Serum micronutrient levels, nucleic acid metabolism and antioxidant defences in pregnant Nigerians: implications for fetal and maternal health.

Micronutrients regulate numerous metabolic processes in pregnancy but their possible antioxidant function and contributions of alterations in their metabolism to fetal and maternal morbidity and mortality have received insufficients attention. Serum levels of copper, manganese and zinc were determined in 40 pregnant Nigerian women spread across the three trimesters of pregnancy and compared with those of 25 non-pregnant women of similar demographic and anthropometric characteristics. Serum levels of uric acid were also determined in both groups of women. The mean serum levels of manganese and zinc were significantly lower in the pregnant than in the non-pregnant state (P<0.02, P<0.002), respectively. Unlike manganese and zinc, copper was significantly elevated in the pregnant than in the non-pregnant state. The endogenous anti-oxidant, uric acid, was also significantly reduced in the pregnant than in the non-pregnant state (P<0.001). Copper levels increased progressively in all the three trimesters of pregnancy compared with controls (P<0.001). However, zinc levels declined steadily in all the 3 trimesters, but only the level of the third trimester was significantly different from the non-pregnant state (P<0.05). Unlike zinc, uric acid rose consistently in all the 3 trimesters compared with the non-pregnant state. Manganese and uric acid were significantly more elevated in the third than the first trimester. One way analysis of variance (ANOVA) and multiple comparisons (Tukey HSD) show that the differences in the antioxidant levels can be ascribed mainly to the second and third trimesters. The prevalence of zinc deficiency was 4.0% in the non-pregnant state as compared to 22.5% in the pregnant subjects. The implications of micronutrient deficiencies and associated antioxidant status in pregnancy are discussed. Considering their role in pregnancy, prevention of such deficiencies and attendant oxidative stress may contribute to a reduction in the incidence of fetal and maternal ill-health, and complications of pregnancy. Interventions should be aimed mainly at the second and third trimesters.

Final report on position of female circumcision in Nigeria.

PIP: Survey data reveal that female genital mutilation (FGM) is being practiced in most Nigerian states, usually on babies and young girls but occasionally during wedding preparations or 7 months into the first pregnancy. Among the few tribes that mutilate women after marriage, husbands carry out the deed. Usually, FGM is performed on a group of girls, but it can also be performed on one girl in her home. The mutilator, who is paid a token fee, uses a knife or a razor. Post-mutilation treatment includes application of a variety of traditional methods. The most usual immediate complication is bleeding but other complications include tearing, septicemia, fistula development, stenosis, delayed second-stage labor, tetanus, urinary obstruction, and dyspareunia. Reasons cited for FGM include tradition, the belief that FGM curbs female promiscuity, and the belief that a baby whose head touches a clitoris during delivery will die. A prominent 1981 newspaper article on the subject reported the view of a physician that the practice ought to be eradicated and the view of a mutilator that it is not likely to be stopped.^ieng