Urban-Rural Comparison of Group B Streptococcus Infection in Pregnancy among Antenatal Women in Cross River State (Published)
Group B streptococcus (GBS) infection is a common cause of infection among the newborn in developing countries. Neonatal mortality is high in Nigeria due to preventable causes which include vertical transmission of Group B streptococcus (GBS) infection. The objective was to determine GBS anogenital infection among pregnant women in rural and urban settings in Cross River State and to compare GBS infection among pregnant HIV positive and negative women. The study was conducted at the antenatal care clinics of University of Calabar Teaching Hospital (UCTH), Calabar as the urban study site and Akamkpa General Hospital (AGH), Akamkpa as the rural site. Study populations were HIV negative and positive pregnant women that were in their third trimester between 35 to 37 weeks of pregnancy in both rural and urban areas. A total of 84 pregnant women were recruitment in each study sites and data were collected on socio-demographic and obstetric history, as well as laboratory samples for assessment of GBS colonization. Each subject recruited in the rural study site was matched with pregnant woman in the urban study site on socio-demographic characteristic which includes age, marital status, and parity. The Prevalence of GBS infection was 13.1% among the rural subjects compared to 8.3% in urban subject and the difference was not statistically significant (p=0.32). Among urban subjects, the prevalence of GBS infection among HIV positive subjects compared to HIV negative subjects were 9.5% and 7.1% respectively and the difference was not statistically significant (p=0.69). Among rural subjects, the prevalence of GBS infection among HIV positive subjects compared to HIV negative subjects (21.4 vs. 4.8%) was statistically significant (p=0.02). Anogenital colonization with GBS is slightly high among pregnant women in rural than urban area, although, it was not statistically significant. Preventive approach is a worthy measure through screening especially among high risk pregnancies in rural areas and follow-up treatment to prevent feto-maternal adverse effects.
Knowledge, Attitude and Practice of Preventive Measures towards COVID-19 among Pregnant Women Attending Selected Primary Health Centre’s in Osogbo, Osun State (Published)
Background: COVID-19 is a new viral disease, and health researchers are currently evaluating its effects on pregnant women and their unborn children. There is dearth of research available to support the argument that pregnant women are at greater risk of COVID-19 disease.Methods: This study used an exploratory research design to examine the knowledge, attitude and practice of preventive measures towards COVID-19 among pregnant women in Osogbo, Osun state. 382 subjects were selected using a simple random technique. Self-developed questionnaire was the instrument used to collect data. The data collected were analyzed using statistical package for social sciences (SPSS) and the results were presented using tables and percentages. Six null hypotheses were tested using chi-square at 0.05 level of significance. Results: Result of this study shows that nearly half of the respondents are within 18-25 (45.0%) years of age, 79(63.6%) are Muslims and 358(93.7%) are from the Yoruba tribe. This study also reveals that the respondents do have significant knowledge on the novel Coronavirus disease and a good attitude towards the prevention of COVID-19 as they practice frequent hand washing, sanitizer use and maintenance of social distancing. From the hypothesis tested, there is significant association between the education level of the respondents and their knowledge and attitude of preventive measures towards COVID-19 and no association between the age of the pregnant women and practice of preventive measures towards COVID-19. Conclusion: From the study, there seems to be a moderate level of awareness on the preventive measures towards COVID-19 among pregnant women in Osogbo but increase in the level of awareness and educational program can be done by the government and health workers in order have a very good attitude and awareness which will eventually improve the rate of adherence and compliance towards COVID-19 preventive measures.
Age, Income, and Medico-Obstetric History as Predictors of Anxiety and Psychological Well-Being among Pregnant Women in Ibadan (Published)
The objective of the study is to examined age, income, and medico-obstetric history as predictors of anxiety and psychological well-being among pregnant women in the third trimester. The participants involved 92 pregnant women with the mean age of 29.61 years (S.D. = 4.42, range = 19.42 years). The study employed one-way factorial design. The state anxiety inventory (STAI), and the general psychological well-being questionnaire were the instruments used. The result of the analysis using anova, and independent t-test showed that the older pregnant women would experience lesser anxiety than the younger women (t = 3.68, df = 90; P <. 05). The psychological well-being of older pregnant women will be higher than younger pregnant women (t =2.06; df = 74; P <.05). Higher income earners exhibited lesser anxiety than lower income earners (F-test = 4.951; df = 91; P <.0091). Higher income earners showed more psychological stable than the lower income earners (F- test = 5.867, df = 75, P<.0043). And that the psychological wellbeing of pregnant women with poorer medico-obstetric history was lesser than those without medico-obstetric history (t = 2.636, df = 80; p <.05). Further studies could investigate women from an entire different culture.
Changes in Blood C-Reactive Protein in Pregnancy and Labour Among Apparently Healthy Pregnant Women in Benin City (Published)
C-reactive protein (CRP), a very sensitive marker, has recently been associated with inflammatory conditions and their management. Pregnancy is a pro-inflammatory state associated with changes in CRP values. Proper interpretation of CRP levels in inflammatory conditions requires good knowledge of these changes. However, most studies and reference values obtained on serum CRP in pregnancy were done in developed western countries. Regional differences in the level of CRP have been reported. It was imperative, therefore, to determine local reference values for CRP in apparently healthy pregnant women in our setting to serve as nomograms. Methods: Longitudinal case-control study with 160 women who met the criteria recruited. These were divided into two arms comprising of study and control, each consisting of 80 women. Maternal serum CRP was measured with competitive immunoassay in the first and second half of pregnancy and labour as women were followed up. Specimens were also obtained for CRP from the control group. Data obtained were analysed using the SPSS version 17 and GraphPad instant 3 software. Categorical variables were expressed as absolute numbers, and percentages and the differences in proportion were analysed using the Chi-square test or Fisher exact test, while continuous variables were presented as means with standard deviations and the differences were analysed with the t-test where appropriate. The level of significance was set as p<0.05. Result: Revealed a progressive increase in the C reactive protein concentration as pregnancy advanced. The rise however attained maximum level during labour. Statistical significance noted for that of labour against non-pregnant as control (p<0.05). Conclusion: C-reactive protein levels may serve as a marker for disease severity, though non-specific. The study shows that serum concentration of C-reactive protein in normal pregnancy for women in our environment should be 82.62 ± 32.19 ng/ml. Also, levels of concentration are increased during labour compared to non-pregnant and pregnant women with a mean value of 93.46 ± 24.00 ng/ml. Therefore, it could be of prognostic value in some pregnancy-associated complications such as preterm labour, premature rupture of membrane, chorioamnionitis, pre-eclampsia and diabetes mellitus.
Perception and Uptake of Focused Antenatal Care among Skilled Birth Attendants in a Tertiary Hospital in Nigeria (Published)
The replacement of the traditional antenatal care service model with focused antenatal care (FANC) has been viewed with mixed feelings by skilled birth attendants. This study therefore, assessed skill birth attendants’ perception and uptake of focused antenatal care at University of Benin Teaching Hospital, Benin City. A descriptive cross-sectional design that utilized convenient sampling to recruit 229 participants comprising of doctors, midwives and nurses from the various obstetrics departments participated in the study. Consent was obtained from the participants and was voluntary. A semi-structured questionnaire with a reliability of 0.72 was used for data collection. Data were analysed using frequencies, percentages and chi-square with the aid of Statistical Package for Social Sciences version 21. Results revealed that 82.4% of the respondents had good knowledge of FANC, while 69.2% of the respondents used FANC, only 2.4% had wrong perception of it usage. Moreover, 48.8% of the respondents had poor level of FANC uptake, 25.6% of respondents had fair uptake of FANC, while 25.6% have good level of its uptake. In addition, a significant association was found between professionals and uptake of focused antenatal care among the skilled birth attendants, while no significant association found between perception and uptake of focused antenatal care among the skilled birth attendants.It is therefore concluded that skilled birth attendants’ knowledge is high and they had positive and good perception to focused antenatal care however their uptake is poor.
Pregnant women with low social support were reported to have symptoms of depression during and after pregnancy, and it has been established that this has implication on complication during child birth. This study aimed at examining the knowledge, attitude and perception of pregnant women about social support during pregnancy. A descriptive cross sectional research design was adopted and questionnaire with reliability 0.82 was used to gather data from 208 pregnant women selected through simple random sampling technique. Data collected was analyzed using SPSS version 20.0. Findings revealed a good perception but negative attitude towards social support. There was a significant association between age and level of social support; marital status and level of social support; number of delivery and level of social support. Identified barriers to social support during pregnancy include poor family income, spouses’ nature of job and hospital policy.
Thirst Perception and Fluid Intake in Pregnant Female Humans in the Three Trimesters of Pregnancy (Published)
This work was done to access the thirst perception and fluid intake of pregnant women in the three trimesters of pregnancy in pregnant women. The study was divided into two main groups Group 1 was made up of euhydrated pregnant women while group 2 was made up of dehydrated pregnant women. For the group 1, a total of thirty pregnant women were used, ten in each trimester of pregnancy. The subjects had water ad libitum. For the group 2, a total of seventy five pregnant women, twenty five in each trimester of pregnancy were dehydrated for eighteen hours. Thirst perceptions were taken 8am the following morning using the visual analogue scale of Thompson et al., (1986). Blood and urine samples were collected and analyzed for electrolyte concentrations. Plasma osmolality was estimated using the formula of Leonard (2003). Results for group 1, showed statistically significant increase (p<0.05) in the thirst perception in the first, second and third trimesters of pregnancy when compared with the non-pregnant women. The volume of water intake till satiety was significantly higher (P<0.05) in the third trimester of pregnancy when compared with non-pregnant women. The increases in volume of water intake in first and second trimesters were not statistically significant. Results for group 2, showed that thirst perception was significantly higher (P<0.05) in pregnant women when compared with non-pregnant women. The thirst perception was significantly increased in the three trimesters of pregnancy when compared with non- pregnant women. The volume of water intake was significantly increased (p<0.05) in the first, second and third trimesters in pregnant women when compared with the non-pregnant women. Our result reveals a significant drop (p<0.05) in plasma osmolality in the pregnant women when compared with the non- pregnant women.. Conclusively, this research has been able to establish that there is decrease in plasma osmolality, but increase in thirst perception, in the three trimesters of pregnancy.
Management Outcome of Uterine Fibroids in Pregnancy in a Secondary Health Facility in Calabar, South-South Nigeria (Published)
Uterine fibroid is the commonest benign tumors of the uterus and may lead to several complications in pregnancy. The objective was to determine the maternal and foetal outcome of fibroids in pregnancy. This prospective study was conducted in Nigerian Navy Hospital, Calabar over 2 year among women with fibroids in pregnancy. Result showed that a total of 889 women booked for antenatal care during the period, of which 72 had fibroids in pregnancy giving the incidence of 8.1%. Majority of the women were within the age group of 30-39 years 39(54.2%) and nulliparae 32(44.4%). A total of 3(4.2%) had 1st trimester miscarriages, 4(5.2%) had preterm delivery, 22(30.6%) had spontaneous normal vaginal delivery at term while 37(51:3%) had caesarean section. In conclusion, uterine fibroid is a common finding in pregnancy and the manifestation varies depending on their size and site. Pregnancies with uterine fibroid are high risks and are commonly associated with complications such as caesarean sections, primary post partum haemorrhage, miscarriage and preterm labour.