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INTRODUCTION: Iraqi pregnant women have a higher prevalence of preeclampsia (PE) compared to pregnant women in neighboring developing nations. Several maternal characteristics, such as gestational weight gain (GWG), mode of delivery, and neonatal complications, have been linked to PE. The aim of this study is to evaluate the level of knowledge of pregnant women about PE. METHODS: This cross-sectional study was conducted in the Kurdistan region in Iraq from 2022 to 2023. Data on women's knowledge was collected using a structured questionnaire consisting of 12 questions. The collected data was then analyzed using statistical methods such as the Mann-Whitney U test, Kruskal-Wallis test, and linear regression. RESULTS: A total of 200 pregnant women diagnosed with PE and hypertension were included in the present study. The majority of participants (n=85; 42.5%) were between the ages of 28 and 37. Additionally, most participants (n=129; 64.5%) were from urban areas, with 45% (n=90) of them being obese. As for the participants' knowledge about PE, only 24.55% (n=49) were unaware of the correct answer, while 61% (n=122) stated that family history is not a risk factor for PE. On the other hand, 60% (n=120) of the participants were aware that previous PE is a risk factor for the current pregnancy, and 58.5% (n=117) indicated the importance of urine tests for pregnant women. Overall, the majority (n=144; 72%) had a low level of knowledge, while a small proportion (n=21; 10.5%) had good and high knowledge about PE. CONCLUSION: The present study provides a comprehensive assessment of the knowledge of PE among Kurdish women, highlighting specific areas where intervention and education could potentially yield significant impact.
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BACKGROUND: Numerous factors can influence decisions regarding the type of delivery of human babies. There is an increasing demand for non-medically indicated cesarean sections (CS) (non-miCS) or CS on request (CSor). Therefore, this survey study aimed to identify the factors that may foster the decision of CS among obstetricians. METHODS: After the sample size calculation returned with 132 needed participants, confidence surveys were sent electronically or disseminated in paper form to nearly all obstetricians (around 200) in the province between mid-August 2021 and mid-February 2022. After signing the consent form, obstetricians were able to provide responses to the four sections of the questionnaire. Data from the copies of the paper were entered into Excel by a local data collector. The data analysis was done using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) and followed the following sequence: summary statistics were done first; then the groups (for and against non-miCS) were compared using analysis of variance (ANOVA); and, finally, regression models were conducted to determine the factors that may affect the favorability of doing non-miCS. RESULTS: A total of 104 obstetricians responded to the survey. Approximately 62.5% of them performed CSor for women who requested it. In addition, more than half (57.7%) agreed that all women had the right and autonomy to choose their mode of delivery. Most providers (65.4) agreed that fear of vaginal delivery (VD) and a bad experience with it are rational reasons for performing a CSor. Unfortunately, some obstetricians (18.3%) faced lawsuits when they refused to perform CSor. As for the factors that may influence the acceptance of obstetricians to non-miCS, it was found that obstetricians who are unsure or refuse to answer (OR=4.30, 95%-CI 1.25-16.29, p=0.025), along with people who do not always perform CSor (OR=4.33, 95%-CI 1.59-12.50, p=0.005) or even refuse it (3.54, 95%-CI 1.05-12.96, p=0.046), are more likely to agree that women have the right to request CSor. CONCLUSION: The surge in CSor rates was mostly correlated with an attempt to escape the fear of VD. However, given the wide discrepancies in obstetricians' opinions in this survey, we cannot draw firm conclusions about the reasons behind this phenomenon. It is also important to explore possible ways to address the problem, such as through litigation with providers who refuse to perform a CSor and through economic reform to protect women from money-grubbing obstetricians.
