ABSTRACT
Season is known to influence human secondary sex ratio but information on this subject is lacking in Nigeria. The objective of this study was to determine the secondary sex ratio (SSR) during the wet and dry seasons in Nigeria. In this retrospective cohort study, the records of all deliveries at St Philomena Catholic Hospital (SPCH), Benin City, Edo State, Nigeria between 1st January, 2005 and 31st December, 2014 (10 years) were retrieved and analyzed. The births were recorded according to the year and month of delivery. Stillbirths and infants with ambiguous genitalia were excluded from the analyses. The total number of live-births during the 10-year period under review was 13,702 and this consisted of 7,007 males and 6,695 females, resulting in a secondary sex ratio of 104.6:100 (1.05:1). In general, the monthly distribution of births was bimodal with a greater peak in May and a lesser peak in October with the highest and lowest SSRs in the months of June and March, respectively. In the dry season, the proportion of male births was higher than the proportion of female births; p > 0.05. In contrast, in the wet season the proportion of male births was lower than the proportion of female births; p > 0.05. In addition, the SSR was higher in the dry season (1.04) compared with the wet season (0.99). In Edo State, Nigeria, the proportion of male births tended to be higher than the proportion of female births during the dry seasons.
ABSTRACT
Human immunodeficiency virus (HIV) infection is a global pandemic with frightening mortality and morbidity, no effective vaccine and curative treatment though it is preventable. Globally heterosexual and vertical transmissions remain the leading means of its spread. The sub Saharan African female adults are the most affected and most of the world HIV positive children were from vertical transmission. Therefore an in-depth knowledge of the women HIV risk factors is crucial to its effective prevention and control. The general objective of this study was to investigate the association between sociodemographic and bio-clinical variables and HIV infection in pregnancy. The specific objectives were to determine the prevalence of HIV infection among pregnant women and to compare the sociodemographic profiles and the bio-clinical variables of HIV seropositive mothers and matched seronegative counterparts. This was a retrospective case control analysis of 116 HIV positive mothers as study group and 232 HIV negative mothers as control group. The data used was obtained from the records of women that delivered between 2009 and 2013 in a mission hospital, in Benin City, Edo state, South-south, Nigeria. Statistical analyses of the data were done, P-value of 0.05 was considered as significant. Our results indicated that the prevalence of HIV seropositivity in pregnancy in this setting was 2.94%. HIV Seroprevalence was statistically significant different among women aged 25-29 years (p=0.048) and 30-34 years (p=0.01), with low (primary) educational attainment (p=0.048) and in government employment (OR.0.25, P=0.006). The seropositive mothers had significantly lower haematocrit (P=0.0015), higher incidence of anemia at booking (P=0.0023) and reduced weight gain at term (P=0.013). Their newborns significantly weighed less at birth (P=0.0032), suffered intrauterine growth restriction (P=0.0002) and low birth weight (P=0.0017). HIV infection in pregnancy is still a significant burden. It appears to have social predictors and materno-fetal health implications. We therefore recommend sustained efforts at personal level especially behavioral and lifestyle adjustment, collective and at government level female gender empowerment to control the scourge.
ABSTRACT
Maternal Age of 35 years or more at first pregnancy and childbirth is considered advanced reproductive age and a high pregnancy risk associated with increased adverse maternal and perinatal outcomes. The industrialized and developing countries are replete with supporting scientific literatures but only a few data on nulliparous women in our setting hence our interest to appraise the correlates of advanced maternal age at first childbirth and obstetric performance in Nigerian women. The objectives were to determine the influence of advanced maternal age at first pregnancy on the obstetric and perinatal outcomes. To compare the obstetric performance of women advanced in maternal age at first delivery with their younger counterparts and to determine the trend of identifiable adverse outcomes with increasing maternal age at first delivery. This was a retrospective comparative study of 1684 nulliparous women that had their childbirth between 2009 and 2013 at a mission Hospital. Those aged 35 years and above were the study subjects while those aged 20 - 34 years the control. Relevant database was raised from the case files. The prevalence of elderly nullipara in this study was 1.6%. They were statistically significant different in primary level of education (OR = 4.1, P = 0.02), prenatal care lack (OR = 2.6, P = 0.02), caesarean section (OR = 2.5, P = 0.0006), incidental myomectomy (OR = 19.1, P < 0.0001), prolonged pregnancy (OR = 0.6, P = 0.04) and episiotomy at vaginal delivery (OR = 0.5, P = 0.01). They were also insignificantly worse in ante partum hemorrhage (APH), induction of labor, perineal tear, HIV infection, postpartum hemorrhage (PPH), preterm birth, Low birth weight (LBW), Intrauterine growth restriction (IUGR), stillbirth ,neonatal birth asphyxia and Perinatal mortality. Caesarean section rate, caesarean myomectomy, APH, induction of labor, stillbirth rate, LBW and Perinatal mortality each maintained a statistical significant linear tendency (P < 0.05) with maternal age. First pregnancy at advanced maternal age is fraught with increased maternal morbidity, perinatal morbidity and mortality. We proffer early education, marriage or and childbearing, quality prenatal care and skilled attendance at delivery for safe motherhood.
ABSTRACT
Pre-eclampsia is known to be associated with various placental morphologic changes as well as fetal growth restriction. Growth restricted neonates are at increased risk of hypoglycaemia in the first three days of life. The aim of the study was to examine the relationship between occurrence of neonatal hypoglycaemia and the relative placental weight in mothers with pre-eclampsia. The blood glucose concentrations of 69 neonates born to mothers with pre-eclampsia were determined three times daily during the first three days of life. The birthweight of each of the neonates as well as the corresponding weight of the placenta were determined and recorded. The relative placental weight was calculated using the formula: Weight of placenta x 100/Birthweight of the infant. Overall prevalence of neonatal hypoglycaemia was 47.8%. Of the 69 neonates, severe neonatal hypoglycaemia (blood glucose < 1.6 mmol/L) was prevalent in 10 (14.5%) and 15(21.7%) had blood glucose level between 1.6 and 2.5 mmol/L. The relative placental weight did not differ with the severity of maternal pre-eclampsia. No statistically significant correlation was obtained between the relative placental weight and neonatal hypoglycaemia.