Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life.

Stress urinary incontinnce (SUI) is a common condition among women. The usual approach to treatment of SUI is a stepwise plan from conservative to surgical procedures. A vaginal pessary is one of the commonly used conservative treatments that offer symptomatic improvement for women with incontinence. This review provides a critical analysis of the benefits and shortcomings offered by vaginal pessaries to patients affected by SUI, with a particular focus on indications, advantages, quality of life, patient satisfaction, and potential complications. To obtain the required information, an extensive search of PubMed and Cochrane databases was performed, covering the time frame from January 2000 to December 2016. We also surveyed the published guidelines of American Urological Association, Canadian Urological Association, American Urogynecological Society, National Institutes of Health (USA), and National Institute for Health and Care Excellence (UK). A total of 192 original research papers, review articles, and clinical trials were identified. The analysis of retrieved data provides evidence that vaginal pessaries constitute an effective nonsurgical option for SUI. The satisfaction rate with pessary use is high and only minor complications, if any, occur, vaginal discharge being the most common. The reviewed studies document that vaginal pessaries provide an adequate control of SUI if they are fit properly and managed by frequent replacements and regular checkups. They should be considered among the first line of treatment for SUI associated with exercise and increased intra-abdominal pressure.

Interprofessional learning experiences: Exploring the perception and attitudes of Saudi Arabian medical and dental students.

OBJECTIVE: The objective of this study is to evaluate the awareness and attitudes of medical and dental students regarding interprofessional learning (IPL). METHODS: A cross-sectional study was conducted with 278 female undergraduate Medical and Dental students from Princess Nourah bint Abdulrahman University, Riyadh. These students undertook IPL in the Foundation block, in basic science teaching, clinical skills' laboratories and in professionalism and learning skills' modules. A modified, validated RIPLS questionnaire with four subscales and 29 items was used to collect data regarding their perception and attitudes towards shared learning. A five-point Likert scale was used with a value ranging from 1 (strongly disagree) to 5 (strongly agree) for each item. Factor analysis was done using Varimox rotation. Student's t test was applied to detect difference between mean scores of medical and dental student's responses Results: The mean age of respondents was 19.8 ± 1.7 years with the majority in the second year of each program. There was no difference in mean responses of the medical and dental students. The respondents favored shared learning in the areas of professional skills and patient care. They agreed that IPL helps to develop respect, trust and appreciation for other professions; however, both groups preferred to learn uni-professionally with regard to developing discrete professional identities and roles. CONCLUSIONS: There is an overall positive response towards IPL and the value of team work; however, more attention needs to be paid to enabling students to learn about the specific roles of each profession in the healthcare team.

Grand multiparity and the possible risk of adverse maternal and neonatal outcomes: a dilemma to be deciphered.

BACKGROUND: The relation between grand multiparity (GMP) and the possible adverse pregnancy outcomes is not well identified. GMP (parity ≥5 births) frequently occurs in the Arab nations; therefore, this study aimed to identify the correlation between GMP and the different adverse maternal and neonatal outcomes in the Saudi population. METHOD: This cohort study was conducted on a total of 3327 women from the labour ward in King Khaled University Hospital, Riyadh, Saudi Arabia. Primiparous, multiparous and grand multiparous females were included. Socio-demographic data and pregnancy complications like gestational diabetes or hypertension, preeclampsia and intrauterine growth restriction were retrieved from the participants' files. In addition, the labour ward records were used to extract information about delivery events (e.g. spontaneous preterm delivery, caesarean section [CS]) and neonatal outcomes including anthropometric measurements, APGAR score and neonatal admission to the intensive care. RESULTS: Primiparas responses were more frequent in comparison to multiparas and GMP (56.8% and 33%, and 10.2% respectively). In general, history of miscarriage was elevated (27.2%), and was significantly higher in GMP (58.3%, p < 0.01). Caesarean delivery was also elevated (19.5%) and was significantly high in the GMP subgroup (p < 0.01). However, after adjustment for age, GMP were less likely to deliver by CS (odds ratio: 0.6, 95% CI: 0.4-0.8; p < 0.01). The two most frequent pregnancy-associated complications were gestational diabetes and spontaneous preterm delivery (12.6% and 9.1%, respectively). The former was significantly more frequent in the GMP (p < 0.01). The main neonatal complication was low birth weight (10.7%); nevertheless, neonatal admission to ICU was significantly higher in GMP (p = 0.04), and low birth weight was more common in primiparas (p < 0.01). Furthermore, logistic regression analysis revealed an insignificant increase in the maternal or neonatal risks in GMP compared to multiparas after adjustment for age. CONCLUSION: Grand multiparous Saudi females have similar risks of maternal and neonatal complications compared to the other parity groups. Advanced age might play a major role on pregnancy outcomes in GMP. Nevertheless, grand multiparty might not be discouraged as long as women are provided with good perinatal care.

Effectiveness of health education programme: Level of knowledge about prevention of cervical cancer among Saudi female healthcare students.

OBJECTIVE: To evaluate the effectiveness of health education programme on the knowledge of human papilloma virus among female medical students. METHODS: This quasi-experimental study was conducted in 2014 at the Princess Nourah bint Abulrahman University, Riyadh, Saudi Arabia, and comprised female medical students. An intervention programme was implemented in the form of lectures, videos, posters, etc. on human papillomavirus. SPSS 20 was used for data analysis. RESULTS: There were 535 participants in the study. There mean age was 20.3±1.3 years. After the intervention, there was a significant increase in the level of knowledge. Of all, 495(92%) students recognised avoidance of sexually transmitted disease, vaccination and screening as effective preventive measures. In comparison to pre-intervention results, significantly higher percentage of students defined risk factors: sexually transmitted disease 392(73.3%) versus 329(61.8%), and human papillomavirus 293(54.8%) versus 151(28.4%). Knowledge regarding sensitivity, 280(52.3%) after the campaign versus 160(30.1%)before, and time to perform Pap smear,229(42.8%) versus 113(21.1%),increased significantly (p<0.05). CONCLUSIONS: Health education programme was effective in improving the level of knowledge on human papillomavirus.

Effectiveness and outcomes of thermablate endometrial ablation system in women with heavy menstrual bleeding.

Heavy menstrual bleeding (HMB) is a common problem in women of reproductive age group with major impact on their quality of life (QoL). The aim was to study the short-term effectiveness of Thermablate Endometrial Ablation System (EAS) and its impact on QoL in women with HMB. This was a prospective cohort study conducted on consecutive 72 women suffering from HMB. The success rate was estimated and patients' QoL was compared before and after the procedure using the Aberdeen menorrhagia severity scale. The mean follow-up period was 18 months (6-24 months). The mean age and body mass index were 48 (±5.2) years 33.2 (±7.4) kg/m2 respectively. Among treated participants, 58 (80.6%) reported the absence of bleeding. A significant decrease was observed in the rate of missed social activity and increase in the leisure time activities. The overall patient satisfaction was 95.7%. Thermablate EAS is an effective minimally invasive treatment with marked improvement in QoL in women with HMB. Impact statement Heavy menstrual bleeding (HMB) is a common problem that affects 11-13% of reproductive age women with major impact on their quality of life (QoL). A variety of methods for endometrial ablation has been used for the destruction of the endometrial lining to treat HMB. The short-term results of this study shows amenorrhoea rate of (80.6%) after the procedure and a significant decrease in the rate of missed social activity and increase in the leisure time activities with marked improvement in QoL. The overall patient satisfaction was 95.7%. Thermablate Endometrial Ablation System is an effective minimally invasive treatment for HMB with advantages of shorter operating time, shorter hospital stay and high-level patient satisfaction. However, further clinical research with large-scale studies and possible comparison with other treatment options are recommended.

Knowledge, attitudes, beliefs, and barriers associated with the uptake of influenza vaccine among pregnant women.

Objective: The purpose of the study was to assess the knowledge, attitudes, beliefs, and factors associated with the uptake of the influenza (flu) vaccination in women within Saudi Arabia during their pregnancy period. Methods: A cross-sectional prospective survey was conducted on 1085 pregnant women at the antenatal clinic over a period of 6 weeks with the provision of influenza vaccination. The questionnaire collected demographic and other data; it included 12 questions on their general knowledge and assessed their attitude toward influenza vaccination, and their awareness of vaccine risk and the potential benefits during pregnancy. The knowledge score obtained was then calculated and compared. Results: A total of 998 patients took part in the questionnaire with a response rate of 92%. There was poor awareness that the flu vaccine is safe to administer during pregnancy (130, 13.1%) and that all pregnant women should receive the flu vaccine (190, 19.1%). Pregnant women with flu vaccine knowledge score of ⩽5 (range 0-12) were significantly less likely to take the vaccine (OR 3.78, 95% CI 2.68-5.26, p < 0.001). There was a low uptake of the vaccine (178, 18.1%) and only 29 (3.0%) had previously been offered the flu vaccine by any doctor during their pregnancy. In addition, 255 (25.8%) were against taking the flu vaccine during pregnancy. Conclusion: The knowledge and uptake of the influenza vaccine among Saudi pregnant women are low. One quarter was against the vaccine during pregnancy. Very few believed the flu vaccine to be safe during pregnancy. Rarely, physicians advise their clients to take flu vaccine.

Evaluation of Sacrospinous Hysteropexy vs. Uterosacral Suspension for the Treatment of Uterine Prolapse: A Retrospective Assessment.

OBJECTIVE: This single-center retrospective study aimed to compare the outcomes of vaginal hysterectomy with utero-sacral suspension (VH/USS) versus sacro-spinous hysteropexy (SSHP) in the management of uterine prolapse at a tertiary care center specializing in Urogynecology. METHODS: The medical records of 50 women with stage 2 or more uterine prolapse treated with VH/USS (n = 26) or SSHP (n = 24) were assessed between January 2006 and December 2012. RESULTS: There were no significant differences between the two groups in terms of body mass index (BMI) and parity P = 0.881 and 0.304, respectively. VH/USS procedure was significantly more successful than SSHP procedure with regard to anatomical success (84.62 vs. 41.67%, P = 0.0028). There was a significantly higher anterior prolapse recurrence with SSHP procedure than with VH/USS (33.3 vs. 7.7%; P = 0.034). SSHP was associated with the lower likelihood of anatomical success and a higher risk of recurrent anterior prolapse in multivariate logistic regression analyzes adjusting for potential confounders. CONCLUSION: The findings of this retrospective study indicate that SSHP appears to be associated with less anatomical objective success and an increased risk of recurrent anterior prolapse in comparison to VH/USS. Further validation of our observations by independent investigators is required.

Correction: Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile.

[This corrects the article DOI: 10.1371/journal.pone.0150297.].

Impact of vitamin D deficiency on maternal and birth outcomes in the Saudi population: a cross-sectional study.

BACKGROUND: Low serum vitamin D [25(OH)D] has been associated with different health problems worldwide. However, its causal role in several diseases remains unclear. We aimed to correlate vitamin D status with maternal and neonatal outcomes in pregnant females. METHOD: One thousand pregnant women were recruited during early labour from the labour ward of King Khaled University Hospital, Riyadh, Saudi Arabia. Detailed medical data of all participants were collected from their records. Delivery events and birth outcomes were also documented. Serum 25(OH)D levels were measured using an enzyme-linked immunosorbent assay. A receiver operating characteristic (ROC) curve was constructed to evaluate the ability of vitamin D levels to predict complicated pregnancies. Regression analysis was used to test the correlation between serum 25(OH)D levels and different variables. RESULTS: Most of the participants were Saudis (89.9 %) and housewives (85.1 %) and 86.4 % of them had vitamin D deficiency (mean: 30.46 ± 19.6 nmol/L). Gestational diabetes mellitus (GDM) was the commonest complication detected (11.1 %) while the history of miscarriage was elevated (24.5 %). There was no association between GDM and low 25(OH)D. Yet, there was a significant negative correlation between serum 25(OH)D levels and fasting blood glucose among females older than 35 years (r = -0.2, p = 0.03). Hypertensive disorders of pregnancy and pre-existing hypertension were less than 1.5 % of frequency. Nevertheless, they were only recorded in women with insufficient and deficient vitamin D. ROC curve revealed that 25(OH)D levels were not able to discriminate between normal and adverse pregnancy outcomes (AUROC curve: 0.51; 95 % confidence interval (CI): 0.44-0.58; p = 0.8). CONCLUSION: Hypovitaminosis D, a highly prevalent health problem among pregnant females in Riyadh, has no relation to adverse pregnancy outcomes except for a higher prevalence of miscarriage in women with low 25(OH)D.

Use of cross-institutional progress test as a predictor of performance in a new medical college.

BACKGROUND: The progress test was initiated by Qassim University in 2000 as a tool to evaluate the educational process among Saudi medical colleges. Princess Nourah Bint Abdul Rahman University (PNU) College of Medicine is a new medical college established in 2012 that implemented the same innovative reformed curriculum of King Saud University College of Medicine. OBJECTIVES: The objective of this study was to use the progress test to evaluate the rate of knowledge acquisition among a new medical school compared to other long-established medical schools in Saudi Arabia. MATERIALS AND METHODS: As part of an ongoing strategy, the progress test was administered before the end of the academic year. Students in PNU were enrolled for 2 years in the progress test. We compared the mean progress test scores for PNU students compared to students at comparable stages in other medical schools in Saudi Arabia. RESULTS: The results showed that the rate of knowledge acquisition was similar in students at PNU to students in other well-established medical schools in Saudi Arabia. CONCLUSION: The present study showed that the interinstitutional progress test demonstrated that the level of acquisition of knowledge and performance of students in a new medical school was similar to other medical colleges in Saudi Arabia.

Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile.

OBJECTIVES: To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant. METHODS: A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated. FINDINGS: The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%. CONCLUSION: Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.

Clinical psychomotor skills among left and right handed medical students: are the left-handed medical students left out?

BACKGROUND: There is a growing perception that the left handed (LH) medical students are facing difficulties while performing the clinical tasks that involve psychomotor skill, although the evidence is very limited and diverse. The present study aimed to evaluate the clinical psychomotor skills among Right-handed (RH) and left-handed (LH) medical students. METHODS: For this study, 54 (27 left handed and 27 right handed) first year medical students were selected. They were trained for different clinical psychomotor skills including suturing, laparoscopy, intravenous cannulation and urinary catheterization under the supervision of certified instructors. All students were evaluated for psychomotor skills by different instructors. The comparative performance of the students was measured by using a global rating scale, each selected criteria was allotted 5-points score with the total score of 25. RESULTS: There were no significant differences in the performance of psychomotor skills among LH and RH medical students. The global rating score obtained by medical students in suturing techniques was: LH 15.89 ± 2.88, RH 16.15 ± 2.75 (p = 0.737), cannulation techniques LH 20.44 ± 2.81, RH 20.70 ± 2.56 (p = 0.725), urinary catheterization LH 4.33 ± 0.96 RH 4.11 ± 1.05 (p = 0.421). For laparoscopic skills total peg transfer time was shorter among LH medical students compared to RH medical students (LH 129.85 ± 80.87 s vs RH 135.52 ± 104.81 s) (p = 0.825). However, both RH and LH students completed their procedure within the stipulated time. CONCLUSIONS: Among LH and RH medical students no significant difference was observed in performing the common surgical psychomotor skills. Surgical skills for LH or RH might not be a result of innate dexterity but rather the academic environment in which they are trained and assessed. Early laterality-related mentoring in medical schools as well as during the clinical residency might reduce the inconveniences faced by the left-handed medical personnel.

Readiness for Self-Directed learning among first year Saudi Medical students: A descriptive study.

OBJECTIVES: The objectives of the present study was to explore the readiness for Self Directed Learning (SDL) among first year Saudi Medical students enrolled at King Saud University (KSU) and Princess NourahBintAbdulrahman University (PNU) in Saudi Arabia. METHODS: First year medical students were invited to participate in a descriptive cross sectional study design. Data were collected using a Self-Directed Learner Readiness Scale (SDLRS) which is a self- assessment tool aimed to assess three main components: self-management, desire for learning and self-control. The students responded to each item of the SDLRS on a 5-point Likert scale. Data were analyzed using SPSS, mean, median and total scores were calculated and were compared among student's groups. RESULTS: The mean score for the desire of learning was the highest (4.08± 0.5) of all the three components of the SDLRS followed by self-control (3.9± 0.9), while the least mean score was for self-management (3.7±0.5). Overall, differences between student's groups were not statistically significant. CONCLUSION: The present study revealed that the overall SDL readiness of participants was good, students were highly motivated for self-learning and had the ability for self-control. However, they need assistance to improve their self-management skills.

Faculty development programs improve the quality of Multiple Choice Questions items' writing.

The aim of this study was to assess the utility of long term faculty development programs (FDPs) in order to improve the quality of multiple choice questions (MCQs) items' writing. This was a quasi-experimental study, conducted with newly joined faculty members. The MCQ items were analyzed for difficulty index, discriminating index, reliability, Bloom's cognitive levels, item writing flaws (IWFs) and MCQs' nonfunctioning distractors (NFDs) based test courses of respiratory, cardiovascular and renal blocks. Significant improvement was found in the difficulty index values of pre- to post-training (p = 0.003). MCQs with moderate difficulty and higher discrimination were found to be more in the post-training tests in all three courses. Easy questions were decreased from 36.7 to 22.5%. Significant improvement was also reported in the discriminating indices from 92.1 to 95.4% after training (p = 0.132). More number of higher cognitive level of Bloom's taxonomy was reported in the post-training test items (p<0.0001). Also, NFDs and IWFs were reported less in the post-training items (p<0.02). The MCQs written by the faculties without participating in FDPs are usually of low quality. This study suggests that newly joined faculties need active participation in FDPs as these programs are supportive in improving the quality of MCQs' items writing.

Knowledge of Saudi female university students regarding cervical cancer and acceptance of the human papilloma virus vaccine.

OBJECTIVES: To assess the level of knowledge regarding cervical cancer and the acceptance of the human papilloma virus (HPV) vaccine among Saudi female students in health colleges. METHODS: This cross-sectional study of a convenient sample encompassed 1400 students in Health Colleges at Princess Nora Bint Abdul Rahman University, Riyadh, Saudi Arabia was conducted between December 2013 and February 2014. A self-administrated questionnaire was distributed to all participants. Data collected included socio-demographic data, knowledge of cervical cancer risk factors and clinical presentation, Pap smear, and HPV vaccine acceptance. The questionnaire reliability as tested by Cronbach's alpha was 0.82. RESULTS: The response rate was 89.9%, and data analysis revealed that 95.7% of students had poor knowledge level. The Pap smear was poorly recognized as a screening tool, with 46.7% of students having heard of the test. Senior and medical students had a significantly higher knowledge score. Father's health profession, high monthly income, and presence of cervical cancer among family members or friends increased the level of knowledge. Vaccine acceptance is influenced by its price, approximately 80% of students thought that an affordable vaccine price should not exceed 300 Saudi Riyals. Perceived barriers to the vaccine were fear of injections and vaccine side effects. CONCLUSION: There is a lack of knowledge and misinformation regarding cervical cancer, Pap smear, and HPV as a major risk factor for cancer of the cervix. These data can be used as a benchmark to formulate effective awareness programs. 

Awareness of an obstetric population about environmental tobacco smoking.

BACKGROUND AND OBJECTIVES: The reported rate of women's smoking is typically low. However, many pregnant women are exposed to environmental tobacco smoke (ETS), which could affect their own health and the health of their growing fetus. The aim of this study was to estimate the magnitude of the problem of exposure to ETS and assess the awareness of postpartum women to ETS and its possible effects. DESIGNS AND SETTINGS: This was a cross-sectional study conducted on 1182 postpartum women at a university hospital in Riyadh, Saudi Arabia, between 1(st) January and 30(th) June, 2012. MATERIALS AND METHODS: A structured questionnaire was used for data collection. Factors associated with the level of understanding of the possible effects of ETS exposure were analyzed. RESULTS: The majority of the participating women knew that exposure to ETS had adverse effects on maternal and fetal health (>80%), but their knowledge of the specific effects on fetal health was limited. The level of mothers' education was found to be associated with better knowledge of effects on mother and fetal health (P < 0.01). CONCLUSION: This study revealed that pregnant women in our sample had limited knowledge of the specific effects of ETS on fetal health. This shortcoming in knowledge needs to be addressed by improving health.

Incidence of Early Postpartum Voiding Dysfunction in Primiparae: Comparison Between Vaginal Delivery and Cesarean Section.

OBJECTIVES: To compare the incidence of early postpartum voiding dysfunction (PPVD) in primiparae women delivered vaginally (VD) to those delivered by elective Caesarean section (CS). METHODS: A prospective study of primiparae in early postpartum period, were grouped into: VD group and CS group. Following the first 24 h from delivery, patients had uroflowmetry and post-void residual urine (PVR) volume measurement. RESULTS: Two hundred and fifty six primiparae women recruited; 204 (81%) had VD and 48 (19%) had primary elective CS. Forty-two women in the VD group (20.2%) diagnosed with PPVD compared to only four (8.3%) in the CS group (P = 0.05). Within VD group, women who had vaginal tear (86.4% vs. 44%, P < 0.001) or epidural analgesia (33.3% vs. 18.1%, P < 0.05) experienced higher incidence of PPVD. CONCLUSION: Women who had normal VD are at higher risk of transient PPVD than those delivered by CS during their early postpartum period.

Recurrent Urinary Tract Infections Management in Women: A review.

Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50-60% of women will develop UTIs in their lifetimes. Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs (RUTI) are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics.

Reliability of Arabic ICIQ-UI short form in Saudi Arabia.

CONTEXT: The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) provides a brief measure of symptoms and impact of urinary incontinence on quality of life. It is suitable for use in clinical practice and research. An Arabic version of the ICIQ-UI SF was translated and validated in Egypt and Syria. AIMS: The objective was to assess the reliability of the Arabic version of the ICIQ-UI SF in women from Saudi Arabia. SETTINGS AND DESIGN: A study at the Urogynecology Clinic was conducted from November 2010 until August 2011. MATERIALS AND METHODS: Thirty-seven consecutive Saudi women attending urogynecologic clinic were recruited. Questionnaires were distributed for self-completion and then redistributed to the same set of respondents two to four weeks later as part of a test-retest analysis for assessing questionnaire's stability. STATISTICAL ANALYSIS USED: Agreement between two measurements was determined by weighted Kappa. Internal consistency was assessed using Cronbach's alpha coefficient. RESULTS: Participants had a mean (SD) age of 39 (9.9), median parity of 4, and mean BMI (SD) of 30.9 kg/m(2) (4.6). There were no differences in the frequency and amount of urine leaks or the impact of UI on quality of life observed between the two visits. Assessment of internal consistency was excellent with the Cronbach's alpha coefficient of 0.97 (95% CI: 0.88-0.98). Participants agreed that the questionnaire was clear, appropriate, and easy to understand. CONCLUSIONS: The Arabic ICIQ-UI SF is a stable and clear questionnaire that can be used for UI assessment in clinical practice and research among Saudi women.

Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women.

BACKGROUND: Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults' diseases including obesity, diabetes and hypertension.The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns' anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. METHOD: This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns' anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. RESULTS: Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2-68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. CONCLUSION: The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.