Primiparous Mothers Research Articles

Knowledge of Breastfeeding Mothers Regarding Caries Prevention in Toddlers.

Mothers' awareness regarding the risk factors for the development of early childhood caries is crucial. The current study aims to examine the knowledge of breastfeeding mothers about their baby's dental health and prevention of ECC while comparing primiparous mothers to multiparous mothers. A total of 165 mothers aged 20-49 y/o participated in the study by completing questionnaires that assessed the knowledge and attitudes of mothers toward their infants' oral health. Results showed that (1) mothers were found to be highly knowledgeable regarding the oral hygiene of their infants and the recommended breastfeeding best practices (71%); (2) mothers with lower education showed poor knowledge regarding the recommended practices of infant oral health; (3) a large proportion of the mothers in the sample (62%) reported that they usually tasted the food before giving it to their baby, in a way they could transmit bacteria to infants; (4) most of the mothers (68%) were not aware that their dental health during pregnancy affects the infants' dental health; and (5) multiparous mothers were more knowledgeable regarding artificial baby milk composition (96%) in comparison with mothers with only a single child (60%). According to the results, there is a need to improve the knowledge of breastfeeding mothers, especially mothers who have one child and mothers with a lower education about their baby's dental health. The results of this study shed light on the knowledge of breastfeeding mothers on this important topic and could serve policymakers to improve practices toward advancing better oral health for infants, without sacrificing the benefits of breastfeeding, which are so crucial for infant health and development.

The Incidence and Outcomes of Late-Term Pregnancy.

Little is known about the outcomes of late-term pregnancy. In this study, we aim to assess the incidence and adverse prenatal outcomes associated with late-term pregnancy. We retrospectively assessed all singleton pregnant mothers who gave birth at Khalij-e-Fars Hospital in Bandar Abbas, Iran, between January 2020 and 2022. All preterm and post-term deliveries were excluded. Mothers were divided into two groups: late-term mothers (41 0/7-41 6/7 weeks of gestation) and term mothers (37 0/7-40 6/7 weeks of gestation). Demographic factors, obstetricfactors, maternal comorbidities, and prenatal outcomes were extracted from the electronic data of each mother. The incidence of late-term births was calculated. The chi-squared test was used to compare differences between the groups. Logistic regression models were used to assess the association of prenatal outcome with late-term pregnancy. There were 8,888 singleton deliveries during the study period, and 1,269 preterm and post-term pregnancies were ruled out. Of the 7,619 deliveries, 309 (4.1%) were late-term, while 7,310 (95.9%) were term. There were no sociodemographic differences between term and late-term mothers. The late-term group had a higher prevalence of primiparous mothers, and the term group had a higher prevalence of diabetes. Late-term mothers had a higher risk of macrosomia (adjusted odds ratio (aOR): 2.24 (95% confidence interval (CI): 1.34-3.01)), meconium amniotic fluid (aOR: 2.32 (95% CI: 1.59-3.14)), and fetal distress (aOR: 2.38 (95% CI: 1.54-2.79)). When compared to term pregnancy, the risk of low birth weight (LBW) was lower in late-term pregnancy (aOR: 0.69 (95% CI: 0.36-0.81)). Late-term pregnancy was found to be more likely to be associated with macrosomia, meconium amniotic fluid, and fetal distress, but serious maternal and neonatal adverse events were comparable to term pregnancy.

Primiparous Mothers' Perception and Expectations Regarding Social Support during the Postpartum Period: A Qualitative Study.

Social support has been found to positively influence the mothering experience. Yet little is known concerning primiparous mothers' perceptions of social support following childbirth. This qualitative study aims to explore primiparous mothers' perception and expectations regarding social support during the postpartum period. This qualitative study with content analysis approach was conducted on 11 postpartum mothers who had been routinely referring to comprehensive health service centers in Kermanshah, Iran, from October 2020 to January 2021 for receiving postpartum care within the first 6 months after birth. Also, to further enrich the study data, interviews were conducted with healthcare providers (n = 6) and husbands (n = 3). Twenty-two semi-structured interviews were conducted individually through a purposive sampling method. Two participants were interviewed twice. Interviews were recorded and transcribed verbatim in Persian and analyzed using conventional content analysis. Three main categories and thirteen subcategories emerged. The main categories were: "comprehensive support", "support barriers," and "support promotion strategies." The main perception and expectation of mothers regarding social support was the sense of not being alone and receiving comprehensive support, especially from the husband and increasing his awareness about this support. An understanding of a comprehensive support, support barriers, and support promotion strategies with respect to social support can help healthcare professionals to develop interventions and programs aimed at promoting mothers' social support in the postpartum period.

Predictors of Birth Asphyxia Among Newborns in Public Hospitals of Eastern Amhara Region, Northeastern Ethiopia, 2022.

Ethiopia ranked fourth in the world in terms of neonatal mortality rates, with birth asphyxia accounting for the majority of neonatal deaths. This study aimed to determine the prevalence of birth asphyxia and associated factors among newborns delivered in government hospitals of the Eastern Amhara region, Northeastern Ethiopia, 2022. A hospital-based cross-sectional study was conducted in 4 government hospitals between March 10, 2022, and May 8, 2022. The subjects in the study were selected using a systematic random sampling technique. Face-to-face interviews and chart reviews were used to collect the data. The association was discovered through multivariate logistic regression analysis. In this study, the prevalence of birth asphyxia was 13.1% (48) of the total 367 newborns. Mothers who could not read and write (AOR = 9.717; 95% CI = 3.06, 10.857); infants born with low birth weight (AOR = 2.360; 95% CI = 1.004, 5.547); primipara mothers (AOR = 5.138; 95% CI = 1.060, 26.412); mothers with less than 37 weeks of gestation (AOR = 4.261; 95% CI = 1.232, 14.746); and caesarian section delivery (AOR = 2.444; 95% CI = 1.099, 5.432) were predictors of birth asphyxia. The magnitude of birth asphyxia has managed to remain a health concern in the study setting. As a result, special attention should be paid to uneducated and primi-mothers during antenatal care visits, and prematurity and caesarian section delivery complication reduction efforts should be bolstered to prevent birth asphyxia and its complications.

Impact of the Quality of Postpartum Sleep on Breast Milk Volume among Primipara Mothers

Impact of the Quality of Postpartum Sleep on Breast Milk Volume among Primipara Mothers

Investigating the effect of educational interventions on maternal competence: A systematic review and meta-analysis.

There have been many studies on maternal competence, but in the studies conducted in this field, different methods have been applied to educate mothers on maternal competence, which do not have a unified approach. This study aims to investigate the effect of educational interventions on maternal competence using a meta-analysis method. In this meta-analysis, a search was made in MEDLINE, CINAHL, PubMed, Scopus, Proquest, Google scholar, SID, and Magiran databases using Mesh and non-Mesh keywords between January 1992 and September 2022. The inclusion criteria included: Studies in which educational and counseling interventions on maternal competence have been investigated, studies that have used the Parenting Sense of Competence Scale (PSOC), RCT or interventional studies, participants who were primiparous women, articles that were published in English and Farsi, studies that reported sample size, mean and standard deviation of maternal competence scores in the intervention and control groups, and studies that scored at least 3 on the Jadad scale. Data were analyzed using Review Manager 5 (RevMan 5.3). In this meta-analysis and systematic review, finally, seven articles met the criteria for entering the research. The number of samples in the intervention group was 430 and in the control group was 429. The average maternal competence score with a 95% confidence interval was 3.51. This meta-analysis showed that educational interventions during pregnancy and after delivery could affect improving the competence of primiparous mothers. Education has increased the maternal competence score in the intervention group by 3.51 units compared to the control group.

Supplemental Material for Primiparous Mothers’ Parenting Self-Efficacy in Managing Toddler Distress: Childhood Nonsupportive Emotion Socialization, Adult Attachment Style, and Toddler Temperament as Antecedents

Supplemental Material for Primiparous Mothers’ Parenting Self-Efficacy in Managing Toddler Distress: Childhood Nonsupportive Emotion Socialization, Adult Attachment Style, and Toddler Temperament as Antecedents

LATCH Score as a Tool to Predict Weight Gain in Term Babies at Six Weeks Post-discharge: A Prospective Cohort Study

Introduction: The LATCH score is an acronym representing L- LATCH, A- Audible swallowing, T- Type of nipple, C- Comfort, H- Hold. It is a comprehensive yet simple breastfeeding assessment tool used to evaluate breastfeeding practices. Babies with a poor LATCH score at discharge are at an increased risk of early breastfeeding cessation and inadequate weight gain. According to World Health Organisation (WHO), only about 44% of infants aged 0-6 months worldwide were exclusively breastfed from 2015-2020, with a goal of increasing this rate to atleast 50% by 2025. There have been very few studies conducted in developing countries regarding this matter. Aim: To determine the correlation between the LATCH score and weight gain at six weeks post-discharge in term babies. Materials and Methods: This prospective cohort study was conducted at MVJ Medical College and Research Hospital, Bengaluru, Karnataka, India, from January 2023 to June 2023. The study included 355 healthy term and singleton babies. LATCH scores were assessed at the time of the first feed, 24 hours, 48 hours, 72 hours, and at the time of discharge. Mothers with a low LATCH score and the reasons for the low score were identified, corrected, and counselled until discharge. Weight gain velocity was analysed at the six-week follow-up. Analysis of Variance (ANOVA) was used to compare the mean values between variables, and Pearson’s correlation was used to analyse the correlation between the LATCH score and weight gain at six weeks post-discharge in term babies. Results: In the present study, the mean age of mothers was 26.21±5.40 years, and there were 200 males and 155 females babies. The mean LATCH score at the time of the first feed was found to be 3.91±1.09, which improved to 5.61±0.890, 7.03±0.742, 7.67±0.578, and 9.12±0.662 at 24 hours, 48 hours, 72 hours, and at the time of discharge, respectively. The reasons for a poor LATCH score were mainly attributed to primiparous mothers (42%) and incorrect positioning (35.5%). A significant positive correlation was found between the improvement of the LATCH score and weight gain at the six-week follow-up. Conclusion: The LATCH score was found to be a simple tool for identifying mothers and infants who require breastfeeding support and timely intervention to sustain breastfeeding. The LATCH score can serve as an effective predictor of weight gain at the six-week follow-up.

Penerapan pijat oksitosin pada nyonya S dalam Asuhan Kebidanan Masa Nifas di Klinik Pratama Amanda

Introduction : Lactation is the process of breastfeeding starting from the process of producing breast milk (ASI), secretion, and expulsion of breast milk to the process of the baby sucking and swallowing. Factors that cause non-smooth milk production in primiparous postpartum mothers can be caused by stress, fatigue, lack of rest, as well as nutrition and nutritional factors. Efforts made to improve breastfeeding and increase milk production in primiparous postpartum mothers include a balanced nutritional diet for breastfeeding mothers, early mobilization, oxytocin massage and breast care. Oxytocin massage is one of the efforts made to facilitate milk production for primiparous postpartum mothers. Oxytocin massage done after giving birth can stimulate the release of the hormones prolactin and oxytocin.
 Purpose: Applying oxytocin massage to breastfeeding on Mrs. S at Amanda Pratama Clinic, Patukan, Ambarketawang, Gamping, Sleman Regency, Special Region of Yogyakarta
 Methods: The type of research method used is descriptive analytic method. This research instrument used the results of examinations, observations or observations of the author, interviews with clients and supporting data listed in the maternal and child health book owned by the client.
 Results : The results of research on breastfeeding on Ny. S after doing Oxytocin massage 15-20 minutes every day for 7 days it increased, starting from the first day 90 ml to 680 on day 7. The increase in milk expenditure occurred as much as 88% for 7 days. The biggest increase occurred on the third day.
 Conclusions: There is an effect of oxytocin massage on breastfeeding in Mrs. S at Amanda Pratama Clinic, Patukan Ambarketawang, Gamping, Sleman Regency, Special Region of Yogyakarta

Analysis of Complementary Therapy Acupresure Points for Lactation on Breastfeeding Success in Aceh Besar Regency

The low coverage of exclusive breastfeeding in Aceh Besar regency is a serious problem for child survival. One of the non-morphological natural methods that can be used to help expedite milk production is acupressure points for lactation therapy. Acupressure points for lactation therapy are one of the solutions to overcome the uneven production of breast milk. Acupressure points for lactation therapy help maximize prolactin and oxytocin receptors and minimize side effects from delayed breastfeeding by the baby. This research method is quasi-experimental with a pre-test and post-test research design. This research was conducted at the Midwives' Independent Practice in Aceh Besar Regency from April to October 2022. The population in this study were primiparous mothers who gave birth at the Independent Midwife Practice (PMB) in Aceh Besar Regency. The total sample of 60 respondents consisted of the intervention group of 30 respondents and the control group of 30 respondents. Data analysis using univariate and bivariate with T-Test Dependent and T-Test Independent. The results showed that there was a significant difference in milk production before and after giving acupressure therapy to breastfeeding mothers with a p-value of 0.000. There is a significant difference in breastfeeding success before and after giving routine care to breastfeeding mothers p-value 0.000. Complementary Therapy Acupressure Points For Lactation is effective in helping to facilitate breastfeeding and increase milk production in primiparous mothers in Aceh Besar Regency.

Psychological Adaptation: Taking Hold of Post Sectio Caesarian Primiparous Mother

Background: Primiparous mothers after SC surgery need support from their families and health workers, especially in adapting to their new roles. The mother will feel worried about her inability and sense of responsibility in caring for her baby. Mothers who cannot adapt well can be at risk of experiencing postpartum blues to postpartum depression.
 Objectives: The purpose of this study is to describe the experience of psychological adaptation: taking hold of post SC primiparous mothers.
 Methods: This study is a qualitative study with a phenomenological approach. The research sample was taken by purposive sampling, namely primiparous mothers after SC surgery as many as 10 mothers. Data collection is based on interview guidelines and observation notes.
 Results: The results showed that all mothers (100%) had never been taught breast care and oxytocin massage during hospitalization; 7 mothers (70%) had little milk production; 8 mothers (80%) mastered breastfeeding techniques; all mothers (100%) were not ready to take care of their own babies; 5 mothers (50%) feel anxious; 8 mothers (80%) experienced changes in sleep patterns; all mothers (100%) did early mobilization; all mothers (100%) received support from their husbands and families
 Conclusion: Primiparous mothers have no previous experience so they need support from health workers and families in achieving their new role as mothers. Health workers are expected to provide support in the form of education and counseling, especially to primiparous mothers about the problems experienced by mothers during the postpartum period.

Secular trends of socio-demographic and lifestyle characteristics among delivering women in Arctic Russia, 1973-2017

ABSTRACT The aim of this study was to describe temporal trends in socio-demographic and lifestyle characteristics among delivering women in two Northern provinces of Russia from 1973 to 2017. Totally 161,730 births were registered in three birth registries. Changes in the distribution of maternal age, education, marital status, smoking during pregnancy were studied using Pearson’s chi-squared tests and one-way ANOVA. The logistic regression models were used to assess factors, contributing to the variations in the prevalence of maternal smoking. The mean age of primiparous mothers increased from 22.1 years in 1973–1980 to 25.4 years in 2012–2017 (p < 0.001). The proportion of primiparous mothers with higher education increased from 26.2% in 2006 to 38.3% in 2017 (p < 0.001). The proportion of cohabiting primiparous women increased from 5.0% to 15.2% over the study period (p < 0.001). The proportion of mothers smoking during pregnancy decreased from 18.9% in 2006–2011 to 14.8% in 2012–2017 (p < 0.001). Downward in the prevalence of smoking was revealed in 2012–2017 compared to 2006–2011 (OR = 137.76; 95%CI:71.62–264.96, OR = 183.74; 95%CI:95.52–353.41, respectively). Over the past decades, women postpone childbearing until receiving higher education, continue living in cohabitation during pregnancy and smoke less.

Effects of relaxation therapy on maternal psychological status and infant growth following late preterm and early-term delivery: a randomized controlled trial

BackgroundMaternal stress is one modifiable variable that could influence mother–infant signaling and negatively affect breastfeeding and infant growth. ObjectivesThis study aimed to test the hypothesis that relaxation therapy would reduce maternal stress and improve infant growth, behavior, and breastfeeding outcomes after late preterm (LP) and early-term (ET) delivery. MethodsA single-blind randomized controlled trial was conducted in healthy Chinese primiparous mother–infant pairs after LP or ET delivery (34+0–37+6 gestation weeks). Mothers were randomly assigned to the intervention group (IG, listening to relaxation meditation at least once a day) or control group (CG, normal care). Primary outcomes—changes in maternal stress (perceived stress scale), anxiety (Beck Anxiety Inventory), and infant weight and length standard deviation score—were assessed at 1 wk and 8 wks postpartum. Secondary outcomes—breast milk energy and macronutrient composition, maternal breastfeeding attitudes, infant behaviors (3-d diary), and 24-hour milk intake—were assessed at 8 wks. ResultsIn total, 96 mother–infant pairs were recruited. There was a significantly greater reduction in maternal perceived stress (Perceived Stress Scale score) (mean difference [MD] = 2.65; 95% CI: 0.8, 4.5) and significantly greater infant weight standard deviation score gain (MD = 0.51; 95% CI: 0.2, 0.9) from 1 wk to 8 wks in the IG than those in the CG. Exploratory analyses showed a significant interaction between intervention and sex, with greater effects on weight gain in female infants. Mothers of female infants used the intervention more frequently with significantly higher milk energy observed at 8 wks. ConclusionsThe relaxation meditation tape is a simple, effective practical tool that could easily be used in clinical settings to support breastfeeding mothers after LP and ET delivery. The findings need confirmation in larger groups and in other populations.

Faktor Fisik dan Psikologis Ibu Bersalin dengan Intensitas Nyeri Persalinan Kala I pada Ibu Primipara

Childbirth is a natural process. In the first stage of labor, physiological muscle contractions will cause pain in the body. One of the factors that can affect labor pain is the mother's age and the psychological support received by the mother in labor. The form of psychological support given to mothers in labor is by presenting birth attendants. This study aimed to determine the relationship between the age of delivery mothers and birth attendants with the intensity of labor pain in the first stage of Primipara mothers. This research method is an observational study with a cross-sectional method on 60 mothers giving birth data analysis using the Mann-Whitney test. The results showed a significant relationship between the mother's age in labor and the birth attendant and the intensity of labor pain. This study concludes that reproductive age and the presence of a birth attendant will significantly assist the mother in going through her labor period with minimal pain and complications.

The incidence and risk factors of meconium amniotic fluid in singleton pregnancies: an experience of a tertiary hospital in Iran

BackgroundSeveral common maternal or neonatal risk factors have been linked to meconium amniotic fluid (MAF) development; however, the results are contradictory, depending on the study. This study aimed to assess the prevalence and risk factors of MAF in singleton pregnancies.MethodsThis study is a retrospective cohort that assessed singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups: 1) those diagnosed with meconium amniotic fluid (MAF) and 2) those diagnosed with clear amniotic fluid. Mothers with bloody amniotic fluid were excluded. Demographic factors, obstetrical factors, and maternal comorbidities were extracted from the electronic data of each mother. The Chi-square test was used to compare differences between the groups for categorical variables. Logistic regression models were used to assess meconium amniotic fluid risk factors.ResultsOf 8888 singleton deliveries during the study period, 1085 (12.2%) were MAF. MAF was more common in adolescents, mothers with postterm pregnancy, and primiparous mothers, and it was less common in mothers with GDM and overt diabetes. The odds of having MAF in adolescents were three times higher than those in mothers 20–34 years old (aOR: 3.07, 95% CI: 1.87–4.98). Likewise, there were significantly increased odds of MAF in mothers with late-term pregnancy (aOR: 5.12, 95% CI: 2.76–8.94), and mothers with post-term pregnancy (aOR: 7.09, 95% CI: 3.92–9.80). Primiparous women were also more likely than multiparous mothers to have MAF (aOR: 3.41, 95% CI: 2.11–4.99).ConclusionsAdolescents, primiparous mothers, and mothers with post-term pregnancies had a higher risk of MAF. Maternal comorbidities resulting in early termination of pregnancy can reduce the incidence of MAF.

PENGARUH PEMBERIAN SARI KURMA TERHADAP LAMA KALA II PADA IBU PRIMIPARA

Prolonged labour is one of the pathological forms of labor. Manggopoh Community Health Center is one of the health centers have high reports of childbirth complications. They are 121 (23%) cases, dominated by cases of prolonged labor. This study aimed to determine The Effect of Dates Extract on Second Phase on Primipara Mothers in the Working Area of Manggopoh Community Health Center in 2021. The type of research was a quasi-experimental approach with pos test only with control group design approach. The population in this study were all maternity mothers in the working area of Manggopoh Community Health Center, as much as 44. By using purposive sampling technique, 32 people were chosen as the samples. The data were collected through observation sheets and it was analyzed by univariate analysis and bivariate analysis using t-independent test. The results showed that the administration of date palm juice had a significant effect on the length of the second stage of labor with an average difference of 4.875 minutes in the second stage of labor and p value = 0.001, where the length of the second stage of labor was shorter in the experimental group. It can be concluded that the administration of date palm juice at the end of pregnancy has a significant effect on the length of the second stage of labor. It is hoped that the Manggopoh Community Health Center will provide health information to pregnant women to always prepare themselves both physically and mentally in facing childbirth, one of them is by utilizing date palm juice at the end of pregnancy which is proven to be effective in the progress of labor. Keywords : Dates, Labor, Stage II

The effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran: study protocol

BackgroundMothers' knowledge about the infant's problems and will provide the necessary care can increase the mother's confidence in providing care for her infant and eliminate misconceptions in primiparous mothers. The present study will be conducted to evaluate the effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran.MethodsThis quasi-experimental study is an educational support intervention protocol for infant care which will be conducted in two phases. The educational support program will be designed in the first phase. The program includes educational sessions on breastfeeding, growth and development of infants and care for children under 1 year of age in a virtual group where a physician, a nurse, a midwife and a healthcare provider are also present. Using the opinions of the experts, the peer group will discuss various points and the research team will finalize the program based on priorities. The second phase of the educational intervention will be conducted experimentally as a pretest–posttest design for the intervention and control groups.DiscussionThe present study will provide useful protocol about the effect of educational support intervention for infant care and the sharing of peer group experiences on infants' growth rates, breastfeeding self-efficacy, and quality of life of their mothers. The current educational package not only combines virtual education and peer experiences in strengthening the education of mothers, but also it can improve mothers' physical and mental health and reduce medical costs by using telephone follow-up in supporting of the mothers of infants.Trial registration: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20210913052457N1, registered 9/10/2021, https://www.irct.ir/trial/59093.

DIGITAL BASED EDUCATION: SMART MOM BREASTFEEDING

Post partum period mothers, especially primipara, often experience problems in the breastfeeding process, this is due to a lack of mother's knowledge, including the lack of information obtained by mothers from health workers and the mother's lack of ability to understand the information obtained, and also do not have experience giving birth. The objectives of this study was to increase the knowledge and ability of mothers in breastfeeding and the baby's ability to breastfeed so that breastfeeding was smooth. This type of research is descriptive in the form of a case study. The subjects studied were 2 patients with the same nursing cases and problems, namely patients with primiparous mothers with ineffective breastfeeding at Muhammadiyah Hospital Palembang. This research was conducted on March 9, 2022 to March 11 2022 and April 12 to April 14 2022. After implementing digital-based education on the audiovisual method for smart breastfeeding mothers, digital-based education results showed that smart mother breastfeeding can increase mothers’ knowledge and ability to breastfeeding as well as babies’ ability to suckle and breastfeeding smoothly. Implementation of digital-based education: smart mother breastfeeding can be applied.

Association between Maternal Age and Complications of Pregnancy in Primipara

Objectives: The purpose of this study was to analyze the association between maternal age and pregnancy outcome in primipara. Methods: We evaluated retrospectively the clinical characteristics and pregnancy outcomes in primiparous mothers who delivered a fetus after more than 22 weeks of gestation in I hospital from January 2017 to December 2018. Statistical analysis was performed using chi-square tests and multivariable logistic regression. The education, occupation, abortion history, assisted reproductive technology (ART) and multiple pregnancy all showed significantly higher incidence, depending on maternal age (&lt;i&gt;p&lt;/i&gt;&lt;0.000). Results: The odds ratio in maternal complications was 2.327 times higher in mothers 40 years and above than mothers 29 years and below, and 1.912 times higher in mothers 35-39 years than mothers 29 years and below. The odds ratio in gestational diabetes was 3.337 times higher in mothers 40 years and above than mothers 29 years and below, and 2.698 times higher in mothers 35-39 years than mothers 29 years and below. Conclusions: Consequently, this study showed a significant association between maternal age and pregnancy outcome in primipara. However, as the maternal age increases, the improvement of socioeconomic status and health level are expected to have a greater impact on outcome of pregnancy despite the physical defects of biological aging.

Antepartum and intrapartum stillbirth rates across gestation: a cross-sectional study using the revised foetal death reporting system in the U.S.

BackgroundThere is a renewed call to address preventable foetal deaths in high-income countries, especially where progress has been slow. The Centers for Disease Control and Prevention released publicly, for the first time, the initiating cause and estimated timing of foetal deaths in 2014. The objective of this study is to describe risk and characteristics of antepartum versus intrapartum stillbirths in the U.S., and frequency of pathological examination to determine cause.MethodsWe conducted a cross-sectional study of singleton births (24–43 weeks) using 2014 U.S. Fetal Death and Natality data available from the National Center for Health Statistics. The primary outcome was timing of death (antepartum (n = 6200), intrapartum (n = 453), and unknown (n = 5403)). Risk factors of interest included maternal sociodemographic, behavioural, medical and obstetric factors, along with foetal sex. We estimated gestational week-specific stillbirth hazard, risk factors for intrapartum versus antepartum stillbirth using multivariable log-binomial regression models, conditional probabilities of intrapartum and antepartum stillbirth at each gestational week, and frequency of pathological examination by timing of death.ResultsThe gestational age-specific stillbirth hazard was approximately 2 per 10,000 foetus-weeks among preterm gestations and > 3 per 10,000 foetus-weeks among term gestations. Both antepartum and intrapartum stillbirth risk increased in late-term and post-term gestations. The risk of intrapartum versus antepartum stillbirth was higher among those without a prior live birth, relative to those with at least one prior live birth (RR 1.32; 95% CI 1.08–1.61) and those with gestational hypertension, relative to those with no report of gestational hypertension (RR 1.47; 95% CI 1.09–1.96), and lower among Black, relative to white, individuals (RR 0.70; 95% CI 0.55–0.89). Pathological examination was not performed/planned in 25% of known antepartum stillbirths and 29% of known intrapartum stillbirths.ConclusionThese findings suggest greater stillbirth risk in the late-term and post-term periods. Primiparous mothers had greater risk of intrapartum than antepartum still birth, suggesting the need for intrapartum interventions for primiparous mothers in this phase of pregnancy to prevent some intrapartum foetal deaths. Efforts are needed to improve understanding, prevention and investigation of foetal deaths as well as improve stillbirth data quality and completeness in the United States.