http://www.biomedcentral.com/bmcpregnancychildbirth/ The editor's pick of recent articles published by BMC Pregnancy and Childbirth 2012-05-14T00:00:00Z Background: Nearly half the world's babies are born at home. We sought to evaluate the training,knowledge, skills, and access to medical equipment and testing for home birth attendantsacross 7 international sites. Methods: Face-to-face interviews were done by trained interviewers to assess level of training,knowledge and practices regarding care during the antenatal, intrapartum and postpartumperiods. The survey was administered to a sample of birth attendants conducting home or outof-facility deliveries in 7 sites in 6 countries (India, Pakistan, Guatemala, DemocraticRepublic of the Congo, Kenya and Zambia). Results: A total of 1226 home birth attendants were surveyed. Less than half the birth attendants wereliterate. Eighty percent had one month or less of formal training. Most home birth attendantsdid not have basic equipment (e.g., blood pressure apparatus, stethoscope, infant bag andmask manual resuscitator). Reporting of births and maternal and neonatal deaths togovernment agencies was low. Indian auxilliary nurse midwives, who perform some homebut mainly clinic births, were far better trained and differed in many characteristics from thebirth attendants who only performed deliveries at home. Conclusions: Home birth attendants in low-income countries were often illiterate, could not read numbersand had little formal training. Most had few of the skills or access to tests, medications andequipment that are necessary to reduce maternal, fetal or neonatal mortality. http://www.biomedcentral.com/1471-2393/12/34 Ana Garces Elizabeth M McClure Elwyn Chomba Archana Patel Omrana Pasha Antoinette Tshefu Fabian Esamai Shivaprasad Goudar Adrien Lokangaka K Michael Hamidge Linda L Wright Marion Koso-Thomas Carl Bose Waldemar A Carlo Edward A Liechty Patricia L Hibberd Sherri Bucher Ryan Whitworth Robert L Goldenberg BMC Pregnancy and Childbirth 2012, 12:34 2012-05-14T00:00:00Z 10.1186/1471-2393-12-34 Little formal training for HBAs Home birth attendants (HBAs) in low-resource countries are often illiterate, lack basic medical equipment, and have little formal training, indicating the need to provide greater training in safe birthing practices and the recognition of life-threatening complications. /content/figures/1471-2393-12-34-toc.gif BMC Pregnancy and Childbirth 1471-2393 12 34 2012-05-14T00:00:00Z PDF Background: Low back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed. Methods: A cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum. Results: Back pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis. Conclusions: Estimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain. http://www.biomedcentral.com/1471-2393/12/30 Eva Thorell Per Kristiansson BMC Pregnancy and Childbirth 2012, 12:30 2012-04-17T00:00:00Z 10.1186/1471-2393-12-30 Back pain in pregnancy not linked to fitness Peak oxygen uptake and physical activity in early pregnancy are not associated with reduced back pain during and after pregnancy, suggesting that pregnancy-related back pain is not a consequence of poor physical conditioning. /content/figures/1471-2393-12-30-toc.gif BMC Pregnancy and Childbirth 1471-2393 12 30 2012-04-17T00:00:00Z XML Background: Two criteria based on a 2 h 75 g OGTT are being used for the diagnosis of gestational diabetes (GDM), those recommended over the years by the World Health Organization (WHO), and those recently recommended by the International Association for Diabetes in Pregnancy Study Group (IADPSG), the latter generated in the HAPO study and based on pregnancy outcomes. Our aim is to systematically review the evidence for the associations between GDM (according to these criteria) and adverse outcomes. Methods: We searched relevant studies in MEDLINE, EMBASE, LILACS, the Cochrane Library, CINHAL, WHO-Afro library, IMSEAR, EMCAT, IMEMR and WPRIM. We included cohort studies permitting the evaluation of GDM diagnosed by WHO and or IADPSG criteria against adverse maternal and perinatal outcomes in untreated women. Only studies with universal application of a 75 g OGTT were included. Relative risks (RRs) and their 95% confidence intervals (CI) were obtained for each study. We combined study results using a random-effects model. Inconsistency across studies was defined by an inconsistency index (I2) > 50%. Results: Data were extracted from eight studies, totaling 44,829 women. Greater risk of adverse outcomes was observed for both diagnostic criteria. When using the WHO criteria, consistent associations were seen for macrosomia (RR = 1.81; 95%CI 1.47-2.22; p < 0.001); large for gestational age (RR = 1.53; 95%CI 1.39-1.69; p < 0.001); perinatal mortality (RR = 1.55; 95% CI 0.88-2.73; p = 0.13); preeclampsia (RR = 1.69; 95%CI 1.31-2.18; p < 0.001); and cesarean delivery (RR = 1.37;95%CI 1.24-1.51; p < 0.001). Less data were available for the IADPSG criteria, and associations were inconsistent across studies (I2 ≥ 73%). Magnitudes of RRs and their 95%CIs were 1.73 (1.28-2.35; p = 0.001) for large for gestational age; 1.71 (1.38-2.13; p < 0.001) for preeclampsia; and 1.23 (1.01-1.51; p = 0.04) for cesarean delivery. Excluding either the HAPO or the EBDG studies minimally altered these associations, but the RRs seen for the IADPSG criteria were reduced after excluding HAPO. Conclusions: The WHO and the IADPSG criteria for GDM identified women at a small increased risk for adverse pregnancy outcomes. Associations were of similar magnitude for both criteria. However, high inconsistency was seen for those with the IADPSG criteria. Full evaluation of the latter in settings other than HAPO requires additional studies. http://www.biomedcentral.com/1471-2393/12/23 Eliana M Wendland Maria Torloni Maicon Falavigna Janet Trujillo Maria Dode Maria Campos Bruce B Duncan Maria Schmidt BMC Pregnancy and Childbirth 2012, 12:23 2012-03-31T00:00:00Z 10.1186/1471-2393-12-23 Predicting gestational diabetes outcomes World Health Organization (WHO) and International Association for Diabetes in Pregnancy Study Group (IADPSG) diagnostic criteria for gestational diabetes both identify risks for adverse pregnancy outcomes, but the IADPSG criteria show less consistency. /content/figures/1471-2393-12-23-toc.gif BMC Pregnancy and Childbirth 1471-2393 12 23 2012-03-31T00:00:00Z XML