Altantuya, Shirchinjav

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Trends in Cesarean Section in a Tertiary Referral Hospital: Time-Series Analysis
(Mongolian National University of Medical Sciences, 2025-06-30)
Enkhmaa, Davaasambuu
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Enkhtaivan, Oyunkhand
;
Batsuuri, Baljinnyam
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Erdenebileg, Nasantogtokh
;
Baatar, Tsedmaa
Objectives: To analyze the causes and indications of C-sections conducted at the tertiary referral center and to forecast future patterns. Methods: We retrospectively analyzed 25,311 delivery records from 2013 to 2022 at the National Center for Maternal and Child Health, Mongolia. All C-sections from 22 weeks’ gestation onward were included. Data were collected using a structured questionnaire form including maternal, obstetric history, surgical indications, and other influencing factors. Causes of C-sections were identified through descriptive statistics, logistic regression, and ARIMA time-series modeling. Statistical analysis was performed using Stata BE 18.0, with p < 0.05 considered significant. Results: The mean gestational age was 38.1±2.09 weeks, the 88.4% of pregnancies were term deliveries, and 42.6% were emergency C-sections. The most common indications for C-section were previous C-section, maternal comorbidity, severe preeclampsia, and fetal distress. According to time-series analysis, despite of no significant change in the C-section rate during the study period, the trends in C-sections are growing. The percentage of nulliparous women in total C-sections is likely to increase by 0.81% per year. In 2030, the percentage of C-sections will reach 35.5%, whereas the percentage of emergency C-sections in total C-sections will reach 59.5%. Conclusions: C-sections for nulliparous women were mainly due to failed birth induction, failed labor stimulation, and fetal distress. It is estimated that the percentage of C-sections in total births will increase by 0.02% annually, reaching 35.5% by 2030.
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Maternal vitamin D intakes during pregnancy and child health outcome
(2023-12)
Nasantogtokh, Erdenebileg
;
Ganmaa, Davaasambuu
;
Altantuya, Shirchinjav
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Amgalan, Bayarsaikhan
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Enkhmaa, Davaasambuu
We conducted a follow up of the children in Mongolia whose mothers received one of the three doses of vitamin D (600, 2000, or 4000 IU daily) during pregnancy as part of the randomized, double-blind, clinical trial of vitamin D supplementation to determine their impact on child health to two years. In the parental trial, 119 pregnant women were assigned to 600 IU/day, 121 were assigned 2000 IU/day, and 120 were assigned 4000 IU/day starting at 12-16 weeks' gestation and continuing throughout pregnancy. At baseline, maternal serum 25(OH)D concentrations were similar across arms; 91 % were 50 nmol/l. As expected, there was a dose-response association between the amount of vitamin D consumed (600, 2000, or 4000 IU daily) and maternal 25(OH)D levels at the end of the intervention. Total 311 children of 311 mothers were followed for 2 years to evaluate health outcomes. We determined the child's health outcomes (rickets, respiratory disease [pneumonia, asthma], and diarrhea/vomiting) using a questionnaire and physical examination (3, 6, and 24 months of age). Low levels of mothers' serum 25(OH)D during pregnancy increased the risk of developing rickets, respiratory illness, and other diseases in children during the early childhood period. Rickets was diagnosed in 15.6 % of children of women who received 600 IU of vitamin D during pregnancy, which was higher than in other vitamin D groups. Children in the group whose mothers received low doses of vitamin D (600 IU/day) had a greater probability of developing respiratory diseases compared to the other groups: pneumonia was diagnosed in n = 36 (35.0 %) which was significantly higher than the group receiving vitamin D 4000 IU/day (n = 34 (31.5 %) p = 0.048). In the group whose pregnant mother consumed 600 IU/day of vitamin D, the risk of child pneumonia was ∼ 2 times higher than in the group who consumed 4000 IU/day (OR=1.99, 95 % CI: 1.01-3.90). The incidence of diarrhea and vomiting in children was 12.1 % lower in the 2000 IU/day group and 13.1 % lower in the 4000 IU/day group compared with the 600 IU/day group (p = 0.051). The offspring of pregnant women who regularly used vitamin D at doses above 600 IU/day had lower respiratory disease, rickets, and diarrheal risks at 2 years.
Scopus© Citations 11

Altantuya, Shirchinjav

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