Microalbuminuria and its association with adverse pregnancy outcome in a tertiary health centre in Nigeria.

Background: Adverse pregnancy outcomes occur more commonly in developing countries and are still prevalent in our sub-region. Microalbuminuria is a marker of endothelial dysfunction and has been proposed as an aetiological factor in the development of some adverse pregnancy outcomes such as pre-eclampsia, intrauterine growth restriction (IUGR) and pre-term labour. Aim: The aim is to determine the prevalence of microalbuminuria and its association with adverse pregnancy outcomes. Methods: This was a prospective cross-sectional study with follow-up amongst women in early pregnancy presenting at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Three hundred and thirty women with singleton pregnancy at gestational age <20 weeks, blood pressure <140/90 mmHg, normal fasting blood sugar and normal renal function were recruited. Those with a history of hypertension, diabetes mellitus, chronic kidney disease, sickle cell anaemia were excluded, multiple pregnancies, urinary tract infection or positive dipstick proteinuria at first contact were excluded. They were recruited consecutively and a structured interviewer-administered questionnaire was completed. Single-spot urine analysis for albumin was performed. The women were followed up to the time of delivery and the puerperium and any adverse outcome were documented. Results: The prevalence of microalbuminuria was 58.4%. The maternal and foetal adverse outcomes such as hypertensive disorders of pregnancy, pre-mature rupture of membrane, IUGR, preterm birth and stillbirth occurred more amongst the women with microalbuminuria. However, there was no statistically significant association between microalbuminuria and having these adverse outcomes (P > 0.05). Conclusion: There was a high prevalence of microalbuminuria amongst healthy pregnant women and pregnancy complications occurred more frequently in women with microalbuminuria than in those without. However, this association was not sufficient to predict adverse outcomes in pregnancy.

Low plasma vitamin D as a predictor of uterine fibroids in a nigerian population.

BACKGROUND: Uterine fibroid is the most common benign tumour of the uterus and the exact cause is unknown. Vitamin D has been found to inhibit cell proliferation and enhance apoptosis in vitro. AIM: The aim of this study is to compare the plasma level of Vitamin D among women with uterine fibroids and those without uterine fibroids. MATERIALS AND METHODS: This was an analytical cross-sectional study conducted among women with uterine fibroids and those without uterine fibroids. An interviewer-administered questionnaire was used to obtain relevant information. Five millilitres of venous blood was obtained for plasma Vitamin D assay. Data analysis was performed using the SPSS version 22. Level of significance was set at P < 0.05. RESULTS: There were 100 participants recruited for the study. The mean age of the participants with uterine fibroid was 35.06 ± 6.6 years and that of controls was 33.28 ± 7 years. The mean plasma level of Vitamin D for all the participants was 12.47 ± 7.53 ng/ml. The mean plasma level of Vitamin D in those with uterine fibroids was significantly lower than in those without uterine fibroid (10.16 ± 7.78 vs. 14.35 ± 6.8; t = 2.517, P = 0.014). It also shows that 1 unit increase in Vitamin D level will reduce the risk of developing uterine fibroids by 8% (odds ratio = 0.92, 95% confidence interval = 0.86-0.99). CONCLUSION: The predictors of uterine fibroids were fewer hours spent outdoors, middle social class and low Vitamin D levels.

Comparison of microalbuminuria among treatment naïve HIV sero-positive and negative adult clients in Faith Alive Foundation Hospital, Jos.

BACKGROUND: This study is to determine microalbuminuria in human immunodeficiency virus (HIV) infected patients before commencement of highly active anti-retroviral treatment (HAART). PATIENTS AND METHODS: Consecutive patients with the HIV infection seen in the HIV counselling and testing (HCT) unit of the Faith Alive Foundation Hospital, Jos, and a similar group of healthy uninfected patients were evaluated for renal disease: Urinary albumin and urinary creatinine were analysed. RESULTS: Of the 200 patients with HIV infection and 100 uninfected controls studied, increased urinary albumin excretion (UAE) was present in 39 (19.5%) of the subjects and 5.0 (5.0%) of controls. The difference between the mean values for the UAE for both subjects and controls [182.3 ± 54.3 and 163.9 ± 39.3 mg/l, respectively (P = 0.006)] was statistically significant. On the other hand the urinary creatinine for both the subjects and controls [11.7 ± 5.2 and 12.0 ± 4.8 mmol/L, respectively (P = 0.6)] was not statistically significant. The difference between the mean urinary albumin/creatinine ratio (UACR) for both subjects and controls [1.8 ± 1.2 mg/mmol and 1.4 ± 0.4 mg/mmol respectively (P = 0.001)] was statistically significant. CONCLUSION/RECOMMENDATION: Increase UAE is a common complication of HIV infection due to a number of factors other than HAART. Early screening for renal disease using microalbuminuria is very useful since the use of medications such as angiotensin converting enzyme inhibitors, which could help reverse progression to end-stage renal disease.