Journal of Family and Reproductive Health

Effectiveness of Birthing Ball Exercises Therapy in Improving Labor Pain and Labor Outcomes: A Systematic Review

2025-01-06T08:28:46+0330

Objective: We must treat every woman with respect and compassion during her childbirth, allowing her to choose how she wants to remember the experience. Midwives and nurses use birthing balls to reduce labor pain and enhance maternal comfort without an epidural. The aim of this systematic review was to critically evaluate the available evidences on the effect of birthing balls on labor pain and labour outcomes.
Materials and methods: Studies identified through PubMed, Semantic Scholar, and Mendeley electronic databases to gather evidences with selected keywords. This review incorporated randomised controlled trials and quasi-experimental research studies that met specific, predefined inclusion criteria. The search generated 441 titles and abstracts, which were further filtered down to 29 publications that were possibly relevant. Out of those, eight studies met the inclusion criteria. Performed a quality assessment of the articles using the JBI quality assessment tool.
Results: All of the included studies show labor pain on a 10-cm Visual Analogue Scale (VAS), and interventional groups reported significantly less labor pain in delivery compared to the control group without birth ball exercise. On labour outcome findings, the intervention group had a higher mean score of cervical dilation in 2 studies, quicker head descent in 3 studies, lower labor time in 4 studies, mother satisfaction throughout labor in 2 studies, and a preference for vaginal delivery in 2 studies.
Conclusion: Clinical implementation of a birthing ball exercise during the process of labor is an effective intervention to reduce labor pain and improve labor outcomes.

Influencing Factor Analysis and Prediction Model of Emergency Caesarean Delivery for Advanced-Age Nulliparous Women at the Time of Hospitalization

2025-01-06T08:28:46+0330

Objective: In Japan, the number of nulliparous pregnant women of advanced age, defined as 35 years or older, has increased, and the age range has lengthened towards older age with the increased use of infertility treatments. Given this trend, adverse labour outcomes, such as emergency caesarean delivery (ECD), are expected to increase. Therefore, by focusing mainly on maternal age and infertility treatment history, we aimed to establish a new prediction model for the likelihood of ECD after identifying the influencing factors related to maternal and labour-related characteristics.
Materials and methods: The medical records of 1,521 pregnant women who were nulliparous between 2017/4/1 and 2024/3/31 at our hospital were retrospectively reviewed. First, for the 675 women who were aged 30 years old or more, we calculated the rates of ECD in 8 groups classified according to maternal age, infertility treatment, and other variables. Next, we performed multivariate logistic regression analysis to assess the effect of each representative factor and established a prediction model based on the number of factors that were significant in the multivariate analysis.
Results: Simple comparisons classified by maternal age revealed a constant increase in the rate of ECD with increasing maternal age, and multivariate analysis revealed 7 significant factors, namely, advanced maternal age, history of using assisted reproductive techniques (ART), small height, high Body mass index (BMI), low Bishop score, late-term delivery, and large infant. In the prediction model constructed with these 7 factors, the rate of ECD increased as the number of these factors increased.
Conclusion: The negative impact of advanced maternal age, namely, 40 years or older, and ART history, on labour outcome is clear. A new prediction model has the potential to identify patients with an extremely high probability of needing an ECD. These results may indicate that the management of the labour process will become more difficult in the future.

Factors Affecting Presentation Delay to the Hospital Among Breast Cancer Patients: A Retrospective Analysis

2025-01-06T08:28:45+0330

Objective: Breast cancer constituted 13.5% of all reported new cancer in India, with a notable mortality rate due to late presentation. The current research aims to address the extent of delay in presentation to the hospital and the factors that contribute to delayed presentation among breast cancer patients.
Materials and methods: A descriptive cross-sectional study was conducted among 138 primary breast cancer patients aged 18 to 60 years, with a time lag of more than 2 weeks between the initial recognition of symptoms and the first medical interaction. These patients were attending the oncology Outpatient Department (OPD) of tertiary care center in Central India, where female breast cancer patients receive treatment and follow-up care. The analysis employed binary logistic regression to assess the factors significantly affecting the delayed presentation to the hospital.
Results: Most of the participants were aged between 40 and 50 years and did not have a family history of breast cancer. The median delay in presentation to the hospital was 2 months. Women having breast lump as initial breast symptom tend to present late (> 3 months) to the hospital (p=0.037) and if the breast lump was smaller, they are more likely to delay seeking medical attention compared to those with larger breast lump (p=0.012).
Conclusion: The study indicates that many patients delayed seeking help due to small breast lumps. Improved screening services are needed for early detection. Future awareness campaigns should emphasize the link between breast lumps and cancer to reduce delays and improve patient quality of life.

Risk Factors Associated With Pediatric Asthma Hospitalization: A Retrospective Case-Control Study

2025-01-06T08:28:45+0330

Objective: To evaluate the risk factors associated with asthma in children hospitalized at Hospital Belen de Trujillo.
Materials and methods: An analytical study of retrospective cases and controls was carried out in which 258 clinical histories of children between 5 to 14 years of age who were hospitalized in the Hospital Belen de Trujillo (HBT) during the period 2015-2019 were included, which were grouped into 129 histories of children who had been hospitalized for asthma (cases) and 129 histories of children hospitalized for a different cause (controls). The frequency distribution will be calculated, the Chi-square statistical test will be used, the odds ratio will be obtained and the 95% confidence interval will be calculated; finally, a multivariate analysis will be performed by means of logistic regression to determine whether the influence of other variables generates a greater risk of developing asthma in children.
Results: The multivariate analysis showed that the factors: cesarean delivery, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age together predict 92. 0% of the cases of asthma; however, taking the influence of all the factors at the same time, it was found that the cesarean delivery route, non-exclusive breastfeeding, obesity and maternal age are significant for the regression (p<0.05), while the factor history of bronchiolitis is not significant (p>0.05). Likewise, when the bivariate analysis of the five variables studied was performed and the Chi-square test was applied, it was found that all five factors were significant (p<0.05) for asthma in children at Hospital Belen de Trujillo.
Conclusion: The factors cesarean delivery route, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age are associated with asthma in children hospitalized at HBT.

TikTok as a Resource for Fertility Information and Support: A Patient Survey

2025-01-06T08:28:44+0330

Objective: TikTok is a rapidly growing social media platform with over 800 million users worldwide. Many patients access fertility-related content across social media platforms, however, this has never been studied related to TikTok. This study aimed to describe patient perspectives and experiences using TikTok for fertility-related content.
Materials and methods: We conducted a cross-sectional web-based survey from April 1st 2023 to October 1st 2023 at a large fertility center in Toronto, Canada. Patients were eligible for inclusion if they self-identified that they use TikTok for fertility-related content and had pursued any form of fertility care. Results of the survey were described with descriptive statistics and thematic analysis.
Results: A total of 23 patients with a mean age of 36.74±6.67 years participated in the online survey. Fertility-related TikTok content included lived experiences of fertility journeys descriptions of fertility treatments or procedures, live-streaming of fertility treatments or procedures, interactive questions and answers, and educational videos. Creators of fertility-related TikTok content include patients undergoing fertility treatments, physicians, naturopaths, counselors, and patient advocates. The most common reasons for liking TikTok for fertility content included empathy or shared experiences, stress relief, and self-education. Reasons for disliking TikTok for fertility information included misinformation, commercialization or advertisements, and negative emotions of stress, anxiety, or emotional upset. Misconceptions seen on TikTok included misinformation about complications and success rates for assisted reproductive therapy, as well as nutritional advice.
Conclusion: Fertility providers should have a growing awareness of information available on TikTok for patients accessing fertility care and assisted reproductive technology.

Exploring the Physical and Mental Health Challenges of Teenage Pregnancy: A Qualitative Study in the Tamale Metropolis, Ghana

2025-01-06T08:28:44+0330

Objective: Teenage pregnancy poses significant public health challenges globally, particularly affecting the physical and mental well-being of adolescent girls. Despite a global decline in teenage birth rates, regions like sub-Saharan Africa continue to experience high prevalence. In Ghana's Tamale metropolis, teenage pregnancy rates have shown a concerning rise, underscoring the need for an in-depth exploration of its multifaceted impacts. This study aims to explore the physical and mental health effects of teenage pregnancy in the Tamale metropolis, capturing their personal experiences and coping mechanisms.
Materials and methods: Employing a qualitative exploratory descriptive design, the study conducted a focus group discussion with 10 first-time teenage mothers aged 13–19 whose babies were less than
1 month. Participants were purposively sampled from antenatal records across five Community-based Health Planning and Services (CHPS) compounds. Discussions, guided by the socioecological model, were transcribed, translated, and thematically analyzed using NVivo software.
Results: Participants reported numerous physical health challenges, including severe nausea, vomiting, exhaustion, musculoskeletal pain, and infections like candidiasis. Mental health struggles encompass feelings of sadness, irritability, anxiety, and societal-induced stress. Coping strategies varied, with reliance on trusted individuals, avoidance of social situations, support from healthcare professionals, and family backing emerging as predominant themes.
Conclusion: This study revealed profound physical and mental health challenges compounded by societal stigma and limited resources. Strengthening social support networks, reducing stigma, and promoting patient-centered care are imperative. Targeted interventions are also essential to enhance health outcomes for these young mothers and their children.

Temporal Trends of Stillbirth in Brazil Disaggregated by Maternal and Gestational Age

2025-01-06T08:28:43+0330

Objective: Stillbirth is a neglected problem that needs to be given a greater visibility, especially in developing countries. This study aimed to describe temporal trends of stillbirth rates disaggregated by maternal and gestational age.
Materials and methods: This is an ecological study conducted in Brazil. Stillbirth rates and temporal trends were calculated using data from 2011-2021, considering variables such as gestational age (≥ 22 weeks) and maternal age (10-19, 20-34, and ≥ 35 years old). Stillbirth rates were presented per 1,000 births, and trends were assessed via autoregressive models.
Results: There were 228,386 stillbirths in Brazil, corresponding to 1 event per 133 live births at ≥ 22 gestational weeks in singleton pregnancies. At ≥28 weeks, the average stillbirth rates were 139.46 per 1,000 births (28-31 weeks), 36.59 per 1,000 births (28-36 weeks), 6.07 per 1,000 births (28-41 weeks), and 5.94 per 1,000 births (28-42 weeks and more). Data disaggregation by maternal age showed that average stillbirth rates were 7.69 per 1,000 births (mothers aged 10-19 years), 6.90 per 1,000 births (mothers aged 20-34 years), and 10.34 per 1,000 births (mothers aged ≥ 35 years). The temporal trends showed statistically significant increase in stillbirth rates in almost all gestational age strata among adolescent mothers, but not among older women.
Conclusion: Older women experienced the highest stillbirth rates in Brazil but with a clear declining trend. The upward stillbirth trends revealed among adolescent mothers suggest that the fetal death prevention must be prioritized in the Brazilian adolescent health policy agenda.

Association Between Sociodemographic Characteristics and Assisted Childbirth by Qualified Personnel in Madagascar

2025-01-06T08:28:42+0330

Objective: This study aims to analyze the association between the likelihood of giving birth in a healthcare facility and various sociodemographic characteristics in Madagascar.
Materials and methods: This study utilized data from the 2021 Madagascar Demographic and Health Survey which included a representative sample of women of reproductive age (15-49 years). The sociodemographic variables analyzed included age, birth order, education level, region residence and economic status with the place of delivery being the primary dependent variable. Data analysis was conducted using R software. A chi-square test was applied to assess associations between variables, with a significance threshold set at 5%.
Results: The prevalence of institutional childbirth services usage in Madagascar was 37.4% (35.1-39.7). The results showed that women under 20 years had an assistance rate of 36.7% (33.9-39.4), while the rate for primiparas reached 49.9% (48.5-51.3). Prenatal visits, mother’s age, birth order, region, residence, education level, and economic quintile significantly influenced access to care, with p-values < 0.0001. Only 17.5% (15.6-19.4) of women in the lowest quintile received qualified assistance at childbirth.
Conclusion: The results highlight the impact of age, birth order, residence, education level, region and socioeconomic status on access to childbirth services, necessitating a multisectoral approach to improve equity.

Abortion Rate Following Chorionic Villous Sampling and Amniocentesis in Twin Pregnancies

2025-01-06T08:28:42+0330

Objective: Amniocentesis and chorionic villus sampling (CVS) are the most widely used prenatal diagnostic methods. Despite their benefits, they can be associated with adverse pregnancy effects, but the exact prevalence of these complications especially in twin pregnancies is not exactly known. Therefore, the present study was conducted to determine post-amniocentesis or CVS complications in twin pregnancies.
Materials and methods: This retrospective observational study was conducted on 187 pregnant women who underwent amniocentesis or CVS in the perinatology department of Yas Hospital affiliated with Tehran University of Medical Sciences from January 2011 to March 2020. All participants were evaluated with amniocentesis or CVS by an expert perinatologist. The study outcomes were considered as the occurrence of vaginal bleeding, rupture of the membranes, chorioamnionitis, and abortion.
Results: The mean age of women was 33.5 ± 6.5 years. About 90 % of pregnant women underwent amniocentesis and the others underwent CVS. In 132 (70.6%) pregnant women, the most common indication for diagnostic prenatal tests was having high-risk first/second-trimester screening followed
by abnormal ultrasound anomaly scan in 31 (16.6%) cases. It was also found that in 80 (42.8%) patients, the placenta site was in the anterior part and 65 (34.8%) in the posterior part. The diagnostic test results were normal in 170 (90.4%) cases, while trisomy 21 was detected in 13 (7%) cases and trisomy 13 in 4 (2.1%) cases. The rate of abortion following CVS or amniocentesis in twin pregnancies was 3.7%, which was not associated with the study variables.
Conclusion: The results of the present study showed that the rate of miscarriage following amniocentesis and CVS in twin pregnancies is 3.7%. Therefore, reassuring the parents about the benefits of amniocentesis or CVS rather than their rare complications is necessary.

Lifetime Attributable Risk for Breast Cancer Induced by High-Resolution Computed Tomography During COVID-19 Pandemic

2025-01-06T08:28:41+0330

Objective: The widespread utilization of high-resolution computed tomography (HRCT) for diagnosing and management of COVID-19 during the pandemic has prompted worries regarding a potential rise in future breast cancer cases. We aimed to estimate the Life Attributable Risk (LAR) of breast cancer in Shiraz, Iran, linked to HRCT use during the COVID-19 pandemic.
Materials and methods: A cross-sectional study was conducted at Namazi Hospital in Shiraz from February 2, 2020, to December 31, 2022.The Imaging Performance Assessment of CT Scanners (ImPACT) patient dosimetry calculator was used to determine organ doses. LAR was computed utilizing the Biological Effects of Ionizing Radiation (BEIR) Committee models.
Results: The sample size was 666, with ages spanning from 15 to 95 years. 25% (168) had HRCT more than once (2 to 8 times). The mean and 95% uncertainty limits (UL) for Total LAR of breast cancer, considering both single and multiple doses of radiation exposure, was 217 (95% UL, 194-244) per 100,000 persons.
Conclusion: According to our research, the risk of potential breast cancer should not be overlooked. It is advised to use the ultra-low-dose protocol over the low-dose in HRCT. Physicians, pulmonologists, and infectious disease specialists are advised to avoid unnecessary and repeated requests for chest HRCT in a short period.