Short Research Article | Asian Journal of Pregnancy and Childbirth. 2020 September 8;3(1):175-178
A Study to Analyze the Incidence, Risk Factors and the Treatment Outcomes in Retinopathy of Prematurity in a Tertiary Care Setup - Case Study

Mridula V. Amarnath

Aim: To study the association between the incidence, risk factors and treatment outcomes in retinopathy of prematurity.

Methodology: A longitudinal observational study was done among 70 babies who fulfilled the criteria for ROP screening at a tertiary care center.

Results: Out of the 70 babies that were screened at our hospital, 25 babies developed some stage of ROP with 10 babies developing Type 1 ROP. It was noted that the mean birth weight, mean gestational age and the duration of oxygen therapy was significantly associated with the development of ROP (P= 0.045,P<0.001 and P<0.001 respectively). Of the 25 babies with ROP, zone 3 was involved in 14 babies and zone 2 was involved in 11 babies.7 babies had stage 1,10 had stage 2 and 8 babies had stage 3. Of the 25 babies with ROP, 12 babies required treatment with laser photocoagulation and all the babies showed regression of ROP following treatment.

Conclusion: Birth weight less than 1.70 kg, gestational age <32 weeks and oxygen therapy were associated with the development of ROP and ROP regressed with laser treatment.

Short Communication | Asian Journal of Pregnancy and Childbirth. 2021 January 27;3(1):212-216
COVID-19 and the Impacts on Maternal Mortality in the State of Pará-Brazil: Brazilian Amazon

Julia Rachel Alves Rodrigues Monteiro, Brena Suelen Gama Macias, Alyne Talita Martires Cabral, Rita do Socorro Rodrigues e Silva, Daniele Melo Sardinha

The maternal mortality rate is an indicator that analyses the quality of care provided to women from prenatal care to delivery and puerperium. The aim is to make a brief communication based on the Epidemiological Bulletin of Maternal Mortality of Pará dated 08/06/2020, describing the rate of maternal mortality in general and by COVID19, to show the impact of the pandemic in pregnant women and puerperal in the state of Pará. It was concluded in this study that the causes of maternal deaths by other obstetric diseases (indirect causes) represented (44), being (20) by COVID-19 in Pará, presenting a worrying number in this category. These occurred mostly in the puerperium in the 30 to 39 age group. However, it was evident that the situation in Brazil was serious, and represents the majority of cases in the world, showing the impacts of the pandemic on pregnant women and puerperal was intense.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 February 21;3(1):1-9
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

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.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 March 4;3(1):10-19
Population Characteristics of Maternal and Child Health Demographic Survey (MCHDS), Gujarat 2019

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

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.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 March 6;3(1):20-26
Association of Maternal Factors with Twin Births: Evidence from Bangladesh Demographic Health Survey

M. Lutfor Rahman, Kazi Shahidul Islam, Tamnna Howlader

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.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 May 1;3(1):27-37
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

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. 

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 May 18;3(1):50-74
Maternal Influences Contributing to under 5 Years Child Malnutrition in Insiza District, Matebeleland South, Zimbabwe

Beauty Ncube, Greanious Alfred Mavondo, Judith Audrey Chamisa

Introduction: Malnutrition remains a childhood scourge in Sub Saharan Africa, Southern Africa, Zimbabwe and in the Insiza District, in particular. With its rich mineral (gold) deposits, robust animal husbandry agricultural industry, varied ecosystems and tourist attraction sites, the district has great potential support self-sufficiency of its population. However, there is a cause of concern as <5-year-olds malnutrition and stunting remain a threat to their lives. The maternal contributions to malnutrition was investigated to explicate underlying attributes of the condition.

Materials and Methods: A mixed method approach, where both qualitative and quantitative research methods were used to prompt and describe in-depth caregivers’ involvement in elements associated with malnutrition and stunting among the <5-year-olds. The quantitative data collection allowed for the quantification of certain maternal attributes on malnutrition on <5-year-olds. Both probability and purposive sampling were used in the study.

Results: Maternal associated factors were observed to contribute towards malnutrition amongst infants in Insiza District. Majority respondents with malnourished <5-year-olds attended FANC (95%), however, late at 7-9 months (38%), at 4-6 months (37%) while 25% were early at 1-3months of pregnancy. For post-natal care, majority of women (77%) visited the health facility as per the stated dates while most male partners (83%) did not accompany their partners to FANC visits. The majority of children were breastfed (97%) with majority initiating the process within the hour of birth 93.1% and 86% not exclusively breastfed. Knowledge of two breastfeeding benefits was 53% prevalent, 27% knew more than two and 20% knew one. The respondents travelled 5-10 kM (50%), 15% >10 kM and 13% stayed within 2 kM. Most children did not receive immunization (56.7%).

Conclusion: The respondents cited that the healthy facility is too far from the furthest village, religious practices, less milk produced by the mother as reasons on maternal factors which contribute to malnutrition. The community knows benefits of breastfeeding but are not practicing exclusive breastfeeding with complementary feeding within six months of birth due to lack of dietary diversity. Immunization was not practiced by the majority respondents.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 May 26;3(1):75-94
An Analysis of Factors Contributing to Late Focused Antenatal Clinic (FANC) Booking for Pregnant Women Attending Hartcliffe Polyclinic in Harare, Zimbabwe

Nyasha Christina Nyereyemhuka, Greanious Alfred Mavondo, Obadiah Moyo, Francis Farai, Mkhwanazi, Blessing Nkazimulo, Ottiniel Chavani, Audrey Judith Chamisa

Introduction: Expectant mothers are recommended and encouraged to book for focused antenatal care on or before the 12th week of pregnancy or within the first trimester to prevent or manage pregnancy-associated challenges. Booking late is when a pregnant woman reports for focused antenatal care for the first time after the first trimester. Focused antennal care is an individualized and quality care provided to pregnant woman for good outcomes. Antenatal care registers at Hartcliffe Polyclinic indicated that the majority of pregnant women were booking late for antenatal care which means they booked after the first trimester against the recommendations. Booking late in pregnancy suggests missed antenatal care as the woman is unlikely to have the recommended visits required of that pregnancy.  Without focused antenatal care, the wellbeing of the mother and in-utero child may be potentially to be negatively impacted. This study aims to establish the major factors that lead to late booking for focused antenatal care. Unmasking these factors may be an important precursor-step which may provide insight and trigger thoughts around mitigating strategies, which potentially will promote early booking for focused antenatal care services.

Methods: Fifty pregnant women, who had booked late for focused antenatal care, were randomly selected to participate in the study. Questionnaires were used to collect data from the participants and quantitative methods were used for data analysis.

Results: The majority of the pregnant women were not aware of the correct time of booking for focused antenatal care and were not aware of the recommended number of clinic visits per pregnancy. The major factors suggested to lead to late-booking were financial challenges, attitude of health personnel, quality of health service, further to cultural and religious beliefs.

Conclusion: Lack of knowledge, age, level of education, marital status, parity, financial difficulties, bad attitude and some cultural beliefs were noted to be the main drivers of late booking. It is envisaged that in future, if these main factors are addressed, potentially an increase in pregnant women registering early for FANC may proportionally be achieved.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 June 24;3(1):95-103
Retrospective Assessment of Low Birth Weight in Nigeria Using Life Table

C. O. Okoro, U. C. Ikediuwa, F. U. Mgbudem, B. Osondu, B. Uwabunkonye

This study focuses on low-birth-weight (LBW) in Nigeria. The main objective is to obtain the life table probability of a mother giving birth to a low-birth-weight child, which may be relevant in assessing the progress of Sustainable Development Goals in Nigeria. The descriptive statistics and method of life table analysis were applied to the dataset on birth weights from the Nigeria Demographic and Health Surveys (NDHS), 1990 to 2013. The result shows that on average, there are approximately 13 LBWs per 1000 live births among mothers aged 25 to 29, which is the highest while the rates declined rapidly in the older ages. The prevalence rate of LBW obtained for the period is slightly below 8.0% (7.9). The incidence rate increased from 7.0% in 1990 NDHS to 10.2% in 2003 NDHS and declined to 7.3% in 2013 NDHS. The consequences of low-birth-weight among women of childbearing age are increasing neonatal and infant mortality rates, which may hinder the achievement of SDGs in Nigeria. We recommend that the government should encourage mothers to deliver their babies in the approved health care facilities to ensure weight measurement at birth.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 June 27;3(1):104-117
The Prevalence of Childbirth Adverse Events (AEs) and Related Factors among Yemeni Mothers and Newborns, Al-Sadaka Teaching Hospital, Aden, Yemen: A Hospital-based Cross-sectional Study

Iman Al- Nakeeb, Amen Ahmed Bawazir

Background: The main objective of this study is to assess the prevalence of adverse events (AEs) and its related factors among mother and newborns during labor in Al-Sadaka Teaching Hospital, Aden City.

Methods: A cross-sectional hospital-based study conducted at Al-Sadaka Teaching Hospital, Aden City among 2526 pregnant women who were consented and eligible to be included in the study. Quantitative date were collected over the study time (180 days on 3-time shifts) by interviewer administered questionnaire and a direct observation of the obstetric interventions during childbirth. Descriptive statistics were performed using the SPSS program and a p-value of <0.05 was considered significant at 95% Confidence Interval (CI). 

Results: A total of 322 adverse event episodes were identified among both mothers and newborns with a prevalence of 12.7% (322/2526) in the study setting. Almost, the majority of the reported AEs were found among mothers (83.2%). Factors such as prolonged second stage labor was found strongly associated with nulliparous mothers during childbirth (P=001), while asphyxia and meconium aspiration as an AEs among newborns were found associated with the performance of episiotomy intervention during childbirth and fundal pressure (P=0.027, P=0.019, respectively).

Conclusions: Prevalence of AEs among mothers and newborns were high in comparison to the international standard. Further nationwide study was recommended to investigate the different factors associated with AEs in health care services in Yemen and to avoid harmful practices as a key mechanism for improving mother safety.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 July 25;3(1):118-123
Predictors of Nutritional Practices among Pregnant Women Attendinag Ante-Natal Clinic in Health Centres in Akpor Kingdom of Obio/Akpor Local Government Area of Rivers State, Niger Delta

Azuonwu Goodluck, Amadi Patience

This study investigated the predictors of nutritional practices among pregnant women attending ante-natal clinic in health centres in Akpor Kingdom of Obio/Akpor Local Government Area of Rivers State. A descriptive design was used for this study. The target population for this study was seven hundred (700) pregnant women. A simple random sampling technique was used to select a sample size of 422. The instrument for data collection was a self-structured questionnaire with a reliability coefficient of 0.70. Data was collected through face to face administration of the questionnaires to the respondents and analyzed using the Statistical Product for Service Solution (SPSS) version 23.0. Hypotheses were tested with the regression statistics at 0.05 alpha level. The findings of the study showed that nutritional preference significantly predicted the nutritional practices of the pregnant women attending ante-natal clinic in health centres in the study area (r = 0.448, p<0.05). Other factors considered in this study such as knowledge (r = 0.078, p>0.05), age (r = 0.010, p>0.05) and educational status (r = 0.061, p>0.05) did not significantly predict the nutritional practices of the pregnant women. It was concluded that the predictor of nutritional practices among pregnant women attending ante-natal in Akpor Kingdom was their nutritional preference. It was recommended that, midwives should focus on conveying health information in their lessons during antenatal visits of pregnant women in such a way that their nutritional preferences can be influenced positively.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 July 27;3(1):124-140
Prevalence and Ultrasound Presentations of Polycystic Ovarian Syndrome in Black African Women Presenting with Infertility: A Case of Women in Referral Health Institutions in Bulawayo, Zimbabwe

Joy Mavondo, Greanious Alfred Mavondo, Francis Farai Chikuse, Blessing Nkazimulo Mkhwanazi, Precious Mdlongwa, Bigboy Tendai Rakata

Introduction: Polycystic ovarian syndrome (PCOS) is an endocrine abnormal condition in women of childbearing age with associated health risks, infertility, diabetes mellitus, endometrial hyperplasia and cardiovascular complications. Ultrasound imaging reporting incidences of PCOS requires continued exploration and updating as the disease profiles tend to continuously evolve due to fluctuating environmental factors, heterogenous population migration as seen in Bulawayo, Zimbabwe and other parts of the world. There are no known past or recent studies that have described ultrasound imaging of PCOS incidences and the prevalence of PCOS in Bulawayo. This study sought to determine the association between factors contributing to prevalence of PCOS and their association with ultrasound presentations in women with infertility in Bulawayo, Zimbabwe aimed at improving diagnostics algorithms of the disease.

Materials and Methods: Equal invitations to participate in the study were issued at hospital-based study centres. A cross-sectional survey was conducted. Informed and consenting participants from Mpilo Central Hospital, United Bulawayo Hospital and Imagegate Diagnostics Centre, who were presenting with menstrual irregularities, acne, hirsutism and infertility, were recruited. Participants age ranged from 15-45 years. All participants had their demographics collected using questionnaires. Body mass index, waist-hip ration, clinical presentations and pelvic transabdominal ultrasound scan survey were determined.

Results: Participants were grouped into age groups 15-24 years, 25-34 years, 35-44 years. Polycystic ovaries presented as 10 or more 2-9 mm ovarian follicles with mean ovarian volume ≥ 10 cm3. In establishing the diagnosis of polycystic ovaries, the criterion of 10 or more 2-9 mm ovarian follicles were found to have the highest representation in the 25-34-year age group. The study showed 30.4% of the clients had polycystic ovaries while 46.4% showed other pelvic pathology and the rest, 23.2% had normal pelvis scan results. The prevalence of polycystic ovaries was significantly higher in 25-34 year age sub-group. Acne and hirsutism were significantly associated with positive ultrasound imaging results for PCOS.

Conclusion: The study updated information on PCOS as seen on ultrasound in women in Bulawayo. All women of childbearing age presenting with infertility and clinical signs of hyperandrogenaemia (e.g. hirsutism, acne) should be screened for polycystic ovaries as part of a women wellness program. Furthermore, it is recommended that sonologists and sonographers be aware of the ultrasound criteria for polycystic ovarian syndrome in women of child-bearing age.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 July 29;3(1):141-153
Prevalence and Intensity of Intestinal Helminths among Pregnant Women Attending Antenatal Clinic in Ebonyi State Nigeria

C. A. Imakwu, J. C. Ozougwu, J. E. Eyo, O. P. Okeke, G. U. Amana, S. C. Eziuzor, J. E. Ekeleme, M. I. Aniekwe

Aim: This present study was conducted to determine the prevalence and intensity of intestinal parasites among pregnant women attending antenatal clinics in Ebonyi State Nigeria.

Methodology: The study was carried out from April 2011 to March 2012 at two purposively selected hospitals in Ebonyi State, Nigeria. Three hundred and sixty pregnant women were randomly selected for this study. Stool samples were examined for intestinal helminths using macroscopic and the microscopic methods. The intensity of the ova was determined directly and graded. Data analysis was performed using Statistical software for social sciences version 20.

Results: Out of the 360 sampled pregnant women, 18.6% was found positive for intestinal helminthic parasites. Three intestinal helminthic parasites isolated were; A. lumbricoides (8.9%), hookworm (6.1%) and T. trichiura (3.6%). The prevalence and intensity were higher during the rainy season than the dry season. First trimester, secundigravidae and (15-20 yrs) age group had the highest prevalence of intestinal helminthic parasites. Pregnant women that ate raw vegetables had a higher prevalence of Ascariasis, trichuriasis and hookworm infection than those that ate cooked vegetables. In relation to source of drinking water, those that got drinking water from river had the highest prevalence of all the parasites. On the type of toilet used, pregnant women who use bush method had the highest prevalence 7(10.9%) for A. lumbricoides and T. trichuria was more prevalent with those who use pit toilet 6(3.8%) while hookworm 12(8.7%), was seen among women using water cistern. In relation to washing of hands after toilet, pregnant women that do not wash hands had higher prevalence of 6(11.5%), 2(3.8%) 6(11.5%) for A. lumbricoides, T. trichuria and hookworm respectively than those that do wash their hands after toilet. Those that ate raw meat had higher prevalence of A. lumbricoides 3(15.8%), T. trichuria 2(10.5%) and hookworm 3(15.79%) than those that did not eat raw meat. Those who walk barefooted had higher prevalence of A. lumbricoides 5(8.3%), T. trichuria 4(6.7%) and hookworm 8(13.3%) than those who do not walk barefooted.

Conclusion: From this study, it is concluded that helminthic parasites are still present in pregnant women at Ebonyi state, therefore there is need to control and prevent their infection so as to eradicate its effects on pregnant women. The creation of awareness on the preventive measures of helminthic infections amongst people in Ebonyi state is urgently needed. Consequently, health education in local languages should be vigorously mounted to create awareness on helminthic diseases.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 August 3;3(1):154-163
Newborn Resuscitation Resources in Selected Rural and Urban Primary Healthcare Centres in Enugu State, Nigeria: A Comparative Analysis

T. F. Okusanya, A. U. Chinweuba, C. I. Nweke, J. N. Esievo

Introduction: Successful neonatal resuscitation involves availability of neonatal resuscitation resources in terms of material and skilled personnel; this is the first and most important step in delivering effective neonatal resuscitation. The study aimed to assess and compare newborn resuscitation resources in terms of materials (availability, types and functionality) and manpower (availability and professional status) in the urban and rural primary healthcare centres in Enugu State, South East Nigeria.

Methods: A Comparative survey design using a multistage sampling technique to select 134 PHC (67 each from both urban and rural area). Data collected by a checklist and a self-structured questionnaire filled by health personnel. Data collection lasted for 12 weeks.

Results: Mucus extractor (rural 88.1%/urban 79.1%) is the most available material for newborn resuscitation. Ventilating devices like Ambu bag, face mask, oral airway, oxygen cylinder etc. are more in the urban than rural. Although, most of the materials are analogue/manual, the urban area has more of electronically/digitally operated materials of which are either fairly or fully functional. The major personnel in both setting (urban 65.7%/rural 85.1%) are Community Health Extension Workers (CHEW); the urban had more of highly skilled professional. Although, some of the personnel in both setting (urban 50.7%/rural 38.8%) rated their skill in newborn resuscitation management as good, majority of them (urban 86.6% / rural 88.1%) had no specialized training on newborn resuscitation. Lack of material (urban 68.7% / rural 80.6%) was a major challenge in newborn resuscitation. There is no significant difference in the availability and functionality but a significant difference in the types of the material and manpower resource.

Conclusion: There is almost same variability of newborn resuscitation resources in the urban and rural area. Adequate resources (material and manpower) should be provided in the PHC in Enugu State this will bring a reduction in the neonatal mortality rate.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 August 3;3(1):164-174
Clients’ Assessment of Quality of Antenatal Care Services at Federal Teaching Hospital Abakaliki, Nigeria: Understanding Key Role of Health Providers

Edmund Ndudi Ossai, Chukwudiebere Ekuma Oko, Nnamdi Okafor, Chinelo Chukwudulue, Jude Uchechukwu Ukwa, Lawrence Ulu Ogbonnaya

Aims: The research objective of this article sought to determine the clients' evaluation of the quality of antenatal care (ANC) at Federal Teaching Hospital Abakaliki, Nigeria.

Study Design:  A descriptive cross-sectional study design was adopted.

Place and Duration of Study: Federal Teaching Hospital Abakaliki, Nigeria. The study took place between April and May, 2018.

Methodology: A systematic random sampling technique was used to select 415 women receiving ANC at the facility. A questionnaire designed by the authors was used as an instrument for the research. A composite index of satisfaction (overall satisfaction) was derived. It was determined by proportion of clients who were satisfied with ANC services, were willing to use facility again for ANC and also recommend to others. It also included those who reported being well received at facility and were satisfied with attitude of Doctors and Nurses. A ‘Yes’ answer to these six variables was regarded as overall satisfaction.

Results: From the results of the study, mean age of respondents was 29.3±4.5 years. It was found that the major reasons for registering at the facility were quest for quality care (41.0%) and facility has trained health workers,(21.4%). Majority, 91.6% intend to deliver at the facility. It was found that majority (73.0%) had overall satisfaction with ANC services. The predictors of overall satisfaction included having attained tertiary education, (AOR=0.4; 95%CI: 0.2-0.8), being unemployed, (AOR=0.6; 95%CI: 0.3-0.9) and intention to deliver in same health facility, (AOR=2.4; 95%CI:1.2-5.1)

Conclusions: The major reasons for choosing the health facility for ANC were health worker related.  Majority of the clients had overall satisfaction with antenatal services and were also willing to deliver at the facility. Being satisfied with ANC services facilitates delivery in health facility and this is capable of improving maternal health in Nigeria. In realizing this, health providers have a prominent role to play. There is thus the need to support health workers in fulfilling this essential role and this may necessitate training health workers on quality of care.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 November 24;3(1):179-185
Prevalence of Falciparum Malaria in Relation to Age, Gravidity, Trimester, Blood Group and Genotype among Pregnant Women

J. C. Ozougwu, C. A. Imakwu, J. E. Ekeleme, O. P. Okeke, G. U. Amana, S. C. Eziuzor, J. C. Ogbodo

Aim: This study was undertaken to ascertain the prevalence of falciparum malaria in relation to age, gravidity, trimester, blood group and genotype among pregnant women attending antenatal in Model Primary Health Centre, Omoku, Rivers State.

Methodology: The study was carried out from January to December, 2019, venous blood samples were collected from six hundred and ten pregnant women selected by simple random sampling, thick and thin blood films were made, stained with giemsa stain and viewed under the light microscope. ABO Blood group and haemoglobin genotype were determined using standard methods. Statistical result was performed using statistical package for social sciences version 20.

Results: The overall prevalence of malaria in relation to age showed that out of the 610 pregnant women tested, 320 were positive for malaria giving an overall prevalence of 52.5℅. The age group between 46 – 50 yrs had the highest prevalence of malaria 100%, while the age group 36-40 yrs recorded the least prevalence of malaria 11.1℅. The prevalence of malaria in relation to gravidity showed that the multigravida had higher prevalence (96.3%) than primigravida which had 45.5℅. The overall prevalence of malaria in relation to gravidity is 54.9%.  With regards to trimester, it showed that pregnant women in their second and third trimester both had the highest prevalence of malaria 57.0℅, while those in the first trimester had the lowest prevalence of 50℅. For blood group it showed that the blood group with the highest prevalence was AB (76.1%), while blood group A had the least prevalence (24.7℅). The overall prevalence of malaria in relation to blood group is 55.6%. In relation to genotype, it showed that genotype AA had the highest prevalence of 85.2℅, while the least prevalence was seen among AS genotype (35.4℅). Prevalence values were statistically significant at P < 0.05. 

Conclusion: This study showed that malaria in pregnancy is still endemic in Omoko, Rivers State, Nigeria. The high prevalence observed in most groups could be because rainy season lasts longer yearly which favours the breeding of Anopheles Mosquito, the malaria vector. There is need for adequate enlightenment on the malaria preventive and control measures to reduce the prevalence of malaria in pregnancy.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 November 28;3(1):186-194
Outcome of Management of Pregnant Women with Decreased Fetal Movements in a Resource Constrained Setting in Southwest Nigeria

Olusola Peter Aduloju, Babatunde Ajayi Olofinbiyi, Olabisi Deji- Dada, Tolulope Aduloju

Aims: To evaluate pregnant women with decreased fetal movements (DFM) identifying the risk factors and perinatal outcomes of such pregnancies.

Study Design: A case-control study.

Place and Duration of Study: Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, between April 1 2017 and March 31 2018.

Methodology: Women with singleton pregnancy presenting to the Department with complaint of DFM (cases) after 28 weeks of gestation were recruited and compared with women with no complaint of DFM that delivered in the facility during the study period. Sociodemographic data, obstetric characteristics. Antenatal risk factors, mode of delivery and perinatal outcomes were obtained using a semi-structured questionnaire. Data collected were analyzed with SPSS and variables were compared using student t test and chi square or Fisher exact test while p value was <0.05.

Results: Out of 1439 women in the third trimester during the study period, 117 women had complaint of DFM with a prevalence of 12.3%. There was no statistical difference in the socio-demographic characteristics between the two groups; P>0.05. The mean gestational age at presentation and delivery were significantly lower among women with DFM (31.95 ± 1.81 weeks versus 37.46 ± 2.98 weeks; P=0.001 and 35.05 ± 1.47 weeks versus 37.46 ± 2.98 weeks; P=0.001 respectively). More women with DFM significantly had preeclampsia and intrauterine growth restrictions (P=0.002), oligohydramnios (p=0.016), caesarean delivery (P=0.005) and SCBU admission (P=0.009). The mean birth weight and Apgar scores at 1 minute were significantly lower in women with DFM (2.64 ± 0.54 kg versus 3.25 ± 0.57 kg; P=0.001 and 7.13 ± 0.68 versus 7.42 ± 0.82; P=0.003 respectively).

Conclusion: This study showed that women with DFM are a higher risk of operative delivery and poor perinatal outcome such birth weight and Apgar score. Maternal perception of fetal movements should form part of risk assessment during routine visits.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2020 December 19;3(1):195-211
Prevalent Factors Influencing Women’s Intention to Limit Childbearing: Empirical Evidence Based on Bangladesh Demography and Health Surveys

Mithun Kumar Acharjee, Md. Nuruzzaman Forhad, Kumer Pial Das

Aims: Bangladesh, as one of the most densely populated countries in the world, is facing an overpopulation crisis. Understanding the factors that influence a women's intention to limit her ability and desire to bear children is important for family planning program purposes and population policies. This paper has focuses on identifying the prevalent factors that influences a woman’s intention to limit pregnancy, by measuring the impact of those factors on her intentions. The paper also provides a few recommendations toward addressing issues regarding childbearing.

Methodology: This study is a retrospective analysis of data from the 2004, 2007, 2011 and 2014 Bangladesh Demography and Health Survey (BDHS). Cases in the study are childbearing-aged married women. The dependent variable is the women’s intention to limit her childbearing, in the forms of desiring more children or not. To measure the impact, a logistic regression model is considered.

Results: Results show that the women studied tended to limit their desire to bear a child is highly associated with older age, the number of children alive, living area concerns, whether a child has already died in the family, family planning and religion. Moreover, a surprising relationship was found among the people of differing economic and education statuses in relation to their tendency to limit a desire for children.

Conclusions: This study identifies different factors, such as access to media, age at first marriage, respondents working status, region, previous child death, religion and the total number of children as the most concurrent features for influencing a woman’s intention to limit pregnancy in Bangladesh. The study intends to initiate a discussion of the impact of these covariates on intentions which limit childbearing desires, which should be helpful to concerned authorities, policymakers and researchers in formulating policies.

Original Research Article | Asian Journal of Pregnancy and Childbirth. 2021 February 8;3(1):217-224
Exploring Women’s Experiences, Maternal Practices and Problems in the Utilization of Maternal Health Services in Kwara State, Nigeria: A Qualitative Study

Salami Abdulganiyu, Adofu Ilemona

Aim: To examine the women’s experiences, maternal practices and problems faced in the utilization of maternal health services in Kwara State, Nigeria.

Methodology: An inductive and thematic analytical approach was adopted in analyzing the qualitative responses obtained from the respondents.

Results: The study found that women indulge in medical pluralism and that the optimal utilization of maternal health services was hindered by unfriendly attitudes of some healthcare providers and inadequacy of drugs in many of the clinics.

Conclusions:    The study concluded that the utilization of maternal health services is influenced by the attitudes of healthcare providers and the availability of affordable drugs and that medical pluralism is a common healthcare practice of some of the respondents.

Review Article | Asian Journal of Pregnancy and Childbirth. 2020 May 2;3(1):38-49
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

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.