Body mass index, weight gain during pregnancy and obstetric outcomes

Objectives: To find out the effects of pregnancy weight gain in different body mass index (BMI) groups on maternal and neonatal outcomes in women delivering singletons at term.Design: Retrospective analysis of clinical records of patients attending antenatal clinics and delivering in hospital from January 1st 1992 to December 31st 2009. Setting: A private specialist hospital.Methods: The records of patients starting antenatal care in the first trimester, attending at least four clinics and delivering singletons from 37 completed weeks up to 42 weeks gestation were analysed. Patients’ booking gestational age, height, weight and obstetric andneonatal outcomes at delivery were noted.Results: The total number of deliveries was 2,391 out of which 1755 (72.4%) were analysed. The overweight and obese group compared to the normal were significantly older, shorter, weighed more at bookingand gained more weight during pregnancy. The overweight or obese were significantly more likely to have induction of labour and be delivered by caesarean section compared to the normal. Maternal and neonataloutcomes which were more significant in the overweight and obese were macrosomia, stillbirth, perineal trauma, post-partum haemorrhage and retained placenta.Conclusions: Most deliveries in the two BMI groups resulted in normal weight babies. Overweight and Obesity is associated with significantly increased incidence of adverse maternal and neonatal outcomes.It is recommended that further studies involving larger samples comparable to those done in western countries are carried out

Outcomes of Pre-Term Premature Rupture of Fetal Membranes at Komfo Anokye Teaching Hospital, Kumasi, Ghana

Context: Pre-term premature rupture of fetal membranes (pPROM) contributes to maternal and fetal morbidity and mortality. These include chorioamnionitis, prematurity and still-births. Various microbial organisms have been implicated. Few studies have been done on pPROM in this environment.Objectives: To determine pregnancy outcomes and microbial organisms in cultures from the endocervix, high vagina and urine of patients with pPROM.Design: Cross-sectional descriptive survey.Setting: Komfo Anokye Teaching Hospital (KATH), Ghana.Subjects: Patients admitted to KATH with fluid loss per vaginam during 1<sup>st</sup> Apil, 2005 to 30<sup>th</sup> September,2005.Methods: Structured pre-tested questionnaires were administered to patients who presented with fluid loss per vaginam followed by physical examination. Microbiology cultures were obtained from patients with proven pPROM between gestational ages 28 to 37 completed weeks. The data wasanalysed using Epi Info software.Main Outcome Measures: Maternal morbidity and mortality; delivery outcomes; microbial organisms from cultures and drug sensitivities.Results: Total antenatal admission was 1459 and eighty-five patients (5.8%) satisfied the study criteria. There was no maternal mortality but four patients (4.7%) developed chorioamnionitis.There were sixtyfour(75%) live births, nineteen (22%) stillbirths and liquor loss stopped in two (3%) resulting in normal term deliveries. The commonest organisms from the cultures were high vagina, Candida spp. (29%); endocervix, Candida spp. (23%); and urine, E. coli (19%). All bacterial isolates were sensitive tonorfloxaxinConclusions: Pregnancy outcomes in pPROM at KATH are unsatisfactory. Further controlled studies on pPROM are advocated and use of norfloxacin in pregnancy needs reconsideration.Keywords: Fetal membranes, microbial organisms

HIV/AIDS awareness and risk behaviour among pregnant women in Semey, Kazakhstan, 2007

<p>Abstract</p> <p>Background</p> <p>Central Asia has one of the most rapidly increasing HIV prevalence in the world. The aim of this study was to evaluate current knowledge, risk behaviour and attitudes to voluntary counselling and testing concerning HIV/AIDS among pregnant women in Semey, Kazakhstan.</p> <p>Methods</p> <p>We collected 226 questionnaires in a consecutive sample from a population on 520 pregnant women. The results were related to ethnicity, age and education level.</p> <p>Results</p> <p>Ninety-six percent had heard about HIV.</p> <p>Positive findings were that 89% and 86% of the women were aware of the two main routes of transmission: sexual intercourses without a condom and sharing needles while injecting drugs. The women had first heard about HIV/AIDS through the media with, 52%, and at school with 40%. Only 46% and 68% of the women pointed out breastfeeding and mother-to-child transmission during pregnancy or delivery as routes of transmission. Eighty-three percent were prepared not to breastfeed their baby if they were found to be HIV positive. Slightly more, 86%, accepted the need to take medicine, but fewer women, 68%, were positive to Caesarean section. Negative findings were that only 28% answered that there are ways to protect oneself against sexually transmitted HIV/AIDS and specified that this was condom use.</p> <p>Conclusion</p> <p>The pregnant women in Semey have poor knowledge about specific mother-to-child HIV transmission and do not know about the means of reducing mother-to-child HIV infection. The information in the public health program needs to be improved. However, most of the women in Semey were positive to prevention strategies for mother-to-child transmission after hearing about it.</p

Awareness and practice of emergency contraception at a private university in Nigeria.

BACKGROUND: The pursuit of formal education now causes many people in developing countries to marry later in life, thereby leading to increased premarital sex and unintended pregnancies. Efforts have been made to characterize awareness and use of emergency contraception (EC) among undergraduate students in public universities in Nigeria; however, it is not known if students in private tertiary institutions adopt different practices or if having an affluent family background plays a role. This pilot study therefore aimed to assess the awareness and use of EC among students at a private Nigerian university toward assisting education planners in developing strategies in improving students' reproductive well-being. RESULTS: Out of 94 female students, 42 (44.7%) had sexual experience, but only 32 (34.0%) were currently sexually active. Six students (6.4%) had had unwanted pregnancies, of which all but one were terminated. Fifty-seven respondents (60.6%) were aware of EC, though only 10 (10.6%) ever practiced it. The greatest source of EC information was from health workers and peers; the lowest source was family or relatives. Most respondents desired orientation and availability of EC on campus. EC awareness among the students was predicted by upper social class background (adjusted odds ratio [OR], 2.73; 95% confidence interval [CI], 1.06-7.45) and upbringing in the Federal Capital Territory (adjusted OR, 4.45; 95% CI, 1.56-14.22). CONCLUSIONS: Though awareness of EC was higher among the private university students in this study than at most public universities, there was no difference in EC usage. A high pregnancy termination rate was observed; dilatation and curettage were mainly adopted. In Nigeria, youth-friendly reproductive health information and access should not be limited to government-owned tertiary institutions but also extended to private ones

Paclobutrazol treatment as a potential strategy for higher seed and oil yield in field-grown camelina sativa L. Crantz

<p>Abstract</p> <p>Background</p> <p><it>Camelina (Camelina sativa </it>L. Crantz) is a non-food oilseed crop which holds promise as an alternative biofuel energy resource. Its ability to grow in a variety of climatic and soil conditions and minimal requirements of agronomical inputs than other oilseed crops makes it economically viable for advanced biofuel production. We designed a study to investigate the effect of paclobutrazol [2RS, 3RS)-1-(4-Chlorophenyl)-4,4-dimethyl-2-(1H-1,2,4-triazol-1-yl)pentan-3-ol] (PBZ), a popular plant growth regulator, on the seed and oil yield of <it>Camelina sativa </it>(cv. Celine).</p> <p>Results</p> <p>A field-based micro-trial setup was established in a randomized block design and the study was performed twice within a span of five months (October 2010 to February 2011) and five different PBZ treatments (Control: T₀; 25 mg l^-1: T₁; 50 mg l^-1: T₂; 75 mg l^-1: T₃; 100 mg l^-1: T₄; 125 mg l^-1: T₅) were applied (soil application) at the time of initiation of flowering. PBZ at 100 mg l^-1concentration (T₄) resulted in highest seed and oil yield by 80% and 15%, respectively. The seed yield increment was mainly due to enhanced number of siliques per plant when compared to control. The PBZ - treated plants displayed better photosynthetic leaf gas exchange characteristics, higher chlorophyll contents and possessed dark green leaves which were photosynthetically active for a longer period and facilitated higher photoassimilation.</p> <p>Conclusion</p> <p>We report for the first time that application of optimized PBZ dose can be a potential strategy to achieve higher seed and oil yield from <it>Camelina sativa </it>that holds great promise as a biofuel crop in future.</p

Global, regional, and national burden of upper respiratory infections and otitis media, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021

Background Upper respiratory infections (URIs) are the leading cause of acute disease incidence worldwide and contribute to a substantial health-care burden. Although acute otitis media is a common complication of URIs, the combined global burden of URIs and otitis media has not been studied comprehensively. We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to explore the fatal and non-fatal burden of the two diseases across all age groups, including a granular analysis of children younger than 5 years, in 204 countries and territories from 1990 to 2021. Methods Mortality due to URIs and otitis media was estimated with use of vital registration and sample-based vital registration data, which are used as inputs to the Cause of Death Ensemble model to separately model URIs and otitis media mortality by age and sex. Morbidity was modelled with a Bayesian meta-regression tool using data from published studies identified via systematic reviews, population-based survey data, and cause-specific URI and otitis media mortality estimates. Additionally, we assessed and compared the burden of otitis media as it relates to URIs and examined the collective burden and contributing risk factors of both diseases. Findings The global number of new episodes of URIs was 12·8 billion (95% uncertainty interval 11·4 to 14·5) for all ages across males and females in 2021. The global all-age incidence rate of URIs decreased by 10·1% (–12·0 to –8·1) from 1990 to 2019. From 2019 to 2021, the global all-age incidence rate fell by 0·5% (–0·8 to –0·1). Globally, the incidence rate of URIs was 162 484·8 per 100 000 population (144 834·0 to 183 289·4) in 2021, a decrease of 10·5% (–12·4 to –8·4) from 1990, when the incidence rate was 181 552·5 per 100 000 population (160 827·4 to 206 214·7). The highest incidence rates of URIs were seen in children younger than 2 years in 2021, and the largest number of episodes was in children aged 5–9 years. The number of new episodes of otitis media globally for all ages was 391 million (292 to 525) in 2021. The global incidence rate of otitis media was 4958·9 per 100 000 (3705·4 to 6658·6) in 2021, a decrease of 16·3% (–18·1 to –14·0) from 1990, when the incidence rate was 5925·5 per 100 000 (4371·8 to 8097·9). The incidence rate of otitis media in 2021 was highest in children younger than 2 years, and the largest number of episodes was in children aged 2–4 years. The mortality rate of URIs in 2021 was 0·2 per 100 000 (0·1 to 0·5), a decrease of 64·2% (–84·6 to –43·4) from 1990, when the mortality rate was 0·7 per 100 000 (0·2 to 1·1). In both 1990 and 2021, the mortality rate of otitis media was less than 0·1 per 100 000. Together, the combined burden accounted for by URIs and otitis media in 2021 was 6·86 million (4·24 to 10·4) years lived with disability and 8·16 million (4·99 to 12·0) disability-adjusted life-years (DALYs) for all ages across males and females. Globally, the all-age DALY rate of URIs and otitis media combined in 2021 was 103 per 100 000 (63 to 152). Infants aged 1–5 months had the highest combined DALY rate in 2021 (647 per 100 000 [189 to 1412]), followed by early neonates (aged 0–6 days; 582 per 100 000 [176 to 1297]) and late neonates (aged 7–24 days; 482 per 100 000 [161 to 1052]). Interpretation The findings of this study highlight the widespread burden posed by URIs and otitis media across all age groups and both sexes. There is a continued need for surveillance, prevention, and management to better understand and reduce the burden associated with URIs and otitis media, and research is needed to assess their impacts on individuals, communities, economies, and health-care systems worldwide. Funding Bill & Melinda Gates Foundation