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Rylander C, Manjavidze T, Nedberg IH, Kerselidze M, Anda EE. Quality of registration of antenatal, intrapartum, and newborn information in the Georgian birth registry. Arch Public Health 2024; 82:244. [PMID: 39716294 DOI: 10.1186/s13690-024-01479-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/16/2024] [Indexed: 12/25/2024] Open
Abstract
BACKGROUND The Georgian Birth Registry (GBR) is a comprehensive digital birth registry covering 99.8% of births nationwide. By law, registration in the GBR is mandatory, with data primarily transferred from medical records (MRs) by designated personnel at medical facilities. We aimed to assess the correspondence of the registration of selected variables between GBR and MRs. METHODS We randomly selected 1,044 women who gave birth in 2018. Data were extracted from the GBR on 27 variables related to pregnancy, childbirth, and the newborn and individually linked to the MRs. We specifically compared the agreement of dichotomous, ordinal, and date variables between the GBR and the MRs to assess the consistency of individual registrations. RESULTS Of the 27 dichotomous, ordinal, and date variables, 22 displayed more than 95% complete agreement with the information in the MRs. The prevalence of maternal morbidity registered in the MRs was lower than expected, while the proportion of fetuses with transverse lies was higher than expected. CONCLUSIONS Most antenatal, intrapartum, and newborn information registered in the GBR has satisfactory agreement with the MRs, with error typical for single data entry system. The lower-than-expected prevalence of gestational diabetes, preeclampsia, hypertensive disorders, and postpartum hemorrhage registered in the MRs, as well as the higher-than-expected prevalence of transverse fetal presentation, warrants in-depth investigation to ensure that the quality of care is satisfactory and to further improve registration in both the MRs and GBR. Therefore, our findings indicate that while the agreement between the GBR and MRs is generally high, MRs are sometimes incomplete or incorrect for certain conditions.
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Affiliation(s)
- Charlotta Rylander
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, 9037, Norway.
| | - Tinatin Manjavidze
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, 9037, Norway
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Ingvild Hersoug Nedberg
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, 9037, Norway
| | - Maia Kerselidze
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Erik Eik Anda
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, 9037, Norway
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Lin L, Yu Y, Gu W, Hu R, Zhu H. Knowledge, attitude and practice regarding constipation in pregnancy among pregnant women in Shanghai: a cross-sectional study. Front Public Health 2024; 12:1378301. [PMID: 39091521 PMCID: PMC11291461 DOI: 10.3389/fpubh.2024.1378301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/03/2024] [Indexed: 08/04/2024] Open
Abstract
Objective This study aims to investigate the Knowledge, Attitude, and Practice (KAP) pertaining to constipation during pregnancy among pregnant women in Shanghai. Methods Demographic data and KAP scores were collected using a questionnaire. Differences across groups were analyzed using either Wilcoxon-Mann-Whitney tests or Kruskal-Wallis analysis of variance. Spearman's correlation analysis was utilized to evaluate the relationships between KAP scores. Multivariable logistic regression analyses were conducted to identify factors that influence KAP scores. Results Encompassing 241 individuals (46.6%) aged between 30 and 34 years, with 349 participants (67.5%) being nulliparous. The median scores for knowledge (possible range: 0-26), attitude (possible range: 7-35), and practice (possible range: 14-70) were 22 (18, 24), 26 (23, 29), and 51 (46, 56), respectively. Multivariate analysis indicated that being a medical professional (OR = 2.222, p = 0.043) and receiving education on constipation during pregnancy (OR = 0.432, p < 0.001) were significantly associated with higher knowledge scores. Factors significantly associated with practice included being aged 30-34 years (OR = 2.745, p < 0.001), aged 35 years and above (OR = 2.514, p < 0.001), working in education (OR = 2.310, p = 0.012), and not experiencing constipation before pregnancy (OR = 1.894, p = 0.001). Conclusion Pregnant women demonstrated satisfactory knowledge, positive attitudes, and proactive practices concerning constipation during pregnancy. To further augment clinical practice, healthcare providers should tailor educational interventions and guidance specifically for pregnant women who are not medical professionals and those who have not received education and guidance related to constipation during pregnancy.
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Affiliation(s)
| | | | | | | | - Hao Zhu
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Moodley Y, Asare K, Tanser F, Tomita A. Maternal exposure to heat and its association with miscarriage in rural KwaZulu-Natal, South Africa: A population-based cohort study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241259171. [PMID: 39066467 PMCID: PMC11282531 DOI: 10.1177/17455057241259171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/21/2024] [Accepted: 05/16/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND We sought to improve the current understanding of how climate change impacts women's reproductive health in sub-Saharan Africa. OBJECTIVES We investigated the relationship between maternal heat exposure and miscarriage (pregnancy ending before 20 weeks gestation) in a South African setting. DESIGN Population-based cohort study. METHODS Our study involved data for pregnancies collected via a health and demographic surveillance system in rural KwaZulu-Natal, South Africa between 2012 and 2016. Data from the South African Weather Service were used to compute maternal exposure to heat during the following time windows for each pregnancy: during the month preceding conception (T1) and during the week preceding the study outcome (either a miscarriage or no miscarriage, T2). Heat exposure was operationalized as a continuous variable and defined as the number of days that a mother was exposed to a mean daily temperature of > 26.6°C (A "hot day," equivalent to a mean daily temperature of > 80°F) during T1 or T2. Binary logistic regression was used to investigate the relationship between maternal heat exposure and miscarriage. RESULTS A total of 105/3477 pregnancies included in our analysis ended in miscarriage (3.0%). Each additional hot day during T1 was associated with a 26% higher odds of miscarriage (odds ratio: 1.26; 95% confidence interval: 1.15-1.38). No significant associations were observed between maternal heat exposure during T2 and the odds of miscarriage (odds ratio: 0.94, 95% confidence interval: 0.73-1.20). The relationship between maternal heat exposure during T1 and the odds of miscarriage was J-shaped. CONCLUSION There is a clear relationship between maternal heat exposure during the month preceding conception and miscarriage in our sub-Saharan African setting. Given the lack of feasible strategies to reduce pregnancy loss associated with prevailing high temperatures in sub-Saharan Africa, progressive climate change will likely exacerbate existing challenges for women's reproductive health in this region.
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Affiliation(s)
- Yoshan Moodley
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Faculty of Health and Environmental Sciences, Central University of Technology, Bloemfontein, South Africa
- Division of Health Systems and Public Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Kwabena Asare
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa, KwaZulu-Natal, South Africa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Centre for Epidemic Response and Innovation, School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- South African Centre for Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, South Africa
| | - Andrew Tomita
- Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Congella, South Africa
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Izulla P, Muriuki A, Kiragu M, Yahner M, Fonner V, Nitu SNA, Osir B, Bello F, de Graft-Johnson J. Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: A scoping review of data from low- and middle-income countries. PLoS One 2023; 18:e0293479. [PMID: 37983214 PMCID: PMC10659187 DOI: 10.1371/journal.pone.0293479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
Global maternal and neonatal mortality rates remain unacceptably high. The postnatal period, encompassing the first hour of life until 42 days, is critical for mother-baby dyads, yet postnatal care (PNC) coverage is low. Identifying mother-baby dyads at increased risk for adverse outcomes is critical. Yet few efforts have synthesized research on proximate and distant factors associated with maternal and neonatal mortality during the postnatal period. This scoping review identified proximate and distant factors associated with maternal and neonatal mortality during the postnatal period within low- and middle-income countries (LMICs). A rigorous, systematic search of four electronic databases was undertaken to identify studies published within the last 11 years containing data on risk factors among nationally representative samples. Results were synthesized narratively. Seventy-nine studies were included. Five papers examined maternal mortality, one focused on maternal and neonatal mortality, and the rest focused on neonatal mortality. Regarding proximate factors, maternal age, parity, birth interval, birth order/rank, neonate sex, birth weight, multiple-gestation, previous history of child death, and lack of or inadequate antenatal care visits were associated with increased neonatal mortality risk. Distant factors for neonatal mortality included low levels of parental education, parental employment, rural residence, low household income, solid fuel use, and lack of clean water. This review identified risk factors that could be applied to identify mother-baby dyads with increased mortality risk for targeted PNC. Given risks inherent in pregnancy and childbirth, adverse outcomes can occur among dyads without obvious risk factors; providing timely PNC to all is critical. Efforts to reduce the prevalence of risk factors could improve maternal and newborn outcomes. Few studies exploring maternal mortality risk factors were available; investments in population-based studies to identify factors associated with maternal mortality are needed. Harmonizing categorization of factors (e.g., age, education) is a gap for future research.
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Affiliation(s)
| | - Angela Muriuki
- Save the Children, Kenya Regional Office, Nairobi, Kenya
| | | | - Melanie Yahner
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Virginia Fonner
- Adroitz Consultants Limited, Nairobi, Kenya
- Department of Health and Nutrition, Save the Children, Dhaka, Bangladesh
| | - Syeda Nabin Ara Nitu
- Department of Global Health, Save the Children Federation Inc, Washington DC, United States of America
| | | | - Farahat Bello
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Joseph de Graft-Johnson
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina, Charleston, South Carolina, United States of America
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Manjavidze T, Rylander C, Skjeldestad FE, Kazakhashvili N, Anda EE. The impact of antenatal care utilization on admissions to neonatal intensive care units and perinatal mortality in Georgia. PLoS One 2020; 15:e0242991. [PMID: 33264324 PMCID: PMC7710101 DOI: 10.1371/journal.pone.0242991] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 11/13/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Appropriate antenatal care (ANC) utilization has direct, significant effects on perinatal mortality (PM). Georgia has one of the highest PM rates (11.7 per 1000 births) in Europe and launched a more intensive ANC programme in 2018. Aim To evaluate the associations between the Adequacy of Prenatal Care Utilization (APNCU) index and neonatal intensive care unit (NICU) admission and PM in Georgia. Methods The Georgian Birth Registry (GBR), with linkage to the Vital Registration System, was used as the main data source; 148,407 eligible mothers and singleton newborns were identified during the observation period (2017–2019). The main exposure was ANC utilization, measured by the APNCU index, and the hospitalization registry was used to validate NICU admissions. Logistic regression analysis was used to assess the associations between the exposure and outcomes while controlling for potential confounders. Results The overall PM rate was 11.6/1000 births, and the proportion of newborns with a NICU admission was 7.8%. 85% of women initiated ANC before gestational age week 12. According to the APNCU index, 16% of women received inadequate, 10% intermediate, 38% adequate, and 36% intensive care. Women who received intermediate care had the lowest odds of PM (adjusted odds ratio [AOR] = 0.56, 95% confidence interval [CI] 0.45–0.70), and newborns of women who received inadequate care had the highest odds of NICU admission (AOR = 1.16, 95% CI 1.09–1.23) and PM (AOR = 1.18, 95% CI 1.02–1.36). Conclusion ANC utilization is significantly associated with newborn asmissions to NICU and PM in Georgia. Women received inadequate care experienced the highest odds of newborn admissions to NICU and PM.
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Affiliation(s)
- Tinatin Manjavidze
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Charlotta Rylander
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
| | - Finn Egil Skjeldestad
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
| | - Nata Kazakhashvili
- Department of Public Health, Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Erik Eik Anda
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø –The Arctic University of Norway, Tromsø, Norway
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