Search Results (29)

Objective: This study aimed to provide pooled predictors of ANC (antenatal care) service use among women of reproductive age in Ethiopia. Methods: Studies were systematically searched using PubMed, Medline, CINAHL, EMBASE, and Google Scholar. The Newcastle–Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to obtain the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger’s regression test. Results: Twenty-two studies with a sample size of 25,671 were included in this review. The identified predictors of ANC service use were highest wealth rank (AOR 1.92 [95% CI: 1.53–2.31]), formal women education (AOR 2.40 [95% CI: 1.75–3.06]), formal husband education (AOR 1.49 [95% CI: 1.36–1.66]), women age ≥ 20 (AOR 1.75 [95% CI: 1.47–2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21–1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11–1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28–1.91]), women autonomy (AOR 1.42 [95% CI: 1.23–1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47–3.79]). Conclusions: Several predictors have increased the ANC service utilization, like wealth status, women’s and their husbands’ education, older/increasing women’s age, media exposure, maternal knowledge about pregnancy complications, planned pregnancy, women’s autonomy to decide on household health care, and positive husband attitude about the ANC service utilization. Full article

Background: Hydrocephalus in preterm and term newborns is a condition with an important impact on medical care and the neurological development of patients, with high expenditures regarding daily care. Imaging nowadays provides valuable information regarding the aetiology of the condition, and it represents a great aid in monitoring the development of the patients. Materials and methods: In this article, we present the cases of five patients with hydrocephalus, for which different imaging methods were used to detect and treat the underlying aetiology, emphasizing the cranial ultrasound examination. Results: The results provided valuable information regarding the utility and feasibility of ultrasound. Moreover, Prechtl’s Assessment of General Movements is yet another useful tool, which in correlation with the use of cranial ultrasound can provide good insight regarding the evolution of the affected newborns. The Kurjak Antenatal Neurodevelopmental Test (KANET, KANE Test) comes in handy in the case of prenatal neurological assessments. Conclusions: Ultrasound examination proves to be a worthy tool capable of detecting the aetiology; however, in several cases, a complementary imaging examination might be needed. The therapeutic approach should take into consideration the diverse aetiology of the disease. Full article

This study aimed to assess pregnant women’s knowledge regarding the benefits and practice of antenatal perineal massage (APM) and their acceptance of APM. A descriptive cross-sectional correlation design was applied to a convenience sample of 104 pregnant women who completed an online questionnaire. The online questionnaire was divided into four categories: (1) sociodemographic and obstetric history and general information about APM, (2) knowledge regarding the benefits of APM, (3) knowledge regarding the practice of APM, and (4) acceptance of APM. Data analysis was performed in SPSS v.26. Frequencies and percentages were taken from all qualitative variables. Most pregnant women had good knowledge: 78.8% had knowledge regarding the benefits of APM, 85.6% had knowledge regarding the practice of APM, and 54.8% reported acceptance of APM. There was a significant correlation between knowledge and practice of APM, indicating that a higher knowledge level leads to good practice of APM. This study highlighted participants’ significantly high amount of knowledge regarding the benefits and practice of APM. Additionally, based on the percentage of participants who had not heard about APM, the study revealed the failure of health-care providers to provide education regarding APM to pregnant women. Further research is needed to establish interventions that improve knowledge and encourage APM practice among pregnant women. Full article

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p-value < 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods. Full article

In Ghana, some pregnant women may not seek antenatal care due to the unavailability of such services in their communities, although preventive service can help reduce maternal mortality with high-quality care. This study aimed to understand the antenatal care opinions of Ghanaian mothers who sought antenatal care, the barriers they faced, and their suggestions for improvement in antenatal care in Ghana. This study’s data were collected in the Central and Ashanti regions in Ghana from June 2023 to January 2024. Four hundred and fifty mothers in Ghana who indicated that they had given birth within the last 10 years of the data collection period took part in the study. Our findings revealed that 93.6% of Ghanaian mothers perceived their antenatal care to be of good quality due to proper examinations, friendly provider–patient interactions, reassurance, fair treatment, and proper education, whereas 6.5% of Ghanaian mothers perceived their care to be of poor quality due to long wait times, impersonal interactions, inadequate facility resources, and barriers to communication. For Ghanaian mothers to receive better outcomes for themselves and their children, it is worth improving healthcare facilities, healthcare provider preparedness, local transportation, and addressing financial constraints to go from suboptimal to optimal health services. Full article

Background: This study aims to evaluate pregnant women’s knowledge of antenatal ultrasound in Saudi Arabia and its correlation with demographic factors like age and education to enhance prenatal care. Methods: A cross-sectional study was conducted in six Saudi Arabian hospitals, involving 22 questions split between sociodemographic information and knowledge of antenatal ultrasound. Descriptive statistics were used to characterize the participants’ demographics and responses. Additionally, inferential statistics were employed to analyze the relationships and differences among the study variables. Results: Among the 531 pregnant women in the study, most demonstrated a good understanding of antenatal ultrasound, identifying its various uses. Specifically, they recognized its roles in evaluating fetal growth (82.5%), placental location (81.7%), amniotic fluid volume (67%), and fetal morphology (65%), predicting the delivery date (79%), and determining the baby’s sex (89%). A majority viewed ultrasound as important (89.3%), safe (82.3%), and tolerable (76.3%) for prenatal care. Additionally, 66.7% felt adequately informed, mainly through clinical staff and doctors. Younger age, lower education, lack of prior ultrasound experience, and first pregnancy were linked to lower knowledge. Approximately 65% were uncertain about the nonionizing radiation properties of ultrasound. Conclusions: The study found that while most pregnant women in Saudi Arabia understand the objectives of antenatal ultrasonography, there are gaps in their knowledge about its nonionizing properties. Younger age, lower education, lack of prior ultrasound experience, and first pregnancy contribute to lower knowledge. Full article

This study aimed to evaluate scientific evidence of the benefit of the use of insecticide-treated nets (ITNs) and Intermittent preventive treatment (IPT) on the birth weight of newborns and the hemoglobin level of the mother when used to prevent malaria during pregnancy. This cross-sectional analytical study was conducted on 467 hospitalized women in the Maternity Ward of Centre Hospitalier de Kingasani II, in the Democratic Republic of the Congo. Data were collected using a structured questionnaire that was pre-tested during a face-to-face interview. Apart from basic statistics, the chi-square test was used to compare proportions. Multivariate analysis (logistic regression) was used to identify variables significantly associated with the 95% confidence interval (CI). The ITN ownership rate was 81% (95% CI: 77–84) and the ITN use rate was 66% (95% CI: 62–70). Sixty-five percent (95% CI: 60–69) reported having received at least three doses of IPT during pregnancy with sulfadoxine-pyramethemine (IPTp-SP). There was a statistically significant difference in hemoglobin levels between hospitalized women who did not use the ITN (9.4 g/dL IIQ: 8.7–9.9) and those who did (11 g/dL IIQ: 9.8–12.2). The non-use of the ITN was associated with low birth weight (aOR = 3.6; 95% CI: 2.1–6.2; p < 0.001) and anemia in pregnant women (cOR = 2.41; 95% CI: 1.16–5.01; p = 0.018). The use of ITN and taking at least three doses of ITP during pregnancy are associated with good birth weight. The number of doses of IPTp received during antenatal care is associated with the maternal hemoglobin level in the third trimester of pregnancy. Full article

Women’s satisfaction has been found to be a good indicator of quality of care and is associated with the utilization of healthcare services. Women’s needs and satisfaction could be improved through the provision of high-quality antenatal care services. This study assessed women’s expectations of and satisfaction with antenatal care and their associated factors in a semiurban setting in Tanzania. A cross-sectional survey using the Expectations and Satisfaction with the Prenatal Care Questionnaire (PESPC) was used to measure pregnant women’s expectations of and satisfaction with antenatal care in the two districts of Kibaha and Bagamoyo, involving 338 pregnant women. The data were analyzed using SPSS version 26. In the expectation subscale, women had high expectations for personalized care (78.4%), other services (from a social worker and nutritionist) (68.8%), and complete care (being taken care of on time, receiving excellent care, and receiving information without prompting) (60.9%), while expectations for continuity of care were the lowest (38.9%). In the satisfaction subscale, women were highly satisfied with providers’ care (being cared for with respect, healthcare provision, the way they were made to feel, and the ability to ask questions) (88.9%), while the least satisfying aspect was system characteristics (e.g., waiting times, scheduling, parking, tests and examinations, and facilities) (63.4%). Distance from a health facility was a significant predictor of both women’s expectations of and satisfaction with antenatal care services, while age and number of pregnancies were also significant predictors of antenatal care expectations. To meet expectations for quality antenatal care services and improve satisfaction with antenatal care, policymakers should improve system characteristics, including the availability of human resources and medical supplies, increased consultation time, flexible schedules, and reduced waiting time. Additionally, ensuring the accessibility of evidence-based health information is important for increasing health literacy among pregnant women. Full article

The exclusive breastfeeding (EBF) intention conceived by pregnant women is the most important predictor of breastfeeding (BF) initiation, duration, and continuation. This study explores the associated factors of EBF intention among pregnant women. This was a descriptive cross-sectional study conducted from November 2022 to January 2023 with 382 pregnant women who came to the outpatient clinic in the Maternal and Children Hospital (MCH). Four instruments were used for data collection: the Infant Feeding Intention scale, the Gender-Friendly BF Knowledge scale (GFBKS), the Iowa Infant Feeding Attitude scale (IIFAS), and the basic data questionnaire. The study findings indicated that 51.8% and 75.9% of gravida women had adequate knowledge and a positive attitude regarding BF. Furthermore, 56.3% of the participants had a high intention for EBF. Binary logistic regression illustrated that occupational status, antenatal care, plan for the current pregnancy, BF practice, last child delivery mode, medical disorder during the current pregnancy, age, BF knowledge, and attitude are potential predictors. The goodness of fit test revealed that 46.8% of the EBF intention could be anticipated through the positive pre-mentioned factors. The low EBF intention is modifiable by addressing the previously positive predictors. BF educational interventions should be tailored based on EBF intention predictors in order to be effective and lead to behavior change. Full article

Newborn screening (NBS) is a public health service that is used to screen for treatable conditions in many countries, including Thailand. Several reports have revealed low levels of parental awareness and knowledge about NBS. Because of limited data on parental perspectives toward NBS in Asia and the differences in socio-cultural and economic contexts between Western and Asian countries, we conducted a study to explore parental perspectives on NBS in Thailand. A Thai questionnaire to assess awareness, knowledge, and attitudes regarding NBS was constructed. The final questionnaire was distributed to pregnant women, with or without their spouses, and to parents of children aged up to one year who visited the study sites in 2022. A total of 717 participants were enrolled. Up to 60% of parents were identified as having good awareness, which was significantly associated with gender, age, and occupation. Only 10% of parents were classified as having good knowledge relative to their education level and occupation. Providing appropriate NBS education should be initiated during antenatal care, focusing on both parents. This study noted a positive attitude toward expanded NBS for treatable inborn metabolic diseases, incurable disorders, and adult-onset diseases. However, modernized NBS should be holistically evaluated by multiple stakeholders in each country because of different socio-cultural and economic contexts. Full article

Background: Congenital diaphragmatic hernia (CDH) is a rare disease associated with major nutritional and digestive morbidities. Oral feeding autonomy remains a major issue for the care and management of these patients. The aim of this study was to specify the perinatal risk factors of delayed oral feeding autonomy in patients treated for CDH. Methods: This monocentric cohort study included 138 patients with CDH. Eighty-four patients were analyzed after the exclusion of 54 patients (11 with delayed postnatal diagnosis, 5 with chromosomal anomaly, 9 with genetic syndrom, 13 with right-sided CDH, and 16 who died before discharge and before oral feeding autonomy was acquired). They were divided into two groups: oral feeding autonomy at initial hospital discharge (group 1, n = 51) and nutritional support at discharge (group 2, n = 33). Antenatal, postnatal, and perisurgical data were analyzed from birth until first hospital discharge. To remove biased or redundant factors related to CDH severity, statistical analysis was adjusted according to the need for a patch repair. Results: After analysis and adjustment, delayed oral feeding autonomy was not related to observed/expected lung-to-head ratio (LHR o/e), intrathoracic liver and/or stomach position, or operative duration. After adjustment, prophylactic gastrostomy (OR adjusted: 16.3, IC 95%: 3.6–74.4) and surgical reoperation (OR adjusted: 5.1, IC 95% 1.1–23.7) remained significantly associated with delayed oral feeding autonomy. Conclusions: Delayed oral feeding autonomy occurred in more than one third of patients with CDH. Both prophylactic gastrostomy and surgical reoperation represent significant risk factors. Bowel obstruction might also impact oral feeding autonomy. Prophylactic gastrostomy seems to be a false “good idea” to prevent failure to thrive. This procedure should be indicated case per case. Bowel obstruction and all surgical reoperations represent decisive events that could impact oral feeding autonomy. Full article

Background: Many pregnant women experience impairments in social, occupational, or other important functioning. Aim: This study aimed to confirm measurement and structural invariance of the Sheehan Disability Scale (SDS) and its validity during early pregnancy. Design: Longitudinal study with two observations. Methods: Questionnaires were distributed to pregnant women attending antenatal clinics at gestational weeks 10–13. Of 382 respondents, 129 responded to the SDS again 1 week later. Results: Confirmatory factor analysis shows good fit with the data: χ²/df = 0, comparative fit index (CFI) = 1.000, standardized root mean square residual (SRMR) = 0, and root mean square error of approximation (RMSEA) = 0.718. There is acceptable configural, measurement, and structural invariance of the factor structure between primiparas and multiparas as well as between two observation occasions. The Pregnancy–Unique Quantification of Emesis and Nausea, Patient Health Questionnaire-9, and Insomnia Severity Index subscales explain 47% of the variance in SDS scores. Conclusion: Perinatal health care professionals should pay more attention to the difficulties and disabilities that pregnant women face. Full article

Omphalocele is a congenital abdominal wall defect with a constant incidence in recent decades, sometimes representing a real burden for neonatal intensive care units due to prolonged hospitalization and the evolution to death. In our study, we aimed to detect the main risk factors of an unfavorable evolution in the case of omphalocele. Methods: Retrospective cohort study of all neonates with omphalocele treated in our tertiary pediatric hospital during the last three decades; from 158 patients, 139 patients were eligible for the study. We tried to determine the risk of death using logistic regression model. Results: If the neonate develops sepsis, then there is an increased risk (13.03 times) of evolution to death. Similarly, the risk of death is 10.82 times higher in the case of developing acute renal failure, 6.28 times higher in the case of associated abnormalities, 5.54 in the case of developing hemorrhagic disease, and 3.78 in the case of conservative treatment (applied for giant omphalocele or severe chromosomal abnormalities). Prematurity increases by 3.62 times the risk of death. All six independent variables contributed 61.0% to the risk of death. The area under the ROC curve is 0.91, meaning that the diagnostic accuracy of our logistic regression model is very good for predicting the contribution of the six independent variables to the risk of death. Conclusion: Although in the past 30 years we witnessed several improvements in the antenatal diagnosis and management of omphalocele, survival rate remained constant, 47.5% overall. Much effort is still needed to eliminate the risk factors for death in this condition. Full article

Congenital diaphragmatic hernia (CDH) is associated with abnormal pulmonary development, which is responsible for pulmonary hypoplasia with structural and functional abnormalities in pulmonary circulation, leading to the failure of the cardiorespiratory adaptation at birth. Despite improvement in treatment options and advances in neonatal care, mortality remains high, at close to 15 to 30%. Several risk factors of mortality and morbidities have been validated in fetuses with CDH. Antenatal assessment of lung volume is a reliable way to predict the severity of CDH. The two most commonly used measurements are the observed/expected lung to head ratio (LHRo/e) and the total pulmonary volume (TPV) on MRI. The estimation of total pulmonary volume (TPVo/e) by means of prenatal MRI remains the gold standard. In addition to LHR and TPV measurements, the position of the liver (up, in the thorax or down, in the abdomen) also plays a role in the prognostic evaluation. This prenatal prognostic evaluation can be used to select fetuses for antenatal surgery, consisting of fetoscopic endoluminal tracheal occlusion (FETO). The antenatal criteria of severe CDH with an ascended liver (LHRo/e or TPVo/e < 25%) are undoubtedly associated with a high risk of death or significant morbidity. However, despite the possibility of estimating the risk in antenatal care, it is difficult to determine what is in the child’s best interest, as there still are many uncertainties: (1) uncertainty about individual short-term prognosis; (2) uncertainty about long-term prognosis; and (3) uncertainty about the subsequent quality of life, especially when it is known that, with a similar degree of disability, a child’s quality of life varies from poor to good depending on multiple factors, including family support. Nevertheless, as the LHR decreases, the foreseeable “burden” becomes increasingly significant, and the expected benefit is increasingly unlikely. The legal and moral principle of the proportionality of medical procedures, as well as the prohibition of “unreasonable obstinacy” in all investigations or treatments undertaken, is necessary in these situations. However, the scientific and rational basis for assessing the long-term individual prognosis is limited to statistical data that do not adequately reflect individual risk. The risk of self-fulfilling prophecies should be kept in mind. The information given to parents must take this uncertainty into account when deciding on the treatment plan after birth. Full article

(1) Background: There is a high neonatal mortality rate in countries with low resources, especially sub-Saharan countries. There is no published data in Sudan on mothers’ knowledge and practice of essential newborn care. This study aimed to assess the maternal knowledge and practice of essential newborn care in Gadarif city, eastern Sudan. (2) Methods: A cross-sectional study was conducted in Gadarif city, eastern Sudan. Postnatal mothers (384) were recruited from postnatal and vaccination clinics. A structured questionnaire was used to collect the data. Mothers who responded to essential newborn care knowledge and practice items at a rate equal to 75% or above were classified as having good knowledge and practice. Logistic regression analysis was performed to identify the factors associated with essential newborn care knowledge and practice. (3) Results: In this study, 268 (66.4%) and 245 (63.8%) of the 384 participants had good knowledge and practice of essential newborn care, respectively. None of the investigated factors (age, residence, education, occupation, parity, antenatal care, and mode of delivery) was associated with knowledge and practice of essential newborn care with sociodemographic and obstetric factors. Mothers with poor knowledge were less likely to have good practices (adjusted odds ratios = 0.41; 95% CI (0.26–0.64)). The reported malpractices were giving dietary supplements to the babies (48.2%), mainly water (40.0%) and cow’s milk (43.2%), and putting substances on the umbilical cord (62.8%), with butter (92.1%) accounting for the majority. (4) Conclusion: In the present study, around two-thirds of the participants had good essential newborn care knowledge and practice. Poor knowledge was less likely to be associated with good newborn care practices. More research is needed to build baseline data for neonatal mortality reduction plans. Full article