Risk factors of perinatal and neonatal mortality in Alexandria, Egypt

Background: Egypt has already achieved the goal of reducing the under-five mortality rate [U5MR] by two-thirds. However, one of the challenges that Egypt currently faces is how to reduce the perinatal and neonatal mortality [PM, NM]. This study aimed to identify the social and biomedical risk factors contributing toward PM and NM in Alexandria, Egypt

Participants and methods: A case-control design was used. Cases were 150 mothers whose index pregnancy terminated in perinatal [from the 28th week of pregnancy to less than 7 days after birth] and neonatal deaths [from the seventh day to less than the 28th day after birth]. They were selected from the antenatal clinic and neonatal care unit of ElShatby University hospital for Obstetrics and gynecology. Controls were 150 mothers with live births ranging in age from 28 days up to 2 months selected from the outpatient clinics of ElShatby University Hospital for Pediatrics

Results: Stepwise logistic regression analysis indicated a higher risk of PM/NM among very young or very old mothers [OR=4.1 and 6.46, respectively], those who had previous PM/NM [odds ratio [OR]=12.7; 95% confidence interval [CI]: 5.04-29.54], grand multiparous [OR=2.23; 95% CI: 1.50-5.42], those with infrequent antenatal visits [OR=3.88; 95% CI: 2.26-6.65], and mothers with complications during the index pregnancy [OR=9.21; 95% CI: 3.40-24.95]

Conclusion: This study confirms the evidence of a positive association between PM/NM and maternal age, obstetric history, and utilization of healthcare services. Appropriate age at marriage and pregnancy, spacing of and limiting the number of births, and improving antenatal, natal, and postnatal care are priority actions that can reduce PM/NM in Alexandria

Canonical correlation analysis of the determinants of menopausal symptoms

To describe the intensity and determinants of symptoms commonly attributed to the menopause among a random sample of women aged 50 to 59 years, selected from the total population of a geographically defined area. Data were collected based on a cross-sectional design using structured questionnaire and face-to-face interview survey. Households. Four hundred and fifty women, aged 50 to 59 years, randomly selected from Alexandria residents by the method of cluster sampling. Self-reported symptoms, factor scores for menopausal symptoms extracted by factor analysis, and an index for the number of experienced symptoms.77.5% of currently married women and 800.3% of unmarried women reported moderate-to-severe symptoms with significant differences between the two groups in intensity of vasomotor [more intense among married], psychological, and miscellaneous [more intense among unmarried]. Canonical correlation revealed seven significant roots among married women explaining 82.2% of variance in menopausal symptoms and four among the unmarried explaining 57.5% of variance. Among married women, the prominent factors in relation to menopausal symptoms are duration of hormone use, obesity, knowledge and attitude concerning menopause, pattern of menopause, and physical activity. Among the unmarried, there were also correlations of menopausal symptoms with same factors in addition to work, education, and time since last menses. Though menopause is a natural biological process, it has been shaped by social, economic, medical, and reproductive factors. Putting these factors in mind of health care workers can help women to go through this passage of life with no or minimal discomfort

Utilization of survival analysis to predict age of natural menopause for working women in Alexandria University

A stratified random sample of 527 women aged 40-65 years was selected in two stages. In the first stage, five colleges were selected randomly from a list of all collages; in the second stage, stratification was made according to job and the sample was allocated proportionally over strata. Two methods of survival analysis were used: The Kaplan-Meier method was used to estimate the median age at the natural menopause and Cox-regression analysis was used to study the correlates of age at the natural menopause. The mean current age of the study group was 47.23 +/- 5.06 years, 26.8% were staff, 59.0% employees and 14.2% workers. Cox-regression revealed that women with higher hazard of menopause at a given age are characteristically of low job category, consumers of red meat > once/week, with a small amount of menstrual bleeding, not practicing sporting, with chronic illness, with > 24 years age at first full-term pregnancy and with late age at menarche. Monitoring of the timing of age at the natural menopause may be a useful instrument to assess the impact of intervention strategies aimed at changing practices related to family planning and contraception