The effect of short interpregnancy interval on birthweight and other pregnancy outcomes in Enugu, Southeast Nigeria.

The time interval between one pregnancy and the next is a modifiable risk factor, and has an effect on pregnancy outcomes. This study compared the effects of short interpregnancy interval (IPI) on fetal birthweight and selected pregnancy outcomes amongst parturients in Enugu, Nigeria. Group A (Subjects) consisted of parturients with short IPI (IPI < 18 months), while group B (Controls) consisted of parturients with normal IPI (IPI ≥ 18 months). Relevant obstetric data were collected at delivery. Mean birthweight was 2664.13 ± 339.25g vs 3670.63 ± 452.69g in women with short IPI and normal IPI respectively (p < .0001). Women with short IPI were more likely to have low birthweight babies compared to those with normal IPI (OR = 7.331, p < .001). Maternal anaemia, preeclampsia and caesarean delivery were significantly more associated with short IPI. Women with short IPI are at greater risk of delivering newborn babies with significantly lower mean birthweight and other associated pregnancy complications than women with normal IPI.Impact StatementWhat is already known on this subject? Short interpregnancy interval has an adverse effect on pregnancy outcomes as shown in studies from Europe and the Americas.What do the results of this study add? This study adds to the body of evidence of the deleterious effects of inadequately spaced pregnancies and draws attention to this in West Africa, sub-Saharan Africa, and an area with low contribution to studies on the effect of short IPI on pregnancy outcomes.What are the implications of these findings for clinical practice and/or further research? With evidence from our own environment, it will further boost evidence for proper education of our mothers on the need for adequate birth spacing to avoid the adverse effects of a short IPI on the next pregnancy.

Association between obesity and abnormal Papanicolau(Pap) smear cytology results in a resource-poor Nigerian setting.

BACKGROUND: Though obesity is associated with some malignancies, its association with cervical cancer is still inconclusive. This study was aimed at determining if there was an association between obesity and cervical epithelial cell abnormalities (CEA). METHODS: This was a cross-sectional comparative study of obese and non-obese women at the Cervical Cancer Screening Clinic, University of Nigeria Teaching Hospital (UNTH), Enugu between January, 2012 and June, 2013. The participants whose body mass index (BMI) were ≥ 30 kg/m2 were classified as obese (200 women) while those whose BMI were < 30 kg/m2 were classified as non-obese (200 women) and the two groups were consecutively recruited at the ratio of 1:1. Pap smear cytology, random blood sugar (RBS) and human immune-deficiency virus (HIV) screening was done for all the participants. Data was analyzed with SPSS version 20. Categorical variables were analyzed using McNemar's test and Chi-squared test. Logistic regression analysis was used to determine the influence of socio-demographic characteristics on cervical epithelial cell abnormalities. The level of significance was set at ≤0.05. RESULTS: Among the obese women, 152(76%) had negative for intra-epithelial lesion or malignancy (NILM) while 48(24%) had cervical epithelial cell abnormalities (CEA). Also 182(91%) non-obese women had NILM while the remaining 18(9%) had CEA. The prevalence of CEA among all the study participants was 16.5%. There was an association between obesity and CEA[OR (95%CI) = 1.353(1.013-1.812); P-value = 0.04].CEA were significantly more common among women who were 40 years and above and single/separated women as well as widows (P-value = < 0.05). CONCLUSION: There was an association between obesity and CEA. This underscores the need for a positive behavioural change among women in order to stem the tide of this public health problem.

Prevalence and sociodemographic determinants of adult obesity: a large representative household survey in a resource-constrained African setting with double burden of undernutrition and overnutrition.

BACKGROUND: The obesity epidemic has continued to spread across the globe involving even poor nations of the world. METHOD: Household population survey of adults aged 20-60 years. Multistage stratified cluster randomised sampling involving both urban and rural statewide representative population samples. Anthropometric measurements were taken using standard methods. Prevalences were weighted and multinomial regression analyses were done. RESULTS: A total of 6628 individuals from 2843 households were surveyed. The weighted overall prevalence for underweight was 9.1% (95% CI 8.1 to 10.1), 65.1% (95% CI 63.6 to 66.6) for normal weight, 19.0% (95% CI 17.8 to 20.3) for overweight and 6.8% (95% CI 6.0 to 7.5) for obese. Men were less likely to be overweight (adjusted OR (AOR) 0.79; 95% CI 0.68 to 0.92) and obese (AOR 0.24; 95% CI 0.19 to 0.31) than women. Urban residents were more likely to be overweight (AOR 1.42; 95% CI 1.18 to 1.71) and obese (AOR 2.09; 95% CI 1.58 to 2.76) than rural residents. Each additional 1-year increase in age increased the risk of overweight by 1.012 (AOR 1.012; 95% CI 1.005 to 1.018) and that of obesity by 1.03 (AOR 1.03; 95% CI 1.02 to 1.04). The low-income class was less likely to be overweight (AOR 0.694; 95% CI 0.507 to 0.951) and obese (AOR 0.44; 95% CI 0.28 to 0.67). CONCLUSION: The prevalence of obesity and overweight in Enugu Nigeria is high and fast approaching that of underweight. Women, urban dwellers, older adults and high-income earners are at higher risk for obesity and overweight. The study provides robust information for public health policies towards the prevention of obesity in Nigeria.

Experiences of women undergoing colposcopy in southeastern Nigeria.

OBJECTIVE: To evaluate the experiences, preferences, and needs of women undergoing colposcopy in southeastern Nigeria. METHODS: Women undergoing colposcopy at 2 centers in southeastern Nigeria between August 1, 2009, and October 31, 2011, were interviewed using structured interviewer-administered questionnaires. RESULTS: In total, 409 women were interviewed. The majority (60.8%) of these women were satisfied with the overall process of colposcopy. Invasion of privacy and re-assuring attitude of attending clinic personnel were reported as the most dissatisfying and most satisfying aspects of colposcopy, respectively. Privacy during the procedure and written take-home information were the most frequently reported needs. Most participants preferred a female colposcopist and the presence of their spouse during colposcopic examination. CONCLUSION: Southeastern Nigerian women are less satisfied with the overall process of colposcopy than their counterparts from high-income settings. The majority of the women interviewed would have an improved colposcopic experience if their privacy concerns and information needs were addressed and their spouses allowed into the examination room. The findings from the present study should encourage existing and emerging colposcopy service providers in low-resource settings to improve both service delivery and their patients' overall colposcopic experience.

Menstrual disorders in adolescent school girls in Enugu, Nigeria.

STUDY OBJECTIVE: To determine the prevalence, pattern of menstrual disorders, treatment practices, and the effect of menstrual disorders on school attendance in adolescent school girls in Enugu, Nigeria. DESIGN: Cross-sectional survey. SETTING: Randomly selected secondary schools. PARTICIPANTS: Postmenarcheal adolescent school girls aged 10-19 years. METHODOLOGY: Pretested, semi-structured questionnaires were used to survey 500 consenting students. The main outcome measures were menstrual disorders. Data was analyzed using SPSS for windows version 15. Data was compared using chi-square test and P ≤ 0.05 was regarded as statistically significant. RESULTS: Four hundred ninety-five students responded giving a response rate of 99%. The mean age of the girls was 14.9 ± 1.7 years. Most were Christians (99.2%) and their mean age of menarche was 12.7 ± 1.3 years. The prevalence of menstrual disorders was 69.4% and dysmenorrhea, premenstrual dysphoric disorder, and short menstrual cycles were the commonest disorder. Being older, later age of menarche, and being domiciled in the boarding house were significantly associated with menstrual disorders (P < 0.05). Dysmenorrhea was responsible for the greatest number of school abscences. The mean days of school absenteeism was 1.8 ± 1.2. In 80% of cases paracetamol, aspirin, or piroxican were the drugs used for symptom relief. Only 16.3% of respondents ever consulted a doctor for their menstrual disorders. CONCLUSION: There was a high prevalence of menstrual disorders as well as a high rate of non-expert treatment of the disorders. This underscores the need for awareness creation. Parents and adolescents should consult trained practitioners when significant menstrual disorder occurs in order to rule out or treat associated or underlying medical conditions.