RÉSUMÉ
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.
RÉSUMÉ
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.