Antenatal Uterotonics as a Risk Factor for Intrapartum Stillbirth and First-day Death in Haryana, India: A Nested Case-control Study

Trends and regional variations in prescriptions dispensed to stimulate uterine contractions at the end of pregnancy in Belgium: A community-based study from 2003 to 2018

PURPOSE

To investigate trends and regional variations in uterotonics dispensed around birth between 2003 and 2018 in Belgium.

METHODS

Data, including outpatient and inpatient prescriptions were extracted from a nationally representative prescription database. The prevalence of uterotonics dispensed during a period including the 7 days before birth, the delivery day and the 7 days after birth was computed over three 4-year-long study periods from 2003 to 2018. The trends between periods and associations between the use of at least one uterotonic and maternal age, region of residence, delivery type and social status were assessed using logistic regression.

RESULTS

In total, 31 675 pregnancies were included in the study. The proportion of pregnancies exposed to at least one uterotonic decreased significantly from 92.9% (95%CI, 92.3-93.4) in 2003-2006 to 91.4% (95%CI, 90.7-92.0) in 2015-2018 for vaginal births and from 95.5% (95%CI, 94.5-96.4) to 93.7% (95%CI, 92.6-94.7) for caesarean sections. However, for vaginal births, the proportion of oxytocin increased from 84.5% (95%CI, 83.7-85.2) to 89% (95%CI 88.3-89.7). A significant association was found between uterotonic agent use and maternal age, region of residence, and delivery type. The dispensation of some uterotonic agents differed significantly between the regions.

CONCLUSIONS

The proportion of pregnancies exposed to at least one uterotonic was high across the study period but decreased slightly between 2003 and 2018. Important variations in uterotonic use between regions highlight the need for improved national guidance.

Perinatal Asphyxia and Its Associated Factors among Live Births in the Public Health Facilities of Bahir Dar City, Northwest Ethiopia, 2021

BACKGROUND

Birth asphyxia is a serious clinical problem of newborn babies, which occurs due to impaired blood-gas exchange and results in hypoxemia. Despite improvements in the diagnosis and management of perinatal asphyxia, it has become the leading cause of admission and neonatal mortality, especially in developing countries.

OBJECTIVE

This study was aimed at assessing factors associated with perinatal asphyxia among live births in the public health facilities of Bahir Dar city, Northwest Ethiopia, 2021.

METHOD

Health facility-based cross-sectional study was employed from April 1-30/2021 in the public health facilities of Bahir Dar city among 517 mother-newborn pairs. The data were collected by systematic random sampling technique, entered by using Epi data 3.1, and analyzed using SPSS 25.0 version. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables.

RESULT

In this study, 21.7% (95% CI: 18.2%-25.5%) of the newborns had perinatal asphyxia. Malpresentation (AOR = 4.06, 95%CI = 2.08-7.94), uterotonic drug administration (AOR = 2.78, 95%CI = 1.67-4.62), meconium-stained amniotic fluid (AOR = 4.55, 95%CI = 2.66, 7.80), night time delivery (AOR = 1.91, 95%CI = 1.17, 3.13), and preterm delivery (AOR = 3.96, 95%CI = 1.98, 7.89) were significantly associated with perinatal asphyxia. Conclusion and Recommendation. In the present study, the proportion of perinatal asphyxia was high. To mitigate this problem, there is a need to focus on early identification of the risk factors like fetal malpresentation, preterm labor/delivery, and managing them appropriately. Administering uterotonic drugs should be based on indication with close supervision.