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Full-Text Articles in Obstetrics and Gynecology

The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta Aug 2021

The Ability And Safety Of Community-Based Health Workers To Safely Initiate Lifesaving Therapies For Pre-Eclampsia In Ogun State, Nigeria: An Analysis Of 260 Community Treatments With Mgso4 And/Or Methyldopa, Akinmade A. Adepoju, Marianne Vidler, Adebayo A. Akadri, Ebun Jaiyesimi, Chimaobi C. Nwankpa, Oluwafayokemi O. Odubena, Sumedha Sharma, Larry Li, Domena Tu, Zulfiqar Ahmed Bhutta

Woman and Child Health

Objectives: To evaluate community-based health workers' ability to identify cases of hypertension in pregnancy, safely deliver methyldopa and magnesium sulphate and make referrals when appropriate.
Study design: This was part of Nigeria Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial (NCT01911494). Community-based Health Workers (CHW) recruited pregnant women from five Local Government Areas (clusters) and used mobile health aid for clinical assessment of pre-eclampsia.
Main outcome measures: The primary outcome was the number of adverse events that occurred after the administration of magnesium sulphate and/or methyldopa to pregnant women by CHWs.
Findings: Of 8790 women receiving mobile …


Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta May 2021

Economic And Cost-Effectiveness Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials In India, Pakistan And Mozambique, Jeffrey N. Bone, Asif R. Khowaja, Marianne Vidler, Beth A. Payne, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Ashalata A. Mallapur, Khatia Munguambe, Rahat Qureshi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: The Community-Level Interventions for Pre-eclampsia (CLIP) trials (NCT01911494) in India, Pakistan and Mozambique (February 2014-2017) involved community engagement and task sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the incremental costs and cost-effectiveness of the CLIP intervention overall in comparison to standard of care, and by PIERS (Pre-eclampsia Integrated Estimate of RiSk) On the Move (POM) mobile health application visit frequency.
Methods: Included were all women enrolled in the three …


Effect Of Consumption Of Animal Milk Compared To Infant Formula For Non-Breastfed/Mixed-Fed Infants 6-11 Months Of Age: A Systematic Review (Protocol), Aamer Imdad, Julie Melissa Ehrlich, Joseph Catania, Emily Tanner-Smith, Abigail Smith, Olivia Tsistinas, Zulfiqar Ahmed Bhutta Feb 2021

Effect Of Consumption Of Animal Milk Compared To Infant Formula For Non-Breastfed/Mixed-Fed Infants 6-11 Months Of Age: A Systematic Review (Protocol), Aamer Imdad, Julie Melissa Ehrlich, Joseph Catania, Emily Tanner-Smith, Abigail Smith, Olivia Tsistinas, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Prevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children's health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal's milk. The objective of this review is …


Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta Dec 2020

Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Kyrgyzstan has made considerable progress in reducing child mortality compared with other countries in the region, despite a comparatively low economic standing. However, maternal mortality is still high. Given the availability of an established birth registration system, we aimed to comprehensively assess the trends and determinants of reproductive, maternal, newborn, and child health in Kyrgyzstan.
Methods: For this Countdown to 2030 country case study, we used publicly available data repositories and the national birth registry of Kyrgyzstan to examine trends and inequalities of reproductive, maternal, and newborn health and mortality between 1990 and 2018, at a national and subnational …


Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon Dec 2020

Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon

Woman and Child Health

Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We …


The Community-Level Interventions For Pre-Eclampsia (Clip) Cluster Randomised Trials In Mozambique, Pakistan, And India: An Individual Participant-Level Meta-Analysis, Peter Von Dadelszen, Zulfiqar Ahmed Bhutta, Sumedha Sharma, Jeffrey Bone, Joel Singer, Hubert Wong, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Tang Lee, Rahat Qureshi, Clip Trials Working Group Aug 2020

The Community-Level Interventions For Pre-Eclampsia (Clip) Cluster Randomised Trials In Mozambique, Pakistan, And India: An Individual Participant-Level Meta-Analysis, Peter Von Dadelszen, Zulfiqar Ahmed Bhutta, Sumedha Sharma, Jeffrey Bone, Joel Singer, Hubert Wong, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Tang Lee, Rahat Qureshi, Clip Trials Working Group

Woman and Child Health

Background: To overcome the three delays in triage, transport and treatment that underlie adverse pregnancy outcomes, we aimed to reduce all-cause adverse outcomes with community-level interventions targeting women with pregnancy hypertension in three low-income countries.
Methods: In this individual participant-level meta-analysis, we de-identified and pooled data from the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised controlled trials in Mozambique, Pakistan, and India, which were run in 2014-17. Consenting pregnant women, aged 12-49 years, were recruited in their homes. Clusters, defined by local administrative units, were randomly assigned (1:1) to intervention or control groups. The control groups continued local standard of …


Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta Jul 2020

Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries …


Factors Associated With Low Birthweight In Term Pregnancies: A Matched Case-Control Study From Rural Pakistan, Atif Habib, Greenow Cr, S Ariff, Sajid Bashir Soofi, A Hussain, Q Junejo, A Hussain, F Shaheen, K Black Nov 2017

Factors Associated With Low Birthweight In Term Pregnancies: A Matched Case-Control Study From Rural Pakistan, Atif Habib, Greenow Cr, S Ariff, Sajid Bashir Soofi, A Hussain, Q Junejo, A Hussain, F Shaheen, K Black

Woman and Child Health

Low birthweight (LBW) remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy (AOR: 2.68; 95% CI: 1.59 - 4.38), nulliparity (AOR: 1.82; 95% CI: 1.26-2.44), having a previous miscarriage/abortion (AOR: 1.22; 95% CI: 1.06-2.35), having < 2 antenatal care (ANC) visits during last pregnancy (AOR: 2.43; 95% CI: 1.34-2.88), seeking ANC in third trimester (AOR: 3.62; 95% CI : 2.14-5.03), non-use of iron folic acid during last pregnancy (AOR: 2.72; 95% CI: 1.75-3.17), having hypertension during last pregnancy (AOR: 1.42; 95% CI: 1.13-2.20), being anemic (AOR: 2.67; 95% CI: 1.65-5.24) and having postpartum weight of