Suicide risk assessment: examining transitions in suicidal behaviors among pregnant women in Perú

Archives of Women's Mental Health - The goals of this research were to characterize suicidal behavior among a cohort of pregnant Peruvian women and identify risk factors for transitions between...     

Appropriate household water treatment methods in Ethiopia: household use and associated factors based on 2005, 2011, and 2016 EDHS data

Background

Diarrheal disease attributable to water and sanitation can be prevented using point-of-use water treatment. In Ethiopia, a small number of households treat water at point-of-use with appropriate methods. However, evidence on factors associated with household use of these treatment methods is scarce. Therefore, this study is intended to explore the household use of appropriate point-of-use water treatment and associated factors in Ethiopia.

Methods

The data of 2005, 2011, and 2016 Ethiopian demographic and health surveys were used for analysis. Households reportedly treating water with bleach, boiling, filtration, and solar disinfection in each survey are considered as treating with appropriate treatment methods. Household water treatment with these treatment methods and factors associated was assessed using bivariate and multivariable regression. In addition, a region level difference in the treatment use was assessed by using multilevel modeling.

Results

The number of households that reported treating water with appropriate water treatment methods was 3.0%, 8.2%, and 6.5% respectively in 2005, 2011, and 2016. Household heads with higher education had 5.99 (95% CI?=?3.48, 10.33), 3.61 (95% CI?=?2.56, 5.07), and 3.43 (95% CI?=?2.19, 6.37) times higher odds of using the treatment methods respectively in 2005, 2011, and 2016 compared to household heads who had no education. There was a significantly high number of households that used appropriate water treatment methods in 2011 (AOR?=?2.78, 95% CI?=?2.16, 3.57) and 2016 (AOR?=?2.18, 95% CI?=?1.64, 3.89) compared to 2005 data. In pooled data analysis, the reported use of the treatment methods is associated with household head education, residency, drinking water sources, and owning radio and television. From a multilevel modeling, within-region variation is higher than between-region variations in the use of treatment methods in each survey.

Conclusions

Below 10% of households reportedly treating water at point-of-use in each survey attributable to different factors. Designing intervention strategies for wide-scale use of treatment methods at the country level is fundamental.

     

Genetic Characterization of Foot-and-Mouth Disease Viruses, Ethiopia, 1981�C2007

Foot-and-mouth disease (FMD) is endemic to sub-Saharan Africa. To further understand its complex epidemiology, which involves multiple virus serotypes and host species, we characterized the viruses recovered from FMD outbreaks in Ethiopia during 1981–2007. We detected 5 of the 7 FMDV serotypes (O, A, C, Southern African Territories [SAT] 1, and SAT 2). Serotype O predominated, followed by serotype A; type C was not recognized after 1983. Phylogenetic analysis of virus protein 1 sequences indicated emergence of a new topotype within serotype O, East Africa 4. In 2007, serotype SAT 1 was detected in Ethiopia and formed a new distinct topotype (IX), and serotype SAT 2 reappeared after an apparent gap of 16 years. The diversity of viruses highlights the role of this region as a reservoir for FMD virus, and their continuing emergence in Ethiopia will greatly affect spread and consequent control strategy of the disease on this continent.     

Gestational diabetes mellitus in relation to maternal dietary heme iron and nonheme iron intake

OBJECTIVE

Higher heme iron intake is associated with increased type 2 diabetes risk. However, no previous study has evaluated gestational diabetes mellitus (GDM) risk in relation to heme iron intake during pregnancy. We investigated associations of maternal preconceptional and early pregnancy heme and nonheme iron intake with subsequent GDM risk.

RESEARCH DESIGN AND METHODS

We conducted a prospective cohort study of 3,158 pregnant women. A food frequency questionnaire was used to assess maternal diet. Multivariable generalized linear regression models were used to derive estimates of relative risks (RRs) and 95% CIs.

RESULTS

Approximately 5.0% of the cohort developed GDM (n = 158). Heme iron intake was positively and significantly associated with GDM risk (P_trend = 0.04). After adjusting for confounders, women reporting the highest heme iron intake levels (≥1.52 vs. <0.48 mg per day) experienced a 3.31-fold–increased GDM risk (95% CI 1.02–10.72). In fully adjusted models, we noted that a 1-mg per day increase in heme iron was associated with a 51% increased GDM risk (RR 1.51 [95% CI 0.99–2.36]). Nonheme iron was inversely, though not statistically significantly, associated with GDM risk, and the corresponding RRs were 1.00, 0.83, 0.62, and 0.61 across quartiles of nonheme iron intake (P_trend = 0.08).

CONCLUSIONS

High levels of dietary heme iron intake during the preconceptional and early pregnancy period may be associated with increased GDM risk. Associations of GDM risk with dietary nonheme iron intake are less clear. Confirmation of these findings by future studies is warranted.Iron deficiency is the most common nutritional deficiency in the U.S. and worldwide (1). In recent years, concerns about iron overload in developed countries have spurred research designed to assess cardiometabolic risks secondary to excess body iron stores and high dietary iron intake (2,3). As a result, iron now is viewed as a double-edged sword for living systems. Increasingly, clinical and epidemiological evidence suggest that both iron deficiency and iron overload influence the production of reactive oxygen species, leading to oxidative stress, systemic inflammation, and alternations in mitochondrial function (4). Taken together, cellular and metabolic alterations secondary to iron overload are thought to contribute to increased risks of hypertension (2), cardiovascular disease (5), and type 2 diabetes (3,6–8).The two kinds of dietary iron, heme and nonheme iron, with distinct metabolic pathways and intestinal absorption potential, are thought to play distinct roles in the pathophysiology of cardiometabolic disorders (4). Heme iron is exclusively present in hemoglobin and myoglobin from animal sources, including red meat and poultry. Nonheme iron, which is abundant in cereals, vegetables, fruits, beans, and dairy products, accounts for >85% of dietary iron intake. Although heme iron accounts for a smaller proportion of dietary iron, it is absorbed two to three times more readily than nonheme iron and is less affected by other dietary constituents. The bioavailability of heme and nonheme iron is influenced by dietary factors, including ascorbic acid, coffee, and whole grains (9). Body iron stores also are important determinants of intestinal absorption of heme and nonheme iron (10).The expanding literature suggests that iron influences glucose metabolism (3). Statistically significant positive associations of dietary iron intake, particularly heme iron, with incident type 2 diabetes has been reported (6–8). These epidemiological associations are supported by findings documenting increased risks of incident type 2 diabetes among individuals with elevated serum ferritin concentrations (6,11). The relationship between nonheme iron intake and type 2 diabetes, however, has been far less consistent. Some (7), but not all (8), investigators have reported inverse associations of incident type 2 diabetes and dietary nonheme iron intake.Although there have been several studies investigating the possible role of dietary iron and body iron stores on glucose metabolism, only a few have enrolled pregnant women, and the results have been inconsistent (12–14). The effect of iron supplement use on gestational diabetes mellitus (GDM) risk also is controversial (14,15). To the best of our knowledge, no previous study has examined the associations of dietary heme and nonheme iron with the risk of GDM. Given mounting available experimental and epidemiological evidence from studies of men and nonpregnant women supporting associations of heme iron and risk of type 2 diabetes, we hypothesized that higher preconceptional and early pregnancy dietary heme iron intake may be associated with increased GDM risk. We also hypothesized that diets high in nonheme iron may be associated with reduced GDM risk. We investigated these hypotheses among a well-characterized prospective cohort of pregnant women.     

Associations of early pregnancy sleep duration with trimester-specific blood pressures and hypertensive disorders in pregnancy

Study Objectives:

We evaluated the influence of maternal self-reported habitual sleep duration during early pregnancy on blood pressure (BP) levels and risk of hypertensive disorders of pregnancy.

Design:

Prospective cohort study.

Setting:

Clinic-based study.

Participants:

A cohort of 1,272 healthy, pregnant women.

Measurements and Results:

We abstracted maternal antenatal BP values from medical records and estimated mean BP differences across hours of sleep categories in regression models, using generalized estimating equations. Odds ratios (OR) and 95% confidence intervals (95% CIs) for pregnancy induced hypertension (PIH) and preeclampsia (PE) in relation to long and short sleep duration were estimated. Mean 1^st and 2^nd trimester systolic (S) and diastolic (D) BP values were similar among women reporting to be short sleepers (≤ 6 h) vs. women reporting to sleep 9 hours. However, both short and long sleep duration in early pregnancy were associated with increased mean 3^rd trimester SBP and DBP. For example, mean 3^rd trimester SBP was 3.72, and 2.43 mm Hg higher for women reporting ≤ 6 h and 7-8 h sleep, respectively, compared with women reporting 9 h of sleep. Mean 3^rd trimester SBP was 4.21 mm Hg higher for women reporting long sleep (≥ 10 h) vs. the reference group. Short and long sleep durations were associated with increased risks of PIH and PE. The ORs for very short (< 5 h) and long (≥ 10 h) sleepers were 9.52 (95% CI 1.83 to 49.40) and 2.45 (95% CI 0.74 to 8.15) for PE.

Conclusions:

Our findings are consistent with a larger literature that documents elevated blood pressure and increased risks of hypertension with short and long sleep duration.

Citation:

Williams MA; Miller RS; Qiu C; Cripe SM; Gelaye B; Enquobahrie D. Associations of early pregnancy sleep duration with trimester-specific blood pressures and hypertensive disorders in pregnancy. SLEEP 2010;33(10):1363-1371.     

The Use of Wearable Technology to Objectively Measure Sleep Quality and Physical Activity Among Pregnant Women in Urban Lima,Peru: A Pilot Feasibility Study

Maternal and Child Health Journal - Sleep quality and physical activity can affect the mental and physical health of pregnant women and their babies in utero. We investigated the feasibility of...     

Trimester-specific blood pressure levels and hypertensive disorders among pregnant migraineurs

Objective.— We evaluated the influence of physician‐diagnosed migraine on blood pressure levels and the risk of hypertensive disorders of pregnancy in a clinic‐based prospective cohort study of 3373 healthy pregnant women. Background.— The relationship between migraine and blood pressure is controversial with results from several studies suggesting positive associations, while others suggest null or inverse associations. To our knowledge, no previous study has investigated blood pressure profiles among pregnant migraineurs. Methods.— We abstracted blood pressure values and delivery information from medical records of women presenting to prenatal clinics in Washington State. Mean blood pressure differences for pregnant migraineurs and non‐migraineurs were estimated in regression models, using generalized estimating equations. We calculated odds ratios and 95% confidence intervals (95% CIs) for gestational hypertension and preeclampsia in relation to migraine status. Results.— Mean first, second, and third trimester systolic blood pressures (SBP) were elevated among pregnant migraineurs as compared with non‐migraineurs. Migraineurs had higher mean third trimester SBP (4.08 mmHg) than non‐migraineurs. Trimester‐specific diastolic blood pressure (DBP) values were variably related with migraine status. Mean first (0.82 mmHg) and third (2.39 mmHg) trimester DBP were higher, and second trimester DBP values were lower (?0.24) among migraineurs as compared with non‐migraineurs. Migraineurs had a 1.53‐fold increased odds of preeclampsia (95% CI 1.09 to 2.16). Additionally, migraineurs who were overweight or obese had a 6.10‐fold increased odds of preeclampsia (95% CI 3.83 to 9.75) as compared with lean non‐migraineurs. Conclusions.— Pregnant migraineurs had elevated blood pressures, particularly SBP measured in the third trimester, and a higher risk of preeclampsia than pregnant women without migraine. Observed associations were more pronounced among overweight or obese migraineurs. Our findings add to the accumulating evidence of adverse pregnancy outcomes among migraineurs.     

Postnatal care service utilization and associated factors among women who gave birth in Debretabour town,North West Ethiopia: a community- based cross-sectional study

Background

World health organization stated that postnatal care is defined as a care given to the mother and her newborn baby immediately after the birth of the placenta and for the first six weeks of life. Majority of maternal and neonatal deaths occur during childbirth and the postpartum period. Scaling up of maternal and newborn health through proper postnatal care services is the best way of reducing maternal and neonatal mortality.

Method

A community based cross sectional study was conducted among 588 mothers who gave birth in the last one year from March 1–21; 2017. Systematic random sampling technique was used to select study participants. A pre-tested and structured questionnaire was used to collect the data. Data was entered in EPI info version 7 and analyzed using SPSS version 21. Logistic regression was applied to identify association between explanatory variables and the outcome variable. An adjusted odds ratio with 95% confidence interval and p-value less than 0.05 was computed to determine the level of significance.

Result

A total of 588 participants were included in the analysis which was the response rate of 100%.The prevalence of postnatal care service utilization in this study was 57.5%.Maternal educational status of secondary school and above (AOR?=?3.29, 95%CI: 1.94–5.57), family monthly income of above 1500 ETB (AOR?=?2.85, 95%CI: 1.21–6.68), alive birth outcome of last pregnancy (AOR?=?5.70, 95%CI: 1.53–21.216), planned and supported last pregnancy (AOR?=?3.94, 95%CI: 1.72–9.01) and institutional delivery of last pregnancy (AOR?=?3.08, 95%CI: 1.24–7.68) were positively associated with PNC service utilization.

Conclusion

This study showed that the overall utilization of PNC service in Debretabour town is low. Mothers’ education, monthly income, last pregnancy birth outcome, wantedness of the pregnancy and place of delivery were significantly associated with postnatal care service utilization. To enhance PNC service utilization and reduce maternal and neonatal mortality women should obtain appropriate education. Furthermore all pregnant women should give birth in the health facilities.