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Articles 1 - 19 of 19

Full-Text Articles in Obstetrics and Gynecology

Infant Growth And Body Composition From Birth To 24 Months: Are Infants Developing The Same?, Shane A. Norris, Lukhanyo H. Nyati, Alexia Murphy Alford, Nishani Lucas, Ina S. Santos, Caroline S. Costa, Rebecca Kuriyan, V Pujitha Wickranasinghe, Shabina Ariff, Andrew P. Hills Jan 2024

Infant Growth And Body Composition From Birth To 24 Months: Are Infants Developing The Same?, Shane A. Norris, Lukhanyo H. Nyati, Alexia Murphy Alford, Nishani Lucas, Ina S. Santos, Caroline S. Costa, Rebecca Kuriyan, V Pujitha Wickranasinghe, Shabina Ariff, Andrew P. Hills

Department of Paediatrics and Child Health

Background: Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries.
Methods: We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length …


Antenatal Dexamethasone For Improving Preterm Newborn Outcomes In Low-Resource Countries: A Cost-Effectiveness Analysis Of The Who Action-I Trial, Who Action Trial Collaborators, Katherine E. Eddy, Joshua P. Vogel, Nick Scott, Dagnachew Fetene, Shabina Ariff, Sajid Bashir Soofi, Lumaan Sheikh, Farrukh Raza, Almas Aamir Oct 2022

Antenatal Dexamethasone For Improving Preterm Newborn Outcomes In Low-Resource Countries: A Cost-Effectiveness Analysis Of The Who Action-I Trial, Who Action Trial Collaborators, Katherine E. Eddy, Joshua P. Vogel, Nick Scott, Dagnachew Fetene, Shabina Ariff, Sajid Bashir Soofi, Lumaan Sheikh, Farrukh Raza, Almas Aamir

Department of Paediatrics and Child Health

Background: After considerable debate, there is now unequivocal evidence that use of antenatal corticosteroids improves outcomes in preterm neonates when used in women at risk of early preterm birth in reasonably equipped hospitals in low-resource countries. We aimed to evaluate the cost-effectiveness of dexamethasone administration in the management of preterm birth in a cohort of pregnant women from five low-resource countries.
Methods: We performed a cost-effectiveness analysis using data from 2828 women (and 3051 babies) who participated in the WHO ACTION-I trial, a multicentre, randomised, placebo-controlled trial that assessed the safety and efficacy of dexamethasone in pregnant women at risk …


Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali Aug 2022

Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan.
Methods: The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and …


Characteristics And Birth Outcomes Of Pregnant Adolescents Compared To Older Women: An Analysis Of Individual Level Data From 140,000 Mothers From 20 Rcts, Nadia Akseer, Emily Catherine Keats, Pravheen Thurairajah, Simon Cousens, Ana Pilar Bétran, Brietta M. Oaks, David Osrin, Ellen Piwoz, Exnevia Gomo, Zulfiqar Ahmed Bhutta Feb 2022

Characteristics And Birth Outcomes Of Pregnant Adolescents Compared To Older Women: An Analysis Of Individual Level Data From 140,000 Mothers From 20 Rcts, Nadia Akseer, Emily Catherine Keats, Pravheen Thurairajah, Simon Cousens, Ana Pilar Bétran, Brietta M. Oaks, David Osrin, Ellen Piwoz, Exnevia Gomo, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.
Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, …


Clavicular Fractures In Newborns: What Happens To One Of The Commonly Injured Bones At Birth?, Hina Mumtaz Hashmi, Nazia Shamim, Vinod Kumar, Naureen Anjum, Khalil Ahmad Sep 2021

Clavicular Fractures In Newborns: What Happens To One Of The Commonly Injured Bones At Birth?, Hina Mumtaz Hashmi, Nazia Shamim, Vinod Kumar, Naureen Anjum, Khalil Ahmad

Department of Paediatrics and Child Health

Introduction: The clavicle is one of the most commonly injured bones during the birth process. The objective of this study was to determine the frequency and outcome of fractured clavicle amongst neonates born in a five-year period at a Secondary Hospital setting and to determine the Maternal and Neonatal Characteristics involved in such cases and compare them with a control group and determine the significance of any factors.
Methods: All cases of fractured clavicle were retrospectively reviewed in a Secondary care hospital setting during a five-year period from July 2015 to June 2020. Maternal and neonatal factors were determined and …


Machine Learning Guided Postnatal Gestational Age Assessment Using New-Born Screening Metabolomic Data In South Asia And Sub-Saharan Africa, Sunil Sazawal, Kelli K. Ryckman, Sayan Das, Muhammad Imran Nisar, Usma Mehmood, Amina Barkat, Farah Khalid, Muhammad Ilyas Muhammad Ilyas, Ambreen Nizar, Fyezah Jehan Sep 2021

Machine Learning Guided Postnatal Gestational Age Assessment Using New-Born Screening Metabolomic Data In South Asia And Sub-Saharan Africa, Sunil Sazawal, Kelli K. Ryckman, Sayan Das, Muhammad Imran Nisar, Usma Mehmood, Amina Barkat, Farah Khalid, Muhammad Ilyas Muhammad Ilyas, Ambreen Nizar, Fyezah Jehan

Department of Paediatrics and Child Health

Background: Babies born early and/or small for gestational age in Low and Middle-income countries (LMICs) contribute substantially to global neonatal and infant mortality. Tracking this metric is critical at a population level for informed policy, advocacy, resources allocation and program evaluation and at an individual level for targeted care. Early prenatal ultrasound examination is not available in these settings, gestational age (GA) is estimated using new-born assessment, last menstrual period (LMP) recalls and birth weight, which are unreliable. Algorithms in developed settings, using metabolic screen data, provided GA estimates within 1-2 weeks of ultrasonography-based GA. We sought to leverage machine …


Cohort Profile: The Alliance For Maternal And Newborn Health Improvement (Amanhi) Biobanking Study, Fahad Aftab, Salahuddin Ahmed, Aneeta Hotwani, Muhammad Ilyas, Mohammad Javaid, Fyezah Jehan, Farah Khalid, Usma Mehmood, Muhammad Imran Nisar, Muhammad Sajid Aug 2021

Cohort Profile: The Alliance For Maternal And Newborn Health Improvement (Amanhi) Biobanking Study, Fahad Aftab, Salahuddin Ahmed, Aneeta Hotwani, Muhammad Ilyas, Mohammad Javaid, Fyezah Jehan, Farah Khalid, Usma Mehmood, Muhammad Imran Nisar, Muhammad Sajid

Department of Paediatrics and Child Health

No abstract provided.


Effect Of Community-Based Kangaroo Mother Care Package On Neonatal Mortality Among Preterm And Low Birthweight Infants In Rural Pakistan: Protocol For A Cluster Randomized Controlled Trial, Shabina Ariff, Atif Habib, Zahid Memon, Tayyaba Arshad, Tariq Samejo, Ikram Maznani, Muhammad Umer, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta Aug 2021

Effect Of Community-Based Kangaroo Mother Care Package On Neonatal Mortality Among Preterm And Low Birthweight Infants In Rural Pakistan: Protocol For A Cluster Randomized Controlled Trial, Shabina Ariff, Atif Habib, Zahid Memon, Tayyaba Arshad, Tariq Samejo, Ikram Maznani, Muhammad Umer, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Neonatal mortality due to preterm birth and low birthweight remains a significant challenge in Pakistan. Kangaroo mother care (KMC) is a unique, low-cost intervention proven to reduce neonatal mortality and morbidity and increase exclusive breastfeeding rates. However, KMC has not been attempted in community settings in Pakistan. We aim to implement and evaluate the effectiveness of a community-based KMC package to reduce neonatal morbidity and mortality among preterm and low birthweight (LBW) infants, which will provide evidence for policy development and the large-scale implementation of KMC across the country.
Objective: The primary objective of this trial is to reduce …


Role Of Community Engagement In Maternal Health In Rural Pakistan: Findings From The Clip Randomized Trial, Zahra Hoodbhoy, Sana Sadiq Sheikh, Rahat Qureshi, Javed Memon, Farrukh Raza, Mai-Lei Woo Kinshella, Jeffrey N. Bone, Marianne Vidler, Sumedha Sharma, Zulfiqar Ahmed Bhutta Jul 2021

Role Of Community Engagement In Maternal Health In Rural Pakistan: Findings From The Clip Randomized Trial, Zahra Hoodbhoy, Sana Sadiq Sheikh, Rahat Qureshi, Javed Memon, Farrukh Raza, Mai-Lei Woo Kinshella, Jeffrey N. Bone, Marianne Vidler, Sumedha Sharma, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Community-based strategies to promote maternal health can help raise awareness of pregnancy danger signs and preparations for emergencies. The objective of this study was to assess change in birth preparedness and complication readiness (BPCR) and pregnant women's knowledge about pre-eclampsia as part of community engagement (CE) activities in rural Pakistan during the Community Level Interventions for Pre-eclampsia (CLIP) Trial.
Methods: The CLIP Trial was a cluster randomized controlled trial that aimed to reduce maternal and perinatal morbidity and mortality using CE strategies alongside mobile health-supported care by community health care providers. CE activities engaged pregnant women at their homes …


Uterine Artery Embolization Combined With Methotrexate For Broad Ligament Ectopic Pregnancy In A 30-Year Old Primigravida, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Shaista Riaz, Samreen Aslam, Zouina Ameena Jun 2021

Uterine Artery Embolization Combined With Methotrexate For Broad Ligament Ectopic Pregnancy In A 30-Year Old Primigravida, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Shaista Riaz, Samreen Aslam, Zouina Ameena

Department of Paediatrics and Child Health

We present the case of 30-year old primigravida female at 11 weeks' gestation who was diagnosed to have ectopic pregnancy on obstetric ultrasound. An MRI pelvis was ordered to assess invasion into the posterior myometrium which confirmed a single right-sided broad ligament-extra uterine pelvic ectopic pregnancy with extrinsic mass effect on the right lower uterine segment without frank myometrial invasion. On an urgent basis, a uterine artery embolization (UAE) was performed by targeting the right femoral artery. Selective catheterization was performed of both uterine arteries and the right side showed a major feeder of the gestational sac. Supplied dose of …


Maternal And Neonatal Morbidity And Mortality Among Pregnant Women With And Without Covid-19 Infection: The Intercovid Multinational Cohort Study, José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Alexey Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva Do Vale, Zulfiqar Ahmed Bhutta Apr 2021

Maternal And Neonatal Morbidity And Mortality Among Pregnant Women With And Without Covid-19 Infection: The Intercovid Multinational Cohort Study, José Villar, Shabina Ariff, Robert B. Gunier, Ramachandran Thiruvengadam, Stephen Rauch, Alexey Kholin, Paola Roggero, Federico Prefumo, Marynéa Silva Do Vale, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Detailed information about the association of COVID-19 with outcomes in pregnant individuals compared with not-infected pregnant individuals is much needed.
Objective: To evaluate the risks associated with COVID-19 in pregnancy on maternal and neonatal outcomes compared with not-infected, concomitant pregnant individuals.
Design, setting, and participants: In this cohort study that took place from March to October 2020, involving 43 institutions in 18 countries, 2 unmatched, consecutive, not-infected women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were …


Conducting Household Surveys On Reproductive Health In Urban Settings: Lessons From Karachi, Pakistan, Mirbaz Khan, Sidrah Nausheen, Imtiaz Hussain, Kristy Hackett, Kaneez Zehra, Khalid Feroz, David Cannin, Iqbal Shah, Sajid Bashir Soofi Feb 2021

Conducting Household Surveys On Reproductive Health In Urban Settings: Lessons From Karachi, Pakistan, Mirbaz Khan, Sidrah Nausheen, Imtiaz Hussain, Kristy Hackett, Kaneez Zehra, Khalid Feroz, David Cannin, Iqbal Shah, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Data collection is the most critical stage in any population health study and correctly implementing fieldwork enhances the quality of collected information. However, even the most carefully planned large-scale household surveys can encounter many context-specific issues. This paper reflected on our research team's recent experience conducting surveys for a quasi-experimental evaluation of a reproductive health program in urban areas of Karachi, Pakistan. We aim to describe the issues encountered and lessons learned from this process, and present some potential solutions for conducting future household surveys in similar urban environments.
Methods: The study followed a three-stage random sampling design. Initially, …


Frequency And Outcome Of Meconium Aspiration Syndrome In Babies Born With Meconium-Stained Liquor At Secondary Care Hospital In Pakistan: A Case Series Study, Abdul Moeed, Heeramani Lohana, Sarwat Urooj, Sheraz Ahmed, Khalil Ahmed, Khadija N Humayun Sep 2020

Frequency And Outcome Of Meconium Aspiration Syndrome In Babies Born With Meconium-Stained Liquor At Secondary Care Hospital In Pakistan: A Case Series Study, Abdul Moeed, Heeramani Lohana, Sarwat Urooj, Sheraz Ahmed, Khalil Ahmed, Khadija N Humayun

Department of Paediatrics and Child Health

Background: Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome; in terms of hospital stay, complications, and mortality.
Methods: The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled …


Successful Completion Of Pregnancy After Mustard Procedure For Transposition Of Great Arteries: A Rare Case From The Developing World, Muhammad Kamran Younis Memon, Ayesha Malik, Saleem Akhtar May 2020

Successful Completion Of Pregnancy After Mustard Procedure For Transposition Of Great Arteries: A Rare Case From The Developing World, Muhammad Kamran Younis Memon, Ayesha Malik, Saleem Akhtar

Department of Paediatrics and Child Health

Surgical repair of transposition of great arteries has undergone various evolutionary changes over the years. The initial of these treatment options was atrial septectomy followed by atrial switch and the current preferred treatment option is arterial switch operation worldwide. Due to various reasons, like lack of medical and surgical expertise atrial switch operation was commonly in practice in developing countries until few years back. Pregnancy in a patient with history of atrial switch operation poses a unique haemodynamic challenge. We report the case of a successful pregnancy in a 26 years old lady who had undergone Mustard repair surgery in …


Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan Dec 2019

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher


Prevalence Of Overweight And Obesity Based On The Body Mass Index; A Cross-Sectional Study In Alkharj, Saudi Arabia, Sameer Al-Ghamdi, Mamdouh M. Shubair, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Khaled K. Aldossari, Mowafa Househ, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally Jun 2018

Prevalence Of Overweight And Obesity Based On The Body Mass Index; A Cross-Sectional Study In Alkharj, Saudi Arabia, Sameer Al-Ghamdi, Mamdouh M. Shubair, Abdulrahman Aldiab, Jamaan M. Al-Zahrani, Khaled K. Aldossari, Mowafa Househ, Shanila Nooruddin, Hira Abdul Razzak, Ashraf El-Metwally

Department of Paediatrics and Child Health

Background: Obesity and overweight are accompanied with several different chronic diseases. Overweight and obesity can be measured by using body mass index (BMI) and is also used widely as an index of relative adiposity among any population. The aim of the study is to evaluate the prevalence of overweight and obesity among general population in Al-Kharj, Saudi Arabia.
Methods: Cross-sectional analysis was undertaken from a representative sample (N = 1019) of the Al Kharj population. Anthropometric measurements including the waist circumference (in centimeters), height (in meters), and weight (in kilograms) of the subjects were undertaken by means of standard apparatus. …


Household Chores As The Main Source Of Physical Activity: Perspectives Of Pregnant Pakistani Women, Zahra Hoodbhoy, Rahat Qureshi, Romaina Iqbal, Qamarunissa Muhabat Apr 2018

Household Chores As The Main Source Of Physical Activity: Perspectives Of Pregnant Pakistani Women, Zahra Hoodbhoy, Rahat Qureshi, Romaina Iqbal, Qamarunissa Muhabat

Department of Paediatrics and Child Health

Objective: To understand the level of physical activity in pregnant women and to identify perceived facilitators and barriers faced by them.
Methods: This cross-sectional study was conducted from January to June 2016 at Aga Khan Maternity and Child Care Centre, Hyderabad, Pakistan, and comprised pregnant women attending the antenatal clinics. They were administered the pregnancy physical activity questionnaire while additional questions were asked to assess perceived barriers and facilitators in pregnancy. SPSS 19 was used for data analysis.
Results: Of the 455 subjects, 179(36%) were physically active. Their median metabolic equivalent of task hours per week was 14.65 (interquartile …


Improved Accessibility Of Emergency Obstetrics And Newborn Care (Emonc) Services For Maternal And Newborn Health: A Community Based Project, Ali Turab, Shabina Ariff, Atif Habib, Imran Ahmed, Masawar Hussain, Akhtar Rashid, Zahid Memon, M. Imran Khan, Sajid Soofi, Zulfiqar A Bhutta Jan 2013

Improved Accessibility Of Emergency Obstetrics And Newborn Care (Emonc) Services For Maternal And Newborn Health: A Community Based Project, Ali Turab, Shabina Ariff, Atif Habib, Imran Ahmed, Masawar Hussain, Akhtar Rashid, Zahid Memon, M. Imran Khan, Sajid Soofi, Zulfiqar A Bhutta

Department of Paediatrics and Child Health

Background: Every year an estimated three million neonates die globally and two hundred thousand of these deaths occur in Pakistan. Majority of these neonates die in rural areas of underdeveloped countries from preventable causes (infections, complications related to low birth weight and prematurity). Similarly about three hundred thousand mother died in 2010 and Pakistan is among ten countries where sixty percent burden of these deaths is concentrated. Maternal and neonatal mortality remain to be unacceptably high in Pakistan especially in rural areas where more than half of births occur.
Method/Design: This community based cluster randomized controlled trial will …


Evaluation Of Health Workforce Competence In Maternal And Neonatal Issues In Public Health Sector Of Pakistan: An Assessment Of Their Training Needs, Shabina Ariff, Sajid B. Soofi, Kamran Sadiq, Asher B. Feroze, Shuaib Khan, Sadiqua N. Jafarey, Nabeela Ali, Zulfiqar A. Bhutta Nov 2010

Evaluation Of Health Workforce Competence In Maternal And Neonatal Issues In Public Health Sector Of Pakistan: An Assessment Of Their Training Needs, Shabina Ariff, Sajid B. Soofi, Kamran Sadiq, Asher B. Feroze, Shuaib Khan, Sadiqua N. Jafarey, Nabeela Ali, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

Background: More than 450 newborns die every hour worldwide, before they reach the age of four weeks (neonatal period) and over 500,000 women die from complications related to childbirth. The major direct causes of neonatal death are infections (36%), Prematurity (28%) and Asphyxia (23%). Pakistan has one of the highest perinatal and neonatal mortality rates in the region and contributes significantly to global neonatal mortality. The high mortality rates are partially attributable to scarcity of trained skilled birth attendants and paucity of resources. Empowerment of health care providers with adequate knowledge and skills can serve as instrument of change. Methods: …