ABSTRACT
OBJECTIVE: Early postpartum home visiting is universal in many Western countries. Studies from developing countries on the effects of home visits are rare. In Syria, where the postpartum period is rather ignored, this study aimed to assess whether a community-based intervention of postnatal home visits has an effect on maternal postpartum morbidities; infant morbidity; uptake of postpartum care; use of contraceptive methods; and on selected neonatal health practices. DESIGN: A randomized controlled trial was carried out in Damascus. Three groups of new mothers were randomly allocated to receive either 4 postnatal home visits (A), one visit (B), or no visit (C). SAMPLE: A total of 876 women were allocated and followed up. INTERVENTION: Registered midwives with special training made a one or a series of home visits providing information, educating, and supporting women. RESULTS: A significantly higher proportion of mothers in Groups A and B reported exclusively breastfeeding their infants (28.5% and 30%, respectively) as compared with Group C (20%), who received no visits. There were no reported differences between groups in other outcomes. CONCLUSIONS: While postpartum home visits significantly increased exclusive breastfeeding, other outcomes did not change. Further studies framed in a nonbiomedical context are needed. Other innovative approaches to improve postnatal care in Syria are needed.
Subject(s)
Community Health Nursing/organization & administration , House Calls , Nurse Midwives/organization & administration , Postnatal Care/organization & administration , Analysis of Variance , Breast Feeding/statistics & numerical data , Community Health Nursing/education , Contraception Behavior/statistics & numerical data , Humans , Infant, Newborn , Morbidity , Nurse Midwives/education , Nurse's Role , Nursing Evaluation Research , Outcome Assessment, Health Care , Patient Education as Topic/organization & administration , Single-Blind Method , Social Support , Syria/epidemiologyABSTRACT
OBJECTIVE: The results on pregnancy outcomes of mothers afflicted with sickle cell trait are still contradictory. This study aimed to examine the fetal and maternal outcomes among a cohort of pregnant women. METHODS: This is a prospective cohort study that examined the fetal and maternal outcomes among 98 women with sickle cell trait (HbAS) and 402 women with normal hemoglobin (HbAA). The study was carried out in 4 health centers serving Palestinian Refugees in Damascus, during the period November 2000 to May 2002. Hemoglobin electrophoresis was carried out for all newly registered pregnancy women. Women were then followed up until 40 days after delivery. Data was collected from antenatal records and interviews with women. RESULTS: Outcomes of pregnancy were compared between women with HbAS and HbAA hemoglobin. There was no statistical difference in the rate of abortion, distribution of birth weight and perinatal mortality. Women with AS hemoglobin reported higher incidence of complications after delivery, namely, fever (risks ratio=4.05, 95% confidence interval=1.34-12.3). CONCLUSION: In this study, pregnancies among women with sickle cell trait demonstrated high risk of complications after delivery. Watchful follow up of pregnancies among women with sickle cell trait is very necessary. Doctors and women must know that although the course of pregnancy among women with HbAS can be benign; it may well carry a high risk on women.
