Search

Background: Smoking during pregnancy is one of the main modifiable factors associated with perinatal morbidity and mortality and maternal complications. Literature is scant regarding smoking habits of pregnant women in Jordan. Objectives: To investigate smoking patterns and attitudes of Jordanian pregnant women towards smoking. Methods: A cross-sectional survey of patterns and attitudes towards smoking among 436 mothers attending healthcare facilities in the Governorate of Irbid, Jordan, between August and September 2019. Results: Out of 436 pregnant women in the Governorate of Irbid, Jordan, 13 (2.9%) quit smoking once pregnancy was conformed, and 77 (17.6%) continued to smoke. Pregnant non-smokers believed that hookah and electronic cigarettes are as bad to health as cigarettes, while smokers believed that hookah and electronic cigarettes are less hazardous than cigarettes (5.19% versus 21.99%, p = 0.001, and 6.49% versus 19.37%, p = 0.009, respectively). Non-smokers were significantly more aware regarding the hazards of smoking on perinatal outcomes, such as abortion (31.94% versus 10.39%, p = 0.001), placental abruption (31.94% versus 10.39%, p = 0.001), intrauterine growth restriction and fetal malformations (36.65% versus 14.29%, p = 0.007), fetal death (30.89% versus 6.49, p < 0.001), neonatal pulmonary diseases (44.50% versus 24.68%, p = 0.024), neonatal asthma (47.12% versus 28.57%, p = 0.038), and ear diseases (42.41% versus 20.8%, p = 0.012). Conclusion: There is a high prevalence of smokers among pregnant women in Jordan. The level of awareness regarding long-term consequences of tobacco use remains low. Educational programs should include information about the hazards of all forms of smoking. Pregnancy provides a good opportunity for promoting smoking cessation.

Objectives To explore knowledge and attitude about Covid‐19, among Syrian refugee mothers in the Governorate of Irbid, where the first outbreak of Covid‐19 in Jordan took place. Methods This is a cross‐section study among Syrian refugee mothers, who were pregnant or having had children. Data was collected through an online questionnaire. The survey link was distributed in April 2020, through the social network's messaging services Facebook and WhatsApp. Contact information was obtained from local community centres and non‐governmental organisations in the town of Irbid, the north of Jordan. Results In total, 389 Syrian refugee mothers participated in the study. It showed that 66% of mother's access information regarding Covid‐19. The main sources of information were Facebook 87%, WhatsApp 69%, television 53%, while 21% indicated that they access professional databases or government websites. In general, Syrian refugee mothers were knowledgeable about Covid‐19 transmission and prevention. However, they lacked adequate knowledge about transmission of Covid‐19 between the mother and the child, and smoking risks associated with Covid‐19. Conclusions There are gaps in the knowledge and attitude of Syrian refugee mothers in the Governorate of Irbid in relation to the Covid‐19 pandemic. There is a need for further health education measures.

BackgroundCognitive abilities like language, memory, reasoning, visualization, and perceptual functioning shape human action and are considered critical to the successful interaction with the environment. Alternatively, hearing loss can disrupt a child’s ability to communicate, and negatively impact cognitive development. Cochlear implants (CI) restore auditory input thereby supporting communication and may enhance cognitive performance. This study compares general cognitive development after cochlear implantation (2017–2019) in two groups of Jordanian children implanted earlier (age:4–6 years,N = 22) and later (7–9 years,N = 16) to the development of randomly selected normal hearing peers (N = 48).DesignVisualization, reasoning, memory, and attention were assessed using the Leiter-R scale at baseline (before implantation), 8 months and 16 months post implantation for children with hearing loss. Same times of testing (baseline, 8 months and 16 months) were used for normal hearing peers.ResultsOver the 16-month period, the cognitive improvement of 4–6-year-old deaf children was greater than that of their normal hearing peers on the scales of visualization (5.62 vs. 4.40), reasoning (2.53 vs. 2.38) and memory (17.19 vs. 11.67). while the improvement of 7–9-year-old was less major than that of their normal hearing peers on all scales.ConclusionsThese results suggest that CI not only enhances communication skills but may improve cognitive functioning in deaf children. However, the extent of this improvement was dependent on age at intervention; current results demonstrated that the children received CI at young ages had better cognitive improvements.

Objectives: This study aimed to determine the stillbirth rate in Jordan and to determine the leading causes of stillbirths. Analyzing the stillbirth data from a large sample size of Jordanian women would be very valuable for planning the resources and improving the services.Methods: The data from the national study of perinatal mortality in Jordan were analyzed. A total of 21,980 women who delivered at a gestational age ≥20 weeks in any of the 18 selected hospitals during the study period (March 2011-April 2012) were analyzed. The stillbirth rate was calculated as the number of stillbirths per 1000 total births. The deaths were also classified according to NICE classification system.Results: The rates of stillbirths were 11.6/1000 total births born after 20 weeks of gestation, 11.2/1000 total births born ≥22 weeks of gestation, 10.6/1000 total births born ≥24 weeks of gestation, and 9.0/1000 total births born ≥28 weeks of gestation. According to NICE classification, the main causes of stillbirths were maternal diseases (19.5%), unexplained immaturity (18.8%), congenital anomalies (17.6%), unexplained antepartum stillbirths (17.6%), obstetric complications (8.4%), placental abruption (5.7%), and multiple births (5%). The expert Panel judged that 34.5% of all fetal deaths were preventable and 30.3% were possibly preventable with optimal care.Conclusions: This study highlighted stillbirth risks in Jordan, which could encourage maternal-infant health-care providers, other researchers, policymakers, and stakeholders to implement solutions and to develop a feasible intervention.

Objectives: This study aimed to assess the value of prophylactic cervical cerclage in prolonging higher-order multiple pregnancies. Methods:This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not. Results: A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 (64.4%) underwent a prophylactic cervical cerclageinsertion procedure and 52 (35.6%) women did not. No significant difference was found between the two groups with regards to maternal age, parity or number of fetuses. However, the mean gestational age at delivery was significantly higher for women without compared to those with prophylactic cervical cerclage (32.9 weeks versus 31.7 weeks) according to both univariate and multivariate analyses (P = 0.013 and 0.046, respectively). Additionally, 40.4% of women without and 14.9% of women with prophylactic cervical cerclage gave birth after 34 gestational weeks (P = 0.003). Conclusion: Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higher-order multiple pregnancies in the current study.

Objectives: To explore the prevalence rates of lifestyle practices linked to fertility disorders. Materials and Methods: A cross-sectional descriptive study, using a validated questionnaire, was conducted among sub-fertile couples attending the fertility center at Jordan University of Science and Technology between February 2013 and August 2014. Results: A total of 126 couples took part in the study. The average length of sub-fertility was 4.2 years. The mean age of the women was 31 years, of whom 70% were

Objective To assess the impact of delivery at 37 weeks of pregnancy versus 38 weeks or later on maternal and neonatal outcomes among women with multiple previous cesareans. Methods In a retrospective study, data were assessed from women with at least two previous cesareans who delivered by cesarean at 37 weeks of pregnancy or later at a tertiary referral hospital in Jordan between January 2013 and November 2015. Results Among 886 eligible women, 505 (57.0%) delivered at 37 weeks (group 1) and 381 (43.0%) delivered at 38 weeks or later (group 2). There was no difference in intraoperative or postoperative complications between the two groups. In multivariate analysis, women in group 2 had lower odds of delivering neonates with respiratory distress syndrome than did those in group 1 (adjusted odds ratio 0.3, 95% confidence interval 0.2–0.5; P=0.046). However, neonatal jaundice was more common in group 2 (adjusted odds ratio 2.1, 95% confidence interval 1.7–2.7; P=0.035). Conclusion Among women with multiple cesareans, delivery at 37 weeks was associated with increased risk of neonatal respiratory morbidity and decreased risk of neonatal jaundice, but not with a reduction in maternal complications, as compared with delivery at 38 weeks or later.

Nonfatal injuries are considered as one of the major public health hazards affecting schoolchildren, and the majority of these injuries occur at school or in the home. A cross-sectional study was conducted over a period of 3 months, March-May 2015. The participants were 4,355 Jordanian schoolchildren in Grades 7-12. The Pearson χ(2) test was computed, and the odds ratio was used to determine the magnitude of various risk factors for nonfatal injuries among schoolchildren. The overall incidence of nonfatal injury was 33.9%. The group most likely to sustain nonfatal injuries was boys, aged 12-15, in Grade 7, whose parents had a low level of education or a high family income. Injury prevention in schools and at homes is a cornerstone for protection or reducing the incidence of injuries. School nurses have a duty to follow up and examine the accident reports and evaluate whether safety policies are applied and are effective in different school settings. Furthermore, health and education authorities should develop a national program for preventing injuries.

Newborns who are compromised at birth require rapid attention to stabilize their respiration attempts. Lack of knowledge regarding basic newborn resuscitation is a contributing factor to poor newborn health outcomes and increased mortality. The purpose of this study was to explore Jordanian midwives’ experiences, education, and support needs to competently perform basic newborn resuscitation. Qualitative descriptive methodology was used to analyze a convenience sample of 20 midwives. A thematic approach was used to analyze the data. Participants discussed their experiences of basic newborn resuscitation including knowledge, skills, and barriers and suggested solutions to improve practice. Four themes were revealed: lack of knowledge and skills in newborn resuscitation, organizational constraints, inadequate teamwork, and educational needs. The midwives perceived that their ability to perform newborn resuscitation was hindered by lack of knowledge and skills in newborn resuscitation, organizational constraints (such as lack of equipment), and poor co-ordination and communication among team members.

Purpose Factors influencing infants' behavioral and vocal (cry) response to painful stimuli are explored to improve pain management plans for infants undergoing immunizations. Design and Methods An observational study design was used. Pain responses of 60 to 75 days-old infants (44% male vs 56% female) undergoing two-month immunization injections were videotaped and coded using the Modified Behavioral Pain Scale (MBPS), and duration of total crying time during injection was recorded. The influences of five factors (gender, caregiver attendance, previous experience of nociception (circumcision), mode of delivery), and weight (birth and current) were examined at baseline, during and post-immunization. Results Higher birth weight was the most significant factor that reduced pain responses during (p = 0.001) and post-immunization (p = 0.03). A higher birth weight reduced full lung crying (p = 0.04), which reflects crying during injection as compared to total crying time. Vaginal delivery had a significant effect on behavioral pain responses of infants only post-immunization (p = 0.006). Parent's presence in the immunization room significantly reduced total crying time (p = 0.03). Uncircumcised male infants had a significant reduction in behavioral pain responses during immunization (p = 0.01) compared to circumcised infants. Conclusions The literature well supports the acknowledgement of early pain experience and its psychological consequences. Knowing and controlling for each of mentioned factors early in life during every painful procedure could improve coping mechanisms of infants for any painful procedures later in life. Practice Implications Control of certain factors during early life experiences can modify pain of immunization.

Conflicting associations between total homocysteine (tHcy), body mass index (BMI) lean body mass, and fat mass in the general population have been reported. We investigated the hypothesis that elevated tHcy levels are associated with increased BMI, waist-to-hip ratio (WHR), and body fat mass percent. In Jordan, obesity and overweight are prevalent among reproductive women and hyperhomocysteinemia, along with obesity and overweight, are independent risk factors for cardiovascular diseases. The participants used in this cross-sectional study were 325 overweight Jordanian women aged between 18 and 49 years old. The main outcome measures were tHcy, BMI, WHR, fat mass, fat-free mass, and total body water. Serum tHcy was analyzed using a liquid chromatography tandem mass spectrophotometry (LC–MS/MS) complete kit. The body compositions were measured using a bioelectrical impedance analyzer. Study participants were stratified according to their tHcy level into two groups, ≤10 μmol/L and >10 μmol/L, and the difference between mean values of body compositions was evaluated. The tHcy was significantly and negatively correlated with age, fat-free mass, and total body water, and significantly and positively correlated with BMI, hip circumference, WHR, fat mass, and dry lean weight. The chi-square and the independent sample t-tests showed statistically significant (P ≤ .05) differences between tHcy and BMI, WHR, fat and fat-free mass, and total body water percentages. In conclusion, BMI, WHR and body fat mass were found to be associated with elevated tHcy levels among overweight reproductive women, and they might be used as independent predictors of the tHcy level.

BACKGROUND: The aim of this study was to evaluate maternal common practice for infant sleep care and the home environment, in order to explore the major risk factors associated with sudden unexpected infant death in Jordan. METHODS: Data were collected via semi-structured questionnaire interview to investigate the sociodemographic features, infant sleep practices and home environments. The sample included 604 mothers with infants