Association between maternal lipid profile and gestational diabetes mellitus

Background: Dyslipidemia is the third component of metabolic syndrome and is a wellknown cardiovascular risk factor. However, the association of dyslipidemia with gestational diabetes mellitus is still a subject of ongoing research in Nigerian obstetric populations.Objective: To determine the relationship between second trimester maternal fasting plasma lipid constituents and gestational diabetes mellitus.Methods: This was a prospective nested case control study that enrolled 288 pregnant women out of which 36 women with GDM (cases) where matched with 72 without GDM (controls) following results of oral glucosetolerance testing and plasma fasting lipid profiles done between 24 28 weeks. The patients were followed up until delivery to document maternal and fetal outcomes. Data was analyzed using Statistical Package for Social Sciences (SPSS). Categorical variables were presented in percentages while continuous variables were expressed as means (±Standard Deviation). Student ttest and Chisquare test or Fishers exact test were used for comparing variables between the two groups. A value of <0.05 at 95%confidence interval was considered statistically significant.Results: The overall mean plasma lipid levels for the four lipid constituents in the study population were 187.9mg/dL, 163.5mg/dl, 49.1mg/dL and 108.1mg/dL for TC, TG, HDLc and LDc respectively. The mean plasma triglyceride was significantly higher in cases compared to the controls: 187.0±67.7mg/dL vs. 151.7±66.4mg/dL, (p = 0.01). Abnormaltriglyceride was significantly associated with GDM (AOR:4.8, 95% CI (1.6-14.4), (p= 0.005).Conclusion:Maternal dyslipidemia (abnormal triglyceride) was shown to be significantly associated with GDM in this study and it appeared to be causally related

Black Women's Predisposition to Preterm Birth; Could We Be Near The Answer.

Background: Pre-term Premature Rupture of Membranes (PPROM) is attributable to several causes including asymptomatic bacterial vaginosis among Caucasians and is commoner among black pregnant women. While malaria and high Body Mass Index (BMI) have been reported among Nigerians, the influence of metalloproteinases on PPROM has never been studied in Nigeria. Methods: A qualitative estimation of active matrixmetalloproteinase-8 (a-MMP-8) to assess the effect of chronic periodontitis on time to conception led to an accidental discovery of widespread elevation of a-MMP-8 among pregnant participants. Values of a-MMP-8 were compared across demographics of participants as well as educational status, BMI and other parameters. Results : One hundred and seventeen of 134 participants (117, 87.3%) had elevated a-MMP-8 based on a novel qualitative assessment using salivary diagnostics. Levels were increased across independent of age, Estimated Gestational Age(EGA), BMI, educational level and trimester. Conclusion: This population of black pregnant women exhibited higher a-MMP-8 levels than reported among pregnant Caucasians independent of demographics, educational level and trimester of pregnancy. Reasons for the association need to be further investigated.

Age at Menarche among School Girls in Sokoto; Northern Nigeria

Background/Objectives: Menarche; the first menstrual period; is influenced by many factors including socio-economic status and rural or urban dwelling. The aims of the study were to compare the age at menarche between rural and urban girls and evaluate the anthropometric indices at menarche. Materials and Methods: A cross-sectional study of rural secondary school girls and urban school girls. A structured questionnaire was used to obtain information on their age at menarche and other relevant data. Their weights and heights were measured using computerized scales and calibrated walls. Results: Two hundred and twenty eight (228) rural girls and four hundred and eighty (480) urban girls that had attained menarche within a year were studied. Mean age at menarche for all the girls was 15.26 years. Mean menarcheal age for the rural and urban girls were 15.32 years and 15.20 years; respectively. Mean weight and height were 47.6 kg and 156.76 cm; respectively for the rural girls and 48.12 kg and 156.8 cm; respectively for the urban girls. There was no significance difference in age of menarche among the groups (P 0.05). Conclusion: The mean age at menarche for the school girls is 15.26 years. There was no difference in menarcheal age between the rural and urban school girls. Further longitudinal studies to compare rural school girls and urban school girls in private schools are required

Determinants of Utilization of Maternity Services in Gidan Igwe; Sokoto; Nigeria

Background: The provision of antenatal care is regarded as the cornerstone of maternal and perinatal health care especially in developing nations and is expected to have a significant impact on achieving the fifth millennium development goal. The aim of this study was to assess the determinants of utilisation of maternity services in Gidan Igwe; Sokoto. Methods: The study was a cross-sectional descriptive one involving 300 women of child bearing age selected through a systematic sampling technique. Data was collected using a set of semi-structured interviewer and self administered questionnaires. Results: Majority; 214 (71.3) of the respondents had no formal education; visited a health facility for antenatal care during their last pregnancy; 218 (72.7) and had their last delivery at home; 190 (63.3). Of the 190 subjects that delivered at home; 165 (85) were assisted by Traditional birth attendants (TBAs). Education was statistically significantly associated with ANC attendance and hospital delivery (P=0.0012). Conclusion: Although; a high proportion of the respondents visited health facilities for ANC; only a few of them delivered in these facilities. There is need to increase public awareness on the use of antenatal care services and delivery by skilled attendants

Ectopic pregnancy in Sokoto; Northern Nigeria

Ectopic pregnancy is an important cause of maternal mortality and morbidity in the first trimester of pregnancy. We report a descriptive, cross-sectional study of ectopic pregnancy presenting to the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, between 1990 and 1997. There were 140 cases of ectopic pregnancy with incidence of 18.1 per 1,000 deliveries. The mean age of patients was 26.7 years and the median parity of cases of ectopic gestation was 1; 32% were nulliparae. Abdominal pain and tenderness were the most frequent symptom and sign respectively. Diagnosis was usually based on clinical findings augmented by procedures including paracentesis abdominis, abdominal ultrasound scan and urine pregnancy test. The ectopic pregnancy was sited in the Fallopian tube in 92% of cases. In 56 cases (41%), there was macroscopic evidence of previous pelvic infection at surgery. 66% of ectopic pregnancies had ruptured at presentation. Treatment was surgical in all but one case, and unilateral salpingectomy was the procedure most frequently performed. The case fatality rate was 1.5%