ABSTRACT
Background: Malaria parasitaemia in pregnant women is associated with adverse maternal and fetal complications including anemia. The study aimed at determining prevalence of anemia among pregnant women with asymptomatic malaria parasitaemia at booking in a tertiary hospital in Abuja, Nigeria. Methods: This was a cross-sectional descriptive study of consented 659 pregnant recruited consecutively at booking for antenatal care. Structured questionnaire was administered on each subject and then blood was taken for their packed cell volumes estimation using Hawksley`s microhaematocrit reader as well as thick and thin blood films for malaria parasites assessment.The data were analysed using 2008 EPI-info 3.5.1(CDC, Atlanta Georgia, USA).. Results: Out of 659 pregnant women screened, 255 (38.7%) had significant malaria parasitaemia. Among women with significant malaria parasitaemia, 176 (69.0%), 68 (26.7%) and 11 (4.3%) had mild, moderate and severe malaria parasitaemia respectively. Prevalence of anemia (PCV< 33%) in the entire study population screened was 38.4% (253/659). Among pregnant women with significant malaria parasitaemia, 163 of them were anaemic, giving prevalence of anaemia of 63.9% (163/255) while anemia was noted in 22.3% (90/404) of women with no malaria parasitaemia. The risk of anemia was significantly higher as the severity of parasitaemia increases among the study (P < 0.00001). Conclusion: Anaemia in pregnancy is common among asymptomatic women with malaria parasitaemia and the risk increased significantly as the severity of malaria parasitaemia increases depicting malaria as a common cause of anemia in our obstetric population. Routine screening for malaria infestation at booking is therefore recommended.
ABSTRACT
Background: Hormonal, emotional and physical changes that occur in pregnancy as well as cultural influences in our society may impact on women’s sexual responses and influence their sexual practices and perceptions regarding sexual intercourse during pregnancy. Aim: This study was undertaken to evaluate the frequency, practices, perceptions and safety of sexual intercourse during pregnancy among pregnant women in Jos, Nigeria. Materials and methods: This was a cross-sectional study of 204 healthy pregnant women at term over a 6-month period. They anonymously completed self-administerd questionnaires regarding sexual activities during pregnancy. Data collected included coital frequency, perceptions and concerns of sexual intercourse during pregnancy, its benefits and problems encountered. Statistical analysis was done using SPSS version 16. Descriptive statistics was performed and chi square test was used to ascertain associations between categorical variables. P < 0.05 was considered significant. Results: All women were sexually active throughout pregnancy but with overall decrease coital frequency compared to the pre-pregnency period. Most adopted sexual positions included side-by-side, man on top and rear positions. Advanced maternal age > 35 years (P = 0.67, OR 1.19, 95% CI 0.54 – 2.65), primigravidity (P = 0.52, OR 0.80, 95% CI 0.40 - 1.60)and nulliparity (P = 0.60, OR 0.83, 95% CI 0.43 – 1.62) had no influence on coital frequency. More than 90.0% of them opined that sex during pregnancy is safe and beneficial including widening of the birth canal, maintenance of emotional attachment between couples, satisfaction of sexual desire and prevention of spousal infidelity. Only 32 (15.7%) of the women developed transient sexual problems including vaginal bleeding and discharge, soreness/pain in the vagina and abdominal pain. Conclusion: There was an observed decrease coital frequency among pregnant women in this study, nevertheless many still have positive attitude towards it, albeit with few misconceptions. Hence, Health providers should include sex education into antenatal care programs so as to dispel fears and clear these sexual misconceptions.
ABSTRACT
Background: Obesity, an emerging public health concern in maternity care with increasing prevalence even in developing countries is associated with maternal and perinatal complications. This study sought to evaluate the impact of maternal obesity on pregnancy outcomes in a cohort of Nigerian women. Study Design: A prospective cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Bingham University Teaching Hospital Jos, between January 2013 and September 2014. Methodology: A study of matched 324 obese [Body mass index (BMI) ≥ 30 Kg/m2] and 324 non-obese women (BMI 18.5 – 24.9 Kg/m2) with singleton pregnancies recruited at the antenatal clinic during their first trimester. They were followed-up to the postpartum period to ascertain development of antenatal, intra-partum, postpartum and fetal complications. Chi square or Fisher’s Exact test and student t-test were done to ascertain any relationship between obesity and the outcome variables using SPSS version 16 (SPSS Inc., Chicago, IL, USA) and P value < 0.05 was considered statistically significant. Results: In comparison with pregnant women with normal BMI, obese women faced higher risk of developing antenatal complications (P = 0.001, Odds Ratio (OR) 5.32, 95% Confidence Interval (CI) 1.90 – 14.94) especially gestational hypertension and pre-eclampsia (P = 0.002, OR 4.66, 95% CI 1.65 – 13.19), having caesarean section (P = 0.043, OR 0.48, 95% CI 0.23 – 0.99) and macrosomic baby (P = 0.005, OR 3.40, 95% CI 1.41 – 8.19). However, no statistical difference with respect to risk of spontaneous miscarriage (P = 0.313, OR 3.08, 95% CI 0.31 – 30.22), preterm delivery (P = 0.167, OR 3.16, 95% CI 0.62 – 16.15), genital tract injury (P = 0.407, OR 0.76, 95% CI 0.40 – 1.46), postpartum haemorrhage (P = 0.199, OR 1.75, 95% CI 0.74 – 4.13), low birth weight babies (P = 0.732, OR 1.27, 95% CI 0.33 – 4.90) and stillbirth (P = 0.080, OR 0.96, 95% CI 0.92 – 1.01). Conclusion: Maternal obesity is associated with elevated risk of hypertensive disorders, caesarean delivery and fetal macrosomia. It is imperative to implement a policy of identifying these women as high risk group at this clinical setting so as to institute appropriate materno-fetal surveillance and management strategies aim at enhancing their pregnancy outcomes.