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Martinelli KG, Gama SGND, Almeida AHDVD, Pacheco VE, Santos Neto ETD. Advanced maternal age and factors associated with neonatal near miss in nulliparous and multiparous women. CAD SAUDE PUBLICA 2019; 35:e00222218. [PMID: 31800791 DOI: 10.1590/0102-311x00222218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 05/28/2019] [Indexed: 11/21/2022] Open
Abstract
The early neonatal period accounts for approximately half of the deaths of young children under one year of age, and the neonatal near miss can recognize factors causing this high number of deaths. Thus, the aim of this study is to determine whether advanced maternal age increases the chance of neonatal near miss, in addition is to identify which factors are associated with the neonatal near miss, stratified by parity. Data are from the 2011-2012 Birth in Brazil study, which used a national population-based sample of 15,092 newborns of women between 20-29 and 35 years of age or more (advanced maternal age). Multiple logistic regression was performed to test the association between neonatal near miss and prenatal and childbirth variables, pre-gestational diseases, obstetric history and socioeconomic characteristics, stratified by parity. Advanced maternal age was to be statistically associated with neonatal near miss in nulliparous (OR = 1.62; 95%CI: 1.05-2.50) and multiparous (OR = 1.51; 95%CI: 1.20-1.91) when compared to women 20-29 years of age. For nulliparous women, the main variables statistically associated with neonatal near miss were multiple gestation (OR = 8.91) and hypertensive disease (OR = 2.57), whereas forceps-assisted vaginal delivery (OR = 7.19) and multiple gestation (OR = 4.47) were the variables associated for multiparous women. Neonatal near miss has been shown to be connected with access to health services for childbirth, gestational complications and maternal characteristics, mainly advanced maternal age. Therefore, to properly monitor and classify maternal gestational risk, to control gestational complications during prenatal care, and to correctly refer these women to childbirth care should be priority strategies for healthcare services.
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Affiliation(s)
- Katrini Guidolini Martinelli
- Universidade Federal do Espírito Santo, Vitória, Brasil.,Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Socio-demographic determinants of low birth weight: Evidence from the Kassena-Nankana districts of the Upper East Region of Ghana. PLoS One 2018; 13:e0206207. [PMID: 30427882 PMCID: PMC6235265 DOI: 10.1371/journal.pone.0206207] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 10/09/2018] [Indexed: 11/19/2022] Open
Abstract
Objective To examine the social, economic and demographic factors that determine low birth weight in the two Kassena Nankana districts of the Upper East region of Ghana. Methods Cross-sectional data was collected from January 2009 to December 2011 using the Navrongo Health and Demographic Surveillance System which monitors routine health and demographic outcomes in the study area. Data on foetal characteristics such as birth weight, and sex and maternal age, parity, maternal education, marital status, ethnicity, religious affiliation and socio-economic characteristics were collected and described. Tests of means, proportions and Chi-squares are employed in bivariate analysis, and adjusted logistic regression models fitted to control for potential confounding variables. All tests were two-sided and test of significance was set at p-value of < 0.05. Results There were 8,263 live births (44.9% females) with an overall average birth weight of 2.85 kg (2.9 kg for males and 2.8 kg for females). The average maternal age was 28 years, median parity 2, maternal literacy rate was about 70% and 83% of mothers were married. The prevalence of low birth weight was 13.8% 95%CI [13.10, 14.6] and more in female babies than in males (15.5% vs 12.2%; p<0.0001). Determinants of low birth-weight after controlling for confounding factors were sex of neonate (OR = 1.32, 95%CI [1.14,1.52]; p<0.0001), maternal age (p = 0.004), and mothers who are not married (OR = 1.44 [1.19, 1.74]; p<0.0001). Conclusion Female neonates in this population were likely to present with low birth weight and maternal factors such as younger age, lower socio-economic status and single parenthood were major determinants of low birth weight. Effective and adequate antenatal care should therefore target women with these risk factors.
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Tafere TE, Afework MF, Yalew AW. Providers adherence to essential contents of antenatal care services increases birth weight in Bahir Dar City Administration, north West Ethiopia: a prospective follow up study. Reprod Health 2018; 15:163. [PMID: 30268132 PMCID: PMC6162936 DOI: 10.1186/s12978-018-0610-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/19/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Low birth weight (LBW) is one of the most important factors affecting child morbidity and mortality worldwide. Antenatal care (ANC) is an opportunity for reaching pregnant women with a number of interventions that may be vital to their health and well-being of their infants. However, data on the link between ANC quality and LBW remain limited especially in developing countries. Therefore, this study was aimed at investigating the effect of ANC service quality on birth weight among pregnant women attending ANC at public health facilities of Bahir Dar City Administration, Bahir Dar, Ethiopia using provision of essential services by providers as proxy for quality of care. METHODS Nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit and selected by systematic sampling were enrolled and followed until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. Women who gave birth at home and those who deliver a premature or still birth baby were excluded as data on birth weight could not be obtained for home deliveries and as the birth weight of the baby might be affected due to prematurity and still birth. Completed data were obtained from 718 women (since the rest women gave birth at home, we could not obtain birth weight data and we exclude them from analysis). The overall ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation was carried out to identify predictors of birth weight by controlling the cluster effect among women who received ANC services in the same facility. RESULTS The prevalence of low birth weight (< 2500 g) was 7.8% (95%CI = 6.0%, 9.7%) with 1.4% versus 10.5% among those who received acceptable and not acceptable quality ANC services respectively, P-value< 0.001. Maternal nutritional advice, iron-folic acid supplementation, tetanus toxoid vaccination, maternal educational status, parity and age were determinants for birth weight. CONCLUSION AND RECOMMENDATION The study showed that access to quality ANC services led to good birth weight outcome. Strengthening adherence of providers to essential components of antenatal care through regular monitoring and need based capacity building is very important for reducing the risk of low birth weight.
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Affiliation(s)
- Tadese Ejigu Tafere
- School of Public Health (SPH), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mesganaw Fanthahun Afework
- School of Public Health (SPH), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Woreku Yalew
- School of Public Health (SPH), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Zgheib SM, Kacim M, Kostev K. Prevalence of and risk factors associated with cesarean section in Lebanon — A retrospective study based on a sample of 29,270 women. Women Birth 2017; 30:e265-e271. [DOI: 10.1016/j.wombi.2017.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/02/2017] [Accepted: 05/05/2017] [Indexed: 11/30/2022]
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Shahabuddin A, De Brouwere V, Adhikari R, Delamou A, Bardají A, Delvaux T. Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011. BMJ Open 2017; 7:e012446. [PMID: 28408543 PMCID: PMC5594213 DOI: 10.1136/bmjopen-2016-012446] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To identify the determinants of institutional delivery among young married women in Nepal. DESIGN Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15-24 years). OUTCOME MEASURE Place of delivery. RESULTS The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery. CONCLUSIONS Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal.
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Affiliation(s)
- Asm Shahabuddin
- Department of Public Health, Instituut voor Tropische Geneeskunde, Antwerp, Belgium
- Department of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Vincent De Brouwere
- Department of Public Health, Instituut voor Tropische Geneeskunde, Antwerp, Belgium
| | - Ramesh Adhikari
- Geography and Population Department, Tribhuvan University, Kathmandu, Nepal
| | - Alexandre Delamou
- Centre national de formation et de recherche en sant rurale de Maferinyah, Forcariah, Guinea
| | - Azucena Bardají
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Therese Delvaux
- Department of Public Health, Instituut voor Tropische Geneeskunde, Antwerp, Belgium
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Mousiolis A, Baroutis G, Sindos M, Costalos C, Antsaklis A. Maternal age as a predictive factor of pre-term birth. An epidemiological study from 1999 to 2008 in Greece. J OBSTET GYNAECOL 2014; 33:28-31. [PMID: 23259874 DOI: 10.3109/01443615.2012.730078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to estimate the risk of pre-term birth in women giving birth in Greece in different age groups. Data about women giving birth in Greece were retrieved from the Hellenic Vital Statistics covering the years from 1999 to 2008. Relative risk using χ(2) contingency tables was estimated among maternal age groups formed. These groups included mothers < 15 years of age, 15-19, 20-34 (used as a control group) and women > 34 (35-39, 40-44, 45-49 and ≥ 50) years of age. Relative risk of each age group was compared with mothers 20-34 years of age. A total of 1,069,413 valid births were included in the study and 72,156 of them were pre-term (6.75% of total count). Results exhibit a 'U'-shaped distribution of risk. Higher risk of pre-term birth is noted in the groups of < 15 years (Pearson χ(2) = 14.964, p < 0.001, risk = 1.569, CI = 1.249-1.970) and above 34 years of age (Pearson χ(2) = 2991.26, p < 0.001, risk = 1.572, CI = 1.546-1.597). For older women, a steep rise in the relative risk for pre-term birth was noted beyond the 40-44 years of age group. Finally, of interest is the fact that 'late' pre-terms (34-36 gestational weeks) account for most of the pre-term birth in mothers beyond 34 years of age.
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Affiliation(s)
- A Mousiolis
- Neonatal Department, Alexandra Hospital, University of Athens, Athens, Greece.
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Lao TT, Sahota DS, Cheng YKY, Law LW, Leung TY. Advanced maternal age and postpartum hemorrhage – risk factor or red herring? J Matern Fetal Neonatal Med 2013; 27:243-6. [DOI: 10.3109/14767058.2013.807240] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mcintyre SH, Newburn-Cook CV, O'Brien B, Demianczuk NN. Effect of Older Maternal Age on the Risk of Spontaneous Preterm Labor: A Population-Based Study. Health Care Women Int 2009; 30:670-89. [DOI: 10.1080/07399330802596473] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stewart CP, Katz J, Khatry SK, LeClerq SC, Shrestha SR, West KP, Christian P. Preterm delivery but not intrauterine growth retardation is associated with young maternal age among primiparae in rural Nepal. MATERNAL AND CHILD NUTRITION 2007; 3:174-85. [PMID: 17539886 PMCID: PMC2367231 DOI: 10.1111/j.1740-8709.2007.00097.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pregnancy during adolescence is associated with adverse birth outcomes, including preterm delivery and low birthweight. The nutrient availability to the fetus may be limited if the mother is still growing. This research aims to study the effects of pregnancy during adolescence in a nutritionally poor environment in rural Nepal. This study utilized data from a randomized controlled trial of micronutrient supplementation during pregnancy in south-eastern Nepal. Women of parity 0 or 1 and of age <or= 25 years who gave birth to a singleton liveborn infant who was measured within 72 h of delivery were included (n = 1393). There was no difference in the risk of low birthweight (OR = 0.96; 95% CI = 0.90-1.02) or small for gestational age (OR = 1.01; 95% CI = 0.94-1.08) per year of increasing maternal age among primiparae. Young maternal age did not affect the anthropometry or gestational age of the offspring of parity 1 women. Each year of increasing maternal age among primiparae was associated with increases in birth length (0.07 cm; 95% CI = -0.01 to 0.16), head (0.05 cm; 95% CI = 0.01-0.09) and chest circumference (0.07 cm; 95% CI = 0.01-0.12), but not weight (9.0 g; 95% CI = -2.1 to 21.8) of their offspring. Young maternal age was associated with an increased risk of preterm delivery among primiparae (OR = 2.07; 95% CI = 1.26-3.38) that occurred at an age cut-off of <or=18 years relative to those 19-25 years. Thus, we conclude that young maternal age (<or=18 years) increased the risk of preterm delivery, but not intrauterine growth retardation, for the first but not second liveborn infant.
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Affiliation(s)
- Christine P. Stewart
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W2505, Baltimore, MD 21205‐2103, USA
| | - Joanne Katz
- Department of International Health, Program in Disease Prevention and Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W5009, Baltimore, MD 21205‐2103, USA, and
| | - Subarna K. Khatry
- The Nepal Nutrition Intervention Project‐Sarlahi, Nepal Netra Jyoti Sangh, Nepal Eye Hospital Complex, PO Box 335, Tripureswor, Kathmandu, Nepal
| | - Steven C. LeClerq
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W2505, Baltimore, MD 21205‐2103, USA
| | - Sharada Ram Shrestha
- The Nepal Nutrition Intervention Project‐Sarlahi, Nepal Netra Jyoti Sangh, Nepal Eye Hospital Complex, PO Box 335, Tripureswor, Kathmandu, Nepal
| | - Keith P. West
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W2505, Baltimore, MD 21205‐2103, USA
| | - Parul Christian
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W2505, Baltimore, MD 21205‐2103, USA
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