Journal of Preventive Medicine and Public Health

Original Article

Adverse Birth Outcomes Among Pregnant Women With and Without COVID-19: A Comparative Study From Bangladesh: Sumaya Binte Masud, Faiza Zebeen, Dil Ware Alam, Mosharap Hossian, Sanjana Zaman, Rowshan Ara Begum, Mohammad Hayatun Nabi, Mohammad Delwer Hossain Hawlader; J Prev Med Public Health. 2021;54(6):422-430. Published online October 21, 2021; DOI: https://doi.org/10.3961/jpmph.21.432

7,133 View
253 Download
6 Web of Science
6 Crossref

Objectives
Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19.
Methods
The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression.
Results
Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative.
Conclusions
Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

Summary

Citations

Citations to this article as recorded by

SARS-CoV-2 infection by trimester of pregnancy and adverse perinatal outcomes: a Mexican retrospective cohort study
Rakesh Ghosh, Juan Pablo Gutierrez, Iván de Jesús Ascencio-Montiel, Arturo Juárez-Flores, Stefano M Bertozzi
BMJ Open.2024; 14(4): e075928. CrossRef
COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh
Rupali J. Limaye, Prachi Singh, Alicia Paul, Berhaun Fesshaye, Clarice Lee, Eleonor Zavala, Sydney Wade, Hasmot Ali, Hafizur Rahman, Shirina Akter, Ruth Karron, Towfida Jahan Siddiqua
Vaccine.2023; 41(26): 3885. CrossRef
The coronavirus disease 2019 infection in pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis
Yeonsong Jeong, Min-A Kim
Obstetrics & Gynecology Science.2023; 66(4): 270. CrossRef
Sources of COVID-19 Vaccine Promotion for Pregnant and Lactating Women in Bangladesh
Berhaun Fesshaye, Sydney A. Wade, Clarice Lee, Prachi Singh, Eleonor Zavala, Hasmot Ali, Hafizur Rahman, Towfida Jahan Siddiqua, Shirina Atker, Ruth A. Karron, Rupali J. Limaye
Vaccines.2023; 11(8): 1387. CrossRef
Impact of SARS-CoV-2 infection in pregnant women and their babies: clinical and epidemiological features
María José Vidal, Èrica Martínez-Solanas, Sergi Mendoza, Núria Sala, Mireia Jané, Jacobo Mendioroz, Pilar Ciruela
Gaceta Sanitaria.2023; 37: 102332. CrossRef
An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting
Firdose Lambey Nakwa, Reenu Thomas, Alison van Kwawegen, Nandi Ntuli, Karabo Seake, Samantha Jane Kesting, Noela Holo Bertha Kamanga, Dikeledi Maureen Kgwadi, Neema Chami, Tshiamo Mogajane, Claude Ondongo-Ezhet, Thulisile Nelly Maphosa, Stephanie Jones, V
Frontiers in Pediatrics.2022;[Epub] CrossRef

Research Support, Non-U.S. Gov't

Effect of Repeated Public Releases on Cesarean Section Rates.: Won Mo Jang, Sang Jun Eun, Chae Eun Lee, Yoon Kim; J Prev Med Public Health. 2011;44(1):2-8.; DOI: https://doi.org/10.3961/jpmph.2011.44.1.2

5,269 View
92 Download
13 Crossref

Abstract PDF

OBJECTIVES
Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. METHODS: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. RESULTS: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. CONCLUSIONS: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

Summary

Citations

Citations to this article as recorded by

Changes in cesarean section rate before and after the end of the Korean Value Incentive Program
YouHyun Park, Jae-hyun Kim, Kwang-soo Lee
Medicine.2022; 101(33): e29952. CrossRef
Mechanisms and impact of public reporting on physicians and hospitals’ performance: A systematic review (2000–2020)
Khic-Houy Prang, Roxanne Maritz, Hana Sabanovic, David Dunt, Margaret Kelaher, Lamberto Manzoli
PLOS ONE.2021; 16(2): e0247297. CrossRef
Ordinal classification of the affectation level of 3D-images in Parkinson diseases
Antonio M. Durán-Rosal, Julio Camacho-Cañamón, Pedro Antonio Gutiérrez, Maria Victoria Guiote Moreno, Ester Rodríguez-Cáceres, Juan Antonio Vallejo Casas, César Hervás-Martínez
Scientific Reports.2021;[Epub] CrossRef
Is a hospital quality policy based on a triad of accreditation, public reporting and inspection evidence-based? A narrative review
Astrid Van Wilder, Luk Bruyneel, Dirk De Ridder, Deborah Seys, Jonas Brouwers, Fien Claessens, Bianca Cox, Kris Vanhaecht
International Journal for Quality in Health Care.2021;[Epub] CrossRef
Impact of public release of performance data on the behaviour of healthcare consumers and providers
David Metcalfe, Arturo J Rios Diaz, Olubode A Olufajo, M. Sofia Massa, Nicole ABM Ketelaar, Signe A. Flottorp, Daniel C Perry
Cochrane Database of Systematic Reviews.2018;[Epub] CrossRef
Non-clinical interventions for reducing unnecessary caesarean section
Innie Chen, Newton Opiyo, Emma Tavender, Sameh Mortazhejri, Tamara Rader, Jennifer Petkovic, Sharlini Yogasingam, Monica Taljaard, Sugandha Agarwal, Malinee Laopaiboon, Jason Wasiak, Suthit Khunpradit, Pisake Lumbiganon, Russell L Gruen, Ana Pilar Betran
Cochrane Database of Systematic Reviews.2018;[Epub] CrossRef
Impact of State Reporting Laws on Central Line–Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units
Hangsheng Liu, Carolyn T. A. Herzig, Andrew W. Dick, E. Yoko Furuya, Elaine Larson, Julie Reagan, Monika Pogorzelska‐Maziarz, Patricia W. Stone
Health Services Research.2017; 52(3): 1079. CrossRef
Effects of Korean hand acupressure on opioid-related nausea and vomiting, and pain after caesarean delivery using spinal anaesthesia
Na Young Ahn, Hye-Ja Park
Complementary Therapies in Clinical Practice.2017; 28: 101. CrossRef
Ordinal Regression Methods: Survey and Experimental Study
Pedro Antonio Gutierrez, Maria Perez-Ortiz, Javier Sanchez-Monedero, Francisco Fernandez-Navarro, Cesar Hervas-Martinez
IEEE Transactions on Knowledge and Data Engineering.2016; 28(1): 127. CrossRef
Exploring the transparency mechanism and evaluating the effect of public reporting on prescription: a protocol for a cluster randomized controlled trial
Xin Du, Dan Wang, Xuan Wang, Shiru Yang, Xinping Zhang
BMC Public Health.2015;[Epub] CrossRef
Application of propensity scores to explore the effect of public reporting of medicine use information on rational drug use in China: a quasi-experimental design
Xiaopeng Zhang, Lijun Wang, Xinping Zhang
BMC Health Services Research.2014;[Epub] CrossRef
Changes in the Cesarean Section Rate in Korea (1982-2012) and a Review of the Associated Factors
Sung-Hoon Chung, Hyun-Joo Seol, Yong-Sung Choi, Soo-young Oh, Ahm Kim, Chong-Woo Bae
Journal of Korean Medical Science.2014; 29(10): 1341. CrossRef
Managing the Primary Cesarean Delivery Rate
DAVID WARE BRANCH, ROBERT M. SILVER
Clinical Obstetrics & Gynecology.2012; 55(4): 946. CrossRef

Original Articles

Changes in Quality of Care for Cesarean Section after Implementation of Diagnosis-Related Groups/Prospective Payment System.: Jun Yim, Young Hun Kwon, Du Ho Hong, Chang Yup Kim, Yong Ik Kim, Young Soo Shin; Korean J Prev Med. 2001;34(4):347-353.

2,144 View
20 Download

Abstract PDF: OBJECTIVES
To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. METHODS: Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were performed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. RESULTS: Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. CONCLUSION: This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data omission in medical records.; Summary

Inter-hospital Comparison of Cesarean Section Rates after Risk Adjustment.: Sang Il Lee, Young Ho Khang, Beom Man Ha, Moo Song Lee, Weechang Kang, Hee Jo Koo, Chang Yup Kim; Korean J Prev Med. 2001;34(4):337-346.

2,056 View
26 Download

Abstract PDF: OBJECTIVE
To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. METHODS: Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. RESULTS: The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. CONCLUSIONS: Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.; Summary

An Appropriateness Evaluation of Cesarean Section, Cholecystectomy, and Admission in Pediatric Pneumonia.: Chang Yup Kim, Hyeong Sik Ahn, Young Seong Lee, Young Dae Kwon, Yong Ik Kim, Young Soo Shin; Korean J Prev Med. 1992;25(4):413-428.

1,944 View
19 Download

Abstract PDF: The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For ceserean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals between hospital groups by size. The most frequent indication of C/S was repeated operation, followed by cephalopelvic disproportion(CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons for admission were 'failure to initial treatment', 'suspected bacterial pnermonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activities would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studies with plentiful subjects and more representative diseases or procedures should be tried.; Summary

Regional Variations in the Cesarean Section Rate and It's Determinants in Korea.: Hye Kyung Kim, Jeon Un Lee, Kang Won Park, Ok Ryun Moon; Korean J Prev Med. 1992;25(3):312-329.

2,112 View
35 Download

Abstract PDF: The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows: It was found that, cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible(15-49 years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities: 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates: In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three dependent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the variance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has been found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.; Summary

English Abstract

Impact of Risk Adjustment with Insurance Claims Data on Cesarean Delivery Rates of Healthcare Organizations in Korea.: Kwang Soo Lee, Sang Il Lee, Kyung Seo, Young Mi Do; J Prev Med Public Health. 2005;38(2):132-140.

1,900 View
30 Download

Abstract PDF: OBJECTIVES
To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. METHODS: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. RESULTS: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final riskadjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test (chi2=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow chi2. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. CONCLUSION: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.; Summary

First
Prev
Page of 1
Next
Last

Search