Medicine

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Author: search.filters.author.Abeysena, C.Subject: search.filters.subject.Pregnancy

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    Risk factors for neonatal sepsis in secondary and tertiary care hospitals of a district in Sri Lanka: A Case-control study
    (IOS Press, 2021) Jayasinghe, C.; Abeysena, C.
    OBJECTIVE: The aim of this study was to determine the risk factors for neonatal sepsis. Methods A case-control study was performed in secondary and tertiary care hospitals of a district in Sri Lanka. Neonates who diagnosed with sepsis based on clinical criteria or culture positivity were taken as the case group (n = 240) and neonates born during the same period who had not been diagnosed with sepsis were taken as the control group (n = 240). The controls were recruited from the community. The study instruments were, pretested interviewer administered questionnaire, a check list and record sheets. Multiple logistic regression analysis was performed. The results were expressed as odds ratios (OR) with the 95% confidence intervals (CI). Results The independent risk factors for neonatal sepsis were history of abortions, still birth, and early neonatal deaths (OR: 6.78; 95% CI: 3.2-14.3), registration of pregnancy after 8 weeks of gestation (OR: 1.91; 95% CI: 1.07-3.4), total antenatal clinic visits ≤4 (OR: 7.18; 95% CI: 2.1-24.5), history of maternal fever prior to the week of delivery (OR: 2.74; 95% CI: 1.25-6.0) leaking amniotic fluid >18 hours (OR: 10.0; 95% CI: 2.1-47.4), performed >3 vaginal examinations before delivery (OR: 3.28; 95% CI: 2.1-24.5), meconium stained amniotic fluid (OR: 10.57; 95% CI: 3.7-29.7), mode of delivery by cesarean section, forceps or vacuum (OR: 2.33; 95% CI: 1.4-3.9), time of birth of the neonate being during on-call hours (OR: 2.12; 95% CI: 1.3-3.5), being a male baby (OR: 1.74; 95% CI: 1.1-2.8), and birth weight <2,500 g (OR: 5.17; 95% CI: 2.8-9.6) of neonates. Conclusion Most of the identified risk factors for neonatal sepsis were modifiable. Stringent implementation of guidelines and protocols would prevent neonatal sepsis. © 2021 Georg Thieme Verlag. All rights reserved.
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    Risk factors for Pregnancy induced Hypertension
    (College of the Community Physicians of Sri Lanka, 2007) Perera, N.; Abeysena, C.
    OBJECTIVE: TO determine the risk factors for pregnancy induced hypertension (PIH). METHODOLOGY: The study was a case control study which was carried out at Castle Street Hospital for Women during August to September 2006. Hundred mothers newly diagnosed as having PlH. were Chosen as cases and 100 with uncomplicated pregnancies as controls. Both cases and controls had a period of amenorrhoea of >20 weeks. Psychosocial Stress was measured using General Health Questionnaire -30 (GHQ) and Modified Life Event inventory. Maternal socio-demographic information and other data were collected using an interviewer administered questionnaire and a record sheet. Multivariate logistic regression analysis was applied to control for confounders and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%Cl). RESULTS: After adjusting for confounding effect experience of ≥2 life events during pregnancy (OR:2.1, 95%Cl:1.1 - 10.9), a maternal BMl of ≥26kg/m2 (OR:2.4, 95%Cl:1.1- 5.0), maternal age of ≥28 years (OR:3.9, 95%Cl:2.0-7.5), history of ante partum haemorrhage (OR:3.4, 95%Clz1.1 - 10.9) and standing for >1.5 hours at one stretch per day (OR:3.4, 95%Cl:1.6 - 7.4) had statistically significant associations with developing PlH. A GHQ score of >5 was not associated with PlH (OR:3.0, 95%Cl: 1.0 -10.0). CONCLUSION: Experience of 22 life events during pregnancy, BMl ≥26 kg/m2, maternal age of ≥28 years, history of antepartum haemoghage and standing for more than 1.5 hours at one stretch per day were risk factors for PlH.
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    Sleep deprivation, physical activity and low income are risk factors for inadequate weight gain during pregnancy: a cohort study
    (Wiley-Blackwell Pub. Asia, 2011) Abeysena, C.; Jayawardana, P.
    AIM: To determine the possible risk factors for inadequate gestational weight gain. METHODS: A population-based cohort study was carried out in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks' gestation and followed up until delivery; the sample size was 710. Trimester-specific exposure status and potential confounding factors were gathered on average at the 12th, 28th and 36th weeks of gestation. Maternal weight was measured at the first antenatal clinic visit and at delivery. Inadequate weight gain was defined as weight gain below the Institute of Medicine recommendations in 2009. Multiple logistic regression was applied and the results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: The risk factors for inadequate weight gain were low per-capita monthly income (OR 1.63, 95% CI 1.03, 2.58), multiparity (OR 1.96, 95% CI 1.34, 2.87), sleeping <8 h/day during the second, third, or both second and third trimesters (OR 1.60, 95% CI 1.05, 2.46), standing and walking ≥5 h/day during the second trimester (OR 1.50, 95% CI 1.04, 2.15), and the newborn being of the male sex (OR 1.50, 95% CI 1.04, 2.16), controlling for the effect of body mass index and gestational age. CONCLUSIONS: Risk factors for inadequate gestational weight gain were low income, being multiparous, sleep deprivation, physical activity in terms of standing and walking, and the male sex of baby.
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    Body mass index and gestational weight gain in two selected Medical Officer of Health areas in the Gampaha District.
    (College of Community Physicians of Sri Lanka, 2011) Abeysena, C.; Jayawardana, P.
    OBJECTIVE: To describe gestational weight gain pattern according to the body mass index (BMI) categories. METHODS: This is a descriptive study conducted in two Medical Officer of Health areas of the Gampaha District. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. Maternal weight was measured at the booking visit, during the second trimester and at delivery. Inadequate and excessive weight gain were defined as weight gain below and above the Institute of Medicine (IOM) 2009 recommendations for the BMI categories as well as Ministry of Health (MoH) recommendations. RESULTS: Two hundred and forty seven (30%) of the women were underweight, 432(52%) were normal weight and 131(18%) overweight and obese. According to the Asian BMI classification, 338(41 %) were normal weight and 225(29%) were overweight and obese. Total mean weight gain for the sample was 10.6(SD 3.3) kg and mean rate of gestational weight gain was 0.27(SD 0.08) kg/week. Mean weight gain during second trimester was 6.7(SD 2.7) kg and during third trimester 3.9(SD 2.2) kg. Mean gestational weight gain and rate of weight gain per week was higher among underweight women. Of the 710, 404(57%) women gained less and 62(8.7%) more weight, than recommended by the IOM, whereas 108(15%) gained more weight by MoH standards. CONCLUSIONS: One third of the women were underweight and mean gestational weight gain and rate of weight gain per week were higher amongst them. More than half of the women gained less weight than recommended.
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    Effect of psychosocial stress and physical activity on low birth weight: a cohort study
    (Wiley-Blackwell Pub. Asia, 2010) Abeysena, C.; Jayawardana, P.; Senevirathne, R. de A.
    AIM: To determine the effect of physical activity and psychosocial stress on low birthweight (LBW). METHODS: A prospective study was carried out in a district of Sri Lanka between May 2001 and April 2002. A total of 885 pregnant mothers were recruited at < or = 16 weeks of gestation and followed up until partus. Trimester-specific exposure statuses along with potential confounding factors were gathered on average at the 12th, 28th, and 36th weeks of gestation. Physical activities were assessed by inquiring about the duration of specific postures adopted per day by housewives during each trimester at home and both at home and during working hours for those who were engaged in paid employment. Psychosocial stress was assessed using the Modified Life Events Inventory and the General Health Questionnaire 30. LBW was defined as a birthweight of less than 2500 g. Multiple logistic regression analysis was applied for controlling confounders and the results were expressed as adjusted odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Standing > 2.5 h/day (OR 2.26; 95%CI 1.10, 4.69) during the second trimester and sleeping 8 h or less/day (OR 2.84; 95%CI 1.49, 5.40) either during the second, third or both trimesters together, an increase in maternal age in years (OR 0.92; 95%CI 0.87, 0.98), and body mass index < 19.8 kg/m(2) (OR 2.2; 95%CI 1.17, 4.22) had a statistically significant association with LBW. Psychosocial stress was not associated with LBW.CONCLUSIONS: Standing > 2.5 h/day and sleeping < or = 8 h/day were risk factors for LBW, whereas psychosocial stress was not
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