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Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.
Fulltext Proportion of women with history of gestational diabetes mellitus who performed an oral glucose test at six weeks postpartum in Johor Bahru with abnormal glucose tolerance

Fatin A, Alina TI

Malays Fam Physician, 2019;14(3):2-9.
PMID: 32175035

Introduction: Glucose testing at six weeks postpartum has been recommended by the World Health Organization as the earliest period in which to detect abnormal glucose tolerance among women with a history of gestational diabetes mellitus (GDM). This study aimed to determine the outcomes of six weeks postpartum glucose testing and its associated factors among women with a history GDM who attended government primary health clinics in Johor Bahru.
Methods: The study was a cross sectional study which was conducted among women with a history of GDM who registered from January to June 2016 at primary health clinics in Johor Bahru and underwent an oral glucose tolerance test at six weeks postpartum. Secondary data were obtained from Maternal Health Records (clinic copy). Data were analyzed using SPSS Version 23.0. Descriptive statistics and simple logistic regression analysis were used.
Results: One hundred and twenty-two women with a history of GDM completed the postpartum glucose testing. Approximately 12% of these women were reported to have abnormal glucose tolerance. Insulin usage (OR:5.44; 95% CI:1.53, 19.43; p=0.009), abnormal glycated hemoglobin (OR:8.70; 95% CI:2.68,26.27; p<0.01), hospital follow-up (OR:3.38; 95% CI: 1.11, 10.34; p=0.033) and neonatal intensive care unit admission (OR:3.96; 95% CI: 1.16, 13.54; p=0.028) were found to have significant associations with abnormal glucose tolerance at six weeks postpartum.
Conclusion: The proportion of women with a history of GDM and abnormal glucose tolerance at six weeks postpartum in Johor Bahru was 12% and was associated with insulin usage, abnormal glycated hemoglobin, hospital follow-up and neonatal intensive care unit admission. Screening during the postpartum period offers a window of opportunity for early identification of diabetes and prediabetes, as women with history of GDM are at increased risk of future glucose intolerance.
Fulltext Intention and actual exclusive breastfeeding practices among women admitted for elective cesarean delivery in Kelantan, Malaysia: A prospective cohort study

Nazirah J, Noraini M, Norkhafizah S, Tengku Alina TI, Zaharah S

Med J Malaysia, 2020 05;75(3):274-280.
PMID: 32467544

INTRODUCTION: The intention of a woman to breastfeed is one of the predictors of breastfeeding initiation and duration.

OBJECTIVE: The aim of this study is to determine exclusive breastfeeding (EBF) intention among women admitted for elective cesarean delivery in Kelantan and their postnatal EBF practices.

METHODS: A total of 171 women, mostly Malays, admitted for elective cesarean delivery at two tertiary hospitals in Kelantan participated in this prospective cohort study. The Malay version of Infant Feeding Intentions (IFI) scale was administered one day before the surgery to determine the EBF intention, and follow-up phone calls were made at one month, three months, and six months after delivery to determine the actual EBF practices.

RESULTS: Before delivery, 86.5%, 82.5% and 77.2% of the women somewhat agreed or very much agreed to practice EBF for 1, 3 and 6 months respectively and the actual EBF practices after delivery were 80.1%, 59.6%, and 42.1%. Women who had the intention to practice EBF for 6 months were about 2 times more likely to practice EBF for 6 months than those who did not have the intention to EBF (OR 2.19, 95% CI: 1.01-4.76). No significant association was found between EBF intention and the actual EBF practices at 1 month and 3 months postnatal.

CONCLUSIONS: The number of women who practiced EBF after cesarean delivery was lower than those who had the intention prior to delivery. The number further declined as the child grew older. Prenatal EBF intention was associated with actual postnatal EBF practices at 6 months.
Fulltext Circadian blood pressure profile and associated cardiovascular risk factors in non-dippers

Siti Suhaila MY, Juwita S, Harmy MY, Tengku Alina TI

International Medical Journal Malaysia, 2013;12(2):23-31.
MyJurnal

Introduction: Ambulatory blood pressure accurately reflects a patient's actual blood pressure than casual or office blood pressure. This study aims to describe the circadian blood pressure profile of hypertensive patients and to identify the associated cardiovascular risk factors in non-dippers.
Methods: A cross-sectional study was conducted from 1st January 2008 to 30th June 2008 among hypertensive patients attending Family Medicine Clinic HUSM. Schiller BR-102 plus was used to get 24 hours blood pressure (BP) reading. Mean of two offices BP were also taken. Non-dippers are defined as a systolic or diastolic nocturnal drop of less than 10%. Analysis was done using SPSS Version 12.
Results: 105 patients were recruited with mean (SD) age of 51.8 (9.34) year old. The mean (SD) 24-hour systolic and diastolic BP was 128.4 (12.7) mmHg and 79.7 (8.74) mmHg respectively. Mean (SD) daytime systolic and diastolic BP was 132.1 (11.72) mmHg and 82.4 (9.41) mmHg while for the night time were 123.3 (12.78) mmHg and 76.2 (9.01) mmHg. Mean (SD) systolic and diastolic office BP was 144.2(15.16) mmHg and 90.2(9.71) mmHg. Percentage of non dippers were 68.6% for systolic and 61.9% for diastolic.
Conclusion: Mean 24 hours and daytime ambulatory BP was normal but the mean night time diastolic and office BP was above-normal value. Majority of the patients were categorized as non dippers. Therefore, using ambulatory BP is clinically important to get a better understanding of blood pressure fluctuations over 24-hour periods compared to simple clinical measurements.
Study site: Family Medicine Clinic, Hospital Universiti Sains Malysia (HUSM), Kelantan, Malaysia
Development of perceptions and attitudes towards Intimate Partner Violence questionnaire for premarital young adults

Wan Soliha WMH, Tengku Alina TI, Anis Kausar G, Zaharah S

Med J Malaysia, 2021 09;76(5):658-664.
PMID: 34508371

OBJECTIVE: The age of young adults is a critical period as they start to explore intimate relationship and prepare for marriage. Although instruments on intimate partner violence (IPV) are available, few include potential predictors of this violent behaviors such as perceptions and attitudes. Therefore, this study aimed to develop a questionnaire to assess perceptions and attitudes toward IPV among premarital young adults.
METHODS: The questionnaire was developed in two stages: item development and scale development. Two forms of validity evidence were applied, which were content validity index (CVI) and face validity index (FVI), to estimate the content validity, response process and internal structure of the tool. This cross-sectional study was conducted among premarital young adults in Kota Bharu, Kelantan. The questionnaire assessed perceptions and attitudes toward IPV on six related components, which were its forms, causes, impacts, supports, acceptance and willingness to disclose.
RESULTS: CVI values for both perceptions and attitudes domains were more than 0.83. Five of the components have few items with low agreement by experts, hence those items were dropped. FVI values for the six domains among premarital young adults were at least 0.83, thus all these items were retained. The final result of development of this questionnaire were 64 items for perceptions and 23 items for attitudes, with five-Likert scale response option.
CONCLUSION: The newly developed tool, named as MYPAIPVQ, is valid based on content validity and face validity to assess perceptions and attitudes toward intimate partner violence among premarital young adults. Before it can be used, further validation studies should be conducted to determine its psychometric properties.