METHODS AND ANALYSIS: This cross-sectional study will recruit 459 postpartum mothers during their 4-week postnatal follow-up in five selected public health clinics in Perak from September 2019 to May 2020. Participants will be mothers aged 18 years and above at 4 weeks postdelivery who are able to understand the English and Malay languages. Non-Malaysians and mothers with known diagnosis of psychotic disorders will be excluded from the study. Sociodemographic information and possible risk factors of the participants will be captured via a set of validated questionnaires, postpartum depression (PPD) will be measured using the Edinburgh Postpartum Depression Scale questionnaire and general depressive symptoms, anxiety and stress will be measured using the 21-item Depression, Anxiety and Stress Scale. Data analysis will be conducted using SPSS V.25.0 (IBM). Besides descriptive statistics, multivariable regression analyses will be done to identify possible risk factors and their independent associations with depression (PPD and general depressive symptoms, combined and separately), anxiety and stress.
ETHICS AND DISSEMINATION: The study protocol was reviewed and approved by the Medical Research Ethics Committee, Ministry of Health Malaysia on 7 August 2019. Results of this study will be reported and shared with the local health stakeholders and disseminated through conference proceedings and journal publications.
REGISTRATION NUMBER: This study is registered in the Malaysian National Medical Research Register with the ID: NMRR-19-868-47647.
METHODS: Retrospective data of 347 patients, consisting of maternal demographics and ultrasound parameters collected between the 20th and 25th gestational weeks, were studied. ML models were applied to different combinations of the parameters to predict SGA and severe SGA at birth (defined as 10th and third centile birth weight).
RESULTS: Using second-trimester measurements, ML models achieved an accuracy of 70% and 73% in predicting SGA and severe SGA whereas clinical guidelines had accuracies of 64% and 48%. Uterine PI (Ut PI) was found to be an important predictor, corroborating with existing literature, but surprisingly, so was nuchal fold thickness (NF). Logistic regression showed that Ut PI and NF were significant predictors and statistical comparisons showed that these parameters were significantly different in disease. Further, including NF was found to improve ML model performance, and vice versa.
CONCLUSION: ML could potentially improve the prediction of SGA at birth from second-trimester measurements, and demonstrated reduced NF to be an important predictor. Early prediction of SGA allows closer clinical monitoring, which provides an opportunity to discover any underlying diseases associated with SGA.
METHODS: A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis.
RESULTS: Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58-58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60-236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32-20.21).
CONCLUSION: Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.
METHODS: We conducted a meta-analysis to identify relevant randomized controlled trials involving infrapatellar fat pad resection and infrapatellar fat pad preservation during total knee arthroplasty in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, and Wanfang database, up to March 2020.
RESULTS: Nine randomized controlled trials, involving 783 TKAs (722 patients), were included in the systematic review. Outcome measures included patellar tendon length (PTL), Insall-Salvati ratio (ISR), rate of anterior knee pain, Knee Society Scores (KSS), and knee range of motion. The meta-analysis identified a trend toward the shortening of the patellar tendon with IPFP resection at 6 months (P = 0.0001) and 1 year (P = 0.001). We found no statistical difference in ISR (P = 0.87), rate of anterior knee pain within 6 months (p = 0.45) and 1 year (p = 0.38), KSS at 1 year (p = 0.77), and knee range of motion within 6 months (p = 0.61) and 1 year (0.46).
CONCLUSION: Based on the available level I evidence, we were unable to conclude that one surgical technique of IPFP can definitively be considered superior over the other. More adequately powered and better-designed randomized controlled trial (RCT) studies with long-term follow-up are required to produce evidence-based guidelines regarding IPFP resection.