1.  Title: Time to deliver on maternal health and family planning best practices: White Ribbon Alliances in Asia and the Middle East make it happen. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 Jul. 12 p. Abstract: White Ribbon Alliances (WRAs) across Asia and the Middle East have become strong advocates for evidence-based strategies to reduce maternal mortality. The USAID | Health Policy Initiative, Task Order 1, has helped to form alliances and support their efforts to scale up family planning (FP) and maternal, neonatal, and child health (MNCH) best practices in the region. This brief highlights the achievements of alliances from Bangladesh, India (Orissa), Indonesia, Pakistan, and Yemen. Language: English Keywords: ASIA | MIDDLE EAST | SUMMARY REPORT | WOMEN | PREGNANCY | POSTPARTUM WOMEN | MOTHERS | ANTENATAL CARE | MATERNAL HEALTH | MATERNAL MORTALITY | AWARENESS | TRAINING ACTIVITIES | HEALTH POLICY | Developing Countries | Demographic Factors | Population | Reproduction | Puerperium | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Knowledge | Training Programs | Education | Policy | Political Factors Document Number: 331562 |
| 2. Title: Understanding the effects of personal and school religiosity on the decision to abort a premarital pregnancy. Author: Adamczyk A Source: Journal of Health and Social Behavior. 2009 Jun;50(2):180-95. Abstract: Although much research has examined the relationship between religion and abortion attitudes, few studies have examined whether religion influences abortion behavior. This study looks at whether individual and school religiosity influence reported abortion behavior among women who become pregnant while unmarried. Hierarchical Logistic Models are implemented to analyze two waves of data from the National Longitudinal Study of Adolescent Health. Findings show that personal religiosity is unrelated to reported abortion behavior. However, conservative Protestants appear less likely to obtain abortions than mainline Protestants, Catholics, and women of non-Christian faiths. Regardless of personal religious affiliation, having attended a school with a high proportion of conservative Protestants appears to discourage abortion as women enter their twenties. Conversely, women from private religious high schools appear more likely to report obtaining an abortion than women from public schools. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | YOUTH | STUDENTS | SECONDARY SCHOOLS | PREGNANCY | UNMARRIED | RELIGION | ABORTION | CATHOLICISM | CHRISTIANITY | DECISION MAKING | PREMARITAL PREGNANCY | Developed Countries | North America | Americas | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Reproduction | Marital Status | Nuptiality | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Behavior | Reproductive Behavior | Fertility | Population Dynamics Document Number: 342236 Notification |
3.  Title: Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda. Author: Atuyambe L; Mirembe F; Annika J; Kirumira EK; Faxelid E Source: Journal of Adolescence. 2009;32:781-796. Abstract: Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Results: Two main themes emerged; ?feeling exposed and powerless?, and ?seeking safety and empathy?. The categories identified in the first theme were ?the dilemma of becoming an adolescent mother? and ?lack of decision power?. In the second theme the following categories were identified: ?cultural practices and beliefs about birth?, ?expectations and experiences?, ?transport, a key determinant to health seeking?, and ?dealing with constraints?. Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health care services but their experiences of the services were rather negative. Transport was a key determinant for health seeking and adolescents to some extent had learnt how to cope with constraints they face. Conclusion and implications: Pregnant adolescents seek health care in both modern and traditional health sectors in order to get safety and empathy. However, our findings indicate that they mostly utilize the traditional sector because it is most accessible in terms of distance, cost and cultural context. Adolescent mothers are disempowered in decision making because of their pregnancy state which often puts them in dilemma. We therefore suggest that policy makers need to improve health systems (including the traditional sector) especially maternal health services for adolescent girls. Improved infrastructure and attitudes of health worker as well as training in delivery of adolescent health services is critical. Language: English Keywords: UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS | YOUTH | PREGNANCY | SAFETY | SAFE MOTHERHOOD | MATERNAL HEALTH | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Public Health | Health | Delivery of Health Care | Programs | Organization and Administration Document Number: 340225 |
| 4. Peer Reviewed Title: Neonatal near miss: a measure of the quality of obstetric care. Author: Avenant T Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Jun;23(3):369-374. Abstract: Thirty-seven percent of under-five deaths occur in the neonatal period. Identifying and correcting factors that contribute to neonatal and maternal care are of the utmost importance. Evaluation of severe acute maternal morbidity, also known as “near miss”, is used to improve obstetric practice. Neonatal near miss in conjunction with neonatal mortality can be used in a similar fashion to identify deficiencies in care. No accepted definition of neonatal near miss currently exists. None of the neonatal morbidity scoring systems is applicable or appropriate for this purpose. Organ system based criteria are objective and allow for identifying severe morbidities and identifying primary causes. This system can be of use in a variety of settings to identify health system problems and to institute remedial action where necessary. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | PREGNANCY | MATERNAL MORTALITY | PERINATAL MORTALITY | MORBIDITY | QUALITY OF HEALTH CARE | MATERNAL-CHILD HEALTH SERVICES | MEASUREMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Reproduction | Mortality | Population Dynamics | Demographic Factors | Population | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology Document Number: 341303 |
| 5. Peer Reviewed Title: Pill use in the month before conception linked to risk of low birth weight, preterm delivery Author: Ball H Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):128. Abstract: Women who use oral contraceptives just prior to conception may be more likely than nonusers to experience adverse birth outcomes, according to a study of health records from the Canadian province of Saskatchewan.1 Those who used the pill within 30 days of their last menstrual period had elevated odds of preterm birth and low birth weight, conditions that are associated with infant morbidity and mortality. The researchers examined records from Saskatchewan Health Databases, which contain information on 99% of the province's residents. They obtained data on physician services, hospital stays and prescription drug use in the year prior to giving birth for a random sample of 50% of women who had a pregnancy between 1997 and 2000. these outcomes. In an analysis that adjusted for women's socioeconomic and chronic disease status, pill use within 30 days of the last menstrual period was positively associated with the occurrence of very low and low birth weight (odds ratios, 3.2 and 1.9, respectively) and preterm delivery (1.6). Use 2-3 months prior to the last menstrual period was not associated with adverse birth outcomes. (excerpt) Language: English Keywords: CANADA | SUMMARY REPORT | WOMEN | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | PREGNANCY | LOW BIRTH WEIGHT | RISK FACTORS | Developed Countries | North America, Northern | Americas | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Methods | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Health Document Number: 341884 |
| 6. Title: Genetic counseling for teratogenic risk due to exposure to medications: 89 pregnancies conceived during oral contraceptive use. Author: Belli S; Mazzola S; Luongo R; Barcella L; Alushi B Source: American Journal of Medical Genetics. Part A. 2009 Jun 5; Abstract: Congenital malformations are relatively frequent (2% of the general population) but only a small proportion of them can be ascribed to medication exposure during pregnancy. Nevertheless, for the purposes of accurate prenatal diagnosis, monitoring and research, is it important to offer teratology counseling to patients exposed to drugs. There are approximately 20 medications currently on the market that have been universally acknowledged as teratogenic. At the current state of the art, exposure of early embryos to oral contraceptives is not considered teratogenic. Oral contraceptive use may be continuous (estrogen and progesterone or progesterone alone) or emergency (levonorgestrel is the only drug authorized in Italy). Like all drugs, oral contraceptives have a therapeutic failure rate, which means that a number of women on oral contraceptives conceive each year and request genetic counseling about teratogenic effects. During the period 1998-2006 at our genetics clinic we received 89 requests for counseling regarding teratogenic risk due to oral contraceptives. Our study of these patients confirms an absence of teratogenic risk for pregnancies occurring during oral contraceptive use. Teratology counseling was useful to reassure the mothers about the low risk (in the case of oral contraceptive use alone), since only 12 women chose to terminate pregnancy. Language: English Keywords: ITALY | RESEARCH REPORT | GENETICS | COUNSELING | EXPOSURE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | LEVONORGESTREL | CONGENITAL ABNORMALITIES | RISK FACTORS | PREGNANCY | Developed Countries | Europe, Southern | Europe | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Health | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Contraceptive Agents, Progestin | Neonatal Diseases and Abnormalities | Diseases | Reproduction Document Number: 341602 |
| 7. Peer Reviewed Title: Mother-to-child transmission of GB virus C in a cohort of women coinfected with GB virus C and HIV in Bangkok, Thailand. Author: Bhanich Supapol W; Remis RS; Raboud J; Millson M; Tappero J; Kaul R; Kulkarni P; McConnell MS; Mock PA; McNicholl JM; Vanprapar N; Asavapiriyanont S; Shaffer N; Butera S Source: Journal of Infectious Diseases. 2009 Jul 15;200(2):227-35. Abstract: BACKGROUND: GB virus C (GBV-C) is an apathogenic virus that inhibits human immunodeficiency virus (HIV) replication in vitro. Mother-to-child transmission (MTCT) of GBV-C has been observed in multiple small studies. Our study examined the rate and correlates of MTCT of GBV-C in a large cohort of GBV-C-HIV-coinfected pregnant women in Thailand. METHODS: Maternal delivery plasma specimens from 245 GBV-C-HIV-infected women and specimens from their infants at 4 or 6 months of age were tested for GBV-C RNA. Associations with MTCT of GBV-C were examined using logistic regression. RESULTS: One hundred one (41%) of 245 infants acquired GBV-C infection. MTCT of GBV-C was independently associated with maternal antiretroviral therapy (adjusted odds ratio [AOR], 5.21 [95% confidence interval {CI}, 2.12-12.81]), infant HIV infection (AOR, 0.05 [95% CI, 0.01-0.26]), maternal GBV-C load (8.0 log(10) copies/mL: AOR, 86.77 [95% CI, 15.27-481.70]; 7.0-7.9 log(10) copies/mL: AOR, 45.62 [95% CI, 8.41-247.51]; 5.0-6.9 log(10) copies/mL: AOR, 9.07 [95% CI, 1.85-44.33]: reference, <5 log(10) viral copies/mL), and caesarean delivery (AOR, 0.26 [95% CI, 0.12-0.59]). CONCLUSIONS: Associations with maternal GBV-C load and mode of delivery suggest transmission during pregnancy and delivery. Despite mode of delivery being a common risk factor for virus transmission, GBV-C and HIV were rarely cotransmitted. The mechanisms by which maternal receipt of antiretroviral therapy might increase MTCT of GBV-C are unknown. Language: English Keywords: THAILAND | RESEARCH REPORT | COHORT ANALYSIS | MOTHERS | INFANT | MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | HIV TESTING | PREGNANCY | RISK FACTORS | ANTIRETROVIRAL THERAPY | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Diseases | Viral Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | HIV Document Number: 342692 |
| 8. Peer Reviewed Title: Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Author: Bollini P; Pampallona S; Wanner P; Kupelnick B Source: Social Science and Medicine. 2009 Feb;68(3):452-61. Abstract: Immigrant mothers in developed countries often experience worse pregnancy outcomes than native women. Several epidemiological studies have described the pregnancy outcome of immigrant women in European receiving countries, with conflicting results. The present systematic review makes a quantitative synthesis of available evidence on the association between pregnancy outcomes and integration policies. We reviewed all epidemiological studies comparing the pregnancy outcome of native versus immigrant women in European countries from 1966 to 2004 and retained 65 for analysis, from 12 host countries. Overall, as compared to native women, immigrant women showed a clear disadvantage for all the outcomes considered: 43% higher risk of low birth weight, 24% of pre-term delivery, 50% of perinatal mortality, and 61% of congenital malformations. The risks were clearly and significantly reduced in countries with a strong integration policy. This trend was maintained even after adjustment for age at delivery and parity. On the basis of an analysis of naturalisation rates, five countries in our sample could be categorised as having a strong policies promoting the integration of immigrant communities. The mechanisms through which integration policies may be protective include the increased participation of immigrant communities in the life of the receiving society, and the decreased stress and discrimination they may face. The results of this study highlight a serious problem of equity in perinatal health across European countries. Immigrant women clearly need targeted attention to improve the health of their newborn, but a deep societal change is also necessary to integrate and respect immigrant communities in receiving societies. Language: English Keywords: EUROPE | RESEARCH REPORT | LITERATURE REVIEW | PREGNANT WOMEN | FETUS | PREGNANCY | MIGRATION | ANTENATAL CARE | HEALTH POLICY | PREGNANCY OUTCOMES | Developed Countries | Population Characteristics | Demographic Factors | Population | Reproduction | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors Document Number: 331051 |
| 9. Title: [Contraceptive use and incidence of pregnancy among women after HIV testing in Abidjan, Ivory Coast] Pratiques contraceptives et incidence des grossesses chez des femmes apres un Author: Brou H; Viho I; Djohan G; Ekouevi DK; Zanou B; Leroy V; Desgrees-du-Lou A Source: Revue d'Epidemiologie et de Sante Publique. 2009 Mar 20; Abstract: BACKGROUND: Within the framework of programs for the prevention of mother-to-child HIV transmission, women who discover their HIV-infection during their pregnancy receive perinatal interventions in order to reduce the risk of HIV transmission to the child. They also receive family planning counselling and free contraceptives in order to avoid a new pregnancy. In this study, we compared contraceptive use and pregnancy incidence between HIV-positive and HIV-negative women who were offered HIV counselling and testing during a program of prevention of mother-to-child HIV transmission. METHODS: In the Ditrame Plus program in Abidjan, 546 HIV-positive and 393 HIV-negative women were HIV-tested prenatally and followed up 2years after delivery. At each post-partum visit, proportions of contraceptive use were noted, by method. The pregnancy incidence was calculated as the number of pregnancies for 100 women-years at risk. Factors related to the arrival of a new pregnancy were analyzed by Cox model. RESULTS: Between 6 and 24 months post-partum, proportions of women using modern contraception varied from 52 to 65% among HIV-positive women, and from 65 to 75% among HIV-negative women. Pregnancy incidence for 100 women-years at risk was 5.70 (95%CI: 4.17-7.23) and 4.37 (95%CI : 2.83-5.91) (p=0.237) and unwanted pregnancy incidence was 1.07 (95%CI: 0.41-1.73) and 2.39 (95%CI: 1.25-3.53) (p=0.023), respectively among HIV-positive and HIV-negative women. The end of post-partum abstinence, the death of the index child and the end of breastfeeding were positively linked to the arrival of a new pregnancy in the post-partum period. CONCLUSION: Among these women prenatally HIV-tested, family planning counselling and regular follow-up was accompanied by a high rate of contraceptive use after delivery, and consecutively to a low pregnancy incidence irrespective of serostatus. In particular, HIV-positive women had fewer unwanted pregnancies than HIV-negative women. Integration of adequate family planning services in the post-partum follow-up in prevention programs plays an important role in reducing the risk of mother-to-child transmission, by reducing pregnancies among HIV-positive women. Language: French Keywords: COTE D'IVOIRE | RESEARCH REPORT | INCIDENCE | PREGNANCY | WOMEN | HIV TESTING | CONTRACEPTIVE USAGE | CLINIC VISITS | VOLUNTARY COUNSELING AND TESTING | POSTPARTUM | FAMILY PLANNING | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Reproduction | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Service Statistics | Program Activities | Programs | Organization and Administration | Puerperium | Program Evaluation Document Number: 330856 |
| 10. Title: Women's health and gender-based clinical trials on etoricoxib: methodological gender bias. Author: Chilet-Rosell E; Ruiz-Cantero MT; Horga JF Source: Journal of Public Health. 2009 Sep;31(3):434-45. Abstract: BACKGROUND: The aim of this study was to determine compliance with published good practice guidelines for gender and clinical trials using etoricoxib. The rationale for choosing etoricoxib was that it is widely used by women and there is evidence of potential interaction with contraceptives and hormone replacement therapy as highlighted in the product characteristics. METHODS: The study reviewed 58 etoricoxib published trials (54 papers) to determine if they met the gender recommendations of the Guidelines of Food and Drug Administration (1993) and the Sex, Gender and Pain Special Interest Group Consensus Working Group Report (2007). RESULTS: Women formed 70% of a total of 49 835 subjects included in the etoricoxib trials, but only 31% of the subjects were in Phase I. About 85.7% of trials did not show sex-stratified data. About 90.6 and 93.3% did not provide efficacy and adverse effects data by sex, respectively. There is scarce information about the influence of issues that specifically affect women. Discussion Women are under-represented in the published etoricoxib trials, specifically, in Phase I. Sex-stratified data on efficacy and adverse effects are scarce in etoricoxib trials. Together with the lack of data on women-specific issues, this suggests that etoricoxib may pose the same potential problems for women as other cyclooxygenase-2 inhibitors. Language: English Keywords: GLOBAL | LITERATURE REVIEW | CLINICAL TRIALS | DRUGS | ADMINISTRATION AND DOSAGE | DRUG INTERACTIONS | CONTRACEPTIVE AGENTS, FEMALE | HORMONE REPLACEMENT THERAPY | SIDE EFFECTS | THROMBOSIS | SEX FACTORS | PREGNANCY | VALIDITY | Clinical Research | Research Methodology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Thromboembolism | Embolism | Vascular Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Reproduction | Measurement Document Number: 342950 |
| 11. Peer Reviewed Title: Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Author: Cronin M; Schellschmidt I; Dinger J Source: Obstetrics and Gynecology. 2009 Sep;114(3):616-22. Abstract: OBJECTIVES:: To determine whether prior oral-contraceptive use has a negative effect on the ability of women to conceive in both the short-term and long-term. METHODS:: The European Active Surveillance Study on Oral Contraceptives (EURAS-OC) was a controlled, prospective, noninterventional cohort study of 59,510 users of oral contraceptives containing drospirenone or other progestins in clinical practice in seven European countries. In a planned secondary analysis, pregnancy outcomes were investigated in 2,064 participants in EURAS-OC who stopped oral-contraceptive use after study entry because of planned pregnancy. The influence of age, parity, progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and smoking status on the rate of pregnancy was assessed. RESULTS:: Overall, 21.1% (95% confidence interval [CI] 19.4-23.0%) of the past oral-contraceptive users were pregnant one cycle after oral-contraceptive cessation. This rate increased to 79.4% (95% CI 77.6-81.1%) at 1 year (13 cycles). Progestin type, ethinylestradiol dose, duration of oral-contraceptive use, and parity had no major influence on the rate of pregnancy after oral-contraceptive cessation. Up to age 35 years, age had only a minor influence on the rate of pregnancy. Rates of pregnancy were reduced in women older than 35 years and in current smokers. CONCLUSION:: Previous oral-contraceptive use does not negatively affect initial and 1-year rates of pregnancy after oral-contraceptive cessation. A comparison of these data with data external to this study indicates that the negative effect of aging on fecundity is not amplified by oral-contraceptive use. LEVEL OF EVIDENCE:: II. Language: English Keywords: EUROPE | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANCY | PREGNANCY OUTCOMES | ORAL CONTRACEPTIVES | LOW-DOSE PROGESTINS | CONTRACEPTION TERMINATION | PREGNANCY RATE | Developed Countries | Studies | Research Methodology | Reproduction | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 342570 |
| 12. Peer Reviewed Title: [Association between iron supplementation during pregnancy and prematurity, low birth weight, and very low birth weight] Associaçăo entre o uso de sais de ferro durante a gestaçăo e nascimento pré-termo, baixo peso ao nascer e muito baixo peso ao nascer. Author: Dal Pizzol TD; Giugliani ER; Mengue SS Source: Cadernos de Saude Publica. 2009 Jan;25(1):160-168. Abstract: The objective was to evaluate the association between prophylactic iron supplementation and prematurity and low birth weight. Pregnant women 20 years and older with 21 to 28 weeks of gestational age were enrolled consecutively in prenatal services in the Unified National Health System in six Brazilian State capitals between 1991 and 1995. Socio-demographic data and information on iron supplementation up until the 28th gestational week were obtained by means of an interview. Outcomes and other variables were collected from medical records. Anemia was present in 31.3% of the 3,865 women. Among anemic women (hemoglobin < 11.0g/dL), 29.8% were taking iron supplements, as compared to 16.7% among non-anemic women (hemoglobin > 11.0g/dL). After adjusting for potential confounders, iron was not associated with prematurity (OR = 0.88; 95%CI: 0.73-1.07), low birth weight (OR = 0.99; 95%CI: 0.75-1.31), or very low birth weight (OR = 0.58; 95%CI: 0.29-1.13). The results suggest that iron supplementation up to the 28th gestational week does not reduce the risk of prematurity, low birth weight, or very low birth weight. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | PREGNANCY | IRON | SERUM IRON LEVEL | VITAMINS AND MINERALS | LOW BIRTH WEIGHT | ANEMIA | TREATMENT | PREVENTION AND CONTROL | South America, Eastern | South America | Latin America | Americas | Developing Countries | Reproduction | Metals | Physiology | Biology | Hemic System | Birth Weight | Body Weight | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341872 |
| 13. Title: Evaluation of the birthweight values of newborns presenting at the Mother-Child Health and Family Planning Center in Yenibosna, Istanbul, Turkey. Author: Dolgun G; Cimen S; Yazici S; Savaser S Source: Nursing and Health Sciences. 2009 Jun;11(2):174-9. Abstract: This study was conducted to examine the effect of a number of variables related to the mother (age, educational level, employment status, cigarette smoking during pregnancy) and to the baby (sex and birth order) on newborns' birthweight. The research was carried out in the province of Istanbul, one of Turkey's large metropolises, at the Mother-Child Health and Family Planning Center in the district of Yenibosna, where 0-1 month old infants had been brought in for phenylketonuria screening and vaccinations. The mean age of the mothers was 26.1 +/- 4.8 years and the mean birthweight of the newborns was 3236.7 +/- 542.2 g. Of the infants, 6.3% were classified as having a low birthweight and 8.3% were large infants. The mean birthweight showed a statistical significance depending upon the infants' sex and birth order. The mean birthweight of the infants of the working mothers, as opposed to the unemployed mothers and the mothers in nuclear families, as opposed to the mothers in extended families, was higher. Language: English Keywords: TURKEY | RESEARCH REPORT | EVALUATION | INFANT | EDUCATION | PREGNANCY | BIRTH WEIGHT | MATERNAL-CHILD HEALTH SERVICES | REPRODUCTIVE AGE | Europe, Southeastern | Europe | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Body Weight | Physiology | Biology | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 341575 |
| 14. Peer Reviewed Title: Contraceptive failure of Depo-Provera®: long-acting reversible contraceptive (LARC) methods do fail too. Author: Farmer L; Patel E Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):59-60. Abstract: This article reports on a case report of a 28-year-old woman, gravida 4 para 1, presenting to primary care for contraception. She opted for Depo-Provera. The patient re-presented with symptoms of nausea 6 weeks following her second Depo-Provera injection. A pregnancy test was positive. A dating ultrasound scan was arranged. This took place 7 weeks after her second Depo-Provera injection and showed a viable pregnancy at 9 weeks 2 days estimated gestation, indicating that conception would have occurred around the time of the second injection. The patient opted for a termination of pregnancy and had a copper-bearing intrauterine device fitted at the time of abortion. Language: English Keywords: UNITED KINGDOM | SUMMARY REPORT | CASE STUDIES | CONTRACEPTION FAILURE | DEPO-PROVERA | PREGNANCY | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Contraceptive Usage | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Reproduction | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329635 |
| 15. Title: Systematic analysis of research underfunding in maternal and perinatal health. Author: Fisk NM; Atun R Source: BJOG. 2009 Feb;116(3):347-56. Abstract: BACKGROUND: Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas. OBJECTIVES: To assess absolute and relative government and charitable funding for maternal and perinatal research in the UK and internationally. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Major research funding bodies and alliances were identified from an Internet search and discussions with opinion leaders/senior investigators. Websites and annual reports were reviewed for details of strategy, research spend, grants awarded, and allocation to maternal and/or perinatal disease using generic and disease-specific search terms. MAIN RESULTS: Within the imprecision in the data sets, < or =1% of health research spend in the UK was on maternal/perinatal health. Other countries fared better with 1-4% investment, although nonexclusive categorisation may render this an overestimate. In low-resource settings, government funders focused on infectious disease but not maternal and perinatal health despite high relative disease burden, while global philanthropy concentrated on service provision rather than research. Although research expenditure has been deemed as appropriate for 'reproductive health' disease burden in the UK, there are no data on the equity of maternal/perinatal research spend against disease burden, which globally may justify a manyfold increase. AUTHOR'S CONCLUSIONS: This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment. Language: English Keywords: UNITED KINGDOM | LITERATURE REVIEW | EVALUATION | POLICYMAKERS | GOVERNMENT | NONGOVERNMENTAL ORGANIZATIONS | CHILDBIRTH | MATERNAL-CHILD HEALTH SERVICES | FINANCIAL ACTIVITIES | ECONOMIC FACTORS | PREGNANCY | GRANTS | RESEARCH ACTIVITIES | EXPENDITURES | Developed Countries | Europe, Western | Europe | Administrative Personnel | Organization and Administration | Political Factors | Sociocultural Factors | Organizations | Pregnancy Outcomes | Reproduction | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology Document Number: 331089 |
| 16. Peer Reviewed Title: Pregnancy outcome in women with an intrauterine contraceptive device. Author: Ganer H; Levy A; Ohel I; Sheiner E Source: American Journal of Obstetrics and Gynecology. 2009 Aug 27; Abstract: OBJECTIVE: To investigate pregnancy outcome in patients who conceived with an intrauterine contraceptive device. STUDY DESIGN: A retrospective study comparing the pregnancy outcome of women with retained intrauterine device (n = 98), patients after intrauterine device removal in early pregnancy (n = 194), and pregnancies without an intrauterine device (n = 141,191) was performed. RESULTS: A significant linear association was documented among the 3 groups and adverse outcomes such as preterm delivery (18.4% in the retained intrauterine device, 14.4 % in removed intrauterine device, and 7.3% in the no-intrauterine device group; P < .001) and chorioamnionitis (7.1% in the retained intrauterine device, 4.1% in removed intrauterine device and 0.7% in the no-intrauterine device group; P < .001). The presence of retained or removed intrauterine device was found as an independent risk factor for both preterm delivery and chorioamnionitis in multivariable models. CONCLUSION: Women conceiving with an intrauterine device are at increased risk for adverse obstetric outcomes, whereas the risk is higher for pregnancies with retained intrauterine device compared with early intrauterine device removal. Language: English Keywords: GLOBAL | ISRAEL | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | PREGNANT WOMEN | PREGNANCY OUTCOMES | IUD | PREGNANCY | LOW BIRTH WEIGHT | PREMATURE BIRTH | Developed Countries | Middle East | Studies | Research Methodology | Demographic Factors | Population | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Birth Weight | Body Weight | Physiology | Biology Document Number: 342708 |
| 17. Peer Reviewed Title: Provision of contraception services and advice for women with cystic fibrosis. Author: Gatiss S; Mansour D; Doe S; Bourke S Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):157-60. Abstract: BACKGROUND AND METHODOLOGY: As the prognosis of patients with cystic fibrosis (CF) improves, issues of sexual health, fertility, pregnancy and contraception are increasingly important. In order to plan the provision of a contraception and sexual health service for women with CF we studied their sexual and reproductive history, their current usage of contraception, the sources and quality of advice they had received, and their particular needs using a confidential questionnaire sent to all women over 16 years of age attending a regional CF centre. RESULTS: Of 55 women (mean age 29.7 years) surveyed, 42 (76%) responded. Thirty-three women (79%) were sexually active and 13 (31%) had experienced 19 pregnancies, five (26%) of which were unplanned. Only half of the women who responded were using contraception. No woman used female sterilisation, the progestogen implant, intrauterine system (IUS) or copper-bearing intrauterine device (IUD) for contraception. Twenty-six (62%) women reported not having received contraceptive advice specific to CF and 24 (57%) said that they had not been warned about the potential interaction between broad-spectrum antibiotics and the combined pill. DISCUSSION: Women with CF have a relatively high rate of unplanned pregnancy and do not receive optimal advice or use the full range of contraceptive methods. CF teams lack training in contraception and contraceptive services may not have a detailed knowledge of CF and its complications. New strategies are needed to focus the knowledge and skills of both teams in providing better services for women with CF. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | CLIENTS | HEREDITARY DISEASES | COMPLICATIONS | CONTRACEPTIVE USAGE | FERTILITY | PREGNANCY | QUESTIONNAIRES | ANTIBIOTICS | GENETIC COUNSELING | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Diseases | Contraception | Family Planning | Population Dynamics | Reproduction | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Counseling | Clinic Activities Document Number: 342139 |
| 18. Title: Migration of an intrauterine contraceptive device during the course of pregnancy: a case report. Author: Glass T; Baker T; Kauffman RP Source: Journal of Minimally Invasive Gynecology. 2009 Jan-Feb;16(1):81-3. Abstract: Uterine perforation by a contraceptive intrauterine device (IUD) is a relatively rare event. These events may result secondary to mechanical force applied during placement (primary perforation) or migration by uterine contractions or surgical manipulation after placement (secondary perforation). A 33-year-old woman with an IUD placed 9 years before admission visited the emergency department with an early pregnancy and a 3-day history of vaginal bleeding. Vaginal examination revealed IUD strings visible at the cervical os, and transvaginal ultrasound confirmed the presence of an IUD in the lower uterine segment and upper cervix. The IUD migrated spontaneously to the fundal myometrium at 15 weeks' gestation. Premature rupture of membranes ensued at 20 weeks' gestation, and, at delivery, the IUD could not be retrieved. Subsequent computed tomography confirmed that the IUD was incompletely embedded in the fundal myometrium and partially extending into the peritoneal cavity. At laparoscopic sterilization 6 weeks later, the IUD had perforated the small bowel, and the device was removed with concomitant bowel repair. This case documents spontaneous migration of a copper IUD from the lower uterine segment through the fundus during early pregnancy and supports removal of asymptomatic ectopic IUDs whenever possible. Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | CASE STUDIES | WOMEN | PREGNANCY | IUD | CONTRACEPTION FAILURE | UTERINE PERFORATION | LAPAROSCOPY | IUD MIGRATION | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Contraceptive Usage | Perforations | Diseases | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 330821 |
| 19. Peer Reviewed Title: Sexual violence and reproductive health among youth in Port-au-Prince, Haiti. Author: Gomez AM; Speizer IS; Beauvais H Source: Journal of Adolescent Health. 2009 May;44(5):508-10. Abstract: The authors examined sexual violence and reproductive health outcomes among sexually experienced youth in Port-au-Prince, Haiti, using the Priorities for Local AIDS Control methodology to identify participants in locations where sexual partnerships are formed. Their findings indicated that sexual violence is common and is significantly associated with condom use, pregnancy experience, and recent STI symptoms. Language: English Keywords: HAITI | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | YOUTH | RAPE | VIOLENCE AGAINST WOMEN | REPRODUCTIVE HEALTH | CONDOM USE | PREGNANCY | SIGNS AND SYMPTOMS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Caribbean | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Domestic Violence | Health | Risk Reduction Behavior | Behavior | Reproduction | Diseases | Reproductive Tract Infections | Infections Document Number: 331242 |
| 20. Title: [Providing emergency contraceptive pills in pharmacies] Author: Heidarsdottir ML; Almarsdottir AB; Geirsson RT Source: Laeknabladid. 2009 May;95(5):343-347. Abstract: Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is. Language: Icelandic Keywords: RUSSIA | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | SEXUAL PARTNERS | EMERGENCY CONTRACEPTION | PREGNANCY | PHARMACY DISTRIBUTION | Developing Countries | Asia, Northern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Contraception | Family Planning | Reproduction | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 341070 |
| 21. Title: Breast cancer in young women and its impact on reproductive function. Author: Hickey M; Peate M; Saunders CM; Friedlander M Source: Human Reproduction Update. 2009 May-Jun;15(3):323-39. Abstract: BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | BREAST CANCER | SURGERY | DRUGS | GENETICS | FERTILITY | CONTRACEPTION | PREGNANCY | BREASTFEEDING | MENOPAUSE | AGE FACTORS | TAMOXIFEN | Oceania | Developed Countries | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Dynamics | Demographic Factors | Population | Family Planning | Reproduction | Infant Nutrition | Nutrition | Population Characteristics | Fertility Agents | Reproductive Control Agents Document Number: 341960 |
| 22. Peer Reviewed Title: Reproductive intentions and outcomes among women on antiretroviral therapy in rural Uganda: a prospective cohort study. Author: Homsy J; Bunnell R; Moore D; King R; Malamba S; Nakityo R; Glidden D; Tappero J; Mermin J Source: PLoS One. 2009;4(1):e4149. Abstract: BACKGROUND: Antiretroviral therapy (ART) may influence the biological, social and behavioral determinants of pregnancy in HIV-infected women. However, there are limited longitudinal data on the reproductive intentions and outcomes among women on ART in Africa. METHODOLOGY /PRINCIPAL FINDINGS: Using a prospective cohort design, we analyzed trends in desire for children and predictors of pregnancy among a cohort of 733 HIV-infected women in rural Uganda who initiated ART between May 2003 and May 2004 and were followed up in their homes until June 2006. Women answered in-depth social and behavioral questionnaires administered every quarter in year 1 after initiating ART, and every 6 to 12 months thereafter. Use of family planning methods was assessed at 18 and 24 months after starting ART. We tested for non-constant pregnancy incidence by using a shape parameter test from the Weibull distribution. We modeled repeated measurements of all variables related to the women's desire for children over time using a generalized estimating equation (GEE) extension to the logistic regression model. Risk factors for pregnancy were examined using Cox proportional hazards model. 711 women eligible for the study were followed-up for a median time of 2.4 years after starting ART. During this time, less than 7% of women reported wanting more children at any time point yet 120 (16.9%) women experienced 140 pregnancies and pregnancy incidence increased from 3.46 per 100 women-years (WY) in the first quarter to 9.5 per 100 WY at 24 months (p<0.0001). This was paralleled by an increase in the proportion of women reporting sexual activity in the past 3 months, from 24.4% at baseline to 32.5% over 24 months of follow-up (p = 0.001). Only 14% of women used permanent or semi-permanent family planning methods by their second year on ART. In the multivariate model, younger age (HR = 2.71 per 10-year decrease, 95% CI: 2.95-3.78), having a BMI>18.5 (HR = 1.09, CI: 1.01-1.18) and not having used condoms consistently in the last 3 months (HR = 1.79, CI: 1.02-3.13) were independently associated with pregnancy. CONCLUSION/SIGNIFICANCE: Women on ART and their partners should be consistently counseled on the effects of ART in restoring fertility, and offered regularly free and comprehensive family planning services as part of their standard package of care. Language: English Keywords: UGANDA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | PERSONS LIVING WITH HIV/AIDS | PREGNANCY | REPRODUCTIVE BEHAVIOR | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | FERTILITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Reproduction | Population Dynamics | HIV Document Number: 330195 |
| 23. Peer Reviewed Title: Term pregnancy with intraperitoneal levonorgestrel intrauterine system: a case report and review of the literature. Author: Hopkins MR; Agudelo-Suarez P; El-Nashar SA; Creedon DJ; Rose CH; Famuyide AO Source: Contraception. 2009 Apr;79(4):323-7. Abstract: BACKGROUND: The risk of adverse effects of fetal exposure to the levonorgestrel intrauterine system (LNG-IUS) has not been established. STUDY DESIGN: In this case report and literature review, we describe a pregnant patient with an intraperitoneal LNG-IUS and the subsequent maternal and neonatal outcomes. A systematic literature search was performed to identify similar clinical reports. The MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, Web of Science and Scopus databases were searched from inception through March 2007. RESULTS: The pregnancy progressed uneventfully and culminated in the elective cesarean delivery of a full-term healthy boy. Of the 35 pregnancies identified in the literature review (34 pregnancies with intrauterine LNG-IUS and 1 term delivery with intraperitoneal LNG-IUS), congenital anomalies were reported in 2 infants (6%). CONCLUSIONS: Fetal exposure to LNG-IUS is associated with a low frequency of congenital anomalies. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | ADOLESCENTS | ADOLESCENT PREGNANCY | LEVONORGESTREL | IUD, HORMONE RELEASING | PREGNANCY | CONTRACEPTION | PREGNANCY OUTCOMES | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | IUD | Contraceptive Methods | Reproduction Document Number: 341632 |
| 24. Title: Andean traditional midwifery in Peru. Author: Ingar C Source: Midwifery today With International Midwife. 2009 Spring;(89):57-9. Abstract: This article provides an overview of common characteristics of the "Andean tradition" regarding conception of the body, pregnancy, and birth. It discusses the birth as ritual and the importance of the figure of the Andean midwife in that ritual. The masculine role in childbirth is also explored, as is maternal care during pregnancy, birth, and after birth. Language: English Keywords: PERU | CRITIQUE | MIDWIVES AND MIDWIFERY | TRADITIONAL BIRTH ATTENDANTS | CHILDBIRTH | TRADITIONAL HEALTH PRACTICES | PREGNANCY | MATERNAL PHYSIOLOGY | KNOWLEDGE | Developing Countries | South America, Western | South America | Latin America | Americas | Health Personnel | Delivery of Health Care | Health | Pregnancy Outcomes | Reproduction | Culture | Sociocultural Factors | Physiology | Biology Document Number: 341185 |
| 25. Title: Menstrual cycle characteristics and offspring sex ratio [letter] Author: James WH Source: Epidemiology. 2009 Sep;20(5):782. Abstract: This letter to the editor argues with the suggestion that the length of women's menstrual cycle relates to the sex of their offspring. It suggests rather that menstrual regularity may be a better variable regarding offspring sex ratio. Language: English Keywords: UNITED KINGDOM | CRITIQUE | WOMEN | SEX RATIO | MENSTRUATION | TIME FACTORS | TESTOSTERONE | PREGNANCY | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Sex Distribution | Sex Factors | Population Characteristics | Reproduction | Population Dynamics | Androgens | Hormones | Endocrine System | Physiology | Biology Document Number: 342518 |
| 26. Title: Seropositivity for Listeria monocytogenes in women with spontaneous abortion: a case-control study in Iran. Author: Jamshidi M; Jahromi AS; Davoodian P; Amirian M; Zangeneh M; Jadcareh F Source: Taiwanese Journal of Obstetrics and Gynecology. 2009 Mar;48(1):46-8. Abstract: OBJECTIVE: There are many studies supporting the role of certain asymptomatic infections such as Listeria monocytogenes (L. monocytogenes) in spontaneous abortion. In some cases, latent listeriosis may complicate the pregnancy, and serologic tests can, therefore, be used to detect the disease. This study was designed to assess the relationship between seropositivity for L. monocytogenes and spontaneous abortion. MATERIALS AND METHODS: A total of 250 women with previous spontaneous abortion and a control group of 200 women with normal full-term deliveries entered the study as case and control groups, respectively. Demographic characteristics were recorded for each subject, and serum samples were obtained from all participants. All serum samples were examined using the indirect immunofluorescence antibody test for L. monocytogenes antibody. Data was analyzed using Chi-squared and t tests. RESULTS: The average age of participants was 25.6 +/- 7.6 years in cases and 25.3 +/- 6.5 years in controls. Eighty-nine (35.6%) of the cases with abortion and 35 (17.5%) of the control group were positive for L. monocytogenes antibody (p = 0.001). No relationship was observed between the number of pregnancies and infection with L. monocytogenes (p = 0.4), or between the number of previous abortions and L. monocytogenes seropositivity (p = 0.2). CONCLUSION: We suggest monitoring L. monocytogenes seroprevalence in pregnant women at high risk of threatened abortion, and further microbiological assessment of symptomatic women for detection of L. monocytogenes and insidious infection. Language: English Keywords: IRAN | RESEARCH REPORT | CASE STUDIES | WOMEN | ABORTION, SPONTANEOUS | PREGNANCY | MONITORING | INFECTIONS | TESTING | Middle East | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy Complications | Diseases | Reproduction | Evaluation | Measurement Document Number: 342081 |
| 27. Title: Determinants of low birth weight in urban Pakistan. Author: Janjua NZ; Delzell E; Larson RR; Meleth S; Kristensen S; Kabagambe E; Sathiakumar N Source: Public Health Nutrition. 2009 Jun;12(6):789-98. Abstract: OBJECTIVE: To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy. DESIGN: Cross-sectional study.ParticipantsFive hundred and forty mother-infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW. RESULTS: Of 540 infants, 100 (18.5 %) weighed Keywords: PAKISTAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | URBAN POPULATION | PREGNANCY | LOW BIRTH WEIGHT | ASCORBIC ACID | NUTRITION INDEXES | Developing Countries | Asia, Southern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Vitamins and Minerals | Nutrition | Health Document Number: 342264 |
| 28. Title: Predictors of stillbirth among HIV-infected Tanzanian women. Author: Kupka R; Kassaye T; Saathoff E; Hertzmark E; Msamanga GI; Fawzi WW Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(5):584-92. Abstract: OBJECTIVE: To determine maternal risk factors for stillbirth among pregnant HIV-infected women in sub-Saharan Africa. DESIGN: Prospective cohort study nested within a micronutrient trial. At enrollment, maternal sociodemographic, obstetric, immunologic, clinical, and nutritional variables were measured. Women were followed through monthly clinic visits until delivery. Multivariate predictors of stillbirth were identified in Poisson regression models. SETTING: Antenatal clinic in a tertiary care hospital in urban Dar es Salaam, Tanzania. POPULATION: N=1,078 women enrolled between 12 and 27 weeks of gestation. MAIN OUTCOME MEASURES: Stillbirth (delivery of dead baby > or = 28 weeks' gestation), fresh stillbirth, and macerated stillbirth. RESULTS: Among 1,017 singleton pregnancies, there were 49 stillbirths, yielding a stillbirth risk of 50.0 per 1,000 deliveries (95% Confidence Interval(CI) = 37.2, 65.6). Of stillbirths with known type, 53.7% were fresh and 46.3% macerated. In multivariate analyses, baseline measures of late (> or = 21 weeks' gestation) study entry (Relative Risk (RR) = 2.13, 95% CI = 1.17, 3.87), CD3 count > or = 1,179 cells/ml (RR = 2.15, 95% CI = 1.16, 4.01), stillbirth history (RR = 3.53, 95% CI = 1.30, 9.59), primiparity (RR = 3.65, 95% CI = 1.83, 7.29), and syphilis infection (RR = 2.06, 95% CI = 1.09, 3.88) predicted increased stillbirth risk. Late study entry, illiteracy, stillbirth history, primiparity, CD3 count > or = 1,179 cells/ml, gonorrhea infection, and previous hospitalization predicted increased risk of fresh stillbirth, while living alone and syphilis infection predicted increased risk of macerated stillbirth. CONCLUSIONS: Applying antenatal screening and preventive tools for the socioeconomic, obstetric, immunologic, and clinical risk factors identified may assist in reducing the high incidence of stillbirth among HIV-infected women in urban sub-Saharan Africa. Language: English Keywords: TANZANIA | RESEARCH REPORT | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | PREGNANCY | HIV INFECTIONS | FETAL DEATH | ANTENATAL CARE | SCREENING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Reproduction | Mortality | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 341226 |
| 29. Peer Reviewed Title: Lack of knowledge about sexually transmitted infections among women in North rural Vietnam. Author: Lan PT; Lundborg CS; Mogren I; Phuc HD; Chuc NT Source: BMC Infectious Diseases. 2009;9:85. Abstract: BACKGROUND: The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. METHODS: A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. RESULTS: Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p < 0.001) did not know any symptoms of STI, 50% could not identify any cause of STI, 59% (54% married vs. 76% unmarried, p < 0.001) did not know that STI can be prevented. Only 31% of the respondents (36% married vs. 14% unmarried, p < 0.001) answered that condom use could protect against STI, and 56% considered partner treatment necessary. Of 40 possible correct answers, the mean knowledge score was 6.5 (range 0-26, median 6). Young, unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p < 0.001). Experience of an induced abortion was significantly associated with a higher level of knowledge. CONCLUSION: The low levels of STI knowledge found among women of reproductive age in a rural district of Vietnam indicate an urgent need of health education interventions, of which, young and unmarried women should be specifically targeted. Language: English Keywords: VIETNAM | RESEARCH REPORT | INTERVIEWS | RURAL POPULATION | WOMEN | UNMARRIED | TARGET POPULATION | KNOWLEDGE | SEXUALLY TRANSMITTED DISEASES | PREGNANCY | TREATMENT | SEXUALLY TRANSMITTED DISEASE PREVENTION | NEEDS | Asia, Southeastern | Asia | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Program Design | Programs | Organization and Administration | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Factors Document Number: 342063 |
| 30. Title: Similarities more striking than differences [letter] Author: Lessa H Source: Midwifery today With International Midwife. 2009 Spring;(89):50. Abstract: A Brazilian midwife comments on birthing options and preferences of Amazonian women. Language: English Keywords: BRAZIL | SUMMARY REPORT | ETHNIC GROUPS | NURSE-MIDWIVES | WOMEN | CULTURE | DELIVERY OF HEALTH CARE | CHILDBIRTH | PREGNANCY | BREASTFEEDING | PROMOTION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Cultural Background | Population Characteristics | Demographic Factors | Population | Health Personnel | Health | Sociocultural Factors | Pregnancy Outcomes | Reproduction | Infant Nutrition | Nutrition | Marketing | Economic Factors Document Number: 341186 |
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