variants on molecular analysis were all missense, with two predominant variants, c.155A>G and c.58T>C. Eight of the nine patients had varying degrees of developmental delay or intellectual disability, while the remaining patient had signs of a learning disorder.</p><p><strong>Conclusion: </strong>Newborn screening has played a crucial role in the early identification and management of patients with hyperphenylalaninemia due to 6-PTPS deficiency. Confirmation of diagnosis through determination of DHPR activity, urine pterins and/or molecular analysis is necessary for appropriate management. However, despite early initiation of treatment, neurodevelopmental findings of patients with 6-PTPS deficiency were still unsatisfactory.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 3","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727362","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":"Diagnostic Performance of a Computer-aided System for Tuberculosis Screening in Two Philippine Cities.","authors":"Gabrielle P Flores, Reiner Lorenzo J Tamayo, Robert Neil F Leong, Christian Sergio M Biglaen, Kathleen Nicole T Uy, Renee Rose O Maglente, Marlex Jorome M Nuguid, Jason V Alacapa","doi":"10.47895/amp.vi0.8950","DOIUrl":"10.47895/amp.vi0.8950","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Philippines faces challenges in the screening of tuberculosis (TB), one of them being the shortage in the health workforce who are skilled and allowed to screen TB. Deep learning neural networks (DLNNs) have shown potential in the TB screening process utilizing chest radiographs (CXRs). However, local studies on AI-based TB screening are limited. This study evaluated qXR3.0 technology's diagnostic performance for TB screening in Filipino adults aged 15 and older. Specifically, we evaluated the specificity and sensitivity of qXR3.0 compared to radiologists' impressions and determined whether it meets the World Health Organization (WHO) standards.</p><p><strong>Methods: </strong>A prospective cohort design was used to perform a study on comparing screening and diagnostic accuracies of qXR3.0 and two radiologist gradings in accordance with the Standards for Reporting Diagnostic Accuracy (STARD). Subjects from two clinics in Metro Manila which had qXR 3.0 seeking consultation at the time of study were invited to participate to have CXRs and sputum collected. Radiologists' and qXR3.0 readings and impressions were compared with respect to the reference standard Xpert MTB/RiF assay. Diagnostic accuracy measures were calculated.</p><p><strong>Results: </strong>With 82 participants, qXR3.0 demonstrated 100% sensitivity and 72.7% specificity with respect to the reference standard. There was a strong agreement between qXR3.0 and radiologists' readings as exhibited by the 0.7895 (between qXR 3.0 and CXRs read by at least one radiologist), 0.9362 (qXR 3.0 and CXRs read by both radiologists), and 0.9403 (qXR 3.0 and CXRs read as not suggestive of TB by at least one radiologist) concordance indices.</p><p><strong>Conclusions: </strong>qXR3.0 demonstrated high sensitivity to identify presence of TB among patients, and meets the WHO standard of at least 70% specificity for detecting true TB infection. This shows an immense potential for the tool to supplement the shortage of radiologists for TB screening in the country. Future research directions may consider larger sample sizes to confirm these findings and explore the economic value of mainstream adoption of qXR 3.0 for TB screening.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447716","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 COVID-19 Outcomes among Healthcare Workers: Findings from the Philippine CORONA Retrospective Cohort Study.","authors":"Adrian I Espiritu, Carl Froilan D Leochico, Isabella E Supnet, Emilio Q Villanueva, Marie Charmaine C Sy, Veeda Michelle M Anlacan, Roland Dominic G Jamora","doi":"10.47895/amp.vi0.9316","DOIUrl":"10.47895/amp.vi0.9316","url":null,"abstract":"<p><strong>Objectives: </strong>While many healthcare workers (HCWs) contracted COVID-19 during the pandemic, more information is needed to fully understand the potential for adverse health effects in this population segment. The aim of the present study is to examine the association between healthcare worker status and neurologic and clinical outcomes in COVID-19 infected inpatients.</p><p><strong>Methods: </strong>Using the nationwide database provided by the retrospective cohort Philippine CORONA study, we extracted relevant data and performed a secondary analysis primarily focusing on the presentation and outcomes of healthcare workers. Propensity score matching in a 3:1 ratio was performed to match HCWs and non-HCWs. We performed multiple logistic and Cox regression analyses to determine the relationship between HCWs and COVID-19 clinical outcomes.</p><p><strong>Results: </strong>We included 3,362 patients infected with COVID-19; of which, 854 were HCWs. Among the HCWs, a total of 31 (3.63%) and 45 (5.27%) had the primary outcomes of in-hospital mortality and respiratory failure, respectively. For both overall and 3:1 propensity-matched cohorts, being an HCW significantly decreased the odds of the following outcomes: severe/critical COVID-19 at nadir; in-hospital mortality; respiratory failure; intensive care unit admission; and hospital stay >14 days.</p><p><strong>Conclusion: </strong>We found that being an HCW is not associated with worse neurologic and clinical outcomes among patients hospitalized for COVID-19.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447811","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":"Association of <i>TP53</i> Germline Variant and Choledochal Cyst among Clinically Diagnosed Filipino Pediatric Patients.","authors":"Danna Mae S Opiso, Germana Emerita V Gregorio, Catherine Lynn T Silao","doi":"10.47895/amp.vi0.9091","DOIUrl":"10.47895/amp.vi0.9091","url":null,"abstract":"<p><strong>Background and objective: </strong>Choledochal cysts (CC) are rare congenital, cystic dilations of the biliary tree occurring predominantly in Asian populations and in females. Patients are usually children presenting with any of the following: abdominal pain, palpable abdominal mass, and jaundice. Its congenital nature hints at a potential genetic cause. A possible causal gene is <i>TP53</i>, a tumor suppressor with a germline variant called rs201753350 (c.91G>A) that changed from a G allele to an A allele, decreasing the cell proliferation suppressing activity of its functional protein. Currently, there is no information on the <i>TP53</i> rs201753350 germline variant available for the Filipino population. This study determined the prevalence of rs201753350 and the association between the functional G allele, the rs201753350 germline variant A allele, and the occurrence of CCs in Filipino pediatric patients in a tertiary government hospital.</p><p><strong>Methods: </strong>Genomic DNA was extracted from blood samples of pediatric patients clinically diagnosed with CC. Controls were DNA samples collected from a previous study. The samples underwent PCR, electrophoresis, and sequencing.</p><p><strong>Results: </strong>A total of 109 participants (22 cases and 87 controls) were included in the study. The A allele (22.94%) occurs at a lower frequency than the G allele (77.06%) among both cases and controls. More individuals have a homozygous G/G genotype (54.13%) than a heterozygous A/G genotype (45.87%) while the homozygous A/A genotype was not observed. The estimated risk of choledochal cyst occurrence is significantly lower in individuals with the A allele (PR: 0.08, 95% CI: 0.01 - 0.55) and the A/G genotype (PR: 0.06, 95% CI: 0.01 - 0.40).</p><p><strong>Conclusion: </strong>There is no significant evidence to suggest an association between the <i>TP53</i> rs201753350 germline variant and the occurrence of choledochal cysts in Filipinos. It is recommended that other mutations within and beyond the <i>TP53</i> gene be investigated for possible associations with choledochal cyst occurrence.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447684","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":"Rare Vulvar Lesions: A Case Series.","authors":"Parul Sinha, Vandana Verma, Apala Priyadarshini, Amrita Upadhyaya, Shruti Gupta","doi":"10.47895/amp.vi0.7933","DOIUrl":"10.47895/amp.vi0.7933","url":null,"abstract":"<p><p>Mass of the vulva include both benign and malignant lesions. Benign mass lesions of the vulva include tumors, hamartomas, cysts, infectious disorders, and non-neoplastic epithelial disorders. Some are rare mass lesions. Here, we presented three rare mass lesions of the vulva. The first case presented with the complaint of vulvar lesion since childhood, while the two cases presented in reproductive age and perimenopausal age. All three cases presented as mass lesions in the vulva with pain or uneasiness during work. In all these cases, excision was done. On histopathological examination, the lesions have different diagnoses which are common in other parts of the body, but rarely present at the vulva. A definitive diagnosis of a vulvar mass lesion is difficult to make, especially in the case of rare mass lesion. Histopathology is the principal tool of diagnosis.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"81-84"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447722","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":"Antibiotic Prescription Patterns among Pediatric Patients with Pneumonia in Primary Care - A Retrospective Cohort Study.","authors":"Jami Aliyah D Salliman, Leonila D Dans, Sally Jane Velasco-Aro, Arianna Maever Loreche-Amit, Cara Lois T Galingana, Mia P Rey, Josephine T Sanchez, Nanette B Sundiang, Herbert S Zabala, Antonio L Dans","doi":"10.47895/amp.vi0.8995","DOIUrl":"10.47895/amp.vi0.8995","url":null,"abstract":"<p><strong>Background and objectives: </strong>The etiology of pneumonia in the pediatric population varies by age group. Among patients one month to 59 months old, viral pathogens are the most common cause of lower respiratory infections. The study aims to determine the frequency distribution of antibiotic prescription among patients one month to 59 months old and to determine the adherence of primary care facilities to local guidelines with recommended antibiotics.</p><p><strong>Methods: </strong>A descriptive retrospective study using electronic medical records was conducted at two primary care sites. Patients aged 1 month to 59 months old seeking consult via telemedicine or face-to-face diagnosed with community acquired pneumonia from April 2019-March 2020 in the rural facility and May 2019-April 2020 in the remote facility were included in the study. The primary outcome was to determine the patterns of antibiotic use in pneumonia in remote and rural areas and adherence to the recommended antibiotics by the 2016 Philippine Academy of Pediatric Pulmonologists pediatric community-acquired pneumonia clinical practice guidelines (CPG).</p><p><strong>Results: </strong>There were 30 pediatric patients diagnosed with pneumonia in the rural facility and 213 in the remote facility. Of these patients with pneumonia, 96.7% and 94.8% were prescribed antibiotics in the rural and remote sites, respectively. The most commonly prescribed antibiotic in the rural facility was co-amoxiclav (26.7%), while amoxicillin (51.6%) was the most common in the remote facility. Adherence to the CPG in the rural site was lower at 23.3% (n=8/30) compared to the remote site which was 55.9% (n=119/213).</p><p><strong>Conclusion: </strong>Primary care physicians prescribed antibiotics in over 90% of the time upon the diagnosis of pneumonia in children aged one month to 59 months old, despite viral pneumonia being the more common in primary care setting. Adherence to recommended antibiotics was higher in the remote setting than in the rural setting. Use of EMR to monitor quality of care can improve patient outcomes and safety, pointing out the importance of improving the quality of documentation in the study sites.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"55-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447683","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":"Why Do Association Studies?","authors":"Mary Ann R Abacan","doi":"10.47895/amp.v59i2.12799","DOIUrl":"10.47895/amp.v59i2.12799","url":null,"abstract":"","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447814","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":"Effectiveness of Tocilizumab in COVID-19 Patients with Pneumonia: A Systematic Review.","authors":"Johanah Laisah M Salo, Lyka Jam N Marcelo, Ariana Claire A Sanchez, Chonamae P Marcelino, Lamadrid-Catublas Hazel Anne, Kevin Jace A Miranda, Rogie Royce Z Carandang","doi":"10.47895/amp.vi0.8188","DOIUrl":"10.47895/amp.vi0.8188","url":null,"abstract":"<p><strong>Background and objective: </strong>COVID-19 contributes significantly to global morbidity and mortality. Age-related comorbidities elevate the risk of severe cases. Studies have recently demonstrated that widely available medications, including tocilizumab (TCZ), can manage severe symptoms. However, its effectiveness is unclear, particularly among the older population. Therefore, this review aimed to evaluate TCZ's efficacy in managing severe pneumonia in individuals aged 50 and older.</p><p><strong>Methods: </strong>We systematically search several databases and gray literature including Web of Science, CINAHL, Academic Search Complete, PsycINFO, PsycArticles, SocINDEX, CENTRAL/Cochrane Library, PubMed/MEDLINE for original research articles in English across several study designs published in the year 2020-2022. A narrative synthesis was conducted to summarize the evidence. We employed the NIH quality assessment tool for observational cohort studies to evaluate risk of bias. Additionally, we utilized GRADE to appraise the certainty of evidence.</p><p><strong>Results: </strong>Among 539 screened articles, only five studies met the selection criteria. Tocilizumab's impact on severe COVID-19 pneumonia revealed a diverse effect on mortality rate, with 29% in the TCZ group, and 40% in the controls died within 30 days of intubation (OR 0.61; 95% CI, 0.27-1.36). It is also reported that TCZ was not associated with mortality, despite faster decline in pulmonary function and prolonged fever. Hospital mortality in the TCZ group was significantly lower than in the controls, and age over 60 was the only significant risk factor. Moreover, administering TCZ reduced mechanical ventilation needs, with 82% extubated compared to 53% in controls. However, 45% in TCZ group was associated with a higher ventilator-associated pneumonia rate than in the untreated group which was 20% (P < 0.001). Despite this, TCZ-treated patients had shorter hospital stays.</p><p><strong>Conclusions: </strong>The effects of tocilizumab on reducing mortality risk and improving the survival rate of COVID-19 patients with pneumonia remained inconclusive. Yet, the majority of results suggested that giving tocilizumab leads to shorter hospital stays, lowers the requirement for mechanical ventilation, and decreases the likelihood of ICU transfer. Tocilizumab is linked to the incidence of secondary infections; hence, this medication should be closely monitored for side effects.</p>","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"72-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447690","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 Mid-upper Arm Circumference as a Predictor of Low Birth Weight Outcome among Newborn Deliveries of Adolescents in a Tertiary Level Hospital.","authors":"Avegail M Cardinal, Vanessa-Maria F Torres-Ticzon, Ma Emma Alesna-Llanto","doi":"10.47895/amp.vi0.9109","DOIUrl":"10.47895/amp.vi0.9109","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis.The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries. A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off","PeriodicalId":6994,"journal":{"name":"Acta Medica Philippina","volume":"59 2","pages":"62-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447695","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}