Pregnant Women Of Reproductive Age Research Articles

Factors associated with miscarriage in Nepal: Evidence from Nepal Demographic and Health Surveys, 2001-2016.

Miscarriage is a major public health concern in low and middle-income countries (LMICs) like Nepal. This study aims to examine the factors associated with miscarriage among pregnant women of reproductive age (15-49 years) in the past 15 years. There were a total of weighted sample of 26,376 cross-sectional pregnancy data from Nepal Demographic and Health Surveys (NDHS) 2001, 2006, 2011, and 2016 combined together, which was used in the study. Multilevel logistic regression analysis that adjusted for cluster and survey weights was used to identify factors associated with miscarriage among pregnant women of reproductive age in Nepal. The results showed that maternal age, contraception, tobacco smoking, wealth index, respondents' educational status, and, caste/ethnicity were found to be strong factors of miscarriage in Nepal. The likelihood of having a miscarriage among older women (≥40 years) was more than 100% (aOR = 2.12, 95% CI [1.73, 2.59]), among non-users of contraception was 88.9% (aOR = 1.88, 95% CI [1.68, 2.11]) (p<005) and non-smoking women had a 19% lower odds of miscarriage (aOR = 0.81, 95% CI [0.69, 0.95]). Respondents from the richest wealth index had 50% (aOR = 1.50, 95% CI [1.22, 1.85]) higher likelihood of miscarriage. Mothers with only primary education had a 25% higher chance of miscarriage (aOR = 1.25, 95% CI [1.09, 1.44]) compared to those with secondary and higher secondary education. In relation to caste/ethnicity, Dalits had 13% lesser likelihood (aOR = 0.87, 95% CI [0.74, 1.02]) and Janajatis had 26% lower chances of a miscarriage than Brahmin/Chettri (aOR = 0.74, 95% CI [0.64, 0.85]). Findings from this study show that miscarriages are associated with maternal age, use of contraception, smoking, wealth index, caste, and ethnicity. Interventions aimed to improve use of contraceptives, avoiding smoking and pregnancy planning on the basis of maternal age, are needed to prevent miscarriage. Also, women from Brahmin ethinicity and those with the highest income index require greater attention when it comes to miscarriage prevention strategies in Nepal.

Social Demographic Dimensions of Contraceptive Use in the Land of Papua: A Cross-Sectional Approach

Background: The use of contraception is one of the efforts to prevent unwanted or mistimed pregnancies. Therefore, it has become a family planning program for motivating families to have ideal plans for pregnancies in time and with a desired number. However, although nationally, 58.7% of married women aged 15-49 years old used contraception in 2019, the percentage of contraceptive users remained the lowest in Papua, with only 13.7% of married women of the same age group using contraceptives in addition to 20% of the women having the unmet need for contraception. This study aims to analyze the determinants of the use of contraception in women of childbearing age in Papua Province.Method: This study employed data from the 2020 National Socioeconomic Survey (Susenas) with a cross-sectional approach. Respondents were 666,866 married women aged 10-54 years. Descriptive statistics and logistic regression analysis were performed using SPSS with a 95% confidence interval (p &lt; 0.05) to express statistical significance.Results: Residence, educational status, pregnancy, employment, age at first marriage, number of children, cell phone ownership, and health insurance were significantly correlated with contraceptive use (p &lt; 0.001). Residence in an urban area, junior high school education, pregnancy, marriage at less than 20 years of age, having more than two children alive, and ownership of a cell phone and health insurance were associated with an increased chance of using contraceptive methods among married women of reproductive age in Papua. The chance to use contraception was the highest for married pregnant women of reproductive age, and the women, in this case, were 35 times more likely to use contraceptives compared to unpregnant ones.

Trends in prevalence and factors associated with unintended pregnancies in Zambia (2001–2018)

BackgroundUnintended pregnancies can pose significant public health concerns for both maternal and child health because of their associated risks and implications. Experience of unintended pregnancies may lead to delay in seeking antenatal care, thus leading to increased risk of complications during pregnancy and childbirth. Globally, the prevalence of unintended pregnancies has declined. However, the problem remains acute in sub-Saharan Africa. This study was conducted to examine the factors associated with an experience of unintended pregnancy among women of reproductive ages in Zambia.MethodsThis study used secondary data from the Zambia Demographic and Health Surveys (ZDHSs) which were conducted between 2001 and 2018. A pooled weighted sample of 4,090 pregnant women of reproductive age 15–49 years at the time of the survey was included in the analysis. Multivariable binary logistic regression model was employed to examine the association between independent correlates and experience of unintended pregnancy. All statistical analyses were conducted using Stata software.ResultsFindings show that the proportion of women of reproductive age who experienced unintended pregnancy in Zambia declined from 50.4% (95% CI: 47.1, 53.8) in 2001 to 45.2% (95% CI: 40.5, 49.9) in 2018. The decline in the prevalence of unintended pregnancy is more pronounced among women age groups 25–29 years and 30–34 years. Increasing age was associated with an increased risk of experiencing unintended pregnancies. On the other hand, women who were living in rural areas (aOR = 0.76; 95% CI: 0.58, 1.00) and those with tertiary education (aOR = 0.46; 95% CI: 0.26, 0.80) were less likely to experience an unintended pregnancy. Women who desired a large family (aOR = 0.45; 95% CI: 0.24, 0.85) and those who watched television (aOR = 0.75; 95% CI: 0.59, 0.94) had lower odds of experiencing unintended pregnancies.ConclusionsThe study has established that the prevalence of unintended pregnancy is still high in Zambia. Women’s age, place of residence, level of education, desired family size and exposure to media were associated with the risk of experiencing an unintended pregnancy. Enhancing access to family planning services and commodities targeting women with low education levels will be key to further reduce unintended pregnancies.

Evaluation of mothers' knowledge about infant sudden death syndrome and its risk factors.

Sudden infant death syndrome is the third leading cause of infant death in the first year of life and is one of the most important health problems around the world. The exact etiology of this phenomenon is not clear yet, but some risk factors, especially prone sleep positions, have been described. Fortunately, by modifying some environmental factors, the SIDS incidence might be decreased. Mothers' and caregivers' knowledge about this neglected event could be an important factor in determining SIDS prevalence. This cross-sectional study was conducted in the pediatric and neonatal specialty clinic of Bahar Shahroud Hospital in 2020. Five hundred and twenty-seven pregnant women of reproductive age (18 to 45 years) were included in the study. Assessment of mothers' knowledge was done using a sudden infant death syndrome risk questionnaire. Statistical analysis of data was performed using independent t-test, Chi-square, and logistic regression. The number of 527 pregnant women of childbearing age participated in our study. 81.9% were under 35 years old. According to the study, factors such as maternal age, mother's level of education, number of pregnancies, and history of previous infant death syndrome had a significant relationship with the mother's level of knowledge about infant death syndrome. The findings showed that the mother's age is over 35 years old during pregnancy (CI: 0.95-0.46-OR: 1.53) and the level of education under a diploma (CI: 3.13-1.6: 06, OR: 1.86), and increasing parity is associated with a lower level of knowledge about infant death syndrome. According to mothers' lack of knowledge about SIDS and the availability of simple and cost-effective methods to prevent SIDS, improving mothers' knowledge about this important event in pregnancy and postpartum, educational sessions are crucial.

PECULIARITIES OF THE COURSE OF PREGNANCY IN WOMEN OF DIFFERENT POPULATION GROUPS BURDENED WITH ANEMIA AND HELICOBACTERIOSIS

Peculiarities of the course of pregnancy in women of different ethnic groups are burdened with anemia and helicobacteriosis in modern living conditions after the pandemic of coronavirus infection, the state of constant stress of the war in Ukraine. The purpose of the study was to determine the characteristics of the course of pregnancy in women of different population groups burdened with anemia and helicobacteriosis&#x0D; Materials and Methods. 30 pregnant women of reproductive age, burdened with anemia, residents of the city of Odesa (group I) and countries of Southeast Asia (group II) were under our observation. All women were registered at the women’s clinic. The monitoring algorithm included clinical and laboratory studies of Helicobacter pylori infection (total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens).&#x0D; Results. The presence of infectious processes in the body of women is one of the etiological factors of gestational complications, including the progression of the severity of anemia in pregnant women. The clinical severity of anemia in pregnant women was consistent with a high coefficient of positivity of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens and a low level of hemoglobin, the level of ferritin, folic acid, cyanocobalamin, the vital trace element iron. Indicators of the clinical course of pregnancy in group I and group II had a significant difference (p&lt;0.05), respectively: early toxicosis (mild, moderate, severe) – 20.0 %, 0 %, 0 % and 26.7 %, 20.0 %, 0 %; syndrome of the threat of early miscarriage - 13.3 % and 33.3 %; late miscarriage threat syndrome – 6.7 % and 20.0 %; secondary placental dysfunction – 0 % and 20.0 %; fetal growth retardation syndrome (FGRS) – 0 % and 6.7 %; intranatal fetal distress – 0 % and 6.7 %. The postpartum period in 13.3 % of women in the 2nd group had a lochiometer.&#x0D; Conclusions. Peculiarities of the course of pregnancy in women of different population groups burdened with anemia and helicobacteriosis consisted in the progression of the severity of the clinical and laboratory course of anemia and gestational complications during the trimesters. The clinical severity of anemia in pregnant women was consistent with a high ratio of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens and a low level of hemoglobin, the level of ferritin, folic acid, cyanocobalamin, the vital trace element iron. It is recommended to determine the ratio of total antibodies (IgG, IgM, IgA) to Helicobacter pylori antigens in the blood of pregnant women with anemia and at the stage of pregnancy planning. Positive results are an indication for examination of all family members.

IMPROVING THE DIAGNOSTICS OF UTERUS SCAR AFTER CESAREAN SECTION

Around the world, the number of caesarean sections is increasing every year. The purpose of the study was tostudy the consistency of the uterine scar after cesarean section in pregnant women of reproductive age; 103 pregnant women and the outcomes of their births were studied. Research and scientific work were carried out for 2020-2022. on the basis of the obstetric department of the multidisciplinary clinic of SamSMU. Based on clinical data, objective examination, ultrasound and Doppler measurements, as well as the amount of collagen type XXVI, in 66 pregnant women the condition of the postoperative scar was assessed as satisfactory and in 37 as insolvent

Health and Sanitation Condition of Pregnant Women: A Case of Arghakhanchi District

This paper aims to explore the situation of sanitation and changing the behaviour of married Nepalese women of reproductive age (15-49). A concurrent mixed-method (qual-quan) research design was employed in this research under the pragmatism worldview. The data are collected through a questionnaire survey, in-depth interviews, and a transect walk. Arghakhanchi district was selected purposively in this study. Diffusion of innovation theory was applied to understand the factors influencing sanitation and hygiene behavior change. The key research participants were the pregnant women of reproductive age (15-45) in the study. A thematic framework was used to analyze qualitative data, while bivariate analysis was performed to show the association between the background variables of sanitation and the health condition of pregnant women. It was found that most of the women used soap and water for hand washing before each meal and after the toilet. There is the provision of soap at hand washing stations and toilets among the study population. However, sufficient hand washing and toilet facilities were not available and 23% of the women reported being scratchy with the use of soap and water regularly.

Factors Associated with Acute Malnutrition among Pregnant Women in Flood Affected Region.

Adequate nutrition before and during pregnancy is necessary to maintain women's reproductive health and to ensure healthy foetal outcome. Pregnant women are at high risk of acute malnutrition specifically during humanitarian crisis leading to adverse effects in foetal outcomes and women's health. This study aimed to assess the factors associated with acute malnutrition among pregnant women visiting Antenatal Clinics in two hospitals and a Primary Health Care Centre of Siraha district in the south-eastern plains of Nepal immediately after 2017 flash flood. A health-institution based cross-sectional study was conducted among 444 pregnant women of reproductive age (15-49 years) in second and third trimester in three health institutions. Data collection was done in the aftermath of 2017 flash floods through face to face interview. Multiple logistic regression analysis was used to identify the factors associated with acute malnutrition defined as Mid Upper Arm Circumference less than or equals to 21 centimetres. Out of 444 participants, 9.9% were found to be acutely malnourished. Participant's education (AOR[Adjusted Odds Ratio]: 3.09, 95% CI[Confidence Interval]: 1.43-6.70), occupation (AOR: 3.16, 95% CI: 1.08-9.22), husband's occupation (AOR: 6.61, 95% CI: 2.17-20.12), household food security (AOR: 3.39, 95% CI: 1.36-8.49) and participant's dietary diversity (AOR:10.06, 95% CI: 3.35-30.27) were found to be statistically significant factors associated with acute malnutrition among pregnant women. Participants' silliteracy, unemployment, husband not employed for cash, household food insecurity and low dietary diversity were found to be statistically significant predictors of acute malnutrition among pregnant women during flash floods.

Assessing the trend of iodine deficiency among antenatal patients of the university of Port Harcourt teaching hospital

Background: Iodine deficiency is a global health problem of public health significance; it is the leading cause of preventable neurodevelopmental impairment in children globally. This deficiency can occur in pregnancy leading to various degree of morbidity. Aims and objective: This study was aimed at determining the pattern and severity of iodine deficiency amongst pregnant women in the University of Port Harcourt Teaching Hospital. Methodology: This study was a hospital-based cross-sectional comparative study that measured the urinary iodine concentration in two subgroups of the population; pregnant women and non- pregnant women of reproductive age. Structured questionnaires were administered to and urine samples were obtained from the participants. The urinary iodine concentration was measured using the Sandell-Kolthoff reaction. The data from the structured questionnaire was entered into a spreadsheet and analyzed using the statistical package for social sciences 25.0 software package (IBM, Armonk, NY, USA). Results: The mean age for the pregnant study group was 32.15±5.2, the median and modal age was 31 years, with a range of 23 to 43 years. Mild iodine deficiency was seen in 57.1% of the non-pregnant respondents and 34.4% of the pregnant respondents. Moderate iodine deficiency was seen in 42.9% of non-pregnant respondents and 56.2% of pregnant respondents. Severe Iodine deficiency was observed only among the pregnant respondents (9.4%) The median urinary iodine concentration (Median UIC) among pregnant women was 42.87ug/l, while the median UIC among non-pregnant women was 52.33ug/l. A Mann-Whitney U test indicated that this difference was statistically significant, U (NPregnant=66, Nnon-pregnant =63) =1234.5, z= -3.98, p≤ 0.001). Conclusion: This study found that iodine deficiency was prevalent among women in the study population (pregnant and non-pregnant women), however, it was more severe in pregnant women. Based on the results of our study there is an urgent need for iodine supplementation in our pregnant women.

The Correlation of High-Risk Age on Women of Reproductive Age and Post Partum Bleeding Case

During the post partum there are physiological changes such as uterine involution and lochia expenditure. Excess lochea discharge to more than 500 cc after delivery is called postpartum hemorrhage. The purpose of this study was to analyze the correlation of high-risk age and the incidence of postpartum hemorrhage in the maternity room of Syuhada Haji Hospital, Blitar City. The type of the study was analytic with a cross sectional approach. The population was all postpartum mothers who gave birth in the maternity room of Syuhada Haji Hospital, Blitar City on January – December 2018. The poplation was 672 respondents and the sample was 97. The sample was taken systematically by random sampling. The measuring instrument used documentation guidelines. The study was carried out by Chi-Square test. It was obtained that X2 count (0.00) was less than á (0.05), then H0 was rejected and H1 was accepted. In conclusion there was a correlation between highrisk age and postpartum hemorrhage incidence. It is expected that the research area will pay more attention in the handling and care of pregnant women of reproductive age so that at the age that is slightly at risk for the occurrence of postpartum hemorrhage, they will not experience postpartum hemorrhage. And women of high-risk age should be able to give birth at hospital in order to reduce complications.

Pregnancy and perinatal outcomes of COVID-19 (SARS-CoV-2)

This article presents current data on the impact of COVID-19 (SARS-CoV-2) on pregnancy and perinatal consequences. The working theories of the pathogenesis of obstetric and fetal complications due to infection during pregnancy, already proven to date, are considered.Symptoms of COVID-19 disease, the risk of their development, and frequency of severe disease in non-pregnant and pregnant women of reproductive age do not differ significantly. However, there are powerful studies that have shown that this infection in pregnant women leads to a high probability of a dramatically severe and fulminant course. Pregnant women with SARS-CoV-2 infection have an increased risk of preeclampsia, incl. severe, hemolysis, thrombocytopenia and increased levels of liver enzymes compared with pregnant women without infection. Women who have COVID-19 are twice as likely to have preterm rupture of the membranes and three times as likely to have a preterm birth compared to the not infected pregnant women.Vertical transmission of the virus from mother to fetus is likely, but data are insufficient to be certain. There is also insufficient evidence of an increased miscarriage rate and teratogenic effects of the COVID-19 virus. However, antenatal fetal death is statistically significantly more common in infected pregnant women than in uninfected pregnant women. Morphological and functional disorders in the chorion/placenta are the main pathogenetic factor in the development of preeclampsia, intrauterine growth retardation, antenatal fetal death and impaired state of the fetus and children born by women with COVID-19.Many studies report that mothers with confirmed COVID-19 infection has asymptomatic babies. At the same time, some studies indicate adverse complications in newborns from infected mothers. The most common neonatal disorders in babies from pregnant women with COVID-19 are tachypnea, hyperthermia, and gastrointestinal disorders, in particular vomiting and flatulence.

Meta-Analysis: Effect of Endometriosis and Intrauterine Device Contraceptive on Ectopic Pregnancy

Background: Ectopic pregnancy is an early complication of pregnancy with high morbidity and mortality. Several studies have examined a history of endometriosis and Intrauterine Device Contraceptive (IUD) use as risk factors for ectopic pregnancy, but have shown mixed results. This study aims to analyze the influence of a history of endometriosis and IUD use on the incidence of ectopic pregnancy based on previous primary studies. Subjects and Method: This was a systematic review and meta-analysis conducted with the PRISMA flow diagram guidelines. The article search process was carried out on the PubMed, Google Scholar, Science Direct, SAGE, JSTOR, and Scopus databases, for articles published from 2005 to 2022. The keywords used were: “Endometriosis” AND “Intrauterine Contraceptive Device” OR “Intrauterine Device” OR “IUD” OR “IUCD” AND “Ectopic Pregnancy” OR “Extrauterine Preg­nancy” OR “Tubal Pregnancy” OR “Pregnancy Outcomes” OR “Pregnancy Complications” AND “Multivariate” OR “Multivariable” OR “Adjusted Odds Ratio” OR “aOR ". Analysis was performed with RevMan 5.3 software. Population: pregnant women of reproductive age. Intervention: endo­metriosis, using the IUD. Comparison: no endometriosis, no IUD use. Outcome: ectopic preg­nancy. Inclusion criteria were full-text observational study articles in English and Indonesian, with ectopic pregnancy as the outcome, analyzed multivariately by including adjusted Odds Ratio/aOR. The analysis was carried out using Review Manager 5.3 software. Results: A total of 11 articles from Asia, Europe, Africa, Australia, and North America were found to meet the criteria and were included in the meta-analysis. The results of the overall analysis of 4 articles consisting of 2 cohort studies and 2 case-control studies were that endometriosis increased the risk of ectopic pregnancy 1.39 times higher than without endometriosis (aOR = 1.39, 95% CI = 1.16-1.68; p &lt; 0.001). The results of the analysis of 7 case-control study articles showed that the use of IUDs increased the risk of ectopic pregnancy 1.35 times compared to not using the IUD and was not statistically significant (aOR = 1.35, 95% CI = 0.45-4.03; p = 0.590). Conclusion: Endometriosis is a risk factor for ectopic pregnancy. IUD use increased the risk of ectopic pregnancy but was not statistically significant. Keywords: endometriosis, intrauterine device contraceptive, ectopic pregnancy, meta-analysis. Correspondence: Afifa Intifadha Habibatullah. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: alfimakrifatulazizahh@gmail.com. Mobile: +6285375335480.

Evaluation of Women with Pregnancy Associated Thrombocytopenia

Objective: To determine frequency of thrombocytopenia among pregnant women Study Design: Descriptive cross sectional study. Place and Duration of Study: Department of Gynaecology &amp; Obstetrics from 1st May 2018 to 30th November 2018. Methodology: One hundred and fifty seven pregnant women of reproductive age of 15-45 years, who were normotensive without any malarial parasite or platelet aggregation seen on peripheral film were included while women with previous pregnancy with history and prior record of thrombocytopenia, on steroids, NSAIDS, or who went through splenectomy were excluded. Selected cases were thoroughly examined investigated for all possible causes. Results: The average age of 32.57±6.63 years, among these 21 [13.37%] were primiparous, 78 [49.68%] multiparous and 58 [36.94%] grand multiparous. Mean gestational age was 36.65±1.82 weeks, Mean Weight was 73.06±16.09 kg, mean height was 161.99±9.96 cm and mean BMI was 27.87±6.25 kg/m2. Conclusion: Thrombocytopenia among pregnant women with 33% prevalence observed. Key words: Pregnancy associated thrombocytopenia (PAT), Pregnancy, Frequency

Factors associated with blood pressure check-up during pregnancy among women of reproductive age in Tanzania: an analysis of data from 2015\u201416 Tanzania Demographic and Health Survey and Malaria Indicators Survey

BackgroundHypertensive Disorder of Pregnancy (HDP) is one of the leading causes of maternal mortality and morbidity amongst pregnant women in the world. Blood pressure check-ups during pregnancy are one of the strategies used to identify hypertensive disorders, hence timely management. Little is known about the factors associated with blood pressure check-ups in Tanzania.MethodThe study used data from 2015—16 Tanzania Demographic and Health Survey and Malaria Indicators Survey (2015—16 TDHS—MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the association between early antenatal booking and maternal services utilization.ResultsThe prevalence of blood pressure checkups during pregnancy was 72.17% at 95% confidence interval of 71.1–73.2%. Factors associated with uptake of blood pressure check-ups were; timely antenatal booking, AOR = 1.496, CI = 1.297–1.726, p < 0.001, late booking was a reference population, age group [> 34 years, (AOR = 1.518, CI = 1.149–2.006, p = 0.003)] with < 20 years used as a reference population, wealth index [middle income, (AOR = 1.215, CI = 1.053–1.468, p = 0.008) and rich, (AOR = 2.270, CI = 1.907–2.702, p < 0.001)] reference population being poor; education level [primary education, (AOR = 1.275, CI = 1.107–1.468, p = 0.001); secondary education, (AOR = 2.163, CI = 1.688–2.774, p < 0.001) and higher education, (AOR = 9.929, CI = 1.355–72.76, p = 0.024)] reference population being no formal education; parity [para 2–4, (AOR = 1.190, CI = 1.003–1.412, p = 0.046) with para one used as a reference population and zones [Unguja Island, (AOR = 3.934, CI = 1.568–9.871, p = 0.004), Pemba Island, (AOR = 5.308, CI = 1.808–15.58, p = 0.002)] and Mainland Urban being the reference population.ConclusionThe study revealed that rural dwelling pregnant women had higher chance of not getting their BP checked. It was also revealed that maternal age, education level, place of residence, wealth index and timing of ANC services were significantly associated with blood pressure check-ups. The study recommends the need to explore significant factors associated with utilization of available free reproductive health services across all public health facilities. It also recommends the need to address prioritized intensive awareness programs and behavioral change interventions on the significance of BP check-ups among pregnant women of reproductive age.

EFFECT OF MATERNAL HIV IMMUNE RECONSTITUTION INFLAMMATORY RESPONSE SYNDROME ON THE RISK OF ADVERSE PREGNANCY-FETAL OUTCOMES IN HIV-1 POSITIVE, ART NAIVE PREGNANT WOMEN OF REPRODUCTIVE AGE IN SELECTED HOSPITALS, NAIROBI, KENYA

Background: Immune reconstitution inflammatory response syndrome (IRIS) is a recovery disease that may be triggered after starting ARV therapy in some individuals. The incidence of adverse pregnancy-fetal outcomes with IRIS has not been studied in Kenya among pregnant women, with focus only, on improved immune response and PMTCT after ART initiation. The indirect effect of ART, the maternal HIV - IRIS on pregnancy outcome has not been elucidated. More than 10% of the global burden of disease is due to pregnancy complications and adverse pregnancy and related birth outcomes and despite recent advances in obstetric medicine, pregnancy complications and adverse birth outcomes are a growing public health concern and economic burden on the health-care system. This has substantial burden of adverse pregnancy-fetal outcomes with prevalence of preterm birth, low birth weight, and small gestational age infants of 19.8%, 14.2%, and 12.6%, respectively, and of still birth and neonatal mortalityat1.9% and 0.4%, respectively. The aim of this study was to evaluate the effect of maternal HIV immune reconstitution inflammatory response syndrome on the risk of adverse pregnancy-fetal outcomes in HIV-1 positive; ART initiated pregnant women of reproductive age in selected hospitals, Nairobi, Kenya. Methodology: The study was conducted among 204 HIV-1 positive, ART initiated pregnant women of reproductive age in selected hospitals, Nairobi, Kenya. A prospective cohort study design was used where the subjects were recruited and followed from the end of first trimester for six and half months after they were confirmed to be HIV positive, and put on ARV treatment using a pretested data collection tool. Bivariate analyses with chi-square test to establish the association between the variables at p-value &lt; 0.05. Logistic regression analysis was performed to identify independent outcome predictors. Adjusted relative risk at 95% confidence interval was determined. Results: The study indicated that, adverse pregnancy-fetal outcome cumulative incidence was 26.47% among women diagnosed with IRIS compared to 10.78% among women not diagnosed with IRIS. The incidence rate estimate was 0.012 and 0.0045 per person’s week respectively with a rate ratio of 012/.0045=2.7. Women with IRIS had 2.46 times the risk of experiencing an adverse pregnancy-fetal outcome compared to those who did not [OR=3; 95%CI: 1.4-6.4; P=.004]. LBW cumulative incidence was the highest with 11 (10.8%) among IRIS exposed women and 3 (2.9%) among non-IRIS exposed women and same case with PTB 8 (7.8%) and 3 (2.9%) respectively. Conclusion: There was a significant relationship of maternal HIV-immune reconstitution inflammatory response syndrome diagnosis with adverse pregnancy-fetal outcomes as a result of ART initiation among HIV-1 positive, pregnant women of reproductive age. This study observes that, being diagnosed with maternal HIV-IRIS following ART initiation during pregnancy among ART naive women is associated with experiencing an adverse pregnancy outcome. This should be a concern in clinical practice as IRIS has self-resolution, it may on the other hand affect pregnancy outcome negatively. PMTCT should integrate monitoring of suspected IRIS cases using the latest defined criteria for its diagnosis in pregnant women starting ant-retroviral therapy especially in resource limited areas.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0658/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Aging-related changes in the calorimetric profile of red blood cells from women with miscarriages

Miscarriages are one of the most common problems of pregnancy abnormalities, however, in most cases the etiology of this pathology is unknown. Herein, we applied differential scanning calorimetry to study the aging process of red blood cells (RBCs) derived from women with miscarriages as compared to healthy non-pregnant and pregnant women of reproductive age, with the aim to identify specific calorimetric features associated with high-risk pregnancy. The calorimetric profiles of RBCs derived from healthy pregnant and non-pregnant women along the cells aging path are characterized with: (1) slow reduction in the hemoglobin heat capacity and (2) downshift of the thermal transitions of hemoglobin, Band 3 and Band 2.1, 4.1 and 4.2 proteins. A large population (71%) of the studied cases with miscarriage are associated with faster aging of RBCs, i.e., faster thermal destabilization of hemoglobin and Band 3 transitions compared to healthy non-pregnant and pregnant women. The results suggest that the accelerated temperature-induced destabilization of RBCs from the majority of women that underwent miscarriages along cells aging is an additional criterion for estimation of the risk of miscarriage.

Characteristics of pregnancy and delivery in women with vitamin D deficiency

Vitamin D deficiency is recognized as a public health problem in many countries around the world, with special attention being paid to pregnant women. In the last decade, studies have been conducted to link vitamin D deficiency during pregnancy with a wide range of obstetric and perinatal complications, namely preeclampsia, gestational diabetes, bacterial vaginosis, fetal growth retardation syndrome, low birth weight, impaired fetal formation and bone loss.Purpose. To study the characteristics of pregnancy and childbirth in women with vitamin D deficiency.Materials and methods. The article presents the study results of the pregnancy and childbirth characteristics in women with vitamin D deficiency. In total, 100 pregnant women of reproductive age were examined and two groups were formed: the main group – 50 pregnant women with vitamin D deficiency and the control group – 50 somatically healthy pregnant women with a normal level of 25(OH)D. Three peripheral blood sampling were performed to determine the serum level of 25(OH)D: at 10–12, 20–22 and 30–32 weeks of gestation.Results. As a result of our study, the most common complications of vitamin D deficiency were: risk of pregnancy termination, which was observed in 28 (56.0 %) women of the main group and in 6 (12.0 %) women of the control group, P < 0, 05. The threat of preterm birth was observed in 19 (38.0 %) women of the main group and 7 (14.0 %) women of the control group, P < 0.05. Mild preeclampsia was diagnosed in 18 (36.0 %) women of the main group and in 4 (8.0 %) women of the control group, P < 0.05; moderate preeclampsia was diagnosed in 9 (18.0 %) women of the main group and in none of the control women; severe preeclampsia – in 2 (4.0 %) women of the main group, which was not characteristic of the control group. Based on the glucose tolerance test in women of the main group, the diagnosis of gestational diabetes (GD) was established in 16 (32.0 %) pregnant women in the second trimester and in 7 (14.0 %) in the third trimester. In this study, it was found that GD was accompanied by first degree obesity in 7 (14.0 %) women of the main group. Bacterial vaginosis at 10–12 weeks was diagnosed in 18 pregnant women: in 15 (30.0 %) women of the main group and in 3 (6.0 %) of the control group, – P < 0.05; at 20–22 weeks in – 28 pregnant women: in 21 (42.0 %) women of the main group and in 7 (14.0 %) of the control group, P < 0.05; at 30–32 weeks it was diagnosed in 37 pregnant women: in 26 (52.0 %) women of the main group and in 11 (22.0 %) of the control group, – P < 0.05. Asymmetric fetal intrauterine growth restriction of the 1st degree was found in 6 (12.0 %), the 2nd degree – in 4 (8.0 %) pregnant women of the main group and no case in the control group women was reported.Conclusions. The established multiple actions of vitamin D and a number of obstetrical and perinatal complications, namely gestational diabetes, early and late spontaneous abortions, preterm birth, bacterial vaginosis associated with vitamin D deficiency, underline the urgency of this problem. The findings indicate that screening of pregnant women for serum vitamin D content with the following timely supplementation during pregnancy will help to reduce the incidence of obstetrical and perinatal complications.

Effectiveness of an Educational Intervention Based on the Theory of Planned Behavior on Fertility Intention of Single-child Women: A Field Trial Study

Aims: Fertility is an important factor for population growth and its proportion. Regarding the overall decrease in the total fertility rate in Iran and reaching below the replacement rate, this study aimed at determining the effect of the education based on the Theory of Planned Behavior (TPB) on women’s fertility intention. Methods &amp; Materials: This interventional study was conducted on 100 pregnant women of reproductive age covered by the Gonabad community health centers. The subjects were selected through two-stage cluster sampling and randomly assigned to the control and experimental groups (n=50 per group). Data were analyzed using SPSS V. 20 and Independent t-test, paired t-test, and Chi-square test. Findings: There was no significant difference between the demographic characteristics of the subjects in the experimental and control groups. Before the intervention, there was no significant difference between the mean score of the theoretical constructs between the two groups. After the intervention, the mean score of attitude (P=0.014), perceived behavioral control (P=0.042), and behavioral intention (P=0.005) were significantly different between the two groups. Conclusion: The results showed that the educational intervention based on TPB could positively affect the fertility intention of single-child women. Hence, it is suggested to use this model in educational programs related to population growth policy and to plan interventions encouraging couples to have another child.

ANATOMIC-FUNCTIONAL STATE OF PELVIC ORGANS IN WOMEN WITH INFERTILITY AND OVARICOVARICOCELE

ANATOMIC-FUNCTIONAL STATE OF PELVIC ORGANS IN WOMEN WITH INFERTILITY AND OVARICOVARICOCELE

The Effect of Health Infrastructure, Adult Literacy, and Household Characteristics on Antenatal Care (ANC) Coverage in Punjab (Pakistan)

Objective: The present study is a cross district analysis of the effect of health infrastructure, adult literacy, and household characteristics on antenatal care (ANC) use in Punjab (Pakistan).&#x0D; Data and Methodology: The unit of analysis is a district. By covering a panel of 35 districts of Punjab, the study has collected the yearly data for the time period 2010 to 2016. The percentage of pregnant women of reproductive age received ANC services in each district is taken as dependent variable. Health physical infrastructure, adult literacy rate, and the percentage of households: having own house, using improved sanitation facilities, and receiving remittances from abroad are taken as explanatory variables. The study used panel Generalized Method of Moments (GMM) to estimate the effects of the explanatory variables on antenatal care. &#x0D; Results: Ranking of the districts on the basis of ANC coverage shows that amongst the 34 districts of Punjab province, Bahawalnagar, Rajan pur, Pakpattan, Kasur, Bahawalpur, and Rahim Yar Khan districts are at the bottom with the lowest use of ANC services by the pregnant mothers. The GMM estimates show that health physical infrastructure, adult literacy rate, and the percentage of households having their own house are positively and significantly affecting the ANC use in Punjab-Pakistan. Hence confirming the healthcare services utilization framework of Andesen and Newman (2005) which explains that formal healthcare system (health physical infrastructure), predisposing factors (adult literacy rate), and enabling factors (households having their own houses) significantly matter in fostering better use of healthcare services.&#x0D; Conclusion: The study advocates the need for investment in health physical infrastructure as well as in overall literacy. At the same time, it suggests that for the better coverage of ANC the geographical targeting can result into better outcomes.