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1.
Women Birth ; 32(3): 263-269, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30093348

RESUMO

BACKGROUND: In the United States, the rates of cesarean delivery are well above the World Health Organization recommended target. Although obesity is a widely established risk factor for cesarean delivery, there is limited population-based research that examines the relationship between gestational weight gain and cesarean delivery. OBJECTIVE: To determine the association between gestational weight gain and unplanned or emergency cesarean delivery. METHODS: We examined 2107 mothers from the Infant Feeding Practices Study II 2005-2007. The Institute of Medicine's current guidelines were used to define categories of gestational weight gain: inadequate (less than the recommended guideline), adequate (within the recommended guideline) and excessive (above the recommended guideline). FINDINGS: Approximately 49.3% and 13.6% of the participants had excessive weight gain and unplanned or emergency cesarean delivery, respectively. A Greater proportion of women with excessive weight gain had an unplanned or emergency cesarean delivery followed by women with adequate and inadequate weight gain, respectively (17.8%, 10.0%, 8.8%; p<0.001). In the multivariable model, compared to women with adequate weight gain, the odds of unplanned or emergency cesarean delivery were higher among women with excessive weight gain (OR 1.56, 95% CI 1.07-2.27, p=0.020). DISCUSSION: Women with excessive gestational weight gain are more likely to experience an unplanned or emergency cesarean delivery, which increases the risk for poor maternal-infant health outcomes. CONCLUSION: It is critical to identify populations at increased risk of unplanned or emergency cesarean delivery and provide preconception and prenatal counseling to achieve and maintain the recommended weight gain for optimal maternal-infant health outcomes.


Assuntos
Cesárea/estatística & dados numéricos , Ganho de Peso na Gestação/fisiologia , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Feminino , Humanos , Saúde Materna , Mães/estatística & dados numéricos , Obesidade/complicações , Gravidez , Fatores de Risco , Estados Unidos , Adulto Jovem
3.
J Community Health ; 43(2): 238-247, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-28776110

RESUMO

Women residing in Eastern Africa are disproportionately affected by cervical cancer. Previous studies have identified risky sexual behavior as a major risk factor for cervical cancer. However, population-based studies examining the relationship between sexual behavior and cervical cancer screening are currently lacking. This descriptive cross-sectional study utilized nationally representative secondary data from the 2014 Kenya Demographic and Health Survey (n = 6104) to examine the association between risky sexual behavior and cervical cancer screening among sexually active women. Both descriptive and inferential statistical methods were utilized. Overall, 20.2% of the study sample reported having cervical cancer examination. Approximately 13.1% of the participants reported involvement in risky sexual behavior. Significantly lower proportion of women engaged in risky sexual behavior reported having cervical cancer examination (14.5 vs. 21.0%; p = 0.001). In the multivariable model, we found a significant interaction between risky sexual behavior and marital status on cervical cancer examination. Among women who were married/living together, risky sexual behavior was negatively associated with cervical cancer examination after adjusting for potential confounders (Prevalence Ratio, 95% CI) (0.42; 0.24-0.74; p = 0.002). The prevalence of having visual inspection with VIA or VILI were lower among women who were involved in risky sexual behavior (0.39; 0.18-0.87; p = 0.022). However, we were unable to detect any significant association between risky sexual behavior and having Papanicolaou test. With increasing incidence of cervical cancer in resource-limited settings, it is critical to identify populations at increased risk of infection and provide effective screening and follow-up services.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Comportamentos de Risco à Saúde , Humanos , Quênia/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
4.
Int J Gynaecol Obstet ; 141(1): 20-25, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29159927

RESUMO

OBJECTIVE: To examine the association between hormonal contraceptive use and vitamin A deficiency among women in Tanzania. METHODS: Secondary analysis of data from 8231 women who participated in the 2010 Tanzania Demographic and Health Survey. Both descriptive and inferential statistical analyses were performed. RESULTS: Overall, 1291 (weight percentage 17.8%) women reported a history of hormonal contraceptive use. The weighted prevalence of vitamin A deficiency was 36.9% (n=3027). After adjustment for potential confounders, women with hormonal contraceptive use had lower odds of vitamin A deficiency (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.66-0.94; P=0.009). There was a negative dose-response relationship between duration of hormonal contraceptive use and vitamin A deficiency. As compared with non-users, the odds of vitamin A deficiency decreased significantly among women who used hormonal contraceptives for 1-12 months (aOR, 0.58; 95% CI, 0.40-0.84; P=0.004) and more than 12 months (aOR, 0.26; 95% CI, 0.15-0.46; P<0.001). Women with a history of using oral contraceptive pills had a lower odds of vitamin A deficiency versus non-users (aOR, 0.49; 95% CI, 0.37-0.65; P<0.001). CONCLUSION: In addition to contraceptive effectiveness, hormonal contraception use might have nutritional benefit in preventing vitamin A deficiency.


Assuntos
Anticoncepcionais Orais Hormonais/uso terapêutico , Deficiência de Vitamina A/epidemiologia , Adolescente , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Prevalência , Tanzânia/epidemiologia , Adulto Jovem
5.
J Hum Lact ; 34(4): 810-820, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29186666

RESUMO

BACKGROUND: Early initiation of breastfeeding increases the likelihood of longer duration of breastfeeding. Factors associated with breastfeeding include maternal sociodemographic, behavioral and health-related characteristics, infant health characteristics, and perinatal factors. Research aim: This study aimed to determine the association between type of birth attendant and early initiation of breastfeeding among women in Ghana. METHODS: A cross-sectional study was conducted using women ( N = 3,087) who participated in the 2014 Ghana Demographic and Health Survey. The main outcome of interest was early initiation of breastfeeding, defined as provision of mother's milk to the infant within 1 hr of birth. Chi-square tests and multivariable logistic regression modeling were performed. RESULTS: Breastfeeding was initiated within 1 hr of birth by 58.3% of women. In the multivariable model, there was a significant interaction between type of birth attendant and place of residence on early initiation of breastfeeding. For rural areas, compared with women who had a nurse or midwife as their birth attendant, the multivariable odds ratios [95% confidence intervals] for early initiation of breastfeeding were lower among women whose birth attendant was a relative or other, 0.20 [0.07, 0.55], p = .002; village health volunteer or traditional health practitioner, 0.21 [0.07, 0.62], p = .005; none, 0.34 [0.12, 0.93], p = .035; community health officer, 0.42 [0.21, 0.85], p = .016; and doctor, 0.48 [0.24, 0.96], p = .037. For urban areas, no significant association was detected between type of birth attendant and early initiation of breastfeeding. CONCLUSION: Findings from the study highlight the need for focused, context-specific, early initiation of breastfeeding promotion and intervention, especially for women and their birth attendants in rural areas.


Assuntos
Aleitamento Materno/métodos , Tocologia/normas , Mães/estatística & dados numéricos , Adolescente , Adulto , Aleitamento Materno/estatística & dados numéricos , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Gana , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Tocologia/estatística & dados numéricos , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
6.
J Am Osteopath Assoc ; 116(12): 770-779, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27893143

RESUMO

CONTEXT: Existing literature suggests participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the prenatal and postnatal periods is associated with lower rates of breastfeeding among WIC-eligible mothers. However, minimal research has been published on the association between WIC enrollment and exclusive breastfeeding. OBJECTIVE: To examine the association between WIC exposure and exclusive breastfeeding at 3 months postpartum. METHODS: We conducted a secondary data analysis using information on 784 low-income women who participated in the longitudinal population-based Infant Feeding Practices Study II between May 2005 and June 2007. The main outcome of interest was exclusive breastfeeding at 3 months postpartum. Logistic regression analysis was used to estimate OR and 95% CI for exclusive breastfeeding relative to WIC enrollment status, controlling for the confounding effects of other maternal characteristics. We further conducted a subgroup analysis among those participating in WIC prenatally to examine the association between receipt of information about infant feeding from WIC and exclusive breastfeeding at 3 months postpartum. RESULTS: The crude prevalence of exclusive breastfeeding at 3 months postpartum was 18.1% of women enrolled in WIC and 41.1% of WIC-eligible nonparticipants (P<.0001). After adjusting for sociodemographic, behavioral, and anthropometric factors, the odds of exclusive breastfeeding at 3 months were lower for women enrolled in WIC (OR, 0.57; 95% CI, 0.37-0.88) when compared with women not enrolled in WIC. In the subgroup analysis, receipt of information from WIC about feeding infants during the prenatal period was not significantly associated with exclusive breastfeeding at 3 months (OR, 0.86; 95% CI, 0.39-1.89). CONCLUSION: Women who were enrolled in WIC and who received information about feeding infants were less likely to exclusively breastfeed than women not in WIC. Continued improvement and adjustment to the existing WIC breastfeeding program could potentially improve these rates. Additional studies that examine the quality of WIC services provided, especially those pertaining to breastfeeding programs, are warranted.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Assistência Alimentar , Adolescente , Adulto , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Mães , Pobreza , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
7.
J Am Osteopath Assoc ; 116(7): 430-9, 2016 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-27367948

RESUMO

CONTEXT: Studies have shown that exclusive breastfeeding at hospital discharge is associated with longer duration of breastfeeding. Method of delivery (MOD) is a barrier that may hinder breastfeeding practices. However, research examining the association between MOD and exclusive breastfeeding at hospital discharge is lacking. OBJECTIVE: To examine the association between MOD and exclusive breastfeeding at hospital discharge. METHODS: We used a cross-sectional study design to conduct a secondary data analysis of 1494 women who participated in the Infant Feeding Practices Study II between 2005 and 2007. Multiple logistic regression was conducted to estimate the OR and 95% CI for the association between MOD and exclusive breastfeeding at hospital discharge, after adjusting for potential confounding variables. RESULTS: The crude prevalence rates of vaginal delivery and cesarean delivery were 74.8% and 25.2%, respectively. The prevalence of exclusive breastfeeding at hospital discharge was 70.6% among respondents who gave birth by cesarean delivery compared with 79.9% of women who gave birth vaginally (P=.001). After adjusting for sociodemographic, behavioral, and anthropometric factors, the odds of exclusive breastfeeding at hospital discharge were lower among women who gave birth by cesarean delivery compared with women who gave birth vaginally (OR, 0.41; 95% CI, 0.24-0.71). CONCLUSION: Women who give birth by cesarean delivery may require additional attention, assistance, and encouragement during their hospital stay to improve rates of exclusive breastfeeding at discharge. Health care professionals should address the issue of MOD when promoting exclusive breastfeeding to maximize the potential for longer-term breastfeeding success.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Parto Obstétrico , Adolescente , Adulto , Cesárea , Estudos Transversais , Parto Obstétrico/métodos , Feminino , Humanos , Prevalência , Fatores Socioeconômicos , Adulto Jovem
8.
Chem Sci ; 7(6): 3569-3573, 2016 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29997849

RESUMO

The impact of remote substituents on the affinity of cucurbit[n]urils (CB[n]) towards a homologous series of guests, which differ from one another only by a single substituent, and adopt the same geometry within the cavity of the macrocycle, is presented for the first time, and is used to decipher the competition between water and the carbonylated portal of CB[7] for the stabilization of positively charged guests. Binding affinities of CB[7] towards substituted N-benzyl-trimethylsilylmethylammonium cations relative to the unsubstituted member (X = H) range from 0.9 (X = CH3) to 3.1 (X = SO2CF3), and correlate very precisely with a linear combination of Swain-Lupton field/inductive (F; 67%) and resonance (R; 33%) parameters tabulated for each substituent. We show that this subtle sensitivity results exclusively from the balance between two competing mechanisms, on which the substituents exert an approximately 11 times greater impact: (1) the solvation of the ammonium unit and its immediate surroundings by water in the free guests, and (2) the coulombic attraction between the ammonium unit and the rim of CB[7] in the complexes.

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