scholarly journals The Impact of Syndromic Management of Vaginal Discharge Syndrome on Adverse Birth Outcomes in Botswana

2021 ◽  
Author(s):  
Christina Fennell ◽  
Modeigi Diseko ◽  
Rebecca Zash ◽  
Gloria Mayondi ◽  
Judith Mabuta ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Vaginal Discharge ◽  
Adverse Birth Outcomes ◽  
Infant Outcomes ◽  
Syndromic Management ◽  
Very Preterm ◽  
Immortal Time Bias ◽  
In Pregnancy

Abstract Background Vaginal discharge syndrome (VDS) is a common clinical diagnosis during pregnancy in Botswana, treated with broad spectrum antibiotics using a syndromic approach. We evaluated associations between the syndromic management of VDS and adverse birth outcomes. Methods The Tsepamo Study performs birth outcomes surveillance at government hospitals throughout Botswana. Obstetric record data collected from August 2014–March 2019 were analyzed. Chi-square tests were conducted to compare proportions of maternal characteristics and infant outcomes. To avoid immortal time bias, all analyses were conducted among women who presented to care prior to 24 weeks gestation, with VDS categorized as present or absent by 24 weeks gestation. Log-binomial regression models were generated to determine associations between treated VDS and infant outcomes. Results VDS was diagnosed in 36,731 (30.7%) pregnant women, of whom 33,328 (90.7%) received antibiotics. Adjusted analyses yielded a harmful association between treated VDS and very preterm delivery (aRR= 1.11; 95% CI, 1.02, 1.21). This association remained when restricting to women with VDS who received the recommended combined treatment regimen. Sensitivity analyses produced non-significant associations when women with treated VDS were compared to women without VDS who received antibiotics for other indications. Conclusions Syndromic treatment for VDS is common among pregnant women in Botswana, and the majority receive antibiotics in pregnancy. Although analyses of VDS occurring later in pregnancy are precluded by immortal time bias, a modest association between treated VDS and very preterm delivery was observed among women diagnosed with VDS by 24 weeks gestation.

scholarly journals Seasonality of adverse birth outcomes in women with and without HIV in a representative birth outcomes surveillance study in Botswana

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045882
Author(s):  
Ellen C Caniglia ◽  
Jasmyn Abrams ◽  
Modiegi Diseko ◽  
Gloria Mayondi ◽  
Judith Mabuta ◽  
...  
Keyword(s):  
Climate Change ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Dry Season ◽  
Surveillance Study ◽  
Adverse Birth Outcomes ◽  
Hiv Status ◽  
Wet Season ◽  
Very Preterm

IntroductionSub-Saharan Africa has the largest number of people with HIV, one of the most severe burdens of adverse birth outcomes globally and particular vulnerability to climate change. We examined associations between seasonality and adverse birth outcomes among women with and without HIV in a large geographically representative birth outcomes surveillance study in Botswana from 2015 to 2018.MethodsWe evaluated stillbirth, preterm delivery, very preterm delivery, small for gestational age (SGA), very SGA, and combined endpoints of any adverse or severe birth outcome. We estimated the risk of each outcome by month and year of delivery, and adjusted risks ratios (ARRs) of outcomes during the early wet (1 November–15 January), late wet (16 January–31 March) and early dry (1 April–15 July) seasons, compared with the late dry (16 July–31 October) season. Analyses were conducted overall and separately by HIV status.ResultsAmong 73 178 women (24% with HIV), the risk of all adverse birth outcomes peaked in November–January and reached low points in September. Compared with the late dry season, the ARRs for any adverse birth outcome were 1.03 (95% CI 1.00 to 1.06) for the early dry season, 1.08 (95% CI 1.04 to 1.11) for the early wet season and 1.07 (95% CI 1.03 to 1.10) for the late wet season. Comparing the early wet season to the late dry season, we found that ARRs for stillbirth and very preterm delivery were higher in women with HIV (1.23, 95% CI 0.96 to 1.59, and 1.33, 95% CI 1.10 to 1.62, respectively) than in women without HIV (1.07, 95% CI 0.91 to 1.26, and 1.19, 95% CI 1.04 to 1.36, respectively).ConclusionsWe identified a modest association between seasonality and adverse birth outcomes in Botswana, which was greatest among women with HIV. Understanding seasonal patterns of adverse birth outcomes and the role of HIV status may allow for mitigation of their impact in the face of seasonal extremes related to climate change.

1365: Admission for Nephrolithiasis in Pregnancy and Risk of Adverse Birth Outcomes

2007 ◽  
Vol 177 (4S) ◽  
pp. 450-450
Author(s):  
Mia A. Swartz ◽  
Mona T. Lydon-Rochelle ◽  
David Simon ◽  
Jonathan L. Wright ◽  
Michael P. Porter
Keyword(s):  
Birth Outcomes ◽  
Adverse Birth Outcomes ◽  
In Pregnancy

scholarly journals Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261895
Author(s):  
Meron Admasu Wegene ◽  
Negeso Gebeyehu Gejo ◽  
Daniel Yohannes Bedecha ◽  
Amene Abebe Kerbo ◽  
Shemsu Nuriye Hagisso ◽  
...  
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Preconception Care ◽  
Previous History ◽  
Care Utilization ◽  
Adverse Birth Outcomes ◽  
Care Services ◽  
History Of ◽  
And Child Health

Introduction There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman’s may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town. Methods A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05. Result This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization. Conclusions The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women’s/couples knowledge & strengthening counseling services is pivotal.

scholarly journals Maternal and perinatal outcomes of hyperthyroidsm in pregnancy at Dr. Cipto Mangunkusumo Hospital, Jakarta, period of January 2015 - December 2016

2021 ◽  
Vol 29 (1) ◽  
pp. 36
Author(s):  
Fita Maulina ◽  
M Adya F F Dilmy ◽  
Ali Sungkar
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Intrauterine Growth Restriction ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Intrauterine Fetal Death ◽  
Adequate Treatment ◽  
Intrauterine Growth ◽  
In Pregnancy

Objectives: To report maternal and perinatal outcomes of hyperthyroidsm in pregnancy.Case Report: There were 3622 cases of delivering pregnant women during the period of the study. From this number, the prevalence of pregnant women with hyperthyroid was 0.2 %. We reported 9 cases of hyperthyroid in pregnancy. The number of pregnancy complication and outcome on pregnant women with hyperthyroidism were preterm labor (44%) and preeclampsia (22%), both were found in group of mother who did taking antihyperthyroid therapy. In those who did not take antihyperthyroid therapy 11% had spontaneous abortion and 11% had preterm delivery. Fetal complications were intrauterine growth restriction (11%) and intrauterine fetal death (23%), both of these complication were on the group who did not take antihyperthyroid. On the contrary, 44% babies were born with normal birthweight in group who took antihyperthyroid.Conclusion: There were differences noted between the group that took adequate treatment and the group that did not take antihyperthyroid. The incidence of intrauterine growth restriction and intrauterine fetal death were high in group that did not took antihyperthyroid therapy but the incidence of preterm delivery as the maternal complication was high in group that did take the antihyperthyroid therapy.  

scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

scholarly journals Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

2018 ◽  
Vol 72 (12) ◽  
pp. 1104-1109 ◽  
Author(s):  
Alice Goisis ◽  
Hanna Remes ◽  
Kieron Barclay ◽  
Pekka Martikainen ◽  
Mikko Myrskylä
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Birth Outcomes ◽  
Conclusive Evidence ◽  
Paternal Age ◽  
Adverse Birth Outcomes ◽  
Maternal Characteristics ◽  
Parental Characteristics ◽  
Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

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