Anaemia in pregnancy: associations with parity, abortions and child spacing in primary healthcare clinic attendees in Trinidad and Tobago

OBJECTIVE: To determine the prevalence of anaemia in antenatal clinic attendees; to investigate the effects of parity, age, gravidity, previous abortions, child spacing and other factors on the prevalence of anaemia in pregnancy. METHODS: This was a retrospective and cross-sectional study. Antenatal records of 2287 pregnant women attending 40 public healthcare centres from January 2000 to December 2005 in Trinidad and Tobago were used. Data pertaining to the investigated variables were recorded. The national prevalence of anaemia was calculated and chi-square tests, odds ratios and logistic regression were used to assess the relationship between anaemia and each variable. RESULTS: The prevalence of anaemia was 15.3% (95% CI 13.4%, 16.6%). No significant difference in the prevalence of anaemia was found among the different clinics or counties. At the first haemoglobin reading, age was inversely related to the presence of anaemia, whereas gestational age at first visit was directly related. At the final haemoglobin reading, parity, gravidity, and previous spontaneous abortions were directly related to the prevalence of anaemia, while the number of visits was inversely related. Age was inversely associated to the severity of anaemia while gravidity was directly related. CONCLUSION: The prevalence of anaemia decreased by 18.7% from 1967. Despite this positive indication, women under 24 years and those commencing antenatal care after the first trimester are still at a higher risk for developing anaemia. Early commencement of antenatal care and close monitoring of the risk groups identified should be strongly advocated.

Origins of colonic preganglionic parasympathetic motoneurons from the central nervous system: A wheatgem agglutinin-horseradish peroxidase study in the ferret (Mustela Putorius furo)

The wheat gem Agglutinin-Horseradish Peroxidase (WGA-HRP)trabsneuronal nerve tracing technique was used to study the localization of colonic preganglionic parasympathetic neurons in the central nervous system of the fettet. The entire colon, from the iliocecal junction to the colorectal junction was subdivided into four segments and the muscular wall of each segment injected separately with the tracer. The ferrets used as controls were also subdivided into four groups. The first group was injected with normal saline, the second group with the tracer following bilateral trunkal vagotomy, the third group intraperitoneally and the fourth group had tracer injection into the hepatic portal vein. The experimental as well as the control of ferrets were allowed to survive for 24 to 96 hours after which they were anaesthetized and perfused sequentilly with normal saline, buffered fixative, and buffered sucrose.Serial transverse frozen sections were taken from the brainstem and the sacral segments of the spinal cord of the ferrets. These were then processed for WGA-Hrp neurohitochemistry and analyzed under light and dark field illuninations. The results of the study show that the dorsal motor nucleus of the vagus nerve (DMX) supplies the anterior 3 segments of the colon while the sacral segment of the spinal cord supplies the post 2 segments of the colon. It is concluded that in the innervation of the colon there is an overlap between the areas supplied by the DMX and those supplied by the sacral segment of the spinal cord (AU)