How the Clamping Distance of the Umbilical Cord affects Microbial Colonization and Cord Separation Time: A Randomized Trial.

OBJECTIVE: This study aimed to explore how umbilical cord separation time and microbial colonization are affected by umbilical cord clamping distance. METHODS: The randomized controlled study included 99 healthy newborns and was conducted at a hospital in Kahramanmaras, Turkey. The newborns were randomly divided into 3 groups: intervention group I (cord length: 2 cm); intervention group II (cord length: 3 cm; control group (not measured). On postpartum day 7, a sample of the umbilical cord was taken to assess microbial colonization. The mothers were contacted via mobile phone on the 20th day for an at-home follow-up. The data were analyzed by applying Pearson's chi-square test, Fisher's exact test, a 1-way analysis of variance test, and Tukey's post hoc Honest Significant Difference test. RESULTS: The mean umbilical cord separation time of the newborns was found to be 6.9 (±2.1) days in the intervention group I, 8.8 (±2.9) days in the intervention group II, and 9.5 (±3.4) days in the control group. The difference between the groups was statistically significant (P < .01). Microbial colonization was detected in 5 of the newborns, across the groups; no significant differences were found between the groups (P > .05). CONCLUSION: In this study, it was determined that clamping the umbilical cord from a distance of 2 cm in vaginally delivered full-term newborns contributed to the shortening of the cord fall time and did not affect microbial colonization.

Evaluation of Midwives' Perceptions of Spirituality and Spiritual Care in Aydin, Turkey.

Spirituality is an integral part of holistic care, but studies have revealed that the spiritual dimension of care is largely neglected in healthcare settings. This study evaluated midwives' perceptions of spirituality and spiritual care. The study is a cross-sectional design and was conducted from April 1 to June 30, 2018 in Aydin, Turkey. The research sample of the study contacted 101 midwives. The Spirituality and Spiritual Care Rating Scale were used to collect data. It was found that the midwives' perceptions of spirituality and spiritual care were affected by age, having children, family type, and working unit (p < 0.05).

Maternal and perinatal outcomes of pregnancy associated with COVID-19: Systematic review and meta-analysis.

INTRODUCTION: This study explored maternal and infant outcomes in the periods of pregnancy, birth and the postpartum, in women with COVID-19. METHODS: After PROSPERO registration (CRD42020191106), scanning for the studies was carried out over the period 5-15 May 2020 in the PubMed, Science Direct, EBSCO and Web of Science databases with the search string: ['COVID-19' AND ('pregnancy' OR 'pregnant' OR 'maternal outcomes' OR 'infant outcomes' OR 'fetal outcomes' OR 'birth')]. Studies reporting maternal and perinatal outcomes of pregnant women with COVID-19 were included. Data were extracted independently by two researchers and combined with meta-analysis and pooled analysis. RESULTS: The 54 studies included in this analysis contained data on 517 pregnant women diagnosed with COVID-19 and 385 infants. Of the pregnant women, 18% had gone into preterm labor and 77% had given birth by caesarean. Of the newborns, 19% had low birth weight, 14% had fetal distress, and 24% were admitted into the neonatal intensive care unit. Nine maternal and eight baby mortalities were reported in the studies. CONCLUSIONS: The study revealed that COVID-19 in pregnant women appeared to be negative maternal and infant outcomes, with mortalities as well.

Effects of Obstetric Interventions During Labor on Birth Process and Newborn Health.

AIM: This study aimed to investigate the effects of the interventions in the delivery room on the delivery process and the newborn health. METHOD: The analytical-cross-sectional study was carried out with 354 puerperal women who gave birth in hospital between December 2016 and June 2017 in a public hospital. The data were collected by the data collection form developed by the researchers. Data analysis was done by using descriptive statistics and chi-square test in SPSS 21.00 program. RESULTS: The interventions were determined in continuous electro fetal monitoring (80.5%), oxytocin induction (79.9%), restriction of free movement (56.8%), amniotomy (49.7%), enema (44.1%), and movement restriction (56.8%). The intervention period of the second phase of delivery was longer and the rate of cesarean section was higher, and the need for NICU, suction difficulty, 5th APGAR score less than 7, trauma development, difficulty in suction, and higher trauma rates were found in infants. It was determined that the rate of oxygen need in puerperals admitted to the delivery room with cervical dilatation below five cm, vacuum and episiotomy applications in those who underwent amniotomy, and vacuum application rates in those undergoing oxytocin inductions were found to be high. In addition, the rate of fundal compression and episiotomy was significantly higher in patients who used continuous electro fetal monitoring, fundal compression and vacuum rate in patients who were administered analgesic drugs, and episiotomy rates in patients using analgesic drugs. CONCLUSION: It has been concluded that interventions in the first phase of labor negatively affect the delivery process and neonatal health and increase the need for intervention in the second phase.

Status of postpartum depression in Turkey: A meta-analysis.

We determined the prevalence of postpartum depression (PPD) and related risk factors in Turkey based on relevant research. This study is a systematic review and meta-analysis and was conducted by performing a scan of the Turkish and English literature over the period of January-February 2016. Most of the research included in this systematic compilation made use of the Edinburgh Postpartum Depression Scale. The scans executed indicated that 4,740 women out of 18,780 were at risk for PPD. In the computations made based on these data, it was found that the consolidated prevalence of PPD was 24% (21%-27% at a confidence interval of 95%) and that this rate varied between 9% and 51%. The study revealed 54 risk factors related to PPD. Those most commonly reported were mental problems/depression prior to pregnancy, unplanned/unwanted pregnancy, low income/socioeconomic level, bad marital relationship/problems with spouse/dissatisfaction with married life, and being a housewife. In this study, we showed that the prevalence rate of PPD is significantly high, that it varies within a wide range, that the prevalence of depression decreased with the increase of the time passed after childbirth, and that it is related to numerous and different factors.

The Correlation Between Breastfeeding Success in the Early Postpartum Period and the Perception of Self-Efficacy in Breastfeeding and Breast Problems in the Late Postpartum.

INTRODUCTION: The research was conducted to determine the correlation between breastfeeding success in the early postpartum period and the perception of self-efficacy in breastfeeding and breast problems in late postpartum. METHODS: This analytic and cross-sectional research was carried out at Aydin Obstetrics and Gynecology and Children's Diseases Hospital. Three hundred twenty-seven primipara mothers who had delivered a single baby of healthy term at 37 or more gestational weeks with no previous experience with breastfeeding and who agreed to cooperate participated in the research. RESULTS: The mothers' mean gestational week of delivery was 39.25 ± 1.10 weeks, and it was found that 56.0% had delivered by cesarean section and 57.0% had started to breastfeed immediately after the birth. The mothers' LATCH mean score was 6.55 ± 0.86; their postnatal breastfeeding self-efficacy mean score was found to be 59.10 ± 7.21. Mothers who had high success in breastfeeding at early postpartum were found to experience fewer problems with their breasts (Z = -2.65, p < 0.05), gave birth by vaginal delivery (Z = -2.88, p < 0.05), and had not received anesthesia during the delivery (Z = -2.52, p < 0.05). In the correlation analysis, it was seen that mothers with high success in breastfeeding also had high self-efficacy scores (r = 0.210, p = 0.003). CONCLUSION: The results of the research indicated that breastfeeding success in the early postpartum period reduced breast problems and increased the perception of breastfeeding self-efficacy in the late postpartum period.

Fathers' knowledge about and attitudes towards breast feeding in Manisa, Turkey.

OBJECTIVE: to determine the extent of knowledge fathers of newborns have about breast feeding and lactation and to examine their attitudes regarding breast feeding. DESIGN: a descriptive, cross-sectional study. SETTING: Manisa Maternity and Children's Hospital. PARTICIPANTS: 203 fathers of newborn infants. FINDINGS: although a wide majority of the participants (92.1%) expressed a desire to have their infants breastfed, it was found that only 58.6% discussed this with their partners. It was discovered that 88.7% of the fathers were happy to help with the housework so that their wives could breast feed while 57.6% stated that breast feeding would be psychologically beneficial to both the mother and the baby. Approximately half of the study subjects (48.8%) expressed an interest in attending an educational programme on breast feeding for fathers. The study also showed that the fathers' level of education, the type of family they were a part of and previously received education on lactation and breast feeding had an effect on their knowledge and attitudes toward breast feeding (p<0.05). CONCLUSION: it was seen that fathers were eager to have their infants breastfed but unable to adequately share such thoughts with their wives. It was also observed that their knowledge about breast feeding and lactation was limited, leading to the conclusion that fathers may benefit from a supportive educational programme on breast feeding.

Impact on quality of life and physical ability of pregnancy-related back pain in the third trimester of pregnancy.

The aim of the study was to evaluate the impact of pregnancy-related back pain on quality of life and physical ability in the third trimester of pregnancy. One hundred women in the 28th-40th week of pregnancy were asked to fill out questionnaires including: general questions about background factors, the Katz's Activity's Daily Living Index (ADL), and Short Form of WHO Quality of Life Questionnaire (WHOQOL-BREF). Back pain intensity was assessed by visual analog scale (VAS), and functional limitation was measured by Oswestry Low Back Disability Questionnaire (OSW). It was found that, in the third trimester, pregnant women with back pain (PBP) with low pain intensity and moderate functional limitation did not have an impact on quality of life but decreased physical ability when compared to pregnant women with no back pain (NBP). As the back pain intensity of pregnant women increases, physical ability decreases.

Turkish nurses' perceptions of spirituality and spiritual care.

AIM: To explore Turkish nurses' perceptions of spirituality and spiritual care and to investigate the relationship between their perceptions and their demographic/independent variables. BACKGROUND: Nurses' perception of spirituality can directly affect how they behave, deal with their patients and communicate with them in regard to the provision of spiritual care. DESIGN: Survey. METHODS: This study employed a convenience sample of 348 staff nurses from the public hospitals in the west of Turkey. The data were collected with two tools; a 'sociodemographic data form' and the 'Spirituality and Spiritual Care Rating Scale' (SSCRS). The response rate was 92% (n = 319). RESULTS: The mean age of the nurses was 31·70 (SD 6·34) years and 22·9% of them had a Bachelor's degree. Among the nurses, 54·98% had ≥ 11 years of clinical experience. The mean score for the SSCRS was 3·21 (SD 0·63) which indicated that nurses' perceptions concerning spirituality and spiritual care were 'uncertain' or 'less clearly' defined. Significant differences were found between nurses' perceptions of spirituality and spiritual care and their ages (p < 0·05), marital status (p < 0·05) and education levels (p < 0·01). CONCLUSION: The research findings suggest that Turkish nurses' perceptions were indecisive and inconclusive. Nurses' educational level, belief in the evil eye and department of employment appeared to have a positive impact on their perception of spirituality and spiritual care. RELEVANCE TO CLINICAL PRACTICE: These findings will enable nurses to consider the importance of spirituality and spiritual care. Grasping these concepts will enable nurses to become more sensitive in their daily practices of spiritual care.

Prevalence and risk factors concerning postpartum depression among women within early postnatal periods in Turkey.

PURPOSE: Postpartum depression (PPD) stands out as an important health issue that affects not only the mother but her partner and the entire family. A few studies from Turkey have found the high prevalence for PPD. In the current study we aimed: (1) to report the prevalence of postpartum depression among Turkish women in Manisa province; (2) description of the association of PPD with risk factors. METHODS: To achieve the goals of the current study, we employed the Edinburgh Postpartum Depression Scale (EPDS). The perceived social support (PSS) scale was used to assess social support in the postnatal period. Socio-demographic and obstetric variables were collected through a socio-demographic and obstetric questionnaire. RESULTS: The mean EPDS scores of the study participants were 8.53 ± 4.93. The EPDS-based prevalence of PPD (a score of ≥13) was 28.3%. We found a significant negative correlation between EPDS scores and perceived social support from the family (PSS-Fa) and from friends (PSS-Fr) scores. The present study also revealed a significant association between postpartum depressive symptomatology and unintended pregnancy, insufficient social support, and previous history of depression. CONCLUSION: The findings of the current study revealed high EPDS-based PPD prevalence in a sample of Turkish women and described a number of risk factors associated with PPD. The high prevalence found in this study indicated a need for developing new interventions for early detection and treatment of PPD. A significant number of Turkish immigrants live in western countries. We believe the findings of the current study may be helpful for physicians in locations where a large number of Turkish immigrants live.

The evaluation of school of health students' knowledge and behavior of healthy life-styles of related to importance to prevent cancer.

This study was planned as a descriptive evaluation of School of Health students knowledge and healthy lifestyle behavior related to prevention of cancer. The study has been carried out in Nursing, Midwifery and Health Official Departments at Celal Bayar University School of Health, between November 2007 and January 2008. The subjects comprised 345 volunteer students. The data were collected using a questionnaire covering nutritional status and attitudes related to the prevention from cancer, and results were assessed using the Health Promotion Lifestyle Profile Scale. The mean age was 20.9 ∓ 2.01 years and 22.6% were male. Some 88.4% of the students considered cancer to be a preventable illness and 70.1% of them believed that it could be prevented by healthy nutrition. The mean score of the Health Promotion Lifestyle Profile Scale was 124.8 (SD, 19.9). In conclusion, it was found that students participating in this study have good level of knowledge on cancer prevention. Health behavior was found to be moderate.

Effect of foot massage to decrease physiological lower leg oedema in late pregnancy: a randomized controlled trial in Turkey.

This study aims to evaluate the effect of foot massage for decreasing physiological lower leg oedema in late pregnancy. Eighty pregnant women were randomly divided into two groups; study group had a 20 min foot massage daily for 5 days whereas the control group did not receive any intervention beyond standard prenatal care. The research was conducted between March and August 2007 in Manisa Province Health Ministry Central Primary Health Care Clinic 1, in Manisa, Western Turkey. Compared with the control group, women in the experimental group had a significantly smaller lower leg circumference (right and left, ankle, instep and metatarsal-phalanges joint) after 5 days of massage. The results obtained from our research show that foot massage was found to have a positive effect on decreasing normal physiological lower leg oedema in late pregnancy.