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- Bastola, K, et al.
(författare)
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Pre-pregnancy body mass index and inter-pregnancy weight change among women of Russian, Somali and Kurdish origin and the general Finnish population
- 2017
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 45:3, s. 314-321
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We studied the differences in the mean pre-pregnancy body mass index (BMI) and mean inter-pregnancy weight change in women of Russian, Somali and Kurdish origin and women in the general Finnish population. Methods: The population-based samples were from the Migrant Health and Wellbeing Study and the Health 2011 Survey conducted in six cities in Finland in 2010–2012. This study included women with at least one birth in Finland. Data on their previous pregnancies in Finland were obtained from the National Medical Birth Register for 318 Russian, 584 Somali and 373 Kurdish origin women and for 243 women in the general Finnish population (reference group). Data on pre-pregnancy weight and height were self-reported in early pregnancy. Linear logistic regression was the main method of analysis. Results: The unadjusted mean pre-pregnancy BMI was higher in Somali (27.0 kg/m2, p<0.001) and Kurdish (25.8 kg/m2, p<0.001) women, but lower in Russian (22.2 kg/m2, p<0.001) women than in the reference group (24.1 kg/m2). The adjusted coefficients for the difference in the mean pre-pregnancy BMI were −1.93 (95% CI −2.77 to −1.09) for Russian, 1.82 (95% CI 0.89–2.75) for Somali and 1.30 (95% CI 0.43–2.17) for Kurdish women compared with the reference group. Among women with at least two births, no statistically significant difference was observed in the mean inter-pregnancy weight change between the migrant groups and the reference group. Conclusions: Somali and Kurdish women had higher mean pre-pregnancy BMIs than women in the general Finnish population and may need special support and health promotion strategies for weight management.
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- Bastola, K, et al.
(författare)
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Pregnancy complications in women of Russian, Somali, and Kurdish origin and women in the general population in Finland
- 2020
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Ingår i: Women's health (London, England). - : SAGE Publications. - 1745-5065. ; 16, s. 1745506520910911-
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Tidskriftsartikel (refereegranskat)abstract
- We compared the prevalence of gestational diabetes and hypertensive disorders in the most recent pregnancy among women of Russian, Somali, and Kurdish origin and women in the general population in Finland. Methods: The study groups were selected from population-based samples of 18- to 64-year-old women. The women were of Russian (n = 318), Somali (n = 583), and Kurdish (n = 373) origin or from the general population (n = 243), and had given birth in Finland between 2004 and 2014. The data were obtained from the National Medical Birth Register and the Hospital Discharge Register. Data on gestational diabetes and hypertensive disorders were extracted based on relevant International Classification of Diseases, Tenth Revision codes. The main statistical methods were logistic regression analyses adjusted for age, parity, body mass index, socioeconomic status, and smoking. Results: The prevalence of gestational diabetes was 19.1% in Kurdish, 14.4% in Somali, 9.3% in Russian, and 11.8% in the general population. The prevalence of hypertensive disorders was 5.4% in the general population, 3.8% in Somali, 3.1% in Kurdish, and 1.7% in Russian. When adjusted for confounders, Kurdish women had two-fold odds for gestational diabetes (odds ratio = 1.98; 95% confidence interval = 1.20–3.32) compared with the general population, but the odds for hypertensive disorders did not differ between groups. Conclusion: Women of Kurdish origin were more likely to develop gestational diabetes. Studies with larger samples are required to confirm these findings to develop prevention strategies for later development of type 2 diabetes. Future research including other migrant groups is recommended to identify differences in pregnancy complications among the women in migrant and general population.
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- KC, Ashish, 1982, et al.
(författare)
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Neonatal resuscitation: EN-BIRTH multi-country validation study.
- 2021
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Ingår i: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 21:Suppl 1
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Tidskriftsartikel (refereegranskat)abstract
- Annually, 14 million newborns require stimulation to initiate breathing at birth and 6 million require bag-mask-ventilation (BMV). Many countries have invested in facility-based neonatal resuscitation equipment and training. However, there is no consistent tracking for neonatal resuscitation coverage.The EN-BIRTH study, in five hospitals in Bangladesh, Nepal, and Tanzania (2017-2018), collected time-stamped data for care around birth, including neonatal resuscitation. Researchers surveyed women and extracted data from routine labour ward registers. To assess accuracy, we compared gold standard observed coverage to survey-reported and register-recorded coverage, using absolute difference, validity ratios, and individual-level validation metrics (sensitivity, specificity, percent agreement). We analysed two resuscitation numerators (stimulation, BMV) and three denominators (live births and fresh stillbirths, non-crying, non-breathing). We also examined timeliness of BMV. Qualitative data were collected from health workers and data collectors regarding barriers and enablers to routine recording of resuscitation.Among 22,752 observed births, 5330 (23.4%) babies did not cry and 3860 (17.0%) did not breathe in the first minute after birth. 16.2% (n = 3688) of babies were stimulated and 4.4% (n = 998) received BMV. Survey-report underestimated coverage of stimulation and BMV. Four of five labour ward registers captured resuscitation numerators. Stimulation had variable accuracy (sensitivity 7.5-40.8%, specificity 66.8-99.5%), BMV accuracy was higher (sensitivity 12.4-48.4%, specificity > 93%), with small absolute differences between observed and recorded BMV. Accuracy did not vary by denominator option. < 1% of BMV was initiated within 1 min of birth. Enablers to register recording included training and data use while barriers included register design, documentation burden, and time pressure.Population-based surveys are unlikely to be useful for measuring resuscitation coverage given low validity of exit-survey report. Routine labour ward registers have potential to accurately capture BMV as the numerator. Measuring the true denominator for clinical need is complex; newborns may require BMV if breathing ineffectively or experiencing apnoea after initial drying/stimulation or subsequently at any time. Further denominator research is required to evaluate non-crying as a potential alternative in the context of respectful care. Measuring quality gaps, notably timely provision of resuscitation, is crucial for programme improvement and impact, but unlikely to be feasible in routine systems, requiring audits and special studies.
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- Paudel, Prajwal, et al.
(författare)
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Meconium aspiration syndrome : incidence, associated risk factors and outcome-evidence from a multicentric study in low-resource settings in Nepal
- 2020
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Ingår i: Journal of Paediatrics and Child Health. - : WILEY. - 1034-4810 .- 1440-1754. ; 56:4, s. 630-635
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Tidskriftsartikel (refereegranskat)abstract
- AimThe aim of this study was to identify the incidence, risk factors and outcome associated with meconium aspiration syndrome (MAS).MethodsAn observational study was conducted in 12 public hospitals in Nepal from 1 July 2017 to 29 August 2018. All babies born within the study period were included in the study. Babies who were diagnosed as MAS were designated as outcome. Data were analysed with bivariate analysis followed by multiple regression analysis.ResultsThe overall incidence of MAS was 2.0 per 1000 livebirths. Babies born at post‐term gestation (adjusted odds ratio (AOR) = 2.41; 95% confidence interval (CI): 1.05–5.55), nulliparity (AOR = 2.26; 95% CI: 1.20–4.28), instrumental delivery (AOR = 4.79; 95% CI: 2.52–9.10) and caesarean delivery (AOR = 3.67; 95% CI: 2.29–5.89) were significantly associated with MAS. Babies with MAS had a 10‐fold risk for pre‐discharge mortality (odds ratio = 9.87; 95% CI: 5.81–16.76).ConclusionsThe findings in this study are consistent with that reported in other studies. MAS has a high risk of neonatal mortality. Thus, monitoring during pregnancy and labour is necessary for early identification of high‐risk conditions associated with MAS. Strengthening of newborn care services is essential to curtail mortality.
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| 9. |
- Paudel, Prajwal, et al.
(författare)
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Meconium aspiration syndrome: incidence, associated risk factors and outcome-evidence from a multicentric study in low-resource settings in Nepal.
- 2020
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Ingår i: Journal of paediatrics and child health. - : Wiley. - 1440-1754 .- 1034-4810. ; 56:4, s. 630-635
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify the incidence, risk factors and outcome associated with meconium aspiration syndrome (MAS).An observational study was conducted in 12 public hospitals in Nepal from 1 July 2017 to 29 August 2018. All babies born within the study period were included in the study. Babies who were diagnosed as MAS were designated as outcome. Data were analysed with bivariate analysis followed by multiple regression analysis.The overall incidence of MAS was 2.0 per 1000 livebirths. Babies born at post-term gestation (adjusted odds ratio (AOR) = 2.41; 95% confidence interval (CI): 1.05-5.55), nulliparity (AOR = 2.26; 95% CI: 1.20-4.28), instrumental delivery (AOR = 4.79; 95% CI: 2.52-9.10) and caesarean delivery (AOR = 3.67; 95% CI: 2.29-5.89) were significantly associated with MAS. Babies with MAS had a 10-fold risk for pre-discharge mortality (odds ratio = 9.87; 95% CI: 5.81-16.76).The findings in this study are consistent with that reported in other studies. MAS has a high risk of neonatal mortality. Thus, monitoring during pregnancy and labour is necessary for early identification of high-risk conditions associated with MAS. Strengthening of newborn care services is essential to curtail mortality.
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