Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country.

BACKGROUND: Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS: A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS: About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION: This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.

Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities.

BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

Acceptance and willingness to pay for COVID-19 vaccines among pregnant women in Vietnam.

OBJECTIVES: The aim of this study was to assess acceptance of COVID-19 vaccination and the willingness to pay (WTP) for it, and investigate associated factors among pregnant women in Vietnam. METHODS: Cross-sectional survey of pregnant women in two obstetric hospitals in Hanoi and Ca Mau provinces, Vietnam. Data on acceptance and WTP for COVID-19, demographic characteristics, maternal characteristics, and risk perceptions toward COVID-19 were collected. Multivariate logistic and linear regression models were performed to identify factors associated with the acceptance and WTP for the vaccine. RESULTS: Of 651 pregnant women, 60.4% accepted to receive the vaccine, and 82.6% of the total pregnant women were willing to pay for a COVID-19 vaccine with the mean amount of WTP of USD 15.2 (SD ± 27.4). The most common reason for refusing vaccination was "Worry about the safety of the vaccine" (66.9%) in Hanoi and "The preventive effect of COVID-19 is low" (45.2%) in Ca Mau. A higher income, having children, self-perceived risk of COVID-19 infection, and perceived risk to friends were associated with a higher likelihood of acceptance and WTP for the vaccine. CONCLUSIONS: Implementing COVID-19 vaccination and resource mobilisation among pregnant women in Vietnam is feasible, although communication programmes to improve risk perception and awareness about vaccine should be developed for facilitating acceptance of the vaccine.

The list experiment: An approach to measuring stigmatized behaviours related to sex-selective abortion.

Vietnam reports one of the highest levels of abortion globally and an increasingly skewed sex ratio at birth. Abortion and related stigmatized behaviours are notoriously difficult to measure, yet understanding women's ability and willingness to engage in sex selection is of interest to demographers and policymakers alike. We piloted the list experiment, an indirect questioning method, to estimate the prevalence of prenatal sex determination and sex-selective abortion. Respondents reported the total number of items they had engaged in from a list, reducing non-response and incentives to under-report. Among 900 women sampled at two hospitals in Hanoi, we estimated a high prevalence of prenatal sex determination. We found a low prevalence of sex-selective abortion, but higher prevalence among specific parity and children's sex composition subgroups. Responses to knowledge and attitudinal questions underscored women's perceived stigma around sex-selective abortion, suggesting the list experiment is a potentially useful tool for studying son preference.

An On-Demand Charging for Connected Target Coverage in WRSNs Using Fuzzy Logic and Q-Learning.

In wireless rechargeable sensor networks (WRSNs), a mobile charger (MC) moves around to compensate for sensor nodes' energy via a wireless medium. In such a context, designing a charging strategy that optimally prolongs the network lifetime is challenging. This work aims to solve the challenges by introducing a novel, on-demand charging algorithm for MC that attempts to maximize the network lifetime, where the term "network lifetime" is defined by the interval from when the network starts till the first target is not monitored by any sensor. The algorithm, named Fuzzy Q-charging, optimizes both the time and location in which the MC performs its charging tasks. Fuzzy Q-charging uses Fuzzy logic to determine the optimal charging-energy amounts for sensors. From that, we propose a method to find the optimal charging time at each charging location. Fuzzy Q-charging leverages Q-learning to determine the next charging location for maximizing the network lifetime. To this end, Q-charging prioritizes the sensor nodes following their roles and selects a suitable charging location where MC provides sufficient power for the prioritized sensors. We have extensively evaluated the effectiveness of Fuzzy Q-charging in comparison to the related works. The evaluation results show that Fuzzy Q-charging outperforms the others. First, Fuzzy Q-charging can guarantee an infinite lifetime in the WSRNs, which have a sufficient large sensor number or a commensurate target number. Second, in other cases, Fuzzy Q-charging can extend the time until the first target is not monitored by 6.8 times on average and 33.9 times in the best case, compared to existing algorithms.

The efficacy of quantitative fetal fibronectin in predicting spontaneous preterm birth in symptomatic women: A retrospective cohort study.

BACKGROUND: Recent data suggest that quantitative measurements of fetal fibronectin can be used accurately to predict increased risk of preterm birth. AIM: The purpose of this study was to demonstrate that the quantification of fetal fibronectin improves diagnostic accuracy in women who present with symptoms suggestive of threatened preterm labour (TPL) using a quantitative fetal fibronectin (qfFN) bedside analyser. STUDY DESIGN: This was a retrospective cohort study of pregnant women who presented between 22+6 and 32+6  weeks gestation with symptoms of TPL who had qfFN measured using the Rapid fFN Q10 system. The ability to predict spontaneous preterm birth (sPTB) within 48 h, 14 days and <34 weeks gestation at qfFN thresholds of 10, 50 and 200 ng/mL was assessed. RESULTS: The overall rate of sPTB <34 weeks was 4.1% (n = 373). For deliveries within 48 h, within 14 days and <34 weeks, a qfFN threshold of 200 ng/mL had positive predictive values of 26.7%, 42.9% and 46.7%, respectively, when compared to patients with qfFN values of 0-9 ng/mL. The corresponding relative risks were 68.5, 53.8 and 38.0, respectively CONCLUSION: Quantitative fetal fibronectin testing with thresholds of 10, 50 and 200 ng/mL allows for more accurate prediction of preterm birth in symptomatic women. This higher degree of discrimination allows for more directed interventions for high-risk patients and reduces the cost and burden of unnecessary treatment for low-risk patients.

Community-Based Screening for Cervical Cancer Using Visual Inspection With Acetic Acid: Results and Lessons Learned From a Pilot Study in Vietnam.

CONTEXT: Vietnam still applies the opportunistic cytology-based screening model, which failed to have an impact on the increasing burden of cervical cancer in Vietnam. OBJECTIVES: To pilot a community-based screening model for cervical cancer using visual inspection with acetic acid (VIA) in Vietnam by training midwife and assistant physician working at grassroots level of health care system. DESIGN: The study employed a pre-experimental design. SETTING: Cases from 2 provinces of Vietnam. PARTICIPANTS: The study trained 36 assistant physicians/midwives working at commune health centers to do VIA screening for cervical cancer and provided screening services for 1945 women 30 to 65 years of age. INTERVENTION: The pilot intervention had 2 aims: train health care workers to do VIA screening and assess the quality of screening services provided by the trained staffs by examining the diagnostics value of VIA. RESULTS: All selected health care workers were able to perform VIA screening method after training. Their VIA services had high diagnostic value: positive predicted value of 11.5% and negative predicted value of 99%; for the detection of cervical intraepithelial neoplasia (CIN) 2, the sensitivity of VIA is 100%, specificity of 67.0%, positive predicted value of 5.7%, and negative predicted value of 100%; for the detection of CIN 3, the sensitivity of VIA is 100%, specificity of 66.5%, positive predicted value of 3.8%, and negative predicted value of 100%. The diagnostic value of VIA is comparable with Papanicolaou test but requires far fewer resources and suitable with community-based setting. CONCLUSION: Local midwives and assistant physicians who currently work at commune health centers and district health centers can be trained to do VIA efficiently. Regarding to implications for policy and practice, VIA can offer significant advantages over Papanicolaou test in low-resource settings like Vietnam, particularly in terms of increased screening coverage, improved follow-up care, and overall program quality.

Medical costs for the treatment of cervical cancer at central hospitals in Vietnam.

Cervical cancer remains the second most common cancer amongst female aged 15 to 44 years old in Vietnam. We estimated medical costs for the treatment of cervical cancer patients. We employed the standard costing approach and health care provider perspective. We first computed the unit cost of 22 medical services related to cervical cancer treatments and then, based on standard cervical cancer treatment protocols, we estimated the cost of nine treatment scenarios for cervical cancer patients. We found that the medical costs for treatment of cervical cancers at central hospitals in Vietnam increased as the cancer progresses into later stages.

Formation techniques for upper active channel in monolithic 3D integration: an overview.

The concept of three-dimensional stacking of device layers has attracted significant attention with the increasing difficulty in scaling down devices. Monolithic 3D (M3D) integration provides a notable benefit in achieving a higher connection density between upper and lower device layers than through-via-silicon. Nevertheless, the practical implementation of M3D integration into commercial production faces several technological challenges. Developing an upper active channel layer for device fabrication is the primary challenge in M3D integration. The difficulty arises from the thermal budget limitation for the upper channel process because a high thermal budget process may degrade the device layers below. This paper provides an overview of the potential technologies for forming active channel layers in the upper device layers of M3D integration, particularly for complementary metal-oxide-semiconductor devices and digital circuits. Techniques are for polysilicon, single crystal silicon, and alternative channels, which can solve the temperature issue for the top layer process.

High accurate and explainable multi-pill detection framework with graph neural network-assisted multimodal data fusion.

Due to the significant resemblance in visual appearance, pill misuse is prevalent and has become a critical issue, responsible for one-third of all deaths worldwide. Pill identification, thus, is a crucial concern that needs to be investigated thoroughly. Recently, several attempts have been made to exploit deep learning to tackle the pill identification problem. However, most published works consider only single-pill identification and fail to distinguish hard samples with identical appearances. Also, most existing pill image datasets only feature single pill images captured in carefully controlled environments under ideal lighting conditions and clean backgrounds. In this work, we are the first to tackle the multi-pill detection problem in real-world settings, aiming at localizing and identifying pills captured by users during pill intake. Moreover, we also introduce a multi-pill image dataset taken in unconstrained conditions. To handle hard samples, we propose a novel method for constructing heterogeneous a priori graphs incorporating three forms of inter-pill relationships, including co-occurrence likelihood, relative size, and visual semantic correlation. We then offer a framework for integrating a priori with pills' visual features to enhance detection accuracy. Our experimental results have proved the robustness, reliability, and explainability of the proposed framework. Experimentally, it outperforms all detection benchmarks in terms of all evaluation metrics. Specifically, our proposed framework improves COCO mAP metrics by 9.4% over Faster R-CNN and 12.0% compared to vanilla YOLOv5. Our study opens up new opportunities for protecting patients from medication errors using an AI-based pill identification solution.

Prenatal diagnosis of atrioventricular discordance with ventriculoarterial concordance by fetal echocardiography: A case report.

OBJECTIVE: To report an extremely rare case of atrioventricular discordance and ventriculoarterial concordance associated with a ventricular septal defect which was diagnosed prenatally. CASE REPORT: By fetal echocardioraphy at 20 weeks' gestation, we diagnosed a rare case of atrioventricular discordance and ventriculoarterial concordance associated with a ventricular septal defect. This is the first case reported from Vietnam prenatally. We present our management of this pregnancy and the baby's neonatal course. This rare anomaly remains a challenge for the baby's early neonatal course before initial neonatal discharge. CONCLUSION: A combined multidisciplinary and individualized approach for the optimal management of this complicated pregnancy and further neonatal surgical treatment plans for the baby are recommended.

Accurate discharge and water level forecasting using ensemble learning with genetic algorithm and singular spectrum analysis-based denoising.

Forecasting discharge (Q) and water level (H) are essential factors in hydrological research and flood prediction. In recent years, deep learning has emerged as a viable technique for capturing the non-linear relationship of historical data to generate highly accurate prediction results. Despite the success in various domains, applying deep learning in Q and H prediction is hampered by three critical issues: a shortage of training data, the occurrence of noise in the collected data, and the difficulty in adjusting the model's hyper-parameters. This work proposes a novel deep learning-based Q-H prediction model that overcomes all the shortcomings encountered by existing approaches. Specifically, to address data scarcity and increase prediction accuracy, we design an ensemble learning architecture that takes advantage of multiple deep learning techniques. Furthermore, we leverage the Singular-Spectrum Analysis (SSA) to remove noise and outliers from the original data. Besides, we exploit the Genetic Algorithm (GA) to propose a novel mechanism that can automatically determine the prediction model's optimal hyper-parameters. We conducted extensive experiments on two datasets collected from Vietnam's Red and Dakbla rivers. The results show that our proposed solution outperforms current techniques across a wide range of metrics, including NSE, MSE, MAE, and MAPE. Specifically, by exploiting the ensemble learning technique, we can improve the NSE by at least [Formula: see text]. Moreover, with the aid of the SSA-based data preprocessing technique, the NSE is further enhanced by more than [Formula: see text]. Finally, thanks to GA-based optimization, our proposed model increases the NSE by at least [Formula: see text] and up to [Formula: see text] in the best case.

Heavy uterine bleeding in adolescent caused by uterine vascular lesion: A case report.

OBJECTIVE: To analyze a case of heavy uterine bleeding in adolescence caused by an arteriovenous malformation (AVM) in Hanoi Obstetrics and Gynecology Hospital, Vietnam. METHODS: We observed a case of a 14-year-old girl, without vaginal sexual intercourse experience, having heavy uterine bleeding caused by AVM. She underwent a laparoscopic operation at the hospital for vascular lesions in the uterine anterior wall, which caused an internal hemorrhage of 1500 ml blood loss into the peritoneal cavity. Three years later, this patient was hospitalized twice for massive vaginal bleeding. RESULTS: Results of ultrasound and magnetic resonance imaging indicated a uterine intramural mass with enlarged vessels connecting to the endometrial cavity. A pelvic digital subtraction angiography was performed and showed profuse bleeding from a ruptured branch of the left uterine artery. This artery was embolized at Bach Mai hospital and the bleeding was stopped. The patient had stable health and normal menstrual periods after 4 months of follow up. CONCLUSION: Abnormal mass with dilated vessels in the myometrium in a patient experiencing heavy uterine bleeding is an exclusive sign of uterine vascular malformation and can be treated by angioembolization.

Impact of Pt grain size on ferroelectric properties of zirconium hafnium oxide by chemical solution deposition.

The effects of the grain size of Pt bottom electrodes on the ferroelectricity of hafnium zirconium oxide (HZO) were studied in terms of the orthorhombic phase transformation. HZO thin films were deposited by chemical solution deposition on the Pt bottom electrodes with various grain sizes which had been deposited by direct current sputtering. All the samples were crystallized by rapid thermal annealing at 700 °C to allow a phase transformation. The crystallographic phases were determined by grazing incidence X-ray diffraction, which showed that the bottom electrode with smaller Pt grains resulted in a larger orthorhombic phase composition in the HZO film. As a result, capacitors with smaller Pt grains for the bottom electrode showed greater ferroelectric polarization. The smaller grains produced larger in-plane stress which led to more orthorhombic phase transformation and higher ferroelectric polarization.

Primary cesarean section rate among full-term pregnant women with non-previous uterine scar in a hospital of Vietnam.

Aim: This article aims to determine the contributing indications for primary cesarean sections among full-term pregnant women with non-previous uterine scars and suggests several potential solutions to reduce the cesarean section rate. Methods: This is a descriptive study with data being retrospectively collected from electronic medical records (EMRs) at Hanoi Obstetrics & Gynecology Hospital, Vietnam, in 2020. We studied 23,631 women at ≥37 weeks of gestation with non-previous uterine scars. Main ICD-10 categories of diagnosis on the EMRs were used to classify the indications. The proportions of indications for primary cesarean sections were calculated, thereby offering potential solutions to reduce the cesarean section rate. Results: The proportion of cesarean sections among full-term pregnancies with non-previous uterine scars was 40.7%. The most common indications for primary cesarean sections were non-reassuring fetal heart rate tracing (40%), labor arrest (31%), and maternal request (11%). Among the low-risk pregnant women, the cesarean section rate was 35.9%, of which the percentages of labor arrest and non-reassuring fetal heart rate tracings and maternal request were 13.6%, 17.7%, and 4.6%, respectively. Conclusions: The proportion of primary cesarean sections among full-term pregnancies with non-previous uterine scars is high; non-reassuring fetal heart rate tracings, labor arrest, and maternal request were three main indications. It is necessary to build the strategies of health organizations regarding the management of clinical practices and the programs improving the knowledge, attitudes, practices of pregnant women and obstetricians regarding cesarean sections.

Improvement of symptoms after hysteroscopic isthmoplasty in women with abnormal uterine bleeding and expected pregnancy: A prospective study.

BACKGROUND: Cesarean scar myometrial defect as known as niche is associated with postmenstrual spotting, suprapubic pain and secondary infertility. Hysteroscopic isthmoplasty has been proposed in the treatment of niche. This study aims to determine the safety and effectiveness of hysteroscopic isthmoplasty in postmenstrual spotting treatment and improvement of spontaneous conceiving. MATERIALS AND METHOD: A prospective study was performed at Hanoi Obstetrics and Gynecology Hospital, Vietnam. We studied women who developed postmenstrual spotting related to niches and had desired to conceive for more than six months. Women with residual myometrium less than 2.5 mm were excluded. Twenty-three eligible women underwent hysteroscopic isthmoplasty with four main steps, including identification of relevant anatomy, resection of the cephalad edge of fibrosis, resection of the caudal edge of fibrosis, and ablation of the niche base. Participants were followed up at 1, 3, and 6 months postoperatively. RESULTS: The mean surgical duration was 17 min, and no complications took place. The number of women with improved postmenstrual spotting symptoms after 1, 3, and 6 months were 39.1% (9/23), 61.9% (13/21) and 68.8% (11/16), respectively. Suprapubic pain resolved in 94% (15/16) of the women in the first month. The rate of spontaneous pregnancies within 6 months of isthmoplasty was 30.4% (7/23). There were no differences in depth niche and residual myometrium thickness on ultrasound in the period before and after hysteroscopy. CONCLUSION: Our study supports that hysteroscopic isthmoplasty is a safe and effective procedure for women with a niche and postmenstrual spotting and wish to conceive.

Neonatal resuscitation monitoring: A low-cost video recording setup for quality improvement in the delivery room at the resuscitation table.

Background: The quality of neonatal resuscitation after delivery needs to be improved to reach the Sustainable Development Goals 3.2 (reducing neonatal deaths to <12/1,000 live newborns) by the year 2030. Studies have emphasized the importance of correctly performing the basic steps of resuscitation including stimulation, heart rate assessment, ventilation, and thermal control. Recordings with video cameras have previously been shown to be one way to identify performance practices during neonatal resuscitation. Methods: A description of a low-cost delivery room set up for video recording of neonatal resuscitation. The technical setup includes rechargeable high-definition cameras with two-way audio, NeoBeat heart rate monitors, and the NeoTapAS data collection tools for iPad with direct data export of data for statistical analysis. The setup was field tested at Mulago National Referral Hospital, Kampala, Uganda, and Phu San Hanoi Hospital, Hanoi, Vietnam. Results: The setup provided highly detailed resuscitation video footage including data on procedures and team performance, heart rate monitoring, and clinical assessment of the neonate. The data were analyzed with the free-of-charge NeoTapAS for iPad, which allowed fast and accurate registration of all resuscitative events. All events were automatically registered and exported to R statistical software for further analysis. Conclusions: Video analysis of neonatal resuscitation is an emerging quality assurance tool with the potential to improve neonatal resuscitation outcomes. Our methodology and technical setup are well adapted for low- and lower-middle-income countries settings where improving neonatal resuscitation outcomes is crucial. This delivery room video recording setup also included two-way audio communication that potentially could be implemented in day-to-day practice or used with remote teleconsultants.

Incidence of Intrapartum-Related Events at the Largest Obstetric Hospital in Hanoi, Vietnam: A Retrospective Study.

Every year, 2.4 million neonates die during their first month of life and even more suffer permanent injury. The main causes are intrapartum-related events, prematurity, and infection, with sub-Saharan Africa and southern Asia being the worst affected regions. With a focus on intrapartum-related events, we aimed to assess the neonatal demographic characteristics, clinical management, and outcomes among neonates born at the largest obstetric hospital in Hanoi, Vietnam. This was a retrospective cross-sectional study that included all the inborn neonates in November 2019, which was selected as a representative month. A total of 4554 neonates were born during the study period. Of these, 1.0% (n = 44) were stillbirths, 0.15% (n = 7) died in hospital, 0.61% (n = 28) received positive pressure ventilation at birth, and 0.15% (n = 7) were diagnosed with hypoxic ischemic encephalopathy. A total of 581 (13%) neonates were admitted to the neonatal unit, among which the most common diagnoses were prematurity (37%, n = 217) and infection (15%, n = 89). Except for the intrapartum-related events, our findings are consistent with the previously documented data on neonatal morbidity. The intrapartum-related events, however, were surprisingly low in number even in comparison to high-income countries. Research on the current clinical practice at Phu San Hanoi Hospital may bring further clarity to identify the success factors.

Endotracheal intubation performance at a large obstetric hospital delivery room, Hanoi, Vietnam.

Introduction: Intrapartum-related events account for nearly 700,000 neonatal deaths globally yearly. Endotracheal intubation is a cornerstone in preventing many of these deaths, but it is a difficult skill to acquire. Previous studies have described intubation performances in high-income countries, but data from low- and middle-income countries are lacking. We aimed to assess the performance of delivery room intubation in a lower middle-income country. Methods: This prospective observational study was conducted at the Phu San Hanoi Hospital, Vietnam, from September 2020 to January 2021. Video cameras were positioned above the resuscitation tables and data were extracted using adopted software (NeoTapAS). All neonates requiring positive pressure ventilation were included. Our main variables of interest were time to first intubation attempt, first intubation attempt duration, and successful first intubation attempt. Results: 18,107 neonates were born during the five months. Of these, 75 (0.4%) received positive pressure ventilation, and 36 (0.2%) required endotracheal intubation of whom 24 were captured on video. The median time to the first intubation attempt was 252 seconds (range 91-771 seconds), the median first attempt duration was 49 seconds (range 10-105 seconds), and the first attempt success rate was 75%. Conclusion: Incidences of positive pressure ventilation and endotracheal intubation were low in comparison to global estimates. Three out of four intubations were successful at the first attempt and the procedural duration was often longer than recommended. Future studies should focus on how to achieve and maintain intubation skills and could include considering alternative devices for airway management at birth.

COVID-19 and delayed antenatal care impaired pregnant women's quality of life and psychological well-being: What supports should be provided? Evidence from Vietnam.

BACKGROUND: This study explored the associations between different structural and functional supports with the quality of life (QOL) and mental well-being of pregnant women whose antenatal care was delayed due to the COVID-19 pandemic in Vietnam. METHODS: A multi-center cross-sectional study was performed on 868 pregnant women. The pregnant women's quality of life questionnaire (QOL-GRAV), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Infant Care Social Support (PICSS) instruments were employed. The satisfaction with care from different sources was measured. Multivariate Tobit Regression models were used. RESULTS: Seventy pregnant women (8.1%) reported that their antenatal care was influenced by the COVID-19. In this group, a higher level of satisfaction with the care of parents-in-law and a higher score of emotional support were associated with a better "Physical and Emotional changes" domain, while a higher level of appraisal support was related to poorer "Physical and Emotional changes" domain. A higher level of satisfaction with relatives' care and a higher score of emotional support were correlated with a better "Life Satisfaction" domain. EPDS score was negatively correlated with satisfaction with parents-in-law care and appraisal support. CONCLUSIONS: Our study highlighted that intervention programs to improve the QOL and psychological well-being of pregnant women in epidemics such as COVID-19 or other diseases in the future should involve other family members such as parents-in-law and relatives as sources of support. LIMITATIONS: The cross-sectional design was unable to draw causal relationships. Recall bias might occur. The convenient sampling method might limit the generalizability of findings.