Publications (9) View all
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Article: Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women.
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ABSTRACT: BACKGROUND: Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults' diseases including obesity, diabetes and hypertension.The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns' anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. METHOD: This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns' anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. RESULTS: Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2--68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. CONCLUSION: The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.BMC Public Health 04/2013; 13(1):341. · 2.00 Impact Factor -
Article: Causes of death certification of adults: an exploratory cross-sectional study at a university hospital in Riyadh, Saudi Arabia.
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ABSTRACT: Saudi Arabia has no precise data on causes of death. We sought to ascertain the commonest causes of death as stated in death certificates of adults and evaluate the completeness of death certificates at a teaching hospital in Riyadh. A cross-sectional study carried out at King Khalid University Hospital in Riyadh, Saudi Arabia, during the year 2008. All death certificates that were issued in 2008 were reviewed and data were checked by two reviewers. Causes of death were coded according to specially-designed codes. The mean (SD) age of death was 63.9 (20.7) years. More than 80% arrived alive at the hospital. Among the 410 certificates, 62.2% had the first reported cause of death being classified as "inappropriate" and this tended to be slightly, but significantly more frequent among women. The first most common appropriately reported cause of death was malignancy of any type (7.3%) followed by ischemic heart diseases (4.9%). Accidents and fractures were more common in the younger age groups and among men. This is the first study that documents the possible gaps among healthcare professionals in Saudi Arabia in their understanding of death and its certification based on the clinical assessment of the deceased. The findings needs to be validated by similar studies from other health care sectors. It is clear, however, that proven educational, system-related and legal interventions to improve the accuracy of death certification are strongly needed if the health care priorities are to be properly identified.Annals of Saudi medicine 11/2012; 32(6):615-22. · 1.07 Impact Factor -
Article: Pre-pregnancy care for women with pre-gestational diabetes mellitus: a systematic review and meta-analysis.
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ABSTRACT: BACKGROUND: Pre-gestational diabetes mellitus is associated with increased risk for maternal and fetal adverse outcomes. This systematic review was carried out to evaluate the effectiveness and safety of pre-pregnancy care in improving the rate of congenital malformations and perinatal mortality for women with pre-gestational diabetes mellitus. METHODS: We searched the following databases, MEDLINE, EMBASE, WEB OF SCIENCE, Cochrane Library, including the CENTRAL register of controlled trials and CINHAL up to December 2011, without language restriction, for any pre-pregnancy care aiming at health promotion, glycemic control and screening and treatment of diabetes complications in women with type I or type II diabetes. Study design were trials (randomized and non-randomized), cohort and case--control studies. RESULTS: Of the 2452 title scanned 54 full papers were retrieved of those 21 study were included in this review. Twelve cohort studies at low and medium risk of bias, with 3088 women, were included in the meta-analysis. Meta-analysis suggested that pre-pregnancy care is effective in reducing congenital malformation, RR 0.25 (95% CI 0.16-0.37), NNT19 (95% CI 14--24), and perinatal mortality RR 0.34 (95% CI 0.15-0.75), NNT = 46 (95% CI 28--115). Pre-pregnancy care lowers HbA1c in the first trimester of pregnancy by an average of 1.92% (95% CI -2.05 to -1.79). However women who received pre-pregnancy care were at increased risk of hypoglycemia during the first trimester of pregnancy RR 1.51 (95% CI 1.15-1.99). CONCLUSION: PPC for women with pre-gestational type 1 or type 2 DM is effective in improving rates of CM, PM and in reducing maternal HbA1C in the first trimester of pregnancy. PPC might cause maternal hypoglycemia in the first trimester of pregnancy.BMC Public Health 09/2012; 12(1):792. · 2.00 Impact Factor -
Article: Pre-existing diabetes mellitus and adverse pregnancy outcomes.
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ABSTRACT: BACKGROUND: Pregnancies complicated by pre-existing diabetes mellitus (PDM) are associated with a high rate of adverse outcomes, including an increased miscarriage rate, preterm delivery, preeclampsia, perinatal mortality and congenital malformations; compared to the background population. The objectives of this study are to determine the prevalence of PDM and to investigate the maternal and the neonatal outcomes of women with PDM. METHODS: This is a retrospective cohort study for women who delivered in King Khalid University Hospital (KKUH) during the period of January 1st to the 31st of December 2008. The pregnancy outcomes of the women with PDM were compared to the outcomes of all non-diabetic women who delivered during the same study period. RESULTS: A total of 3157 deliveries met the inclusion criteria. Out of the study population 116 (3.7%) women had PDM. There were 66 (57%) women with T1DM and 50 (43%) women with T2DM. Compared to non-diabetic women those with PGMD were significantly older, of higher parity, and they had more previous miscarriages. Women with PDM were more likely to be delivered by emergency cesarean section (C/S), OR 2.67, 95% confidence intervals (CI) (1.63-4.32), P < 0.001, or elective C/S, OR 6.73, 95% CI (3.99-11.31), P < 0.001. The neonates of the mothers with PDM were significantly heavier, P < 0.001; and more frequently macrosomic; OR 3.97, 95% CI (2.03-7.65), P = 0.002. They more frequently have APGAR scores <7 in 5 minutes, OR 2.61, 95% CI (0.89-7.05), P 0.057 and more likely to be delivered at <37 gestation weeks, OR 2.24, 95% CI (1.37- 3.67), P 0.003. The stillbirth rate was 2.6 times more among the women with PDM group; however the difference did not reach statistical significance, P 0.084. CONCLUSION: PDM is associated with increased risk for C/S delivery, macrosomia, stillbirth, preterm delivery and low APGAR scores at 5 min.BMC Research Notes 09/2012; 5(1):496. -
Article: Factors associated with successful induction of labor.
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ABSTRACT: To evaluate the prevalence, indications, and factors associated with successful induction of labor (IOL), and maternal and neonatal outcomes. All women booked for IOL at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia from April 2010 to March 2011 were included. The characteristics of women who had successful IOL were compared to those who delivered by cesarean section (CS). A multivariable logistic regression analysis was performed to evaluate the factors associated with successful IOL. During the study period, 564 women had IOL. The prevalence rate of IOL was 16%. Vaginal delivery was achieved in 472 (84%) women. The most common indications for IOL were post-term pregnancy in 174 (31%), and diabetes mellitus in 131 (23.2%) of the participants. Maternal characteristics associated with risk of CS were nulliparity (odds ratio: 1.58; 95% confidence interval: 1.09-2.320; p=0.01), and high maternal body mass index (p=0.01). Neonates of women with successful IOL had significantly higher APGAR scores (p=0.04), and more frequent pH more than or equal to 7.1 at delivery (p=0.02). There was no difference in the rate of post-partum hemorrhage, CS, or ruptured uterus between the women who had IOL, and those who went into spontaneous labor. Nulliparity and maternal weight are the main determinants of the outcome of IOL. Case selection for IOL is vital for achieving outcomes similar to spontaneous labor.Saudi medical journal 03/2012; 33(3):298-303. · 0.52 Impact Factor
