Open Access Original Research Article

A-Case Control Analysis of Thyroid Disorders in Infertile Women at the University of Port Harcourt Teaching Hospital, Nigeria

M. Onwubuariri, G. Bassey, T. Kasso, T. K. Nyengidiki

Asian Journal of Pregnancy and Childbirth, Page 1-9

Background: Thyroid disorders have been associated with anovulatory infertility. The paucity of institution-based infertility data of women with thyroid disorders necessitated this study.

Aims and Objectives: To determine and compare the prevalence and pattern of thyroid disorders in infertile and fertile women at the University of Port Harcourt Teaching Hospital and to assess the predisposing factors to thyroid disorders.

Methodology: It was a case control study involving 162 eligible women with anovulatory infertility from the Gynaecology clinic and 162 eligible fertile women from the family planning clinic. A structured proforma was used to obtain relevant information from participants. Thyroid function test was conducted for each participant. The results were analyzed using the SPSS version 23 software package. Chi-square test was used to compare variables between groups and P value < .05 was considered significant.

Results: Subclinical hypothyroidism was the only thyroid disorder noted with a prevalence of 3.1% among infertile women and 5.6% in fertile women, with no significant difference between both groups (P= .27). Igbo tribe was the commonest ethnic group among the hypothyroid women. Dietary intake of iodine was ‘inadequate’ in all (100%) of the infertile hypothyroid women and 88.9% of the fertile hypothyroid women (P = .439).

Conclusion: Subclinical hypothyroidism was the only identified thyroid disorder and its prevalence was comparable in both fertile and infertile women. Age, family history, dietary intake of iodine, ethnicity and socioeconomic status were not significantly associated with thyroid abnormality.

Open Access Original Research Article

Population Characteristics of Maternal and Child Health Demographic Survey (MCHDS), Gujarat 2019

Kranti S. Vora, Parth A. Tailor, Shahin L. Saiyed

Asian Journal of Pregnancy and Childbirth, Page 10-19

Aims: This research article aims to discuss the preliminary finding of Maternal and Child Health Demographic survey (MCHDS) and compare health and demographic indicators across urban, rural and tribal regions.

Study Design: MCHDS is longitudinal survey design and its methodological considerations are discussed briefly in another article.

Methods: MCHDS comprised 3 rounds, 1) Household survey 2) Maternal survey and 3) Child survey. Census survey method was used incorporating each and every individual from population. Total of 2,70,576 individuals were surveyed belonging to 58897 households in the baseline census. Under child survey, 12,370 under 5 children and under maternal survey 10,999 women (age 15-49) who were either pregnant at the time of survey, or had at least one pregnancy in 5 years preceding the survey were surveyed. Descriptive statistics is used to explore and understand the demographics and Maternal and child health indicators.

Results: Proportion of pucca houses were highest in urban followed by rural and tribal. Majority of the urban household had proper water and sanitation facility, followed by rural and tribal field site. Proportion of salaried employers was highest in urban followed by tribal and rural. Statistics based on wealth index, indicates that proportion of comparatively richer class (highest and fourth) was highest in urban followed by rural and tribal and proportion of poorest class (second and lowest) was highest in tribal followed by rural and urban. 

Conclusion: All three regions have distinct socio-demographic and economic characteristics which coincides with the similar studies and national surveys. Urban and rural population was better off than tribal populations in terms of socio-demographics, economic status, housing, water and sanitation facility and morbidity scenario.

Open Access Original Research Article

Association of Maternal Factors with Twin Births: Evidence from Bangladesh Demographic Health Survey

M. Lutfor Rahman, Kazi Shahidul Islam, Tamnna Howlader

Asian Journal of Pregnancy and Childbirth, Page 20-26

Aims: To investigate which maternal factors are associated with the multiple birth status of a child in a developing country like Bangladesh where neonatal mortality, child nutrition and maternal health are matters of concern.

Study Design: This is a cross-sectional study that collects information through several questionnaires including a women’s questionnaire that provides demographic and health information on mothers and their children.

Place and Duration of Study: The nationally representative health survey “Bangladesh Demographic and Health Survey (BDHS)” was conducted between November 2010 and April 2011.

Methodology: Information on 45842 live births of which 780 were twins and 45062 were singletons were extracted from the database of the Bangladesh Demographic Health Survey (BDHS). The associations between risk factors and the outcome were assessed using crude and adjusted logistic regression models. Statistically significant associations were identified and the strengths of the associations were measured and compared through odds ratios.

Results: The rate of twinning was 17 per 1000 live births.  The association between a child’s birth order and twin birth status appears to be very strong in the data. The crude logistic regression analysis indicates that children from seventh order pregnancies are 7.03 times more likely than first order pregnancies to be twins. Furthermore, adjusted estimates show that an increase of one level of birth order is accompanied by a 1.362 times higher likelihood of being a twin. Although birth interval was significantly associated with the outcome in the bivariate analysis, it was no longer significant after adjusting for other factors in a multivariable model. Moderate to severe maternal anemia and higher maternal education are also found to be associated with increased risk of being a multiple birth.

Conclusion: Birth order is an important correlate of twin birth status in Bangladesh. Higher order pregnancies are more likely to be twin births compared to lower order pregnancies. Among other factors, age of mother, level of maternal anemia and maternal education are associated with the outcome. These factors must therefore be taken into account in any future study aimed at determining the causes of twin births in Bangladesh.

Open Access Original Research Article

Preventing Adverse Maternal and Perinatal Events from Obstetric Interventions Given Women at Childbirth in Al-Sadaka Teaching Hospital, Aden, Yemen

Iman Al-Nakeeb, Amen Bawazir, Abdullah Hattab

Asian Journal of Pregnancy and Childbirth, Page 27-37

Aims: Any perinatal intervention during the childbirth may have significant impact on the outcome of the mother and her newborn. The aim of this study was to correlate the association between the occurrence of adverse events and appropriate intervention, health care providers' commitment to standards of services during labor and working time.

Study Design: This cross-sectional study.

Place and Duration of Study: Tertiary referral hospital-based in Aden city, Yemen. Methodology: A validated questionnaire and observational check list were used to collect the data along the six months study period. Women were included in the study according to criteria: vertex presentation, singleton fetus, and in an active labor. Data were analyzed using SPSS program and p value of <0.05 was considered as significant. Adjusted and unadjusted values were used to examine the association between different types of adverse events and related variables.

Results: A total of 342 adverse event episodes were identified among both mother and newborn with overall prevalence of adverse events was12.7%. Prolonged (labor) second stage was found strongly associated as risk factor during childbirth with multiparousm others (p=001) as well as the use of uterine fundus pressure was detected as one of the intervention method during labor was associated with AEs among mothers (AOR:2.715; 95% CI: 1.223-6.029; P value: 0.014).

Conclusion: Adverse events among mothers constituted the highest percentage in comparison to their occurrence among newborns or among both newborns and their mothers. Interventions such as uterine funds pressure and episiotomy were reported as having considerable adverse events mainly among newborns. 

Open Access Review Article

Exclusive Breastfeeding Practice (EBF), Survival Function and Factors Associated with the Early Cessation of EBF in Developing Countries

Nahian Rahman, Md. Ruhul Kabir, Marium Sultana, Md. Mahmudul Islam, Mohammad Rahanur Alam, Moumita Dey, Md. Sakib Hossain

Asian Journal of Pregnancy and Childbirth, Page 38-49

Exclusive breastfeeding (EBF) till first six months has been constantly discussed in terms of variable practice across societies. The reasons for this fluctuation remain speculative at this point though. Thus, to investigate the issue further considering its importance, this study was conducted which aimed at providing a comprehensive analysis of the prevalence of exclusive breast-feeding, associated factors of early cessation and their effect on survival function of child in developing countries. The study is a literature review based current evidence found in different journals. The analysis shows the prevalence of EBF has not increased significantly and varies in different developing countries mostly hovering around 50% in best scenario and around 35% in most of the countries according to UNICEF global database of 2019. The factors most frequently associated with the breastfeeding exclusively were maternal employment, education, age, mode of delivery, post-natal care and adequacy of breast milk and the effect of these factors on the survival of baby’s has been presented by considering Kaplan-Meier survival estimates found out by different studies. The study also discussed the numerous benefits EBF have on child and mother’s health and how important it is to consider the existing viewpoints towards EBF so that the practice can be improved further in developing countries. The factors responsible for early cessation of EBF re-iterated by many studies, yet the lifesaving practice is not in satisfactory level due to largely maternal health and socioeconomic determinants. Hence, proper concerted actions required for the improvement of EBF practice in many developing countries.