Prevalence and associated factors of structural congenital anomalies in resource limited setting, 2023: a systematic review and meta-analysis.

Background: Several studies have been conducted on structural congenital anomalies (CA). However, there is a paucity of studies that provide a comprehensive review of structural anomalies. We aimed to verify the available research articles to pool the possible risk factors of structural CA in resource-limited settings. Setting: The research articles were genuinely searched using PubMed, Scopus, Cochrane Library, Web of Science, free Google database search engines, Google Scholar, and ScienceDirect databases. Published studies were searched and screened for inclusion in the final analysis, and studies without sound methodologies and review and meta-analysis were not included in the analysis. Participants: This review analyzed data from 95,755 women who gave birth as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. The articles that had incomplete information and case reports were excluded from the study. Results: The overall pooled effect estimate (EI) of structural CA was 5.50 (4.88-6.12) per 100 births. In this systematic review and meta-analysis, maternal illness EI with odds ratio (OR) = 4.93 (95% CI: 1.02-8.85), unidentified drug use with OR = 2.83 (95% CI: 1.19-4.46), birth weight with OR = 4.20 (95% CI: 2.12-6.28), chewing chat with OR = 3.73 (95% CI: 1.20-6.30), chemical exposure with OR = 4.27 (95% CI: 1.19-8.44), and taking folic acid tablet during pregnancy with OR = 6.01 (95% CI: 2.87-14.89) were statistically significant in this meta-regression. Conclusions: The overall pooled effect estimate of structural CA in a resource-limited setting was high compared to that in countries with better resources. Maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure, and never using folic acid were found to be statistically significant variables in the meta-regression. Preconception care and adequate intake of folic acid before and during early pregnancy should be advised. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022384838.

Structural congenital anomalies in resource limited setting, 2023: A systematic review and meta-analysis.

BACKGROUND: A number of studies have looked at neonatal structural birth defects. However, there is no study with a comprehensive review of structural anomalies. Therefor we aimed to verify the best available articles to pool possible risk factors of structural congenital anomalies in resource limited settings. SETTING: Genuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google database search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. PARTICIPANTS: This review analyzed data from 95,755 women who have birthed from as reported by primary studies. Ten articles were included in this systematic review and meta-analysis. Articles which have no full information important for the analysis and case reports were excluded from the study. RESULTS: The overall pooled effect estimate of structural congenital anomalies was 5.50 [4.88-6.12]. In this systematic review and meta-analysis maternal illness effect estimate (EI) with odds ratio (OR) = 4.93 (95%CI 1.02-8.85), unidentified drug use OR = 2.83 (95%CI 1.19-4.46), birth weight OR = 4.20 (95%CI 2.12-6.28), chewing chat OR = 3.73 (95%CI 1.20-6.30), chemical exposure OR = 4.27 (95%CI 1.19-8.44) and taking folic acid tablet during pregnancy OR = 6.01 (95%CI 2.87-14.89) were statistically significant in this meta-regression. CONCLUSIONS: The overall pooled effect estimate of structural congenital anomalies in a resource limited setting was high compared to better resource countries. On the Meta-regression maternal illness, unidentified drug use, birth weight, chewing chat, chemical exposure and never using folic acid were found to be statistically significant variables Preconception care and adequate intake of folic acid before and during early pregnancy should be advised.

Assessment of Iron-Folate Adherence and Associated Factors Among Pregnant Women in Public Health Facilities of Durame Town, Southern Ethiopia.

Introduction: Iron deficiency anemia during pregnancy is a significant public health problem in low- and middle-income countries. The World Health Organization recommended a daily oral dose of iron and folic acid supplements throughout pregnancy. Poor adherence to iron and folic acid supplementation arises in pregnant women associated with serious adverse health outcomes. Objective: This study aimed to assess iron-folate adherence and associated factors among pregnant women in public health facilities of Durame town, Southern Ethiopia, in 2022. Methods: An institution-based cross-sectional study was conducted from March 1-30, 2022. A structured interviewer-administered questionnaire was used to interview a total sample size of 317 participants. Logistic regression analysis was computed, and variables with a p-value of less than 0.25 in the bivariate logistic regression analysis were selected for multivariable logistic regression analysis. Finally, significance was declared at p < .05 with 95%CI. Results: The findings of this study showed that adherence to iron-folate among pregnant women was 180 (60%) (95%CI: 54-65.7). The odds of iron-folate adherence among women who had not had anemia in their current pregnancy were 63% (AOR = 0.37, 95%CI: 0.14-0.99) less likely to have adherence, and the odds of iron-folate adherence among women who had not heard about the disease anemia were 58% (AOR = 0.42, 95%CI: 0.22-0.81) less likely to have adherence. Conclusion: Iron-folate adherence in Durame public health facilities was better compared to other studies even if it was not high enough to prevent anemia and folate deficiency. Women who had not had anemia in their current pregnancy and women who had not heard about the disease anemia were significantly associated with adherence to iron-folate. Thus, healthcare providers should provide health education on the enhancement of adherence to iron-folate utilization and the means how to prevent iron-folate deficiency during their clients' pregnancy.

Timing of Hepatitis B Vaccine Birth Dose in Exposed Newborns, Southwest Ethiopia: A Cross-Sectional Study.

Introduction: Hepatitis B virus disease is a global acute and chronic communicable disease. Mother-to-child transmission is the reason for high carrier rates. Unvaccinated newborns infected through mother-to-child transmission are at >95% risk of developing chronic hepatitis B virus disease. Vaccination is the most effective measure to reduce the global incidence of hepatitis B virus disease. Despite the World Health Organization's target to achieve 90% of the hepatitis B vaccine birth dose by 2030, little is known about the vaccination status of exposed newborns. Objective: The present study aimed to determine the timing of the hepatitis B vaccine birth dose in exposed newborns in Southwest Ethiopia. Methods: An institution-based cross-sectional study was employed on 422 systematically selected exposed newborns from April 2, 2022, to August 28, 2022. A pretested, interviewer-administered questionnaire was used for data collection. Data were entered into Epi data 3.1 and exported into SPSS version 23 software for analysis. Both bivariable and multivariable binary logistic regressions were performed. Variables with a p-value <.05 at a 95% confidence interval (CI) were considered statistically significant. Results: The proportion of neonates who received their first dose of the hepatitis B vaccine on time was 57 (42.5%) (95% CI: 38.3-46.1%). A higher likelihood of vaccinating their exposed newborns on time was associated with formal education (adjusted odds ratio [AOR] = 3.01, 95% CI: 2.21-7.09), four or more ANC visits (AOR = 2.33, 95% CI: 2.05-6.21), and husband engagement (AOR = 4.31, 95% CI: 2.03-6.34). Conclusion: The proportion of timely initiation of the hepatitis B vaccine birth dose in Southwest Ethiopia was low. Thus, strengthening health education on the hepatitis B vaccine, encouraging women to have at least four ANC visits, and encouraging male involvement help improve the timely administration of the hepatitis B vaccine.

Prevalence of early postnatal care services usage and associated factors among postnatal women of Wolkite town, Gurage zone, Southern Ethiopia: a community-based cross-sectional study.

OBJECTIVE: Early postnatal care service usage in developing countries is one of the healthcare service usage problems among postnatal women, which is related to extensive maternal and neonatal complications and mortality. Identification of the prevalence of early postnatal care services usage and associated factors among postnatal women is imperative to develop intervention measures to mitigate their complications and public health impact, which is not well known in Ethiopia, particularly in the selected study area. Thus, this study aimed to assess the prevalence of early postnatal care services usage and associated factors among postnatal women of Wolkite town, southeast Ethiopia. DESIGN: A community-based cross-sectional study design was conducted among 301 postnatal women from 15 May to 15 June 2021. MEASUREMENTS: Data were collected using a pretested structured questionnaire. The collected data were cleaned and entered in EpiData V.3.1 and then exported to SPSS V.23 for analysis. Finally, a multivariate logistic regression model was fitted to identify the factors associated with early postnatal care services usage. The p value<0.05 was considered statistically significant. RESULTS: The finding showed that the prevalence of early postnatal care services usage was 23.3% (95% CI 18.9% to 27.9%). Wanted pregnancy (adjusted OR (AOR)=4.17, 95% CI 1.93 to 9.03), had over four histories of pregnancy (gravida >4) (AOR=2.90, 95% CI 1.18 to 7.11) and had spontaneous vertex delivery (AOR=2.18, 95% CI 1.07 to 9.39) were statistically significant factors of early postnatal care service usage. CONCLUSION: This study has shown that the prevalence of early postnatal care services usage was slightly low when compared with other studies. Thus, community-based health promotion should be an important recommendation to increase early postnatal care service usage among postnatal mothers to improve the level of awareness of early postnatal check-up schedules; done by healthcare providers.

Assessment of complications associated with female genital cutting among postnatal women in Chuko Primary Hospital, Sidama region, Southern Ethiopia.

Objectives: Female genital cutting is a genital operation for a nonmedical reason and involves the cutting away of a part or whole of the female external genitals. Postnatal women with genital cutting could be more vulnerable to circumcision-associated birth complications, and it is still a major health problem during childbirth and the postnatal period in Ethiopia. This study aimed to assess complications associated with female genital cutting among postnatal women in Chuko Primary Hospital, Sidama region, Southern Ethiopia. Methods: An institutional-based quantitative cross-sectional study design was conducted from 01 May 2021 to 15 June 2021. A systematic random sampling technique was used to select study participants. Data were collected by using a structured pretested questionnaire and reviewing medical records. The data were analyzed using SPSS version 23.0. Logistic regression analysis was computed to identify birth complications associated with female genital cutting from independent variables, and significance was declared at p < 0.05 with 95% CI. Results: The proportion of female genital cutting among the participants was 76.8% (95% confidence interval: 71.1, 81.2). Prolonged labor and birth asphyxia were statistically significant female genital cutting-associated birth complications. Conclusion: This study revealed a high proportion of complications associated with female genital cutting. Birth complications such as prolonged labor and birth asphyxia have a statistically significant association with it. Illiteracy and early marriage were the predominant reasons for female genital cutting. Therefore, healthcare providers should educate the rural communities to prevent early marriage and female genital cutting to prevent its complications.

Unintended Pregnancy and Associated Factors Among Women Attending Antenatal Care in Public Hospitals During COVID-19 Pandemic, Southwest Ethiopia: A Cross-Sectional Study.

BACKGROUND: COVID-19 pandemic directly or indirectly increases the burden of unintended pregnancy by limiting women's access to family planning and other reproductive health services. COVID-19 results in extra 15 million unintended pregnancies over a year. Almost all previous studies conducted about unintended pregnancy were before COVID-19 pandemic in Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of unintended pregnancy during the COVID-19 pandemic among women attending antenatal care in public hospitals of southwest Ethiopia. METHODS: This study was cross-sectional and conducted among women attending antenatal care at public hospitals of southwest Ethiopia from June 14 to July 14, 2021. Data were collected using a face-to-face interview. Factors associated with unintended pregnancy were analyzed using binary and multiple logistic regressions with an adjusted odds ratio and 95% confidence interval. Finally, the p-value was used as a graded measure of evidence to quantify the degree of significance. RESULTS: A total of 405 women participated in this study. The overall prevalence of unintended pregnancy was 19.5% (95% CI: 1.44-6.92) among women attending antenatal care during COVID-19 pandemic. Of which, 50.6% were mistimed and 49.4% unwanted. Urban residence (AOR: 3.1 95% CI: 1.44-6.92) and not being primary decision-maker (AOR: 2.85 95CI: 1.18-6.88) had high significance with unintended pregnancy. Not having ANC in a previous pregnancy (AOR: 3.40; 95% CI: 1.02-11.94) and not being exposed to community education about maternal health care (AOR: 2.36; 95% CI: 1.06-5.27) had medium significance with unintended pregnancy. CONCLUSION: One-fifth of women attending antenatal care had unintended pregnancies during the COVID-19 pandemic. Efforts to scale up women's decision-making power on family planning services and access to community education are needed to prevent unintended pregnancy.