Number Of Childbirths Research Articles

The association of adolescent to midlife weight change with age at natural menopause: a population study of 263,586 women in Norway.

Age at menopause varies considerably among women and is linked to health after menopause. Body mass index is associated with age at natural menopause, but the influence of weight change remains unclear. Thus, we studied associations of adolescent to midlife weight change with age at natural menopause. We performed a retrospective population-based cohort study of 263,586 women aged 50-69 years attending BreastScreen Norway (2006-2015). The associations were estimated as hazard ratios (HRs) for having reached menopause using Cox proportional hazard models. We included nine categories of weight change based on recalls of adolescent weight compared to peers and quartiles of midlife weight in kilograms. We adjusted for year and country of birth, education, number of childbirths, height, smoking, and exercise. Women with the largest estimated weight loss had highest hazard of reaching menopause (adjusted HR 1.11, 95% CI: 1.06-1.17) compared to women with estimated stable average weight. Conversely, women with the largest estimated weight gain had lower hazard (adjusted HR 0.96, 95% CI: 0.93-0.99). Women with estimated stable high weight had lowest hazard of reaching menopause (adjusted HR 0.93, 95% CI: 0.90-0.95). Our findings suggest that changes in body weight across the life course may influence the timing of menopause.

Regional trends, spatial patterns and determinants of health facility delivery among women of reproductive age in Nigeria: A national population based cross-sectional study.

Globally, about 810 women die daily from pregnancy and childbirth complications, and the burden is highest in Africa. The United Nations sustainable development goal has a maternal mortality ratio (MMR) target of 70 per 100,000 live births by 2030. Nigeria, the largest country in Africa, has an MMR of 512 per 100,000 live births, thus there is need for intensified efforts to reduce maternal deaths in the country. Proper utilisation of maternal health services including health facilities for delivery is crucial to achieving this. This study assesses the regional trends, spatial patterns and determinants of health facility delivery among women of reproductive age in Nigeria. This is a weighted secondary analysis of the Nigerian Demographic and Health Survey (NDHS). The sample included women who had a live birth in the preceding 5 years of the NDHS 2008, 2013 and 2018. Bivariate analysis and multilevel logistic regression were carried out to assess the determinants of health facility delivery. Trends analysis was done using bar graphs and spatial analysis showed the distribution of health facility delivery by State. Forty-one percent of women delivered their last child in a health facility. The proportion of women who delivered at a health facility increased from 2008 to 2018 for all regions, with exception of the South-south region. Determinants of facility-based delivery include; ethnicity, level of education, wealth index, exposure to mass media (AOR 1.34; 95% CI 1.20-1.50), number of childbirths, number of antenatal visits (AOR 4.03; 95% CI 3.51-4.62), getting a companion to go the health facility (AOR 0.84; 95% CI 0.72-0.98), community level poverty, community level of female education, community distance to health facility, and geographical region. There is an urgent need to deploy appropriate strategies and programme to improve health facility delivery in Nigeria.

Early menarche and childbirth accelerate aging-related outcomes and age-related diseases: Evidence for antagonistic pleiotropy in humans.

Aging can be understood as a consequence of the declining force of natural selection with age. Consistent with this the antagonistic pleiotropic theory of aging suggests that aging results from the trade-offs that promote early growth and reproduction. However, evidence for antagonistic pleiotropy in humans is largely lacking. Using Mendelian Randomization (MR), we demonstrated that later ages of menarche or first childbirth were genetically associated with longer parental lifespan, decreased frailty index, slower epigenetic aging, later menopause, and reduced facial aging. Moreover, later menarche or first childbirth were also genetically associated with a lower risk of several age-related diseases, including late-onset Alzheimer's disease (LOAD), type 2 diabetes, heart disease, essential hypertension, and chronic obstructive pulmonary disease (COPD). We validated the associations between the age of menarche, childbirth, and the number of childbirths with several age-related outcomes in the UK Biobank by conducting regression analysis of nearly 200,000 subjects. Our results demonstrated that menarche before the age 11 and childbirth before 21 significantly accelerated the risk of several diseases, and almost doubled the risk for diabetes, heart failure, and quadrupled the risk of obesity, supporting the antagonistic pleiotropy theory. We identified 128 significant single nucleotide polymorphisms (SNPs) that influenced age-related outcomes, some of which were involved in known longevity pathways, including IGF1, growth hormone, AMPK, and mTOR signaling. Our study also identified higher BMI as a mediating factor in causing the increased risk of certain diseases, such as type 2 diabetes and heart failure, in women with early menarche or early pregnancy, emphasizing the importance of the thrifty gene hypothesis in explaining in part the mechanisms behind antagonistic pleiotropy. Our study highlights the complex relationship between genetic legacies and modern diseases, emphasizing the need for gender-sensitive healthcare strategies that consider the unique connections between female reproductive health and aging.

Clinically significant changes in anal sphincter hiatal area in patients with gestational diabetes mellitus and pelvic organ prolapse.

The prevalence of pelvic organ prolapse (POP) increases with age and parity. Specifically, the prevalence of POP among women aged 20 to 39 is 9.7%, while it rises to 49% among women over 80 years old. Additionally, as the number of deliveries increases, the prevalence of POP also rises accordingly, with a rate of 12.8% for women with one delivery history, 18.7% for those with two deliveries, and 24.6% for women with three or more deliveries. It causes immense suffering for pregnant women. To evaluate the relationship between the levator ani muscle's hiatus (LH) area and POP in patients with gestational diabetes mellitus (GDM) using perineal ultra-sound. The study cohort comprised 104 patients aged 29.8 ± 3.7 years who sought medical care at our institution between January 2021 and June 2023. All were singleton pregnancies consisting of 75 primiparas and 29 multiparas, with an average parity of 1.7 ± 0.5. According to the POP diagnostic criteria, the 104 subjects were divided into two groups with 52 members each: POP group (patients with GDM combined with POP) and non-POP group (patients with GDM without POP). Perineal ultrasound was used to measure differences in the anteroposterior diameter, transverse diameter, and LH area. Receiver operating characteristic curves were drawn to determine the optimal cutoff values for the LH anteroposterior diameter, transverse diameter, and area for diagnosing POP. Statistically significant increase in the LH area, anteroposterior diameter, and lateral diameter were observed in the POP group compared with the non-POP group (P < 0.05). Both groups exhibited markedly elevated incidence rates of macrosomia and stress urinary incontinence. For the POP group, the area under the curve (AUC) for the LH area was 0.906 with a 95% confidence interval (CI): 0.824-0.988. The optimal cutoff was 13.54cm², demonstrating a sensitivity of 83.2% and a specificity of 64.4%. The AUC for the anteroposterior diameter reached 0.836 with a 95%CI: 0.729-0.943. The optimal cutoff was 5.53 cm with a sensitivity of 64.2% and a specificity of 73.4%. For the lateral diameter, its AUC was 0.568 with a 95%CI: 0.407-0.729. The optimal cutoff was 4.67 cm, displaying a sensitivity of 65.9% and a specificity of 69.3%. Logistic regression analysis unveiled that age, body weight, number of childbirths, total number of pregnancies, and gestational weight gain constituted the independent risk factors for the cooccurrence of GDM and POP. Three-dimensional perineal ultrasonography of LH size and shape changes can effectively diagnose POP. Age, weight, number of births, number of pregnancies, and weight gain during pregnancy are independent risk factors affecting the cooccurrence of GDM and POP. GDM can increase the LH area in patients, and an enlarged LH leads to an increased incidence of POP.

Prevalence, Determinants, and Management Options of Scar Site Pregnancy in Women With Previous Cesarean Section: A Study From the Al-Qassim Region.

Pregnancy located outside the uterine cavity following a cesarean section has become more prevalent in recent years due to the increase in cesarean section delivery. This study sought to investigate the prevalence, determinants, and treatment options of scar site pregnancy among women who sought maternal and child health services in a hospital in Buraydah, Al-Qassim region, Saudi Arabia. Utilizing a quantitative retrospective case-control design, 50 women were recruited and assigned to the two groups evenly. Demographic data and risk factors were assessed using a questionnaire, and data were analyzed using SPSS version 27 at a 95% confidence interval and presented intables and figures. Fifty-eight percent of the participants were aged 35 years and above, with 38% reporting a parity of 1-3. Logistic regression revealed that parity (odds ratio (OR) = 10.975, 95% confidence interval (CI) = 0.887-135.861, and p-value = 0.062), the interval between the last and present pregnancies (OR = 0.056, 95% CI = 0.005-0.668, p-value = 0.023), intrauterine contraceptive device (IUCD) use in the last year(OR = 0.070, 95% CI = 0.006 -0.780, p-value = 0.031) were statistically significant in predicting cesarean scar pregnancy. Combined methotrexate and aspiration were the most prevalent treatment options for scar site pregnancy in this study. Scar site pregnancy is a maternal health complication that affects women across all healthcare settings, and its prevalence is not clear due to underdiagnosis and underreporting. The risk of scar site pregnancy increased with an increase in the number of childbirths (parity) and the interval between the last and current pregnancies.

Machine learning techniques to identify risk factors of breast cancer among women in Mashhad, Iran.

Low survival rates of breast cancer in developing countries are mainly due to the lack of early detection plans and adequate diagnosis and treatment facilities. This study aimed to apply machine learning techniques to recognize the most important breast cancer risk factors. This case-control study included women aged 17-75 years who were referred to medical centers affiliated with Mashhad University of Medical Science between March 21, 2015, and March 19, 2016. The study had two datasets: one with 516 samples (258 cases and 258 controls) and another with 606 samples (303 cases and 303 controls). Written informed consent has been observed. Decision Tree (DT), Random Forest (RF), Logistic Regression (LR), and Principal Component Analysis (PCA) were applied using R studio software. Regarding the DT and RF, the most important features that impact breast cancer were family cancer, individual history of breast cancer, biopsy sampling, rarely consumption of a dairy, fruit, and vegetable meal, while in PCA and LR these features including family cancer, pregnancy number, pregnancy tendency, abortion, first menstruation, the age of first childbirth and childbirth number. Machine learning algorithms can be used to extract the most important factors in the diagnosis of breast cancer in developing countries such as Iran.

FACTORS AFFECTING THE AGE OF MENOPAUSE IN PADANG CITY IN 2023

AbstractMenopause is characterized by a consecutive period of amenorrhea lasting 12 months without anyunderlying causes or surgical interventions. The age at which menopause occurs can be influenced byvarious factors, including menarche, number of childbirths, body mass index, and the utilization ofhormonal contraceptives. This study aims to determine the factors that influence the incidence ofmenopause in Padang. This study is an analytical research with a cross-sectional study design. Theresearch was conducted in the working areas of all primary public health centers in Padang fromJanuari 2023 to September 2023. The sample consisted of middle-aged women who visited theworking areas of all primary public health centers during the study period. This study is using aquestionnaire as the research instrument and employing the simple random sampling technique toobtain a sample size of 124 participants. The data analysis was conducted using the Chi- Square test,and utilize the statistical software SPSS. A significant relationship between variables was defined if thep-value &lt; 0.05. The results of this study revealed that the majority of respondents experienced earlymenarche (36.3%), had multiparous pregnancies (33.9%), had underweight body mass index (33.1%),used hormonal contraceptives (52.4%), and experienced late menopause (40.3%). The analysisshowed a significant relationship (p&lt;0.05) between the age of menarche (p=0.036) and parity(p=0.002) with the occurrence of menopause. However, there was no significant relationship (p&gt;0.05)between body mass index (p=0.141) and history of contraceptive use (p=0.069) with the occurrenceof menopause. This study found a significant relationship between the age of menarche and paritywith the occurrence of menopause, while there was no significant relationship between body massindex and history of contraceptive use with the occurrence of menopause among middle-aged womenvisiting the primary public health center areas in Padang.

Pelvic floor dysfunction: prevalence and associated factors

BackgroundPelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions.ObjectiveDetermine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women.Material and methodsThis observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated.ResultsOne thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia.ConclusionsThe prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.

Dietary advanced glycation end products are associated with an increased risk of breast cancer in Iranian adults

BackgroundDietary advanced glycation end products (AGEs) can play an important role in increasing inflammatory factors and oxidative stress as risk factors for cancers. In the present study, we aimed to assess the relationship between dietary AGEs and the risk of breast cancer (BC) in Iranian adult women.MethodsThis hospital-based case-control study includes 401 participants aged ≥ 30 years old. The cases group consisted of 134 women diagnosed with histologically confirmed BC. The control group included 267 women enrolled randomly from patients admitted to the same hospitals. Dietary intake information was determined using a validated food frequency questionnaire, and dietary AGEs intake was computed for all participants. Logistic regression models, adjusted for potential confounders, were used to determine the odds ratios (OR) and 95% confidence interval (CI) of BC across tertiles of dietary AGEs.ResultsThe mean ± SD age and body mass index of the study population were 47.92 ± 10.33 years and 29.43 ± 5.51 kg/m2, respectively. The median (interquartile) of dietary AGEs in all individuals was 9251(7450, 11,818) kU/day. After adjusting for age, first pregnancy age, and energy intake, participants in the highest tertile of dietary AGEs intakes had higher odds of BC compared to those in the lowest tertile of dietary AGEs (OR:2.29;95%CI:1.19–4.39, Ptrend:0.012). Additionally, in the multivariable model, after adjusting for age, age at first pregnancy, energy, menopausal status, family history of cancer, anti-inflammatory drug use, Vitamin D supplementation, physical activity, body mass index, number of childbirths, and history of abortion, breastfeeding, and oral contraceptive pills use, the odds of BC were increased across tertiles of dietary AGEs intake (OR: 2.33; 95%CI: 1.18–4.60, Ptrend: 0.017).ConclusionThe present findings suggest that a diet with high AGEs is associated with a higher likelihood of BC in adult women.

The dose-response relationship of pre-menopausal alcohol consumption with age at menopause: a population study of 280 497 women in Norway.

Previous research suggests that alcohol consumption is associated with high age at menopause. Yet, knowledge about the dose-response relationship is inconsistent. Thus, we studied the pattern of the association of pre-menopausal alcohol consumption with age at natural menopause. We performed a retrospective population-based study using self-reported data from 280 497 women aged 50-69 years attending the Norwegian breast cancer screening programme (BreastScreen Norway) during 2006-15. Associations of weekly alcohol consumption between the age of 20 and 49 years with age at menopause were estimated as hazard ratios (HRs) using Cox proportional hazard models with restricted cubic splines to allow for non-linear associations. We adjusted for year and place of birth, number of childbirths, educational level, body mass index and smoking habits. Mean age at natural menopause was 51.20 years (interquartile range: 49-54 years). The adjusted HR of reaching menopause was highest for women with no alcohol consumption (reference) and the HR decreased by alcohol consumption up to 50 grams per week (adjusted HR 0.87; 95% CI: 0.86-0.88). Above 50 grams, there was no further decrease in the HR of reaching menopause (P for non-linearity of <0.001). Women who did not consume alcohol were youngest at menopause. The lack of a dose-response association among alcohol consumers implies virtually no relation of alcohol consumption with age at menopause. Our findings may suggest that characteristics of the women who did not consume alcohol, not accounted for in the data analyses, explain their younger age at menopause.

The Effect of Pineapple Juice on The Healing of Postoperative Sectio Caesarea Wounds at Bogor City Mulia Pajajaran Hospital in 2023

Background: According to RISKESDAS in 2018, the number of childbirths using the sectio caesarea method in women aged 10-54 years in Indonesia reached 17.6% of the total number of deliveries. Recovery in the puerperium for mothers who have given birth by sectio caesarea surgery can be done by gradual early mobilization, because there is an incision wound on the abdomen of the mother. In addition to the mobilization of factors affecting wound healing is the intake of maternal nutrients. The role of nutrition in wound healing is very important in wound healing. Nutrient intake is high in protein such as in fish, eggs and fruits. Pineapple fruit can accelerate wound healing because there is a bromelain enzyme that can convert protein into amino acids that can regenerate damaged cells so that wound healing will take place faster. Purpose: To know the Effect of Pineapple Juice on The Healing of Postoperative Sectio Caesarea Wounds at Bogor City Mulia Pajajaran Hospital in 2023 Methods: This research is a quasi-experiment with a pre-posttest only control group research design. The sampling technique uses non probability sampling with accidental sampling method. The samples in this study were calculated by large samples with a paired numerical analytical formula with the results of a large sample of 32 samples, and the group was divided into 2, namely the control group and the intervention group. Data collection is carried out by observation. Data analysis was performed using the Wilxocon Test. Results: Based on the results of the study showed that there was an effect of giving Pineapple Juice on wound healing in postoperative sectio caesarea mothers with a p-value of 0.000 meaning &lt; 0.05. Conclusion: Consumption of Pineapple Juice can speed up the healing process of postoperative sectio caesarea wounds at Mulia Pajajaran Hospital, Bogor City. It is hoped that consuming pineapple juice can be recommended and applied by health workers to postpartum mothers whose delivery is by sectio caesarea surgery.

Association between birth-related factors and periodontitis in women: Korea National Health and Nutrition Examination Survey 2013-2018.

Adult women experience several changes in physiological status, such as pregnancy and childbirth, during their life cycle. This study analyses the association between birth-related factors (the number of childbirths, abortions and miscarriages) and periodontitis using data from the Korea National Health and Nutrition Examination Survey, which represents Korean adults. The study used data from Korea National Health and Nutrition Examination Survey VI and VII (2013-2018) and included 10,072 women 19 years or older, with no missing data on the variables assessed. Periodontitis was defined according to the Community Periodontal Index (CPI) criteria. Multiple logistic regression analysis, adjusting for age, household income, education, alcohol consumption, smoking, stress, body mass index, waist circumference, hypertension, diabetes mellitus, an oral examination within 1 year, daily tooth brushing frequency, hygiene products and self-perceived oral health as identified via logistic regression analyses, was performed to determine the association between birth-related variables and periodontitis. In the crude model, the odds ratio (OR) showed a significantly increased risk of periodontitis (CPI ≥ 3) and severe periodontitis (CPI = 4) based on the number of childbirths, abortions and miscarriages (p < .05). After covariate adjustment, periodontitis (CPI ≥ 3) was associated with the number of childbirths (1: OR = 1.92; 95% confidence interval [CI]: 1.47-2.50; 2: OR = 2.03; 95% CI: 1.57-2.61; ≥3: OR = 2.11; 95% CI: 1.60-2.78). Furthermore, severe periodontitis (CPI = 4) was also associated with the number of childbirths (1: OR = 2.33; 95% CI: 1.24-4.38; 2: OR = 2.99; 95% CI: 1.62-5.52; ≥3: OR = 3.34; 95% CI: 1.79-6.21). The findings of this large-scale, nationally representative study suggest that the number of childbirths is associated with the severity of periodontitis. However, the relationship between the number of abortions and miscarriages and periodontitis (CPI ≥ 3) or severe periodontitis (CPI = 4) is not significant.

Toxoplasmosis-Awareness and Knowledge of Pregnant Women in Rural Areas of Malakand Region, Pakistan.

The current study was carried out between October 2017 and October 2018 to explore knowledge, attitudes, practices, and information sources regarding toxoplasmosis among pregnant women in Malakand region, the northwestern part of Pakistan. The current study was carried out between October 2017 and October 2018. A structured questionnaire was used to interview the women after taking verbal informed consent. Graphpad version 5 was used to indicate the differences. Significant was considered as a P-value of less than 0.05. This study revealed poor knowledge regarding toxoplasmosis. Overall, 31.2% of the respondents showed good knowledge, and 39.2% showed moderate knowledge. On the other hand, 29.5% of the participants showed poor knowledge about toxoplasmosis. The average knowledge score of pregnant women was 79 ± 12.2, which is considered to be within the scale of good knowledge. Number of children within the pregnant multipara women was significantly associated with knowledge about toxoplasmosis. Pregnant women who measured in number of childbirths within a women showed the highest mean score of 42.3 ± 13.3 with 57 (44.8%) displaying a good knowledge level. Pregnant women with more than one child had significantly higher (<0.0001) knowledge scores compared to women with one child or none child. The majority of pregnant women with one child used the social media, followed by mass media as sources of information about toxoplasmosis. Scientific sources of information were used more commonly by pregnant women with none of the child birth. Pregnant women knowledge regarding toxoplasmosis was poor as compared to attitudes and practices. Health workers and newspapers/magazines were the main sources of information.

Intimate partner violence and child loss: an evaluation of 7 sub-Saharan African countries.

Intimate partner violence (IPV) and child loss disproportionately affect women in sub-Saharan Africa (SSA). Little research has examined the relationship between IPV and child loss in SSA. We used data from Demographic Health Surveys in 7 countries in SSA (Côte d'Ivoire, Democratic Republic of the Congo, Namibia, Sierra Leone, Togo, Zambia, and Rwanda). Women's Health Module questions assessed lifetime physical, sexual, and emotional IPV. Child loss was calculated as the difference between the number of child births and the number of living children. Logistic regression was conducted adjusting for age, marital status, educational attainment, location of residence, wealth, sexually transmitted infections, and country of origin. Data were weighted and analysed using STATA Software (14.0). Among women who gave birth, approximately one third (31.7%) reported that they lost 1 or more children. Nearly half (44.3%) reported that they experienced physical IPV during their lifetime. Women who had experienced physical, emotional, or sexual IPV were significantly more likely to report a loss of 1 or more children (OR=1.20, 95% confidence interval (CI)= [1.08, 1.33]; OR=1.30, 95% CI= [1.16, 1.45]; OR=1.42, 95% CI= [1.23, 1.65], respectively) in comparison with women who had not experienced IPV controlling for potentially influential covariates. Women who were older, married, had lower educational attainment, and had lower income were more likely to have lost 1 or more children. These results suggest that women who experienced all types of and cumulative exposure to IPV may be more likely to lose a child in SSA.

Hysterectomy on benign indication and risk of pelvic organ prolapse surgery: A national matched cohort study.

Hysterectomy is a frequently performed gynecological procedure but long-term effects remain understudied. Pelvic organ prolapse reduces life quality significantly. The lifetime risk of undergoing pelvic organ prolapse surgery is 20% and parity is known to be the largest risk factor. Studies have shown an increased risk of pelvic organ prolapse surgery after hysterectomy; however, few have studied the compartments which are affected and how this association is affected by surgical route and parity. In this Danish nationwide cohort study, we identified women born in 1947-2000 who underwent hysterectomy during 1977-2018 who were indexed on the day of hysterectomy. We excluded women who immigrated when older than 15 years, who underwent pelvic organ prolapse surgery prior to index, and who were diagnosed with a gynecological cancer prior to or within 30 days of index. Women who underwent hysterectomy were matched 1:5 to references on age and year of hysterectomy. Women were censored at the time of death, emigration, a gynecological cancer diagnosis, radical or unspecified hysterectomy or December 31, 2018, whichever came first. The risk of pelvic organ prolapse surgery after hysterectomy was computed using Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for age, calendar year, parity, income and educational level. We included 80 444 women who underwent hysterectomy and 396 303 reference women. Women who underwent hysterectomy had a significantly higher risk of undergoing pelvic organ prolapse surgery: HRadjusted 1.4 (95% CI 1.3-1.5). In particular, the risk of a posterior compartment prolapse operation was increased: HRadjusted 2.2 (95% CI 2.0-2.3). The risk of prolapse surgery increased with increased parity and by an additional 40% after hysterectomy. Cesarean sections did not seem to increase the risk of prolapse surgery. This study shows that hysterectomy, regardless of surgical route, leads to an increased risk of pelvic organ prolapse surgery, especially in the posterior compartment. The risk of prolapse surgery increased with the number of vaginal births, and not cesarean sections. Women should be thoroughly informed about the risk of pelvic organ prolapse and other treatment options should be considered before choosing hysterectomy to treat benign gynecological diseases -particularly women who have had numerous vaginal births.

Prevalence of the types of childbirth performed at the Hospital Materno Infantil Nossa Senhora de Nazareth-RR in the period 2001-2019

The study aimed to identify the prevalence of the types of childbirths performed at the Maternal and Child Hospital Nossa Senhora de Nazareth in Boa Vista, from 2001 to 2019, through demographic indicators. As for the methodology, this is a descriptive, retrospective study with a quantitative approach. For data collection, the types of childbirths in the Annual Report of Epidemiology of Roraima 2001/2019 were analyzed. It was observed an increase in the number of childbirths over the years mainly in 2019, and these data were confirmed in the boxplot graphs. Regarding vaginal childbirth, there was a reduction over time and a slight increase in recent years. As for cesarean sections, there was an increase over the years. The linear correlation between the variables showed a very weak correlation between the two types of births. The Shapiro test showed that the data follows a Normal distribution. Pearson's correlation test showed that there is no significant linear relationship between the variables. We conclude that despite the slight increase of vaginal childbirth in the last years, cesarean sections showed a high percentage in relation to what is recommended by the Ministry of Health and the World Health Organization.

Evaluation of four different methods of analgesia for pain relief in patients of dilatation &amp; curettage: A randomized comparative study

Introduction: Dilatation and curettage is a diagnostic procedure in management of abnormal uterine bleeding. In a developing country like India with dense population and limited resources it becomes a necessity to provide simple, effective, inexpensive and low-risk method of pain relief which can be used in an outpatient setup. So, this study was planned to determine an effective modality of pain relief for this procedure. Methods: This was a prospective, randomized, comparative study conducted among 140 patients. The patients were divided into 4 groups: Group A: Paracervical block Group B: Paracervical block with intrauterine lignocaine Group C: Intravenous diclofenac Group D: Intravenous diclofenac with intrauterine lignocaine Pain was analyzed using pain rating scale immediately and 30 min after the procedure. Patient was assessed 2 hourly after the procedure using PADSS score (post anaesthetic discharge scoring system scale) and patient was discharged if PADSS score is more than 9. Results: The patients were well matched in age, parity, weight, number of vaginal births, menopausal status and indications for intervention among the groups and no statistically significant differences were observed in the baseline characteristics. Patients in Group B (Paracervical block with intrauterine lignocaine) had significantly low pain score immediately (1.69±0.47)as well as 30 min after the procedure(2.37±0.49), followed by group D (intravenous diclofenac with intrauterine lignocaine 3.71±0.75, 4.51±0.65). Group A and Group C required rescue analgesic in 25 and 22 patients respectively. However, rescue analgesic was required in only 3 patients of group D Early discharge of the patient was observed in group using combination of paracervical block with intrauterine lignocaine which had maximum PADDS score (11.71±0.45 at 2 hours after the procedure). No serious adverse effects were observed during the study. Most common adverse effect observed was nausea and vomiting apart from other minor adverse effect like dizziness, light-headiness, nausea/vomiting, metallic taste and perioral numbness. Conclusion: Adequate intraoperative and postoperative analgesia is ensured when combination of analgesic/ anaesthetic agent is used. Maximum pain relief, as reflected by pain scores was in group using combination of paracervical block and intrauterine lignocaine which also had highest PADDS score that allowed early discharge of the patient.

Nominations and folk beliefs in childbirth rite of Eastern and Western Podilian dialect

The article analyzes dialectal parallels in the corpus of nominations and folk beliefs of thematic group of childbirth rite vocabulary of Western and Eastern Podilian dialects, which are marginal in relation to the core of the speech. It was noted that in the nomination of childbirth rite of Eastern and Western areas of Podilian dialect, the most frequent is the lexical nomination, expressed by substantives and substantivized attributes, attributive word combinations.&#x0D; For each lexical-semantic group, characteristic principles of nomination are defined, in particular, the most productive in both studied areas are: lexical-semantic group of women’s names: action → action figure; age, action → person’s name; number of childbirths → person. Lexical-semantic group of children’s names: action → child’s name; age → child’s name. Lexical-semantic group names of other ritual participants: action, ritual function → doer; actor rank → doer. Lexical-semantic group names of rites: action → name of the rite.&#x0D; Most of the lexemes that serve the childbirth rite are known in the dialects of both areas, which confirms their belonging to the Podil dialect, some lexemes recorded in the Western Podil dialects indicate the proximity of these dialects to other dialects of the southwestern dialect of the Ukrainian language.&#x0D; In the dialects of both studied areas, there is approximately the same system of prohibitions for a pregnant woman and a newborn child, which is expressed at the syntactic level in the design of complex sentences and the use of various subordinating conjunctions. Cultural texts reflect the phonetic systems of Western and Eastern Podil dialects.

The Characteristics and Influencing Factors of Quality of Life in Female Patients with Stress Urinary Incontinence

<i>Objective</i>: To investigate the current status and influencing factors of quality of life in female patients with stress urinary incontinence to provide a basis for making targeted health education in clinic. <i>Methods</i>: A total of 58 female SUI patients hospitalized in our department from July 2020 to February 2021 were selected as subjects for field investigation. The questionnaire was composed of general information and Incontinence quality of life (I-QOL) questionnaire. Multivariate linear regression was used to analyze the influencing factors of quality of life in female patients with stress urinary incontinence. <i>Results</i>: The quality of life score of female patients with stress urinary incontinence was (66.18±6.70). Regression analysis showed that the number of vaginal births, the number of years of illness, the number of abortions, and the living status were the factors affecting the quality of life of female patients with stress urinary incontinence<i>. Conclusions</i>: The quality of life of female patients with stress urinary incontinence is moderately or severely affected. Medical workers should develop targeted health education according to the influencing factors, popularize the knowledge related to SUI, help patients improve the cognition of stress urinary incontinence, and actively cooperate with treatment, so as to improve the quality of life of patients.

Obstetric risk factors for anal sphincter trauma in a urogynecological population.

Obstetric anal sphincter tears are the single major modifiable risk factor for anal incontinence (AI) in women. We undertook a retrospective observational study in a tertiary urogynecology unit to describe the prevalence of sonographic anal sphincter defects in a urogynecological population and investigate obstetric risk factors. Files of women seen for investigation of pelvic floor disorders between January 2014 and May 2021 were reviewed. Sonographic defects of the external anal sphincter were analyzed using stored 4D ultrasound imaging data. Explanatory parameters were number of vaginal births, delivery mode, age at first vaginal birth, and birthweight of the first vaginally born baby. Of 3,037 women seen during the inclusion period, data were missing in 219, leaving 2,818. AI was reported by 508 (18%), with a mean St Marks score of 11 (1-23) and a mean bother score of 5.9 (0-10). External sphincter defects were detected in 945 women (34%), with a "residual defect" in 343 (12%). The strongest risk factors for a residual defect were first vaginal birth and forceps, with higher-order multiparity adding risk. On multivariate analysis, forceps and vaginal parity >5 remained significant predictors, as opposed to age at first birth and birthweight of the firstborn. In this observational study in urogynecological patients, 12% showed a residual EAS defect on imaging. The most obvious risk factors for the diagnosis of a residual defect on exo-anal imaging were the first vaginal birth and forceps, with higher-order vaginal parity conveying additional risk.