Perinatal and Women's Health

Background: Low birth weight (LBW) neonates face a significantly higher risk of complications and mortality compared to those with normal birth weight. This risk is particularly pronounced in low-income countries, where access to quality health care and adequate nutrition is limited. However, there is insufficient data on mortality for LBW neonates while receiving parenteral feedings. Therefore, this study was aimed to investigate the incidence and determinants of mortality among admitted LBW neonates receiving parenteral feeding at Neonatal Intensive Care Units (NICUs) in selected hospitals in Addis Ababa. Methods: A prospective follow-up study was conducted in selected hospitals' NICU from March to June 2022. Data were collected using a structured questionnaire and checklist, and analyzed using STATA software. The assumption for survival analysis was assessed using Kaplan-Meier survival curves and a global test. Bi-variable and multivariable Cox regression analyses were performed to identify determinants of mortality. A p-value of less than 0.05 was used to declare as a significant predictor. Results: Two hundred eighty-nine neonates with their indexed mothers were enrolled for a total of 2242 days. During this follow-up time sixty-six neonates were died, making the incidence rate of mortality among LBW neonates 29.

Background: A female genital fistula is an abnormal connection between a woman's reproductive tract and her urinary tract or rectum. While numerous studies have aimed to determine the success rate of obstetric fistula closure in different health settings, there remains a significant scarcity of data on closure success rates and incontinence rates for various types of fistulas at the regional and sub-regional levels. The success rate reflects the continent's healthcare setup in regard to the World Health Organization standards. Thus, this study aims to determine the success of surgical closure and the continence rate of obstetric fistula in Africa. Methods: This systematic review and meta-analysis review includes studies conducted up to February 2023. Search engines like EMBBASE, Medline, Google, PubMed, Google Scholar, African Journals Online, and ScienceDirect databases were utilized to find articles. The Joanna Briggs Institute critical evaluation checklist was used to evaluate the quality of our review, which was conducted in accordance with PRISMA criteria. Heterogeneity was indicated by a p-value for I 2 statistics of less than 0.05. Publication bias was assessed using the Egger regression asymmetry test. Data were entered into Microsoft Excel and analyzed using STATA 16. Result: This review includes 85 studies. A total of 24 countries from East, West, Central, North, and Southern African sub-regions were included. The overall pooled estimated rate of successful obstetric fistula closure is 86.15 (95% CI: 83.88-88.42). Moreover, the pooled estimated rate of successfully closed vesico-vaginal fistulas but with ongoing or residual incontinence (wet) was revealed as 13.41% (95% CI: 11.15-15.68). The pooled estimated rate of successfully closed rectovaginal fistulas and combined VVF and RVF are 91.06% (95% CI: 86.08-96.03) and 62.21% (95% CI: 48.94-75.49), respectively. Conclusions: The rate of successful obstetric fistula closure in Africa is 86.15, which is higher than the WHO target. However, the surgical closure rate of a combined VVF and RVF is 62.2%, which is significantly lower than the WHO target.

Objective This review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia. Design Systematic review and meta-analysis. Data sources Relevant articles were retrieved from databases such as PubMed, EMBASE, Medline and other search engines. Eligibility criteria for selecting studies The research design for this study had no restrictions, allowing for the inclusion of cross-sectional and case-control studies that examined the prevalence or determinants of pregnancy termination. However, case reports, case series, reviews, editorials and studies published as abstracts only were excluded from the analysis. Data extraction and synthesis The review was precisely in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, and the quality of the review was assessed using the Joanna Briggs Institute critical appraisal checklist. Heterogeneity was indicated by the p value for I 2 statistics less than 0.05. Data were entered into Microsoft Excel, and the analysis was conducted by using Stata V.16. Results The pooled prevalence of pregnancy termination in Ethiopia was 21.52% (95% CI 15.01% to 28.03%). Women who had their first sexual initiation before the age of 18 (OR 1.78; 95% CI 1.13 to 2.82, p=0.14), had irregular menstrual bleeding (OR 1.86; 95% CI 1.25 to 2.77, p=0.76), being a student (OR 4.85; 95% CI 1.98 to 11.91, p=0.20) and had multiple sexual partners (OR 4.88; 95% CI 3.43 to 6.93, p=0.33) were significantly associated with pregnancy termination. Conclusions One in five women terminated their pregnancies, which is higher than in other sub-Saharan countries. Being a student, irregular menstrual bleeding, early initiation of sexual intercourse and multiple sexual partners were determinants of pregnancy termination. Special attention is needed in avoiding early sexual initiation and in reducing sexual risk behaviours.

Background. Pastoralist communities rely on their livestock for at least 50% of their food supply and source of income. Home births raise the risk of maternal morbidity and death, whereas institutional births lessen the likelihood of difficulties during labor. Around 70% of labors in pastoralist regions of Ethiopia were assisted by traditional birth attendants. Methods. Studies done from January 2004 to January 2023, accessed in PubMed, EMBASE, Medline, and other search engines, were included. PRISMA guidelines and JBI critical appraisal checklist were used to assure the quality of the review. Ten articles were included in this review. Data were extracted with Excel and exported to STATA 16 for analysis. Heterogeneity of literatures was evaluated using I 2 statistics and publication bias using the Egger regression asymmetry test and the Duval and Tweedie trimfill analysis. Statistical significance was declared at p value less than 0.05. Result. The pooled estimate of institutional delivery among the pastoralist community in Ethiopia is 21.2% (95% CI: 16.2-26.1). Husbands who were involved to decide place of delivery (OR = 3 47; 95% CI: 1.61, 7.50), women with good knowledge of MCH services (OR = 2 283; 95% CI: 1.51, 3.44), women who had a positive attitude towards MCH services (OR = 1 69; 95% CI: 0.79, 3.6), availability of health institutions (OR = 2 6; 95% CI: 0.95, 7.20), and women who had an ANC follow-up (OR = 2 78; 95% CI: 2.07, 3.73) were higher institutional delivery prevalence among pastoralist women. Moreover, institutional delivery among women who were educated above the college level was more than two times (OR = 2 56; 95% CI: 1.985, 3.304) higher than among women who were not educated. Conclusion. Pastoralist women in Ethiopia were found to be a disadvantaged group for institutional delivery at national level. Husband involvement, educational level, ANC visit, knowledge and attitude for MCH service, and health facility distance were identified to have significant association with institutional delivery.

Background: Maternal and child mortality rates remain a serious public health challenge in Ethiopia. Short interpregnancy intervals are known to negatively impact perinatal and child health; therefore, improving this practice is a key strategy to reduce mortality and adverse outcomes. Objective: This study aimed to evaluate the extent of short intervals between pregnancies and the factors associated with them among women who gave birth at public hospitals in the North Wollo Zone of northeastern Ethiopia in 2023. Design: A facility-based cross-sectional study was conducted in the North Wollo Zone of northeastern Ethiopia in 2023. Methods: This study was conducted on mothers who delivered at public hospitals in the North Wollo Zone of northeastern Ethiopia. The study participants were selected using a systematic random sampling technique between February 1, 2023, and April 1, 2023. Data were collected through an interviewer-administered questionnaire using the Kobo Collect tool and analyzed using SPSS version 27.0. Bivariable and multivariable analyses were performed to determine the relationship between the outcome and predictor variables. A p value of less than 0.05 was considered significant in the multivariable analysis. Results: The study found that 51.5% of participants had short interpregnancy intervals. Several independent factors were associated with a short birth interval, including the status of the last pregnancy (adjusted odds ratio (

Se presentan los resultados obtenidos durante las intervenciones arqueológicas de las campañas desarrolladas en los años 2023 y 2024 en el Yacimiento Arqueológico del Castro del Cerro de los Moros, un recinto fortificado de la Edad del Bronce ubicado en Castillejo de Iniesta (Cuenca). En estas campañas se ha comenzado a excavar un sector de la muralla y en el aterrazamiento que forma la plataforma superior. En la intervención se han documentado al menos dos niveles o fases de ocupación, la primera datada hacia el 2000-1800 a.C. con evidencias de un episodio de incendio y destrucción. En ambas ocupaciones hay una gran cantidad de materiales de todo tipo. Se destaca el interés de la investigación en este enclave para el estudio del origen y evolución del proceso de "Castrificación" durante toda la Edad del Bronce en esta parte del área manchega.

Se presentan los resultados obtenidos durante las intervenciones arqueológicas de las campañas desarrolladas en los años 2023 y 2024 en el Yacimiento Arqueológico del Castro del Cerro de los Moros, un recinto fortificado de la Edad del Bronce ubicado en Castillejo de Iniesta (Cuenca). En estas campañas se ha comenzado a excavar un sector de la muralla y en el aterrazamiento que forma la plataforma superior. En la intervención se han documentado al menos dos niveles o fases de ocupación, la primera datada hacia el 2000-1800 a.C. con evidencias de un episodio de incendio y destrucción. En ambas ocupaciones hay una gran cantidad de materiales de todo tipo. Se destaca el interés de la investigación en este enclave para el estudio del origen y evolución del proceso de "Castrificación" durante toda la Edad del Bronce en esta parte del área manchega.

Background: Despite concerns about worsening pregnancy outcomes resulting from healthcare restrictions, economic difficulties and increased stress during the COVID-19 pandemic, preterm birth (PTB) rates declined in some countries in 2020, while stillbirth rates appeared stable. Like other shocks, the pandemic may have exacerbated existing socioeconomic disparities in pregnancy, but this remains to be established. Our objective was to investigate changes in PTB and stillbirth by socioeconomic status (SES) in European countries. Methods: The Euro-Peristat network implemented this study within the Population Health Information Research Infrastructure (PHIRI) project. A common data model was developed to collect aggregated tables from routine birth data for 2015-2020. SES was based on mother's educational level or area-level deprivation/maternal occupation if education was unavailable and harmonized into low, medium and high SES. Country-specific relative risks (RRs) of PTB and stillbirth for March to December 2020, adjusted for linear trends from 2015 to 2019, by SES group were pooled using random effects meta-analysis. Results: Twenty-one countries provided data on perinatal outcomes by SES. PTB declined by an average 4% in 2020 fpooled RR: 0.96 [95% confidence intervals (CIs): 0.94-0.97]g with

The occurrence of conflicting reports on the improvement of male reproductive function among humans fed diet containing the seed of Mucuna pruriens (MP) have raised a major concern in Nigeria. We assessed the effect of MP seed powder on the reproductive function in 32 adult male albino rats randomized to 4 groups of 8 rats each for 8 weeks. Group 1 (control) was given standard rat chow while groups 2, 3 and 4 were fed diets containing MP seed powder at 0.75 g, 1.5 g and 2.25 g respectively. Serum level of follicle stimulating hormone, testosterone, luteinizing hormone, oxidative stress markers in the testis, epididymal sperm quality and cytoarchitectural structure of the testis were monitored using standard methods. Significant improvements (p < 0.05) in the serum levels of all the hormones, testicular antioxidant defence, epididymal sperm quality without testicular degenerative changes were observed in group 2 compared to other groups. Oxidative stress, severe degenerative architectural lesions in the testis as well as significant reductions (p < 0.05) in epididymal sperm count, percentage motility and significant (p < 0.05) increased in abnormal sperm cells were observed in group 4. MP seed enhances reproductive function in male rats only at a dose level of 0.75g. A dose value higher than 0.75 g may be toxic to the male reproductive system.

Objective: To explore how women who used substances during the perinatal period perceived the care they received from interprofessional perinatal care providers. Design: Appreciative inquiry. Setting: Interprofessional perinatal care clinic in a large urban tertiary care hospital in Canada. Participants: Fourteen women with various backgrounds who used substances during pregnancy, including opioids, marijuana, and/or methamphetamine, and engaged in care with an interprofessional perinatal care team. The participants identified as First Nations (n ¼ 3), Me ´tis (n ¼ 8), and White (n ¼ 3). Methods: Using appreciative inquiry, we followed the 4-D cycle of discovery, dream, design, and destiny to frame the semistructured interviews and analyze the data. Results: Four overarching themes with nine subthemes emerged, representing participants' experiences with the interprofessional perinatal care team. The overarching themes were Safe Care, Compassionate Care, Dignified Care, and Connected Care. Participants suggested opportunities to improve care in relation to integration of cultural care, coordination of postpartum services, and increased support in the birth and hospital setting. Conclusion: The findings highlight the strengths and assets of interprofessional perinatal care from the patients' perspectives. Participants outlined actionable ways for all perinatal providers to deliver safe, compassionate, dignified, and connected care, which can result in life-giving and lifesaving outcomes for patients.

Abstract
The incidence of preeclampsia (PE) is associated with numerous risk
factors that are classified as high and moderate risk factors. In this
context, we carried out this study to determine the potential risks of PE
and to highlight those associated with the severity of the disease. This
is a case-control study of 200 pregnant women, groups of 100
preeclamptic (PG) and 100 non-preeclamptic (NPG) admitted between
March 2022 and January 2023 at the Maternity Ward of Sidi Bel Abbes
(Algeria). Data were analyzed using SPSS for Windows version 20.
Frequencies and percentages were calculated for categorical variables;
the Chi-square test was performed to compare between the two groups;
the risk factors and the odds ratio were identified using binary
regression. The current study showed that the development of PE was
associated with several risk factors, in particular renal disease, BMI ≥
35 and represented potential risk factors for the development of PE
with an a OR of (21.65, 95% CI; 2.56-182.75) and (18.47, 95% CI;
4.37-78.01), respectively. Furthermore, a history of PE and gestational
hypertension were potential risk factors and contributed to the
development of the severe form of PE with an aOR of (6.55, 95%
CI;2.78-15.43) and (7.32, 95% CI; 1.60-33.35); respectively

Date Presented 04/20/2023 Maternal health includes the pre-, peri- and postnatal periods in which women undergo physical, social, and psychosocial stressors. This systematic review explores women’s experiences to note the current and potential role of OT in maternal health. Primary Author and Speaker: Tessann Merkel Additional Authors and Speakers: Madison Beck, Alexis Medva, Faith Wintermantel Contributing Authors: Diana Goodman, Sharon Novalis

Objectives: To assess the impact of introducing NIPS into routine care, using two different approaches, on timing of first ultrasound in pregnancy and rate of genetic diagnostic procedures. Methods: Retrospective study of all screening tests for aneuploidy done in a tertiary academic institution between 1/2010-3/2018. Three different screening protocols were used: 1) 1/2010 -11/2014 all women were offered first trimester screening (FTS); 2) 12/2014 -4/2016, all offered FTS and NIPS; 3) 5/2016-3/2018 all offered FTS or genetic counselling and NIPS. Rates of FTS, NIPS, performance of any scan in first trimester, amniocentesis, chorionic villous sampling and NT scans offered to those who elected NIPS were compared between the three periods. Mann-Whitney, Kruskal-Wallis and Chi-square tests were utilised as indicated. The number of FTS per month remained unchanged after adding NIPS in 2014 but significantly decreased after patients had to choose between NIPS and FTS (p<0.001). Using the 3 rd protocol, fewer had NIPS (115 vs 365, p<0.001) or any type of screen (273 vs 365, p<0.001). On average, 7320 new patients were seen annually in our centre. In the first period, 6708 (91.6%) had ultrasound in 1 st trimester. This dropped to 6168 (84.2%) in the second period and to 4932 (67.3%) in the recent period (p<0.001). Both diagnostic procedures decreased significantly after the introduction of NIPS (p<0.001). The number of NT scans offered to patients choosing only NIPS also decreased over time (46 vs 16, p<0.001). Conclusions: After the introduction of NIPS as an alternative to FTS, fewer women had their first prenatal ultrasound in the first trimester and fewer underwent diagnostic testing.

this study aimed to assess Medication Errors among Nurses in the Intensive Care Unit. Setting this study was conducted at Kafrelsheikh University Hospital, 3critical care units Medical ICU, surgical ICU & Cardiac care unit CCU. Sampling; a convenient sample of 59 nurses working in the mentioned setting. Tools two tools were used for data collection. First tool; a self-administered questionnaire sheet consisted of two parts. Part I concerned with nurses' demographic data. Part II concerned with nurses' knowledge assessment. Second tool; was nurses' practice observational checklist. Results most of the studied nurses had errors in their knowledge and practice of medication safety, regarding all components medication Conclusion; most of the studied nurses had unsatisfactory of both levels knowledge and practice regarding all components medication. Recommendations: the study recommended that; Arranging continuous education programs for nurses, about medication safety and prevention of medication errors

1) Background: The aim of our study is to evaluate whether cell-free DNA testing can overlap the genetic testing of miscarriage tissue in women with early pregnancy loss (EPL) and length of recurrent pregnancy loss (RPL); (2) Methods: We conducted a prospective cohort study at the Pregnancy Loss Unit of the Fondazione Policlinico Universitario A. Gemelli (IRCCS), Rome, Italy between May 2021 and March 2022. We included women with EPL and length of RPL. Gestational age was >9 weeks + 2 days and <12 weeks + 0 days of gestation corresponding to a crown rump length measurement of >25 and <54 mm. Women underwent both dilation and curettage for the collection of miscarriage tissue and for blood sample collection. Chromosomal microarray analysis (CMA) on miscarriage tissues was performed by oligo-nucleotide-and single nucleotide polymorphisms (SNP)based comparative genomic hybridization (CGH+SNP). Maternal blood samples were analyzed by Illumina VeriSeq non-invasive prenatal testing (NIPT) to evaluate the cell-free fetal DNA (cfDNA) and the corresponding fetal fraction and the presence of genetic abnormalities; (3) Results: CMA on miscarriage tissues revealed chromosome aneuploidies in 6/10 cases (60%), consisting of trisomy 21 (5 cases) and monosomy X (one case). cfDNA analysis was able to identify all cases of trisomy 21. It failed to detect monosomy X. A large 7p14.1p12.2 deletion concomitant to trisomy 21 was, in one case, detected by cfDNA analysis but it was not confirmed by CMA on miscarriage tissue. (4) Conclusions: cfDNA largely reproduces the chromosomal abnormalities underlying spontaneous miscarriages. However, diagnostic sensitivity of cfDNA analysis is lower with respect to the CMA of miscarriage tissues. In considering the limitations when obtaining biological samples from aborted fetuses suitable for CMA or standard chromosome analysis, cfDNA analysis is a useful, although not exhaustive, tool for the chromosome diagnosis of both early and recurrent pregnancy loss.

Severe maternal morbidity (SMM) is a nationally recognized outcome metric for describing the incidence of unexpected adverse outcomes of labor and delivery and is meant to assist hospitals in promoting safe obstetric care. However, recent analysis (Hirai et al 2022) has shown that SMM is not correlated with maternal mortality rate (MMR) across US states, raising doubts about its value as a prognostic and policy-relevant measure. Here we extend the Hirai analysis by introducing social and policy variables that may help to explain why state rankings of SMM and MMR are unaligned. Multivariate correlation and regression reveal some factors that move in the same direction for the two metrics, but others that do not. A higher SMM appears to reflect not only underlying maternal risk as MMR does, but also the thoroughness of perinatal care.

While clinical causes like haemorrhage and sepsis dominate discourse on maternal mortality in Nigeria, they often obscure deeper psychosocial origins-particularly unresolved emotional trauma. Drawing from global psychosomatic research, traditional healing frameworks, and personal clinical experience, this paper explores how shame, silence, and emotional repression heighten physiological vulnerability and lead to care avoidance. The argument advances a trauma-informed, dual-system model for maternal health-integrating modern biomedical practices with traditional healing to address root causes holistically.

Across Nigeria, rising infertility rates have led many women to turn to herbal selfmedication, often without medical supervision. However, the informal herbal market remains largely unregulated, posing significant safety concerns. This study presents field observations from three Abuja markets-Karimo, Tipper Garage Gwarinpa, and Utako-highlighting the risks posed by cinnamon misidentification in herbal fertility treatments. Specifically, cassia and Indonesian cinnamon, both high in hepatotoxic coumarin, are commonly sold as Ceylon cinnamon. A case vignette of a woman unknowingly consuming toxic cinnamon daily to manage high prolactin underscores the urgent need for botanical regulation, consumer education, and interdisciplinary collaboration to ensure safe herbal practice in Nigeria.

Background and Aims: Better understanding the challenges faced by patients on medications for opioid use disorder (MOUD), including methadone and buprenorphine, is critical to increasing their use/retention. Social media platforms such as Reddit offer a space for patients to share their experiences with medications. We aimed to identify and characterize challenges faced by patients taking MOUD through analysis of discussions from the r/Methadone and r/suboxone subreddits.

The clinical autopsy of foetuses, stillborn babies, or neonates and the examination of the placenta help to inform the mother's decision-making and her medical care for subsequent pregnancies. Indeed, these post-mortem examinations can identify unexpected congenital malformations or the cause of repeated miscarriage or stillbirth. However, the use of clinical pathology for diagnostic purposes in the context of family planning for bereaved parents with an unfulfilled desire to have a child, and IVF couples has received little attention to date. This article applies Beauchamp and Childress' bioethical framework to identify, assess and systematically discuss ethical issues associated with the use of clinical foetal autopsy in reproductive healthcare within the German legal context. In the format of a clinical ethics consultation, the article examines the current policy on perinatal post-mortem examinations in Germany, and asks whether the clinical foetal autopsy for reproductive health purposes should be part of standard clinical examinations offered to bereaved parents. The conclusion of our research recommends clinical foetal autopsy as ethically acceptable, provided that the necessary resources are available. This recommendation is based on the ethical obligation towards the mother as the patient, which is grounded in the bioethical principles of autonomy and beneficence.

Background: Although advanced maternal age (AMA) has been identified as a risk factor for adverse obstetric outcomes, research efforts continue to gather evidence to describe the relationship. Methods: This was a comparative study conducted at a tertiary health facility. Participants were pregnant women who delivered after viability (28 weeks gestation) at the facility over a ten year period categorized into those with advanced maternal age (>35 years) and younger women (≤35 years). The source of data was the hospital delivery records; data analysis was performed with SPSS version 21.0 while p-value <0.05 was significant. Results: The prevalence of AMA was 8.8% (761/8645), 18 (2.4%) were nulliparous, 351 (46.1%) had tertiary education, 196 (25.8%) had inter-pregnancy interval >24 months while 66 (8.7%) had preterm delivery. AMA was associated with significantly higher occurrence of obstructed labour (204 vs. 129; p0.001) and primary postpartum haemorrhage (208 vs. 123; p0.001). Onset of labour (OR 95%CI [0.470, 0.063-3.493]; p0.450), augmentation of labour (OR 95%CI [0.969, 0.830-1.132]; p0.695) and need for episiotomy (OR 95%CI [1.116, 0.955-1.303]; p0.166) were not statistically different for AMA compared to younger women. The caesarean section rates were 40.0% for AMA and 23.7% for younger women while perinatal mortality rates were 391/1,000 for AMA and 110/1,000 live births for younger women. Conclusion: Pregnancy outcome in women with AMA was poorer with about twice the caesarean section rate and thrice the perinatal mortality rate compared to younger women. Therefore, efforts should be made to limit pregnancy in women with AMA.

Objectives: The umbilical coiling index (UCI) is one of cord parameters for foetal assessment with limited studies in our environment. With recent advances in its evaluation, its significance, pattern, abnormalities and correlates need to be defined in our parturients. Methods: The umbilical cords of 436 neonates were examined. Gross examination was done within 5 min of delivery. The UCI was defined as the number of complete coils per centimetre of cord. Normal UCI was defined as values between the 10 th and 90 th percentiles of the study population. Results: The mean umbilical cord length was 52.7 ± 11.5 cm, mean number of coils was 10.8 ± 5.1 and mean UCI was 0.21 ± 0.099. The range was between 0.0 and 1.0. UCI values of 0.13 and 0.30 were 10 th and 90 th percentiles, respectively. Normal UCI was observed in 351 (80.5%) neonates, 44 (10.4%) and 41 (9.1%) had hypo-and hypercoiled cords, respectively. Congenital abnormalities occurred in the normocoiled and hypercoiled groups but was not demonstrated in the hypocoiled group. The mean value of UCI in neonates with congenital abnormalities was 0.29 ± 0.12 (P = 0.011). There was no significant statistical relationship between foetal outcome and degree of UCI. Conclusion: The UCI was not associated with adverse perinatal outcome in this study.

obstacles (spatial, territorial, institutional) in seeking help. To overcome obstacles, both female victims of PIPV and health and social care professionals used adaptive strategies that varied according to periods of containment (strict lockdown, flexible social distance) and male perpetrators' behaviours. Additionally, the data show that several tools were mobilized by community organizations to ensure the care of women victims of PIPV and their children. Finally, the results highlight the involvement of several actors in the fight against PIPV during Covid-19.

Authors share their experiences from a research on polycystic ovarian syndrome (PCOS) risk among adolescent schoolgirls in
a South Indian state. One hundred and twenty school going adolescent girls from a government funded school in Southern India
were assessed for PCOS risk, among which 40 had PCOS risk (moderate risk 36, high risk 4). These 40 were grouped in to either
experimental or control which 20 each. Experimental group received awareness program and lifestyle modifications (yoga and
exercise) by the researcher in coordination with the schoolteachers at the school premises. Pretest knowledge assessment showed,
16 (80%) in the experimental and 15 (75%) on the control group had ‘moderate’ knowledge. Post intervention, 15 (75%) had
adequate knowledge in the experimental group and 9 (45%) in the control group. Knowledge score during pretest was mean 11.30;
SD 4.91, t = 5.27; p = 0.000 in the experimental group, and 11.25; SD = 4.44, t = 2.85; p = 00.01 in the control group. Knowledge score
of post-test was 11.30; SD 4.91; t = 5.27; p = 0.000 in the experimental and the mean 14.35; S.D 4.44; t = 2.85; p = 0.01 in the control
group. Attitude score during pretest was 51.80; SD = 11.12, t = 0.01; p = 0.000 in the experimental and 53.45 SD = 5.91; t = 2.99; p =
00.01) in the control group. Attitude score during posttest was mean 53.45; SD = 5.91, t = 2.99; p = 0.1 in the experimental group and
53.45 SD = 5.91; t = 2.99; p = 00.01 in the control group. Improvements in knowledge and attitude score demonstrates the feasibility
of lifestyle intervention targeted at adolescent girls, with PCOS risk, in school premises.

Introduction
Women with adequate antenatal care (ANC) experience more reduction in adverse maternal
and perinatal outcomes compared to those with insufficient care. However, the conventional
individualized ANC models have not significantly improved perinatal outcomes.
Comprehensive, woman-centered group ANC (G-ANC) interventions, integrating medical
care with education, demonstrate positive effects on maternal and newborn health. While
promising evidence exists in sub-Saharan Africa, the feasibility, acceptability, and effectiveness
of G-ANC in resource-limited settings require further investigation. The variability
in current studies further indicated the need for meta-analyses and systematic reviews
to consolidate findings and clarify the overall effectiveness of G-ANC interventions. This
synthesis aims to provide comprehensive evidence supporting the implementation of
group prenatal care models in low-resource settings. Ultimately, it seeks to establish robust
evidence to guide policy and practice, contributing to reduced maternal and perinatal
mortality in the region.
Methods and analysis
This systematic review and meta-analysis protocol adheres to the Preferred Reporting
Items for Systematic Reviews and Meta-Analysis Protocols guidelines. A comprehensive literature search will be conducted across multiple electronic databases, including
PubMed/MEDLINE, Web of Science, EMBASE, and CINHAL, to identify pertinent articles
published from January 1, 2016, to June 30, 2024. Experimental studies (pre-post,
quasi-experimental study, cluster randomized controlled trial), prospective cohort design,
prospective comparative study, and qualitative and mixed method designs will be included
in the review. The Abstract and full-text screening will be conducted by three reviewers
using Covidence, according to the eligibility criteria set. The Joanna Briggs Institute (JBI)
Critical Appraisal Tools, specifically designed for JBI Systematic Reviews, will be utilized to
assess the methodological quality of the included studies. Statistical heterogeneity will be
assessed using the Higgins test. Meta-analysis will be conducted using R statistical software
version 4.4.2, which will implement random effects models to determine the weights.
Pre-specified subgroup analysis and sensitivity analysis will be performed as needed. The
study results will be reported in order, starting with primary outcomes and then secondary
outcomes and important subgroup outcomes analyses.
Ethics and dissemination
Ethical approval is not applicable as no original data will be collected. The findings of this
review will be disseminated through publication and conference presentations.
PROSPERO registration number
CRD42024565501

Objective. Maternal stress is a psychological response to the demands of motherhood. A high level of maternal stress is a risk factor for maternal mental health problems, including depression and anxiety, as well as adverse infant socioemotional and cognitive outcomes. Yet, levels of maternal stress (i.e., levels of stress related to parenting) among low-risk samples are rarely studied longitudinally, particularly in the first year after birth. Design. We measured maternal stress in an ethnically diverse sample of low-risk, healthy U.S. mothers of healthy infants (N = 143) living in South Florida across six time points between 2 weeks and 14 months postpartum using the Parenting Stress Index-Short Form, capturing stress related to the mother, mother-infant interactions, and the infant. Results. Maternal distress increased as infants aged for mothers with more than one child, but not for first-time mothers whose distress levels remained low and stable across this period. Stress related to mother-infant dysfunctional interactions lessened over the first 8 months. Mothers’ stress about their infants’ difficulties decreased from 2 weeks to 6 months, and subsequently increased from 6 to 14 months. Conclusions. Our findings suggest that maternal stress is dynamic across the first year after birth. The current study adds to our understanding of typical developmental patterns in early motherhood and identifies potential domains and time points as targets for future interventions.

This case study explores the integrative fertility coaching of a 39-year-old woman who presented a severely diminished ovarian reserve. sticking a balance between natural supportive therapies and timely biomedical intervention, the practitioner provided comprehensive coaching that empowered the client to pursue in vitro fertilization (IVF) alongside targeted holistic support. The case highlights the ethical responsibility of integrative practitioners to prioritize patient welfare over rigid adherence to ideology. It demonstrates how strategic coaching, combining traditional knowledge and scientific evidence, can optimize outcomes while preserving patient autonomy, dignity, and hope. This method emphasises the necessity of making decisions about age-related fertility care that are compassionate, adaptable, and supported by science.

Nursing practice necessitates the application of knowledge, skills, and values in various combinations, all
of which have undergone significant changes in recent decades. There is a greater emphasis on interprofessional
collaboration, as well as possible new and more independent roles for nurses, especially in the emergency units.
Therefore, the study aimed to assess the clinical competence of emergency nurses based on a self-assessment tool.
Methods: a descriptive study design was applied to 87 nurses enrolled in the emergency units at King Khaled and
King Salman Specialist Hospital. A demographic data sheet and clinical competency questionnaire were used for
collecting data. A descriptive statistic: frequency and percentage were carried out. Results reveal that the majority
of emergency nurses have a high level of clinical competency scores.
Keywords: Clinical Competence; Emergency units; Nursing Staff; Self-Assessment; Questionnaire; Hospitals.

Patient satisfaction affects clinical processes and patients' outcomes, the quality of nursing care is crucial in determining how the patients are satisfied with their hospital stay. This study aimed to assess patients' satisfaction with the quality of nursing care provided at emergency departments of King Khalid Hospital and king Salman Specialist Hospital in Hail, Saudi Arabia. A descriptive cross-sectional research design was utilized. Sample included all clients who received nursing care at previous settings and who agreed to participate. A self-administered online questionnaire consisted of two parts: Socio-demographic data sheet of the study subjects & the patient satisfaction with nursing care quality questionnaire (PSNCQQ). Results revealed that more than three quarters of the study subjects had high satisfactory scores regarding total quality of nursing care, the overall quality of the nursing care the patients received during stay in hospital was excellent. In conclusion, the patients were satisfied toward the nursing care provided, they recommended the previous hospital for family and friends.

The use of uterine fundal pressure maneuver to assist pregnant women in the second stage of labor is a controversial issue. Therefore, the aim of this study is to detect the outcomes of delivery by fundal pressure in the second stage of labor. In this cross-sectional study, 166 women with uterine fundal pressure maneuver and 165 samples without uterine fundal pressure maneuverwere delivered. Then, delivery outcome was evaluated in two groups.The results showed that the mean amounts of postpartum hemorrhage of the first 30 min were 681.144(385.2), and 280.2(377.87) in with uterine fundal pressure maneuver and without uterine fundal pressure maneuver groups, respectively. Frequency of episiotomy was in the with uterine fundal pressure maneuver group 21.7% and 1.2% in without uterine fundal pressure maneuver groups. The mean Apgar score in the first minute (7.66 ± 1.07 and 8.63 ± 0.93) and fifth (9.74 ± 0.61 and 9.92.0 ± 0.65) delivery in with uterine fundal pressure maneuver of without uterine fundal pressure maneuver groups was significantly lower, respectively (p <0.001). Rate of infants admitted in neonatal intensive care unit in with uterine fundal pressure maneuver groups was 28.3% and without uterine fundal pressure maneuver groups was 4.9%, respectively: The use of uterine fundal pressure maneuver increased the rate of maternal and neonatal complications. Therefore, physicians and midwives should make the decision about the appropriate use of uterine fundal pressure maneuver based on the patient's individual clinical circumstances.

This review examines perinatal depression, including antenatal (pregnancy-related) and postnatal (after childbirth) depression. It highlights their prevalence, risk factors, symptoms, and impacts on women and families, such as premature birth and significant maternal mental health issues. Causes include environmental stressors, genetic predisposition, and hormonal changes. The review distinguishes between temporary "baby blues" and prolonged postnatal depression influenced by social, psychological, and biological factors. Risk factors include negative family dynamics, a history of mental health issues, and lack of social support. Emphasizing the need for timely intervention and comprehensive mental health care, this review used a comprehensive search strategy across databases like PubMed, Google Scholar, Scopus, and more. Keywords related to perinatal depression were used for screening abstracts and titles, with full-text articles assessed for eligibility. Quality was evaluated using tools like the Newcastle-Ottawa scale (NOS) and the critical appraisal skills programme (CASP). Findings highlight the importance of regular mental health screenings, psychotherapeutic approaches, pharmacological treatments, and robust support systems. Understanding the interactions between biological, psychological, and social factors in perinatal depression is crucial for improving maternal and fetal health outcomes.

Background Intrahepatic cholestasis of pregnancy (IHCP) is a pregnancy-related liver disease associated with adverse pregnancy outcomes, including spontaneous preterm labour, fetal hypoxia, meconium-stained liquor and intrauterine death. In women with IHCP, comorbidities may be associated with a greater risk of stillbirth. Recent studies have suggested that cholestasis of pregnancy may be associated with Gestational Diabetes Mellitus (GDM).

Background People with disabilities experience perinatal health disparities. This qualitative study examines disabled people's experiences of labour and delivery care from a disability justice lens. Methods Semi-structured interviews were conducted between July 2019 and February 2020 with 31 women and transgender people aged 18-45 years with physical, sensory, and/or intellectual/developmental disabilities, who were living in in Ontario, Canada and had given birth in the previous five years. Results People with disabilities described negative experiences of provider-driven, disrespectful, and discriminatory labour and delivery care that can be interpreted as examples of disability injustice and obstetric ableism. People with disabilities also described positive experiences of collaborative, respectful, and disability-affirming labour and delivery care that can be interpreted as examples of disability justice, facilitated by what feminist disability justice scholars and activists call collective access. Conclusions Collective access to labour and delivery care can improve perinatal health care for people with disabilities and promote disability justice. Reimagining care-related decision-making as an interdependent, collaborative, respectful, and disability-affirming process shared between patients and providers can help to facilitate collective access to labour and delivery care.

Teenage pregnancy is considered to be an important public health problem and it is most prevalent in sub-Saharan Africa. Studies from developed and developing countries regard-ing adverse teenage pregnancy outcomes differ. The objective of this study is to investigate adverse obstetric outcome in teenage pregnancy in comparison with the adult pregnancy at a tertiary hospital in South Africa. A retrospective comparative study was conducted target-ing the records of pregnant patients who delivered at a tertiary hospital in South Africa from 1st September – 30th November 2010 where the pregnancy outcome of teenagers who were less than 18 years old were compared with the adult women (≥18 years). Binary logistic regression method was carried out to find if teenage age was a significant predictor for the negative pregnancy outcome. Overall, the teenage pregnancy rate over the study period was 10.3%. Significantly higher rate of caesarean delivery was found among adult mothers compared to ...

Noninvasive prenatal testing (NIPT) heralds a transformative era in prenatal care, revolutionizing fetal health assessment. The recent adoption of aneuploidy screening signifies a significant advancement in prenatal genetic care in India. The current study aimed to assess the cost-effectiveness of ddPCR-based NIPT for detecting chromosome aneuploidies, comparing it with the next-generation sequencing (NGS) platform. This study adopts a laboratory-based observational approach to investigate the cost implications of NIPT for trisomies 13, 18, and 21 using ddPCR and NGS technologies. A meticulously designed cost analysis methodology was employed, adhering to established standards. The yearly capital and operational costs of NIPT were calculated with precision, focusing on the specific methods associated with ddPCR and NGS.

Buprenorphine is a safe and effective medication to treat opioid use disorder (OUD) in pregnant patients and is intended to be continued throughout pregnancy, delivery, and at least the one-year postpartum period. However, delivery often involves the need for acute pain management with opioid medications, such as after a cesarean section. For patients receiving buprenorphine, the provision of prescription opioids may negatively impact OUD treatment outcomes; however, not optimally managing acute pain may also impede OUD treatment benefit. Evidence is needed to disentangle the impacts of opioid prescription provision and methods of pain management in the immediate postpartum period on OUD treatment trajectories, ultimately to inform clinical guidelines tailored to the unique needs of pregnant and postpartum people receiving buprenorphine. Accordingly, this study took an initial step towards this goal to conduct a secondary analysis of a retrospective cohort of pregnant patients taking buprenorphine for OUD at the time of delivery (n = 142) to determine whether receipt of an opioid prescription at birth hospitalization discharge was associated with the time of buprenorphine discontinuation within the 12 months following delivery. Among the sample, 26% (n = 37) were prescribed an opioid at the time of birth hospitalization discharge. The number of weeks post-delivery until buprenorphine discontinuation occurred was shorter amongst patients who were prescribed an opioid (median 11 weeks) compared to patients who were not prescribed an opioid (median 39 weeks; p < 0.001 by Mann-Whitney U test). However, a Cox regression model reported that receipt of an opioid prescription following delivery did not significantly increase the hazard ratio for buprenorphine discontinuation. In other words, OUD patients not prescribed an opioid at birth hospitalization discharge continued their buprenorphine for a longer median duration after delivery compared to their counterparts who received prescription opioids; yet, this finding did not reach statistical significance when taking into account additional clinical variables. The findings indicate how further research is warranted to inform evidence-based post-delivery pain practices for postpartum OUD treatment patients.

Background Patients with opioid use disorder (OUD) often have complex health care needs. Methadone is one of the medications for opioid use disorder (MOUD) used in the management of OUDs. Highly restrictive methadone treatment—which requires patient compliance with many rules of care—often results in low retention, especially if there is inadequate support from healthcare providers (HCPs). Nevertheless, HCPs should strive to offer patient-centred care (PCC) as it is deemed the gold standard to care. Such an approach can encourage patients to be actively involved in their care, ultimately increasing retention and yielding positive treatment outcomes. Methods In this secondary analysis, we aimed to explore how HCPs were applying the principles of PCC when caring for patients with OUD in a highly restrictive, biomedical and paternalistic setting. We applied Mead and Bower’s PCC framework in the secondary analysis of 40 in-depth, semi-structured interviews with both HCPs and patients. R...

Introduction: the presence of perinatal mortality events requires actions of health institutions, which must implement strategies, in order to improve conditions and health status taking into account the causes of events. Objective: identify factors associated with perinatal mortality of the population of health care affiliates of the department of Nariño in 2007. Materials and Methods: this is a quantitative, descriptive, retrospective-evaluative research, since the data correspond to the documentary revision of the medical records of pregnant women with mortality events in 2007. 100% of cases of perinatal mortality were taken, representing the total population. Socio-demographic variables, case studies (protocol handling care, completion of the notification sheet, compliance with technical norms and practice guides) were considered. 34 events were studied, of which 61.8% died in the antepartum, 20.6% in the intrapartum and 17.6% at pre-discharge. A verification guide was applied to each event, while the data was consolidated in the statistical information system EPIINFO version 2000, and the crossing of existing variables was carried out. Once the findings were identified regarding the causes of risk, the chi2 was applied in order to determine the value of P, raising the base line in order to prioritize plans and projects aimed at reducing perinatal mortality rate for the health care provider. Results: of the total population of mothers between the ages of 23 and 26, present the highest number of cases, 56% came from towns and had complete primary schooling, 23% have a spouse, 26% have a history of multiparity. During their pregnancy, these women attended four general medical checks-ups carried out by the primary care level, of which 67% did not use birth control. Regarding the risks the mothers have, there were three cases with chronic hypertension, 3 cases of urinary tract infections, tobacco and alcohol usage, psychological disorders; intrauterine growth retardation was reported in 1 case, which were classified as high-risk pregnancy; 6 pregnancies were not classified, which had relevant aspects to consider. The study demonstrated the failure to record aspects on the medical history. In the childbirth

Teenage pregnancy is considered to be an important public health problem and it is most prevalent in sub-Saharan Africa. Studies from developed and developing countries regard-ing adverse teenage pregnancy outcomes differ. The objective of this study is to investigate adverse obstetric outcome in teenage pregnancy in comparison with the adult pregnancy at a tertiary hospital in South Africa. A retrospective comparative study was conducted target-ing the records of pregnant patients who delivered at a tertiary hospital in South Africa from 1st September – 30th November 2010 where the pregnancy outcome of teenagers who were less than 18 years old were compared with the adult women (≥18 years). Binary logistic regression method was carried out to find if teenage age was a significant predictor for the negative pregnancy outcome. Overall, the teenage pregnancy rate over the study period was 10.3%. Significantly higher rate of caesarean delivery was found among adult mothers compared to ...

En esta ocasión no hemos contado con mano de obra contratada por el Instituto Nacional de Empleo, pues han participado desinteresadamente un total de 38 personas entre licenciados y estudiantes de Historia y alguno más de BUP y COU. El presupuesto de la ...

En buena parte del continente europeo la extensión del ritual funerario de la incineración de los muertos y el resguardo de las cenizas resultantes de la cremación en urnas u otro tipo de contenedores para su ulterior enterra-miento en las necrópolis, ubicadas siempre ...

Objective: This study was performed to characterize neonatal intracranial hemorrhage (ICH) in fullterm vaginal delivery by mode of delivery (epidural analgesia or mechanical assistance such as vacuum extraction (V/E) or forceps delivery) in a Japanese perinatal center. Methods: In a retrospective observational case series study, we examined 6,600 consecutive term singleton vertex vaginal deliveries. Cases with neonatal symptomatic ICH were extracted, and the clinical backgrounds, the delivery courses and the neonatal outcomes of these cases were analyzed. Results: Maternal epidural analgesia significantly increased deliveries with mechanical assistance. ICH was identified in 8 cases (5 in deliveries with V/E and 3 in unassisted deliveries). The incidence of neonatal ICH was 0.24% in deliveries with V/E and 0.07% in unassisted deliveries. Conclusion: The incidence of neonatal ICH in full-term deliveries in a certain Japanese perinatal center was similar to previous reports of such incidence in other countries.

Problem: It is important to evaluate the factors that influence the association between attachment and bonding. Background: Limited studies have examined the role of a variety of variables in the quality of the mother-infant bond. Aim: To investigate the roles of perinatal post-traumatic stress symptoms, psychological resilience, and motherinfant contact barriers. Methods: 206 Turkish mothers of preterm babies and 446 mothers of full-term babies were recruited between March 2018 and April 2019. A multiple-path analysis was implemented. Findings: Parental attachment was positively associated with psychological resilience and negatively associated with mother-infant contact barriers and perinatal post-traumatic stress symptoms. Psychological resilience was positively associated with maternal bonding. In the preterm group, there was no significant association between mother-infant contact barriers and maternal bonding, whereas perinatal post-traumatic stress symptoms and maternal bonding were positively associated. In the full-term group, motherinfant contact barriers and maternal bonding were negatively associated, whereas there was no significant association between perinatal post-traumatic stress symptoms and maternal bonding. Psychological resilience and perinatal post-traumatic stress were mediators between parental attachment and maternal bonding in the preterm group, whereas psychological resilience and mother-infant contact barriers were mediators between parental attachment and maternal bonding in the full-term group. The relationship between psychological resilience and maternal bonding was significantly stronger in the preterm group, and the relationship between mother-infant contact barriers and maternal bonding was significantly stronger in the full-term group. Conclusion: Providing qualified attachment and bonding, mother-infant contact, lessening perinatal post-traumatic stress symptoms, and enhancing the psychological resilience are crucial.

bstract: Quantifying risky people for diabetes mellitus is important to allow for rational planning for delaying of
the onset of the disease. Therefore, we designed this study to identify people at risk for developing Type 2 diabetes
mellitus as a key strategy in prevention or delaying onset of diabetes among Saudi population. Subject and
Method; one hundred and six Saudi men and women (20 - ≥ 65 Yrs.) live in Skaka City share into this cross -
sectional pilot study as a convenient sample from Saudi community. Two tools used into this study, Sociodemographic and Type 2 Diabetes Risk Assessment Form. Results; The study results estimated that more than one
third of the studied sample (36.80%) had moderate risk of diabetes, about one third had high risk of diabetes
(34.00%), and only 13.20% had low risk of diabetes. There are statistically significant differences between age, sex,
level of education and risk of diabetes. Conclusion/ Interpretation; Saudi nation at risk for diabetes mellitus. They
need life modifications. Women and men of all ages should avoid becoming overweight. They should maintain a
moderate level of physical activity, avoid smoking, avoid stress, take vegetable and fruits daily, decrease sweets,
sugars, and fatty diet.
Keywords: Diabetes Mellitus, Risk, Saudi, Prevalence, recommendations.

Background/Problem: To integrate midwife-led care in Belgian maternity services, understanding whether midwives are primed of executing the change is needed.

Aim: To explore Belgian midwives’ readiness for midwife-led care and understand the underlying processes.

Methods: A mixed-methods sequential study: 1) A survey including 414 practising midwives and 2) individual interviews with 12 (student) midwives. General linear model analysis was used to examine the trend between
knowledge, self-efficacy and performance mean scores - indicators of midwife-led care readiness - proposed in a 27-item questionnaire. The Readiness Assessment Framework served as a template for qualitative thematic analysis.

Findings: Template analysis illustrated the underlying mechanisms of midwifery-led care readiness: Governmental and institutional steering and rule-making functions, regulation and reimbursement, awareness of
midwife-led care among stakeholders, capacity to extend primary care postpartum services to antenatal and intrapartum care and healthcare professionals’ lack of awareness of available data of women’s experiences and midwife-led care efficacy in Belgium. These qualitative findings contribute to the understanding of the significant trend with decreasing function for knowledge, self-efficacy and performance mean scores of 25 midwife-led care readiness indicators, and the two non-significant indicators referring to a physiological postpartum period.

Discussion/Conclusion: In determining midwife readiness for midwife-led care, we observed adequate knowledge mean scores, associated with low self-efficacy and even lower midwife-led care performance mean scores. Our
findings suggest limited readiness for MLC in antenatal and intrapartum care. Belgian midwives are the domain experts of postpartum

Prenatal screening and diagnosis are essential for reducing perinatal morbidity and mortality by identifying congenital anomalies and genetic disorders before birth. In Nigeria, a lower-middle-income country, these services are underdeveloped and face significant barriers due to socioeconomic constraints, limited healthcare infrastructure, and cultural challenges. This article reviews the current landscape of prenatal screening and diagnosis in Nigeria, focusing on screening methods, healthcare provider knowledge, and the sociocultural and legal barriers affecting their implementation. Findings indicate that ultrasound is the most commonly used method, while non-invasive prenatal testing (NIPT) remains underutilized due to high costs and limited access. Recommendations for expanding access to these vital services include improving provider training, raising public awareness, and advocating for policy changes to increase service availability, especially in underserved areas.

El oppidum de Monte Bernorio se sitúa en la cima de la montaña caliza de 1.173 m. de altitud que lleva el mismo nombre y está situada en el término municipal de Pomar de Valdivia, (norte de Palencia). (Fig. 1a) La zona principal o recinto interior ocupa una plataforma elevada y relativamente plana en la cima de la montaña y se encuentra rodeado por una muralla de unos 1700 m. de perímetro, acotando un espacio de unas 28 ha. Dispone de tres puertas con accesos for