Prevalence and Factors Associated with Anemia Pregnancy in a Group of Moroccan Pregnant Women

Background: Pregnancy is typically accompanied by an increase of micronutrient requirements in general and especially iron. This increased need may be an additional risk factor for developing anemia. Purpose of the study: The aim of this study is to provide data on the prevalence of anemia of pregnancy in the maternity ward of the regional hospital in the city of Temara, and examine risk factors that may expose women to anemia during pregnancy. Materiel and Methods: A prospective cross-sectional study of a year was conducted to the hospital Sidi Lahcen in the city of Temara. Sociodemographic and nutritional data were collected through a questionnaire, obstetric and medical histories of women in labor and the results of biological tests were recorded from the patient obstetric file. Results: Among the 849 women surveyed, 690 (82%) had performed a blood count, and among these 117 (16.8%) were found anemic, with the following proportions: 57.6% had mild anemia, 41.5% had moderate anemia and a minority (0.8%) had severe anemia. The pregnant women aged over 35 years were the most exposed to anemia during pregnancy (47%) compared with younger women (p < 0.001). Women who had a history of anemia aside from pregnancy and those who had anemia in earlier pregnancies were more prone to developing anemia in the current pregnancy with a statistically significant difference (p < 0.001). The number of pregnancies, number of previous abortions and place of residence had no influence on the occurrence of anemia of pregnancy. The consumption of fortified flour with iron and vitamins as well as consuming iron rich foods was not a protective factor against the development of anemia of pregnancy. Tea consumption near the meal was not a factor exposing to anemia during pregnancy. Conclusion: Anemia is a public health problem in Morocco. Evidence from our study emphasizes the need to implement educational programs to improve the nutritional knowledge and sensitization of women.

Factors of Neonatal Morbidity at the Provincial Hospital Center of Missour

Background: Although neonatal mortality decreases in different regions of the world, it is still a major problem in developing countries and particularly in Morocco. Purpose: The aims of this study are to examine the characteristics of pregnant women in the hospital center in the urban commune of Missour as well as the morphological data of the newborn and identify the risk factors implicated in neonatal morbidity. Materials and Methods: A retrospective study of collected data from records of women who gave birth in the Maternity of Missour during 2012. As well as a prospective study conducted at the maternity in 2013. Results: A total of 1108 women were included in this retrospective survey, of which 45% come from areas located far from the hospital center of the province and sometimes the access is tough in winter. Only 55.1% of pregnancy was followed. Among 1121 births, 49 babies (4.3%) showed a problematic birth situation: 31 (2.7%) newborns were hospitalized in pediatrics, of which 14 are premature. Neonatal mortality rate is 0.6% that is to say 7 early deaths. The risk factors associated to neonatal morbidity are gestational age and weight birth (in 50% of the cases, 85.7% of deaths are premature infants less than 1500 g). 14 (1.2%) were referred and 11 (0.9%) malformed were noticed. The prospective study states that among the 194 women analyzed, 89.7% are housewives. 89.1% have no medical coverage and 25.4% are illiterate. Only 29.2% benefit from a blood sample during pregnancy and 50% benefit from regular ultrasound follow-up. Conclusion: Mortality and neonatal morbidity constitute a public health priority in Morocco. Our work insists on the interest of an organized support of the newborn from the community to the different levels of the health pyramid.

Impact of Educational Materials on the Duration of Exclusive Breastfeeding Assured by Women Who Delivered at the Souissi Maternity Hospital in Rabat

Background: The practice of exclusive breastfeeding (EB) in Morocco has witnessed a worrying decline in recent decades, contrary to the recommendations of the World Health Organization (WHO) which advocates it during the first six months as a significant public health tool. The present study aims to assess the impact of educational materials on mothers’ behaviour with regard to keeping up EB as long as six months, at least. Methods: This is a cohort study with a prospective collection of data over a period of one year, through a questionnaire-based survey of 500 women who delivered at the Souissi Maternity Hospital in Rabat. The subjects were divided into an intervention group sensitized, during the medical visit, by means of information delivered orally about breastfeeding and a booklet containing instructions on breastfeeding management and the benefits of EB, especially when extended for the first six months;and a control group attending the same operation with no awareness-rising through educational materials. To assess EB rates, the subjects had been followed for six months through telephone. Results: 372 women who delivered were followed, 194 from the intervention group and 178 from the control group. The remaining 128 women not followed were lost sight of. A higher percentage of mothers in the intervention group exclusively breastfed their babies up to the age of six months compared to the control group, 55.2% against 38.8% (p = 0.002). The main reason produced by most mothers who ceased to exclusively breastfeed their babies is milk insufficiency. Conclusion: The postnatal nutritional education strategy based on the distribution of educational materials has considerably raised the number of women who exclusively breastfed their babies until the age of six months.

The Issue of Care Given to Premature Infants in the Provincial Hospital Center of Missour

Background: Preterm birth is common in Morocco and it’s around 8%. Several management rules of taking care of preterm infants have been developed but have not been put into action. The geo-graphical inaccessibility to specialized hospitals and the weakness of the reception capacity of the care centers hinder the management of the complications associated with preterm birth. Purpose: The present study is designed to present some epidemiological data of preterm births within the Provincial Hospital Center of Missour during 2012 and to discuss the various problems emerging in the management of treatment and care. Materials and Methods: Retrospective study of preterm births in the maternity ward in the Hospital of Missour during 2012. Results: 37 preterm births among 1121 (3.3%) have been analyzed (51.3% severe premature infants, 45.9% late preterm infants and 2.7% extremely premature infants). 64.2% are originally from difficult areas to reach during winter. All mothers have received upon arrival at the maternity a corticosteroid and calcium antagonists (Adalate*) and an antibiotic treatment to those with a positive infectious anamnesis found in half of the women. We have recorded 3 twin pregnancies and 2 gravidic toxemias. Only 21 babies have been given back to their mothers (namely 56.7%). 5 premature infants (namely 13%) have been referred to the university hospital center of Fez (2 respiratory distress, a malformation and 2 severe premature births) given that there is an absence of a specialized care unit at the hospital, knowing that no baby has received neither surfactant nor caffeine at birth. 14 premature babies (namely 37.8%) have been transferred to the pediatric unit with a total death rate of 16.2% (6 premature) mainly related to neonatal infection and to suffering of the hyaline membranes disease. Conclusion: We emphasize the interest of prevention programs which demand an early diagnosis of preterm birth threats and monitoring high-risk pregnancies, improving the medical care given to low-weight premature by creating “Kangaroo” units at a regional level and the targeting of measures for rural and under-covered areas.

Risk Factors for Breast Cancer of Different Age Groups: Moroccan Data?

Background: Several epidemiological studies have been carried to identify the risk factors for developing breast cancer. The aim of this study was to evaluate the risk factors associated with breast cancer in different age groups in the Moroccan women and to determine susceptible and protective factors. Methods: This was?a case control study?including 400 women with breast cancer and 400 controls of the National Institute of Oncology Sidi Mohamed Ben Abdallah, Rabat, Morocco from 2008 to 2010. These women were interviewed for epidemiological information and risk factor for breast cancer. Results: Early age at menarche, late menopause, oral contraceptive and family history with first degree were positively associated with breast cancer in all the series and in the age group between 22 and 34 years. In the age group between 44 and 34 years, a risk of breast cancer was associated only with a family history of breast cancer. In the age group of 45 years or older, the factors which seem to influence a breast cancer are: late menopause, oral contraceptive and family history in the first degree. In contrast, early childbearing, multiparity and lactation were negatively associated with breast cancer. Conclusion: This study is rather in favour of positive association between hormonal factors and breast cancer, and confirms the protective role of multiparity and lactation.